More than 48 million people in the United States live in poverty. According to Feeding America, food insecurity affects 49 million Americans; most of these households have children. (Food insecurity is defined as a household that is frequently or occasionally without enough food to satiate hunger.) Individuals living food insecure rarely have access to foods recommended by the American Diabetes Association (ADA) such as fresh fruits, vegetables, lean meats and whole grains. As nurses, we understand the importance of a healthy diet that allows our patients to maintain health and recover from illness or injury. But what resources do patients with food insecurity have? Along with governmental programs such as food stamps and WIC (Women and Healthy Children), many communities have food banks, food pantries, and soup kitchens that provide food. As nurses, we may refer patients to these food sources, but, without a clear understanding of how these facilities operate, it’s difficult to educate patients.
A food bank is a nonprofit organization that is a holding warehouse for excess food. This food includes everything from a bag of chips that didn’t sell to a large harvest of bananas. The food bank is able to buy large quantities of all types of meats, fish, produce, fruits, and processed foods for pennies on the pound. This food is then sold to food pantries, soup kitchens, school programs, and so on to allow for distribution. Food banks generally don’t provide food directly to the public; however, in some larger cities food banks distribute to individuals. Food pantries are available in several sites in most communities. These are generally run by churches and community groups as philanthropic outreaches. Food is provided free of charge to individuals in need. Most food pantries stipulate how frequently an individual can obtain food. Because of this, individuals may visit multiple food pantries throughout the month. Food pantries are designed to be a supplemental food source and not a primary source of groceries. Food may be given in care package format or the individuals may be allowed to “shop” and make their own choices. Soup kitchens are direct feeding centers offering a prepared meal to individuals, usually free of charge. Most soup kitchens are located in areas with larger numbers of individuals living in poverty and homeless individuals. Urban soup kitchens are frequently open for multiple meals each day. Soup kitchens in smaller towns may serve one meal a day and only on certain days of the week. Nurses in many roles have the opportunity to provide patients with a list of food pantries, food banks, and soup kitchens in local communities. (See Food resources for those in poverty.)
Food resources for those in poverty
Here is summary of the types of the types of services provided by food banks, food pantries, and soup kitchens
Challenge of healthy eating
Unfortunately, many foods available in soup kitchens and food pantries are overprocessed, highly refined, and high in sodium—not optimal food choices for patients who have chronic illnesses such as diabetes and hypertension. As nurses we can educate patients in making healthy food choices that satiate hunger and remain consistent with a recommended dietary regimen. For example, patients with diabetes will maintain better glucose levels if they pair foods correctly, making sure to eat legumes and vegetables with pasta. Pairing decreases the glucose elevation from the pasta compared with eating pasta alone. Soups are a great option that allows for this pairing at a low cost. For patients with hypertension, encourage rinsing canned vegetables and beans before eating; doing so removes up to 40% of the sodium content.
Supporting patients’ dietary management in the face of daily hunger is a challenge. As nurses, we have the ability to increase patients’ awareness of community resources and provide real-world guidance in food choices, while addressing food insecurity and poverty. S. Renee Gregg is an assistant professor in the school of nursing at Ball State University in Muncie, Indiana. Selected references Bishaw A. Poverty: 2000-2012 American Community Survey Briefs. 2013. http://www.census.gov/prod/2013pubs/acsbr12-01.pdf. Accessed May 30, 2014. American Heart Association. Fresh, Frozen or Canned Fruits and Vegetables: All Can Be Healthy Choices! 2014. http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyCooking/Fresh-Frozen-or-Canned-Fruits-and-Vegetables-All-Can-Be-Healthy-Choices_UCM_459350_Article.jsp#. Accessed May 30, 2014. Hunger and Poverty Statistics. http://feedingamerica.org/hunger-in-america/hunger-facts/hunger-and-poverty-statistics.aspx. Accessed May 30, 2014. Kuhls JP, Habash DL, Clutter JE, et al. The ideal food pantry as designed by food pantry customers. J Acad Nutrition Dietetics. 2012;113(9). Ripsin C, Urban R (2009). Management of blood glucose in type 2 diabetes mellitus. American Family Physician. 2009;79(1), 7.