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Summary Objectives To describe prevalence and trends for overweight and obesity in Australia and to critique the quality of available data on this public health priority. Design Comparison of aggregate prevalence data on adult and childhood overweight and obesity in publicly available national or state-based cross sectional surveys and survey series. Participants All representative population surveys, conducted since 1995, with measured height and weight at a national or state level. Results The most recent measured data found that 63.4% of Australian adults and 27.6% of children were overweight or obese in 2014/15. Tasmania had the highest observed adult prevalence of obesity (32.3%) and of overweight and obesity combined (67.5%). The Australian Capital Territory had the lowest observed prevalence of obesity (23.9%) and of overweight and obesity combined (63.0%). Between 2007/08 and 2014/15, the age-standardised prevalence of adulthood overweight and obesity combined increased from 64.4% to 66.4%. Across states/territories the observed change varied from −5.3% (Western Australia) to 6.0% (Queensland). Amongst children the observed prevalence of overweight and obesity combined increased from 24.7% to 27.6%. Across states/territories the observed change varied from −1.4% (South Australia) to 11.1% (Tasmania). Conclusions In Australia, 1 in 10 more adults are obese today compared to 1995. Limitations in the available data mean it is difficult to conclude on trends over time in children, Indigenous Australians, or by state/territory. We need to ensure the continuation and expansion of our National Health Survey and/or explore novel monitoring options from other countries. [ABSTRACT FROM AUTHOR]

Summary Background Many individuals may not accurately perceive whether their weight status poses a health risk. This paper aimed to determine how accurately Australians perceived their weight status compared to objective measurements, and to determine what factors were associated with underestimating weight status. Methods Participants were 7947 non-pregnant adults from the 2011 to 2012 Australian National Nutrition and Physical Activity Survey, with complete data for self-reported and measured weight status. Multivariate logistic regression was used to examine associations between individual characteristics and accuracy of perceived weight status. Results Overall, 25.5% of the sample underestimated and 3.8% overestimated their weight status. Men were almost twice as likely as women to underestimate (34.0% vs 17.7%, p < 0.001). In both sexes, underestimating weight status was strongly associated with higher waist circumference, satisfaction with weight and older age. In men, underestimation was associated with low education levels and being on a diet, and in women, underestimating weight status was associated with being born overseas and area-level disadvantage. Conclusions At least a quarter of the adult population misperceives their weight status as healthy when in fact they are at increased risk of morbidity and mortality due to overweight and obesity. This may present a major barrier to prevention efforts. [ABSTRACT FROM AUTHOR]

Abstract: Background: To examine whether the recent flattening of mortality rates for coronary heart disease (CHD) observed among young adults in the UK and the US is also occurring in the Australian population. Methods: Mortality data from 1976 to 2006 were used to calculate overall age-adjusted and age-specific mortality rates for Australian adults aged ≥25years. Joinpoint regression was fitted to estimate the annual change and detect points in time where significant changes in the trends occur. Results: Between 1976 and 2006 age-adjusted CHD mortality rates declined by 73% in men and 70% in women. A steady decline continued in older groups. Beginning in 1991, a slowing of the fall in mortality rates was observed in younger men, and CHD mortality rates were essentially flat in men 25–34years. Among men aged 35–44, a reduction of the decline in CHD mortality was observed from 1992, and likewise in men aged 45–54years from 1994. Very similar patterns were observed in women with significant slowdowns starting in 1980, 1988 and 1991 for those aged 25–34years, 35–44years and 45–54years respectively. Conclusions: In Australian men and women aged 25–54years, the CHD mortality decline has slowed since the early 1990s. The most likely explanations for reduction of the CHD mortality decline are attenuations or reversal of the earlier declines in major traditional risk factors (tobacco smoking, serum cholesterol, blood pressure) and diabetes mellitus. [Copyright &y& Elsevier]

Abstract: Objectives: To examine the relationships between physical activity, sedentary behaviour and body mass index (BMI) among a sample of Australian adolescents. Methods: Anthropometric, demographic and behavioural data were collected from students (n =3040 mean age 14.6, 44% female) from 12 secondary schools in South West Victoria, Australia (response rate=48.6%). The appropriate descriptive, univariate and regression analysis were used to examine the strength of the associations between physical activity, sedentary behaviour and odds of overweight or obese and the effect of interaction between physical activity and sedentary behaviour on odds of overweight and obese. Results: Males were more likely to be active during the school day than females and had higher median hours of screen time per school day. Physical activity during the school day was associated with higher standardized BMI (BMI-z) among males. Higher levels of activity after school were associated with lower BMI-z for males and females. For both males and females the odds of overweight or obese were higher among the least active. An interaction was observed for females whereby the prevalence of overweight and obesity among the most physically active was lowest for the least sedentary and highest for the most sedentary. Conclusions: The relationships between physical activity, sedentary behaviour and BMI-z were complex. Interventions to reduce BMI through increasing physical activity or decreasing sedentary behaviour need to consider the complex inter-relationships between these variables and moderating factors such as age, sex and socio economic status in their design and interpretation. [Copyright &y& Elsevier]

Abstract: Several sets of model-based estimates (synthetic estimates) of the prevalence of risk factors for coronary heart disease for small areas in England have been developed. These have been used in policy documents to indicate which areas are in need of intervention. In general, these models have not been subjected to validity assessment. This paper describes a validity assessment of 16 sets of synthetic estimates, by comparison of the models with national, regional and local survey-based estimates, and local mortality rate estimates. Model-based estimates of the prevalence of smoking, low fruit and vegetable consumption, obesity, hypertension and raised cholesterol are found to be valid. [Copyright &y& Elsevier]

Introduction: Applying systems science in public health trials is a recent innovation in childhood obesity prevention. This paper aims to use systems science conventions to propose a theory of change for community-based interventions aiming to build capacity and use exemplars from systems science for obesity prevention to describe how this approach works.Methods: Participants were community-based researchers. A dynamic hypothesis was created in workshops conducted in 2020 and 2021 by identifying variables critical to building community capacity for systems thinking. These were used to develop stock and flow diagrams representing individual causal relationships, feedback loops, and the overall theory of change.Results: The resultant model identified 9 stocks and 4 pairs of central balancing and reinforcing feedback loops. These represented building commitment through relationships, mutual learning, strengthening collaboration, and embedding capacity. The model is described using examples from 3 trials involving 25 communities across Victoria, Australia.Conclusions: This nonlinear and practice-based model illustrates the process of community-based obesity prevention. The model integrates >20 years of community-based intervention implementation experience, providing an overarching theory of how such interventions work to create change and prevent obesity. [ABSTRACT FROM AUTHOR]

• FoodPATH used group model building tocollaborate with Aboriginal organisations around food policy. • Workshops with six ACCOs revealed feedback loops across nine themes. • The issues of junk food marketing, food affordability, nutrition in schools and food knowledge and skills were key issues across all sites. • Group model building enabled Community-driven recommendations for system-wide actions to improve food environments. First Nations peoples have the right to participate in all decisions affecting them. This includes food policy decision-making. In the Australian state of Victoria, the Food Policies for Aboriginal and Torres Strait Islander Health (FoodPATH) project aimed to determine the food policy actions that are likely to be effective and acceptable for Victorian Aboriginal Communities. Community-based workshops were held with six Aboriginal Community-Controlled Organisations (ACCOs) in urban and regional Victoria during 2022. A team of at least three Aboriginal and Torres Strait Islander facilitators guided participants (n = 53) through a series of workshop activities using group model building methods. Group model building is a participatory systems science research method which enables community stakeholders to develop a shared understanding of the system-level drivers of complex problems and co-design actions to address them. Workshop discussions coincided with real-time creation of a visual system map of the interconnected determinants of food choice. Participants used these maps to develop and prioritise actions for improving food environments and nutrition in the community. Participants identified a diverse array of interconnected factors influencing food choice and nutrition in Aboriginal Communities across Victoria. Food access and affordability, junk food marketing, food knowledge and skills and diet and disease were common themes across all sites, while access to junk food, growing local food, traditional Aboriginal foods, and family, Community and culture were key themes in most sites. Results informed a Community-driven agenda, comprising five Community-led actions and five government policy recommendations for improving food environments and nutrition for Victorian Aboriginal Communities. [ABSTRACT FROM AUTHOR]

Climate change impacts mental wellbeing through complex pathways and young people are among the most vulnerable to climate-related anxiety. Minding our Futures used methods from systems science to explore this issue and identify actions to promote mental wellbeing for young Australians (18–24 years). This qualitative study used Group Model Building via three online facilitated workshops recruiting health, youth and climate practitioners and researchers engaged with young people around climate change and/or mental wellbeing (N = 14). Analysis created a systems map and rich description of the relationships between causal factors and their impact on young people. Three themes emerged; "Government, Services and Structures" highlighted underlying structural issues including capitalism and political powerlessness; "Social Norms, Communication and Taking Action" reflected social media and misinformation; and "Personal Experience of Environmental Disasters" described the impact of climate-related disasters and importance of nature and place connection. Participants specified connections between the themes and mental health outcomes. This novel applied translational research process supported key informants to design structural responses to a complex and critical public health issue. Their vision was a multi-faceted approach, co-led with young people, drawing on Indigenous knowledges and change-focused policy, community empowerment and nature-based interventions. • Climate change impacts mental wellbeing through complex pathways. • Young people are among the most vulnerable to climate-related anxiety. • Connection to nature and the local environment are protective factors for mental wellbeing. • Systems dynamics provides a novel model for mapping climate-related drivers of mental wellbeing. [ABSTRACT FROM AUTHOR]