Transcript Food Security and the Early Years

THUNDER BAY DISTRICT HEALTH UNIT
Food Security
and the Early Years
Kim McGibbon, MScCH, RD
Public Health Dietitian
[email protected]
Best Start Conference October 19th, 2010
Outline 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 does the term “food
security” mean to you?
“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.
Canada’s Action Plan on Food Security, 1998
CCHS: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)
Who are the food insecure?
Those with the highest rates of
poverty are most at risk:
• lone parents (female headed
households)
• homeless people
• Aboriginals
Aboriginal & Non-Aboriginal
20
18
16
14
12
10
8
6
4
2
0
% Moderately
Food Insecure
% Severely
Food Insecure
Canada
Aboriginal
Households
NonAboriginal
Households
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.
45
40
35
30
% food 25
insecure 20
15
10
5
0
lowest
Ledrou & Gervais, Health Reports 2005)
low
middle
middle
upper
middle
INCOME ADEQUACY
highest
Households whose major source of income is
social assistance are particularly vulnerable.
Major source of income
Employment
Odds (95% CI) of
reporting food
insecurity
Odds (95% CI) of reporting
compromises in food intake
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:
1. food anxiety
2. compromises in food
quality
3. compromises in food
quantity
-> “hunger”
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
Food Insecurity Can Lead To…
• Decreased intakes protein and energy
• Inadequate intakes of several nutrients
•
• Behavioural and psychsocial
dysfunction
• Cognitive developmental deficits
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
Canadian 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
Insights 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
The Reality
“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.”
Pregnancy
• 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)
Lactation
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:
• 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:
• 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
8
Vegetables & fruit
6
Milk products
Other foods
4
Grain products
Meat, fish, poultry, etc
2
Veg & Fruit
Milk
Other
Grain
Meat
0
Average weekly quantity purchased (kg)
10
- based on data from the 1996 Family Food Expenditure Survey.
0
20000
40000
60000
80000
Per c apita inc ome ($)
(Ricciuto, Tarasuk & Yatchew, Eur J Clin Nutr in press))
Assessing 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?
Community 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
Community 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 Food Security
Continuum
Stage 1
Short-term
Relief
Food Bank
Soup Kitchen
Stage 2
Capacity
Building
Community Garden
Community Kitchen
Food Buying Club
Stage 3
Redesign
Food Policy
Social Advocacy
Capacity Building
Strategies
Community Kitchens...
•
are small groups of
people who get
together to cook
healthy, economical
meals to take home to
their families.
School Breakfast
Programs...
make sure that
every child starts
the school day with
a nutritious meal.
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.
Good 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...
allow people to grow
their own fresh, healthy
produce and reduce
their food costs.
Resources
www.nwofood.ca
Books, 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