THUNDER BAY DISTRICT HEALTH UNIT Food Security and the Early Years Kim McGibbon, MScCH, RD Public...
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Transcript of THUNDER BAY DISTRICT HEALTH UNIT Food Security and the Early Years Kim McGibbon, MScCH, RD Public...
THUNDER BAY DISTRICT HEALTH UNITTHUNDER BAY DISTRICT HEALTH UNIT
Food Security and the Early YearsFood Security and the Early Years
Kim McGibbon, MScCH, RDPublic Health [email protected]
Best Start Conference October 19th, 2010
Kim McGibbon, MScCH, RDPublic Health [email protected]
Best Start Conference October 19th, 2010
Outline for WorkshopOutline for Workshop
• What is the impact of food insecurity
• Strategies – What are families doing, how can we help
• What programs and services offered & how to start them
• Resources
• What is the impact of food insecurity
• Strategies – What are families doing, how can we help
• What programs and services offered & how to start them
• Resources
“Food Security”“Food Security”
exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life.
exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life.
Canada’s Action Plan on Food Security, 1998
CCHS:2004 Key FindingsCCHS:2004 Key Findings
• 90.8% of households were food secure
• 9.2% of households were moderately or severely food insecure (1.1 million
households)
• 5.2% of households with children were food insecure (700,000)
• 90.8% of households were food secure
• 9.2% of households were moderately or severely food insecure (1.1 million
households)
• 5.2% of households with children were food insecure (700,000)
Who are the food insecure? Who are the food insecure?
Those with the highest rates of poverty are most at risk:
• lone parents (female headed households)
• homeless people• Aboriginals
Those with the highest rates of poverty are most at risk:
• lone parents (female headed households)
• homeless people• Aboriginals
Aboriginal & Non-AboriginalAboriginal & Non-Aboriginal
02468
101214161820
Canada AboriginalHouseholds
Non-Aboriginal
Households
% ModeratelyFood Insecure
% SeverelyFood Insecure
02468
101214161820
Canada AboriginalHouseholds
Non-Aboriginal
Households
% ModeratelyFood Insecure
% SeverelyFood Insecure
Canadian Community Health Survey (CCHS) 2004: Income-Related Household Food Security in Canada
The likelihood of food insecurity
increases as the adequacy of income
declines.
The likelihood of food insecurity
increases as the adequacy of income
declines.
05
1015202530354045
% food insecure
lowest lowmiddle
middle uppermiddle
highest
INCOME ADEQUACY
05
1015202530354045
% food insecure
lowest lowmiddle
middle uppermiddle
highest
INCOME ADEQUACY(Ledrou & Gervais, Health Reports 2005)
Households whose major source of income is
social assistance are particularly vulnerable.
Households whose major source of income is
social assistance are particularly vulnerable.
Major source of income
Odds (95% CI) of reporting food insecurity
Odds (95% CI) of reporting compromises in food intake
Employment 1.0 1.0
Social assistance 3.1 (2.3 - 4.0) 3.4 (2.6 – 4.5)
EI, Worker’s Comp, CTB, support/alimony
1.7 (1.2 – 2.6) 1.8 (1.1 – 2.8)
Seniors’ benefits 0.9 (0.7 – 1.5) 1.0 (0.8 – 1.4)
Other 1.0 (0.7 – 1.5) 1.1 (0.7 – 1.6)
(Che & Chen, Health Reports, 2001)
Household food insecurity: a managed process:Household food insecurity: a managed process:
1. food anxiety
2. compromises in food quality
3. compromises in food quantity-> “hunger”
1. food anxiety
2. compromises in food quality
3. compromises in food quantity-> “hunger”
Food Insecurity Can Lead To…Food Insecurity Can Lead To…
• Poorer health status
• Decreased immunity
• Increased family stress, depression, and feelings of deprivation
• Increased absenteeism from work & school
• Decreased ability to concentrate learn & work
• Poorer health status
• Decreased immunity
• Increased family stress, depression, and feelings of deprivation
• Increased absenteeism from work & school
• Decreased ability to concentrate learn & work
Food Insecurity Can Lead To…Food Insecurity Can Lead To…
• Decreased intakes protein and energy
• Inadequate intakes of several nutrients
• • Behavioural and psychsocial dysfunction
• Cognitive developmental deficits
• Decreased intakes protein and energy
• Inadequate intakes of several nutrients
• • Behavioural and psychsocial dysfunction
• Cognitive developmental deficits
Insights from Canadian research:Insights from Canadian research:
• Dietary intakes worsen as food insecurity worsens
• Intakes of food insecure mothers consistently worse than children’s
• For children little indication of nutrient inadequacies
• Adolescents and adults noted nutrient inadequacies for Protein, Vitamin A, Thiamin, Riboflavin, Vitamin B6 & 12, folate, magnesium and phosphorus
• Dietary intakes worsen as food insecurity worsens
• Intakes of food insecure mothers consistently worse than children’s
• For children little indication of nutrient inadequacies
• Adolescents and adults noted nutrient inadequacies for Protein, Vitamin A, Thiamin, Riboflavin, Vitamin B6 & 12, folate, magnesium and phosphorus
Canadian IntakeCanadian Intake• Fewer servings vegetables and fruit
and milk products of 1-3 year old children in food insecure households
• Lack of food choice & monotony of diet; lack of control over food situation
• Higher energy density associated with HFISec for females 19-50
• Higher proportion energy from carbohydrates
• Less vegetables, fruit and milk products in many age categories
• Fewer servings vegetables and fruit and milk products of 1-3 year old children in food insecure households
• Lack of food choice & monotony of diet; lack of control over food situation
• Higher energy density associated with HFISec for females 19-50
• Higher proportion energy from carbohydrates
• Less vegetables, fruit and milk products in many age categories
Insights from Canadian research: cont’dInsights from Canadian research: cont’d
• Increased risk Type II diabetes• Obesity not consistently
associated with food insecurity – highest association among women in marginally food insecure
• Associated with depression in adults and children
• Increased risk Type II diabetes• Obesity not consistently
associated with food insecurity – highest association among women in marginally food insecure
• Associated with depression in adults and children
“We want to follow Canada’s Food Guide but it is impossible”
“Who in their right mind can run off and buy eggs and milk and cheese and all that stuff? I mean, those are the things that children are supposed to eat every day, but those are not the things that children eat if their families are on a fixed income because nobody can afford it.”
“We want to follow Canada’s Food Guide but it is impossible”
“Who in their right mind can run off and buy eggs and milk and cheese and all that stuff? I mean, those are the things that children are supposed to eat every day, but those are not the things that children eat if their families are on a fixed income because nobody can afford it.”
The Reality
PregnancyPregnancy• Several micronutrient intakes increase during
pregnancy (Vit. D, folic acid, iron)
• Effects of deficiency on child may be unreversible (i.e. NTD’s)
• Common concerns: miscarriage, impaired intrauterine growth, reduced birth weight
• Impaired status in utero may impact development of chronic diseases later in life
• Multimicronutrient supplements increase birth weight (more than Fe,FA alone)
• Several micronutrient intakes increase during pregnancy (Vit. D, folic acid, iron)
• Effects of deficiency on child may be unreversible (i.e. NTD’s)
• Common concerns: miscarriage, impaired intrauterine growth, reduced birth weight
• Impaired status in utero may impact development of chronic diseases later in life
• Multimicronutrient supplements increase birth weight (more than Fe,FA alone)
LactationLactation
Supplementation to under-nourished moms:
• Produce more milk• Mothers lose less weight• Extend period of exclusive
breastfeeding• Prevalence of iron deficiency in Can
women 19-50 >10% - linked to dec. BF continuation rates
Supplementation to under-nourished moms:
• Produce more milk• Mothers lose less weight• Extend period of exclusive
breastfeeding• Prevalence of iron deficiency in Can
women 19-50 >10% - linked to dec. BF continuation rates
Household income strategies
to avoid hunger:
Household income strategies
to avoid hunger:
• Increase the supply of money– odd jobs, giving up services such as
the phone, selling possessions, borrowing money, use coupons, return bottles
• Juggle the budget– delaying bill payments, purchasing
food on credit, borrow food, sending kids to relatives, food banks
• Increase the supply of money– odd jobs, giving up services such as
the phone, selling possessions, borrowing money, use coupons, return bottles
• Juggle the budget– delaying bill payments, purchasing
food on credit, borrow food, sending kids to relatives, food banks
Household food strategies
to avoid hunger:
Household food strategies
to avoid hunger:
• Comparison shopping, buy on sale
• Altering recipes to “stretch” the meal
• Serve low cost meals few ingredients
• Serve only food that the family likes
• Cut portion sizes
• Mothers go hungry first
• Comparison shopping, buy on sale
• Altering recipes to “stretch” the meal
• Serve low cost meals few ingredients
• Serve only food that the family likes
• Cut portion sizes
• Mothers go hungry first
Relationship between household food expenditure patterns and per capita income in Canada- based on data from the 1996 Family Food Expenditure Survey.
Per capita income ($)
Ave
rag
e w
ee
kly
qu
an
tity
pu
rch
ase
d (
kg)
0 20000 40000 60000 80000
02
46
81
0
Veg & FruitMilkOtherGrainMeat
Vegetables & fruit
Milk products
Meat, fish, poultry, etc
Grain products
Other foods
(Ricciuto, Tarasuk & Yatchew, Eur J Clin Nutr in press))
Assessing Strengths and NeedsAssessing Strengths and Needs
Look at the situation given. Using the Tool “Issues that influence food intake” assess strengths and challenges
Questions:1. What is making this person/family
food insecure?2. What strategies can be undertaken
to improve their situation?
Look at the situation given. Using the Tool “Issues that influence food intake” assess strengths and challenges
Questions:1. What is making this person/family
food insecure?2. What strategies can be undertaken
to improve their situation?
Community Food SecurityCommunity Food Security
• All community residents obtain a safe, culturally acceptable, nutritionally adequate diet through a sustainable food system that maximizes community self-reliance, social justice, and democratic decision-making.
Hamm and Bellows, 2002
• All community residents obtain a safe, culturally acceptable, nutritionally adequate diet through a sustainable food system that maximizes community self-reliance, social justice, and democratic decision-making.
Hamm and Bellows, 2002
Community Food SecurityCommunity Food Security• Community development strategy
• Encompass basic principles of anti-hunger with a broader scope– long-term, systematic and comprehensive
approaches to address FS for everyone
• Includes all food chain activities– natural resources & agriculture, processing
and distribution, nutrition & health to public policy
• Promotes sustainable agriculture
• Community development strategy
• Encompass basic principles of anti-hunger with a broader scope– long-term, systematic and comprehensive
approaches to address FS for everyone
• Includes all food chain activities– natural resources & agriculture, processing
and distribution, nutrition & health to public policy
• Promotes sustainable agriculture
Community Food Security ContinuumCommunity Food Security Continuum
Stage 1 Short-term Relief
Stage 2 Capacity Building
Stage 3 Redesign
Food BankSoup Kitchen
Community GardenCommunity KitchenFood Buying Club
Food PolicySocial Advocacy
Community Kitchens...Community Kitchens...
• are small groups
of people who get together to cook healthy, economical meals to take home to their families.
• are small groups
of people who get together to cook healthy, economical meals to take home to their families.
School Breakfast Programs...School Breakfast Programs...
make sure that every child starts the school day with a nutritious meal.
make sure that every child starts the school day with a nutritious meal.
Gleaning...Gleaning...
allows individuals and families to pick crops from farmer’s fields that would otherwise not be used or sold, at no cost to them.
allows individuals and families to pick crops from farmer’s fields that would otherwise not be used or sold, at no cost to them.
Good Food BoxGood Food Box
•The Good Food Box is a program for families and individuals who want to purchase high-quality, fresh, local produce at a lower price •Family box for $20 or an individual box for $12.
•Boxes are ordered and paid for by the first Thursday of each month.
•Food is packed and distributed from a main site to local host sites for pick up the second last Thursday of each month.
Community Gardens...Community Gardens...
allow people to grow their own fresh, healthy produce and reduce their food costs.
allow people to grow their own fresh, healthy produce and reduce their food costs.
ResourcesResources
www.nwofood.caBooks, Pamphlets and Videos • Community Kitchens and
Cooking On a Budget• School Meal & Snack Programs• How to set up Gleaning and
Good Food Box Programs• Community Gardens
www.nwofood.caBooks, Pamphlets and Videos • Community Kitchens and
Cooking On a Budget• School Meal & Snack Programs• How to set up Gleaning and
Good Food Box Programs• Community Gardens