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NUTD 9226: Public Health and Community Nutrition

   

Added on  2020-05-03

28 Pages7044 Words85 Views
Food Nutrition1

Title: Health promotion programme for the reduction of children’s consumption of sugar sweetenedbeverages (SSB) among South Australian Aboriginal and Torres Strait Islander children.Description:In this health promotion programme, educational intervention will be provided to the childrenand parents of South Australian Aboriginal and Torres Strait Islander. It is evident that healthpromotion programmes through educational intervention will be useful in improving healthof the people. Health education will be provided at schools and restriction on theconsumption of SSB will be implemented among these children. Quantity and frequency ofSSB consumption will be recorded. Body weight and body mass index of children will bemeasured. This programme will be implemented for 24 months. This programme will bebeneficial in reducing obesity in children. 2

Evidence of need:Consumption of Sugar-sweetened beverages (SSB) is rising as global health concern andmultiple adverse effects are associated with its consumption. Abundant evidence is availablein the form of systemic reviews and meta analysis to establish exposure and effectrelationship between SSB and obesity. Moreover, it has been observed that SSB is theautonomous risk factor for metabolic disease like type 2 diabetes and cardiovascular diseaseand few cancers and dental caries (Te Morenga et al., 2012; Malik et al., 2013). Asconsumption of SSB is associated with multiple health issues, its magnitude is high on healthand well-being of the person (Malik et al., 2010). Consumption of SSBs is more inAboriginal and Torres Strait Islander people as compared to the other population. Along with obesity, there is high prevalence of metabolic disease in these people. A researchproject entitled ‘Next Step’ identified association between food choices and exposure todiseases as priority research area. This project is applicable throughout Australia and moreemphasis is given to Aboriginal and Torres Strait Islander people. This project has moreimportance because it is a community driven project and importance has been given to theneeds and interests of Aboriginal and Torres Strait Islander people (King and Brown, 2015).Comprehensive intervention for SSB consumption, need to be planned which address atmultiple levels because there is widespread availability of SSB and it is in high demandspecifically in the children. As a result, there high magnitude of negative health impact ofSSB and it is difficult to control by planning small scale or localised intervention. It isevident that people in the lower socio-economic status are more vulnerable to adverse healthconditions as compared to the people in high-socioeconomic status (Pampel et al., 2010). Aboriginal and Torres Strait Islander people belongs to low socio-economic class ascompared to non-indigenous people. In these people, adverse health conditions might be dueto more exposure to behavioural and environmental health risk factors, poor living conditionsand inadequate education. Cultural aspects and racism also have major impact on the healthinequalities among indigenous and non-indigenous people in Australia. Hence, for thesepeople community driven intervention need to be carried out (AHMAC, 2015). As compared to the global context prevalence of obesity is more in Indigenous children. Oneof the prominent reason observed for increased prevalence of obesity is consumption ofrefined carbohydrates like SSB (Singh et al., 2010). There is a biological link between theobesity and consumption of SSB. These SSBs overcome the homeostatic regulatory system3

and it lead to reduced satiety and consequently excessive consumption of energy (Hu, 2013).Hence, Australian Dietary Guidelines recommend to limit consumption of SSB in the formsoft drink and cordial. Australian Medical Association and Public Health Association ofAustralia also addressed importance of intervention to limit consumption of SSB.Intervention measures include heavy taxation of soft drinks, channelling of revenue from saleof soft drinks to preventive measures, ban on sale of soft drinks in schools, ban on promotionand advertising of soft drinks to the children. These efforts are in line with the internationaltrials for reduction in SSB consumption. However, there is scarcity of literature fordescription of SSB consumption based on source, demographic and other dietary habits(NHMRC, 2013; AHMAC, 2015). National Children's Nutrition and Physical Activity Survey (NCNPAS) conducted surveyamong 4,487 children aged between 2 and 16 years. In this survey, it was concluded that SSBintake is high in Australian children and it is the need of hour to implement public healthintervention. In this survey, it was observed that supermarkets are the primary source of SSB.Most of these children consumed these beverages at the home. Inadequate education ofparents and children about the health consequences of SSB consumption are mainlyresponsible for more consumption of SSB among Aboriginal and Torres Strait Islanderchildren. SSB contributed approximately 4 % energy in children of age between 2 – 3yearsold and approximately 7.5 % energy in children between 14-16 years old. Independence inthe children of age 14-16 years old is mainly responsible for more consumption of SSB, eventhough it is evident that approximately 75 % of the children used to consume SSB at home.Previous interventions mainly focused on the fast food for assessing consumption of SSB.Due to recent findings, focus of the intervention should be diverted towards SSBconsumption in supermarket and consumption at home. There is variation among children ofdifferent age group for SSB consumption. Children in age group between 2- 3 years prefersto drink sweetened juice and 2 - 5 years prefers to drink sweetened fruit punch and fruitjuice. Consumption of SSB at the critical phase of growth and development can have majorimpact on the health of child for the rest of life (Hafekost et al., 2011; NCNPAS, 2007). A survey was conducted among Indigenous children and in this survey, it was found thatapproximately 65 % Indigenous children are consuming soft drinks containing SSB and outof this approximately 55 % children are consuming these drinks at home. 85 % of these SSBdrinks are purchased from supermarkets. Both parents and children were incorporated in thissurvey and children between age group 11 – 16 years were the target group. Data was4

collected by using standard questionnaires. It was hypothesized that consumption of SSB canlead to augmentation of cases of obesity in Indigenous children. Based on this hypothesis,protocol was developed to carry out actual health promotion programme. Our hypothesisexhibited similar response to 2007 Australian National, Children’s Nutrition and PhysicalActivity Survey. Following are the sample of questions from the survey:1.How much amount of SSB is present in the soft-drinks ? 2.Whether parents are accompanying children while drinking SSB containing soft-drinks ?3.What is frequency of purchase of soft drinks from supermarkets?4.What is frequency of soft drink consumption at home ?5

Programme Plan : Name of the programme : Health promotion programme for the reduction of children’s consumption of sugar sweetened beverages (SSB) among South Australian Aboriginal and Torres Strait Islander children.Target group : In this study, Aboriginal and Torres Strait Islander children between age group of 2 – 16 years will be selected. 600 childrenwill be selected. Out of these 300 will be enrolled in the intervention group and 300 will be enrolled in the control group. Out of 300 childrenin each intervention and control group, 150 male children and 150 female children will be enrolled. All these children will from the rural areasand they will be within the radius of 100 km because it will be feasible to access each and every child. Written consensus will be taken fromthe family members to avoid purchase of SSBs and use of SSBs for children. Goal : To reduce consumption of SSB food and to control obesity in South Australian Aboriginal and Torres Strait Islander children.Health problem:Excess consumption of SSB is directly proportional to the development ofoverweight and obese children in Aboriginal and Torres Strait Islanderpopulation. Different health and social determinants like socioeconomicstatus, psychological risk factors of the family members, social capital,educational status and lifestyle risk factors are mainly responsible for theoccurrence of obesity in these children (Dickson and Manalo, 2014). Foodprice and parents capability to SSB containing foods are the majordeterminants for more consumption of SSB in aboriginal children. Otherdeterminants include accessibility, marketing exposure and accompanyingpeer influence. Parents of the Aboriginal children are unable to providenutritious and healthy diet and medical treatment to their children due toObjectives : To improve knowledge and awareness of negative impacts ofconsumption of SSB drinks. To reduce the consumption of SSB drinks in boys and girls ofschool going and non-going of age 2 – 16 years in Aboriginalpopulation of South Australia in 24 months duration. 6

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