Everything You Know About Food Deserts Is Still Wrong

In her article about ostensibly wasted efforts to fix the “food desert” problem, Elizabeth Nolan Brown quoted a U.S. Department of Agriculture publication, which concluded that proximity to a supermarket doesn’t seem to affect food choices very much. The implication was, any attempt to persuade chains to locate branches in certain neighborhoods is pointless. But things are not always so simple.

As Childhood Obesity News readers will recall, closer examination of matters revealed another facet. Perhaps it is unfair to accuse store owners of plotting to take advantage of a transportationally-challenged captive audience. And yet, despite the presence of a nearby grocery store, the residents of a housing project in Portland found it sensible to periodically carpool to a more distant retail district.

Why? Because, even taking into account the price of gas and the loss of valuable time, groceries cost one-third less at the farther store. That is the difference between spending $60 or $90, or $200 versus $300.

The USDA magazine also concluded that “household and neighborhood resources, education, and taste preferences may be more important determinants of food choice than store proximity.” But education can be introduced at any point, through schools, community centers, not-for-profit organizations, well-intentioned media (as opposed to those with voracious appetites for advertising dollars) and other channels.

A pertinent study

A longitudinal study that gathered Body Mass Index information on 1,000 participants in Chile sought “to discern how BMI increase differs across group and across time.” The children’s stats were recorded at ages 5, 10, 15, and 21. The report read,

We hypothesized that home and family characteristics reflective of less supportive environments during childhood will be associated with higher adult BMI and faster BMI growth between ages 5 and 21 years… The four weight groups differed in acceleration of BMI increase starting at age 5, with bigger children getting bigger faster.

Conclusions: Home and family characteristics that reflect an absence of support for children’s development were associated with overweight/obesity in young adulthood and accelerated BMI growth. Findings identify several home and family characteristics that can serve as preventive or intervention targets.

Yes, yes, yes, early-life conditions are important, and parents are mainly responsible for those. But how is a less supportive environment defined and calculated?

Observer and maternal ratings assessed children’s home and family environments and parenting at 1 and 10 years… Accelerated BMI increase related to lower learning stimulation in the home at 1 year and less parental warmth and acceptance at child age 10.

So, a combination of supposedly impartial but possibly judgmental outsiders, plus a whole lot of self-reporting, a category of data that is less than reliable. The elements included “family stress, father absence, maternal depression, frequent child confinement (in playpen), an unclean home environment at 1 year, and low provision for active stimulation and few stimulating experiences at 10 years.” Who readily admits to any of those things, and how much can an observer possibly know about them?

Kids will be kids

Doubt and cynicism are easy attitudes to adopt when questions of cultural heritage are at stake. But many grownups take a sincere interest in doing their best for their offspring, and are even willing to consider abandoning long-cherished beliefs and practices around food. Once they have a chance to learn better, they feed their children consciously, and those kids develop different tastes. Problem — for at least a segment of the populace — solved.

Some parents look at the cost and availability of health care, and decide to go the prevention route, learning as much as possible about how to keep the young from getting sick in the first place. Kids at a certain age are quite willing to argue with the elders, over the virtue of innovation and the lameness of tradition.

Catch them at the right time, and their innate rebelliousness can turn them into staunch advocates for organic kale. Teenagers get into sports. Suddenly performance is everything, and they become self-righteous prigs about dietary purity. A lot of different factors can come into play.

Your responses and feedback are welcome!

Source: “Five Years and $500 Million Later, USDA Admits That ‘Food Deserts’ Don’t Matter,” Reason.com, 06/13/16
Source: “Home and Family Environment Related to Development of Obesity: A 21-Year Longitudinal Study,” LiebertPub.com, 04/01/19
Photo credit: Erin Costa on Visualhunt/CC BY

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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.

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