“Wealth is Health” or the Impact of “Hidden Hunger”


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Publish date

7th July 2022


Dr. Kate McCann

“Do you have enough to eat?”

Quite often, the question should really be:  “Do you able to get enough vegetables and whole grains to eat?”

Yesterday on the radio, I talked about “Hidden Hunger” as one of the problems that this economic crisis will cause.

Literally, Wealth is Health.  I know the phrase is “Health is your Wealth” — which was probably coined by some rich person who finally got sick and realised couldn’t buy himself a longer lifespan.  But honestly, the “socioeconomics of health” is a formal way of saying that those who are financially struggling are more likely have poorer health outcomes.

That includes those with food insecurity. This is is due to multiple factors, not least of which include stress and sleep.  But nutrition is a key factor.

“Hidden Hunger” is when diet becomes cheaper.  Usually, there is plenty – even too much – energy in the diet that becomes higher and higher in fat (due to fattier cuts of meat, for example), sugar, and processed foods (less whole grains) because they are cheaper.  What happens is that the intake of the micronutrients goes down  – especially nutrients like iron, fibre, Vitamins A, C, D, folic acid.  A person doesn’t feel hungry, they don’t look malnourished – but they most certainly are.  Hidden Hunger.  Unsuprisingly, children, pregnant women, and the elderly can be among those most at risk.

What is food security?  It means you have affordable and safe food that meets all dietary needs and your food preferences.  In that, I would also include access to a well-stocked kitchen to store and prepare food as well as affordable to energy for cooking. And time.  Time is money.  While many money-saving recipe ideas are great, many might require more time or effort than busy families can find.

And this matters. Doctors know that the economy means everything when it comes to health.

  • The drugs we can prescribe – but that many patients can’t afford because they aren’t covered on DPS.
  • Our patients are sitting on 3 year waiting lists because they can’t afford any options.
  • Those who are in the ED for 16 hours because this is the only way you can afford/access urgent health care.
  • And all those conversations we have daily with patients about the health implications secondary to money: stress, lack of time from extra work, more stress, no time for walking, no time for healthy hobbies, even more stress impacting sleep.

Which is why I posted last week that the #economiccrisis really worried me about health impacts.   It will negatively affect many aspects, including increasing stress and anxiety.   But the hardest hit is often nutrition.

If you follow me, you know this isn’t a new concern.  Earlier this year, I noted that the only part of #OperationTransformation that I liked was where they made the recipe ingredients accessible in convenience store chains, often the only options for groceries for patients who live in food deserts- and shops that are usually more full of processed food and less  whole foods, whole grains, fresh fruit and veggies.

And while swaps are helpful – I’ll list a few in a moment – they won’t help those who can’t make choices due to strict dietary restrictions, dependence on support such as food banks, or have limited facilities to prepare food.  Poor nutrition secondary to food insecurity is real, and has direct impact on health.

If you are in the Squeezed Middle, some swaps might help you.  But what this saves in €, often costs in time or effort. Which is equally valuable.  Let’s be clear:   there are many ways to stretch the budget.  Unfortunately, the cheapest food is often the unhealthiest.   This is especially true in rice and pasta – the whole grain options are nearly twice the price.  In this list, we are maximising the family NUTRITION on a budget:

  1. Meal planning: make a menu and a shopping list before going to the shop. Include snacks on your list. Quick check of your shop online will usually tell you what’s on special to help plan to include those items.   Include at least one -or more – meatless night. Shop when you aren’t hungry and you aren’t in a rush.
  2. Replace heavily processed snacks with more whole food options, like popcorn (whole kernel that you have to pop yourself) or rice cakes. Safefood and INDI websites have great ideas.
  3. What to take these off your shopping list? Supplements, sugary breakfast cereals, any bottled water that promises health benefits (it can’t), sugary fizzy drinks, toddler follow-on milks, and consider reducing alcohol.
  4. Swap fresh veggies and fruits for frozen where available. Frozen berries work well in yogurt and porridge.  Frozen veggies work in a stir-fry. Nutritionally equivalent.
  5. Breakfast? Porridge is the clear whole grain and price winner.
  6. Skip the organic option: the nutritional edge, if any, is minimal.
  7. Store own-brand whole foods are often just as nutritious (always check labels).
  8. Use pulses, legumes (I love lentils!) to replace or stretch mince instead of buying cheaper mince (which has more fat). It adds nutrition, fibre, and reduces fat – as well as being much cheaper.
  9. Consider skipping the jars/pouches of baby food: Making your own baby food is cheaper (and nutritious and introduces babies to real tastes of food).  It’s worth following one or more of the several INDI-registered dietitians who do great social media posts and website with weaning recipes and tips.
  10. Bulk and batch cook to reduce food waste. Use the freezer to store leftover meals or left over ingredients.
  11. Take that extra portion for your lunch instead of purchasing or deli-meat (both are usually high salt/ highly processed) sandwiches.  Skip the morning coffee-shop latte on the way to work for home-made (less sugary, lower fat) coffee in a travel mug.
  12. Options to consider if you are lucky enough: if you live near an Asian or ethnic grocer, it’s worth checking prices of legumes, rice, spices, etc.  My local one sells large packages ingredients such as spices and rice.  For some products, the price per kg much cheaper than grocery store. Downside:  this only works for families who can afford the outlay to buy a 5kg  bag of rice, for example, upfront.
  13. Many shops have a scheduled time when they put out reduced food.  You can ask your shop and time your shop when reduced food is more likely to be available.
  14. Whole foods can be cheaper, but more work. If you have the luxury of time, homemade options for things like soups and sauces are healthier and cheaper.

There are no easy or quick answers to this growing problem, but it’s worth at least having this discussion.

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