The use of third-party online meal delivery services (OMDS) e.g., Uber Eats, has become increasingly common globally and in Australia over the past decade. However, there is a lack of information about consumers' awareness of the nutritional content of the meals they order via these platforms.
In 2022, 3,000 adult Australians completed an online questionnaire about OMDS use and other socio-demographic and lifestyle factors. A quota was applied to obtain a nationally representative sample in terms of age, gender, and location. Those who had used OMDS were asked about their awareness of the nutritional content of the meals they order via OMDS.
Sixty-five percent (n=1,958) of respondents had used OMDS, with 26% using them at least once a week and 6.91 times (SD=9.23) on average in the past three months. Forty-two percent of users tended to include a soft drink with their main meal, while 48% tended to include side dishes/other drinks. The majority of OMDS users reported that they did not know the nutritional content of the meal they ordered via OMDS (63%). Older, males, frequent users and food label readers, those meeting the recommended serves of fruits, those with lower BMI, and those who paid a lot of attention to their diet, were significantly more likely (p<.05) to know how many kilojoules/calories were in their meal.
These findings indicate a high use of OMDS by Australian consumers, and despite public health campaigns, about half order soft drinks with their meal. What is of concern is that the majority of users are not aware of the nutritional content of the meals they ordered. Given the increasing popularity of OMDS, public health interventions and policies (e.g., mandatory menu labelling) may help consumers make healthier food choices when using these platforms.

Introduction: Tropical climates, expansive coastlines and an abundance of fresh waterways, all make the Northern Territory (NT) an extremely popular place for recreational water activities. Despite concerted efforts to promote general water safety and warn against the dangers of jellyfish and crocodiles, preventable water-related injury presentations to health services are not uncommon in the NT. To ensure preventive health action is both sustained and effective, we established and implemented a NT specific injury surveillance method to examine and describe water-related injuries.
Methods: We undertook a descriptive analysis of all water-related injury cases that presented to NT public hospitals or government community health clinics in 2023. We examined the nature, cause, place of and activity during injury by key demographic characteristics.
Results: In 2023, there were 220 cases of water-related injuries in the NT. Most injuries were males (71%), 25% were children and 18% were visitors to the NT. The three leading causes of injury were contact with (mostly venomous marine) animals (n=90), non-fatal drownings (n=42) and falls (n=30). Jellyfish were the most common marine animal causing 14 injuries, whilst crocodiles caused 9 injuries. Most hospitalised water-related injuries happened while participating in a sport activity, particularly fishing and swimming, and occurred in open water, stream water or beach environs. The highest count of water-related injuries was in the month of October (n=29).
Conclusion: Key priority areas and population groups of water-related injury were communicated to the NT Water Safety Advisory Council to support collaborations and inform prevention. Biannual reporting will provide evidence to support sustained action. This is an iterative process where the data and prevention will inform each other. Through this approach, we hope to better uncover the underlying causes of injuries and highlight gaps for improved surveillance and targeted preventive health action.

Background: The global population is ageing, leading to a rise in health-related risks and conditions, including frailty. Beyond clinical and behavioural factors, socioeconomic status (SES) is emerging as a critical determinant of health outcomes in older age, influencing frailty risk. This systematic review explores the relationship between SES and frailty in older adults.

Methods: A systematic search was conducted across five electronic databases (EMBASE, MEDLINE, CINAHL, PsycINFO, Scopus) from inception to March 2024. Studies were included if they examined both SES and frailty in older adults. Data extraction was performed, and risk of bias assessments were completed using the ROBINS-E tool.

Results: Thirty-one cohort studies involving 311,619 participants were included. 29 studies were at low risk of bias, and two other studies were found to have some concerns. Findings consistently indicated that lower SES—measured through education, income, wealth, occupational status, and neighbourhood deprivation—was associated with increased risk and progression of frailty. Specifically, 80.8% studies reported a significant link between lower educational attainment and frailty, while 69.2% of studies reported that lower income exacerbated frailty in older adults. 72.7% of studies reported that lower wealth was associated with higher frailty. Studies (77.7%) also reported that less-skilled occupations, for example those that involve heavy manual labour, was associated with higher risk of frailty in older adults. Half of studies reported that neighbourhood SES affected frailty negatively, where those who lived in less advantageous areas were more likely to become frail.

Conclusion: This systematic review highlights a strong association between lower SES and a higher risk of frailty in older adults, underscoring the need for targeted interventions that address these disparities. Future research should focus on investigating the longitudinal relationship between SES and frailty to enhance understanding of their complex interactions, informing policies that promote healthy ageing.

Many community sporting venues sell energy-dense, nutrient-poor options through their canteen facilities which undermine the health benefits of physical activity and contribute to poor nutrition outcomes.

Healthway utilised a settings-based, collaborative approach to partner with Hockey WA promoting the Fuel to Go & Play® message. A priority of this partnership was to reform the food service at Perth Hockey Stadium, set an example for their affiliated organisations and increase the sales of healthy foods and drinks. A number of strategies were developed to achieve this outcome:
• Communication with key stakeholders about the need for change.
• Facilitate a relationship with FoodCore (Fuel to Go & Play®) to provide intensive nutrition support to Hockey WA
• Build the capacity of key administration staff and canteen employees by completing nutrition education to learn about healthy foods and healthy profits
• Install prominent signage to promote healthy options, improve healthy product placement and remove sugary drinks from display.

Hockey WA adopted a whole-of-organisation approach and leveraged new partnerships with healthy brands such as Tucker Fresh (Supermarket) and Bravo apples to support this initiative.
An initial menu assessment found only 27% of items were healthy. This has now increased to 45%. Furthermore, hot chips sales decreased by 48% (96 kgs down to 46kgs per week) and sugary drinks were removed from display, with sales falling from 73% to 51% of total drink sales.

We initially assumed that canteen reform would be a quick and seamless transition. However, it became clear that achieving sustainable results required building on small, incremental changes over a two-year period. Challenges like staff turnover and traditional mindsets presented significant hurdles, yet these obstacles also fuelled a strong drive for sustainable change, reinforcing Healthway’s commitment to best practice in prevention methodologies by applying co-design and collaborative approaches with our partners.

Intro: Handgrip strength (HGS) is considered a proxy of overall muscle strength and a powerful predictor of morbidity and mortality with age. Understanding the factors influencing lifelong muscle function is essential for developing effective prevention strategies to mitigate greater losses in later life. This study aims to systematically review the literature on the factors associated with adult HGS [at follow-up(s) or its rate of change] across the life course.
Methods: Searches were performed in MEDLINE via Ebsco, Embase and SPORTDiscus databases. Longitudinal studies assessing potential factors impacting adult HGS over time were included. A semiquantitative analysis was performed based on previously established definitions of results consistency, using the proportions of studies supporting correlations with HGS.
Results: A total of 117 articles were included in this review. Factors associated with HGS were grouped into 11 domains: demographic, socioeconomic, genetic, early life, body composition, health markers/biomarkers, health conditions, psychosocial, lifestyle, reproductive and environmental determinants. Overall, 103 factors were identified, with 10 showing consistent associations (i.e., supported by at least four studies with ≥60% agreement). Notable factors associated with greater declines in HGS included increasing age, male sex, higher inflammatory markers and cardiovascular diseases. Conversely, education level, medication use, and self-rated health were not associated with the rate of change in HGS. Higher birth weight was associated with a stronger HGS over time, whereas depressive symptoms were linked to a weaker HGS, and smoking habits showed null associations.
Conclusion: Although sex and age may be the main drivers of HGS decline, targeting modifiable factors such as inflammation and cardiovascular diseases is crucial for prevention. Improving birth weight and mental health may also positively impact HGS, underscoring the need for early preventive measures. Our results highlight the complex factors influencing muscle strength and emphasize the importance of a life course perspective in ageing research.

Food insecurity (FI) is a global public health concern, with catastrophic levels in low-income countries and increasing in developed countries, including Australia. The Australian Government’s monitoring and surveillance of FI is limited, with the problem framed as impacting small population sub-groups, and monitoring relies on a single question. This study aimed to estimate the prevalence, severity and factors associated with FI in Western Australia (WA) using the 18-item Household Food Security Survey Module (HFSSM), widely accepted as the gold standard tool, and the proportion was compared with a single measure. The current study used cross-sectional data from the WA Health and Wellbeing Surveillance System (2017-2021), the first time in Australia incorporating the HFSSM in a large population-based survey. Weighted prevalence and severity of FI were calculated from a population representative sample of n=8,684 households. Bivariable logistic regression followed by multivariable model were conducted to assess factors associated with FI. Prevalence of FI was 5.1% using the Canadian HFSSM classification, significantly higher than would be reported using the single measure (3.0%, p-value<0.001). A higher proportion of FI was reported among households with children than those without children (7.2% vs. 4.7%, p<0.001). Unlike the single item, the HFSSM further identified that 3.4% of households experienced moderate and 1.7% experienced severe levels of FI. Significant and positive associations were found between FI and households with low annual income (AOR=5.4; 95%CI=2.5, 11.5), not owning a house (AOR=3.5; 95%CI=2.2,5.5), unable to save money (AOR=8.3; 95%CI=5.1,13.5), ≤Year12 education attainment (AOR=3.2; 95%CI=1.6,6.2), higher BMI (AOR=1.03; 95%CI=1.01,1.06), experienced psychosocial events (AOR=3.5; 95%CI=2.0,6.1), and higher psychological distress (AOR=3.7; 95%CI=1.8,7.4). These findings show that the single measure may underestimate the proportion of FI compared with the Canadian HFSSM classification. Furthermore, prioritising the public health policy, actions and resources according to severity of FI is not possible with the single item.

Emerging evidence shows that physical inactivity is associated with an elevated susceptibility of developing 13 types of cancer. The National Preventive Health Strategy adopts a comprehensive approach to addressing physical inactivity across the entire population in alignment with the Australian evidence-based guidelines on physical activity and sedentary behaviour. Prioritising investment in promoting increased physical activity may facilitate a reduction in the site-specific cancer burden associated with sedentary behaviour.

We recently developed the Physical Inactivity and Cancer policy to present comprehensive, evidence-informed policy initiatives to create supportive environments for Australians to increase participation in physical activity with a focus on mitigating risk of associated cancers and other chronic diseases.   

We conducted an evidence review and engaged key experts in physical activity and cancer prevention to assist with the development of evidence-informed recommendations for the promotion of physical activity among all Australians.

Successfully combatting physical inactivity requires coordinated action across various levels including within the individual, interpersonal, community and policy, and societal domains. Four overarching priority areas were identified: 1) Infrastructure and policy development which alter the physical environment and foster active transportation; 2) Promotion of Australia’s physical activity and sedentary behaviour guidelines for all ages; 3) Enhancing and updating national data collection on physical activity among children; 4) Promotion of intersectoral engagement and strategic partnerships for comprehensive physical activity promotion.  

Physical inactivity is a function of individual, community and societal factors, and requires a comprehensive response. The promotion of physical activity needs to intersect across multiple spheres of influence, and a health in all policies approach is required to ensure all sectors address the causes of and barriers to physical inactivity. Ongoing commitment and resourcing from all levels of government is imperative to effectively support regular physical activity participation among all Australians for the purpose of cancer and chronic disease prevention.

INTRO: Culturally and linguistically diverse (CALD) migrants in Australia face significant disparities in health outcomes (increased overweight/obesity, disease, and certain cancers), compared to the Australian population. Evidence suggests that nutrition interventions, e.g., National Nutrition Foundation’s ‘freshSNAP’ program (funded by the Department of Health Western Australia) can improve childhood eating behaviors by reducing the risk of overweight/obesity improving children’s current and future health outcomes. Presently, nutrition interventions that are adapted for CALD populations are limited. This research aims to co-design culturally appropriate nutrition resources that enhance knowledge and awareness about healthy food for CALD mothers of young children.
METHOD: A stakeholder group representing key organisations and the CALD community has been convened to inform the project. A convenience sample of 15 CALD mothers with children 5-12 years of age have been recruited via project stakeholders. Using the Double-Diamond framework, one of three semi-structured co-design workshops has been conducted with participants (n=6) to: (1) explore the barriers and facilitators to nutritious food preparation/provision and education; (2) review current and develop new culturally appropriate nutrition resources, and (3) elicit key health communication strategies for dissemination.
RESULTS: Preliminary findings under three concept areas were explored. CALD mothers experienced persistent barriers including English literacy, food literacy, cultural food insecurity and cost to healthy food preparation/provision. Facilitators included tailoring information for their preferences, accounting for acculturation experiences. Participants reviewed current resources and reported that to increase cultural appropriateness, communication strategies were to minimize text, utilisation of pictorial format and cultural imaging.
CONCLUSION: Early co-design has indicated that critical elements specific to the CALD community should be considered in resource development. Nutrition resources that are specifically tailored to CALD mothers will likely support the equitable mobilisation of health knowledge. The resources may also enhance knowledge and awareness about healthy food and help in the prevention of overweight/obesity.