diet (6)

Prioritizing Nutrition Security in the US

sliced carrots and green bell pepper on brown wooden chopping board The prevalence of nutrition-sensitive conditions such as obesity and type 2 diabetes has increased substantially in the US during the past 30 years. These conditions, combined with other diet-related ones such as cardiovascular diseases and certain cancers, are associated with the majority of morbidity, mortality, and health care spending nationally. Simultaneously, income inequality has increased, with accompanying self-reported food insecurity disproportionately affecting individuals with lower incomes. Food insecurity has been defined as the state of being without reliable access to a sufficient quantity of affordable, nutritious food, and in 2019 was estimated to affect 10.5% of US households.1 Food insecurity and poor nutrition are closely linked: individuals who report being most food insecure also have higher risks of developing obesity, diabetes, hypertension, coronary disease, stroke, cancer, and associated conditions, even after adjusting for other risks such as age, sex, employment, marital status, race/ethnicity, smoking, insurance status, family size, education, and income.2

For decades, US policies to address hunger and food insecurity have focused largely on providing sufficient calories or quantities of food. However, effectively addressing the current diet-related challenges in the US will require a shift beyond these concepts to the broader concept of nutrition security. Addressing nutrition security, which can be defined as having consistent access, availability, and affordability of foods and beverages that promote well-being and prevent (and if needed, treat) disease, may be the next needed approach to inform clinical care and public policy.

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Food in a Pandemic report published

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The Food in a Pandemic report, commissioned by the FSA and produced by Demos as part of Renew Normal: The People’s Commission on Life after Covid, looks to understand how a new food environment created during the pandemic has impacted the public’s behaviours and preferences. The research included: a nationally representative survey of 10,069 UK adults, a nationally representative online deliberative method called Polis with 1,006 UK respondents, a series of four deliberative workshops, and an open access survey of 911 adults.

Key findings on the public’s experience during the pandemic 

Food insecurity 

The report shows that people have stepped in to help prevent new forms of food insecurity caused by people self-isolating by offering informal forms of support such as shopping for others   

Findings also show there is a public appetite for the government to take action to help feed those without the means to feed themselves. People also tend to be more supportive of preventative actions for food insecurity, such as ensuring well-paid jobs are available to all. Just under two thirds (63%) agreed in the Polis that ‘it is the government’s responsibility to make sure no-one goes hungry’. 

UK food supply 

It’s reported a significant proportion of the population have bought food more locally or grown more food during the pandemic, reflecting a wider move towards individual self-sufficiency. Many of those who have made this move expect it to continue after the pandemic. 

78% of those surveyed supported the UK keeping its current food quality standards, even if food is more expensive and less competitive in the global market. A similar proportion (82%) also supported maintaining the UK’s current animal welfare standards, when presented with the same trade-off against prices and competitiveness. 

Diet and eating habits 

There has been a complex shift in people’s diets during Covid-19, with more home cooking. Although a third (32%) of respondents in the poll reported eating more healthy main meals, a third (33%) ate more unhealthy snacks. 

Some of the restrictions and public health advice, such as stay at home, might have encouraged more healthy eating. Those who have cooked more or eaten healthier main meals tend to expect this change to continue. However, this is likely to be somewhat dependent on the other changes, such as continued flexible working.  

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The COVID-19 pandemic is affecting food and nutrition security through economic and social systems shocks, food system disruptions and gaps in coverage of essential health and nutrition services. Food systems in low- and middle-income countries must adapt and strengthen food and nutrition security in the wake of COVID-19.

Food insecurity, deteriorations in diet quality, micronutrient deficiencies and other forms of malnutrition stem from fundamental, complex and dynamic changes in our food system9. Despite varying burdens and differential mitigation responses to SARS-CoV-2 across the globe, the impacts on national, regional and local food systems have consistently resulted in job losses, income shortfalls and food shortages.

To read the article, click here: Food systems, diets and nutrition in the wake of COVID-19

 

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8060374068?profile=RESIZE_710x Food Standards Scotland’s updated Situation Report – The Scottish Diet: It Needs to Change 2020 highlights the ongoing challenge for people in Scotland to have a healthier diet, including new exploration of the out of home environment, such as food bought ‘on the go’, and from deliveries and takeaways.

It is important to note that this data was captured prior to the COVID-19 pandemic, and therefore provides a baseline for further investigation on its impact on diet in Scotland.

The report shows that:

  • There continues to be a lack of progress towards the Scottish dietary goals and improving obesity and diet related poor health
  • Two out of three people in Scotland remain either overweight or obese, with a higher proportion of people living with obesity in the most deprived areas compared to the least deprived
  • We continue to buy a lot of discretionary foods and drinks, such as confectionery, cakes, biscuits, pastries, savoury snacks and sugary drinks from shops and supermarkets, and these tend to be heavily promoted
  • The food and drink we purchase from the out of home environment tend to be less healthy, with fried chicken and burger meals and sides among the top takeaway meals and dishes
  • People in Scotland support the food environment providing healthier food to make it easier to choose a healthier diet.

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A total diet study in Benin, Cameroon, Mali and Nigeria investigated what people eat, and their exposure to a selection of 800 of the chemicals that can be found in food.

Also in this episode: the impact of the current pandemic on the spices industry in India, and how the European Food Safety Authority communicates food safety in 23 languages.

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A 10-point summary on diet, nutrition and the role of micronutrients

E Fallon, S McAuliffe & S Ray on behalf of the NNEdPro Global Centre for Nutrition and Health (Design by M Abrantes; Reviewed by E Beck, L Buckner, J Bradfield, D Crocombe, M McGirr & K Martin) 26th March 2020. Correspondence to: info@nnedpro.org.uk

In the wake of the current and unprecedented COVID-19 pandemic, on 20th March 2020, the Director-General of the World Health Organization (WHO) emphasised the importance of appropriate diet and lifestyle measures including adequate nutrition to protect the immune system. This is of course not a substitute for adherence, first and foremost, to key public health and medical advice on prevention. However, as vast sections of society spend more time at home, it provides an opportunity to focus on strengthening the four lifestyle pillars of sleep, mind, exercise and diet. To elaborate on diet and nutrition, particularly given the variable quality of online information, we have put together a 10-point summary as general guidance: 

1 The Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2) is highly transmissible and can be potentially lethal. Hence any strategies that can prevent or mitigate respiratory infection risk and strengthen overall immunity are critical at this time. 

2 Poor nutrition, due to either insufficient dietary intake of key nutrients or a poor overall diet quality, can compromise immune function and increase overall infection risk. 

3 Micronutrients, commonly known as vitamins and minerals, are required in small quantities but are critical for health and pivotal in strengthening the immune system. 

4 Multiple micronutrients are essential for good immune function, particularly vitamins A, C, D, E, B2 (riboflavin), B6 (pyridoxine), B12 (cobalamin) and B9 (folic acid) and minerals iron, selenium, zinc, magnesium and copper (Calder, Carr, Gombart & Eggersdorfer, 2020) and these are found in a variety of foods that form part of a balanced diet in line with national guidelines. 

5 There are a variety of foods rich in vitamins and minerals (see below), in particular fruit and vegetables, which can be fresh, tinned or frozen:

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6 In the United Kingdom, as an example, several micronutrient deficiencies are prevalent as the Government’s National Diet and Nutrition Survey (2019) demonstrates widespread inadequacy in the intakes and/or status of vitamin D, vitamin A (retinol), folate and selenium across the UK population and in specific age groups. This is likely to be mirrored more widely across multiple countries. 

7 Certain individuals are at greater risk of micronutrient deficiency; this includes women of childbearing age, particularly pregnant and lactating women, infants and toddlers, children, adolescents (particularly females), older adults (Maggini, Pierre & Calder, 2018), obese individuals, and the critically ill, plus individuals with inflammatory bowel disease (Kilby, Mathias, Boisvenue, Heisler & Jones, 2019) and other chronic inflammatory and malabsorptive conditions. 

8 In many high risk groups, a balanced diet alone may not be sufficient to meet these requirements and deficiencies can contribute to impaired immune function. This can be due to a variety of factors affecting intakes, absorption and also due to increased utilisation of micronutrients during times of infection. In such cases, the immune system can be supported by micronutrient supplementation particularly to help correct deficiencies.

9 As a key example from the UK, Vitamin D supplementation is recommended at 10 micrograms a day, as per guidelines. The average diet provides less than half of this amount. In fact, Public Health England (PHE) is now recommending that people consider taking a Vitamin D supplement of 10ug throughout the spring and summer as lockdown continues and access to sunlight may be limited. This is of particular concern in individuals in the high-risk category, which includes people who are housebound, living in a care home and those with darker skin. 

10 Overall, whilst COVID-19 is causing inevitable distress to one and all, aside from the impact of the viral illness itself, prevention through social distancing and staying at home can affect both mood and feelings. This may cause depression, anxiety, loneliness and irritability. During these testing times, it is important to remember that eating well, staying hydrated, thinking positively, sleeping adequately and staying active will contribute to both physical and mental wellbeing. Some examples of useful UK resources include:

(i) NHS ‘stay at home’ exercises – https://www.nhs.uk/live-well/exercise/gym-free-exercises/

(ii) Doing things for others – www.actionforhappiness.org

(iii) A mental health community pack – https://www.maldon.gov.uk/healthandwellbeing 

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