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Food Deserts May Be a Myth

Food Deserts May Be a Myth

Typically, when it comes to discussions of low-income households vis-à-vis America's obesity problems, food deserts are the first to blame. The Daily Meal's most gluttonous cities list pointed out that the main problem with food deserts isn't how much food is available, but what types of food are available.

Turns out, however, that food deserts and their supposed effects on obesity may be a myth. The New York Times reports that two new studies refute these longstanding arguments.

Dr. Helen Lee, from the Public Policy Institute of California, found that low-income neighborhoods did have twice as many fast-food restaurants and convenience stores as wealthier neighborhoods, but they also had almost twice as many supermarkets or grocery stores.

Thus access to fresh food (or the presence of food deserts) isn't a problem in low-income neighborhoods, the study concludes, and "differential exposure to food outlets does not independently explain weight gain over time in this sample of elementary school-aged children," the study says in the journal Social Science and Medicine.

Furthermore, another study from Roland Sturm of the RAND Corporation finds that a food environment actually does not affect food consumption. Sturm and his researchers examined children and adolescents' diet in comparison to the density of fast-food restaurants, convenience stores, small food stores, grocery stores, and large supermarkets in the area.

The study, published in the American Journal of Preventative Medicine, concludes that there is no correlation between the types of food easily available, the types of diets the children ate, and the childrens' weight.

Of course, further studies will be needed to reinforce these conclusions, but Lee suggests that health advocates reconsider whether or not food deserts should be a large factor in the discussion of childhood obesity in America.


6 Cooking Myths It May Be Time To Let Go Of

Many of us have inherited these pieces of kitchen wisdom, but are they actually true?

As a child, one of the unbreakable rules was "no swimming for 30 minutes after eating." This was gospel, and not to be questioned. Turns out, there was actually nothing true about this "truism." But for many years, children sat around, unhappily, awaiting the end of the 30-minute purgatory.

I only bring this up because there are a few kitchen truisms that I thought we might investigate, just for fun.


Willpower Is a Weight-Loss Scam That's Fueling the Diet Industry

Ever noticed how the most popular diets, intermittent fasting and keto included, always talk about what you can&rsquot eat instead of what you should eat more of? The same negative words are used over and over again: "portion control," "cut out," "eat less," "eliminate," "detox," and "no." Most of us have tried multiple times to "cut out" certain foods &mdash only to flounder. Any weight loss is temporary, or worse, totally nonexistent.

The food and diet industry has the upper hand here. They decide what to restrict, but you get one special sliver of responsibility called willpower. As long as you have the strength to "cut out," "eat less," "eliminate," and "detox" . you can look like Gwyneth Paltrow, too!

But here's what the food and diet industry doesn't want you to know: The term "willpower" as it relates to the food you eat is a myth &mdash and it&rsquos one that sets you up for weight-loss failure.

Whole30, for example, advises cutting sugar, alcohol, grains, legumes, and dairy out of your diet for 30 days. Banning large swaths of food and beverage categories sounds so extreme, it has to work, right? No. There is zero scientific research to support these arbitrary restrictions. For example, beans, lentils, and whole grains are some of the most nutritious foods you can eat!

The super popular keto diet requires getting 10% or less of your total calories per day from carbohydrates, which means cutting out some of the foods with the highest amount of water and dietary fiber, like most fruits, root vegetables, and beans. It's an extreme technique designed to temporarily move the scale down a few pounds. Besides eliminating the joy associated with eating real food, you're very likely going to have to make exceptions for higher-carb foods when you have less control over your environment, like during holidays, vacations, or work functions. This is when willpower-associated language leaves you feeling completely and utterly crappy. You&rsquore "weak," "lazy," and left feeling as though weight loss and better health is impossible.

Willpower is a quick-fix solution that can occasionally get you past a hankering for brownies at 4 p.m., but diets that include restriction depend on a mythical idea of control that ignores basic human biology: The more we restrict, the more likely we are to fail. In fact, a 2017 review found that conventional commercial diets bear no relationship to long-term health and weight management. So why is that, exactly? So many factors play a role in what you&rsquore eating, why you&rsquore eating, and where you physically are when you&rsquore eating.

Yet, the more we focus on restricting what we eat as a means to achieve a goal, the less we wind up actually prioritizing our physical and mental health. Since one diet or another has told us that we need to rely on trusty willpower, we&rsquore primed to blame ourselves even though we&rsquove been set up to fail. This is what leads to a spiral into fear, isolation, and shame &mdash feelings that prime us for depression, anxiety, and weight-cycling.

Our lives are not made up of meal plans, diets, and calorie counting &mdash they&rsquore made up of experiences that provide enrichment and fulfillment in a multitude of ways. A more holistic approach to better health starts with the way we talk (and think) about food as it impacts our health.

If you&rsquore with me on this one, then let&rsquos take some of these triggers head on, and replace them with better language instead.

Repeat after me: There&rsquos no such thing as "willpower." Making more nutritious food choices does not mean having hard and fast rules about the types of foods you eat. Indulging sometimes is 100% a part of eating in a healthful way. While moderation is yet another trope (it&rsquos too subjective to define for everyone!) knowing how you feel before, during, and after eating can help guide your own standard. Think of foods that taste great (but don&rsquot always make you feel that great) as foods you eat sometimes &mdash not always and certainly not never.

Replace "rules" with choices. Being in the driver&rsquos seat when it comes to the food you consume is not some sort of test you have to ace &mdash this is your life! And you have to eat in order to live, am I right?! Remember that your state of health changes by making better, more nutritious food choices more often.

Instead of "good" and "bad," use breakfast, lunch, dinner, snacks, and dessert. Attributing value to the food you eat and ultimately, the way you feel is giving food way too much power. Judging yourself is, frankly, the last thing we need these days. Forget about "good" or "bad" foods, and lose the concept of "cheating" entirely. You eat meals that make up the course of your day &mdash no food in isolation can make or break your state of health.

Consider biology versus "I can&rsquot stop eating&hellip" Lack of willpower usually boils down to three major reasons that have absolutely nothing to do with a bag of potato chips or whatever else seems irresistible to you personally: you're dehydrated, you've skipped or shortchanged a meal, or you're not getting enough sleep. Address those first, and you're in better shape to take on the rest of the day.

Instead of "moderation," think about more. More is more when it comes to produce. Simply choosing more veggies at meals or snacks and more fruit whenever it&rsquos available puts you on the right track to better health.

Remember that you are responsible for upholding your priorities. When something seems irresistible, or when someone attempts to coerce you into doing something that doesn&rsquot feel beneficial to your physical or mental health, remind yourself that you have a choice. You have the option of absolutely eating that irresistible brownie and loving it. It&rsquos also your choice to say no to said brownies (food pushing can be a form of baseless condescension, too). Don&rsquot fall victim &mdash it&rsquos your choice when to enjoy the foods you love.

Ultimately, restriction has no place in our messy, hectic, everyday lives. Yes, you will overeat sometimes. Yes, you will eat sugar when you weren&rsquot planning to eat dessert. Yes, you will sometimes skip breakfast and wind up hoarding donuts in your desk drawer. So what? No one is immune to the realities of everyday life. One meal or day will not derail your state of health. Every time you eat is another chance to practice making choices that build self-confidence in the role you play in your personal health. Remember that, and you&rsquore on the right track.


Myth #3: Orange juice is a healthy breakfast staple.

Fact: "Breakfast without orange juice is like a day without sunshine,"ਊn old ad jingle went. For years, OJ was touted as the perfect breakfast beverage. Now, doctors say you&aposre better off eating an orange instead. That&aposs because fruit juice is loaded with sugar — one eight-ounce glass of orange juice hasꀣ grams of sugar (nearlyਆ teaspoons!) — more than twice that of a medium orange. Plus, you get all the fiber when you eat the whole fruit. Even 100 percent OJ is loaded with natural sugars, not added sugars. Of course, it is high in vitamin C and other important nutrients. So it&aposs not all bad — you just don&apost want to overdo it.

By the way, that crack-down on juice goes for kids, too. In 2017, theਊmerican Academy of Pediatrics tightened their guidelines, saying fruit juice should be off limits for children under one year, and older kids should have just a little.


Contents

By 1973, the term "desert" was ascribed to suburban areas lacking amenities important for community development. [9] A report by Cummins and Macintyre states that a resident of public housing in western Scotland supposedly coined the more specific phrase "food desert" in the early 1990s. [10] The phrase was first officially used in a 1995 document from a policy working group on the Low Income Project Team of the UK's Nutrition Task Force. [10]

Initial research was narrowed to the impact of retail migration from the urban center. [11] More recent studies explored the impact of food deserts in other geographic areas (e.g., rural and frontier) and among specific populations, such as minorities and the elderly. These studies address the relationships between the quality (access and availability) of retail food environments, the price of food, and obesity. Environmental factors can also contribute to people's eating behaviors. Research conducted with variations in methods draws a more complete perspective of "multilevel influences of the retail food environment on eating behaviors (and risk of obesity)." [11]

Researchers employ a variety of methods to assess food deserts including directories and census data, focus groups, food store assessments, food use inventories, geographic information system (GIS), interviews, questionnaires and surveys measuring consumers' food access perceptions. [12] Differences in the definition of a food desert vary according to the:

  • type of area, urban or rural [13]
  • economic barriers and affordability of accessing nutritious foods, including the cost of transportation, price of foods, and incomes of those in the area [10][12][14]
  • distance to the nearest supermarket or grocery store [15]
  • number of supermarkets in the given area [15]
  • type of foods offered, whether it be fresh or prepared [10][12]
  • nutritional values of the foods offered [16]

The multitude of definitions that vary by country has fueled controversy over the existence of food deserts. [12]

It should also be noted that because it is too costly to survey the types of foods and prices offered in every store, researchers use the availability of supermarkets and large grocery stores (including discount and super-center stores) as a proxy for the availability of affordable, nutritious food. [17]

Distance Edit

Distance-based measurements are used to measure food accessibility in order to identify food deserts.

The United States Department of Agriculture (USDA) Economic Research Service measures distance by dividing the country into multiple 0.5 km square grids. The distance from the geographic center of each grid to the nearest grocery store gauges food accessibility for the people living in that grid. [18] [19] Health Canada divides areas into buffer zones with people's homes, schools or workplaces as the center. The Euclidean distance, another method to measure distance, is the shortest distance between the two points of interest, which is measured for gaining food access data, despite the fact that it is a less effective distance metric than the Manhattan Distance. [18] [20]

Different factors are excluded or included that affect the scale of distance. The USDA maintains an online interactive mapping tool for the United States, the "Food Access Research Atlas," which applies four different measurement standards to identify areas of low food access based on distance from the nearest supermarket. [21]

The first standard uses the original USDA food desert mapping tool "Food Desert Locator" and defines food deserts as having at least 33% or 500 people of a census tract's population in an urban area living 1 mile (10 miles for rural area) from a large grocery store or supermarket. [18] [22]

The second and third standards adjust the scale of distance and factor income to define a food desert. In the U.S., a food desert consists of a low-income census tract residing at least 0.5 miles (0.80 km) in urban areas (10 miles (16 km) in rural areas) or 1 mile (1.6 km) away in urban areas (20 miles in rural areas) from a large grocery store. [21] The availability of other fresh food sources like community gardens and food banks are not included in mapping and can change the number of communities that should be classified as food deserts. [23] A 2014 geographical survey found that the average distance from a grocery store was 1.76 kilometers (1.09 miles) in Edmonton, but only 1.44 kilometers (0.89 miles) when farmers' markets and community gardens were included, making it 0.11 miles under the latter definition for an urban food desert. [24]

The fourth standard takes vehicular mobility into account. In the U.S., a food desert exists if 100 households or more with no vehicle access live at least 0.5 miles (0.80 km) from the nearest large grocery store. For populations with vehicle access, the standard changes to 500 households or more living at least 20 miles (32 km) away. [21] [25] Travel duration and mode may be other important factors. [26] As of 2011, public transport is not included in mapping tools. [23]

Fresh food availability Edit

A food retailer is typically considered to be a healthful food provider if it sells a variety of fresh food, including fruits and vegetables. Types of fresh food retailers include:

Food retailers like fast-food restaurants and convenience stores are not typically in this category as they usually offer a limited variety of foods that could constitute a healthy diet. [18] Frequently, even if there is produce sold at convenience stores it is of poor quality. [27] A "healthy" bodega, as defined by the New York City Department of Health and Mental Hygiene, stocks seven or more varieties of fresh fruits and vegetables and low-fat milk. [28]

Different countries have different dietary models and views on nutrition. These distinct national nutrition guides add to the controversy surrounding the definition of food deserts. Since a food desert is defined as an area with limited access to nutritious foods, a universal identification of them cannot be created without a global consensus on nutrition.

Income and food prices Edit

Other criteria include affordability and income level. According to the USDA, researchers should "consider . [the] prices of foods faced by individuals and areas" and how "prices affect the shopping and consumption behaviors of consumers." [29] One study maintains that estimates of how many people live in food deserts must include the cost of food in supermarkets that can be reached in relation to their income. [26]

For instance, in 2013, Whole Foods Market opened a store in the New Center area of Detroit, where one-third of the population lives below the poverty line. Whole Foods is known for its more expensive healthy and organic foods. In order to attract low income residents, the Detroit store offered lower prices compared to other Whole Foods stores. [30] If Whole Foods had not lowered the prices, residents would not be willing to shop there and that area of Detroit would still be considered a food desert.

The difference between a rural and an urban food desert is the population density of residents and their distance from the nearest supermarket. Twenty percent of rural areas in the U.S. are classified as food deserts. [31] There are small areas within each state in the U.S. that are classified as rural food deserts, but they occur most prominently in the Midwest [32] Within these counties, approximately 2.4 million individuals have low access to a large supermarket. [21] [33] This difference in distance translates into pronounced economic and transportation differences between the rural and urban areas. [34] [35] Rural food deserts are mostly the result of large supermarket stores that move into areas and create competition that is impossible for small businesses to keep up with. The competition causes many small grocers to go out of business. This makes the task of getting nutritious, whole ingredients much more difficult for citizens who live far away from large supermarket stores. [36]

In most cases, people who live in rural food deserts are more likely to lack a high school degree or GED, experience increased poverty rates, and have lower median family income. People who live in rural food deserts also tend to be older. This is due to an exodus of young people (ages 20–29) who were born in these areas and decided to leave once they are able. [32]

Based on the 2013 County Health Ratings data, residents who live in rural U.S. food deserts are more likely to have poorer health than those who live in urban food deserts. People who live in rural communities have significantly lower scores in the areas of health behavior, morbidity factors, clinical care, and the physical environment. Research attributes these discrepancies to a variety of factors including limitations in infrastructure, socioeconomic differences, insurance coverage deficiencies, and a higher rate of traffic fatalities and accidents. [37]

In a 2009 study, it was discovered that of the people polled, 64% did not have access to adequate daily amounts of vegetables, and 44.8% did not have access to adequate daily amounts of fruits. Comparatively, only 29.8% of those polled lacked access to adequate protein. This lack of access to fruits and vegetables often results in vitamin deficiencies. This eventually causes health problems for those who live within these areas. [32] When tasked with finding a solution to this problem, research has shown that it will take individual and community actions, as well as public policy improvements, to maintain and increase the capacity of rural grocery stores to provide nutritious, high quality, affordable foods while being profitable enough to stay in business. [32]

Although personal factors do impact eating behavior for rural people, it is the physical and social environments that place constraints on food access, even in civically engaged communities. Food access may be improved in communities where civic engagement is strong, and where local organizations join in providing solutions to help decrease barriers of food access. Some ways communities can do this is by increasing access to the normal and food safety net systems and by creating informal alternatives. Some informal, communal alternatives could be community food gardens and informal transportation networks. Further, existing federal programs could be boosted through greater volunteer involvement. [36]

A 2009 study of rural food deserts found key differences in overall health, access to food, and the social environment of rural residents compared to urban dwellers. [36] Rural residents report overall poorer health and more physical limitations, with 12% rating their health as fair or poor compared to 9% of urban residents. [36] They believed their current health conditions were shaped by their eating behaviors when the future chronic disease risk was affected by the history of dietary intake. [36] Moreover, the 57 recruited rural residents from Minnesota and Iowa in one study perceived that food quality and variety in their area were poor at times. [36] The researchers reached the conclusion that, for a community of people, while food choice which bound by family and household socioeconomic status remained as a personal challenge, social and physical environments played a significant role in stressing and shaping their dietary behaviors. [36]

Food deserts occur in poor urban areas when there is limited or no access to healthful, affordable food options. [38] Low income families are more likely to not have access to transportation so tend to be negatively affected by food deserts. [38] An influx of people moving into these urban areas has magnified the existing problems of food access. [39] While urban areas have been progressing in terms of certain opportunities, the poor continue to struggle. [39] As people move to these urban areas they have been forced to adopt new methods for cooking and acquiring food. [39] Adults in urban areas tend to be obese, but they have malnourished and underweight children. [39] For many people, the reason they cannot get nutritious food is because of a lack of supermarkets or grocery stores [26] When supermarkets are inaccessible it has been shown that vegetable and fruit consumption is lower. [38] When prices are high and there is a lack of financial assistance, many living in places with limited grocery stores find themselves in a situation where they are unable to get the food they need. [40] Another domain to food deserts is that they also tend to be found where poor minority communities reside. [40] Sometimes the issue with urban food deserts is not the lack of food in the area, but rather not enough nutritional knowledge about food. [41]

According to research conducted by Tulane University in 2009, 2.3 million Americans lived more than one mile away from a super market and did not own a car. [42] For those that live in these urban food deserts oftentimes they do not have access to culturally appropriate foods. [42] For many people, who have health restrictions and food allergies, the effects of food deserts are further compounded. [42] The time and cost it takes for people to go to the grocery store makes fast food more desirable. [42] There is also a price variance when it comes to small grocery stores that affect people in lower income areas from purchasing healthier food options. Smaller grocery stores can be more expensive than the larger chains. [42]

Oftentimes urban food deserts are applied to North America and Europe, however in recent years the term has been extended to Africa as well. It has taken time for researchers to understand Africa's urban food deserts because the conventional understanding of the term must be reevaluated to fit Africa's unconventional supermarkets. [42] There are three categories for food deserts: ability-related, assets-related, and attitude-related. [42] Ability-related food deserts are “anything that physically prevents access to food which a consumer otherwise has the financial resources to purchase and the mental desire to buy”. [42] An asset-related food desert involves the absence of financial assets, thus preventing consumption of desirable food that is otherwise available. [42] Lastly there are attitude-related food deserts any state of mind that prevents the consumer from accessing foods they can otherwise physically bring into their home and have the necessary assets to procure. [42] In Cape Town, South Africa supermarkets take up a large portion of retail space. [42] While supermarkets are expanding in poor neighborhoods in Cape Town, their food insecurity is growing at an alarming rate. [42] This is one of the biggest road blocks when understanding food deserts. Based on the European or American understanding of food deserts the fact that there is access to supermarkets by definition would mean that Cape Town does not suffer from food deserts. [42] Not only does Africa suffer from food deserts, but there is a direct link between climate change and the rapid growth of food deserts. [42] While supermarkets are expanding to areas that once did not have supermarkets there is still a disparity when it comes to physical access. [42] In the city of Cape Town asset-related urban food deserts are the main reason for the food insecurity, where people in this area are unable to afford the food that they would prefer to eat. [42]

Climate change plays an important role in urban food deserts because it directly affects accessibility. The main way that climate change affects food security and food deserts is that it reduces the production of food. [42] With limited availability of a product the price rises making it unavailable to those that cannot afford more expensive commodities. [42] In Cape Town specifically supermarkets rely directly on fresh produce from the nearby farm area. [42] Not only does climate change affect the production of food, but it can also damage capital assets that affect accessibility and utilization. [42] Specifically in Cape Town the access to food deserts does not change the severity of food deserts. [42] With limited diversity in their diets those that live in Cape Town are highly dependent on foods of low nutritional value and high calorific value. [42] Utilizing the European or American definition of food deserts does not take into account the dynamic market of other cultures and countries.

Crime plays an important role in food deserts. Where businesses cannot operate safely they tend to close, or relocate to more stable areas. Operating a business in a high crime area is more costly than doing so in a stable area, as security can be a significant cost. Periods of civil unrest can accelerate the flight of businesses in areas where the expectation of safe operation is low. [43] Following the 2020 riots, Chicago had more food deserts than before. [44] North American urban food deserts are the result of stores closing due to unprofitability, not due to companies refraining from entering a potential market area. [45]

The primary criterion for a food desert is its proximity to a healthy food market. When such a market is in reach for its residents, a food desert ceases to exist. But this does not mean that residents will now choose to eat healthy. A longitudinal study of food deserts in JAMA Internal Medicine shows that supermarket availability is generally unrelated to fruit and vegetable recommendations and overall diet quality. [ citation needed ]

The availability of unhealthy foods at supermarkets may affect this relationship because they tempt customers to purchase precooked foods which tend to contain more preservatives. Supermarkets may have such an adverse effect because they put independently owned grocery stores out of business. Independently owned grocery stores have the benefit of being made of the community so they can be more responsive to community needs. [42] Therefore, simply providing healthier food access, according to Janne Boone-Heinonen et al., cannot completely eliminate food deserts, this access must be paired with education. [46] [47]

In a 2018 article in Guernica, Karen Washington states that factors beyond physical access suggest the community should reexamine the word food desert itself. She believes "food apartheid" more accurately captures the circumstances surrounding access to affordable nutritious foods. Washington says, "When we say food apartheid the real conversation can begin." [48]

Access to food options is not the only barrier to healthier diets and improved health outcomes. Wrigley et al. collected data before and after a food desert intervention to explore factors affecting supermarket choice and perceptions regarding healthy diet in Leeds, United Kingdom. Pretests were administered prior to a new store opening and post-tests were delivered 2 years after the new store had opened. The results showed that nearly half of the food desert residents began shopping at the newly built store, however, only modest improvements in diet were recorded. [49]

A similar pilot study conducted by Cummins et al. focused on a community funded by the Pennsylvania Fresh Food Financing Initiative. They conducted follow up after a grocery store was built in a food desert to assess the impact. They found that "simply building new food retail stores may not be sufficient to promote behavior change related to diet." [49] Studies like these show that living close to a store stocked with fruits and vegetables does not make an impact on food choices. [49]

A separate survey also found that supermarket and grocery store availability did not generally correlate with diet quality and fresh food intake. [42] Pearson et al. further confirmed that physical access is not the sole determinant of fruit and vegetable consumption. [49]

Work and family Edit

People who have nonstandard work hours, including rotating or evening shifts may have difficulty shopping at stores that close earlier and instead opt to shop at fast food or convenience stores that are generally open later. [23] [49] Under welfare-to-work reforms enacted in 1996, a female adult recipient must log 20 hours a week of "work activity" to receive SNAP benefits. [50] If they live in a food desert and have family responsibilities, working as well may limit time to travel to obtain nutritious foods as well as prepare healthful meals and exercise. [50]

Safety and store appearance Edit

Additional factors may include how different stores welcome different groups of people [23] and nearness to liquor stores. [51] Residents in a 2010 Chicago survey complained that in-store issues like poor upkeep and customer service were also impediments. [51] Safety can also be an issue for those in high crime areas, especially if they have to walk carrying food and maybe also with a child or children. [51]

Fast food Edit

A possible factor affecting obesity and other "diet-related diseases" is the proximity of fast-food restaurants and convenience stores compared to "full-access" grocery stores. [18] Proximity to fast-food restaurants correlates with a higher BMI, while proximity to a grocery store correlates with a lower BMI, according to one study. [18]

A 2011 review used fifteen years of data from the Coronary Artery Risk Development in Young Adults (CARDIA) study to examine the fast-food consumption of more than 5,000 young American adults aged 18–30 years in different geographic environments. [42] The study found that fast-food consumption was directly related to the proximity of fast food restaurants among low-income participants. The research team concluded that "alternative policy options such as targeting specific foods or shifting food costs (subsidization or taxation)" may be complementary and necessary to promote healthy eating habits while increasing the access to large food stores in specific regions and limit the availability of fast-food restaurants and small food stores. [42] Some cities already restrict the location of fast-food and other food retailers that do not provide healthy food. [52]

Fast-food restaurants are disproportionately placed in low-income and minority neighborhoods and are often the closest and cheapest food options. [42] "People living in the poorest SES areas have 2.5 times the exposure to fast-food restaurants as those living in the wealthiest areas". [53] Multiple studies were also done in the US regarding racial/ethnic groups and the exposure to fast-food restaurants. One study in South Los Angeles, where there is a higher percentage of African Americans, found that there was less access to healthier stores and more access to fast food compared to West Los Angeles, which has a lower African American population. In another study in New Orleans, it was found that communities that were predominantly African American had 2.4 fast-food restaurants per square mile while predominantly white neighborhoods had 1.5 fast-food restaurants per square mile. [54] Researchers found that fast-food companies purposely target minority neighborhoods when conducting market research to open new fast-food restaurants. Existing segregation makes it easier for fast-food companies to identify these target neighborhoods. This practice increases the concentration of fast-food restaurants in minority neighborhoods. [55]

Behavior and social and cultural barriers Edit

The likelihood of being food insecure for Latinos is 22.4%, for African Americans 26.1% and for whites, 10.5%. [56] People who are food insecure often will find themselves having to cut back more at the end of the month when their finances or food stamps run out. Month to month, there are other special occasions that may warrant higher spending on food such as birthdays, holidays, or and unplanned events. [57] Because people who are food insecure are still fundamentally involved in society, so they are faced with the other stressors of life as well as the additional frustration or guilt that comes with not being able to feed themselves or their family. [57]

Other studies have documented a sense of loyalty towards the owners of neighborhood convenience stores as an explanation as to why residents may not change their shopping behaviors. [12]

Steven Cummins also proposed that food availability is not the problem: it is eating habits. [58] Pearson et al. urge food policy to focus on the social and cultural barriers to healthy eating. [59] For instance, New York City's public-private Healthy Bodegas Initiative has aimed to encourage bodegas to carry milk and fresh produce and residents to purchase and consume them. [60]

Pharmacies Edit

In addition to the close proximity of fast-food restaurants and convenience stores, many lower-income communities contain a higher prevalence of pharmacies when compared to medium or high-income communities. [61] These stores often contain a high number of snack foods, such as candy, sugary beverages, and salty snacks that are within arms reach of a cash register in 96% of pharmacies. [62] While pharmacies are important in these communities, they act as yet another convenience store, further exposing low-income residents to non-nutritional food.

Recommended Caloric Intake according to US Department of Agriculture (USDA) [63]
Age Group Gender Recommended Calories
Young Children Boy/Girl 1000-2000
Adolescent Boy/Girl1400-3200 (depending on physical activity)
Adult Female 1600-2400
Adult Male 2000-3200

Regardless of daily caloric intake, if a person does not eat foods that are rich in vitamins and nutrients they are susceptible to diseases related to malnutrition. These diseases include scurvy which results from low vitamin C levels, rickets from low vitamin D levels, and pellagra from insufficient nicotinic acid. [64] Nutrient imbalances can affect a person, especially a developing child in a multitude of ways. Studies show that malnutrition in children can cause problems with academic performance, attention span, and motivation. [65]

Since 2006, the United States has seen an increase in cases of obesity. [66] There are not accessible grocery stores in many food deserts, so people do not have the option of eating fresh produce. Instead, they have access to cheap, fast, and easy food which typically contains excess fats, sugars, and carbohydrates. Examples of such foods include chips, candy, and soda. Several diseases can result from consuming large amounts of these unhealthy food options, including cardiovascular disease, hypertension, diabetes, osteoporosis ,and even cancer. [67]

Fresh produce provides the body with nutrients that help it function effectively. Vegetables are good sources of fiber, potassium, folate, iron, manganese, choline, and vitamins A, C, K, E, B6 and many more. [63] Fruits are good sources of fiber, potassium, and vitamin C. The USDA recommends eating the whole fruit instead of fruit juice because juice itself has less fiber and added sugars. [63] Dairy products contain nutrients such as calcium, phosphorus, riboflavin, protein, and vitamins A, D and B-12. Protein, a good source of vitamin B and lasting energy, can be found in both plant and animal products. [63] The USDA also suggests to limit the percentage of daily calories for sugars (<10%), saturated fats (<10%) and sodium (<2300 mg). [63] Although small amounts of sugars, fats, and sodium are necessary for the body, they can lead to various diseases when consumed in large amounts.

Processed foods Edit

Even knowing the importance of nutrition, an additional barrier people may face is whether they even have the choice. Corner stores often only carry processed food, eliminating the choice of eating fresh. Processed food encompasses any type of food that has been modified from its original state whether from washing, cooking, or adding preservative or other additives. Because it is such a general category, processed foods can be broken down into four more specific groups: "unprocessed or minimally processed foods, processed culinary ingredients, processed foods (PFs), and ultra-processed foods and drinks (UPFDs)." [68]

The original motivation for processing foods was to preserve them so there would be less food waste and there would be enough food to feed the population. [66] By canning or drying fruits and vegetables to try and preserve them, some of the nutrients are lost and oftentimes sugar is added, making the product less healthy than when it was fresh. Similarly, with meats that are dried, there is salt added to help in preservation but results in the meat has a higher sodium content. [66] The ultra-processed foods were not made to be nutrient-rich, but rather to satisfy cravings with high amounts of salts or sugars, so they result in people eating more than they should of food that has no nutritional value. [68] Processed foods may also be made rich with nutrients that many people are lacking in their diets, making up for the lack of fresh food. [69] Some nutritionists may recommend eliminating processed foods from diets, while others see it as a way to reduce food scarcity and malnutrition. [66] In 1990 the Nutrition Labeling and Education Act required nutrition labels on food, making it so people could see what and how much of something they were consuming. With that labeling what some companies did was list things that were not added on the front, but rarely did they add information about nutrients they added. [66] Scientists and nutritionists are looking into ways to create affordably, processed food that is high in essential nutrients and vitamins that also taste good so the consumer is inclined to buy them. [66]

Alcohol Edit

Many areas that are food deserts have disproportionately high numbers of liquor stores. For example, East Oakland has 4 supermarkets and 40 liquor stores. [70] These communities are also often predominantly populated by ethnic minorities. Both Latinos and African Americans are predisposed to disease resulting from alcohol consumption. Some alcohol-related illnesses include stroke, hypertension, diabetes, colon and GI cancer, and obesity. Some studies show that moderating one's alcohol consumption can reduce one's chance of getting cardiovascular disease and even extend one's mental stability into old age. [67]

Self-care is an essential component in the management of chronic conditions and for those who are healthy. Self-care is greatly influenced by food choices and dietary intake. [67] Limited access to nutritious foods in food deserts can greatly impact one's ability to engage in healthy practices. Access, affordability, and health literacy are all social determinants of health, which are accentuated by living in a food desert. [12] There are two main health implications for those living in food deserts: overnutrition or undernutrition. [67] The community may be undernourished, due to no access to food stores. The community may be over-nourished due to a lack of affordable supermarkets with whole foods and a higher concentration of convenience stores and fast-food restaurants that offer prepackaged foods often high in sugar, fat, and salt. [67] Food-insecurity remains a problem for many low-income families, but the greatest challenge to living in a food desert is poor diet quality. Living in a food desert contributes to a higher prevalence of chronic diseases associated with being overweight. [67] Persons living in a food desert often face barriers to self-care, particularly in accessing resources needed to change their dietary habits.

Transportation and geography Edit

People tend to make food choices based on what is available in their neighborhood. In food deserts there is often a high density of fast-food restaurants and corner stores that offer prepared and processed foods. [5]

In rural areas, food security is a major issue. Food security can imply either a complete lack of food, which contributes to undernourishment, or a lack of nutritious food, which contributes to over-nourishment. [5]

According to the United States Department of Agriculture (USDA), [71] community food security "concerns the underlying social, economic, and institutional factors within a community that affect the quantity and quality of available food and its affordability or price relative to the sufficiency of financial resources available to acquire it." [72] Rural areas tend have higher food insecurity than urban areas. This insecurity occurs because food choices in rural areas are often restricted because transportation is needed to access a major supermarket or a food supply that offers a wide, healthy variety of foods, versus smaller convenience stores that do not offer as much produce. [72]

It is critical to look at car ownership in relation to the distance and number of stores in the area. Distance from shops influences the quality of food eaten. [5] A vehicle or access to public transportation is often needed to go to a grocery store. When neither a car nor public transportation is available, diets are rarely healthy. This is because fast food and convenience stores are easier to access and do not cost much money or time. Further, those who walk to food shops typically have poorer diets, which has been attributed to having to carry shopping bags home. [5]

Adherence Edit

Long-term adherence to a healthful, balanced diet is essential to promote the well-being of individuals and society. Many approaches to helping people eat a healthy, balanced diet are ineffective because of "adherence problems" with behavior changes. [73] Dietary adherence is influenced by habits that develop over a lifetime. [8]

It is especially difficult to "adhere" to a prescribed diet and lifestyle (ex. low-salt diet, low-fat diet, low-carbohydrate diet, low-sugar diet) when living in a food desert without enough access to items needed. When high-sugar, high-fat, and high-salt items are the only foods available to people living in a food desert, dietary adherence requires (a) shift in lifestyle/eating habits and (b) access to fresh, healthy, affordable foods. [8]

Decision-making Edit

Decision-making is an important component of self-care that is affected by food deserts. People employ both rational and naturalistic decision-making processes on a routine basis. Naturalistic decisions occur in situations where time is limited, stakes are high, needed information is missing, the situation is ambiguous and the decision-maker is uncertain. Rational decisions are more likely when people have time to weigh options and consider the consequences. [74]

The way individuals living in a food desert make decisions about healthy eating is influenced by a variety of factors. Communities with higher than state average poverty statistics often report low access to affordable food, thus limiting their ability to maintain a healthy diet. [15] For these families living in poverty, many people work multiple jobs with rotating or evening shifts that make it difficult to find time to shop for food. [7] [75] Time constraints affect decision-making and people often choose to go to a closer convenience store rather than travel farther for fresh food. [76] Families in urban food deserts may lack access to a car, which adds to the time needed to shop for groceries. [8] Additionally, convenience stores and corner stores are typically open later hours than traditional grocery stores, making them more accessible. [77]

Another factor that impacts those living in a food desert is safety. High rates of crime are a barrier for those living in food deserts. [78] If people feel unsafe traveling farther to a grocery store, they are more likely to decide to purchase less healthy options at a closer location. In this way, people prioritize their safety over fresh, healthy foods. [78]

Proximity to fast-food restaurants also influences decisions made when choosing meals. How close an individual is to a fast food restaurant is correlated to having a higher BMI, while proximity to a grocery store is associated with a lower BMI. [79] One study found that people living in the poorest areas of the country have more than twice the exposure to fast-food restaurants compared to people living in wealthy areas. [80] Another study used 15 years of data from the Coronary Artery Risk Development in Young Adults (CARDIA) study to examine the fast-food consumption of more than 5,000 young American adults aged 18–30 years in different geographic areas of the US. [46] Proximity to fast food or a supermarket/grocery store was used to predict the type of food consumed. [46] In low-income study participants, the type of food consumed was directly related to the proximity of fast food restaurants. [46] These results suggest that low-income persons living in a food desert make decisions to consume fast-food based on proximity to fast-food restaurants versus distances to a grocery store. [46]

Health literacy Edit

While access poses a major barrier to the practice of self-care in food deserts, health literacy remains a common barrier to nutritional behavioral choices. Health literacy and food deserts can affect all sectors of the population, but it is known that they both disproportionately affect underserved, low-income individuals. [81] Health literacy is the ability to obtain, read, understand, and use health information in order to make appropriate health decisions and follow instructions for treatment. [82] Health literacy affects the ability to perform self-care by influencing decision-making and relationships with health care professionals. Additionally, health literacy and self-efficacy can predict the likelihood of reading food labels, which predicts dietary choices. [83] A study of young adults in a metropolitan area found that those with low health literacy used food labels significantly less than a high health literacy group, suggesting that low health literacy may negatively influence dietary quality. [83] Overall, this data suggests that health literacy is a key factor in explaining differences in dietary habits, as healthy eating is associated with higher nutrition literacy skills. [84] [85]

When considering health literacy and dietary self-care behavior, a study of persons with heart failure found that those with low health knowledge had poor self-care behaviors. [86] This study reveals how health literacy influences one's ability to manage a health condition and make healthy choices. Gaining access to fresh and affordable food is essential to improving health and decreasing social disparities in those living in food deserts. Increasing health education and resources to improve health literacy are also vital for individuals to engage in healthy behaviors, adhere to dietary recommendations, and practice self-care.

All of the aforementioned limitations to nutritional foods have serious consequences for marginalized groups, as they are disproportionately represented in food deserts. Subsequently, dietary-related diseases continue to have a proportionately large impact in these communities. This can be seen in studies examining diabetes and lactose intolerance. 4.9 million non-Hispanic African Americans aged 20 years or older have diagnosed diabetes, according to the Centers for Disease Control (CDC) national survey data. In the United States, some degree of lactose indigestion occurs in an estimated 15% (6% to 19%) of Caucasians, 53% of Mexican Americans, 62% to 100% of Native Americans, 75-80% of African Americans, and 90% of Asian Americans. [87] Additionally, racial and ethnic minorities have a higher prevalence of diabetes as compared to whites, and have a higher rate of complication post-diabetes diagnosis. [88]


What are food deserts, and how do they impact health?

Food deserts are regions where people have limited access to healthful and affordable food. This may be due to having a low income or having to travel farther to find healthful food options.

Without access to healthful foods, people living in food deserts may be at higher risk of diet-related conditions, such as obesity, diabetes, and cardiovascular disease.

Several government bodies are now funding projects to prevent areas from becoming food deserts and to improve people’s access to food in existing food deserts.

Keep reading to learn more about food deserts and how they impact health.

Share on Pinterest Around 23.5 million people in the United States live in food deserts.

Food deserts are areas where people have limited access to a variety of healthful foods. This may be due to having a limited income or living far away from sources of healthful and affordable food.

The United States Department of Agriculture (USDA) define a food desert as an area that has either a poverty rate greater than or equal to 20% or a median family income not exceeding 80% of the median family income in urban areas, or 80% of the statewide median family income in nonurban areas.

In order to qualify as a food desert, an area must also meet certain other criteria. In urban areas, at least 500 people or 33% of the population must live more than 1 mile from the nearest large grocery store. In rural areas, at least 500 people or 33% of the population must live more than 10 miles from the nearest large grocery store.

The USDA identified around 6,500 food deserts between 2000 and 2006. Experts estimate that around 23.5 million people in the U.S. live in low income areas that are farther than 1 mile to the nearest large grocery store. Of these people, 11.5 million have low incomes.

Health inequities affect all of us differently. Visit our dedicated hub for an in-depth look at social disparities in health and what we can do to correct them.

A 2012 USDA report on food deserts suggests that regions with the following characteristics are more likely to become food deserts:

  • very large or very sparse populations
  • low income
  • high levels of unemployment
  • inadequate access to transportation
  • a low number of food retailers providing fresh produce at affordable prices

The report also notes that rural areas located in the West, Midwest, and South of the U.S. are much more likely to be food deserts than rural areas located in the Northeast. This may be because rural areas in the Northeast tend to be closer to urban areas containing grocery stores.

According to the report, rural areas with growing populations may have a lower risk of becoming food deserts.

Experts have not yet reached an agreement regarding the characteristics of the populations that live within food deserts.

According to the 2012 USDA report, some research suggests that neighborhoods consisting primarily of low income minority ethnic groups have limited access to supermarkets compared with wealthier, predominantly white neighborhoods.

The review also cites research suggesting that some low income neighborhoods have a greater number of grocery stores and live closer to these stores than wealthier people. In such cases, the issue may be the affordability of the foods rather than their proximity.

In rural areas, the most important predictor of food access is lack of transportation. This means that people who do not have their own bicycle or vehicle and lack access to public transportation are more likely to lack access to healthful foods.

Since researchers have not reached a consensus on the characteristics of the populations affected by food deserts, further investigations are necessary. Such investigations may help policymakers identify areas at risk of becoming food deserts so that they can implement better access to healthful foods.

Maintaining a healthful diet involves:

  • eating a variety of foods from all food groups
  • controlling calorie intake
  • limiting the intake of saturated and trans fatty acids, added sugars, and excess sodium

According to the 2015–2020 Dietary Guidelines for Americans , a healthful diet should include the following foods:

  • a variety of fruits and vegetables
  • whole grains
  • fat-free or low fat dairy -rich foods, including:
    • seafood
    • lean meats and poultry
    • legumes and seeds products

    People living in food deserts may have limited access to supermarkets and other food retailers offering healthful and affordable foods. Even when convenience stores and small grocers stock healthful foods, they are often too expensive for people with a low income to afford.

    People living in food deserts may therefore be more reliant on food retailers or fast food restaurants offering a more affordable but limited variety of foods.

    The lack of access to healthful foods and easy access to fast foods may be linked to poor diets that are high in sugar, sodium, and unhealthful fats. This can contribute to diet-related conditions such as high blood pressure and cardiovascular disease.

    Some of the health effects of living in a food desert include:

    • a higher incidence of obesity
    • increased prevalence of diabetes
    • other weight-related conditions, especially in children

    Many food deserts also provide limited or unaffordable healthcare services. This contributes to negative health outcomes for people living in these areas.

    People use a number of terms to describe a population’s access to food. The sections below outline some other examples.

    Food swamps

    A food swamp is a region that provides adequate access to healthful and affordable food, as well as an overabundance of less healthful food options.

    In Canadian urban areas, food swamps are more common than food deserts.

    Food mirages

    A food mirage describes an area where people live close to grocery stores offering a variety of healthful foods but cannot afford those foods.

    Because of this, people must travel farther to find healthful foods that are within budget.

    Food insecurity

    Food insecurity refers to limited or insecure access to food because of financial constraints. Families and people with low incomes may not have enough money to afford healthful foods.

    Policymakers are actively looking for solutions to improve access to healthful foods in food deserts throughout the US.

    The Community Food Projects Competitive Grant Program fund sustainable food projects that help low income communities gain access to nutritious and culturally acceptable diets.

    These projects also address broader economic, social, and environmental issues surrounding the food system. Some of the issues that the Community Food Projects aim to address include:

    • increasing the availability of healthful, locally sourced foods through:
      • affordable grocery stores
      • affordable markets
      • backyard and community gardens
      • food assistance programs
      • food buying clubs

      Food deserts are areas where people are unable to gain access to healthful foods. They are a major issue affecting millions of people in the U.S. and around the globe.

      Experts suggest that living in a food desert may put people at increased risk of obesity, diabetes, and other weight-related conditions.

      Community Food Projects are working to improve food systems in food deserts. Their overall aim is to help increase residents’ access to healthful foods.


      6 Answers to Gout Diet Myths

      The roots of diet myths about gout run deep. It was once known as the “disease of kings” because people associated it with the “rich” diet of the wealthy.

      The truth is much more complicated, of course. Up to 4 percent of American adults have gout, and our rising rates of obesity certainly increase our risk. But don’t believe everything you hear when it comes to diet advice and gout. Diet matters — but not always in the way you think.

      1. Should I avoid all “rich” foods?

      No. Patients often ask me about desserts, as well as entrees with rich sauces. It’s a common myth that these foods cause gout. When eaten in moderation, desserts and other rich foods do not affect gout flare-ups. But moderation is the key word. Rich foods may not cause flare-ups directly, but they can cause weight gain. And obesity is a major risk factor for gout attacks.

      “At some point, the misconception spread that people with gout should avoid dairy. But, in fact, certain dairy products — especially milk — can help you remove uric acid from your body.”

      Department of Rheumatologic and Immunologic Disease

      2. Is high fructose corn syrup a problem?

      Yes, absolutely. High-fructose corn syrup is a known factor for gout flare-ups because it raises uric acid levels in your body. It’s also used in far more pre-packaged and processed foods than you might think. When you’re grocery shopping, always check nutrition labels. If corn syrup is an ingredient in a product, don’t buy it.

      3. Do acidic foods lead to high uric acid?

      No. Acidic foods such as tomatoes, citrus and other fruits, beans and dairy products do not necessarily lead to higher uric acid levels. People often assume they do simply because of the word “acid,” but acidic foods and uric acid are not one and the same.

      4. Do I need to stop eating meat if I have gout?

      No, but practice moderation. Avoid organ meats such as liver because they have higher levels of purines, which can cause flare-ups. Moderate intake of lean meats such as chicken and turkey should not affect your condition. Seafood such as shrimp and lobster tends to be higher in purines, though, so don’t make it a regular part of your diet.

      5. Can I still eat dairy?

      Yes. At some point, the misconception spread that people with gout should avoid dairy. But, in fact, certain dairy products — especially milk — can help you remove uric acid from your body. In other words, dairy tends to help rather than hurt people with gout.

      6. Must I stop drinking alcohol?

      Yes, it’s a good idea to cut out alcohol. Alcohol molecules in your body tend to increase uric acid levels, so drinking can push you over the edge and into a flare-up. If you are newly diagnosed and start taking medication, try cutting out alcohol at first. Your doctor may allow you to add a small amount back into your diet over time as your uric acid levels come down. But even then, it’s best to avoid beer and liquor and stick to safer choices such as red wine.

      All myths aside, the best advice for people with gout is to eat fresh, unprocessed foods. Choose complex carbohydrates (from fruits, for example) over refined carbs from packaged or processed foods. And always drink plenty of water because dehydration is a risk factor for an acute attack.

      Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy


      Chocolate doesn't cause acne!

      My fellow chocolate-lovers may be happy to hear that chocolate doesn't exactly cause breakouts.

      A study concludes that the excessive consumption of chocolate isn't a cause for acne. In fact, it doesn't contribute at all! Acne can come from other causes, not necessarily just what you eat.

      To learn about other food myths that were (definitely not covered here), then take a look here.

      Whether you choose to heed these food myths' advice or not, just know that we're all here for a good time, not a long time.


      Celebrate May the 4th at Home with Star Wars Foods and Snacks

      If you want to know what Star Wars Day is, these May the 4th memes will give you an idea! My first inclination to celebrate Star Wars Day is to bake Star Wars desserts and treats. I&rsquove taken to a lot of baking lately. But I also love a good movie marathon and a binge, so you&rsquoll need some Star Wars snacks to keep up with all 9 Star Wars movies in the Skywalker Saga on Disney Plus.

      If you want to know how to watch them, then here&rsquos the Skywalker Order according to my friend, Amiyrah, or here&rsquos the complete Star Wars movie list with a PDF.

      However you want to celebrate May the 4th, a galactic holiday indeed, there&rsquos something for every Padawan. And the Baby Yoda deviled eggs? Come on, those are stinking adorable!


      Recipes you want to make. Cooking advice that works. Restaurant recommendations you trust.

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