For anti-obesity efforts to succeed, experts look to ongoing education rather piecemeal programs.
Michelle Beaulieu was browsing through herbs and fresh vegetables one recent morning at the Midtown Farmers Market -- one of six Minneapolis markets where shoppers can use electronic benefit cards and get a $5 Market Bucks subsidy to buy local produce.
"It's a good relief on my budget," said Beaulieu, who earns about $12,000 a year in her job with AmeriCorps. "My options are pretty limited. Most of the time I do my grocery shopping at Target.''
Market Bucks is one of dozens of efforts across the country -- from New York City's proposed ban on 20-ounce pop bottles to more healthful snacks in Minneapolis parks -- that have sprung up in the latest attack on the nation's obesity epidemic. More than one-third of Americans are obese, and in Minnesota, every county has an adult obesity rate above 21 percent, according to the U.S. Centers for Disease Control and Prevention (CDC). Yet changing ingrained eating habits is difficult, and so far, there is limited evidence to link specific programs with lower rates of obesity or related ailments such as diabetes and heart disease.
One reason is that people think of food as a matter of personal choice -- not, like cigarettes, as something hazardous, said Simone French, director of the University of Minnesota's Obesity Prevention Center.
Changing food habits, French said, might require changing the entire "food environment'' surrounding consumers.
"We've gotten desensitized about supersized portions. You don't even think a 20- or 32-ounce drink looks weirdly huge," French said. "There is no moderation in our food environment."
As a result, single strategies in isolation might not suffice to lower obesity or change eaters' relationships with food, according to Rebecca Payne, a coordinator in the CDC's Division of Nutrition, Physical Activity and Obesity.
Fighting market forces
Market Bucks, which began in 2010, was initially funded by the CDC as one of 50 local projects across the country to cut tobacco use and obesity. The Minneapolis grant ended in June, but Blue Cross and Blue Shield of Minnesota now sponsors Market Bucks.
Although price isn't the only thing consumers consider, cost can be a barrier.
"Food is priced in a way that less healthful foods are cheap," French said. "Hazardous, empty calories with no net value at all cost hardly anything." Estimates by the Yale Rudd Center for Food Policy and Obesity suggest that a 10 percent decrease in fruit prices could result in a 7 percent hike in sales.
Market Bucks may be succeeding. Between 2010 and 2011, the number of electronic-benefit customers at the Midtown, Minneapolis Municipal and Northeast Minneapolis farmers markets more than doubled from 736 to 1,587, according to a Blue Cross report.
And nearly 60 percent of the 160 customers surveyed said they would keep shopping there even if Market Bucks were eliminated.
Changing the menu
Olmsted County in southeastern Minnesota, which also received a CDC grant, is trying another strategy to change the food environment.
The county Health Department worked with Rochester Technical and Community College and its food vendor, Lancer Hospitality, to make healthful snacks and meals more affordable for students. It subsidized a 25 percent discount on foods such as fruit, vegetables with low-fat dips, baked chips, smoothies and trail mix with yogurt-covered raisins.
Sales of several items increased by as much as 30 percent compared with the previous year, according to Michelle Komosinski, a grant coordinator at the Olmsted County Department of Health.
"If healthy food is made more accessible and cheaper than junk food, people are more apt to eat it," said Peter Virnig, a manager at Lancer.
Yet defining "healthy food'' can be a challenge. Some of the items on Lancer's list of healthful foods, for example, could be high in sugars or processed ingredients.
Avoiding overkill can be another. A proposal for healthier food at Minneapolis parks snack stands -- including whole wheat pretzels and no hot dogs -- met with skepticism from some commissioners and is under review.
To shift eating habits for the long term, some advocates say education will be necessary.
In the Twin Cities, food resource hubs organized by community nonprofits teach members how to grow, store, prepare and compost their own food. The community networks distribute seeds and seedlings for members to plant tomatoes, eggplants, kale, beets, Swiss chard and other produce at home or in gardens.
The hubs also organize cooking workshops -- an important element because "many [people] don't have the skills to prepare food. They've been raised on convenience foods," French said.
Last year, the hubs sold out all 600 memberships. This year, 1,000 slots were open.
While people probably won't stop drinking pop or swear off ice cream after participating in the hubs, they might learn how to make a more healthful salad dressing for the vegetables they harvested, said J.P. Mason, the Hawthorne project director for the Youth Farm and Market Project.
"For me,'' Mason said, "that's a huge success."
Daniela Hernandez • 612-673-4088