Search

OBJECTIVE: To examine the associations between financial, physical and transport conditions that may restrict food access (which we define as food security indicators) and the purchase of fast foods and nutritious staples such as bread and milk. DESIGN: Multilevel logistic and multinomial regression analysis of cross-sectional survey data to assess associations between the three indicators of food insecurity and household food shopping adjusted for sociodemographic and socio-economic variables. SETTING: Random selection of households (n 3995) from fifty Census Collector Districts in Melbourne, Australia, in 2003. SUBJECTS: The main food shoppers in each household (n 2564). RESULTS: After adjustment for confounders, analysis showed that a greater likelihood of purchasing chain-brand fast food on a weekly basis compared with never was associated with running out of money to buy food (OR = 1·59; 95 % CI 1·08, 2·34) and reporting difficulties lifting groceries (OR = 1·77; 95 % CI 1·23, 2·54). Respondents without regular access to a car to do food shopping were less likely to purchase bread types considered more nutritious than white bread (OR = 0·75; 95 % CI 0·59, 0·95) and milk types considered more nutritious than full-cream milk (OR = 0·62; 95 % CI 0·47, 0·81). The food insecurity indicators were not associated with the purchasing of fruits, vegetables or non-chain fast food. CONCLUSIONS: Householders experiencing financial and physical barriers were more likely to frequently purchase chain fast foods while limited access to a car resulted in a lower likelihood that the nutritious options were purchased for two core food items (bread and milk). Policies and interventions that improve financial access to food and lessen the effect of physical limitations to carrying groceries may reduce the purchasing of fast foods. Further research is required on food sou

This thesis examined the influences on physical activity, sedentary behaviour and overweight and obesity among a sample of Chinese-Australian and Anglo-Australian adolescents. The results found no significant difference in rates of overweight and obesity; however, lower engagement in daily light-intensity physical activity and greater sedentary participation was revealed among Chinese-Australian adolescents.

Objective: To describe associations between demographic and individual and arealevel socio-economic variables and restricted household food access due to lack of money, inability to lift groceries and lack of access to a car to do food shopping. Design: Multilevel study of three measures of restricted food access, i.e. running out of money to buy food, inability to lift groceries and lack of access to a car for food shopping. Multilevel logistic regression was conducted to examine the risk of each of these outcomes according to demographic and socio-economic variables. Setting: Random selection of households from fifty small areas in Melbourne, Australia, in 2003. Subjects: The main food shoppers in each household (n 2564). Results: A lack of money was significantly more likely among the young and in households with single adults. Difficultly lifting was more likely among the elderly and those born overseas. The youngest and highest age groups both reported reduced car access, as did those born overseas and single-adult households. All three factors were most likely among those with a lower individual or household socio-economic position. Increased levels of area disadvantage were independently associated with difficultly lifting and reduced car access. Conclusions: In Melbourne, households with lower individual socio-economic position and area disadvantage have restricted access to food because of a lack of money and/or having physical limitations due difficulty lifting or lack of access to a car for food shopping. Further research is required to explore the relationship between physical restrictions and food access.

Background : Evidence suggests that differences exist in physical activity (PA) participation among Culturally and Linguistically Diverse (CALD) children and adolescents. It is possible that these differences could be influenced by variations in measurement technique and instrument reliability. However, culturally sensitive instruments for examining PA behaviour among CALD populations are lacking. This study tested the reliability of the Child and Adolescent Physical Activity and Nutrition Survey (CAPANS-PA) recall questionnaire among a sample of Chinese-Australian youth. Methods : The psychometric property of the CAPANS-PA questionnaire was examined among a sample of 77 Chinese-Australian youth (aged 11 - 14 y) who completed the questionnaire twice within 7 days. Test-retest reliability of individual items and scales within the CAPANS-PA questionnaire was determined using Kappa statistics for categorical variables and intraclass correlation coefficients (ICC) for continuous variables. Results : The CAPANS-PA questionnaire demonstrated acceptable test-retest reliability for frequency and duration of time spent in weekly Moderate to Vigorous Physical Activity (MVPA) (ICC ≥ 0.70) for all participants. Test-retest reliability for time spent in weekly sedentary activities was acceptable for females (ICC = 0.82) and males (ICC = 0.72). Conclusions : The results suggest the CAPANS-PA questionnaire provides reliable estimates for type, frequency and duration of MVPA participation among Chinese-Australian youth. Further investigation into the reliability of the sedentary items within the CAPANS-PA is required before these items can be used with confidence. This study is novel in that the reliability of instruments among CALD groups nationally and internationally remains sparse and this study contributes to the wider body of available psychometrically tested instruments. In addition, this study is the first to our knowledge to su

Objective: To document patterns of measured weight and waist circumference (WC) change and the increase in overweight and obesity over a 9-year period. Subjects/Methods: A total of 1044 subjects from two age-defined cohorts aged 39 and 59 in 1991. Height, weight and WC were measured in 1991, 1995 and 2000 and body mass index (BMI) was calculated. Pattern of weight and WC change was studied over approximately 9 years. Results: The prevalence of overweight and obesity increased markedly and the younger cohort showed greater increases in weight and WC than the older cohort. There was no significant difference in mean BMI and/or mean 9-year weight change between men and women in either age cohort, and mean weight gain was similar for all occupational groups. Only 20% of subjects maintained a stable weight (plusminus2 kg), while 42.2 and 17.6% gained greater than 5 and 10 kg over the 9-year period, respectively. The rate of weight gain appeared to be relatively steady over the 9 years among younger subjects but declined in the older subjects in the second half of the observation period. Conclusions: Health promotion strategies to prevent weight gain need to be population-based, targeting all social and age groups, but particularly those in their early middle-age.

Economic factors are important determinants of food security. In terms of food access, financial resources determine an individual’s ability to procure food; on the supply side, the cost of food is equally important. The interplay of these two factors, financial resources and cost, is perhaps the most immediate and important determinant of what people do (or do not) put into their shopping trolleys or purchase at the takeaway and ultimately eat – if you cannot afford it you cannot eat it even if you want to!

The Fresh Kids programme utilized the Health Promoting Schools (HPSs) framework to design a whole-of-school, multifaceted intervention targeting specific behaviours to promote healthy eating and reduce the risk factors associated with childhood obesity. The aim of the programme was to evaluate the effectiveness of the HPS framework to increase fruit and water consumption among primary school-aged children over a 2-year period. The study design was an interrupted time series. Four primary schools in the inner west of Melbourne, Australia, participated in the programme intervention. Baseline data were collected using a lunch box audit to assess the frequency of children with fresh fruit, water and sweet drinks, either brought from home or selected from canteen lunch orders. The lunch box audit was repeated periodically for up to 2 years following programme implementation to assess the sustainability of dietary changes. Across all participating schools, significant increases between 25 and 50% were observed in the proportion of children bringing fresh fruit. Similarly, all schools recorded increases between 15 and 60% in the proportion of students bringing filled water bottles to school and reductions between 8 and 38% in the proportion of children bringing sweet drinks. These significant changes in dietary patterns were sustained for up to 2 years following programme implementation. Targeting key nutrition behaviours and using the HPS framework is an effective and simple approach which could be readily implemented in similar childhood settings. Effective strategies include facilitating organizational change within the school; integrating curriculum activities; formalizing school policy and establishing project partnerships with local community nutrition and dietetic services.

Objective: (i) To describe sub-Saharan African (SSA) post-migration food habits and eating patterns; and (ii) to examine how the food habits of SSA households in Victoria reflect post-migration acculturation. Design: A cross-sectional survey using a snowball sampling technique. Data on food habits and eating patterns were obtained using semi-structured, face-to-face interviews from November 2001 to April 2002. Subjects: A total of 139 households of demographically diverse recent migrants from across sub-Saharan Africa. Setting: Melbourne metropolitan and Melbourne fringes. Analysis: Data were summarised using descriptive statistics. Results: SSA migrants and refugees indicated dietary acculturation characterised by three processes: substitution, supplementation and modification of recipes. They experienced difficulty locating their traditional foods, in particular, African vegetables (34.2%), unprocessed maize meal (29.1%), camel milk (23.1%) and maize grain (13.7%). The new foods adopted since arrival were pizza, breakfast cereals and fast foods, but also included new fruits and vegetables. Takeaway food such as Pizza Hut or McDonalds featured prominently in the SSA post-migration diet. Reasons for eating out were favourite food (48.3%), routine family outing (38.3%), special occasion (33.3%) and no time to cook (25%). A significant change in meal pattern was the inclusion of breakfast, although 21% reported skipping breakfast. Conclusion: Many of the observed dietary changes were not consistent with good health and may predispose this population to rapid weight gain and chronic disease. Rapid modernisation and the Anglo-Australian culture interact in a complex way with traditional eating and socialisation practices of SSA migrants. Understanding these forces can allow effective health promotion and community development strategies to be developed for the future health of SSA migr

Background There is a popular belief that out-of-home eating outlets, which typically serve energy dense food, may be more commonly found in more deprived areas and that this may contribute to higher rates of obesity and related diseases in such areas. Methods We obtained a list of all 1301 out-of-home eating outlets in Glasgow, UK, in 2003 and mapped these at unit postcode level. We categorised them into quintiles of area deprivation using the 2004 Scottish Index of Multiple Deprivation and computed mean density of types of outlet (restaurants, fast food restaurants, cafes and takeaways), and all types combined, per 1000 population. We also estimated odds ratios for the presence of any outlets in small areas within the quintiles. Results The density of outlets, and the likelihood of having any outlets, was highest in the second most affluent quintile (Q2) and lowest in the second most deprived quintile (Q4). Mean outlets per 1,000 were 4.02 in Q2, 1.20 in Q4 and 2.03 in Q5. With Q2 as the reference, Odds Ratios for having any outlets were 0.52 (CI 0.32–0.84) in Q1, 0.50 (CI 0.31 – 0.80) in Q4 and 0.61 (CI 0.38 – 0.98) in Q5. Outlets were located in the City Centre, West End, and along arterial roads. Conclusion In Glasgow those living in poorer areas are not more likely to be exposed to out-of-home eating outlets in their neighbourhoods. Health improvement policies need to be based on empirical evidence about the location of fast food outlets in specific national and local contexts, rather than on popular 'factoids'.

Introduction: The burden of chronic diseases is rapidly increasing worldwide. In  Australia rural populations have a greater burden of disease. Chronic diseases are largely preventable with diet as a key risk factor. With respect to diet-related chronic disease, dietary risk may be due to poor food access, namely, poor availability and/or the high cost of healthy food. It is likely that poor food access is an issue in rural areas. Objective: To assess food access in rural south-west (SW) Victoria, Australia. Methods: A total of 53 supermarkets and grocery stores in 42 towns participated in a survey of food cost and availability in the rural area of SW Victoria. The survey assessed availability and cost of a Healthy Food Access Basket (HFAB) which was designed to meet the nutritional needs of a family of 6 for 2 weeks. Results: Seventy-two percent of the eligible shops in SW Victoria were surveyed. The study found that the complete HFAB was significantly more likely to be available in a town with a chain-owned store (p<0.00). The complete HFAB was less likely to be available from an independently owned store in a town with only one grocery shop (p<0.004). The average cost of the HFAB across SW Victoria was AU$380.30 ± $25.10 (mean ± SD). There was a mean range in difference of cost of the HFAB of $36.92. In particular, high variability was found in the cost of fruits and vegetables. Conclusions: Cost and availability of healthy food may be compromised in rural areas. Implications: Improvements in food access in rural areas could reduce the high burden of disease suffered by rural communities.

Describes adults' perceptions and beliefs about foods that are considered "fattening". Use of qualitative and quantitative methods to determine the prevalence of the perceptions among adults; Range of factors that are considered when judging foods as "fattening"; Limitations in the public's understandings of "fattening foods" which are inconsistent with dietary recommendations.

Objective: To determine the proportion of energy from foods prepared outside the home (FPOH) and the relationships with energy and nutrient intakes and body mass index (BMI). Design: A nutrition survey of a representative sample of the Australian population aged 18 years and over (n = 10 863). Measure used was a 24-hour dietary recall. Underreporters (energy intake/estimated basal metabolic rate (EI/BMR) <0.9) were excluded from analysis. Daily energy and selected nutrient intakes were calculated using a 1996 nutrient composition database for all foods/beverages during the 24-hour period. Results: On average FPOH contributed a significant 13% to total energy intake. About a third of the sample had consumed FPOH in the last 24 hours and on average this group consumed a third of their total energy as FPOH. The relative contributions of fat (for men and women) and alcohol (for women) were significantly higher for those in the top tertile of FPOH consumers. The intakes of fibre and selected micronutrients (calcium, iron, zinc, folate and vitamin C) were significantly lower in this group. After adjustment for age and income no relationship between FPOH and BMI was observed. Conclusions: FPOH make a significant contribution to the energy intake of a third of the Australian population. FPOH contribute to poor nutritional intakes. Altering the supply of FPOH may be an effective means of improving diets at a population level.

OBJECTIVES: (1) To study the relationship between quality of life (QoL) and measured and perceived weight and dieting history in Dutch men and women; (2) to assess the effect of weight loss over a 5 y period on QoL. DESIGN: A cross-sectional study, in a sub-sample longitudinal over 5 y. SUBJECTS: A total of 2155 men and 2446 women, aged 20-59 and recruited from the general population from three towns in The Netherlands. MEASUREMENTS: Body weight, height, self-administered questionnaire including questions concerning demographic variables and weight loss practices as part of the Dutch Monitoring project on Risk Factors for Chronic Disease (MORGEN). The Rand-36 questionnaire was used as the QoL measure. RESULTS: In men, measured overweight (body mass index, BMI>25 kg=m2) was not associated with any dimension of QoL after adjustment for age, educational level and perceived overweight. Perceived overweight was related to reduced scores for general health and vitality. This relationship was independent of measured obesity. A history of repeated weight loss was associated with reduced scores for role functioning due to both physical and emotional problems. In women, measured overweight was significantly associated with lower scores for five out of eight QoL dimensions and perceived overweight with three: general health, vitality and physical functioning. A history of frequent weight loss was related to significantly reduced scores in six dimensions. However, only with history of frequent weight loss, and uniquely in women, was there a significant reduction in scores on mental health and limited emotional role functioning. Measured and perceived overweight and frequent weight loss were all related to reduced scores for physical functioning. Longitudinal data indicate that in older women weight gain of 10% body weight or more was associated with a significant deterioration in QoL.