After gastric bypass surgery, many experience eating difficulties

About 71 percent of the gastric bypass group, compared with 17 percent of the others, could not tolerate certain items, including red meat and foods high in fat or sugar. Water was not tolerated by about 7 percent of those who had had gastric bypass, vs. none of the others. The researchers found no link between the amount of weight people had lost and the digestive problems. Link to story

Markets could put small lists of available products together for different users of their market, including those who have digestive problems. It’s important to remember that many of these folks are just beginning to understand their problems, learning what works and doesn’t. I remember how, after my gallbladder surgery in 2007, I had to figure out what needed to come off my shopping list. It was through trial and error and asking a lot of questions and reading a lot of information that I was able to understand what worked best for me, but in the meantime, I had to give away or throw away some items I bought at first which used to be fine for me but were no longer. Another reason why vendors offering small “sample” amounts of different items can be a great way to invite new visitors (or newly fragile shoppers)  to become regular, return shoppers.

I know of at least one market outreach program that focused on these patients – the wonderful North Union Farmers Markets in my original hometown of Cleveland Oh.

Their frittata project is one of my favorite programs to pull out of my sleeve when markets ask me about ideas for working with obese or recently obese populations. (These programs make me seem smart even though what I really am is well-traveled.) Their project is shared with many other types of healthy food clients too, but I was really taken by the idea they had of working with bariatric patients through the Cleveland Clinic system.

 

More on their project:

The Frittata Project teaches young mothers (and fathers!) how to cook a nutritious meal on a budget to feed their family. The food used in the recipes we teach can be bought at our markets for around $10 (the amount we match in produce perks for EBT-SNAP/Ohio Direction Card). Workshops and demonstrations bring families together to learn how to sustain a nutritious diet while staying within their economic constraints. Our aim is to foster relationships in the community by empowering individuals to make informed decisions about the food they purchase while having the skills to prepare it. In addition to those on EBT-SNAP (Electronic Benefits Transfer- Supplemental Nutrition Assistant Program) and WIC (Women and Infant Children), the program is also open to senior citizens who participate in the Senior Farmers Market Nutrition Program by the Western Reserve Area Agency on Aging.

Our signature frittatas include farm fresh eggs, local grated cheese, a dash of grass-fed cow’s milk, and sautéed spinach seasoned with salt and pepper.

Students go home with not only new skills in the kitchen, but with cooking supplies (pan and spatula) and gift certificates for fresh and local produce from the farmers markets.

‘More on the history of this flagship market organization can be found here.

 

FINI report, Year 1

In Year one, FINI supported incentive programs at almost 1,000 farmers markets, representing 4,000 direct marketing farmers in 27 states. These farmers market programs alone generated almost $8 million in SNAP and incentive sales spent on produce. Program evaluation conducted by grantees indicated uniformly high redemption rates, strong support for the program among stakeholders, and a great deal of collaboration from both public agencies and private program partners. These collaborations were particularly important in conducting outreach to SNAP recipients.

 

FINI_FarmersMarkets_Year1_FMC_170413

6 Things Paul Ryan Doesn’t Understand About Poverty (But I Didn’t, Either) 

Karen Weese is a freelance writer whose work has appeared in Salon, Dow Jones Investment Advisor, the Cincinnati Enquirer, Everyday Family, and other publications.

There are many prescriptions for combating poverty, but we can’t even get started unless we first examine our assumptions, and take the time to envision what the world feels like for families living in poverty every day.

Alternet

Structural racism and farmers markets, Part 2

Recently, I wrote the first post of where markets began and some of the barriers we have encountered along the way to healthy food for all. I hope that those who read it understood the distinction I was making between individual, institutional and structural racism.

In it, I gave my version of the chronological history of markets in order to show the intentional and thoughtful work done by leaders so far. One of those milestones was the work with public health advocates, starting in the early 2000s and one of the examples I use of that is Kaiser Permanente’s creation of farmers markets. This began around 2003, when ob/gyn Dr. Preston Manning had an idea to put a farmers market on the Oakland  KP campus and begat a movement of “market champions”around the U.S. during their shift to wellness rather than crisis care. This report on their markets came out a few years ago and has some very interesting analysis of market interventions.  The evolution of the “campus” market in the emerging market typology spectrum linked below is illustrated in there as is some data on the marked increase in the consumption of fruits and vegetables among surveyed marketgoers, and (what I remember as the surprising outcome to them ) of the increase in social capital for their staff. (Here is the draft version of the market typology.)

The KP markets marked one of the first long-term partnerships with a health care provider interested in them as interventions for their target audience. In other words, it seems to be the beginning of the era of partners realizing markets were more nimble than they had previously seemed and so could be added into new communities for multiple reasons, including those with complex public health goals. The KP/market relationship seemed strained at times (full disclosure: back then, my organization  was in discussion to help KP with their market strategy, but the New Orleans levee breaks of 2005 took precedence for our time. We did continue to discuss markets with them and even included their staff in some of Market Umbrella’s trans•act research into market evaluation), but  KP remained thoughtful about how they supported markets and constantly offered some good critical thinking about the capacity of markets and what success measures that they thought were appropriate.

I became fond of saying that the relationship was a match made in heaven as (back then) markets were all energy with little discipline and public health was all discipline with little energy. These health partnerships have led to many things, like the incentive strategy and the expansion of the voucher programs. There is no doubt that market have adopted a wider view of good food  and done an amazing job at encouraging those with benefit program dollars to come to their markets. Most importantly, markets gained a better understanding of the social determinants of health paradigm.

World Health Organization (WHO) offers a two tier view of these factors: the daily physical environment of a person and the distribution of resources and the political power to change the factors. It is important to address the safety, transportation needs, housing etc of a person who is at-risk in order to offer solutions to repair their health, but without also addressing how that environment ended as less safe or without decent places to live, that individual will remain at risk. What is also important to note about these indicators is that they rely on community wealth being available. Before we tied our market balloon to these pillars of health, our initiatives were often seen as elitist and obsessed with a construct of local that had no relevance to the larger world. Now of course, it is clear that addressing inequities cannot be completed by outside funders swooping in, and that entrepreneurial activity is a necessary aspect for empowerment; efforts across the globe in micro-investing or Slow Money here in the U.S. have shown the trend is appealing even to big time money folks. So economic power at the local level is key to this shift and in food systems, no one does that better than farmers markets.

Kellogg Foundation’s shift about the same time to a continuum of health for families  – encapsulated beautifully at one of their conferences as”first food, early food, school food, community food”  – allowed them  to lead the discussion on this overarching strategy. The foundation focuses on “three key factors of success and their intersections: education and learning; food, health and well-being; and family economic security. Lots of good language to seek out as well viewing some of the work from Kellogg and its partners. Check out their resources.

The CDC definition:

“the conditions in the environments in which people live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Conditions (e.g., social, economic, and physical) in these various environments and settings (e.g., school, church, workplace, and neighborhood) have been referred to as “place.” In addition to the more material attributes of “place,” the patterns of social engagement and sense of security and well-being are also affected by where people live.

http://www.cdc.gov/socialdeterminants/data/index.htm

So place and the civic engagement could be the two buckets to consider. How can markets address either of these? Place is pretty simple isn’t it? Let’s say that your market is working to add at-risk shoppers using an incentive and EBT program and finds that one chief barrier is the lack of public transportation options around your location. It may help to advocate for a bus to alter its route for the market day. Or to add more bike parking to encourage non-drivers or to set aside a few parking spaces close to the entrance for drop-offs, shuttles, jitneys or uber. One great way to look at the place around you is to use PPS’ Placemaking audits and tools and see how inviting your area is.

Clearly, civic engagement is another area that markets could do more with. The Power of Produce (POP) program offered by FMC is a lovely way to offer this. Another might be for the market to work with newly arrived citizens through expanding language choices or the market’s products. Shady seating, community information are also good. But how about market leaders showing up to a housing meeting in their city? Or working on a microinvestment strategy with shoppers and local banks to encourage new producers or other community solutions?

I had the good fortune to attend the BALLE’s “The Future of Health is Local” webinar which dove into the structural work around health and wealth, although more at the institutional purchasing power level. What was really great about it was the detailed insight of health care providers like KP. BALLE is an invaluable resource to anyone working on community wealth strategies. I attended a few of their conferences in the past and had some great meet ups with initiatives and researchers who are embedding the farmers market movement and lessons into their work. It is a great and valuable time for those  thinking of attending an added conference. Definitely check out their resources.

So, the work to include all of the social determinants into our food work is not fully realized. That issue is at the heart of these 2 posts and why (I think) the divide between whites and people of color seems wider and deeper than ever. It is commendable for us to rid our language and actions from individual racist attitudes, and to add institutional partners and programs that add access, but we must go beyond that. If we use our power and privilege to explore and address inequities within the larger physical and political environment, we will start to see better outcomes, and the social determinants framework is as good of a way as any to do that in organizing terms.

Star assessment of community health

 

Related statement from National Young Farmers Coalition.

 

 

 

 

 

Health issues topped the list of scientific studies reaching wide audiences in 2016

In general, health-related studies… had more reach on social media and other online platforms than other scientific studies. Seven of the top 11 most-discussed scientific studies for the year focused on health, as did fully 59 of the top 100. Together, these studies covered a wide spectrum of health-related subjects.

The second-most-discussed health article after the one by Obama was about the prevalence of hospital medical errors, a problem the authors determined was the third leading cause of death in the U.S.

The fifth ranked article was a historical analysis claiming the sugar industry had sponsored research dating back to the 1950s aimed at downplaying the possible links between sucrose and coronary heart disease.

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