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 #Heartweek : #hypertension – the biggest risk factor for #heartattack & #stroke for our mob

 ” 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.

What you don’t know can hurt you. Heart disease and strokes are the biggest killers of Australians, and the biggest risk factor for both of them is high blood pressure.

But high blood pressure – known to doctors as ‘hypertension’ – is a silent killer because there are no obvious signs or symptoms, and many people don’t realise they have it. “

John Kelly CEO-National, Heart Foundation see Press release below

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)

This year, the Heart Foundation’s annual campaign, Heart Week, will shine a spotlight on the importance of diagnosing and treating high blood pressure. In particular, the campaign encourages health professionals to get acquainted with the Heart Foundation’s new hypertension guidelines.

The guidelines recommend:

  • that the management of patients with hypertension should also consider absolute cardiovascular disease risk
  • different treatment strategies for individuals at high risk of a cardiovascular event to those at low absolute cardiovascular disease risk even if they have similar blood pressure readings
  • blood pressure-lowering therapy for patients with uncomplicated mild hypertension (systolic BP, 140–159 mmHg)
  • the benefits of lower targets of < 120 mmHg systolic for patients with at least moderate cardiovascular risk (10-year risk, 20%)
  • a healthy lifestyle, including not smoking, eating a nutritious diet and regular adequate exercise for all Australians.

Did you know that the Heart Foundation in partnership with NPS MedicineWise has produced a collection of hypertension resources for Aboriginal and Torres Strait Islander Australians, and that health professionals can obtain them for free?

The resources include a flipchart for educational sessions, a patient brochure on high blood pressure and flyers on the following medicines:

  • ACE inhibitors
  • angiotensin receptor blockers
  • beta blockers
  • calcium channel blockers
  • thiazide diuretics.

For more information about high blood pressure and Aboriginal and Torres Strait Islander people, see the Australian Indigenous HealthInfoNet web resource about cardiovascular disease.

John Kelly CEO-National, Heart Foundation Press release

New research by the Heart Foundation, released for Heart Week, has found that of the six million Australians who have high blood pressure, more than 2.7 million have high blood pressure that is not treated at all, and 1.4 million have high blood pressure that is treated but not controlled.

This is a recipe for tragedy for individuals and families, too many of whom will have to cope with sudden death or life-long disabilities. Even in young Australians, high blood pressure can cause serious long-term damage; it is linked to chronic kidney disease, as well as Alzheimer’s and other dementias.

The prevalence of uncontrolled high blood pressure is a ticking time-bomb in terms of our already overstretched health system. Each year, heart disease and stroke are responsible for more than 30,000 deaths and $3.1 billion in direct health costs, and their incidence is rising.

At the moment, most people do not realise how crucial blood pressure is to their health. Only seven percent of Australians know that hypertension is a risk factor for heart disease (it causes half of all heart disease deaths), and only two per cent would focus on lowering blood pressure as a way of reducing their heart disease risk. People are much more likely to nominate stress and alcohol as key triggers.

Perhaps surprisingly, the problem of lack of treatment is more common in the cities than in regional Australia. More adults in regional and rural Australia have high blood pressure (39 percent vs 31 percent in the cities). But their city cousins are much more likely to have untreated, uncontrolled high blood pressure (52 per cent vs 37 percent). This might be because people in the regions tend to have more health problems and are more likely to be seeing their GPs regularly.

All adult Australians should have their blood pressure checked by a doctor at least every two years. Every GP should be routinely checking the blood pressure of adult patients who present to them for any kind of problem.

High blood pressure can be managed and controlled.  Your eating patterns, alcohol intake, weight and level of physical activity have a strong influence on your blood pressure.

Many people need to take blood pressure-lowering medicine. You should work closely with your doctor to find the medicine that works best for you.

If you are among the one in 11 Australians who has not had a blood pressure check in the last two years, make that appointment today. Then urge the people you love to do the same. Consider it a heartfelt gift.

Our commitment

The Heart Foundation is a co-signatory to the national Close the Gap campaign. We are committed to improving the life expectancy and quality of life of Aboriginal and Torres Strait Islander people.  No plan or strategy can successfully address these health challenges unless it specifically addresses heart, stroke and blood vessel disease.

For more than a decade, the Heart Foundation has been building knowledge and experience in improving the cardiovascular health of Indigenous Australians.

Our priorities

The Heart Foundation has worked with Aboriginal and Torres Strait Islander peoples to identify the following seven priorities that need to addressed to tackle the unacceptable disparity in health outcomes suffered by the first Australians. The following documents outline how health practitioners can help reduce disparity.

  1. Reduce consumption of tobacco and make healthy lifestyle choices easy (PDF)
  2. Improve early identification and ongoing management of cardiovascular risk factors (PDF)
  3. Improve access to timely and culturally appropriate diagnostic services (PDF)
  4. Strengthen the prevention, diagnosis and treatment of rheumatic heart disease (PDF)
  5. Improve in-hospital disparities in care for patients experiencing acute coronary syndrome (ACS) (PDF) 
  6. Improve participation in cardiac rehabilitation and ongoing care (PDF)
  7. Improve access and adherence to medication across the continuum of the patient journey (PDF)

More information

References

  1. Australian Institute of Health and Welfare (AIHW). Cardiovascular disease and its associated risk factors in Aboriginal and Torres Strait Islander peoples 2004 05, Cat. No. CVD 29, June 2008.
  2. AIHW: Mathur S, Moon L, Leigh S. 2006. Aboriginal and Torres Strait Islander people with coronary heart disease: further perspectives on health status and treatment. Cardiovascular disease series no. 25. Cat. No. CVD 33. Canberra: Australian Institute of Health and Welfare.
  3. Australian Institute of Health and Welfare (AIHW). Heart, stroke and vascular diseases Australian facts 2004. AIHW Cat. No. CVD 27. Canberra: AIHW and National Heart Foundation of Australia (Cardiovascular Disease Series No. 22).

Guidelines, tools and position statements

Source: Heart Foundation and Australian Indigenous HealthInfoNet

Links

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

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

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

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

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

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

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

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

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

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

Your Complete Guide to Bush Tucker in the Northern Territory

Traditional food trends in remote Northern Territory communities

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Methods

Sample

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

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

Data collection

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

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

Data analysis

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

Ethics

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

Results

Participants

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

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

Annual availability of traditional food

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

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

Frequency of traditional food consumption

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

Variety of traditional foods consumed

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

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

The role of traditional food consumption in alleviating food insecurity

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

Discussion

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

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

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

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

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

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

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

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

Implications

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

Acknowledgements

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

 

Aboriginal #Earlychildhood #Obesity Study : We need to reduce the prevalence of overweight/obesity in the first 3 years of life

“People who are obese in childhood are at increased risk of being obese in adulthood, which can increase the risk of cardiovascular disease, some types of cancer, diabetes, and arthritis,”

Research found reducing consumption of sugary drinks and junk food from an early age could benefit the health of Indigenous children, but that this is just one part of the solution to improving weight status.

“We know that Indigenous families across Australia – in remote, regional, and urban settings – face barriers to accessing healthy foods. Therefore, efforts to reduce junk food consumption need to occur alongside efforts to increase the affordability, availability, and acceptability of healthy foods,”

 Ms Thurber, PhD Scholar, from the National Centre for Epidemiology and Population Health at ANU.

A major study into the health of Aboriginal and Torres Strait Islander children has found programs and policies to promote healthy weight should target children as young as three.

Lead researcher Katie Thurber from The Australian National University (ANU) said the majority of Indigenous children in the national study had a health body Mass Index (BMI), but around 40 per cent were classified as overweight or obese by the time they reached nine years of age.

Download the Report Here Thurber BMI Trajectories LSIC

Latest national figures show obesity rates are 60 per cent higher for Aboriginal and Torres Strait Islander peoples compared to non-Indigenous Australians.

In 2013, around 30 per cent of Indigenous children were classified as overweight or obese, and two thirds of Indigenous people over 15 years old were classified as overweight or obese.

Key messages

•  The majority of Aboriginal and Torres Strait Islander children nationally have a healthy Body Mass Index
•  However, more than one in ten Aboriginal and Torres Strait Islander children in Footprints in Time were already overweight or obese at 3 years of age, and there was a rapid onset of overweight/obesity between age 3 and 9 years
•  We need programs and policies to reduce the prevalence of overweight/obesity in the first 3 years of life, and to slow the onset of overweight/obesity from age 3-9 years
•  Reducing children’s consumption of sugar-sweetened beverages and high-fat foods is one part of the solution to improving weight status at the population level
•  To enable healthy diets, we need to (1) create healthier environments and (2) improve the social determinants of health (such as financial security, housing, and community wellbeing). Creating healthy environments is complex, and will require both increasing the affordability, availability, and acceptability of healthy foods and decreasing the affordability, availability, and acceptability of unhealthy foods
•  Programs and policy to promote healthy weight need to be developed in partnership with Aboriginal and Torres Strait Islander communities
•  Despite higher levels of disadvantage, most Aboriginal and Torres Strait Islander children maintain a healthy weight; we need programs and policies that cultivate environments and circumstances that will enable all Aboriginal and Torres Strait Islander children to have a healthy start to life
 

Ms Thurber said improving weight status would have a major benefit in closing the gap in health between Indigenous and non-Indigenous Australians.

“Obesity is a leading contributor to the gap in health,” Ms Thurber said.

“We want to work with Aboriginal and Torres Strait Islander families and communities, as well as policy makers and service providers, to think about what will work best to promote healthy weight in those early childhood years.

“We want to start early, and identify the best ways for families and communities to support healthy diets, so that all Aboriginal and Torres Strait Islander children can have a healthy start to life.”

The research used data from Footprints in Time, a national longitudinal study that has followed more than 1,000 Indigenous children since 2008. It is funded and managed by the Department of Social Services.

Professor Mick Dodson, Chair of the Steering Committee for the Footprints in Time Study and Director of the ANU National Centre for Indigenous Studies, said Aboriginal and Torres Strait Islander children deserve the best possible start in life.

“This study shows just how important it is to support them, their families and their communities to provide a healthy diet and opportunities for physical activity,” Professor Dodson said.

Ms Thurber said using the Footprints in Time study, researchers for the first time were able to look at how weight status changes over time for Aboriginal and Torres Strait Islander children, enabling them to identify pathways that help children maintain a healthy weight.

The research has been published in Obesity.

NACCHO Aboriginal Health and #Smoking : @KenWyattMP announces $35.2 million funding #ACCHO Anti-smoking programs

These health services are all delivering frontline services to prevent young Indigenous people taking up smoking and to encourage existing smokers to quit.

Reducing smoking rates is central to the Government’s efforts to close the gap in life expectancy, but requires a consistent, long-term commitment”

Minister for Indigenous Health, Ken Wyatt

Over 100 NACCHO Articles about smoking

REDUCING INDIGENOUS SMOKING TO CLOSE THE GAP

The Australian Government will provide $35.2 million next financial year to continue anti-smoking programs targeted to Aboriginal and Torres Strait Islander people in regional and remote areas.

Minister for Indigenous Health, Ken Wyatt, said the Government had approved the continuation of funding to 36 Aboriginal Community ControlledHealth Services and one private health service.

“These health services are all delivering frontline services to prevent young Indigenous people taking up smoking and to encourage existing smokers to quit,”  .

“Reducing smoking rates is central to the Government’s efforts to close the gap in life expectancy, but requires a consistent, long-term commitment.

“Smoking causes the greatest burden of disease, disability, injury and earlydeath among Indigenous people and accounts for 23 per cent of the health gap between Indigenous and non-Indigenous Australians.”

Under the Council of Australian Governments (COAG) National Healthcare Agreement, all governments have committed to halving the 2008 adult daily smoking rate among Indigenous Australians, of 44.8 per cent, by 2018.

“The rate of smoking among Aboriginal and Torres Strait Islander people is still far higher than among other Australians and is damaging their health in many ways,” Minister Wyatt said.

It’s unlikely now that we will meet the COAG target, but we are making progress.

“It’s important that anti-smoking programs are meaningful for Indigenous people and changes made in recent years have ensured that only programs which are evidence based and effective are receiving grants.”

Continued funding for the 37 health services follows a preliminary evaluation of the Tackling Indigenous Smoking program which found that it was operating effectively and using proven approaches to changing smoking behaviour.

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

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

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

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

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

Rethink Sugary Drink campaign Download position statement

health-levy-on-sugar-position-statement

Read NACCHO previous articles Obesity / Sugartax

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

See NACCHO Story

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

There will be a special Facebook live event before the screenings

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

To view the position statement click here.

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

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

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

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

Sugar tax adds to the healthy living toolbox 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  • Caroline Wells, is Diabetes Tasmania CEO

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Eliza Newton, Senior Account Director

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

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

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

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

Originally published in The Australian

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

Further NACCHO reading

Sugar Tax     Obesity     Diabetes    Nutrition/Healthy Foods

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

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

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

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

Key Points

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

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

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

Abstract

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

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

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

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

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

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

See for full text

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

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

Keeping your kidneys healthy

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

Healthy eating tips include:

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

Exercise regularly

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

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

Drink plenty of fluids and listen to your thirst.

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

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

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

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

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

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

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

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

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

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

Resource Library

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

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

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

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

marmot

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

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

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

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

kidney-week

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

2025

#Kidneyfirst Aboriginal Health Key points

risk

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

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

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

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

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

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

Food subsidies and taxes significantly improve dietary choices

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

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

The findings were published in PLOS ONE on March 1.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


View the submission

View media release in PDF

Aboriginal Health #Sugartax debate : Sugar consumption is critical to reducing chronic health conditions, including diabetes says NACCHO

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“The high costs of transporting food and groceries to remote communities mean that Aboriginal and Torres Strait Islander people in these areas are already paying inflated prices for these types of products, and all other grocery items.

“These communities are also less able to pay higher costs and have limited access to alternatives, particularly fresh fruit and vegetables – which, because of the long distances they need to be transported, are often past their prime and overpriced when they arrive,”

“Reducing sugar consumption is critical to reducing chronic health conditions, including diabetes; however, there needs to be more work done on how these issues would be overcome before NACCHO could support any tax-based approach such as a sugar tax.”

Chair Matthew Cooke from peak Indigenous health body, National Aboriginal Community Controlled Health Organisation (NACCHO) has expressed reservations about the tax to MJA InSight.

See NACCHO Previous obesity articles HERE

 “sugary drinks were “killing the population” in remote communities, after the senate heard evidence of an “astounding” level of soft drink sales at remote community stores.

Senator Scullion said he has been working with remote stores to restrict the sale of larger bottles of soft drink.

“I’ve been trying to negotiate the two litre and 1.5 litres off the shelves completely,”

“It’s a difficult thing but the evidence shows that whatever portion you buy, a child will drink oneand-a-half litres.”

More recently he went to a community store where water was free, but despite trying to “hide the full-strength coke” it was the popular choice.

He gave one example where a remote community store was drawing half of its total profits from soft drink sales.

“It was the most expensive liquid in that store and everyone went straight there,”

Indigenous affairs minister, Nigel Scullion,

 ” TAXES on unhealthy foods, not subsidies on fruit and vegetables, are effective at reducing the burden of obesity, new research suggests, amid renewed clamour for a sugary drinks tax.

Researchers at the University of Melbourne have found that a subsidy on fresh fruit and vegetables would not on its own produce health gains, because it would lead to an undesirable increase in sodium and energy intake.”

Authored by Sarah Colyer from MJA Insight

However, adding a subsidy to a package of taxes on sugar, fat, salt and sugar-sweetened beverages could be effective, they wrote. The combination of taxes plus the subsidy could avert 470 000 disability-adjusted life years and save $3.4 billion from the health budget, the modelling study found.

The study drew on detailed New Zealand price–elasticity data – which track variations in product uptake with changes in product prices – to quantify disease risk reductions associated with each change in risk factor exposure.

A sugar tax would be most cost-effective, the study found, followed by a salt tax, a saturated fat tax and a sugar-sweetened beverages tax.

Writing in the journal PLOS Medicine, Dr Linda Cobiac and colleagues said that their findings added to the “growing evidence of large health benefits and cost-effectiveness of using taxes and regulatory measures to influence the consumption of healthy foods”.

The findings about the subsidy might at first appear counterintuitive, they said.

“However, using price subsidies or discounts as an incentive to purchase more fruits and vegetables may have the effect of increasing real income available to buy food, including unhealthy products, and could therefore lead to an overall increase in dietary measures such as saturated fat, sodium, or total energy intake,” they wrote.

The federal government is facing growing pressure from public health advocates to tax sugary drinks, with the Australian Greens pledging to introduce a bill on the measure later in 2017.

Writing in the MJA, the University of Sydney’s Professor Stephen Colagiuri urged the government to make the tax a priority as part of a multicomponent strategy against obesity.

That call was echoed in a separate report released last week by the Obesity Policy Coalition, whose member organisations include Cancer Council Victoria, Diabetes Australia (Victoria) and Deakin University.

In his MJA article, Professor Colagiuri cited the introduction of Mexico’s sugary drinks tax in 2014, which was followed by a 12% decline in the consumption of taxed beverages and a spike in bottled water consumption.

“The ongoing impact of [Mexico’s] tax has been challenged with new data suggesting a small increase in sales of SSBs [sugar-sweetened beverages] in 2015, but still lower than the increase in pre-tax sales,” he wrote.

“Arguments that an SSB tax is an ineffective means to reduce consumption are inconsistent with food industry claims of potential damage and job losses, which instead may point to the industry believing that a tax would substantially impact consumption.”

Professor Colagiuri noted that Australia was among the largest global markets for sugar-sweetened beverages, with males aged 4–30 years drinking an average 750 mL (two cans) per day.

“Government pays for health services and consequently has a right and duty to address externalities to promote and protect public health,” he wrote.

However, the federal government last week continued its resistance to any form of sugar tax, with health minister Greg Hunt commenting: “We’re committed to tackling obesity, but increasing the family’s weekly shop at the supermarket isn’t the answer.”

Decrying the proposed tax as a “nanny state” response, assistant minister for health, Dr David Gillespie, noted that Denmark had repealed its sugar tax and dropped plans for a tax on saturated fats.

Indigenous affairs minister, Nigel Scullion, said in 2016 that sugary drinks were “killing the population” in remote communities, after the senate heard evidence of an “astounding” level of soft drink sales at remote community stores.

David Butt, CEO of the National Rural Health Alliance told MJA InSight that his organisation supported “the possibility of taxing sugar-sweetened beverages and using the revenue to subsidise access to healthier food options”.

Professor Andrew Wilson, director of the Menzies Centre for Health Policy at the University of Sydney, said that compared with taxing sugar per se or salt, the proposed tax on sugary drinks had “the virtue of being fairly easy to define”.

“However, these drinks are so cheap to make that the tax will need to be substantial,” he added.

A recent report by the Grattan Institute recommended that sugar-sweetened beverages be taxed at a rate of 40 cents per 100 grams of sugar, increasing the price of a 2-litre bottle of soft drink by 80 cents. This would raise about $500 million a year, according to the Grattan Institute, which predicted a resultant 15% drop in consumption of sugary drinks and a small decrease in obesity rates.

Professor Wilson stressed that any taxation approach should be “part of a package that includes education and support for good nutrition, promotion and facilitation of physical activity, with particular focus on school-aged and older teens, planning considerations and, possibly for some areas and groups, subsidies for fruit and vegetables”.

Dr Cobiac agreed, commenting: “Our modelling shows that the potential health benefits of using taxes and subsidies to improve dietary choices and the nutritional quality of our foods in Australia are huge, but ultimately, they are just one of a number of measures that are needed to tackle obesity.”

Dr Cobiac noted that 13 other countries had announced taxes on unhealthy foods or sugar drinks in the past 5 years.

“It was true that Denmark had revoked its policies,” she said; however, she added that it was likely that as early initiators “they did not fully foresee or plan for dealing with the resulting backlash from the food industry”.

“We will never know what effect the taxes would have had in Denmark; they were repealed before there was a chance to properly evaluate them,” Dr Cobiac said.

“While many people want to eat better and lose weight, it is not easy to sustain the changes in behaviour when we live in an environment where unhealthy foods are widely available, heavily marketed and cheap.

“That environment is unlikely to change without a really comprehensive strategy to tackle the obesity problem.”

Please leave your comment below

7 thoughts on “Sugar tax: what you need to know”

    1. Anonymous says:

      This debate has been going around and around for far too long. In the meantime, overweight and obesity rates are increasing. Public health advocates need to change tack and get on with their ‘real’ jobs to make a positive difference. Scrap the idea of additional taxes on processed foods. And as for ‘modelling studies’ to underpin an evidence base to guide action. We know what to do: listen to people demonstrating ‘Lived Experience’.

    1. Andrew says:

      I second the previous comment. “Modelling” is not evidence. Let’s see real world evidence first — does a tax on sugar actually reduce obesity rates? That is the only evidence that counts.

      As a side point, imposing a “sugar tax” will cause food manufacturers to substitute sugar with other sweeteners, e.g. stevia. The long term health implications of stevia (and other additives) are unknown. Of course public health “experts” love to pretend that they are omniscient and infallible, but some caution is warranted. Let’s not repeat the massive public health failures of the past, such as the notorious food pyramid which was based on the flimsiest of evidence.

    1. Dr Rosemary Stanton says:

      We do know what to do, but the political power of the processed food industry means we get obstruction to anything that might decrease sales of its products. Junk food and drinks contribute 35% of adults’ and over 40% of children’s energy intake. That is the elephant in the room and we need multiple actions to tackle it. A sugar tax is one that is simple to implement, especially applied to drinks.

      Even more importantly, we need to stop promoting junk food and drinks. That means stopping advertising these products during TV programs that children watch. It means sporting teams and sports heros not acting as walking billboards. It needs bans on advergames for children where product placement of junk foods and drinks are visible for the time spent playing the game – which may be 30 minutes. It needs schools to stop selling children junk food and drinks from the school canteen (which negates anything they might learn in the classroom).

      We also need to talk about foods rather than nutrients. The Dietary Guidelines talk about foods. Sadly, almost no one follows them – as shown by the fact that less than 7% eat even the minimal amount of vegetables and fruit recommended, and junk food consumption is so high.

    1. Roger McMaster-Fay MRCOG FRANZCOG says:

      Oh great, another tax and it worked so well on cigarettes!. We are one of the most highly taxed countries in the world! We need a new paradigm to tackle this problem and we doctors should be able to come up with one. What about tax deductions for people who loose weight?

    1. Dr. ARC says:

      Lot’s of salient comments from Rosemary and Roger. I do not believe that drinks alone are the major cause of obesity. As always if you put more calories in than you need or use in exercise the extra calories are stored as fat, period! We need to return to the era of good home cooking and stop eating out at expensive restaurants and quick take away options which are loaded with fat and sugar. Then and only then can we begin to tackle the problem of obesity.

    1. Virginia Fazio says:

      What will the food industry use to replace ingredients that are taxed? Instead of sugar in foods will they use starches and intense sweeteners? Metabolically very little difference between starch and sugar. Will saturated fat be replaced with unsaturated fats that may be less heat stable and produce byproducts may have other health risks? Will consumers go back to adding more salt during cooking and at the table to processed foods with lower salt levels? Research needs to be on the whole diet outcomes if some processed foods carry an additional tax. We know that how the food industry meet consumer demand for low cholesterol and low saturated fat foods did not always result in a “healthy” food. Perhaps as a community we need improved cooking and gardening skills so we rely less on highly processed foods.

  1. Andrew Jamieson says:

    Education, education, education!! Where is ‘health’ on the syllabus at our schools? What public education is there on nutrition despite the valiant efforts of the likes of Rosemary Stanton. We might as well tax cars even more more as we kill lots of people with them! And it has been well pointed out that sugar alone is not responsible for our health woes. Logically we need more put GST on food, however no government would seriously consider this