Overweight and malnourished? The dichotomy may not seem to add up, but nutritional experts say obesity is epidemic among the most malnourished, indigent people in Southern Oregon and the nation at large.

Overweight and malnourished? The dichotomy may not seem to add up, but nutritional experts say obesity is epidemic among the most malnourished, indigent people in Southern Oregon and the nation at large.

"Undernourished is underweight, but you can be malnourished and obese," says Cathy Miller, a Medford-based registered dietitian. "It means you don't have the right nutrition (to be healthy), but you have a lot of body fat."

Julie Kokinakes Anderson, Medford-based registered dietitian, says the phenomenon of obesity among the poor results from consumption of nutrient-poor foods packed with excessive calories, fat, sugar and sodium, such as simple-carbohydrate saltine crackers or ramen noodles.

Without adequate protein, fiber and nutrients, these foods don't provide the same nutrition or satisfaction as a meal rich in nutrients, fiber, protein and moisture, such as fruits, vegetables, legumes and whole grains, says Jenny Slawta, associate professor of health at Ashland's Southern Oregon University.

"You don't feel full because there's almost no fiber in (processed carbohydrates)," Slawta says.

Low-income residents tend to turn to processed carbohydrates because they're inexpensive, have a long shelf life and generally need less preparation to eat, Anderson says.

"Some people don't even have the pots and pans or means to cook anything," she says. "If you have no home, it's pretty difficult to cook at home."

"If you are hungry and you have three cookies, sure, you are going to eat those, versus three apples, which don't hold up and don't last a long time," she adds.

However, food availability, cost and homelessness are not the only causes of diets that perpetuate obesity.

"It's a combination of high poverty and lack of education," Anderson says.

A lack of awareness about proper nutrition is pervasive among clients who use the food pantry at Medford's Seventh-Day Adventist Church on Greenwood Street, says Burnadine Bratton, food pantry director.

"We encourage people to take the nutritious stuff, but most people who come in prefer to take white bread," Bratton says. "If you give them fresh fruit and vegetables, a lot of them will say, 'What do I do with that?' "

ACCESS Inc., Jackson County's emergency food bank, which supplies 22 food pantries including the Seventh-Day Adventist pantry, has tried to combat that trend by starting a program last year designed to educate clients about how food choices and preparation affect their weight and overall well-being, says Philip Yates, ACCESS nutrition programs manager.

The effort was in part a response to staggering statistics from the Oregon Hunger Factor Survey that suggest 27 percent of families who receive free food boxes in Oregon have diabetes, Yates says.

ACCESS recently received 3,000 pounds of winter squash.

"We mashed it and froze it in our commercial kitchen and passed it out with suggestions for recipes, like adding a couple cups to soup," Yates says.

Food pantry directors such as Bratton hand out recipes for how to use produce such as turnips, which some clients may never have eaten or don't know how to prepare.

Although ACCESS does what it can to obtain fresh produce, meat and whole grains for its clients, many items donated to food pantries are simple carbohydrates, such macaroni or ramen noodles, and that's often the kind of food clients want because they're accustomed to it. Beyond a lack of nutrient density, those foods provide less of a sense of satisfaction because of low amounts of fiber and protein, Miller says.

A meal of brown rice and beans would be a healthier alternative, she says.

Compared with a package of ramen noodles, for instance, a 1-cup serving of boiled pinto beans and brown rice mixed together has two-thirds the calories, one-third the sodium and only 10 percent of the fat, yet nearly 10 times the amount of fiber and 23 percent more protein. Protein and fiber help people feel fuller for longer with fewer calories, local nutritionists say. Throw some vegetables into the mix and you add a multitude of other vitamins and minerals, they say.

Miller advises her low-income clients to join The Gleaning Network Inc. in Central Point. The charitable organization partners with food retailers and producers to provide low-income residents with fresh produce for six months for $25.

Portion sizes also contribute to obesity, Miller says. People on a diet of simple carbohydrates may take larger portions because the food isn't satisfying or because they're used to big portions, especially of meat. Either way, the portions sabotage a healthy weight.

Miller recommends watching meat-portion sizes. Cutting down on the amount of meat you buy will free up funds for fresh vegetables and fruit and give you a better chance of being at a healthy weight.

And don't forget the enjoyment factor of eating, Miller says. Food can be comforting.

"If you are poor and lost your job and are at home, one of the last fun things to do is eat," Miller says. "If it gives you something to do and the food is free, you eat."

Reach reporter Paris Achen at 541-776-4459 or e-mail pachen@mailtribune.com.