see references below:  My reading is that evidence is clear that adverse
circumstances are the precursors of obesity -- not the reverse. The costs
of calories arguments indeed may be an oversimplifiaction of the role that
food plays in determining personal identity and coping. The fundamental
debate about human agency versus structural determinants of health and
well-being!

Comments from others?

dr
--------------------------------

from: [log in to unmask]

Dennis, Interesting article. Clearly its better not to be poor and I
support
efforts to increase the wealth of poor Canadians.

However, I'm not sure if the cost per calories thesis is supported in
Canada.

Some rough calculations at today's prices in Nova Scotia
Potatoes = $1.99 for 4,185 calories; Potato chips= $2.50 for 2,576 calories
15 pounds of high quality potatoes      1 pound bag of chips


Bananas  = $4.00 for 2,096 calories  Chocolate bar=$4.00 for 1,800 calories
today bananas were 0.49/pound-superstore      14 oz. chocolate bar
superstore

Dry Raw Lentils = 1542 calories per pound cost between 0.99 and 1.99

Big Mac about 500 calories (I don't know exact figures or cost but believe
these are close estimates) and cost about $2.00?? If these figures are
close
to being correct than the price per calorie from a big mac is about 3 times
the price per calorie from eating lentils.

In these simple examples cost per calorie for healthier, unprocessed foods
seems less (as you would expect) than the cost per calorie for processed
foods.  The comparison of price per calorie for carrots and potato chips
seems
iinnapropriate to me-why didn't the authors compare price per calorie for
potatoes and potato chips?

Is is it possible that some people are poor because they are obese and
unhealthy and don't have the energy to be as productive as they otherwise
would have been? Is there a literature that members of this list know that
tries to further understand what seems to be a clear association between
ill
health and poverty? Does ill health contribute more to poverty or poverty
to
ill health? Are healthy people born in poor circumstances more likely to
leave
an improverished environment leaving the less healthy behind?

What is the role of public education-do grade schools and high schools
provide
adequate, accurate and convincing information about nutritional principles
and
excercise?

I've been unable to find information about minimal cost for an ideal and
acceptable adult diet. Perhaps one of the list members will know a
dietician
or study which has reflected on the cost in Canada of a proper, nutritious
diet.

Many nutritious foods are more affordable than processed foods.  In Nova
Scotia today Banana's were 49 cents/pound and a 14 oz. presidents choice
chocolate bar was $4.00 or 1800 calories for $4.00, bananas seem to provide
slightly more calories for the same price (262 x 8 = 2096 calories) and if
people buy smaller chocolate bars - which you would expect poorer people to
do
the price per calorie would go up further.

For potatoes today 15 lbs. of high quality potatoes cost $1.99 providing
4185
calories.  One pound of potato chips provides 2576 calories and in a large
bag
costs between $2.50 and $4.00.

Dennis and colleagues, I strongly support efforts to improve education and
income for poorer Canadians.  Our current system by which poor Canadians
suffer from a very high marginal tax rate (ie. dramatic reductions of
benefits
as people with social entitlements accept work)seems innapropriate.

Similarly, we could get better value for many of the public and private
dollars we spend on health care. Nova Scotian's spend $40,000,000 per year
on
antidepressants even though the literature (see "The Emperor's New Drugs,
and
"Listening for Prozac but Hearing Placebo) suggests these drugs are barely
better than placebo. At the same time poorer Canadians don't have access to
pubic gymnasia or swimming pools-valuable for excercise in some colder
parts
of Canada.

Best wishes
David Zitner

------------------------------------

[1] McIntyre L, Conner S, Warren J. Child Hunger in Canada: Results of the
1994 National Longitudinal Survey of Children and Youth. Canadian Medical
Association Journal 2000;163(8):961-965.
[2] McIntyre L, Officer S, Anderson B, Raine K, Glanville N, Dayle J. Food
insecurity of low-income lone mothers and their children in Atlantic
Canada. Canadian Journal of Public Health in process.
[3] McIntyre L, Raine K, Dayle J, Anderson B, Glanville N. Food
Provisioning Strategies of Food-Insecure Lone Mothers in Atlantic Canada.
In: World Congress of Public Health Associations; 2000; Beijing; 2000.
[4] McIntyre L, Raine K, Glanville N, Dayle J, Anderson B, Battaglia N.
Low-Income Lone Mothers Sacrifice their Essential Nutritional Needs to Feed
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[5] McIntyre L, Travers KD, Dayle J. Children's Feeding Programs in
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[6] Travers KD. The Social Organization of Nutritional Inequities. Social
Science & Medicine 1996;43(4):543-553.
[7] Travers KD. Using Qualitative Research to Understand the Sociocultural
Origins of Diabetes among Cape Breton Mi'kmaq. Chronic Diseases in Canada
(Health Can) 1995;166(4, Autumn).
[8] Travers KD. Reducing inequities through participatory research and
community empowerment. Health Education and Behaviour 1997;24(3):344-356.
[9] Travers KD, Paul A. The social organization of inequities in health:
Cape Breton Mi'Kmaq communities and diabetes. Ottawa: National Health
Research and Development Program (NHRDP); 1998.
[10] Raine-Travers K, Reutter L, Williamson D, Carlyle K. Training Peer
Interviewers to Assess Low-Income People's Perspectives on Health Services.
In: Qualitative Health Research Conference; 2000; Banff, AB; 2000.
[11] Hay D. School-Based Feeding Programs: A Good Choice for Children?
Victoria, Canada: Information Partnerships; 2000.

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