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The Honolulu Advertiser
Posted on: Monday, May 17, 2004

Are you rich enough to be thin?

 •  Atkins, South Beach diets costly

By Nanci Hellmich
USA Today

Like millions of Americans, Christine Davies would like to lose a little weight. The 37-year-old paralegal from Tacoma, Wash., says she's 30 pounds heavier than she should be.

Jon Orque • The Honolulu Advertiser
And like millions of Americans, she has experimented with whatever is the diet du jour. But in each case, not for long. It wasn't just the discipline required. It was the price tag.

"I tried both the Atkins and South Beach diets, but pound for pound, protein is a lot more expensive than carbs," she says. "The South Beach diet recommends fish about three times a week. I'd have to eat canned tuna three times a week to afford it, and I get tired of eating the same foods.

"Plus, you have to cook everything yourself," she says. "Following it on a day-to-day schedule would be completely impossible because of the complexity of the recipes and the cost of the foods."

She'll get little argument from Phil Lempert, one of the nation's leading experts on food prices and grocery-store shopping. Using exclusive data from AC Nielsen and menus from the best-selling diet books, Lempert calculates that strict adherence to the low-carb, meat lovers' Atkins diet would cost about $100 a week (presuming you eat all meals at home). The salmon-rich South Beach diet priced out at almost $90 a week.

That's far more than the $35 that Davies spends at the grocery store each week to feed herself.

Is this your typical diet?

Menus from the popular South Beach and Atkins diets include ingredients that don't come cheap. Here's a sampling:

The South Beach diet
(one day's menu)

  • Fresh strawberries
  • Mediterranean chicken salad
  • Spinach-stuffed salmon fillet
  • Tossed salad with olive oil
  • Chocolate-dipped strawberries.

The Atkins diet
(45 grams of carbs a day plan, one day's menu)

  • Tomato stuffed with shrimp salad
  • Braised short ribs
  • Canadian bacon
  • Raspberries
  • Green salad with vinaigrette
And it's not just fad diets that can be costly. Some traditional weight-loss and good-nutrition diets recommended by major health groups emphasize lean meat, fish and a wide variety of fresh fruits and vegetables, all pretty pricey for Davies, who feeds a family of four, including two children, ages 10 and 4, and a stay-at-home husband, on a pasta-and-hot-dogs food budget.

To help ends meet on a $42,000-a-year salary ($26,000 after taxes and health insurance premiums), she shops at several stores to get the best food prices. But salmon is $4 to $7 a pound, compared with hot dogs for $1 a pound. She sticks to lower-priced fruits such as apples and bananas, rarely splurging on berries, grapes, peaches or plums.

Bottom line: Dieting is too expensive for Davies and millions of Americans like her. Nutrition experts are beginning to worry that America's war on obesity might be lost because, for many people, it costs too much — in time and in money.

"The rich can afford to be thin in America, and the poor can't," says Barry Popkin, a nutrition professor at the school of public health at the University of North Carolina-Chapel Hill.

"If you make a decent income and decide to lose some weight, you can eat grilled chicken, salads and fresh mango, and play a little tennis," says Adam Drewnowski, director of the Center for Public Health Nutrition at the University of Washington-Seattle. "But a person in a lower-paying job or working two or three jobs is in no position to do that.

"To suggest to the lower middle class or poor that they eat a diet filled with foods like red snapper, radicchio, fresh tomatoes, baby lamb chops, olive oil and merlot wine is blatant economic elitism."

Low income, high weight

Federal researchers are studying the relationship between lower incomes and higher percentages of overweight, but some government statistics already show that link:

About 60.5 percent of people who earn $15,000 to $75,000 are overweight or obese, compared with 56 percent of people who earn more than $75,000, according to the Centers for Disease Control and Prevention's 2002 Behavioral Risk Factor Surveillance System, a large state-based telephone system in which 250,000 participants report their own weight and height. (When adults are actually weighed and measured, about 65 percent of people overall weigh too much.)

The disparity is even more obvious when it comes to obesity (30 or more pounds overweight), according to the National Health Interview Survey from 1999 to 2001. For people below the poverty level, which was then defined as anyone with an annual household income of less than about $17,000, about 26 percent were obese, compared with 18 percent of those with incomes of $67,000 or more.

Drewnowski, who reviewed the latest research and published a review article on the subject in the January issue of American Journal of Clinical Nutrition, is not surprised.

"What's really cheap are foods made with refined flour, added sugar and corn syrup and added fat." People with limited income, he says, "buy foods that fill them up, and who's to blame them? They get the most calories for their money."

Indeed, calorie per calorie, chips are usually cheaper than fresh asparagus; bulk cookies are less expensive than raspberries. Sure, rice and beans are inexpensive, Drewnowski says. "But it's kind of patrician to say, 'The rich can eat a diet high in antioxidants with lots of vegetables and salmon, but for everyone else, rice and beans are good enough.'"

Beyond pricing, access also could be a problem for people who are not as well off. Numerous studies have found that grocery stores in lower-income areas offer far fewer healthful food options.

Lack of choices

Troy Blanchard, an assistant professor of sociology at Mississippi State University in Starkville, did an analysis that examined where large supermarkets and super-center stores are located in comparison with the U.S. population and found pockets of what he describes as "food deserts" — some in inner-city neighborhoods, but some in more generalized areas. He cites, for example, a large swath from North Dakota down through west Texas as having many major "food deserts."

People who live in these "deserts" typically need to drive or take a bus for a half-hour or more to get to a major store; otherwise they need to rely on small grocery stores, convenience markets and "hybrid gas stations" where they choose from a smaller selection of food items at higher prices, Blanchard says. The stores may have hot dogs, fried chicken, doughnuts, deli meats, frozen pizza, pork rinds, candy and some canned foods, but they don't have many — if any — fresh fruits and vegetables.

Most of the poor in America live in urban areas and have "crummy" grocery stores where they often pay more for poorer-quality food, Popkin says.

What's on the menu?

And that pretty much puts the nation's most popular diets out of reach. One day's menu on the South Beach diet, for example, includes fresh strawberries, Mediterranean chicken salad, spinach-stuffed salmon fillet, tossed salad with olive oil, and chocolate-dipped strawberries.

One day on the Atkins 45-grams-of-carbs-a-day plan includes tomato stuffed with shrimp salad, braised short ribs, Canadian bacon, raspberries and a green salad with vinaigrette. Hardly the kinds of items you'd find in a convenience market.

Even when the foods are available, Davies says cost continues to pose a hurdle for most people trying to win the battle of the bulge. And no new academic study or government statistics are likely to convince her otherwise.

"There's a perception that people spend their food budget on processed foods such as cans of Spaghettios and boxes of macaroni and cheese because they are too lazy to eat healthy. But I think people would eat a lot healthier if they could afford to purchase fresh foods."

Anthony DeBarros contributed to this story.