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OMA blog
March 18, 2021
Dr. Samantha Hill, Cardiac Surgeon

Nutrition Month 2021 – Healthy eating for a healthy lifestyle

Food means very different things to different people. Foodies talk about palates. Athletes eat to maximize the efficiency of the fuel powering muscles. For patients with cancer, it is often simply about trying to find adequate caloric intake. For parents, nutrition is about the long-term health and habits of their children. For those with eating disorders, nutrition battles self-perception. But for all of us, what we put in our bodies is fundamental to our overall health.

Nutrition Month is meant to acknowledge the benefits of healthy eating and encourage us to consider our nutrition as part of an overall healthy lifestyle. As a cardiac surgeon, I’m expected to tout the benefits of a heart-healthy diet (think Mediterranean, low salt, red wine). But the truth is that nutrition science is in its very early days. The obesity pandemic clearly indicates that, as a society, we haven’t figured it out. Individuals have very different nutritional needs and responses to nutritional regimes.  Genetics and epigenetics, biomes, in-utero experiences may all matter as much, if not more than the choices we make daily. Every March, the Dieticians of Canada select a theme for Nutrition Month. This year’s theme “Good for You” emphasizes that interindividual variability, but again, with a scarcity of evidence, there’s as much we don’t know as we do.

Here’s what I do know. 

While we may pride ourselves for choosing whole wheat bread over white bread, debate keto- vs vegan diets, and recommend our patients eat a wide variety of fresh fruits and vegetables, we do so from a place of privilege. 

In 2017-18, 1 in 8 Canadian households was food insecure. That’s 4.4 million people, 1 million more than the number reported the decade prior. That represents a 29.4% increase in the number of households with inadequate or insecure access to food due to financial constraints. 

The issue is notably more critical in Nunavut where 57.0% of households are food-insecure, with nearly half being severely so; but here in Ontario, a striking 13% of households were food insecure.  That’s nearly 2 million people, more than a tenth of our population, patients, and neighbours worrying and making do. Here, in Ontario, 3.2% of households experience extreme food security, meaning they miss meals, reduce food intake, and at the most extreme go day(s) without food.  

That population includes children. Pre-COVID, 1 in 6 Ontario children lived in households where there is worry about running out of food, compromise in selection, quality or quantity, or even, missed meals due to lack of money. That statistic doubled to 1 out of 3 households led by female lone parents, a fact which reflects ongoing issues around gender equity and parity.

Similar equity issues appear across racialized communities as well, another fact COVID-19 has made remarkably clear.  The highest rates of food insecurity, nearly 30%, occur among households where the respondent identified as Indigenous or Black as compared with 11 % in self-identified white respondents. Again, that these are the same communities whose economic stability has been hardest hit by COVID-19, leaves us to wonder what that rate is today.

Furthermore, most food-insecure households were among low-wage and precarious workers—proof these jobs simply don’t pay enough to ensure food security. Again, COVID-19 has shown us that many of our essential workers are in the lowest paid brackets, with PSWs needing to work at multiple LTCs to support their families, and some living in shelters because they still cannot. Social assistance programs like welfare and disability programs also demonstrated higher prevalence of food insecurity; a sign rates are simply too low to provide for basic needs.

Doctors know that what we eat can have a profound impact on our physical health. A diet comprised of a variety of foods including plenty of fruits and vegetables, low in salt, sugar and saturated and industrially produced trans-fats, is routinely recommended. Those recommendations are unachievable when the choices are only what is at a food bank, when the last $5can buy one package of lettuce, or a loaf of bread and peanut butter. Food insecurity negatively impacts physical, mental, and social health, costs our healthcare system considerably, and contributes to inequitable health outcomes within our population.

COVID-19 has made so many aspects of our lives harder. For far too many people, that includes basic nutrition. This Nutrition Month, I encourage everyone to take a closer look at where they can make a difference. Can you donate to a foodbank? Support sites like Foodshare? Petition your MPP to be more proactive?  Ultimately, this affects us all. 

And if you have personal questions about your own nutrition, remember to ask your family doctor.