Topics covered:

• Improving Hospital Food and Beverage Environments
• Improving Hospital Physical Activity Environments 
• Improving Support for Breastfeeding Employees 
• Improving Support for Tobacco-Free Hospital Environments
• Hospitals Partner with Public Health to Improve Food Environments:
• Addressing Community Health in Schools, Early Care and Education, and the Clinic 
• Community Benefit: Encouraging Healthy Habits Early
• Children’s Hospitals Working Together to Improve their Food Environments 

To read the issues in this series, go to:  http://www.cdc.gov/nccdphp/dnpao/hwi/resources/hospital_p2p.htm

The public is reminded of the ban on the sale of sugar sweetened beverages from all MidCentral District Health Board premises from next Tuesday (7 April). 

The ban will cover soft drinks, sugary fruit drinks, sports drinks, energy and other drinks where sugar is added to the beverage before sale. Low or no-sugar drinks such as water, unflavoured milk, tea, coffee and artificially sweetened soft drinks will still be available. Sugar will be available for staff and visitors who prefer sweetened tea or coffee (as these drinks contain a lot less sugar than sugar sweetened beverages). Fruit and vegetable juices will still be available, but
limited to 250 ml sizes.

The DHB hopes the ban will encourage staff, and visitors to reduce their consumption of sugary drinks and avoid the associated risks of obesity, diabetes, heart disease and dental problems. Staff have largely been positive about the health-promoting hospital strategy, and
MDHB has been supported in the media for announcing the ban. 

MidCentral Medical Officer of Health Dr Rob Weir says New Zealanders are among the biggest consumers of sugar sweetened beverages. He thanks staff for their support of the ban - which has helped the media highlight the problems with drinking too many sugary drinks, and which will make it easier for patients and staff to model making the healthy choice.

MDHB is one of many DHBs to ban sales of sugary sweetened beverages, and other DHB are expected to follow in coming months.

Today the WHO released the interim report of the Commission on Ending Childhood Obesity. Sir Peter Gluckman is Co-Chair of this Commission arising from his research background and expertise, and independently of his role as Chief Science Advisor to the Prime Minister of New Zealand. He co-chairs the Commission with Dr Sania Nishtar, former Minister of Science, Technology, Education and Training in Pakistan. The report has been informed by the Working Group on Science and Evidence comprising a broad range of scientific experts.

Structured as a consultation document, the interim report has been released by the Commission to seek feedback from all interested parties. As such, the Commission will be holding hearings in all of the WHO global regions. The interim report focuses on identifying and understanding the issues, the extent of the problem, and the rationale for various intervention approaches. While it addresses at a high level the issues of implementation, monitoring and accountability, these will be addressed in more detail in the definitive report. The Working Group on Implementation, Monitoring and Accountability advises the Commission via the Director General and will use the interim report as the background against which to undertake its considerations.

Key points of the interim report include:

• The problem of childhood obesity affects both developed and developing economies;
• The health, social and societal consequences of childhood obesity merit urgent action;
• Many children who are not yet obese are on the pathway to obesity and its health complications;
• Childhood obesity has its origins in multiple factors including biological, behavioural (individuals, peers and families) and contextual;
• Governments have a critical leadership role and solutions will involve multiple agencies of government;
• Civil society, NGOs and the private sector also have a critical role to play, and more constructive relationships will be needed;
• Addressing childhood obesity requires attention not just to the obesogenic environment but also to life course dimensions, and any approaches that do not consider both are unlikely to succeed;
• The interim report highlights a suite of strategies that are likely to be needed but that will require tailoring to local circumstance and context.

The Commission will produce its final report by December 2015. For further information: See http://www.who.int/end-childhood-obesity/en/

MidCentral District Health Board is to ban the sale of sugar-sweetened drinks from its premises by 7 April. 

The ban will cover soft drinks, sugary fruit drinks, sports drinks, energy and other drinks where sugar is added to the beverage before sale. Low or no-sugar drinks such as water, unflavoured milk, tea, coffee and artificially sweetened soft drinks will still be available. Sugar will be available for staff and visitors who prefer sweetened tea or coffee (as these drinks contain a lot less sugar than sugar sweetened beverages). Fruit and vegetable juices will still be available, but limited to 250 ml sizes.

The DHB hopes the ban will encourage staff, and visitors to reduce their consumption of sugary drinks and avoid the associated risks of obesity, diabetes, heart disease and dental problems.

MidCentral DHB's Medical Officer of Health, Dr Rob Weir said: "New Zealand has one of the highest consumption rates of sugar in the western world. Sugar-sweetened beverages are the leading source of sugar for New Zealand children. Sugar-sweetened beverages include soft drinks, sports drinks, energy drinks, fruit drinks, flavoured milk and other beverages that contain added caloric sweeteners. This policy is also about MidCentral taking a leadership role in its local community. It is hoped other workplaces will consider similar bans."

Dr Jeff Brown Pediatrician and Clinical Director of Child Health strongly endorses the removal for sale of sugar-sweetened beverages. "Removal of easy access to sugar-sweetened drinks on MidCentral premises will help set an example to parents and caregivers of the most vulnerable members of society. Children who can spend their first and formative years drinking milk or water will set off on a lifetime journey to better teeth, better nutrition, and better physical health. Hospitals and health centres should be examples of best care, including what drinks we supply and promote." 

Dr Phil Marshall Clinical Director Dental Services also fully supports this move. "Reduction of sugar intake will improve oral health as well as general health. It's not only the sugar content of these drinks which is excessive, but the acidity of some of the drinks means that people are literally dissolving their teeth away if they are frequent consumers. As a leading health service provider we need to take a lead in removing these drinks and advocating for more healthy alternatives."

The DHB noted that many other District Health Boards have instituted similar policies, and that some Councils' are also considering restricting the sale of sugar sweetened beverages. We believe that this ban will make MidCentral DHB a healthier place for staff, visitors and patients, and that our action will encourage people to reduce their consumption of sugar-sweetened beverages."

It is based on the Heart Foundation's Dietary Patterns and Heart Health Background Paper 2013 and the USDA's Series of Systematic Reviews on the Relationship Between Dietary Patterns and Health Outcomes 2014.

To read the full text of this position statement, go to: http://www.heartfoundation.org.nz/uploads/Dietary_patterns_position_statement_2014.pdf

General manager of Northland DHB Child, Youth, maternal, Public and Oral Health Services Jeanette Wedding says the decision has had a lot of support from staff, as well as receiving positive comments from the public, particularly on Facebook.

“The stocks are going down per the Northland DHB’s request that they be reduced during September and we will be monitoring for compliance from 1 October. Thanks to staff and public for their support in initiating a strategy to improve healthy lifestyles.”

To read the full story, go to: http://www.scoop.co.nz/stories/GE1409/S00112/fizzy-free-at-dhb-well-received.htm

Northland DHB will soon be walking the talk by eradicating all sugar-sweetened beverages on-site.

This month, Northland DHB approved the policy for the removal of sugar-sweetened beverages from onsite cafeterias and vending machines and this is on track to take place from October this year.

Sugar-sweetened beverages can contain large amounts of sugar (and, therefore, energy) but few other nutrients. These generally include soft drinks, fruit drinks, iced tea, sports drinks, energy and vitamin water drinks. Low or no-sugar beverage options include water, unflavoured milk, non-sugar added fruit and vegetable juices, tea, coffee, artificially sweetened diet or zero drinks and these will still be available onsite.

The policy has been in the pipeline a long time, according to Northland DHB diabetes dietician Virjean Primeau who has enthusiastically welcomed the outcome.

“It existed when I started here eight years ago but nothing was ever done,” she says. “It’s extremely satisfying to see it finally coming to fruition.”

She says it’s time the Northland DHB practises what it preaches by not selling sugary drinks on-site.

To read the full media release, go to: http://www.scoop.co.nz/stories/GE1408/S00116/goodbye-sugar-sweetened-beverages.htm

Studies in this issue (attached below):

Studies in this issue (attached below):

The report follows a 6-month inquiry by a steering group comprising representatives from 20 of the Royal Medical Colleges and Faculties.

The report presents an action plan for future campaigning activity, setting out 10 recommendations for healthcare professionals, local and national government, industry and schools which it believes will help tackle the nation’s obesity crisis.

Recommendations include:

• Food-based standards to be mandatory in all UK hospitals
• A ban on new fast food outlets being located close to schools and colleges
• A duty on all sugary soft drinks, increasing the price by at least 20%, to be piloted
• Traffic light food labelling to include calorie information for children and adolescents – with visible calorie indicators for restaurants, especially fast food outlets
• £100m in each of the next three years to be spent on increasing provision of weight management services across the country
• A ban on advertising of foods high in saturated fats, sugar and salt before 9pm
• Existing mandatory food- and nutrient-based standards in England to be statutory in free schools and academies.

The report can be downloaded in full text at: http://www.aomrc.org.uk/publications/reports-a-guidance/doc_download/9670-measuring-up.html

Academy of Medical Royal Colleges (2013). Measuring up: The medical profession's prescription for the nation's obesity crisis. London: Academy of Medical Royal Colleges.

The authors consider the role these industries should have in NCD prevention and control and the common strategies that they use to undermine NCD prevention and control. They also assess the effectiveness of self-regulation, public—private partnerships, and public regulation models of interaction with these industries.

To view the full abstract and for information on how to access the full text, go to:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)62089-3/fulltext or contact your DHB library, or organisational or local library for assistance.

Moodie, R., et al. (2013). Profits and pandemics: Prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. The Lancet, 381(9867), 670-679.

Studies in this issue (attached below):

• Diabetes Get Checked programme outcomes
• Using storytelling to improve BP
• Ethnic differences in primary health care access
• Rheumatic Fever Programme in Samoa
• Preventing rheumatic fever recurrence
• Supporting patients with COPD
• Samoan people's views about antibiotics
• The 'Healthy Dads, Healthy Kids' programme
• Will taxing sugary drinks address obesity?

To subscribe to the Pacific Health Review, go to: http://www.pacifichealthreview.co.nz/