A small but telling study from the Johns Hopkins
Children's Center reveals an ominous trend: More than
expected, obesity shadows Baltimore's homeless children and
their caregivers, putting them at high risk for heart
disease, stroke and type 2 diabetes, among other
"Not long ago, homeless people were undernourished.
Our study shows the pendulum has swung the other way.
Obesity might be the new form of malnutrition among the
homeless," said lead author Kathleen Schwarz, a
gastroenterologist at the
Children's Center. "More disturbing, it appears that being
both poor and homeless may increase one's obesity risk."
The study, published in the March issue of the online
journal Medscape General Medicine, looked at 60
children, ages 2 to 18, and 31 caregivers recruited from
eight homeless shelters in Baltimore. Nearly half the
children (25 of 60) were either overweight or at risk for
becoming overweight. Children with weight in the 85th to
95th percentile for their age are considered "at risk,"
while those with weight above the 95th percentile are
classified as overweight. The U.S. Centers for Disease
Control does not use the term "obese" for children.
Compared with children nationally, Baltimore's homeless
poor had a higher percentage of at-risk or overweight
children, pointing to homelessness as an added risk.
Researchers didn't monitor food intake or physical
activity but say that low-cost, calorie-dense meals and
fear of spending time outdoors in high-crime areas are the
None of the children younger than 7 years were
overweight, but their body mass indexes increased with age,
suggesting that obesity risk creeps up as children grow
Exploring the link between the weights of adults and
those of children in their care, researchers found that 77
percent of the caregivers were overweight or obese,
compared to 42 percent of children. "Scientists have long
known that the children of overweight parents are likely to
grow into overweight adults," Schwarz said. "We saw this
dynamic playing out in our study."
These early findings from the Baltimore group may warn
of a national obesity epidemic among America's more than
14.5 million homeless, researchers note, and spell
financial and medical trouble.
"If what we saw in Baltimore's homeless turns out to
be a national trend, we're headed for a crisis that would
cost us hundreds of millions of dollars," Schwarz said.
"That's before we even try to measure the toll in terms of
human suffering and loss of life."
Prevention efforts should focus on ensuring healthier
meals at homeless shelters, educating parents and
caregivers, and providing space for indoor physical
activities in high-crime areas, the researchers say.
Nine million children in the United States are
considered overweight, according to the Institute of
Medicine. If the current obesity trends continue, America's
children could become the first generation in more than a
century to have shorter life spans than their parents,
The study was funded by the National Institutes of
Health. Co-authors are Beth Garrett and Jenifer Hampsey,
both of the Johns Hopkins Children's Center; and Douglas
Thompson, of the Maryland Medical Research Institute,