1. Nutrition and Public Health
Dr Julie Frier
Consultant Public Health
Plymouth City Council

2. 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

3. Health Consequences Morbidity Premature death Dental decay
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

4. 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

5. Position in Plymouth

6. Health inequalities in Plymouth

7. 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)

8. Poverty and deprivation in Plymouth
Child poverty distribution in Plymouth
Source: Her Majesty’s Revenues and Customs, 2009

9. Dental decay

10. Excess weight / obesity
Adults:
Male adult obesity 22%
Female adult obesity 24%
Estimated that obesity rates will double by (Plymouth interim report 2012)
Children:
4-5 years: 9.4% obese
10-11 years: 19.6% obese
Trend for years is upwards
Marked inequalities

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

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

13. 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
Above in all age groups and for years was 15.3%
Non-starch polysaccharides
18g a day
Population mean below this
( g)
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
11-18 years
13% below for Vitamin A
21% girls below for Riboflavin
Iron
5.6% of girls aged years and 3.3% women aged years had evidence of iron deficient anaemia
National Diet and Nutrition Survey

14. What influences these problems

15. 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

16. 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
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

17. Any questions…