A Place at the Table—The Poverty - Obesity Paradox

A Place at the Table—The Poverty-Obesity Paradox

by Risë Rafferty, RDN  |  June 6, 2014

When I think of hunger, I picture an emaciated man with defined ribs, and perhaps a slightly protruding, enlarged abdomen, signaling malnutrition. Associating the enlarged abdomen of an overweight person with hunger has never seriously entered my frame of reference until I recently watched the documentary film, A Place at the Table. Hunger, here in America, was the central theme. Authorities were interviewed as well as those who currently experience hunger. One of the points made was that obesity and hunger often go hand in hand, and that both can be signs of insufficient funds for food. The film provided an alternative way of looking at hunger as well as obesity. Rather than picturing famine, with people roaming through parched land, the hungry are in inner cities as well as in remote locations, but not far from where you live. Millions of Americans are food insecure. The U.S. Department of Agriculture (USDA) defines food insecurity as a state in which consistent access to adequate food is limited by a lack of money and other resources at times during the year. For some it is caused by poverty, for others it is a mix of poverty combined with being without reliable access to a sufficient quantity of affordable, nutritious food. Sadly, in one of the wealthiest and fattest nations in the world, many are food insecure.

According to a report by the USDA, 49 million people in the United States live with food insecurity. Nearly 16 million are children. Roughly, 16 percent of Americans and 21.6 percent of children have uncertain access to food. Sadly, the effect this has on children can have physical and mental ramifications. Nutrition deprivation in the first three years can affect a child for the rest of his or her life. “The lack of adequate nutrition can literally change the architecture of a child’s brain.”1

Ross Fraser, Director of Media Relations at Feeding America, the largest hunger relief charity and network of food banks in the U.S., has researched where the greatest food insecurity is experienced. New Mexico was at the top, with Mississippi, Texas, and even my present home state of Oregon in the top ten. Interestingly, he found that the coexisting incidence of diabetes and obesity was especially high in the states with high rates of food insecurity. “People who live in homes that are food-insecure have twice the rate of type 2 diabetes,” said Fraser. Five states with the highest food-insecurity among children—Mississippi, Georgia, Arkansas, Texas, and North Carolina—had obesity rates above the national rate of 27.1%.”

Research documenting the relationship between hunger and obesity has been mixed. The strongest proof exists for women in this country. “Based on a national sample of 4,509 women, those women who were food insecure were more likely to be overweight than women who were food secure. A study of more than 5,200 women from across the U.S. found that women living in food insufficient households had higher rates of overweight than those in food sufficient households.”3 The association was also seen in children. “In a national sample of almost 7,000 children, childhood food insecurity was associated with overweight even after controlling for age, race, gender, and family poverty index.”4

Refined grains, sugar, and fat cost less per calorie than fresh produce.

One of the factors to this poor-yet-plump paradox, highlighted in A Place at the Table, is the fact that since 1980 the price of fruits and vegetables has increased 40 percent while the price of processed foods has decreased 40 percent. An individual with only three dollars to spend for lunch, for example, has the potential of being able to purchase 3,767 calories worth of processed foods, or 312 calories of whole foods. Why is this? America’s farm policy and what is and is not subsidized by the government plays a major role in determining the price of food. According to the documentary, 70 percent of the quarter of a trillion dollars devoted to food subsidization is received by 10 percent of the farmers. While 84 percent of that money goes to back crops such as wheat, corn, and soy (ingredients found in the majority of processed foods), 1 percent goes to fruit and vegetable farming, causing processed products to be relatively inexpensive. Refined grains, sugar, and fat cost less per calorie than fresh produce. Many women with low incomes may feel forced to purchase less expensive, energy-dense foods in order to protect their families from hunger. A loaf of whole grain bread may be 3 or 4 times as much as a cheap loaf of sliced white bread. Cindy Greenstein, executive director of the Louisiana Food Bank Association, backs up this theory from her observation. She says, “When you see these overweight people, they can actually be hungry as well. People go for the bulk. It’s not about gluttony, it’s about what foods are less expensive.”5

There are several variables and compounding factors that coexist to bring about food insecurity. The documentary highlighted single mothers living in inner city locations where there is limited access to healthier food options in their localities. Available convenience stores or corner markets do not have adequate selections of whole foods, including fresh or even frozen fruits and vegetables. Fast food is cheaper and readily accessible and contributes its share to obesity. Food is more likely to be overeaten when available after it has become an all-absorbing thought due to food insecurity.

Government help does exist, such as SNAP, the Supplemental Nutrition Assistance Program and the Lunch and Breakfast Program. Local charity groups, like Healing Hands, exist and could use help in passing out available foods. Featured in the film was a physician advocating for single mothers who need greater assistance while trying to get jobs to provide for themselves. Churches that cook meals for those in their community in need and other programs are admirable. From the poor-yet-plump paradox it is evident that teaching people how to eat healthfully is just as needful. I realize this will take time, creativity, and patience. Replacing packaged, premade foods with items found in bulk bins, like beans and rice, will not come naturally. However, what if we focused on eradicating hunger and the poor health that comes with obesity at the same time? Mike Manning, president of the Greater Baton Rouge Food Bank, comments, “In south Louisiana, the problem isn’t a lack of food, experts said, it’s a lack of the right kinds of food, such as fresh fruits and vegetables and whole grains. . . . We need for these people to be educated.”6

When thinking about the complicated variable of limited access to healthier food, I thought of Ron Finley’s approach. In his online TED talk Finley says, “How would you feel if you had no access to healthy food? If every time you walked outside the door you see the ill effects of the present food situation on your neighborhood? . . . This has to stop.”7 His answer is gardening. Ron has plowed up empty lots in the middle of south central Los Angeles, as well as front lawns and curbsides. Los Angeles has 26 square miles of vacant lots, enough space to plant 725 million tomato plants. He informs that $1 of green been seeds will give you $75 of green beans to eat. Growing your own food, he says, is like printing your own money.

Jesus was speaking literally when He told us to feed the hungry, but He didn’t limit how creative we could be in doing it. As we see the world’s need and America’s hunger, there is something we all can do. And it will take all of us to do it.

1Thomas C. Frohlich, States Where the Most Kids Go Hungry, 24/7 Wall St., 4/23/14.

2Ibid.

3Relationship between Hunger and Overweight and Obesity, FRAC.

4Ibid.

5Beth Colvin, Poverty, Obesity subtle paradox The Advocate, 2/27/13.

6Ibid.

7Ron Finley, ted.com.

Risë Rafferty, RDN Health Educator
Light Bearers
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  • Informative article Risë.

    The square foot gardening system has fascinated me because of its creativity along the lines you are talking about. City people can grow gardens efficiently in very little space.

    The other thing that is cool is that the Oregon Food Bank is on board with teaching city folk to grow gardens.

  • Danny Whatley

    Excellent article! The rise of type 2 diabetes in America seems to confirm this.