from the Drum …..

Research discussed by The Drum's panel on Thursday night confirms that improvements to Australia's food supply are desperately needed if we are to reduce deaths from Australia's number one killer, heart disease.

Australia has a well-deserved reputation as a global leader in tobacco control. While we still have a long way to go - around 3 million people still smoke - governments listen and act on the advice of public health groups.

Sadly, the same cannot be said when it comes to our food supply. This is deeply disturbing given that it's likely that high body mass has already overtaken smoking as the leading preventable cause of death and disease in this country.

With 3 million obese Australians, we have a problem that demands more attention than it's getting. Obesity, we scarcely need to be reminded, contributes to a broad range of chronic disease including heart disease, stroke, type-2 diabetes (itself a risk factor for heart disease), osteoarthritis and some cancers.

Excessive salt consumption is another killer, with estimates suggesting as many as 6,000 premature deaths a year could be attributed to this cause, mostly from heart attacks and strokes.

The need for more comprehensive action on food is underscored by a new paper prepared for the World Health Organisation.

British epidemiologists from the University of Liverpool this month calculated that a staggering 30,000 cardiovascular deaths could be prevented each year in that country through a more robust approach to food policy and regulation, including relatively simple action such as:

• reducing salt and saturated-fat content of food
• banning the use of industrial trans fats
• promoting greater fruit and vegetable consumption

In other words, the potential health impact of well-targeted food strategies is astounding. It's also highly cost-effective.

In Australia, we've seen steady but slow progress on one key initiative, a fledgling food reformulation program - the Food and Health Dialogue.

The UK reformulation program has sought voluntary agreements with major food companies to set targets for reductions in salt, added sugar, saturated fat, and energy density for different categories of food.

In the UK, targets have been set for more than 80 food categories. We've done 18.

But, most significantly, the UK has achieved a marked - and measured - reduction in salt consumption across the population. Figures released this month reveal a reduction of almost 1.5g in daily salt intake over the past decade.

This may not sound like much. But it equates to 20,000 fewer cardiovascular events - such as heart attacks and strokes - each year, some 8,500 of which would be fatal.

With each heart attack in Australia costing $25,000 in direct healthcare costs and the total healthcare costs of cardiovascular disease amounting to a shade under $8 billion a year, you would think the Treasurer and Finance Minister would be banging on Minister Tanya Plibersek's door demanding robust action on food reformulation.

Put simply, food reformulation should be a no-brainer. Cost to government - virtually nothing. Population health impact - enormous. Benefit to hospital budgets - substantial.

What needs to be done? We must supercharge our food reformulation program, ensuring that it's developed into a world-leading program.

The Federal Government needs to employ more independent food experts, so that they work with food companies and health groups to set the best possible targets - targets that will stretch industry, but targets that are also realistic and achievable.

There needs to be support for education campaigns too, so that there is a much greater understanding about why we need to choose healthier food products - and how to do it. This should be done in conjunction with the Australian National Preventive Health Agency.

Finally, there should be a better, transparent reporting and monitoring regime to show progress and to help keep companies on track.

Australia has got off to a good start on food reformulation, especially under the leadership of the parliamentary secretary for heath, Catherine King. Many companies are enthusiastically participating and reformulating rapidly. As a result, we're removing around 1,000 tonnes of salt a year from bread alone.

But progress in other areas, such as bringing fast food companies to the table, has been less impressive. It's now time for fast food companies to have a focus on reduction of salt in their bread and buns so that all salt levels are similar in these products. If bread in supermarkets can be changed why can't bread supplied to fast food outlets be changed as well?

With people eating out of home more often, food reformulation in this sector is critical if we are to improve the food all Australians eat.

If we're serious about stemming the chronic disease tide, we should be putting as much energy and resources into improving our food supply as we rightly put in to tobacco control.

Dr Lyn Roberts has been with the National Heart Foundation of Australia since 1988 and has been CEO since 2001. View her full profile here.