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

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

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

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

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

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

Indigenous Health Minister Ken Wyatt

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

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

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

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

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

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

Watch video

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

See fundraising website

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

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

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

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

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

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

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

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

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

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

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

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

We can’t do it without you.

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

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

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

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

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

All donations are tax deductible.

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

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

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

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

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

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

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

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

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

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

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

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

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

NACCHO Aboriginal Children’s Health #NDW2017 : Indigenous child health improves when fruit and veg are cheap: study

“There were definitely positive short-term health outcomes and, from our perspective, we observed children’s health was better on this program, as they were sick less often and required less antibiotics,”

Lead author of the study, Dr Andrew Black, from the University of South Australia’s School of Population Health.

“There is compelling evidence that improved diet is associated with improved health outcomes, however evidence on how best to encourage healthier diets at a population level is limited,”

Julie Brimblecombe, Senior Research Fellow at Menzies School of Health Research said that the study ( Julie was not involved ) was unique in that it was initiated and driven by an Aboriginal controlled health service. However, she said more needs to be done to assess the feasibility of this scheme being implemented on a large scale.

Originally published in The Conversation

Providing subsidised fruit and vegetable scheme to low-income Indigenous families in northern New South Wales improves children’s health and significantly reduces antibiotic use, a new study has found.

The new findings, published in the Medical Journal of Australia, showed that eating fruit and vegetables improved the children’s levels of haemoglobin, reduced emergency department attendances and hospital visits for illness.

The researchers analysed data from health assessments, audits and blood testing of children aged 17 years and under from 55 families who attended three Aboriginal community-controlled health services and received a weekly box of subsidised fruits and vegetables.

The participants were assessed 12 months before the program and again 12 months later, between December 2008 and September 2010.

The results of this study showed that the children’s haemoglobin levels significantly increased and the level of prescriptions of oral antibiotics markedly decreased compared to the year previous to the program. However iron deficiency and anaemia did not change significantly.

“I think the nutritional impacts of eating more fruit and vegetables have broader health impacts in the long term but that’s definitely something we’re interested in, the sustainability of this approach.”

said the lead author of the study, Dr Andrew Black, from the University of South Australia’s School of Population Health.

Dr Black said that for all the families involved in the study, the cost of fresh produce is a barrier to consumption of adequate daily fruit and vegetables.

“For a proportion of these families, who are struggling generally with issues in their lives, providing subsidised food isn’t adequate by itself. There are a lot more challenges than making food cheaper for those families, but it’s an important step and helps a significant number of people,” he said.

Dr Black said that “families lined up to participate” in the program.

“They saw value in it and that enthusiasm is wonderful and it is potentially useful for health policy decision-makers to see the importance in this,” he said.

Filling foods

Professor Amanda Lee, an indigenous nutrition expert from the Queensland University of Technology said the study showed that “it’s clear we are losing the battle to improve nutrition in indigenous communities.”

“We need more innovative solutions and fiscal interventions, particularly subsidisation of healthy foods, show a lot of promise.”

Professor Lee said that objective measured data in remote communities showed that Aboriginal and Torres Strait Islander people may eat less than one serve a day of fruit or vegetables.

“People know what to do but they can’t access the fruit and vegetables, they cant afford them or they are not available,” said Professor Lee, who was not involved in the study.

“Fruit and vegetables are quite expensive in rural and regional communities, about 30% more. When people are hungry and they don’t have enough food, you buy food that will fill you up and fruit and vegetables don’t always do that. People are buying take-away, deep fried foods and bread to fill them up because they are hungry.”

Julie Brimblecombe, Senior Research Fellow at Menzies School of Health Research said that the study was unique in that it was initiated and driven by an Aboriginal controlled health service.

However, she said more needs to be done to assess the feasibility of this scheme being implemented on a large scale.

“There is compelling evidence that improved diet is associated with improved health outcomes, however evidence on how best to encourage healthier diets at a population level is limited,” said Dr Brimblecombe, who was not involved in the study.

“Evidence is also needed on the cost effectiveness of such interventions to inform policy and to make sure at a population level we are getting the best value and outcomes for money invested.”

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

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

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

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

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

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

The Sugar Trip on Australian Story  View HERE

All previous NACCHO Diabetes 120 + articles over 5 years

Noting all graphics added by NACCHO

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

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

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

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

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

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

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

Download these Info graphics as PDF poster

Soft-drink-in-Aboriginal-communities-report_summaryFINAL

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

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

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

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

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

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

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

Burunga NT in store promotion

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

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

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

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

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

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

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

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

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

Aboriginal Health and #prevention : New report : @Prevention1stAU health : How much does Australia spend and is it enough?

 ” The verdict is in: Prevention is better than cure when it comes to tackling Australia’s chronic disease burden, but is Australia pulling its weight when it comes to tackling the nation’s greatest public health challenge?

A new economic report looking at what Australia invests in preventive health has found Australia ranks poorly on the world stage and has determined that governments must spend more wisely to contain the burgeoning healthcare budget.

Treating chronic disease costs the Australian community an estimated $27 billion annually, accounting for more than a third of our national health budget.

Yet Australia currently spends just over $2 billion on preventive health each year, or around $89 per person.

One in two Australians suffer from chronic disease, which is responsible for 83 per cent of all premature deaths in Australia, and accounts for 66 per cent of the burden of disease.”

The report, Preventive health: How much does Australia spend and is it enough? was co-funded by the Heart Foundation, Kidney Australia, Alzheimer’s Australia, the Australia Health Promotion Association and the Foundation for Alcohol Research and Education.

Download the report HERE

Preventive-health-How-much-does-Australia-spend-and-is-it-enough_FINAL

Produced by La Trobe University’s Department of Public Health, the report examines trends in preventive health spending, comparing Australia’s spending on preventive health, as well as the funding models used, against selected Organisation for Economic Co-operation and Development (OECD) countries.

The report also explores the question: ‘how much should Australia be spending on preventive health?’

Treating chronic disease costs the Australian community an estimated $27 billion annually, accounting for more than a third of our national health budget.

Yet Australia currently spends just over $2 billion on preventive health each year, or around $89 per person. At just 1.34 per cent of Australian healthcare expenditure, the amount is considerably less than OECD countries Canada, New Zealand and the United Kingdom, with Australia ranked 16th out of 31 OECD countries by per capita expenditure.

Michael Thorn, Chief Executive of the Foundation for Alcohol Research and Education (FARE), a founding member organisation of the Prevention 1st campaign, says that when looking at Australia’s spend on prevention, it should be remembered that one third of all chronic diseases are preventable and can be traced to four lifestyle risk factors: alcohol and tobacco use, physical inactivity and poor nutrition.

“We know that by positively addressing and influencing lifestyle factors such as physical activity, diet, tobacco and   alcohol consumption, we will significantly reduce the level of heart disease, stroke, heart failure, chronic kidney disease, lung disease and type 2 diabetes; conditions that are preventable, all too common, and placing great pressure on Australian families and on Australia’s healthcare systems,” Mr Thorn said.

Report co-author, Professor Alan Shiell says we should not simply conclude that Australia should spend more on preventive health simply because we spend less than equivalent nations, and instead argues that Australia could and should spend more on preventive health measures based on the evidence of the cost effectiveness of preventive health intervention.

“The key to determining the appropriate prevention spend is to compare the added value of an increase in spending on preventive health against the opportunity cost of doing so.

“If the value of the increased spending on preventive health is greater than the opportunity cost, then there is a strong case to do so,” Professor Shiell said.

Professor Shiell says there is clear evidence that many existing preventive health initiatives are cost-effective.

“Studies suggest Australia’s health could be improved and spending potentially even reduced if government was to act on existing policy recommendations and increase spending on activities already considered cost-effective.

“We also suspect that the choice of funding mechanism, or how money is allocated to whom for prevention – is an important factor for the overall efficiency of health prevention expenditure,” Professor Shiell said.

The report highlights England’s efforts in evaluating and monitoring the cost effectiveness and success of its public health interventions and Mr Thorn believes Australia would do well to follow their lead.

“In the United Kingdom we have a conservative government no less, showing tremendous leadership to tackle chronic disease, with bold policy measures like the recently introduced sugar tax and broad-based physical activity programs, all of which are underpinned by robust institutional structures,” Mr Thorn said.

The report will be launched at a Forum at Parliament House in Canberra today, where public health experts, including the World Health Organization’s Dr Alessandro Demaio will explain how they would invest in preventive health if given $100 million to spend.

 

 

 

NACCHO #SorryDay #NRW2017 supports @HeartAust and AHHA @AusHealthcare 18 Hospitals signed to #Lighthouse Hospital Project

 

“Aboriginal and Torres Strait Islander peoples are two-and-a-half times more likely to be admitted to hospital for heart events than non-Indigenous Australians.

For both sexes, Aboriginal and Torres Strait Islander peoples are more likely to have high blood pressure, be obese, smoke and a poor diet.”

Chief Executive Officer Heart Foundation Adjunct Professor John Kelly see Part 2 below Heart map

 ” I thought I was healthy and was quite prepared to ignore the warning signs.

I had a heart attack and survived. It could have been very different.

Having had the scare of a lifetime, Winmar made immediate changes 

At the time I had to change a lot of my dieting, the way you use salts in your food, alcohol, smoking. Those were the sacrifices you have to do as well, which don’t come easily,

“You’ve got to make that choice if you want to fulfil the rest of your life. I’m 52 this year and hopefully [for] another 10 or 15 years I’ll still be around.”

Heart and home: Nicky Winmar and his second chance at life

Nicky Winmar is famously remembered as the Indigenous player who confronted the crowd and pointed to his skin at Victoria Park in the early 1990s in a triumphant stand against racism in footy see full story Part 3 :

A chance meeting with the ACT chief executive of the Heart Foundation, Tony Stubbs, meant he simply had to endorse its message about a positive diet and lifestyle, especially with what’s at stake in Indigenous communities

” NACCHO will provide leadership and guidance to the Lighthouse team in enabling the local Aboriginal and Torres Strait Islander community and Aboriginal health workforce to be intimately involved in designing and implementing the program.

We are very supportive of this program and its contribution to National Sorry Day today, and to Reconciliation Week which starts tomorrow ’

CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO) Patricia Turner pictured below

Download Press Release

Media Release_Sorry Day_Joint HF AHHA NACCHO V2 l

Part 1 : Press Release 18 hospitals sign up to close the gap in Aboriginal and Torres Strait Islander heart health

Eighteen hospitals from around Australia have signed up to the Lighthouse Hospital Project aimed at improving the hospital treatment of coronary heart disease among Indigenous Australians.

See Info HERE Phase 3

Lighthouse is operated and managed by the Heart Foundation and the Australian Healthcare and Hospitals Association (AHHA). It is funded by the Australian Government.

The 18 hospitals cover almost one-half of all cardiac admissions in Australia for Aboriginal and Torres Strait Islander peoples.

Heart Foundation National CEO Adjunct Professor John Kelly said closing the gap in cardiovascular disease between Indigenous and non-Indigenous Australians was a key Heart Foundation priority, and it was highly appropriate that today’s announcement coincided with National Sorry Day.

‘Cardiac care for Aboriginal and Torres Strait Islander peoples is serious business. Australia’s First Peoples are more likely to have heart attacks than non-Indigenous Australians, and more likely to have early heart disease onset coupled with other health problems, frequent hospital admissions and premature death[1].

‘Deaths happen at almost twice the rate for non-Indigenous Australians, yet Indigenous Australians appear to have fewer tests and treatments while in hospital, and discharge from hospital against medical advice is five times as high[2]’, Professor Kelly said.

AHHA CEO Alison Verhoeven says that Lighthouse aims to ensure Indigenous Australians receive appropriate evidence-based care in a culturally safe manner.

‘A critical component of success will be close and genuine collaboration with local Aboriginal and Torres Strait Islander leaders, communities and organisations in the design and implementation of the activities.

‘To borrow from the words of the Prime Minister, Lighthouse will encourage and support hospitals to do things ‘with’ Aboriginal people not ‘to’ them[3].

Free Blood Pressure HERE

See Previous NACCHO Heart Posts

“Many of the hospital admissions for Aboriginal and Torres Strait Islander peoples are preventable and the Heart Foundation is committed to closing the gap in health outcomes for Aboriginal and Torres Strait Islander peoples.”

Heart Foundation National Chief Executive Officer Adjunct Professor John Kelly said these maps brought together for the first time a national picture of hospital admission rates for heart-related conditions at a national, state and regional level.

Or Download report and press release

Australian Heart Maps Report 2016

What is the Lighthouse hospital project?

  • The Lighthouse hospital project is a joint initiative of the Heart Foundation and the Australian Healthcare and Hospitals Association (AHHA).
  • The aim: to improve care and health outcomes for Aboriginal and Torres Strait Islander peoples experiencing coronary heart disease, the leading cause of death among this population.

Australia is a privileged nation by world standards. Despite this, not everyone is equal when it comes to heart health and Aboriginal and Torres Strait Islander people are the most disadvantaged. The reasons are complex and not only medical in nature. Aboriginal and Torres Strait Islander people have a troubled history with institutions of all kinds, including hospitals.

The Lighthouse Hospital project aims to change this experience by providing both a medically and culturally safe hospital environment. A culturally safe approach to healthcare respects, enhances and empowers the cultural identity and wellbeing of an individual.

This project matters because the facts are sobering. Cardiovascular disease occurs earlier, progresses faster and is associated with greater co-morbidities in Aboriginal and Torres Strait Islander peoples. They are admitted to hospital and suffer premature death more frequently compared with non-Indigenous Australians[1].

Major coronary events, such as heart attacks, occur at a rate three times that of the non- Indigenous population. Fatalities because of these events are 1.5 times more likely to occur, making it a leading contributor to the life expectancy gap [2].

PART 3

http://www.theage.com.au/afl/afl-news/nicky-winmar-and-the-moment-he-got-his-second-chance-20170525-gwd8g4.html

Nicky Winmar thought he was healthy and was quite prepared to ignore the warning signs.

The former AFL champion was only 46 and initially dismissed his chest pains as indigestion. Even the next morning, as the pains continued, it took Winmar’s partner to convince him to see a doctor.

Thankfully they got to him in time. Winmar was admitted to hospital and had surgery to insert a stent in an artery. A great of the St Kilda Football Club, he’d had a heart attack and survived. It could have been very different.

That scary episode five years ago has served as Winmar’s wake-up call. His father died the same way, aged 50, on the eve of Winmar’s solitary appearance in an AFL grand final 20 years ago.

“The doctor looked at me and put me in a room with all these machines and said I was having a heart attack,” Winmar recalls.

“It knocked me for six. I’d always trained hard and kept myself well with good food. It gave me a shake-up.

“They put a stent in an artery to keep it open. Afterwards I was so weak I couldn’t get out of bed. I had to learn to walk again.”

Having had the scare of a lifetime, Winmar made immediate changes

“At the time I had to change a lot of my dieting, the way you use salts in your food, alcohol, smoking. Those were the sacrifices you have to do as well, which don’t come easily,” Winmar said.

“You’ve got to make that choice if you want to fulfil the rest of your life. I’m 52 this year and hopefully [for] another 10 or 15 years I’ll still be around.”

Winmar is famously remembered as the Indigenous player who confronted the crowd and pointed to his skin at Victoria Park in the early 1990s in a triumphant stand against racism in footy. The moment was captured by an Age photographer, Wayne Ludbey, and remains an iconic image in footy history.

Then last year Winmar publicly supported his son to highlight the importance of gay rights. Winmar had little to do with his son for nearly 20 years and the pair hadn’t spoken for a decade until, three years ago, Tynan Winmar decided it was time to reconnect and tell his father about his sexuality.

When Nicky Winmar decides to support a cause, he throws his full weight behind it. A chance meeting with the ACT chief executive of the Heart Foundation, Tony Stubbs, meant he simply had to endorse its message about a positive diet and lifestyle, especially with what’s at stake in Indigenous communities.

“When I first met him, he took a step back, thought about it and said this is my opportunity to do something about it,” Stubbs said.

The statistics around heart disease and Indigenous communities are disturbing.

“It’s the biggest single killer of Indigenous Australians,” Stubbs said.

“It’s nearly twice the rate of death of non-Indigenous. We think that gap is too big and we actually want to do something about that and bridge that.

“Unfortunately the Indigenous smoking rate is about 43 per cent, which is about two-and-a-half times the non-Indigenous rate. And in remote areas it’s actually 60 per cent.

“One of the key messages is around quitting smoking and making that decision. Certainly Nicky has done that. And he’s found a huge amount of benefit from that.”

Winmar has a simple message for those in Indigenous communities.

“It’s the No.1 killer in Indigenous communities and towns and country areas that we come from,” he said.

“It’s important that you do go and see your local GP with symptoms that do happen. Ring triple zero and do something about it straight away.”

Winmar is a Saints great across more than 200 matches but played his final AFL season with the Western Bulldogs in 1999. He enjoyed last year’s Doggies breakthrough premiership, especially because they were coached by his friend Luke Beveridge, but the thought of St Kilda’s first flag since 1966 brings a big smile to his face.

Perhaps a smile as big as the one he had when he realised he had a second chance.

1] Austalian Institute of Health and Welfare (AIHW) 2016. Australia’s health 2016. Australia’s health series no. 15. Cat. No AUS 199. Canberra: AIHW

[2] AIHW 2014, CHD and COPD in Indigenous Australians, Cat.No IHW 126

[3] Prime Minister Malcolm Turnbull. 10 February 2016. Speech to Parliament on the 2016 Closing the Gap Report.

NACCHO Aboriginal Health and #childhood #obesity : How #junkfood brands befriend kids on #socialmedia

ABS Overweight and obesity

  • In 2014-15, 63.4% of Australian adults were overweight or obese (11.2 million people). This is similar to the prevalence of overweight and obesity in 2011-12 (62.8%) and an increase since 1995 (56.3%).
  • Around one in four (27.4%) children aged 5-17 years were overweight or obese, similar to 2011-12 (25.7%).

ABS National Health Survey: First Results, 2014-15  

Download this graphic as a poster HERE

LL_ATSI_junkfoodandhealth_infographic

”  We examined how six “high-fat-sugar-salt” food brands approached consumers at an interactive, direct and social level online in 2012 to 2013 (although the practice continues).

If a stranger offered a child free lollies in return for their picture, the parent would justifiably be angry. When this occurs on Facebook, they may not even realise it’s happening.

We found food brands being presented online and interactively in four main ways: as “the prize”, “the entertainer”, the “social enabler” and as “a person”.

Using Facebook, advergames and other online platforms, food marketers can create deeper relationships with kids than ever before. Going far beyond a televised advertisement, they are able to create an entire “brand ecosystem” around the child online.

The latest National Health Survey found that around one in four Australian kids aged 5-17 were overweight or obese.

Food marketers promoting unhealthy options to kids online should be held to account.”

From the Conversation Four ways junk food brands befriend kids online

” Australian households spend the majority (58 per cent) of their food budget on discretionary or ‘junk’ foods and drinks, including take-aways (14 per cent) and sugar-sweetened beverages (4 per cent), according to new research.

Ill health due to poor diet is not shared equally, with some population groups, such as Aboriginal and Torres Strait Islander people and people who are disadvantaged socioeconomically, more at risk.”

Professor Lee, an Accredited Practising Dietician see article 2 Aussies spending most of food budget on junk food

Picture above from WHO Global Strategy for Women’s, Children’s and Adolescents’ Health, 2016-2030

Read NACCHO 20 Articles on Obesity

Read NACCHO 20 Articles on Nutrition Healthy Foods

Article 1 Four ways junk food brands befriend kids online

If a stranger offered a child free lollies in return for their picture, the parent would justifiably be angry. When this occurs on Facebook, they may not even realise it’s happening.

There was outrage after a recent report in The Australian suggesting that the social media company can identify when young people feel emotions like “anxious”, “nervous” or “stupid”. Although Facebook has denied offering tools to target users based on their feelings, the fact is that a variety of brands have been advertising to young people online for many years.

We’re all familiar with traditional print and television advertising, but persuasion is harder for children and parents to detect online. From using cartoon characters to embody the brand, to games that combine advertising with interactive content (“advergames”), kids are exposed to a pervasive ecosystem of marketing on social media.

The blurring of the line between advertising, entertainment and socialising has never been greater, or more difficult to fight.

Kids are vulnerable to junk food advertising

Junk food advertising aimed at both adults and children is nothing new, but research shows that young people are particularly vulnerable.

Their minds are more susceptible to persuasion, given that the part of their brain that controls impulsivity and decision-making is not always fully developed until early adulthood. As a result, children are likely to respond impulsively to interactive and attractive content.

While the issue of advertising junk food to children through television and other broadcast media gets a lot of attention, less is understood about how children are consuming such marketing online.

How brands interact online

We examined how six “high-fat-sugar-salt” food brands approached consumers at an interactive, direct and social level online in 2012 to 2013 (although the practice continues).

Analysing content on official Facebook pages, website advergames and free branded apps, we coded brand placements as primary, secondary, direct or implied brand mentions.

While the content may not be explicitly targeted at children, the colours, skill level of the games and the prizes are attractive to younger people. The responses on Facebook in particular show that young consumers often interact with these posts, sharing comments and reposting.

We found food brands being presented online and interactively in four main ways: as “the prize”, “the entertainer”, the “social enabler” and as “a person”.

1. The prize

The fast food company Hungry Jack’s Shake and Win app has been offered since 2012. By “shaking” the app, it tells you, using your smartphone GPS, which Hungry Jack’s outlet is closest and where you can redeem your “free” offer or discount.

In this way, it combines several interactive elements to push the user towards immediate consumption with the brand coded as a reward.

Hungry Jack’s Shake and Win app screens captured on May 17th 2017. iTunes/Hungry Jacks

2. The entertainer

Free branded video game apps or advergames are also used to engage young consumers, disguising advertising as entertainment.

In the 2012 Chupa Chups game Lol-a-Coaster (which is not currently available on the Australian iTunes store), for example, we found a lollipop appeared as part of game play up to 200 times in one minute. The game is simple to play, full of fun primary colours and sounds, and the player is socialised to associate the brand with positive emotion.

Chuck’s Lol-A-Coaster: an interactive game for Chupa Chups.

3. The social enabler

Brands often leverage Facebook’s “tagging” capability to spread their message, adding a social element.

When a company suggests that you tag your family and friends on Facebook with their favourite product flavour, for example, the young consumer is not only using the brand to connect with others, but letting the brand connect to their own Facebook network. For a brand like Pringles, this increases their reach on social media.

A post on the Pringles’ Facebook page on October 13th, 2016. Facebook/Pringles

4. The person

Some brands also use a humanised character, like Chupa Chups’s Chuck, to voice the brand and post messages to consumers on Facebook.

Often this character interacts with the consumer in a very human way, asking them about their everyday lives, aspirations and fears. This creates the possibility of a long-term brand relationship and brand loyalty.

A Chupa Chups post on September 2nd, 2014 showing the character, Chuck. Facebook/Chupa Chups

Brands need to clean up their act

Using Facebook, advergames and other online platforms, food marketers can create deeper relationships with kids than ever before. Going far beyond a televised advertisement, they are able to create an entire “brand ecosystem” around the child online.

The latest National Health Survey found that around one in four Australian kids aged 5-17 were overweight or obese. Food marketers promoting unhealthy options to kids online should be held to account.

In Australia, the food marketing industry is mostly self-regulating. Brands are meant to abide by a code of practice which, if breached, holds them account through a complaints-based system.

While some companies have also pledged, via an Australian Food and Grocery Council code, not to target child audiences using interactive games unless offering a healthy choice, the current system is too slow and weak to be a real deterrent. That needs to change.

While online food marketing may be cheap for the corporations, the price that society pays when it comes to issues such as childhood obesity is immeasurable.

Article 2 Aussies spending most of food budget on junk food

According to Professor Amanda Lee, who is presenting her research at the Dietitians Association of Australia’s National Conference in Hobart this week, healthy diets are more affordable than current (unhealthy) diets – costing households 15 per cent less.

But according to Australian Health Survey data, few Australians consume diets consistent with national recommendations.

“Less than four per cent of Australians eat adequate quantities of healthy foods, yet more than 35 per cent of energy (kilojoule) intake comes from discretionary foods and drinks, which provide little nutrition – and this is hurting our health and our hip pocket,” said Professor Lee, from the Sax Institute.

She said the figures are particularly worrying because poor diet is the leading preventable cause of ill health in Australia and globally, contributing to almost 18 per cent of deaths in Australia, while obesity costs the nation $58 billion a year.

Her research found that, although healthy diets cost less than current (unhealthy) diets, people in low income households need to spend around a third (31 per cent) of their disposable income to eat a healthy diet, so food security is a real problem in these households.

She added that policies that increase the price differential between healthy and unhealthy diets could further compromise food security in vulnerable groups.

“At the moment, basic healthy foods like fresh vegetables and fruit are except from the GST, but there’s been talk of extending this to all foods. If this were to happen, the cost of a healthy diet would become unaffordable for low-income families,” said Lee.

Lee said Australia needs a coordinated approach to nutrition policy – a call echoed by the Dietitians Association of Australian, the Public Health Association of Australia, the Heart Foundation and Nutrition Australia.

Aboriginal #heart #stroke Health : $15 million #HealthBudget17 Investment in #PhysicalActivity and #healthylifestyles to #takethepressuredown

“We walk from the pier to the swimming pool, but everyone walks their own pace and distance.

Before walking, an Aboriginal health worker takes the blood pressure of the walkers to let them know how their general health is.

The group was about “more than just walking”, with general health checks and healthy food offered as part of the weekly meet-up .We have young and old, Indigenous and non-Indigenous, and everyone gets on really well.”

Community liaison officer Joe Malone : Run jointly by Heart Foundation Walking and the Aboriginal and Torres Strait Island Community Health Service Northgate QLD , the meetings help keep local residents active.

Read Full story HERE

To find a local walking group, head to the Heart Foundation Walking website or call 1300 362 787

NACCHO Aboriginal Health : ” High blood pressure is a silent killer ” new Heart Foundation guidelines

“Disturbingly, about half of Australian adults are not physically active enough to gain the health benefits of exercise. This includes just under half of young people aged 25 to 34 years old. This puts them at higher risk of heart disease, stroke, some cancers and dementia in later life.

“But even moderate exercise is like a wonder drug. Being active for as little as 30 minutes a day, five days a week, can reduce risk of death from heart attack by a third, as well as help you sleep better, feel better, improve your strength and balance, and maintain your bone density. It also manages your weight, blood pressure and blood cholesterol. So we are delighted by the news of the Prime Minister’s $10 million walking challenge.”

Heart Foundation National CEO, Adjunct Professor John Kelly see full below

 ” The Stoke Foundation is excited to announce that the Stroke Foundation is partnering with Priceline Pharmacy for the 2017 Australia’s Biggest Blood Pressure Check campaign.

Australia’s Biggest Blood Pressure Check will take place Wednesday 17 May – Wednesday 14 June with a target to deliver 80,000 free health checks at over 320 locations around Australia including Priceline Pharmacy stores, selected shopping centres and Queensland Know your numbers sites.

Find your nearest free health check location HERE or your Aboriginal Community Controlled Health ( ACCHO )

Heart Foundation applauds Budget funding for Healthy Heart package

At a glance

Regular walking or other physical activity reduces:

  • All-cause mortality by 30%
  • Heart disease and stroke by 35%
  • Type 2 diabetes by 42%
  • Colon cancer by 30%
  • Breast cancer by 20%
  • Weight, blood pressure and blood cholesterol

The Heart Foundation welcomes a $10 million commitment in the Federal Budget to get more Australians active by investing in a walking revolution, and $5 million dedicated to helping GPs to encourage patients to lead a healthy lifestyle.

Federal Health Minister Greg Hunt has announced that $10 million over two years will be allocated to the Heart Foundation to lead the Prime Minister’s Walk for Life Challenge, which will support up to 300,000 Australians to adopt the easy way to better health – regular walking – by 2019.

“Physical inactivity takes an immense toll on the Australian community, causing an estimated 14,000 premature deaths a year – similar to that caused by smoking,” said Heart Foundation National CEO, Adjunct Professor John Kelly.

Heart Foundation Walking is Australia’s only national network of free walking groups. It has helped more than 80,000 Australians walk their way to better health since the program began in 1995, and currently has nearly 30,000 active participants. “We need to inspire Australians to be more active, and walking groups are a cheap, fun and easy way for them to get moving,” Professor Kelly said.

The Heart Foundation wants to see everyone ‘Move More and Sit Less’, including school students, sedentary workers and older Australians. “So we welcome the Government’s National Sports Plan, also announced in the Budget, to encourage physical activity at all levels, from community participation to elite sports.

“The Heart Foundation is also pleased to see a renewed commitment of more than $18 million to the National Rheumatic Fever Strategy, a critical program if we are to Close the Gap in health for Indigenous communities,” said Professor Kelly. “And we welcome the listing of the new heart failure medication Entresto on the Pharmaceutical Benefits Scheme, making it affordable for many more Australians, as well as funding for research into preventative care, and the development of a National Sport Plan, with its emphasis on participation.”

Cardiovascular disease is the leading cause of death for Aboriginal and Torres Strait Islander people, who experience and die from cardiovascular disease at much higher rates than other Australians. 

Aboriginal and Torres Strait Islander people, when compared with other Australians, are:

  • 1.3 times as likely to have cardiovascular disease (1)
  • three times more likely to have a major coronary event, such as a heart attack (2)
  • more than twice as likely to die in hospital from coronary heart disease (2)
  • 19 times as likely to die from acute rheumatic fever and chronic rheumatic heart Disease (3)
  • more likely to smoke, have high blood pressure, be obese, have diabetes and have end-stage renal disease.(3)

From Heart Foundation website

 

NACCHO Aboriginal Health and #junkfood : Download @aihw Report Impact of overweight & obesity on health

Picture above : Nutritionists and dieticians throughout Australia have been criticizing on social media the recent Mc Donald’s  advertising during sports TV for the ” Made for Family ” of Burger , Coke and Chips recommending the #junkfood as not the preferred family meal

” Overweight and obesity, as well as many of the linked chronic diseases, is highly prevalent among Aboriginal and Torres Strait Islander people, with this also varying by socioeconomic group.

Overweight and obesity is a major public health issue, with nearly 2 in 3 adults and 1 in 4 children in Australia considered overweight or obese (AIHW 2016c).

The Australian Burden of Disease Study (ABDS) 2011 modelled the impact of overweight and obesity and showed it is one of the leading risk factors for ill health and death (AIHW 2016a).”

Download the AIHW report HERE : AIHW Obesity Burden of Disease

 ” Outcomes of the meeting included support the public health objectives to reduce chronic disease related to overweight and obesity.

This will include evaluating the effectiveness of existing initiatives and identify potential new initiatives, such as how the food regulation system can facilitate healthy food choices and positively influence the food environment.”

Australian Ministers, the New Zealand Minister responsible for food safety and the Australian Local Government Association met in Adelaide today and agreed the priority areas for the food regulation system for both countries for 2017 – 2021. They also discussed the latest updates on food labelling of sugar and fats and oils and released the two year progress review report on the implementation of the Health Star Rating system. 

The meeting was chaired by the Australian Government Assistant Minister for Health, Dr David Gillespie.

Download Communique HERE : Final Communique 28 April 2017

  • Childhood obesity has been labelled one of the most serious public health issues of the 21st century.
  • Overweight and obese children typically grow into overweight and obese adults, who are susceptible to chronic complaints such as diabetes and cardio vascular disease. These diseases place considerable burdens on national health systems and economies.
  • It can be argued therefore that policy which encourages healthy eating habits is desirable.  However, the increasing availability of foods high in fat, sugar and salt (so called junk foods) across the world has made eating healthily a challenge. 
  • This challenge, according to some research, is compounded by advertising that adversely influences people’s food preferences and consumption patterns. As a consequence of this research, there has been considerable advocacy which has urged governments to place limitations on the advertising of junk foods, particularly to children. 

 

APH : Marketing obesity? Junk food, advertising and kids

“Obesity is markedly more prevalent amongst people of Aboriginal and Torres Strait Islander descent compared to all Australians, with 25 per cent of men and 29 per cent of women being obese.

Aboriginal and Torres Strait Islander communities need information that is culturally appropriate, evidence-based, easily understood, action-oriented and motivating. There is also the need to promote healthy eating to facilitate community ownership and does not undermining the cultural importance of family social events, the role of elders and traditional preferences for some foods. Food supply in Indigenous communities needs to ensure healthy, good quality food options are available at competitive prices.

Primary health care services have a central role in promoting and improving Aboriginal and Torres Strait Islander health and the sector needs specialised training and resources to implement new initiatives and provide culturally appropriate advice.”

Department of Health Website

OBESITY – AUSTRALIA’S BIGGEST PUBLIC HEALTH CHALLENGE

Download AMA Position Statement on Obesity 2016

obesity-2016-ama-position-statement

NACCHO Articles about Obesity

“For Australia’s Aboriginal and Torres Strait Islander peoples, “diet is the single most important factor in the chronic disease epidemic facing Aboriginal communities.” The resolution commits governments “to reverse the rising trends in overweight and obesity and reduce the burden of diet-related noncommunicable diseases in all age groups.”

Dr Mark J Lock is an ARC Discovery Indigenous Research Fellow at the School of Medicine and Public Health, University of Newcastle. See Croakey article Part 2

“Jamie Oliver on behalf of the Wadeye community, I invite you to visit us and teach us to understand healthy eating and nutritious food. Our community would be pleased take you collecting bush tucker traditional way, and you can teach us new skills.

Being healthy means our kids have a better chance in life, and your visit would help make our community strong for the future and ensure our kids to grow up healthy and deadly.”

Hope to hear from you soon,
From Julie see full letter below

“We need all sides of politics to take these issues seriously, to support effective policies and water down the alcohol and junk food and junk drink industries that currently are undermining our health.

In the Medical Journal of Australia, we argue that we are losing the war against alcohol and weight-related illnesses because our nation lacks a comprehensive approach to prevention.”

By Professor Rob Moodie, Melbourne School of Population and Global Health, University of Melbourne.He worked  for NACCHO Member , Congress, the Aboriginal Community controlled health service in Central Australia from 1982-1988.

Full article

NACCHO #Worldhealthweek Obesity News: : Is diet the single most important factor in the chronic disease epidemic facing Aboriginal communities.”

Australian Healthcare Reform Alliance (AHCRA) policy proposals are not driven by ideology but have their foundations in research, evidence and broader policy review.

 ” Aboriginal communities should take advice from the fast food industry “

NACCHO’s 2013 #junkfood V Health campaign reached 20 Million + worldwide

Thus, advocacy for reducing sugar intake, support for plain packaging of tobacco and the better funding of primary and preventive care align with the basic principles of the social determinants of health in achieving better health outcomes.

To underpin this work AHCRA draws on research, aggregated data and reports from reputable sources.

A recent study published by the Australian Institute of Health and Welfare (AIHW) provides insight into the contribution of overweight and obesity to the health burden of chronic disease.

Download the AIHW report HERE : AIHW Obesity Burden of Disease

It highlights the importance of reducing overweight and obesity to prevent the onset and/or reduce the severity of associated diseases in the population.

Health impacts from being overweight or obese are not always immediate, particularly for lifestyle-related diseases, and depend on when exposure occurs and the associated disease.

In this report, only asthma was identified as a linked disease with a direct association in childhood; however, childhood obesity is a risk factor for chronic disease in adulthood and later life.

As well, being overweight and obese in mid-life is associated with increased dementia risk in late life, demonstrating a time lag from exposure to disease development. Other studies also show a reduction in cancer risk in adults who experienced weight loss 10 years prior, also suggesting a time lag.

The result is that prevention and intervention efforts focused on maintaining a healthy weight in children, as well as reducing existing overweight and obesity in all age groups, are likely to result in increased health gains in the future.

This report updates and extends estimates of the burden due to overweight and obesity reported in the Australian Burden of Disease Study 2011 to include people under 25, revised diseases linked to overweight and obesity based on the latest evidence, and estimates by socioeconomic group.

The report includes scenario modelling to assess the potential impact on future health burden if overweight and obesity in the population continues to rise or is reduced. The enhanced analysis in the report shows that 7.0% of the total health burden in Australia in 2011 is due to overweight and obesity, and that this burden increased with increasing level of socioeconomic disadvantage.

 

Aboriginal Health #WCPH2017 #WorldActivityDay : Snapshot report physical activity programs for Aboriginal people in Australia

 

” This is important as sharing information about program practice is an important part of effective health promotion and can serve to guide future initiatives.

The Ottawa Charter outlines a settings based approach to effective health promotion. We found most programs were delivered in community, followed by school, settings. Both have proven efficacy in achieving health outcomes.

They are likely be particularly effective settings for reaching Aboriginal and Torres Strait Islander people given the importance of holistic health promotion and whole-of-community approaches

Capturing current practice can inform future efforts to increase the impact of physical activity programs to improve health and social indicators.

Targeted, culturally relevant programs are essential to reduce levels of disadvantage experienced by Aboriginal and Torres Strait Islanders

Rona Macniven, Michelle Elwell, Kathy Ride, Adrian Bauman and Justin Richards Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, & Australian Indigenous HealthInfoNet

Picture above : Redfern All Blacks recently won the Women’s Division Ella Sevens Rugby Union tournament in Coffs Harbour beating the Highlanders 36-7

Download

 A snapshot of physical activity programs targeting Aboriginal and Torres Strait Islander people in Australia

 

Picture above :The Knight Riders beat the Shindogs 28-21 in the Men’s Final Ella Sevens Rugby Union tournament in Coffs Harbour

Issue addressed

Participation in physical activity programs can be an effective strategy to reduce chronic disease risk factors and improve broader social outcomes. Health and social outcomes are worse among Aboriginal and Torres Strait Islanders than non-Indigenous Australians, who represent an important group for culturally specific programs.

The extent of current practice in physical activity programs is largely unknown. This study identifies such programs targeting this population group and describes their characteristics.

Aboriginal Health

Almost a third of programs aimed to promote physical activity to achieve broader social benefits such as educational and employment outcomes and reduced rates of crime. Health and sport programs are worthy crime prevention approaches.

There are also recognised relationships between physical activity and fitness level and academic achievement as well as social and mental health benefits specific to Aboriginal and Torres Strait Islander populations.

However, a cautious approach to alluding to wider social benefits directly arising from individual programs should be taken in the absence of empirical evidence, as well as the direct effects of standalone programs on health.

Yet the documentation of existing program evaluation measures in this snapshot represents a vital first step in reviewing programs collectively and some have demonstrated encouraging evidence of positive educational and employment outcomes.

There is also some evidence of social benefits, such as community cohesion and cultural identity; derived from sport programs in this snapshot, which are important for Aboriginal and Torres Strait Islander health.

Such programs might therefore contribute to corresponding ‘Closing the Gap’ policy indicators and should be resourced accordingly.

Methods

Bibliographic and Internet searches and snowball sampling identified eligible programs operating between 2012 and 2015 in Australia (phase 1). Program coordinators were contacted to verify sourced information (phase 2). Descriptive characteristics were documented for each program.

Results

A total of 110 programs were identified across urban, rural and remote locations within all states and territories. Only 11 programs were located through bibliographic sources; the remainder through Internet searches.

The programs aimed to influence physical activity for health or broader social outcomes. Sixty five took place in community settings and most involved multiple sectors such as sport, health and education.

Almost all were free for participants and involved Indigenous stakeholders. The majority received Government funding and had commenced within the last decade. More than 20 programs reached over 1000 people each; 14 reached 0–100 participants. Most included process or impact evaluation indicators, typically reflecting their aims.

Conclusion

This snapshot provides a comprehensive description of current physical activity program provision for Aboriginal and Torres Strait Islander people across Australia. The majority of programs were only identified through the grey literature. Many programs collect evaluation data, yet this is underrepresented in academic literature.

 The Famous AFL “Fitzroy All Stars from Melbourne

 

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

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

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

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

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

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

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

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

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

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

Your Complete Guide to Bush Tucker in the Northern Territory

Traditional food trends in remote Northern Territory communities

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Methods

Sample

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

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

Data collection

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

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

Data analysis

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

Ethics

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

Results

Participants

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

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

Annual availability of traditional food

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

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

Frequency of traditional food consumption

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

Variety of traditional foods consumed

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

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

The role of traditional food consumption in alleviating food insecurity

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

Discussion

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

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

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

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

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

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

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

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

Implications

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

Acknowledgements

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