From all at the MJA, welcome to 2007! Our January issues will be slim sisters of their late '06 model siblings (particularly the double December issue, which was fatter than the average catwalk model), but we hope that the content will not disappoint. Exuberant resolutions aside, as the smoke from the fireworks drifts languidly away on New Year's morning, most of us will still be carrying last year's problems. Nonetheless, New Year can be a good time to take stock and make plans. In this issue, some of our authors review the problems that beset us in 2006, and suggest a fresh approach.
Fed up
Obesity maintained a high profile last year, amid squabbles as to whether food or lack of exercise was the main culprit, and tensions between personal responsibility and the role of government.
Contributing to these debates, Harrison et al have shown in their study of the prices and availability of basic healthy food over time in Queensland, that not all Australians have easy access to good nutrition. They conclude that “This is particularly the case for people of low socioeconomic status and other vulnerable groups, such as Indigenous people, who are known to suffer a greater burden of ill health than other Australians”. (“The increasing cost of the basic foods required to promote health in Queensland”)
But there are initiatives to redress this inequity. Webb and Leeder give a brief overview of the ways in which Indigenous communities and health organisations, corporations and government are working together to achieve food security for remote Australia. “This New Year, let us resolve to help solve the problems of Australians living in remote areas who pay higher prices for food . . .”, they propose. (“New Year’s resolution: let’s get rid of excessive food prices in remote Australia”)
Thirty years ago, Gracey wrote of his concern about undernutrition in Aboriginal people. Now he notes the high rates of “lifestyle” diseases such as obesity, diabetes, and cardiovascular and renal disease. But the solutions must be much more far-reaching than directing Indigenous people to change their lifestyles. We need commitment at every level of society to “erase this internationally shameful state of affairs from [our] copybook”. (“Nutrition-related disorders in Indigenous Australians: how things have changed”)
There were strong calls last year for Australians to take more responsibility for what they (and their children) eat. How easy is this in the current environment? Kelly and Chau’s findings that junk food ads in children’s television timeslots often push the boundaries of the existing legislation (“Children’s television sub-standards: a call for significant amendments”) will resonate with many parents, and Beard et al believe that our current nutritional panels do not provide enough information for the average person to make healthy choices. Along with many other experts, they spruik the system of “traffic- light” labelling being introduced in the United Kingdom (“Traffic-light food labels”).
Harms and hazards
The NHMRC guidelines for alcohol consumption during pregnancy are due for review this year and, while there is no doubt that drinking can cause fetal alcohol syndrome, the amount of alcohol that can safely be consumed during pregnancy is hotly debated. Another set of guidelines published last year, aimed at health care practitioners managing women with drug and alcohol problems, concurred with the NHMRC, allowing up to seven standard drinks per week. In response, Whitehall (“National guidelines on alcohol use during pregnancy: a dissenting opinion”) argues strongly that “Abstinence is the only advice we can give pregnant women”.
The link between illicit drug use and mental illness is also controversial, but the 2006-07 budget pledge of $21.6 million over 4 years to improve community awareness of this link indicates that our federal government is willing to act on the available evidence (Jorm and Lubman, “Promoting community awareness of the link between illicit drugs and mental disorders”).
Other research in this issue highlighting hazards includes MacBean and colleagues’ tally of bites by mammals in “Animal and human bite injuries in Victoria, 1998-2004” (dog bites still outnumber those from humans); Mitra et al’s detailed exploration of ladder injuries, which seem particularly problematic in elderly, non-work-related users (“Ladders revisited”); and spotted black snake bite, which certainly causes symptoms but may not require antivenom (Jansen et al, “Spotted black snake (Pseudechis guttatus) envenoming”).
Finally, it’s too late for the festive season, but it’s good to remember at any time to exercise caution when dancing on tables (Johnston et al, “A “paneful” perforation”). We hope the year ahead brings many opportunities for safe and healthy displays of exuberance to all our readers.
Another time . . . another place
Every carbon in fat is derived from sugar that man ate or that the cow ate. Oil or fat is nothing more than congealed candy.
Dr Ruth Armstrong, MJA