(MintPress) — One-third of Americans are obese; another third are overweight. About 26 million Americans have Type 2 diabetes, and another 79 million more are pre-diabetic. Research says that children today have a good chance of becoming the first generation of Americans to die at younger ages than their parents. It’s no secret that obesity has become an epidemic in America.
But does being poor make you fat? “Yes, definitely,” says Dr. Adam Drewnowski, the Director of the Nutritional Sciences Program at the University of Washington in Seattle, in an interview with MintPress.
Researchers like Drewnowski, who is regarded as a leading expert in the field, are continuing to find a link between the poverty and obesity problems that plague American society.
“We need to recognize the fact that obesity really does affect certain populations unequally or disproportionately,” Drewnowski said.
The access to good, healthy food as well as safe athletic facilities and fitness programs are issues facing the impoverished, and these problems are leading more and more Americans to develop health problems and even contributing to early death.
As headlines decry that the population of the U.S. is getting fatter, little attention has been paid to why this phenomenon is happening and how it is disproportionately affecting communities in poverty.
We are what we eat
Experts have noted that those in developed countries, and in urban areas of developing countries, live in an environment that promotes obesity. Rather than suffering from a lack of food, they say the problem is an abundance of too much of the wrong food, especially unhealthy foods and a sedentary lifestyle. For many, the challenge to maintain health means running uphill in a culture that, in many ways, discourages a healthful lifestyle.
People in lower socioeconomic brackets face an especially hard time cultivating a healthy lifestyle and preventing obesity.
“I think it has to do with economic access to healthy foods,” Drewnowski said.
As the number of obese Americans skyrocketed through the 1980s and 1990s, doubling among adults in the U.S. and tripling among children, the problem has been linked to changing times and habits. Sedentary lifestyles and changes in eating habits led many Americans to pack on the pounds. While many more Americans work at desk jobs and use electronic devices, a bigger issue linked to the obesity epidemic is where and what Americans are now eating.
“More than 50 percent of the food dollar is spent outside the home now, and that’s a big difference [from] what it was several decades ago,” says Dr. Kelly Brownell, who directs the Rudd Center for Food Policy and Obesity at Yale in an interview with NPR. “People are eating outside because they’re on the move, they have crowded schedules, they want to take the family out for a treat — and there are so many restaurants out there now to cater to this need. … The problem is when you go out, you tend to eat more and you tend to eat worse than when you eat at home.”
But bigger portions of fatty, fried foods aren’t hallmarks of a healthful diet, which experts say consists of several servings of fruits and vegetables each day, as well as low-fat dairy, lean meat and fish, and whole grains.
“Unfortunately, empty calories are cheap and healthy foods are more expensive,” Drewnowski said.
Food deserts in the fast food nation
Healthy foods tend to be more expensive and harder to find in low income areas than food products with a stable shelf life that don’t require refrigeration, or a $1 cheeseburger advertised on many fast-food chain restaurants’ menus.
“We could count 100 ways or more that the environment has changed in ways that I call toxic. Serving sizes have increased. What used to be the large size at McDonald’s is now the small serving of fries. A muffin used to be smaller than a baseball; now it can be as big as a softball. And this gets multiplied by many products in the food system. Marketing of unhealthy foods is out of control completely. The industry is doing a very poor job of policing itself in that respect,” Brownell said.
Researchers have found that there is an inverse relationship between a food’s energy density (calories per unit weight) and cost. Cheaper foods tend to have more calories per unit of volume, Dr. Barbara Brehm of Smith College wrote in an article published by Fitness Management magazine. “Cookies and potato chips supply about 1,200 calories per dollar, while fresh carrots provide only 250 calories per dollar. If dollars are in short supply, and you have a family to feed, it makes sense that economic pressures will affect your shopping choices,”
But, the problem extends beyond the U.S. border. As Brehm points out, “The cost of food has risen sharply over the past year, with increased demand for food from developing countries, and the diversion of crops for the manufacture of biofuels. If food prices push consumers to choose filling but less-nutritious foods, the rising costs of food may mean that more people than ever will find it difficult to avoid obesity.”
“We are penalizing the undeserving poor,” said Drewnowski.
Many U.S. urban areas have recently been described as “food deserts”, a term meaning that people living in such areas have little or no access to healthy food, including fresh fruits, vegetables, meats and dairy products.
Millions of Americans — mostly poor, many African-Americans — live in these areas.
The United States Department of Agriculture reports that about 23.5 million Americans currently live in food deserts, including 6.5 million children. Typically, food deserts are defined by: 1) the lack or absence of large grocery stores and supermarkets that sell fresh produce and healthy food options; and 2) low-income populations living on tight budgets. Food deserts have also been found to have high levels of obesity, diabetes and cardiovascular diseases in the community, which result from residents buying their food from corner stores that sell processed foods, and plentiful fast food options.
“Poor neighborhoods tend to have fewer supermarkets and more convenience stores and fast food establishments. It’s expensive to be poor — food costs more when purchased at convenience stores rather than large supermarkets,” Brehem says.
Drewnowski’s research focuses on the obesity problem, but several studies he’s done breaks it down on the state level by neighborhood, because, as he says, that paints a better and more in-depth portrait of where the problem is occurring the most.
“We need to think about economic solutions to the problem … we have this idea that poor people are on food stamps and getting fat, so we should take food stamps away, but that’s not really a solution,” he said
Drewnowski’s research has showed that the very poorest of poor in the U.S., those living underneath the federal poverty line of less than $20,000 per year, are not as affected by obesity as those making just a bit more, only one bracket up on the socioeconomic indicators. People with incomes of $20,000 to $35,000 are the hardest hit by the epidemic.
Drewnowski has theorized that households with limited resources to buy enough food often try to stretch their food budgets by purchasing cheap, energy-dense foods that are filling – that is, they try to maximize their calories per dollar in order to stave off hunger.
“We have huge economic disparities in this country,” Drewnowski said, ”obesity is a huge, complex issue, and it’s not going to be solved by eating one specific fruit or vegetable.”
Access to fitness facilities limited in low income areas
People living in low-income areas face additional challenges in fighting back against the obesity epidemic.
“People’s health habits are often constrained by the choices they face in their neighborhoods,” Robert Whitaker, a public health and pediatrics professor at Temple University in Philadelphia told USA Today.
Whitaker has done research which was published in the New England Journal of Medicine that found in addition to the issue of finding grocery stores that are well-stocked with healthy fare such as fresh fruits and vegetables, often poor people don’t have safe places to be physically active and may have greater concerns about safety. This could impact their psychological stress and eating habits, thus making them at greater risk for obesity related issues.
“This study is one of the strongest pieces of evidence yet that improving the environments where low-income families live can have a meaningful impact on their risk of chronic disease,” Whiteaker said.
Whitaker and colleagues studied about 4,500 women with children who lived in public housing in high-poverty areas (40 percent or more of the residents had incomes below the federal poverty level) in Baltimore, Boston, Chicago, Los Angeles and New York City. The majority of the participants were either black or Hispanic, and all lived in public housing. The study found a direct link between obesity and living conditions. Women were followed for several years from 2008-2010, and those who moved to less disadvantaged areas were found to have a decreased risk of developing obesity.
Also, it may be that living in a low-income neighborhood inspires stress. Those individuals face issues such as crime and violence at greater rates and there is also a great amount of uncertainty about the future. When a person is living dollar-to-dollar, they don’t feel secure because they are not able to save money in order to have a financial safety net. This causes a great amount of stress and experts say may actually cause overeating, especially in women.
A study done at the University of Southern Mississippi in 2007 confirms this, stating, “It is theoretically plausible that, in situations of low food security when low-cost energy-dense food is available, emotional eating occurs in response to the stress of uncertain resources.”
In addition, the Food Research Action Center points out that lower income neighborhoods have fewer opportunities for physical activity resources than higher income neighborhoods, including fewer parks, green spaces, bike paths and recreational facilities, making it difficult to lead a physically active lifestyle. Research shows that limited access to such resources is a risk factor for obesity, the national non-profit, which works to combat hunger and malnutrition, says on its website.
While people in poor areas may walk more for transportation, people who fear neighborhood crime restrict outdoor time for themselves and family members.
“It’s not a question of sports facilities,” Drewnowski says, “you can’t jog or run in these neighborhoods, it’s simply unsafe. People don’t want to let their children outside, so they leave them watching television in a back bedroom – not even a front bedroom. They are doing what’s best for them, and for that you can’t blame them.”
William Dietz, director of the Centers for Disease Control and Prevention’s Division of Nutrition, Physical Activity and Obesity, says that current research on the link between poverty and obesity emphasizes “that place matters. What’s striking is that there is a significant impact on severe obesity.”
Stephanie Broyles, an assistant professor and researcher at the Pennington Biomedical Research Center in Baton Rouge, says these latest findings show that “we can’t just ask individuals to change their behaviors; we have to change the environment as well.”
“Your zip code should not determine your health status,” Drewnowski concluded, “but it does.”