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Obesity
and Poverty
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Policy makers are considering raising taxes on high fat and/or sugar foods
in an effort to persuade people to make healthier food choices without considering
the impact on low-income households. Low-income families participate in
publicly funded food-assistance programs thus the relationships between
obesity and food insecurity (limited or uncertain availability of nutritionally
acceptable or safe foods) also has implications for nutrition policies.
This report applied an economic framework to several studies to identify
relationships between obesity, dietary energy density, and energy costs.
Energy density is related to water content, e.g., energy-dense foods are
dry and may contain fat, sugar or starch (chips, candy, fried breads). Beverages
can have the same energy density although different nutrients (juice, milk,
soda).
Based on available studies, population groups with higher rates of obesity
have lower levels of formal education and high rates of poverty. Poverty
and food insecurity are associated with low vegetable/fruit consumption
and lower actual food expenses although food costs take a higher percentage
of discretionary household income. Studies of children's food preferences
indicate they are influenced by familiarity, sweetness and energy density.
Mothers' preferences influence children's food choices. Energy-dense foods
are preferred in times of food scarcity.
The current US diet derives nearly half of its energy from added sugars
and fat. Analysis of supermarket costs of a variety of foods indicates that
the lowest-cost (per unit) sources of dietary energy are fats and oils,
sugar, refined grains, potatoes and beans. Dry foods with a longer shelf
life are usually less expensive than fresh meats and produce which have
a high water content. Advising overweight people to replace sweets and fats
with fresh produce has an economic impact. While energy-dense (high fat
and/or added sugar) diets are related to obesity, the prominent features
of obesity-promoting diets may actually be higher taste preference (palatability)
and relatively low energy costs. Actual US costs are related to agriculture
commodity prices, imports and other food industry policies.
(Drewnowski A and Specter S. Am J Clin Nutrit 2004;79:6-16)
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