Aboriginal and Torres Strait Islander Nutrition †MyAssignmenthelp

Question: Discuss about the Aboriginal and Torres Strait Islander Nutrition. Answer: Introduction: Obesity is a condition that is shown by an very high or unhealthy amount of body fat, which is considered to have adverse health effetcs. It is caused when more calories are consumed than is expended and can be a result of genetic abnormalities, overeating, consumption of food high in fats and inadequate physical activity (Medlineplus.gov, 2018). Presence of obesity is usually measured by calculating the body mass index of individuals (which is the ratio of weight (kg) and the square of the height in (m)), and a BMI above 30kg/m2 is considered obese (Mitchell et al., 2011). Table 1 below shows the types of BMI and their health risk compared to healthy body weight and waist diameter. As per to the Australian Institute of Health and Welfare, obesity is a major public health concern among the leading health risks of Australians, with 63% of adults are either overweight or obese (as of 2014-15) and is found to be more common among indigenous Australians (aihw.gov.au, 2018). Australian Obesity Statistics also shows that 10% of Australians are severely obese and 70% of obese adults are suffering from related health conditions which increases the national health costs by 30% (eatingdisordersaustralia.org.au., 2018). The incidence of obesity is also higher among males (28.4%) than females (27.4%), with an increasing trend (18.9% in 1995 to 27.4% in 2014/15), showing highest prevalence among regional and remote areas (69.2%) and disadvantaged status (66.4%) as shown in the figures below. Obesity among Indigenous Australian population According to the 2012-13 Health Survey by Australian Government on Aborigines and Torres Strait Islanders, it was found that obesity is one of the leading causes of morbidity and mortality in these populations, and 1.6 times more likely to be suffering from obesity, compared to non-indigenous Australians (Pmc.gov.au, 2018). Figure 5 below shows how obesity is more common in the indigenous Australians compared to non indigenous Australians. Figure 6 shows that native/indigenous children between 2-14 years have 2% higher chance of being overweight and 3% of being obese. Figure 7 shows that that the incidence of obesity is consistently high among all adult age groups compared to non indigenous population, with the highest gap in the age group of 18-24, in which indigenous adults are 19% more prone to obesety compared to non-indigenous counterparts in the same age group. This highlights an overall higher health risks faced by the indigenous populations and the necessity to study measures to reduce the risks The selected population form the health promotion plan is the Aboriginal community is Australia. The selected age group can be children (between 2-14 years) and young adults (between 18-24 year) all of whom have the highest probabilities of obesity, as per the statistics. The World Health Organization identifies the different social determinants of health as: social exclusion, employment conditions, public health programs, early childhood development, women and gender equality, globalization, health system performance and urbanization (who.int, 2018). Studies by Sartorius et al. (2015) studied the different social determinants of health related to obesity. The study found that ethnicity, gender, socio-economic status, dietary intake, physical inactivity, educational status and even marriage can affect the probability of obesity. Health Risks of Obesity: The health risks of obesity includes: coronary cardiac disease, hypertension, type 2 diabetes, gall bladder stone, pulmonary problems and cancer (ncbi.nlm.nih.gov, 2018). Other health risks include: cardiac disease and stroke, osteoarthritis, sleep apnea, fatty liver disease and problems during pregnancy (increasing the risk of a c-section delivery). The types of cancer that can occur because of obesity includes: breast cancer, colon/rectum cancer, endometrial cancer, gallbladder cancer, and kidney cancers (niddk.nih.gov, 2018). Among the indigenous populations, the risks of nutrition related chronic health problems are much higher than the general population, and obesity is one of the main risks of morbidity and mortality (healthinfonet.ecu.edu.au, 2018). Different factors are considered to contribute to obesity risks among the indigenous population in Australia that has a complex interplay. Even though the risk of the development of an obesogenic environment prevails through Australia, the problem gets complicated in the indigenous groups due to different geographical, social, economic and infrastructure related factors which affects the availability and choice of food (Lakerveld et al., 2017; ist.psu.edu, 2018) . Other contributors are considered to be: historical, social, geographical, economic, and infrastructure factors which might contribute for the obesity problems in the indigenous Australian population, apart from the genetic factors that also contributes to it (Qasim net al., 2018; healthinfonet.ecu.edu.au, 2018). The genetic risks can be explained by the thrifty genotype hypothesis by Neel (1999). The theory proposes that due to a hunter gatherer lifestyle of certain populations, they have developed insulin resistance to ad apt to the feast and famine conditions. Due to this, an environment with plenty of food and a lack of physical activity can lead to rapid obesity rates. Insulin resistance also is linked to syndrome X, which is a metabolic disorder which further increases risks of obesity (Meigs et al., 2015). Indigenous populations that are exposed to the westernized lifestyle are considered to be more vulnerable to syndrome X. Lifestyle factors like change in diet is also implicated as a risk for obesity (Knibbs Sly, 2014). Since the European occupation, the traditional diet (with low glycemic index) of indigenous population was replaced with diet rich in saturated fats and refined carbohydrates (ist.psu.edu, 2018). The shift from hunter-gatherer lifestyle to a westernized one, and well as the prevalence of unemployment also resulted in a more sedentary lifestyle and limited physical activities (Hughes Kumari, 2017; Haifi et al., 2016). Access to healthy food in remote areas, and higher costs of healthy food, compared to fast food are also significant contributors of obesity among the indigenous populations. Studies have shown that the largest contributors of fat intake were through the consumption of diet high on fat, energy and sugar (Barlow et al., 2016; Imamura et al., 2015). The consumption of sugar sweetened beverages is also higher (4 times the recommended intake) among Aboriginal population compared to non-indigenous populations. Additionally, poverty, high cost of food, poor quality of food in the community stores also increases the prevalence of obesity in this group (NACCO, 2012; Lee et al., 1994; Trewin Madden, 2005; Shannon, 2002; Healthinfonet.ecu.edu.au, 2018; ist.psu.edu, 2018). Informing an effective health promotion and wellness strategy: The Ottawa charter outlines the strategy for health promotion. It considers different conditions as necessities for health and wellbeing, like peace, shelter, education, food, income, stable eco-system, sustainable resource, social justice and equity. Furthermore, improvement in health outcomes requires health advocacy, enable control of individuals over factors that affect their health and mediation of the activities of health promotion (World Health Organization, 2018). In the frameworks of wellbeing, several components are outlined like population, family and community, health, education and training, work, economic resources and housing (Abs.gov.au, 2018). Measurement of wellbeing is a large task that includes the spectrum of birth to death, and encompasses people in a dynamic culture which consists of the natural environment, artificial environment, social arrangements, and human consciousness. The overall wellbeing of people depends on the factors which interact within this culture. The wellbeing is therefore measured by mapping the whole life of an individual and identifying contexts or events that can affect the quality of life, and the wellbeing equation becomes a function of the social, material and natural environments surrounding the individuals (Abs.gov.au, 2018). Care strategies needs to address the frameworks of wellbeing and incorporate the ability to measure it. How the strategies can be used in the improvement of health outcome of the selected population. Improvement in the health outcomes of the selected population can be addressed by the determinants of health that increases the risks of obesity among the indigenous Australian population (Greenwood et al., 2015). Addressing aspects like education and training, work and involving community based action can be suggested (based on the frameworks of wellbeing) which can improve their well being. The proposed strategy can be based upon the structure of the Australian Healthy Weight 2008 initiative that incorporates community wide education, community demonstrations, monitoring evidence as well as performance, coordination and building of capacity. The National Health and Medical Research council designed guidelines for clinical practice to manage the problem of obesity among children and adolescents and adults. The Eat Well Australia action plan published by Strategic Inter-Governmental Nutrition Alliance (SIGNAL) and Dietary Guidelines for Australian Adults, published in 2003, provides specific strategies for the prevention of excess weight gain and monitors the intake of fat and sugar. Be Active Australia plan involves strategies for community education and communication as well as increase of the capacity of workforce, research, monitoring, evaluation, strategic management and coordination. These frameworks mainly highlight the necessity of improving nutrition and control of obesity. Weight loss can also be achieved through the reduction of dietary intake, however long term strategies also should involve changes in behaviour with respect to diet and physical activity. Food purchasing habits should also be addressed in the nutrition intervention and education through the community based programs. Proposed health promotion strategy Based on such aspects, my health promotion plan will include specific aspects from the Ottawa Charter and the frameworks of wellbeing as given below: Education and training of the members of community regarding the risks and health effects of obesity Supporting the individuals to make healthy choice of diet, and providing information on healthy and unhealthy diet Supporting the community members in the engagement in physical activities Helping the community members to have adequate access to healthy food, and limiting access to unhealthy food (like sugar sweetened beverages and die high in saturated fats) Regular monitoring of the health status of the community members, particularly of obese individuals for early signs of health risks Planning interventions for individuals at high risks of co morbidity and supporting them for behavioural or lifestyle changes Supporting the community members to get choose more traditional lifestyle and diet. 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