The economics of food choice behavior: why poverty and obesity are linked.

Obesity in the United States does not affect all segments of the population equally. It is more prevalent in deprived neighborhoods and among groups with lower education and incomes. Inequitable access to healthy foods is one mechanism by which socioeconomic factors can influence food choice behaviors, overall diet quality, and bodyweight. Having a supermarket in the immediate neighborhood has been linked to better diets and to lower obesity rates. However, the affordability of healthy foods may have more of an impact on food patterns than does distance to the nearest store. Grains, added sugars, and added fats are inexpensive, good-tasting, and convenient. Their consumption has been linked to lower quality diets, lower diet costs, and lower socioeconomic status. By contrast, the recommended healthier diets not only cost more but were consumed by more affluent groups. New techniques of spatial analysis are a promising approach to mapping obesity rates and linking them with measures of socioeconomic status based on diverse social and economic aspects of the built environment. Low residential property values predicted bodyweights of women better than did either education or incomes. Shopping in low-cost supermarkets was another powerful predictor of bodyweight. Bodyweight gain may be best predicted not by any one nutrient, food or beverage but by low diet cost. Higher obesity rates in poor neighborhoods may be the toxic consequence of economic insecurity. Alleviating poverty may be the best, if not the only, way to stop the obesity epidemic.