EAT FOR HEALTH Australian Dietary Guidelines

226 Pages·2013·1.85 MB·English

EAT FOR HEALTH
Australian
Dietary
Guidelines
EAT FOR HEALTH
Australian
Dietary Guidelines
Providing the scientific evidence for
healthier Australian diets
2013
© Commonwealth of Australia 2013
Paper-based publication
This work is copyright. You may reproduce the whole or part of this work in unaltered form for your own personal use or, if
you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the
reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction.
Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved
and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being
given the specific written permission from the Commonwealth to do so. Requests and enquiries concerning reproduction and
rights are to be sent to Strategic Communications, National Health and Medical Research Council, GPO Box 1421, Canberra
ACT 2600 or via email to [email protected].
ISBN Print: 1864965746
© Commonwealth of Australia 2013
Electronic document
This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for
your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your
organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices
as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice,
all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or
otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and enquiries
concerning reproduction and rights are to be sent to Strategic Communications, National Health and Medical Research Council,
GPO Box 1421, Canberra ACT 2600 or via email to [email protected].
ISBN Online: 1864965754
Suggested citation
National Health and Medical Research Council (2013) Australian Dietary Guidelines. Canberra: National Health and Medical
Research Council.
Council of NHMRC Endorsement
The Guidelines were considered by the Council on 30 November 2012 for recommendation to the CEO for issuing. The CEO was
pleased to accept the Council’s advice and agreed to issue to guidelines under Section 7(1a) of the National Health and Medical
Research Council Act 1992.
Disclaimer
This document is a general guide to appropriate practice, to be followed subject to the clinician’s judgement and patient’s
preference in each individual case.
The guideline is designed to provide information to assist decision-making and is based on the best available evidence at the
time of development of this publication.
To obtain information regarding NHMRC publications contact:
Email: [email protected]
Phone: Toll free 13 000 NHMRC (13 000 64672) or call [phone]
Internet: http://www.nhmrc.gov.au
NHMRC Publication reference: N55
Published: February 2013
Preface
Never in our nation’s history have Australians had such a wide variety of dietary options. Yet the rising incidence
of obesity and type 2 diabetes in our population is evidence of the need for Australians to improve their health by
making better dietary decisions.
There are many ways for Australians to choose foods that promote their health and wellbeing while reducing their
risk of chronic disease. NHMRC‘s Australian Dietary Guidelines provide recommendations for healthy eating that
are realistic, practical, and – most importantly – based on the best available scientific evidence.
These Guidelines are an evolution of the 2003 edition of the dietary guidelines, integrating updates of the Dietary
Guidelines for Older Australians (1999), the Dietary Guidelines for Adults (2003) and the Dietary Guidelines
for Children and Adolescents in Australia (2003). They also include an update of the Australian Guide to Healthy
Eating (1998).
Providing the recommendations and the evidence that underpins them in a single volume, the Guidelines will
help health professionals, policy makers and the Australian public cut through the background noise of ubiquitous
dietary advice that is often based on scant scientific evidence. They form a bridge between research and evidence-
based advice to address the major health challenge of improving Australians’ eating patterns.
The evidence for public health advice should be the best available. NHMRC is confident that the available evidence
underpinning these guidelines meets that criterion and is stronger than for any previous NHMRC dietary guideline.
Choice of food in Australia has become more complex as we have become a more diverse society, and many
Australians take into account issues such as environmental concerns or cultural priorities in making their choices.
We hope that these Guidelines act as a firm basis upon which these individual decisions may be made.
For more than 75 years the Australian Government, primarily through NHMRC and Australian Government health
departments, has provided nutrition advice to the public through food and nutrition policies, dietary guidelines and
national food selection guides.
NHMRC and all involved in developing these Guidelines are proud and privileged to have the responsibility to
continue this important public service.
Professor Warwick Anderson AM
Chief Executive Officer
National Health and Medical Research Council
February 2013
PREFACE
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Australian Dietary Guidelines
GuiDELiNE 1 To achieve and maintain a healthy weight, be physically active and choose amounts of
nutritious food and drinks to meet your energy needs.
• Children and adolescents should eat sufficient nutritious foods to grow and develop
normally. They should be physically active every day and their growth should be
checked regularly.
• Older people should eat nutritious foods and keep physically active to help maintain
muscle strength and a healthy weight..
GuiDELiNE 2 Enjoy a wide variety of nutritious foods from these five groups every day:
• Plenty of vegetables, including different types and colours, and legumes/beans
• Fruit
• Grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties, such as
breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley
• lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
• Milk, yoghurt, cheese and/or their alternatives, mostly reduced fat (reduced fat
milks are not suitable for children under the age of 2 years)
And drink plenty of water.
GuiDELiNE 3 limit intake of foods containing saturated fat, added salt, added sugars and alcohol.
a. limit intake of foods high in saturated fat such as many biscuits, cakes, pastries,
pies, processed meats, commercial burgers, pizza, fried foods, potato chips,
crisps and other savoury snacks.
• Replace high fat foods which contain predominantly saturated fats such as
butter, cream, cooking margarine, coconut and palm oil with foods which
contain predominantly polyunsaturated and monounsaturated fats such as oils,
spreads, nut butters/pastes and avocado.
• low fat diets are not suitable for children under the age of 2 years.
b. limit intake of foods and drinks containing added salt.
• Read labels to choose lower sodium options among similar foods.
• Do not add salt to foods in cooking or at the table.
c. limit intake of foods and drinks containing added sugars such as confectionary,
sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and
sports drinks.
d. If you choose to drink alcohol, limit intake. For women who are pregnant, planning
a pregnancy or breastfeeding, not drinking alcohol is the safest option.
GuiDELiNE 4 Encourage, support and promote breastfeeding.
GuiDELiNE 5 Care for your food; prepare and store it safely.
AuSTRAlIAN DIETARY GuIDElINES
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National Health and Medical Research Council

Contents
Preface iii
Australian Dietary Guidelines v
introduction 1
Why the Guidelines matter 1
Scope and target audience 2
Companion documents 3
How the Guidelines were developed 5
Five key evidence sources for the Guidelines 5
How the evidence was used 7
Challenges for adoption of the Guidelines 8
How to use the Guidelines 9
GuiDELiNE 1
 Achieve and maintain a healthy weight 11
1.1 Setting the scene 12
1.1.1 Weight status and trends in Australia 12
1.1.2 Health effects associated with weight status 13
1.1.3 Causes of overweight and obesity in the population 14
1.1.4 Physical activity 17
1.2 The evidence for ‘achieve and maintain a healthy weight’ 18
1.2.1 Primary and secondary prevention 19
1.2.2 Dietary patterns and specific foods and drinks 19
1.3 How dietary patterns can affect energy balance and weight outcomes 22
1.4 Practical considerations: achieve and maintain a healthy weight 22
1.4.1 Physical activity and dietary patterns in achieving and maintaining a healthy weight 23
1.4.2 Weight loss in adults who are overweight 24
1.4.3 Pregnant and breastfeeding women 24
1.4.4 Infants, children and adolescents 26
1.4.5 Older people 27
1.4.6 Aboriginal and Torres Strait Islander peoples 27
1.4.7 Australians of Asian origin 28
1.4.8 People with eating disorders 28
1.5 Practice guide for Guideline 1 29
CONTENTS
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GuiDELiNE 2
 Enjoy a wide variety of nutritious foods 31
2.1 Enjoy a wide variety of nutritious foods 32
2.1.1 Setting the scene 32
2.1.2 The evidence for consuming ‘a wide variety of nutritious foods’ 32
2.1.3 How consuming a wide variety of nutritious foods may improve health outcomes 33
2.1.4 Practical considerations: enjoy a wide variety of nutritious foods 33
2.2 Enjoy plenty of vegetables, including different types and colours,
and legumes/beans, and enjoy fruit 36
2.2.1 Setting the scene 36
2.2.2 The evidence for consuming ‘plenty of vegetables’ 36
2.2.3 The evidence for consuming ‘plenty of legumes/beans’ 38
2.2.4 The evidence for consuming ‘fruit’ 39
2.2.5 How consuming plenty of vegetables, including different types and colours, and
legumes/beans, and fruit may improve health outcomes 40
2.2.6 Practical considerations: enjoy plenty of vegetables, including different types and
colours, legumes/beans, and enjoy fruit 42
2.3 Enjoy grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties 44
2.3.1 Setting the scene 44
2.3.2 The evidence for consuming ‘grain (cereal) foods, mostly wholegrain and/or high cereal
fibre varieties’ 45
2.3.3 How consuming grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties
may improve health outcomes 46
2.3.4 Practical considerations: enjoy grain (cereal) foods, mostly wholegrain and/or high cereal
fibre varieties 46
2.4 Enjoy lean meats and poultry, fish, eggs, tofu, nuts and seeds,
and legumes/beans 48
2.4.1 Setting the scene 48
2.4.2 The evidence for consuming ‘lean meats and poultry, fish, eggs, tofu, nuts and seeds,
and legumes/beans’ 49
2.4.3 How consuming lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
may improve health outcomes 52
2.4.4 Practical considerations: enjoy lean meats and poultry, fish, eggs, tofu, nuts and seeds,
and legumes/beans 52
2.5 Enjoy milk, yoghurt, cheese and/or alternatives, mostly reduced fat 56
2.5.1 Setting the scene 56
2.5.2 The evidence for consuming ‘milk, yoghurt, cheese and/or alternatives, mostly reduced fat’ 56
2.5.3 How consuming milk, yoghurt, cheese and/or alternatives, mostly reduced fat, may improve
health outcomes 58
2.5.4 Practical considerations: enjoy milk, yoghurt, cheese and/or alternatives, mostly reduced fat 58
2.6 Drink plenty of water 61
2.6.1 Setting the scene 61
2.6.2 The evidence for ‘drink plenty of water’ 61
2.6.3 How drinking plenty of water may improve health outcomes 63
2.6.4 Practical considerations: drink plenty of water 63
2.7 Practice guide for Guideline 2 64
EAT FOR HEALTH – AusTRALiAn diETARy guidELinEs
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national Health and Medical Research Council
GuiDELiNE 3
 Limit intake of foods containing saturated fat, added salt,
added sugars and alcohol 67
3.1 Limit intake of foods high in saturated fat 68
3.1.1 Setting the scene 68
3.1.2 The evidence for ‘limit intake of foods high in saturated fat’ 69
3.1.3 How limiting intake of foods high in saturated fat may improve health outcomes 71
3.1.4 Practical considerations: limit intake of foods high in saturated fat 71
3.2 Limit intake of foods and drinks containing added salt 73
3.2.1 Setting the scene 73
3.2.2 The evidence for ‘limit intake of foods and drinks containing added salt’ 74
3.2.3 How limiting intake of foods and drinks containing added salt may improve health outcomes 75
3.2.4 Practical considerations: limit intake of foods and drinks containing added salt 75
3.3 Limit intake of foods and drinks containing added sugars 76
3.3.1 Setting the scene 76
3.3.2 The evidence for ‘limit intake of foods and drinks containing added sugars’ 77
3.3.3 How limiting intake of foods and drinks containing added sugars may improve health outcomes 78
3.3.4 Practical considerations: limit intake of foods and drinks containing added sugars 79
3.4 Limit intake of alcohol 80
3.4.1 Setting the scene 80
3.4.2 The evidence for ‘limit intake of alcohol’ 81
3.4.3 How limiting intake of alcohol may improve health outcomes 83
3.4.4 Practical considerations: limit intake of alcohol 83
3.5 Practice guide for Guideline 3 85
GuiDELiNE 4
 Encourage, support and promote breastfeeding 87
4.1 Setting the scene 88
4.2 The evidence for ‘encourage, support and promote breastfeeding’ 89
4.2.1 Breastfeeding incidence and duration 90
4.2.2 Infant growth 91
4.2.3 Cardiovascular disease and excess weight 92
4.2.4 Other benefits 92
4.3 Practical considerations: encourage, support and promote breastfeeding 93
4.3.1 Breastfeeding initiation and duration 93
4.3.2 Supporting and promoting breastfeeding 94
4.3.3 Safe storage of breast milk 95
4.3.4 Alcohol and breastfeeding 95
4.3.5 When an infant is not receiving breast milk 95
4.4 Practice guide for Guideline 4 96
CONTENTS
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National Health and Medical Research Council