by Marion Nestle
Feb 24 2008

Neighborhood influences on obesity

Obesity is more common in low-income areas. Why? It may seem intuitively obvious that lack of adequate income, transportation, cooking facilities, supermarkets, and opportunities for physical activity would make it difficult for people to eat healthfully and be active, but inituition is one thing and evidence is another. My NYU colleagues Jennifer Black and James Macinko now provide the evidence in a most useful review paper. Want to improve the “built environment”? This is a great starting place.

  • Allie

    Interesting study. I believe another factor is lack of affordable health care. Preventative care is simply not affordable for many.

    In my instance, I have osteoarthritis and walking is quite painful for me. Since a knee injury occurred, the pain has become debilitating and I have gained 35 pounds. I have been told surgery is required but even with two jobs, the cost is out of reach for us.

  • Normally, obesity in high-income people should be more common.

  • Shari L.

    As a non-professional food enthusiast, I like the way Michael Pollan answers just about the same question with a much greater simplicity in his new book, Defense of Food. He explains that we learn what and how to eat from our culture.

  • Fentry

    On p.3 I noticed that the authors talked about race (mediated by gender) as a partial explanatory variable. If wonder if the term “race” should really be the more watered-down “genetics” because Europeans, Africans and Hispanics actually belong to continents with a lot of ethnic groups possessing distinct genetic heritages. Each of these continents has different body types associated with different regions (for instance the old mesomorph/ectomorph/endomorph tripartite classification). Today, particularly in the Americas, previously isolated genetic heritages have been combined, making “race,” I think, a problematic explanatory variable.

  • Another factor is irresponsible social programs. The welfare system in this country is not focused on providing healthy nutrition to America’s needy. We simply try to fill a stomach. The reason? Cause it makes us feel better about ourselves. The result is that we have millions of obese needy who are then in need of sickcare. It’s time to focus on real “health”care instead of talking about it. What most people, including this year’s Presidential candidates , are referring to when they say healthcare is actually sickcare. How about we focus on helping folks live healthy, even those in social programs.
    If we really cared about the needy we would encourage healthy eating habits, not the foods that are encouraged through food stamps, wic programs, ,etc.

  • The article stated that “Over one in ten American households is food insecure, and many of these individuals rely on the emergency food system and federal programs to acquire food.”

    My personal experience with food pantries is that they are generally loaded with highly processed junk foods. The USDA program (can’t remember, but I think it’s TEFAP) provided more basic things like meat, rice, powdered milk, etc. but not everyone qualified. One of the pantries started a vegetable stand, which had produce that didn’t meet the supermarket standards, yet it was very affordable and a commendable effort to improve the healthy eating environment. Unfortunately, for reasons I don’t know, that pantry was discontinued.

    On another note, when I was a recent college grad, I once went to an after school program in the DC area to talk to kids about nutrition. Ironically, the kids were eating candy as I taught! All of them. I was too naive back then to inquire about the candy source.

  • I just received an email asking for pantry donations for our local Community Resource Center. I often donate to this group, yet it is dismaying to receive a “wish list” of items that are primarily processed sugar and starch when I know that fresh food is most lacking in their clients diets. I understand there are problems of perishability, fragility, and transportability of fresh foods, but I cannot in good conscience donate more extruded cold breakfast cereals, pasta, or mac-n-cheese boxes. I try instead to donate more nutritionally dense foods that still meets the pantry’s need for shelf-stability: canned meats & stews, canned salmon and sardines, nut butters and nuts, quinoa, olive oil, etc. Not a solution to hunger and poor nutrition, I know, but much better than filling up empty bellies with “nothing”.

  • jen

    I have had similar experiences with donated food items as were mentioned in the comments here. the last “food” drive I participated in actually focused requests on cake mixes and frostings! …Hello! totally confused I went straight to the canned goods and loaded up on vegetables and beans. it is amazing how much you can get for your money.

  • LJ

    Just wanted to mention that people in lower income neighborhoods also tend to try and stretch dollars in food stores by buying products such as macaroni and cheese, spaghetti, tuna helper, hamberger helper, and so on . Anyone that’s had to feed a family knows just what I’m getting at. On limited income you have almost no choice but to eat unhealthy foods.

  • Anton

    Why is this a question? Obviously, low-income people eat too much and don’t move enough.

    Low-income jobs are sedentary. Laborers and factory-workers don’t move. They sit all day.

    And with low incomes, they eat too many calories. Higher income people don’t eat as many calories.

    This is what Marion has proclaimed time after time. It is all about calories in, calories out.

    Why is this a mystery? Low-income people eat too much and don’t move enough.

  • Renata

    Anton’s answer is the mystery: Why is it that low income people eat too much and don’t move enough? Actually, do they really eat too much? Or is the food they have to eat higher in calories? It is one thing for you to go to the store and be conscious of how much you spend on food, but it is another thing altogether when you have to choose between food, rent, and transportation. Also, to say that low income jobs are sedentary is inaccurate. How active is a computer programmer while at work? Compare that to the cashier on his/her feet at the grocery store. As for finding time to exercise, how can you go for a walk in your neighborhood after dinner when there aren’t enough street lights on your street? What if there aren’t any sidewalks? How realistic is it for a low-income family to join a health club or find space in an apartment for a treadmill? So, mystery isn’t why low-income people weigh more and suffer more from chronic disease, it is why don’t they eat healthier and move more?

  • I disagree that limited income requires you to eat unhealthy.

    Eat small amounts of healthy food rather than lots of junk. Don’t waste money on – (sweet drinks, chips, biscuits, cakes, bread, alcohol, cigarettes, packaged cereals, processed foods, tomato sauce) etc. IT’S CHOICES WE MAKE

    As a child we had limited funds – my mother knew how to make nutritious food without relying on processed rubbish.

    Fruit, vegetables, small amount of meat & fish, water & milk, eggs, butter/olive oil, rice/flour, nuts/beans, cheese/cream, oatmeal.

    Amazing how many dishes you can make with those few ingredients.

    My mother came to Australia as a teenage immigrant – didn’t know the language – yet survived. In the home country there was little food, so she knew how to improvise, and choose well. Growing fruit & veg, keeping chickens for egg, all helped.

    I learned from this -and don’t waste good money of rubbish.

  • Renata

    I spent my childhood in Canberra and the environment was so different back then (I’m saying 20 years ago. It’s been that long since I left). There were so many environmental influences there that promoted wellness. There were bike paths to take us all around town, my primary (elementary) school offered healthy foods in their canteen (cafeteria, but more like a kitchen linked to their gym, very simple and run by volunteers, primarily mothers). We also were able to get sports equipment at recess and lunch and we students actually would sign up to be the ones running it. This was very empowering. As a fifth-grader, I was signing out sports equipment to other kids. One adult would be around to make sure things were run right. It was community-based and very low cost. Although there were competitive sports in schools, it was not customary to attend the games, so people played for fun, not fame. There are other things I can think of that promoted wellness in Australia. It was another way of life when I lived there. I often wonder if that was limited to the area I lived in, or if it was just the Aussie way. I often wonder what Americans could learn from this.

    Oh, and Olya’s mother was richer than she thought. She knew how to

  • Renata

    sorry, I inadvertently hit the send button…

    As I was saying…

    Olya’s mother was richer than she thought. She knew how to grow a garden and raise chickens too! Not only that, she had the space to do it. Unfortunately, our primary food supply originates far beyond our backyard and many people lack the knowledge to be any different.

  • Uh, Anton’s comment was dripping with sarcasm.

  • Renata

    Thanks Anna 🙂 Sincerely, If I could change one thing about myself, I would like to have a better sense of humor!

  • I’ll bet you do have a great sense of humor. You certainly have great insight! 🙂 But I know how it is – sometimes we are so seriously focused on an issue, plus *tone* and expression are so still hard to express online, even with emoticons, that we sometimes fail to interpret the message the way it was intended.

    Growing up in the US Northeast, sarcasm came naturally to me. Later, living in the US South for 10 years, I learned to tone it down a bit. Sarcasm just didn’t work well there. Out on the US Left Coast, the middle ground seems to work best with sarcasm.

    You mentioned growing up in Canberra. Isn’t that a rather new, “planned” city? That might account for the adoption of bike lanes and other community amenities. I didn’t make it to Canberra on my one trip to Australia a few years back, but I read nice things about it in Bill Bryson’s book. Davis, CA comes to mind as a US example of a city that is planned well. Of course in So Cal where I live now, it is all about the automobile … . Pedestrian trails are recreation only here, and rarely actually “go” anywhere.

  • Bryan

    I believe this article is interesting in that it targets specifically low-income individuals as being primarily obese, as opposed to the affluent individuals who have an abundance of money to spend on junk food. Just because a family doesn’t make an adequate amount of money, this doesn’t mean they restricted from buying fresh fruits and vegetables. True, some food items that are conducive to health are more expensive, but buying one or two healthy snacks is better than buying Costco’s industrial-sized red liquorish canisters. Obesity is more prevalent in individuals who lack the self-discipline to break free from today’s predominantly sedentary lifestyle of just sitting around in front of a television, as opposed to actively engaging in sports and other forms of physical fitness.
    I believe that a healthy diet can be attributed to family values that are instilled in children at a very young age. I am currently a freshman college student at the University of Washington and I can already tell that many of my fellow students have completely neglected their health by devouring large quantities of fries, pizza, and various fried foods. If a child consumes tacos and tortilla chips in high school, then of course he/she is going to transfer those same qualities into college but on a grander level because mommy and daddy are not there to supervise them. Neighborhood communities and people that we hang out with are major contributors to our own lifestyle, but they do not solely guarantee obesity. In the end it comes down to the individual making the decision between that can of soda or bottle of milk in the drink aisle.

  • Hi – Have been doing a little research on obesity –

    It seems that obesity is a legitimate physical condition. There are biochemical reasons why their bodies want to be fat.

    Certain types of stress can trick your body into wanting to be fat, and activate a ‘Memory’ in your subconscious mind. They feel safer being fat than thin.

    Your body has complete control over how fast you burn fat. If it wants to be thinner it burns fat quickly and easily.

    This may sound ridiculous – that’s what I thought when I first read it. Then I did some research and found that ‘Negative Emotions’ and ‘Limiting Beliefs’ come into play here. We are programmed very early in the game of life, at such a deep level, that we are not even aware of it.

    Anytime your body decides for what ever reason that being fat or staying fat can in some way protect you or help keep you alive, it will activate this ‘Memory’.

    I work with my clients to remove ‘Negative Emotions’ and ‘Limiting Decisions’ with great success. My website can give you more information.

    Hope this has been helpful

    love olya

  • Weight Loss Stimulating Properties of Coconut Oil – a Direct Result of Thyroid Stimulation

    In the 1940’s farmers tried coconut oil to fatten their animals but discovered that it made them lean and active and increased their appetite.

    Whoops! Then they tried an anti-thyroid drug. It made the livestock fat with less food but was found to be a carcinogen (cancer causing drug). In the late 1940’s, it was found that the same anti-thyroid effect could be achieved by simply feeding animals soybeans and corn.

    Thyroid-Stimulating, Anti-Aging Effects of Coconut Oil

    Many researchers have reported that coconut oil lowers cholesterol (Blackburn et al 1988, Ahrens and colleagues, 1957). In 1981, Prior et al. showed that islanders with a diet high in coconut oil showed no harmful health effects. When these groups migrated to New Zealand and lowered their daily coconut oil intake, their total cholesterol and especially their LDL cholesterol – the so-called evil one – increased. The cholesterol-lowering properties of coconut oil are a direct result of its ability to stimulate thyroid function. In the presence of adequate thyroid hormone, cholesterol (specifically LDL-cholesterol) is converted by enzymatic processes to the vitally necessary anti-aging steroids, pregnenolone, progesterone and DHEA. These substances are required to help prevent heart disease, senility, obesity, cancer and other diseases associated with aging and chronic degenerative diseases.

    email me for more information –


  • Pingback: nother specialist who also reports attachment variations said the link between attachment anxiety and tension isn’t new, but the link to immune protection system function is newer. And it’s “not that surprising,” explained Jeni Bur()