breakfast with...dr. lynn mcintyre

Lynn McIntyre MD, MHSc, FRCPC Professor & CIHR Chair in Gender and Health

University of Calgary [email protected]

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PLEASE NOTE:

Many of the slides are from unpublished studies and are subject to change and that the posting of

this presentation in no way constitutes prior publication.

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NOT the flipside of Food Security“Food security exists when all

people, at all times, have physical and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life.” (World Food Summit, 1996)

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Food Insecurity: Household food insecurity refers to the inadequate or insecure access to food due to financial constraints

Hunger: Prolonged, involuntary lack of food that results in illness, weakness or pain that goes beyond the usual uneasy sensation

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A western model for hunger & food insecurity

COMPONENT Household Dimension Individual Dimension

Quantity Food depletion Insufficient intake

Quality Unsuitable food Inadequate diet

Psychological Food anxiety Feeling deprived, lack of

choice

Social Unacceptable means of

food acquisition

Disrupted eating pattern

Source: Modified from Radimer, Olson & Campbell, 1990 (5)

NUMBERS

2007: 8% population

140,442 client visits to Calgary Emergency Food Hamper Program.

Client visits have increased by 57% since the start of the recession.

DYNAMICS

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Nutritional compromise (enough said)

Self-reported health and mental health

Chronic conditionsSpecial case of diabetes, HIV/AIDSChildhood toxicity

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The health burden of food insecurity occurs as a social gradient

The health effects are pervasive and beyond nutrition-related conditions

Food insecurity has bi-directional causality in mental health, perhaps other conditions

Child hunger is toxic to health

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Health condition

Food secureMarginal food

insecurityModerate food

insecuritySevere food insecurity

Self-rated health ('Poor' or 'Fair')**** 7.8 14.4**** 21.0**** 36.6****

Males**** 7.7 14.2*** 20.6**** 40.7****

Females**** 7.9 14.6**** 21.2**** 33.5****

* = p < .05, ** = p < .01, *** = p <.001 and ****= p<.0001, controlling for age sex, education, aboriginal status, province, household income. Ref=Food secure

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Health condition




Self-rated mental health ('Poor' of 'Fair') **** 3.9 7.1 13.6 25.7

Males**** 3.8 7.0* 13.3**** 23.2****

Females**** 4.0 7.3*** 13.8**** 27.5****


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Health condition




Mood or anxiety disorder**** 8.9 16.1**** 22.5**** 34.8****

Males**** 6.5 11.5** 15.9*** 23.0***

Females**** 11.4 19.9**** 27.1**** 43.9****

* = p < .05, ** = p < .01, *** = p <.001 and ****= p<.0001, controlling for age, sex, education, aboriginal status, province, household income. Ref=Food secure

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Health condition




Stress**** 23.7 28.3 34.6 48.4

Males**** 22.7 26.8** 32.9**** 48.3****

Females**** 24.8 29.5**** 35.9**** 48.4****


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Health condition




Migraines**** 10.9 16.5**** 19.2**** 25.0****

Males**** 6.4 9.8 11.5** 16.2***

Females**** 15.6 22.0**** 24.4**** 31.7****


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Health condition




Diabetes**** 4.1 4.5 6.0* 12.1***

Males**** 4.5 4.7 5.6 16.6**

Females**** 3.6 4.3 6.2* 8.6*


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Nutrition Services, Population and Public Health, Chronic Disease Management and Primary Care;

Standards and Practice, AHS;Department of Community Health Sciences, University of Calgary

Diabetes, Hypertension and Cholesterol Centre

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81.6%

10.0%

8.4%

Food Insecure - Moderate

Food Insecure - Severe

Food Secure

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• National prevalence rate – 6.9% (2.5 times higher)

• Provincial (Alberta) prevalence rate – 5.6% (3 times higher)

• Food Insecurity is indeed a serious problem affecting this patient population.

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• Indicates reduced food intake and disrupted eating patterns

• National rate – 1.7% (2007); 2.9% (2004)• Provincial rate – 1.2% (2007)• Total clinic prevalence – 10.0%

Therefore 54.4% of all food insecure respondents experienced food insecurity at the severe level.

Health condition




Heart disease**** 2.4 2.8 3.1 8.1***

Males**** 2.8 3.0 3.4 10.4*

Females**** 2.0 2.6 2.9 6.3***


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Health condition




Obesity

Males 18.3 15.6 16.6 20.4

Females**** 14.7 19.7*** 24.2**** 26.2***


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Health condition




Bowel disorders**** 4.1 4.9* 6.4*** 9.4****

Males** 2.7 2.7 4.7 4.7

Females**** 5.5 6.7** 7.6*** 13.0****


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Health condition




Oral health**** 11.9 22.3**** 28.2**** 40.9****

Males**** 14.1 25.9*** 33.4**** 45.3****

Females**** 9.7 19.3**** 24.6**** 37.6****


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Credit: Cherie Nicholson

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6 cycles of follow up (1994-2004)Child hunger = yes to: “Has your child

(‘you’ if a youth respondent) ever experienced being hungry because the family had run out of food or money to buy food?”

Multiple yes= persistent hungerAdjustments for baseline health, chronic

conditions, asthma, permanent income, and other sociodemographics

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Health Variable Hunger ever Persistent hunger

Child health poor/fair @10-15 yrs

↑↑ OR 1.7 ↑↑ OR 4.7

Youth health poor/fair @ 16-21 yrs

Chronic healthCondition

Youth ↑↑ OR 3.4

Asthma All girls↑↑ OR 2.2

Youth ↑↑ OR 6.1

New theories of biological sensitivity to context

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PLEASE NOTE:

Many of the slides are from unpublished studies and are subject to change and that the posting of

this presentation in no way constitutes prior publication.

32

breakfast with...dr. lynn mcintyre

Education

food preferences

nutritious food

household food insecurity

involuntary lack of

world food summit

health effects

selfreported health

conditions child hunger