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Q&A: Nutrition & Public Health


“We could change our policies so that junk food becomes expensive and healthier food is cheaper.” - Dr. Marion Taylor Baer

DR. MARION TAYLOR BAER’S professional focus has evolved in the nearly 50 years since she graduated from the Fielding School with an MS in nutrition science. An adjunct associate professor in FSPH’s Department of Community Health Sciences, Taylor Baer has long been interested in issues of maternal and child health, especially regarding the nutritional status of children with developmental disabilities and access to preventive care for children with special needs. This interest soon broadened to include U.S. food and nutrition policies and their impact on public health.

Not long after being recognized at the 2016 American Public Health Association annual meeting with the Catherine Cowell Award for her achievements in leadership, planning, administration and mentoring in public health nutrition, Taylor Baer spoke with FSPH’s Public Health Magazine.

Q: What should public health’s message be when it comes to a healthy diet?

A: [Author] Michael Pollan sums it up in seven words: “Eat food, not too much, mostly plants.” That’s really what it boils down to even though it’s not very “sexy,” and the food industry does its best to take advantage of the fact that we don’t have any regulatory definition of what is “natural,” although “organic” and “non- GMO” labels are USDA approved. And so, nutritionists tell people to stay out of the central aisles in the supermarket as much as possible, and to read the labels.

Q: Despite what we know, the majority of adults in the U.S. are overweight or obese, with the highest rates among low-income populations. From a public health standpoint, where are we falling short?


A: There are many contributing factors, but the problem has a lot do with our food policies. If you are hungry and poor you tend to eat junk food, because it’s cheap. Why is it cheap? Through the Agricultural Act passed in Congress every few years, better known as the Farm Bill, our government subsidizes corn and soybean crops — which are used to produce cheap sweeteners and oil — but fruits and vegetables, which could otherwise be less expensive, get very little support in spite of the fact that we tell people to eat more of them. Clearly, our agricultural policies don’t sync with our health policies, in part because nutrition policies and funding for food and nutrition programs are determined by the USDA and not the U.S. Department of Health and Human Services, and in part because we have very powerful people in Congress from the farm states.

Q: When did you become interested in nutrition policy?

A: My master’s program was very bench-science oriented. Then I worked for a long time in an interdisciplinary training program funded by the federal Maternal and Child Health Bureau, focusing on kids with special needs and their families, where it was clear that nutrition was extremely important. But my early clinical focus began to change as I saw families in the context of their communities and became aware of health and nutrition policies that could make a difference in their lives. Surely nutrition education is important, but most people have a pretty good idea of what food is good and what isn’t. On the other hand, we could change our policies so that junk food becomes expensive and healthier food is cheaper. Look at smoking — education went only so far, then we started taxing tobacco and banning smoking in public places, and that’s had a bigger impact. Social norms also played a major role, and it’s encouraging to see the growing public interest in “whole foods.”

Q: Where have our policies improved, and what would your priorities be?

A: The WIC [Special Supplemental Nutrition Program for Women, Infants, and Children] food package was changed in 2009 to be more healthful, which is very positive since WIC covers many of our most vulnerable people, nearly 49 million per month in 2015. The change not only emphasized fruits and vegetables, but also included sources of protein such as tofu and other culturally appropriate healthy foods. The school food programs have made strides in the meals that are being provided. In terms of where we need to go, with the Supplemental Nutrition Assistance Program, which used to be known as food stamps, there is still a debate about whether recipients should be allowed to use that benefit to buy junk food. Taxing foods with high amounts of sugar and/or unhealthy fat could have a positive impact. But we also have to think more broadly. How can you buy healthy food if you’re poor? We have to tackle the problem of poverty, as well as making healthy food affordable and accessible by reprioritizing the Farm Bill expenditures. And we need a health care system in which the incentive is to keep people healthy through preventive measures, which include emphasizing nutrition.

Q: Where do you see the field of nutrition headed?

A: There are two exciting emerging areas of research. First, in the field of epigenetics, animal studies have shown that diet can alter phenotypes by providing nutrients that can turn genes “on and off,” which has amazing future implications. The emerging research on the microbiota — the trillions of microbial cells in the gut of every person — and its relationship to food and metabolism is another important area. We’re discovering that not only do these gut bugs influence the brain, but they can also produce certain nutrients, such as vitamin B12, which can be important to vegans. What comes from these research directions is likely to influence the thinking about what makes an optimal diet at different points during one’s life. Ultimately, in addition to the growing knowledge we have about nutrition science, in the near future more personalized diets may be prescribed to prevent disease and promote optimal health.