FOOD SECURITY
PRESENTER TOOL – REVISED SUMMER 2013
FOOD SECURITY (PREZI)
OUTLINE
Objectives
Ted Talk
Definitions of Food Security
Global Context of Food Security
Local Context of Food Security
Food Security and Primary Care
Discussion / Activity
Additional Resources
OBJECTIVES
• Be able to define food security
• Be familiar with the Millennium Development Goals
that relate to food security
• Be able to name 3 manifestations of food insecurity
in Canada
• Be able to explain to a colleague why an
understanding of food security is relevant to primary
care
JAMIE OLIVER'S TED PRIZE WISH:
TEACH EVERY CHILD ABOUT FOOD
• Sharing powerful stories from his anti-obesity project
in Huntington, W. Va., TED Prize winner Jamie Oliver
makes the case for an all-out assault on our
ignorance of food. Jamie Oliver is transforming the
way we feed ourselves, and our children
JAMIE OLIVER'S TED PRIZE WISH:
TEACH EVERY CHILD ABOUT FOOD
During this TED talk, pay special attention to:
• The evidence Jamie Oliver presents of unhealthy
food choices as a major threat to health
• The arguments for educating our children about
food choices
• Why this talk is relevant to you as a primary care
practitioner
TED TALKS
http://www.ted.com/talks/lang/en/jamie_oliver.html
FOOD SECURITY
• What is food security?
FOOD SECURITY
“When all people at all times have access to
sufficient, safe, nutritious food to maintain a
healthy and active life”
1996 World Food Summit
FOOD AND HEALTH
• What evidence does Jamie Oliver present of Food
Insecurity as a major threat to health?
(4 Americans will die in 20 minutes due to the food
they eat, shortened life span due to food we eat,
diet related disease as the biggest killers, 10% of
healthcare costs)
FOOD SECURITY (EXTRA)
• Food is a basic human need
• Providing global food security is one of the principle
challenges for humanity in current times
"I have the audacity to believe that people
everywhere can have three meals a day for their
bodies, education and culture for the minds and
dignity, equality and freedom for their spirits.“
~ Martin Luther King, Jr., taken from his remarks
upon acceptance of the Nobel Prize
FOOD AND AGRICULTURE
ORGANIZATION (FAO) – UNITED
NATIONS
• Specialized organization of the UN that leads
international efforts to defeat hunger
• Established October 16 1945
• World Food Day is therefore celebrated every
October 16th
• Focuses on achieving food security for all
"What the people of the world want most and have
always wanted...are bread and peace. World Food
Day gives voice to that yearning.“
Patricia Young, National Coordinator WFD USA in remarks to the UN
General Assembly
FOOD AND AGRICULTURE
ORGANIZATION (FAO) – UNITED
NATIONS
FAO’s Mandate:
• To ensure people have regular access to enough
high-quality food to lead active, healthy lives
• To raise levels of nutrition, improve agricultural
productivity, better the lives of rural populations and
contribute to the growth of the world economy
WORLD FOOD SUMMIT -1996
• The FAO called for the 1996 World Food
Summit in response to growing concern
around undernutrition and the ability to
meet future food needs
• Goals of the 1996 Summit were to develop
and implement plans of action to achieve
food security domestically and
internationally
FOOD SECURITY IN CANADA
• Based on the action plan developed at the 1996
World Food Summit
FOOD SECURITY IN CANADA
• “Food security requires that adequate amounts of
safe, healthy, nutritious, culturally acceptable food
be accessible to all in a dignified manner; that food
producers earn a fair return on their labour, and
that food production, harvesting and distribution
methods sustain the environment”
Food Secure Canada
FOOD SECURITY (PREZI)
FIVE A’S OF FOOD SECURITY
Availability - sufficient food for all people at all times
Accessibility - physical and economic access to food for all at
all times
Adequacy - access to food that is nutritious and safe, and
produced in environmentally sustainable ways
Acceptability - access to culturally acceptable food, which is
produced and obtained in ways that do not compromise
people's dignity, self-respect or human rights
Agency - the policies and processes that enable the
achievement of food security
Ryerson University
3 PILLARS OF FOOD SECURITY
• Food availability: sufficient quantities of food available on a
consistent basis
• Food access: having sufficient resources to obtain appropriate
foods for a nutritious diet
• Food use: appropriate use based on knowledge of basic
nutrition and care, as well as adequate water and sanitation
Food Secure Canada
AVAILABILITY
http://farmscapegardens.com/blog/subsidizing-fresh-fruits-and-vegetables-part-ii
http://www.susandopart.com/blog/tag/farmers-markets
ACCESS
http://balanceoffood.typepad.com/balance_of_food/2012/06/think-food-prices-are-high-try-the-northern-territoriesof-canada.html
USE
http://myplus.org/proper-hand-washing-procedures-7-important-things-you-should-know.html
http://www.odditycentral.com/pics/the-tasty-cooked-mice-of-malawi.html
http://www.ivcm.edu.mt/courseJamieO.html
FOOD SECURITY AS A DETERMINANT
OF HEALTH
QUESTIONS TO CONSIDER
• How does an awareness of your patient’s income
and their ability to access nutritious foods impact
upon your ability to care for them?
FOOD SECURITY ON A GLOBAL SCALE
MILLENNIUM DEVELOPMENT GOALS
• Eight Goals developed by the United Nations
• In 2000, all 193 UN member countries signed on to
an agreement to reach these 8 goals by the year
2015
• Goal 1: Eradicate extreme poverty and hunger
• The MDG on hunger requires that the proportion of
people suffering from hunger be halved between
1990 and 2015
http://www.jm.undp.org/files/u80/jpeg%20FILES%20MDG/MDG1.JPG
FOOD SECURITY
• What are some manifestations of food insecurity on
a global scale?
"Hunger is not an issue of charity. It is
an issue of justice."
Jacques Diouf, FAO Director-general
FOOD INSECURITY- MALNUTRITION
• Malnutrition has been growing since the mid-1990s
• Over 1 billion people suffer from hunger
• One sixth of all humanity currently goes hungry every day
• In 2008 malnutrition was affecting approximately 915 million
people
• These trends are expected to worsen given high food prices the
global economy
GLOBAL CONTEXT – LOW INCOME
COUNTRIES
• Food Security depends on supply of food (and the
composition of supply), reliability of supply, and access
• Food is often produced in rural areas however food security in
many countries is higher in urban areas where power to
access is higher
• Have to also consider food utilization- whether micronutrient
intake is sufficient in quantity and balance to allow adequate
absorption of available macronutrients
• Many factors can influence food security: distribution,
corruption, commodity prices, climate change, natural
disasters, gender, power differentials
"Hunger denies, wastes, and degrades the gift of life."
Edouard Saouma, former FAO director-general
FOOD INSECURITY- OBESITY
• Obesity has also been on the rise in the last decades
• The rates of obesity world-wide have more than doubled
since 1980
• In 2008 1.5 billion adults aged 20 and over were
overweight
• Obesity is not always due to food insecurity but can be a
manifestation of an inability to access nutritious food
FOOD SECURITY ON A LOCAL
SCALE
• Can you name some manifestations of food
insecurity in Canada?
MANIFESTATIONS OF FOOD
INSECURITY IN CANADA
• Use of food banks
• Malnourished children and adults
• Widespread obesity in children and adults
• Diabetes in First Nations populations
• Financial problems amongst farmers and fishermen
(and women)
MANIFESTATIONS OF FOOD
INSECURITY IN CANADA
http://www.news1130.com/news/local/article/130183--food-bank-use-is-up-across-canada
http://www.drsharma.ca/people-with-obesity-have-heads-too.html
http://www.nccah-ccnsa.ca/103/First_Nations__Inuit_and_Metis_Public_Health.nccah
OBESITY
“It is a bitter irony that as developing countries
continue their efforts to reduce hunger, some are
also facing the opposing problem of obesity.
Obesity carries a higher incidence of chronic illness
including diabetes, heart disease and cancer. And
while some of the poor are becoming plumper, they
are not necessarily better fed. Obesity often masks
underlying deficiencies in vitamins and minerals”
FAO
http://www.fao.org/FOCUS/E/obesity/obes1.htm
FOOD SECURITY AND PRIMARY CARE
• How does Food Security relate to your role as a
family doctor?
FOOD SECURITY
• As family doctors we are in the business of preventative
care and trying to create good health outcomes for
patients
• It is therefore crucial for us to have a good
understanding of the determinants of health
• Without understanding the factors influencing our
patients’ health, it is difficult to have an impact upon
their health
• Food security or insecurity will greatly affect our patients’
health and is therefore important for family doctors to
address
PRIMARY CARE
“I wish for your help to create a strong, sustainable
movement to educate every child about food,
inspire families to cook again and empower people
everywhere to fight obesity.”
• As family doctors, how can we work towards
making Jamie’s wish a reality?
DISCUSSION & CASES
• These are two of your patients, what do they have
in common, what more do you need to know in
order to care for them? How are you going to help
them?
FOOD INSECURITY – CASE 1
When working in Malawi I saw an 8 month old child
who weighed 4 kg (half the weight of an average
Canadian child). She was in clinic with her
grandmother. Looking at her growth chart, she had
not gained any weight for several months. Lab work
revealed severe anemia with a hgb of 40. What more
would you want to know?
CASE 1 CONTINUED….
On review of history she was breastfed until 4 months
when her mother became pregnant again. At this
point her mother’s milk supply dried up. Since she was
4 months of age the family has struggled to feed her.
When they could afford it they have bought her
cow’s milk. The father recently abandoned the family
and they now have almost no means of getting food
What aspects of food security are important to
consider here?
CASE 2
• Rachel is a patient in my practice in MarkhamStouffville. She is a 42 yr old with 2 kids. She is obese
with a BMI of 40 and has uncontrolled diabetes.
• What information do you need to know in order to
help Rachel achieve better health?
ACTION PLAN
Group Discussion:
• After today’s workshop, make a list of tangible
action plans to implement in your respective
practices.
FOOD SECURITY (EXTRA)
Divide up into groups. How does Food Security relate to your role
as a family doctor?
Gatekeeper – health care costs related to food insecurity
Educational/Teaching role – how important is it to encourage
patients to teach their kids to cook, to cook their own meals,
to make healthy choices, encourage healthy choices (portion
size, fresh foods, less processed), presentations at schools,
cooking classes
Advocate – access to food that is safe, nutritious
Health promotion – live longer if eat healthy, do better in school
FOOD SECURITY AND DFCM CORE
COMPETENCIES
Here are some DFCM core competencies that relate to food
security:
• “Elicit information regarding the social situation of the
patient”(history taking) – ask about income and access to
food
• “Assess the impact of social conditions on the presenting
symptoms” (patient-centered approach) – determine how
inadequate access to healthy food is affecting their health
and their family
• “Link patient’s symptom to their social situation and to a
lifestyle behaviour and in doing so, employ the principles of
disease prevention and health promotion and advocacy”
(treatment plan)
• “Mobilize services within the health care and community
institutions on behalf of the patient” (engages resources)
"For now I ask no more than the justice of eating“
Pablo Neruda, Chilean Poet, Noble Prize Winner