While Mediterranean regions are fighting it out for top healthy nation ranking, Australia is slipping.
Spain has overtaken Italy as the world’s healthiest country, according to Bloomberg’s 2019 Healthiest Country Index, while Australia has dropped two places to number seven.
Despite Australia’s escalating rates of obesity and heart disease, our nation is still well ahead of the US, which has slipped one place to rank 35.
For the Bloomberg index, countries are ranked on elements such as life expectancy and penalised for tobacco use, obesity and other health risks. Environmental considerations like hygiene and access to clean water are also factored in.
In the US, life expectancy has slipped as a result of premature death from drug overdoses and suicides, while the Mediterranean diet, with well-established health benefits, could help explain Spain’s and Italy’s superior rankings.
A different analysis by LetterOne, the Global Wellness Index, is also searching beyond economic data in their quest to identify a healthy society.
The latter index uses metrics including blood pressure, tobacco and alcohol use, obesity, government healthcare spending, rates of depression, happiness and exercise.
According to their breakdown, Canada ranks as number one out of 151 countries. The US doesn’t fare well on this one either, coming in at number 37, while Australia just scrapes into the top 25 healthiest countries at 23.
Overall, what stands out from both lists is that many smaller nations are outperforming countries considered financially well off, reflecting increased awareness that strong economies do not equate to better health.
Even though Australia is doing moderately well in the overall scheme of things, several facts can’t be ignored. For instance, we endure, on average, 11 years of poor health – topping other OECD countries.
Health equality has a long way to go, with a 10-year gap in life expectancy between indigenous and non-indigenous Australians.
More than half of Australia adults have poor health literacy and less than four percent of people consume recommended serves of vegetables and legumes while most Australians don’t follow guidelines for any of the five core food groups.
We are also the second highest meat consumers in the world, eating on average 95 kilograms per person each year (260 grams per day) compared to a world average of 35 kilograms annually.
This is a major concern, given that red meat is classified as a carcinogen by the World Health Organisation.
A recent Lancet report by 37 experts worldwide recommends a dramatic reduction in meat consumption – no more than 28 grams per day – and 100 percent increase in legume, nut, fruit and vegetable consumption globally.
The CSIRO recommends that Australians also need to invest resources to support aging, address increased rates of chronic disease and improve equity in health care access.
Modern times have seen a resurgence in paleolithic diets – for better or worse – as people turn to hunter gatherers for lessons on lifestyle and health.
But we haven’t embraced paleo levels of exercise – and researchers suggest we should pay considerably more attention to our ancestors’ physical activity habits.
Historical records estimate that hunter gatherers, whose survival and transport relied on doing everything manually, accrued more than double, and even triple, the number of daily steps of modern US adults.
In fact, most urban people are less active now than ever before in history.
Whether stone age people were healthier remains debatable because they tended to die young. But they were more likely to be killed by wild beasts and falling rocks than the chronic metabolic diseases that plague modern humans.
Non-communicable diseases are the modern world’s biggest health problem, responsible for substantial limitations in daily activities and 70 percent of all deaths in the US.
Advances in technology have resulted in less physically active lifestyles along with increased sedentary behaviour – and these are not necessarily mirror images of each other.
In other words, many of the ways in which inactivity leads to chronic disease are not the same means by which being active can prevent those diseases – these have different mechanisms of action in the body.
So avoiding sedentary behaviours and engaging in physical activity each have their own distinct benefits.
Broadly, nutrition and exercise physiology expert Frank Booth and colleagues define physical inactivity as “physical activity levels less than those required for optimal health and prevention of premature death”.
Booth and co-authors argue that low activity levels are a primary culprit for most chronic diseases. In fact, they present evidence that being active could prevent at least 35 different conditions ranging from obesity and diabetes to heart disease and depression.
Hippocrates is famously quoted as saying that food is medicine. He also recognised the importance of physical activity.
On the whole, our ancestors’ physical activity levels approximate guidelines set by the World Health Organisation.
For older adults aged 65 and above, WHO recommends at least 150 minutes of moderate-intensity physical activity throughout the week in bouts of at least 10 minutes – and up to 300 minutes for additional health benefits.
There is a lot of confusion about the paleo diet, and experts point out it is not just one diet: they say there are many different variants.
By and large, paleo diet enthusiasts embrace it as an excuse to eat lots of meat. But Dr Kim Lloyd, CEO of the Paleo Society, told NutritionInsight it’s not a meat-based diet.
“True paleo means eating approximately 75 percent plant-based food, non-starchy vegetables, fruit, seeds and tree nuts with the addition of compassionately reared, free range meat, fish and eggs,” she explained.
Many nutrition experts say the diet’s health benefits are attributed to eating fresh foods and avoiding processed meats and other packaged foods. But they caution against omitting whole food groups like dairy, grains and legumes as suggested by many proponents of the diet.
Combined with regular physical activity, this broad dietary approach – a cornerstone of most traditional diets – is surely a wholesome recipe for longevity and good health.