Linking you into the new dietary and infant feeding guidelines, and more

It’s taken nearly four years, reviews of about 55,000 research publications, and endless meetings, consultations and negotiations. (Plenty of blood, sweat and tears, in other words.)

Today the NHMRC finally launched the new Australian Dietary Guidelines and Infant Feeding Guidelines (available here with masses of supporting material).

The aim of this post (thrown together in a hurry) is to quickly link you into some of the relevant documents and the summary below of responses to date (including concerns from public health experts that the guidelines have failed to address environmental and equity concerns).

New dietary guidelines – evidence for healthy choices more certain

At The Conversation, Professor Warwick Anderson, CEO of the NHMRC, acknowledges that the recommendations will be hotly contested, and cautions:

“…the community needs always to think about the possibility of vested interests influencing the debate about what is healthy and what is not, and of the potential influence of sponsors of nutrition research findings, just as we have become more aware of and vigilant about conflict of interest in pharmaceutical research and clinical trials.”

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Responses from various experts at The Conversation

Tim Crowe, Associate Professor in Nutrition at Deakin University, notes that the revised guidelines have a greater focus on foods and food groups rather than nutrients and says this is a good step forward.

Gary Sacks, Research Fellow, Deakin Population Health at Deakin University, is disappointed the guidelines do not adequately consider the environmental sustainability of the food supply chain, a topic he believes should have been integrated throughout the document rather than being sidelined to a discussion in an appendix. He says:

“It is clear that, in putting together the new version of the guidelines, major public health and environmental compromises were made to take into account the profit-seeking interests of the food industry. This is a similar situation to another key government strategic policy document, the National Food Plan (released in 2012), that also does not adequately address nutrition, health and environmental considerations. It is a travesty that the private sector has such strong influence over government policy decisions, and they should have a much more limited role in the policy development process.”

Professor Clare Collins, NHMRC CDF Research Fellow; Co-Director, Priority Research Centre in Physical Activity and Nutrition, says the guidelines “provide a comprehensive source of information about what to eat to improve health. Each chapter sets out the specific guidelines, the research evidence underpinning it and how to implement the guidelines in practical ways.”

Professor Peter Clifton, Laboratory head, Nutritional Interventions, Baker IDI Heart and Diabetes Institute, has several criticisms of the guidelines, including that he says they overstate the benefits of dairy and encourage men to eat too much of grain foods.

Also at The Conversation is analysis of the new Infant Feeding Guidelines.

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Stronger evidence

At her blog, dietitian Emma Stirling says the evidence base has strengthened for:

• The association between the consumption of sugar sweetened drinks and the risk of excessive weight gain in both children and adults
• The health benefits of breastfeeding
• The association between the consumption of milk and decreased risk of heart disease and some cancers
• The association between the consumption of fruit and decreased risk of heart disease
• The association between the consumption of non-starchy vegetables and decreased risk of some cancers
• The association between the consumption of wholegrain cereals and decreased risk of heart disease and excessive weight gain.

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Edited statement from the Public Health Association of Australia

The PHAA has welcomed the Australian Dietary Guidelines (ADG) the Australian Guide to Better Eating (AGBE), and the Infant Feeding Guidelines.

Associate Professor Heather Yeatman, President of the PHAA, said the ADG were important as “the public needs to know this is the place to go for good, authoritative dietary advice”.
She said:

” The challenge for many Australians is that there are so many myths, confusing pieces of advice and falsehoods perpetuated by so-called gurus.  The work of the NHMRC is strongly evidence based and can be relied on by health, medical and education professionals and everyone in the community.

The PHAA is pleased that the guidelines focus on the types of food to eat for health rather than specific nutrients, and the messages are very clear about avoiding added sugars.  In the new ADGs there is a clear distinction between added sugar (such as found in carbonated soft drink) and sugars eaten as part of the whole food such as in an apple.”

However, the PHAA’s CEO Michael Moore was disappointed by the lack of attention to enviornmental concerns. He said:

“The PHAA has argued in a series of submissions that protecting the environment should form a key part of the Dietary Guidelines.

It is a missed opportunity that this aspect of the advice was not taken more seriously.  Food, health and the environment form an integrated system.  It is appropriate and imperative to let people know how to eat to protect the future environment as well as their health.  Our food choices impact on the environment which needs to be a key consideration of dietary advice in Australia, as it is in other countries.  If we destroy the environment that sustains our food supply we will not be in a position to produce good nutritious food and such advice will become redundant.”

He said another area where the ADGs fall short is consideration of social equity, the cost of food and the consequential limitation on choices.

He said: “Food security is a critical factor in a healthy diet.  It seems pointless to provide advice on how people should be eating and feeding their families if they cannot afford it.”

Associate Professor Yeatman said the breastfeeding advice was based on solid evidence but that the real challenge is supporting mothers to continue to breast feed.  More than 90% of Australian women start breastfeeding, but rates at 6 months fall far short of NHMRC targets.

She said: “We need to arrest the dramatic drop-off in the breastfeeding rates so mothers can sustain it up to 6 months of age and beyond.  The ‘baby friendly hospital’ environment supports commencement of breast feeding.  More research is needed into how to support breastfeeding when mum returns home and perhaps back to work.  There is also a key role for health workers to strengthen their advocacy of the benefits of breastfeeding.”

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Statement from the Heart Foundation

The importance of ‘good fats’ has finally been recognised in Australia’s number one nutrition guideline, the National Heart Foundation of Australia said today.

The National Health and Medical Research Council (NHMRC) today released the 2013 revision of the Australian Dietary Guidelines, which now distinguishes between ‘good’ fats (polyunsaturated and monounsaturated fats) and ‘bad’ fats (saturated and trans fats).

National CEO of the Heart Foundation, Dr Lyn Roberts, welcomed the move away from ‘low fat’ messaging, which she said was a significant change from the previous 2003 guidelines that advised Australians to choose low fat foods.

“Australians have been getting the wrong messages for years – we should certainly be reducing bad fats, but it’s important to replace them with good fats. People should not cut all fats from their diet,” Dr Roberts said.

“Australians are now advised to replace high fat foods which contain predominantly saturated fats such as butter, cream, coconut and palm oil with foods that contain predominantly polyunsaturated and monounsaturated fats such as oils, spreads, nut butters/pastes and avocado.

“It’s good to eat some healthier fats and oils such as canola and olive oil, nuts and fish, as they provide essential nutrients for heart health and protect against heart disease.

“Eating too much saturated fat increases the risk of heart disease and we know Aussies are still eating too much of this bad fat. Too much saturated fat contributes to the build up of fatty material, called plaque, on the inside of your blood vessels, clogging your arteries,” she said.

Heart disease is responsible for around 22,000 deaths every year – the number one killer of Australian men and women.

“The Heart Foundation has been advocating for the distinction between ‘good’ fats and ‘bad’ fats and the importance healthier fats have for heart health, so it’s pleasing to see this reflected in the final guidelines,” she said.

“We have an obesity crisis in Australia and the new guidelines will help Australians to understand nutrition and put them on the path to healthier eating.

“The science and evidence around food has been tried and tested to ensure quality evidence underpins our work and after this review the advice hasn’t changed much. Fad diets will come and go, but we still recommend that to maintain good health people should eat a mix of nutritious foods, avoid overeating and limit their intake of saturated fats, added sugars and salt.”

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Previous Croakey articles on the guidelines

• Look beyond the headlines

• Why everyone wants you to eat more – and other problems confronting the dietary guidelines 

• The Australian’s campaign against environmentally friendly eating

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PostScript from Croakey

Is it just me, or are the sample meal plans somewhat Anglo-centric given the diversity of our population and cultures?