Aboriginal Health Please support the @MaiWiruSCF #Sugar Challenge Palyaringkunytjaku – Towards Wellbeing

“ The rates of obesity and insulin resistance syndrome in our communities are now so high that the majority of the adult population over 35 will be affected.

This provides a situation in which we are not aiming to target a subset or at risk group of the population with a nutrition strategy but our whole population is both at risk and suffering disease.”

Professor Paul Torzillo, Medical Director of Nganampa Health Council said in Fighting for “Good Food” (Mai Wiru), submitted by Lorenzo Piemonte, International Diabetes Foundation (2015)

 ” Congratulations, Mai Wiru. They are excited to be taking 10 influential Anangu senior women on a nutrition education retreat so they can experience first hand how a healthy diet feels, and can consequently extend lives in the APY Lands – to do this though, they need your help

Friends,please share this and support it. I met so many wonderful people when I spent two day in the APY Lands last week – they deserve our help.”

Indigenous Health Minister Ken Wyatt

Amata was an alcohol-free community, but some years earlier its population of just under 400 people had been consuming 40,000 litres of soft drink annually.

The thing that I say in community meetings all the time is that, the reason we’re doing this is so that the young children now do not end up going down the same track of diabetes, kidney failure, dialysis machines and early death, which is the track that many, many people out here are on now,”

Mai Wiru, meaning good health, and managed by long-time community consultant John Tregenza.

See Previous NACCHO Post Aboriginal Health and Sugar TV Doco: APY community and the Mai Wiru Sugar Challenge Foundation

Palyaringkunytjaku – Towards Wellbeing is the brain child of Inawantji (Ina) Scales, a young Pitjantjatjara woman from the APY Lands.

Ina has seen too many family and friends, too many Anangu (people from the Anangu Pitjantjatjara Yankunytjatjara Lands) die from diet related illnesses.

Watch video

Ina wants to give Anangu the same opportunity Hope For Health has given Yolngu in the top end

See fundraising website

In 2016 Ina met with Damon Gameau, the founding director of the Mai Wiru Sugar Challenge Foundation.

She told him of her sadness from watching so many people become ill and pass away, she also told of her personal experience from visiting Living Valley Springs and the happiness she felt at now understanding the solutions.

Ina asked Damon for his help, and the Foundation’s help, to share her experiences with other people on the APY Lands.

Here we are today, raising funds to send 10 senior and influential women to an intensive health and nutrition retreat where they will learn and be able to personally experience firsthand, the benefits of healthy eating and living.

By providing a culturally appropriate setting with language interpretation, we will free participants to focus, distraction free, on learning the extensive information that will be provided.

These strong community leaders will then be able to return to community to share their experiences and become healthy living champions.

This is a 2 week trip with an interpreter and staff member to support the women through their learning and experiences, and further to be able to support the women on their return to community.

This will also ensure longer lasting results and help participants maximise their learnings and minimise any stumbling blocks they come across.

Our aim is to have an intensive and immediate impact for these women, enabling them to experience the benefits of healthy eating and living, and to expand their understanding of the impacts of foods on their bodies, to understand the how and why foods have such influence over us.

In their roles in community they can then spread the word about their positive experience and help others make healthier choices.

The participants are being selected based on their location and their capacity to influence on their return.

As a result, these women will become healthy living champions, sharing their knowledge and experience in their regions.

We can’t do it without you.

Help Ina make a good impact on the health of her people, of the Anangu nation.

  • The rate of kidney failure in Aboriginal communities is 15 x the rest of Australia; Type 2 diabetes is 3 x the national average.
  • For too long now high Aboriginal death rates have been attributed to alcohol consumption. The communities and region of the APY lands have now been alcohol free for 40 years yet average life span on the lands is just 55; 20 years lower than the rest of Australia. This is because of poor diet.
  • Professor Paul Torzillo, Medical Director of Nganampa Health Council said in Fighting for “Good Food” (Mai Wiru), submitted by Lorenzo Piemonte, International Diabetes Foundation (2015) “The rates of obesity and insulin resistance syndrome in our communities are now so high that the majority of the adult population over 35 will be affected. This provides a situation in which we are not aiming to target a subset or at risk group of the population with a nutrition strategy but our whole population is both at risk and suffering disease.”
  • Dr Amanda Lee et al in the Australian and New Zealand Journal of Public Health, Nutrition in remote Aboriginal communities: Lessons from Mai Wiru and the Anangu Pitjantjatjara Yankunytjatjara Lands, (2015), state that more than 75% of Indigenous deaths result from potentially avoidable causes. This includes type 2 diabetes, a preventable, non-communicable chronic disease. About 70% of Aboriginal and Torres Strait Islander adults, and 38% of Aboriginal and Torres Strait Islander children were considered overweight or obese in 2015, with an additional 8% of children who are underweight, another major contributor to the avoidable deaths.
  • Communities on the APY Lands have a long history of being proactive, for example, communities took back management of their stores to ensure food security (the availability and affordability of healthy food and essential items on a daily basis through their local store).
  • There are programs in place that address nutrition and health, but the scale of the problem necessitates a spot fire approach and they are struggling to extend and achieve the progressive results needed to combat chronic health and nutrition issues in the Aboriginal population.
  • The success of service delivery in remote communities depends on the level of community involvement and buy-in. By providing an intensive experience with ongoing support community members will be empowered to create and manage change in their communities.

To make this program fly we need your wonderful support to get there!

We know you’re all very busy people and this is why we appreciate your help more than you can know! Here is a list of 10 things that you could do to help us make Ina’s dream of Palyaringkunytjaku – Towards Wellbeing a reality.

  1. Share our emails – when you receive our emails – share them with your friends and networks.
  2. Share our Social Media posts – Follow us on Facebook and invite your friends to do the same.
  3. Talk to your friends, family, colleagues – tell them what we are doing and how they can support us.
  4. Give us a call. We are looking for more support and are ready to answer calls. We can talk in more detail about the project and who knows where a conversation may lead. Email info@maiwirufoundation.org
  5. Hold a fundraising event. Be creative – a donation box at your work for a month, hold a concert, a dinner party with tickets, a raffle, a physical challenge among your friends, a percentage of your office mates salaries for a month. Design your own style of fundraising.
  6. Create your own campaign under this ‘Palyaringkunytjaku’ umbrella – simply click the button at the bottom of the screen that says ‘Fundraisers – Create Your Own’. You can select one of the impact levels and let your friends and family know what the funds raise will enable. You might like to do ‘6 Spoons in June (and July)’ for the length of this campaign and ask for sponsorship, as an incentive
  7. Keep a close eye on our campaign-we need to hit the target, so if we get close and time is short consider donating again to get us over the top
  8. Have you got something special to give? Relevant health products or services? Donate towards our perks or retreat or help with distributing perks to donors.
  9. Send a message through your networks. Do you have a voice in your community? Do you have a big social media following? Perhaps a lot of professional networks? One or two emails during the campaign from you could result in thousands of dollars towards our very important work. We have email templates for you to use and technical support available if you require. Email: info@maiwirufoundation.org
  10. Did we mention sharing our social media, emails and talking to people you know about what we are doing? When people hear and understand your passion, they can be inspired to jump on board.

All donations are tax deductible.

What happens if we get more or less than $63,500?

By hitting $63,500 we can make Ina’s dream a reality and take 10 participants from the APY Lands on this program, means Palyaringkunytjaku can go ahead as Ina hoped.

There are always many people from the APY Lands who would benefit from this experience,, therefore the amount we raise will directly impact on the number of people Ina and the Mai Wiru Foundation are able to support.

The Mai Wiru Sugar Challenge Foundation is an indigenous community-led initiative, implementing nutrition programs in central Australia’s remote APY Lands. After two years of consultation, and multiple visits from nutritionists to indigenous communities, the team are working on three key projects: opening healthy living cafes, funding permanent nutritionists on the ground, and intensive nutrition workshops.

Melbourne filmmaker Damon Gameau embarked on a unique experiment to document the effects of a high sugar diet on a healthy body, consuming only foods that are commonly perceived, or promoted to be ‘healthy’. Damon’s now acclaimed documentary The Sugar Film raises awareness of the hazards of any diet containing too much sugar. In making the film Damon included a segment about an innovative health program initiated by Indigenous communities in the Anangu Pitjantjatjara Yankunytjatjara(APY) Lands, where stores were stocking healthy foods and nutritionists were advising customers on the best food choices. Damon determined to give back to the APY communities who featured in That Sugar Film by supporting them in their mission to take control of their own nutrition and improve the health status of Aboriginal families on the APY Lands.

Damon founded the Mai Wiru (Good Food) Sugar Challenge Foundation, a not-for-profit enterprise working with APY communities in an indigenous-led initiative to improve their health.

The health challenges of Aboriginal people are well documented, with current research identifying a 10 year gap between the life expectancy of indigenous and non-indigenous males and indigenous and non-indigenous females. The report published by the Australian Institute of Health and Welfare : Indigenous Health (2014) found that ‘The largest gap in death rates between Indigenous and non-Indigenous Australians was in circulatory disease deaths (22% of the gap) followed by endocrine, metabolic and nutritional disorders (particularly diabetes) (14% of the gap)’.

You can start your own campaign to raise money for Palyaringkunytjaku – with a goal for one of the impact levels below:

  • For the flights – 1 participant (12 in total) = $767
  • For the 2 week health workshop – per participant (10 participants) = $5,990
  • Meals during transit per person – 4 days (12 people) = $300
  • Vehicle expenses – hire, mileage, fuel, maintenance. Pickup and return to community – 3 vehicles for all participants = $11,169
  • Accommodation Alice Springs – per person 2 nights (each direction) twin share = $150

What happens if we get more or less than $63,500?

By hitting $63,500 we can make Ina’s dream a reality and take 10 participants from the APY Lands on this program, it means Palyaringkunytjaku can go ahead as Ina hoped. There are always many people from the APY Lands who would benefit from this experience, therefore the amount we raise will directly impact on the number of people Ina and the Mai Wiru Foundation are able to support

If you would prefer to make a donation by bank transfer/direct deposit, please see our bank account details below. Please advise by email – info@maiwirufoundation.org – when donation is made so we can issue a tax receipt. Thank you.

Account Name: Mai Wiru Sugar Challenge Foundation
Bank: Suncorp
BSB: 484 799
Acct No: 507433042
Description: Please enter your email address

NACCHO Aboriginal Diabetes Health #NDW2017 : Targeting sugary drinks in remote Indigenous communities

Part of our healthy food strategy is looking at reducing sugary drinks because consumption of sugary drinks across the whole population, but particularly in remote communities, is very high and high intake of sugary drinks has been linked to obesity, diabetes, heart disease, poor oral health and kidney disease.”

Outback Stores health and nutrition manager, Jen Savenake ( Interview Health Times )

Amata SA was an alcohol-free community, but some years earlier its population of just under 400 people had been consuming 40,000 litres of soft drink annually.

The thing that I say in community meetings all the time is that, the reason we’re doing this is so that the young children now do not end up going down the same track of diabetes, kidney failure, dialysis machines and early death, which is the track that many, many people out here are on now,”

Mai Wiru, meaning good health, and managed by long-time community consultant John Tregenza.

The Sugar Trip on Australian Story  View HERE

All previous NACCHO Diabetes 120 + articles over 5 years

Noting all graphics added by NACCHO

A nutrition strategy to reduce the portion size and availability of soft drink has reduced the consumption of sugary drinks in a remote Indigenous community.

Outback Stores, which provides retail services to more than 30 remote stores on behalf of Indigenous communities across the Northern Territory, Western Australia and South Australia, found its strategy decreased the sale of soft drinks by 10 per cent in six months.

Outback Stores health and nutrition manager, Jen Savenake, an Advanced Accredited Practising Dietitian, says the store joined forces with one local community to trial the implementation of extra measures on top of its usual healthy food strategy.

Ms Savenake says the usual policy features measures such as stocking at least half of its fridges with water and diet drinks, with the remainder comprising sugary drinks.

“Our standard policy around sugary drinks includes things like – we always have the water fridges at the front of the store, where you have to go searching for the sugary drink at the back of the store,” she says.

“We have a special deal on water so that we get Mt Franklin water at $1 and the sugary drinks are 25 per cent more expensive than the diet drinks, and the diet drinks are more expensive than the water.

“We don’t promote sugary drinks ever, so we’ll do promotions on water and diet drinks but never promoting the sugary drinks, so you never see them on the end of the aisle and on discount.”

Download these Info graphics as PDF poster

Soft-drink-in-Aboriginal-communities-report_summaryFINAL

Despite the existing measures, Ms Savenake says sugary drinks remain a “really big problem”.

“Part of our healthy food strategy is looking at reducing sugary drinks because consumption of sugary drinks across the whole population, but particularly in remote communities, is very high and high intake of sugary drinks has been linked to obesity, diabetes, heart disease, poor oral health and kidney disease.”

As part of the trial, the store stopped selling sugary drinks on school days between 8.30am and 2pm, and also reduced the soft drink portion size.

“We never stock bottles more than 1.25 litres so we haven’t got any 2 or 2.5 litre bottles but what we looked at was reducing the size of the bottle,” she says.

“So now we stock the biggest selling line in our 1 litre bottle rather than 1.25 (litre) so you get a 25 per cent reduction immediately for all of those.

“We also changed from stocking a 375ml can to a 250ml can and from a 600ml bottle to a 390ml bottle.”

Ms Savenake, who presented the preliminary results of the trial at the recent Dietitians Association of Australia’s (DAA) 34th National Conference, says the remote Indigenous community is now experiencing “some big changes” in the amount of sugary drinks being consumed.

Burunga NT in store promotion

“We still actually need some more time to see what the total results are going to be, but we’re getting at least a 10 per cent reduction in sugary drinks over the comparable period.”

Early indications also show an increase in sales of water, dietary drinks, fruit juices and milk drinks.

While different strategies may be needed in different communities, particularly communities with easy access to other stores, Ms Savenake says dietitians working at the food supply level can have an impact on consumption but they also need to work with all their stakeholders to ensure there is community support for these strategies.

“To do this project in the community, we had the support of the whole community…this is not Outback Stores imposing these conditions on the community, this is the community saying – what can we do to improve the health of our people,” she says.

“So we worked with them to develop that and that’s probably one of the most important things that we got out of it, that yes – we can implement the strategies at the food supply level but we need to make sure that people are on board.

“There is actually a case study where one community banned sugary drinks and what happened was they just set up a huge black market, so people would bring boot loads of the stuff and sell it for $10 a can out of the back of the car, and so it didn’t achieve the desired outcomes because people were just spending a whole lot of money on sugary drinks on their alternative supply route.”

Ms Savenake says Outback Stores will continue to examine the strategies in the community and may expand some of the measures, including smaller portion sizes, to more stores in a bid to assist communities to improve their health.

“I’ve been doing this for 20 years but there’s almost like a tipping point where suddenly there’s a broader community awareness that we all need to get involved in doing something to improve our health and working towards healthier food,” she said.

“We’re still providing choice – you can still get it. It might be just a little bit harder to get, the shop is not open all the time so it’s still your choice around what you want to consume but we’re just providing a few incentives to mean that it’s a little bit more expensive, it’s a little bit less available, but if you really want it, it’s still there.”

NACCHO Aboriginal Health @DiabetesAus #NDW2017 #ItsAboutTime for National #Diabetes Week

 

 “It is National Diabetes Week from 9-15 July and Diabetes Australia’s “It’s About Time” campaign aims to raise awareness about the importance of early detection and early treatment for all types of diabetes.

Too many Australians are being diagnosed with diabetes too late. The is true for both type 1 diabetes and type 2 diabetes. The delay in diagnosis is putting many people at risk of major life threatening health problems.

It’s About Time  we detected all types of diabetes earlier and save lives.

 Aboriginal and Torres Strait Islander people are almost four times more likely than non-Indigenous Australians to have diabetes or pre-diabetes.

Improving the lives of people affected by all types of diabetes and those at risk among Aboriginal and Torres Strait Islander communities is a priority for Diabetes Australia.”

See full Aboriginal and Torres Strait Islander diabetes info below Part 1

Read over 120 NACCHO published articles about Diabetes  in past 5 years

 ” New research has found that only 5% of Australians aged over 40 have had a type 2 diabetes risk check in the past two years.

Also, more than half of people surveyed were unable name any diabetes related complication despite type 2 diabetes being a leading cause of vision loss, kidney damage, heart attacks, stroke and limb amputation.

The release of the research comes at the start of National Diabetes Week as Diabetes Australia launches a new campaign, It’s About Time, to raise awareness of the seriousness of the type 2 diabetes, and urge 500,000 Australians who could have undiagnosed type 2 diabetes to get checked  ”

IT’S ABOUT TIME WE DETECTED  SILENT UNDIAGNOSED TYPE 2 DIABETES see Part 2 below

Part 1 Aboriginal and Torres Strait Islander diabetes info

Watch the short video below for a quick guide to the benefits of the National Diabetes Services Scheme (NDSS) ”

You can reduce the risk of developing type 2 diabetes by eating a more healthy diet and being physically active which will help maintain a healthy weight to keep your sugar (glucose) levels normal and your body strong.

If you have any worries about diabetes, check the symptoms below and find out more from your Aboriginal Health Worker, Health Clinic/Community Centre, Aboriginal Medical Service or doctor.

The following information is from the ‘Keep Culture Life & Family Strong; Know Early About Diabetes’ flipcharts for Indigenous Australians.

It is of a general nature only and should not be substituted for medical advice or used to alter medical therapy. It does not replace consultations with qualified healthcare professionals to meet your individual medical needs.

The ‘Keep Culture Life & Family Strong; Know Early About Diabetes’ resource was originally developed by Healthy Living NT with funding provided by the Department of Health and Ageing through Diabetes Australia. The reprinting and distribution of the most recent addition has been made possible with funding by the National Diabetes Services Scheme (NDSS) – an initiative of the Australian Government administered by Diabetes Australia.

How do you feel? (Symptoms)

If you have any of the following symptoms you should talk to your doctor, health worker or nurse.

  • Feeling tired or weak
  • Go to the toilet a lot
  • Feeling thirsty
  • Leg cramps
  • Feeling itchy
  • Sores and boils that won’t heal
  • Blurry vision
  • Pins and needles
  • Feeling grumpy or angry.

Through a simple test, a doctor can find out if they’re the result of diabetes.

What is it? (About diabetes)

Sugar (glucose) gives your body energy. The sugar (glucose) moves from your blood into your muscles with something called insulin. With diabetes your insulin isn’t working properly, so the sugar (glucose) doesn’t get into your muscles and body easily and there is too much sugar (glucose) in your blood.

Everyone has a little bit of sugar (glucose) in their blood. The optimum sugar (glucose) level is between 4 to 6 mmol/L (after fasting).

Sugar (glucose) is fuel that comes from some of the food you eat and drink. It gives your body energy to do all sorts of things:

  • Walk
  • Think
  • Play sports
  • Hunt
  • Work
  • Rake
  • Gardening
  • Resting.

To help the sugar (glucose) move into your muscles and body cells your body needs something called insulin. Insulin is made in the pancreas – a body part which is near your stomach.

Insulin helps keep your sugar (glucose) levels normal.

With diabetes, the insulin isn’t helping the sugar (glucose) move from your body into your muscles and body cells. So it stays and builds in your body, making your blood sugar (glucose) level high.

Type 2 Diabetes

There are different types of diabetes. A lot of Aboriginal and Torres Strait Islanders have type 2 diabetes. Type 2 is when your body stops the insulin working properly.

Fat bellies, not being active enough, eating a big mob of fatty food can stop the insulin working properly in your body.

Being active, eating healthy and being a healthy weight can help your insulin work better to keep your sugar (glucose) normal. Sometimes people might need to take tablets and insulin everyday to keep their sugar (glucose) levels normal.

Gestational Diabetes

Another type of diabetes is gestational diabetes. This happens when you are pregnant, but not all women get it. It goes away after pregnancy but you and your baby can get type 2 diabetes later in life.

Pre Diabetes

There is also Pre Diabetes or Impaired Glucose Tolerance (IGT). This happens when your sugar (glucose) level is high, but not high enough to be called diabetes. It doesn’t mean you have diabetes now, but it does mean you might get it later. Being active and eating healthy you can slow down the start of type 2 diabetes.

Type 1 Diabetes

Some Aboriginal and Torres Strait Islanders have type 1 diabetes. This usually happens in kids and teenagers. Type 1 diabetes is when your body kills the insulin making part in the pancreas and no insulin is made in your body. To give the body the insulin it needs, insulin injections are needed every day for the rest of their life.

What do I do? (Management of diabetes)

When there is too much sugar (glucose) in your blood it damages your heart, kidneys, feet, eyes and nerves.

You can keep your sugar (glucose) levels normal by:

Eating healthy

  • Have plenty of bush tucker and have shop foods and home cooked meals that are low in fat, sugar and salt.
  • Have something from each of the core food groups every day. They give you energy, fight sickness and help care for your body to keep it strong.
  • Drink plenty of water.

Avoiding and eat less fat, sugar and salt

  • Eat less fat as it makes you put on weight and gives you problems with your heart.
  • Pick meat with no fat or only small bits of fat on it. Cut the fat off the meat and take the skin off chicken.
  • Drain the juices (fat) after cooking meat and scoop out the fat from the top of stews.
  • Avoid cooking with or having fats like butter, oil, margarine or dripping.
  • It is better to boil, steam, stew, grill, microwave or stir-fry food.

Being a healthy weight (not too fat and not too skinny)

  • Do this by eating less, eating healthy and being more active.

Keeping active

  • It helps you lose weight and keep it off and it keeps you healthy.
  • It helps your insulin to work properly.
  • Walk, job, play sport, hunt, garden, work around the place.
  • Be active for 30 minutes or more every day OR do 10 minutes 3 times a day.

Taking your medicine

  • Take your medicine at the times the doctor tells you.
  • Take them with or after eating in the morning, afternoon and supper time every day.
  • Refill your medicine box in the morning (get some more medicine before it gets low and so you don’t run out).
  • Take your medicine with you when you go to see family, walkabout or away from home.
  • Put your medicines somewhere cool, dry and safe so they won’t go bad.
  • Keep your medicines out of reach of kids.

Remember to:

  • Have your check-ups with your doctor, health worker or nurse. Have regular check-ups for your eyes, feet, kidneys, blood pressure, skin and teeth. If you notice anything different about your body talk to your doctor, health worker or nurse.
  • Check your sugar (glucose) levels at the times your doctor, health worker or nurse tells you.
  • See your doctor, health worker or nurse straight away if you feel sick.
  • Check your feet and skin for sores and/or cracks every day.

Why take medicine for? (Medications for diabetes)

Indigenous  

Diabetes medicine helps to keep your body strong and well and it helps to keep your sugar (glucose) levels normal.

When eating healthy, being active and being a healthy weight isn’t working at keeping your sugar (glucose) levels normal, you might need to take tablets and/or insulin.

The doctor might put you on tablets called Metformin to help your insulin work better and to lower the amount of sugar (glucose) in your blood.

After a while the pancreas gets tired from working too hard and can’t make enough insulin, so your doctor might put you on tablets called Sulphonylurea. This medicine helps your body make more insulin.

Or, after awhile, the doctor might need to add another lot of tablets called Glitazone or Acarbose.

Remember to have your medicine with or after eating, in the morning, afternoon or supper time. Take them at the time the doctor tells you to.

All tablets work differently and some can have side effects.

If the following problems don’t go away or if you are still worried about them, then talk to your doctor.

  • Feel sick like you want to vomit (nausea)
  • A sore belly
  • Diarrhoea
  • Sugar (glucose) levels going too low
  • Have fluid build-up (retention)

When your sugar (glucose) levels get too high and stays high the doctor might put you on tablets and give you insulin.

  • Having insulin doesn’t mean you have type 1 diabetes.
  • Insulin isn’t like tablets so it shouldn’t be swallowed.
  • You inject the insulin under your skin in different places on your belly.

Talk to your doctor, health worker or nurse about insulin and what is right for you.

Having too much insulin or taking too many Sulphonylurea tablets can make your sugar (glucose) levels go too low (under 3) and make you hypo (hypoglycaemia).

You can also go hypo (hypoglycaemia) if you are:

  • Not eating, not eating enough or eating too late
  • Being extra active
  • Drinking grog (alcohol).

You might not feel anything when you have a hypo (hypoglycaemia), but sometimes you might feel:

  • Shaky
  • Hungry
  • Get headaches
  • Weak
  • Confused
  • Angry
  • Talk like you’re drunk when you’re not
  • Sweaty.

When you have these feelings or think you are having a hypo (hypoglycaemia), get your sugar (glucose) level up fast by drinking or eating something sweet.

Keep your sugar (glucose) level normal and stop having another hypo (hypoglycaemia) by eating a sandwich or meal after you have something sweet.

Remember, after taking your tablets or insulin:

  • Keep them somewhere cool, dry and safe (maybe in the fridge at home or at the clinic) so that they won’t go bad
  • Keep them out of reach of children
  • Get rid of your syringes/needles and finger pricking needles by putting them in a “sharps container” or “hard plastic” empty container with a lid (see if the clinic has one).

Remember when you go see family, walkabout or are away for home take your tablets and/or insulin with you.

Why me? (Risk factors)

Nobody knows how or why some people get diabetes but there are some things we know that can add to your chances of getting it. You have more chance of getting it when you are Aboriginal or Torres Strait Islander, but not all Aboriginal or Torres Strait Islande people have diabetes.

Aboriginal or Torres Strait Islander people live different to how they used to live. Changes that add to your chances of getting diabetes are:

  • Not as active
  • More overweight
  • Eating fatty salty, sugary foods.

People living the old way were:

  • Active
  • Leaner and fit
  • Eating healthy food (bush tucker).

Other chances of getting diabetes include:

  • It is in your family tree or when someone in your family has diabetes
  • You had diabetes when pregnant
  • You get older
  • You eat too much and you eat too many fatty and sugary foods
  • You are overweight
  • You are not active enough
  • You have pancreatitis (a sickness of the pancreas).

There are things you can’t change or stop you from getting diabetes:

  • It’s in your family
  • You are Aboriginal or Torres Strait Islander
  • You are pregnant with diabetes
  • You are getting older.

The things you can do to slow down the start of diabetes:

  • Eat healthy and be a healthy weight
  • Be active
  • Don’t drink too much grog.

Nobody knows why or how people get diabetes. After a while it can damage your heart, kidneys, eyes, feet and nerves making you really sick.

Talk to your doctor, clinic, nurse or health worker about having a test to find out if you have diabetes.

You can’t always feel it or see it happening, so you might not know you have it.

Part 2 :IT’S ABOUT TIME WE DETECTED  SILENT UNDIAGNOSED TYPE 2 DIABETES

New research has found that only 5% of Australians aged over 40 have had a type 2 diabetes risk check in the past two years.

Also, more than half of people surveyed were unable name any diabetes related complication despite type 2 diabetes being a leading cause of vision loss, kidney damage, heart attacks, stroke and limb amputation.

The release of the research comes at the start of National Diabetes Week as Diabetes Australia launches a new campaign, It’s About Time, to raise awareness of the seriousness of the type 2 diabetes, and urge 500,000 Australians who could have undiagnosed type 2 diabetes to get checked.

Diabetes Australia CEO Professor Greg Johnson said there was great concern about the length of time many people have silent, undiagnosed type 2 diabetes without it being diagnosed.

“It’s about time we detected silent undiagnosed type 2 diabetes. Many people have type 2 diabetes for up to seven years before being diagnosed and during that time up to half begin to develop a diabetes-related complication,” Professor Johnson said.

“The tragedy is that much of the damage to the body that causes diabetes-related complications like vision loss, kidney damage, heart attack, stroke and limb amputation is preventable.

“AUSDRISK is a free, online risk assessment you can take to determine your risk of type 2 diabetes. Despite over 60% of Australians having risk factors for type 2 diabetes, the research shows only 5% of Australians over the age of 40 have done the type 2 diabetes risk assessment in past two years” he said.

The survey found:

  •  Only 21% of Australians over the age of 40 had heard of the Australian Type 2 Diabetes Risk (AUSDRISK) Assessment;
  •  Only 5% of Australians over the age of 40 had completed the AUSDRISK assessment in the past two years; and
  •  More than 51% of people over the age of 18 were unable to name any serious diabetes-related complication despite type 2 diabetes being a leading cause of vision loss and blindness, limb amputation, kidney damage, heart attacks and stroke.

Diabetes NSW & ACT CEO Sturt Eastwood urged people take the free type 2 diabetes risk assessment today.

“Type 2 diabetes is the single biggest challenge confronting Australia’s health system and it’s time we did a better job of detecting type 2 diabetes earlier,” Mr Eastwood said.

“The earlier a diagnosis of type 2 diabetes occurs, the sooner a management plan can be put in place delivering better outcomes for the individual and the community.

“The AUSDRISK check only takes about five minutes. If you take the check and get a high score, see your doctor so they can determine if you have type 2 diabetes.

“If you are diagnosed there is a lot of support and advice, and many effective treatments available to help you manage type 2 diabetes and reduce the risk of developing diabetes-related complications.”

Professor Lesley Campbell from St. Vincent’s Hospital said front line health professionals were spending more and more time treating patients who present with type 2 diabetes complications. Diabetes was often still undiagnosed until admission for heart attack, stroke or lung or heart transplantation.

“Unfortunately we are seeing people with type 2 diabetes diagnosed too late and the impact of late diagnosis and lack of treatment is filling our hospital beds,” Professor Campbell said.

“Diabetes is ranked in the top ten causes of death in Australia and is the leading cause of preventable blindness, limb amputation and end stage kidney disease.

“Much of this can be avoided with early diagnosis and optimal treatment.”

For Sydney woman Belinda Nakauta, having her toe amputated because of type 2 diabetes was a major wake up call.

“I went to the doctor about a urinary tract infection and he suggested I get checked for type 2 diabetes. I was shocked when it came back positive and the scary thing is I have no idea about how long I was living with type 2 diabetes before I was assessed,” Ms Nakauta said.

“Having a toe amputated a couple of years ago was a wakeup call. Having a part of your body cut off, no matter how small, is a scary experience. With the help of a dietitian and regular gym visits, I’ve lost more than 20 kilograms and dramatically cut back on the medication I need to manage my type 2 diabetes.

“I wish I had done something five or ten years ago. I don’t want to be that person in the ICU on dialysis. I don’t want to have foot complications or lose my eye sight. I don’t want to be that person.

“It was about time I started taking my diabetes seriously and I hope my story helps convince all Australians that it is about time we do something about diabetes.”

NACCHO Aboriginal Kidney Health #NAIDOC2017 @KenWyattMP announces $6.3 million investment in family friendly housing for kidney patients

The recent Central Australia Renal Study identified accommodation as the greatest challenge to indigenous kidney patients moving to towns for dialysis,

After relocating, these patients and family members often ended up homeless, socially and culturally isolated, and in many instances having to live in town camps.

We acted promptly, prioritising housing to help solve these challenges for families already under immense financial and emotional pressure from this debilitating disease.

Now patients will be comfortably housed, within easy reach of clinical treatment.”

Indigenous Health Minister Ken Wyatt

A joint housing refurbishment project has delivered accessible, family friendly homes for Northern Territory renal patients.

Welcoming the completion of eight houses in Alice Springs and two in Tennant Creek, Indigenous Health Minister Ken Wyatt said collaboration between the Australian and Territory governments had yielded a win-win for some of the most vulnerable people in the NT.

Download Central Australia Renal Study  Report

Executive summary – Central Australia Renal Study

The Central Australia Renal Study was undertaken against the following background:

  • Increasing numbers of Aboriginal people in the Central Australia (CA) region requiring renal replacement therapy (RRT), predominantly in Alice Springs.
  • Recognition of the lack of culturally appropriate service options and, in particular, service options allowing treatment as close to home as possible.
  • Recognition that treatment may require relocation and, where it does, support needs to be provided for patients and families.
  • Concerns about the negative impact of a lack of culturally appropriate service options on treatment uptake.

The project

The Australian Government contributed $6.3 million to refit and modify the homes, after the NT Government provided the original houses.

Minister Wyatt said Central Australia accounted for more than 640 patients known to have chronic kidney disease stages 3, 4 or 5.

“The problem is particularly high in the NT, where kidney health complications among indigenous people are compounded by remoteness and challenging living conditions,” he said.

Federal Government Investment Indigenous Health

The Government was now investing $3.6 billion over four years from 2017-18 for the Indigenous Australians’ Health Program, an increase of $724 million compared with expenditure over the previous four years.

“Continued growth in the program will improve access to culturally appropriate, comprehensive primary health care for Indigenous Australians and address areas of critical need through targeted investments to close the gap,” Minister Wyatt said.

Background

The Central Australia Renal Study was a joint study by the Australian, Northern Territory, South Australian and Western Australian Governments to develop a range of feasible clinical service delivery models and care pathways to best meet (current and projected) needs for Aboriginal and Torres Strait Islander patients from remote communities requiring dialysis in Central Australia.

The study, funded by the Australian Government, assesses the current issues surrounding the delivery of renal services in Central Australia and takes account of stakeholder consultation and activity-based data.

The study was conducted by the George Institute for Global Health for the Commonwealth Department of Health and Ageing.

The study was commissioned to assess the current issues surrounding the delivery of renal services in Central Australia taking into account, stakeholder consultation and activity-based data. The findings were to inform policy recommendations on the most effective and feasible service delivery options and care pathways for Aboriginal and Torres Strait Islander peoples in need of renal services, including dialysis, and identify issues around the distribution of these services.

The Report of the Central Australia Renal Study consists of four sections:

Executive Summary – PDF 204 KB
Executive Summary (online)

Part 1: Key findings and Recommendations, and Part 2: Final Report – PDF 1316 KB
Part 1: Key findings and Recommendations, and Part 2: Final Report (online)

Part 3: Technical Report – PDF 1706 KB
Part 3: Technical Report (online)

Part 4: Technical Appendices – PDF 939 KB
Part 4: Technical Appendices (online)

 

Aboriginal Health : Second Atlas of Healthcare Variation highlights higher Aboriginal hospitalisation rates for all 18 clinical conditions

 

“The report, compiled by the Australian Commission on Safety and Quality in Health Care, shows us that high hospitalisation rates often point to inadequate primary care in the community, leading to higher rates of potentially preventative hospitalization

The most disturbing example of this  has been the higher hospitalisation rates for all of the 18 clinical conditions surveyed experienced by Aboriginal and Torres Strait Islander Australians, people living in areas of relative socioeconomic disadvantage and those living in remote areas.

 Chairman of Consumers Health Forum, Tony Lawson who is a member of the Atlas Advisory Group.

 “Additional priorities for investigation and action are hospitalisation rates for specific populations with chronic conditions and cardiovascular conditions, particularly:

  • Aboriginal and Torres Strait Islander Australians
  • People living in remote areas
  • People at most socioeconomic disadvantage.

Please note

  • Features of the second Atlas include: Analysis of data by Aboriginal and Torres Strait Islander status

DOWNLOAD Key-findings-and-recommendations

Mr Martin Bowles Secretary Dept of Health  launches the Second Australian Atlas of Healthcare Variation

A new report showing dramatic differences in treatment rates around Australia signals a pressing need for reforms to ensure equitable access to appropriate health care for all Australians, the Consumers Health Forum, says.

“A seven-fold difference in hospitalisation for heart failure and a 15-fold difference for a serious chronic respiratory disease depending on place of residence, are among many findings of substantial variations in treatment rates in Australia revealed in the Second Australian Atlas of Healthcare Variation,” the chairman of Consumers Health Forum, Tony Lawson, said.

“While there are a variety of factors contributing to these differences,  the variation in health and treatment outcomes is, as the report states, an ‘alarm bell’ that should make us stop and investigate whether appropriate care is being delivered.

“These findings show that recommended care for chronic diseases is not always provided.  Even with the significant funding provided through Medicare to better coordinate primary care for people with chronic and complex conditions, fragmented health services contribute to suboptimal management, as the report states.

“We support the report’s recommendation for a stronger primary health system that would provide a clinical ‘home base’ for coordination of patient care and in which patients and carers are activated to develop their knowledge and confidence to manage their health with the aid of a healthcare team.

“The Atlas provides further robust reasons for federal, state and territory governments to act on the demonstrated need for a more effective primary health system that will ensure better and more cost effective care for all Australians.

“The Atlas also examined  variations in women’s health care, and its findings included a seven-fold difference in rates of hysterectomy and  21-fold  difference in rates of endometrial ablation.  The report states that rates of hysterectomy and caesarean sections in Australia are higher than reported rates in other developed nations.  These results highlight the need for continuing support and information on women’s health issues,” Mr Lawson said.

The Second Australian Atlas of Healthcare Variation (second Atlas) paints a picture of marked variation in the use of 18 clinical areas (hospitalisations, surgical procedures and complications) across Australia.

This Atlas, the second to be released by the Commission, illuminates variation by mapping use of health care according to where people live.  As well, this Atlas identifies specific achievable actions for exploration and quality improvement.

The second Atlas includes interventions not covered in the first Atlas, such as hospitalisations for chronic diseases and caesarean section in younger women. It also builds on the findings from the first Atlas – for example, examining hysterectomy and endometrial ablation separately, and examining rates of cataract surgery using a different dataset.

Priority areas for investigation and action arising from the second Atlas include use of:

  • Hysterectomy and endometrial ablation
  • Chronic conditions (COPD, diabetes complications)
  • Knee replacement.

Additional priorities for investigation and action are hospitalisation rates for specific populations with chronic conditions and cardiovascular conditions, particularly:

  • Aboriginal and Torres Strait Islander Australians
  • People living in remote areas
  • People at most socioeconomic disadvantage.

Healthcare Variation – what does it tell us

Some variation is expected and associated with need-related factors such as underlying differences in the health of specific populations, or personal preferences. However, the weight of evidence in Australia and internationally suggests that much of the variation documented in the Atlas is likely to be unwarranted. Understanding this variation is critical to improving the quality, value and appropriateness of health care.

View the second Atlas

The second Atlas, released in June 2017, examined four clinical themes: chronic disease and infection – potentially preventable hospitalisations, cardiovascular, women’s health and maternity, and surgical interventions.

Key findings and recommendations for action are available here.

View the maps and download the data using the interactive platform.

What does the Atlas measure?

The second Atlas shows rates of use of healthcare interventions (hospitalisations, surgical procedures and complications,) in geographical areas across Australia.  The rate is then age and sex standardised to allow comparisons between populations with different age and sex structures. All rates are based on the patient’s place of residence, not the location of the hospital or health service.

The second Atlas uses data from national databases to explore variation across different healthcare settings. These included the National Hospital Morbidity Database and the AIHW National Perinatal Data Collection.

Who has developed the second Atlas?

The Commission worked with the Australian Institute of Health and Welfare (AIHW) on the second Atlas.

The Commission consulted widely with the Australian government, state and territory governments, specialist medical colleges, clinicians and consumer representatives to develop the second Atlas.

Features of the second Atlas include:

  • Greater involvement of clinicians during all stages of development
  • Analysis of data by Aboriginal and Torres Strait Islander status
  • Analysis of data by patient funding status (public or private).

Table of Contents

Chapter 1 Chronic disease and infection: potentially preventable hospitalisations

1.1 Chronic obstructive pulmonary disease (COPD)
1.2 Heart failure
1.3 Cellulitis
1.4 Kidney and urinary tract infections
1.5 Diabetes complications

Chapter 2 Cardiovascular conditions

2.1 Acute myocardial infarction admissions
2.2 Atrial fibrillation

Chapter 3 Women’s health and maternity

3.1 Hysterectomy
3.2 Endometrial ablation
3.3 Cervical loop excision or cervical laser ablation
3.4 Caesarean section, ages 20 to 34 years
3.5 Third- and fourth-degree perineal tear

Chapter 4 Surgical interventions

4.1 Knee replacement
4.2 Lumbar spinal decompression
4.3 Lumbar spinal fusion
4.4 Laparoscopic cholecystectomy
4.5 Appendicectomy
4.6 Cataract surgery
Technical Supplement
About the Atlas
Glossary

Australian Atlas of Healthcare Variation data set specifications are available at http://meteor.aihw.gov.au/content/index.phtml/itemId/674758

 

NACCHO Aboriginal Health and #Nutrition : FYI delegates #WCPH2017 Aboriginal traditional foods key role in protecting against #chronicdisease

“We have long understood that native animal and plant foods are highly nutritious.

There is no evidence that Aboriginal and Torres Strait Islander people had diabetes or cardiovascular disease whilst maintaining a diet of traditional foods, and it has been shown that reverting to a traditional diet can improve health.

In addition to demonstrating significant health benefits, traditional foods remained an integral part of identity, culture and country for Aboriginal and Torres Strait Islander people, while also alleviating food insecurity in remote communities.”

Menzies researcher and lead author Megan Ferguson see research paper in full below

Photo above :  Frank told us how the ‘old people’, which literally means his ancestors, lived under the trees, gathered food and fished in the swamp. He said that during the dry, they used to build a sort of rock stepping-stone bridge to access the island in the swamp where they would gather magpie goose eggs.

Photo above  : With a focus to improve community nutrition, over 2000 bush tucker trees and conventional fruits were planted at the Barunga Community, south of Katherine.

Aboriginal people have been using bush tucker for over 50,000 years, but it was hoped the plantation would lure more children onto a free feed of fruit, instead of a portion of chips. Some of the bush tucker fruits being planted include the Black Plum, Bush Apple, Cocky Apple, Red Bush Apple, and White Currant

 ” The bush tucker diet was high in nutritional density, offering good levels of protein, fibre, and micronutrients. It was low in sugar and glucose, and lower in insulin than similar western foods, and the hunter-gatherer lifestyle meant plenty of physical activity. Some animal foods such as witchetty grubs and green ants were high in fat, but most native land animals were lean, especially when compared with the domesticated animals eaten today.

It was this knowledge of the land that sustained the Aboriginal people of the Northern Territory for tens of thousands of years “

Your Complete Guide to Bush Tucker in the Northern Territory

Traditional food trends in remote Northern Territory communities

The majority of Aboriginal people living in remote Northern Territory communities are regularly using traditional foods in their diets according to research from Menzies School of Health Research published in the Australian and New Zealand Journal of Public Health see below

The paper, Traditional food availability and consumption in remote Aboriginal communities in the Northern Territory reports that a nutritious diet including the consumption of traditional foods plays a key role in protecting against chronic disease for Aboriginal and Torres Strait Islander people living in remote communities.

‘Surveys conducted in remote Northern Territory (NT) communities revealed almost 90% of people consumed a variety of traditional foods each fortnight.

‘In relation to food insecurity we also found that 40% of people obtained traditional food when they would otherwise go without food due to financial hardship or limited access to stores,’ Ms Ferguson said.

The list of traditional food reported during the research is extensive and includes a range of native animal foods including echidna, goanna, mud mussel, long-neck turtle and witchetty grubs and native plant foods including green plum, yam and bush onion.

The 20 remote NT communities surveyed reported that traditional foods were available year round.

‘There is still much to be learnt about the important contribution traditional foods makes to nutrition and health outcomes. We need to work with Aboriginal and Torres Strait Islander leaders to understand more about contemporary traditional food consumption. This is crucial to informing broader policy that affects where people live, how they are educated, employment and other livelihood opportunities,’ Ms Ferguson said.

The article will be available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1753-6405

Traditional food availability and consumption in remote Aboriginal communities in the Northern Territory, Australia

Objective: To explore availability, variety and frequency consumption of traditional foods and their role in alleviating food insecurity in remote Aboriginal Australia.

Methods: Availability was assessed through repeated semi-structured interviews and consumption via a survey. Quantitative data were described and qualitative data classified.

Results: Aboriginal and non-Indigenous key informants (n=30 in 2013; n=19 in 2014) from 20 Northern Territory (NT) communities participated in interviews. Aboriginal primary household shoppers (n=73 in 2014) in five of these communities participated in a survey. Traditional foods were reported to be available year-round in all 20 communities. Most participants (89%) reported consuming a variety of traditional foods at least fortnightly and 71% at least weekly. Seventy-six per cent reported being food insecure, with 40% obtaining traditional food during these times.

Conclusions: Traditional food is consumed frequently by Aboriginal people living in remote NT.

Implications for public health: Quantifying dietary contribution of traditional food would complement estimated population dietary intake. It would contribute evidence of nutrition transition and differences in intakes across age groups and inform dietary, environmental and social interventions and policy. Designing and conducting assessment of traditional food intake in conjunction with Aboriginal leaders warrants consideration.

Aboriginal and Torres Strait Islander Australians have experienced a rapid nutrition transition since colonisation by Europeans 200 years ago, similar to that experienced by other Indigenous populations globally.1 The traditional food system provided a framework for society and was interwoven with culture, a framework that is now eroded by a food system with no distinct cultural ties or values.2 Early reports of Aboriginal people prior to European contact indicate that they were lean and healthy, attributable to an active lifestyle and a nutrient-dense diet characterised by high protein, polyunsaturated fat, fibre and slowly digested carbohydrates.3 The diet was sourced from a wide range of uncultivated plant foods and wild animals and was influenced by the seasons and geographical location; although there were differences in the food sources by location, there were similarities in the overall nutrient profile.3,4 Since colonisation, this nutritious diet has been systematically replaced by high intakes of refined cereals, added sugars, fatty (domesticated) meats, salt and low intakes of fibre and several micronutrients.5–7

There is no evidence that Aboriginal people maintaining traditional diets had diabetes or cardiovascular disease.4 However, the integration of non-traditional foods into the contemporary diet of Aboriginal Australians has led to an excessive burden of lifestyle-related chronic diseases.3 A nutritious diet, such as that afforded by the consumption of traditional foods, plays a key role in protecting against these conditions. Short-term reversion to a traditional diet has demonstrated significant weight loss, improvement in risk factors of diabetes and cardiovascular disease and improvements in glucose tolerance and other abnormalities related to type 2 diabetes mellitus among a small group of Aboriginal Australians.8,9

High levels and a wide variety of polyunsaturated fatty acids, in the context of overall lower fat content, found in native animal foods are one of the benefits of a traditional diet; reported to reduce the risk of developing obesity, type 2 diabetes mellitus and cardiovascular diseases.3,4Traditional foods remain an integral part of the contemporary Aboriginal and Torres Strait Islander diet strongly linked to identity, culture and country. An analysis of national data collected in 2008 reported that 72% of participants aged over 15 years living in remote communities reported having harvested wild foods in the past 12 months;10 and yet there is a dearth of information on the contribution of traditional foods to the contemporary diet of Aboriginal and Torres Strait Islander people.7,11 Most available information is also limited to describing harvesting behaviours and preferences.11 A recent environmental study, for example, in two Australian tropical river catchments reported more than one harvesting trip per fortnight for households in which 42 different animal and plant species were collected over a two-year period. This study also described the food-sharing networks that are likely to play a crucial role in alleviating food insecurity;12 of which 31% of Aboriginal and Torres Strait Islander people living in remote communities report to experience.13Some researchers estimate that more than 90% of foods are purchased and traditional foods contribute less than 5% to dietary energy intake,5 others argue that in some contexts the proportion of purchased foods is much lower.14

This variation likely relates to the diverse study contexts, including where people live, with higher intakes of traditional foods suggested to be consumed in small outstations rather than communities and townships.14 Until recently, most estimates of population level dietary intake have been limited to store-purchased food and drinks,5–7 an extremely valuable source of data, though one the authors acknowledge is limited by a lack of information on traditional food intake. The 2011–13 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS), which included a 24-hour dietary recall, provided the first set of dietary intake data of Aboriginal and Torres Strait Islander people nationally, though it did not aim to provide an estimate of traditional food intake.13This paper explores informant interview and self-report data relating to the: i) availability, ii) frequency and iii) variety of traditional food consumption. It also reports on the role of traditional food in alleviating food insecurity. For this study, traditional food included all native and introduced animal and plant foods procured for consumption. It was conducted as part of the SHOP@RIC study.15

Methods

Sample

A survey of contextual factors, defined as factors that may influence food purchases from the community store, was conducted in each of the 20 communities participating in the SHOP@RIC study, in the Northern Territory (NT), Australia.15 This included a rapid appraisal of traditional food availability through an interview with two key informants who had resided in the community for the previous 12 months. The study was not designed to collect comprehensive data on seasonal availability of traditional foods.

The cohort participating in the customer survey of the SHOP@RIC study15 was drawn from five very remote Aboriginal communities in the NT randomly selected from 20 study communities. All five communities had one food store, most had community-based food programs such as school nutrition and aged care meal programs and all were considered to have access to a traditional food supply from their surrounding lands. Households in each of the five communities were randomly selected and an eligible adult (i.e. community resident, plans to reside in the community for 12 months, >18 years, purchases food from the community store, and is the primary shopper) was invited to participate in a series of three surveys; pre-, post- and six-months post intervention. On completion of each survey, a $20 gift of fruit, vegetables and water was provided. The study aimed to include 150 customers in the cohort.

Data collection

The survey of contextual factors was conducted in English by a research team member, either in person or by telephone, at a time convenient to the key informant. Data were collected at two time points. As early as possible in 2014 and 2015, participants were interviewed about events in the previous year, including traditional food hunted or gathered. Initially, contact was made with the Shire/Council Services Manager of each community, who was invited to participate and recommend another suitable local person to complete the interview. The manager was selected due to their overall knowledge of a broad range of factors affecting store purchases, including population movement, community income and provision of essential services. If this manager could not be contacted, contact was made with someone in the community who was already associated with the main project to determine the most suitable people in the community to respond to these questions.

The customer survey was conducted by a research team, which included an Aboriginal community-based researcher trained in the conduct of the study. Interviews were conducted in English, with translation provided by the local researcher where necessary. The third survey (six months post intervention) was conducted from May 2014 to December 2014, in one community every two months in line with the main study design.15 This survey included a measure of frequency and variety consumption of traditional food in the preceding two weeks and questions to elicit information on the role of these foods in alleviation of food insecurity, the results of which are presented in this paper. A short script introduced the set of questions, noting that these included all hunted and gathered foods, which might be referred to by participants as traditional foods or bush foods, and included introduced species. The questions and response options were: How often do you eat traditional foods? (never, 1 day a fortnight, 1 day a week, 2–3 days a week, on most days, everyday). What type of traditional foods have you eaten? In the last 12 months, were there any times that you ran out of food, and couldn’t afford to buy more? (yes, no). If yes, how often did this happen? (once per week, once every 2 weeks, once per month, don’t know). Are there days when you don’t have enough food and feel hungry? (yes, no). What things can you do to get food on these days? Pictorial resources, with examples of foods known to be consumed across Central Australia and the Top End of the NT, grouped into similar food types, served as prompts. This study did not aim to collect data at the species level as nutrient analysis was not planned. These measures were based on a systematic review of the literature and expert consensus, and were pilot tested in line with the development of the overall customer survey.

Data analysis

The data from the contextual factor survey was entered into an Access database and exported to Excel for analysis. One author (CG) collated the data and verified with MF. Traditional food sources recalled being available over the calendar year and/or at different seasonal periods were described. The quantitative data from the customer survey were described, using Stata Version 14.0 (Stata, College Station, Texas, USA). The qualitative data from the customer survey were managed in an Access database and exported to Excel. One author (CB) allocated each individual food to one of eight categories,16 clarifying any difficult classification of foods with JB and MF.

Ethics

The study was approved by the Human Research Ethics Committee of the NT Department of Health and Menzies School of Health Research, the Central Australian Human Research Ethics Committee and Deakin University Human Research Ethics Committee. Written informed consent was obtained from all participants.

Results

Participants

At least one interview was conducted in each of the 20 study communities for the years 2013 or 2014. In 2013, 30 participants across 19 of the 20 study communities contributed to the contextual data; the participants held roles in the local council, government welfare agency, store, health centre, aged care facility, school and training and employment program. In 2014, 19 participants across 15 of the 20 study communities contributed to the repeat survey, holding roles in the local council, government welfare agency, store, health centre, community men’s program, research institute and training and employment program or were a community resident not in paid employment. In some cases, mobility from employed roles and from the community prevented repeat interview with the same informants each year.

Seventy-three participants aged 18 years or over, most of whom were female (97%), over the age of 35 years (69%) and not in paid employment (56%) contributed to the third customer survey. The participants differed marginally from the original cohort (92% female, 64% >35 years of age, 62% not in paid employment).

Annual availability of traditional food

Traditional foods were consistently reported for all 20 communities to be available year round. Informants reported hunting activity, with someone from all communities recalling a variety of animal foods that were available over the year or that hunting and fishing occurred. Informants from 15 communities across the Top End and Central Australia reported a variety of plant foods available in the previous 12 months. In four of the five communities where no plant foods were reported, it should be noted that data were only able to be collected for one of the two time points.

The survey did not intend to collect data on environmental or other impacts on the availability of the traditional food supply. It is worth noting that informants from three Top End communities and one customer survey participant from a fourth Top End community reported that goanna were in limited numbers or no longer available due to the impact of cane toads. In two Top End communities it was said that turkey were scarce or no longer available and in one of these communities, that the availability of yams had reduced due to environmental damage caused by introduced animals.

Frequency of traditional food consumption

Most (89%) participants reported consuming traditional foods on at least a fortnightly basis, in the two weeks preceding the survey. Seventy-one per cent of participants reported consuming traditional foods at least weekly.

Variety of traditional foods consumed

The variety of traditional foods reported to be available across 20 communities and consumed by participants in the five communities is reported in Table 1. There were a range of different native animal and plant foods and a smaller number of introduced animal foods recalled.

Table 1. List of the varietya of traditional foods reported to be available in communities and to be consumed in the preceding two weeks by a customer cohort.
Community data set (n=20) Participant data set (n=73)
  1. a: Foods listed as per participant response to an open-ended question which did not specify how to identify foods (e.g. as food category [e.g. seafood], food [e.g. fish] or species [e.g. barramundi]). The adjective ‘bush’ and ‘wild’ was provided at times with some foods (e.g. bush turkey and turkey). Occasionally participants used both local and English language; only the English language name is reported here.
  2. b: Echidna was often referred to as porcupine; buffalo as bullocky; cow as beef, cattle or killer.        c: The term shellfish was not used by participants in the customer cohort.
Animals
Native land animals Bandicoot, carpet snake, duck (diving duck), echidna,b emu, goanna (perentie), goose (magpie goose), honey, honey ant, kangaroo, lizard, possum, turkey, wallaby Black-headed snake, duck, echidna,b emu, goanna, goose, kangaroo, turkey
Introduced land animals Buffalo,b cow,b pig Buffalo,b cow,b pig
Fish or seafood Crab (mud crab), crocodile, crocodile egg, dugong, fish (barramundi, black bream, bream, catfish, fresh- and saltwater fish), shellfish (large creek mussel, long bum, mud mussel, mussel, oyster), prawn, stingray, turtle (long-neck turtle, sea turtle, short-neck turtle), turtle egg, water goanna Crab (mud crab), fish (barramundi, black bream, catfish, red snapper), mangrove worm, shellfishc (cone shell, long bum, mud mussel, oyster, periwinkle), stingray, turtle (long-neck turtle, sea turtle, short-neck turtle), turtle egg, water goanna
Witchetty grub Witchetty grubs Witchetty grub
Sugar bag Sugar bag
Plants
Fruit or berry Apple, banana, berry (blackcurrant, conga berry), cashew tree fruit, fruit (not specified), plum (black plum, green plum and sugar plum), sultana Apple, banana, berry, plum (black plum, green plum), raisin, sultana, tomato
Yam or root vegetables Potato, yam Potato, yam (budgu)
Other plants Bean, onion, tomato Bulb (sandy beach bulb), onion
Seed or nut Cashew tree nut Kora (seed)

The role of traditional food consumption in alleviating food insecurity

Most participants (76%) reported experiencing food insecurity. Of the coping strategies identified, 40% related to obtaining traditional food during times they went without food and 53% were borrowing food or money during these times.

Discussion

This exploratory study demonstrates that traditional food makes an important contribution to the contemporary diet of Aboriginal people living in remote NT communities. In 20 remote communities, traditional foods were reported to be available year round. A high frequency and wide variety of traditional foods were reported to be consumed by participants across five remote communities. In this exploratory study, more animal foods than plant foods were recalled to have been consumed and commonly a few animal foods predominated. Accessing traditional foods was reported to be a means of alleviating food insecurity for almost half the people who experienced food insecurity.

There are limited records of the traditional diet of Aboriginal and Torres Strait Islander people prior to European colonisation. Available reports describe gender roles, with women providing daily sustenance through collecting plant foods and small animals and men hunting large animals on a less regular basis, with the balance of plant and animal foods determined by factors including location and season.3 Studies of Canadian Aboriginal people suggest a high intake of traditional animal foods as part of the contemporary diet.17,18 This study suggests that an understanding of the contribution that animal (native and introduced) and plant foods make to the contemporary diet among Aboriginal and Torres Strait Islander people of Australia is warranted.

The frequent self-reported consumption of animal sources of traditional foods, suggests that contemporary population-level dietary assessment using store purchasing data has the potential to over-estimate nutrient deficiencies, particularly of protein, a concern we have previously raised.7,19 In Aboriginal populations elsewhere, it is estimated that traditional foods might contribute anywhere from 10% to 36% of energy and disproportionately to protein and other micronutrients,17,20–23 representing an important dietary contribution. Even weekly or fortnightly consumption of a nutrient-dense food, such as that reported to be consumed in this study, is likely to make an important contribution to the diet.11 Introduced land animal foods, such as buffalos, cattle and pigs, were reported to be hunted and consumed by participants. The contribution of introduced land animals may be influenced by availability and in some areas may be well integrated into the traditional food system.5 In the absence of volume consumption data, it is not possible to draw conclusions on the dietary contribution of introduced land animals. Although these foods contribute to dietary protein intake, the higher quantity of fat and poorer fatty acid profile, compared with native animal foods, is worth noting.3

We have demonstrated that it is possible to measure frequency consumption and to some extent variety of traditional foods consumed – in fact, our impression was that people enjoyed talking about these foods. We acknowledge the limitations of traditional dietary assessment methods, including additional challenges in remote contexts such as the practice of sharing community meals,12,24–27 though also consider that attributes such as the high regard given to traditional food, may aid assessment.24,27,28 Studies have demonstrated how standard tools can be modified to assess individual dietary intake with Aboriginal populations29 and lessons can be learnt from previous dietary survey work in remote Australian Aboriginal communities.15,26

Comprehensive assessment of traditional food consumption would serve a number of purposes. These data would provide an understanding of the different types of traditional foods consumed and the contribution they make to the contemporary diet of Aboriginal people across Australia. This information would assist in developing targeted strategies to ensure sustainable access and increased consumption of traditional foods. This study was not designed to examine differences in consumption of traditional foods across age, gender and other population groups. International studies in Aboriginal populations have found higher intakes of nutrient-poor store foods in young people and higher intakes of traditional foods in older people.17,22,23,30,31 In addition to contributing to improved health through dietary intake, the socio-cultural contribution and opportunity for physical activity that traditional foods provide is important to recognise.21,32,33 The impact that climate change, changes in the natural environment and development policies regarding land and sea use may have on traditional food use and thus health and wellbeing is critical to understand.12,32,34 Although not designed to collect information on environmental and other impacts on traditional food, this study suggests that introduced animals are affecting the availability of small animal and plant foods, at least in the Top End of the NT.

In addition to being nutritionally superior, traditional foods are considered to be a low-monetary form of sustenance, important in a context where people generally have low incomes and where the cost of food is high.12,18,20,35 Similar to our findings, 40% of coastal urban-dwelling Aboriginal people reported increased access of wild resources at times of financial hardship.32 In a small Western Australian outstation, hunting for various types of wild foods has been shown to respond differently to market and economic scarcity.33 The harvest of traditional foods and food sharing networks reduce the reliance on the market economy,10,12 important in a context where high numbers of people report to be food insecure. Others share our opinion that further understanding the role of traditional foods in the diet and in alleviating food insecurity36 is crucial in an environment where few, if any, significant changes are occurring in terms of the high cost of food and prevailing low-income levels.

Data regarding the contribution of traditional foods in the diet and role in livelihoods of Aboriginal people living in remote communities will be important in relation to broader environmental and social policy making. Evidence of the contribution of traditional foods to the contemporary diet of remote Aboriginal people is crucial to informing broader government policy that affects where people live, how they are educated, employment and other livelihood opportunities.10 It has been suggested that the use of traditional foods may be gaining interest nationally and internationally, and in addition to being good for human and environmental health, could provide economic and employment opportunities for Aboriginal and Torres Strait Islander Australians.37 There is a developing interest in sustainability of traditional foods in environmental protection efforts,12 such as working with Aboriginal people to develop adaption strategies to mitigate the impact of climate change on the environment and traditional food supply.32,34 Similarly, traditional food data are used internationally to maintain and improve availability and access to traditional foods as a result of global warming and environmental insults, such as contamination.17,18,21

There are three limitations related to our survey methodology. First, this study relies on self-report data, which is considered to be biased by recall and reporting. To address this, the data were collected through a facilitated recall methodology,38 which improves recall through the use of locally relevant prompts and questions.39 While respondents were asked to recall intake in the preceding two weeks only, it is possible that foods consumed beyond this timeframe were recalled. Second, the individual dietary data was collected from participants in only five remote NT communities; however, these were randomly selected from a larger sample of 20 communities and were spread across the NT. Third, the data were collected based on recall of a two-week period from participants in each community. Normally, frequency consumption data would be collected over a longer period to account for factors such as seasonality, although it has been collected in some studies for shorter periods.17 It was not within the scope of this study to collect longer-term data. The data were, however, collected over a 10-month period from the five communities, two months apart and have been supported by annual availability of traditional foods data from key informants across 20 communities. The key limitation in relation to the semi-structured interviews was that the key informants did not always include an Aboriginal person from each community and so reports of annual availability of traditional foods are likely to be conservative.

Implications

Although focused on availability, frequency and variety, this study provides an important step in improving non-Aboriginal knowledge of the contribution of traditional food in the contemporary diet of Aboriginal Australians living in remote Australia. This study suggests that it is possible to collect data regarding the contribution of traditional foods to diet. These data would complement population-level data collected through community store sales. Data of the nutrient profiles of many traditional foods exists and continues to be built on in Australia. Through a strong collaboration with Aboriginal people, methods for conducting individual dietary assessment of traditional food intake could be developed, which could include methodologies such as repeated 24-hour recall, visual recall40 and food frequency questionnaires, resulting in validated tools for ongoing use in this context. Our limited data, combined with national and international evidence suggest that priorities should include understanding differences across ages, gender, education and employment status and across remote, regional and urban areas in Australia. It is crucial that these processes align with developments in the broader environmental and societal work in this area.

Acknowledgements

The authors are grateful to community residents who provided data and acknowledge that the ownership of Aboriginal knowledge and cultural heritage is retained by the informant. The authors thank Prof Kylie Ball, Anthony Gunther, Elaine Maypilama and Carrie Turner who contributed to the development of the customer survey, those who assisted with pilot testing the customer survey and Federica Barzi who assisted with analyses. The Stores Healthy Options Project in Remote Indigenous Communities was funded by the National Health and Medical Research Council (1024285). The contents of the published material are solely the responsibility of the individual authors and do not reflect the views of the NHMRC. Julie Brimblecombe is supported through a National Heart Foundation Fellowship (100085

 

Aboriginal Health #obesity : 10 major health organisations support #sugartax to fund chronic disease and obesity #prevention

Young Australians, people in Aboriginal and Torres Strait Islander communities and socially disadvantaged groups are the highest consumers of sugary drinks.

These groups are also most responsive to price changes, and are likely to gain the largest health benefit from a levy on sugary drinks due to reduced consumption ,

A health levy on sugary drinks is not a silver bullet – it is a vital part of a comprehensive approach to tackling obesity, which includes restrictions on children’s exposure to marketing of these products, restrictions on their sale in schools, other children’s settings and public institutions, and effective public education campaigns.

We must take swift action to address the growing burden that overweight and obesity are having on our society, and a levy on sugary drinks is a vital step in this process.”

Rethink Sugary Drink campaign Download position statement

health-levy-on-sugar-position-statement

Read NACCHO previous articles Obesity / Sugartax

Amata SA was an alcohol-free community, but some years earlier its population of just under 400 people had been consuming 40,000 litres of soft drink annually.

See NACCHO Story

SBS will be showing That Sugar Film this Sunday night 2 April at 8.30pm.

There will be a special Facebook live event before the screenings

 ” The UK’s levy on sugar sweetened beverages will start in 2018, with revenue raised to go toward funding programs to reduce obesity and encourage physical activity and healthy eating for school children.

We know unhealthy food is cheaper and that despite best efforts by many Australians to make healthier choices price does affect our decisions as to what we buy.”

Sugar tax adds to the healthy living toolbox   see full article 2 below

 ” Alarmingly, with overweight becoming the perceived norm in Australia, the number of people actively trying to lose weight is declining.   A recent report by the Australian Institute of Health and Welfare found that nearly 64 per cent of Australians are overweight or obese.  This closely mirrors research that indicates around 66 per cent of Americans fall into the same category.

With this apparent apathy towards personal health and wellbeing, is it now up to food and beverage companies to combat rising obesity rates?

Who is responsible for Australia’s waistlines?  Article 3 Below

Ten of Australia’s leading health and community organisations have today joined forces to call on the Federal Government to introduce a health levy on sugary drinks as part of a comprehensive approach to tackling the nation’s serious obesity problem.

The 10 groups – all partners of the Rethink Sugary Drink campaign – have signed a joint position statement calling for a health levy on sugary drinks, with the revenue to be used to support public education campaigns and initiatives to prevent chronic disease and address childhood obesity.

This latest push further strengthens the chorus of calls in recent months from other leading organisations, including the Australian Medical Association, the Grattan Institute, the Australian Council of Social Services and the Royal Australian College of General Practitioners.

Craig Sinclair, Chair of the Public Health Committee at Cancer Council Australia, a signatory of the new position statement, said a health levy on sugary drinks in Australia has the potential to reduce the growing burden of chronic disease that is weighing on individuals, the healthcare system and the economy.

“The 10 leading health and community organisations behind today’s renewed push have joined forces to highlight the urgent and serious need for a health levy on sugary drinks in Australia,” Mr Sinclair said.

“Beverages are the largest source of free sugars in the Australian diet, and we know that sugary drink consumption is associated with increased energy intake and in turn, weight gain and obesity. Sugary drink consumption also leads to tooth decay.

“Evidence shows that a 20 per cent health levy on sugar-sweetened beverages in Australia could reduce consumption and prevent thousands of cases of type 2 diabetes, heart disease and stroke over 25 years, while generating $400-$500m in revenue each year to support public education campaigns and initiatives to prevent chronic disease and address childhood obesity.

“The Australian Government must urgently take steps to tackle our serious weight problem. It is simply not going to fix itself.”

Ari Kurzeme, Advocacy Manager for the YMCA, also a signatory of the new position statement, said young Australians, people in Aboriginal and Torres Strait Islander communities and socially disadvantaged groups have the most to gain from a sugary drinks levy.

The Rethink Sugary Drink alliance recommends the following actions to tackle sugary drink consumption:
• A public education campaign supported by Australian governments to highlight the health impacts of regular sugary drink consumption
• Restrictions by Australian governments to reduce children’s exposure to marketing of sugar-sweetened beverages, including through schools and children’s sports, events and activities
• Comprehensive mandatory restrictions by state governments on the sale of sugar-sweetened beverages (and increased availability of free water) in schools, government institutions, children’s sports and places frequented by children
• Development of policies by state and local governments to reduce the availability of sugar-sweetened beverages in workplaces, government institutions, health care settings, sport and recreation facilities and other public places.

To view the position statement click here.

Rethink Sugary Drink is a partnership between major health organisations to raise awareness of the amount of sugar in sugar-sweetened beverages and encourage Australians to reduce their consumption. Visit www.rethinksugarydrink.org.au for more information.

The 10 organisations calling for a health levy on sugary drinks are:

Stroke Foundation, Heart Foundation, Kidney Health Australia, Obesity Policy Coalition, Diabetes Australia

the Australian Dental Association, Cancer Council Australia, Dental Hygienists Association of Australia,  Parents’ Voice, and the YMCA.

Sugar tax adds to the healthy living toolbox 

Every day we read or hear more about the so-called ‘sugar tax’ or, as it should be more appropriately termed, a ‘health levy on sugar sweetened beverages’.

We have heard arguments from government and health experts both in favour of, and opposed to this ‘tax’. As CEO of one the state’s leading health charities I support the state government’s goal to make Tasmania the healthiest population by 2025 and the Healthy Tasmania Five Year Strategic Plan, with its focus on reducing obesity and smoking.

However, it is only one tool in the tool box to help us achieve the vision.

Our approach should include strategies such as restricting the marketing of unhealthy food and limiting the sale of unhealthy food and drink products at schools and other public institutions together with public education campaigns.

Some of these strategies are already in progress to include in our toolbox. We all have to take some individual responsibility for the choices we make, but as health leaders and decision makers, we also have a responsibility to create an environment where healthy choices are made easier.

This, in my opinion, is not nannyism but just sensible policy and demonstrated leadership which will positively affect the health of our population.

 Manufacturers tell us that there are many foods in the marketplace that will contribute to weight gain and we should focus more on the broader debate about diet and exercise, but we know this is not working.

A recent Cancer Council study found that 17 per cent of male teens drank at least one litre of soft drink a week – this equates to at least 5.2 kilograms of extra sugar in their diet a year.

Evidence indicates a significant relationship between the amount and frequency of sugar sweetened beverages consumed and an increased risk of developing type 2 diabetes.  We already have 45,000 people at high risk of type 2 diabetes in Tasmania.

Do we really want to say we contributed to a rise in this figure by not implementing strategies available to us that would make a difference?

I recall being quite moved last year when the then UK Chancellor of the Exchequer George Osborne said that he wouldn’t be doing his job if he didn’t act on reducing the impact of sugary drinks.

“I am not prepared to look back at my time here in this Parliament, doing this job and say to my children’s generation… I’m sorry. We knew there was a problem with sugary drinks…..But we ducked the difficult decisions and we did nothing.”

The UK’s levy on sugar sweetened beverages will start in 2018, with revenue raised to go toward funding programs to reduce obesity and encourage physical activity and healthy eating for school children. We know unhealthy food is cheaper and that despite best efforts by many Australians to make healthier choices price does affect our decisions as to what we buy.

In Mexico a tax of just one peso a litre (less than seven cents) on sugary drinks cut annual consumption by 9.7 per cent and raised about $1.4 billion in revenue.

Similarly, the 2011 French levy has decreased consumption of sugary drinks, particularly among younger people and low income groups.

The addition of a health levy on sugar sweetened beverages is not going to solve all problems but as part of a coordinated and multi-faceted approach, I believe we can effect change.

  • Caroline Wells, is Diabetes Tasmania CEO

3. Who is responsible for Australia’s waistlines? from here

Alarmingly, with overweight becoming the perceived norm in Australia, the number of people actively trying to lose weight is declining.   A recent report by the Australian Institute of Health and Welfare found that nearly 64 per cent of Australians are overweight or obese.  This closely mirrors research that indicates around 66 per cent of Americans fall into the same category.

With this apparent apathy towards personal health and wellbeing, is it now up to food and beverage companies to combat rising obesity rates?

Unfortunately it is not clear cut.  While Big Food and Big Beverage are investing in healthier product options, they also have a duty to shareholders to be commercially successful, and to expand their market share. The reality is that unhealthy products are very profitable.  However companies must balance this against the perception that they are complicit in making people fatter and therefore unhealthier with concomitant disease risks.

At the same time, the spectre of government regulation continues to hover, forcing companies to invest in their own healthy product ranges and plans to improve nutrition standards.

The International Food and Beverage Alliance (a trade group of ten of the largest food and beverage companies), has given global promises to make healthier products, advertise food responsibly and promote exercise. More specific pledges are being made in developed nations, where obesity rates are higher and scrutiny is more thorough.

However companies must still find a balance between maintaining a profitable business model and addressing the problem caused by their unhealthy products.

An example of this tension was evident when one leading company attempted to boost the sale of its healthier product lines and set targets to reduce salt, saturated fat and added sugar.  The Company also modified its marketing spend to focus on social causes.  Despite the good intentions, shareholders were disgruntled, and pressured the company to reinstate its aggressive advertising.

What role should governments play in shaping our consumption habits and helping us to maintain healthier weights? And should public policy be designed to alter what is essentially personal behaviour?

So far, the food and beverage industry has attempted to avoid the burden of excessive regulation by offering relatively healthier product lines, promoting active lifestyles, funding research, and complying with advertising restrictions.

Statistics indicate that these measures are not having a significant impact.  Subsequently, if companies fail to address the growing public health burden, governments will have greater incentive to step in.  In Australia, this is evident in the increased political support for a sugar tax.  The tax has been debated in varying forms for years, and despite industry resistance, the strong support of public health authorities may see a version of the tax introduced.

Already, Australia’s food labelling guidelines have been amended and tightened, and a clunky star rating system introduced to assist consumers to make healthier choices. Companies that have worked to address and invest in healthy product ranges must still market them in a responsible way. Given the sales pressure, it is tempting for companies to heavily invest in marketing healthier product ranges.  However they have an obligation under Australian consumer law to ensure products’ health claims do not mislead.

We know that an emboldened Australian Competition and Consumer Commission (ACCC) is taking action against companies that deliberately mislead consumers.  The food industry is firmly in the its sights, with a case currently underway against a leading food company over high sugar levels in its products. This shows that the Regulator will hold large companies to account, and push for penalties that ‘make them sit up and take notice.’

At a recent Consumer Congress, ACCC Chair Rod Sims berated companies that don’t treat consumers with respect.  He maintains that marketing departments with short-term thinking, and a short-sighted executive can lead to product promotion that is exaggerated and misleading.  All of which puts the industry on notice.

With this in mind, it is up to Big Food and Big Beverage to be good corporate citizens.  They must uphold their social, cultural and environmental responsibilities to the community in which they seek a licence to operate, while maintaining a strong financial position for their shareholders. It is a difficult task, but there has never been a better time for companies to accept the challenge.

Eliza Newton, Senior Account Director

NACCHO Aboriginal Health #KHW17 #Kidneysfirst :Ten bad food habits that will kill you

 ‘ Almost half of heart-related deaths are caused by 10 bad ­eating habits.

Diets high in salt or sugary drinks are responsible for ­thousands of deaths from heart disease, stroke and type 2 ­diabetes, according to a study. Scientists also blamed a lack of fruit and vegetables and high ­levels of ­processed meats.

Researchers looked at all 702,308 deaths from heart ­disease, stroke and type 2 diabetes in the US in 2012 and found that 45 per cent were linked with “suboptimal consumption” of 10 types of nutrients. They mapped data on dietary habits from population surveys, along with estimates from previous research of links between foods and disease, on to data about the deaths to come up with the figures.”

Originally published in The Australian

This is our last NACCHO post supporting Kidney Health Week / Day

Further NACCHO reading

Sugar Tax     Obesity     Diabetes    Nutrition/Healthy Foods

The highest proportion of deaths, at 9.5 per cent, was linked with eating too much salt, while a low intake of nuts and seeds was linked with 8.5 per cent.

Eating processed meats was linked with 8.2 per cent of deaths and a low amount of seafood omega-3 fats with 7.8 per cent. Low intake of vegetables ­accounted for 7.6 per cent and low intake of fruit 7.5 per cent.

Sugary drinks were linked with 7.4 per cent, a low intake of whole grains with 5.9 per cent, low polyunsaturated fats with 2.3 per cent and high unprocessed red meats with 0.4 per cent.

The research, published in the journal JAMA, also found men’s deaths were more likely to have links to poor diet than women’s.

Key Points

Question  What is the estimated mortality due to heart disease, stroke, or type 2 diabetes (cardiometabolic deaths) associated with suboptimal intakes of 10 dietary factors in the United States?

Findings  In 2012, suboptimal intake of dietary factors was associated with an estimated 318 656 cardiometabolic deaths, representing 45.4% of cardiometabolic deaths. The highest proportions of cardiometabolic deaths were estimated to be related to excess sodium intake, insufficient intake of nuts/seeds, high intake of processed meats, and low intake of seafood omega-3 fats.

Meaning  Suboptimal intake of specific foods and nutrients was associated with a substantial proportion of deaths due to heart disease, stroke, or type 2 diabetes.

Abstract

Importance  In the United States, national associations of individual dietary factors with specific cardiometabolic diseases are not well established.

Objective  To estimate associations of intake of 10 specific dietary factors with mortality due to heart disease, stroke, and type 2 diabetes (cardiometabolic mortality) among US adults.

Design, Setting, and Participants  A comparative risk assessment model incorporated data and corresponding uncertainty on population demographics and dietary habits from National Health and Nutrition Examination Surveys (1999-2002: n = 8104; 2009-2012: n = 8516); estimated associations of diet and disease from meta-analyses of prospective studies and clinical trials with validity analyses to assess potential bias; and estimated disease-specific national mortality from the National Center for Health Statistics.

Exposures  Consumption of 10 foods/nutrients associated with cardiometabolic diseases: fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages (SSBs), polyunsaturated fats, seafood omega-3 fats, and sodium.

Main Outcomes and Measures  Estimated absolute and percentage mortality due to heart disease, stroke, and type 2 diabetes in 2012. Disease-specific and demographic-specific (age, sex, race, and education) mortality and trends between 2002 and 2012 were also evaluated.

Results  In 2012, 702 308 cardiometabolic deaths occurred in US adults, including 506 100 from heart disease (371 266 coronary heart disease, 35 019 hypertensive heart disease, and 99 815 other cardiovascular disease), 128 294 from stroke (16 125 ischemic, 32 591 hemorrhagic, and 79 578 other), and 67 914 from type 2 diabetes.

See for full text

The authors, from Cambridge University and two US institutions, said that their results should help to “identify priorities, guide public health planning and inform strategies to alter dietary habits and improve health”.

In an editorial, Noel Mueller and Lawrence Appel, of the Johns Hopkins Bloomberg School of Public Health, said: “Policies that affect diet quality, not just quantity, are needed … There is some precedence, such as from trials of the Mediterranean diet plus supplemental foods, that modification of diet can reduce cardiovascular disease risk by 30 per cent to 70 per cent.”

Keeping your kidneys healthy

It is important to maintain a healthy weight for your height. The food you eat, and how active you are, help to control your weight.

Healthy eating tips include:

  • Eat lots of fruit, vegetables, legumes and wholegrain bread and rice.
  • At least once a week eat some lean meat such as chicken and fish.
  • Look at the food label and try to choose foods that have a low percentage of sugar and salt and saturated fats.
  • Limit take-away and fast food meals.

Exercise regularly

It’s recommended that you do at least 30 minutes of physical activity most days of the week  – exercise leads to increased strength, stamina and energy.

The key is to start slowly and gradually increase the time and intensity of the exercise. You can break down any physical activity into three ten-minute bursts, which can be increased as your fitness improves

Drink plenty of fluids and listen to your thirst.

If you are thirsty, make water your first choice. Water has a huge list of health benefits and contains no kilojoules, is inexpensive and readily available.

Sugary soft drinks are packed full of ‘empty kilojoules’, which means they contain a lot of sugar but have no nutritional value.

Some fruit juices are high in sugar and do not contain the fibre that the whole fruit has.

The role of the kidneys is often underrated when we think about our health.

In fact, the kidneys play a vital role in the daily workings of your body. They are so important that nature gave us two kidneys, to cover the possibility that one might be lost to an injury.

We can live quite well with only one kidney and some people live a healthy life even though born with one missing. However, with no kidney function death occurs within a few days!

The kidneys play a major role in maintaining your general health and wellbeing. Think of them as a very complex, environmentally friendly, waste disposal system. They sort non-recyclable waste from recyclable waste, 24 hours a day, seven days a week, while also cleaning your blood.

Most people are born with two kidneys, each one about the size of an adult fist, bean-shaped and weighing around 150 grams each. The kidneys are located at both sides of your backbone, just under the rib cage or above the small of your back. They are protected from injury by a large padding of fat, your lower ribs and several muscles.

Your blood supply circulates through the kidneys about 12 times every hour. Each day your kidneys process around 200 litres of blood. The kidneys make urine (wee) from excess fluid and unwanted chemicals or waste in your blood.

Urine flows down through narrow tubes called ureters to the bladder where it is stored. When you feel the need to wee, the urine passes out of your body through a tube called the urethra. Around one to two litres of waste leave your body each day as urine.

Resource Library

Kidneys are the unsung heroes of our bodies and perform a number of very important jobs:

  • Blood pressure control – kidneys keep your blood pressure regular.
  • Water balance – kidneys add excess water to other wastes, which makes your urine.
  • Cleaning blood – kidneys filter your blood to remove wastes and toxins.
  • Vitamin D activation – kidneys manage your body’s production of this essential vitamin, which is vital for strong bones, muscles and overall health.

All this makes the kidneys a very important player in the way your body works and your overall health.

NACCHO Aboriginal #kidneysfirst Health #KHW17: International research finds food subsidies and taxes improve dietary choices

marmot

The global food system is causing a staggering toll on human health. And this is very costly, both in terms of real healthcare expenses and lost productivity.

Our findings suggest that subsidies and taxes are a highly effective tool for normalizing the price of foods toward their true societal costs. 

This will not only prevent disease but also reduce spiraling healthcare costs, which are causing tremendous strain on both private businesses and government budgets.”

Senior author Dariush Mozaffarian, M.D., Dr.P.H., dean of the Friedman School

kidney-week

Here are some sobering facts on #obesity from a report by @KidneyHealth as we mark #KidneyHealthWeek
bit.ly/2mrsBRJ
#KHW17

2025

#Kidneyfirst Aboriginal Health Key points

risk

Aboriginal and Torres Strait Islander people are more likely to have end stage kidney disease and be hospitalised or die with chronic kidney disease than non-Indigenous people.4

The greater prevalence of chronic kidney disease in some Aboriginal and Torres Strait Islander communities is due to the high incidence of traditional risk factors, including diabetes, high blood pressure and smoking, in addition to higher levels of inadequate nutrition, alcohol abuse, streptococcal throat and skin infection, poor living conditions and low birth weight, which is linked to reduced nephron development.4

Aboriginal and Torres Strait Islander people experience a higher burden of disease; two and a half times that of non-Indigenous people.

A large part of the burden of disease is due to chronic diseases such as cardiovascular disease, diabetes, cancer, chronic respiratory disease and chronic kidney disease.

This higher burden can be reduced by identifying chronic disease earlier and through the management of risk factors and the disease itself. See more about the management of risk factors here.

A new systematic review and meta-analysis finds that lowering the cost of healthy foods significantly increases their consumption, while raising the cost of unhealthy items significantly reduces their intake.

Food subsidies and taxes significantly improve dietary choices

Interventions that alter food prices can improve people’s diets, leading to more healthy choices and fewer unhealthy choices

While everyone has a sense that food prices matter, the magnitude of impact of food taxes and subsidies on dietary intakes, and whether this varies by the food target, has not been clear. For the review, a team of researchers identified and pooled findings from a total of 30 interventional and longitudinal studies, including 11 that assessed the effect of higher prices (taxation) of unhealthy foods and 19 that assessed the effect of lower prices (subsidies) of healthy foods.

The findings were published in PLOS ONE on March 1.

“To date, evidence on effectiveness of fiscal policies on diet has mostly come from cross-sectional studies, which cannot infer causality. This is why we evaluated studies that examined the relationship between food price and diet over time,” said co-first author Ashkan Afshin, M.D., former postdoctoral fellow at the Friedman School of Nutrition Science & Policy at Tufts University and now at the University of Washington. “Our results show how 10 to 50 percent changes in price of foods and beverages at checkout could influence consumers’ purchasing behaviors over a relatively short period of time.”

In the pooled analysis, each 10 percent decrease in price of fruits and vegetables increased their consumption by 14 percent, and each 10 percent decrease in price of other healthy foods increased their consumption by 16 percent. A change in price of fruits and vegetables was also associated with body mass index (BMI): for every 10 percent price decrease, BMI declined by 0.04 kg/m2.

Conversely, each 10 percent price increase of sugar-sweetened beverages and unhealthy fast foods decreased their consumption by 7 percent and 3 percent, respectively. Every 10 percent price increase in unhealthy foods and drinks was associated with a trend toward lower BMI (per 10 percent price increase: -0.06 kg/m2), but this did not achieve statistical significance.

By merging findings from 23 interventional and 7 prospective cohort studies, the researchers evaluated relationships between the change in the price of specific foods or beverages and the change in their intake. Studies evaluated people’s reported intake or data on sales of foods and beverages. The study populations included children, adults, or both; and countries included the United States, the Netherlands, France, New Zealand, and South Africa. Price change interventions were conducted in various settings such as cafeterias, vending machines and supermarkets. The findings were centrally pooled in a meta-analysis.

Co-first author is Jose Penalvo, Ph.D., M.Sc., Friedman School of Nutrition Science & Policy at Tufts University. Additional authors on this study are Liana Del Gobbo, Ph.D., Stanford University School of Medicine; Jose Silva, M.D., Boston Medical Center; Melody Michaelson, M.Sc., Tufts University School of Medicine; Martin O’Flaherty, M.D., Ph.D., University of Liverpool; Simon Capewell, M.D., D.Sc., University of Liverpool; Donna Spiegelman, D.Sc., Harvard T.H. Chan School of Public Health; and Goodarz Danaei, M.D., D.Sc., Harvard T.H. Chan School of Public Health.

This work was supported by awards from the National Heart, Lung, and Blood Institute of the National Institutes of Health (HL098048, HL115189) and from The New York Academy of Sciences’ Sackler Institute for Nutrition Science. For conflicts of interest disclosure, please see the study.

Afshin, A., Penalvo, J., Del Gobbo, L., Silva, J., Michaelson, M., O’Flaherty, M., Capewell, S., Spiegelman, D., Danaei, G., Mozaffarian, D. (2017, March 1). The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis. PLOS ONE. doi: 10.1371/journal.pone.0172277

About the Friedman School of Nutrition Science and Policy at Tufts University

The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school’s eight degree programs – which focus on questions relating to nutrition and chronic diseases, molecular nutrition, agriculture and sustainability, food security, humanitarian assistance, public health nutrition, and food policy and economics – are renowned for the application of scientific research to national and international policy.

NACCHO Aboriginal #prevention Health : #ALPHealthSummit : With $3.3 billion budget savings on the table, Parliament urged to put #preventivehealth on national agenda

prevention-copy

 ” Recently the Federal Government has spoken in favour of investment in preventive health.

 In an address to the National Press Club in February this year, Prime Minister Malcolm Turnbull said, “in 2017, a new focus on preventive health will give people the right tools and information to live active and healthy lives”.

Health Minister Greg Hunt echoed that sentiment on 20 February announcing the Government was committed to tackling obesity.

Prevention 1st, however, argues the need for a more comprehensive, long-term approach to the problem. Press Release

mathew-cooke

NACCHO was represented at the #ALPHealthSummit by Chair Matthew Cooke pictured above with Stephen Jones MP

Leading health organisations are calling on the Commonwealth to address Australia’s significant under-investment in preventive health and set the national agenda to tackle chronic disease ahead of Labor’s National Health Policy Summit today.

Chronic disease is Australia’s greatest health challenge, yet many chronic diseases are preventable, with one third of cases traced to four modifiable risk factors: poor diet, tobacco use, physical inactivity and risky alcohol consumption.

Adopting preventive health measures would address significant areas flagged as critical by the both major parties, including ensuring universal access to world-class healthcare, preventing and managing chronic disease, reducing emergency department and elective surgery waiting times, and tackling health inequalities faced by Indigenous Australians.

prevention-copy-2

Prevention 1st – a campaign led by the Foundation for Alcohol Research and Education (FARE), the Public Health Association of Australia (PHAA), Consumers Health Forum of Australia (CHF Australia), and Alzheimer’s Australia – is urging the ALP to adopt the group’s Pre-Budget submission recommendations as part of the party’s key health policy framework.

FARE Chief Executive Michael Thorn says it is up to federal policymakers to address Australia’s healthcare shortfalls and that Labor has the perfect opportunity to reignite its strong track record and lead the way in fixing the country’s deteriorating investment in preventive healthcare.

“Australia’s investment in preventive health is declining, despite chronic disease being the leading cause of illness in Australia. Chronic disease costs Australian taxpayers $27 billion a year and accounts for more than a third of our national health budget. The ALP has both the opportunity and a responsibility as the alternate government to set the national agenda in the preventive healthcare space. Ultimately, however, it falls to the Government of the day to show leadership on this issue,” said Mr Thorn.

Its Pre-Budget submission 2017-18, Prevention 1st identifies a four-point action plan targeting key chronic disease risk factors.

Prevention 1st has called for Australia to phase out the promotion of unhealthy food and beverages, and for long overdue national public education campaigns to raise awareness of the risks associated with alcohol, tobacco, physical inactivity, and poor nutrition. Under the proposal, these measures would be supported by coordinated action across governments and increased expenditure on preventive health.

The costed plan also puts forward budget savings measures, recommending the use of corrective taxes to maximise the health and economic benefits to the community. Taxing products appropriate to their risk of harm will not only encourage healthier food and beverage choices but would generate much needed revenue – around $3.3 billion annually.

With return on investment studies showing that small investments in prevention are cost-effective in both the short and longer terms, and the opportunity to contribute to happier and healthier communities, Consumers Health Forum of Australia Chief Executive Officer Leanne Wells urged both the Australian Government and Opposition to take advantage of the opportunity to stem the tide of chronic disease.

“There is an obvious benefit in adopting forward-thinking on preventive healthcare to reduce pressure on the health budget and the impact of preventable illness and injury on society,” Ms Wells said.

The ALP National Health Policy Summit will be held at Parliament House in Canberra on Friday 3 March.


View the submission

View media release in PDF