Prevention of adolescent alcohol misuse
We’re looking at how adolescent alcohol misuse prevention contributes to the reduction of alcohol-related harm in Australia. Our team is collaborating with the major Australian research group in a national community trial that’s evaluating benefits of community-based adolescent alcohol
Our project is the first to measure the health, social and economic benefits that flow from reducing adolescent alcohol use to the whole community and the individuals as they move into adulthood.
Obesity and population health
Our research program is led by Professor Anna Peeters and has links with the Centre for Population Research and the WHO CC. The aim of our research is to bring objectivity and equitability to strategies for tackling rapidly-escalating rates of obesity in Australia.
The Obesity and Population Health group measures risk and how best to deliver interventions, optimising effectiveness and equitability. We use best-practice epidemiology, biostatistics, chronic disease modelling, systematic reviews and policy research. We then work to turn our findings into policy and practice, in collaboration with national and international academic institutions, national government and NGOs.
The focus of our research is on:
Monitoring and measurement
Evaluating different population measures of excess body weight
The body mass index (BMI) is the most common measure for obesity and is used to categorise overweight/obesity in population health surveys. In a number of studies, other obesity indicators - such as waist circumference (WC) - have been shown to be stronger predictors of total body fat and metabolic health risks. However, as WC is associated with greater measurement error, BMI has remained the primary population measure.
Recent evidence of rapidly-changing body compositions worldwide suggests continued use of BMI may lead to substantial underestimation of the health burden of obesity. We propose using new approaches to anthropometry assessment, including combinations of measures, to improve prediction of health outcomes. We want to identify the measures best able to identify individuals with high-risk obesity in population health surveys.
For the effective prevention and treatment of obesity (and its consequences) it’s critical to ensure appropriate health system and policy prioritisation, strategic planning and monitoring. The primary outcome of our project will be recommendations on the optimal measures for future population monitoring of high-risk obesity.
Current obesity and diabetes trends on future cardiovascular disease rates
Despite increases in obesity and diabetes - risk factors for cardiovascular disease (CVD) - Australia has continued improvements in CVD mortality and morbidity.
However we hypothesise that CVD is set to increase, and with the disease burden still to be comprehensively estimated, we’re working to project its prevalence in Australia – based on current obesity and diabetes trends – between 2005 and 2030. This includes analysing the impact of real and hypothetical interventions on future rates of CVD.
We’ve developed models that forecast CVD, coronary heart disease (CHD) and stroke prevalence until 2030. Projected changes in the prevalence of obesity and diabetes and targeted interventions are modelled for their impact on CVD. This model provides a much-needed tool to evaluate and monitor the impact of diabetes prevention and management policies on CVD in Australia.
Implications of increasing duration of obesity
With worldwide populations becoming obese younger, people are living longer with the condition. Demonstrating its strong association with increased diabetes and mortality risks, we’ve shown that middle-aged people who live with obesity for 15-plus years - compared to less than five years - double this risk.
The additional risk for other common and disabling outcomes including CVD, cancer and arthritis, and for disability itself, is unknown. This project involves detailed analysis of the relationship between duration of obesity and risk of a range of chronic diseases.
As all prior burden of obesity studies are based on risk estimates using measurement of bodyweight at one point in time, we hypothesise substantial underestimations. Based on our risk estimates, we’re determining the impact of changes in levels of obesity duration through estimation of the burden of diabetes, hypertension, CHD and disability in Australia.
Healthy food retail environments
YMCA Victoria and Alfred Health have implemented policies to increase the availability of healthy foods and beverages. They’re creating healthier food environments for their customers, clients, staff and visitors. We’re working in collaboration with these organisations to evaluate their impact. Data collected will address changes in consumptions, profitability and implementation.
Global Corporate Challenge evaluation study
Workplace interventions are used to address increases in obesity and physical inactivity, but long-term evaluations are rare. We’ve evaluated the Global Corporate Challenge® (GCC®), a four month pedometer-based program to increase employee activity levels.
We’ve followed 762 participants for two years to determine the short- and long-term health benefits and factors to improve such programs. These findings are essential for government and industry policy decisions in chronic disease prevention.
Currently, we’re also looking at novel outcome benefits such as wellbeing and sleepiness. Our findings suggest that, while improving targeted outcomes of blood pressure and waist-circumference, these programs may simultaneously improve wellbeing and sleepiness in higher-risk groups long-term.
This highlights the importance of exploring a wider range of health benefits from similar interventions. We’ve also developed a tool – Checklist for Healthy Eating and Physical Activity in the Workplace - to assess workplace environment support for healthy behaviour amongst employees.
Reducing inequalities in overweight and obesity
Obesity is strongly socially patterned in Australia, but there’s been no analysis of health implications of its unequal distribution. Our translational program focuses on the extent to which social inequalities in obesity may widen, and the potential effect of obesity prevention and management strategies on this health divide. This is encompassed in the Reducing Inequalities in Obesity (or RIO) work program led by Professor Anna Peeters and Dr Kathryn Backholer.
A greater burden of obesity is seen across a range of markers of socioeconomic position. In high income countries children and adults who live in more socioeconomically disadvantaged areas or who have lower income or lower education generally experience more obesity. These inequalities are likely to translate into inequalities in health, wellbeing and productivity, further steepening the health and social gradients already observed in our communities. As the greatest burden of excess weight falls on the more disadvantaged, reducing these inequalities are likely to substantially improve the population burden of obesity-related disease and associated health care and productivity costs.
RIO encompasses two key outputs:
- A research work program that aims to build the evidence base in 1) describing and understanding socioeconomic inequalities in obesity by using epidemiological methods and 2) understanding the role of obesity prevention and management interventions/policies on socioeconomic inequalities in weight by using epidemiological modelling methods and policy analyses.
- Research translation and knowledge exchange that aims to unite science and policy on the equitable reduction of obesity. This arm of RIO assembles the most up-to-date evidence on the epidemiology and policy implications of socioeconomic inequalities in obesity in an uncomplicated and succinct manner. The result is a range of tools and resources to aid with simple research translation and knowledge exchange on the equitable reduction of obesity. Key partners include the Obesity Policy Coalition, Vic Health and the National Heart Foundation.
This work program is funded by the Australian National Preventive Health Agency, the Australian Research Council and Vic Health. A/Prof Anna Peeters received the 2014 World Obesity Federation Andre Mayer Award and a 2014 Churchill Fellowship and Dr Kathryn Backholer received the 2013 Australian and New Zealand Young Investigator award for their work in this area.
Obesity and healthy ageing
Obesity is a risk factor for many chronic diseases and its increasing prevalence poses a threat to healthy ageing in Australia. We’ve demonstrated that obesity, particularly when measured in mid-life, increases risk of disability. The longer one lives with obesity, the higher the risk of developing disability.
In a study developing a risk prediction algorithm for disability, we identified obesity as one of the strongest modifiable predictors as it increases the risk about three-fold.
This program aims to refine our disability risk prediction algorithm, using it to predict Australian population increases in disability associated with current obesity trends.
We aim to develop it so that an individual can estimate changes in their healthy life expectancy through lifestyle changes. Industries and government sectors will also be able to triage lifestyle interventions, estimating potential benefits and maximising the impact of interventions.
Recent Epidemiology Unit publications
Salom C; Kelly A, Alati R, Williams GM, Patton G, Williams J. Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents. Accepted Drug and Alcohol Review May 2015.
Williams JW, Canterford L, Toumbourou JW, Patton GC, Catalano RF. Social development measures associated with problem behaviors and weight status in Australian adolescents. In press Prevention Science 2015; DOI: 10.1007/s11121-015-0559-6
Chan GCK, Kelly AB, Connor J, Hall W, Young RM, Toumbourou JW, Williams J. Regional versus urban differences in teenage alcohol use: Does parental disapproval account for these differences? Accepted Australian Journal of Rural Health January 2015
Kelly AB, Chan GCK, Mason WA,Williams JW. Brief Report: The relationship between psychological distress and adolescent polydrug use. Accepted Psychology of Addictive Behaviors January 2015
Chan G, Kelly AB, Connor J, Hall W, Young RM, Bush R, Toumbourou JW,Williams J. Variations in alcohol use among adolescents from different countries of birth. Does alcohol-related parenting explain these variations? Submitted Drug and Alcohol Dependence November 2014
Lewis AJ, Kremer P, Douglas K, Toumbourou JW, Hameed MA, Patton GC, Williams J. Gender differences in adolescent depression: Differential female susceptibility to stressors affecting family functioning. In press Australian Journal of Psychology 2015 DOI: 10.1111/ajpy.12086
Rowland B, Toumbourou JW, Satyen L, Livingstone M, Williams J. The relationship between the density of alcohol outlets and parental supply of alcohol to adolescents. Addictive Behaviors 2014; 39: 1898-1903
Li HK, Kelly AB, Chan GCK, Toumbourou JW, Patton GC & Williams JW. The association of puberty and young adolescent alcohol use: Do parents have a moderating role? Addictive Behaviours 2014; 39: 1389-1393
Rowland B, Toumbourou JW, Lata S, Tooley G, Hall J, Livingston M, Williams J. Associations between alcohol outlet densities and adolescent alcohol consumption: a study in Australian Students. Addictive Behaviors 2014; 39(1): 282-288
Jones M, Taylor Lynch K, Kass AE, Burrows A, Williams J, Wilfley DE, Taylor C.B. Universal and Targeted Intervention for Healthy Weight Regulation and Eating Disorder Prevention in High School Students. J Med Internet Res2014; 16(2): e57
Kremer P, Elshaug C, LeslieE, Toumbourou JW, PattonG, Williams J. Physical activity, leisure-time screen use and depression among children and young adolescents. Journal of Science and Medicine in Sport. 2014; 17(2): 183-187
Jonkman H, Steketee M, Toumbourou JW, Cini K, Williams J. Cross-national comparison of community variation in adolescent heavy alcohol use in Australia and the Netherlands. Health Promotion International. 2014; 29(1): 109-117
Smith D, Kelly AB, Chan GCK, Toumbourou JW, Patton GC, Williams, J. Beyond the primary influences of parents and peers on very young adolescent alcohol use: Evidence of independent neighbourhood effects. Journal of Early Adolescence, 2014; 34 (5): 569-584.
Habib C, Toumbourou JW, Mc Ritchie M, Williams J, Kremer P, McKenzie D, Catalano RF. Prevalence and community variation in harmful levels of family conflict witnessed by children: Implications for prevention. Prevention Science. 2014; 15 (5): 757-766.
Harding J, Shaw J, Peeters A, Magliano D. Age-specific trends from 2000-2011 in all-cause and cause-specific mortality in type 1 and type 2 diabetes: a cohort study of over one million people. Diabetes Care, accepted March 2016
K Backholer, C Keating, G Turrell, A Peeters. The impact of a tax on sugar sweetened beverages according to socioeconomic position: A systematic review of the evidence. PHN, accepted March 2016
L Huo, E Wong, J Harding, J Shaw, D Magliano, A Peeters. Burden of diabetes in Australia: life expectancy and disability-free life expectancy in adults with diabetes, Diabetologia, accepted March 2016
O Chimeddamba, D Ayton , N Bazarragchaa, B Dorjsuren, A Peeters and C Joyce. The adoption of roles by primary care providers during implementation of the new chronic disease guidelines in urban Mongolia: A qualitative study. International Journal of Environmental Research and Public Health, accepted February 2016
Stephanie K Tanamas, Viandini Permatahati, Winda L Ng, Kathryn Backholer, Rory Wolfe*, Jonathan E Shaw, Anna Peeters. Estimating the proportion of metabolic health outcomes attributable to obesity: A cross-sectional exploration of body mass index and waist circumference combinationBMC Obesity BMC Obes. 2016 Jan 29;3:4
Danja Sarink, Lee Nedkoff, Tom Briffa, Jonathan E Shaw, Dianna J Magliano, Christopher Stevenson, Haider Mannan, Matthew Knuiman, Anna Peeters.Projected age- and sex-specific prevalence of cardiovascular diseases in Western Australian adults from 2005 to 2045. Eur J Prev Cardiol. 2016 Jan;23(1):23-32
L Huo J Shaw, A Peeters, D Magliano. Life Expectancy of People with Type 1 Diabetes in 1997-2010: a National Registry-based Cohort Study Diabetologia, 2016 Jan 21. [Epub ahead of print]
Bihan H, Shaw J, Backholer K, Peeters A, Magliano D. Socioeconomic position and premature mortality in a cohort of Australian adults (the Australian Diabetes, Obesity and Lifestyle (AusDiab) study). Am J Public Health, 2016 Jan 21:e1-e8. [Epub ahead of print]
Stephanie Tanamas, Michael Lean, Emilie Combet, Antonis Vlassopoulos, Paul Zimmet, and Anna Peeters. Changing Guards: Time to move beyond single measures to assess body compositions of populations. QJM: An International Journal of Medicine, November 2015 pii: hcv201
Professor Catherine Bennett
+61 3 9244 6149
Email Professor Bennett
Centre for Population Health Research
School of Health and Social Development
221 Burwood Highway
Burwood VIC 3125