NACCHO Aboriginal Health and #Obesity #junkfood : 47 point plan to control weight problem that costs $56 billion per year

junk

 ” JUNK food would be banned from schools and sports venues, and a sugar drink tax introduced, under a new blueprint to trim the nation’s waistline.

The 47-point blueprint also includes a crackdown on using junk food vouchers as rewards for sporting performance and for fundraising.

State governments would be compelled to improve the healthiness of foods in settings controlled by them like hospitals, workplaces and government events.

And they would have to change urban planning rules to restrict unhealthy food venues and make more space for healthy food outlets. “

Originally published as Move to ban junk food in schools

Updated Feb 21 with press release from Health Minister Greg Hunt See below

The Australian Government is taking action to tackle the challenge of obesity and encourage all Australians to live healthy lives

“In my view, we should be starting to tax sugary drinks as a first step. Nearly every week there’s a new study citing the benefits of a sugary drinks tax and and nearly every month another country adopts it as a policy. It’s quickly being seen as an appropriate thing to do to address the obesity epidemic.”

A health economist at the Grattan Institute, Stephen Duckett, said the researchers had put together a careful and strong study and set of tax and subsidy suggestions.see article 2 below  

One hundred nutrition experts from 53 organisations working with state and federal bureaucrats have drawn up the obesity action plan to control the nation’s weight problem that is costing the nation $56 billion a year.

The review of state and federal food labelling, advertising and health policies found huge variation across the country and experts want it corrected by a National Nutrition Policy.

The nation is in the grip of an obesity crisis with almost two out of three (63 per cent) Australian adults, and one in four (25 per cent) Australian children overweight or obese.

Obesity is also one of the lead causes of disease and death including cancer.

More than 1.4 million Australians have Type 2 diabetes and new cases are being diagnosed at the rate of 280 per day.

Stomach, bowel, kidney, liver, pancreas, gallbladder, oesophagus, endometrium, ovary, prostate cancer and breast cancer in postmenopausal women have all been linked to obesity.

Half of all Australians are exceeding World Health Organisation’s recommendations they consume less than 13 teaspoons or sugar a day with most of the white stuff hidden in drinks and processed food, the Australian Bureau of Statistics Health Survey shows.

Teenage boys are the worst offenders consuming 38 teaspoons of sugar a day which makes up a quarter of their entire calorie intake.

Dr Gary Sacks from Deakin University whose research underpins the obesity control plan says it’s time for politicians to put the interests of ordinary people and their health above the food industry lobbyists

“It’s a good start to have policies for restricting junk foods in school canteens, but if kids are then inundated with unhealthy foods at sports venues, and they see relentless junk food ads on prime-time TV, it doesn’t make it easy for them to eat well,” he said.

That’s why the experts want a co-ordinated national strategy that increases the price of unhealthy food using taxes and regulations to reduce children’s exposure to unhealthy food advertising.

The comprehensive examination of state and federal food policies found Australia is meeting best practice in some areas including the Health Star Rating food labelling scheme, no GST on basic foods and surveys of population body weight.

While all States and Territories have policies for healthy school food provision they are not all monitored and supported, the experts say.

Jane Martin, Executive Manager of the Obesity Policy Coalition and a partner in the research, said a piecemeal approach would not work to turn the tide of obesity in Australia.

“When nearly two-thirds of Australians are overweight or obese, we

know that it’s not just about individuals choosing too many of the wrong foods, there are strong environmental factors at play – such as the all pervasive marketing of junk food particularly to children,” she said.

The new policy comes as a leading obesity experts says a tax on sugary drinks in Australia would be just as logical as existing mandatory controls on alcohol and tobacco

Professor Stephen Colagiuri from the University of Sydney’s Charles Perkins Centre claims a ‘sugar tax’ help individuals moderate their sugary beverage intake, in much the same way as current alcohol, tobacco, and road safety measures like seat belts and speed restrictions preventing harmful behaviours.

The UK will introduce a sugar tax next year and in Mexico a sugar tax introduced in 2014 has already reduced consumption of sugary drinks by 12 per cent and increased the consumption of water.

Australian politicians have repeatedly dismissed a sugar tax on the grounds it interferes with individual rights.

However, Professor Colagiuri says “individual rights can be equally violated if governments fail to take effective and proportionate measures to remove health threats from the environment in the cause of improving population health.”

Originally published as Move to ban junk food in schools

ARTICLE 2 Australia would save $3.4bn if junk food taxed and fresh food subsidised, says study 

fruit-and-veg

O as published in the Guardian

Australian researchers say subsidising fresh fruit and vegetables would ensure the impact of food taxes on the household budget would be negligible. Photograph: Dave and Les Jacobs/Getty Images/Blend Images

Health experts have developed a package of food taxes and subsidies that would save Australia $3.4bn in healthcare costs without affecting household food budgets.

Linda Cobiac, a senior research fellow at the University of Melbourne’s school of public health, led the research published on Wednesday in the journal Plos Medicine.

Cobiac and her team used international data from countries that already have food and beverage taxes such as Denmark, but tweaked the rate of taxation and also included a subsidy for fresh fruit and vegetables so the total change to the household budget would be negligible.

They then modelled the potential impact on the Australian population of introducing taxes on saturated fat, salt, sugar and sugar-sweetened beverages, and a subsidy on fruits and vegetables. Their simulations found the combination of the taxes and subsidy could result in 1.2 additional years of healthy life per 100 people alive in 2010, at a net cost-saving of $3.4bn to the health sector.

“Few other public health interventions could deliver such health gains on average across the whole population,” Cobiac said.

The sugar tax produced the biggest gains in health, followed by the salt tax, the saturated fat tax and the sugar-sweetened beverage tax.

The fruit and vegetable subsidy, while cost-effective when added to the package of taxes, did not lead to a net health benefit on its own, the researchers found.

The researchers suggest introducing a tax of $1.37 for every 100 grams of saturated fat in those foods with a saturated fat content of more than 2.3%, excluding milk; a salt tax of 30 cents for one gram of sodium above Australian maximum recommended levels; a sugar-sweetened beverage tax of 47 cents a litre; a fruit and vegetable subsidy of 14 cents for every 100 grams; and a sugar tax of 94 cents for every 100ml in ice-cream with more than 10 grams of sugar per 100 grams; and 85 cents for every 100 grams in all other products.

The taxes exclude fresh fruits, vegetables, meats and many dairy products.

“You need to include both carrots and sticks to change consumer behaviour and to encourage new taxes,” Blakely said. “That’s where this paper is cutting edge internationally.

“We have worked out the whole package of taxes with minimal impact on the budget of the household, so you can see an overall gain for the government. The government would be less interested in the package if it was purely punitive, but this provides subsidies and savings to health spending that could be reinvested back into communities and services.”

He said taxing junk foods also prompted food manufacturers to change their products and make them healthier to avoid the taxes.

“For those who might say this is an example of nanny state measures, let’s consider that we don’t mind asbestos being taken out of buildings to prevent respiratory disease, and we’re happy for lead to be taken from petrol. We need to change the food system if we are going to tackle obesity and prevent disease.”

A health economist at the Grattan Institute, Stephen Duckett, said the researchers had put together a careful and strong study and set of tax and subsidy suggestions. “This is a very good paper,” he said.

“In my view, we should be starting to tax sugary drinks as a first step. Nearly every week there’s a new study citing the benefits of a sugary drinks tax and and nearly every month another country adopts it as a policy. It’s quickly being seen as an appropriate thing to do to address the obesity epidemic.”

A Grattan Institute report published in November found introducing an excise tax of 40 cents for every 100 grams of sugar in beverages as part of the fight against obesity would trigger a 15% drop in the consumption of sugary drinks. Australians and New Zealanders consume an average of 76 litres of sugary drinks per person every year.

In a piece for the Medical Journal of Australia published on Monday, the chair of the Council of Presidents of Medical Colleges, Prof Nicholas Talley, wrote that “the current lack of a coordinated national approach is not acceptable”.

More than one in four Australian children are now overweight or obese, as are more than two-thirds of all adults.

Talley proposed a six-point action plan, which included recognising obesity as a chronic disease with multiple causes. He also called for stronger legislation to reduce unhealthy food marketing to children and to reduce the consumption of high-sugar beverages, saying a sugar-sweetened beverage tax should be introduced.

“There is evidence that the food industry has been a major contributor to obesity globally,” he wrote. “The health of future generations should not be abandoned for short-term and short-sighted commercial interests.”

Press Release 21 February Greg Hunt Health Minister

The Australian Government is taking action to tackle the challenge of obesity and encourage all Australians to live healthy lives.

PDF printable version of Turnbull Government committed to tackling obesity – PDF 269 KB

The Turnbull Government is taking action to tackle the challenge of obesity and encourage all Australians to live healthy lives.

But unlike the Labor Party, we don’t believe increasing the family grocery bill at the supermarket is the answer to this challenge.

We already have programmes in place to educate, support and encourage Australians to adopt and maintain a healthy diet and to lead an active life – and there’s more to be done.

Earlier this month, the Prime Minister flagged that the Government will soon be announcing a new focus on preventive health that will give people the right tools and information to live active and healthy lives. This will build on the significant work already underway.

Yesterday, we launched the second phase of the $7 million Girls Make Your Move campaign to increase physical activity for girls and young women. This is now being rolled out across Australia.

Our $160 million Sporting Schools program is getting kids involved in physical activity. Already around 6,000 schools across the country have been involved – with many more to come. This is a great programme that Labor wants to axe.

Our Health Star Rating system helps people to make healthier choices when choosing packaged foods at the supermarket and encourages the food industry to reformulate their products to be healthier.

The Healthy Weight Guide website provides useful advice including tips and tools to encourage physical activity and healthy eating to achieve and maintain a healthy weight.

The Healthy Food Partnership with the food industry and public health groups is increasing people’s health knowledge and is supporting them to make healthier food and drink choices in order to achieve better health outcomes.

We acknowledge today’s report, but it does not take into account a number of the Government programs now underway.

Obesity and poor diets are complex public health issue with multiple contributing factors, requiring a community-wide approach as well as behaviour change by individuals. We do not support a new tax on sugar to address this issue.

Fresh fruit and vegetables are already effectively discounted as they do not have a GST applied.

Whereas the GST is added to the cost of items such as chips, lollies, sugary drinks, confectionery, snacks, ice-cream and biscuits.

We’re committed to tackling obesity, but increasing the family’s weekly shop at the supermarket isn’t the answer

NACCHO Aboriginal Health and Chronic Disease #prevention

 

prevention

 ” The Australian Chronic Disease Prevention Alliance recommends that the Australian Government introduce a health levy on sugar-sweetened beverages, as part of a comprehensive approach to decreasing overweight and obesity, and with revenue supporting public education campaigns and initiatives to prevent chronic disease and address childhood obesity.

A health levy on sugar-sweetened beverages should not be viewed as the single solution to the obesity epidemic in Australia.

Rather, it should be one component of a comprehensive approach, including restrictions on children’s exposure to marketing of these products, restrictions on their sale in schools, other children’s settings and public institutions, and effective public education campaigns[42].

Health levy on sugar-sweetened beverages

ACDPA Position Statement

Key messages

  •  The Australian Chronic Disease Prevention Alliance (ACDPA) recommends that the Australian Government introduce a health levy on sugar-sweetened beverages (sugary drinks)i, as part of a comprehensive approach to decreasing overweight and obesity.
  •  Sugar-sweetened beverage consumption is associated with increased energy intake and in turn, weight gain and obesity. Obesity is an established risk factor for type 2 diabetes, heart disease, stroke, kidney disease and certain cancers.
  •  Beverages are the largest source of free sugars in the Australian diet. One in two Australians usually exceed the World Health Organization recommendation to limit free sugars to 10% of daily intake (equivalent to 12 teaspoons of sugar).
  •  Young Australians are the highest consumers of sugar-sweetened beverages, along with Aboriginal and Torres Strait Islander people and socially disadvantaged groups.
  •  Young people, low-income consumers and those most at risk of obesity are most responsive to food and beverage price changes, and are likely to gain the largest health benefit from a levy on sugary drinks due to reduced consumption.
  •  A health levy on sugar-sweetened beverages in Australia is estimated to reduce consumption and potentially prevent thousands of cases of type 2 diabetes, heart disease and stroke over 25 years. The levy could generate revenue of $400-$500 million each year, which could support public education campaigns and initiatives to prevent chronic disease and address childhood obesity.
  •  A health levy on sugar-sweetened beverages should not be viewed as the single solution to the obesity epidemic in Australia. Rather, it should be one component of a comprehensive approach, including restrictions on children’s exposure to marketing of these products, restrictions on their sale in schools, other children’s settings and public institutions, and effective public education campaigns.

i ‘Sugar-sweetened beverages’ and sugary drinks are used interchangeably in this paper. This refers to all non-alcoholic water based beverages with added sugar, including sugar-sweetened soft drinks and flavoured mineral waters, fortified waters, energy and electrolyte drinks, fruit and vegetable drinks, and cordials. This term does not include milk-based products, 100% fruit juice or non-sugar sweetened beverages (i.e. artificial, non-nutritive or intensely sweetened). 2

About ACDPA

The Australian Chronic Disease Prevention Alliance (ACDPA) brings together five leading non-government health organisations with a commitment to reducing the growing incidence of chronic disease in Australia attributable to overweight and obesity, poor nutrition and physical inactivity. ACDPA members are: Cancer Council Australia; Diabetes Australia; Kidney Health Australia; National Heart Foundation of Australia; and the Stroke Foundation.

This position statement is one of a suite of ACDPA statements, which provide evidence-based information and recommendations to address modifiable risk factors for chronic disease. ACDPA position statements are designed to inform policy and are intended for government, non-government organisations, health professionals and the community.

www.acdpa.org.au

Chronic disease

Chronic diseases are the leading cause of illness, disability, and death in Australia, accounting for around 90% of all deaths in 2011[1]. One in two Australians (i.e. more than 11 million) had a chronic disease in 2014-15 and almost one quarter of the population had at least two conditions[2].

However, much chronic disease is actually preventable. Around one third of total disease burden could be prevented by reducing modifiable risk factors, including overweight and obesity, physical inactivity and poor diet[2].

Overweight and obesity

Overweight and obesity is the second greatest contributor to disease burden and increases risk of type 2 diabetes, heart disease, stroke, kidney disease and some cancers[2].

The rates of overweight and obesity are continuing to increase. Almost two-thirds of Australians are overweight or obese and one in four Australian children are already overweight or obese[2]. Children who are overweight are also more likely to grow up to become overweight or obese adults, with an increased risk of chronic disease and premature mortality[3].

The cost of obesity in Australia was estimated to be $8.6 billion in 2011-12, comprising $3.8 billion in direct costs and $4.8 billion in indirect costs[4]. If no further action is taken to slow obesity rates in Australia, the cost of obesity over the next 10 years to 2025 is estimated to total $87.7 billion[4].

Free sugars and weight gain

There is increasing evidence that high intake of free sugarsii is associated with weight gain due to excess energy intake and dental caries[5]. The World Health Organization (WHO) strongly recommends reducing free sugar intake to less than 10% of total energy intake (equivalent to around 12 teaspoons of sugar), or to 5% for the greatest health benefits[5].

ii ‘Free sugars’ refer to sugars added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.

In 2011-12, more than half of Australians usually exceeded the recommendation to limit free sugar intake to 10%[6]. There was wide variation in the amounts of free sugars consumed, with older children and teenagers most likely to exceed the recommendation and adults aged 51-70 least likely to exceed the recommendation[6]. On average, Australians consumed around 60 grams of free sugars each day (around 14 teaspoons)[6]. Children and young people were the highest consumers, with adolescent males and females consuming the equivalent of 22 and 17 teaspoons of sugar each day respectively [6].

Beverages contribute more than half of free sugar intake in the Australian diet[6]. In 2011-12, soft drinks, sports and energy drinks accounted for 19% of free sugar intake, fruit juices and fruit drinks contributed 13%, and cordial accounted for 4.9%[6]. 3

Sugar-sweetened beverage consumption

In particular, sugar-sweetened beverages are mostly energy-dense but nutrient-poor. Sugary drinks appear to increase total energy intake due to reduced satiety, as people do not compensate for the additional energy consumed by reducing their intake of other foods or drinks[3, 7]. Sugar-sweetened beverages may also negatively affect taste preferences, especially amongst children, as less sweet foods may become less palatable[8].

Sugar-sweetened beverages are consumed by large numbers of Australian adults and children[9], and Australia ranks 15th in the world for sales of caloric beverages per person per day[10].

One third of Australians consumed sugar-sweetened beverages on the day before the Australian Health Survey interview in 2011-12[9]. Of those consuming sweetened beverages, the equivalent of a can of soft drink was consumed (375 mL)[9]. Children and adolescents were more likely to have consumed sugary drinks than adults (47% compared with 31%), and consumption peaked at 55% amongst adolescents[9]. Males were more likely than females to have consumed sugary drinks (39% compared with 29%)[9].

Australians living in areas with the highest levels of socioeconomic disadvantage were more likely to have consumed sugary drinks than those in areas of least disadvantage (38% compared with 31%)[9]. Half of Aboriginal and Torres Strait Islander people consumed sugary drinks compared to 34% of non-Indigenous people[9]. Amongst those consuming sweetened beverages, a greater amount was consumed by Aboriginal and Torres Strait Islanders than for non-Indigenous people (455 mL compared with 375 mL)[9]. 4

The health impacts of sugar-sweetened beverage consumption

WHO and the World Cancer Research Fund (WCRF) recommend restricting or avoiding intake of sugar-sweetened beverages, based on evidence that high intake of sugar-sweetened beverages may increase risk of weight gain and obesity[7, 11]. As outlined earlier, obesity is an established risk factor for a range of chronic diseases[2].

The Australian Dietary Guidelines recommend limiting intake of foods and drinks containing added sugars, particularly sugar-sweetened beverages, based on evidence of a probable association between sugary drink consumption and increased risk of weight gain in adults and children, and a suggestive association between soft drink consumption and an increased risk of reduced bone strength, and dental caries in children[3].

Type 2 diabetes

Sugar-sweetened drinks may increase the risk of developing type 2 diabetes[3]. Evidence indicates a significant relationship between the amount and frequency of sugar-sweetened beverages consumed and increased risk of type 2 diabetes[12, 13]. The risk of type 2 diabetes is estimated to be 26% greater amongst the highest consumers (1 to 2 servings/day) compared to lowest consumers (<1 serving/month)[13].

Cardiovascular disease and stroke

The consumption of added sugar by adolescents, especially sugar-sweetened soft drinks, has been associated with multiple factors that can increase risk of cardiovascular disease regardless of body size, and increased insulin resistance among overweight or obese adolescents[14].

A high sugar diet has been linked to increased risk of heart disease mortality[15, 16]. Consuming high levels of added sugar is associated with risk factors for heart disease such as weight gain and raised blood pressure[17]. Excessive dietary glucose and fructose have been shown to increase the production and accumulation of fatty cells in the liver and bloodstream, which is linked to cardiovascular disease, and kidney and liver disease[18]. Non-alcoholic fatty liver disease is one of the major causes of chronic liver disease and is associated with the development of type 2 diabetes and coronary heart disease[18].

There is also emerging evidence that sugar-sweetened beverage consumption may be independently associated with increased risk of stoke[19].

Chronic kidney disease

There is evidence of an independent association between sugar-sweetened soft drink consumption and the development of chronic kidney disease and kidney stone formation[20]. The risk of developing chronic kidney disease is 58% greater amongst people who regularly consume at least one sugar-sweetened soft drink per day, compared with non-consumers[21].

Cancer

While sugar-sweetened beverages may contribute to cancer risk through their effect on overweight and obesity, there is no evidence to suggest that these drinks are an independent risk factor for cancer[7]. 5

A health levy on sugar-sweetened beverages

WHO recommends that governments consider taxes and subsidies to discourage consumption of less healthy foods and promote healthier options[22]. WHO concludes that there is “reasonable and increasing evidence that appropriately designed taxes on sugar-sweetened beverages would result in proportional reductions in consumption, especially if aimed at raising the retail price by 20% or more”[23].

Price influences consumption of sugar-sweetened beverages[24, 25]. Young people, low-income consumers and those most at risk of obesity are most responsive to food and beverage price changes, and are likely to gain the largest health benefit from a levy on sugary drinks due to reduced consumption[23]. While a health levy would result in lower income households paying a greater proportion of their income in additional tax, the financial burden across all households is small, with minimal differences between higher- and lower-income households (less than $5 USD per year)[26].

A 2016 study modelled the impact of a 20% ad valorem excise tax on sugar-sweetened beverages in Australia over 25 years[27]. The levy could reduce sugary drink consumption by 12.6% and reduce obesity by 2.7% in men and 1.2% in women[27]. Over 25 years, there could be 16,000 fewer cases of type 2 diabetes, 4,400 fewer cases of ischaemic heart disease and 1,100 fewer strokes[27]. In total, 1,600 deaths could potentially be prevented[27].

The 20% levy was modelled to generate more than $400 million in revenue each year, even with a decline in consumption, and save $609 million in overall health care expenditure over 25 years[27]. The implementation cost was estimated to be $27.6 million[27].

A separate Australian report is supportive of an excise tax on the sugar content of sugar-sweetened beverages, to reduce consumption and encourage manufacturers to reformulate to reduce the sugar content in beverages[28]. An excise tax at a rate of 40 cents per 100 grams was modelled to reduce consumption by 15% and generate around $500 million annually in revenue[28]. While a sugary drinks levy is not the single solution to obesity, the introduction of a levy could promote healthier eating, reduce obesity and raise revenue to combat costs that obesity imposes on the broader community.

There is public support for a levy on sugar-sweetened beverages. Sixty nine percent of Australian grocery buyers supported a levy if the revenue was used to reduce the cost of healthy foods[29]. A separate survey of 1,200 people found that 85% supported levy revenue being used to fund programs reducing childhood obesity, and 84% supported funding for initiatives encouraging children’s sport[30].

An Australian levy on sugar-sweetened beverages is supported by many public health groups and professional organisations.

 

NACCHO Aboriginal Health #Obesity and the #sugartax : Barnaby Joyce on the merits of a sugary drinks tax

 sugartax

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

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

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

The Sugar Trip on Australian Story  View HERE

” With most complex issues, you start somewhere.  You come up with evidence-informed policies and you try them out.  You rigorously evaluate their performance, and learn by doing.

But not with obesity.  “Complexity” is the new enemy of action.  Since the causes of obesity are complex, every “single” policy advanced in response can be dismissed as a dangerously simplistic solution to a complex problem.

Welcome to obesity, the problem we’re not allowed to start to fix.

Except with personal responsibility, of course.!!!

A tax on sugary drinks will get National Party politicians in trouble with sugar producers, and Liberal Party politicians in trouble with big food.

The real problem is that it might work.  Based on the experience of Mexico, a sugary drinks tax will very likely cause consumers to purchase fewer sugary drinks.

Despite batting it away, a tax on sugary drinks is on the public agenda, and it’s here to stay.  I don’t see the sugary drinks industry winning on this issue indefinitely.

Partly because Australian health researchers will keep it on the agenda.”

 Edited highlights from :   Sydney Health Law

sugar

 

“We need a national healthy weight strategy which includes a comprehensive approach to tackle overweight and obesity in all parts of Australia.

“While there’s no silver bullet for reducing overweight and obesity rates, there are key policies which we know can make a significant difference to the health of all Australians.”

The Obesity Policy Coalition recommends four key actions by government to address the obesity problem:

  1. Develop and implement a long-term, comprehensive, integrated strategy to address obesity.
  2. Take action to substantially reduce children’s exposure to unhealthy food marketing.
  3. Introduce a 20 per cent tax on sugar-sweetened beverages and use the money raised to offer healthy food subsidies for people on low incomes and to support obesity prevention initiatives.
  4. Make the Health Star Rating System mandatory, to ensure it is displayed on all packaged food products.

The Healthy Communities: Overweight and obesity rates across Australia, 2014-15 report finds that in 2014-15:

  • The percentage of overweight or obese adults ranged from 53% in Northern Sydney to 73% in Country SA
  • Overweight and obesity rates were generally higher in regional PHN areas than in metropolitan PHN areas
  • After excluding adults who were overweight, the percentage of obese adults ranged from 16% in Central and Eastern Sydney to 38% in Country SA
  • The obesity rate was 25% or higher in 18 of the 28 PHN areas for which results were available.

Once more with feeling…Barnaby Joyce on the merits of a sugary drinks tax

When I looked up from marking exams and saw the look on Barnaby Joyce’s face, I just knew he was seeing red about the Grattan Institute’s proposal for a sugary drinks tax, levied at a rate of 40 cents per 100 grams of sugar.

The Grattan Institute report estimates that such a tax would reduce the consumption of sugary drinks by about 15% and generate up to half a billion dollars that could help to pay for a broad array of obesity-related programs.

Imagine!  A public health policy that fights obesity, diabetes and tooth decay AND generates revenue.

The National Party hate the idea. Deputy Prime Minister and Leader of the Nationals, Barnaby Joyce told reporters: Pictured here with the Asst Minister for Rural Health Dr David Gillespie

barnaby

“If you want to deal with being overweight, here’s a rough suggestion: stop eating so much, and do a bit of exercise.  There’s two bits of handy advice and you get that for free.  The National Party will not be supporting a sugar tax”.

Well that’s what he said.

But here’s what I heard: “We know that obesity and diabetes are out of control.  But we have ideological objections to being part of the solution”.

The same day that Minister Joyce shared these thoughts with reporters, the Australian Food and Grocery Council issued a press release saying that it was seeking a “constructive response to obesity”.

“Obesity is a serious and complex public health issue with no single cause or quick-fix solution”, explained the AFGC, but “it is not beneficial to blame or tax a single component of the diet”.

Personal responsibility…the answer to obesity, traffic accidents, terrorism, Zika virus, perhaps everything?

In a limited sense, Barnaby Joyce is right.

The only cure for personal obesity is personal responsibility.

But personal responsibility has turned out to be a spectacularly poor solution to “societal obesity”.

By societal obesity, I am referring to the trend towards overweight and obesity that has arisen over the past few decades and now affects the majority of adult men and women (and more than one in four children).

Since each of us is an individual, and because we live in a culture that prizes individual autonomy, it’s easy to fall into the trap of believing that individual effort, personal motivation, is the solution to the world’s ills.

But just as the global epidemics of obesity and diabetes were not caused by a catastrophic, global melt-down in personal responsibility, personal responsibility is equally unlikely to provide the magic solution.

That’s where public policies come in.

Governments know all this, but with the exception of tobacco control, they seem reluctant to apply their knowledge in the area of preventive health.

The fact is, from road traffic accidents to terrorism, smart governments:

  • acknowledge the complexity of the factors that contribute to societal problems;
  • They acknowledge that multiple interventions are needed, in many settings;
  • They acknowledge that possible solutions need to be trialled now, under conditions of uncertainty, instead of handing the problem to future generations.
  • They monitor the actions they take, because healthy public policy is a dynamic, ongoing process; and finally
  • They give a damn.  Meaning that they recognise they are accountable to the community for helping to solve difficult, societal problems, and for the performance of the public policies they administer.

Imagine if Australia’s government took that approach with obesity.

The debate about a sugary drinks tax is here to stay: it will never go away

A tax on sugary drinks will get National Party politicians in trouble with sugar producers, and Liberal Party politicians in trouble with big food.

The real problem is that it might work.  Based on the experience of Mexico, a sugary drinks tax will very likely cause consumers to purchase fewer sugary drinks.

Despite batting it away, a tax on sugary drinks is on the public agenda, and it’s here to stay.  I don’t see the sugary drinks industry winning on this issue indefinitely.

Partly because Australian health researchers will keep it on the agenda.

It will come back, and back.  Especially as evidence of its success accumulates overseas.

One conversation worth having is how revenues from a sugary drinks tax might support agricultural producers in rural Australia, helping to cushion them from the adverse effects (if any) of the tax and creating incentives for the production of a sustainable and healthy food supply.

That is simply one question worth considering during the process of developing a national nutrition policy (which we don’t currently have).

In the meantime, Australian health advocates need to broaden their base.

Advocacy for public policy action on obesity needs to become more closely integrated with advocacy on food security.   And advocacy in both areas needs to be linked more closely to action on reducing health inequalities.

But enough about all that.  You really came here for Barnaby, didn’t you?

OK, here he is:

The ATO is not a better solution than jumping in the pool and going for a swim. The ATO is not a better solution than reducing your portion size. So get yourself a robust chair and a heavy table and, halfway through the meal, put both hands on the table and just push back. That will help you lose weight.”

healthy-xmas

NACCHO Aboriginal Health Debate : # A sugary drinks tax could recoup some of the costs of #obesity while preventing it

bjoyce

Personal responsibility, not the Australian Tax Office, should determine how much sugar Australians consume, says Barnaby Joyce. Often as not, Barnaby’s recovery program involves half a packet of Marlboros, which he calls bungers.

Barnaby was much agitated on Wednesday about the suggestion by the Grattan Institute that a tax on high-sugar fizzy drinks might go some way towards alleviating Australia’s obesity problem.

“This is one of the suggestions where right at the start we always thought was just bonkers mad,” he declared, adding his party would not be supporting a sugar tax.

This shouldn’t knock you cold with surprise. Barnaby is the leader of the Nationals. Name a sugar-growing area and you’ll find a Nationals or a Liberal National Party member at the local school fete knocking back a mug of raw sugar-cane juice and proclaiming it God’s food.

But Barnaby wasn’t simply stopping at political solidarity with his northern MPs.

He had some Barnaby-advice on how you might lose weight without taxing sugar.

“People are sitting on their backside too much, and eating too much food and not just soft drinks, eating too many chips and other food,” he lectured.

“Well, so the issue is take the responsibility upon yourself. The Australian Taxation Office is not going to save your health, right. Do not go to the ATO as opposed to go to your doctor or put on a pair of sandshoes and walk around the block and…go for a run.

The ATO is not a better solution than jumping in the pool and going for a swim.

The ATO is not a better solution than reducing your portion size.

“So get yourself a robust chair and a heavy table and halfway through the meal, put both hands on the table and just push back. That will help you lose weight.”

Barnaby Joyce, living miracle, offers a health plan : Pictured above David Gillespie Assistant Minister for Rural Health and Member for Lyne

Note 1: The Federal electorates of Lyne which takes in Taree and Port Macquarie has been identified at the Number One stroke ‘hotspot’ in Australia.Refer

Note 2 : The Minister is not to be confused with David Gillespie Author of How Much Sugar and Sweet Poison : Why Sugar makes us fat .

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In the wake of the progress report on Closing the Gap, the Indigenous Affairs Minister Nigel Scullion has declared sugary soft drinks are “killing the population” in remote Indigenous communities.

Key points:

  • Closing the Gap report found worst health outcomes found in remote communities
  • One remote community store drawing half of total profits from soft drink sales, Senator Scullion says
  • Senator Scullion says he thinks attitudes to soft drink are changing

According to evidence provided to Senate estimates today, at least 1.1 million litres of so-called “full sugar” soft drink was sold in remote community stores last financial year.

NACCHO Health News Alert : Scullion says sugary soft drinks ‘killing the population’ in remote Aboriginal communities

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Grattan Institute report

 ” Obesity is a major public health problem  In Australia more than one in four adults are now classified as obese, up from one in ten in the early 1980s.

And about 7% of children are obese, up from less than 2% in the 1980s.

The sugary drinks tax  revenue could be spent on obesity programs that benefit the disadvantaged, reducing the regressivity of the tax.

While the beverage and sugar industries are strongly opposed to any tax on sugar, their concerns are overblown.

A sugar-sweetened beverages tax will reduce domestic demand for Australian sugar by around 50,000 tonnes, which is only about 1% of all the sugar produced in Australia. And while there may be some transition costs, this sugar could instead be sold overseas (as 80% of Australia’s sugar production already is).

A tax on sugary drinks is a public health reform whose time has come.

The Conversation

A sugary drinks tax could recoup some of the costs of obesity while preventing it

In our new Grattan Institute report, A sugary drinks tax: recovering the community costs of obesity, we estimate community or “third party” costs of obesity were about A$5.3 billion in 2014/15.


Obesity not only affects an individual’s health and wellbeing, it imposes enormous costs on the community, through higher taxes to fund extra government spending on health and welfare and from forgone tax revenue because obese people are more likely to be unemployed.

In our new , A sugary drinks tax: recovering the community costs of obesity, we estimate community or “third party” costs of obesity were about A$5.3 billion in 2014/15.

We propose the government put a tax on sugar-sweetened beverages to recoup some of the third-party costs of obesity and reduce obesity rates. Such a tax would ensure the producers and consumers of those drinks start paying closer to the full costs of this consumption – including costs that to date have been passed on to other taxpayers. There is the added benefit of raising revenue that could be spent on obesity-prevention programs.

The scope of our proposed tax is on non-alcoholic, water-based beverages with added sugar. This includes soft drinks, flavoured mineral waters, fruit drinks, energy drinks, flavoured waters and iced teas.

While a sugary drinks tax is not a “silver bullet” solution to the obesity epidemic (that requires numerous policies and behaviour changes at an individual and population-wide level), it would help.

Why focus on sugary drinks?

Sugar-sweetened beverages are high in sugar and most contain no valuable nutrients, unlike some other processed foods such as chocolate. Most Australians, especially younger people, consume too much sugar already.

People often drink excessive amounts of sugary drinks because the body does not send appropriate “full” signals from calories consumed in liquid form. Sugar-sweetened beverages can induce hunger, and soft drink consumption at a young age can create a life-long preference for sweet foods and drinks.

We estimate, based on US evidence, about 10% of Australia’s obesity problem is due to these sugar-filled drinks.

Many countries have implemented or announced the introduction of a sugar-sweetened beverages tax including the United Kingdom, France, South Africa and parts of the United States. The overseas experience is tax reduces consumption of sugary drinks, with people mainly switching to water or diet/low-sugar alternatives.

There is strong public support in Australia for a sugar-sweetened beverages tax if the funds raised are put towards obesity prevention programs, such as making healthier food cheaper. Public health authorities, including the World Health Organisation and the Australian Medical Association, as well as advocates such as the Obesity Policy Coalition, support the introduction of a sugar-sweetened beverages tax.

What the tax would look like

We advocate taxing the sugar contained within sugar-sweetened beverages, rather than levying a tax based on the price of these drinks, because: a sugar content tax encourages manufacturers to reduce the sugar content of their drinks, it encourages consumers to buy drinks with less sugar, each gram of sugar is taxed consistently, and it deters bulk buying.

The tax should be levied on manufacturers or importers of sugar-sweetened beverages, and overseas evidence suggests it will be passed on in full to consumers.

We estimate a tax of A$0.40 per 100 grams of sugar in sugary drinks, about A$0.80 for a two-litre bottle of soft drink, will raise about A$400-$500 million per year. This will reduce consumption of sugar-sweetened beverages by about 15%, or about 10 litres per person on average. Recent Australian modelling suggests a tax could reduce obesity prevalence by about 2%.



Author provided/The Conversation, CC BY-ND

Low-income earners consume more sugar-sweetened beverages than the rest of the population, so they will on average pay slightly more tax. But the tax burden per person is small – and consumers can also easily avoid the tax by switching to drinks such as water or artificially sweetened beverages.

People on low incomes are generally more responsive to price rises and are therefore more likely to switch to non-taxed (and healthier) beverages, so the tax may be less regressive than predicted. Although a sugar-sweetened beverages tax may be regressive in monetary terms, the greatest health benefits will flow through to low-income people due to their greater reduction in consumption and higher current rates of obesity.

The revenue could also be spent on obesity programs that benefit the disadvantaged, reducing the regressivity of the tax.

While the beverage and sugar industries are strongly opposed to any tax on sugar, their concerns are overblown. Most of the artificially sweetened drinks and waters, which will not be subject to the tax, are owned by the major beverage companies.

A sugar-sweetened beverages tax will reduce domestic demand for Australian sugar by around 50,000 tonnes, which is only about 1% of all the sugar produced in Australia. And while there may be some transition costs, this sugar could instead be sold overseas (as 80% of Australia’s sugar production already is).

A tax on sugary drinks is a public health reform whose time has come.

NACCHO Aboriginal Health and Obesity : Should Doctors be taught how to discuss their patients’ excess weight ?

ATSI Obesity

” Being overweight or obese increases the risk of a range of health conditions, including coronary heart disease, Type 2 diabetes, some cancers, respiratory and joint problems, sleep disorders and social problems. The excess burden of obesity in the Indigenous population is estimated to explain 1 to 3 years (9% to 17%) of the life expectancy gap in the NT .

Obesity is estimated to contribute 16% of the health gap between Aboriginal and Torres Strait Islander peoples and the total Australian population

Obesity is associated with risk factors for the main causes of morbidity and mortality among Aboriginal and Torres Strait Islander peoples. It impacts largely through diabetes (half of the obesity burden) and ischaemic heart disease (40%) “

Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report

Download the report ATSI Overweight and Obesity

Download ANPHA Obesity Prevalence Trends

 “With 80% of adults and close to one-third of children expected to be overweight or obese by 2025, doctors are increasingly likely to be working with people who are overweight or obese.

An individual’s weight is a complex and sensitive issue, which may be related to many factors that are not only medical but social, environmental and emotional. The skills to address the issue in a way that communicates the health risks of being overweight without judgement and without inciting negative responses are not easy to acquire or universally taught.”

From The Conversation Adrienne Gordon  Neonatal Staff Specialist, NHMRC Early Career Research Fellow, University of Sydney and Kirsten Black Associate Professor & Joint Head of Discipline Obstetrics, Gynaecology and Neonatology, University of Sydney see full article below (2)

The 2012–13 Health Survey included height and weight measurements to allow body mass index (BMI) scores to be calculated. In 2012–13, 66% of Indigenous Australians aged 15 years and over had a BMI score in the overweight or obese range (29% overweight and 37% obese). Indigenous adults were 1.6 times as likely to be obese as non-Indigenous Australians (after adjusting for differences in the age structure of the two populations).

Indigenous obesity rates varied geographically. Obesity was highest in inner regional areas (40%) and lowest in very remote areas (32%). Rates were similar in major cities (37%) and in outer regional and remote areas (38%). By jurisdiction, obesity rates ranged from 41% in NSW to 29% in the NT. Indigenous women had higher rates of obesity (40%) and lower rates of overweight (26%) compared with Indigenous men (34% and 31% respectively). Of those adult Indigenous women who had an underweight or normal measured BMI, 44% had a waist circumference of 80cm or more, indicating increased risk of developing chronic disease. For both Aboriginal and Torres Strait Islander males and females, the rates for overweight/obesity increased with age, with 80% of the population aged 55 years and over being overweight or obese. Higher proportions of Torres Strait Islanders were overweight/obese than in the Aboriginal population (73% versus 65%).

The 2012–13 Health Survey showed obesity was strongly associated with chronic disease biomarkers (being obese increased the risk of abnormal test results for nearly every chronic disease tested for in the survey). Indigenous obese adults were 7 times more likely to have diabetes than those of normal weight/ underweight (17% compared with 2%). Those who did not meet the physical activity guidelines were more likely to be obese (44%) than those who met the guidelines (36%).

Childhood is a critical period in which inequalities in health determinants such as socio-economic status and overweight/ obesity emerge (Jansen et al. 2013). In 2012–13, Aboriginal and Torres Strait Islander children aged 2–14 years were more likely than non-Indigenous children to be underweight (8% compared with 5%); were less likely to be in the normal weight range (62% compared with 70%); and more likely to be overweight or obese (30% compared with 25%). Obesity rates for Indigenous children increased from the age of 5, with the highest rates at 10–14 years of age (12%). High BMI is found to be a predictor of short sleep duration for children (Magee et al. 2014), which impacts on school performance (measure 2.04) and engagement in physical activity (measure 2.18). It is not possible to compare 2012–13 Health Survey results with previous surveys as the latest results are based on measured BMI rather than self-reported height and weight (as was done before). Research shows rates of overweight/ obesity have increased more rapidly in Aboriginal than non-Aboriginal school-aged children in NSW (Hardy et al. 2014).

In December 2013, national Key Performance Indicators data provided by Australian Government-funded Indigenous primary health care organisations, found that 27% of clients aged 25 years and over were overweight, and 41% were obese (AIHW 2014w).

Obesity is associated with other health risk factors and social determinants of health. One example is prolonged financial stress, which is a predictor of obesity (Siahpush et al. 2014) (see measure 2.08). Low income is associated with food security problems (Markwick et al. 2014) and subsequent dietary behaviour (see measure 2.19). Evidence also shows that incarceration is associated with weight gain and obesity in Indigenous youth (Haysom et al. 2013) (see measure 2.11).

Implications

Given the health risks associated with being obese or overweight, the situation for Aboriginal and Torres Strait Islander peoples requires urgent attention. It is second only to tobacco consumption in terms of contribution of modifiable risk factors to the health gap experienced by Aboriginal and Torres Strait Islander peoples (Voset al. 2007).

An evaluation of a school-based health education programme for urban Indigenous youth found promising results in physical activity, breakfast intake and fruit and vegetable consumption (Malseed et al. 2014), all of which are core components of healthy weight management. Likewise, opportunities exist for obesity prevention in young children through practice-nurse brief interventions (Denney-Wilson et al. 2014).

Reversal of obesity is difficult even in the absence of environmental and social barriers. Therefore, early intervention to prevent the onset of excessive weight gain is likely to be the most effective strategy (Thurber et al. 2014). Studies reporting success in reducing obesity have a number of common characteristics, including: a focus on physical activity and diet opposed to diet alone; the ability to accommodate the preferences of participants; a group focus; and choice between a number of physical activities. Programmes must also be culturally acceptable, conveniently located, easily incorporated into the daily schedule and show goal attainment that is realistic and appropriate (Canuto et al. 2011).

The Australian Government’s Indigenous Australians’ Health Programme aims to actively promote healthier lifestyle choices with culturally secure community education, health promotion and social marketing activities. A Healthy Weight Guide consisting of an interactive website and printed resources is currently being developed to provide guidance and information for consumers to help them achieve and maintain a healthy weight. The guide includes information for Aboriginal and Torres Strait Islander peoples.

Doctors need to be taught how to discuss their patients’ excess weight

Health professionals repeatedly report a lack of confidence in knowing how to address obesity in their patients. They report minimal, if any, training on obesity as well as limited resources for effective conversations and insufficient clinical time to be able to do this well.

Starting a conversation about weight requires not only empathy but awareness of strategies people can use to manage weight issues and an understanding of the range of local services available to assist. It has been shown that although behavioural and medical strategies can be effective, uninformed discussion in the clinic can disengage, stigmatise or shame patients, which then has negative impacts on the outcomes.

Many patients do expect weight-loss guidance from health professionals and the discussion can influence outcomes. In fact, having the conversation and formally diagnosing and documenting excess weight or obesity is the strongest predictor of having a treatment plan and weight-loss success.

Choice of language is crucial

Research has identified the terms “fat” and “fatness” are the least preferred terms. The words “obese” and “obesity” have also been found to arouse negative responses. The National Institute of Clinical Excellence in the UK suggests patients may be more receptive if the conversation is about achieving or maintaining a “healthy weight”.

The STOP Obesity Alliance in the US suggests using “people first” language such that a person “has” obesity rather than “is” obese, similar to “having” cancer or diabetes.

This is part of a debate about whether obesity should be labelled as a disease rather than a risk factor.

Regardless of how this issue is classified, doctors and patients both require the knowledge to understand effective therapies do exist and obesity treatment is not futile. Losing 5-10% of body weight can have a significant impact on risk factors such as blood pressure and can lower the risks of later health problems such as heart disease or type 2 diabetes.

This sort of weight loss also often improves other factors more immediately beneficial to the patient, such as energy levels, mood and mobility.

 

A communication style that encourages shared decision-making and helps people change their behaviour is key. The objective is not to solve the problem but to help the patient begin to believe change is possible and develop a plan about health goals.

Let’s take the case of a woman who presents with urinary incontinence. The woman may describe the problem of needing to wear sanitary pads because of daily leaking of urine. Factors such as obesity will worsen the problem, but the woman may not be aware of this.

The doctor might say:

I hear you’re concerned about your loss of urine, is that correct? Let’s talk about that; and would it be OK to discuss your weight too, as that may be related?

The practitioner might listen for a willingness to have further discussion and then pose a goal-orientated question:

If, as part of our plan to help your urinary symptoms, you decide to work on getting to a healthier weight, what might be a first step?

Repercussions for our kids

For men and women of reproductive age the conversation is potentially not just about their own health but also about that of their children. Women who have higher pre-conception weight and pregnancy weight gain are at increased risk of developing diabetes and heart disease in later life and are less likely to lose weight after they give birth.

This vicious cycle results in larger babies that are predisposed to short-term risks as newborns, longer-term risks of increased childhood obesity and an increased lifetime risk of obesity, diabetes and heart disease.

Between 1985 and 1995 the rate of excess weight and obesity in childhood increased by 50% and obesity tripled in Australia. Animal studies also suggest obesity in the male parent can increase the chance of their offspring developing obesity or diabetes.

The intergenerational nature of obesity therefore means until we address overweight and obesity in adults who are planning a pregnancy, it may be impossible to lower rates of childhood obesity.

The framing of the issue as a problem for patients’ own health as well as for the health of their children is even more complex. However, unless there is a greater understanding of this risk and more training of doctors in talking to patients about obesity this will be difficult to tackle.

Currently, many health professionals remain uncomfortable and unsure in this area of practice. Ensuring the workforce is skilled will also mean there is the ability to discuss weight when it is not the primary issue a patient presents with, but where an important conversation at a critical life stage may actually have lasting effects on patients’ health and that of their children.


Adrienne Gordon will be online for an Author Q&A between 4 and 5pm AEST on Wednesday, 17 August, 2016. Post any questions you have in the comments below.

NACCHO Aboriginal Health: Indigenous doctor striving to break the obesity cycle

Doctor Keevers

“Coming from an indigenous family and seeing that all of my uncles­ and aunties have been overweight for most of their lives and have concurrent illnesses with Type 2 diabetes is definitely a factor,”

“I’ve always been into fitness myself but I’ve seen others in the community who haven’t had the same health and obesity education and how it gets locked into low-socio-economic cycles.”

Medicine graduate Justin Keevers might become the first indigenous doctor to specialise in obesity-related­ surgery.

“There is an emphasis for surgeons not to be super-specialised but I like the idea of becoming an upper-gastrointestinal surgeon with an interest in obesity after seeing how it affects the indigenous community and general popul­ation,” Dr Keevers said.

From The Australian

The 29-year-old former electrician was one of eight indigenous doctors who graduated from Sydney’s University of NSW medicine faculty last week after receiving scholarships from The Balnaves Foundation.

Dr Keevers moved to Sydney from the far north coast of NSW in 2007 and was soon fed up trying to make ends meet as a sparky, so ­applied for medicine through the university’s Nura Gili Pre-Medicine Program.

The program gave him the support base he needed to settle into university life and stick at the ­degree. “I think half of us hadn’t been to school in over five years so that initial stuff about how to write essay­s and assignments, those integ­ral skills that they expect you to have out of high school, was very helpful,” said Dr Keevers, who started as an intern at Prince of Wales Hospital this week.

The six years of study included a year alongside a bariatric surgeon in Port Macquarie, on the NSW mid-north coast, where he formed a plan to tackle the obesity-related diseases that plagued his community back in Byron Bay.

“Coming from an indigenous family and seeing that all of my uncles­ and aunties have been overweight for most of their lives and have concurrent illnesses with Type 2 diabetes is definitely a factor,” he said.

“I’ve always been into fitness myself but I’ve seen others in the community who haven’t had the same health and obesity education and how it gets locked into low-socio-economic cycles.”

Philanthropist Neil Balnaves said Australia was “crying out” for more indigenous doctors and the scholarships were a way of responding to the call. The number of indigenous doctors across the country has doubled in a decade to 204, but for population parity Australia needs 3000.

“We wanted to … dramatically the drop-off rate of students and that was simply about housing the students in the university and surrounding them with mentors and emotional support,” Mr Balnaves said. “Not only are they all graduating but the dropout rate is less than non-indigenous students … (these) young men and women will graduate as doctors and go back with an understanding of their heritage and medicine and … the language and culture.”

NACCHO Aboriginal health survey invitation : Obesity prevention a community based initiative

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Invitation to NACCHO members to participate in CO-OPS Community-based obesity prevention initiative nation-wide survey

Many Indigenous health practitioners are involved in community-based obesity prevention initiatives.

CO-OPS is inviting all community-based initiatives promoting healthy eating, physical activity and healthy weight, to participate in a nation-wide survey.
The purpose of this survey is to describe the nature of community-based obesity prevention practice in Australia.

This will help to document the characteristics of initiatives and the key components that contribute to effectiveness. CO-OPS will use the survey to identify opportunities to support improvements. Information provided in this survey will also supplement CO-OPS’ annual needs assessments.

No other survey of this nature exists in Australia, or to our knowledge, internationally. This survey has been approved by the Deakin University Health Ethics committee.

The survey takes about 20-30 minutes to complete.

Access the survey.

If you require help or have any questions while completing the survey,

please contact Dr. Tahna Pettman on (03) 9035-9591.

The Collaboration of Community-based Obesity Prevention Sites (CO‐OPS Collaboration) is an initiative funded by the Australian Government Department of Health and Ageing.
Our aim is to support community-based obesity prevention initiatives around Australia by providing advice, promoting best practice, disseminating and translating knowledge and by offering networking opportunities.
We create the links between academic, policy and practice professionals to ensure best practice and ongoing cooperation in the promotion of healthy eating, regular physical activity and healthy weight as key factors to help prevent chronic disease.

National obesity strategy a ‘wasteful failure’ Professor Zimmet

Big Mac

In 2009, the federal government’s preventive health  taskforce proposed measures to combat obesity, including increased taxes on  unhealthy food,  a ban on junk food marketing to children, exercise programs in  schools and workplaces and an urban planning overhaul to boost physical  activity.

Should warning labels be on  products other than cigarettes (introduced 1 December 2012)

With obesity, we are where we were with tobacco about 50  years ago.

In a speech to be delivered at a health summit in Canberra  on Monday 3 December , Professor Zimmet, director emeritus at Melbourne’s Baker IDI Heart  and Diabetes Institute, argued there is no political will to reduce  obesity.

By Jill Stark The AGE

THE political response to Australia’s obesity epidemic has  been a ”failure”,  and $49 million spent on healthy lifestyle advertising  campaigns was a ”waste of taxpayers’ money”, a key government adviser  claims.

Professor Paul Zimmet, a member of former prime minister  Kevin Rudd’s preventive health taskforce, says the government’s strategy to  fight the fat is ”weak and fragmented”.

He says he would not have agreed to be on the taskforce –  set up to find ways to reduce the burden of alcohol, tobacco and obesity – if he  had known most of its obesity recommendations would be ignored.

In a speech to be delivered at a health summit in Canberra  on Monday 3 December , Professor Zimmet, director emeritus at Melbourne’s Baker IDI Heart  and Diabetes Institute, will argue there is no political will to reduce  obesity.

  SMH

While congratulating the government for its action on  tobacco control,  he claims it has taken the ”easy option” on obesity, with  ineffective social marketing campaigns.

”The government seems to not have the stomach for obesity  prevention. What is being done at present is fragmented and weak and does not  constitute a serious attempt to tackle the problem,” Professor Zimmet said.

”This is one of the biggest drivers of disease – it  drives type two diabetes, arthritis, heart disease and certain cancers. It’s a  huge load on the community so it’s very disappointing there is no national  effective strategy, despite the taskforce making it very clear that it was the  whole package that was important, not isolated bits and pieces.”

In 2009, the federal government’s preventive health  taskforce proposed measures to combat obesity, including increased taxes on  unhealthy food,  a ban on junk food marketing to children, exercise programs in  schools and workplaces and an urban planning overhaul to boost physical  activity.

But Professor Zimmet said the measures had not been  adopted and money had been squandered on social marketing campaigns such as the  ”Swap It, Don’t Stop It” and ”Measure Up” healthy lifestyle campaigns.

”To spend more than $40 million on social marketing  campaigns without having an integrated strategy is a waste of money. It’s  achieved very little because campaigns like that can’t be done in isolation  without addressing better parks, …  improved food access, addressing indigenous  diabetes and heart disease rates. So really the whole approach to the problem  has been a failure.”

Fellow preventive health taskforce member Mike Daube,  director of the Public Health Advocacy Institute, is  also disappointed by the  government’s lack of action on obesity.

”With obesity, we are where we were with tobacco about 50  years ago. We’re fat, we’re getting fatter and the junk food industry is  immensely powerful, so strong public education needs to be allied with tough  measures, such as dealing with food advertising or food formulation,” Professor  Daube said. ”Having said that, the government has been sensational on tobacco  and you can understand them not wanting to take on every major industry at  once.”

Professor Zimmet will be among a range of speakers at  Monday’s summit, ”Obesity: Changing the Rhetoric, Solutions for the Future”,  organised by newly formed public health lobby group Obesity Australia.

A spokesman for the Department of Health said figures show  childhood obesity rates have stabilised.

”The success Australia has experienced in reducing  tobacco has been the result of 30 years of co-ordinated effort. A similar  long-term view is required to address obesity,” he said.

  ■jstark@theage.com.au

Read more: http://www.smh.com.au/national/obesity-strategy-a-wasteful-failure-20121201-2ao3x.html#ixzz2DrbxhyoI

Brace yourself for a fatter, unhealthier Queensland after health promotion cuts

Amanda Lee 

From The Conversation

Queensland appears intent on dismantling its public and preventive health services. Health Minister Lawrence Springborg last week outlined the rationale for getting rid of more than 150 jobs in nutrition, health promotion and Indigenous health, arguing previous “campaigns” and “messaging” around obesity were “piecemeal” and had “grossly failed”.

The plan now, the minister argued, is to focus on a new centrally-driven and high-profile approach.

On the surface that doesn’t sound so bad.  But even a cursory glance at the details suggests something else is going on.

Of particular concern is the Queensland government’s call for the Commonwealth to invest more in preventive health through the Australia-wide Medicare Local network. This may be a bold attempt to shift costs, or a fundamental misunderstanding of what preventive health is all about – or both.

Although it’s good to see Minister Springborg confirming a commitment to “health prevention campaigns” and “evidence-based medicine”, questions remain as to what this really means for public health in Queensland.

Tackling obesity

One challenge working in the area of obesity is that most people, including decision makers, eat and move, and so are self-informed experts. If this was brain surgery, expert briefings on the evidence would be sought before decisions were made. But addressing obesity is more complex.

To inform decisions about obesity intervention, the scientific evidence needs to be assessed at three levels. Firstly to identify whether something should be done, then to investigate what should be done, and finally to inform how something should be done.

At the first level, there is little disagreement about the magnitude of the problem; something definitely needs to be done about obesity – and urgently. The epidemic of overweight and obesity is sweeping most developed economies. In Australia, the prevalencehas doubled over the past 30 years – it’s now above 60% in adults and around 25% in children.

Obesity is bad news for the health system. In Queensland, excess body weight has now overtaken cigarette smoking as the single greatest risk factor contributing to the burden of disease. In 2008, the health system cost of obesity was A$391 million, with an additional cost of about A$9.96bn in lost well-being across all sectors throughout the state.

But the good news is that most obesity-related conditions are preventable. That such an enormous expense and burden is avoidable, must surely be of interest to any government concerned about its economic outlook, and the well-being and health of its people.

What should be done about it?

To answer, it’s necessary to look at both causes and treatment outcomes.

A surprisingly small daily excess in energy intake is sufficient to account for the weight gain seen in Australians over time.

It’s now clear that changes to our socioeconomic environment are responsible for the current epidemic. These changes actually make it easier for all of us (but particularly those who have limited resources and opportunities) to consume more energy-dense and nutrient-poor foods and drinks, to eat too much, to sit longer and move less.

Being overweight is a normal physiological response to an abnormal “obesogenic” environment. And this is exactly why losing weight is so hard – and keeping it off is harder still.

Studies showconsistently that just telling people to change their behaviour is bound to fail. Generally, mass media advertising increases awareness, but only leads to behaviour change when supported by complementary policies, programs and services provided within the community.


To reduce obesity, we need to make it easier for people to make healthier choices. robnguyen

How can we achieve healthy weight at a population level?

Strategically, the best approach to obesity prevention involves regulatory reform. This has been demonstrated repeatedly in other public health areas such as infectious disease, traffic safety and tobacco control. However, there is little evidence that any governments in Australia currently want to go down this path to combat obesity.

So at a more pragmatic, operational level, the evidence points to two main areas:

  1. Counteract the gross misinformation about food, dieting and exercise so rampant in our society and, at the same time,
  2. Influence sectors beyond health to improve the social and physical environment to make it easier for people to make healthier choices.

And that is exactly what the dismissed nutrition, Indigenous and health promotion workforce was doing in Queensland.

Among many projects, they worked to improve the food supply in child care centres, schools, workplaces, health facilities and remote communities, and encouraged greater physical activity through urban planning. They ran effective, group-based behaviour modification programs to support adoption of healthy habits.

In areas such as mental health and infant feeding, they developed evidence-based training materials and resources to help lighten the workload of clinicians. And their efforts were having traction and providing cost- effective health outcomes for the state.

In 2007, the rate of measured (rather than self-reported) healthy weight among children in Queensland was 2% to 3% higher than in other states where comparable data was available. This equates to 3,000 less children becoming overweight per year, and 1,200 fewer future cases of Type 2 Diabetes per year by 2015.

At its peak, the multi-strategy Go for 2 and 5 fruit and vegetable promotion program exceeded targets, resulting in an additional turnover of A$9.8 million of fresh produce per month in Brisbane alone, and a technical saving of A$55 million per year to the ill-health system state-wide.


Health promotion activities work to improve rates of breast feeding. Ania i Artur Nowaccy

Since 2004, adult physical activity participation rates had increased by over 34%.

And since 2003, rates of exclusive breastfeeding for the first six months of life had quadrupled, and the proportion of infants breastfed at one and six months had increased substantially.

These results demonstrate that preventive health services provided the front line, indeed the vanguard, of medical ill-health services – helping to reduce waiting lists and increase the likely effectiveness of clinical treatment.

What happens next?

Within the health sector, preventive health interventions to address obesity must be applied across the whole continuum – not only in primary care settings like Medicare Locals. But most importantly, concerted, sustained effort is needed beyond the health sector, with non-government organisations, industry and all members of the community.

So, fingers crossed that the promised new “campaigns” will provide more than expensive advertising telling us all to lose weight. And fingers crossed that Medicare Locals will have the resources and abilities to foster partnerships to improve the toxic “obesogenic” environments that continually undermine health messages.

Because, if not, we will definitely lose the war against obesity and growing rates of chronic disease in Queensland. All available evidence tells us that more investment is needed in preventive health – not cuts.