” This review describes how, prior to European settlement in Australia, Aboriginal and Torres Strait Islander peoples were generally healthy and enjoyed a varied traditional diet low in energy density and rich in nutrients.

Now, evidence shows that five of the seven leading risk factors contributing to the health gap between Aboriginal and Torres Strait Islander and non-Indigenous Australians relate to poor diet.

The review also highlights that sustained and effective interventions to improve nutrition will require: an adequately trained workforce; adequate and sustained resourcing; intersectoral partnerships; a practical monitoring, research and evaluation framework; and effective dissemination.”

Download a copy of the review HERE

NACCHO Download nutrition-review-2017

Or Read online here at HealthInfoNet

” At a local level, most mainstream and Community Controlled Primary Health Care Services (ACCHO’s) in Australia could play a critical role in the delivery of nutrition and dietetic services.

To meet the needs of Aboriginal and Torres Strait Islander people, primary health care services need to deliver both competent and culturally appropriate chronic disease care [215, 216].

The involvement of Aboriginal and Torres Strait Islander Health Workers has been identified by health professionals and patientsas an important factor in the delivery of effective clinical care to Aboriginal and Torres Strait Islander people, including nutrition education [215, 217].

Read over 45 NACCHO Aboriginal Health and Nutrition Healthy Foods published over the past 6 years

Press Release : The Australian Indigenous HealthInfoNet (HealthInfoNet) at Edith Cowan University has published a new Review of nutrition among Aboriginal and Torres Strait Islander people.

It provides detailed information on food, diet and nutritional health among Aboriginal and Torres Strait Islander people, and includes data for diet-related conditions; morbidity, mortality and burden of disease.

This review highlights the importance of nutrition promotion and the prevention of diet-related disease, and provides information on relevant programs, services, policies and strategies that help improve food supply, diet and nutritional health among Aboriginal and Torres Strait Islander people.

Lead author Professor Amanda Lee is a Senior Advisor at the Australian Prevention Partnership Centre at the Sax Institute and has more than 35 years’ experience as a practitioner and academic in nutrition, obesity and chronic disease prevention, Aboriginal and Torres Strait Islander health and public health policy.

HealthInfoNet Director, Professor Neil Drew says ‘This review written by Professor Amanda Lee and Kathy Ride (HealthInfoNet Research Team Leader) shows the important role nutrition plays in health. As we see in many areas of Aboriginal and Torres Strait Islander health, community control has been shown to be critical for the success of nutrition programs.’

This review describes how, prior to European settlement in Australia, Aboriginal and Torres Strait Islander peoples were generally healthy and enjoyed a varied traditional diet low in energy density and rich in nutrients. Now, evidence shows that five of the seven leading risk factors contributing to the health gap between Aboriginal and Torres Strait Islander and non-Indigenous Australians relate to poor diet.

The review also highlights that sustained and effective interventions to improve nutrition will require: an adequately trained workforce; adequate and sustained resourcing; intersectoral partnerships; a practical monitoring, research and evaluation framework; and effective dissemination

The United Nations General Assembly has proclaimed a Decade of Action on Nutrition from 2016 to 2025 in recognition of the need to eradicate hunger and prevent all forms of malnutrition, including under-nutrition and over-nutrition, worldwide [2]. The Global nutrition report provides context for nutrition issues internationally and in Australia, including those of Aboriginal and Torres Strait Islanders [5].

Aboriginal and Torres Strait Islander people continue to suffer the worst health of all population groups in Australia, with a high burden of disease and low life expectancy [6-9]. The latest available estimates of life expectancy, released in 2013, show that the gap between Aboriginal and Torres Strait Islander and non- Indigenous Australians remains high at 10.6 years for men and 9.5 years for women [10]. A relatively large proportion of Aboriginal and Torres Strait Islander deaths are premature; during the 5-year period 2009–2013, around 81% of deaths among Aboriginal and Torres Strait Islander people occurred before the age of 75 years, compared with 34% of deaths for non-Indigenous people [6].

Poor nutrition is an important factor contributing to overweight and obesity, malnutrition, cardiovascular disease, type 2 diabetes, and tooth decay [11, 12]. Chronic diseases – such as cardiovascular disease, type 2 diabetes, chronic kidney disease and some cancers- are responsible for at least 75% of the mortality gap between Aboriginal and Torres Strait Islander and other Australians [8].

For example, Aboriginal and Torres Strait Islander people are 1.6 times more likely to die from cardiovascular disease and 3-4 times more likely to die from type 2 diabetes than other Australians.

Yet these diseases are potentially preventable by modifying risk factors such as being overweight and obese, cigarette smoking, physical inactivity and poor nutrition [6, 10, 13]. Five of the seven leading risk factors contributing to the health gap between Aboriginal and Torres Strait Islander and non-Indigenous Australians – obesity, high blood cholesterol, alcohol, high blood pressure, and low fruit and vegetable intake – relate to poor diet [7]. Combined dietary factors contribute the greatest proportion (27.4%) of all risk factors assessed [7].

Poor diet and nutritional status of Aboriginal and Torres Strait Islander people are influenced by many factors, such as socio- economic disadvantage, and geographical, environmental, and social factors [11, 12].

Very few Aboriginal and Torres Strait Islander people meet dietary recommendations for intake of healthy foods [11, 14]. Also, 41% of their daily energy intake is derived from unhealthy ‘discretionary’ foods and drinks that are high in saturated fat, added sugar, salt and/or alcohol (‘junk’ foods), compared to 35% among non- Indigenous Australians [14-16].

The current poor nutritional health of Aboriginal and Torres Strait Islander people is in marked contrast to the situation prior to European settlement in Australia, when Aboriginal and Torres Strait Islander peoples were generally healthy and enjoyed a varied traditional diet low in energy density and rich in nutrients [12, 17].

Key facts

• Aboriginal and Torres Strait Islander people continue to suffer the worst diet-related health of all population groups in Australia.
• Diet-related chronic diseases – such as cardiovascular disease, type 2 diabetes, chronic kidney disease and some cancers – are responsible for at least 75% of the mortality gap between Aboriginal and Torres Strait Islanders and other Australians.
• In 2011, 13 dietary factors were identified as being risk factors for the Australian population (out of 29 risk factors). When combined, the joint effect of all dietary risks combined contributed 9.7% to the burden of disease for Aboriginal and Torres Strait Islander people.
• The nutrition burden among Aboriginal and Torres Strait Islander adults is underscored by malnutrition, which includes both over-nutrition (particularly over-consumption of unhealthy ‘discretionary’ foods) and under-nutrition (dietary deficiencies related to inadequate intake of healthy foods).
• In 2012-13, very few Aboriginal and Torres Strait Islander adults or children consumed adequate amounts of healthy foods consistent with recommendations of the Australian Dietary Guidelines. Furthermore, over two-fifths (41%) of total daily energy reported by Aboriginal and Torres Strait Islander people came from unhealthy foods and drinks classified as ‘discretionary’.
• The current situation is in marked contrast to the situation prior to European settlement of Australia. All available evidence suggests that Aboriginal and Torres Strait Islander Australians were traditionally healthy; enjoying varied dietary patterns of fresh plant and animal foods, low in energy density and rich in nutrients.
• Many historical, socioeconomic, environmental and geographic factors contribute to the current poor diet, nutrition and food security experienced by Aboriginal and Torres Strait Islander people.
• In 2012-13, 66% of Aboriginal and Torres Strait Islander people aged 15 years or older were classified as overweight (29%) or obese (37%); a further 30% were normal weight and 4% were underweight. In addition, 30% of Aboriginal and Torres Strait Islander children aged 2-14 years were overweight (20%) or obese (10%); 62% were in the normal weight range and 8% were underweight.
• Prevalence of poor pregnancy outcomes and infant malnutrition remains high in many areas. Low birthweight, failure to thrive and poor child growth are still serious concerns in many Aboriginal and Torres Strait Islander communities.
• In 2012-13, 83% of Aboriginal and Torres Strait Islander children aged 0-3 years had been breastfed, compared with 93% of non-Indigenous children. Of those who were breastfed, Aboriginal and Torres Strait Islander infants were less likely than non-Indigenous infants to have been breastfed for 12 months or more (12% compared with 21%).
• Based on self-reported usual serves of vegetables eaten per day, only 8% of Aboriginal and Torres Strait Islander people met the vegetable intake recommended in the Australian Dietary Guidelines. Mean reported vegetable intake was less than a third of the recommended amount.
• Based on self-reported usual serves of fruit eaten per day, 54% of Aboriginal and Torres Strait Islander people met the fruit intake recommended in the Australian Dietary Guidelines. Mean reported fruit intake was around half the recommended amount.
• One-quarter (25%) of grain (cereal) foods consumed by Aboriginal and Torres Strait Islander people were from wholegrain and/or high fibre varieties, compared to the recommended 50% or more.
• The average daily consumption of milk, yoghurt, cheese and alternatives for each age-sex group of Aboriginal and Torres Strait Islander people, with the exception of children aged 2-3 years and girls 4-8 years, was considerably lower than the respective recommend number of serves.
• The average daily consumption of lean meats and meat alternatives for each age-sex group of Aboriginal and Torres Strait Islander people, with the exception of girls 2-3 years, was less than the respective recommendations; intake was relatively high in remote areas.
• On average, Aboriginal and Torres Strait Islander people 2 years and over reported consuming an average of 75g (18 teaspoons) of free sugars per day, which equates to an average of 14% of dietary energy, nearly 50% more than World Health Organization (WHO) recommendations. Two-thirds of Aboriginal and Torres Strait Islander people’s free sugar intake came from sugary drinks.
• In 2011-2013, 22% of survey respondents said they had run out of food and couldn’t afford to buy more in the last 12 months. Aboriginal and Torres Strait Islander people in remote areas were more likely to run out of food than those in non- remote areas (31% and 20% respectively).
• The underlying causes of food insecurity in Aboriginal and Torres Strait Islander communities include factors such as low income and unemployment, inadequate housing, over- crowding, lack of educational opportunities, transport, high food costs, cultural food values, food and nutrition literacy, knowledge and skills.
• A range of general Australian Government Department of Health programs contribute to the prevention and management of diet-related disorders among Aboriginal and Torres Strait Islanders at a national level. However, since the expiry of the National Aboriginal and Torres Strait Islander nutrition strategy and action plan 2002-2010, there has been no national coordination of nutrition efforts in Australia.
• Several community-based nutrition programs have demonstrated positive outcomes in the past. The most effective programs have adopted a multi-strategy approach, addressing both food supply (availability, accessibility and affordability of foods) and demand for healthy foods. A major success factor is community involvement in (and, ideally, control of) all stages of program initiation, development, implementation and evaluation, to ensure the intervention is culturally appropriate and tailored to community needs.
• Programs to improve food supply have included a focus on: food retail outlets; local food production, such as school or community gardens; food provided by Aboriginal and Torres Strait Islander and community organisations; and food aid. Community store nutrition policies have been shown to be important influences on the food supply and dietary intake in remote areas.
• While nutrition education alone will not improve food security or dietary intake, it can be effective when combined with a range of other strategies to help people access healthy food, such as cooking programs, peer education, budgeting advice, and group-based lifestyle modification programs.
• A well-supported, resourced and educated Aboriginal and Torres Strait Islander nutrition workforce is essential for the success of nutrition interventions.
• There is a long history of effort to improve nutrition and food security among Aboriginal and Torres Strait Islander people, however there is no current national nutrition policy or strategy in place.
• Improving food supply and security to better prevent and manage poor nutrition and diet-related disease is vital to the current and future health of Aboriginal and Torres Strait Islander Australians. Food and nutrition programs play an important role in the holistic approach to improving health outcomes for Aboriginal and Torres Strait Islander people.