The Faces of Poverty: Malnourished, Hungry and... Obese?

Washington, DC, August 1st, 2002 (PAHO) -- There is a saying in Spanish, "We have good taste, what we don't have is money." And although the popular perception is that poor people are thin and malnourished, studies show a growing trend toward obesity in low-income people.

"The poor do not eat what they want, nor what they know that they should eat, but what they can get," said Patricia Aguirre of Argentina's Ministry of Health and Social Action.

Malnutrition and obesity coexist in the same settings, according to the Pan American Health Organization's Dr. Manuel Peña, editor of the PAHO publication, "Obesity and Poverty: A New Public Health Challenge."

Dr. Peña and Jorge Bacallao recount a study in São Paulo, Brazil of 535 families (2,411 individuals) in a marginal urban population, where it was observed that 30 percent of the children had relative height deficit, while 5.8 percent of the males and 6.8 percent of the females were overweight. Furthermore, nine percent of the adult members of the families was obese. "Those findings demonstrate the coexistence of malnutrition and obesity in the same setting," concluded the study.

In metropolitan Buenos Aires, the main urban concentration in Argentina, Aguirre noted that prices of fruits and vegetables, lean meats and milk products tend to increase more than the average inflation. Thus, "the poor select food rich in carbohydrates, fats and sugars that satisfy their appetites but prevent them from enjoying adequate nutrition, but are integrated well into traditional consumption patterns" and communal cooking traditions, she said.

According to Aguirre, the food industry favors those consumption patterns by segmenting and mass-marketing products of poor quality and higher fat and sugar content to sectors with less purchasing power.

Peña and Bacallao similarly say that the food industry offers various foods rich in fats and sugars but deficient in other essential nutrients. "Their ability to satiate, their agreeable taste, and their low cost make these foods socially acceptable and they are the preferred foods among poorer groups."

Without a doubt, education and the promotion of healthy eating habits influence food consumption.

Inequalities in access to health promotion messages, to health education, and to adequate health services impede gaining knowledge of behavior changes necessary to achieve healthier lifestyles. These increase risk factors for chronic noncommunicable diseases associated with nutrition, such as heart diseases, diabetes, hypertension, some types of cancer, and osteoporosis, among others.

"One very widespread idea is that poor nutrition is the result of ignorance; that the poor put together their food baskets with bread and pasta because they are unaware of the characteristics of an adequate diet," says Aguirre. But studies indicate that "the food pattern is kept stable but the global drop in food consumption cannot be attributed only to a problem of education but also of access."

Obesity and excess weight have been historically underestimated in Latin America and the Caribbean, because they were perceived as remote problems more relevant to a socioeconomic context of abundance. They were also thought less significant that protein malnutrition and other deficiencies associated with poverty. But the current reality in countries of the region has shown that this was an erroneous conception.

That trend toward obesity "should not be interpreted as a external sign concomitant with the phenomenon of development", Dr. George Alleyne, Director of PAHO, said. "...It is deceitful to presume that in the countries of Latin America and the Caribbean obesity is the same harmful by-product of excess that characterizes the high-income societies."

"Furthermore, it is an error to think that the actions that some rich countries have taken to face the adverse effects of obesity and overweight can be copied or adapted. The problem is another one, essentially different and probably more serious in the poor countries," concluded Dr. Alleyne.

PAHO, which also serves as the Regional Office for the Americas of the World Health Organization, was established officially in 1902. The oldest health organization in the world, it works with all the countries of the Americas to improve the health and raise the living standards of their peoples.

Related Information:
PAHO BOOK:
Obesity and Poverty: A New Public Health Challenge