Vegan Australia has called on the country's leading health body to prioritise research into advocating a whole food plant based diet to improve Aboriginal and Torres Strait Islander health. The submission was made to the National Health and Medical Research Council in response to a request about priorities for Indigenous health research.
Recent surveys have shown that Indigenous Australians are at a higher risk of chronic diseases such as heart disease and diabetes. Nutrition is pivotal in the prevention of chronic diseases and research shows that diets that contain no animal products give the highest level of protection against these diseases. Many Indigenous Australians' diets consist mostly of refined carbohydrate and animal protein with low amounts of fresh vegetables and fruit. A culturally-sensitive, integrated program of education into the adoption of a whole food plant based diet may offer hope in managing and/or reversing these debilitating and expensive health conditions in Indigenous communities.
This submission follows on from our earlier submission to the Australian Department of Health on how whole food plant based diets can prevent and manage chronic conditions.
Please read our submission on research priorities for Indigenous health below.
A culturally-sensitive, integrated program of education into the adoption of a whole food plant based (vegan) diet represents an excellent research opportunity into further understanding the significant health benefits that such a diet affords. Whole food plant based diets have been strongly correlated with protection against cardiovascular disease, some cancers, obesity, hypertension, type 2 diabetes, depression and anxiety, all of which conditions impact the Aboriginal and Torres Strait Islander (ATSI) community in alarming numbers1-10,17-20. Whilst the NHRMC recognises vegan diets as healthy and nutritionally adequate, it has yet to investigate the potential for preventing and reversing chronic disease nutritionally23. The North Karelia Project in Finland could serve as a program model. In this approach to reducing chronic disease, coronary heart disease mortality was reduced by 73% among 30-64 year old males, cancer and all-cause mortality were reduced, and general population health was improved through a portfolio of interventions that encouraged movement toward a more plant-based diet, with reduced salt and sugar consumption; smoking cessation; and increased physical activity. Individual measures included working with food manufacturers to reduce the amount of fat, salt and sugar in processed foods; and developing innovative school- and community-based nutrition education programs11.
Eight of the nine National Health Priority Areas (NHPA) agreed upon by Commonwealth and State and Territory governments, non-government organisations, health experts, clinicians and consumers would be addressed with a TCR into whole food plant based nutrition interventions for Indigenous people. With already strong scientific support suggesting amelioration of some cancers, cardiovascular disease, mental health, diabetes mellitus, asthma, arthritis, obesity and dementia1-10,12, this TCR would be pursuing the agenda of the NHPA initiative by "targeting specific areas that impose high social and financial costs on Australian society"13. This TCR would be a high quality, Targeted Health Activity as part of the Department of Health's Indigenous Australians' Health Programme14. Furthermore, this TCR is an evidence-based strategy that would enable policy makers and health workers to fulfil the goals of four of the National Service Improvement Frameworks in reducing risk, managing acute conditions, long term care and care in the advanced stages of disease15.
The Australian Aboriginal and Torres Strait Islander Health Survey in 2012-13 found that Indigenous Australians were at higher risk of asthma, heart disease, diseases of the ear, hearing loss and diabetes16, with mortality in this population being primarily heart disease, diabetes, respiratory disease, lung cancer and suicide17. As many Indigenous Australians' diets consist mostly of refined carbohydrate and animal protein with low amounts of fresh vegetables and fruit18, studying the impact of eating a nutritious vegan diet could offer hope in managing and/or reversing debilitating and expensive health conditions. Such an intervention would be in step with WHO and European Union policies which aim to "be consistent with the protection and promotion of public health"21. In the Marshall Islands, the Diabetes Wellness Program, a study launched in March 2006, yielded reductions in fasting blood sugars, cholesterol and triglycerides via a 100% plant based, high nutrient diet, with lifestyle and nutritional education, and exercise. Participants reported pain reduction, greater ease of movement, improved bowel health, increased energy and weight loss. As the Marshallese face comparable health challenges to Australia's Indigenous community, such a study further indicates the benefits that might also accrue in this population24,25.
The Australian Institute of Health and Welfare (AIHW) estimated that the health expenditure for Aboriginal and Torres Strait Islander people in 2010-11 was $4.6 billion (3.7% of Australia's total recurrent health expenditure)21. As a whole food plant based diet has already been correlated with significantly improved health outcomes in other populations globally1-10,12, a culturally appropriate nutritional program for the ATSI community is likely to dramatically improve outcomes for the health system and economy as a whole. Some plant-based nutritionists estimate that a switch to a healthy vegan diet has the potential to lower healthcare costs upwards of 70-80%, because of decreased medication use, services, and procedures in people eating whole plant-based food. Additionally, eating plants is sustainable environmentally. The impact of the environment on health is often overlooked, yet this dietary intervention also addresses this important factor through the reduction of a significant cause of greenhouse gases and deforestation, ie animal agriculture26,27.
Numerous studies support the use of whole food plant based nutritional programmes in improving health. A comparison of 96,000 participants found that vegans had 75% risk reduction for hypertension, 47% - 78% for type-2 diabetes, and 14% for all cancers, with vegan males experiencing a 42% reduced risk from cardiovascular diseases and 55% from ischemic heart disease1. Whole food plant based diets have demonstrable positive effects on obesity2, mental health5, arthritis9 and dementia12.
A joint report of the WHO and the UNFAO stated, "Households should select predominantly plant-based diets rich in a variety of vegetables and fruits, pulses or legumes, and minimally processed starchy staple foods. The evidence that such diets will prevent or delay a significant proportion of non-communicable chronic diseases is consistent. A predominantly plant-based diet has a low energy density, which may protect against obesity." A TCR which supports ATSI populations adopting a whole food plant based diet would be a tremendously valuable allocation of the NHMRC's Medical Research Endowment Account.
Many thanks to Maya Gibson, Penny Rowe and Robyn Chuter for research, editing and review of this submission.