study.
(g) 24 hour recall data analysis.
Approximately 3,500 food items, consumed by 38 informants on 126 days were coded by me at the Nutrition Section of the Commonwealth Health Department (now Department of Community Services and health), under the guidance of personnel responsible for coding the data for the national survey. Each item of food was then recorded in a data file on a
mainframe computer at the university, and for each item the informants identity number, sex, place of residence, recall number, the day in the pay fortnight the food was consumed, description of the food, cooking method and volume was also recorded. The Department of Health's program to analyse foods for nutrients was then copied to one of the Australian National University's mainframe computers. A second file was then generated, containing the nutrient content for each food item
consumed.*^ Subsequent analysis of these two data files, for foods consumed and nutrients consumed, was done by me using SPSS-X.
(h) interpretation and evaluation.
The results of the dietary survey are discussed in the following chapters. For the reasons outlined above the data collected were not adequate to draw conclusions about the adequacy of individual dietary intakes. Evaluation has therefore been confined to a comparison of group results with those obtained in the national survey. It is important to note that the latter have been published without any
discussion or analysis of their health implications, partly because this I am very grateful to Dr David Feary for assistance with file transfer and reformatting and with the programming necessary to complete these operations.
is an area in which public health policy with respect to nutrition is still being developed and assessed in Australia.
For foods consumed, the mean intakes are derived from 126 days of food consumption, so that the maximum amount of available information about food varieties and patterns of consumption could be evaluated.
However, in order to minimise the effect on mean daily nutrient intake of unequal repeated measures, the mean daily nutrient intakes for men and women were calculated from the mean daily intakes of each
individual. The latter values were also used in the comparisons with Recommended Dietary Intakes (RDI).
One of the major problems in the interpretation of the data was the lack of an appropriate population with which to compare the results. There have been no other dietary studies of adults in urban Aboriginal
communities using 24 hour recall, and there is very little dietary data
available for other lower socio-economic groups in Australia. Thus,
the results of the National Dietary Survey of Adults (1983) have been used as a basis for comparison.
There are however, a number of important ways in which the national sample and the Kempsey sample differ. The national survey was conducted in capital cities only, and the sample is comprised of a variety of ethnic groups.*^ Although a breakdown of both the education and employment status of the national sample is reported (Commonwealth Department of Health 1986), there has been no analysis of the relationship between diet and either education or employment. The
Ethnicity is somewhat obscured however by the fact that only region of birth is shown, which is predominantly Australia (71.9%).
national survey did not include persons under twenty five years of age and data on alcohol consumption were collected and included in the analysis.
The Kempsey survey was confined to an ethnically discreet, rural town population. Persons fifteen years and over were included and very little data on alcohol consumption were collected. Employment rates in the Aboriginal sample were less than half the national rate for males and three fifths of the national rate for females (see Table 4.4). Furthermore, of those in the national sample who were employed, 41% of males and 33% of females were in upper echelon 'professional/technical' and 'administrative/ executive' positions, compared to one in the
Kempsey sample in these job classifications.
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Table 4.4. Comparison of employment rates in the national and Kempsey Aboriginal dietary surveys.
Employment rates %
Australia# Kempsey Aboriginal
males females
88 42
51 33
# Source: Commonwealth Department of Health 1986.
It is thus apparent that the results of the Kempsey survey reflect the dietary habits of an economically less advantaged population than that of the national survey.
Statistical tests have not been used in the analysis of these results. This is because the sampling technique and the data collected were not
adequate to ensure their validity. For example, I was interested to see whether or not there was a significant difference in the mean
intakes of the major nutrient categories (energy, protein, carbohydrate and fat) between diabetics and non-diabetics. However, as already noted I did not have enough recall repeats to evaluate the nutrient intakes of diabetics and non-diabetics on an individual basis. Nor could groups means be used because the total sample was not large enough to divide into groups for the purpose of comparison once sex, age and weight had been taken into account. For these reasons the effect of informants' weight, age, place of residence, and employment status on nutrient
intakes were also not tested.
What follows then are dietary intake data which have been evaluated in the context of both the results of the national survey, and the more general information collected during household interviews and an
extended period of observation and interaction in the Kempsey community.
Conclusion
In this chapter I have argued that there has not been a strong empirical basis for many of the assertions made about Aboriginal diet in urban environments. Only two quantitative studies of food intake have been published and both involved very small groups, which limits the extent to which their findings can be used to generalise about Aboriginal nutrition. In spite of this, very poor dietary habits have frequently been assumed to be ubiquitous in Aboriginal communities.
The paucity of data is almost certainly due in part to the considerable difficulties involved in conducting this kind of research amongst
Aborigines. In this study, methodological considerations had to be
balanced against the realities of conducting research in a rather hostile social environment. Nevertheless, by making home visits and by using a combination of structured household interviews and 24 hour recalls of food intake I was able to gather a significant body of dietary data.
It was clear from these observations that there is a remarkable degree of uniformity of dietary practices in Kempsey Aboriginal households,
regardless of apparent income or physical living conditions (see Chapter 5). This consistency in the patterns of consumption is a reflection of the broader social homogeneity which characterises the Kempsey Aboriginal community (see Chapter 3), and which has its origins in the shared
historical experiences of life at Burnt Bridge and Greenhill (see Chapter 2). These experiences helped shape the post-contact diet and transcend the differences brought about by relocation of many people into the town. Consequently, I would argue that the patterns of consumption, or the kinds and variety of foods consumed, may reasonably be assumed to be representative of the community as a whole.
However, individual nutrient intakes, from which the nutrients consumed are derived (see Chapter 6) are more problematic, because of the lack of representativeness of the sample. As discussed earlier in this chapter, the age distribution of the sample does not reflect the age distribution of the population, and there are more employed and obese/diabetic people and fewer males in the sample than in the community as a whole. The other important omission is alcohol consumption. Notwithstanding these shortcomings, this is the largest quantitative study of urban Aboriginal nutrition ever undertaken and, as I will argue, the results strongly suggest that the extremely poor diet and heavy alcohol abuse thought to be characteristic of urban Aborigines, warrants re-evaluation.
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