The rising cost of living is a key barrier to healthy eating and curbing higher obesity rates. Can GPs help?
It is estimated that only 5% of Australians eat the recommended daily intake of fruits and vegetables, while unhealthy food and drinks are believed to make up 35% of daily energy intake for adults and children.
Maintaining a nutritious diet is unquestionably one of the cornerstones of good health, and the benefits of consuming fresh fruit and vegetables is well known to aid prevention of chronic disease.
However, with the rising cost of living in Australia meaning that more people are struggling to afford to eat healthy food, and obesity rates already climbing, health experts are concerned.
The latest Consumer Price Index figures show a 12.7% year-on-year increase for the cost of vegetables, compared to a 2.6% increase for ‘meals out and takeaway foods’.
Ahead of the 21 May Federal Election, the cost of living is rated as the number one concern among Australians, with food, petrol and healthcare prices under the spotlight.
Dr Ella Barclay is Chair of RACGP Specific Interests Obesity Management and is very familiar with the challenges some of her patients face.
‘This is a difficult one because GPs are certainly well positioned to educate their patients on healthy food choices,’ she told newsGP.
‘But at the end of the day, we cannot dictate the price of food and our patients can only buy what they can afford.’
According to Dr Barclay, the role of the GP is integral to the management and prevention of obesity in the community. She wants Australia’s National Obesity Strategy 2022–32 to act as a framework for all healthcare providers.
‘Our key role is placed in empowering our patients through education, shared decision-making using evidence-based medical practice, and lifelong support,’ she said.
‘It is our job to tailor the management of obese and overweight patients by taking a holistic approach ensuring we include their physical, mental and spiritual health in all aspects of the delivery of their care.
‘By taking this approach, we can ensure our patients receive patient-centred care which will enable them to make the best decision they can for their health and wellbeing.’
A key objective of the National Obesity Strategy is to tackle issue of food insecurity, which already impacts one in six adults and 1.2 million children across Australia.
In rural and remote areas, where food insecurity has long plagued communities, takeaway and fast food is often more available and affordable than fresh food supplies. In Aboriginal and Torres Strait Islander communities, up to one in three children do not receive adequate amounts of fruits and vegetables.
Food insecurity, affordability and inadequate intake of a healthy diet are among the many factors contributing to overweight and obesity rates.
Australia ranked fifth among OECD countries for obesity rates in 2017–19, with around one third (31%) of Australian adults living with obesity. Other statistics show that one in four children is overweight or obese.
The picture is similar overseas. The latest World Health Organization European obesity report reveals that an estimated 59% of adults and almost one in three children (29% of boys and 27% of girls) in Europe are now overweight or obese.
Dr Barclay believes the reasons behind the rising global rates are complex and the solutions are ‘many and varied.’
‘Including the interplay of genetics, environmental influences and metabolic adaptation, this needs to be managed taking a multiple-system based approach,’ she said.
More recently, weight gains were reported across Australia during the COVID-19 pandemic.
In Dr Barclay’s practice, she saw many contributing factors among her patients, including social isolation leading to more ‘emotional’ and ‘boredom’ eating, reduced access to gyms and recreational sports during lockdowns resulting in a lack of exercise, and increased alcohol intake.
‘Furthermore, many people faced incredibly stressful times throughout the pandemic including unemployment, worsening mental health and financial uncertainty,’ she said.
‘All of these factors may have led to food insecurity and subsequently higher consumption of cheaper, poorer quality food.
‘These, along with likely many other factors, may have led to energy excess and subsequently weight gain.’
A recently released study tracking the effects of the pandemic on food security in Australia found that existing weaknesses in food supply and security grew. It calls for ‘coordinated national and community responses’ to improve the ‘stability of local food supply and address underlying determinants of food insecurity’.
Healthcare organisations such as Dietitians Australia are also calling on the Federal Government for action by including a National Nutrition Policy in its National Preventive Health Strategy.
They say the policy would provide a framework to ensure equitable and affordable access to nutritious food for all Australians. Following the 21 May election, the Department of Health is expected to release more details on food prices and access through existing initiatives.
The National Obesity Strategy aims to prevent the rise and reverse the trend in the prevalence of obesity in adults by 2030 and reduce the number of overweight and obese children and adolescents by at least 5% by 2030.
According to the strategy, this can be achieved through implementing a strong, healthy and equitable food and physical activity system, and settings that support healthy behaviours, through population-level interventions and reducing weight stigma.
Through the implementation of evidence-based approaches, the strategy aims to achieve three key ambitions:
- creating supportive, sustainable and healthy environments
- empowering people to stay healthy
- access to early intervention and care.
Despite the complexity of the issue and long-term solutions, Dr Barclay said the strategy is ‘crucial’ in contributing to the world-wide prevention of obesity and overweight over the next 10 years.
‘It discusses the importance of changing our food system to favour access to healthy food and drinks,’ she said.
‘Once this changes at a national level we will likely see a reduction in consumption of unhealthy and processed foods in favour of more accessible and affordable healthy foods and drinks.’
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