Food on the table, shoes on our feet

From burgeoning obesity to undernutrition and food insecurity; from scientists to environmentalists, policymakers, public health experts, activists, farmers and consumers: it seems the whole world is more worried than ever about how the human race can balance and sustain a healthy way of feeding ourselves.

And with good cause — in launching “Food Tank: The Food Think Tank” (http://www.foodtank.org), a new initiative designed as a virtual roundtable for the various participants in the food debate, earlier this month, US-based food activists Ellen Gustafson and Danielle Nierenberg reminded us that, while more than 1 billion people worldwide are obese, nearly 1 billion go to bed hungry every night, and at least 2 billion have nutritional deficiencies.

Gustafson and Nierenberg envisage their new project as a web-based clearinghouse and community to inform, share and scale up innovations that help alleviate hunger and poverty, while protecting the environment. Although it’s early days for the new venture, it makes intuitive sense to have conversations about food that link the various issues, with a view to fixing the whole system, rather than looking at each component in isolation.

Selvey and Carey raise an example of the need for such coordination (doi: 10.5694/mja12.10528). As we approach formal adoption of revised national dietary guidelines, designed primarily to help Australians make better nutritional choices, they voice concern that some of the recommendations will not do the world as a whole any favours. In particular, increasing Australians’ consumption of fish may not be the best strategy, given that fish stocks, globally, are collapsing at an alarming rate.

Public health exponents have been telling us for some time that Australia’s major food-related disease — obesity — has wide-ranging repercussions that are not evenly spread throughout society. In a study of women who gave birth in Victoria’s rural Goulburn Valley, Cunningham and Teale found that about two in three women were overweight or obese, with increased rates of associated complications, which the authors say may have implications for rural maternity service resourcing (doi: 10.5694/mja12.11033). Obesity-related chronic conditions such as type 2 diabetes are also thought to be a factor in the rates of erectile dysfunction in Indigenous men reported by Adams and colleagues (doi: 10.5694/mja12.10490).

Playing any role in health and health care can be daunting, but there is some advice and inspiration in this issue, to help as you don your running shoes for the year ahead. Kirby (doi: 10.5694/mja12.11782) offers a single shard of advice to British Prime Minister David Cameron, which will resonate with Australian readers — avoid making any new promises on health care delivery during 2013, as the odds are against them being kept. Addressing doctors, Wein explains eloquently what not to do in one’s daily work of improving health care and upholding the tenets of our fine profession (doi: 10.5694/mja11.11422).

Some inspiring doctors are remembered in this issue, with tributes to an Australian physician who left an indelible legacy in Tanzania (doi:%2010.5694/mja12.11435), a West Papuan doctor who devoted 40 years of service to Papua New Guinean medicine as a physician and teacher (doi: 10.5694/mja12.11714), and a true champion of women’s health in Australia and abroad (doi: 10.5694/mja12.10948).

Here at the MJA, we are also mourning the passing and remembering the work of Professor Gavin Mooney, a prominent and colourful health economist who was an advocate of, among other things, involving ordinary citizens in decisions about public health and health care. He would probably have approved of the steady stream of voices calling for a more holistic approach to conversations about the big issues affecting human health. Justice, fairness and compassion in health seemed possible whenever Gavin was in the room. Long may his influence continue!