Transcript Guidelines - Public Health Association of Australia

Australian Dietary Guidelines
Incorporating the Australian Guide to Healthy Eating
Public Health Association of Australia’s
Response to the Draft for Public Consultation
Wednesday 15th February 2012
Andrea Begley, MPH, APD
Food and Nutrition Special Interest Group (FANSIG) National-Convenor
School of Public Health, Curtin University
[email protected]
Presentation Outcomes
• Outline PHAA’s Position on Public Health Nutrition & Dietary
Guidelines
• Assess the importance of the historical & current context of
Dietary Guidelines
• Identify the Commendation on Australian Dietary Guidelines
(Guidelines) incorporating the Australian Guide to Healthy
Eating (AGHE)
• Assess potential for further improvements to the Guidelines
• Identify how Guidelines can best be supported
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, 2006
World Public Health Nutrition Association
http:/www.wphna.org/
1.2 Context-New Nutrition Science
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):673-94.
1.3 Context - Food Based Guidelines (WHO)
• Expression of the principles of nutrition
education mostly as foods
• Intended for use by individual members of the
general public, and
• If not expressed entirely as foods, written in
language that avoids, as far as possible, the
technical terms of nutrition science.
Food 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: http://www.fao.org/docrep/X0243E/x0243e00.htm.
2.1 Content- Goals
 Deliver the nutrient requirements for people of varying
age/gender, activity levels and life-stages
 Are culturally acceptable, socially equitable and
environmentally sustainable
 Reflect the current Australian food supply and food
consumption patterns
 Provide some flexibility in food choice and promote health
and wellbeing
National Health and Medical Research Council. Review of Dietary Guidelines.
Canberra 2010 [cited 2010 23rd May]; Available from:
http://hnhmrc.gov.au/your_health/healthy/nutrition/review.htm.
2.1 Content - Commendations
1. Continuing International Recognition of
Australian Dietary Guidelines
– Expert Working Committee
2. Appropriate Goals for this Revision
3. Comprehensive Evidence Based
Process & Supporting Documents
2.1 Content - Commendations
4. Acknowledgement of the Social
Determinants of Health
5. Consistency & Specificity of Guidelines
6. Contribution to Improving Population Food
Literacy
7. Well-defined Presentation & Format
2.2 Content – Strengthening
Associations From Evidence Review
• Sugary sweetened drinks associated with increased
weight gain
• Milk & fruit intake associated with reduced risk
heart disease
• Non-starchy vegetables decreased risk some cancers
• Wholegrain cereals consumption associated with
decreased risk of heart disease as well as excessive
weight gain
• Breastfeeding association with long-term health
benefits
NHMRC, 2011, http://www.eatforhealth.gov.au/page/about-guidelines
2.3 Content - Recommendations
1. Incorporate Environmental Sustainability
– Chapter in 2003 Dietary Guidelines ‘Food for
Health’ Professional Publication
– Number of statements on environment in
Guidelines
– Recommendations:
A) Include evidence in final document
B) Review evidence to develop
environmental guideline
2.3 Content-Recommendations
• PHAA contends that it would be a missed
opportunity to not integrate environmental
considerations in the 2012 revision
• Dietary guidelines need to go further than just
maintaining an ‘interest’ in healthy diets and the
environment
A healthy diet is generally an
ecological sustainable diet
(http://www.gezondheidsraad.nl/en/search/results/guidelines%20for%20healthy%20diet)
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 substitutes
– the 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 snacks
Health Council of the Netherlands. Guidelines for a healthy diet: the ecological perspective. 2011.
2.3 Content - Recommendations
• UK Sustainable Development Commission
– Changes 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 products
• Reducing consumption of food and drink of low
nutritional value (i.e. fatty and sugary foods)
• Reducing food waste
Sustainable Development Commission. Setting the Table: Advice to Government on priority elements of sustainable diets.
London: Sustainable Development Commission; 2009 [cited 2012 15th January]; Available from: Retrieved from
http://www.sd-commission.org.uk/publications/downloads/Setting_the_Table.pdf.
2.3 Content - Recommendations
2. Greater Emphasis on Social Equity & Food Costs
– Low cost foods to achieve a healthy diet in practical
considerations & AGHE
3. Comprehensive Implementation & Dissemination
– Practical Considerations for ALL stages of lifecycle and
vulnerable groups
– Clear simple communications for the population and
individual lifecycle stages
4. Reword & Reorder Guidelines and provide
additional detail in AGHE
Content Recommendations
2.4 Content -Guidelines
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 colours
– Plenty of fruit
– Plenty of grains (cereals) foods, mostly wholegrain such as
bread, cereals, rice, pasta, noodles, polenta, couscous,
oats and barley
– Some lean meat and poultry, fish, eggs, nuts and seeds
and legumes/beans
– Some 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
2.4 Content -Guidelines
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 drinks
– Limit 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 fats
– Limit intake of foods and drinks containing added salt
– Limit intake of foods and drinks containing added sugars. In
particular, limit sugar sweetened drinks
– If you choose to drink alcohol limit intake
2.4 Content -Guidelines
PHAA’s Recommendations
• Guideline 3: Choose amounts of nutritious foods and
drinks to meet your energy needs to achieve and
maintain a healthy body weight
– Children should meet energy needs for healthy growth
and development
– Older people need to maintain muscle strength in
conjunction with healthy weight
– Be physically active every day
PHAA’s Recommendations
Guideline 3 Choose amounts of nutritious foods and drinks
to meet your energy needs to achieve and maintain a
healthy body weight
Guideline 1 Enjoy a wide variety of nutritious foods from
these five food groups every day to maximise health and
environmental sustainability
Guideline 2 Avoid the intake of foods and drinks high in
total energy, fat, salt and added sugars, particularly from
highly processed foods and drinks
Guideline 4 Encourage and support breastfeeding
Guideline 5 Care for your food; prepare and store it safely
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.827-31
3. Supporting the Dietary Guidelines
• National Food Policy
WHO Framework 2008
– Applying Dietary
Guidelines to
Stakeholders
– Develop large &
effective workforce
– National Food and
Nutrition Monitoring
and Surveillance
System
World Health Organisation. A Framework to Monitor and Evaluate Implementation; WHO Global
Strategy on Diet, Physical Activity and Health. Geneva: World Health Organisation; 2008 [cited 2009
9th September]; Available from:
http://www.who.int/dietphysicalactivity/DPASindicators/en/index.html.
Acknowledgments
• Dietary Guidelines Working Committee
to inform 2012 Guidelines
• Professor 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
Comments & Questions