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Health Promotion Forum of New Zealand Runanga Whakapiki Ake i te Hauora o Aotearoa
Diet, Family and child

Action to reduce New Zealand’s alarming childhood obesity rate needs to focus on the physical and social environments we live in, says the New Zealand College of Public Health Medicine.

A third of all Kiwi children are now overweight or obese, which the College says “must be urgently addressed to improve their current and future health”.

“Interventions at an individual level alone are unlikely to be successful in the long term,” says the president-elect of the College, Dr Felicity Dumble.

“We need to adapt our environment and change our social norms so that it’s easier for our children to establish and maintain a healthy weight.”

The College recently released a policy statement addressing childhood obesity; the policy recognised the issue as a significant public health challenge.

Dr Dumble says the College recognises the government’s commitment to addressing childhood obesity, but says New Zealand’s childhood obesity plan should be reviewed and amended as a matter of urgency, to fully reflect the World Health Organization’s (WHO) report titled Ending Childhood Obesity.

“If all of our nation’s children are to be healthy there must be a higher priority placed on addressing the issues causing childhood obesity,” she says.

The WHO Report was released earlier this year, stating no single intervention can halt the “rise of the growing obesity epidemic”.

It says that preventing and treating obesity requires a government-wide approach, in which policies across all sectors take health into account, avoid harmful impacts and thus improve population health and health equity.

In line with the WHO report, Dr Dumble says the College strongly supports three strategic objectives to help reduce childhood obesity in New Zealand;

• Tackle the obesogenic environment and norms

• Reduce the risk of obesity by addressing critical elements in the life course

• Treat children who are obese to improve their current and future health.

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Diet, News

Consumer research by the Health Promotion Agency (HPA) has found food choices for people of all ethnicities are heavily influenced by price and specials. For larger households quantity influences choice as well.  After quantity, the next priority is whether the children will eat it, which is closely linked with brand/taste preferences. While many families will try budget brands, taste preferences win over.

Consumers mention health, but for most it is a low priority; with healthy choices seen as a luxury for those with more money to spend. Fear of not liking unknown brands leads to entrenched and habitual shopping choices; something the Health Star Rating consumer campaign seeks to influence.

The research – aimed at measuring of consumers’ understanding and use of Health Star Ratings – has found around four in every ten shoppers recognise Health Stars when prompted. Pacific shoppers showed higher recognition of the star rating (65%).

Around half of all shoppers accurately understand how to use Health Stars with many saying the higher the stars the healthier the product. However, most people did not yet understand Health Stars should be used to compare foods in similar categories. Although when consumers were shown two different products with Health Stars, consumers can easily identify which food is the healthier choice.

“The Health Star Rating labelling is a really important step to help people make healthier food choices,” said Dr Fran McGrath, who is a member of the Health Star Rating Advisory Group.  “The food industry is adopting the labelling and also making changes so foods are healthier. This is important progress, but only one part of the jig-saw.”

The Health Star ratings is a voluntary front-of-pack labelling system developed for use in New Zealand and Australia. Health Star ratings are for packaged foods as these are the foods with which consumers have the most difficulty, when making healthier choices. Health stars takes the guess work out of reading labels and aims to help consumers make healthier choices quickly and easily when choosing packaged foods.

For more consumer insights and information generally about the Health Star Rating campaign visit the HPA’s page.

hpa-health-star-rating

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Community, Diet, Pacific

Health Promotion Forum’s Senior Health Promotion Strategist Dr Viliami Puloka presented his thoughts home grown solutions to the Pacific’s obesity problem at a recent conference in Wallis and Futuna.

 

Gardening and Health: Let your garden be your health and your health be your garden

Dr. Viliami PULOKA, Senior Health Promotion Strategist, New Zealand Health Promotion Forum

 

Abstract

When Hippocrates, the father of medicine some 2,500 years ago said “Let food be thy medicine and medicine be thy food”, I can assure you he was not talking about fast food like Cheese burgers, Fizzy drinks and French fries. He was talking about fresh produce from people’s home gardens. Being the top physician of his time and a leading scientist in the field of medicine, he knew the importance of good healthy food in providing proper fuel for healthy living. Consumption of foods that are highly processed but empty of proper nutrients is one of the key drivers of the obesity and diabetes pandemic the world is facing today, including Wallis and Futuna.

 

The Wallis & Futuna Chronic Diseases Risk Factor Study in 2009 showed a 17% prevalence of diabetes, and an 87% prevalence of overweight and obesity among the study population. Eating fresh food, locally grown in home gardens is a very good way to prevent and control chronic diseases including diabetes and obesity.

 

The health benefits of growing your own food are well documented. You are in control and decide what to grow. You are not dependent on food produced by someone you do not know, whose interest is your money not your health. Growing your own garden provides opportunities for physical activity which goes hand in hand with good nutrition giving you good health. One can also enjoy fresh air and sunshine, which is good medicine for the whole person.

 

Wallis and Futuna are very fortunate to have such fertile soil, and many people still grow food in their own gardens. The challenge is the ever-increasing amount of readily available imported processed food that competes with traditional local cuisines.

 

I like to suggest that the way forward to good health through home gardening is to ‘return to nature’ and re-claim the socio-cultural and economic value of home gardening and… “Let your garden be your Health and your Health be your garden”.

 

“If I had the same life expectancy as a Tongan man, I’d only have one year and three months left to live.” Statistics show that life expectancy for men in Tonga is 65 years, mainly due to the rise in NCDs[1].

 

A child born in the Pacific today is more likely to die before their grandparents and parents, largely due to the Obesogenic environments. It does not matter whether we are in Samoa, Tonga Vanuatu or Wallis and Futuna our story is one and the same. A healthy baby is born, fully immunized, is well cared for and loved. We invest in their education and they get good qualification, good job and they may earn good money.

 

The food environment however makes it very easy for us to eat ourselves to death. Young Pacific persons develop diabetes as early as age 30 and many develops complications by age 40 requiring amputation at 50 followed by kidney failure  at 55 paving the way for “early preventable death” the plight of Pacifica today.

 

What a loss! Financial/economic investments as well as social and cultural loss that have direct impacts on families and the country as a whole.

 

The presentation discusses NCD issues as related to how we look after our health as “a garden for our food security, health is for our everyday living.” Health isn’t everything, but without health, nothing else matters. Your health is the only resource we have to do life and to contribute to life.  Doctors and nurses have known for many years now that health deteriorates when people don’t eat healthy food. Everyone knows that as a fact but knowledge is not enough to make us do what we know we should be doing.  In the Pacific, NCDs cause up to 40% of sickness and up to 70% of deaths. Over 20% of countries’ budgets are allocated to NCD control in hospitals. Much more resources is needed for prevention and to address the many social cultural determinants outside the hospitals. Some 2500 years ago, Hippocrates said, “Let food be thy medicine and medicine be thy food”. The NCD issue is directly related to what we eat or do not eat. It is therefore important to look at the food we eat with the same respect we give to any medicine we take for any illness.

 

From the food we eat our body have fuel or energy to carry out daily activities. To be healthy, the energy gain from food we eat should be proportional to the energy required for daily activity.

 

This is the problem in the Pacific, we eat and gain way too much energy but spent too little doing minimal physical activity. We drives to the supermarket, buy processed energy rich food instead of working in our gardens.

 

People in the Pacific don’t walk to the hospital, because when they do decide to go, they are too sick to walk.

A 2009 study in Wallis and Futuna revealed high rates of factors causing NCDs.  Not enough fruit and vegetables consumed, inadequate physical activity, high rate of high blood pressure and high rates of obesity.

 

Specifically regarding obesity in Wallis and Futuna, the risk factors are visible as early as age 18. In the 18-24 age group, 51% of men and37 % of women are already obese.

Many people are obese very early in life.

 

In Wallis and Futuna, diabetes prevalence was three times higher in 2009 than 1986. High blood pressure was twice as prevalent and obesity remained high.

If the various NCD risk factors in Wallis and Futuna and are compared with American Samoa (the Pacific NCD champions), the figures for both territories are quite similar.

 

With regard to food security, the issue is access to and the availability and use of food. In Wallis and Futuna, these issues do not really apply, as food is available. The problem is related to the choices local people make in terms of food. We eat what we do not grow, we grow what we do not eat.

 

Geoff Lawton said that all these issues can be solved by gardening. Gardening can really feed both body and mind.

 

When people garden, they know exactly what they are growing, unlike shop items produced in unknown places by unknown people whose interest is more in our wallets than our good health. So it is best to grow our own food. Gardening should be medically prescribed.

 

Uvea is a garden with a few houses dotted around it. Most homes have gardens and gardening has many benefits:

 

  • Stress relief – A study in the Netherlands indicated that gardening is better at relieving stress than other relaxing leisure activities.
  • Brain health – A study that followed people in their 60s and 70s for up to 16 years found that those who gardened regularly had a 36% lower risk of dementia than non-gardeners
  • Nutrition – Studies have shown that gardeners eat more fruits and vegetables than other people. The freshest food you can eat is the food you grow,
  • Healing – Interacting with nature also helps our bodies heal. A landmark study by Roger S. ULRICH, published in the April 27, 1984, issue of Science magazine, found strong evidence that nature helps heal.
  • Immunity – In 2007, University of Colorado neuroscientist Christopher LOWRY, then working at Bristol University in England, made a startling discovery. He found that certain strains of harmless soil-borne Mycobacterium vaccae sharply stimulated the human immune system. It’s quite likely that exposure to soil bacteria plays an important role in developing a strong immune system [7].[m1] [VP2]

Nature is the key to health. We have a certain affinity with nature, because we are part of it and would rather look at a flowery lawn than concrete and steel. We are one with the fenua. Plants and animals must not be simply seen as useful things, but given the same respect we would expect from them.

 

A big challenge and real issue is the war between economic development and health. More than 60% of food consumed locally in many of the Pacific islands are imported from outside. The driving force is economic growth and often done in the expense of good health. By nature, imported food are not fresh, processed and high in sugar, salt and fat. Wallis and Futuna need healthy economy but it can only happens when people are healthy themselves to grow the economy and to enjoy the benefits it produces.

 

A discussion followed Dr Puloka’s presentation, comments were made by participants.  Here is a summary 

 

Pierre CAMI, nurse in Wallis

A lot has been said about preventing, but little about treating these non-communicable diseases. Too often in the Pacific, we tend to try making methods from mainland France fit our situation when they are not necessarily suited to Pacific-island cultural notions about disease.

 

With regard to soda, it’s 15% sweeter in the Overseas Territories than Europe. Individual preventive measures have been mentioned, but the political and traditional authorities should also be used to reduce soda consumption. It has been done in New Caledonia for alcohol. Individual initiative is not enough to win the struggle between business and health. The government and traditional authorities should do their duty and at least start a genuine discussion on these issues. 

 

Viliami PULOKA

Human beings are very strange creatures. As soon as someone advises us to do something, we decide not to listen. My experience has taught me that Pacific islanders are hard to convince. We don’t like listening to reason. To overcome the problem, we need to speak to Polynesians’ hearts and win them over. Pacific people are “heart people” Speak to the hearts not the minds. “We think with our hearts and feel with our minds”

 

We tell people they chose to be the way they are, but how many really did have a choice? People’s choices are limited to what they can afford and can easily do. The campaign must be politically driven for healthy lifestyles and to make healthy choices, easy choices.

 

Pesamino TAPUTAI

It is high time to start asking our political leaders and elected representatives a few tough questions. We need to startle people and ring alarm bells, as the doctor said. I’m grateful to the traditional leaders who are here, because they are the ones who need to get the ball rolling by holding village meetings.

 

In Wallis and Futuna, people sometimes feel that health is something to be ashamed about. The territory’s leaders must set an example. The Catholic mission should also be involved in agricultural, land and health issues. These people still wield some influence and are respected by the community.

 

We shouldn’t be bashful about being healthy. There’s nothing wrong with walking. It is nothing to be ashamed of.

Nicolas SIMUTOGA

 

Banning was mentioned. Smoking is prohibited in public areas. Unfortunately there are advertisements everywhere that tempt people. It’s Big Food that invented these diseases. Politicians are also to blame.

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Diet, News, Policy

The majority of New Zealanders now support a tax on sugary drinks.  That is according to public health advisory group FIZZ (Fighting Sugar in Soft-drinks), which published its findings from two large-scale surveys in the 25 September issue of the New Zealand Medical Journal (NZMJ).  According to the authors “a significant shift has occurred in New Zealanders’ appetite for a tax on sugar-sweetened beverages (SSBs), if the funds collected are to be used to prevent obesity.”

 

coca-cola-obese

 

There is strong political support, from parties outside government, for action to address SSBs, the paper says. A policy brief by the New Zealand Beverage Guidance Panel has been endorsed by the Green, Labour and Māori parties.  The brief “Options to reduce sugar sweetened beverage consumption in New Zealand” outlines 20 suggested initiatives to address the issue.

 

New Zealand has the third highest rage of childhood obesity in the developed world1.  In their NZMJ article the authors cite a recent study, which conservatively attributes a high sugary drink intake to 561 deaths in Australasia every year2.  This is equivalent to 40% of the region’s annual road toll.

 

 “It seems inevitable […] that an SSB tax will be a major part of reclaiming our chil­dren’s health, considering the growing public support for its implementation,” say the authors of the NZMJ paper. “The only question that remains is when.”

To read the full article, click here.  You will need to subscribe to the NZMJ.

 

OECD, OECD Obesity Update 2014. 2014. www.oecd.org/health/ obesity- update.htm

Singh G, Micha R, Khatibzadeh S, Lim S, Ezzati M, Mozaffarian D. Estimated Global, Regional, and National Disease Burdens Related to Sugar-Sweetened Beverage Consumption in 2010. Circulation. June 29, 2015.

 

Jo Lawrence-King

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Diet, News

The NZ College of Public Health Medicine is backing the New Zealand Medical Association’s call for more urgent and coordinated action on the country’s obesity time bomb, claiming it will soon be a bigger problem than smoking.

 

obesity-image

 
With two thirds of adults and one third of children either overweight or obese, the College says that New Zealand is on track for obesity to overtake tobacco as the leading cause of health loss by 2016.
“We can’t afford to overlook the severity and long-term ramifications of this issue and how it will affect children as they grow and develop,” says College president Dr Julia Peters.
“What is needed is a comprehensive approach including legislative and regulatory controls, similar to what has been applied to smoking over the last 30 years.”
Programmes designed to address the issue need to focus on prevention, particularly amongst children and communities in which the epidemic is most profound. We need to be “making the healthy choice the easy choice.”
Fortunately, we have lessons from our success with tobacco control that can be applied to the obesity issue and also some examples of successful community based programmes. However, as a society, we need to galvanise around a long term, comprehensive strategy.
“This problem has crept up on us over 40 years and it is not going to go away overnight. A good place to start is the list of recommendations from the New Zealand Medical Association” said Dr Peters.

 

nzcphm

 

The NZCPHM and NZMA echo the recent call by Consumers International (CI) and World Obesity Federation (WOF) on the international community to develop a global convention to fight diet-related ill health, similar to the legal framework for tobacco control.  Read more.

– See more at: http://www.hauora.co.nz/obesity-worse-than-smoking-for-health-impacts-on-kiwis.html#sthash.hMzfxyuT.dpuf

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Diet, Global, News

Consumers International (CI) and World Obesity Federation (WOF) are calling on the international community to develop a global convention to fight diet-related ill health, similar to the legal framework for tobacco control.

Unhealthy diets now rank above tobacco as a global cause of preventable non-communicable diseases (NCDs).

 

obesity-eating-from-stockxchng

 

The two international membership bodies will officially launch their Recommendations towards a Global Convention to protect and promote healthy diets at the World Health Assembly in Geneva.

The Recommendations call on governments to make a binding commitment to introduce a raft of policy measures designed to help consumers make healthier choices and improve nutrition security for everyone.

Measures include placing stricter controls on food marketing, improving the provision of nutrition information, requiring reformulation of unhealthy food products, raising standards for food provided in public institutions and using economic tools to influence consumption patterns.

Publication of the Recommendations comes on the 10th anniversary of the WHO Global Strategy on Diet and Physical Activity and Health, which recognised the impact of unhealthy diet and lifestyle.

Since then however, global deaths attributable to obesity and overweight have risen from 2.6 million in 2005 to 3.4 million in 2010, thus intensifying the pressure on governments to take stronger action to tackle the rising epidemic of obesity and consequent chronic disease.

Consumers International Director General, Amanda Long says: “The scale of the impact of unhealthy food on consumer health is comparable to the impact of cigarettes. The food and beverage industry has dragged its feet on meaningful change and governments have felt unable or unwilling to act.

“The only answer remaining for the global community is a framework convention and we urge governments to seriously consider our recommendations for achieving that. If they do not, we risk decades of obstruction from industry and a repeat of the catastrophic global health crisis caused by smoking.”

“If obesity was an infectious disease we would have seen billions of dollars being invested in bringing it under control,” said Dr Tim Lobstein, World Obesity Fediration Director of Policy.  “But because obesity is largely caused by the overconsumption of fatty and sugary foods, we have seen policy-makers unwilling to take on the corporate interests who promote these foods. Governments need to take collective action and a framework convention offers them the chance to do this.”

Here in New Zealand the Government has recently announced funding for the Healthy Families NZ scheme, aimed at reducing obesity and improving the health outcomes for more disadvantaged communities around the country.  Read our article from February 2014 on this initiative.

Obesity is a major risk factor for a wide range of non-communicable diseases. Figures show that in 2008, 36 million people died from non-communicable diseases, representing 63 per cent of the 57 million global deaths that year. In 2030, such diseases are projected to claim the lives of 52 million people.

 

Read the full recommendations from CI and WOF.

 

Press release from Consumers International

Photo: Byron Solomon – StockXchng.com

20 May 2014

 

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Diet, Global, News

Consumers International (CI) and World Obesity Federation (WOF) are calling on the international community to develop a global convention to fight diet-related ill health, similar to the legal framework for tobacco control.

 

Unhealthy diets now rank above tobacco as a global cause of preventable non-communicable diseases (NCDs).

 

The two international membership bodies will officially launch their Recommendations towards a Global Convention to protect and promote healthy diets at the World Health Assembly in Geneva.

 

un-palais

 

The Recommendations call on governments to make a binding commitment to introduce a raft of policy measures designed to help consumers make healthier choices and improve nutrition security for everyone.

 

Measures include placing stricter controls on food marketing, improving the provision of nutrition information, requiring reformulation of unhealthy food products, raising standards for food provided in public institutions and using economic tools to influence consumption patterns.

 

Publication of the Recommendations comes on the 10th anniversary of the WHO Global Strategy on Diet and Physical Activity and Health, which recognised the impact of unhealthy diet and lifestyle.

 

Since then however, global deaths attributable to obesity and overweight have risen from 2.6 million in 2005 to 3.4 million in 2010, thus intensifying the pressure on governments to take stronger action to tackle the rising epidemic of obesity and consequent chronic disease.

 

Consumers International Director General, Amanda Long says: “The scale of the impact of unhealthy food on consumer health is comparable to the impact of cigarettes. The food and beverage industry has dragged its feet on meaningful change and governments have felt unable or unwilling to act.

 

“The only answer remaining for the global community is a framework convention and we urge governments to seriously consider our recommendations for achieving that. If they do not, we risk decades of obstruction from industry and a repeat of the catastrophic global health crisis caused by smoking.”

 

“If obesity was an infectious disease we would have seen billions of dollars being invested in bringing it under control,” said Dr Tim Lobstein, World Obesity Fediration Director of Policy.  “But because obesity is largely caused by the overconsumption of fatty and sugary foods, we have seen policy-makers unwilling to take on the corporate interests who promote these foods. Governments need to take collective action and a framework convention offers them the chance to do this.”

 

Here in New Zealand the Government has recently announced funding for the Healthy Families NZ scheme, aimed at reducing obesity and improving the health outcomes for more disadvantaged communities around the country.  Read our article from February 2014 on this initiative.

 

Obesity is a major risk factor for a wide range of non-communicable diseases. Figures show that in 2008, 36 million people died from non-communicable diseases, representing 63 per cent of the 57 million global deaths that year. In 2030, such diseases are projected to claim the lives of 52 million people.

 

Read the full recommendations from CI and WOF.

 

Press release from Consumers International

Photo: Byron Solomon – StockXchng.com

20 May 2014

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Diet, Family and child, HP, News, Policy

mid section view of a man sitting on a bench in a park --- Image by © Royalty-Free/Corbis

 

In an article in Public Health Monitor on 7 February, Prof Boyd Swinburn* took a look at the Australian initiative that has informed the Government’s proposed Healthy Families NZ initiative. His conclusion was that it could work, as long as the initiative is culturally-centred and backed with government policy and regulation.

 

HPF welcomes the Government’s proposed health promotion approach to obesity.  Like Prof Swinburn, we believe it will be essential to back the initiative with policy, regulation and the close involvement of the Māori and Pacific communities.

 

The initiative has been proposed by the Government to address obesity in New Zealand.  Modelled on Australia’s Healthy Together Victoria (HTV) programme, Health Families NZ  is expected to take a large-scale, community-based health promotion approach.  Little more is known about the New Zealand initiative at this stage, but health promoters and public health professionals anticipate it eagerly … with some words of advice for the government.

 

Health Promotion Forum (HPF) agrees.  “We have some great models to refer to in New Zealand,” says the Forum’s Executive Director Sione Tu’itahi. “Healthy Together Victoria is a wonderful initiative and will provide another dimension to the work that has already taken place here.”  Sione and his team believe the following will be essential to the success of the initiative:

 

  • Involve our Māori and Pacific communities.  Marry the Healthy Families NZ initiative with the successful Whanau Ora approach already running in Aotearoa New Zealand.  The success of Whanau Ora is based on self-determination.  Founded on the principles of Te Tiriti o Waitangi, this model provides a template for success that translates across health promotion programmes for this country.

 

  • Revisit the Healthy Eating, Healthy Action programme (HEHA) to identify existing resources, experience and knowledge avoid ‘reinventing the wheel’.

 

  • Take a ‘top-down, bottom-up’ approach.  Community-based health promotion (‘bottom up’) needs support with policy and the regulation (‘top down’) of industries that impact on health, such as the food and leisure industries.

*Boyd Swinburn is Professor of Population Nutrition and Global Health, University of Auckland and Co-Director, WHO Collaborating Centre for Obesity Prevention, Deakin University.

 

 

Jo Lawrence-King

 

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Community, Diet, Maori

He Mara Kai (the food garden) is an initiative focusing on good nutrition and physical activity by supporting Kohanga Reo (Māori speaking early childhood centres) to grow vegetables. It was originally created as part of the Labour Government’s Healthy Eating, Healthy Action (HEHA) initiative 2004-2010.

Theresa Wharekura,  then Manager Te Kupenga Hauora, paints a picture of the initiative, its origins and its plans for the future.

 

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