Overweight in the South

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People from Mississippi are fat. With an adult obesity rate of 33%, Mississippi gobbled its way to the "chubbiest state" crown for the fifth year in a row, according to a new joint report by Trust For America's Health and the Robert Wood Johnson Foundation. Alabama, West Virginia, and Tennessee aren't far behind, with obesity rates over 30%. In fact, eight out of the 10 fattest states are in the South. The region famous for its biscuits, barbecue and pecan pies has been struggling with its weight for years - but then again, so has the rest of the country. Wisconsin loves cheese, New Yorkers scarf pizza, and New Englanders have been known to enjoy a crab cake or two. So why is the South so portly?

For one thing, it's poor. Mississippi is not only the fattest state in the nation but also the poorest, with 21% of its residents living below the poverty line according to the U.S. Census Bureau. Alabama and West Virginia, the second and third fattest states, are tied for fifth-poorest. With a poverty rate of 14%, the South is easily the most impoverished region in the country. "When you're poor you tend to eat more calorie-dense foods because they're cheaper than fruits and vegetables," explains Jeff Levi, executive director of Trust for America. Poor neighborhoods also have fewer grocery stores, even in the rural South. A 2004 study by the University of South Carolina found that most food-shopping options in rural areas fall into the "convenience store" category because grocery stores are located too far away. But although poverty puts people at risk for obesity, it doesn't determine their fate. A number of impoverished states - including Montana, Texas and New Mexico - have relatively low levels of obesity. There must be something else.

Maybe it's the culture. Southerners definitely enjoy their fried chicken (not to mention fried steak, fried onions, fried green tomatoes, fried pickles, and fried cornbread). Even when their food isn't fried, they like to smother it in gravy. But while nutritionists frequently blame Southerners' large guts on their regional food choices, the accusation is a little unfair. Just as Californians don't actually live on wheat grass and tofu, Southerners don't really sit around eating fried chicken every day. "I've not come across anything that says the diet in the Southeast is worse than the rest of the country," says Dr. David Bassett, co-director of the University of Tennessee's Obesity Research Center. "We're definitely in what I like to call the 'stroke belt,'" he explains, referring to the Southeastern states' high percentage of heart disease and hypertension, "but I think that has more to do with Southerners' lack of physical activity rather than the food." (Read "A Brief History of Barbecue.")

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It is not poverty or availability, it is choices. Most southerners are within driving distance of a Super Walmart where all sorts of healthy foods are available. One of the things I noticed when Katrina drove a lot of New Orleans residence to the Brenham, Texas area was an influx of morbidly obese people in the local Super Walmart. Many were on the electric grocery carts.

They did not hangout in the fresh produce isles. You would see them in the starch isles. They tended to load up on insulin stimulators which converts carbohydrates to fat. They may have been eating fatty foods too, but none of those choices were dictated by their income. I suspect that whatever their poverty level they can afford healthy food, they just have not developed a taste for it. Besides, comfort foods are more fun.