Presentation on theme: "Public Health Association of Australia’s"— Presentation transcript:
1 Australian Dietary Guidelines Incorporating the Australian Guide to Healthy Eating Public Health Association of Australia’sResponse to the Draft for Public ConsultationWednesday 15th February 2012Andrea Begley, MPH, APDFood and Nutrition Special Interest Group (FANSIG) National-ConvenorSchool of Public Health, Curtin University
2 Presentation Outcomes Outline PHAA’s Position on Public Health Nutrition & Dietary GuidelinesAssess the importance of the historical & current context of Dietary GuidelinesIdentify the Commendation on Australian Dietary Guidelines (Guidelines) incorporating the Australian Guide to Healthy Eating (AGHE)Assess potential for further improvements to the GuidelinesIdentify how Guidelines can best be supported
3 1.1 Context-Public Health Nutrition “The promotion and maintenance of nutrition-related health and wellbeing of populations through the organised efforts and informed choices of society.”The Barcelona Declaration, 2006World Public Health Nutrition AssociationDGs key tool
4 1.2 Context-New Nutrition Science It is a valued role for public health nutritionists to be engaged in debates regarding these areasPHAA considers that Guidelines provide Australia Government with the opportunity to incorporate and promote the biomedical, social, cultural, economic, environmental and benefits of healthy food intakes to the Australian population.We encourage all organisations and/or individuals to submit comment on the draft by Wednesday 29th February 2012.Beauman C, Cannon G, Elmadfa et al. The principles, definition and dimensions of the new nutrition science. Public Health Nutrition. 2005;8(6A):695-8.Cannon G, Leitzmann C. The new nutrition science project. Public Health Nutrition. 2005;8(6A):
5 1.3 Context - Food Based Guidelines (WHO) Expression of the principles of nutrition education mostly as foodsIntended for use by individual members of the general public, andIf not expressed entirely as foods, written in language that avoids, as far as possible, the technical terms of nutrition science.Characteristics described by the World Health OrganizationFood and Agricultural Organization, World Heath Organisation. Preparation and use of Food-Based Dietary Guidelines. Report of a joint FAO/WHO consultation. Nicosia, Cyprus1996; Available from:
7 2.1 Content- GoalsDeliver the nutrient requirements for people of varying age/gender, activity levels and life-stagesAre culturally acceptable, socially equitable and environmentally sustainableReflect the current Australian food supply and food consumption patternsProvide some flexibility in food choice and promote health and wellbeingNational Health and Medical Research Council. Review of Dietary Guidelines. Canberra 2010 [cited rd May]; Available from:
8 2.1 Content - Commendations Continuing International Recognition of Australian Dietary GuidelinesExpert Working CommitteeAppropriate Goals for this RevisionComprehensive Evidence BasedProcess & Supporting DocumentsPHAA has previously congratulated the NHMRC on the comprehensiveness of the original goals to update the Guidelines as published in 2010 and takes this opportunity to reiterate the importance of these goals. These goals exemplify NHMRC’s position as the peak body on health advice. These comprehensive goals for Guidelines recognize that food not only performs a biological function but also in addition has significant social, cultural and economic roles in Australian lives.4. The Guidelines place appropriate emphasis on a high dietary variety and quality pattern from eating more vegetables, legumes, fruits, and whole grains that have been the cornerstone messages in Dietary Guidelines since The continuation of these messages highlights the consistency in population advice over time.
9 2.1 Content - Commendations 4. Acknowledgement of the Social Determinants of Health5. Consistency & Specificity of Guidelines6. Contribution to Improving Population Food Literacy7. Well-defined Presentation & FormatPHAA has previously congratulated the NHMRC on the comprehensiveness of the original goals to update the Guidelines as published in 2010 and takes this opportunity to reiterate the importance of these goals. These goals exemplify NHMRC’s position as the peak body on health advice. These comprehensive goals for Guidelines recognize that food not only performs a biological function but also in addition has significant social, cultural and economic roles in Australian lives.clear4. The Guidelines place appropriate emphasis on a high dietary variety and quality pattern from eating more vegetables, legumes, fruits, and whole grains that have been the cornerstone messages in Dietary Guidelines since The continuation of these messages highlights the consistency in population advice over time.
10 2.2 Content – Strengthening Associations From Evidence Review Sugary sweetened drinks associated with increased weight gainMilk & fruit intake associated with reduced risk heart diseaseNon-starchy vegetables decreased risk some cancersWholegrain cereals consumption associated with decreased risk of heart disease as well as excessive weight gainBreastfeeding association with long-term health benefitsNHMRC, 2011,
11 1. Incorporate Environmental Sustainability 2.3 Content - Recommendations1. Incorporate Environmental SustainabilityChapter in 2003 Dietary Guidelines ‘Food for Health’ Professional PublicationNumber of statements on environment in GuidelinesRecommendations:A) Include evidence in final documentB) Review evidence to develop environmental guideline
12 2.3 Content-Recommendations PHAA contends that it would be a missed opportunity to not integrate environmental considerations in the 2012 revisionDietary guidelines need to go further than just maintaining an ‘interest’ in healthy diets and the environmentA healthy diet is generally anecological sustainable diet(http://www.gezondheidsraad.nl/en/search/results/guidelines%20for%20healthy%20diet)Draft for public consultation outlines on page 20 that NHMRC aims to work with other agencies to provide guidance for health professionals as they work with clients and patients.PHAA maintains that the NHMRC is the peak body for developing health advice and therefore where there are clear synergies with diet and large amounts of evidence that the NHMRC should confidently report this in Guidelines.
13 2.3 Content - Recommendations Netherlands Government (Win-Win Guidelines)a less animal-based and more plant-based diet, containing fewer meat and dairy products and more whole grain products, legumes, vegetables, fruit, and plant-derived meat substitutesthe reduction of energy intake for those with an excessive body weight, in particular by eating fewer non-basic foods, such as sugary drinks, sweets, cakes and snacksHealth Council of the Netherlands. Guidelines for a healthy diet: the ecological perspective
14 2.3 Content - Recommendations UK Sustainable Development CommissionChanges likely to have the most significant and immediate impact on making our diets more sustainable, in which health, environmental, economic and social impacts are more likely to complement each other:Reducing consumption of meat and dairy productsReducing consumption of food and drink of low nutritional value (i.e. fatty and sugary foods)Reducing food wasteSustainable Development Commission. Setting the Table: Advice to Government on priority elements of sustainable diets. London: Sustainable Development Commission; 2009 [cited th January]; Available from: Retrieved from
15 2.3 Content - Recommendations 2. Greater Emphasis on Social Equity & Food CostsLow cost foods to achieve a healthy diet in practical considerations & AGHE3. Comprehensive Implementation & DisseminationPractical Considerations for ALL stages of lifecycle and vulnerable groupsClear simple communications for the population and individual lifecycle stages4. Reword & Reorder Guidelines and provide additional detail in AGHEPractical considerations for all stages of the lifecyle and vulnerable groups required at end of chaptersIt would be difficult for health professionals and others to intrepret for target groups and for the compling of population resources. Evidence is there just needs to be expanded
18 PHAA’s Recommendations Guideline 1: Enjoy a wide variety of nutritious foods from these five food groups every day to maximise health and environmental sustainability:Plenty of vegetables, legumes/beans including different types and coloursPlenty of fruitPlenty of grains (cereals) foods, mostly wholegrain such as bread, cereals, rice, pasta, noodles, polenta, couscous, oats and barleySome lean meat and poultry, fish, eggs, nuts and seeds and legumes/beansSome 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, mainly tap water
20 PHAA’s Recommendations Guideline 2: Avoid the intake of foods and drinks high in total energy, fat, salt and added sugars, particularly from highly processed foods and drinksLimit intake of foods and drinks containing high total fat, saturated fat and trans fats (Low-fat diets are not suitable for infants)Include small amounts of foods that contain unsaturated fatsLimit intake of foods and drinks containing added saltLimit intake of foods and drinks containing added sugars. In particular, limit sugar sweetened drinksIf you choose to drink alcohol limit intake
22 PHAA’s Recommendations Guideline 3: Choose amounts of nutritious foods and drinks to meet your energy needs to achieve and maintain a healthy body weightChildren should meet energy needs for healthy growth and developmentOlder people need to maintain muscle strength in conjunction with healthy weightBe physically active every dayStart with action ‘choose’ more directive
23 PHAA’s Recommendations Guideline 3 Choose amounts of nutritious foods and drinks to meet your energy needs to achieve and maintain a healthy body weightGuideline 1 Enjoy a wide variety of nutritious foods from these five food groups every day to maximise health and environmental sustainabilityGuideline 2 Avoid the intake of foods and drinks high in total energy, fat, salt and added sugars, particularly from highly processed foods and drinksGuideline 4 Encourage and support breastfeedingGuideline 5 Care for your food; prepare and store it safelyTime for a paradigm shift
24 2.4 Content –AGHE“Trying to revise the guidelines and update the pyramid without consumer testing is a little like trying to reach the North Pole without a compass”Edge MS, 2004, Promoting healthful diets from a public perspective, JADA, vol.104,no.5,pp
26 3. Supporting the Dietary Guidelines National Food PolicyApplying Dietary Guidelines to StakeholdersDevelop large & effective workforceNational Food and Nutrition Monitoring and Surveillance SystemImprove the capacity of Australians to choose a healthy diet in line with the Australian Guide to Healthy Eating and the NHMRC Dietary GuidelinesEat Well Australia pp.13Strategic Intergovernmental Nutrition Alliance of the National Public Health Partnership, 2001, Eat Well Australia An Agenda for Action for Public HealthWHO Framework 2008World Health Organisation. A Framework to Monitor and Evaluate Implementation; WHO Global Strategy on Diet, Physical Activity and Health. Geneva: World Health Organisation; 2008 [cited th September]; Available from:
27 AcknowledgmentsDietary Guidelines Working Committee to inform 2012 GuidelinesProfessor Colin Binns, John Curtin Distinguished Professor, Curtin University for his life-long commitment to Dietary Guidelines and Infant Feeding Guidelines for Health Workers for Australia