The city's board of health got into household economics last week when it heard a report on the high cost of a basket of 166 nutritious foods.
In Toronto, where prices for quality eats are among the lowest on the continent, it costs $120.95 a week to provide a family of four with frugal but healthy meals. For people on fixed incomes from social assistance or minimum wage, that's a 13.25 per cent increase over the last five years, an increase that's almost impossible to cover given Toronto's high rents.
Board members called for increases to social assistance and minimum wage rates, and supported a range of community gardening and cooking programs.
It's certainly no surprise to learn that what folks fill their bodies with bears a closer relationship to their pocketbooks than to a health-food cookbook. One of North America's top food experts, Adam Drewnowski, is barnstorming his way through the leading journals of nutrition professionals, including the current American Journal of Public Health, telling his colleagues they're wrong to lay guilt trips on the people gobbling up empty carbs and fatty meats, or to heap much blame on junk food companies that dupe people into nutritional sin.
Drewnowski, director of the Center for Public Health Nutrition at the University of Washington, is a straight-ahead follow-the-money guy. If you want to understand the spread of obesity, he argues, you have to check out the postal and zip codes of overweight people and the price tags on the foods they buy.
These identifiers tell much more than genetic codes about who's getting fat and why, Drewnowski says. Obesity is widespread in communities marked by poverty and social or racial exclusion. Check out the bargain-basement prices on sweet-nothing carbs and bad fats. People are simply stretching their scarce shopping dollars when they choose comfort foods high in calories and energy and easy to store and prepare.
Veggies and fruit, he suggests, may pack a lot of vitamins and minerals, but pound for dollar they're high in water, low in calories and energy and prone to spoilage. There's more tang for the buck elsewhere. As a return on investment in energy, lard beats lettuce hands down, as candy does raspberries.
He also takes a poke at the goodie-goodie-two-shoes who design the likes of Harvard's Healthier Eating Pyramid, which features vegetables and fruit, complex carbs and lean meats washed down with a nice red wine. This can be "described as a blatant example of economic elitism that fails to consider the limited resources of low-income families." Now, that's a mouthful, especially in a profession not known for its high-sticking style of polemic.
Health promoters will get more value for their money if they turn the tables, Drewnowski says, and focus instead on improving the economic condition of ordinary people, thereby allowing them to make healthier and more luxurious food choices.
Drewnowski is arguably on the right track when he insists obesity is not a bio-medical problem. He's on strong though controversial ground when he suggests that harping on evil food companies deflects attention from broader and more profound economic disorders such as the trend to increased inequality.
But his assessment of good meal deals is at best half-baked. By and large, healthy foods are just as affordable as nutrient-challenged ones. A healthful and anti-obesity diet begins with breast-feeding, most experts agree, because breast milk is packed with nutrients and the good fats that are accessed with physical activity. And perhaps - thanks for the mammary - breast-feeding generates a lifetime memory of emotional warmth that comes from a personal relationship, not a from food substitute. The last time I checked, breast milk cost a lot less than store-bought formula.
My mentor in the area of low-cost but enjoyable meals is Tamara Elliott. She carries on the cooking-simple-meals-from-scratch habits she's been practising since she was nine, when her mother's illness made her responsible for feeding the family.
She keeps food costs low by shopping at garage sales. The $2 purchase of a styrofoam-lined pail lets her make eight serious servings of yogurt from low-fat powdered milk for under $1. A $4 slow cooker means she can cook New England baked beans (beans, onion, apple, carrot, mustard, catsup) and other one-pot specials of the sort that kept our low-income ancestors in about as good shape (which is why the poor were often described as having "rude health") as the chronically ill fat cats who lived too high on the hog.
Whether the issue is protein, fibre, minerals, vitamins or essential fats, low-cost can match high-cost ingredients any day of the week. Almost all nutrient-dense comfort and soul foods that come from folk traditions - from cabbage rolls to haggis to eel to escargots with garlic to puttanesca (prostitute's) pasta and cacciatore (hunters' or poachers') chicken to bird's nest soup - used found or leftover foods that were cheap. But humble pie was usually nutritious. To this day, there's no hefty price tag on many healthy staples such as beans, oats and millet.
Thanks to a food system that converts all customers, rich and poor alike, into mere consumers who add little production value to food, the know-how that kept people alive in the old days is disappearing. Those without economic resources are especially stressed by this de-skilling trend.
When it comes to public policy regarding healthy diets, rebuilding the technical and and social skills around food production and preparation is just as important as income security. These are the forgotten items of our school and societal curriculum.