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Supporting young Australians to eat a healthy diet goes beyond doctors, dietitians and nutritionists; it is a responsibility of government and community and health systems.
Australian young adults aged 18–30 years have some of the poorest diets of all age groups.
Over 90% of young Australians are not eating the recommended two serves of fruit and five of vegetables daily, and > 35% of their total energy intake comes from high added salt and sugars discretionary foods, such as processed meats and confectionary (here).
So what’s the Australian Government’s plan to tackle this issue?
Well, the National Preventive Health Strategy 2021–2030 has set ambitious targets for 2030. These include increasing fruit and vegetable intake to meet the two serves of fruit and five serves of vegetables a day recommendation and reducing total energy intake from discretionary foods down to < 20%, on average.
However, without investment in programs to support young adults, these targets are unlikely to be met.
Here’s why.
Diet and health inequities among young adults
Diets low in vegetables and legumes and high in red and processed meat are top dietary risk factors for heart disease in Australia. Curbing trends in risk factors for heart disease is critical, yet 80% of young Australians are predicted to be overweight or obese by 2025.
What’s more, poor diet and health are not equally distributed among young adults.
Social determinants of health, such as low income and education and high area-level disadvantage, can disproportionately and negatively affect health outcomes.
Where young Australians live matters when it comes to their diet and health; living in areas with greater area-level disadvantage is associated with lower overall diet quality and higher rates of obesity.
Similarly, young Australians living in rural areas tend to have lower levels of education and lower incomes than those living in cities. When it comes to health, rural populations are 1.5 times more likely to experience higher rates of heart disease and 1.3 times more likely to die early. Yet people living in rural areas are 2.5 times more likely to experience barriers to accessing health services than those living in cities.
We find ourselves in a situation where health disparities are disadvantaging our young adults. So, what can doctors, dietitians and nutritionists do about this?
The state of play of personalised programs
One-size-fits all dietary approaches are failing to improve diets (here and here). Tailored, or personalised, interventions may provide a more effective solution as they can address the unique barriers experienced by the target population.
Research shows that adults are more motivated to improve their diet when advice is personalised to them.
On the one hand, personalisation could be as simple as providing advice that is tailored to a person’s dietary habits or preferences, which is what dietitians do. On the other hand, personalisation could be tailored to a person’s biological characteristics or use artificial intelligence to provide real-time advice. The latter can make personalised programs more expensive to run.
But the good news is that even simple personalisation is more effective than one-size-fits all advice.
Most of us own a digital device, meaning that the delivery of personalised programs is often digital. In fact, digitally delivered dietary interventions are an accessible, inexpensive and personalisable solution to Australia’s geographic landscape.
However …
Digitally delivered dietary interventions have not yet reached their potential. This is due to challenges with retaining users’ engagement. Yet, low engagement could be improved by personalising and codesigning the intervention with the target population to ensure it meets their needs.
But, our recent review showed that no personalised digital interventions exist that aim to improve diets in young adults living in rural Australia.
The solutions
If every Australian ate an additional 0.2 serves of vegetables every day (ie, a cherry tomato), health expenditure would reduce by AUD$100 million per year. Critically, more than 1500 deaths in rural areas could be prevented each year if recommendations for fruit and vegetables were met.
The federal, state and territory governments have signalled a commitment to increasing vegetable intake to an average of five serves per day by 2030 in the National Preventive Health Strategy 2021–2030. However, previous high level strategies in this area have not translated into shifts in diets, and investment in nutrition research in rural areas is scarce.
The lack of evidence-based programs to support healthy eating in young adults led our group to establish a new trial, Veg4Me.
Veg4Me is a web application that has been codesigned with young adults living in rural Australia, the Heart Foundation and local government. Veg4Me features personalised recipes, an interactive food environment map tailored to the location of the user, a healthy eating hub with evidence-based resources, weekly newsletters and a goal setting portal. Information on how to support Veg4Me is found at the end of this article.
Call to action
Supporting young Australians to eat a healthy diet goes beyond doctors, dietitians and nutritionists; it is a responsibility of government and community and health systems.
As a result, dedicated and sustained investment in nutrition is need at a national level.
Regular monitoring and surveillance are important for understanding the health of the nation and how it changes over time. The upcoming Intergenerational Health and Mental Health Study (which includes four national studies) will provide much needed high quality evidence on the current diet and health of Australians.
Similarly, the Australian Government’s commitment to develop a National Nutrition Policy is encouraging, as Australia last updated its national nutrition policy in 1992.
Support for nutrition research should also be directed through national schemes, such as the National Health and Medical Research Council, the Medical Research Future Fund and the Australian Research Council.
Collectively, these initiatives and our dedicated nutrition workforce will help shape the future of young Australians, providing much needed support to this at-risk group.
Want to know more?
Veg4Me Study
If you are aged 18–35 years (or have friends, family or colleagues who are) and live in regional Victoria, you may be eligible to participate in the Veg4Me study.
Recruitment for this trial is open until November 2023 and can be accessed here: https://veg4me.deakin.edu.au/
Dr Livingstone is chief investigator on the Veg4Me study, which is funded by a Heart Foundation Vanguard Grant (ID106800).
Personalised and precision nutrition
If you are interested in or work in the field of precision and personalised nutrition, consider joining the 2023 Boden Research Conference (19–20 October 2023, the Shine Dome Canberra and online).
This two-day conference is organised by the Australian Academy of Science National Committee for Nutrition and is supported by the Nutrition Society of Australia, Dietitians Australia and the Australian Nutrition Trust Fund. The conference will empower future leaders in precision and personalised nutrition through workshops, short oral presentations and plenary speakers.
Dr Katherine Livingstone sits on the National Committee for Nutrition and is Chair of the Boden Research Conference. She is a National Health and Medical Research Council Emerging Leadership Fellow and Senior Research Fellow in the Institute for Physical Activity and Nutrition at Deakin University.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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