NUTRITION AND PUBLIC HEALTH

Dr Julie FrierConsultant Public Health Plymouth City Council

Nutrition and Public Health

Food related problems and food safety issues that affect the health of the population

Inequalities Variations in opportunity for health through nutrition

Food supply Food security: Sustainability, quality, safety, climate Food Poverty: deprivation, affordability, availability and

accessibility

Consumption Health problems related to the excessive intake of quantity of

the habitual diet- energy dense, high fat, high sugar, high salt, Health problems related to the inadequate quantity and

quality of the habitual diet- low fibre, micronutrients

Health Consequences

Premature death 70,000 lives saved each year if population diet matched nutritional guidelines on fruit and vegetables, saturated fat, added sugar and salt intake. (Food Matters 2008)

MorbidityDental decayExcess weight / ObesityType II diabetesCardiovascular diseaseCancerIron deficient anaemiaPoor bone healthMental health and wellbeingFood poisoning / infection

Nutrition and Public Health

The purpose of public health in Plymouth is to “improve and

protect Plymouth’s health and wellbeing, and improve the

health of the poorest fastest.”

Key contribution will be access to good nutrition for all

Position in Plymouth

Health inequalities in Plymouth

Poverty & food poverty

10 million people and 3 million children live in poverty

11,700 children living in poverty in Plymouth Food Poverty can be defined as the inability

to access healthy affordable food whether due to lack of income, transport issues or lack of knowledge or skills around how to cook food.

In UK the poorer people are, the worst their diet

Plymouth Foodbank reporting a 40% increase in those receiving food (over 4,000 people)

Poverty and deprivation in PlymouthChild poverty distribution in Plymouth

Source: Her Majesty’s Revenues and Customs, 2009

Dental decay

Excess weight / obesity

Adults: Male adult obesity 22% Female adult obesity 24% Estimated that obesity rates will

double by 2050. (Plymouth interim report 2012)

Children: 4-5 years: 9.4% obese 10-11 years: 19.6% obese Trend for 10-11 years is upwards

Marked inequalities

Excess weight trends for children aged 4-5 years in Plymouth

Excess weight trends for children aged 10-11 years in Plymouth

Population diet deficiencies

Measure 

Recommended Actual

Fruit / Vegetables 5 a day 31% adults at 4.1 portions11% boys at 3.0 portions8% girls at 2.8 portions

Saturated fat No more than 11% of food energy

12.7 % of food energy

Non Milk Extrinsic Sugars

No more than 11% of food energy

Above in all age groups and for 11-18 years was 15.3%

Non-starch polysaccharides

18g a day Population mean below this (13.3-13.8g)

Vitamins Reference Nutrient Intake Close to or above (not Vitamin D)(about 1 in 5 had 25-OHD concentration below lower threshold for Vitamin D adequacy

Vitamin A / riboflavin Reference Nutrient Intake 11-18 years 13% below for Vitamin A21% girls below for Riboflavin

Iron   5.6% of girls aged 11-18 years and 3.3% women aged 19-64 years had evidence of iron deficient anaemia

National Diet and Nutrition Survey

What influences these problems

Food related problems that affect the health: influences

Socio-economic, cultural and environmental factors that influence our living conditions: the food chain, accessibility to shops and outlets, housing situation- facilities to cook and eat, poverty, education approach and level

Social and community networks: food culture, social norms, informal learning: cooking & food skills

Individual lifestyle factors: knowledge and skills for cooking, individual taste and preference

Variation in these =Inequalities in opportunity for health through good nutrition

Solutions- multifaceted and everybody's business

Public health approach to the food systemAim: Affordable and nutritious food for all

Combat inequality in access to health through food Increase food security Reduce food poverty Ensure equity of access and availability for all especially the most

vulnerable Identify and remove barriers to healthy food

Strengthen food culture for health Increased available information food, diet and health Foster knowledge and skills of food and nutrition -Cooking skills,

growing skills and social value of food Focus on maternal and childhood nutritional health Promote healthy choices to combat chronic disease and obesity

Any questions…