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Access to fresh food grocers does not improve food choice

Dominika Osmolska Psy.D.'s picture

Community reformers and healthy-eating advocates have long decried the dearth of fresh food grocers in urban centers as one important reason these “food deserts” are ground zero for health problems such as obesity. Now a study published Monday in the Archives of Internal Medicine finds that people don’t necessarily eat fresh fruits and vegetables when they are available, turning the whole question upside down.

The study, which tracked thousands of people in several large cities for 15 years, found that it was income, and not availability, which was the strongest factor in food choice.

The results negate the idea that lack of access to fresh produce and other healthful foods is a major driver in the disproportionate rates of obesity among the poor, or that simply encouraging grocery chains to open in deprived areas will fix the problem, said study lead author Barry Popkin, director of the Nutrition Transition Program at the University of North Carolina in Chapel Hill.

Grocery food stores, it must be admitted, are brimming with unhealthy, processed food as much as, if not more than, the fresh, whole kind. To add insult to injury, the healthy options are often the more expensive. It is pretty much an invariable rule of thumb of grocery shopping: the least quality product tends to be the cheapest. Try comparing grass-fed, organic choice-cut meat with its commercial counterpart. The price difference will be no less than shocking.

Contrary to intuitive logic, the price of convenience or fast food is often cheaper than grocery store food, which must also be cooked. So pound for pound, and natural-resource expenditure, the fast meal at the fast food joint around the block gives you more bang for the buck.

The study looked at more than 5,000 African American and Caucasian men and women in Birmingham, Ala., Chicago, Minneapolis and Oakland between 1985 and 2001. The researchers assessed participants' diets over the years and tracked how far they lived from supermarkets and fast-food restaurants.

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The researchers found that living near fast-food restaurants was associated with a greater consumption of fast food, especially among low-income men. But the scientists also found that easy access to supermarkets was not linked to a greater consumption of healthful foods such as fruits and vegetables, low-fat dairy products, lean meats and whole grains.

Other studies corroborate the results of the current project. For example, in one, the introduction of a large supermarket did not increase fruit and vegetable consumption in a poor community in Scotland; in another, a 2011 survey of Latino immigrant women in New York City found no relationship between supermarket proximity and eating more fruits and vegetables.

Dr. Jonathan Fielding, director of the Los Angeles County Department of Public Health, says that the cheapest calories come from fried foods, chips and sodas, making them the obvious choices for individuals who must count every penny in their pocket.

Policymakers have been pushing for guidelines that limit the number of fast-food restaurants in low-income neighborhoods based on studies reporting lower obesity rates in communities with more supermarkets and fewer fast-food chains. But the picture may not be quite so straightforward. What policymakers have not been taking into consideration is that those people living in poverty may not be able to afford standard supermarkets food prices. Perhaps the supermarket industry knows this from market research of their own – which may explain why they don’t open their outlets in impoverished neighborhoods.

Another factor to consider is habit. Supermarkets in poverty-stricken areas will still make a better profit with unhealthy, processed food because it is the kind that people living within that population demographic may prefer. If they grow up with it since infancy, it is no wonder that it is what the palate prefers. Despite many healthy eating public education programs, changing these habits tends to be a slow, uphill battle. And processed food always comes attractively packaged, besides being convenient. Human nature being what it is, it likes convenience.

Individuals living in poverty may not grow up in a food culture in which food preparation skills have been passed down. And many may not have the leisure time to pick out choice food, then go home and cook it over a slow fire, so to speak. I doubt a single mother of two has the requisite time or resources to provide her family with a sumptuous meal at the end of the day. After working long hours, say, housekeeping at the local hotel, it’s all she can do to grab any convenient meal before tackling the commute, picking the kids up from daycare or school, and getting home for a few precious hours before she has to do her day’s hard work all over again tomorrow.

We forget that those traditional, whole-food diets of by-gone eras were prepared by clans of women whose essential duties revolved around the selection and cooking of food for the family.