Food labeling combats obesity in low-income communities

The epidemic of obesity is a substantial contributor to adverse health issues for all ages in the United States and disproportionately affects those living in low-income and minority neighborhoods. Even as the cost to treat overweight and obesity-related health issues continue to increase, it is harder for these communities to access healthier food options.

In a new policy brief from the Texas Medical Center Funding Program Collaborative, with funding from the Texas Medical Foundation, researchers lead by E. Lisako J. McKyer, PhD, MPH, FAAHB, professor and associate dean for climate and diversity at the Texas A&M School of Public Health, implemented a consumer-friendly food labeling system in neighborhood corner stores to indicate the difference between healthy and unhealthy options and denote calorically dense, nutritionally poor foods.

The research team worked in collaboration with the Children and Neighbors Defeat Obesity Houston(CAN DO Houston), an organization that aims to prevent obesity with a focus on youth, as well as Texas Southern University and Baylor College of Medicine, to promote healthier eating habits in low-income and minority communities using the “Go, Slow, Whoa!” food labeling system with green, yellow and red, respectively.

The system was created to increase consumer awareness and knowledge of nutritional values in corner stores in low-income communities in Harris County. The green-yellow-red system was implemented in 10 stores in the Sunnyside and Pasadena communities with labeling systems like shelf talkers, aisle violators, and wall posters. According to McKyer, most people in these communities use neighborhood corner stores for buying food because access to supermarkets is an issue in low-income communities.

“That’s why we consider this not merely a health issue, but a social justice issue,” McKyer said. “If the children in these neighborhoods could get the good food they needed and to the schools they need to, we wouldn’t have social and health problems because they would be able to be their optimal selves. In the end, they would actually become people who contribute to the tax base that funds these programs. That’s why projects like this, as well as social programs, are not charity or giveaway. It’s really an investment because a child can either become my mayor or my robber. Which do you think I want?”

Research findings indicated the labeling system raised awareness in customers of healthier food options. Their most significant finding was the resulting enthusiasm from store personnel and owners and the effects the labeling had on customers, McKyer said.

Over 80 percent of customers who observed the food labels at the participating corner stores said the “Go, Slow, Whoa!” system helped them understand nutritional value. Overall, 75 percent of customers reported the labels had little to no effect on their purchases, but despite their claims, the results showed there was a significant increase in the purchases of healthier food options.

Store personnel reported an increase in sales of fresh fruits, healthy snacks, fresh vegetables and herbs with 75 percent responding that there was an introduction of new fruits and vegetables in their store. An unintentional result was a decrease in cigarette sales, which McKyer said is traditionally one of the largest profits for the corner stores.

Most store clerks said there was little to no effort in updating their store to the “Go, Slow, Whoa!” system. Over 66 percent did not find it troublesome to implement the food labeling system and over 80 percent said they thought the system should be put into effect in every neighborhood corner store.

The researchers tracked sales through the inventory of healthier food options to follow the success of the new system in addition to data collection from surveys with the community, group interviews, customers, store management and personnel. Monthly food sampling and demonstrations were conducted, and CAN DO Houston Executive Director Jasmine Opusunju, DrPH, directed the training of local youth on the labeling system to help promote healthy eating.

“This was a project where we partnered with an agency that’s already in the community and has a trusted relationship with them,” McKyer said. “You can’t implement programs like this without a community partner. Otherwise you’re an outsider coming in, and it doesn’t help the sustainability of the program when funding is gone. I would hope one important lesson that researchers learn is the importance of community-based research where the community has a voice and they’re a true and active partner, not just a place where research takes place.”

The policy implications and recommendations to improve access, purchases and consumption of healthier food options in neighborhood corner stores include special recognition, tax incentives for stores using the labeling system and support from the Healthy Food Financing Initiatives.

By putting these policy recommendations into effect, the presumptive outcome would be support for, in particular, corner stores and greater potential to impact the presently built environment, leading to improving health outcomes.

“A five-pound weight loss in one person statistically does very little,” McKyer said. “But a five-pound weight loss across a population—which is thousands of people —you can see in the aggregate the decrease in that population’s risk for a myriad of health problems. Public health isn’t about the one, it’s about the all.”

It is too early to tell if the cost of healthy food options will decrease in conjunction with the increase of customers purchasing healthy food, McKyer said. However, the data does show the communities involved in the research study all began to choose healthier food options because it was an easier choice, which was found to be a key tool to changing purchasing behaviors.

“My hope is the results of this study will help stores receive healthier options at lower costs in the future,” McKyer said.

– by Savannah Mehrtens