your body is a wonderland

Poor, Obese Children Not Eating Enough

November 19th, 2008

A new study from the Journal of the American Dietetic Association reveals something interesting (and possibly counterintuitive to many people) about poor, obese children: they aren’t eating enough.

Children living in poverty are obese in part because they don’t eat enough to meet the daily nutritional requirements needed for cell function and metabolism, a study shows. A 9-year-old should consume 1,400 to 2,200 calories daily… But in the study of 1,400 children from poorer neighborhoods, 44 percent were consuming less than 1,400 calories, and 33 percent were obese.

“This study shows these kids were not eating enough,” Trevino said. “And when they did eat, it was all the wrong things.” Missing from the children’s diets were four key nutrients: calcium, magnesium, potassium and phosphorus. When magnesium — found in cooked spinach and other foods — is missing from the diet, it can predispose an individual to diabetes, Trevino said.

This reminds me of our nutritioatnist, who talked about adding nutrients like potassium into diets, rather than taking things out. This suggest that his approach is right, and that we should focus on making sure kids are getting the nutrients they need (and obviously getting physical activity) not on putting them on restrictive diets.

This study is a good reminder that people living in poverty should be given access to inexpensive foods that provide these key nutrients, both for themselves and for their kids. I think we can all get behind that, right?

Posted by mo pie

Filed under: Cold Hard Cash, Health, Kids, Science

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18 Responses to Poor, Obese Children Not Eating Enough

  1. Sarah, on November 19th, 2008 at 5:18 pm Said:

    So much recent research has focused on the connection between poverty and obesity. It’s particularly sad that there are so many children, whether they’re obese or not, who aren’t getting the nutrition that they need. There’s a new charitable organization started up in Toronto called the Healthy Food Bank, which collects money to give to food banks across North America with the stipulation that it be used to buy only nutritious food. All their expenses are covered by sponsors, so every cent donated is used to buy healthy food for people who cannot otherwise get it. http://healthyfoodbank.com/

  2. living400lbs, on November 19th, 2008 at 5:34 pm Said:

    Very interesting. Thanks for sharing!

  3. spacedcowgirl, on November 19th, 2008 at 7:53 pm Said:

    And cue the insistences that 9-year-olds can’t possibly need that much food and these kids must still be eating way too much in 5… 4… 3…

    (Not here, just in general)

    I am saddened but not surprised to see the results of this study. It always infuriates me when people are totally insensitive to the connection between poverty and obesity except in the sense of “poor people are obviously too stupid and lazy to know that fast food is bad for them.”

  4. Elizabeth, on November 19th, 2008 at 8:42 pm Said:

    What really gets me about this article is that there is incredible resistance to acknowledging that some people are naturally fat…if some children are consuming too few calories and are–gasp–still fat, it must be because of some nutrient deficiency. So the thin kids eating too little, what, they magically DON’T have this deficiency?

    Obviously, kids of all sizes need proper nutrition and it should be a priority that they get it. Why is this even presented as an “obesity” issue? Shouldn’t it be an “our kids are under-fed” issue?

    This really should also be another nail in the coffin of the “fat people are so damn greedy” argument. (And for that matter, it should make all those people on 1200 calorie a day diets reevaluated a little.) In all but the most extreme cases of starvation, people will have all kinds of different body sizes.

  5. Entangled, on November 19th, 2008 at 9:10 pm Said:

    I was going to insist that obviously it’s calories in/calories out, but spacedcowgirl beat me to it. Sarcasm foiled!

  6. lilacsigil, on November 19th, 2008 at 9:29 pm Said:

    Stressed bodies exhibit signs of stress! News at 10.

    Actually, I think it’s excellent that this kind of research is being done – I always wondered why we weren’t seeing reports of malnourishment in kids raised on junk food, fat, thin or in between.

  7. wellroundedtype2, on November 19th, 2008 at 9:42 pm Said:

    There’s a dietitian I know who works primarily with poor people who calls the people she works with, starving people in fat bodies.
    When I first heard it (before I met her in person) I took it as kind of a harsh statement. But once I got to know her better it was clear to me that she wasn’t criticizing their bodies but merely describing them.
    It seems like a contradiction, “starving people in fat bodies,” but only if you think that fat bodies are caused by getting more than one needs.
    Thanks for linking to this here.

  8. demimonde, on November 19th, 2008 at 11:42 pm Said:

    First, being poor and fat myself, this comes as no shocker to me at all.

    Second, on the whole “starving people in fat bodies” thing (which is brilliant!)… Isn’t there some theory that starvation actually makes your body produce more fat? In starvation mode, our body stores what calories it can in the only way it can: by turning food into fat. At least this is what I’ve heard. Absolutely no empirical data to back it up. Anybody know if this is true?

  9. Benjamin Teal, on November 20th, 2008 at 12:41 am Said:

    Ok, so I went out and read the article. The summary at KansasCity.com (linked above) is only taking from the abstract of the actual study.

    Before I comment on the article itself, I want to preface it by saying that I STRONGLY agree that some people are predisposed to being (or naturally, as Elizabeth put it above) overweight. Unfortunately, after reading the actual Journal Article, the data collected in this case does not support that notion as strongly as KansasCity.com would lead us to believe.

    The study, “Diabetes Risk, Low Fitness, and Energy Insufficiency Levels among Children from Poor Families,” goes much farther than just looking at macronutrient and caloric intake; it also looks extensively at fitness levels.

    The data showed that only 11.1% of the children had acceptable fitness levels.

    Fitness was measured using a “step test,” where basically the change in heart over baseline after stepping up and down onto a small stool for five minutes.

    There are a couple of interesting observations in the “Discussion” section of the article; I will paste a couple of quotes below (with my commentary in () after each quote):

    “There are several possibilities to explain the food insufficiency and obesity paradox. Individuals not having enough food at certain time periods may engage in binge eating or compromise the nutritional quality of their diets when food becomes available resulting in being overweight. Binge eating may promote fat accumulation due to the dramatic rise in postprandial lipid, glucose, and insulin levels. Following periods of fasting, the liver is primed to synthesize lipids and increase fat storage capacity.”

    (this goes directly to some of the comments above, about how binging followed by fasting often triggers a fat storage mechanism)

    “A second limitation was the use of children’s self assessment of dietary intake. Inaccurate reporting has been shown among populations from different age, sex, ethnicity, culture, education, social class, and nationality regardless if food records, dietary recalls, food frequency questionnaires, food weighed, and cafeteria menus were used. That study participants worldwide knowingly or subconsciously systematically misreport their dietary intake and that energy intake is consistently and significantly in opposite direction to BMI and body fat appears all too coincidental.”

    (the children in this study were asked to recall everything they ate the previous day, and previous studies of suggested, basically, the higher the BMI or BF%, then the more likely the person is to underestimate their food intake)

    “Could obesity in children be more closely related to low physical activity and low micronutrient intake than to excessive energy intake? Children in our study had low fitness levels and low calcium, magnesium, potassium, phosphorus, and folate dietary intake. The literature showing the relationship between inactivity and obesity is extensive…”

    (I think that based on the data in this study, we cannot rule out the possibility. The dietary recommendations are based on a normal (acceptable) level of physical fitness, and the data here suggests that the vast majority of the children studied did not meet that standard. The “calories out” side of the equation is at least as off kilter as the “calories in” side).

    So, that is the summary of the article. Hopefully it was helpful. It is just disappointing to me that KansasCity.com would put a certain spin on a scientific study without actually reading what the authors said. I would be interested to know what you all think…

  10. Pingback: Poor, Obese Children Not Eating Enough « The Middle Manager

  11. julie, on November 20th, 2008 at 1:26 am Said:

    Adding to what lilacsigil said, I think malnutrition encourages various ailments such as depression, ADD, hyperactivity, who knows. Food has to contain the things that make us run well, and if it doesn’t, we may not run so well.

  12. Rachel, on November 20th, 2008 at 10:28 am Said:

    These anti-obesity activists don’t seem to quite get it. To treat obesity, especially childhood obesity, you must first treat poverty. What they’re doing is the equivalent to treating a brain tumour with Advil.

  13. Jackie, on November 20th, 2008 at 10:37 am Said:

    Nutrioatnist cracked me up, seriously.

  14. Alyssa, on November 20th, 2008 at 11:52 am Said:

    Rachel puts it perfectly. We try to treat the symptom without looking for the cause, for so many things!
    And at the root of many of these issues is poverty. But we don’t do much about it. Why not give incentives to companies that set up shop in poor neighborhoods, providing jobs and services to people who need them?
    In downtown Los Angeles, there’s a place called Tent City. Hundreds of homeless people have set up makeshift tents there, just a few blocks away from the brand-new, state of the art, multi-million dollar Disney Hall. And just a few miles from the McMansions of Beverly Hills and Bel Air. But so many people just ignore this, and spend their money on $10,000 handbags and over-priced baby strollers.
    OK, End of rant.

  15. spacedcowgirl, on November 20th, 2008 at 9:41 pm Said:

    Benjamin, I don’t really see where any of those things change the reported thrust of the results that much. That binge eating hypothesis in particular sounds like total pie-in-the-sky speculation based on assumptions about fat people that are not really possible to confirm or refute based just on this study’s methodology.

    I’m sure inactivity is a factor here, but I also don’t know what the researchers consider normal/acceptable in terms of physical fitness, or whether that correlates to the activity level assumed by the recommended daily caloric intake for that age group back whenever it was developed. I’d have to know for sure that the kids weren’t meeting the fitness level originally conceived when the dietary guidelines were established in order to agree that this is necessarily significant. There are just too many assumptions out there about “kids are obviously way fatter than they used to be and are obviously eating too much crap and obviously not exercising enough, therefore we know the whole story before we even start.” I question all of those assumptions.

  16. Benjamin Teal, on November 20th, 2008 at 11:52 pm Said:

    Dang it, passion takes over when I write sometimes, so I apologize in advance for the long reply…

    @spacedcowgirl,

    I agree. And, as you said, “… therefore we know the whole story before we even start,” was really the point I was trying to make about how the research was presented at KansasCity.com. To me, they were suggesting a conclusion from the start.

    I am passionate about data, statistics, and research (I know, strange in my own right). For research such as this, where there seems to be a counterintuitive result, I like to put on the scuba gear and take a deeper dive.

    As I said earlier, I absolutely believe that there are people who cannot control their weight. I am definitely not one of those who believes everybody who eats less and exercises more will definitely lose weight, or that everyone should even strive for that goal. I don’t want you all to think that I am in that bucket.

    I was more trying to say that this research doesn’t necessarily support a hypothesis that there is another underlying cause of obesity in the group of children studied. Based on how the data are presented in the article, the I think the authors go out of their way to walk both sides of the fence and hedge their findings on both sides.

    They really did not take a stance at all other than to say that when these children did eat, they ate bad things.

    The authors simply, IMHO, did not go far enough to draw any concrete conclusion as to the cause of the obesity in this group of children.

    What could they have done better?

    The results of the study aren’t changed for sure. There are still 44 percent of the children studied consuming less than 1,400 calories (assuming accurate recollection on the children’s part, which I am willing to assume), and 33 percent were obese (no recollection needed, that is a fact).

    There is no evidence that any of the obese children were in the underfed group. The study simply does not say how many of the 33 percent obese were in the 44 percent underfed group; and it also does not state how many of the 89 percent below acceptable fitness levels were in THAT group.

    I was really hoping that was included in the main journal article. I think that information would have been the most interesting part and would have allowed us to start drawing some concrete conclusions.

    Unfortunately the authors did not show us how all of the descriptive stats overlapped.

    Your point about the physical fitness as it relates to calorie expenditure is a good one, and one I fundamentally agree with. The research could have gone further and attempted to measure daily caloric expenditure.

    However, the problem is with the way the research was spun (IMO) at KansasCity.com. That news piece seems to imply that the researches uncovered something unusual in that childhood obesity is not related to net calorie expenditure, the onus of proof shifts to the researcher, not the reader.

    It is like a study saying that gas powered cars absorb more carbon dioxide than it produces. It would be up to the researcher to prove that it is true, rather than the reader’s to prove that it is not.

    I apologize for the long post. Like I said, I am actually on the double yellow lines on this particular issue; I believe that people are individuals and should first strive to happy in their own bodies, no matter what that body looks like.

    Like I said, I am passionate about data and statistics are research, so I tend to get passionate about how the results are interpreted, That said, if I have overstepped my bounds in my way, I definitely apologize.

  17. Miriam Nadel, on November 21st, 2008 at 5:42 am Said:

    Re: the fitness question, it’s not like there are safe playgrounds for kids to run around on in poor neighborhoods.

    And I’m sure everybody knows about the grocery shopping problem – lack of stores carrying fresh vegetables, etc.

  18. spacedcowgirl, on November 24th, 2008 at 11:33 am Said:

    Fair enough, Benjamin. I especially see your point about how the researchers could have separated out the caloric intake of the kids in the different weight categories to provide additional information. I didn’t mean to jump on your comment and I think you have made some very good points. I always like it when stats people are in the house to keep researchers/reporters honest on this kind of stuff. :)

    From my point of view, and perhaps this is not ideal, but I was just thrilled to see an article “spin” results (if that is indeed what it did) in a way that is not vilifying to fat people. Reporting spins results on obesity all the time and 99.9999999% of the time it’s in the “fat people are ignorant evil pigs with no self-control and fat kids are disgusting lazy blobs” vein, so imperfect though it may be, it’s nice to see some reporting that acknowledges ambiguous results from a study of this kind.

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