KISS your health goodbye! How Big Chocolate influences Obesity and Diabetes in Low Income Americans

Chocolate is everywhere. From grocery stores to gas stations, this sweet tasting, divine bar of goodness is inescapable in normal American life, especially if you’re in poverty. While Americans consume 12 pounds of chocolate each year, Americans categorized as “in or near poverty” consume more chocolate than individuals who are not in poverty (O’Neil et al.), and given that nearly 32% of the U.S. population is at or near poverty (Aulls), it is important to study their eating habits. The chocolate consumption habits of the poor, both in terms of quality and quantity, has consequences for both their health and ethical chocolate production. A study of the chocolate selection at the Dollar Tree shows that the chocolate marketed towards low income individuals is of the cheaper, unhealthier variety, produced without concern for human rights or the environment. The prevalence of Big, cheap chocolate is indicative of both the obesity and diabetes epidemic facing low income Americans today and the severe human rights violations and ethical concerns surrounding chocolate production.

Visiting the Dollar Tree

To get a concrete sense of the chocolate selection low income Americans often have and its implications for health and ethical concerns, I took a trip to the Dollar tree in Somerville. While there, I looked at several factors such as price point, types of chocolates available, the number of chocolates that were advertised as ethically certified through Utz or Fair Trade, and finally, the nutritional value of these types of chocolates. In this observation, only bars of chocolate or an amalgamation of chocolate and other ingredients (such as peanut butter or wafers) were studied.

A Dollar Tree was chosen as a case study to represent the shopping experience of a low income American because of its prevalence in food deserts and “because the American economy of late has pushed so many middle-class people into poverty, and poverty is what pushes people to line up at the cash registers of…Dollar stores” (Griffin-Nolan). Food deserts “are areas where people have limited access to a variety of healthy and affordable food” (Dutko) and usually contain “households with low incomes, inadequate access to transportation, and a limited number of food retailers providing fresh produce” (Dutko). Since these individuals cannot afford cars, they rely on places such as convenience stores and dollar stores such as the Dollar Tree. In fact, “three chains, Dollar General, Family Dollar, and Dollar Tree, made up two-thirds of new stores in food deserts” (Schneider) because large grocery stores don’t want to risk lower profit margins. While obviously not all lower income Americans live in food deserts, nearly “23.5 million people” (Dutko) do. In addition, dollar stores offer individuals food products and other items at a fraction of other stores’ prices, making them the natural choice if you’re on a budget. Given that these stores also accept some form of EBT, or foods stamps, a Dollar Tree store is a good sample of a typical low income American’s shopping experience.

Food Deserts
A visual map showing where food deserts are located in the United States. Food deserts are areas that do not have grocery stores in close vicinity that carry fresh produce. This is why the map highlights the populations that do not have access to fresh food via grocery stores with darker colors. Notice how food deserts are concentrated in the southern part of the United States.

There are however 3 primary issues with selecting a Dollar Tree. First, with some exceptions, everything in the store is $1, which may imply that craft chocolates or chocolates that were created ethically may be absent from the store due to their traditionally higher prices. Second, Dollar Trees are usually small, meaning the chocolate selection might be limited. Thirdly, low income Americans don’t always shop at the Dollar Tree, and may instead opt to visit a Walmart which might have a much larger chocolate selection. However, given that the closest Walmart in the Boston Metro area is over an hour and a half away on public transit while Dollar Trees are typically no more than 15 minutes away on transit anywhere in the city, studying a Dollar Tree might accurately represent where a low income person living in Boston may shop.

Observations

The findings at the Dollar Tree were not surprising. Of the 37 different types of chocolate bars present, all but one of them were produced by either Mars, Nestle, or Hershey’s. The lone chocolate bar not created by the companies mentioned was created by Russell Stover. None of the chocolate bars were craft chocolate bars or produced by small companies. In addition, none of the chocolates were Fair Trade or Utz certified, or certified as organic. The only chocolate bar that was close to having a label marking it as ethical was Crunch, which had the Nestle Cocoa Plan label. According to Nestle’s website, the Cocoa Plan “aims to improve the lives of cocoa farmers and the quality of their products” (“The Nestle Cocoa Plan”); however, upon closer inspection of their website, it is unclear how this plan improves the livelihood of farmers or reduces child labor. Furthermore, the only chocolates without fillings were a Hershey’s Chocolate bar, the Russell Stover solid chocolate bar, the Dove Milk Chocolate bar, and Kisses. Other chocolates had a combination of nuts, peanut butter, caramel, mint, or wafer filling. In addition, there was only one white chocolate option, which was the Hershey’s Cookies ‘n’ Creme Bar. There were no dark chocolate options available.

Chocolate Supply at the Dollar Tree
A picture of a chocolate bar selection at a Dollar Tree in Somerville (not all chocolate selections are pictured). As you can see, all the chocolates (or candies) present were produced by large corporations. Notice how Hershey’s has 9 chocolate cases on the stand and M&M’s has 5, suggesting that these are the most popular chocolates sold at this particular Dollar Tree.

Health Claims

Most chocolate bars made some health claims, though their actual nutritional value was questionable. Hershey’s chocolate bar had “Made with Farm Fresh Milk” on the bar, and the 3 Musketeers proudly wrote “45% less fat than the leading Chocolate Brands.” While the 3 Musketeers bar contains 5 grams of saturated fat and Hershey’s bar contains 8g (which is indeed close to 45% less), a Hershey’s bar only has 24g of sugar, while a 3 Musketeers bar has nearly twice as much at 40g of sugar. Another claim on the “Crunch” bar was that it was made with “100% Real Chocolate” and that it had “No artificial Flavors or Colors.”

Price

The price point was the same across all chocolates, which was $1. The Dollar Tree also had a value pack which included 6 smaller “fun size” chocolate bars of the same type in a packet for $1. The weight of the fun sized packet of chocolates was 75g or $.013/gram, while a normal chocolate bar was 1.55 oz, or about 44g, costing twice as much at $.022/gram. Only the Hershey’s Milk Chocolate Bar, Crunch, Snickers, Kit Kat, Reeses, 100 Grand, and Butterfingers bars were sold in fun sized packets, making them the cheapest chocolate options.

Crunch Value Pack vs. Normal Bar
A picture of the two sizes of chocolates sold (minus the candies in boxes). Chocolate was either sold in bar form (1.55 oz) or in fun sized packets (6/0.45oz, or 2.7oz total). Since each were a dollar, the fun sized packet is more economical, which encourages shoppers to buy more chocolate. Notice on the fun sized packet the “Nestle Cocoa Plan” Label, which is actually absent on the normal sized bar, and how the “100% Real Chocolate” claim on the normal bar was not on the fun sized packets; however, both had “No artificial Flavors of Colors” on the wrappers. Choosing to place different labels (an ethical one vs. a health conscience one) says something about who buys what, or who the company is trying to target with these two sizes.

Actual Nutrition

In terms of actual nutrition, the worst chocolate bar for saturated fat was a Hershey’s Milk Chocolate Bar, with 8g of saturated fat and 13g of total fat, and the best bar for saturated fat was the York Peppermint Patty, with 1.5 grams of saturated fat and 2.5 grams of total fat. The worst bar in terms of sugar was a Three Musketeers, with 40g of sugar, and the best in terms of sugar content was the Hershey’s Cookies ‘n’ Creme bar, which contained 19g of sugar. For reference, a healthy adult should consume between 25 and 37 grams of sugar each day and around 16g of saturated fat per day.

Discussion

The chocolate selection at the Dollar Tree has three worrisome implications: Big Chocolate takes advantage of gross human rights violations present in the chocolate supply chain to sell at low prices; Big Chocolate pumps chocolate bars with cheap alternatives such as sugar and other ingredients to even further lower the price of their chocolate bars; finally, because of the two reasons mentioned, the cheapest chocolate on the market (the one that low income Americans will buy) is filled with inordinate amounts of sugar and fat, fueling the diabetes and obesity epidemic plaguing low income Americans today. In the next section, I will substantiate these claims and explain how they feed into one another and result in unhealthy Americans and abused workers and farmers.

Cheap Cacao

The cheapest chocolate available at the Dollar Tree was produced by Big Chocolate companies, Mars, Nestle, and The Hershey Company. These companies typically get their cacao beans from West African farms or plantations by interacting with complicated systems involving national, government, and local powers (Martin); however, human rights violations run rampant on these farms. More often than not, these farms are pressured to lower their cost of production by these large chocolate corporations, which results in child labor, abuse, slavery, and extremely unsafe working conditions. Slavery and child labor are the most salient problems, which exposes nearly “half million to 1.5 million child workers” (ACI Group) to dangerous work conditions, with “more than half reporting injury at work” (Martin). Some individuals, including children, “are trafficked and forced to labor without or with little pay on cocoa farms” (Martin), but these human rights violations are often overlooked in favor of cheaper cacao prices.

Cheap Ingredients

While human right violations in the chocolate supply chain decrease the price Big Chocolate pays for their cacao, their inclusion of insane amounts of sugar, milk, and other ingredients further pushes down the price of their chocolate. Let’s take a look at a normal Hershey’s Milk Chocolate Bar. According to the Nutrition Label, the ingredients are Milk Chocolate (Sugar; Milk; Chocolate; cocoa butter; Lactose; Milk Fat; Soy lecithin; PGPR, Emulsifier, Vanillin, Artificial Flavors). According to the FDA, “ingredients are listed in order of predominance, with the ingredients used in the greatest amount first, followed in descending order by those in smaller amounts” (FDA). Sugar is the first listed ingredient, which is vastly cheaper than cacao as sugar is about $0.26/lb. Assuming that “chocolate” is made of cacao beans, this is the most expensive ingredient used, since the ICCO price was around $1.35/lb on May 3, 2018, which is over 5 times the cost of sugar. It is clear that chocolate manufacturers inject their products with incredible amounts of sugar because it is the cheapest ingredient. But it wasn’t just Hershey’s; of the 37 bars I observed, all of them had sugar listed as the very first ingredient on the nutrition label, meaning these bars are no more than a hint of chocolate and a heap of sugar. In addition, most bars weren’t pure chocolate, but instead contained peanuts, caramel, nougat, and other cheaper costing ingredients that further increase the sugar content and decrease the cost to make the bar.

Hershey's bar
Nutrition bar for a Hershey’s Milk Chocolate bar. Note the high saturated fat and sugar content. In addition, the first ingredient listed on the ingredients list in the parenthesis is sugar, implying that sugar comprises most of the bar, not milk or even cacao.

Health Implications

Knowing that nearly all the candy bars had more sugar content than the recommended daily allowance, it’s apparent why the US population, especially the lower income one, is so incredibly unhealthy. The average amount of sugar present in these bars was 29 grams, while it is recommended that children consume no more than 25 grams of sugar daily, and adults between 25 and 37.

Sweet Lies

But why is consuming so much sugar, which low income people disproportionately do, such a problem? Sugar has been identified as the leading cause for the obesity and diabetes outbreak in modern American. Although some experts argue that fat, not sugar, is the main proponent of diabetes and obesity, seeing who has funded sugar research is alarming. Multiple corporations such as Coca-Cola, Hershey’s, and Nabisco have given millions to the Sugar Association, or ISRF, to exonerate sugar. The ISRF attempted to shift the blame of obesity and diabetes to fat intake and create multiple research panels to argue that any research that points sugar to negative health claims is inconclusive. They have funded researchers such as Edward Biernan, who claimed that diabetics “need not pay strict attention to their sugar intake,” and Ancel Keys who claimed “Cholesterol and dietary fat—especially saturated fat—were the likely causes of heart disease” (Taubes). The FDA even subcontracted a committee “led by biochemist George W. Irving Jr., who had previously served two years as chairman” (Taubes) of the ISRF to determine if sugar was harmful, which has caused uncertainty of sugar’s effect on health for decades.

However, while the ISRF and Big Chocolate tried to hide the truth about sugar, the verdict is out. New research suggests that not only is sugar “addictive in much the same way as cigarettes and alcohol,” but the “overconsumption of them is driving worldwide epidemics of obesity and type 2 diabetes” (Taubes). No wonder “obesity rates in the United States have more than doubled, while the incidence of diabetes has more than tripled” (Taubes). Regarding diabetes, “long term consumption of sucrose can result in a functional change in the capacity to metabolize carbohydrates and thus lead to diabetes mellitus” (Taubes).

Obesity and Diabetes in Low Income Americans

Rates of diabetes and obesity are even more startling among low income individuals and children. “Those live in the most poverty-dense counties are those most prone to obesity. Counties with poverty rates of >35% have obesity rates 145% greater than wealthy counties” (Levine). In addition, “diabetes may be up to two times more prevalent in low income populations compared to wealthy populations” (Rabi, Doreen M et al.). This is believed to the case because “that individuals who live in impoverished regions have poor access to fresh food,” (Levine) and are instead bombarded with food items that are loaded in sugar. This is consistent with the unhealthy and sugary chocolate selection at the Dollar Tree.

ObesityDiabetes
Two maps indicating Obesity (Top) and Diabetes (Bottom) occurrences in the United States, with darker shades of blue indicating a higher percent of obese/diabetic people. Notice how these two maps are similar in that areas with higher rates obesity are the same ones with higher rates of diabetes, suggesting that there is a correlation between the two. In addition, there seems to be higher percentages of both obesity and diabetes in the South, which coincidentally homes more food deserts. In fact, the food desert map above shows a correlation between food deserts and obesity/diabetes since the areas that have a higher percentages of obesity/diabetes also have more food deserts.

In regards to children, the “number of overweight children in the US has tripled since 1980” (Albritton 344), and low income children “were more likely to be overweight than higher income children (7 percent vs. 4 percent)” (Lin). Companies, such as Hershey’s, specifically target children to develop a lifetime loyalty of their products, and it’s working. Research shows that sugar is addicting, almost as addicting as tobacco (Albritton 344), and when children and even adults consume these products, they will desire their products throughout their life and continue to consume them with disastrous results. “Overweight children often become overweight adults, and overweight in adulthood increases the risk of developing many diseases, including type 2 diabetes, high blood pressure, coronary heart disease, stroke, and…cancer” (Lin). 

The Big Takeaway

By understanding how Big Chocolate reduces the price of its chocolate, we can see how cheap chocolate has crippled the low income population in the United States. But a question still remains: given all this information on how terrible sugar and cheap chocolate are for you and the world, why do low income individuals continue to consume it? Do low income customers just not care the people who make their chocolate, or even their own health? Or is it that don’t have a choice, or the proper education to understand how sugar will affect them?

Packaging and propaganda have made it incredibly difficult for low-income individuals to choose the products that match their values. They are bombarded with misleading information on bars that contain supposedly 45% less fat when in fact it contains twice the amount of recommended daily sugar, they are told that bars bought through the “Nestle Cocoa Plan” will help farmers and eliminate child labor when in reality no one understands how these organizations impact the lives of farmers, and lastly, they are told by their doctors and schools to reduce their saturated fats intake when it is in fact sugar that is killing them. While it may be true that some low income consumers just don’t care about what they buy, the widespread misinformation and the products available renders them almost helpless in choosing products that are good for them and the world. It’s on us to give not only these individuals, but everyone the power to know what we put into our bodies and its effect on the world around us. Perhaps it’s time to take the power out of Big Chocolate and Sugar’s hands and place it into where it belongs—the consumer’s.

 

Works Cited:

ACI Group. “Is Your Favorite Chocolate the Product of Child Labor?” Edited by The Nation Blogs, The Nation’s Blogs, ACI Information Group, 22 Dec. 2014, scholar.aci.info/view/1464ec3e2ee6b730146/14a738db750000f00b2.

Albritton, Robert. 2012[2010]. “Between Obesity and Hunger: The Capitalist Food Industry.”

Dutko, Paula., et al. Characteristics and Influential Factors of Food Deserts. U.S. Dept. of Agriculture, Economic Research Service, 2012.

Griffin-Nolan, Ed. “DOLLAR STORES MAKE A BUCK ON POVERTY.” Syracuse New Times, 6 Aug. 2014, p. 43.

Levine, James. “Poverty and Obesity in the U.S.” American Diabetes Association. 01 May, 2018, http://diabetes.diabetesjournals.org/content/60/11/2667

Lin, Biing-Hwan, and United States. Department of Agriculture. Economic Research Service, issuing body. Nutrition and Health Characteristics of Low-Income Populations. Body Weight Status. United States Department of Agriculture, Economic Research Service, 2005.

Martin, Carla. AAAS 119x: Chocolate, Culture, and the Politics of Food .Lecture 7: Modern Day Slavery. 2018.

O’Neil, Carol E., Victor L. Fulgoni, and Theresa A. Nicklas. “Association of Candy Consumption with Body Weight Measures, Other Health Risk Factors for Cardiovascular Disease, and Diet Quality in US Children and Adolescents: NHANES 1999–2004.” Food & Nutrition Research 55 (2011): 10.3402/fnr.v55i0.5794. PMC. Web. 3 May 2018.

“Overview of Food Ingredients, Additives & Colors.” U.S. Food and Drug Administration/U.S. Department of Health and Human Services, 01 May, 2018, https://www.fda.gov/food/ingredientspackaginglabeling/ucm094211.htm  

Rabi, Doreen M et al. “Association of Socio-Economic Status with Diabetes Prevalence and Utilization of Diabetes Care Services.” BMC Health Services Research 6 (2006): 124. PMC. Web. 4 May 2018.

Schneider, Mike. “Grocery Chains Leave Food Deserts Barren.” The Epoch Times, 7 Dec. 2015, pp. A4–A5.

Taubes, Gary and Christin Kearns Couzens. “Big Sugar’s Sweet Little Lies.” http://www.motherjones.com/environment/2012/10/sugar-industry-lies-campaign

“The Nestle Cocoa Plan” Nestle, 01 May. 2018, http://www.nestlecocoaplan.com.

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