Transcript Food Security and Health

Kimberly Reid RD
Prince Edward Family Health Team
April 12, 2012
“Social injustice is killing
people on a grand scale”
Closing the gap in a generation, World Health Organization, 2008
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Our Family Health Team is a group of skilled
health professionals working together to
provide better access to high quality, coordinated health care and health services, as
close as possible to where you live
Our team includes; 25 family physicians, 5
nurse practitioners and a supporting team of
nurses, dietitians, social workers,
pharmacists, respiratory therapists,
psychiatrists, visiting specialists (internist,
pediatrician, etc.) and a full administrative
team
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Our community has chronic illness
◦ Hastings and Prince Edward County
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Obese or overweight 56.5%
Diabetes
8.0%
Asthma
6.1%
High blood pressure
19.4%
State Health Status
very good or excellent 53.5%
(88
(12
( 9
(30
140)
480)
520)
260)
(83 460)
South East sub-LHIN mapping March 2009
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Residents are living on a low income
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Belleville
Prince Edward
Central Hastings
North Hastings
Quinte West
15.1%
9.2%
12.7%
11.3%
11.1%
(7850)
(2410)
(2860)
(1350)
(6220)
South East sub-LHIN mapping March 2009
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More that 1.1 million households or 9.2%
were food insecure at some point in the
previous year (2004)
2.7 million Canadians or 8.8% lived in food
insecure households in 2004
Canadian Community Health Survey Cycle 2.2, Nutrition, 2004
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High stress increases levels of a hormone
called cortisol in the body
Cortisol can increase blood pressure, insulin
resistance and cholesterol
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Household food insecurity is associated with the
consumption of poorer quality diets
Nutrient inadequacies were noted for:
◦ Protein (found in all cells and is required for growth and
development)
◦ Vitamin A (required for retinal development and cell
growth, particularly epithelial)
◦ Thiamin (required for cell processes such as breakdown
of sugars and amino acids)
◦ Riboflavin (required for processes of energy metabolism)
Kirkpatrick SI. et al, Food insecurity is associated with nutrient inadequacies
among Canadian adults and adolescents, 2008
◦ Vitamin B6 (required for metabolism of amino acids
and release of sugars in the body)
◦ Vitamin B12 (required for metabolism and DNA
synthesis)
◦ Magnesium (required for nerve processes and blood
vessel regulation)
◦ Phosphorus (required for development of cell
membranes and is a component of DNA)
◦ Zinc (requiring in many bodily processes and
deficiency can lead to growth retardation, delayed
sexual maturation, infection susceptibility, and
diarrhea)
Kirkpatrick SI. et al, Food insecurity is associated with nutrient inadequacies
among Canadian adults and adolescents, 2008
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An analysis of the American National Health
and Nutrition Examination Study was
completed to determine the association
between food security and risk for overweight
or obesity
Overweight is BMI ≥85%ile and obese is BMI
≥95%ile.
Casey PH. et al. The association of child and household food insecurity with
childhood overweight status, 2006
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Children in food insecure households were
more likely to demonstrate significant
associations with being at risk in the
following groups;
◦ 12-17 year old
◦ Girls
◦ White
Casey PH. et al. The association of child and household food insecurity with
childhood overweight status, 2006
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Food insecure children have also been shown
to have lower cognitive and academic
performance
◦ Lower arithmetic scores
◦ More likely to have repeated a grade
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Living in low income households increases
risk throughout adulthood
If living in food secure households as an adult
risk decreases but is still higher than those
who have never experienced food insecurity
Position of the American Dietetic Association: Food insecurity and
hunger in the United States, 2006
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In an analysis of the1997 National Population
Health Survey individuals in food-insufficient
households were more likely to report heart
disease, diabetes, high blood pressure and
food allergies
All of these disease are in some part
controlled or prevented by dietary
modifications
Quantity vs. Quality!
Vozoris NT. et al. Household food insufficiency is associated with poorer health,
2003
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Our food choices play a significant role in the
prevention and management of chronic
diseases.
To maintain calories on a low income foods
that are chosen often are low cost, energy
dense and nutritionally poor foods (refined
carbohydrates with added sugars, fats and
sodium)
Seilgman HK. et al. Hunger and socioeconomic disparities in chronic disease,
2010
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Between 1985 and 2000 prices have
increased disproportionately
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Soft drinks 20%
Fats and oils 35%
Sweets 46%
Fresh fruits and vegetables 118%
Seilgman HK. et al. Hunger and socioeconomic disparities in chronic disease,
2010
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Women living on a low income are 40-50%
more likely to develop diabetes
Adults with diabetes are 40% more likely to
achieve poor glycemic control due to cyclic
eating and poor food choices
Adults with diabetes who experience food
insecurity have 5 more physician encounters
per year than their counterparts ($$)
Seilgman HK. et al. Hunger and socioeconomic disparities in chronic disease,
2010
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An analysis of the National Population Health
Survey and the Canadian Community Health
Survey examined the following trends from
1994-2005:
◦ Heart disease
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27% increase in lowest income category
37% increase in lower middle income category
12% increase in upper middle income category
6% increase in highest income category
Lee DS. et al. Trends in risk factors for cardiovascular disease in Canada:
temporal, socio-demographic and geographic factors, 2009
◦ Diabetes
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56% increase in lowest income category
93% increase in lower middle income category
59% increase in upper middle income category
0% increase in highest income category
◦ Hypertension
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85% increase in lowest income category
80% increase in lower middle income category
80% increase in upper middle income category
117% increase in highest income category
Lee DS. et al. Trends in risk factors for cardiovascular disease in Canada:
temporal, socio-demographic and geographic factors, 2009
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Food insecurity has been connected with
mental health conditions
◦ Depression, particularly maternal depression
◦ Suspension from school
◦ Difficulty getting along with others in school and
the workplace
◦ Need of counselling by a psychologist/psychiatrist
◦ Increased risk of suicide
Position of the American Dietetic Association: Food insecurity and hunger in
the United States, 2006
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When meeting with/counselling people with a
chronic disease we need to address these issues
◦ 72% of people with diabetes on social assistance state
that they lack the resources to eat the way the have been
taught at their diabetes education centre
◦ Encourage the Special diet allowance, Special necessities
supplement, Monitoring for health, Trillium drug
benefits, etc.
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Encourage low-cost preventative health care
◦ Active lifestyles, regular visits with PCP, community
services (community kitchens, education groups, etc)