Fast Food is (Surprisingly) Not the Reason Diabetes is More Common in Poor Americans

Fast Food is (Surprisingly) Not the Reason Diabetes is More Common in Poor Americans

People are quick to blame fast food for the increased prevalence of lifestyle-related diseases amongst America’s poorest communities, but new research shows that we’re jumping to the wrong conclusions.

There’s no doubt that people in lower income brackets have a higher instance of lifestyle-related diseases. A 2010 Canadian study showed that people earning under $15,000 a year doubled their risk of contracting type-2 diabetes, and a 2009 study in Current Cardiology Reviews showed that the longer that a person lived in poverty, the more likely he or she was to contract heart disease, with an 82 percent increase in the risk for those who were disadvantaged as children.

But while people have been quick to point fingers at fast food for this problem – for instance, encouraging the city of Los Angeles to instate a ban on new fast food restaurants in low income neighborhoods in South L.A. in 2008 – it turns out that correlation does not prove causality in this case.

Mythbusting the Link Between Fast Food and Income

New research from Jay Zagorsky of Ohio State University and Patricia K. Smith of the University of Michigan proves beyond a shadow of a doubt that the common conviction that fast food is the reason for health problems amongst America’s poor is unfounded. Their research found not only that low-income and high-income adults consume almost the same amount of fast food, but that members of the middle class are more likely to indulge in a Big Mac and fries than the poorest Americans, albeit not by much.

Seventy-nine percent of 8,000 people reported eating fast food at least once during the three-week survey; 23 percent ate three or more fast food meals per week. When broken down by socio-economic status, the survey reflected that about 80 percent of those with the lowest 10 percent of income ate at least once at a fast food restaurant, compared to about 85 percent of those who were ranked near the middle and 75 percent in the richest 10 percent.

“Everyone eats fast food,” says Zagorsky. “The poor, the rich, the middle class. It’s not just poor people.”

The common misconception, he says, stems in large part from what L.A. was attempting to avoid with its legislation: the fact that fast food restaurants are far more likely to crop up in low-income neighborhoods.

“People associate fast food with poorer neighborhoods,” says Zagorsky, “and they sort of make the logical connection that since fast food came from poor neighborhoods, it must be poor people who eat fast food… except for me, who happens to be popping in here.”

Why Do People Turn to Fast Food?

Even though people know that fast food is unhealthy, they keep going back to it – even when they can afford something healthier. But the reasoning behind this trend doesn’t boil down to income, but rather time.

The study revealed that while socio-economic status doesn’t contribute to likelihood of chowing down on Burger King, the time crunch resulting from long hours at work and not much downtime does. Given the “fast” in its name, it’s perhaps no surprise that people who are short on time are more likely to opt for fast food, but Trudy Scott, Food Mood Expert and Certified Nutritionist, suggests that it’s more complicated than that. She says that it’s not just ease, but also comfort, that makes time-crunched individuals choose the drive through.

“When you work long hours, you have less time for leisure, no time to exercise or do yoga, and little time to get outdoors into nature,” she says. “This can lead to low serotonin and low GABA levels causing you to stress-eat carbs, self-soothe with comfort food, and self-medicate with fast-food.”

Low serotonin and low GABA (gamma-Aminobutyric acid – the neurotransmitter that reduces neuronal excitability) can make people anxious and stressed, something that they then instinctively try to fix by eating starchy, fatty foods, according to a 2016 study in the International Review of Neurobiology.

“Chronic stress can negatively affect hypothalamic-pituitary-adrenal axis functioning, thus influencing eating behavior and increasing desirability of highly palatable foods,” reads the study.

Long-term, however, serotonin and GABA are better raised by eating a whole food diet, exercising, and reducing stress through yoga or meditation, according to Scott, so by choosing fast food, people are renewing, rather than solving, the problem.

So Why Are Poorer People Getting Sicker?

This study unfortunately puts us back at square one when it comes to the reasons behind the higher instances of lifestyle-related diseases amongst America’s poorest.

Zagorsky doesn’t have the answer, but he does have a hypothesis linking lifestyle-related illness less with what poor Americans are eating but rather when they’re eating it.

“Poor people tend to get money at irregular intervals,” he says. With the SNAP program, for instance, people receive their income once a month. Because of this, Zagorsky notes, they tend to eat a lot of food at the beginning of the month, when they can afford it, “and then they sort of diet – not willingly” at the end of the month. This cycle of bingeing and starving is “not really good for maintaining a nice, stable weight,” according to Zagorsky.

Solving the Fast Food Problem

While the city of Los Angeles had its heart in the right place when it attempted to reduce fast food establishments in poorer neighborhoods, this isn’t the right way to go about solving the problem of lifestyle-related disease amongst America’s poorest – nor is it a great way to encourage middle- and upper-class Americans to steer clear of Happy Meals.

“If government wants to get involved in regulating nutrition and food choices,” said Zagorsky in a University news release, “It should be based on facts.”

The Conversation suggests that government intervention would be better put to use by making nutritious foods more readily available more easily, for example by reducing red tape required for food trucks or mobile soup kitchens serving real foods. Legislation to revitalize food deserts would also be helpful, bringing inexpensive healthy food options to neighborhoods where healthy food tends to be more expensive, and the introduction of free or inexpensive programs encouraging people to get outside and exercise could reduce instances of stress and anxiety, making people less likely to reach for fast food as a temporary solution to this problem.

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Emily Monaco

Emily Monaco is an American food and culture writer based in Paris. She loves uncovering the stories behind ingredients and exposing the face of our food system, so that consumers can make educated choices. Her work has been published in the Wall Street Journal, Vice Munchies, and Serious Eats.