Another facet to the issue is metabolic programming. Some of us are 
going to be fatter on the same number of calories than others, based on 
whether our mothers and grandmothers went hungry during pregnancy. Some 
forms of poverty are generational, making people who are poor now more 
likely to have had parents and grandparents who were poor. Deprivation 
during pregnancy seems to program an infant to be thrifty metabolically, 
increasing fat deposition in case bad times recur. There's an entire 
generation of women who were told (in the 1950s) to gain only 15 lb 
during pregnancy, to ensure a small baby and an easy birth. They were 
also often bullied into artificially feeding on a 4 hour schedule, 
giving their babies a triple whammy.

As for cheap foods, the really nutritionally impaired stuff such as 
artificially flavored and colored non-carbonated drinks, trans-fat laden 
baked goods, and white bread are cheap. Poor mothers are often stressed 
by other concerns, substance abuse in the family, lack of a spouse or a 
support system, high crime neighborhoods, long work hours, and might not 
have the energy to expend on cooking fresh foods. Also, if you've never 
seen a vegetable that didn't come from a can (I didn't until I got a job 
in a coffee shop as a teen, and was taught how to prepare fresh veggies) 
you don't know what to do with them.

Additionally food choices have a large cultural component. Long after 
families have dropped their language, dress, and relational customs, 
they're still eating like their ancestors did. Especially when 
traditional (largely vegetable based) foods become Americanized, they 
can wind up with excessive fat. Contrast Mexican cuisine and the 
American fast food versions of the same dishes! Traditional food ways 
are also imperfect. Customs, beliefs about what is edible and what is 
not, expense and availability issues, all play into creating a food way.

So, it is a complex issue, and there are many many factors. Nutrition 
education early in life when attitudes are forming coupled with 
breastfeeding and good pregnancy nutrition are a start. Safer 
neighborhoods so kids can play outside and get exercise, dealing with 
social problems in a constructive ways to relieve stress of moms is 
another, and changing advertising rules will help as well.
Catherine Watson Genna, IBCLC  NYC

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