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What this series is about As we age, keeping physically active is essential. It not only improves the appearance of the body, it also prevents the occurrence of health complications in the future. Join the discussion in this series as we research the various programs that can help maintain a healthy body. |
Part 3: Staying Young: Nutrition (c)
The personal costs of being over weight
People who are very overweight often face difficulties that their normal-weight peers do not. Frequent doctor visits are a fact of life for these overweight people due to the development of weight-related disorders like diabetes and osteoarthritis. Along with the daily difficulties associated with these diseases, the very overweight person may be affected financially as a result of weight-related expenses.
Australia's Health 2006
A new report, Australia's Health 2006, released by the Australian Institute of Health and Welfare (AIHW) on 21 June 2006, indicates that Australia's international ranking for numerous aspects of health is among the top 10 of the world's developed countries. Ref: www.aihw.gov.au/publications
Chapter 3 of this report describes the determinants of the health of Australians, providing a background for its great potential of prevention and health promotion. The conceptual framework shows biomedical and genetic factors, health behaviours, socioeconomic and environmental factors as key determinants for health and wellbeing that can be influenced by interventions and by resources and systems.
Among the many factors that influence an individual’s health are their knowledge, attitudes and beliefs about lifestyle behaviours, help-seeking behaviours, and other health decisions. A range of theories aim to explain the relationship between cognitive states and behaviour (or behaviour change), which can be distilled to a handful of key factors including:
• an individual’s behaviour intention
• environmental constraints
• skill or ability
• anticipated outcome of a given behaviour
• other supporting factors such as self-standards and self-efficacy.
Dietary behaviour
Diet plays a major role in health and in recent decades much evidence has shown that diet can either reduce or increase the risk of various diseases (NHMRC 2003). Dietary guidelines for children, adults and older Australians from the NHMRC recommend consuming a wide variety of nutritious foods, including a high intake of plant foods such as cereals, fruit, vegetables, legumes and nuts. They also recommend moderating sugar and fat intake, limiting saturated fat intake, choosing foods low in salt and limiting alcohol intake.
In addition, the guidelines highlight the need to encourage and support breastfeeding and to prepare and store food safely.
For Indigenous peoples, the focus is on diet-related diseases, access to healthy food, promotion of breastfeeding, nutrition for mothers and babies, children’s nutrition, renal disease and dental health.
Current priorities for action on nutrition include promoting fruit and vegetable consumption, healthy weight, and good nutrition for mothers, babies and school-aged children, as well as improving nutrition for vulnerable groups and reducing structural barriers to safe and healthy food.
Fruit and vegetable intake
Fruit and vegetable consumption is strongly linked to the prevention of chronic disease and to better health. The 2003 NHMRC dietary guidelines recommend that adults consume two to four serves of fruit, and four to eight serves of vegetables per day. However, despite concerns about the over-consumption of food in large sections of the population, many are not consuming adequate fruit and vegetables. An analysis of self-reported data from the 2004–05 National Health Survey (NHS) shows that 85.7% of people aged 18 years or over did not usually have five serves of vegetables per day, and 46.0% did not have two serves of fruit.
The proportions of people reporting inadequate fruit and vegetable consumption were similar for each State and Territory. For vegetable consumption, rates ranged from 80.2% in Western Australia to 89.8% in the Australian Capital Territory; and in fruit consumption, the rates ranged from 44.0% in Victoria to 50.0% in South Australia.
Table 3.15: Inadequate consumption of vegetables/fruit, persons aged
18 years or over, 2004–05 (per cent)
The NHMRC 2003 data also estimated that inadequate fruit and vegetable consumption was responsible for 1.4% of the total burden of disease in Australia. Further, the findings of Lock et al (2005) estimate that 1.8% of the global burden of disease may be attributed to inadequate consumption of fruit and vegetables.
Food security
The term “food security” refers to the availability of healthy, affordable foods and the capacity of individuals and communities to access them. Food insecurity can affect nutritional status. In the 2001 National Health Survey (NHS) 4.7% of male respondents aged 19 years or over, and 5.6% of females, indicated that there had been times in the previous 12 months when they had run out of food and could not afford to buy more (AIHW unpublished analysis of NHS data). These results were similar to those obtained in the 1995 National Nutrition Survey. Food insecurity can be of particular concern for some population groups. Further, data from the 2001 survey also showed that people with no post-school qualifications were significantly more likely to report running out of food and being unable to buy more (6.5%), compared to those with higher degrees (2.6%).
Older people of all backgrounds may be particularly vulnerable to food insecurity. This can result from problems with mobility or transport that lead to difficulty in accessing shops (Russell et al. 1998). People living in rural and remote areas of Australia are also vulnerable as they typically pay more for healthy food and perishable items, such as dairy products and fruit and vegetables, which are frequently in short supply and of poorer quality (NHMRC 2003a). Many Aboriginal and Torres Strait Islander people live in these areas and poor nutrition contributes to their poor health (NHMRC 2000). Others at risk are the poor, people with a disability, the homeless, and those who suffer from substance abuse, alcoholism and some chronic diseases.
Over-consumption of food
While it is important to encourage the population to consume more fruit and vegetables and to address issues surrounding food insecurity, over-consumption of foods, particularly those high in energy and low in nutrients, is a serious problem for the Australian population. Over-consumption, or the consumption of more kilojoules than are required to meet energy needs, is contributing to Australia’s increase in obesity, itself a significant risk factor for conditions such as cardiovascular disease and Type 2 diabetes.
In fact, data from the National Dietary Survey of School Children and the National Nutrition Survey indicate that average energy intake rose by nearly 15% and 12%, respectively, for boys and girls aged 10–15 years between 1985 and 1995. Data from the National Dietary Survey of Adults and the National Nutrition Survey, respectively, indicated that energy intake increased by around 350 kilojoules per day for adults aged 25–64 years living in state capital cities between 1983 and 1995 (Cook et al. 2001).
Saturated fat intake
A diet high in saturated fat increases the risk of coronary heart disease through its effect on raising the blood cholesterol level, notably its LDL component. In 1995, saturated fat accounted for around 13% of total energy intake by Australian adults, higher than the recommended maximum level of 10% (AIHW 2004). The major sources of saturated fats in the adult diet are milk, cheese, butter, pastries, potato chips and meat (ABS & DHAC 1998).
As dairy products contribute significantly to saturated fat intake, the proportion of people who usually consume whole milk may be a useful indicator of saturated fat intakes. From the 2004–05 NHS, 52% of males and 39% of females usually consumed whole milk from cows (ABS 2006).
Bibliography
Australia's Health 2004. AIHW analysis of ‘Filling the gaps in data pooling’ survey (December 2004), AIHW.
Australia's Health 2006, Australian Institute of Health and Welfare (AIHW). ISSN 1032-6138; ISBN 1 74024 565 2; AIHW Cat. No. AUS 73.
AIHW analysis of VIC Population Health Survey (DHS 2004), AIHW.
Blokstra A, Burns CM, Seidell JC 1999. Perception of weight status and dieting behaviour in Dutch men and women. International Journal of Obesity Related Metabolic Disorders. Jan; 23(1): 7-17.
Cook T, Coles-Rutishauser I and Seelig M 2001. Comparable data on food and nutrient intake and physical measurements from the 1983, 1985 and 1995 national surveys. Canberra: Commonwealth Department of Health and Aged Care.
Dieting Linked to Increased Wealth : Study Finds 2005. Ohio State University, Research Communications, Centre for Human Resource Research.
Fries JF, Koop CE, Beadle CE, et al 1993. Reducing health care costs by reducing the need and demand for medical services. New England Journal of Medicine; 329: 321- 325.
Household Food Security in the United States . Household Spending on Food, 2004/ERR-11, Economic Research Service, USDA,
www.ers.usda.gov/publications/
Lock K, Pomerleau J, Causer L et al 2005. The global burden of disease attributable to low consumption of fruit and vegetables: implications for the global strategy on diet. Bulletin of the World Health Organisation 83:100-8.
National Health Survey 2004-05: summary of results. ABS 2006. ABS Cat. No. 4364-0.
NSW Population Health Survey (unpublished data); SA Monitoring and Surveillance System, (unpublished data); WA Health and Wellbeing Surveillance System, (unpublished data), cited in Australia’s Health 2006.
Pomerleau J, Lock K, Knai C and McKee M 2005. A systematic review of interventions designed to increase adult fruit and vegetable intake. Journal of Nutrition 135:2486-2495.
Russell C, Hill B and Basser M 1998. Older people’s lives in the inner city: hazardous or rewarding? Australia and New Zealand Journal of Public Health 22(1):98-106.
The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. National Heart Lung and Blood Institute, June 1998.
Prevalence of Overweight and Obesity Among Adults: United States, 1999-2002 http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese/obse99.htm
Private insurance spending on obesity-related problems increased tenfold in 15 years.The Nations Health 2006, online article http://www.apha.org/tnh/index.cfm?fa=Adetail&id=1243
Sturm R 2002. The Effects of Obesity, Smoking and Drinking on Medical Problems and Costs. Health Affairs. Mar/Apr: 245-253.
Zagorsky JL 2005. Health and Wealth: The late-20th century obesity epidemic in the U.S. Economics and Human Biology. Jul; 3(2):296-313.
Monika
Monika Bhatia
Project Manager and Editor, Quality4life
14 July 2006
