Archive for the ‘Indigenous health’ Category





The facts about cholesterol levels

CSIRO is carrying out research to develop strategies for reducing cholesterol levels, the risk of heart disease and other conditions that are food-related and correctable through modifying our diet.


CSIRO is carrying out research in a number of dietary areas to develop strategies for reducing cholesterol levels, the risk of heart disease and other conditions that are food-related and correctable through modification of diet.

High levels of cholesterol are a risk factor for coronary artery disease (heart attacks and angina).

What is it?

Cholesterol is an essential type of fat that is carried in the blood.

All cells in the body need cholesterol for internal and external membranes.

It is also needed to produce some hormones and for other functions.

The body generally makes all the cholesterol it needs.

Some dietary cholesterol is normally excreted via the liver, however eating too much saturated fat leads to excess cholesterol in the blood stream.

Why is high cholesterol a problem?

High levels of cholesterol in the blood stream are a risk factor for coronary artery disease (heart attacks and angina).

If your cholesterol level is 6.5 mmol/L or greater your risk of heart disease is about 4 times greater than that of a person with a cholesterol level of 4 mmol/L.

High blood levels of cholesterol are a risk factor for coronary artery disease (heart attacks and angina).

Not all people with high cholesterol levels get heart disease.

About 30 per cent of the community will die of heart disease and most of these will be over 65 years old.

Heart disease usually takes 60-70 years to develop, but if you discover your cholesterol level is high you should see your doctor within the next 2-3 months, not necessarily tomorrow.

Other risk factors for heart disease include smoking, high blood pressure and obesity.

Cholesterol – the good and the bad

Cholesterol is carried in the blood stream in particles called lipoproteins.

These are named according to how big they are:

  • the very large particles are called Very Low Density Lipoproteins (VLDL)
  • the intermediate size ones are called Low Density Lipoprotein (LDL) and these particles cause heart disease
  • the smallest particles are called High Density Lipoproteins (HDL) and these particles actually protect against heart disease.

What to do if your cholesterol level is high

The most effective way to lower your cholesterol is to reduce the amount of animal fat in your diet by various means.

You could:

  • reduce cheese intake and/or substitute low fat varieties
  • choose reduced fat milks
  • substitute polyunsaturated margarine for butter
  • choose lean cuts of meat and remove all visible fat
  • eat skinless chicken, fish or beans
  • beware of pies, pasties, fish and chips and commercial cakes (hidden fat)
  • make cakes at home with polyunsaturated fat, cook chips with polyunsaturated or monounsaturated oil
  • lose weight if overweight.

If you make a number of changes to your diet you can expect your cholesterol to fall by 10 per cent.

About 15 per cent of people will see no change and another 15 per cent will see changes of 20-30 per cent.

How high is high?

If your cholesterol is between 5.5 and 6.5 your risk of heart disease is only increased by a small amount.

Don’t panic but make a few moderate changes to your diet.

However if you already have heart disease, or one of your parents developed heart disease at an early age, (less than 55 years of age) then you need to make bigger changes.

If your cholesterol is higher than 6.5 then you need to make more changes.

If despite changes to your diet your cholesterol level remains above 6.5 you may need medication, especially if you have the other risk factors mentioned or you have a family history of heart disease- see your doctor.

What about triglycerides?

Triglycerides are a stored energy source.

Most of the triglyceride is found in the very large particles, the VLDL.

Under some circumstances high blood triglyceride can be a risk factor.

If your cholesterol is high (greater than 6.5) and your HDL cholesterol is low (less than 0.9) then triglycerides can increase the risk of heart disease if they are greater than 1.7.

Triglyceride levels greater than 10 can cause inflammation of the pancreas which is a very serious condition.

How can I lower my triglyceride?

Reduce your intake of animal or hard vegetable fats, lose weight and reduce alcohol intake.

Alcohol is very powerful at elevating triglyceride.

See your family doctor if it remains elevated as you may require medication.

Find out more about CSIRO’s work in Diet & Nutrition.


Cholesterol explained

  Cholesterol is a type of fat that is part of all animal cells. It is essential for many of the body’s metabolic processes, including hormone and bile production, and to help the body use vitamin D. However, there’s no need to eat foods high in cholesterol. The body is very good at making its own cholesterol; you don’t need to help it along. In fact, too much cholesterol in your diet can lead to heart disease.

Cholesterol is essential
Cholesterol is produced by the liver and also made by most cells in the body. It is carried around in the blood by little ‘couriers’ called lipoproteins. We need blood cholesterol because the body uses it to:

  • Build the structure of cell membranes
  • Make hormones like oestrogen, testosterone and adrenaline
  • Help your metabolism work efficiently; for example, cholesterol is essential for your body to produce vitamin D
  • Produce bile acids, which help the body digest fat and absorb important nutrients.

Two types of cholesterol
Cholesterol is a white and waxy substance. There are two types of cholesterol:

  • Low density lipoprotein (LDL) cholesterol – called the ‘bad’ cholesterol because it goes into the bloodstream and clogs up your arteries.
  • High density lipoprotein (HDL) cholesterol – called the ‘good’ cholesterol because it helps to take the ‘bad’ cholesterol out of the bloodstream.

Safe blood cholesterol levels
Health authorities recommend that cholesterol levels should be no higher than 5.5mmols per litre. Approximately 50 per cent of adult Australians have a blood cholesterol level above 5mmols per litre. This makes high blood cholesterol a major health concern in Australia.

Effects of high cholesterol levels
The liver is the main processing centre for cholesterol. When we eat animal fats, the liver returns the cholesterol it can’t use to our bloodstream. When there is too much cholesterol circulating in our bloodstream, it can build up into fatty deposits. These deposits cause the arteries to narrow and can eventually block the arteries completely, leading to heart disease and stroke.

You do not need cholesterol in your diet
You don’t need to eat foods that contain cholesterol; your body can produce all the cholesterol it needs. High cholesterol foods are usually foods high in saturated fats. These foods should be limited in a healthy diet.

Foods that contain cholesterol
The cholesterol in your diet comes mainly from the saturated fats found in animal products. All foods from animals contain some cholesterol. Foods from plants do not contain cholesterol. Other sources of dietary cholesterol are full fat dairy foods, eggs and some seafood.

How to avoid saturated fats
The best way to maintain healthy levels of cholesterol in your diet is to limit foods high in saturated fats. Try to avoid:

  • Fatty meats
  • Full fat dairy products
  • Processed meats like salami and sausages
  • Snack foods like chips
  • Most takeaway foods, especially deep fried foods
  • Cakes, biscuits and pastries.

Diet tips to help reduce your cholesterol
The most important thing you can do to reduce your cholesterol level is to maintain a healthy lifestyle. You should try to:

  • Limit the amount of cholesterol-rich foods you eat.
  • Increase the amount and variety of fresh fruit, vegetables and wholegrain foods you have each day.
  • Choose low or reduced fat milk, yoghurt and other dairy products or have ‘added calcium’ soy drinks.
  • Choose lean meat (meat trimmed of fat or labelled as ‘heart smart’).
  • Limit fatty meats, including sausages and salami, and choose leaner sandwich meats like turkey breast or cooked lean chicken.
  • Have fish (fresh or canned) at least twice a week.
  • Replace butter and dairy blends with polyunsaturated margarines.
  • Include foods in your diet that are rich in soluble fibre and healthy fats, such as nuts, legumes and seeds.
  • Limit cheese and icecream to twice a week.

Lifestyle tips to help reduce your cholesterol
Changing some of your lifestyle habits may also help to reduce your cholesterol levels. Suggestions include:

  • Reduce your alcohol intake to no more than one or two drinks per day, and avoid binge drinking.
  • Don’t smoke. Smoking increases the ability of LDL cholesterol to get into your cells and cause damage.
  • Exercise regularly (for example, at least 30 minutes of brisk walking daily). Exercise increases the HDL levels and reduces LDL levels in the body.
  • Lose any excess body fat. Being overweight may contribute to elevated blood LDL levels.
  • Control your blood sugar levels if you have diabetes. High blood sugars are linked to an increased risk of atherosclerosis.

Don’t cut out all dairy foods
Some people believe that cutting out dairy foods altogether is the safest option, but this isn’t true. Dairy foods are an important part of the daily diet and contribute many essential nutrients, especially calcium. You should switch to low fat types, which will reduce the risk from saturated fats.

You don’t need to avoid eggs and seafood
Some foods are high in cholesterol but they’re fine to eat in moderation, as long as your overall diet is low in saturated fats. For example:

  • Egg yolks – these are high in cholesterol but are rich in several other nutrients. It is recommended that you limit the number of eggs you eat to the equivalent of one a day (whole or in dishes).
  • Seafood – prawns and seafood contain some cholesterol but they are low in saturated fat and also contain healthy omega-3 fatty acids. Seafood is a healthy food and should not be avoided just because it contains cholesterol. However, avoid fried and battered seafood.

Foods that may lower cholesterol levels
Some studies have suggested that eating oats and legumes may lower LDL cholesterol. Food components like saponins (found in chickpeas, alfalfa sprouts and other foods) and sulphur compounds (like allicin – found in garlic and onions) may also have a positive effect on cholesterol levels.

Plant sterols can lower cholesterol levels
Plant sterols are found naturally in plant foods including sunflower and canola seeds, vegetable oils and (in smaller amounts) in nuts, legumes, cereals, fruit and vegetables. Some margarine has concentrated plant sterols added to it. Plant sterol enriched margarines may help to lower LDL cholesterol.

Medication may be needed
For some people diet and lifestyle changes are not enough. High blood cholesterol levels are also linked to genetics. Some people inherit altered genes that cause high cholesterol, and this can usually not be changed by lifestyle or diet.

If you are at risk of coronary heart disease and your LDL cholesterol level doesn’t drop after scrupulous attention to diet, your doctor may recommend medications to force your LDL levels down. However, diet and exercise will still be important, even if you are taking medication. Your doctor may also refer you to a specialist who treats cardiovascular disease.

Where to get help

Things to remember

  • Cholesterol is a fatty substance essential to many metabolic processes.
  • Your body needs cholesterol, but it can make its own – you don’t need to consume cholesterol in your diet.
  • High levels of LDL cholesterol in the blood have been linked to coronary heart disease.
  • Foods high in saturated fats tend to boost LDL cholesterol.

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No need for Aust trans fat ban: food regulator

The regulatory body that sets food standards in Australia says there is no need at this stage to ban food outlets from selling food that has trans fats added to it.

In America, California has become the first state there to ban restaurants and food retailers from using trans fats – artificial fats that are linked to coronary and heart disease.

But Food Standards Australia New Zealand says local surveys have found that, unlike many other countries, Australians consume a low level of trans fats.

It says only 0.6 per cent of their daily kilojoules comes from trans fats – well below World Health Organisation recommendations.

FSANZ spokeswoman Lydia Buchtmann says efforts are underway to keep the level of consumption low.

“Our concern is that people might overreact as they have overseas where there are bans in place and move back to unhealthy saturated fats, to start cooking in lard for example, which would be much worse because we are actually consuming far too high levels of saturated fats,” she said.

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Dengue carrying mosquito could threaten Melbourne

Researchers says outbreaks of the potentially deadly dengue fever could strike throughout northern Australia and as far south as Melbourne if the asian tiger mosquito invades Australia’s mainland.

The mosquito is capable of transmitting up to 22 viruses, and Darwin’s Menzies School of Health Research says there is growing concern that it will infiltrate the Australian mainland.

Researcher Bart Currie is part of the Northern Territory’s surveillance team for emerging diseases and says the pest has been established on the Torres Strait Islands for about two years and a national strategy is needed to ensure it does not reach the mainland.

“The time is now to deal with that, and prevent it getting to the mainland,” he says.

“From the experience that’s happened in the Americas and in other parts of the world, this mosquito once it gets a foothold, it’s going to be incredibly hard, if not impossible, to eradicate.”

George Hapgood, who heads a Queensland Health program that it trying to eradicate the species from the Torres Strait Islands, says the program is only funded until next year and longer term commitment is needed.

“There is a need particularly with the Northern Territory and Western Australia to be aware of what’s happening.

“I think it is of concern to the whole of Australia, not just Queensland.”

Mr Currie agrees.

“This is one of these things where the whole issues of Commonwealth versus state responsibility is possibly leading to less activity than may be ideal in order to prevent the potential future problem which will be unable to be dealt with once it gets out of hand.”

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Nurse practitioners ready for a bigger role in health system

By Ged Kearney

A care nurse helps a pensioner

(Reuters: Christian Hartmann, file photo)

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Nurse practitioners may well be the answer to Australia’s health concerns.

For Australians to see the benefits of real and sustainable health reform there must be major reform to the way health services are funded and delivered. This means putting nursing and midwifery at the centre of decisions in health and health reform.

Vital to a full and effective utilisation of the nursing and midwifery workforce is the role of nurse practitioner, yet they are unable to operate to their full scope of practice due to current funding barriers.

Nurse practitioners are registered nurses and midwives with advanced educational preparation and experience who are authorised to practice in an expanded nursing role. There are currently around 300 nurse practitioners in Australia who can be found working in illness prevention, chronic disease management, aged care, emergency care, wound care, diabetes education, sexual health and rural health.

These nurses and midwives seek candidacy through the nursing regulatory authority in their state or territory and must undergo rigorous review to be authorised to practice as a nurse practitioner. Most have at least five years in their chosen area of practice post-registration and at least seven to nine years study, inclusive of masters-level university qualification.

Nurse practitioners have been shown to bring immense benefit to areas of need, improving quality of and accessibility to health care services for all Australians whether in rural and remote Australia or in residential aged care facility. The benefits they bring have been well documented across Australia and indeed throughout the world.

Programs like the Walwa Bush Nursing Clinic and the ACT aged care nurse practitioner pilot provide evidence that nurse practitioners offer health care efficiency and improve patient care outcomes.

The Alfred Hospital in Melbourne recently conducted a study that demonstrated nurse practitioners operating out of the emergency department had reduced waiting times, staff stress, and patient returns and improved patient outcomes and satisfaction.

Nurse practitioners bring greater efficiency and quality of patient care to Australia’s health system, but are severely limited in their practice because of outdated funding structures.

While nurse practitioners are authorised to refer patients to other health professionals and prescribe some medications, there is currently no mechanism that allows patients to claim any subsidy from the Pharmaceutical Benefits Scheme (PBS) or Medical Benefits Scheme (MBS), as is the case for medical practitioners.

This is a massive disincentive for patients who can be forced to pay hundreds of dollars more for prescriptions or medical tests when they are ordered by a nurse or midwife practitioner as opposed to a GP. Subsequently they are currently under-utilised and left feeling under-valued.

Unless the Federal Government gives the patients of nurse practitioners access to pharmaceutical rebates they will continue to be under-utilised to the detriment of all Australians.

In addition to the obvious benefits to health care consumers in Australia, the role of nurse practitioner offers experienced nurses greater access to career opportunities in clinical practice. Some nurses do not want to move out of clinical nursing into education or management.

The opportunity to become a nurse practitioner offers an incentive to remain in the profession whilst providing expert nursing care. The regulatory process must be reviewed to facilitate advanced practice by suitably qualified nurses and midwives and improve community access to care.

Now that the Federal Government has put health reform on the agenda the time is right to better utilise the expertise of these skilled practitioners, enabling greater access to and equity within the public health system and offering nurses and midwives greater opportunity for career development, encouraging them to stay or if they have left, to return to the profession.

Ged Kearney is the federal secretary of the Australian Nursing Federation.

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Coroner finds ‘non-sniffable’ petrol caused boy’s death

The Northern Territory coroner has found the low aromatic Opal fuel was behind the death of a 12-year-old boy at the Aboriginal community of Hermannsburg, 130 kilometres west of Alice Springs.

In his findings handed down today, coroner Greg Cavanagh found the boy died in April last year when he suffocated from sniffing Opal fuel.

Mr Cavanagh found the promotion of Opal fuel as non-sniffable to be misleading.

He has recommended the Northern Territory and Federal Governments and the fuel’s manufacturer, BP Australia, ensure the fuel is not promoted as a harmless substance because it can lead to death from ingesting or sniffing.

It’s the first known death linked to Opal.

In light of the Coroner’s recommendation, Chandran Vigneswaren from BP says they will review how Opal is promoted, but says they may continue to market it as “non-sniffable” despite the findings.

“In practically every place in which we refer to Opal, be it online or on printed material or wherever it may be, we have some reference to the fact that Opal, like any fuel, is a volatile substance and should not be sniffed.

“So BP takes our commitment to the community in terms of safety in all of our products very seriously.”

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NSW ‘shifting blame’ on Indigenous gastro problem

The New South Wales Government is facing criticism over water and sewerage conditions in remote Aboriginal communities.

The Sydney Morning Herald is reporting that over the past 12 years there has been a 218 per cent rise in NSW hospital admissions of Aboriginal children suffering gastroenteritis.

Documents obtained by the State Opposition show NSW Government departments are arguing over who should pay to improve sanitation conditions in 75 Indigenous communities in the state.

State Nationals leader Andrew Stoner says Indigenous communities are living with third world water and sewerage systems while government agencies continue to shift responsibility.

“It’s just scandalous that in the 21st century in the premier state of one of the wealthiest nations in the world, many New South Wales Aboriginal communities around country New South Wales, still have unhygienic water and no sewerage,” he said.

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Qld Health guilty of breaches over nurse rape case

An investigation has found Queensland Health breached workplace health and safety laws in the Torres Strait.

The finding follows the alleged rape of a nurse at a local health clinic in February.

The Health Department must show that security issues have been addressed, both in the Torres Strait and across Queensland.

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