Red Alert

Posts Tagged ‘Obesity’

Health By Numbers

Posted by on December 19th, 2012

Both Vernon Small and Corin Dann anointed Tony Ryall their politician of the year. Both cited the same reason: When was the last time you heard of a health scandal?

I agree that Tony Ryall is the best politician on National’s front bench. But that doesn’t make him a good Health Minister. By forcing hospitals to focus on delivering short term statistics he can crow about in Parliament and micro-managing any emerging issue that will resonate with National’s base he has managed the politics of the health portfolio sublimely.

But by sucking resources out of public and primary health and refusing to do anything to prevent the looming obesity crisis or the fact that poverty is a primary driver of ill health, Tony Ryall is setting future health ministers up for massive problems. They will have to grapple with a health system that simply will not be able to cope with the demand that will be placed upon it. Very difficult choices will have to be made about how much we spend on health, how the revenue is raised and what the public health system can deliver. If we leave that all too late, drastic steps will need to be taken and the public health system as we know it will cease to exist.

Just like superannuation, National has their head in the sand on health. They are more worried about getting the numbers right for today’s political purposes rather than doing what is right for the future.

Tony Ryall has build a magnificent house of cards. It looks splendid right now, but the signs it could collapse at any time are there:

Maryan Street has already called Ryall out on his dodgy elective surgery numbers. Simple procedures get priority over more complex surgeries regardless of the outcome they achieve for the sole purpose of getting the numbers up.

At the Health Select Committee fincncial review of the Ministry of Health I pointed out that despite both Labour and National getting elective surgery waiting times down to now being on par with the USA and National diverting resources into getting more and more surgeries done, New Zealand ranks amongst the worst developed countries for post-operative complications such as infections and surgical items being left in the patient. So it’s all about quantity, not quality. Of course, those post-op complications are costly and soak up resources that could be used on better things.

Today there is an emerging story that the national screening programme which identifies hearing irregularities in newborns has been botched resulting in up to two-thousand babies being recalled to hospital to have their hearing re-checked. Why? Because some of the screeners only tested one ear and, bizarrely, some tested themselves rather than the baby. As Associate Health Minister Jo Goodhew had to concede on Radio NZ this morning the only logical explanation for this was to save time, get more tests done and produce the numbers the Government is looking for.

Good on the Government for dumping this story after Parliament has risen so this little health scandal can be squashed before the next question time and good on Ryall for sending Goodhew to face the music. Perhaps it was to make up for his sexist graphic about doctors and nurses (which again contained dodgy numbers).

Tony Ryall the best politician of 2012? Yes. But he’s a crap Health Minister and we will all be paying for it in the future.


Duckworth-Lewis Food Labelling

Posted by on December 9th, 2012

Buried inside a media release about innovative health food claims from Kate Wilkinson’s office late on Friday was the news that National has, predictably, let industry interests trump public health on the issue of front-of-pack food labelling.

With obesity and diabetes being the most pressing health challenges New Zealand (like other developed nations) is facing, helping people take better control of their own nutrition is absolutely vital.

Choice is important and there is no point in sanctimoniously dictating to people what they should and should not eat, but we can provide simple information and signals to help people make informed decisions.

The right thing to do is establish a universal and simple-to-read ‘traffic light’ type system that people can easily interpret whilst doing their shopping.

What was announced was not a new system but a report prepared by an advisory group  consisting of both industry and health representatives. (Oddly the Health Promotion Agency and its predecessor the Health Sponsorship Council are not represented. Perhaps Kate Wilkinson thought Katherine Rich could wear both her conflicting hats at the same time while she represented the  Food and Grocery Council).

Kate Wilkinson says the report identifies a set of principles that will provide a useful guide to food businesses that want to adopt front of pack labelling.

So it’s voluntary which means the manufacturers of those foods that people need to eat sparingly will avoid it like the plague.

It’s also complicated with foods to be compared within categories, not with all other foods and using a points system rather than the simple traffic light system. In a win for the PC brigade, negative labels will not be used, only varying degrees of positive labels.

Incredibly, it suggests that the really bad foods, the ones with no positive nutritional value should have no label at all.

By the the time I finished reading it I was surprised the group hadn’t recommended shoppers use the Duckworth-Lewis method to determine what foods they should buy.

Predictable but nevertheless disappointing.  Once again National shows it has no concept of public health and is happy to keep pouring money into the treatments it chooses and putting more strain on the health system in the future.

I think that the best system is this one developed by Sanitarium. It combines individual nutrient ratings with an overall rating while still retaining the simple traffic light approach. This is what we should be pursuing.


Addicted to Food

Posted by on December 30th, 2011

Perhaps it’s just because Christmas overeating is still heavy on my mind (and other body parts) but I’ve noticed there seems to have been a lot of discussion about causes of and suggested solutions to obesity over the last few days.

Waikato University scientist, Dr Pawel Olszewski suggests sugar and fat may produce changes in the brain which resemble the effects of addictive drugs. This may have a profound impact on the way governments, health practitioners and communities plan to combat the impact of the growing incidence of obesity.

We must be careful, though, not to directly equate sugar and fat, which our bodies need, to nicotine, alcohol, THC, amphetamines etc which we can quite happily do without:

Dr Olszewski says that while the brain responds to tasty foods in ways that have a lot in common with its reaction to drugs, he stresses there is a clear distinction between the complex mix of substances found in foods and a single compound such as morphine or nicotine. For this reason he describes over-eating patterns as “addictive-like”.

“We don’t want to send the message that if you’re eating a sandwich, that you’re consuming a drug. However palatable, high-sugar foods very often increase activity of the same brain circuits that are involved in the creation of the addictive state.

“So we believe this addictive-like behaviour stems from the effect that nutrients, in particular sugar and to some extent fat, have on the same set of brain areas that drive addiction.”

Tony Falkenstein, chief executive of Just Water International, made the connection and took it to a seemingly logical conclusion by suggesting a sugar tax. (Which, of course, would benefit his company).
This drew a thoughtful rebuttal from Dr Jim McVeagh at MacDoctor:

Immediately one can see the absolute pointlessness of a sugar tax. Potatoes, white bread, rice and pasta become sugar in the body as fast as pure cane sugar and nearly as fast as glucose powder. Taxing sugar is like sticking your finger in the dyke when the tsunami alarm has just gone off. And taxing carbohydrates in general is just adding a tax to nearly all food.

I’m inclined to agree that taxing sugar is pointless and taxing fat just becomes ridiculously complex as you attempt to define ‘good’ and ‘bad’ fats.
As Jim McVeah says,

all that causes obesity is taking in more calories than you burn up.

So if an excise-type tax were to be used in an attempt to curb obesity, the only logical approach I can think of is for it to be based on calorie density. Extremely calorie dense foods tend to be those that we ought only to eat occasionally although I expect there will be exceptions. A similar  effect could be achieved by taking GST off  low-calorie density foods. Both approaches have flow-on consequences that would have to be thought through before suggesting that either is worth implementing.

Add to the mix research released from Ohio State University this week that shows the attachment between mothers and toddlers is linked with incidence of obesity and you quickly get the picture that obesity is not straight forward and solutions will be neither singular nor simple.

Obesity is a significant driver of the increasing cost of healthcare and therefore cannot be ignored. Developing prevention and treatment strategies is the responsibility of governments as much as it is the responsibility of parents, communities and individuals.


Health System on its Head

Posted by on February 8th, 2010

Last month when Rahui Katene suggested more public money be put into providing stomach stapling operations as an answer to obesity-related health complications I knew in my gut that it was the wrong message and needed to be challenged.

But I also know a couple of people for whom this type of operation has been extremely beneficial and has extended their life expectancy immensely. As a final option – when all other avenues have been explored – it should be considered.

Today, however, the completely arse-about-face approach to healthcare the National / Act / Maori Party government take has taken a step into the ludicrous.

Reports this morning bemoaning the additional costs to ACC of dancing-related accidents typify the thinking:

Prevention = Bad, Cure = Good
                             or
 Long term plans = Bad, Short-term stats in time for the election = Good

Should we discourage kids from playing sport because they might get injured? Should we not go to the gym because we might pull a muscle? Should we all sit on the couch and watch TV or play Playstation rather than go for a walk as a family?

And having lived that type of lifestyle, will the Government then pick the tab on surgery to make it all OK?

There is no sense whatsoever in taking away the services that teach people to take responsibility for their own health and assist people to make early interventions and then putting more ambulances at the bottom of the cliff.


A nation of couch potatoes?

Posted by on July 17th, 2009

Worrying new data released by the OECD this week shows one in four New Zealanders are overweight. All of us pay for the health-related costs of that. Obesity is one of the major health risks facing New Zealanders, but National has taken a knife to initiatives to combat this growing problem.

So far the Government has cut funding to the Obesity Action Coalition, is threatening to remove Fruit in Schools, has dumped reducing obesity as a health target and has cut nearly $5 million from the diabetes ‘Lets get Checked’ budget. They’ve pulled the plug on healthy food in schools, cut budgets for Mission On and Push Play, and no doubt there is more to come.

Without appropriate intervention it has been estimated there could be up to 180,000 New Zealanders living with Type 2 Diabetes by 2011. One dollar spent on preventing obesity is repaid many times over in the long-run. So what is the appropriate role for the state? Should we focus on preventative measures or simply wait until people become dependent on the ‘nanny state’ for their healthcare?