Employing Dietitians Pays Off for Supermarkets

Stephanie Storm, The New York Times, August 24, 2012

MOLINE, Ill. — Lois E. Florence recently left her doctor’s office with a diagnosis of colitis, an intestinal disorder, and a complicated set of instructions for changing her diet.

After several setbacks she had a chance conversation with the pharmacist at her local Hy-Vee grocery store here that changed everything. 

He referred her to the store’s dietitian, Dawn Blocklinger, and on a recent sunny morning, the two of them spent almost an hour compiling a list of the foods Mrs. Florence, 79, could eat and alternatives for the ones she couldn’t, like rye bread to replace wheat and Tofutti instead of ice cream. 

Then they went shopping. 

Hy-Vee is the only grocery chain in the country that posts a registered dietitian in almost every one of its 235 stores. In rural areas, some of its more than 190 dietitians serve a cluster of stores. 

That puts it at the forefront of a phenomenon sweeping the grocery business as it tries both to capitalize on growing consumer awareness of the role food plays in health and wellness and to find new ways to fend off competition from specialty markets like Whole Foods and big-box stores like Walmart. 

“There’s been an explosion of interest in having a dietitian among grocery store retailers in the last three or four years,” said Annette Maggi, chairwoman of the supermarket subgroup of the food and culinary professionals practice group at the Academy of Nutrition and Dietetics and a consultant to the retail and food manufacturing industries. 

The supermarket subgroup now has more than 400 members and its numbers are rising, Ms. Maggi said. Jane Andrews at Wegman is widely regarded as the grande dame of supermarket dietitians, becoming the first dietitian on its staff in 1988 and now supervising a team of six. Other regional chains like Meijer, Giant Eagle, Bashas’ and H-E-B also have them, and bigger grocery stores are getting involved, too. 

Kroger, which already has dietitians on staff, is adding more of them to its King Soopers chain in the West.

At Meijer, a regional supermarket chain in the Midwest, the five dietitians do about 100 events a quarter, 80 to 85 appearances at community events, health assessments with company employees, in-store cooking demonstrations and educational programs on health subjects like diabetes and heart disease. 

They also are responsible for maintaining pages on the company Web site and producing a variety of pamphlets and booklets. 

“Like almost all of us, I started out in a hospital, but I switched because I wanted to talk to people about what they were eating before they got sick,” said Shari Steinbach, the lead dietitian at Meijer. 

Ms. Steinbach has been a grocery store dietitian for 24 years, and she said she had never seen interest in the position so high. “I think retailers are starting to see our value,” she said. “They can document increased sales of healthier items, the e-mails from shoppers wanting appointments, the invitations from manufacturers wanting us to come to their conferences.” 

Andy McCann, senior vice president for retail health at Hy-Vee, said he got about three or four calls and e-mails each week from other grocery store operators wanting to know more about Hy-Vee’s dietitians.

One of the most frequent questions callers have is how Hy-Vee calculates its financial return on its investment in dietitians. “We have store directors in eight states who have looked at it and say they can’t afford not to have a dietitian in their stores,” Mr. McCann said. “It’s very difficult to calculate a return on investment, but when you look at day to day what the dietitians do, it’s easy to see how they’re valuable.” 

At Hy-Vee, dietitians offer in-store consultations and store tours with customers, hold cooking classes, assemble take-home meals, take biometric screenings, do presentations in schools, businesses and civic events, work with merchandisers, help set up community gardens, assess products for nutritional value and a variety of other things. 

They also explain the NuVal system, a nutritional scoring system done by independent nutritionists and medical experts that more and more retailers, including Hy-Vee, are deploying to help consumers assess products.

The dietitian’s role is expanding, said Phil Lempert, a grocery industry expert and author of the blog Supermarket Guru. “The field of nutrition is getting more and more complicated,” Mr. Lempert said. 

“Merchants used to buy on price and promotion, but you can’t buy that way any more with all the product claims. You need someone around who understands whether products can really deliver, whether they’re safe.” 

He has set up a new organization, the Retail Dietitians Business Alliance, that will offer its members a weekly newsletter with tips on merchandising, webinars about how to demonstrate the value of a dietitian in a retail setting, and workshops at gatherings like Expo West in March and the Food Marketing Institute’s Health and Wellness Conference. 

Recently, Kristen Decker, the dietitian at the Utica Ridge Hy-Vee in Davenport, Iowa, just across the Mississippi River from Moline, spent her morning preparing Fast Fit Meals, a program that supplies three meals and two snacks a day totaling 1,200 to 1,500 calories to cover five days a week. Shoppers pay $75 for a week and pick up the food and instructions for preparing it each day on a specific day of the week. 

“We have four weeks of menus, and they never eat the same thing twice during that period,” Ms. Decker said. “There is a mix of fresh, frozen and dry, and if you don’t like fish or broccoli, we’ll find a substitute.”

Six shoppers were stopping by that evening to pick up meals, but Ms. Decker said that number would double after the summer break. 

“Customers don’t have a lot of time, or they don’t know what to look for,” she said. “The claims on the front of the packaging aren’t always about nutrition, or sometimes they just don’t know what’s important. I had a customer, for instance, ask about whether he should be more concerned about sugar or fat.” 

Megan Leahy, the deli manager at the Hy-Vee in Rock Island, Ill., knows to watch the fats she eats. Ms. Leahy has Chrissy Watters, the dietitian in her store, monitor her cholesterol, heart rate, weight and other biometrics, which entitles her to a discount on her insurance. 

“Your glucose is perfect,” Ms. Watters told her. “You’re still working on your waist circumference.”

She recommended more aerobic activity, eating more fish and using canola oil. 

Ms. Leahy has started running, and she said Ms. Watters had given her some ideas for foods lower in cholesterol, including a spinach dip made with yogurt. But she wrinkled her nose at the mention of fish, which all of the dietitians said was a hard sell. “I’m like a 5-year-old when it comes to trying new food,” Ms. Leahy said. 

While Ms. Watters was giving a tour of the store, a call came in from Chris Carlson, a shopper whom she had advised. Mr. Carlson had come to her after having a blood test showing his triglycerides were at 880 and his total cholesterol was at 332. 

“I knew I needed to make significant changes, and I had contacted various groups, but they all wanted me to pay a lot of money to do their programs,” Mr. Carlson said. 

His wife had consulted with a Hy-Vee dietitian when her mother found out she was gluten intolerant, and she suggested he make an appointment with Ms. Watters. “She gave use some ideas about how to change our diets with different meats and get off the sugar and walked us through the store,” Mr. Carlson said. 

He called that day, two months later, because he had been to the doctor and his cholesterol had dropped to 170 and he had lost 27 pounds. “As someone whose business is sales, I can see how having someone like Chrissy is good for Hy-Vee,” Mr. Carlson said.

Why government needs a diet

George F. Will, The Washington Post,  August 22, 2012

 

Because the possibility of effectively supervising government varies inversely with government's size, so does government's lawfulness. This iron law of Leviathan is illustrated by a dispiriting story that begins with the American Recovery and Reinvestment Act of 2009, a.k.a. the stimulus — that supposedly temporary response to an economic emergency.

Because nothing is as immortal as a temporary government program, Communities Putting Prevention to Work (CPPW), a creature of the stimulus, was folded into the Patient Protection and Affordable Care Act of 2010, a.k.a. Obamacare. And the Centers for Disease Control and Prevention (CDC), working through the CPPW, disbursed money to 25 states to fight, among other things, the scourge of soda pop.

In Cook County, Ill., according to an official report, recipients using some of a $16 million CDC grant "educated policymakers on link between SSBs [sugar-sweetened beverages] and obesity, economic impact of an SSB tax, and importance of investing revenue into prevention." According to a Philadelphia city Web site, a $15 million CDC grant funded efforts to "campaign" for a "two-cent per ounce excise tax" on SSBs. In California, an official report says that a $2.2 million CDC grant for obesity prevention funded "training for grantees on media advocacy" against SSBs. A New York report says that a $3 million grant was used to "educate leaders and decision-makers about, and promote the effective implementation of . . . a tax to substantially increase the price of beverages containing caloric sweetener." The Rhode Island Department of Health used a $3 million grant for "educating key decision-makers to serve as champions of specific . . . pricing and procurement strategies to reduce consumption of" SSBs. In government-speak, "educating" is synonymous with "lobbying." 

Clearly some of the $230 million in CDC/CPPW anti-obesity grants was spent in violation of the law, which prohibits the use of federal funds "to influence in any manner . . . an official of any government, to favor, adopt, or oppose, by vote or otherwise, any legislation, law, ratification, policy, or appropriation." But leaving legality aside, is such "nutrition activism" effective?

Not according to Michael L. Marlow, economics professor at California Polytechnic State University, and Sherzod Abdukadirov of the Mercatus Center at George Mason University. Writing in Regulation ("Can Behavioral Economics Combat Obesity?"), a quarterly publication of the libertarian Cato Institute, they powerfully question the assumptions underlying paternalistic policies such as using taxes to nudge individuals to make consumption choices that serve their real but unrecognized interests — e.g., drinking fewer SSBs. 

Paternalists wield two weapons: mandating the provision of more information (e.g., calorie counts for restaurant menu items); and increasing the cost of bad decisions, meaning those of which the paternalists disapprove.

Marlow and Abdukadirov respond: "Most obese individuals know they are heavy, and that many of the foods they eat are high-calorie. They also face the stigma often linked to obesity. They hardly need the government to give them additional incentives to lose weight. People aware of their mistakes also have strong incentives to correct them."

Research indicates that overweight individuals have "reasonably close" to accurate estimates of the increased health risks and decreased life expectancy associated with obesity. Hence the weakness of mandated information as a modifier of behavior. A study conducted after New York City mandated posting calorie counts in restaurant chains concluded that, while 28 percent of patrons said the information influenced their choices, researchers could not detect a change in calories purchased after the law.

Other research findings include: A study of nearly 20,000 students from kindergarten through eighth grade found that among those with easy access to high-calorie snacks in schools, 35.5 percent were overweight — compared with 34.8 percent of children in schools without such snacks. Nutrition policy is replicating a familiar pattern: Increased taxes on alcohol and tobacco mostly decrease consumption by light users, not the heavy users who are the social problem and whose demand is relatively inelastic.

The robust market in diet books, weight-loss centers, exercise equipment, athletic clubs, health foods — between 1987 and 2004, 35,272 new food products were labeled "no fat" or "low fat" — refutes the theory that there is some "market failure" government must correct. But as long as there are bureaucrats who consider themselves completely rational and informed, there will be policies to substitute government supervision of individuals for individuals' personal responsibility. 

As the soft paternalism of incentives fails, there will be increasing resort to the hard paternalism of mandates and proscriptions. Hence the increasing need to supervise our supervisors, the government.

New Report: America Trashes Forty Percent of Food Supply

Press Release - Natural Resources Defense Council

New Report:  America Trashes Forty Percent of Food Supply

August 21, 2012

New analysis by the Natural Resources Defense Council: "Food is simply too good to waste. Even the most sustainably farmed food does us no good if the food is never eaten. Getting food to our tables eats up 10 percent of the total U.S. energy budget, uses 50 percent of U.S. land, and swallows 80 percent of freshwater consumed in the United States. Yet, 40 percent of food in the United States today goes uneaten. That is more than 20 pounds of food per person every month. Not only does this mean that Americans are throwing out the equivalent of $165 billion each year, but also 25 percent of all freshwater and huge amounts of unnecessary chemicals, energy, and land. Moreover, almost all of that uneaten food ends up rotting in landfills where it accounts for almost 25 percent of U.S. methane emissions. Wasted: How America is Losing Up to 40 Percent of Its Food from Farm To Fork to Landfill – analyzes the latest case studies and government data on the causes and extent of food losses at every level of the U.S. food supply chain. It also provides examples and recommendations for reducing this waste."

Mark Bittman: Let's Make Him Do It

Mark Bittman, The New York Times, August 16, 2012

For positive change in the issues that affect our daily lives — not only food but also jobs, income, housing — we need active political leadership. But until President Obama is pushed more strongly by the left, the coming presidential election represents a choice between a full-fledged attack on government services and a continuing slide into the gloomy and depressing world of austerity economics. That’s a real choice, but it’s not a happy one.

When Obama has been pressured on issues, like gay rights, immigration and the Keystone XL pipeline, he’s responded positively. But he hasn’t been pushed on food, and as a result has not followed up on campaign promises like his vow to label foods containing genetically modified ingredients, nor has he used his bully pulpit to try to protect SNAP (food stamps) from the ravages of Congress. Since there isn’t a real food movement — yet! — progressives haven’t made Obama do much.

At least he won’t dismantle government, as Mitt Romney and Paul Ryan would. Ryan’s anti-stimulus plan is an unemployment-boosting scheme that would finance the military at a high level, the social safety net at the lowest possible level (Ryan is calling for a 17 percent cut in food stamps, enough to elicit criticisms from a pair of high-ranking Catholic bishops, for example) and just about nothing else. It benefits no one but the superrich and their representatives.

Not that that’s anything new. Most people — call them working class, middle class or the 99 percent — have less money than they did a generation ago; the superrich have scads more. A vast majority of Americans are on the losing side of the class war, as evidenced by lower pay scales, eviscerated unions, fewer benefits, later retirement, shortened or eliminated vacations, starved municipalities and of course the quality of our food and the impact it has on us and the environment.

Obama has seen more power and money arrayed against him than perhaps any Democrat ever. But his lack of a workable plan for economic recovery and his right-leaning stances on fiscal responsibility and debt reduction remind us that the basic problem is not one of “progressive” Democrats versus “conservative” Republicans.

This isn’t new either: in the last 40 years we’ve witnessed a long, steady move to the right, which Democrats occasionally whine about, protest and even fight, but in which they’ve been mostly complicit. Unless you reduce defense budgets — practically unheard of — whenever you cut taxes, you starve social programs and infrastructure, thus undermining the legitimate and beneficial role of government. (Even “progressive” Democrats are onboard with some cuts to food stamps in the as-yet-unpassed farm bill.) With government providing fewer services, it becomes easy to persuade people that it’s an albatross, so why not cut taxes further? Enter Paul Ryan.

Candidate Obama led us to believe that he was a different kind of Democrat, and he stirred new and even skeptical old voters. Yet he’s disappointed many supporters. You can argue that his hands have been tied: money is power — Citizens United has made this even more so — and until there’s meaningful electoral and campaign-finance reform, along with real limits on lobbying, there’s no chance for real progress.

President Obama didn’t create this system; he’s a product of it. A fundamental problem now is that the right has devised both a strategy and a movement, and the left has done neither. “All the bold answers are only from one side,” Van Jones, author of “Rebuild the Dream,” told me. “But we have to stop acting like there’s one person with agency in America, whose name is Obama. It’s not what he should do — it’s what we should do.”

That’s right. Only by building real movements around food and other important issues can we pressure Obama (or even Romney; just look at the inroads the right made with a Democrat in office) to act in the interests of the great majority. A strategy for this is neatly outlined in the just-published paper “Prosperity Economics” by Jacob Hacker and Nate Loewentheil, which counters the nonsense of austerity economics and lays out a credible plan for public investments and economic security, a plan that could help revive jobs and growth and ensure “that gains are broadly shared.” Their agenda improves on most economic plans by adding demands for dramatic political reform. “The best ideas are of little use without political movements, and those movements can only succeed in a political regime in which votes count more than money,” Hacker said to me.

It’s worth voting for progressives, but it’s equally important to recognize that until there is real pressure from the left, the money and influence of the right will continue to pull any president in that direction.

Growing the food movement: lists of advocacy groups

Marion Nestle, Food Politics, August 1, 2012

Whenever I give a talk, someone in the audience invariably asks how to get involved in food advocacy. My suggestion is usually to go online and look for local groups working on issues of interest or, if lucky enough to have a nearby Edible magazine, read the ads.

These are still useful starting points and I list them and others in the FAQ section on this site (questions 3 and 4).

More recently, I’ve been asked a more complicated question: Why don’t all those organizations get together? If they did, they would form a major political force.

Vivian Wang, an undergraduate at NYU, asked that very question after one of my talks. She volunteered to start doing some preliminary work by attempting to identify local and national food advocacy groups.

It didn’t take her long to discover the enormity of that task.

Nevertheless, she created spreadsheet of the groups she was able to find. She organized her findings by the tabs at the bottom, which she named:

· Long Lists: These are groups with websites that provide information about resources including many other advocacy groups.

· NYC-based: Groups in New York City. These are also given on different spreadsheets in the other categories

· Advocacy

· Agriculture

· Education

· Hunger

· Local Food

· Organic Food

· Urban Farming

· NYU-based: food and nutrition clubs at New York University


See also - http://blogs.law.harvard.edu/foodpolicyinitiative/files/2012/06/CAREER-GUIDE-JUNE-2012-v4.pdf

Efforts to Tackle Global Obesity Shaping a New Investment Megatrend, Says New BofA Merrill Lynch Report

Analysis Pinpoints Sectors and Companies Developing Obesity Solutions. 

Bank of America website, August 2012

Increasing efforts to tackle obesity over the coming decades will form an important new investment theme for fund managers, according to a new BofA Merrill Lynch Global Research report called “Globesity - The Global Fight Against Obesity.”

“Global obesity is a mega-investment theme for the next 25 years and beyond. Obesity may be the most pressing health challenge facing the world today and efforts to tackle it will shape thinking by policy makers and in boardrooms around the world,” said Sarbjit Nahal, equity strategist at BofA Merrill Lynch Global Research.

BofA Merrill Lynch has identified a Global Fighting Obesity Exposure Stocklist-50+ centering on four areas: Pharmaceuticals and Healthcare; Food; Commercial Weight Loss, Diet Management and Nutrition; and Sports Apparel and Equipment.

The report by the BofA Merrill Lynch ESG (Environment, Social, and Governance) and Sustainability team identifies that efforts to reduce obesity is a “megatrend” with a shelf-life of 25 to 50 years. It charts the rise of obesity globally and the ballooning costs. BofA Merrill Lynch analysts across several sectors have collaborated to identify the sectors and companies developing long-term solutions. Earlier this year, the firm’s biotech team highlighted in “The Skinny on Obesity” the growing potential for development of new drugs to combat weight gain. “The FDA has historically had little risk tolerance for weight loss drugs, but recently has shown increased support for their development,” said Steve Byrne, biotechnology analyst at BofA Merrill Lynch Global Research.

Globally, 500 million people are obese and 1.4 billion are overweight. Obesity is the fifth greatest cause of death, leading to 2.8 million fatalities each year. Worldwide prevalence of obesity doubled between 1980 and 2008, according to the World Health Organization. By 2030, 65 million more Americans will be obese if current trends continue. While its impact is well-known in the West, obesity is rising quickly around the world. Obesity in Europe has tripled in 30 years. It is growing rapidly in emerging markets as diets westernize. Brazil, where 16 percent of the population is obese, is on track to match U.S. obesity levels by the 2020s. Obesity has reached levels of up to 20 percent in Chinese cities. A quarter of Russian women are obese.

Growing costs and tighter regulations spur fight against obesity

The costs of managing obesity are much greater than previously believed. In May 2012, the U.S. Institute of Medicine estimated the annual cost of obesity-related illness in the U.S. alone is more than $190 billion – equal to 21 percent of annual medical spending. Previous studies estimated 10 percent.

Medical costs for treating obese patients are 40 percent higher than for non-obese patients. Treating obese patients comes at a higher premium than treating smokers. Obesity adds 50 percent to annual medical costs, while smoking adds 20 percent. High levels of global childhood obesity and growing obesity in emerging markets will further increase global costs.

As happened with smoking, it is likely that the growing cost burden of obesity on governments, corporates and wider society will spur collective action and greater regulation. BofA Merrill Lynch expects widespread scrutiny of lifestyle aspects associated with obesity including food and drink, schools, work environments, insurers, tackling sedentary lifestyles, and encouraging increasing physical activity.

Investment ideas for fighting globesity

Investors should take a long term view and a broad perspective in selecting stocks as part of the globesity theme, in our view. BofA Merrill Lynch Global Research has identified more than 50 global stocks across four key entry points:

· Pharmaceuticals and Health Care – We look at companies taking advantage of the FDA’s increased support for obesity drug development. We also highlight companies tackling related medical conditions and needs including diabetes, kidney failure, hip and knee implants. We also consider equipment such as patient lifts, bigger beds and wider ambulance doors.

· Food – We position companies on their efforts to access the $663 billion “health and wellness” market, as well as on how they are reformulating their portfolios to respond to increasing pressure such as “fat taxes” to reduce sugar and fat levels.

· Commercial Weight Loss, Diet Management and Nutrition – Up to 50 percent of some western populations pursue dieting, targeted nutrition and behavioral change making it a $4 billion market in the U.S. and growing globally.

· Sports Apparel and Equipment – This is the longer-term play, but we believe that promoting physical activity will become a key priority for more government health policies.

BofA Merrill Lynch Global Research
The BofA Merrill Lynch Global Research franchise covers more than 3,300 stocks and 880 credits globally and ranks in the top tier in many external surveys. Most recently, the group was named Top Global Research Firm of 2011 by Institutional Investor magazine; No. 1 in the 2012 Institutional Investor All-Asia survey for the second consecutive year; and No. 2 in the 2012 Institutional Investor All-China, All-Europe and All-Japan surveys. The group was also named No. 2 in the inaugural 2012 Institutional Investor Emerging Markets Equity and Fixed Income survey, covering Emerging Europe, Middle East and Africa; No. 2 in the 2011 All-Latin America and All-America Equity team surveys; and No. 3 in the 2011 Institutional Investor All-America Fixed Income and All-Brazil Research team surveys.

Additionally, BofA Merrill Lynch Global Research was named the No. 1 Global Broker by Financial Times/StarMine, as well as ranking No. 1 in the U.S. and Europe and No. 2 in Asia. The group was also named No. 1 in Asia and No. 2 in the U.S. in the Wall Street Journal Best on the Street 2012 Analysts Surveys. The group was also the winner of the Emerging Markets magazine’s EM Research Global Award for 2010 and 2011.

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