Research published recently in the American Journal of Clinical Nutrition1 investigated the food intake of low income adults. Using data from the NHANES survey performed in the United States, the researchers analysed the associations between income levels and dietary intake and dietary quality. The results showed that few of the low-income adults investigated attained the recommended intake of whole grains, whole fruit, vegetables, fish, nuts, seeds or legumes. However, when the researchers analysed the fructose containing foods such as sweets, bakery desserts and sugar sweetened soft drinks they found their intakes were high. In addition, high intakes of nitrite and nitrate containing processed meats were also consumed. When the researchers looked at the overall quality of the participants diets, they found that between 13 and 22 % of all the adults surveyed did not meet any of the nutritional guidelines for healthy eating in the United States.
This study therefore confirms previous findings regarding the association between poverty and low quality nutritional intakes (here). This explains the association between low socioeconomic status and Western lifestyle diseases such as obesity, type 2 diabetes, cancer and cardiovascular disease. Interestingly, when the study authors investigated the subjects further to see if they were enrolled on the Supplemental Nutrition Assistance Programme (SNAP; the new name for the Food Stamp Programme), they found that those enrolled on the programme had a lower nutritional quality to their diet than those eligible for enrolment, but not currently in receipt of help. This supports other data showing an association between enrolment in SNAP and obesity in adult women. Other data has shown associations between SNAP and greater adiposity, dyslipidaemia (elevated triglycerides in combination with lower high density lipoprotein), elevated fasting glucose, and the metabolic syndrome.
It is not clear if the association between access to SNAP and increased risk of metabolic dysfunction is causal. However, the fact that similar income adults not in receipt of SNAP show no similar associations suggests that this may indeed be the case. Therefore government reliance may result in poorer health outcomes compared to independent living. The relationship between SNAP participation and metabolic dysfunction could be explained by previous research showing a greater intakes of meat, added sugar and fat, as well as lower intake of fish and vegetables, in those subjects in receipt of food stamps. Of particular concern is the finding that SNAP participants consume 60 % more sugar sweetened soft drinks compared to non-participants of equal social economic status. These reports support the growing consensus that Western lifestyle diseases are caused by poor quality nutrition and those most likely to suffer this affliction are the poorest in society.
Poverty is known to be associated with poor health and yet the nature of the association is not fully understood. Generally it is accepted that high quality nutrition can be accomplished on a low income (here). In fact, although the price of some food is cost prohibitive (here), whole grains, legumes, fruit and vegetables are cheap and readily available. In fact some of the poorest populations in the World have low rates of Western disease because of the simple, unprocessed and cheap food they consume. Therefore other reasons must explain the association between poverty and Western disease. Low quality housing in large estates with poor transport networks with mainly convenience food outlets may explain the association. In fact, the number of fast food restaurants in inner city areas suggests that selling low quality food to people of low socioeconomic status is big business.
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