Panel Discussion: How to Create Healthier Food Environments. Presented at the Empowering Eaters: Access, Affordability, Healthy Choices, and Food is Medicine Summit in Support of a National Strategy on Hunger, Nutrition, and Health “The Health and Wellbeing of Future Generations in Policy.” Co-hosted by Duke University and Food Tank on March 3, 2024.
Panelists:
- Kelliann Blazek, Special Assistant to the President for Agriculture and Rural Policy, The White House
- Alice Ammerman, Director of the Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill
- Gavan Fitzsimons, Professor, Duke Fuqua School of Business
- Chef Rob Kinneen, Outreach Director and Native Alaskan Chef, NĀTIFS
- Moderated by Danielle Nierenberg, President, Food Tank
Transcript
Danielle Nierenberg, FoodTank
We are going to turn to our next panel to explore the importance of healthier food environments. I’d like to welcome our speakers, Kelliann Blazek, the special assistant to the President for Agriculture and Role of Policy in the White House; Chef Rob Kinneen, a native Alaskan chef, and the Outreach Director for the North American Traditional Indigenous Food Systems, also known as NATIFS; Alice Ammerman, a professor in the Department of Nutrition at the Gillings School of Global Public Health, and the Director of the Center for Health Promotion and Disease Prevention at UNC Chapel Hill; and Gavan Fitzsimons, a professor of marketing and psychology at the Duke Fuqua School of Business.
Kelliann, I’m going to start with you. The Biden-Harris, Administration’s National Strategy on Hunger, Nutrition, and Health prioritizes healthier food environments. I’m wondering, to help set the stage for this conversation, what is a healthier food environment? What’s a food environment?
Kelliann Blazek, The White House
As Dani mentioned in the national strategy, pillar three is all about healthier food environments, and that means anywhere there are people, we need to make sure that the healthier option is the easy option, as a former or previous panelist mentioned. And so that really starts with kids, that starts in schools. And maybe we’ll do a little bit of audience polling. Raise your hand if you ate school meals when you were growing up. Okay. For those in the live stream, most folks in the room just raise their hand. There’s actually 30 million kids who eat school meals every day. And so it’s a huge reach. And one of the things that we’re really focused on in the Biden-Harris administration is making sure that there are healthier food options in schools. USDA issued a proposed rule around healthier food options in schools to make sure that nutrition standards in school meals are actually aligned with the US dietary guidelines.
That rule will be finalized this spring, and one of the pieces that I’m most excited about is what would be the first ever added sugar limit in that proposed rule. We know that kids are consuming way too much added sugar, as are a lot of us, but that’s kind of baked in, no pun intended, but baked into the food system. So it’s not like people are adding sugar at home, same for sodium. We’re not adding sodium at home, it’s just baked into processed foods. And so we understand that we can’t flip a switch and turn this on or off overnight. This has to be incremental progress. So the proposed rule would actually phase in an added sugar limit over time. That would do two things. One, it would give manufacturers time to actually reformulate their products, and two, it would give kids time to have their palates adjust to those new foods. So that’s just one of the actions that we’re taking to create a healthier food environment.
Danielle Nierenberg, FoodTank
Thank you for helping explain all that. It’s so important to really set the stage. Chef Rob, I want to turn to you. Kelliann mentioned kids and young folks, and we have really learned that young folks not only need healthy foods, but they need those culturally relevant options. And I’m wondering if you can explain how NATIFS works with tribal colleges to get more traditional foods, more culturally relevant foods into those dining halls?
Chef Rob Kinneen, NATIFS
For the past… Well, actually I just got back from Minneapolis last week where we put together 20 meals, meal plans, basically menus for the Red Cloud School in Pine Ridge, South Dakota. So backing up, the recipes that we did were culturally relevant for Pine Ridge and the Plains area. And they were also, NATIFS has got a pre-contact food philosophy. So if you were to dine at Owamni, the restaurant that is now owned by Natives in Minneapolis, Minnesota, which is award-winning, you would actually have no beef, pork or chicken, no flour, no refined sugar, no dairy. If you walk into this bustling restaurant that’s been sold out for three years and there’s no dairy.
And so I think you back up and you say, “Well, what is there?” There’s bison, there’s turkey, there’s crickets, there’s lake fish, there’s three sisters, there’s a lot of indigenous foods, nixtamalization of corn. So while that’s not from the Great Lakes region, but we’re borrowing from our brothers and sisters. So we’re taking those food philosophies and we’re integrating them into the food program with Red Cloud School. Well, we’re in some steps right now with another bigger national entity that works with tribal schools. So we’re actually going to start working with an institutional model. And again, not only are we bringing culturally relevant foods to institutional landscapes that we’re also creating, I think what will happen is opening up dialogue for those indigenous farmers that are producing those indigenous foods to start growing their worth by having those foods available on bigger corporate dining entities like a Cisco or a US foods.
Danielle Nierenberg, FoodTank
And you’ve talked to me about the importance of contracts with those food producers, those foragers, to make sure that they have a long-term security to be able to do that. Can you talk more about why that’s important?
Chef Rob Kinneen, NATIFS
I think a really great point of view on this is that we’re working with the USDA FDPIR, Food Distribution Program Indian Reservations. So when you think of indigenous food, there’s a commodity food box. It’s a part of that program. That box serves as the identity of Turtle Island, which is from Florida to Maine to California to Alaska. And I’d give you a box that represents that food, that doesn’t really seem right. So I know one of the things that we’re looking at is we talk about constantly is regionalizing that box of food.
Danielle Nierenberg, FoodTank
Sure.
Chef Rob Kinneen, NATIFS
People in Florida probably don’t really care about salmon, so it’s just kind of like what can we do to regionalize that food? But what that will also do is integrate regional food systems. Breaking that up into a regional facet will also create regional demand for those traditional foods for a culturally relevant client base.
Danielle Nierenberg, FoodTank
Yes, it’s so important to think about food systems more regionally rather than the way we’ve been thinking about them for so long. Thank you for all of that. Gavan, if I can turn to you and shift gears a little bit. I want to talk about this definition of healthy. We throw this term around a lot, but the definition doesn’t regularly change for companies. And I’m wondering, how do we balance the need for consensus while also recognizing that health and nutrition research will continue to evolve, we’ll continue to learn new things.
Gavan Fitzsimons, Duke University
Yes, so I think I might be one of the few sort of representatives of the business community here today.
There’s a couple out here. I spent a lot of time partnering with big businesses and many of them are, it might shock many in the room, very interested in providing healthier foods to their consumers, not surprisingly because they see it as a profit incentive. I’m a business school professor. I don’t think that’s a bad thing. I think that we should not shy away from the profit incentive as a way to get healthier foods into our children’s diets. The challenge that I hear over and over again from the big food service providers and the manufacturers and the retailers are that they feel like the goalposts keep changing. And so if we go back five years ago, it was fats, and we go back, then it was salt, and now no offense, it’s added sugar, and they’re trying to develop products which takes, in some cases, years, that meet the needs of the consumer.
And yet it’s really, really difficult. Allison, her team of researchers, are working away and coming out with really cool science on what is healthy. But I think it’s really hard for these big companies to… And I’m not crying a river for them, but they find it difficult. For example, I work with a very large food service provider. They do 8 million meals to children every day in America. They have a team of about 45 chefs and researchers that are working literally flat out to develop healthier foods for kids. Why? Because if they are healthier than the other food service providers, what’s going to happen? They’re going to get more contracts, make more money. In my mind, this is a good thing. That’s why I partner with them and provide advice for nothing because I think it’s a good thing. And yet their guys say to me, “Well, added sugar, nobody used to stress about, now we’re stressing about added sugar. What’s it going to be next year?”
And I think it would be incredibly helpful if we could as a community, communicate whatever that might be. Right? So again, not crying a river on their part, but I would like to suggest to those of folks out here, and we’ve heard a lot of folks in government doing amazing work, a lot of folks like Rob doing really entrepreneurial stuff in the community. This is amazing. There’s a resource in these giant Fortune 500 companies and unlimited amounts of money that could be put to work in this domain. If we can just basically tell them what is it that consumers are going to want so that they can make it, they can make their money, and our kids can eat healthier.
Danielle Nierenberg, FoodTank
Again, it’s about that communication, connecting the dots. Thank you so much for bringing that up. Alice, if I can turn to you, Gavan talked about meeting the needs of eaters or consumers, and one of your areas of interest is around medically tailored meals. And I’m wondering if you can talk about what these meals are and how they help eaters access more nutritious food at home, especially for, I imagine elderly people, people who are sick. Can you talk more about that?
Alice Ammerman, UNC Chapel-Hill
Yes. I think we have a lot of opportunity coming with the medically tailored meals. Food is medicine. You’ll be hearing about that in the next panel I think. And just a lot of efforts to try to make healthy food more accessible. We haven’t said much so far about the fact that food needs to taste good for people to eat, and it needs to be culturally relevant. That’s often a big part of taste. I started a little company that makes healthy frozen meals and our favorite compliment is when people say it doesn’t even taste healthy. So it’s a little sad, but it kind of conveys the fact that people have this assumption that healthy food tastes bad, so we need to work.
And if people aren’t going to be eating the food that companies are trying to make to be healthier, then it’s not going to work economically. So we have to do that. So the medically tailored meals, it’s a way to try to reach people who may not have access to healthier options, may not have tried some things that could fit into their culture. We have the 1115 waiver in North Carolina, really important thing that’s giving us the opportunity to use Medicaid dollars to fund medically tailored meals, medically tailored groceries, and being able to get that to people who are in need and hopefully then encourage them to adopt some of those ways of eating.
Danielle Nierenberg, FoodTank
Thank you so much and thanks for bringing up the deliciousness points. I want to come back to you in a minute, but Kelliann, I think Alice brings up some interesting points, especially around some of the efforts that are underway for school meals and ways to make them more nutritious and delicious. Can you talk a little bit more about that?
Kelliann Blazek, The White House
Yeah, absolutely. One of the things I love about coming to Food Tank convenings is everyone has so much passion for these issues, but everyone’s food story is a little bit different. So everyone has relationship with food. My relationship with food started on my family’s farm. I’m from rural Wisconsin. We grew up raising beef cattle, and so I’ve seen firsthand how the local food economy can really open doors for local farmers who are looking for new markets. And one of the things that we’re proud of doing at USDA in this administration is trying to connect the dots between local food producers and schools.
And obviously we have the farm to school program, which is really helpful, but we actually invested $200 million in cooperative agreements between USDA and states’ tribes and territories, to help them enter into agreements with local producers to get that food into schools with a specific target for underserved and small producers. So this is really a win-win-win. It’s a win for local producers who are looking for new markets, it’s a win for making sure there’s culturally relevant foods in schools, and it’s a win for kids who are looking for delicious, healthy local foods. And so we’re really proud of that investment.
Danielle Nierenberg, FoodTank
Thank you so much. Gavan, keeping on this theme of kids and making food environments better for them, are there strategies that stand out for you that encourage young eaters to consume healthy food?
Gavan Fitzsimons, Duke University
Sure. Maybe if I can take 10 seconds to just comment on something that Kelliann and Alice raised. One fun thing that we’ve been finding is we’ve been highlighting in our communications to consumers that foods are local by saying where they’re from and etc. And it turns out when people find out that the food is locally grown or raised, they think it’s both delicious and healthy. So it breaks that cycle, that ugly cycle that many of us have learned over the years. So that’s a fun thing for it hopefully. So focus, highlight local. It’s really awesome. Some of the things that we do with children to try to motivate them to make healthier choices, it’s not Rocket science, it’s basic motivation and try to encourage them. We ran a test program with a school district in Western North Carolina, six or seven schools in partnership with the big organization. We called it the Fruit and Veggie Challenge.
We gave the kids stickers for every additional serving of fruits and vegetables that they consumed at lunch. They had each class then put the stickers up and they had a competition for who had the most stickers at the end of the Fruit and Veggie Challenge. And then the class that won, won a prize. It was not a pizza party. And those kids then learned for a week that fruits and vegetables can be interesting and fun and rewarding. And then we tracked fruit and vegetable consumption over the coming weeks and lo and behold, they ate more fruits and vegetables even when there were no stickers, when there was no incentive. It was heightened if we got parents involved at home. And so that’s not anything fancy. It’s just trying to give the kids something that rewards them, that encourages them to try some things. When they find they like them, they respond really positively.
Danielle Nierenberg, FoodTank
Again, it’s common sense. It’s not rocket science. Right? It’s so interesting to me. Chef Rob and Alice, I want to turn to you because I think a big part of what we’re talking about when we talked about local, we’re talking about healthy foods, we need to procure those things in such a way that is beneficial for farmers, and Chef Rob, we heard about the trauma of some indigenous folks who are black and brown folks going back to farming that their grandparents might’ve done. How do we encourage a procurement system that emphasizes culturally relevant foods in those regional food systems that you mentioned before? Sorry.
Chef Rob Kinneen, NATIFS
No, that’s a big one. But I think that that’s, again, going back to something like a model like the FDPIR program.
Danielle Nierenberg, FoodTank
Yeah.
Chef Rob Kinneen, NATIFS
Food Distribution Program Indian Reservations. I think that, I mean, what I love so much about working with natives and working with Sean, he’s very eloquent in the way he can talk about the history and trauma of indigenous people in this country and bring it without being abrasive or confrontational.
It’s just very matter of fact. And I think that part of it is really understanding that dialogue so we understand why the indigenous food system is the way it is today, but to rebuild it, I think that with… A good example is the FDPIR program. Something that goes into that box that represents food for an indigenous community should be contractually obligated to come from a [inaudible 00:17:49] or indigenous farmer producer. And if the means aren’t there to get that, then there should be funding available to solidify that base.
A good example, I know that people are interested in bison, but when you look at the bison, what the FDPIR box needs to produce a pound of bison for 550 confederate tribes across the country, there’s no indigenous producer that can do that. So then it goes to a non-indigenous purveyor. There should be a preference with the 638, a Self-Determination Act for example. There’s a lot of different ways that we can leverage that information and bring it to, but also I think there needs to be an understand of why that is the case. I don’t want to get into all that right now, but I would say that I think those dialogues need to come out as well.
Danielle Nierenberg, FoodTank
I think Sean Sherman will bring up some of that later, too. So thank you for that. And sorry for such a complex question, but you answered it so eloquently and so matter of factly. I really appreciate it.
Kelliann Blazek, The White House
I just wanted to mention since you brought up bison and the FDPIR program, we do have a pilot that we launched specifically around trying to address the challenges that Rob mentioned in terms of the quantity that’s needed to have USDA purchase bison, et cetera. The pilot is ongoing right now, but essentially it allows USDA to purchase smaller portions of bison directly from tribal producers and also allows them to use local distribution to get it directly to tribal nations. So a lot of times in government programs when we’re trying to figure something out, we do it in a pilot fashion to see how it works, but we’re really looking forward to seeing how that plays out and how we can work in partnership with the tribes. Obviously, tribal self-determination is a key cornerstone of this administration, this president, so we’re really committed to figuring it out.
Danielle Nierenberg, FoodTank
Thank you. Thank you both for that. Alice, the procurement process for your medically tailored meals and these delicious frozen foods that people don’t know are healthy, how does that work?
Alice Ammerman, UNC-Chapel Hill
Well, one approach is just to emphasize what foods are locally available and using that and recipes and school meals and things like that. So like sweet potatoes, that’s our state vegetable, if anybody didn’t know that. They’re wonderful because they last a long time. They’re pretty inexpensive. So we use those in almost every meal. So my research hat, I study the Mediterranean diet and how it affects health, and I think a lot of people have the misconception that if you eat a Mediterranean diet you have to eat grape leaves and olives primarily. But the nice thing is that it’s really the science behind the Mediterranean diet, which is that transition that Gavan talked about of now we’re looking at healthier, good quality oils that you tend to find in Mediterranean foods, and then the usual fruits and vegetables, nuts and things. So we’ve adapted what we call the Med South Diet, which is taking the Mediterranean diet and applying it to the kinds of foods that people are more used to eating here.
And that can, to take that to an extreme, I worked with some folks in Kenya who you may know that a lot of low and middle-income countries, they’re finding they’re developing the same chronic disease rates that we are here because unfortunately a lot of it, shipping our own eating practices and ultra processed foods over there. And it didn’t take very much to look at their recipes and say, “How about a little bit more of this? Put some of this here.” It turns out they use a lot of collard greens just like we do here in the south. So there are a lot of ways to culturally adapt the science of the Mediterranean diet into healthier and culturally relevant foods.
Danielle Nierenberg, FoodTank
I’m so glad that that’s finally coming about because I know that the Mediterranean diet has been applauded as the only option. We should all be eating that way, but to recognize that it doesn’t look the same, these culturally relevant diets that look different almost everywhere. We only have a few minutes left, so I want you all to sort of answer briefly if you can, the role that the private sector plays in supporting the creation of healthier food environments. And so maybe Gavan, if I can start with you.
Gavan Fitzsimons, Duke University
I think it’s underutilized right now, and I think there’s an opportunity… If you think about how getting something passed through our government right now has already been mentioned, gridlock is tough and it’s very hard to get things to be implemented. If a very large company thinks they can increase their profits by rolling out healthier food to our children nationally, it’ll happen next week. And so I think there’s a huge opportunity for us there to… And some of it is in demonstrating through entrepreneurial activities like the kind of stuff that Rob’s describing, just how it can work, and then those big companies can learn and leverage that and roll it out on a mass scale. And so, look to them for opportunities.
Kelliann Blazek, The White House
Yeah, it’s absolutely integral to the success of a lot of the policies we’re working on through the federal government. So school meals is a great example. We can push policies and rulemakings that advance higher nutrition standards for school meals, but unless the products exist in the marketplace, it’s hard to implement for schools. If there’s no products to buy, it’s easy for them to push back and say, not feasible, the market’s not ready yet. And so through the White House challenge to end hunger and build healthy communities that my colleague, Will, mentioned earlier, one of our focus areas was trying to partner with the private sector to cultivate commitments around healthier food products and reformulating food products. And one of the commitments that we highlighted last week was one from the International Dairy Foods Association, which is committing lowering added sugar in school milk. And so that will directly support the rulemaking that we’re working on to ensure that healthier products get in schools.
Alice Ammerman, UNC-Chapel Hill
One reminder is the private sector isn’t just large corporations. Like Chef Rob, farmers are in the private sector and it’s not a bad thing to make money. People in rural areas need opportunities to make money. So if we can support local businesses that serve people in the community and also it sustains them economically, that’s all really important. So entrepreneurial efforts can be very broad and are really important to economic development.
Chef Rob Kinneen, NATIFS
I guess echoing a lot of it, I would agree. I know that I’m working with, I said a large national food corporation and they’re not doing that because they want to feel warm inside. They’re doing it because they know that they can use our information, our intellectual knowledge to create a recipe that will create demand, that will create more clients and customers. Health happens to be a byproduct of that situation, in my opinion. So I have to also understand, I feel as if I need to know where I am in this situation. And then I will say, I got to cater the White House Tribal Nations Summit this year in DC and it was actually really exciting to hear a lot of the advances going on with this administration regarding the red tape of, for example, USDA processing facilities on tribal nations.
Because if your land is a trust, you cannot leverage it to get a USDA approved bison processing facility. So what are we going to do about that? How can we do that? How can we do that and move forward? And so that is being addressed. I do appreciate that. I don’t know, it’s a little bit of a mixed bag there as far as things to do.