1
|
Yarning about Diet: The Applicability of Dietary Assessment Methods in Aboriginal and Torres Strait Islander Australians-A Scoping Review. Nutrients 2023; 15:nu15030787. [PMID: 36771491 PMCID: PMC9919225 DOI: 10.3390/nu15030787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Conventional dietary assessment methods are based predominately on Western models which lack Aboriginal and Torres Strait Islander knowledges, methodologies, and social and cultural contextualisation. This review considered dietary assessment methods used with Aboriginal and Torres Strait Islander populations and assessed their applicability. Four electronic databases and grey literature were searched with no time limit applied to the results. Screening, data extraction and quality appraisal were undertaken independently by two reviewers. Out of 22 studies, 20 were conducted in rural/remote settings, one in an urban setting, and one at the national population level. The most frequently used and applicable dietary assessment method involved store data. Weighed food records and food frequency questionnaires had low applicability. Modifications of conventional methods were commonly used to adapt to Indigenous practices, but few studies incorporated Indigenous research methodologies such as yarning. This highlights an opportunity for further investigation to validate the accuracy of methods that incorporate qualitative yarning-based approaches, or other Indigenous research methodologies, into quantitative data collection. The importance of developing validated dietary assessment methods that are appropriate for this population cannot be understated considering the high susceptibility to nutrition-related health conditions such as malnutrition, overweight or obesity, diabetes, and cardiovascular disease.
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Maitjara Wangkanyi: Insights from an Ethnographic Study of Food Practices of Households in Remote Australian Aboriginal Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218109. [PMID: 33153133 PMCID: PMC7663776 DOI: 10.3390/ijerph17218109] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/30/2020] [Accepted: 10/30/2020] [Indexed: 02/07/2023]
Abstract
Many historical, environmental, socioeconomic, political, commercial, and geographic factors underscore the food insecurity and poor diet-related health experienced by Aboriginal people in Australia. Yet, there has been little exploration of Aboriginal food practices or perspectives on food choice recently. This study, with 13 households in remote communities on the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands, fills this gap using ethnographic and Indigenist methods. Results highlight Anangu resourcefulness, securing food despite poverty and adversity, and provide unique insights into factors influencing the three major types and range of dietary patterns identified. These factors include household economic cycles and budgeting challenges; overcrowding and family structures, mobility and ‘organization’; available food storage, preparation and cooking infrastructure; and familiarity and convenience. Structural and systemic reform, respecting Aboriginal leadership, is required to improve food security.
Collapse
|
4
|
Abstract
We conducted a longitudinal dietary intervention study to assess the impact of a store-based intervention on mediators and moderators and consequent dietary behaviour in Indigenous communities in remote Australia. We assessed dietary intake of fruit, vegetable, water and sweetened soft drink, mediators and moderators among 148, eighty-five and seventy-three adult participants (92 % women) at baseline (T1), end of intervention (T2) and at 24 weeks post intervention (T3), respectively. Mediators included perceived affordability and self-efficacy. Moderators were barriers to eat more fruit and vegetables and food security. Mixed-effects models were used to determine changes in mediators and moderators with time and associations between these and each dietary outcome. Perceived vegetable affordability increased from T1 (19 %; 95 % CI 11, 27) to T2 (38 %; 95 % CI 25, 51) (P=0·004) and returned to baseline levels at T3. High self-efficacy to eat more fruit and vegetables and to drink less soft drink decreased from T1 to T3. A reduction in soft drink intake of 27 % (95 % CI −44, −4; P=0·02) was reported at T3 compared with T1; no changes with time were observed for all other outcome measures. Regardless of time, vegetable intake was positively associated with self-efficacy to cook and try new vegetables, no barriers and food security. The dietary intervention went someway to improving perceived affordability of vegetables but was probably not strong enough to overcome other mediators and moderators constraining behaviour change. Meaningful dietary improvement in this context will be difficult to achieve without addressing underlying constraints to behaviour change.
Collapse
|
5
|
The Relative Validity of the Menzies Remote Short-Item Dietary Assessment Tool (MRSDAT) in Aboriginal Australian Children Aged 6⁻36 Months. Nutrients 2018; 10:nu10050590. [PMID: 29748493 PMCID: PMC5986470 DOI: 10.3390/nu10050590] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 01/21/2023] Open
Abstract
The Menzies Remote Short-item Dietary Assessment Tool (MRSDAT) can be used to derive a dietary index score, which measures the degree of compliance with the Australian Dietary Guidelines. This study aimed to determine the relative validity of a dietary index score for children aged 6–24 months, living in a Remote Aboriginal Community (RAC), derived using MRSDAT. This validation study compared dietary index scores derived using MRSDAT with those derived from the average of three 24-h recalls. Participants were aged 6–36 months at the first dietary assessment and were living in a RAC. The level of agreement between the two methods was explored using Lin’s concordance correlation coefficient (CCC), Bland-Altman plots, weighted Cohen’s kappa, and Fischer’s exact and paired t-tests. Forty participants were recruited. The CCC was poor between methods (R = 0.35, 95% CI 0.06, 0.58), with MRSDAT estimating higher dietary intake scores for all food groups except fruit, and higher dietary quality scores by an average of 4.78 points/100. Community-based Aboriginal researchers were central to this validation study. MRSDAT was within the performance range of other short-item dietary assessment tools developed for young children, and shows promise for use with very young children in RACs.
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Whalan S, Farnbach S, Volk L, Gwynn J, Lock M, Trieu K, Brimblecombe J, Webster J. What do we know about the diets of Aboriginal and Torres Strait Islander peoples in Australia? A systematic literature review. Aust N Z J Public Health 2017; 41:579-584. [PMID: 28898509 DOI: 10.1111/1753-6405.12721] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/01/2017] [Accepted: 07/01/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To provide an overview of published research on the dietary intake of Aboriginal and Torres Strait Islander peoples. METHODS Peer-reviewed literature from 1990 to October 2016 was searched to identify studies that measured the dietary intake of Australian Aboriginal and Torres Strait Islander populations. Study quality was assessed using a purposely devised quality appraisal tool. Meta-analysis was not possible due to the heterogeneity in dietary intake assessment methods. A narrative synthesis of study findings, where key themes were compared and contrasted was completed. RESULTS Twenty-five articles from twenty studies with outcome measures related to dietary intake were included. Dietary intake was assessed by electronic store sales, store turnover method, 24-hour dietary recall, food frequency questionnaire and short questions. Consistent findings were low reported intakes of fruit and vegetables and high intakes of total sugar and energy-dense, nutrient-poor food and beverages. CONCLUSIONS While differences between studies and study quality limit the generalisability of the findings, most studies suggest that the diets of Aboriginal and Torres Strait Islander peoples are inadequate. Implications for public health: A more concerted approach to understanding dietary patterns of Aboriginal and Torres Strait Islander peoples is required to inform policy and practice to improve diet and nutrition.
Collapse
Affiliation(s)
- Sarah Whalan
- Menzies School of Health Research, Northern Territory
| | - Sara Farnbach
- The George Institute for Global Health, New South Wales
| | - Lena Volk
- The George Institute for Global Health, New South Wales
| | - Josephine Gwynn
- Faculty of Health Sciences, University of Sydney, New South Wales
| | - Mark Lock
- School of Medicine and Public Health, University of Newcastle, New South Wales
| | - Kathy Trieu
- The George Institute for Global Health, New South Wales
| | | | | |
Collapse
|
8
|
Ferguson M, Brown C, Georga C, Miles E, Wilson A, Brimblecombe J. Traditional food availability and consumption in remote Aboriginal communities in the Northern Territory, Australia. Aust N Z J Public Health 2017; 41:294-298. [PMID: 28370899 DOI: 10.1111/1753-6405.12664] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 01/01/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To explore availability, variety and frequency consumption of traditional foods and their role in alleviating food insecurity in remote Aboriginal Australia. METHODS Availability was assessed through repeated semi-structured interviews and consumption via a survey. Quantitative data were described and qualitative data classified. RESULTS Aboriginal and non-Indigenous key informants (n=30 in 2013; n=19 in 2014) from 20 Northern Territory (NT) communities participated in interviews. Aboriginal primary household shoppers (n=73 in 2014) in five of these communities participated in a survey. Traditional foods were reported to be available year-round in all 20 communities. Most participants (89%) reported consuming a variety of traditional foods at least fortnightly and 71% at least weekly. Seventy-six per cent reported being food insecure, with 40% obtaining traditional food during these times. CONCLUSIONS Traditional food is consumed frequently by Aboriginal people living in remote NT. Implications for public health: Quantifying dietary contribution of traditional food would complement estimated population dietary intake. It would contribute evidence of nutrition transition and differences in intakes across age groups and inform dietary, environmental and social interventions and policy. Designing and conducting assessment of traditional food intake in conjunction with Aboriginal leaders warrants consideration.
Collapse
Affiliation(s)
- Megan Ferguson
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Northern Territory.,School of Population Health, Division of Health Sciences, University of South Australia
| | - Clare Brown
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Northern Territory.,School of Population Health, Division of Health Sciences, University of South Australia
| | - Claire Georga
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Northern Territory
| | | | | | - Julie Brimblecombe
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Northern Territory
| |
Collapse
|
9
|
Fluctuations in money availability within an income cycle impacts diet quality of remote Indigenous Australians. Public Health Nutr 2017; 20:1431-1440. [PMID: 28069086 DOI: 10.1017/s1368980016003360] [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] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To consider the plausible nutritional impacts of fluctuations in money availability within an income cycle for remote Indigenous Australians. DESIGN Community-level dietary intake (energy, micro/macronutrients) and expenditure on foods and beverages (F&B) were estimated over one year for three remote Indigenous Australian communities (Northern Territory, Australia) using monthly F&B transaction data. F&B that were likely to be consumed during a period within an income cycle when money was relatively limited (low money period (LMP) foods) were identified by panel consensus and scenario modelling was conducted to simulate the nutritional outcomes of a range of F&B selection responses to having an LMP. RESULTS All scenarios resulted in reduced diet quality during the LMP relative to overall average diet values. Protein and fat energy percentages were reduced and carbohydrate energy percentage increased. Despite reduced expenditure, declines in energy intake were typically buffered due to the reduced energy cost ($AU/MJ) of the LMP diet. The micronutrient profile of the LMP diet was substantially poorer, such that additional key micronutrients dropped below population-weighted Estimated Average Requirements/Adequate Intakes. CONCLUSIONS The modelling undertaken herein suggests that even a short period of low money within an income cycle may noticeably contribute to the reduced diet quality of remote Indigenous Australians and exacerbate lifestyle disease risk. Dietary strategies that are designed to respond to diets and expenditure during different income cycle periods, rather than the overall average diet and expenditure, should be considered for improving diet quality and reducing cardiometabolic disease risk in remote Indigenous Australians.
Collapse
|
10
|
Lee A, Rainow S, Tregenza J, Tregenza L, Balmer L, Bryce S, Paddy M, Sheard J, Schomburgk D. Nutrition in remote Aboriginal communities: lessons from Mai Wiru and the Anangu Pitjantjatjara Yankunytjatjara Lands. Aust N Z J Public Health 2015; 40 Suppl 1:S81-8. [DOI: 10.1111/1753-6405.12419] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/01/2014] [Accepted: 03/01/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Amanda Lee
- School of Public Health and Social Work, Queensland University of Technology
- School of Exercise and Nutrition Sciences, Queensland University of Technology
| | | | | | | | | | | | | | - Jamie Sheard
- School of Exercise and Nutrition Sciences, Queensland University of Technology
| | | |
Collapse
|
11
|
Black AP, Vally H, Morris P, Daniel M, Esterman A, Smith F, O'Dea K. High folate levels in Aboriginal children after subsidised fruit and vegetables and mandatory folic acid fortification. Aust N Z J Public Health 2015; 38:241-6. [PMID: 24890482 DOI: 10.1111/1753-6405.12235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 09/01/2013] [Accepted: 02/01/2014] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To evaluate the impact of a fruit and vegetable (F&V) subsidy program for disadvantaged Aboriginal children in Australia, implemented alongside the introduction of mandatory folic acid fortification of bread-making flour. METHODS A before-and-after evaluation was undertaken of a F&V subsidy program at three Aboriginal community-controlled health services in New South Wales. The program provided a weekly box of subsidised F&V linked to preventive health services and nutrition promotion for families. In this analysis, red blood cell (RBC) folate was assessed together with self-reported dietary intake at baseline and 12 months later in a cohort of 125 children (aged 0-17 years). RESULTS No children had low RBC folate at baseline or at follow-up; however, 33 children (26%) exceeded the reference range of RBC folate at baseline and 38 children (30%) exceeded the reference range at follow-up. Mean RBC folate levels increased substantially in children at follow-up (mean RBC folate z-score increased +0.55 (95%CI 0.36-0.74). Change in F&V intake (p=0.196) and mean bread intake (p=0.676) were not statistically significant predictors for change in RBC folate levels. CONCLUSIONS RBC folate levels increased among these disadvantaged Aboriginal children following mandatory folic acid fortification and participation in a subsidised F&V program. Even before mandatory folic acid fortification, none of these children had low RBC folate. IMPLICATIONS The effect on health of mandatory fortification of foods with folate is not clear, hence, ongoing population-based monitoring of folate levels to assess the impact of mandatory folic acid fortification is important.
Collapse
Affiliation(s)
- Andrew P Black
- School of Population Health, Division of Health Sciences, University of South Australia; Bulgarr Ngaru Medical Aboriginal Corporation, Grafton, New South Wales
| | | | | | | | | | | | | |
Collapse
|
12
|
Liberato SC, Kearns T, Ward F, Brimblecombe J. Use of electronic visual recording to aid assessment of dietary intake of Australian Aboriginal children living in remote communities. Aust N Z J Public Health 2015; 40 Suppl 1:S27-9. [PMID: 26094949 DOI: 10.1111/1753-6405.12373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/01/2014] [Accepted: 01/01/2015] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To assess the feasibility of using electronic visual recording in combination with food records to evaluate dietary intake in Aboriginal infants and children. METHODS All foods and drinks consumed by the child over four consecutive days were recorded in daily food records and pictures or videos. Feasibility was assessed by determining i) proportion of meals reported to be consumed; ii) cost of data collection; iii) day-to-day variation in energy intake and; iv) acceptability of the method. RESULTS Dietary intake data was collected from three girls and five boys aged 11 months to eight years, five over four days and three during one day, at a cost of $3,300 per child. One-third of the 89 meals reported to be consumed through the food records were electronically recorded. Most photographs were taken in the first two days with the number of meals electronically recorded decreasing each day over the four-day period. There was a large day-to-day variation in energy intake. CONCLUSIONS Use of electronic recording to aid individual usual dietary intake data collection was feasible. Collection periods spread over 1-2 weeks may be more appropriate due to the large variance in day-to-day dietary intake.
Collapse
Affiliation(s)
| | | | - Felicity Ward
- Menzies School of Health Research, Northern Territory
| | | |
Collapse
|
13
|
Scelza BA, Bird DW, Bliege Bird R. Bush Tucker, Shop Tucker: Production, Consumption, and Diet at an Aboriginal Outstation. Ecol Food Nutr 2014; 53:98-117. [DOI: 10.1080/03670244.2013.772513] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
14
|
Brimblecombe J, Ferguson M, Liberato SC, O'Dea K, Riley M. Optimisation modelling to assess cost of dietary improvement in remote Aboriginal Australia. PLoS One 2013; 8:e83587. [PMID: 24391790 PMCID: PMC3877064 DOI: 10.1371/journal.pone.0083587] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 11/05/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The cost and dietary choices required to fulfil nutrient recommendations defined nationally, need investigation, particularly for disadvantaged populations. OBJECTIVE We used optimisation modelling to examine the dietary change required to achieve nutrient requirements at minimum cost for an Aboriginal population in remote Australia, using where possible minimally-processed whole foods. DESIGN A twelve month cross-section of population-level purchased food, food price and nutrient content data was used as the baseline. Relative amounts from 34 food group categories were varied to achieve specific energy and nutrient density goals at minimum cost while meeting model constraints intended to minimise deviation from the purchased diet. RESULTS Simultaneous achievement of all nutrient goals was not feasible. The two most successful models (A & B) met all nutrient targets except sodium (146.2% and 148.9% of the respective target) and saturated fat (12.0% and 11.7% of energy). Model A was achieved with 3.2% lower cost than the baseline diet (which cost approximately AUD$13.01/person/day) and Model B at 7.8% lower cost but with a reduction in energy of 4.4%. Both models required very large reductions in sugar sweetened beverages (-90%) and refined cereals (-90%) and an approximate four-fold increase in vegetables, fruit, dairy foods, eggs, fish and seafood, and wholegrain cereals. CONCLUSION This modelling approach suggested population level dietary recommendations at minimal cost based on the baseline purchased diet. Large shifts in diet in remote Aboriginal Australian populations are needed to achieve national nutrient targets. The modeling approach used was not able to meet all nutrient targets at less than current food expenditure.
Collapse
Affiliation(s)
- Julie Brimblecombe
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Megan Ferguson
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Selma C. Liberato
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Kerin O'Dea
- Menzies School of Health Research, Darwin, Northern Territory, Australia
- Division of Health Sciences (School of Population Health), University of South Australia, Adelaide, South Australia, Australia
| | - Malcolm Riley
- Commonwealth Scientific Industrial Research Organisation (Animal, Food and Health Sciences), Parkville, Victoria, Australia
| |
Collapse
|
15
|
Brimblecombe J, Ferguson M, Liberato SC, Ball K, Moodie ML, Magnus A, Miles E, Leach AJ, Chatfield MD, Ni Mhurchu C, O’Dea K, Bailie RS. Stores Healthy Options Project in Remote Indigenous Communities (SHOP@RIC): a protocol of a randomised trial promoting healthy food and beverage purchases through price discounts and in-store nutrition education. BMC Public Health 2013; 13:744. [PMID: 23938097 PMCID: PMC3751924 DOI: 10.1186/1471-2458-13-744] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 07/17/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Indigenous Australians suffer a disproportionate burden of preventable chronic disease compared to their non-Indigenous counterparts--much of it diet-related. Increasing fruit and vegetable intakes and reducing sugar-sweetened soft-drink consumption can reduce the risk of preventable chronic disease. There is evidence from some general population studies that subsidising healthier foods can modify dietary behaviour. There is little such evidence relating specifically to socio-economically disadvantaged populations, even though dietary behaviour in such populations is arguably more likely to be susceptible to such interventions.This study aims to assess the impact and cost-effectiveness of a price discount intervention with or without an in-store nutrition education intervention on purchases of fruit, vegetables, water and diet soft-drinks among remote Indigenous communities. METHODS/DESIGN We will utilise a randomised multiple baseline (stepped wedge) design involving 20 communities in remote Indigenous Australia. The study will be conducted in partnership with two store associations and twenty Indigenous store boards. Communities will be randomised to either i) a 20% price discount on fruit, vegetables, water and diet soft-drinks; or ii) a combined price discount and in-store nutrition education strategy. These interventions will be initiated, at one of five possible time-points, spaced two-months apart. Weekly point-of-sale data will be collected from each community store before, during, and for six months after the six-month intervention period to measure impact on purchasing of discounted food and drinks. Data on physical, social and economic factors influencing weekly store sales will be collected in order to identify important covariates. Intervention fidelity and mediators of behaviour change will also be assessed. DISCUSSION This study will provide original evidence on the effectiveness and cost-effectiveness of price discounts with or without an in-store nutrition education intervention on food and drink purchasing among a socio-economically disadvantaged population in a real-life setting. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12613000694718.
Collapse
Affiliation(s)
- Julie Brimblecombe
- Menzies School of Health Research, Building 58, Royal Darwin Hospital Campus, Rocklands Drive, Tiwi, NT 0810, Australia
- Charles Darwin University, Ellengowan Dr, Casuarina, NT 0810, Australia
| | - Megan Ferguson
- Menzies School of Health Research, Building 58, Royal Darwin Hospital Campus, Rocklands Drive, Tiwi, NT 0810, Australia
- Charles Darwin University, Ellengowan Dr, Casuarina, NT 0810, Australia
| | - Selma C Liberato
- Menzies School of Health Research, Building 58, Royal Darwin Hospital Campus, Rocklands Drive, Tiwi, NT 0810, Australia
- Charles Darwin University, Ellengowan Dr, Casuarina, NT 0810, Australia
- University of South Australia, Frome Rd, Adelaide, SA 5000, Australia
| | - Kylie Ball
- Centre for Physical Activity and Nutrition Research, Deakin University, Burwood Hwy, Burwood 3125, Australia
| | - Marjory L Moodie
- Deakin Health Economics Faculty of Health, Deakin University, 221 Burwood Hwy, Burwood 3125, Australia
| | - Anne Magnus
- Deakin Health Economics Faculty of Health, Deakin University, 221 Burwood Hwy, Burwood 3125, Australia
| | - Edward Miles
- Indigenous Community Volunteers Level 1, 29 Cavanagh St, Darwin, NT 0801, Australia
| | - Amanda J Leach
- Menzies School of Health Research, Building 58, Royal Darwin Hospital Campus, Rocklands Drive, Tiwi, NT 0810, Australia
- Charles Darwin University, Ellengowan Dr, Casuarina, NT 0810, Australia
| | - Mark D Chatfield
- Menzies School of Health Research, Building 58, Royal Darwin Hospital Campus, Rocklands Drive, Tiwi, NT 0810, Australia
- Charles Darwin University, Ellengowan Dr, Casuarina, NT 0810, Australia
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Kerin O’Dea
- Menzies School of Health Research, Building 58, Royal Darwin Hospital Campus, Rocklands Drive, Tiwi, NT 0810, Australia
- University of South Australia, Frome Rd, Adelaide, SA 5000, Australia
| | - Ross S Bailie
- Menzies School of Health Research, Building 58, Royal Darwin Hospital Campus, Rocklands Drive, Tiwi, NT 0810, Australia
- Charles Darwin University, Ellengowan Dr, Casuarina, NT 0810, Australia
| |
Collapse
|
16
|
Abstract
OBJECTIVE To examine the feasibility of using point-of-sale data to assess dietary quality of food sales in remote stores. DESIGN A multi-site cross-sectional assessment of food and nutrient composition of food sales. Point-of-sale data were linked to Australian Food and Nutrient Data and compared across study sites and with nutrient requirements. SETTING Remote Aboriginal Australia. SUBJECT Six stores. RESULTS Point-of-sale data were readily available and provided a low-cost, efficient and objective assessment of food and nutrient sales. Similar patterns in macronutrient distribution, food expenditure and key food sources of nutrients were observed across stores. In all stores, beverages, cereal and cereal products, and meat and meat products comprised approximately half of food sales (range 49–57 %). Fruit and vegetable sales comprised 10.4 (SD 1.9) % on average. Carbohydrate contributed 54.4 (SD 3.0) % to energy; protein 13.5 (SD 1.1) %; total sugars 28.9 (SD 4.3) %; and the contribution of total saturated fat to energy ranged from 11.0 to 14.4% across stores. Mg, Ca, K and fibre were limiting nutrients, and Na was four to five times higher than the midpoint of the average intake range. Relatively few foods were major sources of nutrients. CONCLUSIONS Point-of-sale data enabled an assessment of dietary quality within stores and across stores with no burden on communities and at no cost, other than time required for analysis and reporting. Similar food spending patterns and nutrient profiles were observed across the six stores. This suggests potential in using point-of-sale data to monitor and evaluate dietary quality in remote Australian communities.
Collapse
|
17
|
MACKERRAS DE, SINGH GR, SAYERS S. The Aboriginal Birth Cohort Study: When is a cohort study not a cohort design? Nutr Diet 2010. [DOI: 10.1111/j.1747-0080.2010.01451.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
18
|
Navigating new territory: Lecture in honour of Cheryl Rae, formerly Principal Nutritionist, Northern Territory Health. Nutr Diet 2009. [DOI: 10.1111/j.1747-0080.2009.01364.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
19
|
Burgess CP, Johnston FH, Berry HL, McDonnell J, Yibarbuk D, Gunabarra C, Mileran A, Bailie RS. Healthy country, healthy people: the relationship between Indigenous health status and "caring for country". Med J Aust 2009; 190:567-72. [PMID: 19450204 DOI: 10.5694/j.1326-5377.2009.tb02566.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 04/01/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate associations between "caring for country" -- an activity that Indigenous peoples assert promotes good health -- and health outcomes relevant to excess Indigenous morbidity and mortality. DESIGN, SETTING AND PARTICIPANTS Cross-sectional study involving 298 Indigenous adults aged 15-54 years in an Arnhem Land community, recruited from March to September 2005. MAIN OUTCOME MEASURES Self-reported involvement in caring for country, health behaviours and clinically measured body mass index (BMI), waist circumference, blood pressure, type 2 diabetes status, albumin to creatinine ratio (ACR), levels of glycated haemoglobin (HbA(1c)) and high-density lipoprotein (HDL) cholesterol, lipid ratio, score on the five-item version of the Kessler Psychological Distress Scale (K5), and 5-year cardiovascular disease (CVD) risk. RESULTS Controlling for sociodemographic characteristics and health behaviours, multivariate regression revealed significant and substantial associations between caring for country and health outcomes. An interquartile range rise in the weighted composite caring-for-country score was significantly associated with more frequent physical activity, better diet, lower BMI (regression coefficient [b] = - 2.83; 95% CI, - 4.56 to - 1.10), less abdominal obesity (odds ratio [OR], 0.43; 95% CI, 0.26-0.72), lower systolic blood pressure (b = - 7.59; 95% CI, - 12.01 to - 3.17), less diabetes (OR, 0.12; 95% CI, 0.03-0.52), lower HbA(1c) level (b = - 0.45; 95% CI, - 0.79 to - 0.11), non-elevated ACR (OR, 0.28; 95% CI, 0.13-0.60), higher HDL cholesterol level (b = 0.06; 95% CI, 0.01-0.12), lower K5 score (b = - 0.97; 95% CI, - 1.64 to - 0.31) and lower CVD risk (b = - 0.77; 95% CI, - 1.43 to - 0.11). CONCLUSIONS Greater Indigenous participation in caring for country activities is associated with significantly better health. Although the causal direction of these associations requires clarification, our findings suggest that investment in caring for country may be a means to foster sustainable economic development and gains for both ecological and Indigenous peoples' health.
Collapse
Affiliation(s)
- Christopher P Burgess
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Burgess CP, Berry HL, Gunthorpe W, Bailie RS. Development and preliminary validation of the 'Caring for Country' questionnaire: measurement of an Indigenous Australian health determinant. Int J Equity Health 2008; 7:26. [PMID: 19094240 PMCID: PMC2628914 DOI: 10.1186/1475-9276-7-26] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Accepted: 12/18/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND 'Caring for Country' is defined as Indigenous participation in interrelated activities with the objective of promoting ecological and human health. Ecological services on Indigenous-owned lands are belatedly attracting some institutional investment. However, the health outcomes associated with Indigenous participation in 'caring for country' activities have never been investigated. The aims of this study were to pilot and validate a questionnaire measuring caring for country as an Indigenous health determinant and to relate it to an external reference, obesity. METHODS Purposively sampled participants were 301 Indigenous adults aged 15 to 54 years, recruited during a cross-sectional program of preventive health checks in a remote Australian community. Questionnaire validation was undertaken with psychometric tests of internal consistency, reliability, exploratory factor analysis and confirmatory one-factor congeneric modelling. Accurate item weightings were derived from the model and used to create a single weighted composite score for caring for country. Multiple linear regression modelling was used to test associations between the caring for country score and body mass index adjusting for socio-demographic factors and health behaviours. RESULTS The questionnaire demonstrated adequate internal consistency, test-retest validity and proxy-respondent validity. Exploratory factor analysis of the 'caring for country' items produced a single factor solution that was confirmed via one-factor congeneric modelling. A significant and substantial association between greater participation in caring for country activities and lower body mass index was demonstrated. Adjusting for socio-demographic factors and health behaviours, an inter-quartile range rise in caring for country scores was associated with 6.1 Kg and 5.3 Kg less body weight for non-pregnant women and men respectively. CONCLUSION This study indicates preliminary support for the validity of the caring for country concept and a questionnaire designed to measure it. This study also highlights the importance of investigating Indigenous-asserted health promotion activities. Further studies in similar populations are merited to test the generalisability of this questionnaire and to explore associations with other important Indigenous health outcomes.
Collapse
Affiliation(s)
- Christopher P Burgess
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, Australia.
| | | | | | | |
Collapse
|
21
|
Brimblecombe J, Mackerras D, Clifford P, O'Dea K. Does the store-turnover method still provide a useful guide to food intakes in Aboriginal communities? Aust N Z J Public Health 2007; 30:444-7. [PMID: 17073226 DOI: 10.1111/j.1467-842x.2006.tb00461.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To consider the application of the store-turnover method as a guide to assess food intake in remote Aboriginal communities. METHOD Food sources in a remote Aboriginal island community were documented. The contribution of quantifiable food sources to total community-level fresh fruit and vegetable availability was determined. RESULTS The store remains the single largest supplier of fruit and vegetables overall (54%), however its contribution varies depending on the subpopulation of interest. A store-turnover alone may significantly underestimate community-level dietary intake, depending on the contribution of other food sources. CONCLUSIONS Changes in the food supply in remote communities, coupled with methodological complexities inherent in the store-turnover method, challenge its application in a contemporary context. IMPLICATIONS A simplified version of the store-turnover method is needed that could be widely applied by community people and health practitioners seeking to initiate and monitor interventions to improve diet quality.
Collapse
|
22
|
Lee AJ, Hobson V, Katarski L. Review of the nutrition policy of the Arnhem Land Progress Association. Aust N Z J Public Health 1996; 20:538-44. [PMID: 8987227 DOI: 10.1111/j.1467-842x.1996.tb01636.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The process of implementation and the effect of the nutrition policy of the Arnhem Land Progress Association (ALPA) were reviewed three years after implementation of the policy in five remote Aboriginal community retail stores in May 1990. In 1993, compliance with the policy varied among stores. Recommended foods were available regularly in most communities; however, promotional and educational components of the policy were not widely implemented. Dietary improvements were evident in those communities where stores most complied with the policy. Some aspects of the ALPA nutrition policy require modification, and renewed commitment to the policy is likely to improve further the diet in the Aboriginal communities involved. The ALPA nutrition policy is a potential model for the development of other local food and nutrition policies in remote Aboriginal communities.
Collapse
Affiliation(s)
- A J Lee
- Menzies School of Health Research, Darwin
| | | | | |
Collapse
|
23
|
Lee A, Bonson AP, Powers JR. The effect of retail store managers on aboriginal diet in remote communities. Aust N Z J Public Health 1996; 20:212-4. [PMID: 8799099 DOI: 10.1111/j.1753-6405.1996.tb01821.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Key nutrient densities of the diet of two remote northern coastal Aboriginal communities were measured using the store-turnover method during the periods that three store managers were responsible for each store respectively. Individual store managers were a greater determinant of nutrient density than the community itself. Furthermore, nutrient densities tended to be highest in both communities when their stores were administered by one particular store manager. The results support the notion that store managers wield considerable power over the food supply of remote Aboriginal communities, and raise questions concerning the ability of Aboriginal community members to influence their own food supplies in retail stores. However, the study also confirms that store managers can be important allies in efforts to improve Aboriginal dietary intake.
Collapse
Affiliation(s)
- A Lee
- Menzies School of Health Research, Darwin
| | | | | |
Collapse
|
24
|
Lee AJ, Bonson AP, Yarmirr D, O'Dea K, Mathews JD. Sustainability of a successful health and nutrition program in a remote aboriginal community. Med J Aust 1995; 162:632-5. [PMID: 7603373 DOI: 10.5694/j.1326-5377.1995.tb126048.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To assess the long term effect of a nutrition program in a remote Aboriginal community (Minjilang). DESIGN Evaluation of nutritional outcomes over the three years before and the three years after a health and nutrition program that ran from June 1989 to June 1990. Turnover of food items at the community store was used as a measure of dietary intake at Minjilang and a comparison community. SETTING A community of about 150 Aboriginal people live at Minjilang on Croker Island, 240 km north-east of Darwin. A similar community of about 300 people on another island was used as the comparison. RESULTS The program produced lasting improvements in dietary intake of most target foods (including fruit, vegetables and wholegrain bread) and nutrients (including folate, ascorbic acid and thiamine). Sugar intake fell in both communities before the program, but the additional decrease in sugar consumption during the program at Minjilang "rebounded" in the next year. Dietary improvements in the comparison community were delayed and smaller than at Minjilang. CONCLUSIONS The success of the program at Minjilang was linked to an ongoing process of social change, which in turn provided a stimulus for dietary improvement in the comparison community. When Aboriginal people themselves control and maintain ownership of community-based intervention programs, nutritional improvements can be initiated and sustained.
Collapse
Affiliation(s)
- A J Lee
- Menzies School of Health Research, Darwin, NT
| | | | | | | | | |
Collapse
|