Centre for Translational Research in Chronic Diseases, University of Otago and the Prio Policy Centre Law Lecture Theatre, Old Government Buildings, Wellington
"Who cares about New Zealand's waistline?" Ten days ago a newspaper headline literally took my breath away. It was a mere three words - Diabetes tsunami predicted.
The Ministry of Health report, Diabetes Policy Model, revealed that at least one in ten New Zealand adults will have type two diabetes within twenty years in a disease of almost tsunami proportions.
It was an association that almost every New Zealander could relate to. Last September, the tsunami that killed nearly 200 people in Samoa and Tonga, was a natural disaster that wreaked havoc on the lives of families; a disaster that over a year later is still painfully felt in homes across the Pacific and here in Aotearoa. The diabetes tsunami that has hit Aotearoa has massive consequences in terms of the loss of life, the loss of limbs, heart, gum and kidney disease. Complications of diabetes are manifest as the leading cause of amputations and blindness.
Up until a year ago, a tsunami was probably thought of as a calamity that happened elsewhere; a crisis that suddenly crept up on a community, unannounced and unprepared for. And that's where the association with diabetes comes unstuck.
Because unlike natural disasters, diabetes is something that each of us has the power to prepare for; and significantly to prevent.
And that is why I was so pleased to respond to the initiative of the Prior Policy Centre, and the Centre for Translational Research in Chronic Diseases, in hosting this conference today.
This is a very important forum for all of us to consider the potential we have to make a difference in addressing the risk of obesity and its co-morbidities.
It asks us all to consider one fundamental question - who cares about New Zealand's waistline?
I am hoping by the end of this seminar there will be an unanimous response - we do.
And I mean a collective we - all of us who live here. For encouraging people to eat better and maintain a healthy lifestyle is something which can occur in every family, every community.
Of course truly understanding what a healthy lifestyle is part of the challenge facing us.
What we have is lots of evidence about a portrait of health which reports that in 2006/07: One in five children under 14 years of age were overweight; and one in twelve were obese; One in three adults were overweight and one in four obese; And in particular Maori and Pasifika peoples have a greater prevalence of obesity.
I note the Auditor-General's recent report into the effectiveness of the Get Checked diabetes programme recommended that district health boards must work with primary health organisations to continue to focus on removing the barriers for Maori and Pasifika peoples accessing the Get Checked programme.
Much of the policy work within the Ministry of Health is very individually focused. I believe what we need to do is to take a whanau/family approach to diabetes.
But I think it should also be noted that we need research into the prevalence of diabetes in indigenous communities to understand how best to address the causes, and focus our efforts on outcomes we can all aspire to.
There are also some interesting differences across all of these statistics which might bear further study. For example, what we learn in the National Survey of Children and Young People is that from the age of ten years, physical activity levels decline; healthy eating behaviours decline; unhealthy eating behaviours increase and screen time increases.
Another distinguishing feature is that females aged 20 to 24 years were significantly more likely to be obese than males of the same age - this was also the age group in which the prevalence of obesity was highest.
I normally steer clear away from statistics of this nature - but I have to admit they worry me.
When you listen to the situation for our ten year olds - and then the consequences for our twenty year olds - it is absolutely obvious that there is something we can all do, to help our young people maintain a healthy weight throughout life and reduce the risk of disease.
Of course one step we can take is to focus on what we eat - through comprehensive food and nutrition guidelines for health practitioners and for the general public. Effective, accessible, user friendly advice is an important first step towards encouraging all of us to eat a variety of healthy foods each day.
And with the Advertising Standards Authority Children's Code of Advertising in place, there are specific requirements for advertisers to exercise a particular duty of care for food advertisements directed at children.
I am interested in work that the Ministry of Health is doing with the National Heart Foundation to work alongside the food industry to create healthier options - reducing far, salt and sugar content.
And I've been a big fan of the Fruit in Schools programme which has been targeted in lower decile schools. We all know that one of the biggest barriers preventing universal uptake of fruit and vegetables has been the price factor, so the initiative to increase fruit consumption is a really tangible intervention making fruit a viable choice.
But we know that freeing our shelves of donuts and fish and chips, isn't going to happen overnight, and will never be the complete answer. I also know, personally, how extremely difficult it is to stop eating particular foods. Addiction doesn't discriminate.
A healthy lifestyle is, however, far more than an absence of unhealthy food.
It's also about physical activity, recreation, and participating in organised sport.
Last year, Government invested $82 million in the KiwiSport programme to help start a pattern which we would hope would lead to a lifetime of enjoyment and challenge through sport.
But I'm also really interested in what we are calling Green Prescriptions Active Families programmes - these are the types of community based health initiatives designed specifically to increase physical activity in children aged under 18 years of age. Last year there were over seven hundred families involved in such a programme.
Finally, I want to return to the association made with the diabetes tsunami I referred to earlier.
One of the most incredible things that has emerged out of the natural disasters in the Pacific, or more recently our own devastation emerging out of the earthquake in Christchurch has been to see the resilience and the enduring optimism that reflects the community response.
In much the same way, I truly believe the collective strength of our families and our communities offers the most remarkable lesson for how we answer the question: who cares about New Zealand's waistline?
You will all be aware of my efforts to increase the number of publicly funded bariatric surgery operations.
The Minister of Health and I are looking at a number of options to ensure there is a sustainable increase in bariatric surgery, and I hope we will be in a position to make an announcement in the next few months.
I have a deeply personal commitment to the whole issue of reducing obesity and increasing healthy lifestyle. Eleven months ago my life changed dramatically - and for the better. While I attribute much of my new outlook to the impact of bariatric surgery; I could not possibly have achieved such change without the staunch and consistent support of my children, my mokopuna, my husband, my greater whanau.
At our marae we are consistently trying to increase the range of healthy options we have so that our tables are laden with fruit and bottles of water rather than lollies and fizz. And so I am so proud to stand here in front of you today, to share with you the excitement; and the wonder that each day now brings, as I approach life with so much more energy; and so much more hope.
My story is not just one about a surgical procedure - not withstanding the huge value I place on having such interventions in place. My experience has also been so positive because of the difference made within our household; the influence I can see for our mokopuna through the approach we now take to maintaining a healthy lifestyle.
The greatest gift for me, as a result of the changes I have made, is that I not only feel well, but I know that wellbeing amongst our whanau is a shared priority; an outcome and an aspiration that all of us hold dear.
I thank you, again, for the opportunity to be part of this very special forum; and I will be keenly awaiting the recommendations that come out of this day.
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