Outreach health services through urban health project

The George Institute for Global Health has implemented outreach health programs and services with support from HCL Foundation. The activities are specifically aimed at making health services affordable and accessible. They help identify people at risk and encourage them to seek and use the available health services more effectively.

The urban health program provided promotion, education, and engagement with communities and key stakeholders on various health issues to facilitate better care and healthier societies through community-centric approaches.

Food, Diet and Obesity

Submission to the House of Lords Committee on Food, Diet and Obesity Call for Evidence on Food, Diet and Obesity

The George Institute for Global Health is pleased to contribute to the UK Government’s call for evidence on the links between food, diet, and obesity. 

Unhealthy foods and beverages are pervasively marketed, and are a powerful tool used by food manufacturers to alter food preferences, stimulate unhealthy food purchases, and adversely impact human health. 

Research produced by The George Institute for Global Health and other world-leading health and medical research institutes across the world indicates that the limited uptake of healthy and sustainable diets is associated with increased rates of diet-related non-communicable diseases (NCDs), including overweight and obesity, dental caries, diabetes, and some cancers. As a global medical research institute, we have highlighted findings and recommendations from our research that are pertinent to the United Kingdom (UK) context. While the scope of this enquiry is not focused on assessing the impact on the environment of food and treatments for obesity, we consider this an important topic that should be addressed in a future enquiry.

In this submission, we discuss the role of ultra-processed foods (UPFs) and sugar-sweetened beverages in causing obesity. Several changes are recommended to improve public health, including mandatory reformulation of food products to reduce unhealthy ingredients, clearer labelling to warn consumers about unhealthy choices & advertising of unhealthy foods and drinks. 

In summary, based on our evidence, we advise that the House of Lords Committee implement the following actions:

  1. Enforce comprehensive and mandatory policy measures, encompassing nutrition labelling policies, reformulation policies to encourage healthier food and beverage options, regulation on unhealthy food and beverage marketing and on advertising and taxes for less healthy products. Increase the affordability of healthier food alternatives (e.g. use of subsidies).
  2. Develop guidance around the role of UPF and HFSS products in a healthy diet and for tackling obesity, including a regulatory definition for UPF that is objective, verifiable and precise, using information readily found on the pack, such as the ingredients list and nutrition information panel.
  3. Mandate the inclusion of coloured front-of-pack labels on food and beverages to assist consumers in evaluating food quality and making informed decisions and provide detailed guidance on the design elements of health warnings and other considerations for implementing labelling policies.
  4. Engage meaningfully with communities and relevant stakeholders in shaping nutrition outcomes, granting them formal roles throughout the policy cycle, thereby facilitating the co-design of nutrition policies.
  5. Design policies relevant to diet and obesity that are gender-responsive and transformative, with their implementation monitored for any sex or gender differences, including by funding research that is disaggregated by sex and gender, at time of collection, analysis, and dissemination. 
  6. Develop and implement policies that are protected from industry influence and accompanied by a transparent process for monitoring, reviewing, and enforcement. This entails establishing clear and strict conflict of interest policies and mandating the disclosure of interactions between government and industry, including financial contributions.

For further information, please read our full submission 

Leads

Policy Papers - 18/07/2024

Dr Sonali Gnanenthiran

George Institute receives MRFF grant to transform patient care following stroke

Cardiovascular researchers at the George Institute for Global Health have been awarded funding for The LOTUS Trial (LOw dose combinations To improve stroke oUtcomeS) from the Medical Research Future Fund (MRFF) to determine if a new model of care can improve the critical risk factors of blood pressure and cholesterol management in stroke survivors.

Dr Sonali Gnanenthiran, chief investigator and cardiologist at The George Institute said there is an urgent need to improve secondary stroke prevention. More than 445,000 stroke survivors are living with this debilitating condition and a further 27,400 Australians experience a stroke each year1.

Currently only one in ten Australians who have experienced a stroke achieve the recommended targets for long-term blood pressure and cholesterol putting them at high risk of recurrent strokes and heart attacks.

“The $2.5 million MRFF Cardiovascular Health Mission grant over five years provides us with a huge opportunity to engage with patients, carers, doctors and nurses to simplify care and transform the way we manage stroke patients once they leave hospital, regardless of where they live,” she explained.

The LOTUS Trial will assess whether early use of low doses of combination therapy to treat blood pressure and cholesterol will achieve better outcomes than usual care. Central to the plan to improve blood pressure is a new multi-mechanism, single pill combining three anti-hypertensive medications at low doses, developed by George Medicines. The team-based program will also involve nurse-led telehealth, involving 400 people across trial sites across Australia. Nurses will phone trial participants to support therapy and encourage adherence. 

“This new model of care has simplicity and support at its core, which we anticipate will result in clinically significant reductions in blood pressure and cholesterol in this high risk population,” said Dr Gnanenthiran.

Blood pressure and cholesterol are the most treatable risk factors for preventing cardiovascular events in stroke survivors. Despite this, up to 30% of ischaemic stroke survivors cease medications for both these conditions within one year of experiencing their stroke.

“Small reductions in blood pressure and cholesterol make a big difference so we have to get better at keeping people on their medications,” said Dr Gnanenthiran. ‘’A 10 mmHg reduction in systolic blood pressure translates to a one-third reduction in recurrent stroke and up to a 20% reduction in cardiovascular events. Every 1 mmol/L reduction in LDL translates to approximately 20% reduction in stroke.’’

Reference

Stroke Foundation. No Postcode Untouched. Stroke in Australia. Nov 2020. https://strokefoundation.org.au/media/juuba3qm/no-postcode-untouched-30-october-final-report.pdf

Leads

Further reading

Why do we need to #SwitchTheSalt?

Almost everyone eats salt and almost everyone eats too much of it. Eating too much salt increases blood pressure, leading to heart attacks, strokes and deaths. Despite the efforts by governments and medical organisations over the last decade to reduce population salt intakes, little progress has been made. This is because people have become accustomed to the taste and dietary habits are hard to change. Salt is also a widely used ingredient in food manufacturing, and progress towards lowering levels in packaged foods has been slow.

What is potassium-enriched salt?

Potassium-enriched salt is a practical and scalable approach to lowering blood pressure and with it, the risk of strokes, heart attacks and death. Salt is made up of 100% sodium and chloride. A potassium-enriched salt, however, has some of the harmful sodium chloride replaced with potassium chloride. Potassium-enriched salt can be used as a direct substitute for table salt in cooking and seasoning, with most people unable to taste the difference.

Why is potassium important?

Potassium helps lower blood pressure and the main sources in the diet are fresh fruits and vegetables. The widespread potassium deficiency that we see today is largely because we’re eating more processed and packaged foods (which tend to be high in salt, or sodium) and less fresh produce. Some food processing methods can also remove some of the naturally occurring potassium from the source ingredients.

There is now even stronger evidence supporting the use of potassium-enriched salt. In particular there are now large international studies demonstrating that switching to potassium-enriched salt has clear protective effects on blood pressure, stroke, cardiovascular disease events and premature deaths in different populations. 

Visit our evidence library for a comprehensive collection of published research on all aspects of potassium-enriched salt.

Evidence library

But despite the weight of evidence, a systematic review of  high blood pressure treatment guidelines from around the world showed that while almost all mention sodium reduction, only a handful made specific reference to potassium-enriched salt. So we believe it is time to update all guidelines to encourage doctors to consider recommending potassium-enriched salt to people with high blood pressure.

Where can you find it?

Potassium

Want to know if you can buy potassium-enriched salt in your country? Use our product finder below which has links to brands available around the world. Where no product link exists, we’ve included an example of where it can be purchased online.

Watch: the health harms of salt in numbers

Impact of sepsis in Australia

Photography brings to life impact of sepsis in Australia

A compelling new photography exhibition titled ‘SOMEBODY #coulditbesepsis’ has launched in Sydney to highlight the impact of sepsis in Australia. From 17 to 28 July, striking images and moving personal stories of sepsis survivors and families who have lost loved ones will be displayed for the first time at Art Space on The Concourse, Chatswood, Sydney.

The exhibition is a collaboration between Sydney-based documentary photographer Helene Cochaud, Sepsis Australia, and real Australians affected by sepsis who have shared their stories of strength, resilience and hope.

Helene Cochaud said the project was a true partnership between herself and the survivors and families involved, providing a way to make their important stories heard.

“After watching a powerful episode of Australian Story about a sepsis survivor, I felt compelled to contact Sepsis Australia to find out more about the condition.

“Like many people, I had heard of sepsis but had little insight into what it is, its impact or how to recognise the symptoms that can absolutely save lives. Meeting with survivors and collaborating on this project has been a positive, life-changing experience,” she said.

Dr Brett Abbenbroek, Program Manager, Sepsis Australia and Asia Pacific Sepsis Alliance, highlighted the exhibition's role in giving a voice to the sepsis community in Australia and raising much-needed awareness.

“Sepsis is a complex, poorly recognised illness. Any infection can trigger it, causing organ failure and leading in many cases to death or life with permanent disability. 

“But sepsis is treatable if it’s caught early. The value of the personal stories Helene has captured cannot be overstated in raising community awareness of the signs of sepsis and bring attention to the lives of survivors and their families,” he said. 

Sepsis is one of the most common and deadly diseases worldwide, claiming around 8,700 Australian lives each year. Nearly half of the survivors are left with disabilities or impaired function, facing an increased risk of death in the following months and years. 

While anyone can develop sepsis, paediatric sepsis accounts for nearly half of all cases and is a major cause of preventable childhood death. Up to a third of surviving children face severe complications such as amputations, cognitive impairment, psychological impacts and other long-term conditions. 

Despite affecting around 55,000 Australians each year, community awareness of sepsis is dangerously low. Its early symptoms, such as fever, nausea and body pain, are often mistaken for other conditions like flu or gastroenteritis. Sepsis progresses rapidly, with the risk of death increasing by 8% for every hour that treatment is delayed. It is critical to recognise the early signs, act fast, and always ask: ‘Could it be sepsis?’

To offer insights into the creation of this important project and the impact of sepsis, a panel discussion with Helene Cochaud, Dr Brett Abbenbroek, survivors and families who have lost loved ones to sepsis, will be held at the exhibition on 20 July. 

Event details: www.willoughby.nsw.gov.au/Events/SOMEBODY-coulditbesepsis

Visit https://www.australiansepsisnetwork.net.au/ for more information about sepsis. 

 

Leads

Further reading

Australian Hypertension Taskforce unveils Roadmap to transform high blood pressure control and reduce preventable deaths

Media release

The National Hypertension Taskforce, led by the Australian Cardiovascular Alliance and Hypertension Australia, has now published a Roadmap to improve Australia’s blood pressure control rates from the current 32% to 70% by 2030. Achieving this target will make Australia a global leader in blood pressure management. 

Australian teenagers say zero alcohol products are appealing and could act as a gateway to alcohol use

Media release

New research commissioned by Cancer Council, led by The George Institute for Global Health, and published today in Appetite, found that over half (56%) of Australian teenagers aged 15–17 surveyed agreed zero alcohol products looked appealing, and said the packaging was attractive (54%).

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