HOW TO PREVENT CANCERS

It is a good morning exercise for a research scientist to discard a pet hypothesis every day before breakfast. It keeps him young.
-Konrad Lorenz

This week's news brought a story that remind me that sometimes, the best science involves letting go of previously held hypotheses.

Access to quality, health food, particularly fruits and vegetables, is something that has occupied a good deal of news space in recent years. And with good reason. If people can't get healthy food, all the health education in the world telling them to eat it isn't going help. The result has been a lot of attention on food deserts - the lack of supermarkets in certain neighborhoods. How pervasive are these food deserts and what do the food options look like in these areas? Jim Griffioen takes a powerful look at this in his hometown of Detroit over at Urbanophile. He shows, in great detail, the incredible depth and breadth of quality locally owned food purveyors within Detroit. He also points out that a quick Google search locates a number of smaller chain grocery stores. Does Detroit have a Whole Foods or Super Target? No, but Griffioen argues they don't need one. I have been reading his personal blog for some time and one of my favorite series has always been his photos of the family's "haul" from Detroit's Eastern Market. The photos highlight an incredible diversity of delicious looking produce and food that is locally grown or produced. Kudos to Griffioen for pushing journalists and researchers to examine these questions in more detail - and draw new conclusions when the data indicates it.

This morning, I had the extreme pleasure of hearing Dr. Bill Dietz of the CDC's Division of Nutrition and Physical Activity in the Center for Chronic Disease Prevention and Health Promotion speak about Policy and Environmental Changes to Prevent and Control Obesity at the Washington University School of Medicine Grand Rounds. Dr. Dietz touched on many topics, but one that stood out to me was the focus CDC has on its list of priority strategies to address important health behaviors: increasing access to fruits and vegetables through retail stores.

I'm sure many of my fellow news junkies saw the NY Times Magazine story about Walgreens' new program to eliminate food deserts. A food desert the NY Times describes as "urban neighborhoods where there are few grocers selling fresh produce, but a cornucopia of fast-food places and convenience stores selling salty snacks (though, strictly speaking, the term can be applied to rural or suburban areas, too). Often the problem afflicts low-income areas abandoned or shunned by food businesses that focus on better-off consumers"

Food deserts are a problem that numerous non-profit and community groups have worked to tackle. Most notable is probably the Food Trust based in Pennsylvania. The Food Trust work has expanded to other states and has had some notable successes in encouraging supermarket development and expanded farmers' market programs. Perhaps it shouldn't be surprising then that when the US government announced the $400+ million Healthy Food Financing Initiative to bring grocery stores to underserved communities, it did so in Philadelphia.

Do big intiatives like this work? The general consensus is cautious optimism. Certainly having the White House behind programs like this is a big deal. But, as Marion Nestle noted, voluntary programs such as these don't always move us very far in the path to healthier communities. That businesses are seeing an opportunity here, perhaps points to some real movement (even if the cynic in me points out that this is about the bottom line for any business). I'm looking forward to seeing Walgreens provide some data on the successes (or not) of their program, something the Times article notes it has been unwilling to do so far. I'm also curious to see more data on whether these programs change fruit and vegetable intake, and ultimately rates of associated comorbidities, like obesity. Economic disparities have a big effect on food choices and the economic challenges facing families will be a big driver of our success in food access and numerous other health challenges.