• 17Aug

    A few days ago, inspired by Jamie Oliver’s Food Revolution programs, I was having a look at the WHO Global Database to find out how big of a problem is obesity for Australia (no pun intended).

    The measure of overweight and obesity is the body mass index (or BMI, in kg per square meter). You can calculate your BMI in this link, or you can calculate your BMI through the formula: BMI= weight (kg)/ [height(m)]^2

    Obesity is defined as a BMI of 30 or greater. Overweight is defined as a BMI equal or greater than 25.

    There is 2009 data for the US from the CDC here. West Virginia, the selected state for Jamie’s program, has an obesity rate of 31%. But the highest rate is in fact found for Mississippi, with a rate of 34.4%.

    In Australia, there is some recent data on the National Health Survey here. This is the result of a sampling of about 10,000 people (roughly a ratio of 50:50 male:female). There are two types of statistics:  measured and self-reported BMI. I am reporting here measured BMI, as studies have shown that people self-reporting tend to under-estimate their BMIs.

    According to this survey (and if considered representative of the population), about 41% males in Australia are overweight and 22% are obese. Lower percentages for these two categories are observed for females, with 27.7% overweight and 19% obese.

    Unfortunately, this data does not allow the fine grain detail that is available for the US. For those interested in watching a presentation that clearly shows the evolution of weight changes in the US, download a great power point presentation here.

    But, how do we compare with other countries? I am presenting here two maps that shows data from the WHO for 2010. Now, I am not sure this is truly 2010 estimates, I suspect these are extrapolations based in 2005 obesity/overweight rates and current population. But most current comparisons among countries are based on this set of data.

    This map shows the comparison for women with BMI over 25 (overweight):

    And this is the comparison for males with BMI over 25 (overweight):

    Australia ranks at #41 in women obesity, while New Zealand ranks at #17 and Mexico at #23.

    But if we use only male data, Australia ranks in #12, while New Zealand comes at #14 and Mexico at #15. Countries with higher male overweight/obesity rates than AUS are Nauru, Cook Islands, Micronesia, Tonga, Samoa, Niue, United States, Argentina, Greece, Palau and Kiribati.

    So, there are some interesting observations from this: firstly, in Australia the message to slow down on unhealthy foods and start going to the gym has to permeate to the John’s and Joe’s, rather to the Jane’s  and…err..Julia’s.

    Secondly, we need better data on obesity in Australia and how the foods we eat are affecting our health. This is the type of data that really pays a dividend to the government. For example, inadequate fruit and vegetable consumption was estimated to be responsible for 2.1% of the total burden of disease in Australia in 2003. This represents about AUD$1.2 billion of the total health expenditure per year, of which 70 %  is funded by federal, state, territory and local governments.

    Thirdly, we need to understand whether the way we design food distribution systems in Australia is affecting the accessibility to healthy foods such as fruit and vegetables. For all the criticism copped by supermarkets, a survey in rural Victoria found that a complete Healthy Food Access Basket is more likely to be found in a town with a chain-owned store, and less likely to be available from an independently owned store in a town with only one grocery shop (Burns, 2004). However, supermarkets are present only when there is a population of consumers that guarantees a minimum profit. In the absence of supermarkets in some rural towns, independent grocery businesses act as proxies of fruit and vegetable outlets, but the prices paid are in average higher than in a supermarket (Palermo, 2008).

    Further, studies that investigate the access to affordable and nutritious food consider that areas that are 16 km away from a supermarket store constitute a “food desert” (Blanchard and Lyson, 2006, Morton and Blanchard, 2007, United States Department of Agriculture, 2009) . Well, if we use this definition I am sure we will find that plenty of areas in Australia are “food deserts”. My own research (to be published soon, I will let you know when and where to get a copy) shows that in Victoria, there are about 330 collection districts that are over 20 km away from the nearest store and about 56 collection districts 60 km away from the nearest supermarket. So, for people living in these locations , the options for healthy eating may be scarce and expensive.

    Interesting articles on the subject:

    Burns, C., Gibbon, P., Boak, R., Baudinette, S. & Dunbar, J. (2004), “Food cost and availability in a rural setting in Australia.”, Rural and Remote Health Research, Education, Practice and Policy, Vol. 4.

    Burns, C. M. and Inglis, A. D. (2007), “Measuring food access in Melbourne: Access to healthy and fast foods by car, bus and foot in an urban municipality in Melbourne”, Health & Place, Vol. 13 No. 4, pp. 877-885.

    Palermo, C., Walker, K., Hill, P., McDonald, J. (2008), “The cost of healthy food in rural Victoria”, Journal of Rural and Remote Health Research, Education, Vol. 8.

    Palermo, C., Walker, K., Hill, P., McDonald, J. and Wilson, A. (2007), “Development of a healthy food basket for Victoria”, Australian and New Zealand Journal of Public Health, Vol. 31 No. 4, pp. 360-363.

    Blanchard, T. C. and Lyson, T. (2006), “Food Availability and Food Deserts in the Nonmetropolitan South, Assistance Needs of the South’s Vulnerable Populations,” Southern Rural Development Center.

    Morton, L. W. and Blanchard, T. C. (2007), “Starved for Access: Life in Rural America’s Food Deserts “, Rural Realities Vol. 1 No. 4, pp. 1-10.

    United States Department of Agriculture (2009), “Access to Affordable and Nutritious Food: Measuring and Understanding Food Deserts and Their Consequences”, Report to Congress,  pp. 1-160.