Sunday, April 10, 2005

BRISBANE, AUSTRALIA VIA CAIRNS

More great meetings in Queensland and connecting with 1973 Eisenhower Fellow Sir Leo and wife Lady Mary.

I arrived in Brisbane after a mid afternoon of appointments in Cairns. In Cairns I met with professionals focused on nutrition policies and programs in Queensland. I have found it fascinating to observe Australians and see how physically different they look than the average sighting of Americans. I thought I had a trained eye on this subject and to me Australians looked to weigh significantly less than their western cultured cohorts from the US of A. But unfortunately, I found out, this is not supported by the science. Australians must really want to be like Americans as they are only 5-10 years behind our overweight or obesity statistics. Furthermore and sadly, the children of Australia stand toe to toe or rather pound to pound or kg to kg with our American youth. Driving factors seem to be very much the same--having one overweight or obese parent increases the chances of having an obese child by 25%, if both parents tip the scales the chances increase by 50 to 60 %. Other common factors include too many kids not playing and choosing video games over activity common to their parents generation such as kick the vegemite can, steal the kunekune bacon and red rover, red rover send capitan cook right over. The most startling statistic I found here is as follows--the impact of the increase of marketing by the food and beverage industry to effectively, strategically and thoughtlessly send our children key messages to drive their relentless request for fast and processed foods as standard fare for energy input is to put it mildly, significant. Generally, a 1 to 2 % average increase in energy input can lead to a 2 to 5 pound average annual weight gain. Hold on to your Krispy Kremes for this next critical piece--children in Australia are now eating 11% more than they were 10 years ago (remember, they are no better or worse than our all American kids). What I found even more alarming is it would take an additional 2 1/2 hours of energy output--each day--to balance this increase food and sugar consumption. We are having enough trouble convincing people in authority to help our children get 30 to 60 minutes of daily physical activity--how will we be successful in getting policies or people to find 3 to 4 hours of time each day to be active so they can continue at their current rate of stuffing their faces? Suggestions welcomed.

I am now convinced, more than ever, we need to have the courage to face the food and beverage industry to convince them to be a partner in finding effective solutions to help our children. We cannot risk an entire generation on a short term profit margin and greed. We cannot compete against their savey and effective marketing messages. It is well documented that mass media messages on healthy behaviors does not work and does not lead to behavior change. Enviromental and policies changes are the best hope we have--we must act on this information.

My Brisbane appointments focused on meeting with a variety of professional in cancer related programs, clinics or research centers. Melanoma, skin cancer, is almost a national entitlement--if you live here and you live long enough, it is almost certain you will face some type of skin cancer. The Australian boomers are much like us--raised on a must be tan mentality with a sunscreen mixture of baby oil and iodine. They are now showing the consequences of this risky behavior. Australia has created policies and public health education campaigns to assist with attitude and behavior change regarding sun exposure. There is a multi media campaign on use of SPF sunscreen lotion--encouraging all Australians to "Slip, Slap and Slop" it on. But more importantly there are some policies in place such as a policy targeting children includes a "no hat, no play" requirement in all schools and well shaded outdoor areas. You must have a hat on your head at all times walking to and from school and for any outdoor activity. I could not fine any research indicating this was making a difference--but it certainly seems like a great idea.

My other key focus area in Brisbane was in breast cancer. Mammagrams are a covered benefit of the public health system starting at age 50 and offered ever other year. Women can chose to have an annual screening or start at age 40 if they want to, they just have to pay for it out of pocket. If someone has a family history of breast cancer they can secure permission from their General Practitioner to have a screening prior to age 50. It is noteworthy to know that of all the breast cancers detected, only 5% are in women with a family history resulting in 95% being presented in women for the first time in their family medical background. I asked about the issue of breast self-exams and like in America--I got mixed feedback. For the most part, Australians are no longer recommending this as a tool for secondary or early detection. Most seem to have modified their statement to encourage women to know their breasts and to look for changes.

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