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Op-ed: School meals key to controlling diabetes rate

'It’s in all of our best interests'

March 17, 2020 — 

The following is an op-ed written by Joyce Slater, associate professor of community nutrition and principal investigator for the FANS (Food and Nutrition Security) study in the department of food and human nutritional sciences at UM. It was originally published in the Winnipeg Free Press on Mar. 17, 2020. 


If Premier Brian Pallister thinks he shouldn’t implement a universal school-meal program because families should be having breakfast together, maybe he should chew on this: happy nuclear families dining on stacks of pancakes served by mom is the stuff of TV.

The Free Press has recently highlighted the myriad of food-related challenges real families face, including the lack of money to regularly purchase healthy food, lack of time, the demands of single parenting, and working multiple jobs at irregular hours. Poorly nourished kids don’t learn well.

Poor nutrition is the leading risk factor for developing chronic diseases that cost us a bundle. A 2019 systematic review of 195 countries in The Lancet medical journal found “suboptimal diet is responsible for more deaths than any other risks globally, including tobacco smoking.” Our suboptimal diet is the result of food insecurity and food environments that readily enable over-consumption of highly processed foods with too much fat, sugar and salt.

Everyone is affected, because we all eat. And telling us to simply eat healthier is completely ineffective (we have been told that for decades). Here in Winnipeg, a 2016 nutrition pilot study in one school division showed that 90 per cent of people, and 80 per cent of students, were not consuming enough fruits, vegetables and milk and alternatives. A more comprehensive study currently under way, with more than 1,500 Grade 9 students throughout Manitoba, shows more than 20 per cent of respondents are from food-insecure households.

Of particular concern is type 2 diabetes, which affects about one in 12 adults globally. The development of type 2 diabetes is greatly increased by excess body weight; 27 per cent of Canadian adults are obese, and 30 per cent of children are overweight or obese. Diabetes is a terrible disease that disproportionately (but not exclusively) affects low-income and Indigenous populations; it has huge costs for individuals in terms of diminished health outcomes and premature mortality, and to society in terms of health care and other related costs.

Type 2 diabetes used to be called adult-onset diabetes, but that’s no longer the case because more and more children are developing it. In fact, Manitoba has the highest rates of type 2 diabetes in children in Canada by eight-fold: nationally 1.54 per 100,000 children are afflicted; in Manitoba it’s 12.45 per 100,000. These numbers skyrocket in adulthood, and not just for older adults.

Data from the recently released Winnipeg Food Atlas on the Manitoba Collaborative Data Portal show that in the year 2020, diabetes (more than 90 per cent of cases are type 2) is expected to afflict more than 12,000 35-to-49-year-olds in Winnipeg alone. Another 5,000 have undiagnosed diabetes, and more than 28,000 have pre-diabetes (half will go on to develop diabetes).

In 2020 this one preventable disease, in this age group, is estimated to cost the province $99.9 million for direct medical (50 per cent) and societal costs (50 per cent). That’s just for the 35-to-49-year-old age group; for the entire Winnipeg population in 2020, the tab for diabetes will exceed $700 million, and is projected to be over $1.1 billion by 2032.

None of this money goes to prevention, yet the World Health Organization states diabetes is at least 80 per cent preventable.

The premier’s recent mandate letter to the minister of health mentions the development of a diabetes-prevention strategy for the province. This is a good sign; but what we don’t need are more “healthy eating tips” on a website, or a few short-term, small-scale “lifestyle” interventions that are tasked with unrealistic outcomes.

Approaches such as these are like using a garden hose on an inferno. In order to start turning this incredibly expensive Titanic around, we need deep prevention that goes beyond exhorting families to do better. We need to do better by our children. We need to give them proper tools such as food education, healthy food environments and living wages.

A universal school meal program would be an excellent step toward improving the diets and health of our youth. It’s in all of our best interests. And it’s chump change compared to the cost of doing nothing and maintaining the status quo.

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