Wednesday, April 18, 2012

Money and obesity. Is there a link?

It's a staple of popular belief, even cited by First Lady Michelle Obama, that poor neighborhoods are food deserts, generally void of healthy fare. As a result, it is believed that  socioeconomically challenged people are nutritionally disadvantaged because they cannot access nutritionally-sound food, which results in increased solicitation of fast food restaurants and a higher incidence of obesity. Well it turns out, based on two new studies, that such neighborhoods may, in fact, be food swamps, concentrated with a high density of grocery stores and supermarkets in addition to the fast food establishments.

To quote the NY Times, "Such neighborhoods not only have more fast food restaurants and convenience stores than more affluent ones, but more grocery stores, supermarkets and full-service restaurants, too. And there is no relationship between the type of food being sold in a neighborhood and obesity among its children and adolescents."

Okay, so I guess you may say we can cross that cause off the obesity list.  I say hold your horses.

First, even though stores like groceries and supermarkets may be present, the studies revealed nothing about pricing. Over the course of my lifetime, I have read and witnessed numerous cases of predatory pricing in poorer neighborhoods. There have been a number of publicly reported mortgage scams involving companies charging higher rates and costs to poorer people. I know of clothing stores located in poor neighborhoods that charge a premium for their wares because they know that convenience is more important for their customers who can't easily get to malls and mainstream stores to shop comparatively. So just because the stores are in the neighborhoods doesn't mean they sell affordable healthy food.

Second, it takes more time, effort, and decision-making to prepare healthy food versus buying fast food.  In his book, Willpower, Roy Baumeister lays out a cogent argument that willpower is a function of decision-making--the more decisions you make the less willpower you have. He bases this on studies that show that decisions require neurotransmitters which rely on blood sugar. As decisions are made, sugar is depleted, and fatigue takes hold unless sugar is replenished. (This is not an excuse nor should it be construed as a reason to consume white sugar products; rather, it merely indicates that eating throughout the day complex carbohydrates found in fruits and vegetables allows for better decision-making.)

Baumeister gives the example of the car buying experience. Devious or clever car dealers, you make the call, exhaust your decision-making ability early with your choosing the free stuff such as interior and exterior colors and then wait until the end of the process to entice you with the expensive add-ons. (Next time you buy a car, eat well before you go and start with the add-ones.) Another example he gives in that in the Israeli penal system, paroles are less likely to be granted before lunch and at the end of the day, and more likely at the start of the day and after lunch. The reason he gives is that when their decision-making has been taking place for a while, the parole board members become more wary of making bad decisions and err on the side of caution by denying parole. The study he cites states that it made no difference whether it was an Arab or Jew that were up for parole; instead, the time of day was a major deciding factor. (By the way, the Israeli's addressed this finding by providing fruit snacks to the parole board members throughout the day.)

It's been said that the only people who think more about money than rich people are poor people who think of nothing else. Applying Baumeiter's thesis to poor people, by the time they need to make dinner plans, they are mentally depleted from the numerous decisions they needed to make all day, which are far in excess of the more affluent. So let's cut poor people some slack for making poor dietary decisions at the end of the day.

Now don't get me wrong. I'm not condoning this sad state of affairs nor dismissing it as incurable. The facts remain that poor people experience more obesity than wealthier people, although there are plenty of overweight and even obese "rich" people and plenty of fit and well-nourished "poor" people. Nevertheless, society has a serious problem wanting a definitive solution.

The solutions to the obesity epidemic are not easy regardless of what some pundits argue. It will take the concerted effort of public and private crusaders to teach people the true value of good food choices,  provide consistent access to affordable "healthy" foods, and the support and guidance of the the health care industry to effect real change. The pace to date has been slow but the topic has gotten much attention of late and let's hope it stays on everyone's radar and a solution is found.

In the interim, here's a new recipe my daughter shared with me. Kale, a type of cabbage-like, green leafy vegetable, has the highest nutrient density of virtually any vegetable and should be part of a healthy diet.

Cut off and put the the leaves of Kale into a bowl
Tenderize the leaves with lemon juice.
Add a touch of olive oil and a dash of salt.
Cut mango slices into the salad and add pumpkin or pine nuts.
You may also add a tsp of honey if needed.

This salad blows me away and I suspect you will love it as well. Hearty appetite!

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