NACCHO Aboriginal Health and #chronicdisease @SandroDemaio How #obesity ups your chronic disease risk and what to do about it

” Almost two in every three Australian adults are now overweight or obese, as are one in four of our children.

This rising obesity burden is the outcome of a host of factors, many of which are beyond our individual control – and obesity is linked to a number of chronic diseases.”

Dr Sandro Demaio is an Aussie medical doctor and global expert on non-communicable diseases. Co-host of the ABC TV series ‘Ask the Doctor’, author of 30 scientific papers and ‘The Doctor’s Diet’ (a cookbook based on science) see Part 2 below 

This article was originally published HERE 

Part 1 NACCHO Policy

” The committee heard that Aboriginal Community Controlled Health Organisations (ACCHOs) run effective programs aimed at preventing and addressing the high prevalence of obesity in Aboriginal and Torres Strait Islander communities.

Ms Pat Turner, Chief Executive Officer of National Aboriginal Community Controlled Health Organisation (NACCHO), gave the example of the Deadly Choices program, which is about organised sports and activities for young people.

She explained that to participate in the program, prospective participants need to have a health check covered by Medicare, which is an opportunity to assess their current state of health and map out a treatment plan if necessary.

However, NACCHO is of the view that ACCHOs need to be better resourced to promote healthy nutrition and physical activity.

Access to healthy and fresh foods in remote Australia

Ms Turner also pointed out that ‘the supply of fresh foods to remote communities and regional communities is a constant problem’.

From NACCHO Submission Read here 

” Many community members in the NT who suffer from chronic illnesses would benefit immensely from using Health Care Homes.

Unfortunately, with limited English, this meant an increased risk of them being inadvertently excluded from the initiative.

First, Italk Alice Springs produced the English version of the story. Then using qualified interpreters, they produced Aboriginal language versions in eight languages: Anmatyerre, Alyawarr, Arrernte, East Side Kriol, West Side Kriol, Pitjatjantjara, Warlpiri and Yolngu Matha

Read Article HERE

Figure 2.22-1 Proportion of persons 15 years and over (age-standardised) by BMI category and Indigenous status, 2012–13
Proportion of persons 15 years and over (age-standardised)

Source: ABS and AIHW analysis of 2012–13 AATSIHS

Read over 60 Aboriginal Health and Obesity articles published by NACCHO over past 7 Years

What is chronic disease?

Chronic disease is a broad term, which includes type 2 diabetes, heart disease, cancers, certain lung conditions, mental illness and genetic disorders. They are often defined by having complex and multiple causes, and are long-term or persistent (‘chronic’ actually means long-term).

How is obesity linked to chronic disease?

Obesity increases the risk of developing certain chronic diseases, including cardiovascular diseases (heart disease and stroke), sleep disorders, type 2 diabetes and at least 13 types of cancer.

Type 2 diabetes and obesity:

Obesity is the leading risk factor for type 2 diabetes, and even being slightly overweight increases this risk. Type 2 diabetes is characterised physiologically by decreased insulin secretion as well as increased insulin resistance due to a combination of genetic and environmental factors. Left uncontrolled, this can lead to a host of nasty outcomes like blindness, kidney problems, heart disease and even loss of feeling in our hands and feet.

Obstructive sleep apnoea and obesity:

This is another chronic disease often linked to obesity. Sleep apnoea is caused when our large air passage is partially or fully blocked by a combination of factors, including the weight of fat tissue sitting on our neck. It can cause us to jolt awake, gasping for oxygen. It leads to poor sleep, which adds physiological pressure to critical organs.

A woman preparing vegetables for a meal

Cancer and obesity:

This is a disease of altered gene expression. It originates from changes to the cell’s DNA caused by a range of factors, including inherited mutations, inflammation, hormones, and external factors including tobacco use, radiation from the sun, and carcinogenic agents in food. Strong evidence also links obesity to a number of cancers including throat cancer, bowel cancer, cancer of the liver, gallbladder and bile ducts, pancreatic cancer, breast cancer, endometrial cancer and kidney cancer.

Obesity is also associated with high blood pressure and increased risk of heart attack and stroke.

This might sound overwhelming, but it’s not all bad news. Here are a few things we can all start to do today to reduce our risk of obesity and associated chronic disease:

1. Eat more fruit and veg

Most dietary advice revolves around eating less. But if we can replace an unhealthy diet with an abundance of fresh, whole fruits and vegetables – at least two servings of fruit per day and five servings of vegetables – we can reduce our risk of obesity whilst still embracing our love for good food.

2. Limit our alcohol consumption

Forgo that glass of wine or beer after a long hard day at work and opt instead for something else that helps us relax. Pure alcohol is inherently full of energy – containing twice the energy per gram as sugar. This energy is surplus and non-essential to our nutritional needs, so contributes to our widening waistlines. And whether we’re out for drinks with mates or at a function, we can reduce our consumption by spacing out our drinks and holding off before reaching for another glass.

3. Get moving

While not everyone loves a morning sprint, there are many enjoyable ways to maintain a sufficient level of physical activity. Doing some form of exercise for at least 30 minutes each day is an effective way of keeping our waistlines in check. So, take a break to stretch out the muscles a few times during the workday, spend an afternoon at the local pool, get out into the garden or take some extra time to ride or walk to work. If none of these appeal, do some research to find the right exercise that will be fun and achievable.

Two women exercising in a park together

4. Buddy up

There’s nothing like a bit of peer pressure to get us healthy and active. Pick a friend who has the same goals and encourage each other to keep going. Sign up for exercise classes together, meet for a walk, have them over for a healthy meal, share tips and seek out support when feeling uninspired.

5. Prioritise sleep

Some argue that sleep is the healthy icing on the longevity cake. The benefits of a good night’s sleep are endless, with recent research suggesting it can even benefit our decision-making and self-discipline, making it easier to resist that ‘between-meal’ treat. Furthermore, lack of sleep can increase our appetite and see us lose the enthusiasm to stay active.

Above all, we need to foster patience and perseverance when it comes to achieving a healthy weight. It might not happen overnight, but it is within reach.

Let’s start today!

Co-host of the ABC TV series ‘Ask the Doctor’, author of 30 scientific papers and ‘The Doctor’s Diet’ (a cookbook based on science), Dr Sandro Demaio is an Aussie medical doctor and global expert on non-communicable diseases.

NACCHO Aboriginal Health and #Obesity : #refreshtheCTGrefresh : Download the Select Committee into the #Obesity Epidemic in Australia 22 recommendations : With feedback from @ACDPAlliance @janemartinopc

The Federal Government must impose a tax on sugary drinks, mandate Health Star Ratings and ban junk food ads on TV until 9 pm if it wants to drive down Australia’s obesity rates, a Senate committee has concluded.

The Select Committee into the Obesity Epidemic, comprising senators from all major parties and chaired by Greens leader Richard Di Natale, has tabled a far-reaching report with 22 recommendations.”

See SMH Article Part 1 below

Download PDF copy of report

Senate Obesity report

Extract from Report Programs in Aboriginal and Torres Strait Islander communities

The committee heard that Aboriginal Community Controlled Health Organisations (ACCHOs) run effective programs aimed at preventing and addressing the high prevalence of obesity in Aboriginal and Torres Strait Islander communities.

Ms Pat Turner, Chief Executive Officer of National Aboriginal Community Controlled Health Organisation (NACCHO), gave the example of the Deadly Choices program, which is about organised sports and activities for young people.

She explained that to participate in the program, prospective participants need to have a health check covered by Medicare, which is an opportunity to assess their current state of health and map out a treatment plan if necessary.

However, NACCHO is of the view that ACCHOs need to be better resourced to promote healthy nutrition and physical activity.

Access to healthy and fresh foods in remote Australia

Ms Turner also pointed out that ‘the supply of fresh foods to remote communities and regional communities is a constant problem’.

From NACCHO Submission Read here 

Recommendation 21 see all Recommendations Part 2

The committee recommends the proposed National Obesity Taskforce is funded to develop and oversee culturally appropriate prevention and intervention programs for Aboriginal and Torres Strait Islander communities.

Recommendation 22

The committee recommends the Commonwealth develop additional initiatives and incentives aimed at increasing access, affordability and consumption of fresh foods in remote Aboriginal and Torres Strait Islander communities.

“Unhealthy weight is a major risk factor for cancer, diabetes, heart disease, stroke and kidney disease. Preventing obesity in children is particularly important, as it is difficult to reverse weight gain once established,” 

Chair of the Australian Chronic Disease Prevention Alliance Sharon McGowan said limiting unhealthy food marketing would reduce children’s exposure to unhealthy food and its subsequent consumption.See in full Part 3

“Obesity in this country has reached epidemic proportions, but it is not a problem without a solution. Today’s report demonstrates a willingness from representatives across all political parties to investigate the systemic causes of obesity and develop a way forward.”

A key recommendation from the Inquiry’s report is the introduction of a tax on sugary drinks; something the OPC has led calls for, and which has been supported by around 40 public health, community and academic groups in the Tipping the Scales report.

Jane Martin, Executive Manager of the Obesity Policy Coalition, said that when two thirds of Australians are overweight or obese, the Inquiry’s comprehensive report provides an acknowledgement of the scale of the problem and a blueprint for tackling it .See part 4 Below for full press release

Part 1 SMH Article 

About 63 per cent of Australian adults are overweight or obese.

In a move that will likely delight health groups and enrage the food and beverage industries, it has recommended the government slap a tax on sugar-sweetened beverages (SSB), saying this would reduce sugar consumption, improve public health and push manufacturers to reformulate their products.

“The World Health Organisation has recommended governments tax sugary drinks and, at present, over 30 jurisdictions across the world have introduced a SSB tax as part of their effort and commitment toward preventing and controlling the rise of obesity,” the report said.

While health groups, such as Cancer Council, have demanded a 20 per cent levy, the committee suggested the government find the best fiscal model to achieve a price increase of at least 20 per cent.

“The impacts of sugary drinks are borne most by those on low income and they will also reap the most benefits from measures that change the behaviour of manufacturers,” it said.

About 63 per cent of Australian adults and 27 per cent of children aged 5 to 17 are overweight or obese, which increases the risk of developing heart disease and type 2 diabetes.

At the heart of the report is the recognition of the need for a National Obesity Taskforce, comprising government, health, industry and community representatives, which would sit within the Department of Health and be responsible for a National Obesity Strategy as well as a National Childhood Obesity Strategy.

“Australia does not have an overarching strategy to combat obesity,” it said.

“Many of the policy areas required to identify the causes, impacts and potential solutions to the obesity problem span every level of government.”

The committee has also urged the government to mandate the Health Star Rating (HSR) system, which is undergoing a five-year review, by 2020.

The voluntary front-of-pack labelling system has come under fire for producing questionable, confusing ratings – such as four stars for Kellogg’s Nutri-Grain – and becoming a “marketing tool”.

“Making it mandatory will drive food companies to reformulate more of their products in order to achieve higher HSR ratings,” the report said.

“The committee also believes that, once the HSR is made mandatory, the HSR calculator could be regularly adjusted to make it harder to achieve a five star rating.”

Pointing to a conflict-of-interest, it has recommended the HSR’s Technical Advisory Group expel members representing the industry.

“Representatives of the food and beverage industry sectors may be consulted for technical advice but [should] no longer sit on the HSR Calculator Technical Advisory Group,” it said.

The government has also been asked to consider introducing legislation to restrict junk food ads on free-to-air television until 9pm.

The group said existing voluntary codes were inadequate and also suggested that all junk food ads in all forms of media should display the product’s HSR.

The committee is made up of seven senators – two  Liberals, two Labor, one each from the Greens and One Nation and independent Tim Storer.

The Liberals wrote dissenting statements, saying a taskforce was unnecessary, HSR should remain voluntary, there shouldn’t be a sugar tax, and current advertising regulations were enough.

“No witnesses who appeared before the inquiry could point to any jurisdiction in the world where the introduction of a sugar tax led to a fall in obesity rates,” they said.

Labor senators also said there was no need for a sugar tax because there isn’t enough evidence.

“Labor senators are particularly concerned that an Australian SSB would likely be regressive, meaning that it would impact lower-income households disproportionately,” they said.

Committee chair, Dr Di Natale said: “We need the full suite of options recommended by the committee if we’re serious about making Australians happier, healthier, and more active.”

Part 2 ALL 22 Recommendations

Recommendation 1

The committee recommends that Commonwealth funding for overweight and obesity prevention efforts and treatment programs should be contingent on the appropriate use of language to avoid stigma and blame in all aspects of public health campaigns, program design and delivery.

Recommendation 2

The committee recommends that the Commonwealth Department of Health work with organisations responsible for training medical and allied health professionals to incorporate modules specifically aimed at increasing the understanding and awareness of stigma and blame in medical, psychological and public health interventions of overweight and obesity.

Recommendation 3

The committee recommends the establishment of a National Obesity Taskforce, comprising representatives across all knowledge sectors from federal, state, and local government, and alongside stakeholders from the NGO, private sectors and community members. The Taskforce should sit within the Commonwealth Department of Health and be responsible for all aspects of government policy direction, implementation and the management of funding

Recommendation 3.1

The committee recommends that the newly established National Obesity Taskforce develop a National Obesity Strategy, in consultation with all key stakeholders across government, the NGO and private sectors.

Recommendation 3.2

The committee recommends that the Australian Dietary Guidelines are updated every five years.

Recommendation 6

The committee recommends the Minister for Rural Health promote to the Australia and New Zealand Ministerial Forum on Food Regulation the adoption of the following changes to the current Health Star Rating system:

  • The Health Star Rating Calculator be modified to address inconsistencies in the calculation of ratings in relation to:
  • foods high in sugar, sodium and saturated fat;
  • the current treatment of added sugar;
  • the current treatment of fruit juices;
  • the current treatment of unprocessed fruit and vegetables; and
  • the ‘as prepared’ rules.
  • Representatives of the food and beverage industry sectors may be consulted for technical advice but no longer sit on the HSR Calculator Technical Advisory Group.
  • The Health Star Rating system be made mandatory by 2020.

Recommendation 7

The committee recommends Food Standards Australia New Zealand undertake a review of voluntary front-of-pack labelling schemes to ensure they are fit-forpurpose and adequately represent the nutritional value of foods and beverages.

Recommendation 8

The committee recommends the Minister for Rural Health promote to the Australia and New Zealand Ministerial Forum on Food Regulation the adoption of mandatory labelling of added sugar on packaged foods and drinks.

Recommendation 9

The committee recommends that the Council of Australian Governments (COAG) Health Council work with the Department of Health to develop a nutritional information label for fast food menus with the goal of achieving national consistency and making it mandatory in all jurisdictions.

Recommendation 10

The committee recommends the Australian Government introduce a tax on sugar-sweetened beverages, with the objectives of reducing consumption, improving public health and accelerating the reformulation of products.

Recommendation 11

The committee recommends that, as part of the 2019 annual review of the Commercial Television Industry Code of Practice, Free TV Australia introduce restrictions on discretionary food and drink advertising on free-to-air television until 9.00pm.

Recommendation 12

The committee recommends that the Australian Government consider introducing legislation to restrict discretionary food and drink advertising on free-toair television until 9.00pm if these restrictions are not voluntary introduced by Free TV Australia by 2020.

Recommendation 13

The committee recommends the Australian Government make mandatory the display of the Health Star Rating for food and beverage products advertised on all forms of media.

Recommendation 14

The committee recommends the proposed National Obesity Taskforce is funded to develop and oversee the implementation of a range of National Education Campaigns with different sectors of the Australian community. Educational campaigns will be context dependent and aimed at supporting individuals, families and communities to build on cultural practices and improve nutrition literacy and behaviours around diet, physical activity and well-being.

Recommendation 15

The committee recommends that the National Obesity Taskforce, when established, form a sub-committee directly responsible for the development and management of a National Childhood Obesity Strategy.

Recommendation 16

The committee recommends the Medical Services Advisory Committee (MSAC) consider adding obesity to the list of medical conditions eligible for the Chronic Disease Management scheme.

Recommendation 17

The committee recommends the Australian Medical Association, the Royal Australian College of General Practitioners and other college of professional bodies educate their members about the benefits of bariatric surgical interventions for some patients.

Recommendation 18

The committee recommends the proposed National Obesity Taskforce commission evaluations informed by multiple methods of past and current multistrategy prevention programs with the view of designing future programs.

Recommendation 19

The committee recommends the proposed National Obesity Taskforce is funded to develop and oversee the implementation of multi-strategy, community based prevention programs in partnership with communities.

Recommendation 20

The committee recommends the proposed National Obesity Taskforce develop a National Physical Activity Strategy.

Recommendation 21

The committee recommends the proposed National Obesity Taskforce is funded to develop and oversee culturally appropriate prevention and intervention programs for Aboriginal and Torres Strait Islander communities.

Recommendation 22

The committee recommends the Commonwealth develop additional initiatives and incentives aimed at increasing access, affordability and consumption of fresh foods in remote Aboriginal and Torres Strait Islanders

Part 3 Protect our children chronic disease groups support calls to restrict junk food advertising

Junk food advertising to children urgently needs to be better regulated.

That’s a recommendation from the Senate report on obesity, released last night, and a message that the Australian Chronic Disease Prevention Alliance strongly supports.

Chair of the Australian Chronic Disease Prevention Alliance Sharon McGowan said limiting unhealthy food marketing would reduce children’s exposure to unhealthy food and its subsequent consumption.

“Unhealthy weight is a major risk factor for cancer, diabetes, heart disease, stroke and kidney disease. Preventing obesity in children is particularly important, as it is difficult to reverse weight gain once established,” Ms McGowan said.

Ms McGowan said one in four children are already overweight or obese, and more likely to grow into adults who are overweight or obese with greater risk of chronic disease.

“While there are multiple factors influencing unhealthy weight gain, this is not an excuse for inaction,” she said. “Food companies are spending big money targeting our kids, unhealthy food advertising fills our television screens, our smartphones and digital media channels.

“Currently, self-regulation by industry is limited and there are almost no restrictions for advertising unhealthy foods online – this has to stop.

“We need to act now to stem this tide of obesity and preventable chronic disease, or we risk being the first generation to leave our children with a shorter life expectancy than our own.”

The Australian Chronic Disease Prevention Alliance also welcomed the Report’s recommendations for the establishment of a National Obesity Taskforce, improvements to the Health Star Rating food labelling system, development a National Physical Activity Strategy and introduction of a sugary drinks levy.

“We support the recent Government commitment to develop a national approach to obesity and urge the government to incorporate the recommendations from the Senate report for a well-rounded approach to tackle obesity in Australia,” Ms McGowan said.

Part 4

Sugary drink levy among 22 recommendations

The Obesity Policy Coalition (OPC) has welcomed a Senate Inquiry report into the Obesity Epidemic in Australia as an important step toward saving Australians from a lifetime of chronic disease and even premature death.

Jane Martin, Executive Manager of the Obesity Policy Coalition, said that when two thirds of Australians are overweight or obese, the Inquiry’s comprehensive report provides an acknowledgement of the scale of the problem and a blueprint for tackling it.

“Obesity in this country has reached epidemic proportions, but it is not a problem without a solution. Today’s report demonstrates a willingness from representatives across all political parties to investigate the systemic causes of obesity and develop a way forward.”

A key recommendation from the Inquiry’s report is the introduction of a tax on sugary drinks; something the OPC has led calls for, and which has been supported by around 40 public health, community and academic groups in the Tipping the Scales report.

“Sugar is a problem in our diets and sugary drinks are the largest contributor of added sugar for Australians. Consumption of these beverages is associated with chronic health conditions including type 2 diabetes, heart disease, some cancers and tooth decay,” Ms Martin said.

“We have been calling for a 20% health levy on sugary drinks for a number of years, but Australia continues to lag behind 45 other jurisdictions around the world that have introduced levies. When sugary drinks are often cheaper than water, it’s time to take action.”

The report also calls for a review of the current rules around junk food advertising to children.

Ms Martin insisted any review should prioritise an end to the advertising industry’s selfregulated codes.

“We know industry marketing is having a negative effect; it directly impacts what children eat and what they pester their parents for. It’s wallpaper in their lives, bombarding them during their favourite TV shows, infiltrating their social media feeds and plastering their sports grounds and uniforms when they play sport,” Ms Martin said.

“With more than one in four Australian children overweight or obese, it’s time for the Government to acknowledge that leaving food and beverage companies to make their own sham rules allows them to continue to prioritise profits over kids’ health.”

While the Inquiry’s report calls for a National Obesity Strategy, a commitment announced by the COAG Health Ministers earlier this year, Ms Martin stressed that this must be developed independently, without the involvement of the ultra-processed food industry, which has already hampered progress to date.

“The OPC, along with 40 leading community and public health groups, have set out clear actions on how best to tackle obesity in our consensus report, Tipping the Scales. These actions came through strongly from many of the groups who participated in the inquiry and we are pleased to see them reflected in the recommendations.

“The evidence is clear on what works to prevent and reduce obesity, but for real impact we need leadership from policy makers. We need to stop placing the blame on individuals. The Federal and State governments must now work together to push those levers under their control to stem the tide of obesity.”

The senate inquiry report contains 22 recommendations which address the causes, control of obesity, including:

  • The establishment of a National Obesity Taskforce, with a view to develop a National Obesity Strategy
  • Introduction of a tax on sugar-sweetened beverages
  • The Health Star Rating system be made mandatory by 2020
  • Adoption of mandatory labelling of added sugar
  • Restrictions on discretionary food and drink advertising on free-to-air television until 9pm
  • Implementation of a National Education Campaign aimed at improving nutrition literacy and behaviours around diet and physical activity
  • Form a sub-committee from the National Obesity Taskforce around the development and management of a National Childhood Obesity Strategy

BACKGROUND:

On 10 May 2018, the Senate voted to establish an inquiry to examine the impacts of Australia’s obesity epidemic.

The Select Committee into the obesity epidemic was established on 16 May 2018 to look at the causes of rising levels of obese and overweight people in Australia and how the issue affects children. It also considered the economic burden of the health concern and the effectiveness of existing programs to improve diets and tackle childhood obesity. The inquiry has received 145 submissions and has published its full report today.

The Committee held public hearings from public health, industry and community groups. The OPC provided a submission and Jane Martin gave evidence at one of these sessions.

NACCHO Aboriginal Health and Obesity NEWS : 1.Network Submission to the Select Committee’s #Obesity Epidemic in Australia Inquiry and our 13 recommendations: 2.Healthy Food Partnership Survey

 

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

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

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

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

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

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

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

Download the full 15 Page submission HERE

Obesity Epidemic in Australia – Network Submission – 6.7.18

 ” The Healthy Food Partnership is a mechanism for government, the public health sector and the food industry to cooperatively tackle obesity, encourage healthy eating and empower food manufacturers to make positive changes.

The Healthy Food Partnership’s Reformulation Working Group has developed draft reformulation targets for sodium, sugars and/or saturated fats, in 36 sub-categories of food.  These food categories are amongst the highest contributors of sodium, sugars and saturated fat to Australian population level intakes.”

See Healthy Food Partnership Survey Part 2 Below

Read over 50 NACCHO Aboriginal Health and Obesity articles published in past 6 years 

 

Introduction to NACCHO Network Sumission and selected extracts 

The National Aboriginal Community Controlled Health Organisation (NACCHO) is the peak body representing 143 Aboriginal Community Controlled Health Services (ACCHSs) across Australia.

ACCHSs provide comprehensive primary health care to Aboriginal and Torres Strait Islander people through over 300 Aboriginal medical clinics throughout Australia.

ACCHSs deliver three million episodes of care to around 350,000 people each year, servicing over 47% of the Aboriginal population, with about one million episodes of care delivered in remote areas.

The Aboriginal Community Controlled Health Service (ACCHS) sector is the largest single employer of Indigenous people in the country, employing 6,000 staff, the majority of whom are Aboriginal or Torres Strait Islander.

The evidence that the ACCHS model of comprehensive primary health care delivers better outcomes than mainstream services for Aboriginal people is well established.

Without exception, where Aboriginal people and communities lead, define, design, control and deliver services and programs to their communities, they achieve improved outcomes.

The ACCHS model of care has its genesis in Aboriginal people’s right to self-determination, and is predicated on principles that incorporate a holistic, person-centred, whole-of-life, culturally secure approach.

The ACCHS principles of self-determination and community control remain central to wellbeing and sovereignty of Aboriginal people. Equipped with inequitable levels of funding and resources ,

ACCHSs continue to meet the ongoing challenges of addressing the burden of disease in Aboriginal communities.

Executive summary

The National Aboriginal Community Controlled Health Organisation (NACCHO) welcomes the opportunity to provide input into the Inquiry into the Obesity epidemic in Australia.

Aboriginal and Torres Strait Islander people represent approximately 3% of the Australian population yet are disproportionately over-represented on almost every indicium of social, health and wellbeing determinant.

Social determinants and historical factors such as intergenerational trauma, racism, social exclusion, and loss of land and culture are commonly recognised as causative factors for these disparities.

In 2008 the Council of Australian Governments (COAG) committed to addressing the health disparity between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians by adopting the Closing the Gap initiative. Whilst gaining some success in achieving convergence for some health indicators, wide health and wellbeing disparity still remains for both children and adults.

The life expectancy gap between Indigenous and non-Indigenous Australians remains 10.6 years for males and 9.5 years for females.

As a major contributor to morbidity and mortality among Indigenous Australians, obesity is estimated to account for 16% of the health gap between Aboriginal and Torres Strait Islander peoples and the total Australian population.

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

Closing the Gap, including the gap attributable to obesity, requires ensuring the ACCHS sector is resourced to deliver the full range of core services required under a comprehensive and culturally safe model of primary health care. The effectiveness of ACCHSs has long been recognised, with many able to document better health outcomes than mainstream services for the communities they serve.

Combating the burden of obesity and its health effects for Indigenous Australians demands a strategic and coordinated whole-of-society approach at a national level by the Federal Government.

Without coordinated, sustained national action, efforts to improve the health status of Aboriginal children are likely to fail. In recognising the need to seriously address this critical and increasing gap in Indigenous health, NACCHO welcomes this inquiry and proposes the following recommendations:

  1. Government to work in partnership with NACCHO and the ACCHS sector to develop policies and plans that are responsive to the needs of Aboriginal communities
  2. A commitment to increase the understanding of Aboriginal and Torres Strait Islander peoples of the health significance of overweight and obesity, and facilitating access for these communities to resources which support healthy eating and physical activity
  3. Additional investment to build organisational capacity within the ACCHS sector and to increase the capacity of Aboriginal Health Promotion Officers to maintain a focus on public health initiatives
  4. Government to encourage professional support systems for, and assist Aboriginal Health Worker’s and other primary care workers to provide advice to adults and children about weight management as part of existing health checks and screening programs – this may be achieved by encouraging the MBS Aboriginal Health Check item to communicate more effectively the importance of physical activity, nutrition and weight management
  5. Fund the development of Aboriginal and Torres Strait Islander cultural awareness training for health care professionals covering care, education and information relating to food, physical activity, lifestyle choices and health service arrangements
  6. In understanding that health promotion is more difficult in regional and rural Australia, targeted funding should be dedicated to these areas to overcome the pervasive problems associated with distance
  7. A commitment to ongoing consultation with Aboriginal communities on what can be achieved at a local level to effectively promote healthy eating and physical activity for children
  8. Facilitate access for Aboriginal and Torres Strait Islander communities to resources which support lifestyle changes, including access to information, physical activity opportunities, and healthy food choices
  9. The prevalence of childhood obesity and the absence of culturally specific programs for Aboriginal and Torres Strait Islander people warrants further work in the development of culturally appropriate programs and tailored communication strategies alongside mainstream campaigns and messages
  10. Given the paucity of studies on Indigenous children, there is a need for further research on effective obesity prevention interventions for Indigenous families. This requires commitment to more detailed monitoring of young Indigenous children’s diets and their physical activity
  11. Government to work with the food industry and community stores to implement retail intervention strategies to positively influence access to and consumption of healthy food choices for Aboriginal and Torres Strait Islander communities
  12. Consider mechanisms to sustain programs on physical activity, nutrition and weight management that have proven effective
  13. Ensure significant participation of Aboriginal and Torres Strait Islander people in national surveys and evaluations by enhancing the sampling frame and applying culturally appropriate recruitment strategies

Evidence-based measures and interventions to prevent and reverse childhood obesity, including experiences from overseas jurisdictions

Evidence-based profiling of obesity and overweight in Indigenous Australian children has been poor, with very little known about the effectiveness of culturally adapted children’s interventions. Given the impact on health, finances and community, the need for better strategies and interventions to manage obesity are now being recognised by the entire health system.

Historically, initiatives have focused on nutrition or physical activity as separate entities and have shown modest effects. In recent years, global interventions considering the wider ‘obesogenic environment’ have been recommended, with policymakers and public health practitioners increasingly turning to evidence-based strategies to discover effective interventions to childhood obesity.

It is important to note, however, that the rapidly growing body of literature has meant many recommendations for childhood obesity have often relied on research that has not been systematically reviewed and focused more on assessing the internal validity of study results than on evaluating the external validity, feasibility or sustainability of intervention effects.

Experience in several countries has shown that successful obesity prevention during childhood can be achieved through a combination of population-based initiatives.li There is strong evidence for the effectiveness of school-based strategies, acting as an ideal setting for interventions to support healthy behaviours, and can also potentially reach most school age 9 children of diverse ethnic and socioeconomic groups. The Centre for Disease Control and Prevention (CDC) recommends a curriculum that is culturally appropriate and a school environment that reflects the culture within the community by demonstrating cultural awareness in healthy eating and physical activity practices.l

Examples of school-based strategies include policies that limit student access to foods and beverages that are high in fats and sugar, contributing to decreased consumption during the school dayliii, and efforts to increase physical activity leading to a lowered body mass indexliv and improved cognitive abilities,lv especially in younger children. An evaluation of a school-based health education program for urban Indigenous youth found compromising results in physical activity, breakfast intake and fruit and vegetable consumption, all of which are core components of healthy weight management.lvi

Studies have examined the effectiveness of culturally specific versions of programs to tackle obesity, including a US study comparing a mainstream program with a culturally adapted version. Findings were that cultural adaptations improved recruitment and retention numbers, with the authors recommending that to improve program design, ethnic communities and organisations should be approached to collaborate with researchers in design, modifications, recruitment techniques, implementation, evaluation and interpretation of results.lvii

A 2013 Canadian pilot evaluation of a whole-school health promotion program, Healthy Buddies, involved researchers consulting Aboriginal community members about how the program could be more effective, sustainable and culturally appropriate, resulting in a new version called Healthy Buddies – First Nations. Prior to implementation, communities were able to review the program and tailor its cultural appropriateness. Lesson content and visual aids were amended to resemble Aboriginal children, as well as Aboriginal food and activities.lviii In promoting social responsibility through the buddy system, the program showed a significant lowering in BMI and waist circumference and was considered particularly important for remote communities.

Systematic and evidence-based reviews have suggested promise in tailoring programs to be more culturally appropriate for specific ethnic and culturally diverse groups. The 2014 Global Nutrition Report, which examined the limited access to supermarkets and a reliance on fast-food as contributing to the growing prevalence of obesity in American Indian communities, recommended that interventions need to be multi-faceted, culturally sensitive, grounded in cultural traditions, and developed with full participation of American Indian communities.lix

Similar recommendations were made in a review by Toronto Public Health, identifying that interventions targeting children from low socioeconomic or culturally diverse backgrounds can positively impact on physical activity levels and dietary intake. This highlights the need to consider focusing on specific cultural backgrounds, like Indigenous Australians, when planning obesity prevention interventions to achieve better outcomes.

The role of the food industry in contributing to poor diets and childhood obesity in Australia

Improving the access to and availability of nutritious food is a vital step to combating the prevalence of obesity. Indigenous people living in rural and remote areas in particular face significant barriers in accessing nutritious and affordable food.

The level and composition of food intake is influenced by socio-economic status, high prices, poor quality fruit and vegetables in community stores, and unavailability of many nutritious foods.lxi This is indeed exacerbated by the exposure to high levels of unhealthy food marketing across a range of media. 10

The ubiquitous marketing of unhealthy food creates a negative food culture, undermining nutrition recommendations.

Substantial research documents the extensiveness and persuasive nature of food marketing in Australia; importantly, the vast majority of all food and drink marketing, regardless of medium or setting, is for food and drinks high in fat, sugar and/or salt.lxii Australian children are exposed to high levels of unhealthy food marketing through a range of mediums, including sponsorship arrangements with children’s sport. With research identifying a logical sequence of effects linking food promotion to individual-level weight outcomes,lxiii it is clear that food marketing influences children’s attitudes and subsequent food consumption.

Australia’s National Preventative Health Taskforce has highlighted the importance of restricting inappropriate marketing of unhealthy food and beverages to children as a cost-effective obesity prevention strategy.lxiv Clear affirmative action in Australia to such marketing has been lacking to date, compounding the need for Government to explore options for regulating the production, marketing and sale of energy-dense and nutrient-poor products to reduce consumption.

Research has shown that the prevalence of obesity increases and consumption of fruit and vegetables decreases with increasing distance to grocery stores and supermarketslxv and a higher density of convenience stores and take-away food outlets.lxvi Cost is also a major issue, with the price of basic healthy foods increased by 50% or more in rural and remote areas where there is a higher proportion of Indigenous residents compared to non-Indigenous residents than in urban areas.lxvii The purchasing behaviour of children is particularly sensitive to price, and can have significant effects over time.

Foods of better nutritional choice, including fresh fruits and vegetables, are often expensive due to transportation and overhead costs, or only minimally available.lxviii Comparatively, takeaway and convenience food, often energy-dense and high in fat or sugar, are less affected by cost and availability.

A study of intake of six remote Aboriginal communities, based on store turnover, found that intake of energy, fat and sugar was excessive, with fatty meats making the largest contribution to fat intake.lxx Compared with national data, intake of sweet and carbonated beverages and sugar was much higher in these communities, with the proportion of energy derived from refined sugars approximately four times the recommended intake.

Recent evidence from Mexico indicates that implementing health-related taxes on sugary drinks and on ‘junk’ food can decrease purchase of these foods and drinks.lxxi A recent Australian study predicted that increasing the price of sugary drinks by 20% could reduce consumption by 12.6%.lxxii Revenue raised by such a measure could be directed to an evaluation of effectiveness and in the longer term be used to subsidise and market healthy food choices as well as promotion of physical activity.

It is imperative that all of these interventions to promote healthy eating should have community-ownership and not undermine the cultural importance of family social events, the role of Elders, or traditional preferences for some food. Food supply in Indigenous communities needs to ensure healthy, good quality foods are available at affordable prices.

In Summary

It is widely understood that many Aboriginal and Torres Strait Islander people, predominantly children, are at high-risk of ill-health due to overweight and obesity. This is likely to lead to a widening gap in health outcomes for Indigenous Australians if prevention efforts are not improved. Despite the identified health and economic gains which can be achieved by using a social determinants and culturally appropriate approach, Australia is yet to embed such thinking in health policy.

Policy in isolation will not solve the epidemic of childhood obesity for Indigenous children. What is required, is urgent action to address poverty, education, unemployment and housing, all of which are factors that shape a child’s ability to engage with healthy behaviours. There also needs to be close ongoing national monitoring through the collection of comparable data; more detailed monitoring of the composition of young Indigenous children’s diets and physical activity is necessary to determine whether patterns are changing in response to interventions.

Undeniably, strategic investment is needed to implement population-based childhood obesity prevention programs which are effective and also culturally appropriate, evidence-based, easily understood, action-oriented and motivating. Interventions must be positioned within broad strategies addressing the continuing social and economic disadvantages that many Indigenous people experience and need to have an emphasis on training community-based health workers, particularly in the ACCHS sector who are best placed to respond to the increasing rates of obesity and associated health concerns for Aboriginal and Torres Strait Islander people.

The ACCH sector has a central role in promoting and improving health outcomes for Indigenous people yet requires additional targeted funding and resources to implement new initiatives, including intervention, education, and research to encourage physical activity and healthy nutrition. Indeed, multifaceted strategies involving the public, private and ACCHS sector, along with community participation and government support, are required to gradually reverse this trend.

NACCHO and its Affiliates in each State and Territory appreciate the opportunity to make this submission on behalf of our member services. With circumstances unimproved after years of policy approaches, the need remains to overturn the prevalence of overweight and obesity of Indigenous people. There needs to be a commitment at all levels of government in terms of funding, policy development, and support for the implementation of culturally appropriate programs and services. There must be a recognition that self-determination of Aboriginal and Torres Strait Islander people will be the foundation of true progress.

NACCHO strongly recommend that Government engage in meaningful dialogue with NACCHO, NACCHO’s Affiliates in each State and Territory and ACCHSs in relation to the proposals canvassed in this response; and work in partnership to address the significant prevalence of obesity in Aboriginal and Torres Strait Islander people, especially children

 

Part 2 Overview Healthy Food Partnership Survey 

The Healthy Food Partnership is a mechanism for government, the public health sector and the food industry to cooperatively tackle obesity, encourage healthy eating and empower food manufacturers to make positive changes.

The Healthy Food Partnership’s Reformulation Working Group has developed draft reformulation targets for sodium, sugars and/or saturated fats, in 36 sub-categories of food.  These food categories are amongst the highest contributors of sodium, sugars and saturated fat to Australian population level intakes.

Please note the different closing dates relating to feedback on the various nutrient targets.

Why We Are Consulting

The Healthy Food Partnership (Partnership) recognises that many companies are already reformulating their products to improve the nutritional quality and aims to build on (rather than replicate) these efforts.

It is not the intention of the Partnership to disadvantage companies that are already reformulating, but to recognise and support their efforts to date, and encourage those companies that are yet to engage in reformulation activities to move towards improving the nutritional profile of their products.  Targets will create certainty for industry of what they, and their competitors, should be aiming for.

Feedback is sought on the feasibility of the draft targets, the appropriateness of the draft category definitions (including products which are included or excluded), and the proposed implementation period (four years).  Consultation feedback will inform the final recommendations of the Reformulation Working Group, to the Partnership’s Executive Committee.

Deidentified information from submissions will be provided to the Reformulation Working Group and other committees involved with the Healthy Food Partnership.

Submissions will be published at the end of the consultation period, unless confidentiality has been requested.

Begin survey

NACCHO Aboriginal Health and #Obesity : Contributions to the Select Committee into the #obesity epidemic in Australia close 6 July

” More than two-thirds (69%) of Aboriginal and Torres Strait Islander adults were overweight or obese (29% overweight but not obese, and 40% obese). Indigenous men (69%) and women (70%) had similar rates of overweight and obesity (ABS 2014a).

One-third (32%) of Indigenous men and more than one-quarter (27%) of Indigenous women were overweight but not obese, while 36% of Indigenous men, and 43% of Indigenous women were obese ”

See NACCHO Aboriginal Health article

There is clear and robust evidence that children’s exposure to unhealthy food advertising influences their food choices, influences their diets, and can contribute to poor diets, overweight and obesity.

Despite Australian children’s high rates of overweight and obesity, there are few controls on advertising practices targeting advertisements for unhealthy foods and beverages to children in Australia and much is left up to self-regulation by the food and beverage industry.

The Obesity Policy Coalition advocates for improved regulatory controls to reduce children’s exposure to this type of harmful advertising

SEE OPC Page

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

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

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

 OPC Executive Manager Jane Martin 

Download the report HERE  tipping-the-scales

Read over 90 Aboriginal Health Obesity articles published over the past 6 years

The Senate is currently holding a Select Committee into the Obesity Epidemic in Australia, with a focus on childhood obesity. The Committee will be exploring the prevalence, causes, harm and economic burden of childhood obesity. They will also be exploring the effectiveness of existing policies and programs to address childhood obesity and role of the food industry in contributing to childhood obesity.

The Select Committee provides a valuable opportunity for us to show that there is an urgent need for action to prevent obesity, particularly among children. It also comes at a critical time when pressure is mounting on the Australian Government to act.

Submissions to the Inquiry are due by Friday 6 July 2018. Submissions can be made to Committee Secretary at obesitycommittee.sen@aph.gov.au. You can also find out more about the Committee here.

If you want to put in a submission please use one of the following:

Please use this opportunity to encourage others to make a submission on this important issue, the more submissions the better.

If you want to share this with your colleagues through your website or bulletins, here is some material to use.

Tipping the Scales report

In September 2017 more than 35 leading community, public health, medical and academic groups united for the first time to call for urgent Federal Government action to address Australia’s serious obesity problem.

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

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

Tipping the Scales: Australian Obesity Prevention Consensus

This consensus document delivers a rigorous and evidence-based agenda to our Federal Government and establishes the key elements to include in a national strategy, as well as the basis for an ongoing dialogue, about the best ways to address the obesity epidemic.

Tipping the Scales: summary sheet

Summary document of the Tipping the Scales eight key points.

 

 

 

NACCHO Aboriginal Health @VACCHO_org @Apunipima join major 2018 health groups campaign @Live Lighter #RethinkSugaryDrink launching ad showing heavy health cost of cheap $1 frozen drinks

 

“A cheeky, graphic counter-campaign taking on cheap frozen drink promotions like $1 Slurpees and Frozen Cokes has hit Victorian bus and tram stops to urge Australians to rethink their sugary drink. 

Rather than tempt viewers with a frosty, frozen drink, the “Don’t Be Sucked In” campaign from LiveLighter and Rethink Sugary Drink, an alliance of 18 leading health agencies, shows a person sipping on a large cup of bulging toxic fat. “

NACCHO has published over 150 various articles about sugar , obesity etc

Craig Sinclair, Chair of Cancer Council Australia’s Public Health Committee, said while this graphic advertisement isn’t easy to look at, it clearly illustrates the risks of drinking too many sugary drinks.

“Frozen drinks in particular contain ridiculous amounts of added sugar – even more than a standard soft drink.”

“A mega $3 Slurpee contains more than 20 teaspoons of sugar.

That’s the same amount of sugar as nearly eight lemonade icy poles, and more than three times the maximum recommended by the World Health Organisation of six teaspoons a dayi.”

“At this time of year it’s almost impossible to escape the enormous amount of advertising and promotions for frozen drink specials on TV, social media and public transport,” Mr Sinclair said.

“These cheap frozen drinks might seem refreshing on a hot day, but we want people to realise they could easily be sucking down an entire week’s worth of sugar in a single sitting.”

A large frozen drink from most outlets costs just $1 – a deal that major outlets like 7-Eleven, McDonald’s, Hungry Jacks and KFC promote heavily.

LiveLighter campaign manager and dietitian Alison McAleese said drinking a large Slurpee every day this summer could result in nearly 2kg of weight gain in a year if these extra kilojoules aren’t burnt

“This summer, Aussies could be slurping their way towards weight gain, obesity and toxic fat, increasing their risk of 13 types of cancer, type 2 diabetes, heart and kidney disease, stroke and tooth decay,” Ms McAleese said.

“When nearly two thirds of Aussie adults and a third of kids are overweight or obese, it’s completely irresponsible for these companies to be actively promoting excessive consumption of drinks completely overloaded with sugar.

“And while this campaign focuses on the weight-related health risks, we can’t ignore the fact that sugary drinks are also a leading cause of tooth decay in Australia, with nearly half of children aged 2– 16 drinking soft drink every day.ii 

“We’re hoping once people realise just how unhealthy these frozen drinks are, they consider looking to other options to cool off.

“Water is ideal, but even one lemonade icy pole, with 2.7tsp of sugar, is a far better option than a Slurpee or Frozen Coke.”

Mr Sinclair said a health levy on sugary drinks is one of the policy tools needed to help address the growing impact of weight and diet-related health problems in Australia.

“Not only can a 20% health levy help deter people from these cheap and very unhealthy drinks, it will help recover some of the significant costs associated with obesity and the increasing burden this puts on our public health care system,” he said.

This advertising will hit bus and tram stops around Victoria this week and will run for two weeks. #

 

FROZEN DRINKS: More  FACTSiii 

About LiveLighter: LiveLighter® is a public health education campaign encouraging Australian adults to lead healthier lives by changing what they eat and drink, and being more active.

In Victoria, the campaign is delivered by Cancer Council Victoria and Heart Foundation Victoria. In Western Australia, LiveLighter is delivered by Heart Foundation WA and Cancer Council WA.

For more healthy tips, recipes and advice visit

www.livelighter.com.au

About Rethink Sugary Drink: Rethink Sugary Drink is a partnership between the Apunipima Cape York Health Council, Australian Dental Association, Australian Dental and Oral Health Therapists’ Association, Cancer Council Australia, Dental Health Services Victoria, Dental Hygienists Association of Australia, Diabetes Australia, Healthier Workplace WA, Kidney Health Australia, LiveLighter, The Mai Wiru Sugar Challenge Foundation, Nutrition Australia, Obesity Policy Coalition, Stroke Foundation, Parents’ Voice, the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) and the YMCA to raise awareness of the amount of sugar in sugar-sweetened beverages and encourage Australians to reduce their consumption.

Visit www.rethinksugarydrink.org.au for more information.

NACCHO Aboriginal Health and #Obesity : Download @AIHW report : A picture of overweight and obesity in Australia

Obesity

 ” Aboriginal and Torres Strait Islander children and adolescents are more likely to be overweight or obese than non-Indigenous children and adolescents.

In 2012–13, 30% of Indigenous children and adolescents aged 2–14 were overweight or obese, compared with 25% of their non-Indigenous counterparts. One in 10 (10%) Indigenous children and adolescents aged 2–14 were obese, compared with 7% of their non-Indigenous counterparts (ABS 2014a).

Prevalence among Indigenous children and adolescents see section 2 below

 ” In 2012–13, more than two-thirds (69%) of Aboriginal and Torres Strait Islander adults were overweight or obese (29% overweight but not obese, and 40% obese). Indigenous men (69%) and women (70%) had similar rates of overweight and obesity (ABS 2014a).

One-third (32%) of Indigenous men and more than one-quarter (27%) of Indigenous women were overweight but not obese, while 36% of Indigenous men, and 43% of Indigenous women were obese ”

Prevalence among Indigenous adults see section 3 below

Read over 30 NACCHO Aboriginal Health and Obesity articles

afile-5

Download AIHW Report HERE

aihw-phe-216.pdf

 ” Australian food ministers expect parents to make healthier choices for their families, but take no action on giving them the tools to know how much added sugar is in food. Shameful, given AIHW stats showing obesity has doubled in 2-5 year olds in the last 20 years.

 Health Ministers acknowledge that added sugar labelling is an issue but delay taking any action. Added sugar labelling has been delayed since 2011, this is very disappointing.”

Communique : The Australia and New Zealand Ministerial Forum on Food Regulation (the Forum) met in Melbourne Friday 24 Nov . The Forum is chaired by the Australian Government Assistant Minister for Health, Dr David Gillespie 

Download full Communique Forum Communique 24 November 2017

Sugar Labelling

In April 2017, the Forum Ministers agreed a work program on sugar that included:

  • ̵further evidence gathering activities by Food Standards Australia New Zealand on consumer understanding and behaviour;
  • ̵international approaches to sugar labelling; and
  • ̵an update of the policy context.

Noting the desire of Forum Ministers to take a whole-of-diet, holistic approach to food labelling, Forum Ministers considered that information about sugar provided on food labels does not provide adequate contextual information to enable consumers to make informed choices in support of dietary guidelines. Forum Ministers agreed to continue examining regulatory and non-regulatory options to address this issue.

Forum Ministers also noted the range of existing complementary initiatives outside of the food regulation system that address sugar intakes, such as the current review of the Health Star Rating system, policy work underway on the labelling of fats and oils, and the work of the Healthy Food Partnership.

Jane Martin Obesity Coalition updating our NACCHO Post from last week

NACCHO Aboriginal Health #sugar and #Sugardemic : Todays meeting of Health Ministers is a real chance to improve #HealthStarRatings for our Mob

Part 1 Executive summary

Overweight and obesity is a major public health issue in Australia. It results from a sustained energy imbalance—when energy intake from eating and drinking is greater than energy expended through physical activity.

This energy imbalance might be influenced by a person’s biological and genetic characteristics, and by lifestyle factors.

This report brings together a variety of information to create a picture of overweight and obesity in Australia.

It summarises factors that influence people’s energy intake and expenditure and contribute to the rising prevalence of overweight and obesity, as well as some approaches aiming to reduce its prevalence.

It presents the prevalence of overweight and obesity in children, adolescents, and adults, and includes trends over time, differences among population groups, and the health and economic impact of overweight and obesity.

One-quarter of children and adolescents are overweight or obese

In 2014–15, 1 in 5 (20%) children aged 2–4 were overweight or obese—11% were overweight but not obese, and 9% were obese.

About 1 in 4 (27%) children and adolescents aged 5–17 were overweight or obese—20% were overweight but not obese, and 7% were obese.

For both children aged 2–4 and 5–17 years, similar proportions of girls and boys were obese. For children aged 5–17, the prevalence of overweight and obesity rose from 21% in 1995 to 25% in 2007–08, then remained relatively stable to 2014–15.

Nearly two-thirds of adults are overweight or obese, and obesity is on the rise

In 2014–15, nearly two-thirds (63%) of Australian adults were overweight or obese. The prevalence of overweight and obesity has steadily increased, up from 57% in 1995—which has largely been driven by a rise in obesity.

The prevalence of severe obesity among Australian adults has almost doubled over this period, from 5% in 1995 to 9% in 2014–15.

In 2014–15, 71% of men were overweight or obese, compared with 56% of women. A greater proportion of men (42%) than women (29%) were overweight but not obese, while a similar proportion of men (28%) and women (27%) were obese.

More men than women were overweight or obese in 2014–15; a similar proportion were obese overweight or obese overweight but not obese

For children aged 5–17, the prevalence of overweight and obesity rose from 1995 to 2007–08 and remained relatively stable to 2014–15

Some groups are more likely to be overweight or obese than others

Compared with non-Indigenous Australians, Indigenous adults are more likely to be overweight or obese, and Indigenous children and adolescents are more likely to be obese.

Those who live outside of Major cities, or who are in the lower socioeconomic groups are more likely to be overweight or obese than others.

Overweight and obesity has high health and financial costs

Among adults, overweight and obesity has adverse health and economic impacts, including a higher risk of developing many chronic conditions, and of death (due to any cause).

Overweight and obesity was responsible for 7% of the total health burden in Australia in 2011, 63% of which was fatal burden. In 2011–12, obesity was estimated to have cost the Australian economy $8.6 billion.

Small changes, big health gains

If all Australians at risk of disease due to overweight or obesity reduced their body mass index by just 1 kilogram per metre squared, or about 3 kilograms for a person of average height, the overall health impact of excess weight would drop substantially.

Maintaining any weight loss is critical for long-term health gains.

Indigenous Australians and those living outside Major cities or who are in lower socioeconomic groups are more likely to be overweight or obese

Approaches for reducing overweight and obesity

Population health approaches to address overweight and obesity provide an opportunity for widespread benefit. They include laws and regulations, tax and price interventions, community-based interventions—including those in schools and workplaces—and public education through platforms such as social marketing campaigns.

Individual-level approaches are also important, and may either be preventive, or incorporate treatment strategies such as weight loss surgery.

Part 2 Prevalence among Indigenous children and adolescents

Aboriginal and Torres Strait Islander children and adolescents are more likely to be overweight or obese than non-Indigenous children and adolescents.

file2-2

In 2012–13, 30% of Indigenous children and adolescents aged 2–14 were overweight or obese, compared with 25% of their non-Indigenous counterparts. One in 10 (10%) Indigenous children and adolescents aged 2–14 were obese, compared with 7% of their non-Indigenous counterparts (ABS 2014a).

At age 15–17, 35% of Indigenous adolescents were overweight or obese, compared with 24% of non-Indigenous adolescents of the same age, and 14% of Indigenous adolescents were obese, double the proportion (7%) of non-Indigenous adolescents.

Indigenous boys and girls were most likely to be overweight but not obese at age 10–14 (26% for boys, and 25% for girls) (Figure 3.4), and they were most likely to be obese at age 15–17 for boys (17%), and 5–9 for girls (13%).

Part 3 Prevalence among Indigenous adults

In 2012–13, more than two-thirds (69%) of Aboriginal and Torres Strait Islander adults were overweight or obese (29% overweight but not obese, and 40% obese). Indigenous men (69%) and women (70%) had similar rates of overweight and obesity (ABS 2014a).

file3-1

One-third (32%) of Indigenous men and more than one-quarter (27%) of Indigenous women were overweight but not obese, while 36% of Indigenous men, and 43% of Indigenous women were obese.

Indigenous men were most likely to be overweight but not obese at age 45–54 (38%), and to be obese at 55 and over (47%). Indigenous women were most likely to be overweight but not obese at 55 and over (32%), and were more likely to be obese, rather than overweight but not obese, at all ages. This was most noticeable in women aged 45–54, who were more than twice as likely to be obese (51%) than overweight but not obese (25%) (Figure 4.7).

In 2012–13, after adjusting for differences in age structure, Aboriginal and Torres Strait Islander adults were 1.2 times as likely to be overweight or obese as non-Indigenous adults, and 1.6 times as likely to be obese (ABS 2014a).

Part 4 Prevalence by Primary Health Network area

There are 31 Primary Health Network (PHN) areas across Australia, and reporting at these smaller, local areas can provide results that could be masked in national-or state/territory-level results.

PHNs commission and connect health services within PHN area boundaries, which are defined by the Department of Health (Department of Health 2016). The information in this section relates to the population living within the area covered by a particular PHN.

In 2014–15, of measured PHN areas, the Country South Australia PHN area had the highest prevalence of overweight and obesity, at almost three-quarters of adults (73%) (Figure 4.8). The Northern Sydneyfile-5

PHN area had the lowest prevalence, with just over half of adults being overweight or obese (53%). Four PHN areas had proportions of overweight and obese adults of 70% or more—Country South Australia, Western New South Wales, Darling Downs and West Moreton (Queensland), and Western Victoria.

The prevalence of overweight and obesity among adults varied between metropolitan and regional PHN areas. In 2014–15, regional PHN areas had higher proportions of adults who were overweight and obese (69%) than metropolitan PHN areas (61%).

There was no significant difference between the proportion of overweight but not obese adults in metropolitan (36%) and regional (34%) PHN areas. But the difference was significant for obesity alone—more than one-third (35%) of adults in regional PHN areas were obese, compared with about one-quarter (24%) in metropolitan PHN areas (AIHW 2016e).

Structure of this report

  • Chapter 2 describes the factors that influence overweight and obesity in Australia, including food and nutrition, physical activity, sedentary behaviour, and the ‘obesogenic environment’.
  • Chapters 3 and 4 present the most recent Australian data on prevalence and trends in overweight and obesity, including breakdowns by remoteness area, socioeconomic group, and Indigenous status, as well as international comparisons of obesity prevalence, and data on overweight and obesity for Australian mothers during pregnancy.
  • Chapter 5 presents data on the health impacts of overweight and obesity in Australia, including chronic conditions, death, and the burden of disease associated with overweight and obesity, as well some of the direct and indirect economic impacts.
  • Chapter 6 describes approaches that have been implemented in Australia to target overweight and obesity at the individual level, such as weight loss surgery, and population level, including laws and regulations, tax and price interventions, community-based interventions, and health promotion measures.
  • Supplementary data tables for the data presented in figures throughout this report are available on the AIHW website at: <https://www.aihw.gov.au/reports/overweight-obesity/ a-picture-of-overweight-and-obesity-in-australia/data>.

Table of contents

1 Introduction

  • Defining overweight and obesity
  • Measuring overweight and obesity in children
  • Structure of this report

 

2 Factors leading to overweight and obesity

◦Food and nutrition

◦Physical activity

◦The obesogenic environment ◾Schools

◾Workplace

◾Home and neighbourhood

◾Media influence

◾Increase in convenience foods and portion sizes

3 Overweight and obesity among children and adolescents

◦Prevalence of overweight and obesity in children and adolescents

◦Trends in prevalence

◦Prevalence by birth cohort

◦Prevalence by remoteness area

◦Prevalence by socioeconomic group

◦Prevalence among Indigenous children and adults

4 Overweight and obesity among adults

◦Prevalence of overweight and obesity in adults

◦Body mass index

◦Waist circumference

◦Trends in prevalence

◦Prevalence by birth cohort

◦Prevalence by remoteness area

◦Prevalence by socioeconomic group

◦Prevalence among Indigenous adults

◦Prevalence by Primary Health Network area

◦International comparisons

◦Maternal overweight and obesity

5 Impact of overweight and obesity

◦Health impacts

◾Chronic conditions

◾Mortality

◾Burden of disease

◦Economic impacts

6 Approaches for reducing overweight and obesity

◦Laws and regulations

◦Tax and price interventions

◦Community-based interventions

◦Health promotion

◦Weight loss surgery

  • Appendix A: Classification of overweight and obesity for children and adolescents
  • Appendix B: Defining socioeconomic groups
  • Appendix C: Measuring overweight and obesity
  • rates at Primary Health Network area level
  • Appendix D: State and territory policy actions and infrastructure support actions
  • Glossary
  • References
  • List of tables
  • List of figures
  • List of boxes
  • Related publications

Obesity

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

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

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

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

 OPC Executive Manager Jane Martin 

Download the report HERE  tipping-the-scales

Read over 30 + NACCHO Obesity articles published last 5 years

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

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

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

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

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

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

Watch video HERE : How does junk food marketing influence kids

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

ABS Overweight and obesity

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

ABS National Health Survey: First Results, 2014-15  

Download this graphic as a poster HERE

LL_ATSI_junkfoodandhealth_infographic

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

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

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

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

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

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

From the Conversation Four ways junk food brands befriend kids online

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

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

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

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

Read NACCHO 20 Articles on Obesity

Read NACCHO 20 Articles on Nutrition Healthy Foods

Article 1 Four ways junk food brands befriend kids online

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

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

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

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

Kids are vulnerable to junk food advertising

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

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

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

How brands interact online

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

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

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

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

1. The prize

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

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

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

2. The entertainer

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

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

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

3. The social enabler

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

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

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

4. The person

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

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

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

Brands need to clean up their act

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

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

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

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

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

Article 2 Aussies spending most of food budget on junk food

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

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

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

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

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

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

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

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

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

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

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

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

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

Download the AIHW report HERE : AIHW Obesity Burden of Disease

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

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

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

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

Download Communique HERE : Final Communique 28 April 2017

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

 

APH : Marketing obesity? Junk food, advertising and kids

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

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

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

Department of Health Website

OBESITY – AUSTRALIA’S BIGGEST PUBLIC HEALTH CHALLENGE

Download AMA Position Statement on Obesity 2016

obesity-2016-ama-position-statement

NACCHO Articles about Obesity

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

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

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

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

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

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

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

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

Full article

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

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

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

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

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

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

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

Download the AIHW report HERE : AIHW Obesity Burden of Disease

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

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

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

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

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

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

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

 

Aboriginal #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.