Review of 2021 Census Topics

To gather information that will allow the Early Life Nutrition Coalition to better drive awareness and action that supports empowerment and behavioural change for improved nutritional status during the First 1,000 Days – that being prior to conception through to toddlerhood. Key areas of focus include: maternal nutrition before, during and after pregnancy; paternal health and diet; promoting the importance of breastfeeding for as long as possible; introducing solids, including known allergens, at around six months; and positive nutritional role modelling by parents and caregivers, health care professionals, society and policy makers.

A growing body of evidence shows that the First 1,000 Days provides a critical window of opportunity where a healthy environment, particularly good nutrition, can positively influence lifelong health by reducing the risk of obesity, allergy, type-2 diabetes, cardiovascular disease and improved mental wellbeing.

Globally, we are facing an obesity epidemic and life expectancy has declined relative to historical patterns. Both poor lifestyle choices and nutrition contribute significantly to this situation.

The Early Life Nutrition Coalition believes every child deserves the best possible start to life.

During pregnancy, a variety of health care professionals provide valuable information that will impact the life-long health of the unborn child. However, access to these healthcare professionals is not uniform across the country.

Understanding what services are being accessed and in what regions will allow for the better placement and utilisation of health specialists, as well as better investment into their knowledge and understanding of the importance of The First 1,000 Days in shaping life-long health outcomes.

The questions suggested by the Early Life Nutrition Coalition are focused on an individuals experience and actions, as such the information is easily recalled and recorded.

The questions are also straight forward in nature.

The topic is related to health and infant nutrition, with a focus on breastfeeding and access to pregnancy related health services.

The topic questions require yes / no answers, so they are easily coded, and are appropriate for collection via Census.

Yes, as this is a health related topic that focuses on understanding and subsequent action, it will be highly relevant to future Census', as it is relevant to the future health of all Australians.

While data from 2010 investigates breastfeeding in Australia, there is no national data relating to the long-term implications or access to services and information relating to nutritional intake during The First 1,000 Days.

The rapid increase in prevalence of chronic diseases, including metabolic and allergic disease, as well as neurodevelopmental disorders, is a significant national health problem, with a growing body of evidence now linking the nutritional environment in early life to an increased risk of disease in adulthood.

The risk of developing these diseases is influenced by a range of factors across an individual’s lifespan. Environmental exposures during fetal development and infancy are now considered responsible for a significant part of lifetime disease risk, as they can trigger changes in the developing offspring.

Research has identified vulnerable time periods, including prior to conception and during fetal and early postnatal development, where exposure to environmental factors, including poor nutrition, can trigger adaptations in the growing fetus. While these effects may be adaptive in the short-term, they may also be associated with adverse outcomes in childhood and later life, including a greater risk of metabolic diseases, such as obesity, type 2 diabetes and heart disease, as well as allergy.

Among other factors, maternal and paternal health and lifestyle behaviours are key determinants of pregnancy outcomes and the longer-term health of the offspring. Identifying vulnerable periods in fetal development provides an important opportunity for parents and caregivers, healthcare professionals, society and policy makers to intervene and optimise future health outcomes.

The Early Life Nutrition Coalition was established in 2017 as a sub-committee of the Perinatal Society of Australia and New Zealand. The Coalition is an affiliation of concerned professional, academic, advocacy, corporate and healthcare groups working collaboratively to communicate and promote the importance of early life nutrition as a long-term preventative health measure to health care professionals, new and expectant parents and adolescents.

The Coalition has taken the liberty of suggesting the following questions for consideration. Of course, the Coalition is eager to work closely with the Australian Bureau of Statistics to further refine the topic under review:

1. During and in the months immediately following your pregnancy/ies, which of the following health services did you access? (Select all that apply)
• Diabetes Educator
• Dietitian
• General practitioner
• Lactation consultant
• Midwife
• Naturopath
• Nutritionist
• Obstetrician
• Paediatrician
• Paediatric Dietitian
• Pharmacist
• Other
• None

2. Did you breastfeed any or all your children, and if so, thinking of your youngest child, for how long? (Please select one)
• Yes, less than four weeks
• Yes, less than three months
• Yes, more than three months but less than six months
• Yes, between six and twelve months
• Yes, more than twelve months
• No

3. For your pregnancy/ies did you modify or adjust your diet and nutritional intake? (Please select one)
• Yes, I took pregnancy and breast feeding supplements
• Yes, I took pregnancy and breast feeding supplements, as well as adopted a healthier diet
• No, I didn’t take pregnancy supplements or alter my diet

4. Are you aware of the belief that nutrition during the First 1,000 Days (from conception through to toddlerhood) can help shape long-term health outcomes for your child? (Please select one)
• Yes, but not that it is referred to as the First 1,000 Days
• Yes, I am aware of the First 1,000 Days
• No, unaware of the notion of the First 1,000 Days