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Indigenous child health improves when fruit and veg are cheap: study

Providing subsidised fruit and vegetable scheme to low-income Indigenous families in northern New South Wales improves children’s…

Providing a subsidised fruit and vegetable box to Indigenous families improved child health outcomes, the study showed. AAP Image/Tara Ravens

Providing subsidised fruit and vegetable scheme to low-income Indigenous families in northern New South Wales improves children’s health and significantly reduces antibiotic use, a new study has found.

The new findings, published in the Medical Journal of Australia, showed that eating fruit and vegetables improved the children’s levels of haemoglobin, reduced emergency department attendances and hospital visits for illness.

The researchers analysed data from health assessments, audits and blood testing of children aged 17 years and under from 55 families who attended three Aboriginal community-controlled health services and received a weekly box of subsidised fruits and vegetables.

The participants were assessed 12 months before the program and again 12 months later, between December 2008 and September 2010.

The results of this study showed that the children’s haemoglobin levels significantly increased and the level of prescriptions of oral antibiotics markedly decreased compared to the year previous to the program. However iron deficiency and anaemia did not change significantly.

“There were definitely positive short-term health outcomes and, from our perspective, we observed children’s health was better on this program, as they were sick less often and required less antibiotics,“ said the lead author of the study, Dr Andrew Black, from the University of South Australia’s School of Population Health.

“I think the nutritional impacts of eating more fruit and vegetables have broader health impacts in the long term but that’s definitely something we’re interested in, the sustainability of this approach.”

Dr Black said that for all the families involved in the study, the cost of fresh produce is a barrier to consumption of adequate daily fruit and vegetables.

“For a proportion of these families, who are struggling generally with issues in their lives, providing subsidised food isn’t adequate by itself. There are a lot more challenges than making food cheaper for those families, but it’s an important step and helps a significant number of people,” he said.

Dr Black said that “families lined up to participate” in the program.

“They saw value in it and that enthusiasm is wonderful and it is potentially useful for health policy decision-makers to see the importance in this,” he said.

Filling foods

Professor Amanda Lee, an indigenous nutrition expert from the Queensland University of Technology said the study showed that “it’s clear we are losing the battle to improve nutrition in indigenous communities.”

“We need more innovative solutions and fiscal interventions, particularly subsidisation of healthy foods, show a lot of promise.”

Professor Lee said that objective measured data in remote communities showed that Aboriginal and Torres Strait Islander people may eat less than one serve a day of fruit or vegetables.

“People know what to do but they can’t access the fruit and vegetables, they cant afford them or they are not available,” said Professor Lee, who was not involved in the study.

“Fruit and vegetables are quite expensive in rural and regional communities, about 30% more. When people are hungry and they don’t have enough food, you buy food that will fill you up and fruit and vegetables don’t always do that. People are buying take-away, deep fried foods and bread to fill them up because they are hungry.”

Julie Brimblecombe, Senior Research Fellow at Menzies School of Health Research said that the study was unique in that it was initiated and driven by an Aboriginal controlled health service.

However, she said more needs to be done to assess the feasibility of this scheme being implemented on a large scale.

“There is compelling evidence that improved diet is associated with improved health outcomes, however evidence on how best to encourage healthier diets at a population level is limited,” said Dr Brimblecombe, who was not involved in the study.

“Evidence is also needed on the cost effectiveness of such interventions to inform policy and to make sure at a population level we are getting the best value and outcomes for money invested.”

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20 Comments sorted by

  1. James Jenkin

    EFL Teacher Trainer

    Might the study actually show availability of cheap fruit and vegetables leads to better health outcomes - no matter how you make it happen?

    Government subsidies were used in the study, but might not be the only solution.

    Could there be other ways of increasing the range of food available in small communities generally? With the help of governemnt and business?

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  2. Stephen Ralph

    carer

    Again we get a study that states what should have been obvious in the first place.

    The piece says that "people lined up to get the fruit"............

    What do the communities eat at other times?

    Are they given nutritional education?

    This article highlights more of the same paternal attitude taken - handing out fruit, whilst admirable, is just a token effort.

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    1. Lorna Jarrett

      Former PhD candidate, physics teacher

      In reply to Stephen Ralph

      Stephen,

      People lined up to participate in the research - that's rather different from lining up to collect a veggie box. For one thing, they were committing to invasive blood tests of their children as well as a lot of other health tests and no doubt a mountain of paperwork. For medical research of this type, getting enough people who're willing to put up with the inconvenience is often a struggle.

      The point is that the families weren't just lining up for a free food handout - they were lining up to actively participate in a study aimed at improving the nutrition and health of their kids.

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    2. Stephen Ralph

      carer

      In reply to Lorna Jarrett

      Yeah I get it.....but this is 2013

      What took so long?

      And anyone can tell you fresh fruit and veg will be fantastic for you.

      Again what have "they" been eating for the past decades and has anyone cared up until now.

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    3. David Thompson

      Marketing Research

      In reply to Stephen Ralph

      Indeed, now doubt there will be a follow up stunning 'research' discovery:
      "Little girls smile when they get a free pony"!

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  3. Lorna Jarrett

    Former PhD candidate, physics teacher

    Encouraging results from a study that seeks to strengthen Indigenous health rather than patching up the damage.

    The first thing that sprang to mind for me was - is it possible for Indigenous people to grow their own food? Here's a link to Ron Finley's inspiring talk about gardening in South Central LA. As he says, "growing your own food is like printing your own money":

    http://www.ted.com/talks/ron_finley_a_guerilla_gardener_in_south_central_la.html

    Specifically I'm thinking of permaculture…

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  4. rory robertson
    rory robertson is a Friend of The Conversation.

    former fattie

    I salute all those working to improve Indigenous health and education. It is one of the very most important jobs in the nation. And, yes, lets get people eating more fresh and canned vegetables and fruit and meat and fish and eggs and cheese. The sorts of things I grew up on across remote and country Australia (excluding WA and Tassie).

    But that is only part of the solution. We also need to do what we can - especially via education - to stop less-well-off Australians from wrecking their health…

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  5. Paul Prociv

    ex medical academic; botanical engineer

    An excellent report, which simply confirms the general notion that "closing the gap" will rely not so much on more mindless and frantic governmental cash handouts, often around election time, but on somehow encouraging and supporting people in remote and deprived communities (and that's not only indigenous people) to take responsibility for their own health, and that of their dependants. After all, not so long ago (when I was a kid, in the 1950s), the health of the general Australian community was…

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    1. Account Deleted

      logged in via email @drdrb.net

      In reply to Paul Prociv

      Paul, was your study on anaemia published somewhere?

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  6. Gordon Angus Mackinlay

    Clinical Psychologist

    My God this is NEW!!!!

    Quite obviously Archie Kalokerinos never existed? This is exactly what he was promoting back in the early 1960's, and actively doing in rural NSW. And whilst he lost the plot in later years, he was still promoting it in 2000 when he received the title of Greek Australian of the century.

    The difference between him and this very minor study is that the lack of cheap fruit and vegetables just does not affect Aboriginals Australian's in remote rural Australia, but all…

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    1. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Gordon Angus Mackinlay

      Gordon, I forgot to mention milk in my list above. Of course, there are not many kids (or adults) these days sharing our decades-ago joys of getting in the cow and milking her by hand on a rainy July morning. It's all I can do these days to walk 400 yards up the hill in the dark to get the newspapers.

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  7. Max Kamien

    Emeritus Professor of General Practice & Corlis Fellow of the RACGP at University of Western Australia

    In the late 1960s David Jose from the Queensland Institute for Medical Research showed that doing anything from adding iron to the diet to issuing deworming medication improved the poor health of Aboriginal children. Fresh fruit and vegetables have long been known to do the same thing. In many parts of Australia these are prohibitively expensive. But even in parts of Australia where they are cheap and plentiful Aboriginal children and their elders opt for pies, chips and aerated drinks.So the issue is complex.
    Archie Kalakorinas unproven thesis was that Aboriginal children could not metabolise Vitamin C and that it had to be injected. So, although his heart was in the right place he was not actually an advocate of oral nutritional interventions in improving the health of Aboriginal people.

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    1. Stephen Ralph

      carer

      In reply to Max Kamien

      " In many parts of Australia these are prohibitively expensive"

      The money spent on I.A health over the past decades has probably amounted to billions of dollars.

      I can't believe we are almost in the same place we were in 1960 - someone pull a finger out before more decades go past and we are still standing still.

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    2. David Thompson

      Marketing Research

      In reply to Max Kamien

      " In many parts of Australia these are prohibitively expensive".
      In which case, do what other responsible adults do. Move!

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    3. Clive Bond

      logged in via Facebook

      In reply to Max Kamien

      Archie Kalakerinos did indeed advocate oral nutritional intervention. I attended one of his talks on the subject. One of his 'pet' recomendations was large doses of vitamin C orally. Even if you had no symptoms.

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    4. R. Ambrose Raven

      none

      In reply to David Thompson

      Responsible adults will know that people who can't afford to buy decent food are even less likely to be able to afford to move. Anyway, where to? Food is less expensive in the cities, but housing is far more costly.

      These are all very obvious issues, David.

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  8. Clive Bond

    logged in via Facebook

    Sounds good. However doing a study that blind willy knows the answer to doesnt achieve much. How about teaching them to grow fruit and vegs! Or better still get them off this socialist round about. Anyone who has worked in these rempte communities knows how government handouts destroy incentive. Health workers do a magnificent job under extreme and often abusive conditions. Its time communities were taught responsibility. You dont need a funded study to know that.

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  9. Gordon Angus Mackinlay

    Clinical Psychologist

    In reply to Max Kamien.

    "Archie Kalakorinas .............. So, although his heart was in the right place he was not actually an advocate of oral nutritional interventions in improving the health of Aboriginal people."

    Whilst I do think that Archie had really lost the plot in his latter years, I must defend him in regard to oral nutrition. I well remember him getting 'stuck into' Charlie Perkins about the subject in 1976 and how it was up to his people to do the simple work, and in the late…

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  10. R. Ambrose Raven

    none

    Due to both complacency and ideology, food security in Australia is deteriorating. As with many other problems, the warning signs are emerging amongst the disadvantaged and low income groups. Food insecurity arises for them through increasingly not having sufficient food, being unable to afford food when hungry; having a poor diet due to those limited food options; anxiety about the next meal; or having to rely on food relief.

    High food costs, poor access to healthy foods/convenience of take-away…

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