Image: Hamburger
Paul J. Richards  /  AFP - Getty Images file
The link between poverty and obesity may seem counterintuitive, but health researchers say tight budgets lead to weight gain as consumers seek cheap-but-filling calories.
By JoNel Aleccia Health writer
updated 10/30/2008 8:21:26 AM ET 2008-10-30T12:21:26

Tough times inspire belt-tightening, or so the popular notion goes, but scientists who study public health say they’re worried that a slumping economy will make American waistlines wider than ever.

Rising unemployment, higher food prices and dwindling savings may exacerbate the nation’s obesity problem, sending already high rates ballooning as consumers turn to cheaper, less healthful choices ranging from boxed mac ‘n’ cheese to fast-food dollar menus.

“All evidence suggests that obesity is the toxic consequence of a failing economic environment,” said Adam Drewnowski, a professor of epidemiology at the University of Washington in Seattle.

As households struggle with falling incomes and with food prices expected to jump 6 percent this year, according to the U.S. Department of Agriculture, families are scrimping on groceries. Nearly six in 10 Americans said they’ve cut back on the quality or quantity of the food they buy, according to an annual hunger survey released this week by Hormel Foods Corp.

But that doesn’t mean they’re dieting, noted Drewnowski, whose research has found a consistent link between poverty and obesity, including a recent study that showed that obesity rates were five times higher in lower-value Seattle ZIP code areas than in upscale neighborhoods.

“It is quite possible to spend less and eat more,” said Drewnowski. “The very cheapest foods are calorie-rich and nutrient-poor. Because they contain refined grains, sugars and fats, they also taste good and, of course, are easy to come by.”

Although more than a third of the nation’s adults and children are obese, according to the federal Centers for Disease Control and Prevention, the rate recently appeared to stabilize, particularly among young people ages 2 to 19. But Drewnowski said the current economic crisis, which affects a wide swath of society, is likely to erase any progress, leading to more obesity and related health harms, from heart disease to diabetes.

“Now that we are all poor, the rates will go up again,” he said. “I predict an increase that will become apparent in about three years.”

Whole grains, fresh fruit costs too much
Financiallystressed shoppers are likely to trade pricey whole grains, fresh fruits and vegetables for low-cost but high-fat alternatives, said Lauren A. Haldeman, an associate professor in the Department of Nutrition at the University of North Carolina at Greensboro, who studies poverty and obesity.

That's partly because fruits and vegetables cost more for less energy than processed foods, said Dr. Judith Wylie-Rosett, a professor of epidemiology and population health at the Albert Einstein College of Medicine in New York.

"If you follow the five-to-nine suggestion [for daily fruit and vegetable servings], the diet is an almost threefold increase in price," she said.

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Check obesity rates in your stateIt's also partly because some consumers aren't used to adding fresh produce to their diets and because the marketing for convenience foods is too enticing to resist.

“There are deals all the time for 99-cent burgers,” Haldeman said. “They’re low in nutrition, but they also satiate. If they’ve got to feed a family, they’re going to look for these low-cost foods.”

At the same time, those grappling with economic uncertainty may be more likely to seek sweet or high-fat comfort foods and less likely to exert the effort it takes to maintain a nutritious diet.

“I wonder if they’re feeling emotionally and mentally able to cook a low-fat meal, to learn a new skill, to read a food label,” Haldeman said. “It might just be easier to stop off and get a hamburger or chicken nuggets.”

Sales figures appear to support that theory. Fast-food giant McDonald's last week credited the company’s Dollar Menu in part with boosting third-quarter sales in the U.S. by 4.7 percent in an otherwise dismal restaurant market.

Diane Michna, 49, of Winchester, Calif., doesn’t need sales data to tell her that fast food is a cheap way to keep up with the appetites of three adolescent boys.

“We are forced to purchase the unhealthy and fattening low-cost premade frozen meals or to eat out getting the dollar-menu specials as I no longer can afford to feed my kids the healthy foods they deserve,” she said. “We eat a lot of Top Ramen, that’s for sure.”

Michna, who retired from the local sheriff’s department after a knee injury, is supporting her two sons, ages 11 and 18, and is a guardian for another boy, also 18. She also feeds the kids peanut butter and jelly sandwiches and homemade pizza, but she worries about the impact of her fixed budget on their health; two of the boys are already overweight.

“My youngest boy, I’m worried about him getting diabetes,” she said. “It’s the french fries. He grew up loving Happy Meals.”

Michna said she feels the problem acutely because she remembers what it was like to buy quality food, including meats, fish, fresh fruits and vegetables. “Eating fast food was a once in a blue moon option only,” she said. “Now even a lemon costs a dollar or more and they used to be 10 cents.”

‘A change of lifestyle’
New victims of the economic crisis may be especially vulnerable to weight-related health problems, said Gwendolyn Lipscomb, director of the office of minority health in Alabama, one of three states with overall obesity rates that top 30 percent.

“Those who have been economically independent with good health insurance coverage and retirement benefits might be more prone to the onset of obesity and diabetes, due to the stress and the compromises they have to make,” she said. “It would be a new thing for them, a change of lifestyle.”

Even consumers who’ve been able to focus on losing weight now worry that the bad economy will undermine their efforts. Bonnie Barnett, 48, of Hemet, Calif., has shed 45 pounds since January, thanks to lean meat, fresh produce — and regular workouts at a local health club.

“It was the hardest thing I’ve ever done,” she said.

But Barnett works for the fleet services department of a local car dealership, where workers have seen layoffs and pay cuts in recent months. Her own salary has been reduced by half and now she’s afraid she’ll have to give up her gym membership — “$30 is $30,” she says — and shop for cheaper, less healthful food.

Good food, lean times“I’m afraid the weight is all going to come back,” she said. “The healthy stuff costs a lot more. I just went to the grocery store and spent $50 tonight and came back with nothing.”

Not everyone agrees that hard times have to decimate a decent diet. Dozens of readers told that they’ve reduced their food costs and improved their health by cooking more at home, cutting back on expensive kinds of meat and produce, relying on leftovers and reducing waste.

Kim Kopen, a 48-year-old mother of two from of Oak Grove, Minn., had to take a hard look at her grocery budget after her husband, a union bricklayer, was recently laid off — again.

“I love organic, but I’ve gone away from organic,” said Kopen, who can’t work outside the home because she is disabled by rheumatoid arthritis. “We’re doing a diet that is less expensive with less fresh fruits and vegetables and more frozen. We’ve been doing a lot of carbohydrates. Potatoes are cheap.”

Actually, death rates fall in a downturn
But not all researchers agree that bad times equal bad health. Christopher J. Ruhm, a professor of economics at UNC Greensboro, said his research shows the opposite — that overall death rates fall during economic downturns and rise during booms. Similarly, several health markers — including smoking, alcohol consumption and obesity — actually improve when the economy tanks.

“The drop in tobacco use occurs disproportionately among heavy smokers, the fall in body weight among the severely obese and the increase in exercise among those who were completely inactive,” Ruhm wrote.

However, Ruhm is quick to emphasize that he’s not suggesting that an economic crisis is a good thing: “Never am I saying that if you go from rich to poor you’ll be better off,” he said.

And, even he notes that his past research has focused on what he describes as “garden variety recessions,” not the global economic crisis now unfolding.

“It seems possible that this is something bigger,” he said.

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