NACCHO Aboriginal Health and #Obesity : Download #TippingtheScales Report Leading health orgs set out 8 urgent actions for Federal Government

“Sixty-three per cent of Australian adults and 27 per cent of our children are overweight or obese.

This is not surprising when you look at our environment – our kids are bombarded with advertising for junk food, high-sugar drinks are cheaper than water, and sugar and saturated fat are hiding in so-called ‘healthy’ foods. Making a healthy choice has never been more difficult.

The annual cost of overweight and obesity in Australia in 2011-12 was estimated to be $8.6 billion in direct and indirect costs such as GP services, hospital care, absenteeism and government subsidies.1 “

 OPC Executive Manager Jane Martin 

Download the report HERE  tipping-the-scales

Read over 30 + NACCHO Obesity articles published last 5 years

Read over 30+ NACCHO Nutrition and Healthy foods published last 5 years

Thirty-four leading community, public health, medical and academic groups have today united for the first time to call for urgent Federal Government action to address Australia’s serious obesity problem.

In the ground-breaking new action plan, Tipping the Scales, the agencies identify eight clear, practical, evidence-based actions the Australian Federal Government must take to reduce the enormous strain excess weight and poor diets are having on the nation’s physical and economic health.

Led by the Obesity Policy Coalition (OPC) and Deakin University’s Global Obesity Centre (GLOBE), Tipping the Scales draws on national and international recommendations to highlight where action is required. Areas include:

  1. Time-based restrictions on TV junk food advertising to kids
  2. Set clear food reformulation targets
  3. Make the Health Star Rating mandatory by July 2019
  4. Develop a national active transport strategy
  5. Fund weight-related public education campaigns
  6. Introduce a 20% health levy on sugary drinks
  7. Establish a national obesity taskforce
  8. Develop and monitor national diet, physical activity and weight guidelines.

OPC Executive Manager Jane Martin said the eight definitive policy actions in Tipping the Scales addressed the elements of Australia’s environment which set individuals and families up for unhealthy lifestyles, rather than just focusing on treating the poor health outcomes associated with obesity.

Watch video HERE : How does junk food marketing influence kids

“Sixty-three per cent of Australian adults and 27 per cent of our children are overweight or obese. This is not surprising when you look at our environment – our kids are bombarded with advertising for junk food, high-sugar drinks are cheaper than water, and sugar and saturated fat are hiding in so-called ‘healthy’ foods. Making a healthy choice has never been more difficult,” Ms Martin said.

“The annual cost of overweight and obesity in Australia in 2011-12 was estimated to be $8.6 billion in direct and indirect costs such as GP services, hospital care, absenteeism and government subsidies.1 But Australia still has no strategy to tackle our obesity problem. It just doesn’t make sense.

“Without action, the costs of obesity and poor diet to society will only continue to spiral upwards. The policies we have set out to tackle obesity therefore aim to not only reduce morbidity and mortality, but also improve wellbeing, bring vital benefits to the economy and set Australians up for a healthier future.”

Professor of Epidemiology and Equity in Public Health at Deakin University, Anna Peeters, said the 34 groups behind the report were refusing to let governments simply sit back and watch as growing numbers of Australians developed life-threatening weight and diet-related health problems.

“For too long we have been sitting and waiting for obesity to somehow fix itself. In the obesogenic environment in which we live, this is not going to happen. In fact, if current trends continue, there will be approximately 1.75 million deaths in people over the age of 20 years caused by diseases linked to overweight and obesity, such as type 2 diabetes, cancer heart disease, between 2011-20501,” Professor Peeters said.

“Obesity poses such an immense threat to Australia’s physical and economic health that it needs its own, standalone prevention strategy if progress is to be made. There are policies which have been proven to work in other parts of the world and have the potential to work here, but they need to be implemented as part of a comprehensive approach by governments. And they need to be implemented now.

“More than thirty leading organisations have agreed on eight priorities needed to tackle obesity in Australia. We would like to work with the Federal Government to tackle this urgent issue and integrate these actions as part of a long-term coordinated approach.”

In addition to the costs to society, the burden of obesity is felt acutely by individuals and their families.

As a Professor of Women’s Health at Monash University and a physician, Professor Helena Teede sees mothers struggle daily with trying to achieve and sustain healthy lifestyles for themselves and their families, while having to deal with the adverse impact of unhealthy weight, especially during pregnancy.

“As a mother’s weight before pregnancy increases, so does the substantive health risk to both the mother and baby. Excess weight gain during pregnancy further adds to these risks and is a key driver of infertility, long-term obesity, heart disease and type 2 diabetes, while for the child, their risk of becoming overweight or obese and developing chronic diseases in later life greatly increases,” Professor Teede said.

“The women I see are generally desperate for help to improve their lifestyle and that of their families. They want to set themselves and their families up for healthy, long lives.

“Currently, there is a lot of blame placed on individuals with unhealthy diets and lifestyles seen as being due to individual and family discipline. Women from all backgrounds and walks of life struggle with little or no support to achieve this. It is vital that we as a community progress beyond placing all responsibility on the individual and work towards creating a policy context and a society that supports healthy choices and tips the scales towards obesity prevention to give Australian families a healthy start to life.”

The calls to action outlined in Tipping the Scales are endorsed by the following organisations: Australian Chronic Disease Prevention Alliance (which includes the Heart Foundation, Cancer Council Australia, Kidney Health Australia, Diabetes Australia and the Stroke Foundation), Australian Health Policy Collaboration (AHPC), Australian Medical Students’ Association (AMSA), Australian & New Zealand Obesity Society (ANZOS), Australasian Society of Lifestyle Medicine, Baker Heart & Diabetes Institute, CHOICE, Consumers Health Forum of Australia, Deakin University’s Global Obesity Centre (GLOBE), Institute For Physical Activity and Nutrition (IPAN), Monash Centre for Health, Research and Implementation (MCHRI), LiveLighter, Menzies School of Health Research, The University of Melbourne’s Melbourne School of Population & Global Health, Melbourne Children’s (which includes The Royal Children’s Hospital Melbourne, Murdoch Children’s Research Institute and the University of Melbourne), the National Rural Health Alliance Inc, Nutrition Australia, Obesity Australia, Obesity Policy Coalition, Obesity Surgery Society of Australia & New Zealand, Parents’ Voice, Public Health Association of Australia and Sugar By Half.

Download the Tipping the Scales action plan and snapshot at opc.org.au/tippingthescales


1. Obesity Australia. Obesity: Its impact on Australia and a case for action. No time to Weight 2. Sydney, 2015.

NACCHO #Aboriginal Health and #Diabetes @theMJA the @NHMRC #Indigenous guidelines need update

Early onset of type 2 diabetes is very common in Aboriginal communities following Westernisation, so I agree with the recommendations of NACCHO and the RACGP, which recommended early screening.

Whether you do it annually or every 3 years is a less important question to me, and very patient-dependent.

Only 18% of Indigenous adults were tested for diabetes annually, as per the more intensive guidelines by the National Aboriginal Community Controlled Health Organisation (NACCHO), leading the authors to claim that the RACGP/DA guidelines were more practicable “

Professor Kerin O’Dea, Professor Emeritus at the University of South Australia and Honorary Professor at the University of Melbourne, said that the NHMRC recommendations “really need to be updated”.

Originally published MJA

Read over 120 diabetes related posts by NACCHO over past 5 years

MORE can be done to increase diabetes screening rates among Indigenous Australians and enable earlier intervention, say experts who are calling for a greater focus on young adults.

A study published in the MJA found enormous variation in diabetes screening rates between different Aboriginal Community Controlled Health Services (ACCHSs).

The proportion of Indigenous adults screened for diabetes at least once in 3 years – as per the Royal Australian College of General Practitioners and Diabetes Australia (RACGP/DA) guidelines – ranged from 16% to 90% between different services.

Overall, 74% of Indigenous adults received a screening test for diabetes at least once between 2010 and 2013, the study found, based on de-identified data on 20 978 patients from 18 ACCHSs.

Only 18% of Indigenous adults were tested for diabetes annually, as per the more intensive guidelines by the National Aboriginal Community Controlled Health Organisation (NACCHO), leading the authors to claim that the RACGP/DA guidelines were more practicable.

Extract Overview provided by NACCHO

Download a full copy of 2 nd edition

http://www.racgp.org.au/download/documents/AHU/2ndednationalguide.pdf

Type 2 diabetes is most commonly found in obese adults who develop increasing insulin resistance over months or years. For these patients there is a substantial ‘prediabetic’ window period of opportunity to offer preventive interventions. Screening for diabetes is safe, accurate and cost effective, and detects a substantial proportion of people who may not otherwise have received early intervention.1 This chapter discusses type 2 diabetes in adults who are not pregnant.

The prevalence of type 2 diabetes in Aboriginal and Torres Strait Islander populations is 3–4 times higher at any age than the general population, with an earlier age of onset.2 The precise prevalence is hard to pinpoint; a 2011 systematic review of 24 studies showed prevalence estimates ranged from 3.5–31%, with most lying between 10% and 20%. Diabetes prevalence in remote populations is approximately twice that of urban populations and is higher among Aboriginal and Torres Strait Islander people.3

Aboriginal and Torres Strait Islander men and women die from diabetes at 23 and 37 times the rate of non-Indigenous Australian men and women respectively, in the 35–54 years age group.4 Large scale clinical trials have demonstrated that appropriate management of diabetes can prevent the development or delay the progression of complications such as myocardial infarction, eye disease and renal failure.5

Obesity is a very strong predictor for diabetes; a body mass index (BMI) ≥30 kg/m2 increases the absolute risk of type 2 diabetes by 1.8–19-fold, depending on the population studied. A cohort study of non-diabetic Aboriginal adults aged 15–77 years in central Australia found that those with a BMI of ≥25 kg/m2 had 3.3 times the risk of developing diabetes over 8 years of follow up compared to those with a BMI <25 kg/m2.1 The AusDiab study found that three measures of obesity: BMI, waist circumference and waist-to-hip ratio, all had similar correlations with diabetes and CVD risk.6 Waist circumference performed slightly better than BMI at predicting diabetes in a remote Aboriginal community

The study defined screening tests to include glycated haemoglobin (HbA1c) testing as well as the oral glucose tolerance test and venous glucose level testing.

Barriers to screening included being aged under 50 years, being transient rather than a current patient and attending the service less frequently, the study found. The authors concluded that particular attention should be given to increasing the screening rate in these groups.

The finding that young people were less likely to be tested was “intuitively reasonable”, the authors said, given that the risk of developing diabetes rises with age. However, they suggested that it was still best practice to test Indigenous adults from the age of 18 years, as it provided a “substantial opportunity for limiting the impact of type 2 diabetes”.

Indigenous Australians aged 25–34 years are five times more likely to have diabetes or high blood sugar levels than non-Indigenous Australians of the same age, they noted.

Despite this difference between Indigenous and non-Indigenous people, the National Health and Medical Research Council (NHMRC) only recommends screening Indigenous people for diabetes once they are aged over 35 years, and doing it every 3 years.

Professor Kerin O’Dea, Professor Emeritus at the University of South Australia and Honorary Professor at the University of Melbourne, said that the NHMRC recommendations “really need to be updated”.

“Early onset of type 2 diabetes is very common in Aboriginal communities following Westernisation, so I agree with the recommendations of NACCHO and the RACGP, which recommended early screening,” she told MJA InSight.

“Whether you do it annually or every 3 years is a less important question to me, and very patient-dependent,” she said.

Professor O’Dea said that more widespread use of HbA1c testing could increase the screening rate in Aboriginal communities, particularly among younger people and those who were more transient.

“If screening for diabetes was just a simple opportunistic HbA1c test, you wouldn’t have so many problems getting people to have it done,” she said. “HbA1c testing will give you a good idea of the mean glucose level, and unlike the glucose tolerance test, you don’t have to ask the patient to return in the fasting state.

“If it does turn out that the patient has borderline diabetes, then you can ask if they are prepared to do a glucose tolerance test,” she added.

Study co-author, Associate Professor Christine Paul, said that there was significant variation in the use of HBA1c testing across sites and across time in the study.

“I think it is possible that increasing the use of HbA1c as a screening test may help [to increase screening rates]; however, I don’t think it’s the main answer,” she said. “Clearly some health services need support to get systems in place, regardless of which test they use.”

 

NACCHO Aboriginal Health : Tributes to Dr G Yunupingu and Mr Yami Lester – Men without sight but not without a vision

 

Not far from that creek crossing, at Maralinga, when Yami Lester was a 12-year-old, the British government, in collusion with our Australian government, exploded a series of atomic weapons.

A black mist rolled over their lands, hurting the eyes of this young boy. After a relatively short period of time he became blind.

At his funeral service, we were moved by the singing of Paul Kelly, whose song Maralinga told the story of Mr Lester.

Paul Kelly also worked with the second blind man I wish to commemorate today, Dr G Yunupingu, who brought his beautiful, ethereal voice, in his Yolngu language, to people across the world.

Both men died, in part, due to kidney disease.

Dr Yunupingu had suffered from liver and kidney diseases for many years. He was just 46 years of age. Mr Lester died from end-stage renal failure.”

Extracts from Senator DODSON (Western Australia) Senate Tribute in full Part 2

Picture above from  : Yami Lester: More than 500 people travel to South Australia’s far north for leader’s funeral  : Image and full name used with Permission from family

 ” Dr G Yunupingu ‘s uncle, senior Gumatj elder Djunga Djunga Yunupingu, is reported to have told the crowd at the National Indigenous Awards last week that Dr G Yunupingu ‘built a bridge between Indigenous and non- Indigenous Australia with his music.

Both Yolngu and Balanda walking together hand in hand—two laws, two people, one country.’

These words speak to the moving and reconciling impact of the life Dr G Yunupingu lived, which, sadly, was all too short.

The coalition government and this parliament recognise kidney disease as an important health condition impacting too greatly on our first Australians. Recognising this, we have invested in significant renal services, including dialysis, and we will continue to push for improved services for Territorians.

Dr G Yunupingu’s achievements over his life have left a legacy in the music industry. He will remain one of Australia’s most treasured music artists, described by the Prime Minister as a remarkable Australian who shared Yolngu language with the world through music.

Extracts from Senator Scullion (Northern Territory ) Senate tribute Part 1 Below

 ” We owe him (Mr Lester)  a great debt because he faced adversity with understated courage, with humility, with humour, with great strength.

In a world without nuclear threats and risks Mr Lester would have been a great stockman. In a world with nuclear threats and risks he would crack his whip loud, hard, sharp and constant to sound a different alarm.

Mr Lester made it part of his life’s work to fight for people affected by nuclear testing and to campaign for Indigenous land rights, and we’ve just heard today what a success he made of that and what a difference he made.

Vale, Mr Lester, and our condolences go out to his family and friends.

I was at Garma just a couple of weeks ago, where his legacy was celebrated and his passing very strongly felt.

You could feel it everywhere over the weekend at the time of Garma.

I just want to add, very briefly, to the comments that Senator Dodson just made around kidney disease and the need to address kidney disease in this country, given the impact it has had on these two great Aboriginal Australians.”

Extracts Senator SIEWERT (Western Australia ) senate Tribute in full Part 3 Below

Part 1 Full Text  Senator SCULLION: I move:

That the Senate records its sincere condolences at the deaths, on 21 July 2017 of Mr Kunmanara Lester OAM, and on 25 July 2017 of Dr G Yunupingu, places on record its gratitude and admiration for their service to the nation, and tenders its profound sympathy to their family and community in their bereavement.

I rise on behalf of the coalition government to pay respects and provide sincere condolences to the families, friends and communities of two remarkable men, two First Australians, who have each made such a difference to the nation through their own respective life paths.

Today the Senate pays respects to the outstanding and remarkable contributions of Dr G Yunupingu and Mr Yami Lester. Perhaps what is most striking is that both of these men lived a life without sight, but certainly not without insight and vision, for these two men saw and strived for a better future for their people using both words and action.

I was incredibly saddened by the news of Dr G Yunupingu’s passing, having had the delight of spending time with him in very different circumstances to most people, on his country.

In my previous life as a commercial fisherman, I and my young family at the time spent many years around Dr G Yunupingu’s country, around his home, particularly on the northern end of Elcho Island.

I consider myself blessed to have been able to know this man on his country, when many would see he was most himself.

In fact, I learned that, despite being born blind, Mr G Yunupingu was a great optimist and a man who made the best of everything.

He was a hero of his people and his community and a champion of the Indigenous music industry.

In fact, he was a champion of the Australian music industry, taking Indigenous music and Australian culture to the world.

Learning to play the guitar from an early age, Dr G Yunupingu joined the acclaimed Yothu Yindi band as a teenager.

This band changed the Australian music industry for the better and, more importantly, changed the psyche of our nation through its thought-provoking songs and powerful lyrics.

This music compelled you to listen.

It was music that made all who heard it stop and listen, to listen and learn.

Dr G Yunupingu ‘s uncle, senior Gumatj elder Djunga Djunga Yunupingu, is reported to have told the crowd at the National Indigenous Awards last week that Dr G Yunupingu ‘built a bridge between Indigenous and non- Indigenous Australia with his music.

Both Yolngu and Balanda walking together hand in hand—two laws, two people, one country.’

These words speak to the moving and reconciling impact of the life Dr G Yunupingu lived, which, sadly, was all too short.

The coalition government and this parliament recognise kidney disease as an important health condition impacting too greatly on our first Australians. Recognising this, we have invested in significant renal services, including dialysis, and we will continue to push for improved services for Territorians.

Dr G Yunupingu’s achievements over his life have left a legacy in the music industry. He will remain one of Australia’s most treasured music artists, described by the Prime Minister as a remarkable Australian who shared Yolngu language with the world through music.

Dr G Yunupingu stands among the many Yolngu leaders who have gone before him, including those who were signatories of the Yirrkala bark petitions that were tabled in Parliament this very week back in 1963. Family, friends, fellow Territorians, fans and followers will mark Dr G Yunupingu’s life and provide a final farewell on Tuesday, 19 September at the Darwin Convention Centre.

Today the Senate also provides its sincere condolences to the family and friends of Mr Yami Lester OAM, who passed away on 21 July 2017.

Born in the early 1940s in the APY Lands, on Granite Downs Station in the far north of South Australia, Yami, a Yankunytjatjara man, would go on to live a legacy of leadership that our country acknowledges with sincerity.

The stature of Mr Lester’s leadership was demonstrated in all he did, including as first chair of Pitjantjatjara Council, regional councillor, zone commissioner, driving force of the Institute of Aboriginal Development and chair of the Nganampa Health Council.

Mr Lester is a man who rose from personal tragedy. He was tragically blinded as a young man as a result of the black mist from the nuclear bomb test that blew through his homelands in South Australian when he was only a child. In the decades that followed, Mr Lester’s passion was to fight for justice and restoration for his people and rightful recognition.

He was courageous and persistent. He succeeded in delivering better outcomes for the community he served—for land rights, the health of his people, education, language and culture. He fought for a better future, better health, better education and better jobs.

In all of this, he demonstrated the power of his influence in bringing about major change.

At the state funeral, which I attended with my colleagues Senator Dodson and the member for Lingiari from the other place, I spoke with Mr Lester’s son, Leroy, who shared with me his father’s passion about improving school attendance in his own community.

Mr Lester knew the benefits education can bring not only to his people but to all Australians.

His record of achievement has left a legacy of better outcomes for his community, his people and his nation. Mr Lester advocated for the Pitjantjatjara land rights act. He was part of the historic handover of Uluru-Kata Tjuta, and we remember how he stood alongside Governor-General Sir Ninian Stephen in 1975 and interpreted speech.

He tirelessly advocated for the McMillan royal commission into the British nuclear test that later saw his people compensated.

Mr Lester’s leadership created a legacy that will not be forgotten. He will be remembered as a man of great strength, intelligence, courage and great kindness.

The Prime Minister has described Yami as an extraordinary Australian whose courageous life will be remembered forever.

Both Yami Lester and Dr G Yunupingu leave behind loving families and a nation that is better off for their contribution and worse off for their passing.

We the Australian government commemorate the remarkable lives they lived and pay respect to the legacy they leave. Vale Dr G Yunupingu and Yami Lester.

Part 2 Senator DODSON (Western Australia) :

Today I rise to commemorate the memory of two great Indigenous Australians who have passed since the last sitting of the Senate—Mr Yami (Kunmanara) Lester and Dr G Yunupingu, two blind Aboriginal men who had a vision for Australia. Despite their physical impairment they were far-seeing and insightful, and their lives give testament to their strength and resilience.

From humble beginnings in remote and isolated parts of our continent, one in the desert, the other in the saltwater country, they changed our nation for the better.

Of the two men, I knew Yami Lester the better.

I am proud to call him a friend, a leader and a mentor.

Last week, thanks to the generosity of the Minister for Indigenous Affairs, I was privileged to attend his state funeral in the remote South Australian community of Walatina.

Very few state funerals have occurred in a place so remote.

The hearse, a Land Cruiser embellished with flowers, stopped at a dry creek crossing.

Senior women travelling with his body took the opportunity to point to the dry creek bed at Walkinytjanu, in the middle of the desert, where Mr Lester was born.

While we waited for the Governor, the Premier, the South Australian Minister for Aboriginal Affairs, the Leader of the Opposition and other dignitaries we had a chance to feel the power of the simple birthplace, under the gum trees in the red sand, at a soakage in the desert.

Not far from that creek crossing, at Maralinga, when Yami Lester was a 12-year-old, the British government, in collusion with our Australian government, exploded a series of atomic weapons.

A black mist rolled over their lands, hurting the eyes of this young boy. After a relatively short period of time he became blind.

He believed this was as a direct result of this evil mist. He spent six or so years in a home in Adelaide, where only a younger person spoke his language, Yankunytjatjara. He became a ‘broomologist’, as he used to say, making brooms in the Adelaide school for the blind.

As an adult, with his wife Lucy, he moved to Alice Springs, where I came to know him and learn from his wisdom and insight into life and politics.

He became a leader of Aboriginal organisations there. With the late Reverend Jim Downing he established the Institute for Aboriginal Development, promoting Aboriginal language and culture against the grain of assimilation and forced social and cultural change.

They developed practical measures to assist families living in poverty and worked to reduce infant mortality by helping people to understand the causes of poor health and disease.

I recall giving a speech in Alice Springs on a topic I’ve now forgotten.

Yami pulled me up in the middle of the speech and said words that I took to heart. He said: ‘You’re a smart young man but you have to make a picture book for me in your speech; you need to paint a picture, so that I can see what you are talking about!’.

He was a leader in the struggle to establish Aboriginal controlled and managed organisations in Central Australia; to get recognition of land rights in South Australia; to get Uluru and Kata-Tjuta National Parks returned to traditional owners; and to establish a royal commission into the Maralinga tests.

In all of these struggles his wisdom, courage, determination and commitment were tempered by a wicked and irrepressible sense of humor and an infectious delight in life.

He was a mad supporter of the Melbourne Football Club.

This man, who could not see, showed us a vision of a reconciled Australia and led us on that path.

To his family—Lucy, Leroy, Rosemary and Karina—we express our thanks to you for allowing him to share his time with so many of us.

We wish you well in your future. At his funeral service, we were moved by the singing of Paul Kelly, whose song Maralinga told the story of Mr Lester.

Paul Kelly also worked with the second blind man I wish to commemorate today, Dr G Yunupingu, who brought his beautiful, ethereal voice, in his Yolngu language, to people across the world.

He was born on Elcho Island in the Northern Territory. As his song says, ‘I was born blind. I don’t know why.’ Dr G Yunupingu grew up in Galiwinku, the settlement on Elcho Island, off the north coast of Australia, which is over 500 kilometres northeast of Darwin.

Being blind, he spent his youth with his family absorbed in the Methodist mission environment, and become immersed in the world of music. He was a member of the famous Yothu Yindi band, whose classic song Treaty still resonates today, and the Saltwater Band. It was his solo albums that brought him fame and worldwide acclaim.

His amazing voice was complemented by the cello playing of his collaborator, friend and translator, Michael Hohnen.

Dr G Yunupingu performed for Her Majesty the Queen and for President Barack Obama, but it was the way in which his songs and music brought Yolngu culture and ideas into the minds of so many Australians that is his great gift to us all.

Dr G Yunupingu’s uncle—as the minister has said—senior Gumatj leader David Djunga Djunga Yunupingu, told the crowd in Darwin that his nephew had built a bridge between Indigenous and non-Indigenous Australians with music, but died before the country was truly at peace. He said:

He left us without knowing his place in this nation, without knowing true unity for all Australians.

Both men died, in part, due to kidney disease.

Dr Yunupingu had suffered from liver and kidney diseases for many years. He was just 46 years of age. Mr Lester died from end-stage renal failure.

He made the choice not to move from his home in Walatinna to Alice Springs for dialysis, allowing the disease to take him on his home country.

We’ve lost two great Aboriginal Australians to the scourge of renal disease. In this place we must mark the passing of these great Australians by committing ourselves to doing more to eradicate this epidemic.

Part 3 Senator SIEWERT (Western Australia )

It was with great sadness that I learned of the passing within days of each other of Mr Lester and Mr G Yunupingu.

Both men have made such a great contribution to this country.

I should say that Scott Ludlam would like to be here today to talk about and share his condolences for Mr Lester, because he worked with Mr Lester and other anti-nuclear campaigners to get justice and to campaign against the nuclear industry.

I think it was very fitting, and I’m so pleased, that Mr Lester got to see the commitment to the expansion of the gold card to those affected by the nuclear tests, in the budget in May.

I’m really pleased that he got to see that because he campaigned for such a long time for justice, for the people who are affected by the radiation from the British nuclear tests in Maralinga.

At least he got to see that.

It is a shame that Scott isn’t here to also add to the condolences.

Mr Dave Sweeney, who is a very well-known antinuclear campaigner and who worked with Mr Lester for a very long time, said of his passing:

We owe him a great debt because he faced adversity with understated courage, with humility, with humour, with great strength.

In a world without nuclear threats and risks Mr Lester would have been a great stockman. In a world with nuclear threats and risks he would crack his whip loud, hard, sharp and constant to sound a different alarm.

Mr Lester made it part of his life’s work to fight for people affected by nuclear testing and to campaign for Indigenous land rights, and we’ve just heard today what a success he made of that and what a difference he made.

Vale, Mr Lester, and our condolences go out to his family and friends.

Mr G Yunupingu—what a huge contribution he made to Australia and the world, sharing his music with the world.

It was such beautiful music which made such strong statements, such heartfelt statements, and enabled people to understand his culture through his words and his music.

His music is a lasting contribution to this country.

I was at Garma just a couple of weeks ago, where his legacy was celebrated and his passing very strongly felt.

You could feel it everywhere over the weekend at the time of Garma.

I just want to add, very briefly, to the comments that Senator Dodson just made around kidney disease and the need to address kidney disease in this country, given the impact it has had on these two great Aboriginal Australians.

People are aware that this has been discussed extensively in this chamber, and we need to keep talking about it until it gets the attention that it needs and we stop the going backwards and forwards between the state and territories and the Commonwealth about who pays for what.

It absolutely needs to be addressed. The causes need to be addressed, so that we don’t get to the point where we need end-stage treatment such as dialysis.

These two men’s legacies will constantly remind us of that.

Vale, Dr G Yunupingu and, as I said, the Greens add their condolences to this motion. I should also say thank you to Minister Scullion and Senator Dodson who ensured that we do get to commemorate these two great men in this chamber.

The ACTING DEPUTY PRESIDENT: I now ask all senators to stand in silent support of the motion.

Question agreed to, honourable senators standing in their places.

Aboriginal #Nutrition Health and #Sugar : @healthgovau Health Star Rating System review closes 17 August

 ” The Health Star Rating System has been marred by anomalies. Milo powder (44% sugar) increased its basic 1.5 Stars to 4.5 by assuming it will be added to skim milk. About one in every seven products bearing health stars goes against the Department of Health’s own recommendations.

Those of us working in public health question why obvious junk foods get any stars at all.”

See Sugar, sugar everywhere MJA insight article in full Part 3 below

  ” In 2012-13, Aboriginal and Torres Strait Islander people 2 years and over consumed an average of 75 grams of free sugars per day (equivalent to 18 teaspoons of white sugar)1. Added sugars made up the majority of free sugar intakes with an average of 68 grams (or 16 teaspoons) consumed and an additional 7 grams of free sugars came from honey and fruit juice. “

ABS Report abs-indigenous-consumption-of-added-sugars 

See Part 1 below for Aboriginal sugar facts

The Health Star Rating (HSR) Advisory Committee (HSRAC), responsible for overseeing the implementation, monitoring and evaluation of the HSR system is undertaking a five year review of the HSR system.

The five year review of the system is well underway, with a public submission process opening on 8 June 2017 on the Australian Department of Health’s online Consultation Hub.

Since the consultation period has been opened there has been strong interest in the system from stakeholders representing a diverse range of views.

To ensure that as much evidence as possible is captured, along with stakeholders’ views on the system, a further two week extension to the consultation period has been agreed and it will now close on 17 August 2017

See full survey details Part 2 Below

Part 1 Aboriginal sugar facts

ABS Report

abs-indigenous-consumption-of-added-sugars

Aboriginal and Torres Strait Islander people consume around 14 per cent of their total energy intake as free sugars, according to data from the Australian Bureau of Statistics (ABS).

The World Health Organization (WHO) recommends that free sugars contribute less than 10 per cent of total energy intake.

Director of Health, Louise Gates, said the new ABS report showed Aboriginal and Torres Strait Islander people are consuming an average of 18 teaspoons (or 75 grams) of free sugars per day (almost two cans of soft drink), four teaspoons more than non-Indigenous people (14 teaspoons or 60 grams).

OTHER KEY FINDINGS

    • Aboriginal and Torres Strait Islander people derived an average of 14% of their daily energy from free sugars, exceeding the WHO recommendation that children and adults should limit their intake of free sugars to less than 10% of dietary energy.
    • Free sugars made the greatest contribution to energy intakes among older children and young adults. For example, teenage boys aged 14-18 years derived 18 per cent of their dietary energy from free sugars as they consumed the equivalent of 25 teaspoons (106 grams) of free sugars per day. This amount is equivalent to more than two and a half cans of soft drink. Women aged 19-30 years consumed 21 teaspoons (87 grams) of free sugars, which contributed 17 per cent to their total energy intake.
    • The majority (87%) of free sugars were consumed from energy dense, nutrient-poor ‘discretionary’ foods and beverages. Two thirds (67%) of all free sugars consumed by Aboriginal and Torres Strait Islander people came from beverages, led by soft drinks, sports and energy drinks (28%), followed by fruit and vegetable juices and drinks (12%), cordials (9.5%), and sugars added to beverages such as tea and coffee (9.4%), alcoholic beverages (4.9%) and milk beverages (3.4%).
    • Intakes were higher for Aboriginal and Torres Strait Islander people living in non-remote areas where the average consumption was 78 grams (18.5 teaspoons), around 3 teaspoons (12 grams) higher than people living in remote areas (65 grams or 15.5 teaspoons).
    • Aboriginal and Torres Strait Islander people consumed 15 grams (almost 4 teaspoons) more free sugars on average than non-Indigenous people. Beverages were the most common source of free sugars for both populations, however Aboriginal and Torres Strait Islander people derived a higher proportion of free sugars from beverages than non-Indigenous people (67% compared with 51%).

Part 2 @healthgovau Health Star Rating System review closes 17 August

Introduction

The Health Star Rating (HSR) Advisory Committee (HSRAC), responsible for overseeing the implementation, monitoring and evaluation of the HSR system, is undertaking a five year review of the HSR system. The HSR system is a front-of-pack labelling (FoPL) scheme intended to assist consumers in making healthier diet choices. The findings of the review will be provided to the Australia and New Zealand Ministerial Forum on Food Regulation (Forum) in mid‑2019.

In parallel with this consultation on the HSR system five year review, the HSRAC is conducting a dedicated investigation of issues and concerns raised about the form of the food (‘as prepared’) rules in the Guide for Industry to the HSR Calculator. These enable additional nutrients to be taken into account when calculating star ratings based on foods prepared according to on-label directions. A specific consultation process seeking input into this investigation opened on 19 May 2017 and will close at 11.59 pm 30 June 2017. The form of the food (‘as prepared’) consultation can be viewed on the Australian Department of Health’s Consultation Hub.

The HSR system

The HSR system is a public health and consumer choice intervention designed to encourage people to make healthier dietary choices. The HSR system is a voluntary FoPL scheme that rates the overall nutritional profile of packaged food and assigns it a rating from ½ a star to 5 stars. It is not a system that defines what a ‘healthy’ or ‘unhealthy’ food is, but rather provides a quick, standardised way to compare similar packaged foods at retail level. The more stars, the healthier the choice. The HSR system is not a complete solution to assist consumers with choosing foods in line with dietary guidelines, but should be viewed as a way to assist consumers to make healthier packaged food choices.  Other sources of information, such as the Australian Dietary Guidelines and the New Zealand Eating and Activity Guidelines, also assist consumers in their overall food purchasing decisions.

The HSR system aims to:

1. Enable direct comparison between individual foods that, within the overall diet, may contribute to the risk factors of various diet related chronic diseases;

2. Be readily understandable and meaningful across socio-economic groups, culturally and linguistically diverse groups and low literacy/low numeracy groups; and

3. Increase awareness of foods that, within the overall diet, may contribute positively or negatively to the risk factors of diet related chronic diseases.

The HSR system consists of the graphics, including the words ‘Health Star Rating’, the rules identified in the HSR system Style Guide, the algorithm and methodology for calculating the HSR identified in the Guide for Industry to the HSR Calculator, and the education and marketing associated with the HSR implementation.

The HSR system is a joint Australian, state and territory and New Zealand government initiative developed in collaboration with industry, public health and consumer groups. The system is funded by the Australian government, the New Zealand government and all Australian jurisdictions during the initial five year implementation period.

From June 2014, food manufacturers started to apply HSRs to the front of food product packaging. Further information on the HSR system is available on the HSR website. The New Zealand Ministry for Primary Industries (MPI) website also provides information on the HSR system in New Zealand.

Purpose and scope of the review
The five year review of the HSR system will consider if, and how well, the objectives of the HSR system have been met, and identify options for improvements to and ongoing implementation of the system (Terms of reference for the five year review).

With a focus on processed packaged foods, the objective of the HSR system is:

To provide convenient, relevant and readily understood nutrition information and /or guidance on food packs to assist consumers to make informed food purchases and healthier eating choices.

The HSRAC has agreed that the areas of communication, system enhancements, and monitoring and governance will be considered when identifying whether the objectives of the HSR system have been achieved.

Although HSRAC will need to be a part of the review process, a degree of independence is required and independent management and oversight of the review is an important factor to ensure credible and unbiased reporting. An independent consultant will be engaged to undertake the review. Specific detail about the scope of the review will be outlined in the statement of requirement for the independent consultant. A timeline for the five year review of the HSR system has been drafted and will be updated throughout the review.

Next steps in the review process

As part of the five year review, HSRAC is seeking evidence based submissions on the consultation questions provided in this discussion paper.

This consultation is open to the public, state and territory governments, relevant government agencies, industry and public health and consumer groups.

Making a submission

The HSRAC is seeking submissions on the merits of the HSR system, particularly in response to the consultation questions below. The aim of the questions is to assist respondents in providing relevant commentary. However, submissions are not limited to answering the questions provided.  Please provide evidence or examples to support comments. Some areas of this review are technical in nature therefore comments on technical issues should be based on scientific evidence and/or supported by research where appropriate. Where possible, please provide citations to published studies or other sources.

While the HSRAC will consider all submissions and proposals put forward, those that are not well supported by evidence are unlikely to be addressed as part of the five year review.

Enquiries specifically relating to this submission process can be made via email to: frontofpack@health.gov.au. Please DO NOT provide submissions by email.

After the consultation period closes the HSRAC will consider the submissions received and will prepare a summary table of the issues raised which will be published on the HSR website. All information within the summary table will be de-identifiable and will not contain any confidential material.

HSRAC will treat information of a confidential nature as such. Please ensure that material supplied in confidence is clearly marked ‘IN CONFIDENCE’ and is provided in a separate attachment to non-confidential material. Information provided in the submissions will only be used for the purpose of the five year review of the HSR system and will not be used for any other purpose without explicit permission.

Please see the Terms of Use and Privacy pages at the bottom of this page for further information on maintaining the security of your data.

For further information about the HSR system, including its resources and governance structure, please refer to the Australian HSR website and the New Zealand MPI website.

Part 3 Sugar Sugar MJA Insights

Originally published Here

IT’S hard to escape sugar, not only in what we eat and drink, but also in the daily news and views that seep into so many corners of our lives.

There’s nothing new about concern over sugar. I can trace my own fights with the sugar industry back to the 1960s, and since their inception in 1981, the Australian Dietary Guidelines have advised limiting sugary foods and drinks. The current emphasis in many articles in newspapers, magazines, popular books and online blogs, however, go further and recommend eliminating every grain of the stuff from the daily diet.

Taking an academic approach to the topic, the George Institute for Global Health has published data based on the analysis of 34 135 packaged foods currently listed in their Australian FoodSwitch database. They found added sugar in 87% of discretionary food products (known as junk foods in common parlance) and also in 52% of packaged foods that can be described as basic or core foods.

The George Institute’s analysis is particularly pertinent to the Department of Health’s Health Star Rating System, and found that some of the anomalies in the scheme could be eliminated by penalising foods for their content of added sugars rather than using total sugars in the product, as is currently the case.

The definition of “added sugars” used in Australia also needs attention, a topic that has been stressed in the World Health Organization’s guidelines. I will return to this later.

In Australia, the nutrition information panel on the label of packaged foods must include the total sugars present. This includes sugars that have been added (known as extrinsic sugars) as well as any sugars present naturally in ingredients such as milk, fruit or vegetables (intrinsic sugars).

There is no medical evidence to suggest that intrinsic sugars are a problem – at least not if they occur in “intact” ingredients. If you consume fruit, for example, the natural dietary fibre and the bulk of the fruit will limit the amount of the fruit’s intrinsic sugars you consume. However, if the sugar is extracted from the structure of the fruit, it becomes easy to consume much larger quantities. Few people could munch their way through five apples, but if you extract their juice, the drink would let you take in all the sugar and kilojoules of five apples in less than a minute.

The Australian Dietary Guidelines do not include advice to restrict fruit itself because there is high level evidence of its health value. The guidelines do, however, recommend that dried fruit and fruit juice be restricted – the equivalent of four dried apricot halves or 125 mL juice consumed only occasionally.

Contrary to the belief of some bloggers, Australia’s dietary guidelines have never suggested replacing fat with sugar. That was a tactic of some food companies who marketed many “low” or “reduced” fat foods where the fat was replaced with sugars or some kind of refined starch.

The wording of Australia’s guideline on sugar has changed. The initial advice to “avoid too much sugar” led to the sugar industry’s multimillion dollar campaign “Sugar, a natural part of life”. This included distributing “educational” material to the general public, politicians, doctors, dentists, pharmacists and other health professionals discussing the importance of a “balanced diet”.

In spite of fierce lobbying by the sugar industry, the next revision of the guidelines retained a sugar guideline, although it was watered down to “eat only moderate amounts of sugars”. Some school canteen operators reported that they had been confronted by sweet-talking sellers of junk foods omitting the word “only” from this guideline.

The evidence for sugar’s adverse effects on dental health have long been known, but the evidence against sugar and its potential role in obesity and, consequently, in type 2 diabetes and other health problems has grown stronger. The most recent revision of the National Health and Medical Research Council’s Dietary Guidelines, therefore, emphasises the need to “limit” added sugars and lists the foods that need particular attention.

Sugary drinks have been specifically targeted because the evidence against them is strong and extends beyond epidemiological studies. Double-blind trials now clearly link sugary drinks with weight gain, the only exceptions being a few trials funded by the food industry.

Added sugar is not the only topic for public health concern, and hence the government’s Health Star Rating System was set up to introduce a simple front-of-pack labelling scheme to assist Australians reduce their intake of saturated fat, salt and sugars from packaged foods.

A specially commissioned independent report (Evaluation of scientific evidence relating to Front of Pack Labelling by Dr Jimmy Chun Yu Louie and Professor Linda Tapsell of the School of Health Sciences, University of Wollongong) found that added sugars were the real problem, but the food industry argued that the scheme should include total sugars because this was already a mandatory inclusion on food labels and routine chemical analysis couldn’t determine the source of sugars.

This was a strange argument since food manufacturers know exactly how much sugar they add to any product, just as they know how many “offset” points the Health Star Rating System allows for the inclusion of fruit, vegetable, nuts or legumes. The content of these ingredients is only disclosed on the food label if used in the product’s name.

The Health Star Rating System has been marred by anomalies. Milo powder (44% sugar) increased its basic 1.5 Stars to 4.5 by assuming it will be added to skim milk. About one in every seven products bearing health stars goes against the Department of Health’s own recommendations.

Those of us working in public health question why obvious junk foods get any stars at all.

How can caramel topping or various types of confectionery, such as strawberry flavoured liquorice, each get 2.5 stars? Why do some chocolates sport 3.5 stars, while worthy products such as Greek yoghurt without any added sugars get 1.5 and a breakfast cereal with 27% sugar gets four stars?

The fact that over a third of Australian’s energy intake comes from discretionary products (40% for children) is the elephant in the room for excess weight. We need to reduce consumption of these products and allotting them health stars is not helping.

It’s clearly time to follow our dietary guidelines and limit both discretionary products and added sugar. Of the nutrients used in the current algorithm for health stars, the George Institute’s analysis shows that counting added rather than total sugars has the greatest individual capacity to discriminate between core and discretionary foods.

However, in moving to mandate added sugars on food labels and using added sugars in health stars, it’s vital to define these sugars. The World Health Organization has done so: “Free sugars refer to monosaccharides (such as glucose, fructose) and disaccharides (such as sucrose or table sugar) added to foods and drinks by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates”.

Regular sugar in Australia could be described as cane juice concentrate. It has no nutrients other than its carbohydrate. Fruit juice concentrates are also just sugars with no nutrients other than carbohydrates. At present the Health Star Rating System allows products using apple or pear juice concentrate to be counted as “fruit” and used to offset the total sugars. This is nonsense, and gives rise to confectionery, toppings and some breakfast cereals scoring stars they do not deserve.

Other ways to boost health stars also need attention. Food technologists boast they can manipulate foods to gain extra stars (Health Star Rating Stakeholders workshop, Sydney, 4 August 2016). For example, adding wheat, milk, soy or other protein powder, concentrated fruit purees or a laboratory-based source of fibre such as inulin will all give extra “offset” points to reduce adverse points from saturated fat, sugar or salt. Indeed, some food technologists have even suggested they could revert to using the especially nasty trans (but technically unsaturated) fatty acid from partially hydrogenated vegetable oils to replace naturally occurring saturated fat.

My alternative is to go for fresh foods and minimise packaged foods. If the stars look too good to be true, check the ingredient list. But remember that Choice found sugar may go by more than 40 different names. Buyer beware!

NACCHO Aboriginal Dental Health @AUS_Dental : It’s #DentalHealthWeek #SugaryDrinksProperNoGood

” Apunipima is participating in a range of activities over the next fortnight to celebrate Dental Health Week (7-13 August)

Our staff will be talking about the link between sugary drinks and tooth decay, and promoting the messages

#SugaryDrinksProperNoGood and #DrinkMoreWaterYoufla,

part of Apunipima’s Healthy Communities social marketing campaign, which aims to reduce sugary drinks consumption among Aboriginal and Torres Strait Islander people in Cape York.”

From Apunipima’s Healthy Communities Mob Part 2 below

 ” The National Oral Health Plan outlines guiding principles that will underpin Australia’s oral health system and provides national strategic direction including targeted strategies in six Foundation Areas and across four Priority Populations. Aboriginal and Torres Strait Islander People being a priority population.”

Download plan here

 Watch our interview with Aboriginal dentist Gari Watson on NACCHO TV

Part 1 : National Oral Health Plan identifes Aboriginal People as Priority Population

A proportion of Aboriginal and Torres Strait Islander people have good oral health. On average, however, Aboriginal and Torres Strait Islander people experience poor oral health earlier in their lifespan and in greater severity and prevalence than the rest of the population. Aboriginal and Torres Strait Islander people are also less likely to receive treatment to prevent or address poor oral health, resulting in oral health care in the form of emergency treatment.

  • There is limited representation of Aboriginal and Torres Strait Islander people in the oral health workforce and many dental services are not culturally sensitive. For example, strict appointment times and inflexibility regarding ‘failure to attend’ may result in a fee to the consumer.
  • Trends indicate that the high-level dental decay in deciduous (baby) teeth is rising
  • Aboriginal people aged 15 years and over, attending public dental services, experience tooth decay at three times the rate of their Non-Indigenous counterparts and are more than twice as likely to have advanced periodontal (gum) disease
  • Aboriginal people experience complete tooth loss at almost five times the rate of the non-Indigenous population
  • The rate of potentially preventable dental hospitalisations for Aboriginal and Torres Strait Islander people is higher than other Australians. Accessibility of services is a key factor contributing to the current gap between the oral health of Aboriginal and Torres Strait Islander people and the rest of the population.
  • More than two in five Aboriginal and Torres Strait Islander people over the age of 15 defer or avoid dental care due to cost. This is compared with one in eight (12.2%) who delayed or did not go to a GP.

Improving the overall oral health of the Aboriginal and Torres Strait Islander people will require more than a focus on oral health behaviours. Culture, individual and community social and emotional wellbeing, history, demography, social position, economic characteristics, biomedical factors, and the available health services within a person’s community all form part of the complex causal web which determines an individual’s oral health status.

“Reducing sugary drinks will not only protect their teeth but also their wider health.This is yet another justification for the introduction of a health levy on sugar-sweetened beverages as a preventive public health measure”

This Dental Health Week Michael Moore, CEO of the ( PHAA)  Public Health Association of Australia (PHAA) and other members of the Rethink Sugary Drink Alliance are urging Australians to reduce their consumption of sugary drinks.

Read over 25 NACCHO dental articles

Read over 25 NACCHO Nutrition  Articles

Read over 10 NACCHO Articles Sugar Tax

Dental Health Week Website

Dept of Health Dental Website

Part 2  #SugaryDrinksProperNoGood – It’s Dental Health Week!

Apunipima staff will run activities with children and young people as well as hold health information stalls in Weipa, Napranum and Mapoon to promote the campaign messages in Dental Health Week

‘The team will run a workshop for Western Cape College secondary students alongside Dr Matt More, Head of Dental Services for Torres and Cape Hospital and Health Service in Weipa,’ Apunipima Health Promotion Officer Kiarah Cuthbert said.

‘We will be talking to young people about the amount of sugar in popular drinks, such as soft drinks, sports drinks and energy drinks and the impact of that sugar on your teeth and overall health.’

‘From there, we will head to Mapoon to spend time at the primary school yarning with kids about the sugar in drinks. We will also invite the kids to take part in a local art competition with the winner’s work used to promote the #DrinkMoreWaterYoufla message in Mapoon.’

‘Apunipima staff will then hold a health information stall at Napranum store and run an after school activity at Napranum PCYC, where young people will also have the chance to take part in a local art competition to promote the #DrinkMoreWaterYoufla message.

These activities will be supported by Napranum Tackling Indigenous Smoking Health Worker, Ernest Madua who will also be yarning with people about what smoking can do to your teeth and mouth.’

Apunipima Child Health Nurse Robyn Lythall, Chronic Disease Health Worker Georgia Gibson and Dietitian Jarrah Marsh gave kids from Nola’s Daycare and George Bowen Memorial Kindergarten Apunipima ‘Drink More Water Youfla’ water bottles last week which will really save the staff lugging big containers of water!

The bottles are plastic, easily stored in the fridge and will have the children’s photos on them so the kids know which one is theirs!

Big esso (thank you) to the Apunipima teams that helped with this!

The few remaining water bottles are being kept for children receiving their four year old health checks and their immunisations to help them get healthy habits for school.

Staff are encouraging kids coming in for health checks and shots to fill their bottles from the watercooler at the Hopevale Primary Health Care Centre on their way out.

The Healthy Communities Project Team (Cara Laws, Tiffany Williams, Kiarah Cuthbert and Kani Thompson) would like to thank Hopevale staff for sharing the water bottles, which are merchandise from our Sugary Drinks Proper No Good – Drink More Water Youfla campaign.

Picture: Childcare worker Auntie Irene Bambie and Georgia Gibson

Acid, sugar in sugary drinks pose serious threat to teeth

Part 3 Australians urged to choose tap water this Dental Health Week

Many Australians know that sugary drinks are not a healthy dietary choice, but they may not realise the serious damage they cause to teeth.

In line with the theme of Dental Health Week (7–13 August 2017) – Oral Health for Busy Lives, the health and community organisations behind Rethink Sugary Drink are calling on Australians to think of their teeth before reaching for a sugary drink when out and about.

Chair of the Australian Dental Association’s Oral Health Committee, Professor David Manton, said sugary drinks contained sugar and acid that weakens tooth enamel and can lead to tooth decay.

“Dental decay is caused by sugars, especially the type found in sugary drinks. These drinks are often acidic as well. Sugary drinks increase the risk of decay and weaken the tooth enamel, so it’s best to avoid them,” Prof Manton said.

“The best advice is to stick to tap water. Carry a water bottle with you to avoid having to buy energy drinks, soft drinks, sports drinks and other sugary drinks when you’re on the go. You’ll be doing your bank balance a favour too.”

Chair of the Public Health Committee at Cancer Council Australia, Craig Sinclair, said knowing the oral health impacts associated with sugary drinks further highlighted the need for a health levy on these beverages in Australia.

“Australians, and our young people in particular, are drinking huge volumes of sports drinks, energy drinks, soft drinks and frozen drinks on a regular basis – some are downing as much as 1.5 litres a day,” Mr Sinclair said.

“While regular consumption is associated with increased energy intake, weight gain and obesity, it also heightens the risk of tooth decay.

“We know through economic modelling that a 20 per cent health levy on sugar-sweetened beverages could reduce consumption in Australia and prevent thousands of cases of type 2 diabetes, heart disease and stroke over 25 years, while generating $400-$500m each year.

“This extra revenue could be used for public education campaigns and initiatives to prevent chronic disease, reduce dental caries and address childhood obesity.

“While a health levy is not the only solution for reducing sugary drink consumption, if coupled with a range of strategies it could have a significant impact on the amount Australians are drinking and minimise their impact.”

The Rethink Sugary Drink alliance recommends the following actions in addition to a health levy 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.

Protect your teeth from sugary drinks with these tips:

  • Follow the Australian dietary guidelines: Focus on drinking plenty of tap water (it has no acid, no sugar and no kilojoules), limiting sugary foods and drinks and choosing healthy snacks (e.g. fruits and vegetables).
  • Find out how much sugar is in your favourite drink using the nutrition information panel on your drink or on the Rethink Sugary Drink website – it might surprise you
  • Carry a water bottle and fill up at the tap, so you don’t have to buy a drink if you’re thirsty.
  • Be aware of sugar disguised as a ‘healthy’ ingredient such as honey or rice syrup. It might sound wholesome but these are still sugars and can still cause decay if consumed frequently.
  • If you do drink sugary drinks, use a straw so your teeth are less exposed to the sugar and acid.
  • Take a drink of water, preferably tap water that has been fluoridated, after a sugary or acidic drink to help rinse out your mouth and dilute the sugars.
  • Do not sip a sugary or acidic drink slowly or over a long duration. Doing so exposes your teeth to sugar and acid attacks for longer.

For more information, visit http://www.dentalhealthweek.com.au/

About Rethink Sugary Drink: Rethink Sugary Drink is a partnership between the Apunipima, Australian Dental Association, Australian Dental and Oral Health Therapists’ Association, Cancer Council Australia, Dental Health Services Victoria, Dental Hygienists Association of Australia, Diabetes Australia, Healthier Workplace WA, Heart Foundation, Kidney Health Australia, LiveLighter, The Mai Wiru Sugar Challenge Foundation, Nutrition Australia, Obesity Policy Coalition, Stroke Foundation, Parents’ Voice, the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) and the YMCA 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.

Part 4  : Sugary drinks erode more than tooth enamel poor oral health brings knock-on effects

This Dental Health Week the Public Health Association of Australia (PHAA) and other members of the Rethink Sugary Drink Alliance are urging Australians to reduce their consumption of sugary drinks. “Reducing sugary drinks will not only protect their teeth but also their wider health”, said Michael Moore, CEO of the PHAA. “This is yet another justification for the introduction of a health levy on sugar-sweetened beverages as a preventive public health measure”, he added.

Australia is in the top ten of countries with the highest level of soft drink consumption. Around a third of Australians regularly consume sugar-sweetened beverages (SSBs) such as soft drinks, flavoured waters and energy drinks. These drinks are widely recognised by dental experts as a major contributor to tooth decay and erosion.

Mr Moore said, “It’s well known that sugary drinks are linked to dental health problems which can lead to significant amounts of discomfort and disability in themselves. However poor oral health is also associated with major chronic health conditions such as heart disease, diabetes and respiratory disease. Additionally, there are often compounding health effects between these types of comorbidities. Sugary drinks also strongly contribute to weight gain and obesity, so they negatively impact on health in multiple ways”.

Mr Moore continued, “At the individual-health level, it’s very important people avoid consuming these drinks on a regular basis, while at the population-health level it’s time we introduce a health levy on sugar-sweetened beverages to reduce the harms they cause.”

“Research shows that a health levy on these drinks will effectively reduce their consumption, especially if implemented as part of a wider approach to address poor nutrition and diet-related disease. What is needed is a national nutrition policy, restrictions on the marketing of sugary drinks toward children, limiting their availability in schools and at events attended by children and young people and public education campaigns about the adverse health impacts of SSBs. These could easily be funded by the revenue generated by the levy”.

The theme of 2017 Dental Health Week is ‘Anywhere Anytime – Oral Health for Busy Lives’, which recognises that many Australians feel they don’t have time to properly care for their oral health due to their busy schedules. However, avoiding sugary foods and beverages which damage teeth is a simple preventive measure people can take and can be encouraged by governments.

“Along with maintaining proper oral health care, one of the easiest things people can do to protect their teeth and in turn their broader health, is to avoid sugar-laden drinks and to favour drinking tap water,” Mr Moore concluded.

 

NACCHO Research Alert : @NRHAlliance Aboriginal health risk factors #rural and #remote populations

 ” Health risk factors like smoking, excessive drinking, illicit drug use, lack of physical activity, inadequate fruit and vegetable intake and overweight have powerful influences on health, and there are frequently clear inter-regional differences between the prevalence of these.

While it can be argued that there is some degree of personal choice involved in whether individuals have a poor health risk profile, there is clear evidence that external factors such as environment, opportunity, and community culture each have very strong influences.

For example, access to affordable healthy food can often be poor in smaller communities and this, coupled with lower incomes in these areas, adversely affects the quality of peoples’ diets, the prevalence of overweight, and consequently the prevalence of chronic disease.”

From the National Rural Health Alliance Research View HERE

National data pertaining to personal health risk factors typically comes from the ABS National Health Survey and the AIHW National Drug Strategy Household Survey (NDSHS). Some State and Territory Health Departments run their own health surveys (which cannot be aggregated nationally with each other or with the ABS survey because of the different methodologies and definitions used (think different State rail gauges). Consequently data describing aspects of health in regional and especially remote areas can be thin (ie with imprecise estimates in some or all areas).

Example 1

Table 14: Fruit and vegetable consumption, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

Roughly 60% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate fruit intake, closer to 50% in remote areas (compared with around 50% of all Australians 18+ in major cities and regional/rural areas).

Roughly 95% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate vegetable intake, perhaps higher (98%) in Very remote areas (compared with around 90%-94% of all Australians 18+ in major cities and regional/rural areas).

Example 2

NACCHO provided graphic

Table 16 Below : Overweight and Obesity, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

Aboriginal and Torres Strait Islander people in rural/regional and Remote areas (29%-33%) were a little more likely to be overweight than those in Major cities (28%), with those in Very Remote areas (26%) least likely to be overweight.

Aboriginal and Torres Strait Islander people in Inner regional areas (41%) were more likely to be obese than those in Major cities (38%), but those in Outer regional (36%) and remote areas (~33%) were less likely to be obese.

Overall, Aboriginal and Torres Strait Islander people in Inner Regional areas were most likely to be overweight/obese (70%), those in Major cities, Outer Regional and Remote areas were less likely to be overweight/obese (~66%), while those in Very Remote areas were the least likely to be overweight/obese (59% )

At the time of writing, the most recent National Health Survey was conducted in 2014-15[1], while the most recent AIHW NDSHS[2] was conducted in 2016, with most recently available results from the 2013 NDSHS. The most recent ABS Australian Aboriginal and Torres Strait Islander Health Survey[3] was conducted in 2012-13.

Some organisations (eg the Public Health Information Development Unit (PHIDU)) have calculated modelled estimates for small areas (eg SLA’s and PHN’s), where the prevalence of some risk factors has been predicted based on the age, sex and socioeconomic profile of the population living there.

Some sites (eg ABS) present risk factor data as crude rates, other sites (eg PHIDU) present risk factor data as age-standardised rates.  The advantage of the age-standardised rates is that the effect of age is largely removed from inter-population comparisons.

For example, older populations (eg those in rural/regional areas) would be expected to have higher average blood pressure than younger (eg Major cities) populations even though the underlying age-specific rates happened to be identical in both populations (because older people tend to have higher blood pressure than younger people).

While crude rates for the older population will be higher, the age-standardised rates in such a comparison would be the same – indicating a higher rate that is entirely explainable by the older age of one of the populations.

Both crude and age standardised rates are useful in understanding the health of rural and remote populations.

 


[1] http://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.001

[3] http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocumentSmoking

Table 1: Smoking status, by remoteness, 2013 and 2014-15

MC

IR

OR/Remote

Percentage

Current daily smoker (18+) (crude) 2014-15 (a)

13.0

16.7

20.9

Current smoker (18+) (Age standardised) 2014-15 (b) (includes daily, weekly, social etc smoking)

14.6

19.0

22.4

MC

IR

OR

Remote+ Very Remote

Current smoker (daily, weekly, or fortnightly) 14+ (crude) 2013 (c)

14.2

17.6

22.6

24.6

Current smoker (daily, weekly, or fortnightly) 14+ (Age standardised) 2013 (d)

14.2

18.6

23.6

24.4

Mean number of cigarettes smoked per week, smokers aged 14 years or older 2013 (e)

85.9

113.1

109.4

126.2

Sources:

Compared with Major cities (13%), the prevalence of daily smoking by people 18 years and older in Inner regional (17%) and Outer regional/Remote areas (21%) is higher.

The NDSH survey reflects these trends albeit with a slightly different age group (14+) and a different definition of smoking (daily plus less frequently), but the NDSH survey adds detail for remote areas where smoking rates are higher again (around 25% versus around 23% in Outer regional).

In addition, the average number of cigarettes smoked by each smoker is higher in regional/rural areas (~110/week) than in Major cities (86/week), and higher again (126/week) in remote areas.

 

Smoking – exposure, uptake, establishment, quitting

Table 2: Smoking characteristics by Remoteness, 2013, 2014 and 2014-15

MC

IR

OR

remote

8.8

17.8

19.3

27.8

Proportion of pregnant women who gave birth and smoked at any time during the pregnancy (2013, crude, National Perinatal Data Collection, exposure tables, Table 5.1.2 )

8.5

17.0

18.9

27.5

Proportion of pregnant women who gave birth and smoked in the first 20 weeks of pregnancy (2013, crude, National Perinatal Data Collection) exposure tables, Table 5.2.2)

3.6

3.1

4.1

*9.4

Proportion of dependent children (aged 0–14) who live in a household with a daily smoker who smokes inside the home (2013, crude, NDSHS exposure tables, Table 6.3)

2.5

2.0

2.7

*2.9

Proportion of adults aged 18 or older who live in a household with a daily smoker who smokes inside the home (2013, crude, NDSHS, exposure tables, Table 7.3)

16.2

15.4

14.7

15.5

Average age at which people aged 14–24 first smoked a full cigarette (2013, crude, NDSHS, uptake tables, Table 9.3)

17.8

22.7

17.8

28.3

Proportion of 12–17 year old secondary school students smoking at least a few puffs of a cigarette (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, uptake tables, Table 10.3

54.7

61.1

64.9

67.2

Proportion of persons (aged 18 or older) who have smoked a full cigarette (2013, crude,  NDSHS, uptake tables, Table 10.8)

2.5

3.4

2.5

3.7

Proportion of secondary school students (aged 12–17) who have smoked more than 100 cigarettes in their lifetime (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, transition tables, Table 2.3)

20.2

25.9

44.1

45.2

Proportion of young people (aged 18–24) who have smoked more than 100 cigarettes in their lifetime (2013, crude, NDSHS, transition tables, Table 2.6)

21.3

16.8

19.0

15.5

Quitting: Proportion successfully gave up for more than a month (2013, crude, NDSHS, cessation tables, Table 4.3)

29.2

34.2

31.7

32.9

Quitting, Proportion unsuccessful (2013, crude, NDSHS, cessation tables, Table 4.3)

46.3

48.0

47.4

45.2

Quitting: Proportion any attempt (2013, crude, NDSHS, cessation tables, Table 4.3)

35.2

36.3

36.1

36.0

Mean age at which ex-smokers aged 18 or older reported no longer smoking (2013, crude, NDSHS, cessation tables, Table 11.2)

53.1

51.5

46.3

45.0

The proportion of ever smokers aged 18 or older who did not smoke in the last 12 months (2013, crude, NDSHS, cessation tables, Table 12.3)

4.9

6.0

4.8

7.0

Proportion of secondary school students (aged 12–17) who were weekly smokers (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, established tables, Table 1.3)

6.9

9.3

6.8

10.4

Proportion of secondary school students (aged 12–17) who were monthly smokers (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, established tables, Table 13.3)

13.0

16.7

21.2

18.8

Proportion of adults aged 18 or older who are daily smokers (2014-15, crude, ABS NHS, established tables, Table 3.3)

10.9

7.8

2.9

n.p.

Proportion of smokers aged 18 or older who are occasional smokers (smoke weekly or less than weekly) (2014-15, crude, ABS NHS, established tables, Table 14.3)

40.1

44.7

42.3

52.7

Proportion of Aboriginal and Torres Strait Islander people aged 18 or older who are daily smokers (2012-13, crude, ABS Australian Aboriginal and Torres Strait Islander Health Survey 2012–13, established tables, Table 8i.3)

Source: http://www.aihw.gov.au/alcohol-and-other-drugs/data/ (sighted 11/7/17)
Note: Those estimates above with asterix have large standard errors and should be treated carefully.

Women in rural and remote areas were much more likely to smoke during pregnancy, with 28% of women in remote areas smoking during pregnancy, compared with 18-19% in regional/rural areas, and 9% in Major cities.

It is unclear whether exposure to environmental tobacco smoke varies by remoteness.

Young people outside major cities appeared to have their first cigarette at an earlier age (~15 years as opposed to ~16 years in Major cities.

Secondary school students in Inner regional (~23%) and remote (~28%) areas were more likely to have had at least a few puffs of a cigarette than those in major cities (~18%).

While 20% of young people in Major cities had smoked more than 100 cigarettes in their lifetime, 26%, 44% and 45% of young people in Inner regional, Outer regional and remote areas had done so.

People outside Major cities were as likely or slightly more likely to have attempted to quit smoking, but were less likely to be successful (and more likely to be unsuccessful).

A higher proportion of secondary students outside Major cities were weekly or monthly smokers (6%, 5% and 7% in IR, OR and remote areas versus 5% in Major cities weekly, 9%, 7%, and 10% in IR, OR and remote areas versus 7% in Major cities monthly).

Table 3: Current daily smoker, Aboriginal and Torres Strait Islander people 15+ years, by Remoteness, 2012-13

MC

IR

OR

R

VR

Crude Percent

Current daily smoker

36.2

40.9

39.8

47.4

51.1

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocument Table 2 (sighted 12/7/17)

Prevalence of smoking amongst Aboriginal and Torres Strait Islander people 15 years and older is around 35%-40% in Major cities and regional/rural areas, and close to 50% in remote areas. Note that while the pattern is similar in Table 2 and Table 3 above, the figures for 18+ and 15+ year olds are slightly different.

Smoking Trends

Table 4: Comparison of declines in smoking rate estimates across remoteness areas, people 18+, based on ABS NHS surveys, 2001 to 2011-12

Survey year

MC

IR

OR/Rem

Australia

Crude percent daily smokers

2001

21.9

21.9

26.5

22.4

2004-05

19.9

23.0

26.2

21.3

2007-08

17.5

20.1

26.1

18.9

2011-12

14.7

18.3

22.2

16.1

2014-15

13.0

16.7

20.9

14.5

Source: ABS National Health Surveys

From Table 4 above, rates of smoking have clearly declined in Major cities areas, but have been slower to decline in Inner regional and Outer regional/Remote areas. Rates of smoking in rural areas, apparently static last decade, now appear to be declining. Rates in Major cities and Inner regional areas have declined to 0.59 and 0.76 times the 2001 rates in these areas. The 2014-15 rate in Outer regional areas is 0.79 times the 2001 rate.

Figure 1: Daily smokers 18 years and older, 2007-08, 2011-12 and 2014-15, NHS

Figure 1: Daily smokers 18 years and older, 2007-08, 2011-12 and 2014-15, NHS

Source: ABS NHS http://www.aihw.gov.au/alcohol-and-other-drugs/data/ established tables, Table 3.3 (sighted 11/7/17)

Figure 2: Smokers 14 years and older, 2007, 2010 and 2013, NDSHS

Figure 2: Smokers 14 years and older, 2007, 2010 and 2013, NDSHS

Source: AIHW NDSHS http://www.aihw.gov.au/alcohol-and-other-drugs/data/ tobacco smoking table S3.12 (sighted 11/7/17)

Note: Smokers include daily, weekly and less frequent smokers.

Figures 1 and 2 above both show clear declines in Major cities and Inner regional areas, but the trend in Outer regional and Remote areas is less clear, with ABS data showing a decline in daily smoking rates for people aged 18+ between 2007-8 and 2014-15, but NDSHS data showing little change in smoking rates for people 14+ between 2007 and 2013.

Alcohol

Table 5: Alcohol risk status, by remoteness, 2013 and 2014-15

Alcohol consumption

MC

IR

OR/Rem

Exceeded 2009 NHMRC lifetime risk guidelines, people 18+, crude %, 2014-15 (a)

16.3

18.4

23.4

Exceeded 2009 NHMRC lifetime risk guidelines, people 15+, age standardised %, 2014-15 (b)

15.7

17.4

22.0

Exceeded 2009 NHMRC single occasion risk guidelines, people 18+, crude %, 2014-15 (a)

42.7

48.5

46

MC

IR

OR

R/VR

Abstainer/ex-drinker, crude %, 14+, 2013 (c)

23.1

18.9

20.5

17.5

Low lifetime risk, crude %, 14+, 2013 (c)

60.2

62

56.9

47.6

High lifetime risk, crude %, 14+, 2013 (c)

16.7

19.1

22.6

34.9

low single occasion risk, crude %, 14+, 2013 (c)

40.4

41.8

38.1

30.8

Single occasion risk less than weekly, crude %, 14+, 2013 (c)

23.5

24.4

23.6

22.8

Single occasion risk at least weekly, crude %, 14+, 2013 (c)

13

14.9

17.8

28.9

Sources:

Table 6: Alcohol consumption against 2009 NHMRC guidelines, Aboriginal and Torres Strait Islander people 15+ years, by Remoteness 2012-13

MC

IR

OR

R

VR

Percent

Exceeded lifetime risk guidelines

18.0

18.7

18.2

22.5

14.3

Exceeded single occasion risk guidelines

56.7

57.4

50.7

59.0

41.4

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocument Table 2 (sighted 12/7/17)

The figures in Table 6 are not strictly comparable with those for the total population in Table 5, because  Table 6 refers to people who are 15 years and older, while Table 5 refers to people who are 18 years and older.

The percentage of the 15+ ATSI population exceeding 2009 NHMRC Lifetime risk guidelines is around 15-20% with little apparent inter-regional variation, compared with, for the total population 18+,  16% in Major cities, increasing to 23% in Outer regional/remote areas.

The percentage of the 15+ ATSI population exceeding the 2009 single occasion risk guidelines is around 50-60%, and around 40% in Very remote areas, compared with, for the total population 18+,  40-50% in Major cities, rural and regional areas.

Alcohol trends

Table 7: Type of alcohol use and treatment for alcohol, by remoteness area (per 1,000 population)

MC

IR

OR

R/VR

single occasion risk (monthly) 2004

287

304

321

370

2007

285

292

312

437

2010

274

312

329

413

2013

250

273

315

422

lifetime risk 2004

200

215

234

262

2007

199

210

238

314

2010

189

225

251

310

2013

167

191

226

349

very high risk – yearly 2004

167

185

206

243

2007

172

183

206

288

2010

161

183

218

266

2013

151

166

194

258

very high risk – monthly 2004

77

84

104

130

2007

78

89

100

153

2010

79

94

113

154

2013

70

70

100

170

very high risk – weekly 2004

21

27

41

38

2007

24

28

24

50

2010

37

43

54

78

2013

27

28

38

70

Closed treatment episodes 2004–05

61

72

60

58

2007–08

76

84

80

129

2010–11

69

96

87

135

2013–14

68

79

93

155

Source: NDSHS,  http://www.aihw.gov.au/alcohol-and-other-drugs/data/  alcohol -supplementary data tables, Table S18

Notes:
Single occasion risk (monthly): Had more than 4 standard drinks at least once a month
Lifetime risk: On average, had more than 2 standard drinks per day
Very high risk (yearly): Had more than 10 standard drinks at least once a year
Very high risk (monthly): Had more than 10 standard drinks at least once a month
Very high risk (weekly): Had more than 10 standard drinks at least once a week

There is a clear increase in the prevalence of people who drink alcohol in such a way as to increase their single occasion risk (eg from car accident, assault, fall, etc) and their lifetime risk (eg from chronic disease – liver disease, dementia, cancer etc) as remoteness increases.

In 2013, single occasion risk ranged from 25% of people 14 years or older in major cities to 42% of people in remote areas, while lifetime risk increased from 17% in major cities to 35% in remote areas.

In 2013, The prevalence of people who drank more than 10 standard drinks in one sitting at least once per week, increased from just under 3% in Major cities to 7% in remote areas.

In 2013-14, there were just under 70 closed treatment episodes per 1,000 people living in Major cities, increasing to around 80 and 90 per 1,000 population in Inner and Outer regional areas, to 155 per 1,000 people living in remote Australia.

 

Illicit drug use 2013

Table 8: Illicit drug use, “recent users” 14+, 2013

MC IR OR remote

Crude percent

Cannabis

9.8

10.0

12.0

13.6

Ecstasy

2.9

1.5

1.6

*1.8

Meth/amphetamine

2.1

1.6

2.0

*4.4

Cocaine

2.6

0.8

*1.1

*2.5

Any illicit drug

14.9

14.1

16.7

18.7

Source: AIHW National Drug Strategy Household Survey, 2013. http://www.aihw.gov.au/alcohol-and-other-drugs/data/  Illicit drug use (supplementary) tables S5.6, S5.11, S5.17, S5.21, S5.26.

Note: * indicates large standard error (therefore some degree of uncertainty)

Illicit drug use appears to be higher in Outer regional and remote areas compared with Major cities and Inner regional areas, in large part due to higher rates of cannabis use in these areas, but with apparent lower use of ecstasy and cocaine in regional areas compared with Major cities.

 

Physical activity

Table 9: Physical inactivity, people 18+, 2014-15

MC

IR

OR/Remote

Percentage of people aged 18+ who undertook no or low exercise in the previous week (crude) (a)

64.3

70.1

72.4

Percentage of people aged 18+ who undertook no or low exercise in the previous week (age standardised) (b)

64.8

68.6

71

Sources:
(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) PHIDU (ABS NHS data) (http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas) sighted 18/7/2017

Note that level of exercise is based on exercise undertaken for fitness, sport or recreation in the last week.

Physical inactivity appears to be more prevalent with remoteness, increasing from 65% of people in Major cities to 71% in Outer regional/remote areas.

Table 10: Average daily steps, 2011-12

MC

IR

OR/Rem

Average daily steps, 18+ years, 2011-12 (a)

7,393

7,388

7,527

Average daily steps, 5-17years, 2011-12 (b)

9,097

9,266

9,160

Sources:

In 2011-12, adults living in Outer regional/Remote areas took slightly more steps than those living in Major cities or Inner regional areas, while the number of steps taken by children and adolescents in regional/Remote areas was slightly greater compared with those in Major cities.

Table 11: Average time spent on physical activity and sedentary behaviour by persons aged 18+, 2011-12

MC

IR

OR/Remote

Australia

Hours

Physical activity(a)

3.9

3.4

3.9

3.8

Sedentary behaviour (leisure only)(b)

29.3

28.0

27.9

28.9

Sedentary behaviour (leisure and work)(b)

40.2

35.2

36.0

38.8

Notes:
(a) Includes walking for transport/fitness, moderate and vigorous physical activity.
(b) Sedentary is defined as sitting or lying down for activities.

Source: ABS 2011-12 Australian Health Survey (Physical activity) http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0042011-12?OpenDocument  Table 5.1

Adults living in Inner regional and Outer regional/Remote areas were about as likely as (or very slightly less likely than) those in Major cities to be sedentary in their leisure time, but appeared to be slightly less likely to be sedentary overall (ie their work involved a greater level of physical activity).

Table 12: Whether children aged 2-17 years met physical and screen-based activity recommendations, 2011-12

MC

IR

OR/Rem

Crude percentage

Met physical activity recommendation on all 7 days(a)(b)

27.5

34.3

34.2

Met screen-based activity recommendation on all 7 days(b)(c)

28.0

29.7

31.0

Met physical activity and screen-based recommendations on all 7 days (a)(b)(c)

9.7

10.9

14.2

Notes:
(a) The physical activity recommendation for children 2–4 years is 180 minutes or more per day, for children 5-17 years it is 60 minutes or more per day. See Physical activity recommendation in Glossary.
(b) In 7 days prior to interview.
(c) The screen-based recommendation for children 2–4 years is no more than 60 minutes per day, for children 5-17 years it is no more than 2 hours per day for entertainment purposes.

Source:
ABS 2011-12 Australian Health Survey (Physical activity) http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0042011-12?OpenDocument  Table 14.3

Children in rural and regional Australia appeared more likely (34% vs 28%) to meet physical activity recommendations and slightly more likely (30%vs 28%) to meet screen-based activity recommendations than their Major cities counterparts.

 

Fruit and vegetable consumption

Table 13: Fruit and vegetable consumption, people 18+ years, by remoteness, 2014-15

MC

IR

OR/Remote

Crude Percentage

Inadequate fruit consumption(a)

50.0

50.6

51.2

Inadequate fruit consumption(b)

50.4

48.3

48.0

Inadequate vegetable consumption(a)

93.4

93.5

89.3

Inadequate vegetable consumption(b)

n.p.

n.p.

n.p.

Sources:
(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) PHIDU (ABS NHS data) (http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas) sighted 18/7/2017

Note that adequacy of consumption is based on comparison with 2013 NHMRC guidelines.

Half of adult Australians eat insufficient fruit, with little clear difference between major cities and regional/rural areas.

Around 90% of adult Australians ate insufficient vegetables, with little clear difference between major cities and regional/rural areas.

Table 14: Fruit and vegetable consumption, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

MC

IR

OR

R

VR

Crude Percent

Inadequate daily fruit consumption (2013 NHMRC Guidelines)

59.0

60.6

56.9

54.9

49.1

Inadequate daily fruit consumption (2003 NHMRC Guidelines)

62.1

63.6

59.8

58.3

51.6

Inadequate daily vegetables consumption (2013 NHMRC Guidelines)

95.9

93.5

93.6

94.5

97.9

Inadequate daily vegetables consumption (2003 NHMRC Guidelines)

93.8

90.6

90.5

91.2

96.1

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocument Table 2 (sighted 12/7/17)

Roughly 60% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate fruit intake, closer to 50% in remote areas (compared with around 50% of all Australians 18+ in major cities and regional/rural areas).

Roughly 95% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate vegetable intake, perhaps higher (98%) in Very remote areas (compared with around 90%-94% of all Australians 18+ in major cities and regional/rural areas).

 

 

Overweight and Obesity

Table 15: Overweight and Obesity, people 18+ years, by remoteness, 2014-15

MC

IR

OR/Remote

Crude Percentage

Persons, overweight/obese (a)

61.1

69.2

69.2

Age standardised percentage

Males overweight (b)

43.8

41.1

34.3

Males obese (b)

25.8

33.1

38.2

Females overweight (b)

28.9

28.3

30.1

Females obese (b)

25.0

32.4

33.7

People  overweight (b)

36.2

34.4

31.4

People obese (b)

25.4

32.6

35.8

Sources:
(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) ABS NHS http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas

Adults in rural/regional areas are more likely to be overweight or obese than people in Major cities (69% vs 61%).

However, there were inter-regional BMI and gender differences:

  • Compared with those in Major cities, males in Inner regional and especially Outer-regional areas were less likely to be overweight (41% and 34%, vs 44%) but much more likely to be obese (33% and 38% vs 26%).
  • Compared with those in Major cities, females in Inner regional and Outer-regional areas were about as likely to be overweight (~29%) but much more likely to be obese (~33% vs 25%).

 

Table 16: Overweight and Obesity, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

MC

IR

OR

R

VR

Crude Percent

Overweight

27.5

28.8

30.1

32.5

26.4

Obese

37.9

41.3

36.2

33.1

32.3

Overweight/obese

65.4

70.1

66.2

65.6

58.8

Aboriginal and Torres Strait Islander people in rural/regional and Remote areas (29%-33%) were a little more likely to be overweight than those in Major cities (28%), with those in Very Remote areas (26%) least likely to be overweight.

Aboriginal and Torres Strait Islander people in Inner regional areas (41%) were more likely to be obese than those in Major cities (38%), but those in Outer regional (36%) and remote areas (~33%) were less likely to be obese.

Overall, Aboriginal and Torres Strait Islander people in Inner Regional areas were most likely to be overweight/obese (70%), those in Major cities, Outer Regional and Remote areas were less likely to be overweight/obese (~66%), while those in Very Remote areas were the least likely to be overweight/obese (59%).

These figures compare with 61% – the prevalence of overweight/obesity for (predominantly non-Indigenous) people living in Major cities.

 

High blood pressure

Table 17: High blood pressure, people 18+, by Remoteness, 2014-15

MC

IR

OR/Remote

Percentage

Crude % (a)

21.9

27.1

24

Age standardised % (b)

22.7

24.6

22.1

Sources:

(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) ABS NHS http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas

Age for age, people in rural/regional Australia appeared to be as likely, or very slightly more likely to have high blood pressure than their counterparts in Major cities (~23% vs ~24%). However, because people in rural/regional areas are older (on average), the prevalence of people with high blood pressure is higher (~26% vs 22%) than

Updated 31/07/2017
To view archived Risk Factors click here

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)