the budget diet

A couple weeks ago the NYT featured this story about the realities of eating in American on a tight budget. It featured a California couple who spent a month eating on a dollar per day - $2 per day for their household. They blogged about their experience here. The already vegetarian couple lived on beans and grains. Fresh fruits and vegetables were pretty much out of their budget reach. He lost 13 pounds while she lost 5.

I was struck by how similar some of the issues faced by the couple are to those I see all around me in Port-au-Prince. In Haiti, 80% of households live on less than 2 dollars per day - about half live on less than $1. From my personal observations, food prices are really not so different from those in the USA. A small can of condensed milk (enough for 1 baby bottle if reconstituted) costs 20 gourdes - about 50 US cents. A single banana averages about 8-10 gourdes - 20 to 25 US cents. A packet of saltine crackers is about the cheapest option out there at 5 gourdes - 8 cents US. The photo above features the ingredients of labouyi bon bon sel - generally considered the cheapest and quickest porridge there is (quick cooking means cheap because you don't have to pay for as much charcoal for the cooking fire). With the milk - which some families can't afford, it costs 30 gourdes (75 cents) to prepare.

Multiply those food costs by 2-6 children and 1-3 adults and it is no wonder that the pictures and news coming out of Haiti are so sad. In the context of rising global food prices and in the wake of the hurricanes child malnutrition is on the rise. I know I've personally seen more and more cases of severe malnutrition among children of mothers at our clinic.

On the flip side, for most families living on a tight food budget in the USA, risk of obesity is actually the greater concern. The NYT article also featured findings a study of food prices in Seattle-area supermarkets conducted by the University of Washington which found that: “energy dense” junk foods, which pack the most calories and fewest nutrients per gram, were far less expensive than nutrient-rich, lower-calorie foods like fruits and vegetables. The prices of the most healthful foods surged 19.5 percent over the two-year study period, while the junk food prices dropped 1.8 percent."

The United States is not the only the only place where relative poverty is associated with growing risks of obesity. PRI's The World did an interesting series on obesity at the end of 2007 including this story from the Republic of South Africa.

In what has been coined "the nutrition transition" there has been a documented increase in nutrition-related chronic diseases such as obesity, diabetes and heart disease in many low and middle income countries at all income levels. Most telling of the complexity of this trend is the growing number of households where two forms of malnutrition co-exist - overnutrition (obesity) in mothers and undernutrition in children. Analysis of a 1989 national survey in Brazil showed that among malnourished children under 4 years old, almost 22% had an overweight or obese mother.