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Low back pain (LBP) is a universal public health problem for all age groups, related to the upright stance of humans. Postpartum LBP is more common and can lead to limitations to women's daily activity. Knowledge about preventing postpartum LBP is limited, and the relationship between prenatal physical activity (PA) and LBP remains inconclusive. We conducted a prospective cohort study of 1807 singleton pregnant Vietnamese women to investigate the association between prenatal PA and postpartum LBP using logistic regression analyses. The prevalence of postpartum LBP was 12.3% (n = 222). Women reporting LBP spent more hours sitting per week. Relative to the lowest level of total PA, the highest level was associated with reduced odds of postpartum LBP (odds ratio = 0.55; 95% confidence interval = 0.38-0.80). Inverse associations with LBP were also observed for light intensity, moderate-to-vigorous intensity, household/caregiving, occupational, and transportation activities. Overall, prenatal PA was inversely associated with postpartum LBP in Vietnamese women.

Objectives: To assess associations between maternal depression and breastfeeding practices in mothers in the Maldives., Design: A prospective cohort study. The validated questionnaires contained information on demographics, breastfeeding initiation, breastfeeding duration, and the Edinburgh Postnatal Depression Scale. Logistic regression analyses were used to assess association between Edinburgh Postnatal Depression Scale score and breastfeeding practices while adjusting for lifestyle determinants. Cox regression was done to measure the association between maternal depression and breastfeeding duration., Settings: Antenatal clinic at Indira Gandhi Memorial and ADK Hospitals in Male', Maldives., Subjects: A total of 458 mothers from the antennal clinics were interviewed at 36 weeks of gestation and again at 1, 3, and 6 months after birth., Results: Antenatal depression at 36 weeks of gestation was associated with late initiation of breastfeeding (adjusted odds ratio = 3.0, 95% confidence interval = 1.3-6.8). Postnatal depression was associated with shorter duration of exclusive, full, and any breastfeeding ( P < .001)., Conclusion: Depression is negatively associated with breastfeeding practices. There is a need to manage antenatal postnatal depression in mothers in order to encourage them to initiate breastfeeding earlier and to breastfeed for longer.

The aim of the study was to document perinatal depression in mothers in the Maldives and associated factors. A cohort of 458 mothers was recruited at the 2 major hospitals in Malé, the Maldives, and followed from 36 weeks of pregnancy to 3 months after birth. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure maternal depression. Maternal sociodemographic factors and infant's health were also recorded. The prevalence of depressive symptoms (EPDS score ≥13) at 36 weeks of pregnancy and at 1 and 3 months postpartum were 24%, 27%, and 12%, respectively. Having experienced stressful life events is an established risk factor for maternal depression across these time points. Having depressive symptoms during the postpartum period is significantly associated with presence of antenatal depressive symptoms. Future studies may look into effectiveness of strategies that cope with stressors in the management of maternal depression.

Increasing prostate cancer incidence in the Asia-Pacific region may be related to a more sedentary lifestyle resulted from economic growth and rapid urbanization. The present case-control study of 640 men aged 64 to 75 years was conducted in Vietnam between 2013 and 2015 to ascertain the relationship between physical activity and prostate cancer risk, accounting for the duration of sitting time. Reduced prostate cancer risks were found for men engaging in medium (15.8-47.3 metabolic equivalent task [MET]-h/week) and high (>47.3 MET-h/week) physical activity levels, with the adjusted odds ratios being 0.52 (95% confidence interval = 0.35-0.77) and 0.27 (95% confidence interval = 0.14-0.49), respectively. This association was independent of sitting time. Analyses of joint association of physical activity and sitting time also found a reduction in the cancer risk for higher energy expenditure levels. Similar results were evident for both low-medium and high grade tumors. The findings are important for developing health strategies to prevent prostate cancer in Asian countries.

Nutrition is a major determinant of health throughout all stages of life and together with smoking is the most important risk factor for morbidity and mortality in the Asia Pacific Region. The workshop participants examined Dietary Guidelines and Food Guides that are in use in our region, together with additional materials from the World Health Organization, UNICEF and the World Cancer Research Foundation. The resulting set of guidelines is meant as a reminder of the main issues to be covered in a general public health education program. It may also be of value in reminding public health practitioners, educators, administrators, and policy makers of current nutrition issues. It may additionally be useful as a checklist of the issues to be considered in public health programs and regulations. The main areas of nutrition that are included in the Guidelines are eating a variety of foods, including vegetables, fruits, whole grain cereals, and nuts. Choose fish, poultry, and meats grown in a sustainable way. Appropriate growth, including avoiding obesity, and physical activity are important. Breastfeeding is the basis of infant nutrition and nutrition of mothers is an important public health measure. Negative factors in the Asian diet include salt, refined sugar, alcohol and fats. The APACPH Dietary Guidelines will need to be kept under review and modified to meet regional differences in food supply. The Guidelines will be useful as a checklist of the issues to be considered in public health programs, addressing both acute and chronic diseases.

Utilization of community health centres for child health care instead of hospital outpatient clinics is being promoted in China. To evaluate breastfeeding rates and health outcomes of infants who received health care from hospital outpatient clinic or community health centre, a prospective cohort study with six months follow-up was undertaken in Chengdu, China. Participants were 845 mothers and their infants, 417 receiving care from one hospital and 428 from five community health centres. The 'any breastfeeding' rates at one and three months post-partum were significantly lower (p < 0.01) in the hospital outpatient clinic (84% and 68%) than community health centres (92% and 78%). The presence of common illness problems was similar, though the prevalence of lower respiratory tract infection was significantly higher in the hospital group (14.6% vs. 6%, p < .01). No difference in infant growth was observed between the two groups. The results support continuing expansion of child health-care services through community health centres in China., (© The Author(s) 2015.)

Background: Postnatal depression is a disorder that can lead to serious consequences for both the mother and infant. Despite the extensively documented health benefits of breastfeeding, its association with postnatal depression remains uncertain., Objective: To investigate the relationship between full breastfeeding at 3 months postpartum and postnatal depressive symptoms among mothers in Sabah, Malaysia., Methods: A prospective cohort study of 2072 women was conducted in Sabah during 2009-2010. Participants were recruited at 36 to 38 weeks of gestation and followed up at 1 and 3 months postpartum. Depressive symptoms were assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale (EPDS). Repeated-measures analyses of variance was performed to compare the depression scores over time and between subgroups of breastfeeding mothers., Results: Approximately 46% of women were fully breastfeeding their infants at 3 months postpartum. These mothers had significantly (P < .001) lower mean EPDS scores at both 1 and 3 months postpartum (mean ± SD, 4.14 ± 4.12 and 4.27 ± 4.12, respectively) than others who did not initiate or maintain full breastfeeding for 3 months (4.94 ± 4.34 and 5.25 ± 4.05, respectively). After controlling for the effects of covariates, the differences in EPDS scores remained statistically significant (P = .001) between the 2 breastfeeding groups., Conclusion: Full breastfeeding appeared to be negatively associated with postnatal depressive symptoms for mothers residing in Sabah., (© The Author(s) 2015.)

This systematic review examined trends in the prevalence of type 2 diabetes mellitus (T2DM) and identified its risk factors among adults in Vietnam. PubMed, Web of Science, Wiley Online Library, and Scopus databases were searched to identify relevant literature. The search yielded 10 studies, including 2 national surveys and 8 regional investigations. National prevalence estimates of T2DM were 2.7% in 2002 and 5.4% in 2012. The estimates for the northern region were 1.4% in 1994 and 3.7% in 2012 and those for the southern region were 3.8% in 2004, 7.0% in 2008, and 12.4% in 2010. The major determinants of T2DM included older age, urban residence, high levels of body and abdominal fat, physical inactivity, sedentary lifestyle, genetic factors, and hypertension. The prevalence rate by gender was variable in both national and regional studies. There was insufficient information available on some potentially important risk factors such as smoking, dietary intake, income, and educational level. Our review signifies a rapidly growing prevalence of T2DM in Vietnam and suggests that extra effort is required to prevent and control this disease., (© 2015 APJPH.)

Background: Breastfeeding is accepted as the best way of feeding infants, and health authorities recommend exclusive breastfeeding to around 6 months of age, but despite the evidence of its benefits, few mothers meet this goal. Infants who are exclusively breastfed in the early postpartum period are more likely to continue breastfeeding at 6 and 12 months, reinforcing the role that Baby-Friendly hospital practices play in supporting exclusive breastfeeding., Objectives: This study aimed to determine the rate of breastfeeding initiation and identify the factors associated with exclusive breastfeeding at discharge from hospital for rural mothers., Methods: The prospective cohort study recruited 489 women from hospitals in regional Western Australia following the birth of their infant. Breastfeeding exclusivity at discharge was assessed based on mothers' self-reported infant feeding behavior during her hospital stay. The self-administered baseline questionnaire was completed by 427 mothers., Results: Breastfeeding was initiated by 97.7% of the mothers in this cohort, with 82.7% exclusively breastfeeding at hospital discharge. The odds of exclusive breastfeeding at discharge were more than 4 times higher for women whose infants did not require admission to the special care nursery (adjusted odds ratio [aOR] = 4.43; 95% confidence interval [CI], 1.98-9.99). Demand feeding (aOR = 3.33; 95% CI, 1.59-6.95) and 24-hour rooming-in (aOR = 2.31; 95% CI, 1.15-4.62) were also significant positive factors., Conclusion: The findings suggest that hospital practices are strong predictors of exclusive breastfeeding. Greater emphasis on Baby-Friendly hospital practices in the early postpartum period may help the establishment of exclusive breastfeeding, assisting rural mothers to reach established international breastfeeding recommendations., (© The Author(s) 2014.)

Background: Prelacteal feeds and delayed initiation of breastfeeding may lead to undernutrition of the infant but are still prevalent in many countries., Objective: A prospective cohort community-based study was conducted in central Nepal to ascertain the rate of early breastfeeding initiation and factors associated with the introduction of prelacteal feeds., Methods: Breastfeeding information was collected from 639 women who recently gave birth in the Kaski district of central Nepal. Backward stepwise logistic regression analysis was performed to determine factors associated with the use of prelacteal feeds., Results: The incidence of prelacteal feeds was 9.1%, with infant formula being the most common prelacteal food. Approximately 67% and 90% of mothers breastfed within 1 hour and 4 hours of delivery, respectively. Women who reside in urban areas (odds ratio [OR] = 2.68; 95% confidence interval [CI], 1.35-5.39), first-time mothers (OR = 2.15; 95% CI, 1.15-4.02), and those who underwent cesarean section (OR = 10.10; 95% CI, 5.47-18.67) were more likely to give prelacteal feeds to their infants., Conclusion: The early initiation of breastfeeding with colostrum as the first feed was common in the study area. The introduction of prelacteal feeds was associated with urban residency, first-time motherhood, and cesarean delivery., (© The Author(s) 2014.)

Background: Studies have identified numerous factors affecting breastfeeding initiation and duration, including maternal education, mode of delivery, birth weight, socioeconomic status, and support of the infant's father., Objective: The objective was to investigate the effects of an antenatal education session and postnatal support targeted to fathers., Methods: The Fathers Infant Feeding Initiative (FIFI Study) is a randomized controlled trial to increase the initiation and duration of breastfeeding that was conducted in 8 public maternity hospitals in Perth, Western Australia. A total of 699 couples were randomized within hospitals to either intervention or control groups. The intervention consisted of a 2-hour antenatal education session and postnatal support provided to fathers., Results: The any breastfeeding rate for the intervention group was significantly greater at 6 weeks: 81.6% in the intervention group compared to 75.2% in the control group, odds ratio 1.46 (95% CI, 1.01-2.13). After adjustment for age and hospital, the odds ratio for any breastfeeding in the intervention group was 1.58 (1.06-2.35) and for socioeconomic status (SES), 1.56 (1.06-2.30). The infants of older fathers were more likely to be breastfed at 6 weeks compared to infants of younger fathers (P < .01), and infants of fathers with high SES more likely than infants of fathers with low SES (P = .013)., Conclusion: Even a small increase in breastfeeding rates brings public health benefits. In this study, a minimal intervention was found to significantly increase any breastfeeding at 6 weeks: 81.6% in the intervention group compared to 75.2% in the control group.

Background: Breastfeeding practices might be influenced by migration to another country. Although the "healthy migrant effect" is commonly reported in epidemiology, evidence for it in breastfeeding practices is weak., Objectives: This study aimed to compare the initiation and duration of breastfeeding between Chinese Australian migrants and Chinese mothers in mainland China and test the healthy migrant effect in Chinese Australian migrants in Perth, Western Australia., Methods: A survey was undertaken of 239 Chinese mothers living in Perth and 1844 mothers living in Chengdu, Sichuan Province, PR China, with a response rate of 96.7% and 87.8%, respectively., Results: The breastfeeding initiation rate in Chinese Australian mothers (94.1%) was higher than in mothers in China (86.2%, P < .001). Chinese Australian mothers also had a longer breastfeeding duration, greater "full breastfeeding" rate at 6 months, and greater "any breastfeeding" rates at 6 and 12 months. After controlling for potential confounding variables, the results of the binary logistic regression analysis showed that the location of the mother (Australia or China) was associated with breastfeeding practices. Chinese mothers living in Chengdu were less likely to initiate breastfeeding (odds ratio = 0.47, 95% confidence interval, 0.25-0.89) and breastfeed their babies at 12 months (odds ratio = 0.48, 95% confidence interval, 0.33-0.69) than Chinese mothers in Perth., Conclusion: The higher breastfeeding initiation and longer breastfeeding duration by Chinese migrant mothers in Perth than mothers in Chengdu suggest a "healthy migrant effect."

Background: Factors associated with breastfeeding need to be explored in the northwest of China., Objective: This study aimed to measure the full duration of breastfeeding and identify factors associated with breastfeeding in Shihezi City in Northwest China., Methods: A prospective cohort study was undertaken to obtain details of child feeding practices using structured questionnaires in 2007-2010. Before discharge from hospitals, 681 mothers were randomly recruited and interviewed in maternity units for breastfeeding. After discharge, the mothers were contacted by telephone at monthly intervals within the first 6 months and then at 2-month intervals until discontinuation of breastfeeding., Results: The breastfeeding initiation rate was 95.9%. The breastfeeding rates then declined to 69.6% at 6 months, 29.7% at 12 months, and 2.3% at 24 months. The median duration of "any breastfeeding" was 9 months. The exclusive breastfeeding rate was low because of the high rate of prelacteal and early complementary feeding. Cox regression analyses revealed that mothers who had preterm babies believed that breast milk could not meet infants' needs and intended to breastfeed for less than 6 months, and mothers with late onset of lactogenesis II and whose parents lived in Xinjiang were more likely to stop breastfeeding. Younger maternal age, employment, and suffering from illness were also associated with a shorter duration of breastfeeding., Conclusion: The duration of "exclusive" and "any breastfeeding" was below the Chinese and World Health Organization breastfeeding goals. Shorter duration of breastfeeding was associated with having grandparents residing within the same province, maternal age, illness and employment, gestational age, and delayed onset of lactogenesis.

Background: Community attitudes toward breastfeeding in public influence how comfortable women feel about continuing breastfeeding. Knowledge of the social context helps target breastfeeding-promoting interventions., Objective: To examine trends in Western Australian adult attitudes toward breastfeeding in public places., Methods: As part of 5 cross-sectional surveys from the Western Australian Nutrition Monitor Survey Series conducted between 1995 and 2009, 5496 adults aged 18 to 64 years were asked whether it was acceptable for mothers to breastfeed their babies in public places, including shopping centers, workplaces, and restaurants, and on public transport. Descriptive statistics and multinomial regressions were used to describe factors associated with attitudes toward publicly breastfeeding., Results: There was no change in the acceptance of breastfeeding in shopping centers, restaurants, and workplaces and on public transport over time, but in 2009, significantly fewer people said that it was unacceptable to breastfeed in public compared with 1995. Women, people older than 44 years, those born outside Australia, and the less educated were those most likely to say that breastfeeding in public was unacceptable. In the years that the question was asked, more than 97% of respondents said that breastfeeding was acceptable if a separate room was provided., Conclusions: Making breastfeeding acceptable and pleasant for mothers in public spaces is a key policy recommendation. Women, people older than 44 years, and those born outside Australia were most likely to respond that breastfeeding in public was unacceptable unless a room was provided. Given that, on average, 70% of the population said that breastfeeding in public was acceptable, investigation into why some women do not think so is warranted.

In the aftermath of many disasters the silence is punctuated by the crying of infants, hungry infants. The aim of this paper is to discuss ethical issues in feeding infants after disasters. The Asia Pacific region generates 25% of the world's GDP, but experiences 45% of natural disasters and 42% of the economic losses due to disasters. The region has 61% of the world's population, but 86% of the population affected by disasters. Breastfeeding, exclusive to six months and continuing thereafter, is important for growth and the health of the infant in the short term and later in life. In most natural disasters, mothers and infants will both suffer, but in some disasters, such as earthquakes and building collapses, infants can survive in small spaces. Infants separated from mothers require a wet nurse (rarely available) or feeding with infant formula and sterile water. Formula companies often donate supplies of infant formula but distribution should follow ethical principles. Mothers who are injured or short of food can still continue breastfeeding and don't need formula. Where formula must be used, health workers need to follow the highest ethical standards to avoid promoting infant formula to vulnerable communities in the post recovery phase.

The prevalence of childhood overweight and obesity in China has increased in recent decades. However, studies reported from China use several different definitions and growth references, making it difficult to compare the rates of obesity from different regions. It also makes it difficult to establish the extent of secular trends in obesity and to make international comparisons. This article reviews the definitions of childhood obesity used in Chinese studies published over the past 10 years. The majority (79%) of the Chinese studies used a definition of >120% of the mean value of the National Center for Health Statistics reference population to diagnose childhood obesity. Only 7 studies (9%) conducted in China measured childhood obesity using age-specific and sex-specific body mass index (BMI) cutoffs, including International Obesity Task Force cutoffs, Centers for Disease Control 2000 and World Health Organization 2006 BMI curves, and Chinese BMI curves. It is important that a consistent and applicable definition is used and all studies accurately define the obesity with growth reference, cutoff criteria, sample selection, and age distribution. The use of sex-specific and age-specific BMI cutoffs should be considered when undertaking future studies of obesity in Chinese children.

This study ascertained the level of alcohol intake and alcoholic beverages consumed by Japanese older adults. Persons aged 55 to 75 years residing in central and southern Japan were recruited and interviewed face-to-face on their habitual alcohol consumption. Among the 577 (359 men and 218 women) participants from 10 districts/prefectures, 60.5% (75.5% for men and 35.7% for women) regularly drank alcoholic beverages on at least a monthly basis. Beer was the most preferred beverage (45.2%), followed by shochu (19.8%) and sake (16.1%). The mean alcohol consumption was 22.2 g/day (95% confidence interval 19.3-25.2) overall, but drinkers had a much higher mean intake of 36.6 g/day (95% CI 32.4-40.8). Moreover, it is alarming that 25.5% of male drinkers were heavy drinkers consuming more than 60 g of alcohol on average per day. Alcohol control measures should be developed to curtail the excessive drinking by older adults.

This study investigated the consumption level, beverage preference and factors affecting alcohol intake by Japanese COPD patients. Three hundred patients diagnosed with COPD within the past four years were recruited from six hospitals in central Japan and interviewed. Of the 278 eligible participants (244 men and 34 women), 61.5% of male and 23.5% of female patients drank alcohol regularly on at least a monthly basis. The most preferred alcoholic beverage was beer (30.9%). The overall mean alcohol consumption was 29.7 (SD 42.5) g/day but drinkers had much higher mean intake of 52.2 (SD 44.8) g/day. Alcohol consumption level was significantly associated with the habit of adding soy sauce to food, gender and dyspnea but not the smoking status. The high alcohol consumption by COPD patients is alarming, with drinkers drinking well exceeded the government's recommended limit of 20 g daily. Alcohol control programs targeting male patients should be promoted to minimise the harm due to excessive drinking.

The fast increase in the rate of uptake of smoking amongst adolescent girls in Malaysia is a public health concern. The objective of this study was to investigate factors that influenced the initiation of smoking and the effects of advertisement on consolidating the smoking habit among teenage girls in the urban city of Kuala Lumpur. Qualitative research was conducted using both interviews and focus group discussions with groups of adolescent girls. Data collected was analysed using grounded thematic theory methodology and validated using methodological triangulation. The reasons for initiating smoking elicited from the study can be grouped into 4 general themes; influence by peers, influence of seeing parents smoking, misguided belief that it could alleviate stress and finally that it would impress others. Smoking imageries in media and advertisements were not primary influencing factors in the initiation of smoking but it encouraged them to progress to become regulars. Ways should be sought to empower girls to feel more confident about resisting pressures to initiate smoking. This could be done through activities such as positive peer sports, education on how to alleviate stress and curbing of smoking imageries in the media.

This study describes the development and reproducibility of a 128-item quantitative food frequency questionnaire (FFQ) to measure usual food consumption for women in southeast China. The FFQ was pre-tested using 51 Chinese women who recently migrated to Australia. Cronbach's alpha coefficient was 0.81 for internal consistency. The reliability of the FFQ was then assessed by another test-retest study. A sample of 41 women residing in southeast China was interviewed twice within 12 weeks. Intraclass correlation coefficients were moderate to high for mean food group consumption (0.43-0.96) and mean daily nutrient intakes (0.47-0.89). Kappa statistics for eating habits ranged from 0.27 to 0.89 in the test-retest. The mean ratio of energy intake to basal metabolic rate was 1.73 (S.D. 0.39) in both test and retest samples. The study confirmed that the FFQ method using standard containers is appropriate to assess dietary intake for women in southeast China.

To identify determinants of the initiation and duration of breastfeeding by Chinese Australian mothers, a cross-sectional survey of 506 Mandarin-speaking women in Perth, Western Australia, was conducted. Doctors' support of breastfeeding was positively associated with the initiation of breastfeeding both in the mothers' home countries (odds ratio [OR], 9.94; 95% confidence interval [CI], 3.17-31.18) and in Australia (OR, 16.78; 95% CI, 7.12-39.55) and with duration. Mother's level of education was positively associated with the initiation of breastfeeding in the mother's home country (OR, 3.04; 95% CI, 1.36-6.80) and positively associated with the duration of breastfeeding both in the mother's home country and Australia. Father's preference for breastfeeding was positively associated with the initiation of breastfeeding of the mother giving birth in Australia (OR, 4.96; 95% CI, 1.93-12.66). Health professionals can provide invaluable support for mothers initiating and continuing breastfeeding in this population. Prenatal education also needs to emphasize the ways in which fathers can support and contribute to breastfeeding.

A prospective study of 556 women from Perth, Western Australia, and 503 women from the Darling Downs area, Queensland, Australia, was conducted to identify factors associated with the abandonment of breastfeeding prior to hospital discharge. In total, 88% of women initiated breastfeeding, but 5% discontinued breastfeeding while still in the hospital. Discontinuation of breastfeeding prior to discharge was associated with a number of psychosocial factors, namely, infant feeding method being chosen after becoming pregnant, a perception by the mother that the infant's father either preferred formula feeding or was ambivalent about how the infant was fed, and whether the mother's own mother had ever breastfed. Judicious questioning prenatally regarding a women's commitment to, social support for, and prior exposure to breastfeeding will help identify those women most at risk of abandoning breastfeeding prematurely. Such women should be targeted for additional support while in the hospital.

The acquisition of information technology and research skills is fundamental for all students in Public Health because of its fundamental emphasis on population studies. In the Curtin University, Division of Health Sciences the School of Public Health has the responsibility of introducing communication and IT skills to all students, both undergraduate and postgraduate. A special program of information technology skills is offered. The age of the Internet has meant added temptation for students in terms of plagiarism and all students and staff must be aware of their ethical obligations in this area. The advent of flexible learning strategies will provide many opportunities for Schools of Public Health, both in the education of their students and in the continuing education of public health practitioners. APACPH member institutions could usefully pool their resources to develop flexible learning resources.

There has been rapid development in the Asia-Pacific region, leading to improvements in the food supply and nutrition. The high prevalence of low birth weight has been a problem in many countries and continues to be a problem in some parts of the region. In the past few years an epidemic of obesity and chronic disease has emerged. The fetal origins hypothesis links the high prevalence of low birth weight and recent increasing obesity to explain the emerging epidemic of chronic disease. One public health strategy to challenge this epidemic is the promotion of breastfeeding of all infants. Breastfeeding has been shown to protect against childhood obesity, and is "dose related", that is, the longer an infant is breastfed, the lower the risk of obesity.

This study investigates the quality of life (QOL) for adolescents residing in Perth, Western Australia. The Quality of Life Profile-Adolescent Version (QOLPAV), a generic self-reported questionnaire, was administered to 363 adolescents aged between ten and 18 years who were enrolled in 20 high schools within metropolitan Perth. Stepwise regression analysis of the data showed that age, control, opportunity and perceptions of health have significant associations with QOL. It was also found that adolescents with a chronic condition and those without have similar QOL scores. This suggests that, in terms of QOL, the chronically ill adolescents do not view themselves as different from their healthy counterparts.

Public health nutrition is focused on the prevention of diet-related diseases and the attainment of good health, through policy, education and health promotion. It involves many sectors of the community, cooperating to improve the health and wellbeing of the population with emphasis on prevention, equity, wellbeing and improved quality of life. In the majority of western countries, an epidemic of coronary heart disease (CHD) began after World War One, reaching its peak in the 1970's. In Asia, the epidemic began after WW2 with the rapid economic development of the region. In western countries, of which Australia is a typical example, health promotion activities and improved hospital treatment have been effective in reducing the impact of the CHD epidemic. The life expectancy of the population has steadily grown to 75.6 years for males and 81.3 years for females. Despite major advances in the prevention and treatment of cardiovascular disease, it is still the leading cause of premature mortality and morbidity in Australia. Furthermore, cardiovascular disease shares common risk factors with other leading causes of death, including lifestyle behaviours (diet, physical inactivity, alcohol consumption, smoking), physiological states (obesity, hypertension, high blood cholesterol) and socioeconomic factors. For Asia, the challenge is to implement public health policies that will tackle the epidemic of chronic disease before it reaches its peak. Health Promotion policies will be important for all countries. The use of the disability adjusted life years (DALY) methodology to measure the association between the cause of disease and relate its occurrence to health outcomes will be an important public health planning tool.