more_vertChampion of public nutrition. Born in Welwyn, UK, on June 23, 1944, he died of cancer in Killington, VT, USA, on Aug 28, 2018, aged 74 years.
Preference: Nutrition
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Government expands football partnership aimed at young Indigenous health
The health, wellbeing and future prospects for children in remote communities will be winners, through a major extension of the successful John Moriarty Football program to 12 centres across New South Wales and Queensland.
The Federal Government is committing up to $4.5 million for the expansion, to be driven through a partnership between the Football Federation of Australia (FFA) and John Moriarty Football (JMF).
JMF and FFA will work together to provide senior coaching staff, mentoring, training and education for children involved in the program. FFA will also identify and support pathways to national football programs.
“This is a game-changing move for Aboriginal and Torres Strait Islander communities, designed to help children between two and 16 to reach their full potential in football, in education and in life,” Indigenous Health Minister Ken Wyatt said.
“We have seen the success in the remote Northern Territory centres of Borroloola and Robinson River, which have been involved in the program since it was established in 2012, with more than 90 per cent of children in Borroloola now participating.
“Two hundred children have enrolled each year, including Shay Evans who is now playing with the Westfield Young Matildas.
“I congratulate Shay and her fellow JMF scholarship winners, but scores of other participants are also continuing to kick personal and life goals, both on and off the field.”
The JMF program is community driven, with children supported to attend school and make healthier lifestyle choices.
The expanded program will focus on primary health through:
- Nutrition programs, with meal plans developed by a sports dietitian;
- Mental wellbeing, through emotional self-regulation training, with coaches focussing on building resilience;
- Community cohesion, through gatherings to support tournaments and holiday clinics encouraging community interest and participation; and
- Parental involvement to enable families to improve health through physical activity.
JMF Managing Director Ros Moriarty said the Foundation was “extremely grateful” for this “very significant” funding commitment.
“We look forward to replicating our model of football as a powerful tool for wellbeing, supporting resilient, healthier outcomes for young players, their families and communities,” Ms Moriarty said.
NSW and Queensland communities to participate will be selected on the basis of evidence of strong local interest and intention to embrace the program.
“Our game has a deep history of Indigenous participation, and this step will allow us to do so much more to improve health outcomes for Indigenous children,” said Moriarty Foundation Board Member and FFA Board nominee Craig Foster.
“Football has the power to unite the whole community to support opportunity for all young Australians.”
FFA Chief Executive David Gallop said FFA had been a keen supporter of John Moriarty Football for several years.
“Matildas Head Coach Alen Stajcic has visited Borroloola on a number of occasions and scouted Shay Evans back in 2014,” he said.
“This announcement will help achieve our vision of involving more Indigenous Australians in football, as players, coaches, referees and administrators.
“We look forward to working closely with John Moriarty Football to generate significant health and community benefits while offering a pathway for Indigenous footballers to emulate the success of Young Matilda Shay.”
Mr Wyatt said regular sport and physical activity, particularly for young children, has documented and far reaching health benefits.
“It reduces the risk of obesity, increases cardiovascular fitness, promotes healthy growth of bones and muscles, improves coordination and balance, and gives children a greater self-confidence and belief in their abilities, on and off the sporting field,” the Minister said.
“The JMF program has the potential to contribute to Closing the Gap in health equality, education and employment, and positively impact on the high chronic disease prevalence rates among First Nations people.”
The three-year funding will be provided through the Indigenous Australians’ Health Program over 2018–19 and 2020.
Massive malnutrition deaths among children in Yemen
Eighty-five thousand children under the age of five are estimated to have died from acute malnutrition in Yemen during the course of the three-year war there.
The United Nations has declared that up to 14 million Yemenis are suffering from famine, with the war causing the world’s worst humanitarian crisis.
The Save the Children charity has calculated that 84,700 children died between April 2015 and October 2018 from untreated cases of severe malnutrition.
The aid workers in Yemen say many cases go unreported because only half of the country’s health facilities are operational and many people are too poor to access those that are open.
Food, medicines and other humanitarian aid and supplies are also not reaching the country.
“For every child killed by bombs and bullets, dozens are starving to death and it’s entirely preventable,” said Save the Children’s Yemen director Tamer Kirolos.
“Children who die in this way suffer immensely as their vital organ functions slow down and eventually stop. Their immune systems are so weak they are more prone to infections with some too frail to even cry.
“Parents are having to witness their children wasting away, unable to do anything about it.”
If acute malnutrition is left untreated, up to 30 per cent of children in the conflicted are will die each year, the charity stated.
Fighting in Yemen worsened in 2015 when a Saudi-led coalition launched an air attack against the Houthi rebel movement that had forced President Abdrabbuh Mansour Hadi to flee the country.
Intermittent fasting is no better than conventional dieting for weight loss, new study finds
With a global diet industry worth US$168.95 billion, it’s clear the world is obsessed with weight loss. But what’s the best diet for losing weight and improving health? One of the most promising diets to have gained attention recently is intermittent fasting, which the media has crowned a miracle weight loss solution. But according to a recent study, when it comes to losing weight, intermittent fasting isn’t any more effective than conventional dieting.
Intermittent fasting is an eating pattern that condenses daily food intake into one time-restricted period, then fasting for the rest of the day. One of the most popular versions of intermittent fasting is the “5:2 diet”. This allows five days of unrestricted eating and two days (usually non-consecutive) eating a very low-calorie diet, typically about 500 kcal. The diet’s biggest appeal is the flexibility to tailor it to your lifestyle.
Enthusiasm for intermittent fasting was fuelled by data from animal studies that suggested fasting could help reduce the risk of diabetes, cardiovascular disease and certain types of cancer. However, few studies have actually examined the effects of intermittent fasting on humans for longer than six months. Carrying out long-term studies that control diet is difficult because it’s hard to get people to stick to them, and results can be affected by outside factors.
This recent study was conducted over a 50-week period, making it one of the longest intermittent fasting studies to date. Researchers split 150 participants into three groups. One group followed the 5:2 intermittent fasting diet (with two non-consecutive “fast” days per week eating about 500 kcal), while the second group reduced daily calorie intake by approximately 20%. A third control group weren’t instructed to change their diet.
During the first 12 weeks, a trained dietitian worked closely with participants to ensure they stuck to the allocated diet. After 12 weeks, participants continued following their diet without the dietitian. The effects of the diets were then evaluated using a number of health assessments after 12, 24 and 50 weeks.
Researchers measured body weight, body fat, insulin sensitivity (risk of diabetes indicated by ability to control blood glucose) and cholesterol. They also analysed 82 genes linked to obesity and metabolic disease.
The study’s key finding was that intermittent fasting and daily calorie restriction both led to significant weight and fat loss compared to the control group. But intermittent fasting was no more effective than conventional dieting for losing weight. Intermittent fasting also didn’t improve any marker of health more than daily calorie restriction.
Drop-out rates were low but similar for both diet groups, suggesting participants found these similarly easy to stick to. Other long-term intermittent fasting studies in humans have shown similar results.
This study essentially confirms a well-understood weight loss principle: whatever method you use, in order to lose weight you must reduce your total calorie intake. The 5:2 diet is designed specifically to reduce your total weekly calorie intake by a similar amount as a daily calorie restriction diet. So perhaps it’s not too surprising that end results are similar.
The study also showed a trend for greater weight loss in the intermittent fasting group after 12 weeks, but greater weight regain (about 2kg) between 24 and 50 weeks. This suggests that intermittent fasting could aid short-term weight loss but might not be a good method for sustained, long-term weight loss.
My own research found that people following a very-low calorie diet (550 kcal) experienced reduced levels of the “hunger” hormone ghrelin the following day. As high concentrations of ghrelin are associated with feeling hungry, lower concentrations of it after a very-low calorie diet suppress appetite, and could help people with short-term weight loss.
However, this study wasn’t able to show the same health improvements (such as insulin sensitivity) that previous animal studies showed. These studies used longer, more severe methods of calorie restriction (often fasting completely), which the 5:2 diet doesn’t normally include.
But one human study found that following the 5:2 diet for three months improved insulin sensitivity over daily calorie restriction diets, if the two very-low calorie days were done consecutively. This suggests intermittent fasting might provide additional benefits if the period of calorie restriction is extended.
Whether intermittent fasting can be successful beyond 50 weeks is not yet known. And though drop-out rates were low, the study still demonstrated that intermittent fasting isn’t immune to the gradual decline in adherence associated with other diets. This means, like most diets, it’s only effective when there’s an active effort to maintain it.
Questions still remain about intermittent fasting, specifically whether all methods (such as the warrior diet, where you only eat one large meal in the evening) are similarly effective. Another form of intermittent fasting, known as time-restricted feeding (where people can only eat during a fixed four, six, or eight-hour eating window) is also receiving considerable attention, with one study suggesting the time of the day you eat might be as important as what you eat. Research is underway to determine the best time to eat, how long you should fast, and how these diets specifically affect health
When it comes to dieting, there is no one-size-fits-all solution. This study showed that intermittent fasting and calorie restriction are equally effective for weight loss and improving metabolic health. So the best, and likely most successful, diet for yourself is probably one that fits your lifestyle.
David Clayton, Lecturer in Nutrition and Exercise Physiology, Nottingham Trent University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Measles growing in some countries
Gaps in vaccination coverage have led to an increase in reported cases of measles around the world. In 2017, numerous countries experienced severe and protracted outbreaks of the disease.
Because of these immunisation gaps, measles outbreaks occurred in all regions, and there were an estimated 110 000 deaths related to the disease.
Updated disease modelling data provides the most comprehensive estimates of measles trends over the last 17 years. It shows that since 2000, over 21 million lives have been saved through measles immunisations. However, reported cases increased by more than 30 percent worldwide from 2016.
The Americas, the Eastern Mediterranean Region, and Europe experienced the greatest upsurges in cases in 2017, with the Western Pacific the only World Health Organisation (WHO) region where measles incidence fell.
“The resurgence of measles is of serious concern, with extended outbreaks occurring across regions, and particularly in countries that had achieved, or were close to achieving measles elimination,” said Dr Soumya Swaminathan, Deputy Director General for Programs at WHO.
“Without urgent efforts to increase vaccination coverage and identify populations with unacceptable levels of under-immunised or unimmunised children, we risk losing decades of progress in protecting children and communities against this devastating, but entirely preventable disease.”
Measles is a serious and highly contagious disease. It can cause debilitating or fatal complications, including, severe diarrhoea and dehydration, pneumonia, ear infections and permanent vision loss. Babies and young children with malnutrition and weak immune systems are particularly vulnerable to complications and death.
The disease is preventable through two doses of a safe and effective vaccine. For several years, however, global coverage with the first dose of measles vaccine has stalled at 85 per cent. This is far short of the 95 per cent needed to prevent outbreaks, and leaves many people, in many communities, susceptible to the disease. Second dose coverage stands at 67 per cent.
“The increase in measles cases is deeply concerning, but not surprising,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance.
“Complacency about the disease and the spread of falsehoods about the vaccine in Europe, a collapsing health system in Venezuela and pockets of fragility and low immunisation coverage in Africa are combining to bring about a global resurgence of measles after years of progress. Existing strategies need to change: more effort needs to go into increasing routine immunisation coverage and strengthening health systems. Otherwise we will continue chasing one outbreak after another.”
Responding to the recent outbreaks, health agencies are calling for sustained investment in immunisation systems, alongside efforts to strengthen routine vaccination services. These efforts must focus especially on reaching the poorest, most marginalised communities, including people affected by conflict and displacement.
The agencies also call for actions to build broad-based public support for immunisations, while tackling misinformation and hesitancy around vaccines where these exist.
“Sustained investments are needed to strengthen immunization service delivery and to use every opportunity for delivering vaccines to those who need them,” said Dr Robert Linkins, Branch Chief of Accelerated Disease Control and Vaccine Preventable Disease Surveillance at the U.S. Centers for Disease Control and Prevention (CDC) and Measles and Rubella Initiative Management Team Chairman.
The Measles and Rubella Initiative is a partnership formed in 2001 of the American Red Cross, CDC, the United Nations Foundation, UNICEF, and WHO.
Artery hardening begins before high school: Australian study
Only a minority of Australian 12-year-olds have ideal cardiovascular health, research shows, with arterial stiffening evident before some children start high school.
A team from Melbourne’s Murdoch Children’s Research Institute assessed the cardiovascular health of 1028 Australian children aged 11-12 using the seven risk factors of the American Heart Association’s Cardiovascular Health (ICVH) score: physical activity, weight, diet, blood glucose, cholesterol, blood pressure and smoking status.
Only 7% of the children (76) had a perfect ICVH score, and only 39% (406) achieved ideal levels in six out of the seven metrics. The median score was 5/7.
For the first time, the researchers demonstrated that ICVH scores in children were associated with vascular function.
Each additional point in a child’s ICVH score was associated with slower carotid-femoral pulse wave velocity (0.07m/s reduction in pulse wave velocity) and greater carotid elasticity (0.009% per mm Hg).
This relationship was largely mediated by BMI and blood pressure, according to the study published this month in the International Journal of Cardiology.
Study co-author, Professor David Burgner of the University of Melbourne told doctorportal: “If parents were aware that even before their child starts high school, risk factors such as increased BMI and raised BP were already associated with stiffer arteries – which increases the chance of heart attack and stroke as adults – then you’d hope that would galvanise families to try to reduce their risk factors.”
“Cardiovascular disease risk occurs from childhood onwards and we already see associations between risk factors and preclinical changes in the arteries by mid-childhood,” he said.
A family problem
The researchers also assessed 1,235 parents of the children – in most cases the mothers.
The median ICVH score in the parents was lower than in children (4/7), and the association with vascular function was stronger, the study found.
ICVH scores in adults were also linked with changes in vascular structure. Each additional point in an adult’s ICVH score was associated with a smaller carotid intima-media thickness (-7.3μm per metric unit), a measure of subclinical atherosclerosis.
The study found children whose parent had non-ideal health in any of the seven metrics had substantially higher odds for non-ideal health in that metric, for all metrics except physical activity and serum glucose. Children typically did more exercise than their parents.
Ideal diet was the metric least likely to be attained by both adults and children.
Family-based interventions
Professor Burgner said the study highlighted the need for family-based interventions to reduce cardiovascular risk from early on in life.
“Clearly many of the risk factors are shared within families, so considering the family rather than the individual as the unit for interventions that address modifiable environmental risk factors such as increased physical activity or diet may have more impact than just focusing on the adult or child in isolation,” he said.
Professor Burgner said it was unknown whether the poorer vascular function seen in children with lower ICVH scores in the study was reversible.
“The adverse changes in children are smaller than in adults and only relate to the elasticity of the arteries. This likely reflects a longer cumulative exposure to risk factors the older you get,” he said. “Certainly the consensus is that children are physiologically more ‘plastic’, so changes are likely to be reversible, but it is not well understood.”
The study cohort was drawn from the Longitudinal Study of Australian Children and Child Health Checkpoint. The authors cautioned that it was likely to have under-represented socio-economically disadvantaged families.
Dr Richard Liu, another co-author of the study, said that BP measurement should be routine in children. However in practice it was rare.
“Arguably all children with a raised BMI should be screened but it is important that it be done appropriately – that abnormal readings are repeated at least twice, the cuff is appropriately sized and equipment calibrated, and values are measured against established centiles for age, sex and height,” he said.
[Editorial] We need to talk about meat
Humans and the livestock they consume is a tale that impacts lives in a deep and meaningful sense. Human history is interwoven with production of meat for consumption, and its availability and nutritional value as a source of protein has played a major part in diet as far back as we can imagine, shaping regional identities and global movements. The emotionally charged debate over the ethical suitability of meat consumption may never reach a conclusion, but it is only comparatively recently that the climate impact of livestock rearing, and the nutritional and health issues caused by meat have become a pressing concern.
[Editorial] Time to address nutritional security
Last week, the Global Panel of Agriculture and Food Systems for Nutrition (GLOPAN) published a policy brief: Preventing nutrient loss and waste across the food system: policy actions for high quality diets. The brief argues that loss and waste of high-nutrient foods from our global food systems is a huge problem, which, if addressed, could help tackle all forms of malnutrition and improve poor-quality diets that lead to ill health.
Being heart smart could prevent cognitive decline in women
New research has revealed that cardiovascular risk factors, particularly high cholesterol, play a role in the development of cognitive decline, further highlighting the importance of kickstarting healthy heart habits earlier in life.
Professor Cassandra Szoeke, director of the Healthy Ageing Program at the University of Melbourne and lead researcher, said the results showed that strategies to target vascular damage are vital to prevent brain cell loss.
“Neurodegenerative brain disease works insidiously for decades before people are diagnosed with dementia – we need to stop it in its tracks, or ideally before it starts.”
“What you do now affects what you will be decades later.”
What did the study involve?
The Australian study, published in Brain Imaging and Behaviour, included 135 participants from the Women’s Healthy Ageing Project. These women had completed midlife cardiovascular risk measurement in 1992, followed by an MRI scan and cognitive assessment in 2012.
The researchers found that higher midlife Framingham Cardiovascular Risk Profile (FCRP) score was associated with greater White Matter Hyperintensity (WMH) volume two decades later, and was predominantly driven by the impact of HDL cholesterol level.
Structural equation modelling demonstrated that the relationship between midlife FCRP score and late-life executive function was mediated by WMH volume.
“We saw those with low brain volume lost even more volume over the next 10 years,” Professor Szoeke said.
The authors wrote that their results indicated that intervention strategies targeting major cardiovascular risk factors at midlife might be effective in reducing the development of WMH lesions and thus late-life cognitive decline.
Massive exercise changes aren’t needed – but being active every day is key
“We all know we should eat healthily and exercise, but we also know many people who start up a program are not participating 3 months later, and 12 months later even less are still participating,” Professor Szoeke said.
Going into the study, her research team had expected that women who did intense physical activity would have the best cognition down the track.
“We found it was those who did activity every day over the 20 years of follow-up. It could be walking the block or gardening or a mix of Saturday dancing, Sunday walking home, and Monday walking to work – but it is each and every day for 20 years.”
Professor Szoeke said the impact of the research should be a greater recognition that vascular risk is modifiable, If it’s left unchanged, this will lead to brain damage in the form of WMH, low brain volume and poor cognition.
She said modifying this risk doesn’t mean a huge lifestyle change. In fact, the benefit can be obtained from just being more active.
“Move often and eat healthily. Choose what works for you, change it as you need, and do it each and every day.”
Women are disproportionately affected by dementia
Women account for around two-thirds of all dementia cases. Understanding the reasons behind this is an issue close to Professor Szoeke’s heart.
She said while women generally live 3 to 4 years more than men, it is not just an effect of age. The fact that the symptoms, assessment, treatment, management and prevention of heart disease differs between men and women suggested that cardiovascular risk also plays a role.
“Last year, the Australian Hidden Hearts report was released, showing that women have more heart disease, heart failure and stroke than men,” Professor Szoeke said.
“The Health Minister Greg Hunt has announced an update of women’s health policy. There has been $18 million announced for research to fill these gaps in knowledge, particularly highlighting issues not often focused on in traditional women’s health.”
She said the strategic areas for the new update reflect key issues for women, including mental health, dementia, chronic disease and healthy ageing.
“I hope we can quickly see major improvements with investment in these areas.”
[Comment] Reform of primary health care in Pakistan
With a neonatal mortality rate exceeding 45 per 1000 livebirths, a UNICEF report ranked Pakistan as the riskiest place to be born on earth.1 Although the recent Demographic and Health Survey indicates that the situation has improved, the neonatal mortality rate in Pakistan is among the highest in the world.2 Other health indicators, particularly those pertaining to maternal and child health and nutrition, are worse than other countries in the region with comparable or lower socioeconomic indicators.