A new study, published by BMJ Global Health, underlines the importance of involving indigenous communities in programmes to improve diets.
Called Effects of food policy actions on Indigenous Peoples’ nutrition-related outcomes: a systematic review, the report was prompted by the health inequities of indigenous people in high-income countries including Canada, Australia, New Zealand and the United States.
Life expectancy at birth for Indigenous people is five to 10 years lower than for other citizens, thanks to socio-economic disparities and institutional racism, added to the history of dispossession.
The study found that programmes implemented without Indigenous leadership or consultation, such as income management, fail to improve nutrition outcomes and could be harmful.
It said traditional food systems protected human health and natural environments for millennia. Indigenous people worldwide maintained healthy and sustainable food systems, grounded in trans-generational knowledge of lands, waterways, seasonal food sources, sophisticated agricultural practices and food preparation methods.
Industrialised diets have increased obesity, type 2 diabetes and other diet-related chronic diseases
Traditional foods were derived from biodiverse plant and animal sources, high in protein, fibre and micronutrients and low in fat, sugar and salt. Food is intimately connected to land, family, history and culture, as well as to social, emotional and spiritual well-being.
However, European colonisation and the transition to industrialised diets has increased the prevalence of obesity, type 2 diabetes and other diet-related chronic diseases, affecting in particular Indigenous populations.
Although nutrition-related health conditions disproportionately affect Indigenous populations, indigenous people maintain valuable ecological knowledge and continue to advocate for greater control over their food systems.
A key finding of the review is that population-wide policies can reduce health inequities. These should include mandatory food fortification, reformulation and front of pack labelling systems. This is exemplified by mandatory folic acid fortification in Australia, which almost completely closed the gap in Neural Tube Defects between Indigenous and non-Indigenous infants. Voluntary fortification, on the other hand, widened this gap.
The study found three interventions focussed on reducing sugar-sweetened drinks improved health outcomes for Indigenous children, including dental health and insulin sensitivity.
It reviewed 78 studies from Canada, Australia, Aotearoa/New Zealand and the USA. It said the most effective interventions combined educational strategies with policies targeting food price, composition and availability of good food, in shops and schools.
