Not Too Rich Or Too Thin

By Lisa Takeuchi Cullen

One of the first things that strike foreigners visiting the U.S. is that the rich tend to be skinny and the poor fat. Studies bear this out. The less money you have in America, the likelier you are to be overweight. One in 4 adults below the poverty level is obese, compared with 1 in 6 in households with an income of $67,000 or more. For minorities, poverty has an even heavier effect: obesity strikes 1 in 3 poor African Americans.

On the surface, this makes little sense. If the poor must struggle to buy groceries, how can they pack away enough to gain all that weight? The assumption used to be that the poor were making bad food and lifestyle choices--Krispy Kremes instead of crispy greens. But now researchers have begun to suspect that the blame lies elsewhere.

The cost of food--quality food--is perhaps the best place to start. Calorically speaking, the best bang for the buck tends to be packed with sugar, fat and refined grains (think cookies and candy bars). In general, processed foods hog ever larger portions of all Americans' diets--one reason we spend just a tenth of our incomes on food today, compared with a fifth in 1950. But a pound of lean steak costs a lot more than a pound of hot dogs. "The stomach is a dumb organ," says J. Larry Brown, director of the Center on Hunger and Poverty in Waltham, Mass. "It doesn't know anything about quality. It knows only when it's full."

Processed foods aren't just cheap, tasty and filling. They're also more accessible. One study found that 28% of Americans live in what nutritionists call "food deserts," places where big supermarkets are at least 10 miles, or a 20-min. drive, away. People who live in these places wind up buying much of their daily groceries from convenience stores or gas stations, where they can find Chef Boyardee but not baby carrots. Some communities are trying to remedy this. Philadelphia, for instance, recently announced a $100 million effort to open 10 supermarkets in urban neighborhoods. But for much of the country, says Troy Blanchard, a sociology professor at Mississippi State University who studies this issue, "you have people who are literally distanced out of healthy diets."

Children of the poor face especially steep odds in fighting obesity. The cash-strapped schools many of them attend are more likely than others to cut physical-education classes and strike franchise deals with snack-food and beverage makers. After school, working parents would rather their kids stay inside watching TV than play outside in unsafe streets. Those hours in front of the tube, meanwhile, feed them a diet of ads heavy on sugary cereals and greasy burgers. No wonder obese adolescents are twice as likely to come from low-income families.

Though the ballooning obesity problem among the poor is finally getting the attention of academics and the government, nobody has yet come up with an easy fix. "Our remedies are very middle class," says Adam Drewnowski, director of the Center for Public Health Nutrition at the University of Washington. "They tell you, Seek a healthy diet and exercise. Well, if you're working two jobs and living in a trailer, you're in no mood to get home and make a salad." In the end, fitness may have less to do with genetics than with tax brackets. --By Lisa Takeuchi Cullen