The Australian Dietary Guidelines
This power point presentation is provided to support health and education professionals in disseminating and implementing the new 2013 NH&MRC Dietary Guidelines to consumers, community settings and other food system stakeholders. Some slides have a slight focus on Victoria, however these can be adapted to your local situation. This resource was developed by the Food Systems & Nutrition Policy team, Department of Health Victoria. For a PowerPoint file version please e-mail:
[email protected] Except where otherwise indicated the images in this publication show models and illustrative settings only and do not necessarily depict actual services, facilities or recipients of services. © Department of Health, May 2013
The Australian Dietary Guidelines
The new Australian Dietary Guidelines
Veronica Graham State Public Health Nutritionist Webinar for prevention workforce staff in local government, community health, Department of Health and Victorian Healthy Eating Enterprise stakeholders 29 April 2013
The new Australian Dietary Guidelines were released February 2013
Australia’s food environment can be difficult to navigate • • •
The average large chain supermarket has almost 12,000 food products Dominant marketing of unhealthy food A food culture accepting ‘discretionary’ foods as foods to eat everyday
The dietary guidelines provide a helping hand through the food maze
Getting to know the guidelines today
We will cover: • Process of updating the guidelines • The new Australian Dietary Guidelines • Selected highlights and key differences from the 2003 guidelines • Using the new resources • Discussion - implications for practice, programs and policy • Your questions
Updating the guidelines
Three years in the making
Led by an expert committee and overseen by the Council of the National Health and Medical Research Council (NHMRC). 2 core processes in identifying the technical content 1. Dietary modelling: Modelled 100’s of dietary patterns to meet optimum health - Foundation and Total diets 2. Systematic Literature Reviews: Over 55,000 pieces of research • •
Numerous targeted consultations & two periods of public consultation with over 280 submissions received Expert national and international independent review to ensure recommendations were reflective of the evidence.
Three years in the making
Victorian Department of Health contribution: • Extensive contribution to drafts via State Chief Health Officer • Families Roundtable Discussion with the Minister of Health in January 2012 • Discussions held internally across relevant departments and with other Victorian public health organisations.
Key sources of evidence used…
• • • • • •
Previous dietary guidelines: adults, children Nutrient Reference Values The Evidence Report The Food Modelling System Key authoritative government reports Scientific literature
The new Australian Dietary Guidelines
The Australian Dietary Guidelines ‘providing the scientific evidence’ Forming the bridge between the research and evidence based advice
Introducing the 5 guidelines
Within each chapter: each guideline is supported by four subheadings Note: the new guidelines incorporate children, teens pregnancy, breastfeeding all in one Four main subheadings for each guideline 1. Setting the scene 2. Evidence and evidence statements 3. How eating a particular food (or particular dietary pattern) may improve health outcomes 4. Practical considerations - different target groups
Guideline 1
Guideline 1: Achieve and maintain a healthy weight.
Guideline 1
Evidence Statement: 17 in Guideline 1 Evidence statement
Grade
Consumption of sugar-sweetened beverages is associated with increased risk of weight gain in adults and children.
B
Behavioural interventions including diet and exercise reduce the risk of overweight or obesity in overweight children. These interventions are more effective when they are family-based.
A
Consumption of three to five serves per day of cereal foods (mainly wholegrain) is associated with a reduced risk of weight gain.
B
Guideline 1
Practical considerations - different target groups Adults Pregnant and breastfeeding women Older people Aboriginal and Torres Straight Islander peoples Low SES
Remote Infants
Vegetarian and vegan Children and adolescents
Guideline 2
Guideline 2: Enjoy a wide variety of nutritious foods
Guideline 2 Evidence: 28 evidence statements in guideline 2 Evidence statement
Grade
The evidence suggests the consumption of a dietary intake pattern aligned with national dietary guidelines is associated with reduced morbidity and mortality.
C
Consumption of each additional daily serve of fruit and/or vegetables is associated with a reduced risk of coronary heart disease p 37
B
Consumption of vegetables is associated with reduced risk of stroke
B
Consumption of more than 1 serve of spinach is associated with reduced risk of colorectal cancer p 38
C
Every evidence statement has little paragraph giving you the exact reference list and a bit more info.
Guideline 2 Evidence: 28 evidence statements in guideline 2 Evidence statement: some wholegrain examples
Grade
Consumption of cereal foods ( especially wholegrain is associated with reduced risk of cardiovascular disease in adults
B
Consumption of cereal foods ( especially 3 serves of wholegrain) is associated with reduced risk of type 2 diabetes
B
Consumption of cereal foods 3 – 5 serves of ( mainly wholegrain) is associated with reduced risk of weight gain
B
An example of what it says in the practical consideration section… Based on current consumption data children over the age of 4 would require 20-60% more wholegrain foods and 10-30% less refined cereal foods (cake/biscuits etc )
Guideline 3 Guideline 3: Limit intake of foods containing saturated fat, added salt, added sugars and alcohol.
Key update
Stronger wording
Guideline 3
Replace saturated fats with poly and mono unsaturated fats
Guideline 3
Stronger wording on added sugars…LIMIT
Guideline 3
Evidence: 17 evidence statements Evidence statement
Grade
Consumption of soft drinks is associated with increased risk of reduced bone strength p78 direct effect of soft drink or inverse relationship with milk?
C
Consumption of sugar-sweetened beverages is associated with increased risk of weight gain in adults and children.
B
Consuming a diet low in sodium reduces blood pressure in children up to 18 years of age.
B
Decreasing consumption of sodium decreases blood pressure in normotensive adults: a reduction of 1800mg reduces systolic blood pressure by about 2mmHg
A
and diastolic blood pressure by about 1mmHg.
Guideline 4
Guideline 4: Encourage, support and promote breastfeeding.
Guideline 5
Guideline 5: Care for your food; prepare and store it safely.
Comprehensive food safety information, including resources such as posters, can be found at: http://www.health.vic.gov.au/foodsafety/
Selected highlights and key differences from the 2003 guidelines
Changes to serves required • Increase by 1.5-2.5 serves in children and adolescents • Increase by 1 serve in 19-60 year old men • No change for women, except for when breastfeeding
• Increase by half a serve in younger children, decrease by 1 serve in older adolescents • No changes for men • Decreased serves for pregnant and breastfeeding women
Changes to serves required • Decrease by 1-4 serves in children and adolescents • Decrease by up to 6 serves in men (max 6 instead of 6-12) • Around 6 serves instead of 4-9 serves for women • Serve size has decreased
• Increase by half a serve in younger children • Increase by up to 2 serves in men • Increase by around 1.5 serves for women
• Increase by about half a serve across all ages.
Changes to discretionary or “extra” or off the plate foods “…not an essential or necessary part of our dietary patterns.” Meaning there is a zero requirement “If chosen, they should be eaten only sometimes and in small amounts.” “To meet additional energy needs, extra serves from the Five Food Groups ….”
What types of foods are considered discretionary? Higher added sugars
Higher fat
Higher fat and added sugars
High alcohol
Energy drinks Fruit drinks Honey Jams, marmalade Some sauces Sugar Sugar confectionary Sweetened soft drinks and cordials Sweetened waters Syrups Sports drinks
Bacon, ham Butter, cream, ghee Certain tacos, nachos, enchilada Crisps Dairy blends Frankfurts etc Meat pies Pastry Pizza Potato chips Quiche Salami/mettwurst Some processed meats Some sauces/dressings Spring roll
Biscuits Cake Chocolate/Bars Dessert custards Doughnuts Ice cream Iced Buns Muesli bars Puddings Slices Some confectionary Some sauces/ dressings Sweet muffins Sweet pastries Sweet pies and crumbles
Beer Liqueurs Mixed alcoholic drinks Port Sherry Spirits Wines
Infants and toddlers now included in Guidelines
For the first time recommendations for the five food groups exist from age 7 months! Previous guidelines gave no recommendations for age under 4 years.
Using the resources
Summary
• Consumer friendly • Very visual • Practical advice - putting the evidence into practice • Tips, BMI, what to eat, how much
A new ‘plate’
Educator Guide : very handy
Provides more detailed information on : amounts and types of foods for optimal health and wellbeing. It is intended for dieticians, nutritionists, primary and secondary school teachers and other health educators Practical activities
Educator Guide: blank plates, how to read labels, sample meal plans
Plus Eat for Health consumer resources: children, adults, during pregnancy
Eat for Health posters
Eat for Health calculators http://www.eatforhealth.gov.au/eat-health-calculators
Sample eating plans – children
http://www.eatforhealth.gov.au/sites/d efault/files/files/the_guidelines/adg _sample_meal_plan_child.pdf
Eat for Health – interactive game http://www.eatforhealth.gov.au/nutrition-calculators/food-balance
Ordering resources http://www.eatforhealth.gov.au/contact-us Ordering NHMRC Publications NHMRC Publications available in print can be obtained from: National Mailing and Marketing E-mail:
[email protected] Phone: 02 6269 1080
Discussion - implications for practice, programs and policy
How do we apply the resources in our everyday settings? Here’s one strategy…
But this might prove difficult to implement.
How do we use the resources in our everyday settings? The average Victorian primary school child’s lunch box contains 3.1 serves of ‘extra’ foods everyday *
How do we use the resources in our everyday settings? WorkHealth checks of 500,000 Victorians found 93% of workers reported eating less than the daily recommended intake of fruit and vegetables *
Additional resource: The Healthy Food Charter Anyone providing or promoting healthy food and eating…. Organisations, ambassadors and health champions; professionals and educators; communities developing and implementing food policies and programs; food industry; organisations that want to influence healthier food procurement and promotion. Available online
Where to find resources and contact www.eatforhealth.gov.au – Guidelines and associated public resources for health professionals, policy makers, educators, etc – Australian Guide to Healthy Eating (the “plate”)
http://www.health.vic.gov.au/nutrition/ – Link to Healthy Food Charter
http://vheas.vic.gov.au/ – Contact details for Victorian Healthy Eating Advisory Service
Questions?
Thank you for attending
