When Gov. Ted Kulongoski took the “food stamp challenge” last April, eating with a budget of $21 for a week to raise awareness of hunger, his shopping basket contained imitation cheese, Cup-o-Noodles, a $1 loaf of bread and three boxes of macaroni and cheese. Not exactly the makings of a healthy diet, although he also bought zucchini, bananas and plain yogurt.

“I was tired at the end of the day,” he told a reporter for The New York Times last spring, noting that the eating pattern had affected him.

His week was a crash course in what many Oregonians struggle with each day: The challenge of being healthy and feeling full on a limited budget.

Now, a study published recently in the Journal of the American Dietetic Association has found that trying to meet that challenge could be a reason that the obesity epidemic hits low-income people harder. The study concludes that the higher cost of healthy food puts it out of reach for a segment of the population.

“The prevailing notion was that healthy food was available and people were making wrong decisions,” said Adam Drewnowski, director of the Nutritional Sciences Program at University of Washington’s School of Public Health and Community Medicine, and an author on the study. That reasoning, he says, is flawed. “People want to eat healthy, they would prefer to give their children healthy foods, but sometimes they can’t afford it.”

For the study, Drewnowski and his colleagues purchased 372 food items from Seattle-area stores and compared the costs to the food’s calories. They found that foods that cost the most per calorie included blueberries, watermelon, cantaloupe, strawberries and lobster. The least expensive were foods such as peanut butter, margarine, sugar and potato chips.

“Fresh fruit and vegetables, meat and fish were expensive sources of calories but also give you more nutrients,” said Drewnowski. “The energy-dense foods tend to be nutrient poor, but they were cheap.”

Many of the cheapest items in the store – beans, sugar, chips, candy – are those calorie-rich items that allow us to stretch our food dollars. Some of these items, even most, can be part of a healthy diet. However, everyone from the federal government to the diet doctors recommends a diet rich in produce, low-fat dairy and whole grains. These are by no means the most expensive items in stores, but, the study concluded, feeding a family on that type of diet may be out of reach for many people.

The study implies that economic factors are likely behind the obesity epidemic. When people have to ration their money, they aim to get the most bang for their buck or, in the case of food, the most calories per dollar. The problem is that in today’s world, that can mean less nutritious foods. Obesity is not a problem of motivation or education or laziness, says Drewnowski. “It really is the food prices.”

Another issue, though one not addressed by Drewnowski’s study, is that many recommended fresh food items spoil. For busy families, or families that live far away from a grocery store, that can present an additional challenge. “A lot of people in rural areas only shop once a week,” says Carol Schrader, a nutritionist at St. Charles Bend. They don’t want to buy produce, she says, “because it’s too expensive and won’t last for long.”

Putting it to the test

In our own experiment, The Bulletin went to a local grocery store and purchased about 2,300 calories of food. Half of our calories came from foods that packed lots of calories for a small price: crackers, chips and candy. The other half we bought referring to a list of foods recommended for a healthy diet: beans, chicken and lots of fresh produce.

At the checkout line, though they contained a nearly equal number of calories, our healthy food basket cost $24.09, almost seven times as much as our less-than-healthy basket, which set us back a mere $3.51.

However, in terms of heft, we got a lot more food with the healthy basket. It took three grocery bags to carry, as opposed to just one for the other foods.

Though that might mean the healthy calories would make more meals, it would not likely stretch far enough make up for the dramatic price difference, says Drewnowski. A study of French adults, he says, found that a person would need to cut calories by one-third in order to keep the same budget while switching from calorie-dense to healthier foods. “The price differential is just too great,” he said, to make it a viable diet for those with a limited income.

The issue of obesity comes into play because not all calories are created equal, and people tend to overeat foods in the caloric-but-cheap category. Foods that are smaller in size but higher in calories don’t fill us up as fast as those bigger but with fewer calories (think of a handful of chips versus a big bowl of salad). That can work against the health of people who rely on the high-calorie foods to stretch their food dollar, leading to weight gain or obesity.

“It’s easier to overeat energy-dense foods,” says Drewnowski. It’s “an extra bar of chocolate versus a pound of spinach.”

Eating nutrient-poor foods, says Bend nutritionist and wellness coach Jennifer Moore, sets up a craving cycle that often leads to overeating. You may be satisfied for an hour or two, she says, but you will soon be reaching for more. “You’re not giving your body nutrients,” she says, which sets you up to want more and more food.

Though there’s no direct evidence that lower-income people eat more calories, Drewnowski’s own research is adding support to his theory.

Two years after their initial purchases, the researchers bought the same products at the same stores again. What they found surprised them.

“We were absolutely staggered to find that the healthy foods were the ones that outpaced inflation,” said Drewnowski. Healthy foods showed greater price increases and some, such as red peppers, doubled in price in the two years of the study.

Because of those price increases, says Drewnowski, low- income people will find it increasingly difficult to feed a family healthy food. “If you have X dollars, do you buy two apples or a frozen pizza? Same cost. What do you give your children?”

Inside

• Tips to buy healthy food without breaking the bank, see Page E9.