Poverty, obesity, and malnutrition

Obesity and malnutrition
Photo by Anna Pelzer on Unsplash

The UK is in the middle of several epidemics.  One is Covid.  Another is obesity.  The third is malnutrition. Poverty, obesity, and malnutrition are also adding huge burdens to our already overstretched health services. And they are happening to all ages, genders and ethnicities. Sadly, only the infectious one is really hitting the headlines.  

Although obesity is getting some coverage, it is most often as something of a ‘blame game’ or an announcement of yet another ineffectual government initiative. And nobody is talking about malnutrition. When we hear the word ‘malnutrition’ most people visualise stick-thin children with protruding bellies.

The idea of extreme overweight being malnutrition is too unfamiliar to feel real. But malnutrition simply means too little or too much intake of energy and nutrients. It is a scale with starvation at one end and obesity at the other.  

Obesity in Kent 

In Kent, levels of overweight and obesity are slightly higher than the national average with 64% of adults and 25% of children classed as either overweight or obese. But this is not evenly spread across the county. Where there is a higher proportion of poverty (Gravesend, Dover, Swale) obesity is higher than the national average. More affluent areas (Sevenoaks, Tonbridge, Tunbridge Wells) have obesity levels below the national average.

Of course, not everyone living in an area of deprivation will be obese and not everyone living in an affluent area will be a healthy weight. However, there is growing recognition that obesity and poverty go hand in hand in our modern world. In poverty, food choices become far more limited. Sometimes those choices can come down to paying for food or paying for heating. At which point, healthy food choices simply do not get factored in.  

Healthy food costs three times more

A pack of doughnuts at a supermarket costs less than £1 while a pack of apples can cost nearly £2. In fact, a recent report found that healthy foods cost three times more than unhealthy foods. And if the choice is to pay for either food or heating, where does cooking fall?

The energy cost of cooking is significant and, here, choices also need to be made: 30 seconds in the microwave, or at least half an hour on a cooker top or oven?

Poverty and food banks in Kent 

Two decades ago, there were very few food banks in the UK.  Now there are more than 2,200 of them, and over 60 of these are in Kent.  In 2008 the Trussell Trust reported that they provided three-day emergency food parcels to 25,899 people in the UK. In 2021 that number had increased to more than 2.5 million. Some independent foodbanks that are not part of the Trussell Trust have reported that they fed more people in the first six months of 2020 than they fed during the whole of 2019.  

Despite having some of the wealthiest areas in England, outside of London, Kent also has some of the most deprived areas in the country, with deprivation rising in nine out of the 12 Kent local authorities in the last year.

Food bank use in Kent has increased significantly over the last few years, partially because of the roll out of Universal Credit, and partially as a result of the upheaval of Covid lockdowns and job losses. One Trussell Trust foodbank in Kent saw an increase of 200% between April 2020 and March 2021. 

No fresh food in food banks 

Most food banks cannot accept fresh food because it spoils too quickly and they do not have the facilities to store it safely. Although food banks do their best to provide healthy food options, and many have nutritional guidelines, a lot of the food donated by the public is classified as ultra-processed food.

Ultra-processed food is made in factories from ingredients which are created from other foods, things like high fructose corn syrup, hydrolysed protein and modified starch as well as chemically produced additives. None of these ingredients would be used in home cooking or eaten as stand-alone foods.  

Processed food 

Ultra-processed food is cheap. It is widely available; it has a long shelf life; and it often requires little in the way of cooking. It is sold in bright shiny packaging that makes it look attractive, and it is aggressively marketed. Most of it contains plenty of highly processed fat, salt and sugar, along with additives to make it taste good. It contains little or no vitamins, minerals, or omega-3 fats and consumption of ultra-processed food is absolutely linked with overweight and obesity.

To make matters worse, ultra-processed food does not even fill you up. It generally contains little or no fibre or protein, key components in foods which help us feel full because they put bulk into our stomach.

Ultra-processed food needs very little chewing because many of the ingredients are effectively pre-digested, and chewing is one of the things that triggers the chemical signals to our brain about feeling full. And the fat, sugar and salt it contains are potentially addictive.

Poverty is bad for your health

Government data shows that people with children who were reliant on food banks or had lower incomes, ate a lot more junk food and far fewer fruit and vegetables during the various lockdowns of the last 18 months. Currently, around a third of children and 12% of adults eat less than one portion of fruit and vegetables a day.

The government says we should be eating five-a-day, but for those who rely on food banks, or even those who buy their own food but are on limited budgets, this is impossible. The quality of the food provided by food banks depends largely on what donations they receive. And research shows that all too often those donations, whilst well meant, are not always the best from a nutritional perspective.  

We have known that poverty is bad for our health for over a century. We now know that poverty, obesity and poor diet all increase the risk of both getting Covid-19 and being really ill, or even dying. But the negative effect on the health of the nation from the nutritionally poor diet too many are eating will have an even longer lasting impact.

Poverty is one of the greatest threats to the development and health of children. Although poor nutrition impacts everyone, because children grow so quickly, even short periods of poor nutrition can affect their health and wellbeing for the whole of their lives.  

Supermarkets, food banks and nutrition 

Some supermarkets are partnering with food banks, providing donations of food and other goods. It would be extremely useful if supermarkets could coordinate with local food banks on nutrition guidelines so that they could signpost what is needed, perhaps with shelf stickers.

But, even more importantly, as a society as a whole we need greater awareness and understanding of the intimate connection between food and health.