
If You're Poor in America, You Can Be Both Overweight and Hungry - pseudolus
https://www.bloomberg.com/opinion/articles/2019-07-17/how-hunger-and-obesity-coexist-in-america
======
michaelbrave
Based on a lot of the comments here it seems a lot of you don't understand
what it's like to be poor, how soul crushing it is, how unescapable it is, how
you have to make short term choices at the expense of the future just to
survive.

A good example of this would be smoking, you know it's bad for you, we all do,
it's an expensive habit and it's something people from poverty are more likely
to do. Why you ask? Because they use it to keep going, it's a stimulant, it
gives and extra bit of energy to keep going, to keep working those multiple
shitty jobs with shifting hours, small breaks and soul crushing atmospheres.

It's hard to think about the future when you are being crushed by the present
reality.

It's much the same with junk food. When time is the thing you don't have and
money is the second thing you don't have. Cooking food, especially prep heavy
food like beans that have to be soaked overnight, then boiled the next day,
then if it's a large enough batch (which it would have to be for efficiency)
you have to place it in containers, portion it out etc. We are talking about
hours in a day that you don't have (made worse if you are raising a family,
working two jobs, taking care of extended family, as many of the poor do). So
instead you buy a hotdog from a 7-11 or a shitty vending machine hamburger at
work. Life gets worse, seems like there is no hope of it getting better until
eventually that little bit of you food you enjoy is about the only part of
your life you enjoy, because what else is there.

It actually almost makes sense in a way since you are getting the most calorie
bang for you buck, and when that dollar has to go really far, and you aren't
sure if food will run out later, the quick math that supports the immediate
future over the long term one is what wins out.

I'll never understand the cruelty of trying to place the blame of systemic
problems on those effected by it.

~~~
username90
> Based on a lot of the comments here it seems a lot of you don't understand
> what it's like to be poor, how soul crushing it is, how unescapable it is,
> how you have to make short term choices at the expense of the future just to
> survive.

I know what it is like to be poor. I have been poor. I have had a lot of
friends who were poor. Yet few of them were fat. Poor people are not very fat
where I'm from. People in USA are not fat because they are poor, they are fat
because they are in USA. Blaming it on poverty is a cop-out. I'm not sure why
they are fat, but there is no universal law that poor people make bad choices
and don't have time to cook.

~~~
AstralStorm
There is a difference in pricing structure. Junk and unhealthy food in the US
is much cheaper and more available than basic ingredients which you could use
to make wholesome meals. Also much easier to store.

We had a similar problem in Poland in 60s, people in some areas ate a lot of
bleached flour (and potato flour) in various forms, inviting health disasters
and obesity. But that was due to lack of availability of other things mostly.

Pricing structure influences availability for poor. The "feel good" addictive
factor is a real kicker. Some foods should come in black coffin boxes with a
warning label on top.

~~~
briancleland
That's interesting. How was the pricing structure problem addressed?

~~~
AstralStorm
Initially, the availability issues were fixed by rationing (dreaded food
coupons), then by improving production and transport, and finally the Berlin
Wall fell, after a short hyperinflation almost everybody can afford basic food
and most kinds of produce (except meat) are cheap.

The problem is somewhat flipped now that affluent people overeat or eat fast
food due to time pressure. These are more expensive than produce and basic
components (excluding most kinds of meat, still) even including preparation
and work required. Fewer people cook at home, though healthier take out
options are quite available in many places. Small restaurants, kinda like old
American "greasy spoon" but healthier and more often with disposable cheap
packaging and cutlery - big catering is barely competitive. Replacing in many
instances previous "milk bars" with both cheap and more gentrified options
depending on area.

I think the main difference is how near these are to living and work spaces.

------
ng12
> The U.S. Congress, for one, should increase funding for the Supplemental
> Nutrition Assistance Program — food stamps — on which 50 million American
> families depend.

This is anecdotal but I used to work at a corner store in a poor neighborhood.
We received plenty of customers paying with EBT but not once (literally, _not
once_ ) did someone come in and buy peanut butter, pasta, bread, canned
veggies, or any of the cheap nutritious foods with EBT. It was always junk
food (or worse, candy and soda). It seems to me SNAP is a very small part of
the problem compared to a lack of education and resources.

~~~
okmokmz
I shop at a local Hispanic grocery store, and I'm always surprised how many
people will buy soda, sugary breakfast cereals, candy, essentially boxed fast
food, and other garbage with their food stamps rather than the great fresh
produce, meats, seafood, etc. that's available. It certainly isn't everyone,
but it does seem to be the majority anecdotally. I agree that education is a
far more important piece of resolving this issue

~~~
Sharlin
One should not underestimate the extent to which stress, depression, and
anxiety can make us crave comfort food, and rob the energy to do things like
cook your own meals. Especially if you're a working poor and already tired
when you get home.

~~~
Reedx
True, but that's a self reinforcing feedback loop.

Eat junk -> Feel like crap, low energy -> Eat more junk

Not a good long term strategy. There are widely available low cost foods that
can help break that loop. Rice, beans, eggs, frozen vegetables... In fact
frozen vegetables are often more nutritious than non-frozen, unless you're
eating close enough to picking time.

~~~
Sharlin
> that's a self reinforcing feedback loop.

That's exactly the point. You don't break out of those just by deciding one
day to be rational.

~~~
loco5niner
People do it all the time. It's unfortunately the exception, not the rule.

------
jimbokun
Just came back recently from vacation in Italy, and was very sad to walk into
an American supermarket again.

My gut reaction was "where is the food?" Just row after row of stuff in boxes,
with a few fresh fruits and vegetables in one row and a small deli counter,
and even there the meats and cheeses are far more processed and industrial
scale.

In Italy there were multiple sections of meats and cheeses, fresh breads
clearly delivered that morning, in season fruits and vegetables. (I noticed
all of the vendors had lots of cherries and apricots, displayed far more
prominently and in greater quantities than anything else. Of course it was
because they were in season, so that was what all the Italians wanted to buy.)

Even a tiny little corner market had a section for fresh bread, and chunks of
really good quality cheese for about €1.

I don't know if it's cultural difference or quality of Italian soil and
climate or something else, but seemed like it was cheaper and more convenient
to eat real food there than processed and packaged junk.

~~~
Booktrope
Where are you shopping? Most US supermarkets have lots of fresh fruits and
vegetables, as well as a meat counter and often recently-thawed fish. ("Fresh"
fish can't actually be distributed without days of delay unless you live very
nearby to where it's caught.) There's also always fresh high-quality bread,
though there may be some excessively processed carbs as well Deli's usually
don't provide very healthy food -- it's all processed. When I was in Italy a
few years ago, supermarkets were very similar to those in the US.

~~~
jimbokun
It's the relative quantities and pricing and placement of the various kinds of
foods.

There was a much larger selection and variety of fresh breads. The meats and
cheeses in Italy heavily emphasize where and how they are produced, with
official designations enforced by law. You can get those products imported in
the US, but they cost a lot more, of course.

In general, the most common items in Italian supermarkets are what get labels
like "artisinal" and "organic" and much higher prices than what you would pay
in Italy.

And I still haven't seen a convenience store in the US with high quality fresh
breads and cheese.

Maybe the simplest way to think about it, the average Italian supermarket is
Whole Foods but much cheaper.

(And don't get me started on the pinnacle of civilization that is the Italian
Bar! I need to write a blog article on that.)

I will say, now that I'm back in the U.S., I have been finding the fresh bread
and fruits and vegetables, and where they are cheaper, that maybe I missed
before because I was seeking it out.

------
username90
In my experience people cook what their parents cooked. The immigrants from
the middle east cooked middle eastern food, the native Europeans cooked
European food etc. And those immigrants were very poor, so being poor is not
really an excuse. Also they open their own stores stocking wares useful for
middle eastern food in areas with lots of immigrants, so food deserts becomes
opportunities for poor people to make a career. This means that there are
basically no undeserved areas, if people live somewhere there will be ways to
buy healthy food there.

Why isn't this happening in the US? Do people suddenly forget how to cook when
they move there? Or is it the strange zoning laws which prevents people from
opening local stores with affordable groceries? Or is it some selection
effect, like people who cares about food don't immigrate there? I mean, if
fresh produce would sell then grocery stores would obviously stock them. And
fresh produce sells very well basically everywhere else in the world, so what
is the problem with USA?

~~~
castlecrasher2
>Why isn't this happening in the US?

My personal experience with this is that the cheap, unhealthy, sugar-loaded
foods are the obvious choice when you don't know any better. I mean, they're
delicious, and a lot of people are overweight, so why not?

I've since learned that maintaining my weight is important, and that means I
should end a meal being just hungry enough to eat more, and if I'm losing
weight that means being hungry at the end of a meal, and proteins and healthy
fat choices help me from getting so hungry I eat a whole tray of brownies.

As for comparing this to other countries, I think the lifestyle of the US is
more sedentary in comparison, and for me at least I get more hungry the less I
do during the day. I sometimes eat because I'm bored, and that means sugary
stuff. When I lived in Brazil and walked around all day I ate a lot but never
really cared for sugary stuff the way I do now.

------
hirundo
Protein. If I binge on carbs I can be painfully full but still hungry. If I
eat a hunk of roast beast I feel like pushing it away long before I'm
physically stuffed. And the satiety lasts longer. I've spent years now N=1
testing the hypothesis that protein satiates me faster and longer than the
other macro nutrients, and it seems to pass each test.

~~~
rubicon33
I've never understood the "not full eating carbs" thing. This isn't the first
time I've heard it either.

Myself ... I get full eating food. Carbs, protein, whatever it is. If I eat a
lot of it, I'm full.

I guess what I find interesting and the point of my response is that there is
clearly a difference from person to person in how their body produces the
"full" feeling. Somehow in your case, a belly full of carbs, blocks (or
inhibits) that full signal from firing?

~~~
logfromblammo
This may be related to ones number of copies of the amylase-coding genes.

Put a saltine in your mouth and start chewing it, without swallowing. Note the
amount of time required until it starts to taste sweet.

Anecdotally, I _never_ taste sweetness from this test. And I do not feel
satiated by high-carb foods. I could eat spaghetti until I'm basically the
gluttony murder victim from "Seven". The satiety signal from carbs is almost
completely absent. The feeling of fullness only comes from the physical
stretching of the stomach, or from other macronutrients.

That's why low-carb diets work better for me. I eat less when only eating
foods that make me feel as though I have eaten at all.

~~~
rubicon33
That's an interesting theory. I'm curious though -

If you are low in the amylase enzyme then I would actually expect
carbohydrates to NOT cause weight gain. Doesn't that enzyme break down complex
carbs into consumable (usable) simple sugars?

~~~
logfromblammo
Both the salivary glands and pancreas produce amylase, but in different
isoforms. Salivary amylase is ptyalin, coded by the AMY1 gene. Pancreatic
amylase is coded by AMY2. Humans have multiple copies of these genes, and more
copies means more amylase is produced. Someone with 4 copies of AMY1 can still
digest starch, but someone with 16 copies of AMY1 might have most of their
eaten starches reduced to oligosaccharides long before their ptyalin is
inactivated in the stomach. More copies of AMY1 is directly correlated to
historic populations with higher starch consumption.

Gut biota will also make their own amylases.

An amylase blocker causes carbohydrate malabsorption, and that is about the
same as a lactose-intolerant person consuming lactose. The starches end up
getting fermented in the intestine. The gut biota will consume most of them,
but I suppose it is possible they might drop some on the floor for the
intestine to absorb.

My hypothesis is that the slower rate of digestion of starch produces a lesser
effect on perceived satiety.

------
gomez9
Why not regulate junk food advertising? I don't watch much television, but
when I do, it's shocking to see how normalized unhealthy food is in society.

~~~
save_ferris
The problem is the lack of access to quality, affordable, nutritious food.
Food deserts are a huge problem in many parts of the US, where lower income
households simply don’t have access to healthy food.

I don’t see how regulating advertising solves this problem.

~~~
maximente
> The problem is the lack of access to quality, affordable, nutritious food

not buying this - lentils are a nearly complete protein, don't really expire,
certainly aren't expensive, and i don't think could be viewed as anything but
healthy

~~~
Sharlin
You're also assuming that people know how to make tasty meals out of lentils,
or have the energy to do so. The idea of quality food encompasses not looking
and tasting like grue.

~~~
maximente
i'm just responding to a strong and overly simplified claim, quoted above.

that people don't have cooking skill or patience indicates other problems
other than access to food - i happen to agree - so i think it's fair to say
the claim should include other things like: commuting etc. leads to low
energy/motivation to cook leads to choosing unhealthier foods; lack of
community structure means there aren't as many people to cook for so less
efficient, etc.

again, OPs claim is that food access is "the problem"; i just think it should
include other things, such as what you said.

------
hi41
Food stamps, to foster good health, must exclude unhealthy items. I have seen
people buying potato chips and sugary soda drinks in exchange for food stamps
at convenience stores in Brooklyn. How is this practice even okay? If we want
healthy population then food stamps must fruits and vegetables but must
exclude soda and chips.

~~~
swang
you know how much fruit/vegetables cost right? stop policing what people buy
with their food stamps.

what's the #1 item people on SNAP buy? Soda. what's the #2 item people not on
SNAP buy? Soda. What's the #2 item on SNAP? Milk #1 on non-SNAP buyers? Milk

It's not much difference between what people on SNAP and not on SNAP buy. It's
just people not minding their own business because they think people don't
deserve food stamps.

[https://www.huffpost.com/entry/food-stamps-
diet_n_582f4bd7e4...](https://www.huffpost.com/entry/food-stamps-
diet_n_582f4bd7e4b058ce7aaadea0)

You want to force people to buy healthier food? Provide more for food stamps.

~~~
logfromblammo
The more I think about it, the more I convince myself that charitable food
security benefits should not be distributed as a cash-equivalent.

Food stamps don't bring grocery stores into food deserts. And food stamps
don't stop the corner store from charging $2/lb for bananas when a suburban
grocery store is charging $0.60/lb for them.

If you pump more money into EBT/SNAP/WIC, the bananas go up to $3/lb, and the
people still get fat while hungry. There's always a way for someone to siphon
the value out of a cash entitlement benefit.

I think food security might be better served in the short term by using the
funds to buy market baskets similar to those provided by farm shares, and
deliver the food directly to the recipients, or at least to walkable
distribution points. In the long term, the money has to be used to produce a
surplus of food beyond what the cash market currently provides, to be put into
a separate supply chain that is resistant to diversion or manipulation by
middlemen.

This goes hand-in-hand with housing security, where the government builds new
housing units, to rent or condo, then uses some percentage of them for
housing-insecure people, at reduced cost to them. It doesn't do as much good
to get a free (to you) 10# bag of government potatoes if you don't have
anywhere to safely cook them.

You can't push a string. You can't pull sand.

Pumping more money into a community is not going to change anything when its
defining characteristic is that the mechanisms to move money out are already
limited by the amount of money left inside.

~~~
milesokeefe
This already exists in a form alongside SNAP, called TEFAP[1]. Except food
isn't directly distributed to receipts, instead it goes to soup kitchens, food
pantries, local distribution organizations and the like.

[1]:
[https://en.wikipedia.org/wiki/Temporary_Emergency_Food_Assis...](https://en.wikipedia.org/wiki/Temporary_Emergency_Food_Assistance_Program)

------
misiti3780
Interesting the article does not attribute any of the obesity to lack of
exercise. It doesnt matter if your live in poverty or you are well-off, if you
consume more calories than your burn day-over-day, you are going to gain
weight.

~~~
lgeorget
Exercising is very beneficial for your health for a lot of reasons but it
cannot prevent overweight without a proper diet.

The role of exercising has been exaggerated by Coca-Cola and other junk food
sellers to shift the blame away from them:
[https://well.blogs.nytimes.com/2015/08/09/coca-cola-funds-
sc...](https://well.blogs.nytimes.com/2015/08/09/coca-cola-funds-scientists-
who-shift-blame-for-obesity-away-from-bad-diets/?_r=0).

~~~
module0000
The idea that exercise cannot prevent obesity without a proper diet is _very_
misleading. Yes, if someone eats 7k calories and does _not_ train like an
olympian, they are going to gain weight. However, you can consume 5k calories
a day whilst exercising( _properly_ ) 5 days a week, and remain very trim and
"cut" as the term goes. Proper exercise is not popular though, because if it
was easy....well everyone would do it.

The idea that "you have to burn more calories exercising than you eat" is 100%
false. The calories you burn _while_ exercising make up less than half of the
calories you burn _because_ of exercising. Lean muscle mass maintenance
caloric requirements exceed adipose tissue requirements by an order of
magnitude. Simplified: the more lean muscle mass you have, the more calories
your body will burn with zero effort to support that muscle mass.

That said, a proper diet is a great idea for a ton of reasons. I replied only
to point out that proper exercise carries a _lot_ of weight(no pun intended).

~~~
lgeorget
I understand your point but food is not just a sum of calories. Not all food
is metabolised the same. Athletes consume a lot of calories but avoid junk
food.

Edit: as I read your comment again, actually, I think we mostly agree.

------
4ntonius8lock
I'm really surprise that this is a title on a news story.

When I was growing up as a little child, I saw a very poor obese person. I
asked my mom how could this be. She told me when you eat trash, you get fat,
but since you don't get nutrition, you stay hungry. It was the third world, so
instead of fast food it was rice and lard, but the same concept.

This was 30~ years ago.

Recently, I started volunteering at a food pantry.

I was shocked at how many grown men and women say: 'but I see a ton of fat
poor kids... they don't need food'.

I mean, there's a remarkable level of ignorance and lack of empathy you need
to have to use such an observational to jump to such a conclusion.

The fact that such a well known fact is a title on bloomberg news piece is a
sad statement to the status of our society.

------
calvinbhai
I think the problem with people with lower income buying crappy food boils
down to the infrastructure they can afford for their food purchases.

If they rely on packaged food / edibles for everything, it’s probably because
they don’t even have a good kitchen+fridge+storage space. Fruits and
vegetables spoil easily, so it’s time consuming to keep bringing produce
that’ll spoil most of the time.

So even if snap buyers can afford to buy produce in store, being able to buy
stuff that won’t spoil, I think pushes them towards such foods

------
nabla9
Even more overweight people suffer from malnutrition than huger. Carbs are
cheap, proper nutrition may not be.

There was recently post in HN describing how sailors in Japanese Navy suffered
fro beriberi while having access to calories.
[https://www.atlasobscura.com/articles/rice-disease-
mystery-e...](https://www.atlasobscura.com/articles/rice-disease-mystery-edo-
tokyo-navy-beriberi)

~~~
machiaweliczny
I think that calling it carbs is dishonest. Carbs from oats/rice etc. are fine
IMO.

The problem is with simple sugar without any other nutrients(protein/fiber).
Also soda intake in USA is scary.

I never met (educated) overweight person who was suprised about their weight
(gain). Most people just eat a lot of sweets (but are fine with it).

~~~
nabla9
> Carbs from oats/rice etc. are fine IMO.

They are not. Eating white rice leads to malnutrition. You need vitamins and
micronutriets, not just carbs and proteins.

~~~
perl4ever
White rice is enriched with vitamins in the US precisely because it used to
lead to malnutrition when people depended on it.

And brown rice is also generally available.

------
pseudolus
Perhaps an indirect way of tackling the problem is increasing the quality and
diversity of school lunch programs in low-income areas susceptible to obesity.
Compared to lunch programs in some European countries, especially France, US
lunch programs are unlikely to inspire much appreciation for healthy eating
[0]. In short, get them while they're young. Also, bring back home economics
programs for both boys and girls with an emphasis on healthy food preparation.
It's a great life skill.

[0] [https://cromwell-intl.com/travel/france/school-lunch-
menus/](https://cromwell-intl.com/travel/france/school-lunch-menus/)

[https://qz.com/515148/a-typical-week-of-school-lunch-for-
kid...](https://qz.com/515148/a-typical-week-of-school-lunch-for-kids-in-
paris-vs-new-york/)

------
philip1209
Calories-in/calories-out is broken. This isn't a simple "overeating" / "feast
or famine" problem - it's that people are eating carbohydrate-rich food.
Insulin then shoots up, triggering fat storage.

~~~
sn9
And if they're in a persistent caloric deficit, they'll experience a net loss
of body fat.

It's physically impossible to gain body fat in a caloric deficit.

------
0x8BADF00D
Pretty spot on analysis. Unfortunately, if your body has been in a state of
caloric deficit for a long period of time, as soon as you eat slightly above
your basal metabolic rate, your body will start to store the excess as fat.

~~~
copperx
I've seen this repeated as dogma. Is this based on empirical science, or just
a hunch?

------
jajag
I've often wondered that if you give someone a calorifically rich but
nutritionally poor food stuff, will the body eat to excess to try and make up
for the nutritional deficit?

------
buckthundaz
Much of this is due to protein dilution through the course of time, from
hunter & gatherers to agricultural societies to industrial and post-industrial
societies. [1]

[1] 'How the Body Uses Protein vs Energy' by Dr. Ted Naiman, MD. link:
[https://www.youtube.com/watch?v=jLh78As-
MOs](https://www.youtube.com/watch?v=jLh78As-MOs)

------
peter_retief
Not just America, Africa has the same problem of poor people filling up with
cheap carbohydrates and sugar. Diabetes, heart disease, cancer, aka Metabolic
syndrome

------
crooked-v
The tl;dr:

> Food-insecure and low-income families face unique challenges that impair
> their ability to consume a healthful diet and maintain an ideal body weight.
> Their lifestyles tend to be sedentary because of their built environments,
> and their food tends to be served in large portions. The relatively
> inexpensive, calorie-dense food at their immediate disposal often lacks the
> nutrients needed for optimal health. As a result, though they may follow a
> nutritious diet for short periods, these are punctuated by cycles of
> financial and personal stress that lead to food deprivation, overeating,
> limited access to health care, reduced opportunities for physical activity
> and greater exposure to unhealthy food environments.

------
dhoman
For all the people arguing that healthy food can be cheap. Not really... My
cousins on my mom's side grew up in a house hold of 3 generations, the house
had one car, which was used for getting to and from work. Breakfast was
walking to the corner store and buying a thing of donuts. None of them knew or
could afford to cook. Things like cooking are more difficult if you are
constantly having utilities turned off on you, don't have a car, etc.

~~~
drak0n1c
Cost isn't the issue, but you're right that ignorance is. At the very same
corner store a week's worth of eggs, peanut butter, and bread costs the same
as a morning's worth of donuts for the family.

