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Australian lifeboat guidelines - Medical Journal of Australia

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  • Australian lifeboat guidelines - Medical Journal of Australia

    From other web sites (if not published on FT yet):
    * The full food lifeboat guidelines are available at www.foodlifeboat.com.au
    See bottom text.
    __________________________________________________ ____________

    December 28th, 2007
    Politics, Media, Bird flu
    Australian News: Stockpile food for flu crisis
    December 16, 2007 12:00am
    Link
    EVERY Australian household should stockpile at least 10 weeks? worth of food rations to prepare for a deadly flu pandemic, a panel of leading nutritionists has warned.
    World health experts now agree a pandemic is inevitable and will spread rapidly, wiping out up to 7.4 million people globally and triggering rapid food shortages.
    Australia is expected to be among the first countries hit because of its proximity to Asia and high levels of international traffic.
    But Woolworths and Coles, the nation?s two major supermarket chains, will run out of stock within two to four weeks without a supply chain ? or even faster if shoppers panic.
    This has prompted a team of leading nutritionists and dietitians from the University of Sydney to compile ?food lifeboat? guidelines to cover people?s nutritional needs for at least 10 weeks.

    Their advice ? published in the Medical Journal of Australia ? would allow citizens to stay inside their homes and avoid contact with infected people until a vaccine becomes available.
    The lifeboat includes affordable long-life staples such as rice, biscuits, milk powder, Vegemite, canned tuna, chocolate, lentils, Milo and Weet-Bix.
    Jennie Brand-Miller, professor of human nutrition at the University of Sydney and co-leader of the study, believes it is common sense to stockpile food before a pandemic strikes.
    ?It?s really not a question of if: it?s a question of when,? she said.
    ?We are going to have an epidemic. Chances are it will be avian flu (bird flu) but it might be something else.
    ?It will spread very rapidly just like flu does normally because it?s a highly contagious organism, except this will be a really lethal one. What we suffer from is a false sense of security that someone else is looking after all this.?
    While there are emergency plans within governments, hospitals and the food industry, individuals will still need to take personal precautions in a disaster, she said.
    The most important message for the Australian public is to avoid going out in public when the pandemic hits, the research found.
    ?We know that once it becomes a highly transmissable virus it will probably fly around the world within three weeks,? Prof Brand-Miller said.
    ?We know it?s got all the right conditions to start in Indonesia or Asia and there have already been human transmissions.
    * The full food lifeboat guidelines are available at www.foodlifeboat.com.au
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    __________________________________________________ ______________

    <TABLE id=header cellSpacing=0 cellPadding=0 border=0><TBODY><TR><TD></TD></TR></TBODY></TABLE><TABLE id=body cellSpacing=0 cellPadding=0 border=0><TBODY><TR><TD><TABLE id=inner cellSpacing=0 cellPadding=0 border=0><TBODY><TR><TD>The Food "Lifeboat": food and nutrition considerations in the event of a pandemic or other catastrophe

    Large catastrophes have caused the collapse of empires and civilizations . Science and knowledge may help prevent some catastrophes, but urbanisation and narrowly concentrated food supplies, climate change and terrorism contribute to considerable risk. Viruses such as SARS (severe acute respiratory syndrome) and influenza A/(H5N1) or "bird flu" are among the most immediately identifiable risks. In the event of a highly lethal pandemic, emergency measures such as closing schools, staying home with family and friends, avoiding contact with other people (until all have been immunized) will be instrumental in avoiding infection. Individuals 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 must be available, and ways to distribute the food must be planned.
    But which foods and in what quantities? It is logical that they 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 will be nutrient dense providing the recommended macro- and micronutrients for all members of the family. Ideally, they can be eaten without cooking in case gas and electricity fail. Cost, volume and storage space are further considerations.

    In Table 1 we provide an example of a food list providing 9 MJ per day for 10 weeks for one person that covers all known nutrient needs. This example was generated using the nutrient analysis software Foodworks? (5), 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. Together, these two sources make it possible to compose diets with the appropriate quantity of nutrients. As the majority of the population has no access to detailed nutrient data, we have developed these examples to demonstrate 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.
    Table 1

    An example of a food list providing 9 MJ per day. Daily food ration and purchase list for 10 weeks for one person is shown. The food covers all nutrient needs.
    <TABLE cellSpacing=2 cellPadding=0 width="100%" border=0><TBODY><TR><TD class=tablecell height=20>Food</TD><TD class=tablecell align=middle>g/day</TD><TD class=tablecell align=middle>kg/person/10 weeks </TD></TR><TR><TD class=tablecell height=20>Milk powder, NS fat, dry*</TD><TD class=tablecell align=middle>65</TD><TD class=tablecell align=middle>4.6</TD></TR><TR><TD class=tablecell height=20>Weet-Bix (regular) (Breakfast cereal)</TD><TD class=tablecell align=middle>30</TD><TD class=tablecell align=middle>2.1</TD></TR><TR><TD class=tablecell height=20>Pasta, regular, dry</TD><TD class=tablecell align=middle>20</TD><TD class=tablecell align=middle>1.4</TD></TR><TR><TD class=tablecell height=20>Instant noodles</TD><TD class=tablecell align=middle>20</TD><TD class=tablecell align=middle>1.4</TD></TR><TR><TD class=tablecell height=20>Rice</TD><TD class=tablecell align=middle>25</TD><TD class=tablecell align=middle>1.8</TD></TR><TR><TD class=tablecell height=20>Dehydrated potato flakes</TD><TD class=tablecell align=middle>15</TD><TD class=tablecell align=middle>1.1</TD></TR><TR><TD class=tablecell height=20>Tortilla</TD><TD class=tablecell align=middle>10</TD><TD class=tablecell align=middle>0.7</TD></TR><TR><TD class=tablecell height=20>Biscuit, savoury </TD><TD class=tablecell align=middle>15</TD><TD class=tablecell align=middle>1.1</TD></TR><TR><TD class=tablecell height=20>Biscuit, wholemeal</TD><TD class=tablecell align=middle>20</TD><TD class=tablecell align=middle>1.4</TD></TR><TR><TD class=tablecell height=20>Oil, canola</TD><TD class=tablecell align=middle>20</TD><TD class=tablecell align=middle>1.4</TD></TR><TR><TD class=tablecell height=20>Powdered soup</TD><TD class=tablecell align=middle>20</TD><TD class=tablecell align=middle>1.4</TD></TR><TR><TD class=tablecell height=20>Sweet chilli sauce</TD><TD class=tablecell align=middle>10</TD><TD class=tablecell align=middle>0.7</TD></TR><TR><TD class=tablecell height=20>Tomato concentrate</TD><TD class=tablecell align=middle>10</TD><TD class=tablecell align=middle>0.7</TD></TR><TR><TD class=tablecell height=20>Tuna, canned</TD><TD class=tablecell align=middle>60</TD><TD class=tablecell align=middle>4.2</TD></TR><TR><TD class=tablecell height=20>Spam, regular</TD><TD class=tablecell align=middle>40</TD><TD class=tablecell align=middle>2.8</TD></TR><TR><TD class=tablecell height=20>Lentils, dry</TD><TD class=tablecell align=middle>20</TD><TD class=tablecell align=middle>1.4</TD></TR><TR><TD class=tablecell height=20>Peas, green canned</TD><TD class=tablecell align=middle>20</TD><TD class=tablecell align=middle>1.4</TD></TR><TR><TD class=tablecell height=20>Three beans mix </TD><TD class=tablecell align=middle>50</TD><TD class=tablecell align=middle>3.5</TD></TR><TR><TD class=tablecell height=20>Baked beans, canned in tomato sauce</TD><TD class=tablecell align=middle>20</TD><TD class=tablecell align=middle>1.4</TD></TR><TR><TD class=tablecell height=20>Corn, canned</TD><TD class=tablecell align=middle>50</TD><TD class=tablecell align=middle>3.5</TD></TR><TR><TD class=tablecell height=20>Sun-dried tomatoes</TD><TD class=tablecell align=middle>20</TD><TD class=tablecell align=middle>1.4</TD></TR><TR><TD class=tablecell height=20>Milo (Beverage base)</TD><TD class=tablecell align=middle>10</TD><TD class=tablecell align=middle>0.7</TD></TR><TR><TD class=tablecell height=20>Seaweed, dried</TD><TD class=tablecell align=middle>10</TD><TD class=tablecell align=middle>0.7</TD></TR><TR><TD class=tablecell height=20>Raisins</TD><TD class=tablecell align=middle>30</TD><TD class=tablecell align=middle>2.1</TD></TR><TR><TD class=tablecell height=20>Honey</TD><TD class=tablecell align=middle>10</TD><TD class=tablecell align=middle>0.7</TD></TR><TR><TD class=tablecell height=20>Almonds</TD><TD class=tablecell align=middle>20</TD><TD class=tablecell align=middle>1.4</TD></TR><TR><TD class=tablecell height=20>Apricots, dried, raw</TD><TD class=tablecell align=middle>20</TD><TD class=tablecell align=middle>1.4</TD></TR><TR><TD class=tablecell height=20>Juice, carrot</TD><TD class=tablecell align=middle>50</TD><TD class=tablecell align=middle>3.5</TD></TR><TR><TD class=tablecell height=20>Juice, orange</TD><TD class=tablecell align=middle>50</TD><TD class=tablecell align=middle>3.5</TD></TR><TR><TD class=tablecell height=20>Vegemite (Yeast extract)</TD><TD class=tablecell align=middle>2</TD><TD class=tablecell align=middle>0.1</TD></TR><TR><TD class=tablecell height=20>Chocolate</TD><TD class=tablecell align=middle>30</TD><TD class=tablecell align=middle>2.1</TD></TR></TBODY></TABLE>Total daily ration gives 9.0 MJ, providing 80 g protein, 80 g fat, thereof 23 g saturated fat (10 % of total energy intake is coming from saturated fat, and 31% of the fat intake is saturated fat), 18 g polyunsaturated fat (22% of the fat intake), 35 g monounsaturated fat (47% of the fat intake). The cholesterol intake is 101 mg per day. Percent of energy from protein, fat and carbohydrate: 16 E% protein, 34 E% fat, 50 E% carbohydrates. Recommended intake of all nutrients is covered for women and men, except for folate intake which is not covered for women of childbearing age, therefore they may consider a folate supplement. *In case of lactose intolerance, the intake of dry milk powder may be reduced and replaced by soy protein powder. Alternatively, the milk may be fermented and used in form of sour milk.
    The cost of this diet for 10 weeks for one person is about $500. The most expensive items are: Milk powder, Weet-Bix, spam, chocolate.
    Table 2

    Example of a list of simple dry foods that will cover basic energy needs (9 MJ per day), and most nutrients except vitamin C and vitamin A. Daily food ration and purchase list for 10 weeks for one person is shown. The food items could be packed in airtight packages filled with inert gas of a few kilos per package, and stored in food stores throughout the country. In addition multivitamin tablets have to be provided.
    <TABLE cellSpacing=2 cellPadding=0 width="100%" border=0><TBODY><TR><TD class=tablecell height=20>Food</TD><TD class=tablecell align=middle>g/day</TD><TD class=tablecell align=middle>kg/person/10weeks</TD></TR><TR><TD class=tablecell height=20>Wheat flour, wholemeal plain</TD><TD class=tablecell align=middle>150</TD><TD class=tablecell align=middle>10.5</TD></TR><TR><TD class=tablecell height=20>Oats, raw</TD><TD class=tablecell align=middle>100</TD><TD class=tablecell align=middle>7.0</TD></TR><TR><TD class=tablecell height=20>Oil, Canola</TD><TD class=tablecell align=middle>25</TD><TD class=tablecell align=middle>1.8</TD></TR><TR><TD class=tablecell height=20>Milk powder, dry*</TD><TD class=tablecell align=middle>65</TD><TD class=tablecell align=middle>4.6</TD></TR><TR><TD class=tablecell height=20>Lentils, dry</TD><TD class=tablecell align=middle>30</TD><TD class=tablecell align=middle>2.1</TD></TR><TR><TD class=tablecell height=20>Peas, split, green/yellow, dry</TD><TD class=tablecell align=middle>40</TD><TD class=tablecell align=middle>2.8</TD></TR><TR><TD class=tablecell height=20>Noodles, dry</TD><TD class=tablecell align=middle>50</TD><TD class=tablecell align=middle>3.5</TD></TR><TR><TD class=tablecell height=20>Vegemite (yeast extract)</TD><TD class=tablecell align=middle>2</TD><TD class=tablecell align=middle>0.1</TD></TR><TR><TD class=tablecell height=20>Fruit, mixed, dried</TD><TD class=tablecell align=middle>35</TD><TD class=tablecell align=middle>2.5</TD></TR><TR><TD class=tablecell height=20>Almonds, raw</TD><TD class=tablecell align=middle>40</TD><TD class=tablecell align=middle>2.8</TD></TR><TR><TD class=tablecell height=20>Multivitamin/mineral supplement</TD><TD class=tablecell align=middle>One tablet </TD><TD class=tablecell align=middle>One box</TD></TR></TBODY></TABLE>This example gives 9 MJ per day, with 80 g protein and 76 g fat, thereof 14 g saturated fat (6 % of the energy intake comes from saturated fat and 20% of the fat intake is saturated fat), 18 g polyunsaturated fat (26% of the fat is polyunsaturated fat) and 39 g monounsaturated fat (54% of the fat is monounsaturated fat). The daily cholesterol intake is 43 mg. Percent of energy from protein, fat and carbohydrate: 16 E% protein, 32 E% fat, 52 E% carbohydrates. Recommended intake of nutrients is covered for women and men, except for vitamin C and vitamin A, and these would have to be given as supplements and for women at childbearing age the intake of folate and iron is lower than recommended.
    *In case of lactose intolerance, the intake of dry milk powder may be reduced and replaced by soy protein powder. Alternatively, the milk may be fermented and used in fermented, sour form.
    In addition, about 2 litres of water per day per person would be required.
    This diet costs about 250 $ for one person for 10 weeks. The most expensive items are: dry milk powder and noodles.
    Preparing Your Pantry and Meals

    Overview
    The food items listed provide sufficient nutrition for the body�s needs. This does not mean you are limited to the suggested foods; however substitutions can impact on the nutrients provided by the diet.
    Pantry Maintenance
    It is important when foods are stored for use later in the week, month or year that the use by date is evident and that older supplies are used first. It is recommended that 10 weeks supply of food items is necessary to be stored in the pantry, freezer and refrigerator. Practicality recommends that freezer and refrigerator items should be kept to the minimum. Start by ascertaining the meals /foods that you and your family prefer eating and whether they can replace some of the items on the food lists with nutritional security. Identify the foods on our list that do not routinely appear in your meals or snacks and begin trying new recipes so you have a series of meals and snacks that your family will eat if necessary. Each week buy a few additional foods for the pantry with a good date life eg some pasta have 2-3 years shelf life. Do not stockpile foods in a separate place allowing them to go out of date. Make them part of your normal pantry and replace when used. When purchasing foods, consider the size of the packaging. Some foods deteriorate quickly once opened and for these, buy the packaging size sufficient for one meal only.
    Meal Preparation
    Review your regular family recipes. Water and power supplies may be disrupted during an outbreak of pandemic flu and this will influence meal preparation. Because of this the meals that can be prepared with minimal implements and equipment are ideal ie one pot cookery. Make a file of these recipes. Another member of the family may need to prepare the meals if you are unwell. It is important that we do drink water everyday and not waste supplies for the washing and cleaning of excessive pots nor wasting cooking water. Rice should be cooked using the absorption method and the water left over from cooking pasta should be reused in soups and casseroles, wherever possible. Consider a supply of paper plates should water for dishwashing becomes limited.
    Essential Kitchen Equipment
    2 can openers
    Glass measuring jug
    Metal stirring / serving spoon
    Plastic, non porous chopping / preparation board
    Large Mixing Bowl
    Saucepan with tight fitting lid
    Aluminium Foil Cling Wrap


    Anna Haug*, Jennie Brand-Miller**,Olav Albert Christophersen***, Jennifer McArthur**, Flavia Fayet**, Stewart Truswell**

    *Visiting scholar at the University of Sydney from Norwegian University of Life Sciences, 1432 Aas, Norway

    **The University of Sydney, NSW 2006 Australia

    ***Ragnhild Schibbyes vei 26, Oslo, Norway

    website: Scott Dickinson
    </TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>
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