The economics of obesity: How cheap processed food is fuelling the pandemic

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Easy access to cheap unhealthy food is causing obesity in Europe and the West to spiral - and the phenomenon is spreading to developing countries.

Another study suggesting that the relative cheapness of calorie-dense processed foods is a risk factor for obesity in upper- and middle-income countries has been published in the US.

The study, conducted by The International Food Policy Research Institute (IFPRI) and published in the Journal of Nutrition, is the first to examine a link between food prices and undernutrition. It concluded that the high cost of healthy food in developing countries was linked to child stunting. But it also noted that while healthier foods become cheaper over the course of development, so too do unhealthy processed foods, like soft drinks.

So you have, on one hand, the problem of too many people in the developed world without access to expensive healthy food such as milk. While “the relative cheapness of calorie-dense processed foods has been implicated in the high rates of obesity observed in upper-income countries, as well as the rapid increases in obesity observed in transition economies, such as China.”

Because the relative cheapness of unhealthy calories is an important explanation of the obesity epidemic in higher-income countries, the research predicted significant increases in overweight prevalence among adult populations globally.

"Public health agencies in upper income countries have been concerned with the high consumption of sugar-rich foods for some time," said the study’s co-author Harold Alderman, "but our study shows that these products often become very affordable in middle income countries, and sometimes even in relatively poor countries where obesity rates are really on the rise."

The study went on to recommend taxation and regulation efforts - such as food labelling - to curb consumption of unhealthier foods.

The researchers noted that policymakers have several tools available to help make nutrient-rich foods relatively more affordable, including nutrition-sensitive agricultural investments that could make healthy foods cheaper.

"These findings raise an important agenda for future research: understanding why food prices vary across countries, and sometimes within them, and how best to change food prices in a way that leads to better diets and nutrition outcomes in rich and poor countries alike," study co-author Derek Headey said.

Innovation not charity

But how to best change prices without the prospect of more regulation and red tape on the food industry?

Doug Rauch, former president of Trader Joe’s, has founded a new low-cost health food store called Daily Table in Boston, Massachusetts. According to its website, the prices are low enough to compete with fast food restaurants. It also sells “grab-n-go” options for those who don’t have time to cook.

Rauch affords these prices by working a deal with vendors to purchase food that might ordinarily get thrown out for arbitrary reasons. This allows Rauch to buy at drastically reduced prices or even receive donation.

“When 49 million Americans aren’t able to eat properly, and because of it their health suffers – and they get obesity, heart disease, diabetes, in their teenage and young adult years – this is going to be a health care cost tsunami that hits all of us,” said Rauch.

Environmental factors are fuelling obesity epidemic

The IFPRI study’s results were echoed in separate comments from Professor Corinna Hawkes, who serves as Vice Chair of the London Child Obesity Taskforce, set up by the Mayor of London with the ambitious goal of reducing obesity among London's children.

Writing on the London Assembly website, she said there exist a host of environmental factors, including cheap unhealthy food, in children’s lives that make it “difficult to shift the problem”.

She said that initiatives enacted by the taskforce, such as the ban of junk food advertising on London’s transport network, had led to some ‘small gains’. “The percentage of kids aged 4/5 affected by overweight or obesity has declined from 23% to 22% since 2006/07. Some boroughs and wards can celebrate larger downward trends,” she said.

But this was not the case everywhere. She noted that for 10/11 year olds, the numbers swing ever upward, as does the difference between rich and poor.

At age 10-11, a child in London’s poorest neighbourhoods is twice as likely to be affected by overweight or obesity then those living in London’s least deprived neighbourhoods,” she wrote.

As a solution to the childhood obesity epidemic, she called for a child-centred approach that understands how the system around children can be changed.

To illustrate the role of environment in obesity she gave the example of a two-and-a-half year old boy who lives in a tiny flat with no kitchen, no space to play, and no money for play activities.

Cheap snacks are a way of soothing his restless energy,” she said.

She also the noted that teenagers often frequent local chicken shops to socialise and regard them as places where they don’t ‘feel judged’. 

We need a connected set of actions around children as they go about their daily lives, actions that enable children of all ages to enjoy eating healthy diets, drinking water and moving more,” she wrote.

She added that the nature of work, housing, and poverty for their parents needed addressing. “We need children’s help in designing the actions we know are important. It’s no use asking food outlets to provide free water refills, for example, if children don’t feel welcome in these places, or if new water fountains are placed in places seen as unsafe. If we are going to fix the system, we need to understand how people experience it on the inside.”

Source

‘The Relative Caloric Prices of Healthy and Unhealthy Foods Differ Systematically across Income Levels and Continents’

The Journal of Nutrition

Authors: Derek D Headey and Harold H Alderman

DOI: https://doi.org/10.1093/jn/nxz158