Type 2 diabetes food advice uk,janis joplin cover xandra,diabetes medication with fewest side effects of,type 2 diabetes home test kit boots instructions - 2016 Feature

All content on this website is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Oats, green tea, newer varieties of breakfast cereals, herbal powders and medicines are some of these that are tried and tested not just by the ones suffering the medical conditions but also by people who want to take the road to good health. One of the biggest challenges in managing diabetes type 2 – (the condition in which the body is unable to use insulin hormone to digest glucose from the sugar) is, always having to watch what we eat in order to manage the condition.
Bad: There are certain high-carbohydrate vegetables too, which need to be taken in moderation. Bad: Refined flour which processed foods such as white breads, cookies, pastries etc are rich in, should be avoided. Good: Naturally occurring fats, such as monounsaturated fats found in almonds, avocados or polyunsaturated fats found in sunflower seeds are good for the health of the heart. Bad: Refined oils that most of the junk foods are cooked in, cheese, and butter contain saturated fats are high calorie foods which are best avoided.
Good: Fresh fruits taken in moderation are good for the health as they are a rich source of dietary fiber and can also curb your craving for sugar.
Bad: Stay away from canned fruits which are preserved with tons of sugar or even fruit juices that are prepared using lot of sugar and do not have the nutrients of the whole fruit. Let’s first look at what brown rice is and how it is different from the regular, more popular version of white rice. Helps to reduce weight: As brown rice is produced by merely removing the husk, the additional layers that white rice lacks, contributes to high fiber. Cuts risk of colon cancer: Brown rice is a rich source of selenium, a trace mineral that has several benefits to the body.
Protects from free radicals: Brown rice is a rich source of manganese, yet another trace mineral, which protects cells from the effects of free radicals that are produced during energy release. Reduces the effects of cardiovascular conditions: For people, especially women in the post menopausal phase of life, consumption of brown rice often is highly beneficial, as it slows down the deposit of plaque that narrows the blood vessels.
Reduces cholesterol: Brown rice contains natural oil that lowers the bad cholesterol or the LDL cholesterol.
Protection against heart disease: Brown rice consists of a phyto-nutrient known as plant lignan. Source of magnesium: Magnesium is a wonder mineral that has several positive functions in the body. Prevents gall stones: Some studies have shown that consumption of brown rice can help avoid the development of gall stones. It is wonderful to take note that brown rice provides so many benefits and helps us lay a healthy foundation for a good life. To understand how brown rice helps manage diabetes type 2 better, it is important to understand a little bit of the digestion process.
Now, in the case of brown rice, the grain is more fibrous as it has the two outer layers of bran and germ intact. Brown rice is indeed a wonderful food for diabetics to keep their blood glucose levels under check.
As brown rice contains more fiber, it takes little bit more effort in cooking this form of rice. It is never too late to switch to healthier forms of the foods that we are presently having. First and foremost, there are two types of Diabetes, and they are very different from one another.
Diabetes is a serious health condition that not only affects your lifestyle, but puts you at risk for other health conditions including high blood pressure, stroke, and nerve damage.  Many Americans are at risk for type 2 diabetes, and the numbers are growing yearly.
One change that I always recommend to my clients when we discuss lifestyle-eating, and healthy living options that can be made, is to give up soda.
People often look at me, horrified.  They would rather I ask them to nibble on a pigs ear!  Here are some facts for you about regular and diet sodas and what they do to your body and your mind.
Sedentary lifestyle is a medical term used to describe a lifestyle with little or no physical activity.  It is commonly found in both the developed and developing world, and is characterized by sitting, reading, watching television or using the computer for much of the day, with little or no vigorous physical exercise. Approximately 50% of America’s youth aged 12–21 are not regularly physically active.  Moreover, physical activity declines dramatically during adolescence. A sedentary lifestyle increases the risk of developing diabetes, hypertension, colon cancer, depression and anxiety, obesity, and weak muscles and bones. According to the CDC, nationally in 2000, 78% of the population was at risk for health problems related to lack of exercise, which is regular and sustained physical activity.
Avoid all these dangers of a sedentary lifestyle by making the choice to exercise regularly!  Check out our tips for getting started. This chart from I Love Charts, is an interesting demonstration of how much sugar is in our food… Sometimes without us realising it.
I’m surprised by the orange (s0 much sugar?) – and delighted by the strawberries! Sweet Life is a South African diabetic community for those who have diabetes, both Type 1 diabetes and Type 2 diabetes. Sign up for our newsletter!Get all the latest news and info from the South African diabetes community, delivered to your inbox - for free! The content of this site is intended as information and is not a substitute for seeking advice from a medical professional. This site complies with the Health on the Net Foundation Code for trustworthy health information: verify here. IntroductionNowadays there is a mass of information and advice available from different sources about nutrition and health, and interested individuals can find details about the nutrients (e.g. Data snapshotIn the March 2010 quarter the unemployment rate for Pacific peoples was 14.4 percent, higher than for all ethnicities.
Inadequate housing affects children more than adults, particularly children in low-income families, in larger families, rental dwellings, and more deprived neighbourhoods (Centre for Housing Research, 2010). Social cohesion means cohesive community relationships with levels of participation in communal activities and public affairs, and a high number of community groups. A healthy diet is a key determinant of health outcomes and is particularly important for the growth and development of children and young people.Food choices are influenced by affordability as well as personal, family, and cultural preferences.
Data snapshotThe National Children’s Nutrition Survey conducted in 2002 found that Pacific children were the least likely to bring their food from home to school, and most likely to buy it from a canteen, shop, or takeaway.Pacific children had a lower mean energy intake than Maori children (but higher than European children), and derived a higher portion of their energy intake from fat. Physical activity is known to protect against obesity and cardiovascular disease, particularly in combination with a healthy diet (National Institute for Health and Clinical Excellence, 2010).
Life at Faith City‘Life-changing’ is how participants have described the Life 12 Week Weight Loss Challenge run by Manukau’s Faith City Church.The first Life challenge was held late in 2010.
New Zealand has one of the highest obesity rates among OECD countries (Ministry of Social Development, 2009).
Smoking is the biggest single cause of preventable morbidity (the non-death impacts of disease) and mortality in OECD countries, including New Zealand, and is well recognised as the leading risk factor for many forms of cancer, respiratory disease, and cardiovascular disease in adults.
More Maori and Pacific peoples smoke (45 percent and 31 percent, respectively) compared with the total New Zealand population (20.7 percent) (Ministry of Health, 2008k). Potentially hazardous drinking carries a high risk of damage to physical and mental health; including death and injury due to traffic accidents, drowning, suicide, and violence. Problem gambling can result in a range of negative effects for the gambler, their families, and the wider community. People’s beliefs and practices in relation to health and illness influence the ways they engage in health-promoting behaviours and access health services. Pacific peoples’ beliefs and practices may be different from mainstream understandings about health and illness. Access to timely and effective health care is an important determinant of health outcomes, for both death rates and the impact that chronic conditions have on Pacific peoples.
Data snapshotImmunisation provides protection against a range of communicable diseases, and is considered to be one of the most cost-effective public health interventions. For the 12 months to October 2010, 89 percent of Pacific two-year-olds were fully immunised, compared with 87 percent of European two-year-olds.
Screening identifies potential health problems at an early stage in people who do not show any symptoms. Breast and cervical cancer screening programmes have been effective in reducing mortality in the general population. The Primary Health Care Strategy (Ministry of Health, 2001b) established primary health organisations (PHOs) to provide structures for the local delivery of primary health-care services. The benefits of health care are dependent upon the quality of care received as well as accessibility of care. The average time spent annually with GPs during visits is a key indicator of access and use of primary care. Secondary care includes services provided by specialists, as well as in-patient and out-patient care in public and private hospitals.
Health is strongly influenced by a broad range of cultural, social, economic, and environmental factors. The authors, Phil Edwards and Ian Roberts, said: a€?When it comes to food consumption, moving about in a heavy body is like driving around in a gas guzzler.
A medical research carried out by the University of Michigan indicates that about half of all youngsters that use amoxicillin as a cure for bacterial infections develop amoxicillin rash. There are numerous types of amoxicillin allergy rashes that are caused by use of amoxicillin. Exfoliative rashes: These are rashes that leads to skin itching that can easily spread to other areas.
In addition to these and several other rashes, amoxicillin, like other penicillin drugs can cause anaphylaxis which is a life threatening condition. An insensitive amoxicillin rash may be a result of an infection like mononucleosis infection. Amoxicillin is one of the most commonly used drugs in treatment of bacterial infections in children. It is of utmost importance that parents contact health care providers as soon as they spot rashes in baby after administering antibiotics. Allergy to amoxicillin produces side effects to the users such as diarrhea, fever, skin rash, nausea and vomiting. Symptoms such as change in normal functioning of mind, fever and intense itching also calls for immediate medical solution. Itching: is a skin irritation or sensation that prompts a desire to scratch the affected region. Children affected by Stevens-Johnson syndrome require close hospital monitoring usually in the Intensive Care Unit (ICU) since the condition is life-threatening.
Children who have already experienced allergies to all types of penicillin should avoid antibiotics and amoxicillin. Youngsters who have medical records showing that they are allergic to antibiotics should also not be allowed to use them because they have a high chance of developing allergic reactions. In some cases, the amoxicillin rashes disappear by themselves, so you can still continue taking the medications. Breastfeeding mothers should consult a qualified medical professional because amoxicillin can be passed to the baby through breast milk. In case your child experiences bloods in stool or watery diarrhea, it is necessary to seek medical help immediately.
In conclusion, it is important to take to take amoxicillin rash seriously especially where it is accompanied by severe symptoms like breathing problems and intense itching. Use of this website and the information contained herein does not create a doctor-patient relationship.
True to this adage, the clutches that modern lifestyle conditions such as diabetes have over us have paved ground for the mushrooming of several health and food-related businesses. Our ancestors or even family members belonging to the older generation however did not allow these conditions to take control of their lives. There is a stark increase in the blood sugar level upon eating even a small quantity of food. In general, it is important to watch out for foods that have a high level of carbohydrates as they are easily broken down to glucose, which is difficult for the insulin-resistant body to convert to energy. There are however different forms of this wonder grain each created through variety of processes and each differing in its effects on our health. White rice is produced by removing further two layers, the bran and the germ, leaving behind the endosperm. Additionally, manganese also provides the body energy by helping in carbohydrate and protein digestion. It is in fact a key nutrient that our body requires to moderate the action of calcium and keeping our nerves and muscles regulated.
When we consume food, the acids, enzymes and the other processes break down the food into simple elements that can be absorbed by the intestines. It in fact comes as a surprise that rice was at one point in time consumed in its healthy whole format. Learning new varieties of recipes with such healthier alternatives makes our culinary experiments interesting. Many people engage in a variety of defenses and excuses when faced with the diagnosis of Type 2 Diabetes.
Whether the patient is diagnosed with Type 1 or Type 2, the health care issues involved are painful and costly.  Peripheral neuropathy is a painful and difficult to treat complication of diabetes. The quality of housing and household crowding are closely related to the risk of developing ARF, meningococcal disease, respiratory disease, and other infectious diseases.Due to their low income, many Pacific families live in less affluent communities. Healthier food options are often more expensive than those with high concentrations of fat and sugar, and those that are nutritionally limited.
Thirty-three mostly Pacific women completed the three-month course, which is designed for those who are very overweight and are keen to eat more healthily and be more active.Life involves training four times a week, sessions with a nutritionist and three weekend retreats to help address the psychological reasons behind obesity and unhealthy lifestyles. Obesity is associated with many adult health conditions such as cardiovascular disease, type 2 diabetes, cancer, and psychological and social problems (Ministry of Health, 2008e). Exposure to cigarette smoke (during a mother’s pregnancy and in childhood) is recognised as a major risk factor for sudden unexplained death in infancy syndrome and respiratory illness (Ministry of Health, 2005).Smoking is an important contributor to inequalities in life expectancy between ethnic groups. Alcohol problems are also associated with high-risk sexual behaviour and consequent problems.Fewer Pacific peoples drink alcohol than the general population.
Pacific peoples’ understandings tend to be characterised by a holistic perspective, where healthy and strong families are the basis for the well-being of individuals and communities. Suicide, for example, can be seen as the “ultimate rejection of one’s family” and a bereaved family can experience a “sense of failure to adequately care for and support the individual who is ill” (Beautrais et al, 2005).
In 2006, just over 90 percent of New Zealand infants were enrolled with Plunket, which provides clinical assessment, health promotion and parent education services.
Screening improves health outcomes by offering effective interventions before diseases become advanced. An increase in the uptake of cervical screening and the introduction of the HPV vaccination programme in 2008 (which has reported high coverage among Pacific girls (Minister of Pacific Island Affairs, 2010) should contribute to lower incidence of, and deaths from, cervical cancer in the future.
The levels of coverage are below the target of 70 percent of all eligible women, but there has been a sustained increase in coverage for Pacific women. Each PHO has an enrolled population, and is responsible for providing services to this population.In October 2007, nearly 100 percent of Pacific peoples were enrolled with a PHO6. The quality of health care is in part determined by interpersonal care; the interaction between health-care professionals and health-care users or their caregivers. The National Primary Medical Care Survey found that Pacific, Maori, and Asian people spent significantly less time with GPs, after controlling for a range of other variables. Secondary care services are normally accessed by referral from primary care or hospital emergency departments.
In general, people with fewer socio-economic resources tend to have poorer health outcomes due to a combination of reduced material resources, greater exposure to health risks and behaviours, greater psychosocial stress, and reduced access to health services.Many Pacific peoples have not experienced success in the education system, and therefore tend to have lower incomes and live in communities with the fewest economic resources. The estimate of the socio -economic contribution is based on analysis undertaken in relation to the impact of socio-economic inequality on the difference between the Maori and the European or other ethnic group in the NZ Census-Mortality Study. That is, they were physically active for at least 30 minutes a day, for at least five days in the previous week.
The survey uses AUDIT, which is a ten-item questionnaire covering alcohol consumption, abnormal drinking behaviour, and alcohol-related problems. This data is from the Enriched CBF Register produced by HealthPac at the Ministry of Health.


Although amoxicillin rash may appear scary for most parents, there is no specific treatment for amoxicillin rashes. Being administered orally, they are absorbed faster than other antibiotics such as lactic antibiotics. However, you should seek treatment for allergy to amoxicillin if it continues itching for up to 6 days.
The amoxicillin rash signs may not be diagnosed early because amoxicillin rash may affect the adults long after you have stopped using the drugs. Parents are supposed to provide health care providers with medical allergy records of their children to avoid administration of new antibiotics. If your body is allergic to certain drugs, it is important to obey the instructions of the doctor to avoid developing allergic reactions. However, if the symptoms are severe like intense itching, you can discuss with your health care provider and he may ask you to stop using the drugs.
If amoxicillin rash is accompanied by breathing problems it is appropriate to visit a doctor. Always consult with your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.
A chat with our grandmother would help us make the revelation that there are indeed several forgotten recipes and foods that were not only a treat to our taste buds but were also full of goodness and health. While there is no cure for this condition, regular physical activity and controlled eating patterns can help in management of the condition.
It is shown that selenium inhibits proliferation of cancer cells and also repairs of DNA of damaged cells.  In addition to this selenium works together with Vitamin E and helps prevent heart disease, decreasing symptoms of asthma, and controlling the effects of rheumatoid arthritis. These lignans are found to be having functions of reducing the risk of breast, other hormone-dependent cancers and other heart diseases.
This further has effects in lowering high blood pressure, reducing effects of asthma and also reducing the risk of stroke and heart attack.
When white rice is consumed, it is easily broken down to the elemental form of the carbohydrate – glucose. Experts suggest that brown rice went out of fashion as it doesn’t look good or taste as good as white rice.
Some of the common recipes include brown rice salad, fried brown rice, brown rice pie and so on. Please no link dropping, no keywords or domains as names; do not spam, and do not advertise! Unfortunately, ignoring the information isn’t an answer that will help or resolve anything. Food labels can also provide useful details on the amounts of the different nutrients contained in a food. For example, the proportion of Pacific households (with at least one Pacific adult) spending more than 30 percent of their income on housing was 33 percent in 2009, reflecting a steady increase from 23 percent in 2004 (Ministry of Social Development, 2010, p69).Students attending schools in communities with fewer economic resources tend to experience less education success than those in more affluent communities (Ministry of Social Development, 2009, p138). The prevalence of factors associated with lower levels of well-being, such as widespread smoking, obesity, hazardous drinking, and non-casino gaming machines, is greater in these communities.
Societies with diminished social cohesion have higher mortality rates and worse social outcomes than those with high levels of social cohesion (Stansfeld, 2006).Most Pacific communities have strong social connections, often centred on church and community activities.
Affordability of food is a significant issue for Pacific households, who were the least likely to report that they could always eat properly. The training sessions include gym workouts, weights, running, boxing, aquarobics, and hill running. Obesity is primarily caused by poor nutrition and sedentary lifestyles (Ministry of Health, 2008e). Pacific peoples who drink alcohol are more likely to be New Zealand-born and young (Alcohol Advisory Council of New Zealand, 2009). Similarly, 7.6 percent of the Pacific population reported experiencing problems as the result of someone else’s gambling, double the number of adults in the total population who reported being affected by someone else’s gambling. Suicide prevention, support, and other interventions must therefore be tailored to work with and within existing beliefs and attitudes.Similarly, culturally-based attitudes towards sex mean that Pacific youth often have reduced access to information regarding sexual health.
It includes the provision of health education and prevention services, coordination and treatment of less serious illnesses, and referral to secondary care.Other than emergency departments, primary care services are the first step into the health system. Pacific infants (87.2 percent) were less likely than European, but more likely than Maori infants to be enrolled (Craig et al, 2007, p121).
Effective screening is dependent on well-structured and organised processes and the monitoring of indicators of process quality. One of the providers, BreastScreen South, has reached the 70 percent target for both Maori women and Pacific women (National Screening Unit, nd, a). For the overall population, the target coverage is 75 percent (Massey University, Centre for Public Health Research, 2008). Craig et al (2007) reported that Pacific children and young people had higher enrolment rates compared with non-Pacific people. Underlying good interpersonal skill are communication skills, the building of trust, understanding and empathy, the discussion and explanation of the patients’ symptoms, and involvement in decisions regarding management or treatment of a patient’s condition (Campbell, Roland, & Buetow, 2000). Overall, Pacific patients spent an average of 18.8 minutes less time annually with GPs than European patients.
Despite this, Pacific peoples are actively involved in their communities and have strong social and cultural resources with strong family ties, church affiliation, and community support. The only amoxicillin rash treatment would be to continue using antibiotics.  The amoxicillin rash duration is generally 3 days although it can extend to 6 days.
Baby amoxicillin rash first leaves a reddened skin that later turn to become rashes or irritation. If someone is allergic to certain other substances or food and gets exposed to those items, it can be greatly misleading. You’ll find that if amoxicillin rash is not accompanied by other complications, the rashes disappear by themselves within a few days.
In other instances, if the patient recovers it may be necessary to continue using the drugs.
Warning signs should be handled with care; only then you can rest assured that you can manage amoxicillin rash and its symptoms. People suffering from these conditions are willing to give almost all of these a try and end up getting disappointed when they don’t see the desired results in their health or well-being.
Comfort and convenience have driven us to choose processed foods, which have short and long term effects on the body and health. Processing of rice to enhance its taste has led to health problems taking control over our lives. Brown rice requires a little lesser amount of water than what is used for cooking white rice. However, the nutrient information available can seem quite complex, is not well understood by the majority of consumers, and it is of limited use when preparing family menus without a good knowledge of nutrition. Pacific students tend to have poorer education outcomes than other students from the same communities.
An individual’s identity and well-being are traditionally dependent on family heritage, connections, roles, and responsibilities. They were also more likely (at nearly 50 percent) than Maori and Europeans to report sometimes running out of food due to lack of money (Ministry of Health, 2003). Social interaction is one of the factors that promote participation in physical activity (De Bourdeauhuiji, 1998), which in turn encourages social cohesion and social well-being.Pacific children have relatively high levels of incidental physical activity (such as walking to school), although they participate less than other groups in organised leisure and sport.
Day one of the challenge requires participants to push four-wheel drive vehicles around a carpark.Faith City project manager Essendon Tuitupou says women in last year’s challenge called it “life-changing”. Smoking accounted for 37 percent of this loss for men and 13 percent of the loss for women (Ministry of Health, 2001a). However, the Youth 2007 Survey found that twice as many Pacific students are regular smokers compared with European students.Living in a house with a smoker influences children and young people to take up smoking, and contributes to respiratory and other childhood illnesses. Overall, those aged 35–44 years had the highest prevalence of problem gambling (Ministry of Health, 2008a). Parents are less available to provide advice, as it is considered culturally inappropriate for children to discuss sexual health with their parents. They are crucially important in identifying serious illnesses that are then managed in conjunction with secondary and tertiary services. The results demonstrate that effective means are available to engage with Pacific peoples and deliver care services. BreastScreen South used a communications campaign where Maori and Pacific women were the priority audience, as it was apparent they were groups who were less familiar with the service (National Screening Unit, nd, b).
From 2011, the coverage target will be 80 percent (National Screening Unit nd, e).Since 2007, National Cervical Screening Programme communications campaigns have been particularly focused on encouraging more Maori and Pacific women to have regular smears (National Screening Unit nd, c). Fifteen percent of Pacific peoples were enrolled with a Pacific PHO and the remainder with a mainstream PHO (Ministry of Health, 2010c). Improvements in the annual consultation rate coincide with the implementation of the Primary Health Care Strategy (Ministry of Health, 2001b) and the reduction in fees to access primary care.To access services, people must first be aware that the services are available and that they are needed.
Only 21.2 percent of Pacific adults compared with 31 percent of non-Pacific adults used medical specialists in the previous 12 months. These community ties provide protection from some of the worst consequences of illness, and health services can be promoted to Pacific peoples through community organisations.Lower incomes mean that many of the conditions or factors that support good health, such as good nutrition and quality housing, are less accessible. From this low base about 85 percent of Pacific peoples are sending remittances overseas (Money Pacific, 2010). Although most of these side effects are not life threatening, it is necessary to seek medical help for some of the side effects. This condition is characterized with severe blistering and reddened rashes that cause the top layer of the skin to slough off. Provide your doctor with detailed information about all the symptoms that your child experienced with the amoxicillin rashes.
If your child is allergic to amoxicillin it means that even other types of penicillin drugs can result in allergic reactions. This combined with sedentary lifestyle and lack of exercise invites lifestyle conditions to become an integral part of our lives. Apart from being fibrous, the magnesium in brown rice is responsible for acting as a co-factor for over 300 enzymes. It is indeed high time we start including this brown, nutty, chewy and more superior form of rice to our diet and take the road to good health.
This is a result of a combination of factors, including lower levels of participation in early childhood education and teaching and learning practices throughout schooling that are less effective for Pacific students(Statistics NZ and Ministry of Pacific Island Affairs, 2010).Poor education reduces peoples’ employment opportunities. This reduces access to employment or education opportunities, community activities, and health care.
Having a strong sense of belonging seems to reduce the likelihood that an individual will consider or attempt suicide (Beautrais et al, 2005).In the 2006 Census, 83 percent of Pacific peoples stated they had at least one religion, compared with 61 percent of New Zealand overall. The 2002 National Children’s Nutrition Survey found that Pacific children were more likely than European children to be the most active, and the least likely to be the least active. In 2006, 48.1 percent of Pacific children under the age of 15 years lived in a household with a smoker (Craig et al, 2007, p165).
Primary care services have historically been centred around GP and practice nurse services, but more recently these have been expanded to involve multi-disciplinary teams and a broader range of services.
It was considered that this may reflect the difficulties of working through caregivers during the consultation, or generational or cultural differences (Davis et al, 2005). These findings are concerning given the documented high health needs of Pacific peoples, particularly the prevalence of chronic health conditions.Cultural competence is the ability of individuals and systems to understand and appreciate the differences and similarities within and among groups. Pacific peoples were even less likely to visit medical specialists when the specialist was located at a private facility.
Pacific peoples experience greater exposure to risk factors such as smoking, alcohol, and poor nutrition, with Pacific youth being particularly at risk.
However, in most times, amoxicillin side effects rash in children will disappear with time (not more than 6 days). If amoxicillin rash symptoms persist for more than a week, rush to your doctor for amoxicillin rash treatment.
A wonderful aspect about eating brown rice is that, it gives us the satiety in just small quantities. They give an indication of what a person should be eating in terms of foods rather than nutrients, and provide a basic framework to use when planning meals or daily menus.
4 percent).For the 12-month period to October 2010, 89 percent of Pacific 2-year-olds were fully immunised, compared with 87 percent of European 2-year-olds.
The 2006 Census of Population and Dwellings showed that 35 percent of Pacific peoples had no qualifications, compared with 25 percent of all New Zealanders.
Improvements in health can be achieved by improving educational performance and other social and economic circumstances. Pacific students express the importance of spiritual beliefs (57 percent) much more frequently than European students (20 percent) (Helu et al, 2009). The biggest thrill for me is when those ladies go away and continue with physical activity themselves.”Members of the group forged strong friendships and have continued to train together.
Interestingly, the rate of parents ‘smoking at home’ was much lower than overall parental smoking rates, indicating that approximately half of Pacific families with smokers do not support smoking inside the house.Youth smoking rates are a key predictor of adult smoking behaviour, as taking up smoking early increases the risk of smoking-related diseases. Overall, Pacific adults experienced greater levels of harmful consequences subsequent to drinking and those who drank reported greater alcohol consumption (Huakau et al, 2005).According to the results of a 2003 Alcohol Advisory Council (ALAC) survey that looked at youth access to alcohol, Pacific young people are more likely to be non-drinkers compared with other ethnicities. Pacific young people are less likely to access sexual health services as they are concerned that others may find out (Ministry of Health, 2008i). Programmes with a strong community-support focus, including provision of transport to attend appointments, have also had a positive effect on cervical screening participation rates.Cost is recognised as a continued barrier and the Ministry of Health supports subsidised cervical screening for groups where the uptake of screening services is lower (H Lewis, personal communication, October 2010). Similarly, medical insurance, which can allow more timely access to health care, is held by half as many Pacific (19 percent) as non-Pacific adults (38. Exposure to these risk factors contributes to a greater incidence of chronic diseases (such as diabetes, stroke, and ischaemic heart disease) among Pacific peoples. By eating just a small portion, we feel full and get the satisfaction of having had a wholesome meal. Characteristics as described by the World Health Organization (WHO) are1: the expression of the principles of nutrition education mostly as foods intended for use by individual members of the general public, and if not expressed entirely as foods, written in language that avoids, as far as possible, the technical terms of nutritional science. The unemployment rate is higher for Pacific peoples (14.4 percent in the March 2010 quarter) than for any other ethnic group (Statistics NZ, 2010). This has been discussed in Education and Pacific peoples in New Zealand (Statistics NZ and Ministry of Pacific Island Affairs, 2010) and will be explored in a future report on economic development. Voluntary work underpins a wide range of groups and organisations whose activities contribute to social well-being.
The survey found that about two-thirds of Pacific young people (compared with just under half of young people overall) are non-drinkers (McMillen, Kalafatelis & De Bonnaire, 2004).
Appropriate sexual and reproductive health information needs to be made available by alternative means.The relatively low success rate of smoking cessation programmes among Pacific peoples may be related to the belief, held by a relatively large number of Pacific smokers (24.
Cultural competence training of professionals improves patient satisfaction and the number of patients continuing with agreed medical care plans.
6 percent) (Ministry of Health, 2008a).‘Did-not-attend’ rates for out-patient appointments appear to be consistently higher among Pacific peoples. Alcohol consumption is associated with a greater risk of injury through accidents and violence. It is heartening to see that brown rice is starting to move from the shelves of organic food stores to supermarkets, thereby increasing our access to it.
FBDG should provide simple, food-based messages that are relevant to the population concerned and practical to follow.
Since the March 2008 quarter, the rise in Pacific unemployment has been greater than the total rise in unemployment. The General Social Survey 2008 showed that 42 percent of Pacific peoples had done voluntary work in the previous four weeks, significantly more than the mainly European ethnic group (Ministry of Social Development, 2010).The General Social Survey showed that 85 percent of Pacific peoples had at least weekly face to face contact with friends compared to 79 percent of the total population. This may be because Pacific children have higher rates of incidental activity, but lower rates of participation in organised leisure and sport, which is what SPARC measured.Research findings about adult levels of activity are mixed. However, among young people who do drink, Pacific youth consumed, on average, 6.9 standard drinks.
Those Pacific people who used face-to-face counselling services were experiencing more severe harm5 than those from other ethnic groups (Francis Group, 2009).


Pacific primary care providers deliver integrated services that include health promotion, primary care, secondary care, and social services. 4 percent), followed by lack of time, lack of availability of a suitable appointment, and not wanting to make a fuss. It impacts on the ability of an individual to communicate with health professionals, to discern what good advice is, and to translate this into action. The New Zealand Health Practitioners Competence Assurance Act 2004 requires professional bodies to ensure that set levels of cultural competence are met by practitioners (Tiatia, 2008). Addressing these risk factors will improve Pacific peoples’ health outcomes.People’s beliefs and practices in relation to health and illness influence their behaviour and how they access health services. Pacific peoples are over-represented in non-skilled and lower-skilled occupations (Ministry of Pacific Island Affairs, 2010).
The Youth 2007 Survey found that 17 percent of Pacific youth had helped others in their community in the last 12 months, (Helu et al, 2009) compared with 14 percent of youth overall (Adolescent Health Research Group, 2008). The New Zealand Health Survey (Ministry of Health, nd, f) found that only about half of New Zealand’s total population, and slightly fewer Pacific peoples (46.1 percent), were sufficiently active to gain any health benefits3. Fonua Mo’ui grants are designed to improve Pacific peoples’ health by supporting initiatives that promote healthy eating and physical activity. Since 1999, the number of smokers in the total New Zealand population has been trending down for all groups including Pacific boys and girls (Paynter, 2010). Pacific smokers are also most likely to believe that smokers should be able to quit without the assistance of a programme (Ministry of Health, 2009a). They aim to provide services that incorporate Pacific cultural care and language components to ensure the services are more appropriate for, and responsive to, Pacific peoples. Pacific peoples were significantly more likely than non-Pacific people to cite cost as a reason for an unmet GP need.
Those with limited health literacy have worse health status than those with adequate health literacy.
This applies to both nurses (Nursing Council of New Zealand, nd) and doctors (Medical Council of New Zealand, 2006). The higher rate among Pacific peoples may reflect the barriers Pacific peoples face in accessing services, including getting time off work, transport difficulties, cultural beliefs, and a lack of cultural responsiveness (Ministry of Health, 2008f).Surgical admissions (which tend to be elective rather than emergency) are lower for Pacific peoples. For example, attitudes to sexual health act as a barrier to Pacific peoples accessing sexual health services and protecting their sexual health.
Evidence from previous recessions also suggests that unskilled workers are hit hardest in times of recession, when unemployment rates for unskilled workers increase more than those for skilled workers (Department of Labour, 2009).Figure 1 shows that approximately half of all Pacific children and young people live in a crowded house, a higher proportion than other ethnic groups. Pacific peoples were the most sedentary group (undertaking less than 30 minutes of physical activity in the previous week) – 19. The Youth 2007 Survey found that Pacific students regularly smoked at twice the rate of European students, and that rates were highest among Samoan and Cook Island students (Helu et al, 2009).The 2006 Census showed that there are sub-group differences within the Pacific population. The proportion of Pacific young people (32 percent) who reported ‘binge drinking’ at least once in the previous four weeks was slightly lower than European young people (Helu et al, 2009).Drinking alcohol at an early age is associated with greater adverse health outcomes (Odgers et al, 2008). These findings show that beliefs regarding the nature of nicotine addiction and cessation options need to be changed in order to increase the number of Pacific people who give up smoking.
Access to care has been improved through lowering fees, providing local facilities, and giving nurses a greater role in primary care. Cost is also a factor in the collection of prescribed medications (Jatrana, Crampton, & Norris, 2010). Older people, those with more limited education, lower socio-economic groups, and those whose primary language is not local tend to have more limited levels of health literacy (Adams et al, 2009). Access to coronary artery bypass grafts (CABG) operations, angioplasties, and major joint-replacement operations has improved (Ministry of Health, 2006b). Lack of knowledge of tobacco addiction and smoking cessation interventions may prevent Pacific peoples accessing cessation services and traditional respect for authority may prevent Pacific peoples demanding the best care within the health system. A child growing up in an over-crowded house will be more susceptible to communicable diseases (Hawker, 2005) and over-crowding can have a detrimental effect on successful learning. It is estimated that three-quarters of Pacific peoples in New Zealand send money to family members in the Pacific region (Money Pacific, 2010).As well as building resilient and supportive communities, social connections also provide useful foundations for community health interventions.
4 percent – and were 40 percent more likely to be sedentary than the total New Zealand population. Drinking socially at an early age can cause increased short-term harm such as motor vehicle injuries and deaths, suicide, as well as longer-term harm from alcohol dependence, abuse, and related medical conditions (Alcohol Advisory Council of New Zealand, 2002). Nicotine replacement therapies are considered ineffective by a large number of Pacific peoples, and a relatively low proportion of Pacific peoples in south Auckland made claims for subsidised nicotine replacement therapies.
Pacific providers have shown better results for the management of patients with long-term conditions than other providers (Ministry of Health, 2010c). The Adult Literacy and Life Skills Survey 2006 showed that, overall, the literacy of Pacific peoples was lower than other ethnic groups (Statistics NZ and Ministry of Pacific Island Affairs, 2010). Ambulatory-sensitive hospitalisations (ASH) are admissions that are potentially avoidable through primary care interventions. While the number of admissions for coronary operations is low compared with the need experienced by Pacific peoples (Tukuitonga & Bindman, 2002), the inequalities in angioplasty operations are narrowing. Projects that “create and reinforce strong social connections across Pacific communities” (Tait, 2008) provide useful foundations for effective public health action.
SPARC’s 2008 Active NZ Survey used the same criteria as the New Zealand Health Survey, and had similar findings. Tokelauans are the most likely to be regular smokers, followed by Cook Islanders (38 percent), Niueans (33 percent), Tongans (29 percent), and Samoans (28 percent). Among young people, Cook Islanders are the heaviest drinkers with the most harmful drinking patterns, while Samoan men and women, and Tongan women are the least likely to drink (Ministry of Health, 2008i).
Although more Pacific people are likely to smoke, 60 percent fewer Pacific people used nicotine replacement therapies compared with Europeans (Thornley, Jackson, Mcrobbie, Sinclair, & Smith, 2010). This may be due to a combination of factors, including poor communication of services by providers and difficulties managing the required application processes. Pacific peoples experience other factors that contribute to limited health literacy, such as lower socio-economic status and language difficulties. Between 1999 and 2005, there was a larger growth in the number of Pacific peoples receiving angioplasties than in the number of non-Maori, non-Pacific peoples receiving angioplasties (Ministry of Health, 2006b). Dietary recommendations were often based on observations, such as those of James Lind, a surgeon in the British navy during the 18th century who demonstrated that limes and oranges cured scurvy in sailors whereas other remedies such as vinegar and cider did not. For example, the success of initiatives such as the MeNZB and HPV vaccination campaigns in Pacific communities has been attributed to these strengths (F Tupu, personal communication, 2009; CBG Health Research Ltd, 2006). An ALAC study also found that Pacific young people, born and raised in New Zealand, consumed alcohol more frequently, pointing to the influence of acculturation factors (Alcohol Advisory Council of New Zealand, 2009).
A Counties Manukau study of Pacific and Maori parents showed that these groups had a low awareness of other available cessation options (Glover & Cowie, 2010). For example, in education, difficulty with application processes was one of the main reasons identified for poor access to supplementary support (particularly when language is a barrier) (Clark et al, 2007; Rivers, 2005). The incidence of ischaemic heart disease among Pacific peoples suggests that this group would have a greater need for angioplasties.
Smoking is particularly common for young Samoans and Cook Islanders, older men, Pacific-born men – particularly Tongan men, and younger New Zealand-born women, particularly Tokelauan and Cook Island women.Traditionally, Pacific men were more likely to be smokers than Pacific women. This clearly indicates that these groups of smokers need to be better informed.The traditional respect for authority figures in Pacific communities can make it more difficult for Pacific people to question their health professionals and demand more effective services (Statistics NZ and Ministry of Pacific Island Affairs, 2010). This involved placing foods with similar characteristics into the same food group and advising people to eat from each group every day. This can lead to Pacific peoples being disempowered in the health system, not receiving services as needed, and therefore experiencing poorer outcomes.
However, rates did decline for Pacific children aged 0-4 years (Ministry of Health, 2008c).There is some evidence that the delivery of effective health care to Pacific peoples is improving. However, during the 1970s nutritionists became concerned with the over-consumption of fats, especially saturated fats, and sugars, and the lack of fibre in the diet. Between 2001 and 2007, the proportion of people with diabetes receiving an annual check through the Get Checked Programme has increased, including for Pacific peoples, who have higher coverage than other ethnic groups. As a result, advice in developed countries tended to become more nutrient-based, with emphasis on macro- rather than micronutrients. Prescription of statin medication also increased markedly for all ethnic groups, including Pacific peoples (Ministry of Health, 2008b). This may be due to the fact that smoking was traditionally a male activity in the Pacific Islands. In a study of people with both type 1 and type 2 diabetes in Counties Manukau, access to tests and appropriate medication was consistent across ethnic groups (Smith et al, 2010). The plan for action marked a change from policies dictated by numbers to policies focussing on prevailing public health problems. It appears Pacific women born in New Zealand have been influenced by local smoking behaviour. A study of patients with type 2 diabetes in south and west Auckland showed Pacific peoples, who visited a regular GP, had a higher average number of consultations, equivalent frequency of testing, but worse glucose control.
They were less likely to be on a statin, despite higher serum lipids compared with the total population (Robinson et al, 2006).Overall, Pacific peoples receive less effective care. Access to care and the quality of care is improving but outcomes are not equivalent to other ethnic groups. The reasons for this are complicated, and seem to include a combination of late presentation, receiving appropriate medication and treatment less often, and less effective ongoing management. Seven years later, ILSI Europe, in collaboration with the FAO, organised a follow up workshop with 6 out of the 19 countries that participated in the first workshop.
This is influenced by the cultural attitudes and expectations of both Pacific peoples and those in the health system, and by levels of financial resources. Improved cultural competence of services will improve the quality of consultations and services, promote improved health-care delivery, and improve health outcomes. The results showed that out of the 48 participating countries, 25 had national FBDG that had been endorsed by the government.
The Network of Excellence is studying micronutrient requirements and the development of recommendations for vulnerable population groups.
Hereby, it seeks to create tools which should help EFSA and other institutions charged with setting micronutrient recommendations. The aim of EURRECA is to produce Europe-wide scientific consensus on the evidence appropriate for developing micronutrient recommendations.
The Network will be collaborating throughout this project with EFSA.7In May 2009 the Food and Agricultural Organization of the United Nations (FAO) in collaboration with the European Food Information Council (EUFIC) organised a workshop on the development, communication and evaluation of FBDG. These diseases may partly derive from an excess intake of calorific nutrients and a shortage of certain micronutrients. Updates are essential to adapt the guidelines to the evolving scientific knowledge on the relationship between food, nutrition, and health, and to changing food habits and lifestyles. Visual materials used to communicate FBDG messages must also be clear and comprehensible to be successful.
Radical changes to current habits will be less successful than recommendations on small changes, which will be easier to communicate and implement.
It is recommended that all relevant stakeholders are involved in producing education material since this enhances the materials’ quality. When a message is communicated several times, via different media, the message is reinforced and the impact will be more significant.
Upon revision made on the basis of this first testing, a second check with consumers should be performed to test their understanding. The purpose of outcome evaluation is to measure the results or impacts of the FBDG (knowledge, attitude, behaviour, practice etc.). Process evaluation on the other hand entails assessing how a message is disseminated or implemented.
The most important question to ask when carrying out such an evaluation is whether the communication campaign was implemented as planned. It is easier to monitor activity than effect, considering that indicators of activity are relatively easy to collect and quantify (e.g.
Note that such statistics may not paint a true picture of consumption, therefore one should be cautious when interpreting the data. Monitoring of this is essential in that one must have knowledge about food composition to measure nutrient intake trends in the population. In effect, to measure effectiveness of FBDG it is necessary to have the guidelines monitored and evaluated.
Nearly all guidelines include advice about foods containing fat, foods containing sugar and the consumption of fruits and vegetables.
They also often contain advice on eating protein-containing foods, foods rich in carbohydrates and dietary fibre, restricting salt, taking enough fluids, controlling alcohol intake and body weight, and other aspects of lifestyle such as getting enough physical activity and eating regular meals. Although here, percentages representing the ideal food groups’ contribution to a healthy diet are displayed. The green colour is found at the base of the pyramid (cereals, fruits and vegetables) and hence indicates that those foods should constitute the largest part of the diet. Milk and dairy products and meat, fish and eggs are in the orange, middle part of the pyramid. The orange colour signifies that only moderate amounts of these foods are needed for a healthy balanced diet.
Finland and Spain use a circle as well as the pyramid, and the German pyramid depicts a circle at the base of its 3D pyramid.
Most circles are proportionally segmented in accordance with the recommended contributions from each food group. The Portuguese and German graphics have water at the centre of the circle whilst the Spanish circle depicts both water and exercise at the centre. A considerable amount of care and attention has to go into the choice and design of the pictures to ensure that typical foods are included, that nothing important is omitted, that there is a good mix for the local culture and that they are visually appealing. Foods from which higher amounts can be consumed are found at the top of the stairs, whilst the ones that should only be consumed in small quantities are found at the bottom. The French guidelines are also shown in a table containing recommendations on the amount of each of the six food groups, salt and fluids that should be consumed. This includes using the names of the food groups (as in the UK plate) or the foods within the group (e.g.
This text gives further information and advice on the types of foods and quantities to be consumed for each group as well as additional tips which may also include advice on fluids, alcohol, physical activity and body weight. Graphical representations, with a minimum amount of text, are helpful but may imply that everyone should eat exactly the same amount from each food group every day.As individuals, we do not all have exactly the same dietary needs and more than one dietary pattern is consistent with good health. Individuals should be aiming for the balance suggested over a period of several days or weeks. This also allows for foods that should not be eaten daily to have a place in the diet.Graphic FBDG have still to resolve how to deal with mixed dishes and convenience foods. They are all based on the principle to provide guidance for a healthy balanced diet that will help prevent non-communicable diseases such as heart disease and cancer. Common recommendations include eating plenty of fruits, vegetables and complex carbohydrates, and choosing foods which are lower in saturated fat, salt and sugar. The use of food groups, as in food pyramids and circles, ensures the inclusion of all basic foods and gives positive messages about what we should be eating as well as some qualifying information to help us avoid eating too much of certain foods. Key elements in the development phase are that nutrient gaps, likely intakes, typical foods and proper choice ranges are identified prior to formulating FBDG. For effective implementation, FBDG messages should be practical and their communication short, comprehensible and culturally accepted to ensure a broad uptake by the public. The latter can be enhanced through repeated, targeted communications via diverse media channels.
Scientific Opinion of the Panel on Dietetic Products, Nutrition and Allergies on a request from the EC on Food-Based Dietary Guidelines.
2005, Kaunas University of Medicine, National Nutrition Centre under Ministry of Health, Faculty of Medicine of Vilnius University.



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