Abstract
BackgroundThe cost and dietary choices required to fulfil nutrient recommendations defined nationally, need investigation, particularly for disadvantaged populations.ObjectiveWe used optimisation modelling to examine the dietary change required to achieve nutrient requirements at minimum cost for an Aboriginal population in remote Australia, using where possible minimally-processed whole foods.DesignA twelve month cross-section of population-level purchased food, food price and nutrient content data was used as the baseline. Relative amounts from 34 food group categories were varied to achieve specific energy and nutrient density goals at minimum cost while meeting model constraints intended to minimise deviation from the purchased diet.ResultsSimultaneous achievement of all nutrient goals was not feasible. The two most successful models (A & B) met all nutrient targets except sodium (146.2% and 148.9% of the respective target) and saturated fat (12.0% and 11.7% of energy). Model A was achieved with 3.2% lower cost than the baseline diet (which cost approximately AUD$13.01/person/day) and Model B at 7.8% lower cost but with a reduction in energy of 4.4%. Both models required very large reductions in sugar sweetened beverages (−90%) and refined cereals (−90%) and an approximate four-fold increase in vegetables, fruit, dairy foods, eggs, fish and seafood, and wholegrain cereals.ConclusionThis modelling approach suggested population level dietary recommendations at minimal cost based on the baseline purchased diet. Large shifts in diet in remote Aboriginal Australian populations are needed to achieve national nutrient targets. The modeling approach used was not able to meet all nutrient targets at less than current food expenditure.
Highlights
Similar to that of other low income populations, the contemporary diet of Aboriginal Australians has been characterised as excessive in refined carbohydrate, sodium, and low in fruit and vegetables[1;2]
Sampling of communities Convenience sampling was used to select three remote communities that were invited to participate in the study. These communities were located in the Northern Territory, had previously provided electronic point-of-sale data for research, and were characteristic of the variation in size, distance from a metropolitan centre and number of food businesses and services observed in remote Aboriginal communities[1]
Protein as a percentage of energy was below the recommended range and total sugars as a percentage of energy were more than three times the recommended level (Table 4)
Summary
Similar to that of other low income populations, the contemporary diet of Aboriginal Australians has been characterised as excessive in refined carbohydrate, sodium, and low in fruit and vegetables[1;2]. Surveys to assess the cost of a defined basket of foods in different states[4;5] and the Northern Territory (NT) of Australia[6] have consistently demonstrated relatively higher food costs outside major cities that increase with categories of remoteness[4]. Poor quality diets are associated with low socioeconomic position in Australia[7,8,9] and other developed countries[10;11]. This is significant for Indigenous Australians, where past estimates reveal nearly one-third (30.8%) of Aboriginal households in the severe poverty category[12]. The cost and dietary choices required to fulfil nutrient recommendations defined nationally, need investigation, for disadvantaged populations
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