The relationship between obesity and poverty: A literature review
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Many health problems in the United States are related to disparities in income and education. Over the past half-century, America has developed intensifying and increasingly costly problems of obesity and poverty. Specifically, diet quality, dietary energy-density and nutrient-density, and energy cost are topics that help explain this relationship. In the United States, highest obesity rates appear in demographics of the population with the highest incidence of poverty and least education. Lower income consumers within rich nations, like the United States of America, consume lower-quality diets than do higher income consumers. One element of causation is that there is an inverse relationship in the United States between energy density and energy cost. This equates to energy-dense foods composed of refined grains, extrinsic sugars, and unhealthy fats (saturated and trans fats) representing the most convenient low-cost option to the consumer. This is in large part due to the lowering of energy costs through technological innovation. The high energy density and palatability of sweets and fats that are prevalent in low-cost, pre-prepared foods and beverages are associated with higher energy intakes in clinical and laboratory studies. Food insecurity and poverty have been found to be linked with lower gross expenditures on food, low fruit and vegetable consumption, and lower-quality diets. Such diets are more affordable than are prudent diets consisting of lean meats, fish, fresh vegetables, and fruit, based upon dietary programming models. The association between poverty and obesity may be partially influenced by the low cost of energy-dense foods. Moreover, the high palatability of sugar and fat reinforces this relationship, as animal studies show that prolonged consumption of fats and sweets may permanently affect the metabolic mechanisms of reward. This economic framework provides an explanation for the observed links between socioeconomic variables and obesity when the intervening variables of taste, convenience, dietary energy density, and energy costs are studied. More and more Americans are becoming overweight and obese while consuming more added sugars and fats, and spending a lower percentage of their disposable income on food. The linkage between obesity and poverty suggests that a lasting solution must address both issues and will require medical, educational, and political components. One option is for the U.S. federal government to implement a policy initiating a taxation-subsidy program taxing unhealthy and subsidizing healthy food and beverage to aid America in its fight against obesity.