From the archives: A call for understandable information on food labels

Note: This post originally appeared on Stanford Medicine’s award-winning medical blog, Scope.  This is being archived here for professional posterity.

The individual-sized bag of Fritos sitting on my desk has 320 milligrams of sodium, no cholesterol, 3 grams of protein and 180 calories of fat. But what do those numbers actually tell me about the snack? Is it good for me? Bad for me? Somewhere in-between?

Today, the Institute of Medicine issued areport (.pdf) urging the Food and Drug Administration to begin labeling food with easy-to-read ratings on nutritional value. Instead of the nutrition-ese we’ve grown accustomed to seeing on food packaging, the proposed system would rate food based on its sodium, sugar and fat content on a scale from zero to three, with three being the best possible rating for the given factor.

In spite of new diets emerging each year promising dazzling results and studies published on a seemingly weekly basis proclaiming new nutritional information, Americans still spend more than $145 billion each year in obesity-related health costs. As Ellen Wartella, PhD, a professor of psychology at Northwestern University and leader of the Institute of Medicine committee advocating the new rating system (which has been likened to the Energy Star program labels on consumer products), points out in a Bloomberg article:

Americans today have access to more information about nutrition than any previous generation, and yet the nation is facing a crisis of obesity and diet-related chronic disease. It’s clear that there is a disconnect between dietary recommendations and actual consumption.

The Grocery Manufacturers Association, which launched its Facts Up Front program in January, asserts that consumers would rather make judgments on healthy food for themselves than be told what’s good for them by the government. But in a commentary on MSNBC’s Vitals blog, bioethicist Art Caplan, PhD, offers that:

Big government is an easy target but the industry argument misses the point. The government’s role is to get industry to give you trustworthy useful information. Telling you that Captain Crunch is fortified with iron does not make it healthy for kids to eat sugary breakfast foods.

As I try to make sense of the nutritional gibberish on the back of my bag of Fritos, I nod in affirmation.


From the archives: A mandate for insurance companies to cover autism treatment

Note: This post originally appeared on Stanford Medicine’s award-winning medical blog, Scope.  This is being archived here for professional posterity.

I was almost 21 before I had any concept of what autism was or what it meant, especially for those families affected by it. But in just a few weeks, I found myself immersed in the issues after taking a job as a behavior instructor for an early-intervention Applied Behavior Analysis (ABA) program.

So I took notice when California Gov. Jerry Brown signed SB 946 – a bill mandating that private insurance companies provide coverage for families seeking ABA therapy as autism treatment. The law will take effect in July 2012.

Insurers have argued that behavior therapy is more aligned with education than with actual health care, but in a Los Angeles Times column, David Lazarus points out these types of treatments are medically necessary. And pricey:

Autism, like nearly all chronic conditions, is expensive. It requires not just medical treatment but also extensive educational, behavioral and vocational support.

A study from the Harvard School of Public Health found that direct medical and nonmedical costs for a severely autistic person can run as much as $72,000 a year. People with milder forms of autism can face costs of about $67,000 annually.

Insurers are concerned about cost: A statement from the California Assocation of Health Plans (an industry group) predicted that SB 946 would drive up health care costs by $850 million a year. But the financial impact of the legislation varies depending on who you ask. The California Health Benefits Review Program conducted an evaluation of the bill for the state legislature estimating that annual costs of the law would actually be closer to $93 million – no small amount of change, but a far cry from $850 million.

The issue is certainly complicated, and there is still quite a bit of time before we begin to see how this will unfold. But as someone who now considers herself an advocate for early intervention and for ABA, I can’t help but wonder if this isn’t a win for many families in California.