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In Reply: We agree with Drs Egger and Tapia Granados that economic downturns can produce specific health benefits, an effect partially attributable to transient reductions in risk behaviors such as smoking and alcohol consumption, as well as other changes such as reduced overtime work hours. The writers draw attention to the work of Ruhm, which provides further information.¹

We do not believe that extreme experiences of German-occupied Europe or post–Soviet-era Cuba reliably inform our understanding of how US obesity prevalence may change in the coming decade. Barring profound disruption of food production and distribution, recession will not severely reduce the availability of calories in the domestic food supply, presently estimated to be about twice that required on a per-capita basis.² Rather, we believe that the primary effect of financial stress will be on dietary quality, encouraging consumption of highly processed, commodity-based products over more nutritious but costly vegetables, fruits, and . . . [Full Text of this Article]

David S. Ludwig, MD, PhD
david.ludwig@childrens.harvard.edu
Children's Hospital
Boston, Massachusetts

Harold A. Pollack, PhD
University of Chicago
Chicago, Illinois

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