Lisa Schubert

Social capital meets identity Aboriginality in an urban setting

This article reports on a qualitative study of social capital within an urban Aboriginal and Torres Strait Islander context. Using data generated from 100 Aboriginal and Torres Strait Islander participants in focus group discussions and in-depth interviews collected by Aboriginal community development workers, this article describes two worlds of social capital available to Aboriginal and Torres Strait Islander people. The primary source of bonding social capital comes from family and wider Aboriginal and Torres Strait Islander community connections. In the context of an oppressive history and experiences of ongoing racism and discrimination, a second world of bridging social capital remains elusive to many Indigenous Australians. Our findings suggest that to understand the tensions between the two social capitals requires an engagement with the complexities of identity. We argue that it is vital to explore the texture of social capital, rather than just measure its volume.

Household Food Strategies and the Reframing of Ways of Understanding Dietary Practices

While the use of households as a study focus is not a new concept in nutrition research, recent sociological literature has highlighted methodological advances in household strategy research that deserve attention. This article introduces and examines the conceptual relevance and analytical scope of household food strategies (HFS) research. Peoples household food strategies and dietary practices go together as do legs and walking, and yet to listen to public commentary on, for example, the current public health cause célèbre- the childhood obesity epidemic- we hear little, if any, balanced discussion of domestic food provisioning work, but much ideological posturing re parental responsibility, resisting the temptation of the abundance of fast food in our environment, and the importance of cooking from scratch. Using HFS as a unit of analysis highlights the process of integrating two critical sets of factors: household resources and preferences on the one hand, and the broader social and cultural shaping of dietary practices on the other. Such an approach has the advantage of avoiding an overemphasis on agency. Specifically, this article outlines a search for a coherent and integrated theoretical and methodological framework suited to studying households and dietary practices under circumstances of resource constraint and rapid social or political change. Developments in cultural sociology and anthropology, particularly, have much to offer a research agenda to support contemporary food and nutrition policy making in a post-modern world.

Food, eating and body image in the lives of low socioeconomic status rural Mexican women living in Queretaro State, Mexico

Qualitative research using semi-structured interviews and key informant interviews were used to explore how women from low socioeconomic rural households in Queretaro State, Mexico perceived and reacted to their obesogenic environment. Reduced availability of healthy food options and household financial constraints along with reduced agency of women in this setting were factors that limited womens ability to access and consume diets consistent with the promotion of good health. The cultural values that emphasised obesity as a desirable state for women and the womens social networks that promoted these values were also identified as playing a role in reinforcing certain behaviours. Public health advocates wanting to design interventions in such settings need to be sensitive to the cultural as well as the environmental context described for rural Mexican women.

Evaluation of the Good Start Program: a healthy eating and physical activity intervention for Maori and Pacific Islander children living in Queensland, Australia

BackgroundReducing the prevalence of obesity and chronic disease are important priorities. Maori and Pacific Islander communities living in Australia have higher rates of obesity and chronic disease than the wider Australian population. This study aims to assess the effectiveness of the Good Start program, which aims to improve knowledge, attitudes and practices related to healthy eating and physical activity amongst Maori and Pacific Islander communities living in Queensland.MethodsThe intervention was delivered to children aged 6–19 years (N = 375) in schools by multicultural health workers. Class activities focused on one message each term related to healthy eating and physical activity using methods such as cooking sessions and cultural dance. The evaluation approach was a quantitative uncontrolled pre-post design. Data were collected each term pre- and post-intervention using a short questionnaire.ResultsThere were significant increases in knowledge of correct servings of fruit and vegetables, knowledge of sugar and caffeine content of common sugar-sweetened drinks, recognition of the consequences of marketing and upsizing, and the importance of controlling portion size (all P < 0.05). There was also increases in knowledge of physical activity recommendations (P < 0.001), as well as the importance of physical activity for preventing heart disease (P < 0.001) and improving self-esteem (P < 0.001). In terms of attitudes, there were significant improvements in some attitudes to vegetables (P = 0.02), and sugar-sweetened drinks (P < 0.05). In terms of practices and behaviours, although the reported intake of vegetables increased significantly (P < 0.001), the proportion of children eating discretionary foods regularly did not change significantly, suggesting that modifying the program with an increased emphasis on reducing intake of junk food may be beneficial.ConclusionThe study has shown that the Good Start Program was effective in engaging children from Maori and Pacific Island backgrounds and in improving knowledge, and some attitudes and practices, related to healthy eating and physical activity. The evaluation contributes valuable information about components and impacts of this type of intervention, and considerations relevant to this population in order to successfully change behaviours and reduce the burden of chronic disease.

‘Hey, We Are the Best Ones at Dealing with Our Own’: Embedding a Culturally Competent Program for Māori and Pacific Island Children into a Mainstream Health Service in Queensland, Australia

ObjectiveWe present the results of one component of an external evaluation of Good Start Program (GSP), a community-based program for the prevention of chronic disease among Maori and Pacific Island (MPI) communities living in the state of Queensland, Australia.DesignAn evaluation of the GSP was undertaken using a mixed methods approach. This paper reports on the qualitative component where interview and focus group data was collected, using Talanoa, a culturally tailored research methodology. Respondents included school students, community groups, teachers and parents, as well as the Good Start implementation team.Result(s)The five broad themes that emerged from this evaluation related to (i) components of cultural-competence and (ii) perceived impact of the program. The views of all participants reinforced the importance of culturally appropriate programs and highlighted how the multicultural health workers (MHWs) contributed to the program’s perceived success. The challenges in understanding restrictions of the mainstream health service framework were noted indicating the need for it to be flexible in incorporating culturally appropriate components if a program was to be embraced.ConclusionThe qualitative evaluation of the GSP suggests that culturally tailored programs, delivered by MHWs, have the potential to impact positively on community-level behavioural changes that improve health. These findings, supported by studies from other countries, contribute to the evidence that cultural-tailoring of programs is critical for ensuring that culturally appropriate initiatives are embedded in health care systems that support multicultural communities. Embedding includes the development of culturally appropriate policies, a culturally competent workforce and long-term funding to support culturally competent initiatives.

The effect of zinc supplementation on body composition and hormone levels related to adiposity among children: a systematic review.

OBJECTIVE To provide a comprehensive synthesis of the effects of Zn supplementation on childhood body composition and adiposity-related hormone levels. DESIGN Five electronic databases were searched for randomized controlled trials of Zn supplementation studies published before 28 February 2015. No statistical pooling of results was carried out due to diversity in study designs. SETTING Community- or hospital-based, from fourteen developing and developed countries. SUBJECTS Children and adolescents aged 0 to 10 years. RESULTS Seven of the fourteen studies reported an overall or subgroup effect of Zn supplementation on at least one parameter of body composition, when determined by anthropometric measurements (increased mid upper-arm circumference, triceps skinfold, subscapular skinfold and mid upper-arm muscle area, and decreased BMI). Three out of the fourteen studies reported increased mean value of total body water estimated by bio-impedance analysis and increased fat-free mass estimated by dual energy X-ray absorptiometry and by total body water. Zn supplementation was associated with increased fat-free mass among stunted children. One study found supplementation decreased leptin and insulin concentrations. CONCLUSIONS Due to the use of anthropometry when determining body composition, a majority of the studies could not accurately address whether alterations in the fat and/or fat-free mass components of the body were responsible for the observed changes in body composition. The effect of Zn supplementation on body composition is not consistent but may modify fat-free mass among children with pre-existing growth failure.

Analysis of Front-of-Pack labelling systems on packaged non-alcoholic beverages for Australian consumer guidance

Aim Numerous Front-of-Pack nutrition labelling systems have been proposed in recent years to assist consumers in making healthier food choices, including reducing sugar intake. Packaged beverages represent one product category that has undergone significant diversification and has emerging new subcategories. The present study examined the implications of applying three different currently used or proposed Front-of Pack nutrition labels to a range of pre-packaged beverage products to descriptively assess their potential utility. Methods The Traffic Light System, % Daily Intake label and the Health Star Rating system were applied in accordance with established criteria and standards on 31 non-alcoholic pre-packaged beverages representing eight subcategories. Results There were often considerable differences between labelling system ratings for the same products. The Traffic Light System had similar labelling when comparing soft drinks and fruit juice and sodium content was marked as low for all tested products. Percentage Daily Intake reflected similar results for regular soft drinks and fruit juices; however, in terms of energy, liquid breakfast ranked highest followed by energy drinks, fruit juice and soft drinks. The Health Star Rating showed the fruit juice category to be healthier than other beverages, including water. Diet products scored 0.5–1 stars more than regular products. Conclusions The Health Star Rating system was concluded to be more suitable to label beverages based on better utility, applicability and ease of identifying healthier beverage choices; however, this system would benefit from further refinement. Labelling simplicity, health representativeness, marketplace utility and consumer comprehensiveness are important considerations for future labelling development.

Maternal Working Characteristic Is Associated with Child Underweight in Urban Middle-Class Families of Indonesia

Abstract of paper that presented at 20th International Congress of Nutrition, Granada, September 2013.Background and Objectives: Indonesia is one of the countries facing nutrition transition with an increased proportion of the middle-class population. Few studies explored young child feeding practice amongst middle class families in developing countries. This study aims to assess child feeding practices and their associations with child nutritional status in urban area of Indonesia. Methods: The study was designed as a mixed-method study in an urban middle-class community, comprising of a qualitative study amongst 26 families of young children and a case-control study involving 288 (109 cases and 179 controls) children aged 12-36 months. Cases were mild to moderately underweight children, while controls were normal weight children. The data collection methods consisted of in-depth interview for the qualitative phase and anthropometry measurements, structured interviews pertaining to child feeding practices and 24-hours recall for the quantitative phase. Results: The qualitative study suggested that mothers appeared to have positive attitude and were familiar with many brands of toddler formula milk. Mothers reported challenges in encouraging their children to eat and relied on formula milk to increase child’s food intake.The results of the case-control study showed that only 10.4% children received six-month exclusive breastfeeding and there was a significantly higher proportion of control than case children who were offered formula milk within their first month of life. Almost all children (91.7%, CI = 87.7 – 94.5) had low dietary diversity (consumed 1-3 food groups) in the last 24 hours. Formula milk was the largest contributor to child’s energy intake amongst the control children. Conclusions: The low dietary diversity warn potential problems for the health of Indonesian children. A large government strategy on complementary feeding practices including controlling the marketing activities of formula milk need to be enhanced.

Beverage consumption in Australian children

Background/objectivesWhile beverages are an important dietary source of water and some essential nutrients, consumption of sweet beverages has increasingly been linked to adverse health outcomes. Currently there is a paucity of longitudinal consumption data on beverage consumption in Australian children.Subjects/methodsThe Longitudinal Study of Australian Children has run biennially since 2004. Twenty four-hour recall data collected over 6 waves from the birth cohort (aged 0–1 year at baseline) was analysed and demographics were assessed for associations.ResultsFive thousand one hundred and seven children participated at baseline, with a 71–90% retention of participants at each wave. Water consumption remained consistent with age over time, with more than 90% consuming more than one glass in the last 24-h. Proportions of fruit juice consumers decreased overall. Soft drink and cordial consumer proportions increased from 1% (0–1 year), to 28% (2 years) and 43% (10 years). Between 2 and 10 years, proportions of consumption of full-cream milk decreased by 8% and for skim milk this proportion increased by 51%. High proportions of consumers of soft drink/cordial was significantly associated with older children, males, children with a medical condition, living in a rural area, low socio-economic status and Indigenous Australians.ConclusionsWater consumption remained consistently high across the ages, while fruit juice was commonly introduced into the diet early childhood. While proportions of fruit juice consumers decreased after the age of 2 years, proportions of soft drink consumers increased. The findings from this study should assist with surveillance data and inform policy and interventions aimed at reducing consumption of sweet beverages.

Non-alcoholic beverage marketing in 100 highest grossing movies 2010-2014

Australian sales of hyperpalatable beverages (HPB) (a term used to describe naturally or artificially sweet beverages) have followed a consistent upward trend since 2000. The purpose of this paper is to examine HPB brand placements in the top 20 annual highest grossing movies in Australia in 2010-2014.,A content analysis was undertaken on the 20 highest grossing movies annually from 2010 to 2014. Movies were analysed according to the prevalence and portrayal of branded beverages.,In total, 35 per cent of movies contained an HPB brand placement. Movies were more likely to be classified M, MA15+, R/R18+, and categorised as comedy, or action/adventure genre. Soft drinks were the most prevalent category (60.9 per cent), and Coca Cola Company manufactured 40.6 per cent of the brands that were embedded throughout the movies.,This study revealed some of industry’s non-direct marketing strategies through HPB placement in movies. Findings suggest that further scrutiny is needed of the relatively underresearched medium of beverage advertising.