I'm italian and I visited united states a couple of months ago. In my opinion the biggest problem is that you don't have decent food at affordable prices. Healthy food has nonsensical high prices and if you want something at a human price you don't have much choice except fast food. What a shame.

That's partly because much of the government subsides go towards subsidizing corn, ending up in high fructose corn syrup and all the junk food most people consume. It's quite sad, that everyone is so okay with this.

Personally, I try to eat as healthy as possible and use my nutrient finder (https://kale.world/c) to find high nutrient, low calorie foods, which end up being mostly beans, vegetables and fruits.

Wow - the rest of the thread aside, that's a fantastic nutrition tool.

edit: I just fed it one of the tasks I've found most frustrating - how to optimize protein:carbs ratio without resorting to meat. Most of the diet advice I've seen on that question is unhelpful, since it emphasizes for "enough protein" and not ratio. But this turned up exactly what I was after.

Agreed, the subsidized corn is also used as cheap feed for low quality meat. On the flip side fruits and vegetables receive the lowest subsidies. Plus the lower cost of unhealthy foods decreases demand for relatively more expensive healthy foods, lowering demand which drives prices up even higher. Tough to keep perishable foods when people don’t buy them as quickly. It’s a self reinforcing cycle to the bottom.

Did you make this kale.world? It's pretty nifty.

yes. Thank you.

I'm curious about this. I lived in a predominantly Latino (mostly Puerto Rican) neighborhood of Brooklyn for a while a couple of years back. The supermarkets were full of fresh, cheap food, yet the customers (who were consistently overweight and often obese, including the kids) were piling their shopping carts up with terrible stuff -- sugary cereals (Froot Loops etc.), sugary drinks (sodas, fruit juices, Caprisun, iced tea), white bread, snacks (cookies, doughnuts, potato chips), tons of frozen microwave meals, etc. I never saw a shopping cart filled with anything healthy and unprocessed. And I realized that I was actually being very picky walking through this place. I had to ignore 90% of the stuff they stock their shelves with because it's unhealthy.

Places like Whole Foods have the same problem, of course -- it's also full of sugary drinks and cookies, except they're labeled "organic" and made with "natural sugar cane" or agave, or they're things low/no fat yogurt (containing more sugar than the full fat ones). You can get fat on Whole Foods groceries if you're not super picky.

Definitely seems odd on its face, but if you dig into it, you'll see that it's SO much more complex than simple access. Other factors include, but are certainly not limited to:

Time to prepare: fresh foods generally take a lot longer, and a lot more effort to prepare than processed foods. When you've got each available parent working two jobs then this is a huge barrier.

Knowledge of preparation: especially in immigrant populations, not everybody has access to the ingredients they're used to.

Knowledge of nutrition: it's not like life comes with an instruction manual, and if you got little to no nutrition education, you probably don't realize the impact of those empty calories.

Fussy Kids: people who appeasing fussy kids (yeah yeah yeah... the hardos without kids will say you should just force them to eat it. Life isn't so straightforward.)

Waste: this is a huge factor. If you've got a tiny amount of cash and you need to spend it on things that will ensure you wont starve, something that will potentially go bad in a few days is a risky proposition, so you tend to stock up on heavily processed shelf stable items.

Price: Cheap is in the eye of the beholder. You can get a whole bag of chips for the same price as 2 apples. When you have a REALLY borderline income, your "cheap" is a lot different than someone else's.

There's plenty of other factors. Check out the research on it for more info. Really interesting stuff to dig into.

> Fussy Kids: people who appeasing fussy kids (yeah yeah yeah... the hardos without kids will say you should just force them to eat it. Life isn't so straightforward.)

My friends with children basically fall into two camps: one camp that agrees with you and blames their kids, and the other camp that just feeds their kids healthy food because, like your pet dog or cat, can't drive to the grocery store when it refuses to eat its croquetas.

Spending time with the families of my friends, the real issue seems to be with the adults either giving in to their children because they don't want to bother, feeding their children boxed food because they don't have the energy, or feeding their children bad food because they themselves don't eat much healthy food.

It hurts to watch you child starve because they are being picky. I had a teacher tell me she didn't want to eat peas one night, so her father sent her to bed hungry. She woke up a few hours later, went downstairs to her cold plate of peas still on the table, and ate the whole thing.

I had a classmate in high school who ONLY ate pancakes and fries. He was from a wealthy family and his mother had various supplements she would put in the pancakes to keep him healthy. We went on a week long canoe trip where you obviously can't eat pancakes and fries 24/7. 3 days in, this guy is starving, and for the first time in his life had pasta, trailmix, and eggs.

Children don't have fully developed faculties for reasoning, you can't take a reasonable approach to solving pickiness. Things seem to taste better the hungrier you get, so I think the approach to pickiness is to starve them out.

My dad made me sit at the table until I finished my milk and peas. After waiting two hours to spite him, I then had to drink warm milk and eat cold peas anyways. I learned pretty quickly that the manipulation didn't work on him.

I have no doubt that a lot of parents have that "my little angel" syndrome that keeps them from disciplining their children, but notice how that doesn't free them from the responsibility nor allow them to blame their kids.

I can appreciate that I was really fortunate to have parents that put in that sort of effort. My mom would also cut up vegetables like turnips for us after school that we would scarf down. They set me up for a healthy lifestyle as an adult that didn't take much effort on my part.

I know a lot of people didn't have those kinds of advantages, so they especially don't come naturally for them once faced with raising children and having to make those decisions themselves.

I wonder if it is a good approach to force children to finish their plates?

Seems like not. There are some studies [0][1][2] that show parental control over food intake may result in children's (mostly girls') obesity since it teaches children to ignore their satiety/hunger mechanism and thus overeat.

It may lead to the situation that once grown up, they could keep this habit of leaving the plate empty no matter how full they feel.

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2045650/

[1] https://www.ncbi.nlm.nih.gov/pubmed/11358344

[2] http://www.dailymail.co.uk/femail/article-2384361/Leading-nu...

It's really super easy to judge people from the outside, especially with parenting. None of these decisions are made in a vacuum, and especially in low-income immigrant populations, there are many factors at play. When you've got a double digit food budget in which you can't waste a penny, no spouse around to help, and 3 kids who all need help with their homework, then fighting a nightly battle over eating food that takes longer to prepare and you could barely afford to begin with is probably a lot less important.

Maybe the reason is that in a large part of the US, there isn't a strong home cooking culture. You can really tell the difference if you walk into a Daiso store (japanese dollar store). The variety of cooking-related gadgets and trinkets is mind boggling. In japan, they also do home economics (cooking) in school and culturally, ability to cook is often portrayed in media as one of the "checklist" qualities when looking at a romantic partner.

No instructions on the label of a pak choi, and no industry gain from suggesting recipes using it, since it would just be rice, cheap meats and/or other vegetables. Blue Apron and similar services might be superfluous for some, as well as expensive, but they at least inspire people to use more basic ingredients. I don't know where one starts to educate people in making "real" food. New/old school subject?

Way back when, there used to be home economics but that was really oriented toward the women who were clearly going to get married and cook for their husbands/families. As gender roles changed, home economics pretty much went away.

The funny thing is, Froot Loops has no more sugar per equivalent serving than most granola which people naively assume is more "healthy".

I compared them them [1] with a random granola product [2] available from Whole Foods. Percentages by weight:

                Total carbs  Sugar  Fiber  Protein
  Froot Loops           86%    34%    10%     6.8%
  Granola               72%    18%    14%    10.0%

Froot Loops definitely loses here. The granola has half the amount of sugar.

[1] http://smartlabel.kelloggs.com/Product/Index/00038000391187

[2] https://www.instacart.com/whole-foods/products/25454-kind-he...

Well it depends but most granola has more fibre than fruit loops which means it is healthier because it has a lower glycemic load. Even so—not a huge fan of sweetened granola.

I was in Bologna not too long ago and I was baffled by how fresh, high quality ingredients are available at affordable prices. I've seen similar quality ingredients in the Bay Area but they charge an arm and a leg for it. I don't know how the Italians do it or why we Americans have such a hard time doing something similar.

When we were in Italy even the freeway rest stops had excellent fresh food. Here you can't find anything even remotely edible on freeway stops.

Try switching from Whole Foods to your nearest Mexican grocer.

I remember 10+ years ago how the food at Charles de Gaulle Airport in Paris was better than most food in the US. It was kind of sad.

Why would "fresh" and "high quality" make you lose weight?

I can't think of too many food products that are making people fat that can be called fresh and high-quality.

Fruit and vegetables come to mind.

That's a good question. I think it has to do with a lot of food that are not calorie dense and more likely to satiate you simply taste better fresh and not so great past a certain age. On the flip side, foods that tends to taste good for a long time also tend to be calorie dense and some studies suggest aren't likely to trigger the signals for satiation.

Healthy food isn't expensive. You can buy chicken breast for $3 to $5 a pound. You can buy a head of lettuce for $2. Oatmeal is dirt cheap. Most vegetables are less than $3 a pound.

It may be true that these ingredients are available in certain markets for those prices, but that isn't accounting for a significant portion of the true overall cost of healthful eating.

Healthy food tends to spoil, and if you're not able to go shopping multiple times a week and have unpredictable availability for meal preparation, you're going to see a lot of spoilage. If 30% of your fresh produce ultimately spoils, your actual cost is 43% higher.

Healthy food requires a degree of planning and execution which takes time and focus. Finding healthy options which are appealing for 3x meals a day is a lot of work if you aren't happy with 1 or 2 standbys every day.

Healthy food is extremely hard to find on the go. If you don't have a kitchen at your disposal generally you are shit out of luck for finding something that is truly healthy. So for example, the quality of my diet is highly inversely correlated with the amount of travel I am doing in a given month.

Making unhealthy choices more expensive through taxes is extremely regressive for many of these reasons.

>Healthy food tends to spoil, and if you're not able to go shopping multiple times a week and have unpredictable availability for meal preparation, you're going to see a lot of spoilage. If 30% of your fresh produce ultimately spoils, your actual cost is 43% higher.

That's not at all true. I eat healthy, lots of vegetables, beans, lean meat,and so on, and I go shopping only once every two weeks. Apples keep for weeks, ditto cauliflower in the refrigerator, kale, cabbage, tomatoes, and so on. Meat you can freeze. Dry beans keep forever, and plus there is canned goods.Plus flavorings like salsa in a jar. I waste virtually nothing.

And it is cheaper than living off of processed foods, unless you are living off of pure starches like macaroni and cookies.

You do know have to know how to cook. Nothing fancy, just the basics like boiling beans, chopping vegetables, mixing together a bunch of things to get something that tastes reasonably good. And it does take time.

The issue, as you suggest, isn't so much that healthy food isn't available at a reasonable price but that turning it into meals may be challenging for someone working two jobs and lacking a proper kitchen. I don't think anyone can seriously dispute that. I just think it's mostly a mistake to lay the problem solely on prepared and fast food--which often isn't actually all that cheap.

As for travel, yeah. I started doing a lot more a number of years back and it took me a while to get more disciplined about it. I find it's more about regulating my intake than eating healthy per se. I try to avoid eating just because some food has been laid out for me. And I tend to keep things to one or two full meals a day.

Frozen vegetables aren't bad for you.

Definitely agree about finding healthy food on the go. Mostly salads.

you're suggesting that humanity has historically had easier access to healthy (fresh) food as they went shopping multiple times a week? I doubt this. What makes you think there was improved transportation options or significant amount of free time ?

Either they lived in a city with multiple food stands and stores within walking distance, or they lived on a farm and grew it themselves.

>> Most vegetables are less than $3 a pound.

And you call that cheap.... In my country most vegetables cost below 1$ per kilogram, which is 6 times cheaper. I think this has to do with EU policy of subsidies for farmers.

"most vegetables cost below 1$ per kilogram"

I haven't seen 0.80 EUR/kg in Germany for vegetables, so I wonder where you live. I've assumed vegetables are rather cheap in Germany due to very high competition. Lettuce is around $1.85 a piece, carrots are 1 EUR/kg or 1.50 EUR/kg when organic. Karfiol is 2 EUR/kg here.

The cheapest discounters (Aldi) are little bit cheaper.

Cheapest I've seen in a UK Lidl was a kilo of carrots discounted to 20p. I can't see how that could possibly pay for any of the supply chain but I'll take it.

Up here in Scotland I think we have a good illustration of how obesity can be a cultural problem, especially linked to alcohol. There's a reasonable amount of healthy food available but the traditional preference is all fat, starch and sugar.

I partially agree with you guys substaining that there were cheap healthy things, but for my experience they were exceptions. I could find very rarely vegetables at affordable price and at decent quality together. Or they were cheap, or they were decent. And a head of lettuce at 2$ is a high price. As exceptions examples, avocados were good and cheap.

>avocados were good and cheap

Maybe in California. Certainly not in the eastern US.

Canned vegetables are usually not very nutritious but a lot of frozen vegetables are pretty cheap year-round as well.

You're right, California, Nevada and Arizona, I visited the west coast.

I may be wrong, but I think OP is referring to buying it at a restaurant instead of at a grocery store.

No, that sounds about right. At the normal grocery store in my area, for example, cauliflower, broccoli, cabbage are $1.99/pound right now, celery is $1.49/pound. Asparagus is much more expensive, I think around $4.99/pound.

I cheat by shopping at the local Korean grocery store instead, prices are much cheaper but you have to sort through the produce to make sure quality is up to par.

If you're buying non-frozen leafy greens that have been sitting around before getting sold a great deal of nutritional content has degraded and you can definitely taste it.

Vegetables aren't subsidized the same way corn is.

That is around 2 times what i pay in germany

In the Midwest chicken is often $2 a pound. Vegetables vary a lot, but $3 a pound is about right for perishable stuff other than greens (which are more expensive). Carrots and onions and the like are way less than $3 a pound.

A little OT: The price for food in Germany are to my knowledge one of the lowest in the world compared to the average income.

This trend of food getting cheaper all the time has led to a real „industrialised“ agricultural sector in Germany. This effect is good for the consumer because an egg costs like 15 euro cents, but it is horrible for the environment and especially for the animals. You just can‘t produce so much cheap food without tremendous sacrifices.

Food prices here in Germany indeed are very low. In my experience this has another bad side effect. Many people expect food to be that cheap and don't even consider buying 'good' food for higher prices (even if they can afford it).

E.g. I buy ecological eggs (not the 'supermarket-ecological' ones) and they cost about 45 cents a piece. That's at least 3 times the usual price.

Vegetables have very few calories. Look at the cost per calorie: http://www.mymoneyblog.com/what-does-200-calories-cost-the-e...

Broccoli is $2.93 per 200 Calories. Doritos are 39 cents per 200 calories. That's the issue.

I don't think access to raw calories is the problem here, given that we're talking about people being _overweight_. Broccoli provides considerably more satiety per calorie than Doritos, to say nothing of the difference in healthfulness.

You could raise the price of Doritos to be higher than broccoli and overweight people will still choose the Doritos.

Source: Me

I would add that many Americans seem totally unaware that junk food is bad for them and for their kids. Even in well-educated families, I would see kids drinking soda and eating snacks all the time. As I understand it, it is also a political issue, food corporation have huge marketing power and any attempts of regulation draw big protests (free will / nanny state arguments).

My ex has a degree in biology, yet can't understand that feeding the kids box mac-and-cheese and pasta multiple times per week (because it is easy to prepare) is what's making them fat, not just the portion sizes. So yeah, what you describe is real. I'd take it one step further though - not only do most Americans not really understand the content of their food, but most can't cook. They have really no understanding of how to plan means, shop for meals, or prepare meals quickly. So then you throw in long working hours and commute times and they feel compelled to reach for food that is fundamentally unhealthy.

I would suspect most kids learned to cook because a parent was home doing all the cooking, and when they got home from school they would be expected to assist with meal prep.

With both parents working, less time to prepare meals, we are raising a generation who on average has a lot less first-hand experience with how to cook, and certainly how to cook healthy balanced meals.

Here's what's weird for me... my mom came from a traditional farm family - so she really knew how to cook. She was also a home economics teacher for many years, so she taught middle schoolers how to cook. While I remember vaguely being in the kitchen with her as a kid, I really don't remember her ever teaching me anything in particular. It certainly wasn't an every-day thing for me to help with meal prep. But, today I'm a really good cook and have done the majority of meal prep for my family (3 kids) both in and out of being in a two-adult household. I guess what I'm saying is -- I agree with you, but I also think that too many adults cop out on "I don't know how to cook!!!!" when it is actually not that hard to figure it out. Anyone can make a salad, throw some veggies in a wok, make some rice and beans, etc. The healthiest meals are in many cases the easiest to make, but somehow people think it is even easier to grab that frozen lasagna out of the freezer.

I watched a good youtube video that compared the 7/11-level food available in japan vs america and was convinced that this is one of the biggest issues.

What's the healthiest thing you can get in a 7/11 in the States? An apple? One of those shitty packaged sandwiches that has a slice of ham with a mysterious wad of splooge? A hotdog that's been turning on the spit all day?

Then you realize this is how it is every step of the way. It's a cultural problem. With a lot of the world trailing right behind.

You can blame everything on personal choice, and that might make you feel good, but that doesn't help us solve systemic issues.

I live in Mexico now which has some of the worst obesity issues as well due to their soft drink consumption. They just had a president that was the ex-president of Coca Cola.

> It was during the Fox's leadership of Coca-Cola Mexico that Coke became Mexico's top-selling soft drink, increasing Coca-Cola's sales by almost 50%.

But Mexico still has healthy enough food that's readily available. Getting a bag of chips from 7/11 has to compete with a just-as-cheap taco stand right outside. I find it easy to eat pretty healthy here for that reason. I love some tacos and nopal salad.

Meanwhile in Austin you can't even find a taquero outside of East Riverside.

And, of course, the lack of walkability in the US is horrifying. I don't ever want to live somewhere where I can't walk to a fruit stand or cafe ever again. I think of any time I've felt dullness in my life and every time it was at a point in my life where I had to drive everywhere. Like playing an open-world game and only using fast travel, missing out on all the small interactions that turn out to be the spice of life.

For whatever reason, there seems to be a gap in the US between convenience store and full-fledged grocery store. There are various mostly non-chain markets in many cities but, for the most part, you either have pretty much junk food or you have to find a big grocery store. In London at least there are a lot more of the Sainsbury Local or other chains that don't have the selection of a bigger store but aren't just junk either.

It's the walkability again. If I'm getting in a car, I may as well go somewhere that will have everything I could possibly need.

Also, I do feel the store you mention, and similar ones, are de-emphasising veg in favour of higher margin packaged/processed items. Although, they are wildly optimised for each store placement so it is difficult to tell.

This isn't really a fair comparison: not a lot of people in the states buy food at 7/11, while it is much more common in Japan. With the volume that 7/11's do in the states, they can't really support bento boxes or whatever you'd find at the grocery store lunch counters (which, actually, are very comparable to Japan 7/11, but not as widespread).

I don't understand this. Rice, potatoes, vegetables are still cheap here. I guess if you're looking at restaurants, this is true. If you are with a group and have to go eat somewhere, they usually provide healthy options which are not too expensive compared to the unhealthy ones (though sometimes, that's just due to smaller portions).

Maybe you have a different experience, having just visited, instead of living here.

addendum: it also depends quite heavily on the area's cost of living, apparently. I just bought a sack of potatoes for $0.40/lb, whereas https://news.ycombinator.com/item?id=16448984 says potatoes in LA are $1.88/lb (nearly 5x as expensive).

I completely agree, but my thoughts are that it is biology in action -- people crave fats and sugars, and by themselves rice, beans, etc don't have much flavor. Or, the average American's palate has become so conditioned to sugar that they think those things don't have flavor. They have also been conditioned to think of meat as the go-to source for protein. Plus, frankly, there is a stigma of "rice and beans" being poor people food or even "ethnic" food in some circles, Ie: compare a meat / potato / bread heavy "traditional" American diet.

I found buying fruits and veggies in LA to be much cheaper than Seattle, unfortunately. Both are still cheaper than Switzerland (but then...what is cheap in Switzerland?).

yes. And beans. Beans are very cost effective, 1 to 2$ per pound or less. And they're very high in nutrients: Protein, Fiber, and countless micronutrients, super low in sodium and fat. They're easy to make too.

Decent by Italian standards is pretty decent. But if we're talking about fresh fruit and vegetables, go to any Asian market. Or Walmart. It's not that expensive.

There's few good reasons to be eating tripe if you live in a city or live in a 'food desert' (spare me) and have a car.

The real problem is the overabundance of crap choices crowding out the sensible ones.

For example, here's Walmart's online store: https://www.walmart.com/all-departments#food--household---pe.... Now look at the categories: Beverages, Snacks & Cookies (listed before meals), Candy & gum.

Ctrl + F for 'fresh', and all I get is flowers. Madness.

By contract, here's Tesco in the UK: https://www.tesco.com/groceries/?icid=dchp_groceriesshopgroc...

Fresh food is top of the list. And three sub-sections are all 'fresh' something.

There's zero reason Walmart can't do the same. Except for the fact that Americans demand soda and 800 different types of cookies, so that's what they're supplied with.

Edit: this submission was bumped from first to the third page within minutes...for whatever reason. Comment to upvote ratio perhaps?

My local Walmart isn't my favorite store in the world to go to for fresh produce and meat. The selection and quality are generally inferior to a couple of local regular supermarkets. But I could absolutely shop for food there that isn't all highly processed.

The thing is that, as you suggest, the pre-packaged deli section is bigger than the unprocessed meat section. And then there's the soda aisle, the chip aisle, etc. Shelf space is hugely tilted toward "junk" and other highly processed food.

My regular supermarkets have lots of processed food too of course. (And nothing wrong with a lot of that in moderation.) But it's far less skewed than in the case of Walmart.

I wonder if there are any subsidies paid for by taxpayers to the businesses that sell us cheap, unhealthy food.

Freedom to kill ourselves and each other, it seems...

Subsidies are the opposite of freedom. But other than that, good point.

I find healthy food to be very accessible in the United States if you cook for yourself. Most of our grocery stores have huge varieties of produce and lean proteins are relatively inexpensive. I think eating fast food is becoming more and more common as well as people buying pre-made packaged foods to heat up at home which are often just as unhealthy as fast foods.

> Most of our grocery stores have huge varieties of produce and lean proteins are relatively inexpensive

It depends on where you live. In the U.S. poor and working class neighborhoods often lack grocery stores. The only options are convenience stores where fresh, healthy food is very expensive, availability is limited, and quality is poor. I've read that the problem is on such a wide scale that it significantly impacts health. Cities work at attracting grocery chains to poor neighborhoods.

Try it yourself: Try shopping for groceries in a neighborhood with those demographics in your town. Or just layer a map of income with a map of grocery stores; I think I can predict where you will find the Whole Foods.

Here's a map that talks about this:

http://americannutritionassociation.org/newsletter/usda-defi...

Shelf space at the stores seems to be shifting more toward prepared and semi-prepared foods. This comes at a cost of more carbs, sugar, etc. I interpret this trend as consumer choice, that people are preferring to spend less time cooking and preparing meals.

If you have a strong food culture that demands fresh ingredients (Italy) then the prices may follow.

Not shelf space -- shelf placement.

An entire new science of how people shop developed in the past few decades. The centermost aisles are prime territory. So, the higher-margin, fast-turnover items get center aisles and medium height (easily seen) shelves. Wholesalers actually pay for placement rights for things like chips and soda -- that's why they are organized by brand rather than product.

Produce gets moved to one end of the store (generally the end nearest the main entrance because produce is low priority for shoplifters.

> I'm italian and I visited united states a couple of months ago. In my opinion the biggest problem is that you don't have decent food at affordable prices. Healthy food has nonsensical high prices and if you want something at a human price you don't have much choice except fast food. What a shame.

We recently just spent a week in Spain. We went to the grocery store and bought a whole cart full of food for like 20 euros. I was blown away. The equivalent amount of food in the US would have easily been like 100 dollars, probably more.

My (potentially incorrect) impression was that the Common Agricultural Policy in Europe meant that the affordable food prices you get used to could just be the result of subsidies. So any country with different subsidies would have surprisingly high food prices and give you sticker shock, but that wouldn't really mean all that much, it's like the difference between paying for it in the store vs paying for it with taxes. Is this plausible?

Perhaps you're thinking only of restaurants, because healthy food is far cheaper than fast food or any restaurant food in general, but it does require going to any grocery store and then spending a few minutes cooking.

Meh, veggies, rice, etc. are super-cheap everywhere in the world.

It doesn't take money to eat healthy. It's not that fast food restaurants are the only choice is you don't have money. You can go to a grocery store and eat extremely healthy if you want to.

Those who eat at fast food restaurants all the time are more uneducated than poor (although both things might go hand-in-hand), and might not know how many calories are in a burger or more importantly sodas (I've seen people drinking liters every day).

You can buy an apple instead of a can of coke and save you both a few hundred calories and a few pennies. Nothing to do with money.

FWIW Vietnam War prisoners (Americans held in North Vietnam) strongly tended to live longer than their peers after release. Years without artificial light eating a basic diet and limited calories made a big difference, even without factoring out torture.

In contrast the starvation diet the Japanese imposed on their WWII prisoners (from Hong Kong in particular) shortened their lives quite a bit.

Veggies are not cheap here, its cheaper in the UK and even in Singapore where everything is imported than in California.

Aww, come on! How much is 1 kg of carrots or potatoes?

Banana (0.25 kg) 0.63 $

Oranges (0.30 kg) 1.04 $

Tomato (0.20 kg) 0.85 $

Potato (0.20 kg) 0.60 $

Onion (0.10 kg) 0.26 $

Lettuce (0.20 head) 0.28 $

Not the best source probably, but by looking at https://www.numbeo.com/food-prices/in/Los-Angeles it doesn't seem like one can easily go broke from buying vegetables.

Yeah, all of those are single serving prices that you're looking at, and only the onion (and I guess lettuce if it's not romaine) is actually a vegetable. Potatoes are starches, the others are fruits (with higher sugar). They don't list much in the way of vegetable prices.

But, even given that; I can buy a head of lettuce for $1.40. Okay. Or, I could buy an 8 pack of little debbie snack cakes for the same amount. 5 servings of lettuce that has nearly no nutritional substance, and that I have to combine with something else anyway to make it palatable...or 8 servings of convenient, enjoyed food.

If I wanted crunch, I can get a giant bag of tortilla chips for $1, too. Why would I buy a head of lettuce for 40% more, when it takes more work, and more ingredients inflating the price even higher?

It was stated that the obesity crisis might be caused by the cost of vegetables (or otherwise healthy food). This is nonsense. I don't know why you're getting picky with definitions while that was just an example to prove that it's not as if an eggplant is $20 and a cheeseburger $1.

> Or, I could buy an 8 pack of little debbie snack cakes for the same amount. 5 servings of lettuce that has nearly no nutritional substance, and that I have to combine with something else anyway to make it palatable...or 8 servings of convenient, enjoyed food.

Right. I would never eat that, though. There are also plenty of ways to make vegetables palatable: eggplants with tomatoes with spices are very tasty, for instance.

I'm also not saying that junk food isn't cheaper, just that healthy food is affordable for everyone.

Same here, I was chasing asian street food for breakfast. From my touristy experience US breakfasts consist of no vegetables and all sorts of sweets.

Not a lot of vegetables but eggs, sausage, and bacon are very common. But yes, if you’re vegan or at least prefer food that is more vegetable in nature you’ll have a tough time other than fruit.

I'm quite far from a vegan, but eating all you mentioned + waffles with syrup really is too much for my stomach. Some salad/tomatoes/cucumber next to that would have helped.

Honestly this is only slightly true. Beans are 2 bucks a pound, cabbage is 2 bucks a head, bananas are 50 cents a pound, chicken is 4 bucks a pound, lentils are 2 bucks a pound, broccoli is 3 bucks a pound, yams are 1.5 bucks a pound, green bell peppers are 1 each, peanuts are 4.5 a pound, etc.

You get my point but I think it's more of a culture and convenience thing.

I don't get this. You'll get just as fat with "healthy" food. People aren't skipping small portions of healthy food because it's expensive - they just don't want to eat it at all, or they want to eat enough of it to feel full and satisfied, which is going to make them fat.

>"This is directly related to the way American cities are designed. It’s a car centric culture where big houses are far away from each other."

New York City is perhaps one of the most walkable cities in the world. It's also a place where you absolutely do not need a car and the majority of residents don't have a car. Yet 34% or New Yorkers are overweight and 22% are obese.[1]

The BMI statistic for the EU are none too encouraging either. [2]

[1] http://www1.nyc.gov/site/doh/health/health-topics/obesity.pa...

[2] http://ec.europa.eu/eurostat/statistics-explained/index.php/...

Well, honestly, this comment is only giving more credence to OP, since, apparently, the US average is 70% is much much worse than the 34% of NY.

EDIT: Haha, apparently the HN crowd is very quick to point out inconsistencies since the original comment has been up 2 minuites and there are already 3 comments pointing the same thing (and counting)

56% (22%+34%). Which is indeed lower than 70% but also note that the 70% is very unevenly distributed across states.

The numbers there are additive. (34 + 22) = 56%. Still lower than the national average, but not half.

Even if it doesn't explain 100% of it, it's still striking that the overweight rate in NYC is, according to your figures, less than half of the US average.

But even at half of the US average its still at a level considered epidemic.

I think you may have proven the point. That's less than half the general population.

I don't believe so.

Given that its a reference for one of the great "walking cities", I think it disputes the OPs assertion "the design of American cities" and "car culture" are substantial contributors.

In other words whether one walks or or drives to McDonalds probably matters very little.

I'm the OP.

I agree NYC should be better but a number of problems are present there:

1. Cultural. I haven't been there for two years, but people use the subway, not the bike lanes. And I remember as recent at 2010 taxis were very prevalent, although slightly less so last time I was there. Though that could be Uber. The walkability of a city isn't just its density, it's its zoning, the width of its streets, the expected work hours. NYC is fast food, finance, media. Though they're still better off than the average American, they are no Amsterdam.

2. They have many of the problems that most American cities have: Dirt cheap unhealthy food and sugar consumption rates that are unhealthily high.

3. Many people come to NYC to make it. If they're coming from the rest of America they're coming in overweight.

>"I haven't been there for two years, but people use the subway, not the bike lanes."

The bike lanes are actually quite busy. This was true two years ago as well. It has also been steadily increasing with the increase in the number of Citibikes. The NYC DOT even has stats that support this [1]

>"They have many of the problems that most American cities have: Dirt cheap unhealthy food and sugar consumption rates that are unhealthily high."

There's also shortage of affordable and healthy options in just about every neighborhood.[2] There's also plenty of Whole Food and fruit and vegetable are present outside most bodegas.

>"Many people come to NYC to make it. If they're coming from the rest of America they're coming in overweight."

That's is a pretty absurd statement. People come for all kinds of reasons and they generally bring their A game if trying to "make it."

[1] http://www.nyc.gov/html/dot/html/bicyclists/cyclinginthecity...

[2] https://www.timeout.com/newyork/restaurants/the-best-healthy...

>"There's also shortage of affordable and healthy options in just about every neighborhood.[2] "

This should have been:

There's also NO shortage of affordable and healthy options in just about every neighborhood.[2]

While I agree American cities don't promote the most healthy lifestyles, it's not like city-dwelers are less healthy or more obese on average than those who live in the country.

You're spot on with your second paragraph though. There is a lot of misinformation about nutrition, dieting, and food in general, and it's all aimed at one goal: turning a profit. Sugar is one of the major culprits, but over eating in general in America is an issue.

We need to start health education on a basis of Calories in vs. Calories Out, what healthy bodies actually look like, and dispel the myths of fad dieting and fat-burning-exercise routines/equipment.

Eat a balanced diet, consisting of little to no processed foods, and keep your calories close to your TDEE (or below if you are overweight).

Exercise for long-term health (physical and mental), not weight loss binges.

It's really that simple.

Pretty much all cities and towns in the U.S. are car centric. Large amounts of space wasted in the form of parking lots. Houses are mostly built away from grocery stores and shops. Usually there are no decent foot paths to get to them. It’s not just a phenomenon of large cities. It’s pretty much everywhere.

It really depends on the city. A lot of the "urban/rural" statistics are somewhat clouded by the fact that most American cities aren't really walkable outside of a central business district that nobody really lives in, and that its residents probably have to drive out of to get to such basic places as a grocery store.

The correlation looks a lot firmer when you look at overweight rates compared to population density or walkability instead of trying to just coarsely bucket it into "urban/suburban/rural".

Absolutely.

I think people underestimate how much walking or physical activity they’d need to do to counterbalance the calorie surplus they have on a daily basis. You’d literally need to be fast walking for hours and hours a day. Cars don’t help, but walking for an extra 3-4hrs a week isn’t the major factor here. It’s the pound of cheese you had melted on everything, or the 24oz Cola.

> It's really that simple.

Everything you list is simple, but nearly impossible for most people to stick with for life. It's not a matter of education, it's the fact that implementing that plan is physically and emotionally painful and wears most people down inside of a week or two.

As I've gotten older I've come to appreciate pro surfer Laird Hamilton's perspective on making friends with pain. That doesn't mean you should be a masochist, just stop seeing pain as something to always avoid.

http://www.espn.com/espn/story/_/page/bodyreecehamilton/just...

Sugar seems to be a major driver of this development. The main problem is likely excessive sugar and especially fructose consumption starting with the emerge of cheap HFCS in most products. Dr. Robert Lustig has put a lot of research into the causes of the obesity crisis. He goes into great detail in his lectures on YouTube https://youtu.be/ceFyF9px20Y?t=51m41s He also argues against the "gluttony and sloth" prejudice by saying that you eat too much and move to little as a consequence of messed up hormones due to excessive fat. Not the other way around. The problem is probably more dimensional but the correlation between increasing Sugar/HFCS amounts in foods and the onset of obesity seems to be pretty strong.

You should read Stephen Guyenet to challenge what you've heard about sugar, both his twitter and his blog. He's a Ph.D. neuroscientist who studies the connection of the brain to fatness for a living.

A recent tweet from him:

    Most comprehensive analysis of macronutrients vs. lifespan, fatness, health in mice.  High fat + high carb + low protein = highest body fat.  High fat + high carb + high protein = highest insulin.  High carb + low fat + low protein = longest lifespan.

https://twitter.com/whsource/status/965330116468502529

There is an air of certainty about low carbs permeating our culture right now that is not justified by the evidence at all. The Kitavans today get 70% of their calories from potato and have no diabetes or metabolic syndrome.

Look up Ray Peat for a good argument in favor of sugar. Plenty of people are thriving on high sugar diets.

For my own part, I've consumed 1300 or so calories of sugar a day for 20 years and my biomarkers are 99th percentile. I'm very consistent about resistance training and I don't overeat, both factors likely dwarfing my sugar intake.

Of course, obviously that's an anecdote, but I would caution anyone who automatically judges someone else for their sugar consumption. You might be wrong about sugar and, more importantly, you might be wrong about sugar paired with a particular person's genes or other lifestyle factors.

Because of my high sugar consumption, I eat relatively low fat and protein. What if that's better for you, assuming you don't overeat?

Guyenet is somewhat in favor of the hypothesis that sugar increases fatness, but he thinks it's because humans are susceptible to the "unnatural" increase in food reward that adding extra sugar induces, not because sugar is toxic in and of itself.

Were this the case, you would see a correlation between urban development and obesity rates; cursory examination of obesity rates and population density (and our basically unchanged urban planning methods since the 1960s) reflect that this is not the case.

I'd like to note that poor quality of food does not make one overweight (and lack of exercise does not either).

Exercise and good food are good for you (diabetes and heart disease are bad) but in terms of weight what matters is pure number of calories consumed. This has been true from everything I've read on the subject and what I've seen from my own underweight failures and triumphs to gain weight.

Americans just eat too much, for a variety of reasons.

You are spot on here -- I lost ten pounds in just the past few weeks simply by upping my step count.

Taking it one step further though... I think about my forebear farmers. When I would hear my grandmother talk about the huge meals they would eat daily, you'd think they were all 300 pounds and died of heart disease by 40. Instead, they were trim and lived into their 80s and 90s. The reason being that they were physically active all day long on the farm. In a modern services economy though, we have to go to a gym, go for a run, IE: build physical activity into our day. After a long work day, this is a mental challenge for many people just as much as a time challenge. So, in many ways it's an artifact of the transition away from the farming / industrial economy of the past that many segments of the population have simply not addressed.

I moved from Canada to the US a few years back, and gained an enormous amount of weight and gained a bunch of health issues, all food related. Here's my take on it.

Food is much, MUCH cheaper. Not a big difference at the grocery store for whole produce and raw ingredients (though it is cheaper). But the processed foods, premade stuff, deserts, drinks, etc? A fraction of the cost.

Restaurants are also much, much cheaper. Where I used to work, going to the sit down restaurant next door downtown brought me down 20-25 bucks. A similar restaurant downtown where I now live has equivalent food for 8-10 bucks. I make 4 times my Canadian salary and pay a lot less taxes, so effectively, it's virtually not worth it for me to cook, if my only constraint was money.

Sugar in EVERYTHING. Food that used to be a little bit sweet (not necessarily health, but not the end of the world) is drenched in sugar. I have to be careful when I get an orange juice in case its sugar added. A milkshare at the local icecream shop has way more sugar. Sugar sugar sugar EVERYWHERE.

Ordering food is also way easier, with formerly Foodler, GrubHub, Doordash, etc. I have no idea if those services became common up north after I left, but that was a big change, being able to order from 100 different restaurants at any point in time, sometimes in the middle of the night, with a few mouse clicks.

The portions: Cheesecake Factory exists up north, but it's not considered normal. Here, while the portion sizes are certainly above average, they aren't exactly unique either. You have Outback and the like all service you enough food to last you 3 days.

I also find it a lot more common to have fatty or sugary snacks at the office, and soft drinks, etc.

I'll shamefully admit I have zero self control when it comes to food. I have a sweet tooth like no other. But the price and availability constraints in my hometown stopped me from going overboard. For a while I was pretty much flush at my "recommended" weight. After I moved here? Things got really bad for me.

You are not wrong, but I will say that overweight is a really low threshold. For me at 6'5", it's about 200lbs at the top. Factor in that tall people generally have more variance in torso to leg ratio, and it makes it difficult to get down to that weight. I was 235 lbs when I left the Army and was incredibly trim. At 200 lbs, I would have been very skinny. At the middle of the healthy range, 175 lbs, I would look incredibly skinny.

My goal weight is 200. I've got 100 to go and I've lost 40 so far. I got there because of the sugar and depression, but I thought it was important to note that 200 for me is going to be incredibly skinny. I don't think it is practical for most people to maintain that.

The top of the normal BMI range for someone 6'5" tall is actually 210 lbs. That's not incredibly skinny nor would it be impractical for most people to maintain.

Just wrote a little Medium article about your post, as your comments about car culture made me wonder:

Will Autonomous Cars & Mobile Gyms Help With America's Obesity Epidemic: https://medium.com/@nicolaerusan/will-autonomous-cars-mobile...

Def, the nutritional issues are still there & so are the issues around communal activity - but I think for a lot of people I know who have long commutes to work, the opportunity to exercise in transit would be compelling.

> It’s a car centric culture

I don't really see the correlation. In Brazil, obesity is commonly associated with lower incomes, and if you were to correlate with the transportation system usage patterns there, one might misguidedly conclude that public transit usage is related to obesity. It seems more logical to make a correlation with lack of food variety (in both cases, cheaper food tend to be heavy on carbs and fats) and sedentary lifestyle

The reason Americans eat that much sugar is not the "one won't hurt" mentality, but the fact that the government singled out fat as the only source of evil, and companies started adding sugar to everything because without fat everything tastes like cardboard.

I bet most of the sugar consumed is from things that no one would think contain as much sugar as they do (like--bread, meat, etc.), which is added to make it more palatable.

I was curious so I checked the bread in my cupboard. The generic loaf of white bread has high fructose corn syrup, and the fancy whole wheat loaf has sugar. Both are pretty high up in the ingredient list.

Yes because in European bakeries they might add butter to make it taste good, but in America no one would buy it because it wouldn't say "fat-free", so they add sugar.

By and large, the mass produced American breads aren’t very good. But the bread sitting on my counter right now from Trader Joe’s, which is not actually an artisanalproducer, doesn’t seem to have any added sugar. No it’s not a mass market product but it’s also something that’s more than “no one” buys.

It should be plausible to design a scientific study on how much a car centric culture is causing overweightness.

Why is it only now that obesity is reaching such epidemic proportions though? We've had a car-centric culture since Post WW2. Why haven't we seen this epidemic before?

Because GP's reasoning is likely not to be correct. The proliferation of cheap, high calorie foods along with a sedentary lifestyle (including occupations that require very little physical activity) are more likely to blame than 'cars did it.'

I would add that food corporations devote a lot of resources to make people eat their junk. It's not only that the food is there to eat. Companies like Coca Cola or Mac Donald's spend billions to convince people to eat their stuff.

The rates have been steadily going up since that time, though. It makes sense that you would see a gradual ramp up in a drastic change like ths.

I don't have sources to back this up, but here's some thoughts:

* Gradual changes in types of labor? (From agriculture -> industrial -> office jobs) which are less calorically intensive.

* Changes in food? Calorie-dense food is cheaper and easier to get than ever. People have less free time to cook healthy meals (working more hours, far fewer homemakers, longer commutes, more time spent doin extracurriculars outside the home, etc). As a result, people consume more calories because they're easy to get.

* Health/Food misinformation. The demonization of nutritional 'fat' which lead to it being replaced by sugar, which is even more addictive.

* Changes in drink consumption? Alcohol consumption is up (at least compared to ~25 years ago), and alcoholic drinks area very high in calories.

* Childhood changes due to changes in food and care. More high-calorie, "manufactured" foods introduced earlier into peoples lives sets them up for a lifetime of bad habits and problems that only compound over time.

If you look at the obesity charts, year by year, you can see precisely the year obestity took off like a rocket. It was the year following the US Gov announcement that Fat is evil. This caused all the food manufacturers to start pumping everything full of sugar. In the coming decades, gym memberships increased quickly to no avail - you can't out excercise a terrible diet.

Add in addictive computers, TV, and vidya - and that's probably your answer.

Suburbs are growing farther and farther away.

More indoor entertainment than ever (Internet, video games)

No free spaces, parking lots for kids and young adults to just go out to walk/play

Took some time for the cumulative effect of all this to show up.

tangentially relevant and interesting summary on mass-transit in the US https://www.youtube.com/watch?v=-cjfTG8DbwA