Nutrition and health | UniSC | University of the Sunshine Coast, Queensland, Australia

The MaMi Project: Investigating maternal micronutrient availability and impacts in Vanuatu

2023 - 2024

Maternal (Ma) micronutrient (Mi) deficiencies refer to the suboptimal intake of critical minerals and vitamins peri-conception and during pregnancy. In utero, the fetus sources micronutrients from the maternal diet, delivered via the mothers’ blood to the placenta. Maternal micronutrient deficiencies (MDs) increase the risk of fetal growth restriction and congenital anomalies which directly increase risks of fatal preterm birth, stillbirth, perinatal and infant deaths.

Pacific Island Countries and Territories (PICT) peoples are at increasing risk of disability and death caused by non-communicable diseases attributed to malnutrition and MDs. Children born in PICTs are on average seven times more likely to be stillborn or die perinatally or as infants relative to neighbouring countries.

The MaMi (Bislama for “mum”) project focuses on Vanuatu and is partnering with colleagues from the Vanuatu Ministry of Health. Vanuatu is reported as having high rates of stillbirth, perinatal and infant death; increasing malnutrition rates and identified as being poorly represented in PICT focused MD research.

The project aims to:

1. Develop a strong partnership with the Vanuatu Ministry of Health (MoH) and local non-government organisations (NGOs) to enhance local research capacity and UniSCs reputation in PICTs such as Vanuatu.
2. Determine approximate micronutrient intakes of reproductive aged women in urban, semi-rural and remote Vanuatu.
3. Record Ni-Vanuatu experiences of birth complications, stillbirth, and perinatal/infant loss in urban, semi-rural and remote areas.

Project team: Dr Georgia Kafer, Dr Barnaby Dixson, Dr Rachael Thurecht and Ms Eliza Kitchener from UniSC

Partners: Dr Jenny Stephens, Mr Rex Turi, Dr Matt Cornish and Ms Nerrida Hinge from the Vanuatu Ministry of Health and Emma Dorras from Wan Smolbag (NGO).

Funding: UniSC Amount: $50,000

Development of a NOVA screener for ultra-processed food consumption in the Pacific Islands

2022 - 2024

Food systems in the Pacific Islands have changed dramatically over the past 50 or so years. Diets that were primarily based on local, traditional staple foods, are now becoming more reliant on imported, highly processed foods.

Ultra-processed foods (UPFs) are "multi-ingredient, industrially formulated mixtures. UPFs are formulated mixtures highly processed to the extent that they are no longer recognizable as their original plant or animal sources. Most are manufactured to be ready to eat or ready to heat, requiring no preparation before quick, easy consumption" (FAO/Popkin, 2020). These UPFs have been directly linked to overweight, obesity and many diet-related non-communicable diseases (FAO/Popkin, 2020).

While we know that across the Pacific Islands the availability of these UPF’s is increasing, there is limited data on actual consumption. This project seeks to develop a screener tool that can be used to measure UPF consumption in the Pacific Islands.

The tool being developed is based on the work of Costa CS, Faria FR, Gabe KT, Sattamini IF, Khandpur N, Leite FHM, et al. Nova score for the consumption of ultra-processed foods: description and performance evaluation in Brazil. Rev Saude Publica. 2021;55:13. https://doi.org/10.11606/s1518-8787.202105500358

Project Team: Dr Sarah Burkhart (UniSC), Ms Bridget Horsey (UniSC), Ms Jessica Raneri (DFAT/ACIAR), Dr Priscila Machado (Deakin University), Belinda Christensen, Dallas Thom (UniSC), with assistance from colleagues at University of Sao Paulo, Brazil.

Funding: Unfunded

Understanding School Food Provision in the Pacific: Scoping the potential of local food systems to improve diets, nutrition and livelihoods

2022 – 2023

Supplying nutritious food in schools has the potential to improve child health, education and school attendance outcomes, while also benefitting the broader community through the establishment of connections with local food systems.

This scoping study aims to better support the integration of local agriculture into school food provision in Pacific Island countries.

It will provide an understanding of existing and potential links between local agriculture and schools for the sustainable supply of nutritious food to students, exploring policy, institutional and farmer capacity settings and their associated enablers and barriers. It will also establish relationships and stimulate discussion and engagement, seeking consensus on how a successful farm to school food program may work in the Pacific.

The findings will be used to inform potential future research aimed at creating additional opportunities along supply chains and improving local food procurement across the region.

Project team: Dr Sarah Burkhart (lead), Dr Danny Hunter (The Alliance for Bioversity International and CIAT) (lead), Dr John Oakeshott (The Pacific Community) and Mrs Jessica Raneri (the Australian Centre for International Agricultural Research and the Department of Foreign Affairs and Trade).

Funding: This research is supported by $250,000 in funding from the Australian Centre for International Agricultural Research (ACIAR).

Dietary intake methodology and reporting in Pacific Island Research

2021

Understanding dietary intake is important for assessing the health of a community. To date, methods of dietary intake assessment used in the Pacific Islands have been limited and inconsistent, leading to difficulty in determining dietary intake patterns in the region. This project aims to firstly explore the methods used to collect and analyse dietary intake data of residents in Pacific Island countries.

We Undertook a scoping review to define and describe these methods, and how they have been used in 24 countries. The findings of the scoping review will be used to identify gaps and inform the development of a suite of context-specific tools that can be used to effectively assess dietary intake in these populations.

Project team: Dr Dana Craven (project leader), Mr Chris Vogliano, Ms Bridget Horsey, Prof Steven Underhill and Dr Sarah Burkhart.

Reference: Craven, Dana Louise; Vogliano, Chris; Horsey, Bridget; Underhill, Steven; Burkhart, Sarah. Dietary assessment methodology and reporting in Pacific Island research, JBI Evidence Synthesis: November 12, 2020 - Volume Online First - Issue  

Improving nutrition through women’s and men’s engagement across the seaweed food chain in Kiribati and Samoa

2020 - 2021

Seaweeds are a source of food and livelihoods throughout the Pacific region. This project takes an action research approach to engage families (both women and men) with collaborative inquiry through a lens of gender inclusive nutrition-sensitive agriculture.

Working with government, non-government and industry partners, we aim to transform seaweed fisheries as part of a nutrition-sensitive coastal food system comprised of short supply chains, village-based processing, targeted sustainable use of natural resources and marketing for family consumption.

As part of this project, we are developing and evaluating gender-inclusive activities in two Pacific countries, Kiribati and Samoa, to shift the focus of seaweed production from an export commodity only to one that provides direct benefits to the health and wellbeing of local communities, as well as income opportunities for women.

Project team: Dr Libby Swanepoel (project lead), Prof Nick Paul, Dr Silva Larson, Ms Courtney Anderson and Prof Barbara Pamphilon (University of Canberra).

Funding: Australian Centre for International Agricultural Research, 2020-2021, $250,000.

References:
Swanepoel, L., Tioti, T., Eria, T., Tamuera, K., Tiitii U, Larson. S. and Paul, N. (2020). Supporting Women's Participation in Developing A Seaweed Supply Chain in Kiribati for Health and Nutrition. Foods. Mar, 9(4):382.

Butcher, H., Burkhart, S., Paul, N., Tiitii, U., Tamuera, K., Eria, T., and Swanepoel, L. (2020). Role of Seaweed in Diets of Samoa and Kiribati: Exploring Key Motivators for Consumption. Sustainability, September,12: 7356.

Gathering evidence and supporting multi-stakeholder engagement on the role of diets and food systems in the prevention of obesity and non-communicable diseases in Pacific Island Countries (Fiji)

2019 - 2020

Nutrition transition in Pacific Island countries, including Fiji, has had significant impacts on human health. In collaboration with the Food and Agriculture Organization of the United Nations (FAO-UN), this project aims to provide evidence-based data on nutrition and health outcomes in Fiji and connections to the Fijian food system.

The project involves examining local food environments, including availability of and accessibility to food, school food environments, and mapping the fresh food system. We have explored food consumption in select population groups and have investigated the impact of COVID-19 on dietary behaviours.

We also aim to develop an understanding of how the multisector policy landscape influences dietary behaviours. An important component of this project is the identification and use of entry points for policy dialogue. A key outcome of this project will be a roadmap outlining opportunities for future research and actions to inform a comprehensive and evidence-based approach for maintaining a healthy weight and  preventing non-communicable diseases (NCDs).

Project team: Dr Sarah Burkhart (project leader), Dr Dana Craven, Ms Bridget Horsey, Ms Jenna Perry, Ms Tarli O’Connell, Dr Yuchan Zhou, Ms Tara McKenzie and Prof Steven Underhill.

Funding: Food and Agriculture Organization of the United Nations, 2019, $221,000 (AUD).

School Food Programmes in the Pacific Islands: A Scoping Review and Capacity Needs Assessment

2018 - 2019

Significant changes to the food environment have negatively affected the health of Pacific Island populations, particularly that of children and adolescents. The provision of nutritious food in schools has the potential to improve the health, educational status, and attendance of children at school, as well as the wider community through links with local food systems.

In this project, we collaborated with FAO to assess the current state and capacity for school food programmes in 14 Pacific Island countries. We found that while stakeholders recognised a need for school food programmes, a limited number were in use and were likely limited by the local food environment, resourcing (physical, financial and human), geographical location, knowledge capacity and communication.

One of the key outcomes of this project has been the co-development of a Pacific School Food Network with a vision to improve the health of Pacific Island children, their families and their communities through healthier school food environments. This project complements the School Nutrition Education Programs project that was completed in 2017/2018.

Project team: Dr Sarah Burkhart (project lead), Dr Dana Craven, Ms Bridget Horsey, Ms Breanna Jones and Prof Steven Underhill.

Funding: Food and Agriculture Organization of the United Nations, 2018, $157,540 (AUD).

Reference: https://www.pacificschoolfoodnetwork.org/ 

School Nutrition Education Programmes in the Pacific Islands: A Scoping Review and Capacity Needs Assessment

2017 - 2018

As food environments have changed throughout the Pacific Islands, it is even more important that individuals and communities have the knowledge and skills to make healthy food choices. The behaviours that one learns during childhood set the scene for later life, with schools an ideal setting to learn and support healthy dietary behaviours.

The aim of this project was to identify and analyse the capacity for School Nutrition Education Programmes (SNEP) in 14 Pacific Island countries to inform and propose recommendations for a sustainable regional and local SNEP. In this collaborative project with FAO, we found identified three types of SNEP in use in the Pacific region: curriculum, gardening and other relevant programs (i.e. sport-based, school -food). and We also found that the capacity to develop, implement, monitor and evaluate SNEP across the Pacific region varies.

While there is recognition of the benefits of SNEP, there are many challenges to designing, implementing and evaluating SNEP in this region. This project put forward recommendations to support school nutrition education activities in the Pacific region, leading to ongoing work in these areas.

Project team: Dr Sarah Burkhart (project lead), Dr Libby Swanepoel, Ms Breanna Jones and Prof Steven Underhill.

Funding: Food and Agriculture Organization of the United Nations, 2017, $161,398 (AUD).

References:
Burkhart, S. (2019). School Nutrition Education Programmes in the Pacific Islands: Scoping review and capacity needs assessment. Apia: Food and Agriculture Organization of the United Nations Final Report, 130pp.

The Fiji Times (2018). Pacific partners unite to discuss school nutrition education, 1 September, https://www.fijitimes.com/pacific-partners-unite-to-discuss-school-nutrition-education/ 

Food choice and perceptions of change in Samoan food systems

2018 - Ongoing

Throughout the Pacific region changes in food practices, and reduced consumption of traditional, local foods have been recognised as contributing to diet-related non-communicable disease. Samoan food systems have experienced significant change in recent years due to globalisation, urbanisation and climate change, leading to dramatic changes in the health of this population. Exploring and understanding how Samoans perceive the food environment to have changed, and what influences food choice, may be of use for targeted healthy eating education and promotional activities in the adult Samoan population.

This project, a collaboration between UniSC and the National University of Samoa (NUS), explores influences on food choice in Samoa, food literacy (Honours project) and perceptions of change in the food environment. We have found that access to food-related amenities has increased in Samoa. This has in-turn impacted food purchasing and consumption behaviours, where health, sensory appeal, mood, convenience and food origin are important influences on food choice. An additional phase of this project currently explores the impact of the COVID-19 pandemic on food choice in adult Samoans.

Project team: Dr Sarah Burkhart (co-lead), Dr Dana Craven, Ms Grace Kammholz (Honours student), Dr Ramona Boodoosingh (NUS co-lead), A/Prof Safua Akeli (NUS), Ms Jyothi Abraham (NUS).

Funding: This research is supported by funding from the NUS Research and Ethics Committee and UniSC.

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