Rich And Poor Kids Eat
Same Diet, Poor Get Fatter

By Brad Evenson
The National Post
Part Six Of A Six-Part Series

Children from poorer families tended to be most overweight, researchers say. But don't blame the parents because how they brought them up seemed to make no difference at all.
Liz Goodman is part of a growing group of researchers who believe growing up poor, or feeling poor, makes you fat.
"Over the past 20 years, economic and social inequalitites have been rising," says Dr. Goodman, an obesity researcher at Brandeis University in Waltham, Mass.
"And it's interesting that there's this burgeoning epidemic of obesity at the same time."
As another scientist puts it, "Poverty really does get under your skin."
In Canada, kids from poor families are twice as likely to be obese as rich kids. A study published in August in the International Journal of Obesity found 6.4% of children in the wealthiest quarter of the Canadian population were obese, compared with 12.8% of those in the poorest quarter. The heaviest children live in single-parent homes, with 46% either overweight or obese.
It's easy to blame obesity on poor diet and lack of exercise. But this is overly simplistic, like blaming high unemployment on the number of people watching afternoon television. It doesn't explain underlying causes.
Experts say the deeper roots of the obesity problem lie at the crossroads between social status and biology. Generally speaking, even if rich kids and poor kids eat exactly the same diet -- from Big Macs and fries to tofu and granola -- the poor kids get fatter.
"I believe that there's much more biology to this than what we've been willing to recognize in the past," says Dr. Goodman.
The centre of this poverty-obesity link is a hormonal pathway known as the HPA axis. This is a loop connecting the hypothalamus, a jellybean-size part of the brain that governs appetite, and the pituitary and adrenal glands, which secrete a variety of hormones, including the stress hormone cortisol.
Cortisol helps the liver convert fat into the lightning bursts of energy the body needs to escape danger, a vital function. But it also signals the body to accumulate mounds of fat in the abdomen, building the "apple" shape that is so hazardous to health.
"When you have too much cortisol, you have Cushing's disease, which is an illness that causes central fat deposition," says Dr. Goodman.
Once this fat builds up, it spews a toxic array of chemical signals back to the brain and into the body. "It's a vicious cycle," she says.
Research shows children raised in low socioeconomic settings produce greater amounts of cortisol, a stress hormone.
In a 2001 study, researchers from McGill University measured the hormone levels of 300 children from poor to wealthy families. They found three times as much cortisol in low-income kids compared with rich kids.
"The differences are especially big in elementary school," says lead researcher Sonia Lupien.
Not only does increased cortisol lead directly to a fat waistline, Dr. Lupien points out it can also trigger depression, which opens a surprising new chapter in obesity research.
The conventional thinking goes that kids who are fat get depressed about their plight. But in a 2002 study of 10,000 U.S. teens, published in the journal Pediatrics, Dr. Goodman and her colleagues discovered just the opposite.
"We looked at people who were overweight or obese at the beginning and whether or not that increased depressive symptoms over time. And it didn't," she says.
"But if you were depressed [but not overweight] at the beginning, you were more likely to become overweight. In fact, there was about a twofold increase in risk of becoming obese."
In other words, skinny depressed kids get fat, and fat depressed kids get even fatter, which explains why some doctors have successfully treated some obesity patients with the anti-depressant Prozac.
Poverty can lead to obesity in other ways than stress. Many low-income parents cannot afford to enroll their children in organized sports. They may also choose less healthy foods at the supermarket and use TV or video games as babysitters, says Mark Tremblay, senior scientific advisor for health measurement at Statistics Canada.
This is unfortunate, because kids with elevated cortisol need the most physical activity to lower it.
"The child from the poorer background with the altered hormone profile would benefit to a greater extent from exercise, because that's what exercise does," says Dr. Tremblay. "It helps get cortisol and other hormones under control. It blunts future stress responses to that. So the lower [socioeconomic status] child would have more to gain."
Dr. Tremblay does not believe poverty leads inevitably to a high body mass index -- it's not destiny, he says. Lack of exercise, too much TV and video games are more potent factors. But he agrees biology plays a big role in the obesity of the underclass.
"Clearly, it's at the cellular level that the calories are used up and the energy liberated," he says. "So the biology has a huge impact."
While many people blame mothers and fathers for the obesity of their children, research shows parenting styles -- strict, abusive, lax or indifferent -- make little difference. A Duke University study published this year in the journal Pediatrics tracked nearly 1,000 white North Carolina children aged nine to 16 for a period of eight years. Young boys -- but not girls -- seemed especially vulnerable to dual cases of depression with obesity. And researchers found kids from poorer families tended to be most overweight. But how their parents brought them up, strict or lenient, seemed to make no difference.
"My biggest surprise was that ... almost none of the [parenting styles] were significant in predicting obesity," says lead researcher Susan Mustillo, of Duke University Medical Center.
Anyone doubting the links between stress, poverty and fat need only look at Eastern Europe after the collapse of the Soviet Union.
After the reunification of Germany in 1990, the body mass indexes of East German children and young adults rose sharply compared with those in West Germany. German public health officials say class inequalities rose after reunification, leading to poverty and unemployment, which had powerful health effects.
An even more stark example of the connections between chronic stress, social dislocation, abnormalities of the HPA axis and cortisol secretion comes from a 1998 study done in Sweden and Lithuania. Researchers from Link°ping University compared 150 randomly sampled men, aged 50, from the cities of Vilnius and Link°ping, to assess their risks of heart disease. At the time, Lithuania was struggling to adjust to a Western style economy.
"Compared to Link°ping men, Vilnius men had unfavourable psychosocial coronary risk factors," said lead researcher Margareta Kristenson.
"They reported more job strain, more social isolation, less effective coping strategies, lower self-esteem, more depression and vital exhaustion."
Perhaps the most remarkable finding was the stress response. When the researchers subjected the Swedish men to a stress test, the subjects' cortisol levels jumped sharply. But the levels in the Lithuanians barely budged -- they were already high. While levels soon dropped to normal in the Swedes, they ebbed much more slowly in the Vilnius men.
"This attenuated stress response has earlier been shown in states of chronic stress," reported Dr. Kristenson.
Health researchers say Canada is starting to look more like Lithuania than Sweden these days. They blame the shift to conservative governments.
"In Ontario, the risk of diabetes is four times higher in low-income women than high income," says Dennis Raphael, an associate professor in the School of Health Policy and Management at York University in Toronto.
Diabetes mellitus, a common complication of obesity, is twice as common among middle-aged Canadians with household incomes less than $30,000 than those living in households with incomes of $60,000 or higher. And rates have increased sharply since the mid-1980s. By 2010, an estimated four million Canadians will have diabetes.
Dr. Raphael says the shift to more conservative governments around the world is a big factor.
"If you're serious about population health, and if you're serious about heart disease and diabetes, then you don't want to create the kind of policy environments we've been creating in Ontario and in Canada," he says.
"You don't want to increase housing insecurity, you don't want to increase income insecurity, you don't want to increase food insecurity, and you don't want to go out of your way to make life difficult for people."
Source: The National Post. Part six of a six-part series. For more information please contact <>
From Liz
Hi Jeff -
This is interesting...seems as though poverty effects more than heart disease.
There is some research suggesting that even when richer kids have the fat genes, they do not get as fat as the more impoverished children. So, I'm guessing it's a little of both, genes and environment. I'm not suggesting it's the parents, what I am saying, is that it's the child's perception of being poor that causes the psychological reaction, which in turn causes a physical reaction.
If you have ever talked to people with a weight problem, you will discover, that many of them have tried changing their diets and exercised themselves to death and they are still overweight.
Hmmm... My opinion on the whole matter is this, the human body reacts to mental states and environmental toxins in many different ways. Some folks get cancer, others heart disease, some get gout or arthritis and some people gain weight. With a growing body of evidence that suggests that it's not ALL in the diet, I think many people are going to have to change theri attitudes about overweight people. There is just to much evidence available fro a variety of sources. Too many results from studies carried out in the last 20 years to claim, it's all in the overeating!
Love:) Liz
From Dian Nicholson
Dear Jeff,
I'm a metaphysician... that is to say I am a person who assists people who suffer symptoms to identify the emotional issues behind physical symptoms.
The science mentioned in this article is lagging way behind those of us, like Louise Hay (You Can Heal Your Body - Hay House), who have long seen the connection... the very SPECIFIC connection... between the mindset and the body's health.
The issue of obesity has never been about diet. It has ALWAYS been an issue of self-protection, fear, and self-rejection. Specifically, "oversensitivity; often represents fear and shows a need for protection. Fear may be a cover for hidden anger and a resistance to forgive." Where the fat accumulates will tell me instantly exactly what fear the person is dealing with. How much and how long it has been there will tell me roughly when the problem started... as well as how little has been done about it.
Fat arms: Anger at being denied love
Fat belly: Anger at being denied nourishment
Fat hips: Lumps of stubborn anger at the parents
Fat Thighs: Packed childhood anger. Often rage at the father. ( And how many women complain of 'saddlebags'? )
You get the drift.
The research that is now showing the mind-body connection for what it truly is.... REAL.... is only now addressing the obvious facts that come out anytime statistics on any group with the same condition are gathered. For example, it is no surprise that married men live longer than single ones... married men are (although fewer and fewer couples know how to have good relationships) more likely to be nurtured, cared for, appreciated and loved.
Here's one example of the Louise Hay list of connections between mind and body:
Menopausal problems: "Fear of no longer being wanted; Fear of aging; Self-rejection; Not feeling good enough." Indications: The organs involved are located in the area of the second chakra, or energy vortex on the subatomic level of the body. The second chakra is totally involved with matters of putting into action those dreams, ambitions and desires we have. When the mind stops creating new things, the body just follows along on that line of thought....and this works because at the subatomic level, all energy is thought-responsive, and proven to be so!
And another:
Cancer: "Deep hurt; Longstanding resentment; deep secret or grief eating away at the self. Carrying hatreds." And the attitude, directly connected with that specific pain, of "what's the use, it'll never change"..
In dealing with patients who have healed and stayed clear, we find that they changed their minds along with the 'treatment' they received. In those who do not heal, we find that their mind is in lockstep with the original wound or grief.
Just as in the article you posted, where women felt supported, needed and loved, they recovered from their breast cancers much more fully and quickly than those who did not, who worsened and in many cases, died.
Louise Hay and Caroline Myss are two leaders in the field, which has been nicknamed
"Psychoneuroimmunology (PNI)" by researchers. What I have found in my practice of nearly 15 years is that in no case has their lists of conditions and their connected attitudes ever let me down in exposing a causative factor.
Exposing the issue is NOT the whole solution, however. One cannot affirm anything one does not completely believe, inside and out. Therefore one must examine the generation point of the emotions involved, and truly resolve those issues... and that is where my work hits the ground running.
I am most grateful to you for showing this cutting-edge information about what healing really consists of, because it leads folks like me, who do not have enough of a forum to teach what should be taught, to comment and share the truth about our health with those who wish to have it.
Thanks muchly, Jeff... please keep up the good work!
Dian Nicholson AMA




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