ANF guidelines for healthy food choices

The Australian Nutrition Foundation (ANF) was one of the first community service organisations to work with food industry , having pioneered the concept of corporate membership since its inception in 1982. ANF has worked closely and successfully with industry - the development of the ANF Food Selection Guidelines for Children and Adolescents is one example of this collaboration. While the guidelines were initially developed for use in school canteens, they can be used in a range of institutions where caterers wish to have tender specifications for purchase of healthy food for children and adolescents.

Food literacy

The term 'food literacy' is increasingly being used to describe the knowledge, skills and behaviours needed to feed yourself. In the last five years the use of this specific term has more than tripled in the research literature. The term is now commonly used in food and nutrition policy(Department of Agriculture Fisheries and Forestries, 2013; Glickman, Parker, Sim, Del Valle Cook, & Miller, 2012; Vandenbroeck, Goossens, & Clemens, 2007) and by a range of different industries, including, health, education and sustainable agriculture (Colatruglio, 2015; Piscopo, 2015; Voget-Kleschin, 2014). This article will look at what has led to the emergence of this term and then go on to define it based on the author's own PhD research which involved two studies, one of food experts and one of 16-25 year olds which aimed to identify the components of food literacy.

Food literacy: Definitions, components, learning and links to diet and health outcomes

Recently, the term ‘food literacy’ has emerged in policy, research and practice to describe the collection of knowledge, skills and behaviours required to practically meet food needs. This presentation will described research undertaken to empirically define the term and propose its impact on nutrition

Improving food supply

Improving the availability, accessibility and affordability of healthy food equitably is fundamental to improving nutrition and health. While theoretical models abound, in real world complex systems rarely are there opportunities to address leverage points systematically to improve food supply. This presentation describes efforts over the last 30 years to do just that by remote Australian Aboriginal communities, where a single community store is usually the major dietary source. Areas addressed include store governance and infrastructure, wholesale supply, transport and pricing policies including cross-subsidization. However, while there have been dramatic improvements in the availability, quality and price of fruit, vegetables and most other healthy foods over this time, the proportion of communities' energy intake from energy-dense nutrient-poor foods and drinks has increased. One cause may be the disproportionate increase in supply of unhealthy choices in terms of variety and shelf-space, consistent with changes in the food supply in broader Australia. The impact of changing social and environmental factors, food preferences and price elasticity will also be explored briefly. Clearly much more needs to be done to reduce the high prevalence of diet-related chronic disease in some vulnerable groups. In particular, efforts to continually improve the availability and affordability of healthy food also need to address the predominance of unhealthy choices in the food supply.

Introduction: Food literacy for contemporary food and eating

This chapter provides an introduction to the term “food literacy”. Its use in the literature, policy and practice, implies that the term is an attempt to encapsulate the knowledge, skills and behaviours needed for everyday eating. This chapter will first review the use of the term in policy and practice, then go on to review what is known about contemporary food and eating and its influence on the emergence of this term and conclude with an overview of the key ideas to be explored in this book.

A definition of food literacy and its components

This chapter defines food literacy and its components using the empirical data collected in two studies undertaken in 2010 and 2011 as part of the author’s PhD thesis. The first was a Delphi study of Australian food experts and the second was a study of young adults across a spectrum of disadvantage. Defining food literacy and identifying its components was an iterative process. At different times throughout the research, each study informed the other. This chapter will describe the components of food literacy, the data used to identify them and how they combined to produce a definition of food literacy.

The development of food literacy

This is the first of four chapters examining the development of food literacy. It reports the findings of the Young People Study, described in earlier chapters. Participants reflected on the evolution of their food and eating style. They describe this at the individual level but in doing so discuss the interplay between other key institutions of health, education and community organisations. These results are considered alongside learning and development theory to propose how food literacy develops, including the role of individuals, households, communities and nations, and their influence to each other.

Food literacy: Key concepts and the elephants in the room

This chapter summarizes the content of this book. It identifies key issues that require further investigation and development. It re-enforces key concepts.

Food Literacy: Key Concepts for Health and Education

Globally, the food system and the relationship of the individual to that system, continues to change and grow in complexity. Eating is an everyday event that is part of everyone’s lives. There are many commentaries on the nature of these changes to what, where and how we eat and their socio-cultural, environmental, educational, economic and health consequences. Among this discussion, the term "food literacy" has emerged to acknowledge the broad role food and eating play in our lives and the empowerment that comes from meeting food needs well. In this book, contributors from Australia, China, United Kingdom and North America provide a review of international research on food literacy and how this can be applied in schools, health care settings and public education and communication at the individual, group and population level. These varying perspectives will give the reader an introduction to this emerging concept. The book gathers current insights and provides a platform for discussion to further understanding and application in this field. It stimulates the reader to conceptualise what food literacy means to their practice and to critically review its potential contribution to a range of outcomes.

A nutrition and physical activity intervention for family child care homes

Background Family child care homes (FCCHs) provide child care to 1.9 million children in the U.S., but many do not meet established child care standards for healthy eating and physical activity. Purpose To determine the effects of a community-based train-the-trainer intervention on FCCHs policies and practices related to healthy eating and physical activity. Design Quasi-experimental design with replication in three independent cohorts of FCCHs. Setting/participants Registered FCCHs from 15 counties across Kansas participated in the Healthy Kansas Kids (HKK) program. Resource and referral agencies (RRAs) in each county recruited and enrolled between five and 15 child care providers in their service delivery area to participate in the program. The number of registered FCCHs participating in HKK in Years 1 (2006-2007); 2 (2007-2008); and 3 (2008-2009) of the program were 85, 64, and 87, respectively. A stratified random sample of registered FCCHs operating in Kansas (n=297) served as a normative comparison group. Interventions Child care trainers from each RRA completed a series of train-the-trainer workshops related to promotion of healthy eating and physical activity. FCCHs were subsequently guided through a four-step iterative process consisting of (1) self-evaluation; (2) goal setting; (3) developing an action plan; and (4) evaluating progress toward meeting goals. FCCHs also received U. S. Department of Agriculture resources related to healthy eating and physical activity. Main outcome measures Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) self-assessment instrument (NAP SACC-SA). Analyses of outcome measures were conducted between 2008 and 2010. Results Healthy Kansas Kids FCCHs exhibited significant improvements in healthy eating (Delta=6.9%-7.1%) and physical activity (Delta=15.4%-19.2%) scores (p<0.05). Within each cohort, pre-intervention scores were not significantly different from the state average, whereas post-intervention scores were significantly higher than the state average. Conclusions Community-based train-the-trainer interventions to promote healthy eating and physical activity in FCCHs are feasible, sustainable, and effective.

Cost-effectiveness of an intervention to reduce emergency re-admissions to hospital among older patients

Background. The objective is to estimate the cost-effectiveness of an intervention that reduces hospital readmission among older people at high risk. A cost-effectiveness model to estimate the costs and health benefits of the intervention was implemented. Methodology/Principal Findings. The model used data from a randomised controlled trial conducted in an Australian tertiary metropolitan hospital. Participants were acute medical admissions aged >65 years with at least one risk factor for readmission: multiple comorbidities, impaired functionality, aged >75 years, 30 recent multiple admissions, poor social support, history of depression. The intervention was a comprehensive nursing and physiotherapy assessment and an individually tailored program of exercise strategies and nurse home visits with telephone follow-up; commencing in hospital and continuing following discharge for 24 weeks. The change to cost outcomes, including the costs of implementing the intervention and all subsequent use of health care services, and, the change to health benefits, represented by quality adjusted life years, were estimated for the intervention as compared to existing practice. The mean change to total costs and quality 38 adjusted life years for an average individual over 24 weeks participating in the intervention were: cost savings of $333 (95% Bayesian credible interval $-1,932:1,282) and 0.118 extra quality adjusted life years (95% Bayesian credible interval 0.1:0.136). The mean net41 monetary-benefit per individual for the intervention group compared to the usual care condition was $7,907 (95% Bayesian credible interval $5,959:$9,995) for the 24 week period. Conclusions/Significance. The estimation model that describes this intervention predicts cost savings and improved health outcomes. A decision to remain with existing practices causes unnecessary costs and reduced health. Decision makers should consider adopting this 46 program for elderly hospitalised patients.

What works elsewhere? A review of physical activity intervention studies

Obesity and type 2 diabetes mellitus (T2D) have reached epidemic proportions in many parts of the world with numbers projected to rise dramatically in coming decades (Wang and Lobstein, 2006; Zaninotto et al., 2006). In Australia, and consistent with much of the developed world, the problem has been described as a ‘juggernaut’ that is out of control (Zimmet and James, 2007). Unfortunately the burgeoning problem of non-communicable diseases, including obesity and T2D, is also impacting developing nations as populations are undergoing a nutrition transition (Caballero, 2005). The increased prevalence of overweight and obesity in children, adolescents and adults in both the developed and developing world is consistent with reductions in all forms of physical activity (Brownson et al., 2005). This brief paper provides an overview of the importance of physical activity and an outline of physical activity intervention studies with particular reference to the growing years. As many interventions studies involving physical activity have been undertaken in the context of childhood obesity prevention (Lobstein et al., 2004), and an increasing proportion of the childhood population is overweight or obese, this is a major focus of discussion.

Randomised controlled trial of an automated, interactive telephone intervention to improve type 2 diabetes self-management (Telephone-Linked Care Diabetes Project) : study protocol

Background: An estimated 285 million people worldwide have diabetes and its prevalence is predicted to increase to 439 million by 2030. For the year 2010, it is estimated that 3.96 million excess deaths in the age group 20-79 years are attributable to diabetes around the world. Self-management is recognised as an integral part of diabetes care. This paper describes the protocol of a randomised controlled trial of an automated interactive telephone system aiming to improve the uptake and maintenance of essential diabetes self-management behaviours. ---------- Methods/Design: A total of 340 individuals with type 2 diabetes will be randomised, either to the routine care arm, or to the intervention arm in which participants receive the Telephone-Linked Care (TLC) Diabetes program in addition to their routine care. The intervention requires the participants to telephone the TLC Diabetes phone system weekly for 6 months. They receive the study handbook and a glucose meter linked to a data uploading device. The TLC system consists of a computer with software designed to provide monitoring, tailored feedback and education on key aspects of diabetes self-management, based on answers voiced or entered during the current or previous conversations. Data collection is conducted at baseline (Time 1), 6-month follow-up (Time 2), and 12-month follow-up (Time 3). The primary outcomes are glycaemic control (HbA1c) and quality of life (Short Form-36 Health Survey version 2). Secondary outcomes include anthropometric measures, blood pressure, blood lipid profile, psychosocial measures as well as measures of diet, physical activity, blood glucose monitoring, foot care and medication taking. Information on utilisation of healthcare services including hospital admissions, medication use and costs is collected. An economic evaluation is also planned.---------- Discussion: Outcomes will provide evidence concerning the efficacy of a telephone-linked care intervention for self-management of diabetes. Furthermore, the study will provide insight into the potential for more widespread uptake of automated telehealth interventions, globally.