Hunger and obesity are same problem for the poor in U.S.

Scientific understanding is challenging the conventional wisdom about hunger — now framing it as a scourge that a±icts not only people who get too few calories, but also those who consume mostly sugar and refined starch. Under this new understanding, people eating the wrong kind of diet can suffer from both hunger and obesity.

A more scientifically accurate view of hunger and obesity couldn’t come at a better time. Obesity affects about 40 percent of the U.S. population, almost one in four Americans had trouble affording food in 2021, and the price of food has risen more than 11 percent since this time last year.

So nutrition experts rightly applauded the White House Conference on Hunger, Nutrition and Health because the discussion steered away from helping people get enough calories and instead focused on getting people enough real food. That’s also the focus behind a multibillion dollar initiative from the administration of President Joe Biden to end hunger in America by 2030.

The idea the kind of food matters more than the number of calories consumed started as a heretical minority view but has gradually become mainstream. The old thinking that all calories are alike and obesity was caused by lack of willpower couldn’t explain why poverty, food deserts and obesity have been concentrated in the same communities.

“That puzzled me for many years; how could it be that people who were hungry or didn’t seem to have enough money to buy enough food could be more overweight or obese than people who had lots of resources,” said Walter Willett, professor of epidemiology and nutrition at the Harvard School of Public Health.

Calories measure the amount of energy available from food, but the human body can’t be fueled up the way a car can. “We have learned a lot over the years. There are multiple lines that connect poverty, food insecurity and obesity,” Willet says. “One of the most important connections is just simply poor food quality.”

If this new scientific view is correct, it means hunger has actually contributed to the dramatic rise in obesity over the last 30 years — a 70 percent increase in adults, and an 85 percent rise in children.

Scientists still disagree over exactly what constitutes the best human diet — clashing over whether people should eat a higher proportion of fat or carbohydrates. But emerging from the fray is some agreement about the kind of diet that’s harmful to human health. Unfortunately, it includes the food that’s cheapest, most convenient, most available in poor areas, and most heavily marketed — foods and drinks that are high in sugar or corn syrup, and starchy foods such as white bread, chips and fries.

David Ludwig, an endocrinologist at Harvard School of Public Health and Boston Children’s Hospital, is lead author of a new paper that explains how hunger and obesity might be directly connected. It’s all based on the hormone insulin.

The paper, published in the European Journal of Clinical Nutrition, and including Willett as a co-author, details the way different forms of carbohydrates act in the body. When in the form of fruits, vegetables, beans or some whole grains, they are absorbed slowly because of the fibrous plant material surrounding the carbohydrates, but in white bread or sugary cereal or soda they’re absorbed fast and generate spikes of insulin. That insulin causes people to feel hungrier and put on weight.

If that idea is right, it calls for a very different solution to America’s hunger and obesity problems than the conventional view that people gain weight because they lack self-control and eat too much.

There can be a lot of variety in a healthy diet: Ludwig points out traditional cultures from the Inuit to Laplanders to Plains Indians ate diets high in animal fat during much of the year, while other cultures thrive on mostly plants. What nobody seems to thrive on is sugar, white flour, soda and fries. In his experience, people choose the wrong foods for economic reasons. “Many low-income families would love to have access to healthier whole foods.”

Humans are diverse in our shapes and sizes — we don’t all have to be skinny to be healthy, and some obese people may be suffering from hunger. Can a government initiative really end hunger by 2030 — just eight years from now? The Biden administration might need more help from Congress for such an ambitious goal, but any effort that starts with a science-based approach will help save and improve many lives.