Wealth is health: the food poverty divide
As Dr Eva Orsmond uncovers Ireland's contrasting eating habits, Alex Meehan asks the experts if a low income inevitably leads to bad meal choices?
When you see an overweight person in the street, do you judge them for it? What about in the supermarket - do you look into their trolley to see if they're buying junk food? What about when you see an overweight child walking to school: do you blame their parents?
If they were honest, many people would admit to doing just that. But is it fair and, most importantly, is it right? Or are there more complicated issues at play than simple willpower when it comes to choosing the foods we eat and the exercise we do - or don't - take?
The truth is that the science behind the obesity crisis is complex, with many contributing factors and causes combining to cause it. And one of the biggest can be how rich or poor you are. There is a strong connection between your income level and where you live with your health and life expectancy.
If you live in an affluent area, you can expect to live around seven years longer than someone who lives in a disadvantaged area. If you live in a disadvantaged area and you are female, you are eight times more likely to smoke and experience all the health problems that come with that.
This health inequality is also strongly linked to eating habits and diet. On Monday night, in a documentary for RTE One, Ireland's Health Divide, Dr Eva Orsmond addressed some of the issues that health inequality creates in Ireland.
She travelled to disadvantaged areas, such as Moyross in Limerick, and wealthy parts of Dublin, such as Glasthule, to compare the diets of families she found there, and in the process, the woman who once brought a contestant on Operation Transformation to tears with her criticism of her diet learned some hard lessons about food poverty.
"Initially I thought of food poverty in terms of people taking responsibility for their behaviour," she said. "Now I see how the cards are stacked against people who live in disadvantaged areas. I've seen the challenges they face just to get by."
The parents from poorer backgrounds featured on Dr Eva's programme were living in challenging situations, doing their best to feed their families to the best of their abilities given their resources and knowledge.
They were living in overcrowded homes, coping with poorly heated accommodation and, in one case, facing eviction. Understandably, this causes significant stress and contributes to what Trinity College sociology professor Richard Layte describes as cognitive load. People in this situation, Layte says, are literally in a survival mentality, and making informed choices around things like food is therefore extremely challenging.
Added to this is the fact that eating well isn't always cheaper. In 2016, Safefood calculated that the cost of feeding a household healthily in Ireland ranged from €55 for a single adult to €160 per week for a family of two adults and two children - unaffordable sums for those on social welfare.
"People on low incomes do eat less well and are at higher risk of certain diseases such as heart disease and certain cancers, and diet is part of the situation," says Dr Marian O'Reilly, chief specialist for nutrition with Safefood.
"It does cost extra to eat a healthy balanced diet than a diet that's very highly processed with low levels of variety and low in fruit and vegetables. For those on low incomes, in particular families with kids, it can take up to a third of their total income to buy a healthy week's food."
A third of the household budget is a huge amount to spend on food when rent has to be paid, fuel has to be bought and clothing and other essentials are also needed.
"Food is the flexible part of the budget and the priority just becomes filling up the family with calories so nobody is hungry," says O'Reilly.
So how can you eat better on an extremely limited budget? Food writer Catriona Redmond runs the Wholesome Ireland website, where she blogs about how to cook well on a budget. After her first child was born, she lost her job and had to learn how to make ends meet with scarce resources.
"I think part of the problem stems from the [lifting of the] marriage ban in the 1970s, and the resultant lack of cooking skills being passed on in the home. Up until then, women gave up their jobs when they got married and stayed at home and that meant they were there to pass on these skills to their kids," she says. "That stopped happening, and more women went out to the workplace. So we have a generation of parents who don't know how to cook and don't teach their kids to cook."
However, the problem isn't just kids who can't cook, it is adults too. Redmond recommends getting on to YouTube for cooking tutorials and she also has a lot of time for chef Neven Maguire's cookbooks.
"A lot of his recipes are cooked on a budget and you can learn a lot from a good cookbook," she says.
For Ballinasloe woman Nuala O'Connor and her husband Finbar McLaughlin, eating healthily is a challenge but one they take on enthusiastically. In particular, O'Connor believes that eating well shouldn't be dependent on having access to cash.
"How could eating healthily be more expensive than eating junk? The difference in cost between processed food and home-made is enormous," she says. "You have to make time for cooking but, once you do, you can save a lot. We all take turns cooking in our house. We don't buy fizzy drinks, cakes or crisps - these things are treats and if they're not in the house, then they can't be eaten. I have a sweet tooth like everyone else and if I have a bag of chocolate in the house, the reality is I'll eat it."
O'Connor is a vegetarian while her husband is a vegan, but not all the family share their habits. They have three children: Cúán (23), Finn (15) and a daughter Juno (8), all living at home. While the youngest, Juno, is also a vegetarian, her two brothers aren't and that means the family has to shop for everyone's tastes.
"We're lucky - we are naturally predisposed towards liking lighter and healthier food so it's not a hardship to eat healthily. We certainly don't feel deprived or that we're on a diet in any way. This is just the normal way to eat for us."
The family's finances are tightly controlled - O'Connor is a writer while McLaughlin is a computer programmer - and the monthly food bill is recorded in a spreadsheet.
O'Connor said she spends an average of €500 a month on food, mostly shopping at her local Aldi supermarket.
"Feeding big healthy guys is a challenge - they eat a lot and keeping them full up can be hard. We have lots of salads, stir fries and casseroles, but sometimes the boys want meat and bulkier foods. In general, they like heavier meals than we (their parents) do," she says.