Diet deficiencies need urgent action

REGULATION of the food industry, improved access to fresh food and simplified nutritional information are key to improving the concerning dietary trends in remote Aboriginal communities and many low-socioeconomic areas, according to nutrition and public health experts.

Professor Kerin O’Dea, professor of population health and nutrition at the University of South Australia, said it was “absolutely vital” to address the nutritional deficiencies highlighted in a MJA study of three remote Aboriginal communities. (1)

The multisite, 12-month assessment found that of the total food expenditure in the communities, 15.6% was on sugar-sweetened drinks, while only 2.2% was on fruit and 5.4% was on vegetables. It also found that white bread was a major source of energy and most nutrients in the three communities.

Professor O’Dea, a coauthor of the study, told MJA InSight the nutritional concerns highlighted in the study had implications for all low-socioeconomic communities.

She said she was “appalled” at the study’s finding that white bread was a major source of key nutrients, such as protein and iron, in these remote communities.

“One Aboriginal community refers to white bread as their ‘long-life food’”, she said. “It’s filling, it’s cheap and, superficially, it looks alright.” But she said it was also important to consider the quality of the nutrients being consumed.

“The best-quality protein is lean meat and fish, and Aboriginal people would have been consuming that in very large amounts traditionally.”

Dr Jacqui Webster, head of food policy at the George Institute, said the lack of access to fresh fruit and vegetables in remote areas needed to be addressed urgently.

She said there were three components of access to ensure a healthy diet — access to a supply of healthy food via retailers; access to the financial resources to secure a healthy diet; and access to education about what constitutes a healthy diet.

“We need to be certain that we have adequate strategies in place to ensure that those three elements of access [are available] for all different communities”, Dr Webster said.

In an MJA editorial, leading nutritionist Dr Rosemary Stanton called for dietary advice to focus on whole foods, rather than on individual nutrients. “The realistic — and wise — course of action is to look at diet in terms of foods and eating patterns rather than taking a reductionist approach and concentrating on a single nutrient that is almost never consumed on its own.” (2)

Professor O’Dea agreed, saying it was also important to evaluate the quality of the food supply, which was becoming increasingly complex.

“It’s almost impossible to have a low enough sodium intake if you eat our processed food supply — you’d have to make your own bread, you’d have to make your own breakfast cereals,” she said.

Professor O’Dea said regulatory change was essential, but unlikely to succeed while the processed food industry was represented in policy discussions.

“While we insist upon having [the food industry] at the table, we’re not going to make progress. We would never have made progress [on tobacco] if the tobacco industry had been at the table. This is harder than tobacco, because we all have to eat.”

Dr Webster said aggressive marketing of highly processed food and drink and an over-abundance of supply made it very challenging for people to access the right nutrients.

“People are spending the limited amount of money they have on nutrient-deficient foods, such as sugar-sweetened beverages”, she said.

She said consumers were “hungry” for simplified nutritional information. The George Institute last year launched a smart phone app called FoodSwitch, which allows users to scan the barcode of more than 38 000 food products to access a colour-coded interpretation of the food’s nutritional content. The app is used by about 300 000 people. (3)

“It’s evidence that people want simplified nutritional information”, Dr Webster said.

In a letter published in the MJA, researchers called for the monitoring of salt consumption and its effects in Aboriginal and Torres Strait Islander peoples. (4)

- Nicole MacKee

1. MJA 2013: 198: 380-384
2. MJA 2013: 198: 350-351
3. The George Institute: FoodSwitch
4. MJA 2013: 198: 365-366

Posted 15 April 2013