OLD GREENWICH, CT—Genomics researchers may be popping champagne corks over the recent discovery of genetic variants responsible for obesity. But among children living in poor inner-city neighborhoods, the risk of obesity is far more likely to be linked to diet and environment than genetics.
Researchers at the Department of Community and Preventive Medicine, Mount Sinai Medical School, New York, recently showed that proximity and prevalence of fast food restaurants and bodegas—neighborhood convenience stores selling cheap junk food—are strong predictors of obesity among inner-city children.
It is not too difficult to understand what’s driving the epidemic of obesity in poor Black and Hispanic communities in New York City and other urban centers. The sad reality is that a family in a neighborhood like New York’s East Harlem has far easier access to junk food than to fresh produce and other healthy food options.
Maida Galvez, MD, and her Mount Sinai colleagues surveyed the prevalence and proximity of bodegas and fast food joints in East Harlem—a low-income, largely Hispanic section of Manhattan. They found that bodegas selling little else but sodas, candy, and high-fat, sugar-laden, canned and packaged foods outnumber stores selling fresh fruit, vegetables and other healthy foods by almost 20 to 1. Fast food restaurants showed a similar though slightly lower prevalence ratio.
Bodegas proved to be an accurate predictor of both body weight and waist-to-hip ratio in the community’s children, reported Dr. Galvez, at the annual meeting of the Eastern Society for Pediatric Research.
The Mount Sinai researchers canvassed the neighborhood on foot, cataloging all food stores into one of 4 categories: supermarkets, grocery stores, convenience stores (bodegas) or specialty stores. They also took total body measurements from a cohort of 82 neighborhood children, between the ages of 6 and 8. They identified the presence of various types of food stores on the blocks where these kids lived, correlating this with the children’s weight.
Looking at East Harlem as a whole, they found 182 bodegas, but only 10 supermarkets and 9 grocery stores.
There was a measurable relationship between the number of bodegas in a child’s immediate vicinity, and the odds of that child being overweight/obese. Those with three or more bodegas on their block had a mean waist–hip ratio of 0.89. Those with no bodegas on their blocks had a mean ratio of 0.85. The data were adjusted for age, race and gender, and the difference was statistically significant.
Dr. Galvez and her team did gather some information on the prevalence of fast food in the childrens’ environment, though this was not formally part of their study. They found almost as many fast food places as there were bodegas.
Simply put, the vast majority of people—especially young children—are eating what’s closest at hand. In a neighborhood like East Harlem, that usually means junk food. Exhausted parents, struggling to get by and often working two jobs, are not likely to make the 10 or 12-block trek to supermarkets to buy fresh healthy food, which they then have to take home and cook. More often than not, they stop at the corner bodega or grab dinner for the kids at Mickey D’s.
Dr. Galvez’ findings have major implications for the future health of communities like East Harlem, and for public health initiatives aimed at preventing obesity, diabetes, and heart disease. It is easy for healthcare professionals to preach the virtues of healthy diets and lifestyle changes; it is far more difficult for families living in neighborhoods like East Harlem to actualize those changes.
Public health efforts need to address day-to-day realities faced by people in poor inner-city communities, and they need to take into account the profound impact of food industry marketing and distribution on the lifestyles of these families.
