Relationship between malnutrition and health

1. Relationship between malnutrition and health By Auréa Cormier, ndsc, Ph. D. EmeritusProfessor of Nutrition Université de Moncton

2. Presentation Outline • Four scenarios of low-income households to illustrate the difficulties to eat nutritious foods1; • Impact of poverty on health; • Effects malnutrition throughout the life cycle; • Nutritional status of the elderly and associated health risks; • Conclusion. 1 These scenarios are based on calculations from Statistics Canada and the Common Front for Social Justice’s data.

3. 1. Worker at $9.50/hr (40 hrs per week) with a spouse and 2 children INCOME • Wages $19 760 • Payroll deductions$1 377 • Net income $18 358 • Child Care Tax Benefit $7 475 • GST benefit $772 DISPOSABLE INCOME $26 605 EXPENSES • Shelter $8,712 • Power $1,940 • Telephone $360 • Car expenses $6,854 • Childcare $3,118 • Clothing $2,586 • Personal care $1,016 • Food $9,674 TOTAL EXPENSES $34,260 This family lacks $7,600 and will cut into its food budget

4. 2. Single mom with a 9-year old son INCOME • Wages $17,290 • Deductions $2,365 • Net income $14,925 • Child Care Tax Benefit $3,985 • GST return $639 DISPOSABLE INCOME $19,549 EXPENSES • Shelter $8,004 • Power $1,506 • Telephone $360 • Car expenses $6,854 • Childcare $3,118 • Clothing $1,293 • Personal care $1, 016 • Food $2,933 TOTAL EXPENSES25 084 $ She is short by $5,500 and may cut on food expenses (detrimental to her son)

5. 3. A 55-year old woman living alone on social assistance INCOME • Social assistance $6,444 • GST return $253 DISPOSABLE INCOME $6, 697 EXPENSES • Room at $325/mo .$3,900 • Telephone $360 • Travel (Bus passes) $696 • Clothing $565 • Personal care $1,016 • Food $2,573 TOTAL EXPENSES $9,110 She is short by over $2,400 and cannot afford an apartment nor proper food so she goes to a food bank

6. 4. A 75 year-old woman with old age pension + gararanteed income suppl. INCOME • Pension + suppl. $15,088 • GST return $386 DISPOSABLE INCOME $15, 474 EXPENSES • Shelter $7,740 • Power $1,107 • Telephone $360 • Bus pass + taxis $936 • Clothing $565 • Prescription drugs $1,440 • Personal care $1,016 • Food $2,573 TOTAL EXPENSES S15,737 She is short by $263 because of medical expenses (She needs 8 pills per day (50% of seniors take 5 medicationor more/day)

7. Overall, many low-income people are worried about their food intake • These four scenarios show that certain groups do not have enough money to buy nutritious food; • These calculations are conservative because there is nothing included for health care, leisure, newspapers and books, educational activities and insurance payments.

8. Impact of poverty on health1 • Health status is worse for those with lower incomes and this was demonstrated in 16 studies conducted in four different countries; • A national survey indicates that 73 % of Canadians in the highest income group rated their health as excellent while only 47% of Canadians in the lowest income group reported excellent health. 1 Source: Shelley Phipps. 2003. The Impact of Poverty on Health

9. Disease frequency (Source: Phipps, 2003) • Chronic diseases are much more common in the poorest regions of Canada: • 10.1% of adults between 15 and 64 years old living in the Maritimes reported high blood pressure versus a national average of 6.8%; • 17.0% of children from the Maritimes suffered from asthma, compared to 12.7% for children’s national average.

10. Three major effects of malnutrition • Difficiencies in protein, vitamins and minerals (iron, zinc, vitamins A, B6, B12, C and folates) lower the level of antibodies, making people more prone to various infections, the flu, etc. • An iron defficiency reduces the size and color of red blood cells, thus lowering oxygen transport to tissues (this leads to fatigue, muscle weakness, drop in productivity, etc.); • A lack of calcium is associated with calcium withdrawal from bones (fragile, and less dense)

11. Infant mortality rate in Canada

12. In the U.K., a 10-year difference in life expectancy was observed between rich and poor neighbourhood; • Income increase is associated with improved health status, especially among the poorest; • Countries with the narrowest income gap are those where the population is in better health • Our elected politicians would improve the health of our population if they increased the taxes of the wealthy to provide a better social safety net for those who are the poorest.

13. Effets of malnutrition throughout the life cycle Baby Elderly person Child Woman with poor health Pregnant status woman Adolescent

14. Higher mortality rate Malnutrition of mother during pregnancy Baby with low birth weight Set-back in mental development Poverty in the early years is detrimental to health Increased risk of chronic disease during adulthood

15. Inadequate diet Baby with low birth weight Enfant with retarded growth Frequent infections Reduced mental ability Poor health

16. Inadequate diet Child with retarded growth Adolescent with retarded growth Insufficient health care Reduced mental ability Poor health

17. Inadequate diet Adolescent with retarded growth Pregnancy with insufficient weight gain Insufficient health care High maternal mortality rate Poor health

18. Adult in poor health Elderly person in poor health Inadequate diet

19. Nutritional status of elderly people Study by Dr Lita Villalon based on 340 Moncton seniors1 • Over 60% of seniors living ate home consume less that the number of food portions recommended by the Canada Food Guide for: • Dairy products • Fruit and vegettables • Cereal products 1Published in Port Acadie, 18-19, fall 2010, spring 2011

20. Nutritional status of seniors (continued) • Calcium, zinc and vitamin D intakes were insufficient in the case of 80% of seniors; • Low intakes of calcium, vitamin D, folates and zinc should concern us; • Calcium, vitamin D and folates are associated with healthy bones and cardiovascular health.

21. Nutritional status of seniors (Continued) • Zinc plays an important role in the immune system; a difficiency may cause alterations in mental capacity, a loss of appetite or diarrhea; • Among the 340 seniors studied, 80% had at least one chronic health problem; • Three health problems or more were noted in 33 %, of the cases.

22. Conclusion • Many individus and families in New Brunswick do not have enough money to eat healthily. • Research shows clearly that low income people are in poorer health: they are sick more often, levels of infant mortality are higher, life expectancy is shorter, etc. • The negative impacts of malnutrition are carried throughout the life cycle, especially during the senior years.