Discrimination and inequality leading factors in poor nutrition and obesity, flag experts

14 Jul 2023 --- Attention is being brought to racial discrimination and an uneven distribution of obesity levels for people of color as several recent studies have evidenced the link. Scientists and health organizations call for action to address the issue through nutritional education, children’s healthcare and social media strategies and closing the racial inequality gap.

A study by the New York University, published in Jama, used body mass index to measure obesity and a Perceived Discrimination scale to assess interpersonal racial discrimination and found that the children and adolescents that experienced racial discrimination had a positive association with being overweight.

“Socioeconomics, access to healthy food and food education are interconnected and indicative of a broader issue – structural racism. This refers to policies or the lack thereof that have resulted in limited access to nutritious food, inadequate education quality and a lack of food education,” Adolfo Cuevas, assistant professor of social and behavioral sciences at the NYU School of Global Public Health and the study’s lead author, tells Nutrition Insight.

“To effectively tackle racial discrimination, adopting a comprehensive approach that includes targeted policy interventions is crucial. These interventions should address issues such as segregation, housing discrimination and unequal employment opportunities, contributing to disparities in access and opportunities.

Cuevas further argues that exposure to racial discrimination must be acknowledged as a social determinant of obesity and a significant contributor to obesity disparities among children and adolescents.

Another study from the University of Boston, US, found that close to one-fourth of adolescents in the US suffered obesity between 2017 and 2020 with disproportionate percentages – 26% Hispanic, 25% Black and 17% White teenagers. 

Poor nutrition
Discrimination can contribute to an increased risk of obesity through poor nutrition, Cuevas stresses.

“As we mention in the paper, negative emotions induced by discrimination can lead individuals to consume sugary drinks as a coping mechanism. The food industry can take several steps to address this issue and promote healthier food options for all. They can enhance accessibility by expanding the availability of healthier food options in communities affected by racial discrimination.”

Discrimination can contribute to an increased risk of obesity through poor nutrition, Cuevas stresses.He further argues that the industry can also adopt responsible marketing practices by reducing the promotion of unhealthy foods and instead focusing on promoting healthier alternatives. 

“It’s important to acknowledge that these steps will not eliminate exposure to discrimination. However, by promoting healthier choices and creating a culture of health, the food industry can contribute to reducing the impact of discrimination on individuals’ health outcomes.”

The UK government has been on track to address the issue of marketing unhealthy foods through an advertising ban after 9 PM on television and a ban on “buy one get one free” for junk food items. Both bans were planned to come through this year, although both are postponed until 2025, which has caused critiques from various health groups.

Addressing racism
Cuevas says that one potential approach to address the impact of racism is by implementing screening protocols to identify patients who report experiencing racism and assessing their mental health conditions. 

“Pediatricians can also work with parents to identify strengths and protective factors. Collaboratively, for example, they can strengthen social networks and create a safe and supportive environment where children feel comfortable discussing their experiences with racial discrimination. This approach needs to be implemented simultaneously with school-based intervention.”

“For instance, integrating cultural education into school curricula can help children learn about their own cultural heritage, traditions and history, emphasizing the contributions and experiences of their racial or ethnic group. As such, it is crucial to educate and train teachers and administrators on culturally relevant and inclusive practices to eliminate racism within educational settings,” Cuevas says.

The American Heart Association has also warned that the looming summer break poses a threat to increased rates of child obesity especially among the Hispanic population.

“Factors contributing to excess weight in children include a high-calorie diet, sedentary lifestyle, biological factors and genetic conditions. But, Latino youth with obesity also may face sociocultural, environmental and behavioral influences that prevent them from keeping a healthy weight, said Sharon Taverno Ross, associate professor of health and human development and director of the Latino Family Health Laboratory at the University of Pittsburgh, US, School of Education.TikTok was the preferred platform to learn about health and weight management.

“They’re more likely to live in low-income neighborhoods, more likely to live in poverty” due to structural factors and systemic racism. Their neighborhoods may be less walkable and have less access to physical activity resources and safe community areas, such as parks and playgrounds,” Ross adds.

Social media
The study from Boston University School of Public Health (BUSPH), published in JMIR Pediatrics and Parenting, found a potential remedy to racial inequities in obesity through the social media platform TikTok. The results found that young people, especially those of color, are turning to the platform for advice on diets and fitness.

The authors argue that even though social media has a reputation for being harmful to mental health, platforms such as TikTok also hold the potential to promote health if health strategies are applied, as 80% of youth use the app.

“These findings highlight that future interventions must be culturally tailored and consider the unique needs and experiences of adolescents of color,” says study lead and corresponding author Dr. Monica Wang, associate professor of community health sciences at BUSPH and chair of the Narrative Office at Boston University Center for Antiracist Research.

Additionally, they found that TikTok was the preferred platform to learn about health and weight management while highlighting that the participants are aware of misinformation on the platform.

Recently, researchers from the University of Vermont, US, found that the most viewed content on TikTok relating to food, nutrition and weight perpetuates a “toxic diet culture” among teens and young adults. The authors stressed that “expert voices are largely missing from the conversation.”

By Beatrice Wihlander