Overweight Obesity And Chronic Disease In Australia

OVERWEIGHT, OBESITYAND CHRONIC DISEASESIN AUSTRALIAPOLICY BRIEFSUMMARY In Australia, rates of overweight and obesity haverisen alarmingly in recent decades in all agegroups, with the increase most marked amongobese adults. Overweight and obesity in adults and children isassociated with significant health impacts andeconomic burdens. A comprehensive range of interventions isurgently required to achieve behaviour change,improve diets and lifestyles, and reduce theburden of chronic disease in Australia.Persons aged 18 and over- Proportion overweight or6obese people in 1995 and 2014-2015WHAT ARE THE STATISTICS?In Australia, the proportion of men and women aged18 years and over that is overweight or obese hasincreased significantly in recent decades. In 1995,64.9% of males and 49.4% of females wereoverweight or obese. However, in 2014–2015 theproportions had climbed to 70.8% of males and156.3% of females. Australia’s adult obesity rate hasbeen estimated to be the fifth highest amongst OECD2countries. In 2014–15, around 27.2% of allAustralian children aged 5–17 years were either3overweight or obese, with 7.4% living with obesity.Rates of overweight and obesity increase with age.Of men aged 45 years and over, almost four in five(79.4%) were overweight or obese in 2014-15, whiletwo in three women (65.7%) of the same age wereoverweight or obese.4Data released by Roy Morgan Research in 2014 hasfound that around 11 million Australians are currently5overweight by an average of 16.5 kilograms.Perhaps of most concern has been the dramatic risein the proportion of the population who are obese(with a BMI of 30 or more). This proportion hasincreased across all age groups over time, up from18.7% in 1995 to 27.9% in 2014–15, an increase ofalmost 10%.There is a concerning social and economic gradientevident in overweight and obesity trends with peoplein lower socio-economic groups more likely to beoverweight and obese than those in higher socio7economic groups. Aboriginal and Torres StraitIslander Australians also experience8disproportionately high rates of obesity. Theprevalence of overweight and obesity is also higheramong people living in regional and remote areas9compared to those living within major cities.POLICY BRIEF: OVERWEIGHT, OBESITY AND CHRONIC DISEASE IN AUSTRALIA – JAN 20181

CAUSES OF OVERWEIGHT ANDOBESITYEngaging in physical activity while minimisingconsumption of discretionary (energy dense, nutrientpoor) food and drink is the best way to maintain ahealthy weight. Modelling indicates that the increasedenergy intake that has occurred over the past fewdecades is more than enough to explain the parallel10increase in body weight. This increased energyintake has occurred mainly as a result of increasedconsumption of energy-dense, nutrient poor (high fat11and/or sugar) foods and beverages.The consumption of energy dense, nutrient poorfoods has increased significantly among adults andchildren over the past 30 years. For example, onethird of adults and almost half of children drink sugary12drinks daily. Young Australians, in particular, arecommonly high consumers of energy dense, nutrient13poor products such as soft drink, burgers and chips.Australian adults’ diets are comprised, on average, of35% ‘junk’ food including sugary drink and alcohol.Amongst children, 40% of the diet is made up of14‘junk’ food . Australian households spend 58% oftheir food budget on unhealthy foods and drinks and15just 15% on fruit and vegetables . Data from theNational Health Survey 2014–2015 has shown that7% of Australian adults, and 5.4% of children, meetthe recommended 5 serves of vegetables per day,with fruit consumption also generally falling short of16recommended serves.HEALTH IMPACTSPoor diets and high body mass index are the majorrisk factors contributing to Australia’s significant17disease burden, ahead of smoking-related illness.Overweight and obesity lead to heightened risk ofdeveloping chronic diseases including cardiovasculardisease and type 2 diabetes. A recent review of morethan one thousand studies by International Agencyfor Research on Cancer found that that beingoverweight or obese increases risk for at least 13types of cancer, including common cancers such as18breast and colon.Obesity is also the leading risk factor for type 219diabetes.Even being overweight significantly20increases the risk. The contribution of overweightand obesity to cardiovascular disease and diabetes issignificant. Dietary risk factors are estimated tocontribute 35% and 33% of the disease burdenrespectively and high body mass contributes 21%21and 49% respectively.Childhood obesity is also associated with a range ofvery serious health problems and increases the risk22of premature illness and death later in life.Research shows that 25–50% of obese adolescents23remain obese into adulthood. Studies also suggestthat the risk of cardiovascular disease and all-causemortality is elevated among those who were24overweight during childhood. If current trendscontinue, approximately 1.75 million deaths will havebeen caused by overweight and obesity between252011 and 2050.ECONOMIC IMPACTSIf the obesity epidemic in Australia is not checked, itis estimated that by 2025, 83% of males and 75% offemales over 20 will be overweight or obese. Thiswould have an enormous impact on health care26spending, chronic disease and quality of life. Thecosts of overweight and obesity are already verysignificant with the total annual cost of obesity inAustralia in 2011–2012 has been estimated to be 8.6 billion, including 3.8 billion in direct costs and27 4.8 billion in indirect costs. Using a measure thatincludes loss in wellbeing, estimates reach around 120 billion a year, which is equivalent to 8% of the28economy’s annual output.In the long term, it is expected that the economiccosts of obesity will increase significantly, andpossibly double, due to the prevalence and incidence29of diabetes.WHAT ACTION HAS BEEN TAKENTO ADDRESS OBESIT Y INAUSTRALIA?In 2008 the Australian Government (Government)announced the assembly of the National PreventativeHealth Taskforce (Taskforce) to develop strategies totackle chronic disease caused by tobacco, alcohol30and obesity. In September 2009 the Taskforcereleased a final report entitled Australia: TheHealthiest Country by 2020 – National PreventativeHealth Taskforce Strategy – The Roadmap for Action(the Roadmap). The Roadmap outlined 27POLICY BRIEF: OVERWEIGHT, OBESITY AND CHRONIC DISEASE IN AUSTRALIA – JAN 20182

recommended actions designed specifically toreduce and control obesity in Australia. Therecommendations focused on preventative healthmeasures and were proposed to be implemented in astaged manner from 2009. In 2010, the thenGovernment published its response to the Roadmap,indicating its plans and intended actions.guidance on a range of evidence-based policyinterventions that governments should consider, toreduce the burden of NCDs. Further the recent WorldHealth Organization’s Commission on Ending35Childhood Obesity Report provides a modelcomprehensive strategic approach, strategicobjectives and policy options.Eight years have now passed since the Roadmapwas released and overall progress has beendisappointing, with preventative health not a highpriority for the current Government. Of particularconcern was the 2014 abolition of the AustralianNational Preventative Health Agency (ANPHA),which had been set up in 2011 to drive preventativehealth initiatives and research. Commonwealthfunding provided to states to deliver healthy lifestyleintervention programs under the NationalPreventative Health Agreement was also stopped.Policy interventions that have been identified as mostpressing for Australian governments in addressing36obesity include:Although state and territory governments’approaches to obesity prevention vary, there areseveral examples of strong leadership at the stategovernment level. Important initiatives include theNSW government’s commitment to reduce childhoodobesity through actively monitoring rates ofoverweight and obesity, increasing communityeducation and introducing and resourcing a healthy31canteen strategy. The Australian Capital Territory’sTowards Zero Growth – Healthy Weight Action Plan2013, sets out cross-sectoral responsibilities,priorities and goals for the improvement of health32within the Territory. Local governments have alsobecome key drivers of health promotion andprevention policy. For instance, the Victorian PublicHealth and Wellbeing Plan include actions bymunicipalities to reduce sugary drinks. Victorianmunicipalities are becoming leaders in creatinghealthy drinks environments by adopting strategies toincrease access to water and reduce consumption of33sugary drinks with the assistance of the VictorianGovernment’s Healthy Choices guidelines. Adoption of a whole-of-government obesityprevention strategy ; Reducing children’s exposure to marketing forunhealthy foods and beverages on television aswell as other platforms including sportsponsorship; Improving the Health Star Rating System, aninterpretive front of pack labelling system, toinform healthy choices; Provision of funding for sustained, effective massmedia education campaigns to improve diets andprevent obesity; Commit sustained funding and ongoing supportfor a comprehensive diet and nutrition surveyconducted every 5–10 years; Establish targets for national population dietaryintake and for reductions in key nutrients in majorfood categories; Interventions to reduce consumption of sugarsweetened beverages, including a health levy onsugary drinks.For more information about the types of regulatoryreforms and policies that are needed to addressoverweight and obesity in Australia, please refer tothe OPC’s Policy Briefs and submissions, available atwww.opc.org.au.POLICY ACTION NEEDEDThere is increasing support and impetus from theinternational community and peak health bodies totake decisive policy action on overweight andobesity. The World Health Assembly’s Global ActionPlan for the Prevention and Control of Non34communicable Diseases 2013–2020 providesPOLICY BRIEF: OVERWEIGHT, OBESITY AND CHRONIC DISEASE IN AUSTRALIA – JAN 20183