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Lopes CVA, Dharmayani PNA, Ronto R, Hunter J, Mihrshahi S. Food Choices, Sustainability and Australian Native Foods: Perceptions among University Students. Foods 2024; 13:1677. [PMID: 38890905 PMCID: PMC11172005 DOI: 10.3390/foods13111677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024] Open
Abstract
(1) Background: Urgent changes in our food choices are needed for more sustainable, resilient and equitable food systems. Australian native plant-based foods have both environmental and health benefits. Including these foods in our diet may reduce both the risk of chronic diseases and the impact of climate change. This study explored the perceptions and attitudes towards food choices, sustainability and Australian native plant-based food among university students. (2) Methods: A cross-sectional online survey was completed by 212 university students in Australia from October to December 2022. Questions included information about sociodemographic characteristics, food choices, Australian native foods and the impact on sustainability. Logistic regression was used for analyses. (3) Results: Most participants recognised the impact of food choices on sustainability. There was a significant association between recognition of the impact of food choices on sustainability and the environmental and nutritional benefits of Australian native foods (OR = 2.89, 95% CI 1.29, 6.46, p = 0.010). Students who were familiar with or had tried Australian native plant-based foods were significantly more likely to recognise their environmental and nutritional benefits (p < 0.001). (4) Conclusions: Students who recognise the impact of food choices on sustainability and the benefits of Australian native foods are more likely to include native foods in their diet. More studies are needed to investigate the specific native foods consumed and the barriers and facilitators to the intake of these foods.
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Affiliation(s)
- Carla Vanessa Alves Lopes
- Department of Health Sciences, Faculty of Medicine Health and Human Sciences, Macquarie University, Macquarie Park, Sydney, NSW 2109, Australia (S.M.)
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2
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Chappell E, Chan E, Deen C, Brimblecombe J, Cadet-James Y, Hefler M, Stubbs E, Ferguson M. Using photovoice to generate solutions to improve food security among families living in remote Aboriginal and/or Torres Strait Islander communities in Australia. BMC Public Health 2024; 24:785. [PMID: 38481178 PMCID: PMC10935805 DOI: 10.1186/s12889-024-18200-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
The right to food security has been recognised internationally, and nationally in Australia by Aboriginal Community Controlled Health Organisations. This study aims to explore food (in)security and solutions for improvement of food security in remote Aboriginal and/or Torres Strait Islander communities in Australia, from the perspective of caregivers of children within the context of the family using photovoice. Participants took part in workshops discussing participant photographs of food (in)security, including solutions. Themes and sub-themes with associated solutions included traditional food use, sharing as a part of culture, the cost of healthy food, energy and transport, and housing and income. Community leaders used these data in setting priorities for advocacy to improve food security in their communities.
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Affiliation(s)
- Emma Chappell
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia.
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia.
| | - Ellie Chan
- Central Australian Aboriginal Congress, Alice Springs, NT, 0871, Australia
| | - Caroline Deen
- Apunipima Cape York Health Council, Bungalow, QLD, 4870, Australia
| | - Julie Brimblecombe
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia
- Department of Nutrition, Dietetics and Food , Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
| | - Yvonne Cadet-James
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Apunipima Cape York Health Council, Bungalow, QLD, 4870, Australia
- Indigenous Education and Research Centre, James Cook University, Bungalow, QLD, 4870, Australia
| | - Marita Hefler
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia
| | - Emma Stubbs
- Central Australian Aboriginal Congress, Alice Springs, NT, 0871, Australia
| | - Megan Ferguson
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia
- Department of Nutrition, Dietetics and Food , Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
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Zhang J, Netzel ME, Pengelly A, Sivakumar D, Sultanbawa Y. A Review of Phytochemicals and Bioactive Properties in the Proteaceae Family: A Promising Source of Functional Food. Antioxidants (Basel) 2023; 12:1952. [PMID: 38001805 PMCID: PMC10669417 DOI: 10.3390/antiox12111952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
In recent decades, natural plant-based foods have been increasingly used to improve human health due to unhealthy modern dietary patterns, such as the consumption of foods high in sugar and fat. Many indigenous species have been used by Aboriginal peoples for their food and therapeutic properties. Thus, it is important to understand the health-enhancing bioactive profile of Australian indigenous species. The Proteaceae family, such as the genera of Protea, Macadamia, and Grevillea, have been commercially used in the horticulture and food industries. Researchers have reported some findings about Persoonia species, one of the genera in the Proteaceae family. The aim of this review was to provide an overview of the family Proteaceae and the genus Persoonia, including distribution, traditional and commercial uses, phytochemicals, bioactive properties, potential opportunities, and challenges. In this review, bioactive compounds and their properties related to the health benefits of the Proteaceae family, particularly the Persoonia genus, were reviewed for potential applications in the food industry.
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Affiliation(s)
- Jiale Zhang
- ARC Industrial Transformation Training Centre for Uniquely Australian Foods, Queensland Alliance for Agriculture and Food Innovation (QAAFI), The University of Queensland, Indooroopilly, QLD 4068, Australia; (J.Z.); (M.E.N.); (D.S.)
| | - Michael E. Netzel
- ARC Industrial Transformation Training Centre for Uniquely Australian Foods, Queensland Alliance for Agriculture and Food Innovation (QAAFI), The University of Queensland, Indooroopilly, QLD 4068, Australia; (J.Z.); (M.E.N.); (D.S.)
| | - Andrew Pengelly
- Indigenous Plants for Health Association, 196 Bridge St, Muswellbrook, NSW 2333, Australia;
| | - Dharini Sivakumar
- ARC Industrial Transformation Training Centre for Uniquely Australian Foods, Queensland Alliance for Agriculture and Food Innovation (QAAFI), The University of Queensland, Indooroopilly, QLD 4068, Australia; (J.Z.); (M.E.N.); (D.S.)
- Phytochemical Food Network, Department of Crop Sciences, Tshwane University of Technology, Pretoria 0001, South Africa
| | - Yasmina Sultanbawa
- ARC Industrial Transformation Training Centre for Uniquely Australian Foods, Queensland Alliance for Agriculture and Food Innovation (QAAFI), The University of Queensland, Indooroopilly, QLD 4068, Australia; (J.Z.); (M.E.N.); (D.S.)
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4
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Kesa H, Tchuenchieu Kamgain AD, Kwazi Zuma M, Mbhenyane X. Knowledge, Perception and Consumption of Indigenous Foods in Gauteng Region, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6961. [PMID: 37887699 PMCID: PMC10606043 DOI: 10.3390/ijerph20206961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 10/28/2023]
Abstract
Urbanisation in South Africa has led to a nutritional transition from traditional diets (mainly based on indigenous foods) to a Western diet. Currently, the country is one of the most concerned about the prevalence of associated malnutrition and non-communicable diseases. One should, therefore, question the position of indigenous foods (IFs) in the population's eating habits since their nutritional and health value is known. This study aimed to collect updated data on South Africans' true awareness and consumption of indigenous foods, especially in the Gauteng region (the most urbanised province of the country). A quantitative cross-sectional research survey was conducted (n = 746). Among a list of 18 IFs, grain sorghum 32.4% (n = 242), marula 32% (n = 239), pearl millet 21.7% (n = 162), amadumbe 19.3% (n = 144) and cowpea 18.6% (n = 139) were the best known. However, the study noticed a maximum consumption of 19.3% (grain sorghum). Overall, this consumption was seasonal, and its level was significantly defined by race (p < 0.05). Black people consume more IFs compared to coloured people, Indian people and white people. Participants mostly consumed these foods for nutritional and health reasons and pointed out the problem of availability. "Poor image" was rated the lowest by all races (black 5.8%, coloured 4.2%, Indian 7.0% and white 4.1%) regarding the reasons for no or low consumption of IFs. Whatever the race, the desire to increase IF consumption was positive. The promotion of their integration into South African diets should, therefore, be considered as an intervention strategy.
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Affiliation(s)
- Hema Kesa
- Food Evolution Research Laboratory, School of Tourism and Hospitality, University of Johannesburg, Johannesburg 2092, South Africa
- Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town 8000, South Africa
| | - Alex D. Tchuenchieu Kamgain
- Food Evolution Research Laboratory, School of Tourism and Hospitality, University of Johannesburg, Johannesburg 2092, South Africa
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaoundé 13033, Cameroon
| | - Mthokozisi Kwazi Zuma
- Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town 8000, South Africa
- Agricultural Research Council, Central Office, Smallholder Agricultural Development Unit, Pretoria 0002, South Africa
| | - Xikombiso Mbhenyane
- Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town 8000, South Africa
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Booth S, Deen C, Thompson K, Kleve S, Chan E, McCarthy L, Kraft E, Fredericks B, Brimblecombe J, Ferguson M. Conceptualisation, experiences and suggestions for improvement of food security amongst Aboriginal and Torres Strait Islander parents and carers in remote Australian communities. Soc Sci Med 2023; 320:115726. [PMID: 36753996 DOI: 10.1016/j.socscimed.2023.115726] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/14/2022] [Accepted: 01/24/2023] [Indexed: 01/26/2023]
Abstract
This study aimed to determine perceptions of the lived experience of food insecurity and suggestions to improve food security in four remote Aboriginal communities in the Northern Territory, and Queensland. Participants were Aboriginal and/or Torres Strait Islander pregnant and breastfeeding women, and parents/carers of children aged six months to five years. Semi-structured interviews (n=17) were conducted between June-July 2021 and the data thematically analysed using a four stage process. No specific term was used by participants to describe being either food secure or insecure. Descriptions of food security were centred in food sharing, food sufficiency, and family activities. Elements describing food insecurity were physical pain and emotional stress, adults going without food, seeking family help and managing without food until payday. Factors contributing to food insecurity were reported to be: (i) Low income and unemployment, (ii) Cost of living remotely, (iii) Resource sharing, and (iv) Impact of spending on harmful commodities and activities. Three themes were conceptualised: (1) Cultural practices buffer food insecurity, (2) Coping with food insecurity, (3) People accept a degree of food insecurity as normal. Findings suggest Aboriginal and Torres Strait Islander cultural practices such as sharing food buffer episodic food insecurity and constitute 'cultural food security'. Despite use of cultural practices (e.g., procuring traditional food) and generic coping strategies, regular episodes of food insecurity often aligned with the off week of social assistance payments. Household energy (electricity) security was coupled to food security. Suggestions for improving food security included better transport and food access, extending electricity rebates, increases in the regularity of social assistance payments, and computer access and training in budgeting. Policies to advance food security should embody deeper Aboriginal and Torres Strait Islander descriptions and experiences. Community-derived policy suggestions which aim to increase access to adequate, regular, stable household income are likely to succeed.
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Affiliation(s)
- Sue Booth
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, 4072, Australia; College of Medicine & Public Health, Flinders University, Australia.
| | - Caroline Deen
- Apunipima Cape York Health Council, Bungalow, Queensland, 870, Australia
| | - Kani Thompson
- Apunipima Cape York Health Council, Bungalow, Queensland, 870, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill, Victoria, 3168, Australia
| | - Ellie Chan
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, 0870, Australia
| | - Leisa McCarthy
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, 0810, Australia
| | - Emma Kraft
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, 0870, Australia
| | - Bronwyn Fredericks
- Office of the Pro-Vice Chancellor (Indigenous Engagement), The University of Queensland Brisbane, Queensland, 4072, Australia
| | - Julie Brimblecombe
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, 4072, Australia; Department of Nutrition, Dietetics & Food, Monash University, Notting Hill, Victoria, 3168, Australia; Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, 0810, Australia
| | - Megan Ferguson
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, 4072, Australia; Department of Nutrition, Dietetics & Food, Monash University, Notting Hill, Victoria, 3168, Australia; Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, 0810, Australia
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Fyfe S, Hong H, Schirra HJ, Smyth HE, Sultanbawa Y, Rychlik M. Folate vitamers in the Australian green plum: Through growth and ripening and across locations. Front Nutr 2022; 9:1006393. [PMID: 36313068 PMCID: PMC9614220 DOI: 10.3389/fnut.2022.1006393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/29/2022] [Indexed: 11/24/2022] Open
Abstract
The green plum is a native fruit of Australia that grows on the tree Buchanania obovata. This study aimed to confirm the high level of folate in green plums by analyzing a large number of ripe samples from multiple locations and to understand how folate vitamers change as the fruit grows through maturity stages. This study analyzed green plums for five vitamers of folate, H4folate, 5-CH3-H4folate, 5-CHO-H4folate, 10-CHO-PteGlu, and PteGlu (folic acid) using a stable isotope dilution assay on a liquid chromatograph mass spectrometer (LC-MS). Green plums were tested from four locations, two harvests and five maturity stages. Another 11 ripe samples, each from different tree clumps from one location, were also tested as were ripe red-colored green plums. The results show the 5-CH3-H4folate in green plum increases and accumulates in the fruit through development, ripening and senescence. The ripe green plums contain between 82.4 ± 5.5 and 149.4 ± 10.7 μg/100 g Fresh Weight (FW). The red-colored green plums are even higher in folate, with total folate measured as 192.5 ± 7.0 and 293.7 ± 27.4 μg/100 g FW, and further analysis of them is suggested. There is some variation in amounts of folate between fruit from different locations and sets of trees, but all ripe green plums tested are considered good dietary sources of folate.
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Affiliation(s)
- Selina Fyfe
- Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Brisbane, QLD, Australia
- Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD, Australia
| | - Hung Hong
- Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Brisbane, QLD, Australia
- School of Agriculture and Food Science, The University of Queensland, Brisbane, QLD, Australia
| | - Horst Joachim Schirra
- Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD, Australia
- School of Environment and Science, Griffith University, Brisbane, QLD, Australia
- Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - Heather E. Smyth
- Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Brisbane, QLD, Australia
| | - Yasmina Sultanbawa
- Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Brisbane, QLD, Australia
| | - Michael Rychlik
- Queensland Alliance for Agriculture and Food Innovation, The University of Queensland, Brisbane, QLD, Australia
- Chair of Analytical Food Chemistry, Technical University of Munich, Freising, Germany
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Tartaglia J, Giglia R, Darby J. Developing culturally appropriate food literacy resources for Aboriginal children with Foodbank WA's Superhero Foods ®. Health Promot J Austr 2022; 33 Suppl 1:150-162. [PMID: 35194892 PMCID: PMC9790422 DOI: 10.1002/hpja.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/20/2022] [Indexed: 12/30/2022] Open
Abstract
ISSUE ADDRESSED In Australia, food sovereignty of traditional landowners has been marginalised by the globalisation of food systems and resulted in limited opportunities for children to experience familiar bush tucker foods as healthy choices, particularly in a school environment. Superhero Foods® themed teaching resources focus on the development of nutrition education materials that included traditional Aboriginal foods together with contemporary foods readily available in regional/remote communities. METHODS Consultation with an Aboriginal expert and Aboriginal artist; local, regional/remote teachers and stakeholders informed the development of tailored resources including food cartoon characters, school lesson plans and a storybook. The latter was guided by a resource development model. Users of the resources were surveyed to ascertain the useability, alignment with the Australian Dietary Guidelines, cross-curricular learnings and cultural relevance. RESULTS Respondents across regional/remote and urban locations completed a lesson plan and food character (clipart) survey (N = 51) and storybook survey (N = 14). Respondents advised the resources were relevant, enjoyable, engaging and culturally appropriate for all students regardless of Aboriginality. The resources provided learning opportunities for all children to enhance knowledge about Aboriginal culture and bush foods. Independent evaluation has further indicated the translation of messaging into student's knowledge and learning. CONCLUSIONS Key enablers to the success of the resource included; free online access, the highly engaging nature of the resources and adaptability to be implemented across a number of Aboriginal language groups in WA. Ensuring visual representation of healthy choices was fundamental to reinforcing nutrition messaging. Superhero Foods resources are a positive and important inclusion in the health promotion toolbox for Aboriginal children. SO WHAT?: Superhero Foods are novel nutrition education resources depicting Aboriginal foods and Aboriginal children. These food literacy resources will engage children's understanding of Aboriginal culture, improve food literacy and strengthen equitable access for regional and remote communities.
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Affiliation(s)
| | | | - Jill Darby
- School of Medical and Health ScienceEdith Cowan UniversityJoondalupAustralia
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Butovskaya M, Rostovtseva V, Dronova D, Burkova V, Adam Y. Variations in limited resources allocation towards friends and strangers in children and adolescents from seven economically and culturally diverse societies. Sci Rep 2022; 12:15232. [PMID: 36075940 PMCID: PMC9458677 DOI: 10.1038/s41598-022-19354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 08/29/2022] [Indexed: 11/24/2022] Open
Abstract
Humans are unique among primates in altruism and sharing limited recourses towards non-kin. Our study revealed the differences in proportions of individuals ready to share limited resources with virtual friend compared to virtual stranger in children and adolescents from seven ethnic groups, represented by four traditional rural African societies from Tanzania with different types of economy and three societies from Russia. The study was conducted between 2015 and 2020, and the data on 2253 individuals (1104 males and 1149 females) were obtained. Six economic games with limited resource allocations were conducted: Prosocial, Envy, and Sharing games with imagined friends and stranger partners accordingly. All players were later classified according to their decisions in all six games into four behavioral types: egoistic, egalitarian, altruistic, and mixed. The effects of population origin, gender, age, and stranger/friend type of interaction on the behavior were estimated by multinomial logistic regression. It was demonstrated that more respondents prefer altruistic and egalitarian behavior than egoistic and mixed in the whole sample. However, significant parochial effect was found. The study revealed significant main effects of ethnicity, age, and the interaction effects of ethnicity and parochial tendencies, and ethnicity and age on the behavior of players.
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Affiliation(s)
- M Butovskaya
- Institute of Ethnology and Anthropology of the Russian Academy of Sciences, Leninskiy pr-t, 32a, Moscow, Russia, 199334. .,National Research University Higher School of Economics, Moscow, Russia. .,Russian State University for the Humanities, Moscow, Russia.
| | - V Rostovtseva
- Institute of Ethnology and Anthropology of the Russian Academy of Sciences, Leninskiy pr-t, 32a, Moscow, Russia, 199334
| | - D Dronova
- Institute of Ethnology and Anthropology of the Russian Academy of Sciences, Leninskiy pr-t, 32a, Moscow, Russia, 199334
| | - V Burkova
- Institute of Ethnology and Anthropology of the Russian Academy of Sciences, Leninskiy pr-t, 32a, Moscow, Russia, 199334.,National Research University Higher School of Economics, Moscow, Russia
| | - Y Adam
- Institute of Ethnology and Anthropology of the Russian Academy of Sciences, Leninskiy pr-t, 32a, Moscow, Russia, 199334
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A Socio-Cognitive Review of Healthy Eating Programs in Australian Indigenous Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159314. [PMID: 35954672 PMCID: PMC9367833 DOI: 10.3390/ijerph19159314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 02/05/2023]
Abstract
Purpose: This paper aims to understand the challenges to healthy eating for Indigenous Australians using a Social Cognitive Theory lens. Understanding the environmental, cognitive, and behavioural barriers to healthy eating for Indigenous populations in Australia will help identify current gaps and highlight future actions needed in this area to close the gap for Indigenous Australians. Study design: Narrative review of interventions of healthy eating programs in Australian Indigenous communities sourced using a systematic search protocol to understand the environmental, cognitive, and behavioural barriers to healthy eating among Indigenous Australians and to identify gaps and future actions needed to address this from 2010–2020. Results: The search produced 486 records, after duplicates were removed and the inclusion and exclusion process were utilised, seven interventions were retained in nine studies. The seven interventions had multiple study designs, from randomised control trials to case studies. Conclusions: Further work needs to explore the long-term feasibility of providing fruit and vegetable discounts and the impact of remoteness for the delivery of healthy food. Dietary interventions need to be clearly described, and fidelity and process of the design and implementation process to help with replication of work.
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10
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Effects of Nutritional Interventions on Cardiovascular Disease Health Outcomes in Aboriginal and Torres Strait Islander Australians: A Scoping Review. Nutrients 2021; 13:nu13114084. [PMID: 34836337 PMCID: PMC8620344 DOI: 10.3390/nu13114084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 11/26/2022] Open
Abstract
Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components.
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11
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Patel J, Durey A, Naoum S, Kruger E, Slack-Smith L. Oral health education and prevention strategies among remote Aboriginal communities: a qualitative study. Aust Dent J 2021; 67:83-93. [PMID: 34767269 DOI: 10.1111/adj.12890] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The delivery of effective oral health promotion strategies is essential to improving oral health outcomes among remote Aboriginal communities. This study aimed to explore the perceptions and attitudes of Aboriginal Australians living in remote Kimberley communities towards oral health education and disease prevention. METHODS Semi-structured interviews and yarning circles were carried out following purposive sampling of Aboriginal adults living in the East Kimberley region of Western Australia. RESULTS A total of 80 community members participated in the yarning process. School-based oral health promotion and community-driven restrictions on the sale of sugary food and drink were seen as positive strategies in improving oral health. Lifestyle changes brought about by modernity, internet availability and fixed community stores were perceived to create new challenges and shift the priorities for those living in remote communities. CONCLUSIONS Community-based yarning may better inform future oral health strategies in the Kimberley. A neoliberal approach of shifting responsibility onto the individual ignores the complex social inequities faced by Aboriginal people living in remote communities where macro-level determinants such as remoteness, food security and education significantly influence decisions around diet and oral health.
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Affiliation(s)
- J Patel
- School of Population and Global Health, The University of Western Australia, Perth, Australia.,UWA Dental School, The University of Western Australia, Perth, Australia
| | - A Durey
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - S Naoum
- UWA Dental School, The University of Western Australia, Perth, Australia
| | - E Kruger
- School of Human Sciences, The University of Western Australia, Perth, Australia
| | - L Slack-Smith
- School of Population and Global Health, The University of Western Australia, Perth, Australia
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Hunt W, Bedoya‐Perez M, Geesink G, Van Den Heuvel A, Mullen J, Frost D. Harvesting Agile Wallabies for human consumption in the Northern Territory of Australia. ECOLOGICAL MANAGEMENT & RESTORATION 2021. [DOI: 10.1111/emr.12495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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McKay FH, Godrich SL. Interventions to address food insecurity among Aboriginal and Torres Strait Islander people: a rapid review. Appl Physiol Nutr Metab 2021; 46:1448-1458. [PMID: 34637657 DOI: 10.1139/apnm-2020-1075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Food insecurity disproportionately impacts Aboriginal and Torres Strait Islander Australians. This review sought to investigate research and evaluations of programs and interventions implemented to address food insecurity among Aboriginal and Torres Strait Islander communities. A rapid review was conducted to collate the available research from 6 databases. The search was conducted in May 2020. Search constructs related to food insecurity, Aboriginal and Torres Strait Islander people, and Australia. Twenty-five publications were included in this review, 24 reported on an intervention, while 9 were evaluations of an intervention. Interventions included behaviour change projects, including projects that sought to change purchasing and cooking behaviours, school-based education programs, and gardening programs. In general, the studies included in this sample were small and lacked a systematic consideration of the factors that shape the experience of food insecurity among Aboriginal and Torres Strait Islander people specifically. Based on the findings of this review, authors suggest greater consideration to the systematic determinants of food insecurity among Aboriginal and Torres Strait Islander communities to have lasting and sustainable impact on food insecurity. This review has been registered with the international prospective register of systematic reviews (PROSPERO: CRD42020183709). Novelty: Food insecurity among Aboriginal and Torres Strait Islander people poses significant risk to health and wellbeing. Small-scale food security interventions may not provide ongoing and sustained impact. Any intervention to promote food security will need to involve Aboriginal and Torres Strait Islander people and be sustained once external parties have left.
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Affiliation(s)
- Fiona H McKay
- School of Health and Social Development, Faculty of Health, Deakin University, Melbourne Burwood Campus, Burwood, VIC 3125, Australia
| | - Stephanie L Godrich
- School of Medical and Health Sciences, Edith Cowan University, South West Campus, Bunbury, WA 6230, Australia
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14
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Christidis R, Lock M, Walker T, Egan M, Browne J. Concerns and priorities of Aboriginal and Torres Strait Islander peoples regarding food and nutrition: a systematic review of qualitative evidence. Int J Equity Health 2021; 20:220. [PMID: 34620180 PMCID: PMC8499519 DOI: 10.1186/s12939-021-01551-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 09/11/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander Australians experience persistent health and social inequities. Chronic conditions, many of which are diet-related, are leading contributors to the burden of disease and health inequity in Australia. First Nations Peoples have the right to be involved in all policy decisions affecting them. This review aimed to synthesise Aboriginal and Torres Strait Islander Peoples' concerns and priorities about food and nutrition in order to inform policies to improve health equity. METHODS MEDLINE, CINAHL, Informit and Google Scholar were systematically searched to identify qualitative studies-published from January 2008-that included data from Aboriginal and/or Torres Strait Islander Peoples about their concerns and priorities related to food and nutrition. Data were extracted from included studies using a pre-determined template and study quality was assessed using the Aboriginal and Torres Strait Islander Quality Appraisal Tool. Qualitative findings were synthesised using inductive thematic analysis and categorised based on an ecological model of health. RESULTS Twenty-one studies were included. Key factors influencing food and nutrition were identified across all levels of the ecological framework. These included interpersonal and institutional racism, junk food availability and marketing, food accessibility and affordability, housing conditions, food knowledge and cooking skills, and connection to family and culture. CONCLUSIONS Documenting Aboriginal and Torres Strait Islander Peoples' lived experiences of the colonised food system is one step necessary for informing policy to tackle food and nutrition inequities. Based on existing qualitative research, food and nutrition policymakers should prioritise building a supportive food environment by focusing on self-determination; ensuring access to healthy, affordable food and safe housing; and by eliminating systemic racism.
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Affiliation(s)
- Rebecca Christidis
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Locked Bag 20000, Geelong, Victoria Australia
| | - Mark Lock
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Locked Bag 20000, Geelong, Victoria Australia
| | - Troy Walker
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Locked Bag 20000, Geelong, Victoria Australia
| | - Mikaela Egan
- Victorian Aboriginal Community Controlled Health Organisation, 17-23 Sackville St, Collingwood, Victoria Australia
| | - Jennifer Browne
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Locked Bag 20000, Geelong, Victoria Australia
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15
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Knudsen L, Lyons JG, O’Dea K, Christensen DL, Brimblecombe JK. Antioxidant biomarkers and cardiometabolic risk markers in an Aboriginal community in remote Australia: a cross-sectional study. Public Health Nutr 2021; 24:4937-4948. [PMID: 33261694 PMCID: PMC11082824 DOI: 10.1017/s1368980020004899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 11/11/2020] [Accepted: 11/26/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE High-quality diets, characterised by nutrient-rich foods, are one of the foundations for health and well-being. Indicators of diet quality, antioxidants, are associated with protection against cardiometabolic diseases. The current study explores relationships between plasma antioxidants and cardiometabolic risk among Aboriginal people in Australia. DESIGN As part of a community-driven health promotion programme, we conducted a cross-sectional study including a health-behaviour questionnaire, plasma antioxidants and cardiometabolic risk markers (anthropometric, blood pressure measurements, fasting glucose, glycated Hb (HbA1c), lipids, C-reactive protein and albumin-creatinine-ratio) continuous and categorised into population-specific cut-offs. Antioxidants (β-carotene, β-cryptoxanthin, lycopene, lutein-zeaxanthin, retinol and α-tocopherol measured using HPLC) were applied to a principal component analysis, which aggregated these into a single component. Linear regression models were applied to investigate associations between the antioxidant component and cardiometabolic risk markers. SETTING Community in a remote area in Northern Territory, Australia. PARTICIPANTS A total of 324 Aboriginal people, mean age 35·5 (range 15-75) years. RESULTS Antioxidant component levels were higher among individuals with higher self-reported vegetable intake (P < 0·01), higher among individuals with higher self-reported fruit intake (P = 0·05) and lower among current smokers (P = 0·06). Linear regression revealed an inverse association between the antioxidant component and C-reactive protein (β = -0·01, P < 0·01) after adjusting for confounders. CONCLUSION Higher plasma antioxidant levels, indicators of diet quality, were associated with lower levels of high-sensitivity C-reactive protein in this Aboriginal population in remote Australia. This association suggests plasma antioxidants may be protective against inflammation; however, longitudinal studies are needed to examine this potentially protective relationship.
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Affiliation(s)
- Lenette Knudsen
- Education Department, Steno Diabetes Center Copenhagen, 2820Gentofte, Denmark
| | - Jasmine G Lyons
- Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Kerin O’Dea
- School of Health Sciences, University of South Australia, Adelaide, Australia
- Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Dirk L Christensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Julie K Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
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16
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Leonard D, Buettner P, McDermott R, Makrides M. The iron content of healthy diets for one day for breastfed babies and young children. Nutr Diet 2021; 78:415-423. [PMID: 33594814 DOI: 10.1111/1747-0080.12655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/30/2020] [Accepted: 11/18/2020] [Indexed: 11/30/2022]
Abstract
AIMS Early childhood anaemia due to iron deficiency is widespread in remote communities across northern Australia. Current recommendations for healthy food to complement breastfeeding at age 6 to 23 months include iron-rich and iron-enriched foods. An electronic nutrient analysis was undertaken to assess the iron content of hypothetical healthy diets for breastfed babies and young children aged 6 to 23 months in Australia, in comparison with their estimated requirements. METHODS Hypothetical diets for 1 day were developed that were consistent with the Foundation Diets for breastfed infants 6 to 12 months and for toddlers 13 to 23 months. Nutrient content was derived using the Australian Food Composition database in FoodWorks 10. The iron content of these two diets were compared with Estimated Average Requirements (EARs) and Recommended Dietary Intakes (RDIs) for iron for infants aged 7 to 12 months and children aged 1 to 3 years. RESULTS The iron content of the hypothetical diet for breastfed infants aged 6 to 12 months (5.8 mg) was less than the EAR (7 mg, 83%) and the RDI (11 mg, 53%). For young breastfed children aged 13 to 23 months, the iron content of the hypothetical diet was 4.4 mg; above the EAR (4 mg, 110%) but less than RDI (9 mg, 49%). CONCLUSIONS Breastfeeding has health and neurodevelopmental benefits for infants and young children that are particularly important in remote Australia where food insecurity and poor nutrition compromise health and wellbeing. Adequate iron intake is also important for neurodevelopment in early life but healthy diets for breastfed babies and young children may have insufficient iron content to meet requirements. The upcoming revision of the Australian Dietary Guidelines provides an opportunity to consider this issue.
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Affiliation(s)
- Dympna Leonard
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Petra Buettner
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Robyn McDermott
- Public Health Medicine, University of South Australia, Adelaide, South Australia, Australia
| | - Maria Makrides
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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17
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Kenny TA, Little M, Lemieux T, Griffin PJ, Wesche SD, Ota Y, Batal M, Chan HM, Lemire M. The Retail Food Sector and Indigenous Peoples in High-Income Countries: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238818. [PMID: 33261090 PMCID: PMC7730644 DOI: 10.3390/ijerph17238818] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
Indigenous Peoples in high-income countries experience higher burdens of food insecurity, obesity, and diet-related health conditions compared to national averages. The objective of this systematic scoping review is to synthesize information from the published literature on the methods/approaches, findings, and scope for research and interventions on the retail food sector servicing Indigenous Peoples in high-income countries. A structured literature search in two major international databases yielded 139 relevant peer-reviewed articles from nine countries. Most research was conducted in Oceania and North America, and in rural and remote regions. Several convergent issues were identified across global regions including limited grocery store availability/access, heightened exposure to unhealthy food environments, inadequate market food supplies (i.e., high prices, limited availability, and poor quality), and common underlying structural factors including socio-economic inequality and colonialism. A list of actions that can modify the nature and structure of retailing systems to enhance the availability, accessibility, and quality of healthful foods is identified. While continuing to (re)align research with community priorities, international collaboration may foster enhanced opportunities to strengthen the evidence base for policy and practice and contribute to the amelioration of diet quality and health at the population level.
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Affiliation(s)
- Tiff-Annie Kenny
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Correspondence: or
| | - Matthew Little
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Tad Lemieux
- Department of English Language and Literature, Carleton University, Ottawa, ON K1S 5B6, Canada;
| | - P. Joshua Griffin
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Department of American Indian Studies, University of Washington, Seattle, WA 98195, USA
| | - Sonia D. Wesche
- Department of Geography, Environment and Geomatics, Faculty of Arts, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Yoshitaka Ota
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Nippon Foundation Ocean Nexus Center, EarthLab, University of Washington; Seattle, WA 98195, USA
| | - Malek Batal
- Département de nutrition, Faculté de médecine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
- Centre de recherche en santé publique (CReSP), Montreal, Quebec, QC H3N 1X9, Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa, Ottawa, ON K1N 9A7, Canada;
| | - Melanie Lemire
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Institut de biologie intégrative et des systèmes (IBIS), Université Laval, Quebec, QC G1V 0A6, Canada
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18
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McCartan J, van Burgel E, McArthur I, Testa S, Thurn E, Funston S, Kho A, McMahon E, Brimblecombe J. Traditional Food Energy Intake among Indigenous Populations in Select High-Income Settler-Colonized Countries: A Systematic Literature Review. Curr Dev Nutr 2020; 4:nzaa163. [PMID: 33274307 PMCID: PMC7695808 DOI: 10.1093/cdn/nzaa163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/14/2020] [Accepted: 10/16/2020] [Indexed: 11/14/2022] Open
Abstract
The traditional diets of Indigenous Peoples globally have undergone a major transition due to settler colonialism. This systematic review aims to provide a perspective of traditional food intake of Indigenous populations in high-income settler-colonized countries. For inclusion, studies reported the primary outcome of interest-traditional food contribution to total energy intake (% of energy)-and occurred in Canada, the United States (including Hawaii and Alaska), New Zealand, Australia, and/or Scandinavian countries. Primary outcome data were reported and organized by date of data collection by country. Forty-nine articles published between 1987 and 2019 were identified. Wide variation in contribution of traditional food to energy was reported. A trend for decreasing traditional food energy intake over time was apparent; however, heterogeneity in study populations and dietary assessment methods limited conclusive evaluation of this. This review may inform cross-sectoral policy to protect the sustainable utilization of traditional food for Indigenous Peoples.
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Affiliation(s)
- Julia McCartan
- Department of Nutrition, Dietetics, and Food, Be Active Sleep Eat (BASE) Facility, Monash University, Notting Hill, Victoria, Australia
| | - Emma van Burgel
- Department of Nutrition, Dietetics, and Food, Be Active Sleep Eat (BASE) Facility, Monash University, Notting Hill, Victoria, Australia
| | - Isobelle McArthur
- Department of Nutrition, Dietetics, and Food, Be Active Sleep Eat (BASE) Facility, Monash University, Notting Hill, Victoria, Australia
| | - Sharni Testa
- Department of Nutrition, Dietetics, and Food, Be Active Sleep Eat (BASE) Facility, Monash University, Notting Hill, Victoria, Australia
| | - Elisabeth Thurn
- Department of Nutrition, Dietetics, and Food, Be Active Sleep Eat (BASE) Facility, Monash University, Notting Hill, Victoria, Australia
| | - Sarah Funston
- Department of Nutrition, Dietetics, and Food, Be Active Sleep Eat (BASE) Facility, Monash University, Notting Hill, Victoria, Australia
| | - Angel Kho
- Department of Nutrition, Dietetics, and Food, Be Active Sleep Eat (BASE) Facility, Monash University, Notting Hill, Victoria, Australia
| | - Emma McMahon
- Menzies School of Health Research, Spring Hill, Queensland, Australia
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics, and Food, Be Active Sleep Eat (BASE) Facility, Monash University, Notting Hill, Victoria, Australia
- Menzies School of Health Research, Royal Darwin Hospital Campus, Casuarina, Northern Territory, Australia
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19
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Prevalence and Socio-Demographic Predictors of Food Insecurity in Australia during the COVID-19 Pandemic. Nutrients 2020; 12:nu12092682. [PMID: 32887422 PMCID: PMC7551067 DOI: 10.3390/nu12092682] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 08/31/2020] [Accepted: 08/31/2020] [Indexed: 01/22/2023] Open
Abstract
The COVID-19 pandemic has exacerbated economic vulnerabilities and disrupted the Australian food supply, with potential implications for food insecurity. This study aims to describe the prevalence and socio-demographic associations of food insecurity in Tasmania, Australia, during the COVID-19 pandemic. A cross-sectional survey (deployed late May to early June 2020) incorporated the U.S. Household Food Security Survey Module: Six-Item Short Form, and fifteen demographic and COVID-related income questions. Survey data (n = 1170) were analyzed using univariate and multivariate binary logistic regression. The prevalence of food insecurity was 26%. The adjusted odds of food insecurity were higher among respondents with a disability, from a rural area, and living with dependents. Increasing age, a university education, and income above $80,000/year were protective against food insecurity. Food insecurity more than doubled with a loss of household income above 25% (Adjusted Odds Ratio (AOR): 2.02; 95% CI: 1.11, 3.71; p = 0.022), and the odds further increased with loss of income above 75% (AOR: 7.14; 95% CI: 2.01, 24.83; p = 0.002). Our results suggest that the prevalence of food insecurity may have increased during the COVID-19 pandemic, particularly among economically vulnerable households and people who lost income. Policies that support disadvantaged households and ensure adequate employment opportunities are important to support Australians throughout and post the COVID-19 pandemic.
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20
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Hare MJL, Barzi F, Boyle JA, Guthridge S, Dyck RF, Barr ELM, Singh G, Falhammar H, Webster V, Shaw JE, Maple-Brown LJ. Diabetes during pregnancy and birthweight trends among Aboriginal and non-Aboriginal people in the Northern Territory of Australia over 30 years. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2020; 1:100005. [PMID: 34327339 PMCID: PMC8315488 DOI: 10.1016/j.lanwpc.2020.100005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/15/2020] [Accepted: 06/29/2020] [Indexed: 10/27/2022]
Abstract
Background Early-life risk factors, including maternal hyperglycaemia and birthweight, are thought to contribute to the high burden of cardiometabolic disease experienced by Indigenous populations. We examined rates of pre-existing diabetes in pregnancy, gestational diabetes mellitus (GDM) and extremes of birthweight over three decades in the Northern Territory (NT) of Australia. Methods We performed a retrospective cohort analysis of the NT Perinatal Data Collection from 1987 to 2016, including all births >20 weeks gestation, stratified by maternal Aboriginal identification. Key outcomes were annual rates of pre-existing diabetes, GDM, small-for-gestational-age, large-for-gestational-age, low birthweight (<2500 g), and high birthweight (>4000 g). Logistic regression was used to assess trends and interactions. Findings 109 349 babies were born to 64 877 mothers, 36% of whom identified as Aboriginal ethnicity. Among Aboriginal women, rates of GDM and pre-existing diabetes, respectively, were 3 · 4% and 0 · 6% in 1987 and rose to 13% and 5 · 7% in 2016 (both trends p<0 · 001). Among non-Aboriginal women, rates of GDM increased from 1 · 9% in 1987 to 11% in 2016 (p<0 · 001), while pre-existing diabetes was uncommon (≤0 · 7% throughout). Rates of small-for-gestational-age decreased, while rates of large-for-gestational-age and high birthweight increased in both groups (all trends p<0 · 001). Multivariable modelling suggests that hyperglycaemia was largely responsible for the growing rate of large-for-gestational-age births among Aboriginal women. Interpretation The burden of hyperglycaemia in pregnancy has grown substantially in the NT over three decades and is impacting birthweight trends. The prevalence of pre-gestational diabetes in Aboriginal women is among the highest in the world. Funding Diabetes Australia Research Program.
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Affiliation(s)
- Matthew J L Hare
- Wellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Federica Barzi
- Wellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Steven Guthridge
- Centre for Child Development and Education, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Roland F Dyck
- Department of Medicine, Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Elizabeth L M Barr
- Wellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Gurmeet Singh
- Child Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia.,Department of Paediatrics, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Henrik Falhammar
- Wellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Vanya Webster
- Indigenous Reference Group, Diabetes across the Lifecourse: Northern Australia Partnership, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Jonathan E Shaw
- Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Louise J Maple-Brown
- Wellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
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21
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Sociodemographic factors associated with food insecurity: data from the 2003-2014 New South Wales Population Health Survey. Public Health Nutr 2020; 23:1857-1867. [PMID: 32408925 DOI: 10.1017/s1368980019005159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To determine the prevalence and sociodemographic factors associated with food insecurity in the state of New South Wales (NSW), Australia. DESIGN Cross-sectional analysis of food insecurity data collected by the NSW Population Health Survey between 2003 and 2014. Multiple logistic regression was used to examine associations with key sociodemographic variables. SETTING NSW, Australia. PARTICIPANTS 212 608 survey participants responded to the food insecurity survey question between 2003 and 2014. 150 767 of them were aged ≥16 years. The survey sample was randomly selected and weighted to be representative of the NSW population. RESULTS On average 6 % of adults aged ≥16 years experienced food insecurity in NSW. The odds of food insecurity appeared to increase from one survey year to the next by a factor of 1·05. Food insecurity was found to be independently associated with age, sex, marital status, household size, education, employment status, household income, smoking status, alcohol intake and self-rated health. The association with income, smoking status and self-rated health appeared to be the strongest among all covariates and showed a gradient effect. Food insecurity appeared to increase significantly between the age of 16 and 19 years. CONCLUSIONS The prevalence of food insecurity appears to be rising over time. Given the negative health consequences of food insecurity, more rigorous measurement and monitoring of food insecurity in NSW and nationally is strongly recommended. The findings provide support for interventions targeting low-income and younger population groups.
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22
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Wilson A, Wilson R, Delbridge R, Tonkin E, Palermo C, Coveney J, Hayes C, Mackean T. Resetting the Narrative in Australian Aboriginal and Torres Strait Islander Nutrition Research. Curr Dev Nutr 2020; 4:nzaa080. [PMID: 32467866 PMCID: PMC7241202 DOI: 10.1093/cdn/nzaa080] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 04/14/2020] [Accepted: 04/30/2020] [Indexed: 11/14/2022] Open
Abstract
As the oldest continuous living civilizations in the world, Aboriginal and Torres Strait Islander peoples have strength, tenacity, and resilience. Initial colonization of the landscape included violent dispossession and removal of people from Country to expand European land tenure and production systems, loss of knowledge holders through frontier violence, and formal government policies of segregation and assimilation designed to destroy ontological relationships with Country and kin. The ongoing manifestations of colonialism continue to affect food systems and food knowledges of Aboriginal peoples, and have led to severe health inequities and disproportionate rates of nutrition-related health conditions. There is an urgent need to collaborate with Aboriginal and Torres Strait Islander peoples to address nutrition and its underlying determinants in a way that integrates Aboriginal and Torres Strait Islander peoples' understandings of food and food systems, health, healing, and well-being. We use the existing literature to discuss current ways that Australian Aboriginal and Torres Strait Islander peoples are portrayed in the literature in relation to nutrition, identify knowledge gaps that require further research, and propose a new way forward.
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Affiliation(s)
- Annabelle Wilson
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Roland Wilson
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Robyn Delbridge
- Department of Health Professions, Swinburne University, Melbourne, Victoria, Australia
| | - Emma Tonkin
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| | - John Coveney
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Colleen Hayes
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Tamara Mackean
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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23
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Cubillo B, McCartan J, West C, Brimblecombe J. A Qualitative Analysis of the Accessibility and Connection to Traditional Food for Aboriginal Chronic Maintenance Hemodialysis Patients. Curr Dev Nutr 2020; 4:nzaa036. [PMID: 32285023 PMCID: PMC7141846 DOI: 10.1093/cdn/nzaa036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 12/16/2019] [Accepted: 03/09/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Due to the lack of resources in remote Aboriginal communities within the Northern Territory of Australia, Aboriginal people requiring chronic maintenance hemodialysis often must relocate from their home communities to Darwin city permanently to receive ongoing care. This phenomenon can cause distressing isolation from important traditional food, land, and family. OBJECTIVE The aim was to identify the relation to traditional food from an Aboriginal perspective and the enablers and barriers to accessing traditional food post-relocation from remote regions of the Northern Territory, Australia, to the urban city of Darwin. METHODS This was a qualitative study design with a total of 12 Aboriginal participants (4 males, 8 females) receiving ongoing hemodialysis at the Nightcliff Renal Unit. Participants had all relocated from a remote region to Darwin. Interviews were conducted between July and September 2018 in Darwin, Australia. Data interpretation was conducted by an Aboriginal researcher and co-authors with a combined 30 y of experience conducting research with Aboriginal people in a health context. Data analysis comprised an inductive thematic analysis approach with an indigenist knowledge interpretation lens to construct, reaffirm, and protect Indigenous views. RESULTS Traditional food was an important part of participants' identity and strongly connected to social, emotional, spiritual and physical health, and well-being. Access to traditional food post-relocation is associated with enablers and barriers including mobility, local knowledge, social support networks, commercial access, and economics. CONCLUSIONS Dialysis patients who are dislocated from remote Aboriginal communities to Darwin experience clear disruption to traditional food access, consumption, availability, and knowledge dissemination to the younger generations.
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Affiliation(s)
- Beau Cubillo
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Julia McCartan
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Christine West
- Northern Territory Department of Health Nightcliff Renal Unit, Nightcliff, Northern Territory, Australia
| | - Julie Brimblecombe
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
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Sjöholm P, Pahkala K, Davison B, Juonala M, Singh G. Socioeconomic status, remoteness and tracking of nutritional status from childhood to adulthood in an Australian Aboriginal Birth Cohort: the ABC study. BMJ Open 2020; 10:e033631. [PMID: 31992605 PMCID: PMC7045147 DOI: 10.1136/bmjopen-2019-033631] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES To determine prevalences of underweight and overweight as well as low and high waist-to-height ratio (WHtR) in three prospective follow-ups and to explore tracking of these measures of nutritional status from childhood to adolescence and adulthood. The influence of socioeconomic status, remoteness, maternal body mass index (BMI) and birth weight on weight status was assessed. DESIGN Longitudinal birth cohort study of Indigenous Australians. SETTING Data derived from three follow-ups of the Aboriginal Birth Cohort study with mean ages of 11.4, 18.2 and 25.4 years for the participants. PARTICIPANTS Of the 686 Indigenous babies recruited to the study between 1987 and 1990, 315 had anthropometric measurements for all three follow-ups and were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES BMI categories (underweight, normal weight, overweight and obesity),WHtR categories (low and high), sex, areal socioeconomic disadvantage as defined by the Indigenous Relative Socioeconomic Outcomes index, urban/remote residence, maternal BMI and birth weight. Logistic regression was used to calculate ORs for belonging to a certain BMI category in adolescence and adulthood according to BMI category in childhood and adolescence. RESULTS Underweight was common (38% in childhood and 24% in adulthood) and the prevalence of overweight/obesity increased with age (12% in childhood and 35% in adulthood). Both extremes of weight status as well as low and high WHtR tracked from childhood to adulthood. Underweight was more common and overweight was less common in remote and more disadvantaged areas. Birth weight and maternal BMI were associated with later weight status. There were significant sex differences for prevalences and tracking of WHtR but not for BMI. CONCLUSIONS Socioeconomic factors, remoteness and gender must be addressed when assessing nutrition-related issues in the Indigenous communities due to the variation in nutritional status and its behaviour over time within the Indigenous population.
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Affiliation(s)
- Pauline Sjöholm
- Department of Medicine, University of Turku, Turku, Finland
- Department of Anesthesiology, Vaasa Central Hospital, Vaasa, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Belinda Davison
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Gurmeet Singh
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
- Northern Territory Medical Program, Flinders University, Darwin, Northern Territory, Australia
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Thompson A, Munkara G, Kantilla M, Tipungwuti J. Medicinal plant use in two Tiwi Island communities: a qualitative research study. JOURNAL OF ETHNOBIOLOGY AND ETHNOMEDICINE 2019; 15:40. [PMID: 31419986 PMCID: PMC6697989 DOI: 10.1186/s13002-019-0315-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 07/17/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Traditional medicinal plants are still used today in many Aboriginal communities across Australia. Our research focused on the contemporary use of such plants in the two communities within the Tiwi Islands, Wurrumiyanga and Pirlangimpi. METHODS This qualitative research project performed a video ethnography, community interviews, and a trial intervention to better understand the extent to which these plants are still used throughout the community and how they may be used more in the future. RESULTS We found that several plants are still used predominantly as medicinal washes to treat skin disorders and/or as a tea to treat congestion associated with cold and flu. Those plants that are commonly used are found near to the community in large amounts and are recognized as being both safe and effective. CONCLUSIONS Within the community, it is the elder women who remain most knowledgeable about these plants and continue to make them for their families. However, there are many families who no longer know how to make these traditional medicines though they express a desire to use them. Therefore, it would be beneficial to have a central location or method to produce traditional medicine for the community-a bush pharmacy.
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Affiliation(s)
- Adam Thompson
- Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811 Australia
| | - Gemma Munkara
- Strong Women’s Group, Wurrumiyanga (Tiwi Islands), Tiwi Land Council, PO Box 38545, Winnellie, NT 0821 Australia
| | - Marie Kantilla
- Strong Women’s Group, Wurrumiyanga (Tiwi Islands), Tiwi Land Council, PO Box 38545, Winnellie, NT 0821 Australia
| | - Jacinta Tipungwuti
- Strong Women’s Group, Wurrumiyanga (Tiwi Islands), Tiwi Land Council, PO Box 38545, Winnellie, NT 0821 Australia
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Kagie R, Lin SYN, Hussain MA, Thompson SC. A Pragmatic Review to Assist Planning and Practice in Delivering Nutrition Education to Indigenous Youth. Nutrients 2019; 11:E510. [PMID: 30818853 PMCID: PMC6471092 DOI: 10.3390/nu11030510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 11/16/2022] Open
Abstract
Many health promotion campaigns have incorporated multi-component nutrition interventions to promote healthy diet-related behaviours among Indigenous communities, particularly children and adolescents. However, these campaigns show mixed results and while research often describes outcomes of approaches and interventions, it does not extensively describe implementation processes and best practices for nutrition education for Indigenous youth. To enhance knowledge and understanding of best processes in nutritional education approaches with Indigenous youth, we conducted a search using multiple databases including PubMed, Google Scholar, the Australian Indigenous HealthInfoNet and Australian government research databases to identify relevant peer-reviewed and grey literature as well as educational resources, such as websites and handbooks for teachers, parents, and students. We list and describe common features of successful nutritional interventions in Indigenous settings, steps for nutrition education targeting youth, school-based nutrition education for different ages, and general guidelines for teaching Indigenous students. Current best practice and knowledge gaps for the delivery of nutrition education to Indigenous youth are described.
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Affiliation(s)
- Robin Kagie
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald St, Geraldton, WA 6530, Australia.
| | - Szu-Yu Nancy Lin
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald St, Geraldton, WA 6530, Australia.
| | - Mohammad Akhtar Hussain
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald St, Geraldton, WA 6530, Australia.
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, The University of Western Australia, 167 Fitzgerald St, Geraldton, WA 6530, Australia.
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McKay FH, Haines BC, Dunn M. Measuring and Understanding Food Insecurity in Australia: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030476. [PMID: 30736305 PMCID: PMC6388276 DOI: 10.3390/ijerph16030476] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 01/29/2023]
Abstract
The number of Australians seeking food aid has increased in recent years; however, the current variability in the measurement of food insecurity means that the prevalence and severity of food insecurity in Australia is likely underreported. This is compounded by infrequent national health surveys that measure food insecurity, resulting in outdated population-level food insecurity data. This review sought to investigate the breadth of food insecurity research conducted in Australia to evaluate how this construct is being measured. A systematic review was conducted to collate the available Australian research. Fifty-seven publications were reviewed. Twenty-two used a single-item measure to examine food security status; 11 used the United States Department of Agriculture (USDA) Household Food Security Survey Module (HFSSM); two used the Radimer/Cornell instrument; one used the Household Food and Nutrition Security Survey (HFNSS); while the remainder used a less rigorous or unidentified method. A wide range in prevalence and severity of food insecurity in the community was reported; food insecurity ranged from 2% to 90%, depending on the measurement tool and population under investigation. Based on the findings of this review, the authors suggest that there needs to be greater consistency in measuring food insecurity, and that work is needed to create a measure of food insecurity tailored for the Australian context. Such a tool will allow researchers to gain a clear understanding of the prevalence of food insecurity in Australia to create better policy and practice responses.
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Affiliation(s)
| | - Bronte C Haines
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Waterfront campus, Geelong, Victoria 3220, Australia.
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Ferguson M, O'Dea K, Altman J, Moodie M, Brimblecombe J. Health-Promoting Food Pricing Policies and Decision-Making in Very Remote Aboriginal and Torres Strait Islander Community Stores in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122908. [PMID: 30572601 PMCID: PMC6313585 DOI: 10.3390/ijerph15122908] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/10/2018] [Accepted: 12/14/2018] [Indexed: 11/16/2022]
Abstract
Aboriginal and Torres Strait Islander people living in remote communities in Australia experience a disproportionate burden of diet-related chronic disease. This occurs in an environment where the cost of store-purchased food is high and cash incomes are low, factors that affect both food insecurity and health outcomes. Aboriginal and Torres Strait Islander storeowners and the retailers who work with them implement local policies with the aim of improving food affordability and health outcomes. This paper describes health-promoting food pricing policies, their alignment with evidence, and the decision-making processes entailed in their development in community stores across very remote Australia. Semi-structured interviews were conducted with a purposive sample of retailers and health professionals identified through the snowball method, September 2015 to October 2016. Data were complemented through review of documents describing food pricing policies. A content analysis of the types and design of policies was undertaken, while the decision-making process was considered through a deductive, thematic analysis. Fifteen retailers and 32 health professionals providing services to stores participated. Subsidies and subsidy/price increase combinations dominated. Magnitude of price changes ranged from 5% to 25% on fruit, vegetables, bottled water, artificially sweetened and sugar sweetened carbonated beverages, and broadly used 'healthy/essential' and 'unhealthy' food classifications. Feasibility and sustainability were considered during policy development. Greater consideration of acceptability, importance, effectiveness and unintended consequences of policies guided by evidence were deemed important, as were increased involvement of Aboriginal and Torres Strait Islander storeowners and nutritionists in policy development. A range of locally developed health-promoting food pricing policies exist and partially align with research-evidence. The decision-making processes identified offer an opportunity to incorporate evidence, based on consideration of the local context.
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Affiliation(s)
- Megan Ferguson
- School of Public Health, The University of Queensland, Brisbane 4072, Australia.
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Darwin 0811, Australia.
| | - Kerin O'Dea
- Division of Health Sciences, University of South Australia, Adelaide 5001, Australia. Kerin.O'
| | - Jon Altman
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood 3125, Australia.
| | - Marjory Moodie
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong 3220, Australia.
| | - Julie Brimblecombe
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Darwin 0811, Australia.
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne 3168, Australia.
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Magnus A, Cobiac L, Brimblecombe J, Chatfield M, Gunther A, Ferguson M, Moodie M. The cost-effectiveness of a 20% price discount on fruit, vegetables, diet drinks and water, trialled in remote Australia to improve Indigenous health. PLoS One 2018; 13:e0204005. [PMID: 30260984 PMCID: PMC6160015 DOI: 10.1371/journal.pone.0204005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 09/01/2018] [Indexed: 11/21/2022] Open
Abstract
This paper estimates the cost-effectiveness of a 20% price discount on healthy food and beverages with and without consumer nutrition education, as trialled in remote Northern Australia. Changes in actual store sales, from the pre-discount baseline period, were analysed for population impact on consumption of fruit and vegetables, water and artificially sweetened soft drinks, in addition with total dietary weight (grams), energy (Mega Joules), and sodium (milligrams). Disability Adjusted Life Years (DALYs), arising from changes in dietary risk factor prevalence in the population, were estimated as the primary health outcome in a multi health-state Markov model. The costs of the strategies were sourced from paid invoices and time estimates of staff providing store-based discount promotion and consumer education. The incremental cost-effectiveness ratio adopted a partial societal perspective, (including health and retail sector costs), as cost per DALY averted and was presented in 2011 Australian dollars. The price discount, helped address a gap in food price equity for residents of remote communities. However, the discount strategy, with or without consumer education led to a net loss of population health –36 95%CI (-47,-25) or -21(-28, -15) DALYs respectively, at increased cost to the retail and health sectors, of AUD860000 95%CI (710000, 1million) or AUD500000 (410000, 590000). The strategies trialled were thereby categorised as dominated by current practice while acknowledging considerable uncertainty surrounding the health outcome estimates. The 20% discount on limited targeted products appeared to need to be considered in conjunction with other marketing strategies to support healthy food choices, if remote Australian Indigenous population health is to be improved.
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Affiliation(s)
- Anne Magnus
- Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- * E-mail:
| | - Linda Cobiac
- Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Julie Brimblecombe
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Royal Darwin Hospital Campus, Tiwi, Northern Territory, Australia
| | - Mark Chatfield
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Royal Darwin Hospital Campus, Tiwi, Northern Territory, Australia
| | - Anthony Gunther
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Royal Darwin Hospital Campus, Tiwi, Northern Territory, Australia
| | - Megan Ferguson
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Brisbane, Queensland, Australia
| | - Marj Moodie
- Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Global Obesity Centre, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Abstract
Small Island Developing States (SIDS) are island nations that experience specific social, economic and environmental vulnerabilities associated with small populations, isolation and limited resources. Globally, SIDS exhibit exceptionally high rates of non-communicable disease (NCD) risk and incidence. Despite this, there is a lack of context-specific research within SIDS focused on life course approaches to NCD prevention, particularly the impact of the early-life environment on later disease risk as defined by the Developmental Origins of Health and Disease (DOHaD) framework. Given that globalization has contributed to significant nutritional transitions in these populations, the DOHaD paradigm is highly relevant. SIDS in the Pacific region have the highest rates of NCD risk and incidence globally. Transitions from traditional foods grown locally to reliance on importation of Western-style processed foods high in fat and sugar are common. The Cook Islands is one Pacific SIDS that reports this transition, alongside rising overweight/obesity rates, currently 91%/72%, in the adult population. However, research on early-life NCD prevention within this context, as in many low- and middle-income countries, is scarce. Although traditional research emphasizes the need for large sample sizes, this is rarely possible in the smaller SIDS. In these vulnerable, high priority countries, consideration should be given to utilizing 'small' sample sizes that encompass a high proportion of the total population. This may enable contextually relevant research, crucial to inform NCD prevention strategies that can contribute to improving health and well-being for these at-risk communities.
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31
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McMahon E, Wycherley T, O'Dea K, Brimblecombe J. A comparison of dietary estimates from the National Aboriginal and Torres Strait Islander Health Survey to food and beverage purchase data. Aust N Z J Public Health 2017; 41:598-603. [PMID: 29044897 DOI: 10.1111/1753-6405.12718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 04/01/2017] [Accepted: 07/01/2017] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE We compared self-reported dietary intake from the very remote sample of the National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (VR-NATSINPAS; n=1,363) to one year of food and beverage purchases from 20 very remote Indigenous Australian communities (servicing ∼8,500 individuals). METHODS Differences in food (% energy from food groups) and nutrients were analysed using t-test with unequal variance. RESULTS Per-capita energy estimates were not significantly different between the surveys (899 MJ/person/day [95% confidence interval -152,1950] p=0.094). Self-reported intakes of sugar, cereal products/dishes, beverages, fats/oils, milk products/dishes and confectionery were significantly lower than that purchased, while intakes of meat, vegetables, cereal-based dishes, fish, fruit and eggs were significantly higher (p<0.05). CONCLUSION Differences between methods are consistent with differential reporting bias seen in self-reported dietary data. Implications for public health: The NATSINPAS provides valuable, much-needed information about dietary intake; however, self-reported data is prone to energy under-reporting and reporting bias. Purchase data can be used to track population-level food and nutrient availability in this population longitudinally; however, further evidence is needed on approaches to estimate wastage and foods sourced outside the store. There is potential for these data to complement each other to inform nutrition policies and programs in this population.
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Affiliation(s)
- Emma McMahon
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Royal Hospital Campus, Northern Territory.,Centre for Population Health Research, School of Health Sciences, University of South Australia
| | - Thomas Wycherley
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Royal Hospital Campus, Northern Territory.,Centre for Population Health Research, School of Health Sciences, University of South Australia
| | - Kerin O'Dea
- Centre for Population Health Research, School of Health Sciences, University of South Australia
| | - Julie Brimblecombe
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Royal Hospital Campus, Northern Territory
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32
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Leonard D, Aquino D, Hadgraft N, Thompson F, Marley JV. Poor nutrition from first foods: A cross-sectional study of complementary feeding of infants and young children in six remote Aboriginal communities across northern Australia. Nutr Diet 2017; 74:436-445. [DOI: 10.1111/1747-0080.12386] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 08/08/2017] [Accepted: 08/10/2017] [Indexed: 01/17/2023]
Affiliation(s)
- Dympna Leonard
- Centre for Chronic Disease Prevention, Cairns Institute; James Cook University; Cairns Queensland Australia
- Tropical Public Health Services; Queensland Health; Cairns Queensland Australia
| | - Danielle Aquino
- Menzies School of Health Research; Darwin Northern Territory Australia
- Indigenous Australia Program; The Fred Hollows Foundation; Katherine Northern Territory Australia
| | - Nyssa Hadgraft
- Baker Heart and Diabetes Institute; Melbourne Victoria Australia
- Kimberley Aboriginal Medical Services Ltd.; Broome Western Australia Australia
| | - Fintan Thompson
- Centre for Chronic Disease Prevention, Cairns Institute; James Cook University; Cairns Queensland Australia
| | - Julia V. Marley
- Kimberley Aboriginal Medical Services Ltd.; Broome Western Australia Australia
- The Rural Clinical School of Western Australia; The University of Western Australia; Perth Western Australia Australia
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