Hunger and malnutrition cost the United States an extra $160bn a year in the treatment of chronic health conditions, according to a report released to coincide with Thanksgiving that exposes the consequences of “food insecurity” among poorer American families.



The study, commissioned by Christian charity Bread for the World, is believed to be the first to apportion a share of the long-term costs of illnesses such as diabetes that are linked to a lack of access to affordable, nutritious food.



Although most attention has focused in recent years on reducing American obesity rates, the authors of the report claim there is in fact a “two-headed pandemic” in the US, caused by both a lack of healthy food and obesity.



Government statistics suggest that between 2008 and 2014 at least 48.1 million people a year were classed as “food insecure”, meaning they could not always afford to eat balanced meals, including 19.2% of all households with children. Census researchers define food insecurity as both an inability to afford regular nutritious food or periods of outright hunger.



At the launch of the report, Dawn Pierce, a nurse from Idaho who was forced to rely on food stamps after losing her job, gave an emotive account of the difficulty she faced in feeding her son and herself in a way that helped her manage her type II diabetes.



“Food stamps are wonderful, but if you only get $317 a month, you are going to buy the most food you can buy with that money, and the most food you can go buy is a case of Top Ramen for $4.20 and cans of chili for 69 cents,” she said.



“I gained 40lb on food stamps. I mean, how can you be hungry and be fat? But that’s totally possible when you are eating junk and Top Ramen instead of salad and a roast and mashed potatoes and homemade gravy.”



Pierce also spoke of the stigma of being forced on to food stamps, now known as the supplemental nutrition assistance program (Snap), and the difficulty of juggling her son’s needs with her own diet and medication.



“Sitting in the parking lot I cried for an hour before I went in, because I could not believe I had to ask for help,” she said.

“It’s humiliating and embarrassing. I dreaded the day my son came home and asked me for cookies for school or muffins for some project or pot luck because I didn’t plan for that. I didn’t have that in the food budget.



“I brought healthier stuff just for my son but not me, because he was more important,” added Pierce.

“One night I was lying in bed and hardly slept at all, and I was trying to figure out why my heart rate was close to 120 and why I had a raging headache and I ran through the list of things I ate that day and it was crap. It was chili cheese Fritos and I had coffee and some corn nuts and grabbed an 89-cent hamburger from McDonald’s and I realised that this has got to change. My blood sugar was 279.”



The study found that food insecurity increases by nearly 50% the chances of becoming a “high cost user of healthcare services” within five years.



Healthcare costs have soared in the US and account for 24% of all federal spending, while federal food assistance is just 3% of spending.



“Nowhere are the hidden costs of hunger and food insecurity greater than in health care,” said the Rev David Beckmann, president of Bread for the World.

“Access to nutritious food is essential to healthy growth and development, and can prevent the need for costly medical care. Many chronic diseases – the main causes of poor health as well as the main drivers of healthcare costs – are related to diet.”

