NACCHO Aboriginal Health and #Sugarydrinks : @BakerResearchAu Study reveals the damaging effects for inactive, young, obese people who consume soft drink regularly : What’s going on inside your veins ?

“ With lifestyle-related diseases such as obesity rising rapidly and sugar sweetened beverages the largest source of added sugars in Western diets, understanding the ‘real world’ health impact is critical in determining ‘real world’ prevention and intervention strategies,”

Professor Bronwyn Kingwell, the study’s senior author : See Baker Institute Press Release Part 1

If you did this day in, day out, your pancreas would be under considerable stress – and this is how diabetes can develop.

Having a little can of soft drink in the morning is going to have lasting effects throughout the day.”

If your diet has too much sugar in it, forcing your body to keep your insulin high all the time, eventually your cells will grow insulin-resistant. That forces the pancreas to make even more insulin, adding to its workload. Eventually, it will burn out

Professor Bronwyn Kingwell. See SMH Article Part 2 What’s going on inside your veins after you drink a soft drink

See NACCHO Nutrition ,Obesity , Sugar Tax,, Health Promotion 200 + articles published over 6 years and see our policy below

 ” The 2012-13 Health Survey identified that Indigenous adults were 1.6 times as likely to be obese as non-Indigenous Australians, with the prevalence increasing more rapidly in Aboriginal school-aged children.

Overweight and obesity in childhood are important predictors of adult adiposity, increasing the risk of developing a range of medical conditions, each of which is a major cause of morbidity, mortality and health expenditure.

While it is surprisingly clear what needs to be done to improve the health of Indigenous children, recent cuts to Indigenous preventative workforce and nutrition programs throughout Australia have severely reduced the capacity to respond.

Comprehensive primary health care is a key strategy for improving the health of Indigenous Australians and is an important platform from which to address complex health and social issues associated with obesity.

Closing the Gap, including the gap attributable to obesity, requires ensuring the ACCHS sector is resourced to deliver the full range of core services required under a comprehensive and culturally safe model of primary health care.

The effectiveness of ACCHSs has long been recognised, with many able to document better health outcomes than mainstream services for the communities they serve. “

Extract from NACCHO Network Submission to the Select Committee’s Obesity Epidemic in Australia Inquiry. 

Download the full 15 Page submission HERE

Obesity Epidemic in Australia – Network Submission – 6.7.18

Press Release : Study reveals the damaging metabolic effects for inactive, young, obese people who consume soft drink regularly

We know drinking soft drink is bad for the waistline, now a study by Baker Heart and Diabetes Institute researchers provides evidence of the damaging metabolic effects on overweight and obese people who regularly consume soft drink and sit for long periods.

Researchers have quantified the detrimental effects on glucose and lipid metabolism by studying young, obese adults in a ‘real-world’ setting where up to 750ml of soft drink is consumed between meals daily and where prolonged sitting with no activity is the norm.

The results, outlined by PhD candidate Pia Varsamis in the Clinical Nutrition journal, show how habitual soft drink consumption and large periods of sedentary behaviour may set these young adults on the path to serious cardiometabolic diseases such as fatty liver disease, type 2 diabetes and heart disease.

Whilst most studies to date have focused on the relationship between soft drink consumption and obesity, the large amount of added sugars contained in these drinks has additional implications beyond weight control.

Watch TV Interview

Senior author, Professor Bronwyn Kingwell, who heads up the Institute’s Metabolic and Vascular Physiology laboratory, says the acute metabolic effects of soft drink consumption and prolonged sitting identified in this latest study are cause for concern.

“With lifestyle-related diseases such as obesity rising rapidly and sugar sweetened beverages the largest source of added sugars in Western diets, understanding the ‘real world’ health impact is critical in determining ‘real world’ prevention and intervention strategies,” Professor Kingwell says.

She says this study quantified the effects of soft drink consumption compared to water on glucose and lipid metabolism in a context that was reflective of typical daily consumption levels, meal patterns and activity behaviours such as sitting for long periods.

The study, involved 28 overweight or obese adults aged 19–30 years who were habitual soft drink consumers. They participated in two separate experiments on different days drinking soft drink on one and water on the other both mid-morning and mid-afternoon during a 7-hour day of uninterrupted sitting.

Professor Kingwell says the combination of soft drink and prolonged sitting significantly elevated plasma glucose and plasma insulin, while reducing circulating triglycerides and fatty acids which indicates significant suppression of lipid metabolism, particularly in males.

She says the metabolic effects of a regular diet of soft drink combined with extended periods of sitting may contribute to the development of metabolic disease in young people who are overweight or obese, including predisposing men to an elevated risk of fatty liver disease.

“The acute metabolic effects outlined in this study are very worrying and suggest that young, overweight people who engage in this type of lifestyle are setting themselves on a path toward chronic cardiometabolic disease,” Professor Kingwell says. “This highlights significant health implications both for individuals and our healthcare system.”

Part 2 : Here’s what’s going on inside your veins after you drink a soft drink

Orginally published Here

Half an hour after finishing a can of soft drink, your blood sugar has spiked.

So you’re probably feeling pretty good. Your cells have plenty of energy, more than they need.

Maybe that soft drink had some caffeine as well, giving your central nervous system a kick, making you feel excitable, suppressing any tiredness you might have.

But a clever new study, published this week, nicely illustrates that while you’re feeling good, strange things are going on inside your blood vessels – and in the long run they are not good for you.

For this study, 28 obese or overweight young adults agreed to sit in a lab for a whole day while having their blood continuously sampled.

The volunteers ate a normal breakfast, lunch and dinner. At morning tea and afternoon tea, researchers from Melbourne’s Baker Heart and Diabetes Institute gave them a can of soft drink.

Their blood samples revealed exactly what happened next.

Sugar from, say, a chocolate bar is released slowly, as your digestive system breaks it down.

With a can of soft drink, almost no break-down time is needed. The drink’s sugar starts to hit your bloodstream within about 30 minutes. That’s why you get such a big spike.

Your body responds to high levels of blood sugar by producing a hormone called insulin.

Insulin pumps through the bloodstream and tells your cells to suck in as much sugar as they can. The cells then start burning it, and storing what they can’t burn.

That quickly reduces the amount of sugar in the blood, and gives you a burst of energy. So far so good.

But the sugar keeps coming. High levels of blood sugar will quickly damage your blood vessels, so the body keeps making insulin.

In fact, just having two cans of soft drink meant the volunteers’ insulin stayed significantly higher than usual – all day.

After lunch, and another soft drink for afternoon tea, their sugar and insulin levels spiked again.

And, once again, over the next few hours blood sugar dropped but insulin levels stayed stubbornly high – right through to late afternoon, when the study finished.

The study demonstrates that two cans of soft drink is all it takes to give your pancreas – the crucial organ that produces insulin – a serious workout, says Professor Bronwyn Kingwell, the study’s senior author.

Watch Video 

We get more sugar each year from beverages than all the sweet treats you can think of combined.

“If you did this day in, day out, your pancreas would be under considerable stress – and this is how diabetes can develop,” says Professor Kingwell. “Having a little can of soft drink in the morning is going to have lasting effects throughout the day.”

If your diet has too much sugar in it, forcing your body to keep your insulin high all the time, eventually your cells will grow insulin-resistant. That forces the pancreas to make even more insulin, adding to its workload. Eventually, it will burn out.

But something else interesting is happening inside your body as well.

Insulin tells your body to burn sugar. But it also tells it to stop burning fat.

Normally, the body burns a little bit of both at once. But after a soft drink, your insulin stays high all day – so you won’t burn much fat, whether you’re on a diet or not.

One of the study’s participants, Michelle Kneipp, is now trying as hard as she can to kick her soft-drink habit.

She’s switched soft drinks for flavoured sparkling water. “It still tastes like soft drink, and it’s still got the fizz,” she says.

“But it’s hard, because sugar’s a very addictive substance.”

 

NACCHO Commentary ” So, lets reset the Aboriginal Health agenda now! Plus two major launches at the #IndigenousHealthSummit 1. @KenWyattMP Helping reduce kidney transplant barriers 2. Aboriginal Kids – a healthy start to life: Report of the Chief Health Officer 2018

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Launch 1 Ken Wyatt and Kidney transplants

We know our First Nations people have substantially higher rates of end-stage kidney disease but are much less likely to receive a kidney transplant.

By identifying the barriers and developing a national framework to address them, this panel can advise on an integrated model of care to change and save lives.

People with kidney failure have two kidney replacement therapy options – dialysis or a kidney transplant.”

Indigenous Health Minister Ken Wyatt AM said Turnbull Government funding of $250,000 would allow the Transplantation Society of Australia and New Zealand (TSANZ) to lead a comprehensive review into the hurdles, service gaps and practical challenges faced by Aboriginal and Torres Strait Islander patients receiving treatment for renal disease.

See full press release Part 3 below

Launch 2 Aboriginal Kids – a healthy start to life: Report of the NSW Chief Health Officer 2018

The Report of the Chief Health Officer 2018 Aboriginal Kids – a healthy start to life was released on 21 June 2018. The Report was developed in collaboration with the Aboriginal Health and Medical Research Council and focuses on key improvements in the health of Aboriginal children in NSW in the first five years of life.

The Report emphasises the importance of services and programs being carried out in partnership with Aboriginal people, their communities, the Aboriginal Community Controlled Health Sector and across government.

Services and programs that have helped to achieve improvements in Aboriginal child health are highlighted throughout the Report.

Further information on the health of Aboriginal children and the NSW population can be found on HealthStats NSW​​.

Download chief-health-officers-report-2018

Part 2 So why do we need to reset? Contribution from NACCHO CEO Pat Turner

It is important to acknowledge how far we have all come together over the last 100 years. The new medical technology now saves countless lives, the testing regimens are first rate, surgical care has been enhanced and our people now have pathways to a multitude of careers and thrive in the health workforce.

Some are even in positions of ‘real power’ to advocate for reforms.

So let’s be clear that Australia has a world-class health system,  but not for all of us! So, let’s focus today on the fact that health outcomes for Aboriginal and Torres Strait Islander people in Australia are still a long way from those of non-Indigenous people.

That is why we need to reset and do it now!

NACCHO is the national peak body representing 144 Aboriginal Community Controlled Health Services in over 304 clinics and health settings. We provide about three million episodes of care each year for about 350,000 people which is provided by almost 6,000 staff. In very remote areas, our services provided about one million episodes of care.

Over 50 per cent of the workforce is Aboriginal and we are working at increasing that.

So, our ACCHOs are universally acknowledged as effective in primary health care despite endless amounts of red tape, data manipulation, dealing with inconsistent funding models, constantly reacting to the medical crisis ‘du jour’ – what is it today Minister? -oh that’s right- STI outbreaks in Northern Australia due to various state government departmental health budget cuts.

Our Aboriginal leadership matrix works in health but is yet to be fully funded or accepted by government in other public service sectors!

Why are the Aboriginal self-determination concepts accepted only by parts of our machinery of federal government rather than as a whole of government planning principle? The Feds pick and choose what they like, what they fund and how they access our Indigenous data!

That’s not to mention the usual buck-passing between commonwealth and state entities which drive us all mad with inconsistent and arbitrary decisions made on behalf of our people. The system is actually designed to work against our best interests.

We don’t need more goodwill and the best of intentions from the government. We require more commitment to the concept of Aboriginal self-determination through meaningful engagement.

This week the PM told the Local Government Association Dinner in Canberra that they are all agreeing on what (they) wanted to achieve and then committing our respective resources to work in coordination to achieve it.

Why can’t they offer that same deal to us? working collaboratively with our local communities is especially vital when you realise that our Aboriginal population will increase to one million people by 2030.

And why is it that our governments are at such a disadvantage when modelling economic or health data for such a small segment of the overall population? I’m as mystified as you to that answer after almost 50 years in Indigenous affairs!

I have lost count of the number of speeches I have given over the years on this subject regarding Aboriginal people’s health to numerous gatherings, meetings, conferences, forums, roundtables and symposiums. I don’t need to refresh my memory like the government needs to do ever election cycle of what is wrong NACCHO just wants to reset the agenda to the solutions we Aboriginal people have developed over the years!

NACCHO wants to help our people live healthier, longer lives, supported by better, more targeted health services across the nation.

Now we are funded by the Australian Government to support improvements in Indigenous health through the Aboriginal Community Controlled Health Services network and to bring the voices of those services into health policy decisions in Canberra. So they need to listen to us when we say we want to reset the agenda and draw on our collective experience.

NACCHO is independent of, trusted by and offers a strong voice to the federal government for the provision of specific community sector health care needs for Aboriginal people that is controlled by Aboriginal people. This ensures a strong voice in policy work and participation in policy development and legislation advocating and dealing with the issues as they arise or as reforms are discussed.

I coordinate 25 staff who sit on some 80 national committees and bodies. Historically NACCHO has a proud tradition and has developed over the last 20 years a strong coalition of support with other NGO’s already across a diverse range of areas.

We offer an alternative point of view enhanced by years of dedicated experience. Aboriginal perspectives from our governing bodies and staff about culturally appropriate healthcare needs are admired and respected by government.

According to the AIHW Aboriginal and Torres Strait Islander peoples represented 3.3 per cent of the population or 787,000 people.

The median age of an Aboriginal is 23 years and only one in ten reported speaking one of the 150 Australian Indigenous languages at home.

As many of you would know, the state of Aboriginal health continues to be cause for both national shame and requires national action.

I’m still as frustrated as some of you are that we have not Closed the gap for Indigenous people or had meaningful reconciliation in this nation.

I believe there is no agenda more critical to Australia than enabling Aboriginal people to live good quality lives while enjoying all their rights and fulfilling their responsibilities to themselves, their families and communities.

Aboriginal people should feel safe in their strong cultural knowledge being freely practiced and acknowledged across the country. This should include the daily use of our languages, in connection with our lands and with ready access to resources.

Aboriginal people should feel free from racism, empowered as individuals and have educational opportunities, careers, and health services to meet their needs and overcome inequality, poverty and increase life expectancy.

Now the Australian Government’s 2007 commitment to Close the Gap between Indigenous and non-Indigenous life expectancy within a generation was welcome. But the Close the Gap agenda did not deliver on a fundamental change to the way governments work with Aboriginal people or effect real change to the social determinants of health for our people.

I want to be very clear why we need to reset the agenda as meaningful progress against the closing the gap targets is now stalling and,  in many cases, is going backwards.

I am also concerned that the Government is now shifting the focus to ‘prosperity’ targets, when we don’t even have the basic targets on track.

The figures paint a staggering reality. The Australian Institute of Health and Welfare tells us that the mortality gaps are still not closing quickly enough.

No government can preside over widening mortality gaps and maintain goals to improve life expectancy and child mortality rates. On average Indigenous men and women die 15 years earlier than other Australians. Indigenous people suffer chronic diseases that are entirely preventable and have virtually been eliminated in the non-Indigenous population: trachoma, rheumatic heart disease and congenital deaths as a direct result of the current Syphilis outbreak across Australia, are but three examples.

But of course, it’s not all bad news, NACCHO, its Affiliates and our hardworking Member services have had recent success with various national health programs. As you know Alcohol consumption during pregnancy can result in birth defects and behavioural and neurodevelopmental abnormalities including Fetal Alcohol Spectrum Disorder (FASD). Smoking rates are declining and NACCHO is working to stop any increase in STI rates arcoss the nation.

Aboriginal culture has many strengths that can provide a positive influence, such as supportive extended family networks, connection to country and language. It is imperative that a person’s health be considered in the context of their social, emotional, spiritual and cultural wellbeing, and that of their community. We know that being able to better manage and control your own affairs is directly linked to improved wellbeing and mental health.

This is where the community-controlled health sector and Aboriginal Health Workers are uniquely placed.

Our Member services build ongoing relationships to give continuity of care so that chronic conditions are managed and preventative health care can be effectively targeted.

So, for any reset to be successful Aboriginal communities need to be properly resourced, and Aboriginal people need to be in control. NACCHO continues to call on the Australian Government to invest in the expansion of the Aboriginal Community Controlled Health Services, especially to reach more people living in remote isolated areas.

So, lets reset the agenda now!

Part 3


An expert panel will investigate and identify any barriers faced by First Nations people in need of kidney donations, to help ensure equity of access to lifesaving and life changing transplants.

Minister Wyatt said that, in December 2016, there were 1,987 Aboriginal and Torres Strait Islander Australians receiving such therapy.

“Of these, 13 per cent had received a kidney transplant, compared with 50 per cent of other Australians, revealing that First Nations people were nine times as likely to be reliant on dialysis,” said Minister Wyatt.

“While the Turnbull Government is funding improvements to dialysis services and renal disease prevention measures in regional and remote communities, our commitment to transplant access is absolute.”

The panel will comprise people with expertise in working in community, clinical settings, research and public policy and will consult widely across First Nations communities and the health and transplantation sectors.

“I have heard many moving stories of the trauma and heartache caused by renal disease, including in my own family,” Minister Wyatt said.

“This review aims to increase Aboriginal and Torres Strait Islander transplant rates, reduce the burden of regular dialysis and give more First Nations people the chance to live fulfilling lives on country and in their communities.”

The panel’s work will help inform development of a long-term strategy for organ donation, retrieval and transplantation being undertaken by the Commonwealth, as agreed by the COAG Health Council. It is hoped the strategy will be ready for consideration by COAG in 2019.

Funding for TSANZ for the project is provided under the Indigenous Australians’ Health Programme (IAHP).

The Turnbull Government is investing $3.9 billion in Aboriginal and Torres Strait Islander health over the next four years, with the IAHP providing comprehensive, high-quality and culturally appropriate primary health care services across the nation.

NACCHO Media Alerts : Top 10 Current Aboriginal Health News Stories to keep you up to date

1. Aboriginal sexual health: The Australian : Was the syphilis epidemic preventable ? NACCHO responds

2.Royal Flying Doctors Service extra 4-year funding $84 million Mental Health and Dental Services

3.Nurses PAQ continues political membership campaign spreading false and misleading information about our cultural safety

4.AMSANT has called for re-doubled efforts to implement the recommendations of the Royal Commission into the care and protection of children in partnership with NT Aboriginal leaders

5.Dialysis facilities worth $17 million are sitting padlocked, empty and unused in WA’s north

6.ALRC Report into Incarceration of Aboriginal and Torres Strait Islander People.

7. Minister Ken Wyatt : Listening to Indigenous Needs: Healthy Ears Program Extended with $29.4 commitment

8.Tangentyere Alice Springs Women’s Family Safety Group visits Canberra

9.Minister Ken Wyatt launches our NACCHO RACGP National Guide to a preventative health assessment for Aboriginal and Torres Strait Islander people

10. Your guide to a healthy Easter : #Eggs-actly  

 

1.Aboriginal sexual health: The Australian : Was the syphilis epidemic preventable ? NACCHO responds

“These (STIs) are preventable diseases and we need increased testing, treatment plans and a ­culturally appropriate health ­education campaign that focuses resources on promoting safe-sex messages delivered to at-risk ­communities by our trained Aboriginal workforce,”

Pat Turner, chief executive of peak body the National Aboriginal Community Controlled Health Organisation, is adamant about this.

Read full article in Easter Monday The Australian or Part B below

2.Royal Flying Doctors Service extra 4-year funding $84 million Mental Health and Dental Services

Read full press release here

 

3.Nurses PAQ continues political membership campaign spreading false and misleading information about cultural safety

SEE NACCHO Response

SEE an Indigenous Patients Response

See Nurses PAQ Misleading and false campaign

4. AMSANT  has called for re-doubled efforts to implement the recommendations of the Royal Commission into the care and protection of children in partnership with NT Aboriginal leaders

Read full AMSANT press Release

Listen to interview with Donna Ah Chee

Press Release @NACCHOChair calls on the Federal Government to work with us to keep our children safe

#WeHaveTheSolutions Plus comments from CEO’s @Anyinginyi @DanilaDilba

4.Dialysis facilities worth $17 million are sitting padlocked, empty and unused in WA’s north

Read full Story HERE

6.ALRC Report into Incarceration of Aboriginal and Torres Strait Islander People;

Read Download Full Transcript

Senator Patrick Dodson

Download the report from HERE

Community Groups Call For Action on Indigenous Incarceration Rates

7. Minister Ken Wyatt : Listening to Indigenous Needs: Healthy Ears Program Extended with $29.4 commitment

The Australian Government has committed $29.4 million to extend the Healthy Ears – Better Hearing, Better Listening Program, to help ensure tens of thousands more Indigenous children and young adults grow up with good hearing and the opportunities it brings.

Read Press Release HEAR

8.Tangentyere Alice Springs Women’s Family Safety Group visits Canberra

This week the Tangentyere Women’s Family Safety Group from Alice Springs were in Canberra. They shared with politicians, their own solutions for their own communities, and they are making an enormous difference.
Big thanks to all the Tangentyere women who made it to Canberra.

Read Download the Press Release

TANGENTYERE WOMEN’S FAMILY SAFETY GROUP (FED

9. Minister Ken Wyatt launches our NACCHO RACGP National Guide to a preventative health assessment for Aboriginal and Torres Strait Islander people

Read press releases and link to Download the National Guide

10. Your guide to a  healthy Easter : #Eggs-actly  

And finally hope you had a Happy Easter all you mob ! After you have enjoyed your chocolate eggs and hot cross buns , this is how much exercise you will require to work of those Easter treats .

For medical and nutrition advice please check with your ACCHO Doctor , Health Promotion / Lifestyle teams or one of our ACCHO nutritionists

 

Part B Full Text The Australian Article Easter Monday

There is no reason it should have happened, especially not in a first-world country like Australia, but it has: indigenous communities in the country’s north are in the grip of wholly treatable sexually transmitted diseases.

In the case of syphilis, it is an epidemic — West Australian Labor senator Patrick Dodson ­described it as such, in a fury, when health department bureaucrats mumbled during Senate estimates about having held a few “meetings” on the matter.

There have been about 2000 syphilis notifications — with at least 13 congenital cases, six of them fatal — since the outbreak began in northern Queensland in 2011, before spreading to the Northern Territory, Western Australia and, finally, South Australia.

What’s worse, it could have been stopped. James Ward, of the South Australian Health and Medical Research Institute, wrote in mid-2011 that there had been a “downward trend” over several years and it was likely at that point that the “elimination of syphilis is achievable within indigenous ­remote communities”.

But governments were slow to react, and Ward is now assisting in the design of an $8.8 million emergency “surge” treatment approach on the cusp of being rolled out in Cairns and Darwin, with sites in the two remaining affected states yet to be identified.

It will be an aggressive strategy — under previous guidelines, you had to have been identified during a health check as an active carrier of syphilis to be treated. Now, anyone who registers antibodies for the pathogen during a blood prick test, whether actively carrying syphilis or not, will receive an ­immediate penicillin injection in an attempt to halt the infection’s geographical spread.

This is key: the high mobility of indigenous people in northern and central Australia means pathogens cross jurisdictions with ­impunity. Australian Medical ­Association president Michael Gannon calls syphilis a “clever bacterium that will never go away”, warning that “bugs don’t respect state borders”.

Olga Havnen, one of the Northern Territory’s most respected public health experts, points out that many people “will have connections and relations from the Torres Strait through to the Kimberley and on to Broome — and it’s only a matter of seven or eight kilometres between PNG and the northernmost islands there in the Torres Strait”.

“This is probably something that’s not really understood by the broader Australian community,” Havnen says. “I suspect once you get a major outbreak of something like encephalitis or Dengue fever, any of those mosquito-borne diseases, and that starts to encroach onto the mainland, then people will start to get a bit worried.”

Olga Havnen, CEO of the Danila Dilba Health Service, says transmission is complex issue in Australia’s indigenous communities.
Olga Havnen, CEO of the Danila Dilba Health Service, says transmission is complex issue in Australia’s indigenous communities.

But it is not just syphilis — ­indeed, not even just STIs — that have infectious disease authorities concerned and the network of Aboriginal Community Controlled Health Organisations stretched.

Chlamydia, the nation’s most frequently diagnosed STI in 2016 based on figures from the Kirby Institute at the University of NSW, is three times more likely to be contracted by an indigenous Australian than a non-­indigenous one.

The rate was highest in the NT, at 1689.1 notifications per 100,000 indigenous people, compared with 607.9 per 100,000 non-indigenous Territorians. If you’re indigenous, you’re seven times more likely to contract gonorrhoea, spiking to 15 times more likely if only women are considered. Syphilis, five times more likely.

As the syphilis response gets under way, health services such as the one Havnen leads, the Darwin-based Danila Dilba, will be given extra resources to tackle it. “With proper resourcing, if you want to be doing outreach with those people who might be visitors to town living in the long grass, then we’re probably best placed to be able to do that,” she says.

But the extra focus comes with a warning. A spate of alleged sexual assaults on Aboriginal children, beginning with a two-year-old in Tennant Creek last month and followed by three more alleged ­attacks, has raised speculation of a link between high STI rates and evidence of child sexual assault.

After the first case, former NT children’s commissioner Howard Bath told this newspaper that STI rates were “a better indicator of background levels of abuse than reporting because so many of those cases don’t get reported to anyone, whereas kids with serious infections do tend to go to a ­doctor”. Others, including Alice Springs town councillor Jacinta Price and Aboriginal businessman Warren Mundine, raised the ­spectre of the need for removing more at-risk indigenous children from dangerous environments.

Children play AFL in Yeundumu. Picture: Jason Edwards
Children play AFL in Yeundumu. Picture: Jason Edwards

However, Sarah Giles, Danila Dilba’s clinical director and a medical practitioner of 20 years’ standing in northern Australia, warns this kind of response only exacerbates the problem. She is one of a range of public health authorities who, like Havnen, say connecting high STI figures to the very real scourge of child sex abuse simply makes no sense. They do not carry correlated data sets, the experts say.

“One of the things that’s really unhelpful about trying to manage STIs at a population level is to link it with child abuse and mandatory reporting, and for people to be fearful of STIs,” Giles says. “The problem is that when they’re conflated and when communities feel that they can’t get help ­because things might be misinterpreted or things might be reported, they’re less likely to present with symptoms. The majority of STIs are in adults and they’re sexually transmitted.”

Havnen says there is evidence of STIs being transmitted non-sexually, including to children, such as through poor hand ­hygiene, although Giles says that is “reasonably rare”. And while NT data shows five children under 12 contracted either chlamydia or gonorrhoea in 2016 (none had syphilis), and there were another five under 12 last year, Havnen points to the fact that over the past decade there has been no increasing trend in under 12s being affected. Where there has been a rise in the NT is in people aged between 13 and 19, with annual gonorrhoea notifications increasing from 64 cases in the 14-15-year-old ­female cohort in 2006 to 94 notifications in 2016.

In the 16-17-year-old female ­cohort the same figures were 96 and 141 and in the 12-13-year-old group it rose from 20 in 2006 to 33 in 2016. Overall, for both boys and girls under 16, annual gonorrhoea notifications rose from 109 in 2006 to 186 in 2016, according to figures provided to the royal ­commission into child detention by NT Health. Havnen describes the rise as “concerning but not, on its own, evidence of increasing ­levels of sexual abuse”.

Ward is more direct. Not all STIs are the result of sexual abuse, he warns, and not all sexual abuse results in an STI. If you’re a health professional trying to deal with an epidemiological wildfire, the distinction matters — the data and its correct interpretations can literally be a matter of life and death.

Indeed, in its own written cav­eats to the material it provided to the royal commission, the department warns that sexual health data is “very much subject to variations in testing” and warns against making “misleading assumptions about trends”. Ward says: “Most STIs notified in remote indigenous communities are ­assumed to be the result of sex ­between consenting adults — that is, 16 to 30-year-olds. Of the under 16s, the majority are 14 and 15-year-olds.” He says a historically high background prevalence of STIs in remote indigenous communities — along with a range of other ­infectious diseases long eradicated elsewhere — is to blame for their ongoing presence. Poor education, health services and hygiene contribute, and where drug and ­alcohol problems exist, sexually risky behaviour is more likely too. The lingering impact of colonisation and arrival of diseases then still common in broader ­society cannot be underestimated.

But Ward claims that an apparently high territory police figure of about 700 cases of “suspected child sexual offences” in the NT over the past five years may be misleading. He says a large number of these are likely to be the result of mandatory reporting, where someone under 16 is known to have a partner with an age gap of more than two years, or someone under 14 is known to be engaging in sexual activity. Ward points out that 15 is the nationwide ­median sexual debut age, an age he suggests is dropping. At any rate, he argues, child sex abuse is unlikely to be the main reason for that high rate of mandatory ­reporting in the NT.

Areyonga is a small Aboriginal community a few hours drive from Alice Springs.
Areyonga is a small Aboriginal community a few hours drive from Alice Springs.

Data matters, and so does how it is used. Chipping away at the perception of child sexual abuse in indigenous communities are the latest figures from the Australian Institute of Health and Welfare showing the rate of removals for that crime is actually higher in non-indigenous Australia.

According to a report this month from the AIHW, removals based on substantiated sex abuse cases in 2016-17 were starkly different for each cohort: 8.3 per cent for indigenous children, from a total of 13,749 removals, and 13.4 per cent for non-indigenous children, from 34,915 removals.

Havnen concedes there is a need for better reporting of child abuse and has called for a confidential helpline that would be free of charge and staffed around the clock by health professionals.

It’s based on a model already in use in Europe that she says deals with millions of calls a year — but it would require a comprehensive education and publicity campaign if it were to gain traction in remote Australia. And that means starting with the adults.

“If you’re going to do sex ­education in schools and you start to move into the area about sexual abuse and violence and so on, it’s really important that adults are ­educated first about what to do with that information,” she says. “Because too often if you just ­educate kids, and they come home and make a disclosure, they end up being told they’re liars.”

These challenges exist against the backdrop of a community already beset by a range of infectious diseases barely present elsewhere in the country, including the STIs that should be so easily treatable. It is, as Havnen is the first to admit, a complex matter.

Cheryl Jones, president of the Australasian Society for Infectious Diseases, says the answer is better primary treatment solutions and education, rather than trying to solve the problem after it has ­occurred. “For any of these public health infectious disease problems in ­remote and rural areas, we need to support basic infrastructure at the point of care and work alongside communities to come up with ­solutions,” she says.

Sisters play in the mud after a rare rain at Hoppy's 'town camp' on the outskirts of Alice Springs.
Sisters play in the mud after a rare rain at Hoppy’s ‘town camp’ on the outskirts of Alice Springs.

Pat Turner, chief executive of peak body the National Aboriginal Community Controlled Health Organisation, is adamant about this. “These (STIs) are preventable diseases and we need increased testing, treatment plans and a ­culturally appropriate health ­education campaign that focuses resources on promoting safe-sex messages delivered to at-risk ­communities by our trained Aboriginal workforce,” Turner says.

The Australian Medical ­Association has called for the formation of a national Centre for Disease Control, focusing on global surveillance and most likely based in the north, as being “urgently needed to provide national leadership and to co-ordinate rapid and effective public health responses to manage communicable diseases and outbreaks”.

“The current approach to disease threats, and control of infectious diseases, relies on disjointed state and commonwealth formal structures, informal networks, collaborations, and the goodwill of public health and infectious disease physicians,” the association warned in a submission to the Turnbull government last year.

However, the federal health ­department has rebuffed the CDC argument, telling the association that “our current arrangements are effective” and warning the suggestion could introduce “considerable overlap and duplication with existing functions”.

“I think it (the CDC) might have some merit, if it helps to ­advocate with government about what needs to happen,” Havnen says, “but if these things are going to be targeted at Aboriginal bodies, it needs to be a genuine partnership. It’s got to be informed by the realities on the ground and what we know. That information has to be fed up into the planning process.”

NACCHO Aboriginal Health #Junkfood #Sugarydrinks #Sugartax @AMAPresident says Advertising and marketing of #junkfood and #sugarydrinks to children should be banned

 

 ” Poor nutrition has been linked to the reduced health outcomes experienced by Aboriginal and Torres Strait Islander people, contributing to conditions known to disproportionately affect this population, including type 2 diabetes, kidney disease and some cancers.

Twenty two per cent of Aboriginal and Torres Strait Islander people live in a household that has, in the past 12 months, run out of food and not been able to purchase more. Food insecurity increases for Aboriginal and Torres Strait Islander people who live in remote areas.

Efforts to Close the Gap must recognise the potential impacts of improved nutrition on health outcomes, as well as the implications of food insecurity “

AMA Position Statement on Nutrition 2018

Download AMA Position Statement on Nutrition 2018

Advertising and marketing of junk food and sugary drinks to children should be banned, and a tax on sugar-sweetened beverages should be introduced as a matter of priority, the AMA says.

Releasing the AMA Position Statement on Nutrition 2018, AMA President, Dr Michael Gannon, said today that eating habits and attitudes toward food are established in early childhood.

“Improving the nutrition and eating habits of Australians must become a priority for all levels of government,” Dr Gannon said.

“Governments should consider the full complement of measures available to them to support improved nutrition, from increased nutrition education and food literacy programs through to mandatory food fortification, price signals to influence consumption, and restrictions on food and beverage advertising to children.

“Eating habits and attitudes start early, and if we can establish healthy habits from the start, it is much more likely that they will continue throughout adolescence and into adulthood.

“The AMA is alarmed by the continued, targeted marketing of unhealthy foods and drinks to children.

“Children are easily influenced, and this marketing – which takes place across all media platforms, from radio and television to online, social media, and apps – undermines healthy food education and makes eating junk food seem normal.

“Advertising and marketing unhealthy food and drink to children should be prohibited altogether, and the loophole that allows children to be exposed to junk food and alcohol advertising during coverage of sporting events must be closed.

“The food industry claims to subscribe to a voluntary code, but the reality is that this kind of advertising is increasing. The AMA calls on the food industry to stop this practice immediately.”

The Position Statement also calls for increased nutrition education and support to be provided to new or expecting parents, and notes that good nutrition during pregnancy is also vital.

It recognises that eating habits can be affected by practices at institutions such as child care centres, schools, hospitals, and aged care homes.

“Whether people are admitted to hospital or just visiting a friend or family member, they can be very receptive to messages from doctors and other health workers about healthy eating,” Dr Gannon said.

“Hospitals and other health facilities must provide healthy food options for residents, visitors, and employees.

“Vending machines containing sugary drinks and unhealthy food options should be removed from all health care settings, and replaced with machines offering only healthy options.

“Water should be the default beverage option, including at fast food restaurants in combination meals where soft drinks are typically provided as the beverage.”

NACCHO Campaign 2013 : We should health advice from the fast food industry !

Key Recommendations:

·         Advertising and marketing of unhealthy food and beverages to children to be prohibited.

·         Water to be provided as the default beverage option, and a tax on sugar-sweetened beverages to be introduced.

·         Healthy foods to be provided in all health care settings, and vending machines containing unhealthy food and drinks to be removed.

·         Better food labelling to improve consumers’ ability to distinguish between naturally occurring and added sugars.

·         Regular review and updating of national dietary guidelines and associated clinical guidelines to reflect new and emerging evidence.

·         Continued uptake of the Health Star Rating system, as well as refinement to ensure it provides shoppers with the most pertinent information.

Aboriginal and Torres Strait Islander people

Food insecurity

Food insecurity occurs when people have difficulty or are unable to access appropriate amounts of food.13

It has been estimated that four per cent of Australians experience food insecurity,14 though it is likely the extent of the problem is much higher.

Food insecurity is associated with a range of factors, including unstable living situations, geographic isolation and poor health.

It is more prevalent in already disadvantaged communities. In households with limited incomes, food budgets can be seen as discretionary and less of a priority.

This can result in disrupted eating habits and an over-reliance on less nutritious foods.

Food insecurity can have significant health implications, such as increased hospitalisation and iron deficiency anemia (in children) and increased kidney disease, type 2 diabetes and mental health issues (among adolescents and adults).

Poor nutrition has been linked to the reduced health outcomes experienced by Aboriginal and Torres Strait Islander people, contributing to conditions known to disproportionately affect this population, including type 2 diabetes, kidney disease and some cancers.16

Twenty two per cent of Aboriginal and Torres Strait Islander people live in a household that has, in the past 12 months, run out of food and not been able to purchase more. Food insecurity increases for Aboriginal and Torres Strait Islander people who live in remote areas.17

Efforts to Close the Gap must recognise the potential impacts of improved nutrition on health outcomes, as well as the implications of food insecurity. The development and implementation of potential solutions must be led by Aboriginal and Torres Strait Islander people.

The nutrition of Aboriginal and Torres Strait Islander people living in remote communities may be heavily dependent on Outback Stores. The 2009 Parliamentary Inquiry ‘Everybody’s Business: Remote Aboriginal and Torres Strait Community Stores’ resulted in a number of practical recommendations to increase the availability and affordability of healthy foods in Outback Stores, many of which have not been implemented.

Recommendation

These Stores, in consultation with local communities, should prioritise and facilitate access to affordable nutritious foods.

The AMA Position Statement on Nutrition 2018 is available at https://ama.com.au/position-statement/nutrition-2018

 

NACCHO Aboriginal #ChooseHealth wishes you a very Healthy Xmas and #sugarfree 2018 New Year #SugaryDrinksProperNoGood

 ”  This campaign is straightforward – sugary drinks are no good for our health.It’s calling on people to drink water instead of sugary drinks.’

Aboriginal and Torres Strait Islander people in Cape York and throughout all our communities experience a disproportionate burden of chronic disease compared to other Australians.’

‘Regular consumption of sugary drinks is associated with increased energy intake and in turn, weight gain and obesity. It is well established that obesity is a leading risk factor for diabetes, kidney disease, heart disease and some cancers. Consumption of sugary drinks is also associated with poor dental health.

Water is the best drink for everyone – it doesn’t have any sugar and keeps our bodies healthy.’

Apunipima Public Health Advisor Dr Mark Wenitong

WATCH Apunipima Video HERE

“We tell ‘em kids drink more water; stop the sugar. It’s good for all us mob”

Read over 30 NACCHO articles Health and Nutrition HERE

https://nacchocommunique.com/category/nutrition-healthy-foods/

 ” Let’s be honest, most countries and communities (and especially Aboriginal and Torres Strait Islanders ) now face serious health challenges from obesity.

Even more concerning, so do our kids.

While no single mission will be the panacea to a complex problem, using 2017 to set a new healthy goal of giving sugar the kick would be a great start.

Understand sugar, be aware of it, minimise it and see it for what it is – a special treat for a rare occasion.

This New Year’s, make breaking up with sugar your planned resolution.

“Hey sugar – it’s not me, it’s you…”

Alessandro R Demaio  Global Health Doctor; Co-Founded NCDFREE & festival21; Assoc. Researcher, University of Copenhagen and NACCHO supporter ( First Published 2016 see in full below )

 

We recommend the Government establish obesity prevention as a national priority, with a national taskforce, sustained funding and evaluation of key measures including:

  • Laws to stop exposure of children to unhealthy food and drink marketing on free to air television until 9.30 pm
  • Mandatory healthy food star rating from July 2019 along with stronger food reformulation targets
  • A national activity strategy to promote walking, cycling and public transport use
  • A 20 per cent health levy on sugary drinks

Australia enjoys enviable health outcomes but that is unlikely to last if we continue to experience among the world’s highest levels of obesity.

 CEO of the Consumers Health Forum, Leanne Wells

NACCHO Aboriginal #HealthStarRating and #Nutrition @KenWyattMP Free healthy choices food app will dial up good tucker

” Weight gain spikes sharply during the Christmas and New Year holiday period with more than half of the weight we gain during our lifetime explained just by the period between mid-November and mid-January.

Public Health Advocacy Institute of WA

 ” Labels that warn people about the risks of drinking soft drinks and other sugar-sweetened beverages can lower obesity and overweight prevalence, suggests a new Johns Hopkins Bloomberg School of Public Health study.

The study used computer modelling to simulate daily activities like food and beverage shopping of the populations of three U.S. cities – Baltimore, San Francisco and Philadelphia.

It found that warning labels in locations that sell sugary drinks, including grocery and corner stores, reduced both obesity and overweight prevalence in the three cities, declines that the authors say were attributable to the reduced caloric intake.

The virtual warning labels contained messaging noting how added sugar contributes to tooth decay, obesity and diabetes.

The findings, which were published online December 14 in the American Journal of Preventive Medicine, demonstrates how warning labels can result in modest but statistically significant reductions in sugary drink consumption and obesity and overweight prevalence.”

Diabetes Queensland : Warning labels can help reduce sugary drinks consumption and obesity, new study suggests

 

Global recognition is building for the very real health concerns posed by large and increasing quantities of hidden sugar in our diets. This near-ubiquitous additive found in products from pasta sauces to mayonnaise has been in the headlines and in our discussions.

The seemingly innocuous sweet treat raises eyebrows from community groups to policy makers – and change is in the air.

Let’s review some of the sugar-coated headers from 2016 :

  • The global obesity epidemic continued to build while more than two-in-three Australian adults faced overweight or obesity – and almost one in four of our children.
  • Science around sugary drinks further solidified, with consumption now linked to obesity, childhood obesity, heart disease, diabetes (type-2), dental caries and even lower fertility.
  • Australians were estimated to consume a staggering 76 litres of sugary drinks each since January alone, and new reports highlighted that as much as 15% of the crippling health costs associated with obesity could result from sugary drinks consumption.
  • Meanwhile around the planet, more countries took sound policy measures to reduce sugar consumption in their citizens. France, Belgium, Hungary, Finland, Chile, the UK, Ireland, South Africa and many parts of the United States implemented, continued or planned the implementation of pricing policies for sugary drinks.

In short, the over-consumption of sugar is now well recognised as a public health challenge everywhere.

With all this in mind and a New Year ahead, it’s time to put big words into local action. With resolutions brewing, here are seven helpful tips to breaking up with sugar in 2017.

1. Understand sugar

When it comes to sugar, things can get pretty confusing. Below, I shed some light on the common misunderstandings, but let’s recheck sugar itself – in simplest terms.

Sugar is a type of refined carbohydrate and a source of calories in our diet. Our body uses sugar and other sources of calories as energy, and any sugar that is not used is eventually stored as fat in our liver or on our bellies.

“Free sugars” are those added to products or concentrated in the products – either by us or by the manufacturer. They don’t include sugars in whole fruits and vegetables, but more on that later. For a range of health reasons, the World Health Organization recommends we get just 5% of our daily calories from free sugars. For a fully grown man or woman, this equates to a recommended limit to sugar consumption of roughly 25 grams – or 6 teaspoons. For women, it’s a little less again.

Consume more than this, and our risk of health problems rises.

2. Quit soft drinks

With 16 teaspoons of sugar in a single bottle serving – that’s more than 64 grams – there’s nothing “soft” about soft drinks. Including all carbonated drinks, flavoured milks and energy drinks with any added sugars, as well as fruit drinks and juices, sugary drinks are a great place to focus your efforts for a healthier 2018. Sugary drinks provide no nutritional value to our diets and yet are a major source of calories.

sugartax

What’s more concerning, evidence suggests that when we drink calories in the form of sugary drinks, our brains don’t recognise these calories in the same way as with foods. They don’t make us feel “full” and could even make us hungrier – so we end up eating (and drinking) more. In this way, liquid calories can be seen as even more troubling than other forms of junk foods. Combine this with studies that suggest the pleasure (and sugar spike) provided by sugary drinks may make them hard to give up – and it’s not difficult to see why many of us are drinking higher amounts, more often and in larger servings. This also makes cutting down harder.

The outcome is that anything up to one-seventh of the entire public cost of obesity in Australia could now result from sugary drinks. In other words, cut out the sugary drinks and you’ll be doing your own health a favour – and the health of our federal and state budgets.

3. Eat fruit, not juice

When it’s wrapped in a peel or a skin, fruit sugars are not a challenge to our health. In fact, the sugars in fruit are nature’s way of encouraging us to eat the fruit to begin with. Fruits like oranges, apples and pears contain important fibres. The “roughage” in our foods, this fibre is healthy in many ways but there are three in particular I will focus on. First, it slows our eating down; it is easy to drink a glass of juice squeezed from 7 apples, but much harder to eat those seven pieces whole. Second, it makes us feel full or satiated. And third, it slows the release of the sugars contained in fruit into our blood streams, thus allowing our bodies to react and use the energy appropriately, reducing our chances of weight gain and possibly even diabetes.

Juice, on the other hand, involves the removal of most of those fibres and even the loss of some of the important vitamins. What we don’t lose though, is the 21 grams or more than five teaspoons of sugar in each glass.

In short, eat fruit as a snack with confidence. But enjoy whole fruit, not juice.

4. Sugar by any other name

High-fructose corn syrup, invert sugar, malt sugar and molasses – they all mean one thing: sugar.

As the public awakens to the health challenges posed by sugar, the industry turns to new ways to confuse consumers and make ‘breaking up’ more difficult. One such way is to use the many alternative names for sugar – instead of the ‘s’ word itself. Be on the lookout for:

Evaporated cane juice, golden syrup, malt syrup, sucrose, fruit juice concentrate, dextrose and more…

5. Eat whole foods where possible

Tomato sauce, mayonnaise, salad dressings, gravies, taco sauces, savoury biscuits and breakfast cereals – these are just some of the many foods now often packed with hidden, added sugars.

A study found that 74% of packaged foods in an average American supermarket contain added sugars – and there is little evidence to suggest Australia would be dramatically different. Added to food to make it more enjoyable, and moreish, the next tip when avoiding such a ubiquitous additive is to eat whole foods.

It’s hard to hide sugar in plain flour, or a tomato, or frozen peas. Buying and cooking with mostly whole foods – not products – is a great way to ensure you and your family are not consuming added sugars unaware.

6. See beyond (un)healthy claims

Words like “wholesome”, “natural” and “healthy” are clad on many of our favourite ingredients. Sadly, they don’t mean much.

Even products that are full of sugar, like breakfast cereals and energy bars, often carry claims that aim to confuse and seduce us into purchase. Be wary – and be sure to turn the package over and read the ingredients and nutrition labelling where possible (and if time permits).

7. Be okay with sometimes

The final but crucial message in all of this is that eating or drinking sugar is not a sin. Sugar is still a part of our lives and something to enjoy in moderation. The occasional piece of cake, or late night chocolate – despite the popular narrative painted by industry to undermine efforts for true pricing on sugar – these occasional sweet treats are not the driving challenge for obesity. The problem is that sugary drinks, and sugar in our foods, have become every day occurrences.

With this in mind, let’s not demonise sugar but instead let’s see it for what it is. Enjoy some juice or bubbles from time to time but make water the default on an everyday basis. With the average can of cola containing 39 grams or 9 teaspoons of sugar, be OK with sometimes.

Bitter truth

Let’s be honest, We now face serious health challenges from obesity.

Even more concerning, so do our kids.

Learn more about our ACCHO making Deadly Choices

 

NACCHO Aboriginal Health @AHPC_VU #AusHealthTracker report outlines growing health divide between the have and have nots

 ” Australia’s Health Tracker by Socio-Economic Status, a new report from the Australian Health Policy Collaboration at Victoria University, shows close links between socio-economic disadvantage and poor health as the gap widens between the have and have not’s.

Ten million Australians in low socio-economic brackets are at high risk of dying early from chronic disease, an alarming snapshot of the nation’s health shows

Australians sitting in the lowest SES bracket are:

  • Four times more likely to die from diabetes
  • Three times more likely to die from a respiratory disease
  • Two and a half times more likely to die from cardiovascular disease
  • Seventy per cent more likely to suicide and
  • Sixty per cent more likely to die from cancer.

People in lower SES brackets have higher risks of diabetes, heart disease, cancer, and depression.  

AHPC Director Rosemary Calder said the health divide in relation to chronic disease and risk factors is stark.

Download the Report

australias-health-tracker-by-socioeconomic-status

Chronic disease claimed the lives of 49,227 people before the age of 75 in lower socio-economic groups in the past four years – more than the capacity of the Sydney Cricket Ground.

“This is the story here, we are seeing working families struggle due to skyrocketing costs of housing, utilities and food and this is having a significant effect on their health outcomes,” she said.

Those often referred to as the working poor are at much greater risk of poor health, more likely to be obese, less likely to do exercise and much more likely to smoke, Professor Calder said.

Australia’s Health Tracker by Socio-Economic Status is not just about the health of communities who are most disadvantaged it alarmingly shows that the health of 40 per cent of Australians with low incomes – the working poor – is in jeopardy.”

“Being socially and economically disadvantaged is not only bad for your health it’s also much more likely to kill you,” Professor Calder said. “Our report shows not everyone has a fair go at living a long, healthy and prosperous life.”

But it’s not just the disadvantaged at risk. Australia’s Health Tracker data also shows alcohol is being consumed at risky levels in higher socio-economic groups. High cholesterol is another risk factor that affects the advantaged while rates of high blood pressure is evenly spread across all socio-economic groups.

Part 2 Public Health Association of Australia (PHAA)

This week Public Health Association of Australia (PHAA) co-hosted the launch of Australia’s Health Tracker by Socio-Economic Status (SES), a new report by the Australian Health Policy Collaboration at Victoria University.

The report highlights the growing health disparities in Australia which correlate closely with socio-economic status. Those in the lowest SES bracket experience significantly poorer health compared to those in the middle and highest brackets.

Michael Moore, CEO of the PHAA said, “One of the key principles underpinning the work of the PHAA is the social determinants of health.

The Health Tracker is a clear illustration of these determinants at work. Those who experience social and economic disadvantage also experience a much higher risk of non-communicable disease such as diabetes, respiratory disease, heart disease and cancer. They are also much more likely to experience serious mental health issues.”

“These health conditions are often long-term and eventually result in an earlier death. This research illustrates that disadvantaged Australians are indeed more likely to die from one of these diseases. The report paints a stark picture of how one’s place on the social and economic ladder has a direct impact on life expectancy,” Mr Moore said.

The report shows that 40% of Australians on low incomes are currently experiencing decreased health.

Such poor health outcomes can be attributed to multiple factors including lack of access to healthcare, poor nutrition, high rates of obesity, and high smoking rates. The rising cost of living from the increasing prices of housing, utilities and food is also manifesting in poorer health outcomes in the population.

Mr Moore said, “Every year chronic disease is claiming the lives of thousands of Australians under 75 in lower socio-economic groups at an alarming rate. However, this is not adequately accounted for in our national health policy and programs. Instead of prioritising our most vulnerable, we are applying one-size-fits-all health policies.”

“Ultimately, the focus ought to be significantly increased funding in preventive health, as this is the simplest, most effective and economically sound solution. Currently, Australia invests a pathetic 1.5% of its health budget on preventive health measures and programs.

It really needs to be 5% of health spending as a bare minimum, and we are unlikely to see a meaningful reduction of chronic disease without this investment,” Mr Moore added.

“At present, one in two Australians have a chronic disease, and many have more than one condition. The good news is that almost a third of this could be entirely prevented with greater investment in public health initiatives designed to reduce obesity, smoking, and alcohol consumption as well as increasing physical activity,” Mr Moore concluded.

Part 3 Are we dooming our children to a darker health future?

Latest figures on the diet and lifestyle of Australia’s children signal a troubling future for their health unless governments implement an effective national response , the Consumers Health Forum says.

“The Australia’s Health Tracker statistics released today should disturb us all as they indicate that many children now have higher risk factors for poor health than their parents,” the CEO of the Consumers Health Forum, Leanne Wells, said. “In many instances the risk factors are even worse for Indigenous children.

“The danger signals for our children are showing that in crucial aspects children are already following less healthy lifestyles and diets than their parents, in areas like physical activity and consumption of junk food and too much sugar.

“For instance, 70.8 per cent of children aged 5 – 11 years are not meeting physical activity recommendations and that compares with 44.5 per cent of adults. A brighter feature in the otherwise bleak picture for Indigenous children is that fewer, 40.5 per cent, do not meet the physical activity target.  But when it comes to children who are overweight or obese, 32.8 per cent of Indigenous children are in this category compared to 25.6 per cent for children overall in this age group.

“More than 70 per cent of children aged 9 – 13 years consume too much sugar compared to 47.8 per cent of adults.

“Is Australian society dooming its children too shorter, less healthy lives by failing to take the steps now that we need to take to encourage more physical activity and discourage unhealthy food and drink consumption?

“The picture portrayed in the Health Tracker data compiled by the Australian Health Policy Collaboration highlights the need for a systemic national approach to focus on common risk factors, tackling health inequities and disparities.

“Both medical leader, Dr Mukesh Haikerwal, and financial guru Alan Kohler, told the National Press Club launch of the new report today that stronger preventive health measures would save our society billions in reducing illness and early death and avoidable hospital costs.  As Mr Kohler said, “sugar in my view needs to be more expensive” to reflect its cost to health care.

“Currently Australia dedicates only 1.5 per cent of its health expenditure to prevention which could help reduce the widespread incidence of chronic disease that afflicts one in every two Australians.  What is needed now would not bankrupt the budget. But it would represent a healthy investment in Australia’s future,” Ms Wells said.

“We need to rethink prevention and take a longer-term view about where we should be investing in health.”

 

 

 

NACCHO Aboriginal Health @KidneyHealth : Download @MenziesResearch Indigenous Australians travelling 1000 kilometres for kidney dialysis: report

 

 

” Remote Aboriginal Australians with kidney disease have demanded equitable access to life-saving treatment closer to home to prevent the removal of people from their traditional homelands.

In a new Menzies School of Health Research report, patients and carers from across northern and central Australia called on state, territory and federal government health ministers to overhaul the system to provide more holistic care.”

Download Report Here

Menzies IPV_REPORT_FINAL_09112017

Report lead author Dr Jaquelyne Hughes says the current model meets medical needs, but missed the mark in helping indigenous people feel connected to their country, families and culture.

“We heard, overwhelmingly, of how people felt lonely, distressed and isolated following relocation to access treatment,” Dr Hughes said.

Some patients reported homelessness and desperation because of this disconnect, describing having to stay in the long grass when Darwin hostels are booked out.

A Torres Strait Islander said many sick people are forced to travel up to 1000 kilometres to Cairns and Townsville to receive dialysis.

“And they cry, their tears are running, because they want to go back home, they miss their families, they miss the lifestyle of the islands, because they are islanders,” the patient said.

Many noted the disease can fracture communities as elders become ill and are relocated together with their relatives, who miss out on cultural obligations and suffer disruptions to education and employment.

“We want them (the elders) to stay in communities. They are the old people; they have to hold country and family together for us,” one patient said.

“Families living in Darwin (for dialysis) are missing out on ceremonies, funerals and other important stuff,” another person said.

Dr Hughes said the only type of care available to most indigenous renal failure sufferers was designed by and for people in cities at the expense of those in the bush.

MENZIES Press Release

Indigenous people with kidney disease living in remote and rural Australia as well as their support networks have made a resounding call for equitable health care closer to home in a report released today by Menzies School of Health Research (Menzies).

In the ‘Indigenous Patient Voices: Gathering Perspectives, Finding Solutions for Chronic and End-Stage Kidney Disease’ 2017 symposium report, renal patients and carers from across northern and central Australia highlighted the need for more holistic care and services to be made available closer to home.

Report lead author Dr Jaquelyne Hughes said current health care systems met medical care needs, but missed the mark in helping Indigenous people feel connected to their country, communities and culture while they received treatment.

“We heard, overwhelmingly, of how people felt lonely, distressed and isolated following relocation to access treatment,” Dr Hughes said.

“Some patients reported homelessness and desperation because of this disconnect. They are not rejecting the desire to live well; they are rejecting the only model of care available to them.

“The care available to kidney patients was designed by and for people who live close to cities. This automatically excludes people who live further away and in the bush.”

The report follows the Indigenous Patient Voices Symposium held during September in Darwin in conjunction with the 53rd Annual Scientific Meeting of the Australia and New Zealand Society of Nephrology (ANZSN).

Dr Hughes is one of many health practitioners urging the Australian state, territory and federal government health ministers to respond to this call to action.

“Consumer engagement is a national priority of Australian health services, and the symposium showed many Aboriginal and Torres Strait Islander people are willing to provide feedback to support the necessary health care transformation,” she said.

“We’ve highlighted the patient-reported barriers to accessing quality services for chronic and end-stage kidney disease, how and where services are delivered, how information is communicated and developing pathways and career opportunities for Indigenous Australians within the renal health care workforce.”

The report is available via the Menzies website at http://bit.ly/2znSx7d.

The Indigenous Patients’ Voices Symposium was supported by Kidney Health Australia, Astellas Pharma Australia and Novartis Pharmaceuticals Australia.

 

 

 

NACCHO Aboriginal Health #Sugartax News : @Apunipima Dr Mark Wenitong launches #SugaryDrinksProperNoGood

 

 ” This campaign is straightforward – sugary drinks are no good for our health.It’s calling on people to drink water instead of sugary drinks.’

Aboriginal and Torres Strait Islander people in Cape York experience a disproportionate burden of chronic disease compared to other Australians.’

‘Regular consumption of sugary drinks is associated with increased energy intake and in turn, weight gain and obesity. It is well established that obesity is a leading risk factor for diabetes, kidney disease, heart disease and some cancers. Consumption of sugary drinks is also associated with poor dental health.

Water is the best drink for everyone – it doesn’t have any sugar and keeps our bodies healthy.’

Apunipima Public Health Advisor Dr Mark Wenitong

Read over 30 NACCHO articles Health and Nutrition HERE

https://nacchocommunique.com/category/nutrition-healthy-foods/

Read over 15 NACCHO articles Sugar Tax HERE  

https://nacchocommunique.com/category/sugar-tax/

Apunipima Cape York Health Council  launched its Sugary Drinks Proper No Good – Drink More Water Youfla social marketing campaign on Thursday 2 November.

The campaign was developed with, and for, Aboriginal and Torres Strait Islander people of Cape York, and is supported by the national Rethink Sugary Drink Alliance – a group of organisations, including Apunipima, Diabetes Australia and the Cancer Council, concerned about the health impacts of sugary drinks.

The launch will see the campaign webpage (part of the Rethink Sugary Drink website) go live, and the release of three videos featuring NRL legend Scotty Prince inviting people to Drink More Water Youfla.

Channel 7 News Coverage

#SugaryDrinksProperNoGood and #DrinkMoreWaterYoufla.

VIEW HERE

Media was invited to Apunipima’s Cairns office where the three clips were distributed, a sugary drinks display set up, and Apunipima Public Health Medical Advisor Dr Mark Wenitong was for interview and photos opportunities.

‘This campaign is straightforward – sugary drinks are no good for our health. It’s calling on people to drink water instead of sugary drinks like soft drinks, sports drinks and fruit drinks,’ Dr Wenitong said.

Head of Prevention at Cancer Council Victoria and spokesperson for Rethink Sugary Drink Alliance Craig Sinclair said Apunipima’s campaign was prevention – focused and could save lives.

‘This is a vitally important campaign that has the capacity to not only improve lives but save them.’

‘It may sound simple, but cutting out sugary drinks can have a big impact on your health. Sugary drinks are key contributor to being overweight or obese which puts you at risk of cancer, heart disease, type 2 diabetes, stroke, and kidney disease. Apunipima Cape York Health Council is to be congratulated for taking this innovative prevention-led approach.’

The campaign was funded by the Australian government via the Northern Queensland Primary Health Network (NQPHN).

‘We’re pleased to be supporting Apunipima in this comprehensive health promotion initiative to address consumption of sugary drinks, which are one of the key contributors to overweight and obesity,’ said NQPHN CEO Mr Robin Moore.

‘Apunipima have a strong track record of developing and undertaking effective health promotion initiatives for our local communities, and are a key agency improving the skills and knowledge of the health promotion workforce across the region.’

‘NQPHN is committed to helping to close the gap and we are confident this initiative will make a significant contribution to that goal.’

Prominent Far Northern doctor calls for Australian sugar tax

A PROMINENT doctor has reignited calls for a sugar tax, in order to prevent the Far North’s chronic disease rate from climbing even higher.

Apunipima Cape York Health Council has launched a federally-funded social media campaign, to discourage Aboriginal and Torres Strait Islander people from consuming sugary drinks.

The “Sugary Drinks Proper No Good — Drink More Water Youfla” campaign, featuring videos by NRL legend Scotty Prince.

It calls on people to drink water instead of sugary drinks, like soft drinks, sports drinks, and fruit drinks.

The campaign has been launched to tackle the high rate of chronic diseases in the Far North such as Type 2 diabetes and heart disease.

Apunipima public health medical advisor Dr Mark Wenitong said a sugar tax placed on junk food and beverages would go a long way to helping reduce this rate.

“We’ve seen this happen in a few South American countries, in Mexico,” he said.

“If those countries can introduce (a sugar tax) as a health benefit to their population, then I don’t see why we can’t.

“I know the beverage industry will often say ‘this will affect the most disadvantaged people, because they’ll have to pay’, our answer to that is, it’s killing most disadvantaged people already, because they’ve got higher risk factors.

“It affects their chronic disease status more than other people in Australia.”

Cairns Hospital, earlier this year, became one of the first hospitals in Queensland to implement strategies to restrict patient and staff access to soft drinks.

Vending machines and the two cafes at the hospital only sell sugar-free soft drinks.

Dr Wenitong said the Cairns and Hinterland Hospital and Health Service should go an extra step by restricting other junk food being sold at its facilities, like chocolate bars and chips.

“At some stage, I think they’ll have to think about the accessibility of those things, particularly for younger people,” he said.

“I don’t think it’s a bad idea, by at least making them less visible and less accessible, so kids just don’t see them and want them.”

CHHHS executive director Tina Chinery said they had received no complaints from patients, staff or visitors when their healthier drink strategy was rolled out earlier this year.

“Healthcare facilities play an important role in promoting the health and wellbeing of patients, staff and visitors,” she said.

“Cairns Hospital is leading by example and creating environments that support patients, staff and visitors to make healthy choices easy.”

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.

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!