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A food "lifeboat": Food and nutrition considerations in the event of a pandemic or other catastrophe

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Abstract

Influenza pandemics are a real risk and are best managed by self-isolation and social distancing to reduce the risk of infection and spread. Such isolation depends on availability of food of adequate quantity and quality. Australia has one of the most concentrated food supplies of any country, making rapid food depletion more likely in a crisis. Food stockpiling by both authorities and citizens is an important safety precaution that should be given greater media coverage. Food and nutrition guidelines are provided for survival rations in the event of a pandemic or other catastrophe.
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Crisis
A food “lifeboat”: food and nutrition considerations in
the event of a pandemic or other catastrophe
Anna Haug, Jennie C Brand-Miller, Olav A Christophersen, Je nnif e r McArthur, Flavia Fayet and Stewart Truswell
MJA 2007; 187 (11/12): 674-676
Introduc tionWhich foods and in what quantities?Competing interestsAuthor detailsReferences
Abstract
Influenza pandemics are a real risk and are best managed by self-isolation and social
distancing to reduce the risk of infection and spread.
Such isolation depends on availability of food of adequate quantity and quality.
Australia has one of the most concentrated food supplies of any country, making rapid
food depletion more likely in a crisis.
Food stockpiling by both authorities and citizens is an important safety precaution that
should be given greater media coverage.
Food and nutrition guidelines are provided for survival rations in the event of a pandemic or
other catastrophe.
arge catastrophes have caused the collapse of empires and civilisations.1 Science and
knowledge may help prevent some catastrophes, but urbanisation and narrowly concentrated
food supplies, climate change and terrorism contribute to considerable risk. Viruses
responsible for severe acute respiratory syndrome (SARS) and avian influenza A (H5N1) or
“bird flu” are among the most immediately identifiable risks. The World Health Organization has stated
that the risk scenario associated with an outbreak of pandemic H5N1 influenza should be considered
more serious than was previously assumed.2
Early self-isolation and social distancing measures are known to be highly effective.3 In the event of a
lethal pandemic, emergency measures such as closing schools, staying home with family and friends,
and avoiding contact with other people (until all have been immunised) will be instrumental in avoiding
infection. People employed in essential services or occupations may be required to reside at their
workplace for the whole period of the crisis. To achieve this type of isolation, sufficient food of
adequate quality and quantity must be available.
The Australian Government and the Australian Food and Grocery Council (AFGC) have been planning
for such a scenario for several years and have advanced plans in place (Russell Neal, AFGC,
Canberra, ACT, personal communication). Nonetheless, the logistics and practicalities of household
food stockpiling should be given greater media coverage. Australia has one of the most concentrated
food supplies of any country, being dominated by two large supermarket chains. These organisations
operate with such efficiency that their logistic chains hold only a few weeks’ supplies (Russell Neal,
AFGC, personal communication). If the supply chain shuts down, or if there is no delivery from central
stores, supermarkets’ stocks will be depleted within 2–4 weeks (Clare Buchanan, Public Relations
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Officer, Woolworths Pty Ltd, Sydney, NSW, personal communication). If domestic stockpiling begins
at this late stage, then depletion will be accelerated.
Food supplies in the home will need to last as long as it takes for vaccine development and
production. For ordinary seasonal influenza vaccines, there is a lag of 6 months or more after a new
virus strain has first been discovered until a new vaccine is available for distribution. For weather-
related catastrophes, food stockpiles might be required for much longer. A destabilised global climate,
where small changes in atmospheric and ocean circulations have major consequences for
temperature, rainfall, wind and storm patterns, may precipitate food stockpile dependence for several
years.4 While long-term food stockpiling could be considered a governmental responsibility, we
suggest that home stockpiling of food to last about 3 months might be done by individual households.
This would allow a window of time for governments to put emergency action plans and food deliveries
in place.
Which foods and in what quantities?
It is logical that the foods to be stockpiled should be staples and well accepted, easy to store, packed
where possible in an inert gas for a longer shelf life, and not dependent on refrigeration. Importantly,
they should be nutrient-dense, providing the recommended macronutrients and micronutrients for all
members of the family.5 Ideally, they can be eaten without cooking, in case gas and electricity fail.
Cost, volume and storage space are further considerations.
A food stockpile should provide an average energy intake of about 9 MJ (2150 kcal) per person per
day in order to avoid significant weight loss. This is near the average intake — men need a little more
than women, while children need less.5 In a home quarantine situation, physical activity is not likely to
be high.
Box 1 shows a food “lifeboat” for one person for 10 weeks, and in Box 2, we provide an example of a
food list that provides one person with 9 MJ per day for 10 weeks and covers all known nutrient
needs. This example was generated using the nutrient analysis software, FoodWorks (Professional
Edition 2007; Xyris Software, Brisbane, QLD), which is based on the composition of Australian foods,
and commonly used by Australian dietitians. The recommended daily intake of specific macronutrients
and micronutrients for adults and children is published by the Australian Government Department of
Health and Ageing.5 Together, these two sources make it possible to compose diets with the
appropriate quantity of nutrients. As most people have no access to detailed nutrient data, we have
developed these examples to show what is needed, and typical of what might be acceptable. We
acknowledge that such food lists are culturally and ethnic-specific, and that other food combinations
are possible.
It would be cheaper and require less storage space to rely on multivitamin tablets rather than canned
fruit and vegetables to cover the requirements of vitamins such as C and A. For this reason, Box 3
shows a food list that covers basic nutrient requirements when taken together with a multivitamin–
mineral supplement. Indeed, some micronutrients do not need to be consumed on a daily basis
because of the capacity of the body to store them (eg, vitamin A). Our calculations allow for cooking
losses. While the foods can be eaten raw, some foods taste better cooked. In the event that the
electricity or gas supply fails, a gas cylinder to fuel a barbeque might make eating more enjoyable.
In Australia, most people have adequate money and storage space to build up their own store of
foods. For those who do not, federal, state and local governments should consider a plan to construct
food stockpiles across the country.
Further suggestions, recipes and guidelines are given on our website
(http://www.foodlifeboat.com.au). This is a university-linked, not-for-profit initiative, developed by
dietitians and public health nutritionists.
1 The food “lifeboat” for one person for 10 weeks
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All the foods listed in Box 2 in the quantities required are displayed. Food courtesy of Woolworths Pty Ltd.
2 Suggested food list of a daily ration for one person (providing 9 MJ
per day) and purchase list for 10 weeks
Food g/day kg/person for 10 weeks
Milk powder, full-fat, dry* 65 4.6
Weet-Bix, regular (breakfast cereal) 30 2.1
Pasta, regular, dry 20 1.4
Instant noodles 20 1.4
Rice 25 1.8
Dehydrated potato flakes 15 1.1
Tortilla 10 0.7
Biscuit, savoury 15 1.1
Biscuit, wholemeal 20 1.4
Oil, canola 20 1.4
* In case of lac tose intolerance, the intake of dry milk powder m ay be replaced by s oy protein
powder. Alternatively, the milk m ay be fermented. Sanitarium Australia, Sydney, NSW. Hormel
Foods C orporation, Austin, Minn, USA. § Nestlé Australia, Sydney, NSW . Kraft Foods Limited,
Melbourne VIC.
Total daily ration provides 80 g protein and 80 g fat com prising 24 g s aturated fat (31% of fat
intake and 10% of energy intake), 20 g polyunsaturated fat (22% of fat intake) and 36 g
monounsaturated fat (47% of fat intake). The daily choles terol intake is 101 mg. Energy intake is
16% from protein, 34% from fat and 50% from c arbohydrate. Recomm ended intakes of all
essential nutrients are provided for wom en and men, except for folate (w hich is not adequate for
women of c hildbearing age, so a folate supplement might be c onsidered).
The cos t of this diet for 10 weeks for one person is about $500. The most expensive items are
milk powder, Weet-Bix, SPAM, and chocolate.
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* In case of lac tose intolerance, the intake of dry milk powder m ay be replaced by s oy protein
powder. Alternatively, the milk m ay be fermented. Sanitarium Australia, Sydney, NSW. Hormel
Foods C orporation, Austin, Minn, USA. § Nestlé Australia, Sydney, NSW . Kraft Foods Limited,
Melbourne VIC.
Total daily ration provides 80 g protein and 80 g fat com prising 24 g s aturated fat (31% of fat
intake and 10% of energy intake), 20 g polyunsaturated fat (22% of fat intake) and 36 g
monounsaturated fat (47% of fat intake). The daily choles terol intake is 101 mg. Energy intake is
16% from protein, 34% from fat and 50% from c arbohydrate. Recomm ended intakes of all
essential nutrients are provided for wom en and men, except for folate (w hich is not adequate for
women of c hildbearing age, so a folate supplement might be c onsidered).
The cos t of this diet for 10 weeks for one person is about $500. The most expensive items are
milk powder, Weet-Bix, SPAM, and chocolate.
Powdered soup 20 1.4
Sweet chilli sauce 10 0.7
Tomato conce ntrate 10 0.7
Tuna, canned 60 4.2
SPAM, regular (luncheon meat) 40 2.8
Lentils, dry 20 1.4
Peas, green, canned 20 1.4
Three beans mix 50 3.5
Baked beans, canned in tomato sauce 20 1.4
Corn, canned 50 3.5
Sun-dried tomatoes 20 1.4
Milo§ (beverage base) 10 0.7
Seaweed, dried 10 0.7
Raisins 30 2.1
Honey 10 0.7
Almonds 20 1.4
Apricots, dried, raw 20 1.4
Juice, carrot 50 3.5
Juice, orange 50 3.5
Vegemite (yeast extract) 2 0.1
Chocolate 30 2.1
3 A list of simple dry foods that will cover basic energy needs (9 MJ
per day) and most nutrients for one person, assuming multivitamin
tablets are provided, and a purchase list for 10 weeks
Food g/day kg/person for 10 weeks
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* In case of lac tose intolerance, the intake of dry milk powder m ay be replaced by s oy protein
powder. Alternatively, the milk m ay be fermented. Kraft Foods Limited, Melbourne VIC.
Total daily ration provides 80 g protein and 76 g fat com prising 15 g s aturated fat (20% of fat
intake and 6% of energy intake), 20 g polyunsaturated fat (26% of fat intake) and 41 g
monounsaturated fat (54% of fat intake). The daily choles terol intake is 43 mg. Energy intake is
16% from protein, 32% from fat and 52% from c arbohydrate.
Vitamins C and A would have to be taken as supplements. O therwis e, recomm ended intakes of
all essential nutrients are provided for wom en and men, except for folate (which is not adequate
for women of childbearing age, s o a folate supplement might be cons idered) and iron (which is
provided at a lower level than recomm ended).
In addition, about 2 litres of water per person per day would be required.
This diet costs about $250 for one pers on for 10 weeks . The mos t expensive item s are dry milk
powder and noodles. These food items c ould be packed in airtight pac kages filled with inert gas
of a few kilograms per pac kage, and stored in food stores throughout the country.
Wheat flour, wholemeal, plain 150 10.5
Oats, raw 100 7.0
Oil, canola 25 1.8
Milk powder, dry* 65 4.6
Lentils, dry 30 2.1
Peas, split, green/yellow, dry 40 2.8
Noodles, dry 50 3.5
Vegemite (yeast extract) 2 0.1
Fruit, mixed, dried 35 2.5
Almonds, raw 40 2.8
Multivitamin–mineral supplement One tablet One box
Competing interests
None ide ntified.
Author details
Anna Haug, PhD, Visiting Associate Professor1
Jennie C Brand-Miller, BSc, PhD, FAIFST, Professor of Human Nutrition1
Olav A Christophersen, Medical Student2
Jennifer McArthur, MHPEd, APD, Dieti tian1
Flavia Fayet, BSc, MNutrDiet, PhD Candidate1
Stewart Truswell, MD, FFPHM, FRACP, Emeritus Professor1
1 University of Sydney, Sydney, NSW.
2 Ragnhild Schibbyes, Oslo, Norway.
Correspondence: J.BrandmillerATmmb.usyd.edu.au
References
Weiss H, Bradley RS. What drives societal collapse? Science 2001; 291: 609-610. <PubMed>1.
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World Health Organization. Influenza research at the human and animal interface. Report of a WHO
working group. Geneva: WHO, 2006. http://www.who.int/csr/resources/publications/influenza
/WHO_CDS_EPR_GIP_2006_3C.pdf (accessed Mar 2007).
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Duerr HP, Brockmann SO, Piechotowski I, et al. Influenza pandemic intervention planning using InfluSim:
pharmaceutical and nonpharmaceutical interventions. BMC Infect Dis 2007; 7: 76-90. <PubMed>
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Chiang JC, Koutavas A. Climate change: tropical flip-flop connections. Nature 2004; 432: 684-685.
<PubMed>
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Australian Government Department of Health and Ageing, National Health and Medical Research
Council, New Zealand Ministry of Health. Nutrient reference values for Australia and New Zealand
including recommended dietary intakes. Canberra: Commonwealth of Australia, 2006.
http://www.nhmrc.gov.au/publications/synopses/_files/n35.pdf (accessed Jun 2007).
5.
(Received 27 Mar 2007, accepted 11 Sep 2007)
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... Especially Vitamin C will guarantee a powerful immune system. In this pandemic, it is necessary to know about types of food that can improve immunity [16]. Micronutrients, such as vitamins and trace elements, are known to play essential roles in both innate and acquired immune responses, Deficiencies in micronutrients can decrease immunity like deficiency of vitamin C & D can be associated with impaired immune responses and can increase the risk of systemic infections. ...
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The COVID-19 pandemic was a great shock to the entire world in January 2020 last year and is still posing a major threat to the entire humanity. Coronavirus 2 (SARS-CoV-2) infection around the globe has become a crucial health menace mainly because of its high transmission potential and the unpredictability of disease progression. A lot of studies have been conducted studying the method of diagnosis and therapeutic management of the disease. Appropriate lifestyle changes regarding diet, yoga, sleep, and steam inhalation may help shift the population distribution of infection risk and aid in preventing severe COVID-19 disease. A balanced diet containing enough macronutrients and diverse micronutrients is a prerequisite of an optimally functioning immune system. Considering the high requirement of Prevention and Management of COVID-19, this study is planned to compose the various Breathing techniques (Pranayama), Yoga postures, diet for immunity building, steam inhalation technique and other methods which can helps for the prevention and management of COVID-19.
... Ces auteurs ont décrit des apports énergétiques de l'ordre de 2080 ± 520 kcal chez 1565 hommes et 1940 ± 430 kcal chez 1438 femmes, valeurs légérement inférieures à celles dans la présente étude. Des travaux antérieurs, notamment par Haug et al. recommandent en cas d'une pandémie ou autre catastrophe sanitaire, que les personnes aient des besoins énergétiques relativement modérés pour le maintien d'une bonne santé et d'un poids optimal (26). La situation de confinement imposant une réduction des activités professionnelles pour les personnes adultes actives et une limitation de la vie personnelle autour d'une routine quotidienne (souvent domestique pour les femmes), accentue le désir de consommer du "tout venant". ...
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Context & objective. Nutritional impact of lockdown due to the COVID-19 pandemic has not yet been studied in African environment. This study aimed to analyze the nutritional characteristics of active adults and the elderly Congolese to screen for possible deficiencies. Methods. The cross-sectional survey was carried out between April and May 2020, during the 2nd Covid-19 lockdown. Few households in Bacongo (Brazzaville) were randomly recruited and interviewed, using a quantitative food-type questionnaire, adressing the nature and quantity of food consumed throughout the day. Daily intakes were measured and reported as percentage of energy supplied respectively by carbohydrates, lipids and proteins; as well as trace elements, and few vitamins. Results. The overall average nutritional value around 2123.5 ± 494.5 kcal reflects an insufficient intake; specifically for proteins (33,5g/d) and fat (59,5g/d) requirements, except for carbohydrates (81,5%). The intakes of calcium (613.9 mg), phosphorus (709,8 mg), and magnesium (267,5 mg) met the recommended standards. Iron intakes were at the lower limit of normal (7.7 mg) in subjects aged more than 66 yrs to. Vitamin intakes were relevant for vitamins A and C, while slightly deficient in subjects aged 31- 59 yrs for vitamins B1 and B2. Conclusion. The present observations suggest a negative nutritional impact of lockdown, highlighting the need for targeted nutritional strategies of food supplementation. Keywords: Sub-Saharan Africa, Nutritional assessment, Containment, COVID-19, Adult
... There is currently no proof that any supplement can improve immune function or treat or prevent viral infections. To combat COVID-19, we must be aware of the specific foods that can strengthen our immune systems [4]. A tool for assessing dietary quality, the Healthy Eating Index (HEI-2015), has been used to research the relationships between dietary quality and health outcomes [5]. ...
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Background Nutritional status and physical activity are essential to maintain a strong immune system. No definite pharmacological strategies for Coronavirus disease 2019 treatment are presently available, so natural enhancement of the immune system is in need. Our goal was to assess the correlation of healthy diet and physical activity on COVID-19 disease outcome. Methods This cohort study was conducted on 68 adult patients who contracted mild (38) or moderate [30] cases of COVID-19, recruited via a convenience sampling technique from the outpatient clinic, Kasr Al-Aini Faculty of Medicine, Cairo University Hospital. Patients' Healthy Eating Index (HEI) and degree of physical activity as measured by the Global Physical Activity Questionnaire were evaluated and linked with several inflammatory markers. Results Most of patients with mild COVID-19 patients (92.1%) were physically active, compared to only 50% of moderate COVID-19. The total Metabolic Equivalent Task-min/week was positively correlated with the lymphocyte percentage. The median total HEI score was significantly higher in the patients with mild COVID-19 than with moderate COVID. Significant positive correlations observed among the lymphocyte count and total HEI-2015. There was approximately a 64% reduction in the probability of acquiring moderate COVID-19 illness for each unit rise in The HEI. Conclusion Healthier nutrition and Physical activity correlated with reduced COVID-19 disease severity.
... There is currently no proof that any supplement can improve immune function or treat or prevent viral infections. To combat COVID-19, we must be aware of the specific foods that can strengthen our immune systems [4]. A tool for assessing dietary quality, the Healthy Eating Index (HEI-2015), has been used to research the relationships between dietary quality and health outcomes [5]. ...
Article
Full-text available
Background Nutritional status and physical activity are essential to maintain a strong immune system. No definite pharmacological strategies for Coronavirus disease 2019 treatment are presently available, so natural enhancement of the immune system is in need. Our goal was to assess the correlation of healthy diet and physical activity on COVID-19 disease outcome. Methods This cohort study was conducted on 68 adult patients who contracted mild (38) or moderate [30] cases of COVID-19, recruited via a convenience sampling technique from the outpatient clinic, Kasr Al-Aini Faculty of Medicine, Cairo University Hospital. Patients’ Healthy Eating Index (HEI) and degree of physical activity as measured by the Global Physical Activity Questionnaire were evaluated and linked with several inflammatory markers. Results Most of patients with mild COVID-19 patients (92.1%) were physically active, compared to only 50% of moderate COVID-19. The total Metabolic Equivalent Task-min/week was positively correlated with the lymphocyte percentage. The median total HEI score was significantly higher in the patients with mild COVID-19 than with moderate COVID. Significant positive correlations observed among the lymphocyte count and total HEI-2015. There was approximately a 64% reduction in the probability of acquiring moderate COVID-19 illness for each unit rise in The HEI. Conclusion Healthier nutrition and Physical activity correlated with reduced COVID-19 disease severity. Trial registration The study was registered on clinical trial.gov maintained by the US National Library of Medicine (CinicalTrials.gov identifier = NCT04447144; https://clinicaltrials.gov/) (25/06/2020).
... 36 Vitamin C has been known to boost the immune system and prevent any viral infection. 36,37 Healthy meals and optimal nutritional intake will impact the immune system through cell activation, signalling molecule modification, and gene expression. A variety of dietary components also determines the composition of gut microbes which then form the immune response in the body. ...
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The archaeological and historical record shows many instances of societal collapse. These events have traditionally been explained by a combination of social, political, and economic factors. In their Perspective, [Weiss and Bradley][1] argue that there is increasing evidence for climate as the primary agent in the collapse of prehistoric and early historic societies. They also consider the possible effects of future anthropogenic climate change. [1]: http://www.sciencemag.org/cgi/content/full/291/5504/609
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Influenza pandemic preparedness plans are currently developed and refined on national and international levels. Much attention has been given to the administration of antiviral drugs, but contact reduction can also be an effective part of mitigation strategies and has the advantage to be not limited per se. The effectiveness of these interventions depends on various factors which must be explored by sensitivity analyses, based on mathematical models. We use the freely available planning tool InfluSim to investigate how pharmaceutical and non-pharmaceutical interventions can mitigate an influenza pandemic. In particular, we examine how intervention schedules, restricted stockpiles and contact reduction (social distancing measures and isolation of cases) determine the course of a pandemic wave and the success of interventions. A timely application of antiviral drugs combined with a quick implementation of contact reduction measures is required to substantially protract the peak of the epidemic and reduce its height. Delays in the initiation of antiviral treatment (e.g. because of parsimonious use of a limited stockpile) result in much more pessimistic outcomes and can even lead to the paradoxical effect that the stockpile is depleted earlier compared to early distribution of antiviral drugs. Pharmaceutical and non-pharmaceutical measures should not be used exclusively. The protraction of the pandemic wave is essential to win time while waiting for vaccine development and production. However, it is the height of the peak of an epidemic which can easily overtax general practitioners, hospitals or even whole public health systems, causing bottlenecks in basic and emergency medical care.
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A long climatic record shows that episodic wet periods in northeastern Brazil are linked to distant climate anomalies. The ocean-atmosphere system can evidently undergo rapid and global reorganization.
<PubMed> 1. eMJA: A food " lifeboat " : food and nutrition considerations in the ... http://www.mja.com AM World Health Organization. Influenza research at the human and animal interface Report of a WHO working group
  • H Weiss
  • Rs Bradley
Weiss H, Bradley RS. What drives societal collapse? Science 2001; 291: 609-610. <PubMed> 1. eMJA: A food " lifeboat " : food and nutrition considerations in the... http://www.mja.com.au/public/issues/187_11_031207/hau1035... 5 of 6 3/03/2010 7:53 AM World Health Organization. Influenza research at the human and animal interface. Report of a WHO working group. Geneva: WHO, 2006. http://www.who.int/csr/resources/publications/influenza /WHO_CDS_EPR_GIP_2006_3C.pdf (accessed Mar 2007).
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Home | Issues | eMJA shop | Terms of use | Terms and Conditions | Classifieds | More... | Contact | Topics | Search The Medical Journal of Australia eMJA ©The Medical Journal of Australia 2007 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377 eMJA: A food "lifeboat": food and nutrition considerations in the... http://www.mja.com.au/public/issues/187_11_031207/hau1035... 6 of 6 3/03/2010 7:53 AM