Episode 128: Food insecurity and obesity.
Nausheen defines food insecurity, presents some statistics about obesity, and how food insecurity is linked to obesity. She ends her presentation with possible solutions to this problem.
Written by Nausheen Hussain, OMS3, Western University of Health Sciences, College of Osteopathic Medicine of the Pacific. Editing by Hector Arreaza, MD.
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Arreaza: Hello, my name is Hector Arreaza. I am a family physician, currently practicing and teaching in the Central Valley of California. Today we will talk about an important and growing problem: Food insecurity and its relationship to obesity. I would like to introduce my guest today, Nasheen Hussain.
Arreaza: Can you tell me what defines food insecurity?
Nausheen: As defined by the U. S. Department of Agriculture (USDA), food insecurity is the limited availability of nutritionally adequate food or the limited access to this food. So, I want you to imagine you are living in a community where the closest grocery store is not within walking distance, you have no reliable access to transportation, and you are surrounded by liquor stores, McDonald’s, and Burger King. Now you can see the two parts of that definition: the grocery store with healthy food exists, but it is too far, and you can't get to it. Whereas within walking distance is nonnutritious food. I want to challenge our audience to pay attention to these two concepts in the communities around them.
Arreaza: I have noticed a concentration of fast-food places lining certain streets. Now that we understand the concept, do we know if there is a way to quantify or measure food insecurity?
Nausheen: Yes, Dr. Arreaza. So, the term “food swamp” actually describes what you just stated. To answer your question, yes. Food insecurity is actually measured by the USDA by a 6-18 item questionnaire - asking questions such as: Were you worried if food would run out before you got money to buy more? It is conducted as an annual supplement to the Current Population Survey.
Arreaza: The Current Population Survey (CPS) is the primary source of labor force statistics for the population of the United States. It is sponsored jointly by the U.S. Census Bureau (bee-uro) and the U.S. Bureau of Labor Statistics (BLS). The CPS is conducted monthly.
Nausheen: The 2021 questionnaire identified 12.5% of households in the U. S. as being food insecure. However, this may underestimate the true number of individuals who may be suffering from food insecurity.
Arreaza: Screening for food insecurity is not been routinely done in many clinics. Food Insecurity: Preventive Services. An Update for This Topic is In Progress. LAST UPDATED: Jul 24, 2022. So now, let’s talk about the connection of this to obesity. What factors in general increase the likelihood of obesity?
Nausheen: Sure! Obesity is classified based on a person’s body mass index or BMI, which is your weight in kilograms (or pounds) divided by the square of height in meters (or feet). A BMI of 30 or greater is considered to be in the obesity category. Obesity is affected by several factors, such as a person’s genetics, level of activity, and a high-calorie diet consisting of low-nutrition food.
Arreaza: How does food insecurity play into this?
Nausheen: Think back to the example we discussed earlier. If a person is experiencing food insecurity due to a lack of access, they will use what is around them (fast food, 24-hour mart without fresh foods) so they can put food on the table. If it is due to financial inaccessibility, they will choose to, say, go to Jack in the Box for their $5.00 deals. Both of these lead to a diet filled with non-nutritious food. This shouldn’t come as a surprise: most people that experience food insecurity are likely to be living in low-income communities. The generalization here is that these communities tend to have fewer parks, and if they are present, there tends to be a lot of litter and a cloud of unsafe space hovering over it.
Arreaza: I see what you mean.
Nausheen: These people will probably be less likely to go out for walks and take their kids out…leading to a sedentary lifestyle. The last association I see is that of mental health. People who are struggling to find food are likely to have stress due to their circumstances and there is a relationship that has been found between depression and the increased likelihood of developing obesity. As a recap, there are three effects of food insecurity that contribute to obesity: lack of adequate nutrition, lack of physical activity, and poor mental health.
Arreaza: So, there are several factors of food insecurity that seem to be making individuals more likely to develop obesity. Why does it matter?
Nausheen: Well obesity is the gateway to several other diseases such as diabetes and hypertension, which are known to the medical profession as "silent killer diseases." In short, what we typically refer to as "that person is larger built" can have major adverse effects on health and can substantially reduce a person's longevity and quality of life. If we can understand and reduce risks of developing obesity, we can prevent the onset of the disease and/or prevent the progression to more severe outcomes. To bring this more into perspective, the CDC found that from 2017-2020, 1 in 5 children had obesity and about 2 in 5 adults had obesity, with an overall prevalence of 41.9% in the U.S.
Arreaza: Let’s talk about possible solutions.
Nausheen: I think the best solution to this issue has to be two parts. 1. Increased access to healthy foods. 2. Nutrition education on how foods you put into your body impact your health both now and long term. I work with urban farmers in Pomona, CA as part of a grassroots effort to increase access to nutritious foods.
Arreaza: Tell me more about it.
Nausheen: The system consists of several small-scale community farms that produce chemical-free, pesticide-free, fresh vegetables and fruits that are sold to the community members at a low price or a “pay what you can, take what you need” basis. I believe replicating this system in other communities is effective because 1. It is important for the people to know and trust where their food is coming from, and 2. People can volunteer to help the community farms thrive which not only allows for the sustainability of efforts but gives them a reason to be outside and be active which helps combat obesity!
Arreaza: I believe nutrition education is a key element to combat obesity, but the battle is unfair. I see there needs to be a better effort from our government to control such things as the false advertisement of so-called “healthy foods” and “miracle supplements” that promise the cure of obesity. I feel like there needs to be more control of these vendors and pay for false science.
Nausheen: Nutrition education itself is also important so that people understand what nutrients their bodies need, what foods can give it to them, how to cook those foods, and lastly how it all affects their health. This should start from elementary school with short lessons embedded into the school curriculum.
Arreaza: Thank you for sharing that. This brings our episode to a close. If you are or if you know someone who is struggling with food insecurity, find some resources in your community such as food banks, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and other resources.
Nausheen: Find community gardens where you live.
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Conclusion: Now we conclude episode number 128 “Food insecurity and obesity.” Nausheen explained that a lack of access to fresh and healthy foods is linked to increased risk of obesity. Dr. Arreaza called for improved controls for scammers and pseudoscientists that frequently commit fraud to patients who are struggling with obesity.
This week we thank Hector Arreaza and Nausheen Hussain. Audio editing by Adrianne Silva.
Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week!
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Sources:
- Hartline-Grafton, H. (2018, April 18). Understanding the connections: Food insecurity and obesity (October 2015). Food Research & Action Center. Retrieved February 5, 2023, from https://frac.org/research/resource-library/understanding-connections-food-insecurity-obesity.
- U.S. Department of Health and Human Services. (2022, March 24). What are overweight and obesity? National Heart Lung and Blood Institute. Retrieved February 5, 2023, from https://www.nhlbi.nih.gov/health/overweight-and-obesity.
- Food Security in the U. S. - Measurement. USDA ERS - Measurement. (2022, October 17). Retrieved February 5, 2023, from https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/measurement.
- Craven, K., Patil, S. (unknown). Understanding Food Security & Obesity Paradox: A Case Study. Department of Family Medicine, Brody School of Medicine.
- Blasco BV, García-Jiménez J, Bodoano I, Gutiérrez-Rojas L. Obesity and Depression: Its Prevalence and Influence as a Prognostic Factor: A Systematic Review. Psychiatry Investig. 2020 Aug;17(8):715-724. doi: 10.30773/pi.2020.0099. Epub 2020 Aug 12. PMID: 32777922; PMCID: PMC7449839.
- Centers for Disease Control and Prevention. (2022, May 17). Childhood obesity facts. Centers for Disease Control and Prevention. Retrieved February 6, 2023, from https://www.cdc.gov/obesity/data/childhood.html.
- Centers for Disease Control and Prevention. (2022, May 17). Adult obesity facts. Centers for Disease Control and Prevention. Retrieved February 6, 2023, from https://www.cdc.gov/obesity/data/adult.html
- Royalty-free music used for this episode: “Gushito - Latin Pandora." Downloaded on October 13, 2022, from https://www.videvo.net/
