Everything You Know Is Wrong — Again

Family Safety Day

In the realm of childhood obesity research, it seems like April Fool’s Day comes around pretty often. Time after time, a study seems to indicate some hopeful discovery, which turns out to be not an advance but a false alarm.

Most people seem to have assimilated the idea that a nutritious diet is more easily attained by children in the higher economic strata. But among its many other accomplishments, the EarlyBird Diabetes Study upset a few applecarts by refuting the social inequality element of childhood obesity.

The EarlyBird report said in so many words:

Social inequalities no longer a major factor in obesity. All children today are at risk, regardless of family income or postcode… Social inequality is not associated with physical inactivity. The assumption that children of lower socio-economic status suffer from their lack of structured opportunity for physical activity is not reflected in the evidence. Indeed, analysis suggests that poorer boys may be marginally more, rather than less, active than those who are wealthier.

Social inequality is not associated with metabolic risk. Our data do not support the assumption that obesity, metabolic disturbance and thus risk of type 2 diabetes are more prevalent among less affluent children. In today’s increasingly obesogenic environment, youngsters from all backgrounds appear to be vulnerable.

Their conclusion is that, rather than concentrating on kids from less privileged socio-economic groups, social service agency efforts need to cover the whole spectrum.

In related news, an American study found no compelling evidence for the Food Desert theory, which also concerns economic differences. The public has become used to the idea that in poor urban areas and in rural parts of the country it is very difficult to find food that is both healthful and affordable, because while there may be fast-food outlets and convenience stores, they suffer from a lack of full-range grocery stores where fresh produce can be purchased.

But the government considers these claims by advocates of policy change and the media to be “tentative.” As the report from the Centers for Disease Control and Prevention phrases it:

Hypotheses that link the food environment with obesity claim that proximity to fast-food outlets, convenience stores, or small grocery stores undermines diet quality, whereas proximity to supermarkets or full-range grocery stores enhances it by providing healthful products, mainly fruits and vegetables.

The problem of neighborhood food environments comes up often when policy is being made. When these matters are being considered, one difficulty is that definitions of “neighborhood” have not been consistent. The report says:

Few studies have examined the association between varying neighborhood sizes and dietary intake and weight status. The objective of this study was to examine the associations of number and type of neighborhood food environments with dietary intake and body mass index (BMI) measures by using definitions of ‘neighborhood’ based on various geographic sizes… Associations between food environment measures and obesity are not reliably replicated, and dietary behaviors are not consistent with these associations.

Last year, a Rand Corporation study came to basically the same conclusion. In The New York Times, Gina Kolata sums the evidence about inner cities:

Such neighborhoods not only have more fast food restaurants and convenience stores than more affluent ones, but more grocery stores, supermarkets and full-service restaurants, too. And there is no relationship between the type of food being sold in a neighborhood and obesity among its children and adolescents.

Expressing what seems to be the sentiment of a great many Americans, online commentator Jonathan Kirsten, in a note appended to a Washington Herald article, calls for individual responsibility and goes as far as to identify the Food Desert idea as a “conspiracy theory”:

I don’t see why you need a huge multidisciplinary research study to show the ‘food desert’ idea is a false fad. Going to a Food Max, which is a large supermarket in downtown Los Angeles, I would wait in line with other customers with shopping carts full of processed foods (frozen pizzas, frozen fried chicken, sodas) without a single fruit or vegetable. Of note, these processed foods are ridiculously expensive!

Your responses and feedback are welcome!

Source: “Key Findings from EarlyBird,” EarlyBirdDiabetes.org
Source: “Neighborhood Food Outlets, Diet, and Obesity Among California Adults, 2007 and 2009,” CDC.gov, 03/14/13
Source: “Studies Question the Pairing of Food Deserts and Obesity,” The New York Times, 04/18/12
Source: “Junk food science,” HeraldNet.com, 08/13/12
Image by USAG-Humpreys.

One Response

  1. Wow, those are some stunning reversals on common assumptions. What other factors might be at play? I think it’s still difficult to separate socio-economics from the equation because wealthier families do have access to more expensive (and usually healthier) fresh foods, but, interesting to see that higher incomes do not necessarily protect children from obesity as once believed.

Leave a Reply

Your email address will not be published. Required fields are marked *

FAQs and Media Requests: Click here…

Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources