How Limited Budgets Push Families Toward Processed Food — and What It Costs All of Us

By Garrett Zhou

Imagine you are a low income family in America. You’ve paid your rent, utilities, and other bills for the month, and you’ve only got $300 left for a month’s supply of food. 30 days of food, and only $300 to spend. That’s only $10 a day. Your options are pretty limited, and the first priority is always to make sure you don’t go hungry. Nutrition comes second, which essentially means it’s an afterthought. Chips, fast food, soda, and sweets are all excellent in terms of calories per dollar, but don’t have nearly enough nutrients to be classified as adequately nutritious. That leads us to the paradox: people can be overweight and malnourished at the same time. America has plenty of food, yet millions are food insecure and millions have diabetes; two trends that are linked at the root. There are 47.9 million people living in food-insecure households in the US as of 2024, and roughly 40.1 million people with diagnosed or undiagnosed diabetes as of 2023. There are also millions of overweight individuals in the US. This means that we have enough food for everyone, but distribution and affordability are the primary drivers of this polarization.

Food and nutrition might seem like the same issue, but they aren’t. The definition of food security given by the USDA is enough food for an active, healthy life. The definition of nutrition security is access to foods that promote well being and prevent/treat disease. Those are two very different things. A household that eats three full meals a day may still be far from the recommended nutritional intake. Under President Biden, the USDA framed this as a policy shift, where hunger policy implementation alone isn’t enough; nutrition policy implementation is also necessary for a healthy American population. As a low-income family, the grocery store is also a trap. Should they choose white rice, or whole grains? Whole grains have much more nutritional value, so obviously they should be preferred, right? However, white rice is higher in calories and costs far less, so in the eyes of a low-income American family there’s no reason to buy something more expensive that will fill you up less than the white rice. This logic also applies when choosing between fresh vegetables or ramen, frozen meals or fresh, lean protein, and soda or fruit/milk. A full stomach doesn’t always mean good health. 

When a low-income family goes grocery shopping, they like to stretch their budgets by buying energy-dense, shelf-stable food. Statistically, healthy foods cost far more per calorie, and the prices of healthy foods have historically risen considerably faster than junk food, further discouraging low-income households from buying healthy alternatives. There is clear-cut evidence to support this: according to FRAC, households maximize calories per dollar to avoid hunger. Monsivais and Drewnowski found that the least energy-dense foods, such as fruits and vegetables, cost roughly $18.16 per 1000 calories compared to $1.76 for the most energy-dense foods (fats, sweets, and refined grains). In addition, a Seattle supermarket study conducted in 2007 found that low-calorie foods rose nearly 20% in price over two years while energy-dense foods actually fell in price by 2%. The pattern among low-income households is clear: hunger comes first, nutrition is often brushed off. 

So, what’s the connection between hunger and diabetes? Food-insecure adults are 2-3x more likely to have type 2 diabetes. For individuals with extreme food insecurity, they are 2x more likely to have diabetes even after adjusting for BMI. A longitudinal Canadian study found that people with food insecurity face over a 2x higher risk of developing diabetes over the span of 12 years. This isn’t just correlation; four main pathways reinforce each other. First, diet: cheap meals high in carbohydrates and high glycemic loads create insulin resistance. Then, irregular eating patterns develop from skipping meals when money is tight and overeating when food is available. Next, chronic stress from financial anxiety develops and affects hormones and blood sugar. Finally, there are healthcare tradeoffs. When money is tight, families must choose between groceries, insulin, and doctor visits, all of which drain the family’s resources. Diabetes is actually the most expensive chronic health condition in the US, costing the US economy $413 billion per year. 

Here’s a fact I’ll bet you didn’t know: statistically, food-insecure adults pay $1,863 more per year in healthcare costs. Feeding America estimates that excess healthcare costs from food insecurity are roughly $53 billion a year. 

The Biden USDA nutrition security framework plans to treat hunger and diet-related disease together instead of separately or focusing on just hunger alone. In the meantime, SNAP and school meals are helping but have major limitations, such as benefit levels and food environment. Some promising interventions include food security screening in clinics, produce prescriptions and medically tailored meals, SNAP incentives for fruits and vegetables, and grocery store access investments in underserved areas called food deserts. I believe, similarly to the Biden Administration, that hunger policy and health policy must be the same policy.

Food security is not a shortage problem; it’s a quality and access problem. The cheapest way to eat, which is heavily preferred by low-income families, is often the most dangerous and unhealthy way to eat. Diabetes and hunger share a root: it’s what people can afford to put into their shopping cart. Hungry individuals can’t put enough into their carts, while diabetics are often low-income and primarily consume foods high in carbs and fats. Therefore, until policy treats nutrition as healthcare, the cycle will continue. 

References

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Centers for Disease Control and Prevention. “Diabetes and Food Insecurity.” Last reviewed September 5, 2024. https://www.cdc.gov/diabetes/healthy-eating/diabetes-food-insecurity.html.

Centers for Disease Control and Prevention. “National Diabetes Statistics Report.” Last reviewed May 15, 2024. https://www.cdc.gov/diabetes/php/data-research/index.html.

Feeding America. The Healthcare Costs of Food Insecurity. July 2019. https://www.feedingamerica.org/sites/default/files/2019-07/The%20Healthcare%20Costs%20of%20Food%20Insecurity%20Brief_July%202019.pdf.

Food Research & Action Center. Why Low-Income and Food-Insecure People Are Vulnerable to Poor Nutrition and Obesity. Washington, DC: FRAC, 2017. https://frac.org/wp-content/uploads/frac_brief_nutrition_obesity_2017.pdf.

Gucciardi, Enza, Mandana Vahabi, Nicole Norris, John Paul Del Monte, and Cecile Farnum. “The Intersection between Food Insecurity and Diabetes: A Review.” Current Nutrition Reports 3, no. 4 (2014): 324–32. https://doi.org/10.1007/s13668-014-0104-4.

Monsivais, Pablo, and Adam Drewnowski. “The Rising Cost of Low-Energy-Density Foods.” Journal of the American Dietetic Association 107, no. 12 (2007): 2071–76. https://doi.org/10.1016/j.jada.2007.09.009.

Seligman, Hilary K., Andrew B. Bindman, Eric Vittinghoff, Alka M. Kanaya, and Margot B. Kushel. “Food Insecurity Is Associated with Diabetes Mellitus: Results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999–2002.” Journal of General Internal Medicine 22, no. 7 (2007): 1018–23. https://doi.org/10.1007/s11606-007-0192-6.

Tait, Cheryl A., Mary L’Abbé, Peter M. Smith, and Laura C. Rosella. “The Association between Food Insecurity and Incident Type 2 Diabetes in Canada: A Population-Based Cohort Study.” PLOS ONE 13, no. 5 (2018): e0195962. https://doi.org/10.1371/journal.pone.0195962.

U.S. Department of Agriculture. USDA Actions on Nutrition Security. Washington, DC: USDA, March 2022. https://www.usda.gov/sites/default/files/documents/usda-actions-nutrition-security.pdf.

U.S. Department of Agriculture, Economic Research Service. “Food Security in the U.S.: Key Statistics & Graphics.” Accessed July 13, 2026. https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/key-statistics-graphics.