Food: Too Much and Too Little

Actual malnutrition among American children (weight more than two standard deviations below normal) is rare in the U.S. Most of the estimates that I found range around 1%. Still, there are roughly 45 million children under 12 in the U.S., so 1% amounts to almost half a million children. Malnutrition seems considerably more common among the elderly, although I had trouble finding reliable statistics. The best estimates seem to run around 5% for elderly adults living in the community, but much higher in residential care facilities.  The phrase “poster child” says something about our response to the plights of various groups — there’s a reason we don’t talk about “poster elders.”  But this is a significant and growing segment of the population with its own distinctive set of issues.

In any event, many more households suffer from food insecurity. A 2013 USDA survey found that “5.6 percent (6.8 million households) had very low food security—that is, they were food insecure to the extent that eating patterns of one or more household members were disrupted and their food intake reduced, at least some time during the year, because they could not afford enough food.” Again, adults seem primarily affected: there were only about 1% of households where ”food insecurity among children was so severe that caregivers reported that children were hungry, skipped a meal, or did not eat for a whole day because there was not enough money for food.”  Fuller statistics can be found here.

Obesity, as everyone knows, is a much more common problem in the United States. This CDC map shows its prevalence across the country:

Paradoxically, just as poverty is a risk factor for food insecurity, it is also a risk factor for obesity.

Apart from the fact that our food system doesn’t seem to be producing very good results, what other lessons can we draw from these facts? There are some very general lessons: averages are misleading, and society has done better at dealing with production-side issues than consumption-side problems. As to the first, the average American is neither obese nor malnourished. That’s very good but it doesn’t disprove the existence of serious nutrition problems. Similarly, average air quality may be less important than air quality in particular locations, which may be quite variable even in the same city. As to the second, consumption patterns seem difficult to change, whether the problem is overeating or overuse of energy.

As to food policy, it seems clear that multiple strategies are going to be needed to address undernutrition and obesity.  But the first step toward recovery is, as always, recognizing that you’ve got a problem.

malnutrition, obesity, public health