NUTRITION AND PUBLIC
HEALTH
Dr Julie Frier
Consultant Public Health
Plymouth City Council
Nutrition and Public Health
Food related problems and food safety issues that
affect the health of the population
Inequalities
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Variations in opportunity for health through nutrition
Food supply
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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
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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)
 Morbidity
Dental decay
Excess weight / Obesity
Type II diabetes
Cardiovascular disease
Cancer
Iron deficient anaemia
Poor bone health
Mental health and wellbeing
Food 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 Plymouth
Child 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 portions
11% boys at 3.0 portions
8% 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 A
21% 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 system
Aim: Affordable and nutritious food for all
Combat inequality in access to health through food
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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
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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…