The Importance of Meaningful Metrics

When activists get together to design better ways to make healthful food accessible to more people, they look at several factors. The local density of convenience stores is one. Often combined with gas stations, they are designed for travelers concerned more with speed and urgency than with nutrition.

Such establishments carry many products that can be eaten, but that should perhaps not be eaten. In recent years, they have begun to stock apples and bananas, and even plastic containers of vegetable and fruit salad. These suppliers are not to be depended on for the ingredients to make nutritious family meals.

The presence in a neighborhood of numerous fast foot outlets is not a reassuring sign, either. They are legendary purveyors of items that are energy-dense (a slightly nicer way to say high-calorie) and laced with questionable additives. Planners like to think that if people had a full-service grocery store nearby they would quit McDonald’s.

That dream is crushed by such comments as this one, received by Dr. Pretlow’s Weigh2Rock website, in response to a poll concerning Michelle Obama’s Let’sMove! program. A 14-year-old girl, describing herself as 5’4″ tall and 230 pounds heavy, contributed:

There are actually a lot of activities in my school, like intramural sports and i was in them, didn’t help a smidge. And there ARE healthy affordable foods where i live, it doesn’t mean that we buy them. I don’t think she has thought about the fact that there are multiple mcdonalds in every town. For years people have had programs and activities to help obese people and it hasn’t really helped. There are many holes in this plan.

As the preceding quotation asserts, although healthful, and even affordable food can be had, people do not necessarily want it. This is not to say they are incapable of change. But a general rule of therapy is, you have to meet people where they are at. Just because a produce department exists customers do not automatically flock to it. They bypass the veggie bins and proceed with alacrity to the ice cream freezer. When science and logic conflict with human nature, human nature usually wins.

When experts are plotting how to put enough of everything everywhere, basic questions need to be asked. How do we know what is enough, in each particular area of human habitation? Residents of different areas live under diverse conditions and hold very disparate values in terms of what they perceive to be the necessities of life.

And yet, it is important to measure the variables in useful ways. As the authors of one study phrased it,

Properly situating these assets in neighborhoods in need requires localized data on both the location of food outlets and the populations served. Previous literature on food deserts has generally used an ad hoc definition of what constitutes “access”.

Current ad hoc definitions likely lead to misidentification and inappropriate use of resources. Proper documentation of food access is a precondition for the design of appropriate measures to ameliorate the situation.

“Ad hoc” means made up on the spot, or what some call quick-and-dirty. The ability to think on our feet is one of the best traits we humans have going for us. People need to try new methods. When culture gets stuck in any kind of rut, it’s usually an indicator of trouble ahead.

Science, in particular, likes colleagues to work together by agreeing on basic items like measurement standards. Scientists want to be able to compare results between one study and the next, and it’s not as simple as choosing between liters and quarts. When their decisions will translate into public policy, those decisions matter.

Your responses and feedback are welcome!

Source: “Redefining the Food Desert: Combining Computer-Based GIS with Direct Observation To Measure Food Access,”, Dec 2014
Photo credit: Susan Fitzgerald (Spin Spin) on Visualhunt/CC BY-ND

Leave a Reply

Your email address will not be published.

FAQs and Media Requests: Click here…

Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources