10/29/2014 01:20 EDT | Updated 12/29/2014 05:59 EST

Canadians Can Be Malnourished and Obese at the Same Time


There's more attention being paid to food insecurity. There should be. It's a blight on Canadian health policy, especially where kids are concerned. Here let's talk about the linkage between food insecurity, poverty and obesity: the "hunger-obesity paradox."

You don't have to be poor to be fat. (Fat, rather than obese, is the preferred term for some who are overweight; I use both). The percentage of men who are fat tends to be spread across the economic spectrum. For women, there is more concentration of obesity among those who are poor. Those with low incomes are much more likely to rely on government programs, including those that are focused on providing basic requirements for food and drink. Their children can be at heightened risk for many negative outcomes. The meeting of fundamental nutritional needs has come to be referred to as "food security," a term that emphasizes that people have to have not only enough calories but also sufficiently healthy ones in their diets.

A focus on obesity, on the one hand, and the need for and lack of food security for the poor, on the other, has led to the "hunger-obesity paradox": individuals can be both fat and ill-fed simultaneously. Or, as some term it: "the new malnutrition." Lack of food security and the hunger-obesity paradox are not exclusive to the poor. It's possible to be affluent, fat, and have a nutritiously challenged diet. It's also possible to be poor, thin, and to lack food security (not enough calories at all? Enough but not disposed to be fat for whatever reason?) But issues of weight, nutrition, and poverty can combine to produce particularly tough results. People with very low incomes can turn to cheap energy dense foods to fill up: too many calories; too little nutrition.

Our emphasis should be on good eating/drinking and physical activity, for everyone, with a de-emphasis on weight. We should aim for all individuals to be "food secure" regardless of their size. To the extent that food security can lead to permanent weight loss or prevents excessive weight gain so much the better. But the priority should be on achieving a nutritious, calorically adequate diet for as many people as possible. That goal is very hard to attain on a limited income, especially in terms of children.

And discussions of food security and the poor need to be linked to larger concerns about poverty and health status. Generally speaking, poorer individuals are poorer in terms of their health as well. Food insecurity and its consequences are but one aspect of being poor and its negative effects on a person's well-being.

As one U.S. commentator has eloquently and provocatively put it: "In an era of stagnant wages, dystopian politics and cultural anomie, eating indulgent, if unhealthful, food has become a last redoubt of enjoyment for Americans who don't feel they have much control in their lives." To obsess about obesity, especially the weight of low income people, is to pave over a more significant and sobering point: If we deal with income inequalities the population will be healthier.

Meanwhile church and other groups, such as the Christian Resource Centre in the renewed Regent Park in Toronto, struggle to provide nutritious meals and purchasing-cooking skills to as many poor people as possible. There are various proposals to systemically address these pressing issues including increasing the minimum wage, providing for a guaranteed income, and targeted subsidies for nutritious food for those in poverty. We need to take action. Poor Canadians, especially kids, deserve better.


Photo galleryTackling food security in our communities: We Scare Hunger See Gallery