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Healthy Eating - Healthy Action
Oranga Kai - Oranga Pumau

Newsletter
Issue 2, February 2007


In this issue:


Address from the Minister


Welcoming in a Healthy New Year
Hello and Happy New Year to you all. By now, most of you will be back into the swing of work and summer holidays will be a distant memory. I trust you all had
a wonderful relaxing and enjoyable break and I wish you a productive, safe and healthy 2007.

Eating well and being physically active are two of the most important things people can do for good health and wellbeing. Since the New Zealand Health Strategy identified three key population health objectives in December 2000, the government has been committed to fostering an environment where individuals, families and communities are supported to eat well, live physically active lives and maintain a healthy body weight.

Last year, this response was given a boost when a dedicated Healthy Eating-Healthy Action (HEHA) team was established to deliver the high-level actions outlined in the HEHA Implementation Plan 2004-2010. In particular, the team turned the spotlight on seven key HEHA actions – leadership and co-ordination, actions in the school setting,breastfeeding, communication, primary care, industry, and monitoring, research and evaluation.

Make no mistake, the HEHA team – together with a myriad of other players across the country, such as DHBs, PHOs, NGOs, Industry and associated agencies – has made solid inroads into delivering its key initiatives so far. Fruit in Schools, for instance, has been a particular success with around 270 low-decile schools participating at the end of 2006 – a major increase from the 60 schools that started the programme in October 2005. That means that around 57,000 Kiwi kids in low-decile primary
schools around the country receive a free piece of fruit every school day.

Similarly, major inroads have been made in establishing the Nutrition Fund, which can be accessed by all schools and early childhood education services and is aimed at enabling and supporting them to become healthy eating environments. And the Food and Beverage Classification System is being developed to assist
these educational settings to improve the food and nutrition they offer young New Zealanders.

One success story I’m particularly proud of is the world-leading agreement that was signed between government and two of New Zealand’s biggest beverage companies just before Christmas. This voluntary agreement with Coca-Cola Amatil NZ and Frucor Beverages Ltd to remove full sugar fizzy and energy drinks from secondary schools by 2009 is the first in the world to be negotiated directly between government and industry leaders and illustrates what can be achieved when we work together.

But these examples are just the tip of the iceberg. We still have some way to go on the journey to reduce obesity and increase the physical activity of all New Zealanders. This year I am confident we will make good progress with this objective, particularly in the areas of social marketing, with a multi-media campaign due to be launched later this year, developing a breastfeeding campaign to further the great strides already achieved with the Baby Friendly Hospital Initiative, and furthering the aims of Mission On, a broad-based package of initiatives aimed at improving the nutrition and physical activity of young New Zealanders. These, of course, complement the extensive work currently taking place all over the country to pursue HEHA’s goals. I look forward to working with you on these critical projects this year.

Regards

Pete Hodgson
The Hon Pete Hodgson, Minister of Health

World First Removes Full Sugar Fizzy Drinks from Schools by 2009


Months of intensive work by the Ministry’s Healthy Eating Healthy Action (HEHA) team, Coca Cola and Frucor, came to fruition late last year with the signing of an agreement between the Health Minister Pete Hodgson and two of New Zealand’s biggest beverage companies to remove full-sugar fizzy and energy drinks from secondary schools by 2009.

The voluntary agreement between the government, Coca-Cola Amatil NZ and Frucor Beverages Ltd is the world’s first to be negotiated directly between government and industry leaders.

The agreement will see the removal of approximately 1.1 million litres of full-sugar beverages from schools over the next three years.

Mr Hodgson said the agreement was evidence of what could be achieved when government and industry leaders work constructively together.

“This agreement is a major step forward for the Food Industry Accord and shows once again what can be achieved when we reach for co-operative, rather than regulatory, solutions.”

According to HEHA’s Programme Manager, Cynthia Maling, the agreement forms an important part of the work being done to address the challenge that poor nutrition and a lack of activity pose to young New Zealanders.

“The HEHA team has been making solid inroads into addressing the issues of reducing obesity, improving nutrition and increasing physical activity over the past year or so,” says Cynthia. “This agreement strongly supports that work and shows that the food industry is serious about playing its part too.”

December’s agreement between the government, Coca-Cola Amatil NZ and Frucor Beverages follows the launch last year of the government’s Mission On programme, which is aimed at promoting nutrition and increased physical activity in 0-24 year-old New Zealanders. Mission On, which is delivered by the Ministries of Health and Education and Sport and Recreation New Zealand (SPARC), includes initiatives to improve the quality of food served in schools, reduce children’s exposure to the advertising of unhealthy food, and to promote physical activity.

Mission On Launches Campaign


The government’s campaign to encourage young New Zealanders from 0-24 years to eat healthily and increase their physical activity gained further prominence with Sport and Recreation New Zealand’s (SPARC) ‘Move it with Mervyn’ campaign.

Launched just prior to Christmas, the campaign features an animated character called Mervyn whose message is to encourage school-age children to spend less time in front of the computer or TV, and more time being active. A campaign targeting older children is planned for spring 2007.

SPARC’s Programme Team Leader for Mission On, Deb Hurdle, says Mervyn’s television advertisement promotes a series of Push Play physical activity cards.

“These activity cards give children ideas for games they can play over the summer holidays instead of playing on the computer or watching TV,” says Deb.

“The cards are similar to those produced in 2004 to support Push Play, but feature 10 new activities including elastics, Kilikiti and hacky sack.”

The cards will be available free of charge from Countdown supermarkets and from selected sports stores including Stirling Sports, Rebel Sports, Sportspower and
Sportsworld. They will also be available to download from the SPARC website.

“SPARC also negotiated a free sponsorship deal with TVNZ to show a 10-second ‘into’ and ‘outro’ either
side of TV2’s family movies over the summer holidays.

“The intro showed Mervyn congratulating himself on all the physical activities he’s been doing, before sitting himself down in front of the movie for a well-earned break. In the outro, he jumps up ready for more action and urges kids to check out the activity cards and get moving too. The Mission On logo also comes on screen going into each ad break,” says Deb. Sports Minister Trevor Mallard officially launched the campaign to media at a primary school in Wainuiomata the week before Christmas, where he was joined by a life-sized Mervyn and netballer Irene Van Dyke.

Youth Have Their Say on Food and Exercise


Bring 14 under 20-year-olds together from a range of gender, age, ethnic, geographic and socioeconomic backgrounds. Get them thinking about various nutritional issues. And what do you get?

A unique youth perspective on food and nutrition in the school setting.

That’s what the HEHA team found when it convened the first meeting of the national Youth Advisory Group (Rise E Tu) late last year.

Megan Grant, HEHA’s Senior Adviser (Nutrition) says the Youth Advisory Group was established to provide the Ministries of Health and Education with youth input on a range of initiatives related to improving nutrition, increasing physical activity and reducing obesity for young people.

“The first meeting of the Group was held in December in Wellington and at that meeting, we focused on getting to know each other, as well as understanding what the participants would be doing and where their work will fit with the Ministry of Health.”

Megan says the 14 participants, who ranged in age from 12-18 years, heard about the various school initiatives, including the Food and Beverage Classification System, the Food and Nutrition Guidelines and the Nutrition Fund.

“They especially focused on the Classification System,and we workshopped how the project could be ‘sold’ to different demographic groups.”

A second meeting of the Youth Advisory Group is planned for March, again in Wellington. The agenda will include the new Mission On Initiative 2 project, relating to student-led nutritional health promotion, with a focus on food and nutrition.

“They will also participate in a health promotion skills workshop and be encouraged to think about projects they’d like to take back to their respective schools and communities.”

Participants will be helped to identify local contacts in their communities, including HEHA Project Managers, Ministry of Youth Development Regional Youth Participation Advisers, youth workers and youth health promoters, says Megan.

A third meeting of the Group is planned for June 2007, after which the Group will be reviewed.

The Youth Advisory Group was developed by the New Zealand Association for Adolescent Health and Development (NZAAHD), a national nongovernment organisation committed to supporting innovative health and education policies and programmes affecting 12-25 year-olds.

The Ministry of Health contracted the NZAAHD to establish and facilitate the group. Members were solicited via postcards and letters to schools, alternative education providers and youth groups. More than 130 applications were received and 14 members were eventually selected based on their interest/experience and diversity of perspective in relation to nutrition and physical activity, and on achieving a good mix of gender, age, ethnicity, socio-cultural and geographical factors.

HEHA Project Manager Profile: Kate Sladden


A key tool for delivering the HEHA Strategy is the HEHA Project Managers. These personnel will be contracted by the 21 DHBs to design and implement local solutions in their respective regions. This is the first in a regular column of interviews with the new Project Managers, profiling their background and turning the spotlight on how they aim to spread the HEHA message in their areas. First up is Kate Sladden, HEHA Project Manager for the Auckland DHB (ADHB).

Kate has the honour of being the first of the 21HEHA Project Managers appointed to the position. She took up her role on 8 January this year and says she’s relishing the opportunity to flex the nutritional muscles she first developed in her previous role as a Public Health Dietitian with the Auckland Regional Public Health Services (ARPHS).

“My work at the ARPHS covered a range of initiatives which has served me in good stead to take on the HEHA role, says Kate.
“These included implementing nutritional programmes in manufacturing worksites, the ‘Healthy Kai Programme’ which promoted healthier ready-to-eat food choices in town centres, and providing nutrition support and resources to other health workers.”

She’s barely got her feet under the desk and already Kate is focusing on key areas such as meeting with a range of stakeholders to gain their perspective of the HEHA programme and to find out more about programmes currently underway in the wider Auckland region.

“The list of people to talk to seems to get longer each day! However the general reaction to my position and the HEHA work programme has been great and people are very willing to meet and supply information for the stocktake. There are very positive vibes about HEHA around the DHB and I feel excited about the potential for this new role.”

Kate says she’s been heartened by the number of agencies who are already running a variety of innovative programmes in the district.

“Therefore I see a key role of the DHB is ensuring that providers in the district feel well supported and connected to a common plan and goal for HEHA. An effective collaborative planned approach at district level can be enhanced with innovative programmes which are carefully evaluated to demonstrate what works and what doesn’t.

Kate believes the biggest challenge of her new job will be determining programmes and strategies that will make a difference.

“Previously my work focused on the nutrition component of HEHA, so I’m looking forward to learning more about the physical activity programmes underway in the district.

And to ensure that she’s walking the talk, Kate “starts the day in a HEHA way” by walking up eight flights of stairs to her office!

Building the Foundations of a New Social Marketing Campaign


With just months to go until the launch of the new social marketing programme for healthy eating,the Health Sponsorship Council (HSC) is experiencing increasing interest from those working in public health nutrition about what the programme will do and how it will work with existing programmes and interventions at national and local levels.

There has been great interest from the sector in the last few months, according to Michelle Mako, the HSC’s Healthy Eating Programme Manager.

“We’ve been working hard to respond and connect with our colleagues across public health nutrition so that we can explore together how the programme will work for all of us. We want to be sure the new programme will support the great work already being done in our communities. The last thing we want to do is to re-invent the wheel or duplicate what is already out there.”

One of the main ways the HSC is hoping to achieve this is by increasing awareness of what social marketing is, what this approach entails and how it translates at a national and community level. Iain Potter, HSC’s Chief Executive, explains: “With so much happening in the sector at different levels, we think it is vital to help build awareness of how a social marketing approach can support sector-wide efforts in tackling a population health issue. Although the term ‘social marketing’ is being increasingly used across public health, the understanding of what social marketing is and how it works is still often unclear.”

The HSC follows an established process to develop a social marketing programme, drawing on international evidence, expert advice, consumer research and internal expertise to drive the programme planning processes to fruition.

“Put simply, social marketing is the application of the concepts and tools of commercial marketing to achieve socially desirable goals. While it takes its ideas from commercial marketing, key differences are that people are the focus not profit, goals are linked to population health and welfare, and often the problems are highly complex, requiring consideration of a range of strategies over a long time period. There’s no quick fix,” says Iain.

Some of the key features that identify a social marketing approach include:
  • Strong consumer focus: understanding the needs and wants of the target audience and using that understanding to drive the programme activities.
  • Voluntary ‘exchange’: understanding that the behaviour change will involve a ‘cost’ and an ‘exchange’ by the individual, who will need to make the change voluntarily.
  • Research: this underpins every step of the process including strategy development, target audience analysis and segmentation, development of messages, channels, and monitoring and evaluation.
  • Market segmentation: people with similar characteristics are grouped together and appropriate strategies are devised to reach and influence those groups.
  • Marketing mix: elements of the marketing mix are used including product, price, place, promotion, policy and publics/partners. The product on offer is an idea or behaviour that the social marketer wants the target group to buy into. Every time we buy a product it will involve a price, not necessarily financial. Place is where and how the target group is reached. The more places the better. Promotion involves a range of methods used to communicate with the target group, from advertising and sponsorship to community involvement. Social marketers can assist with influencing the behaviour of policy makers and others who are in a position to change the environment. Publics/partners – working with groups who have influence over the target audience.
  • Acknowledging the competition: understanding how your product will compete with other brands, products, habits and influences.

A primary focus for the HSC in the next few months is the fourth P – promotion, as it will be launching a mass media and communications campaign that will work to build awareness among target audiences of what the programme is, what the behavioural goal is and what techniques and tools will support healthy eating practices. The HSC will also be working to help create supportive environments and strengthen community action, with the long-term view of sector-wide engagement.

“If you look at the example of Smokefree and Auahi Kore, the brands have evolved to provide a rallying point for the sector that are owned and used by those working in tobacco control to support and add weight to their efforts at a national and community level,” says Iain. “This has worked really well for tobacco control and we hope to achieve a similar outcome with the healthy eating programme.”

For further information about social marketing visit www.socialmarketing.co.nz. For information about the Healthy Eating programme contact Michelle Mako or Anna Passera.

DHB Evaluation Fund


Funding for the evaluation of nutrition and physical activity initiatives has been given a boost with the establishment of the HEHA DHB Evaluation Fund. Set up by the Ministry of Health, the Fund provides $1.6 million a year to support the evaluation of regional, district and local initiatives currently taking place (or planned) in the nutrition and physical activity arena.

HEHA’s Public Health Medicine Specialist, Dr Harriette Carr, says the Fund will also support the many collaborative programmes with partners such as Regional Sports Trusts, Primary Health Organisations, Maori and Pacific providers, education sector groups, NGOs and local government.

“The purpose of the fund is to support the evaluation of programmes that have potential and appear to be making a positive difference towards implementing HEHA but have not been formally evaluated. Additionally, it can support evaluations already in place that need extra financial support,”says Harriette.

“The fund is only available to DHBs and applications need to be forwarded by DHBs. Although the Ministry requires the evaluation of initiatives to be overseen by DHBs, the initiatives to be evaluated do not necessarily need to be DHB led.”

DHBs may subcontract out the evaluation of the initiatives but will need to retain oversight and manage the subcontract. The Ministry welcomes joint proposals from more than one DHB but a nominated lead DHB is required. Applications for the first round of funding close on April 30th 2007. Application forms are available by emailing harriette_carr@moh.govt.nz.

The Fund is also aimed at:
  • developing the evidence base of what works (and what doesn’t) to support improved nutrition, increased physical activity and reduced obesity
  • further developing the DHB’s evaluation capacity, and
  • assisting DHBs to find out whether their region’s programmes and initiatives are really making a positive difference for their communities.

The HEHA Logo


The HEHA logo is the standard visual brand for all communications which bear the HEHA name or promote the HEHA message.

Sharon Stephenson of HEHA Communications says the vibrant red and green logo, which incorporates a skipping rope and an apple and is used in the masthead of this newsletter, is now available for use in the resources of pre-approved stakeholders.

“Such stakeholders include DHBs, Public Health Units and such partner agencies as SPARC, the Ministry of Education and the Ministry of Youth Development,” says Sharon.

“Other users, however, will need to seek the Ministry of Health’s permission to use the HEHA logo, whether as a lead brand or as a secondary one (ie in conjunction with other logos).”

There are, however, defined circumstances where the HEHA logo cannot be applied, including on products and services aimed at commercial gain or in conjunction with logos or brands that contradict the intent and key messages of the HEHA strategy (eg with fast-food brand or less healthy foods).

A robust set of guidelines has been developed for the use of the HEHA logo and these, along with the logo in various formats, are now available on a CD Rom. All DHB HEHA Project Managers will be given a copy of the CD at the February workshop but copies are available from sharon_stephenson@moh.govt.nz.

“We would reiterate the Ministry of Health’s position of encouraging DHBs in particular to make use of the HEHA logo in their resources and activities that support the HEHA strategy, such as newsletters and posters. Not only will this save DHBs the expense and time of developing their own logo, but it will also raise the HEHA profile and provide consistency of its use across New Zealand,” says Sharon.

National Nutrition and Physical Activity Public Health Conference


May 23-25 2007, Rotorua
The programme and call for abstracts for the national nutrition and physical activity public health conference in Rotorua, May 23-25 2007, is now available on the Agencies for Nutrition Action (ANA) website (www.ana.org.nz).

ANA’s Conference Co-ordinator Christina McKerchar says the theme for the conference this year is Ngahuru.

“Ngahuru means ten in Maori, so the first day of the conference will focus on obesity. We have a keynote programme designed around reviewing the last ten years of action to prevent obesity in New Zealand and hopefully providing some stimulating insight. Ngahuru can also mean harvest, so on day two of the conference we will bring in the food security theme,” says Christina.

“The focus on day three is really about action and we are highlighting some of the really innovative work that is happening out there. We also recognise the conference is an important time for workforce development so we have tried to fit in a few workshops that will be of interest to those working in this area.”

Christina says the conference is a good opportunity to catch up on who is doing what.

“So I’d encourage providers to put in an abstract about what they are doing. We haven’t forgotten about physical activity – there is a separate physical activity stream as well,” she says.

HEHA Works Collaboratively with Industry


Being passionate about a healthier New Zealand has landed Sally Hughes the job of Senior Analyst – Industry with the HEHA team.

With a background in health promotion and social marketing, Sally believes she is well positioned to take on the newly-created role.

“I will be working closely with the Food Industry Group to achieve the aims of 2004’s Food Industry Accord, a voluntary agreement between government and food industry participants such as producers, distributors, retailers, marketers, advertisers and the media to commit to HEHA’s goals,” says Sally.

“I have been encouraged by the commitment of industry to address the issue of obesity. Obviously the industry wants to avoid legislation with negative commercial impact, but it is also concerned aboutthe trends in obesity and the impact on the health of New Zealanders. Industry is aware of its significant influence on people’s diets and activity levels, and is conscious of being socially responsible. Also from a bottom line perspective, it makes good sense to meet a demand for healthier products.”

Sally is working with Robert Bree, Executive Director of the Food Industry Group, to identify the work programme for 2007. So far this includes:
  • building the Food Industry Group network and increasing the effectiveness and influence of the Food Industry Accord
  • working with the food industry around the MoH’s new Food and Beverage Classification System
  • reducing food marketing pressure on children
  • increasing the range of nutritious foods available and decreasing the salt, sugar and fat content of popular foods.

Upcoming Events


Bike Wise Week, 24 Feb – 4 March 2007
If one of your New Year’s resolutions for 2007 has been to get fit, or even if you just enjoy getting out in the fresh air, here’s an opportunity to get on your bike!

Bike Wise Week is the only nationally co-ordinated event promoting biking as a valid, fun and healthy means of transport and enjoyment.

Tens of thousands of New Zealanders take part in events across the country. The national event is coordinated by regional and city councils, sports trusts, businesses, environmental groups, parents, public health units, cycling advocates, schools, the retail sector and more.

A key part of the week includes ‘Go by Bike Day Breakfast’ which this year falls on Wednesday 28 February. On Go by Bike Day, Kiwis are encouraged to ditch the car or bus and take their bike instead.

And to encourage you, around 30 centres throughout New Zealand will be hosting a free breakfast at the Go by Bike Day centres where there will also be entertainment, prize draws and lots of cycling antics. Ride your bike to your local Go by Bike centre to take part in the healthy breakfast to kick start your day.

For further information, go to www.bikewise.co.nz

Library Corner


The following include the latest publications and articles in the HEHA arena:

Books
  • Nutritional health: strategies for disease prevention
    Publisher: Totowa, N.J.: Humana Press Inc., c2006 . Edition: 2nd ed.
  • The queen of fats: why omega-3s were removed from the Western diet and what we can do to replace them.
    Author/Speaker: Allport, Susan. Publisher: Berkeley: University of California Press, c2006

Articles:
  • NZ Medical journal 26-January-2007, Vol 120 No 1248
    This issue features several articles on food related issues in NZ abstracts online. Full text available to subscribers
    http://www.nzma.org.nz/journal/index.shtml

    Articles include:
  • More evidence for action on New Zealand’s obesogenic school environment and food pricing
    Nick Wilson, George Thomson, Gabrielle Jenkin
  • The price of healthy eating: cost and nutrient value of selected regular and healthier supermarket foods in New Zealand
    Cliona Ni Mhurchu, Siddharth Ogra
  • Food choices among students using the school food service in New Zealand
    Jennifer Utter, David Schaaf, Cliona Ni Mhurchu, Robert Scragg
  • Metabolic syndrome prevalence in a multicultural population in Auckland, New Zealand
    Dudley Gentles, Patricia Metcalf, Lorna Dyall, Gerhard Sundborn, David Schaaf, Peter Black, Robert Scragg, Rod Jackson
  • Relationship of different measures of socioeconomic status with cardiovascular disease risk factors and lifestyle in a New Zealand workforce survey
    Patricia Metcalf, Robert Scragg, Peter Davis
  • Metabolic control with insulin pump therapy: the Waikato experience
    Elham Reda, Angelica Von Reitzenstein, Peter Dunn
  • Physical activity to prevent obesity in young children
    Authors: Reilly JJ et al BMJ 2006;333:1041
  • Promotion of physical activity by Canadian Registered Dietitians in daily practice
    J Hum Nutr Diet. 2007 Feb;20(1):37-40. Johnson, S T etal
  • The Eating and Physical Activity Habits of Inner-city Adolescents
    Sweeney NM et al. J Pediatr Health Care. 2007 Jan-Feb;21(1):13-21.
  • Healthy eating, exercise, and weight: impressions of sexual minority women
    Bowen DJ et al. Women Health. 2006;44(1):79-93.
  • Addressing barriers to health promotion in underserved women
    Timmerman GM. Fam Community Health. 2007 Jan-Mar;30(1 Suppl):S34-42.

Healthy Eating Healthy Action Tips


Because the HEHA vision is an environment where all New Zealanders are supported to eat well, live physically active lives and maintain a healthy body weight, we in the HEHA team are all for practical ways that can help make this goal a reality.

In each issue of HEHA Action Report, we’ll bring you a couple of simple nutritional and physical activity tips which we would encourage you to incorporate into your daily lives.

Healthy Eating
If you’re feeling the urge to snack, choose food based on vegetables and fruits, breads and cereal and low-fat milk and milk products, which are lower in fat than potato crisps, biscuits or pastries.

Healthy Action
If you have a meeting with one or two other people that doesn’t require too much note-taking, how about putting on your walking shoes, hat, sunblock, and sunnies and going for a walk while talking – great for those after lunch meetings on sunny days.

Contact Details


We would love to get your feedback on this bi-monthly electronic newsletter and, of course, to hear how HEHA is being implemented in your respective regions. Please send your contributions to heha@moh.govt.nz


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