- - Monday, October 23, 2017


Imagine Grandma toiling her days away in a factory. That’s the image that came to mind as Secretary of Agriculture Sonny Perdue called for stiffer work requirements for Supplemental Nutrition Assistance Program (SNAP) recipients. With a $70 billion annual price tag, SNAP is the costliest item in the Farm Bill. Mr. Perdue’s proposal aims to edge out some participants and cut costs. With most beneficiaries being children, elderly or the already working, that’s not an effective solution or one that most people will warm to.

A better way is to modernize SNAP. We can provide more food for more people for a lot less money than we are spending now.

Currently, SNAP rules require retailers to stock the items in the U.S. Department of Agriculture’s (USDA) 1956 four food groups: meat, dairy products, grains and vegetables/fruits. But SNAP actually pays retailers for virtually anything that passes for food: sodas, processed cheese and meats, potato chips, energy drinks and even candy. There are no rules about the nutritional value of what is sold, so junk food is part of the taxpayer-subsidized program.

And health risks follow. Economically disadvantaged people are 70 percent more likely to develop Type 2 diabetes, compared with wealthier people. They are at high risk for obesity and hypertension. And tragically, that means that poor people are a gold mine, not just for junk-food manufacturers being paid by SNAP, but also for the pharmaceutical industry making money, hand-over-syringe, for a plethora of drugs to treat their diabetes, cholesterol problems, hypertension and other food-related diseases.

Other USDA food programs follow healthier guidelines. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is continually updated with health in mind, and does not include steak, pork chops, chicken, sodas, energy drinks, candy or the other less-than-healthful products that are still in SNAP. And while SNAP participants have worse diets and worse health than their nonparticipating friends and neighbors, WIC participants are healthier than nonparticipants. Similarly, USDA’s MyPlate puts special emphasis on fruits and vegetables and has no meat group at all. If SNAP were refocused on the simple, healthful staples that are neglected in the standard American diet — vegetables, fruits, whole grains and beans — it would provide much better nutrition, and each SNAP dollar would go much further.

What kinds of meals would those healthy staples turn into? A breakfast of oatmeal topped with strawberries, or maybe blueberry pancakes or fresh cantaloupe. Lunch could be a hearty bean chili, chickpea salad, vegetable fajitas, a bean burrito or vegetable soup. Dinner could be angel hair pasta topped with mushrooms, chunky vegetables and tomato sauce, black beans and rice with salsa, or veggie pizza. And all of these foods — tasty as they may be — are simple and cheap.

Earlier this year, the American Journal of Preventive Medicine published an analysis by my colleagues showing that a program focusing on these healthful foods could save as much as $26 billion every year. At the same time, it would dramatically boost the healthfulness of meals. Emphasizing vegetables and fruits means getting plenty of vitamins and minerals and, at the same time, much less fat and cholesterol.

Harvard University researchers developed a nutrition rating system, called the Alternative Healthy Eating Index. With that rating system, economically disadvantaged people in the United States currently have average score of 33 out of a possible 110. Those in the highest socioeconomic category have a current score of 41. But a program focusing on healthy vegetables, fruits, whole grains and legumes would score 75. In other words, we will improve participants’ nutrition and health, and save money at the same time.

Better health brings even more savings over the long run. According to the American Diabetes Association, the average cost of treating diabetes is $7,900 per person per year. Then add the costs of treating other food-related conditions: high cholesterol levels, hypertension and obesity-related cancers. Now, imagine a nutrition program designed not only to provide food but also to give the gift of health. That is what SNAP should be, and easily could be.

But wait a minute: Shouldn’t the program be designed to give away candy, sodas and other junk food if that is what people want? Isn’t it a bit patronizing to focus only on healthful foods? Entrepreneur and vegan Russell Simmons skewered that argument, saying in a recent commentary, “If people need help — if parents are out of work and need food for their children — they deserve simple, healthful foods that will take hunger out of the equation and will supplement the food they are buying already. What’s patronizing is to think that poor people are somehow tantrum-prone children who can’t handle a program focused on nutritious and healthful foods.”

Rather than kicking people out of SNAP and cursing the program for its cost, we can accommodate everyone who is eligible and save money, if we want to. And we will all be better off.

So, no factory job for Grandma. Let’s make healthful foods abundantly available and trim the taxpayer costs of both food and medical bills attributable to SNAP.

• Neal Barnard, a physician, is the president and founder of the nonprofit Physicians Committee, an adjunct associate professor of medicine at the George Washington University School of Medicine and Health Sciences, and a fellow of the American College of Cardiology.

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