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

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 tion — Which foods and in what quantities? — Competing interests — Author details — References
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
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(Received 27 Mar 2007, accepted 11 Sep 2007)
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