This week the New York Times posted this map:

http://www.nytimes.com/imagepages/2010/03/14/nyregion/14hungergr.html?ref=nyregion

This may indeed be shocking news to many, that in the US (one of the most affluent nations in the world) we have communities where alarmingly high rates of obesity coexist with alarmingly high rates of hunger.  How is this possible?  According to FRAC (the Food Research and Action Center), these areas of poverty are hit with a double-edged sword. 

They say:

For many households, the lack of money can contribute to both hunger and obesity. This apparent paradox is driven in part by the economics of buying food.

Households without money to buy enough food often have to rely on cheaper, high calorie foods to cope with limited money for food and stave off hunger. Families try to maximize caloric intake for each dollar spent, which can lead to over consumption of calories and a less healthful diet.

Thorough reviews of the scientific literature find no evidence that federal nutrition program participation causes obesity. In fact, some research finds that participation in federal nutrition programs greatly reduces the risk of overweight among food-insecure girls.

Research also shows that mothers restrict their food intake during periods of food insufficiency in order to protect their children from hunger. These chronic ups and downs in food intake can contribute to obesity among low-income women.

In the New York Times article accompanying the figure above, we learn that the term hunger has been removed from official documentation of these epidemics.  Personally, I think renaming hunger as ‘food insecure’ may lessen the impact of its meaning.

To quote the article:

Such studies present a different way to look at hunger: not starving, but “food insecure,” as the researchers call it (the Department of Agriculture in 2006 stopped using the word “hunger” in its reports). This might mean simply being unable to afford the basics, unable to get to the grocery or unable to find fresh produce among the pizza shops, doughnut stores and fried-everything restaurants of East Fordham Road.

“Hunger and obesity are often flip sides to the same malnutrition coin,” said Joel Berg, executive director of the New York City Coalition Against Hunger.

If we are really dealing with obesity and hunger as two sides of the same coin, why is our first lady Michelle Obama only tackling childhood obesity?  Isn’t it the combination of poverty and food insecurity (hunger or obesity) that we should be examining as a nation?  Obama stimulated lots of news coverage this week over her efforts, including a speech given to the Grocery Manufacturer’s Association, where she said:

"We need you not to just tweak around the edges but entirely rethink the products you are offering, the information that you provide about these products, and how you market those products to our children.”

Of course this effort and the many other nationwide efforts to improve school nutrition and lunch programs, are a great start (see also the link below to UK chef Jaime Oliver’s TED prize for fighting obesity).  Obama’s initiatives to get school children interested in gardening, thereby garnering their interest in eating fresh and varied produce, is also a great start.  But its time this nation started developing a healthy appreciation for body weight, while using a logical and fact-based approach to managing human health and metabolic dysregulation.

As a start, there needs to be attention given to the unfair stigma that overweight and obese people face in our country.  Body weight, as OS’s Dr. Linda Shiue so succinctly put it recently – is as simple, and as complex, as energy in vs. energy out.  Of course, a person with normal physiology who increases their caloric intake and/or decreases their activity will probably put on weight – and increased body weight in many cases does lead to metabolic dysregulation and harmful health effects like type 2 diabetes, heart disease, or some cancers.  But so many other drives play into our body weight regulation systems: hedonic feeding (our brain’s dopaminergic drive to eat highly palatable foods even if we don’t require the energy), energy expenditure (our body’s basal metabolic rate that burns calories independent of our activity levels), and potential environmental impacts on this whole metabolic system (the types and amounts of nutrition we get, our overall health, sleep status, etc) also play a role.  So simply blaming the obese woman on the street for her own weight issues, or reverting to name-calling (lazy, for instance) is simply an ignorant and uninformed response to our nation’s obesity epidemic.  Its an oversimplification of a complex problem.

So-called fat acceptance societies go the other direction, aiming not only to reduce stigma, but to accept people of all sizes.  This is a stance that is both headed in the right direction, but also can go too far.  Its true, some people considered overweight or obese on the soon-to-be-outdated BMI scale are actually metabolically healthy (normal glucose tolerance, low triglycerides, normal blood pressure, etc), and some people considered of normal weight are in fact quite unhealthy.  So the BMI spectrum is not simple and straightforward.  But for the most part, people of all weights aim to obtain optimum health – and if that means losing or gaining weight to do so, they will.  Therefore, accepting body weight independent of health seems like a dangerous notion.  But these fat acceptance movements are doing a great service to society by attempting to lessen the body weight stigma.

The National Association to Advance Fat Acceptance views these sorts of discriminatory acts as a civil rights violation.  In fact, if we heard this type of talk about any other group of people based on religion, race, or ethnicity, we would immediately react.  From the NAAFA mission:

Founded in 1969, the National Association to Advance Fat Acceptance (NAAFA) is a non-profit civil rights organization dedicated to ending size discrimination in all of its forms. NAAFA's goal is to help build a society in which people of every size are accepted with dignity and equality in all aspects of life. NAAFA will pursue this goal through advocacy, public education, and support.

Fat and body weight are always in the news.  Just glance through some recent news stories and you’ll see how director Kevin Smith was recently removed from a plane because his size was too large for one plane seat, or how Howard Stern recently criticized Oscar-nominated actress Gabourey Sidibe for her weight, claiming she’d never work in Hollywood again because of it.  In these cases, I do think that the missions of Michelle Obama, the NAAFA, Jaime Oliver, and FRAC are synergistically bringing this nation in the right direction: a new, more informed understanding of body weight and health.

 *******************************

Aliquot enjoys a good science discussion.  For this post, please share, rate, comment or send a message.  Much appreciated!

********************************

Sources cited:

Links to the Smith and Sidibe stories:

http://www.msnbc.msn.com/id/35406030/

http://abcnews.go.com/Entertainment/howard-stern-gabourey-sidibes-size-limit-career/story?id=10066348

 NYTimes articles cited above:

http://www.nytimes.com/2010/03/16/health/16essa.html?ref=science

http://www.nytimes.com/2010/03/14/nyregion/14hunger.html?src=me

FRAC:

http://www.frac.org/html/hunger_in_the_us/hunger&obesity.htm

Michelle Obama’s Obesity initiatives:

http://www.huffingtonpost.com/2010/03/16/michelle-obama-talks-anti_n_501430.html

 http://cnsnews.com/news/article/61157

NAAFA:

http://www.naafaonline.com/dev2/ 

NAAFA timeline from Time: