Eat For Health Program & The Australian Dietary Guidelines

Submitted by sylvia.wong@up… on Wed, 07/01/2020 - 11:52

Your diet influences your health. Therefore, the Australian Federal Government, in particular, the National Health and Medical Research Council which is part of the Department of Health and Aging, has implemented an initiative called the Eat For Health program.

The program is essentially a website that encompasses the following information:

  • The Australian Dietary Guidelines - Provides detailed information on healthy eating, portion sizes, and food safety, presented as five separate guidelines.

  • Food essentials - Implementation guides for the recommendations presented in the Australian Dietary Guidelines.

  • Educational and promotional resources - Includes brochures, posters, and an educator guide which can be downloaded, printed and used for information sessions and displays.

  • Eating well tips - Advice and tips on eating well, choosing nutritious foods and healthy recipes.

  • Eat for health calculators - Online calculators to help you calculate daily energy needs, daily nutrient requirements, and average recommended number of serves per food group.

The information provided via the Eat For Health program/website is all based on the latest scientific research and evidence.

Whilst the target audience for the Eat For Health program mainly comprises health professionals such as Dietitians, Nutritionists, General practitioners (GPs), and Nurses and lactation consultants). It is certainly alos a valuable resource for other interested parties which can include fitness professionals. The information is presented in an easy to read format, suitable for distribution to a wide range of people.

The Australian Dietary Guidelines in booklet form

Sub Topics
Achieve and maintain a healthy weight.

National Health and Medical Research Council

Tape Measure, Bottle of Water, Gym Free-Weights, Bowl of Healthy Food

To achieving and maintain a healthy weight it is essential to be physically active but also fuel the body with appropriate amounts of nutritious food and drinks to meet energy needs. People expend a lot of energy whilst exercising and also undertaking other physical activity, like housework, certain types of employment, looking after children etc...

In order to receive enough nutrients and energy to perform these tasks, the body must be given the right balance of protein, complex carbohydrates, calcium, and iron. Essentially, proper nutrition gives your body the fuel it needs to perform at its highest level and helps to achieve and maintain a healthy weight.

In addition to this basic advice, this guideline provides specific recommendations to the following groups:

  • Children and adolescents - They 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 - They should eat nutritious foods and keep physically active to help maintain muscle strength and a healthy weight.

Enjoy a wide variety of nutritious foods.
National Health and Medical Research Council

 

The Guidelines specify five groups of foods from which people should select their daily food intake from:

  1. Vegetables and Legumes/Beans - This is one of the largest recommended food groups, and it's recommended that a good variety of colours are considered when selecting specific vegetables to purchase and eat.

  2. Fruit - Should be eaten fresh, raw, and in its whole form to maximise the nutritional benefits. Eating dried fruit regularly is not recommended as it is high in kilojoules, can stick to the teeth and increases the risk of dental decay. Fruit juice should only be drunk occasionally as it is acidic and can increase dental erosion as well as lacking the beneficial dietary fibre that comes from eating whole fruit. This fibre content helps with the digestion of the natural fructose (sugar) that fruit contains meaning fruit juice has quite a high sugar content.

  3. Grain (cereal) foods - Should be mostly wholegrain and/or high cereal fibre varieties, such as bread, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley.

  4. Lean meats and alternatives - Lean meats include poultry and fish as well as lean red meat. The alternative reference includes eggs, tofu, nuts and seeds, and legumes/beans. This group is a good source of protein and other vitamins and minerals.

  5. Milk, yoghurt, cheese and/or their alternatives - Should be mostly reduced fat (note: reduced-fat milk is not suitable for children under the age of 2 years).

And finally, drink plenty of water. It is recommended that adults drink between 2.1 - 2.6 litres per day (or 8-10 cups).

The five food groups are not evenly distributed. You may have previously seen them illustrated in a pyramid shape or as per the image below in a pie chart or plate shape.  The image below is known as the Australian Guide to Healthy Eating, it provides a visual guide to how the five food groups from this guideline should be distributed in terms of serving sizes. 

To achieve a balanced diet, the biggest portion in any given meal or daily food intake should be allocated to the combined Vegetables and Fruit groups, followed by the Grains group, then Lean Meats and finally Milk, Yoghurt and Cheese. 

The Australian Guide to Healthy Eating also identifies certain food and beverage items which should only be consumed in limited quantities. Including, Fats and Oils, Soft Drinks, Alcohol, Cake, Confectionary and Take-away burgers/chips.

Poster of the five food groups outlined in the Australian Dietary Guidelines

Portion size is a commonly misunderstood concept and it is easy to consume too much food, even healthy food. Ideal portion sizes will vary depending on whether a person is male, female, young, old, highly active or mostly sedentary. However, some guides to  assist with determine appropriate quantities are:

Food Group Food Item Serving Size
Vegetables Cruciferous Vegetables (cooked) 75g (½ cup)
Cooked orange vegetables (sweet potato, pumpkin etc...) 75g (½ cup)
Raw leafy green vegetables 75g (1 cup)
Potato and other starchy vegetables ½ medium potato
Fruit Apple, Banana, Orange, Pear 1 piece (150g)
Apricots, Kiwi Fruit, Plums 2 pieces (150g)
Diced, Cooked or Canned Fruit (preferably with no added sugar) 150g (1 cup)
Fruit Juice (100% no added sugar) 125ml (½ cup)
Grains Wholegrain bread or bread roll 1 slice or ½ a medium roll
Cooked rice, pasta, noodles etc... 75-120g (½ cup)
Crumpet or English Muffin 1
Lean Meat Beef, Lamb, Pork, Venison or Kangaroo 65g or ½ cup mince or 2 small chops or
2 slices of roast meat.
Chicken or Turkey 80g
Fish 100g fish fillet or 1 small can
Dried beans, lentils, chickpeas etc... 150g (1 cup)
Tofu 170g
Milk, Yoghurt, Cheese Fresh, UHT, or powdered milk 250ml (1 cup)
Evaporated unsweetened milk 120ml (½ cup)
Yoghurt 200g (¾ cup)
Hard Cheese (ie. Cheddar) 40g (2 slices or 4x3x2cm piece)
Ricotta Cheese 120g (½ cup)
Soy, Rice, or other cereal milk with at least 100mg added calcium per 100ml 250ml (1 cup)
Limit intake of foods containing saturated fat, added salt, added sugars and alcohol.
National Health and Medical Research Council

 

This guideline is fairly self-explanatory, however, there are some specific recommendations on how it can be achieved and also some situations where the guideline is not necessarily applicable:

  • 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.

  • 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.

  • Limit intake of foods and drinks containing added sugars such as confectionery, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and sports drinks.

  • 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.

Photo showing various fatty foods: pizza, burgers, hot dogs, chips, as well as soft drink and beer

Encourage, support and promote breastfeeding.
National Health and Medical Research Council

 

This guideline may not be particularly relevant to the majority of fitness professionals, however, some classes or sessions may consist of new mothers and their babies. It is important to never judge or offer any specific advice in regards to this topic, however,  the following tactics are appropriate:

  • Have a suitable private area available for nursing mothers.

  • Promote via brochures or posters on display. 

Baby being breastfed

Care for your food; prepare and store it safely.
National Health and Medical Research Council

 

Generally appropriate for people who are cooking and storing food, which may not be applicable in a fitness environment. However, many fitness centres and health clubs also run cafeterias or sell drinks and snakes from kiosks. It is also appropriate if any special events are planned where there may be a barbeque or a cake-stall. 

Some considerations relating to basic food safety include:

  • Wash your hands prior to preparing food.

  • Ensure food is stored, prepared, and served at the correct temperature ie. frozen goods stored at -18°, cold goods stored at between 0° and 5°, hot foods should be heated to at least 75° and not allowed to drop below 60° prior to serving.

  • Do not mix food items that are going to be eaten raw (ie. salad) with the juices of uncooked meat. For example, use separate chopping boards and knives.

  • Ensure foods are utilised within their recommended use-by date.

  • Ensure the food storage and preparation area is not contaminated with insects or vermin.

The Educator Guide, which is a resource in the Eat For Health Program, provides a comprehensive overview of the program and the Australian Dietary Guidelines and is especially useful for personnel responsible for the provision of healthy eating information. It contains detailed tables of serving sizes, associated kilojoules, and various examples of eating recommendations for different cohorts. There are also helpful templates that can be used to help clients to formulate their healthy eating plan.

It must be noted that any information or advice that is provided to clients must be based on the generic and publicly available information from this guide and also the other resources of the Eat For Health Program. It is also prudent to remember that information and advice only be provided to healthy individuals who do not have extenuating lifestyle circumstances.

Chapter Five of the Educator Guide covers information regarding Energy and Nutrient Requirements, in particular, two different types of dietary patterns:

Based on the five food groups with some allowances for discretionary foods, they are baseline diets that consist of the minimum amount of kilojoules required to maintain a healthy weight depending on the demographic group the individual belongs to. These diets are modelled on a weekly basis which allows for daily fluctuations because it is recognised that daily eating patterns are not identical. Some people will eat less on certain days (ie. if they are at home) and more on other days (ie. if they are socialising or having takeaway).

The Educator Guide details recommended servings per day of each food group, portion sizes, and the associated kilojoules associated with different foods.

The number of kilojoules assigned to each group is based on the smallest and least active person in that group, therefore daily quotas may need to be higher for most individuals. For example, the average adult needs approximately 8700 kilojoules per day to maintain a healthy weight. This will vary depending on the gender, age, and activity level of the individual.

Different groups that have Foundation Diets include:

  • Children and Adolescents

  • Adults 

An example of a Foundation Diet for a 35-year-old woman who is 160cm and moderately active may look like this:

  Grain Vegetables & legumes Fruit Milk, Yoghurt & Cheese Lean Meats, Poultry and Eggs Spreads and Oils Total
Number of serves per day 6 5 2 2.5 2.5 2  
Kilojoules per serve 500 100-350 350 500-600 500-600 250  
Total kilojoules 3,000 500-1,750 700 1,250-1,500 1,250-1,500 500 7,200-8,950

Refer to the Educator Guide for information about recommended servings and kilojoules per servings for other demographics such as men or adolescents.

An extension of foundation diets they cater to individuals whose height, age, physical activity level, or lifestyle factors means they require additional energy to be consumed. For example, women who are pregnant or breastfeeding require additional kilojoules at different stages. 

The Educator Guide provides detailed summaries of the additional daily kilojoules that may be required by various cohorts.

An example of a Total Diet for a 35 year-old-woman who is 160cm and moderately active may look like this (an extension of the example in the Foundation Diet section).

  Grain Vegetables & legumes Fruit Milk, Yoghurt & Cheese Lean Meats, Poultry and Eggs Spreads and Oils Discretionary Foods Total Additional Kilojoules
Number of additional serves per day 2 2 1 0 0 1 0.5  
Kilojoules per serve 500 100-350 350 - - 250 600   
Total kilojoules  1,000 200-700 350 - - 250 300 2,100-2,600

Therefore, in this example, the individual consumes her maximum Foundation Diet kilojoules plus her maximum Total Diet kilojoules making her total kilojoules for the day 11,550. This is fine if her physical characteristics or energy expenditure rate allows for these extra kilojoules, however, if she does not require them, they just end up being stored as excess fat.

According to the Educator Guide the different categories of physical activity which contribute to the need for increased kilojoules in a Total Diet are:

  • Sedentary activities - Mainly sitting or lying down, using little energy.

  • Light activities - Standing and moving around in the home, workplace or community.

  • Moderate activities - Walking briskly, gentle swimming, social tennis. 

  • Vigorous activities - Makes you huff and puff, talking is difficult. Includes jogging, aerobics, and sports such as football and netball.

The number of additional kilojoules that are required to help fuel these activity levels will vary substantially from one person to the next. It is very difficult to provide a generic example as it relies so heavily on factors such as age, gender, and height.  However, the below estimates of additional kilojoules required are based upon men and women aged between 31 - 50 who fit into the different activity level categories.

Men (aged 31-50) height in cm's Inactive / Sedentary LIght Activity Moderate Activity High Activity
160cm 0kj 1300kj 2500kj 3800kj
170cm 500kj 1800kj 3200kj 4500kj
180cm 1000kj 2400kj 3800kj 5300kj
190cm 1500kj 3000kj 4500kj 6000kj

 

Women (aged 31-50) height in cm's Inactive / Sedentary LIght Activity Moderate Activity High Activity
150cm 0kj 1100kj 2100kj 3100kj
160cm 300kj 1400kj 2500kj 3600kj
170cm 700kj 1800kj 3000kj 4100kj
180cm 1000kj 2200kj 3400kj 4600kj

The average adult requires approximately 8700 kilojoules (or 2080 calories) per day to maintain a healthy weight. This will vary depending on daily activity levels, age, height and current weight. There are various online tools and apps that can be utilised to keep track of daily kilojoule intake. Examples include MyFitnessPal and Foodswitch by Bupa

By law, food labels in Australia must display the number of kilojoules (and the breakdown that contributes to these kilojoules) the food item contains per 100g (or 100ml).  It is also common to see the amount of kilojoules 'per serving' with an estimated number of servings per packet size. 

Comprehensive example of a food label showing nutritional information and providing additional facts and recommendations about each section. Available from the Educator Guide of the Eat For Health program.

As can be seen with this label, the manufacturer is claiming that there are 16 (30g) servings in the total packet. Each serving size is worth 432kj. If an individual consumes more than one of these servings they must multiply the number of kilojoules per serving by the number of servings they consume. In some products, it can be difficult to determine how many servings have been consumed without the use of scales.

Food labels also provide specific information about the various macronutrients such as protein, fat, and carbohydrates. Macronutrients are the main energy sources for the human body and must be consumed via food as the body does not naturally produce them. 

Largely derived from eating animal products it can also be found in nuts and legumes. It is essential for the building of muscle mass. In the food label example above, the total protein is 2.8g per serving and 9.3g per 100g. 

The main functions of fat include: serving as an energy reserve that can be used by the body during times of fasting, helping the body absorb vital fat-soluble vitamins such as A, D, E and K, and providing an insulating layer for the organs and to keep the body warm.

There are different types of fat:

  • Saturated fat - Derived from animal sources such as red meats, poultry, and full-cream dairy products. They tend to contain a lot of kilojoules. Linked to high-cholesterol levels and cardiovascular disease. 

  • Trans fat (fatty acids) - Can occur naturally in some meats and dairy items although normally in low amounts. However, the food industry often manufactures trans fats to help extend the shelf-life of a product. This is done by adding hydrogen to liquid vegetable oils to make the oils more solid. Trans fats are often found in processed foods such as frozen pizza, baked goods, crackers, and margarine. 

  • Triglycerides - The body converts any type of fat that is not used immediately for energy requirements into triglycerides and stores them as excess fat cells. 

  • Monounsaturated fats - One of the 'good fats' that provide protection for the heart and blood vessels by improving cholesterol levels and assisting in insulin and blood sugar control. Foods such as olives and avocados have high levels of monounsaturated fats.

  • Polyunsaturated fats - Another example of a 'good fat' that helps to improve cholesterol levels and decrease the risk of cardiovascular disease. Derived from plant-based sources such as soybeans, sunflower oil, walnuts, and flaxseeds as well as some times of fish such as salmon, tuna, herring, mackerel, and trout. Polyunsaturated fats also contain Omega-3 and Omega-6 fatty acids which help to reduce inflammation, lower blood pressure levels, promote healthy skin and hair growth, and improve brain function.

In the food label example above, the total amount of fat is 0.4g per serving and 1.2g per 100g. This total figure is then broken down to highlight the saturated fat content which is 0.1g per serve or 0.3g per 100g. Saturated fat is potentially the most dangerous type of fat and should be avoided or reduced where possible. According to the Australian Dietary Guidelines, it is recommended that less than 3g per 100g is best for saturated fat, therefore this particular product is OK.

The carbohydrate content of a product is where sugar originates from. Carbohydrates provide vital energy for the body and in particular brain function, however, not all carbohydrates are created equal. They are divided into two types

  • Simple - Have just one or two sugars which are easier for the body to burn. Simple carbohydrates are found naturally in fructose (in fruit) and in galactose and lactose (milk products) as well as refined sugar which is added to products such as lollies and soft drinks. Refined sugar does not contain any nutrients and the energy level is often in excess of human requirements hence this type of sugar is usually converted into triglyceride fat leading to weight gain.

  • Complex - Known as polysaccharides, this type of carbohydrates has three or more sugars and are harder for the body to digest/burn hence they provide a more sustained energy source. Found naturally in starchy foods such as beans, peas, lentils, peanuts, potatoes, corn, parsnips, and whole-grains.

In the food label above the total number of carbohydrates are 18.9g per serving and 62.9g per 100g. This total figure is then broken down to highlight the added sugar content which is 3.5g per serve or 11.8g per 100g. The Australian Dietary Guidelines recommend that added sugar content should not exceed more than 15g per 100g, therefore whilst this product does have a moderately high amount of added sugar it is still within the guidelines.

Recent research has indicated that following a low glycemic index eating plan helps to achieve sustained weight loss. All carbohydrates have a glycemic index rating, this indicates how quickly the carbohydrate raises blood sugar levels. For example, simple carbohydrates have a high glycemic index rating whereas complex carbohydrates have a much lower rating. The National Diabetes Services Scheme has produced a helpful fact sheet on the glycemic index it can be accessed here.

Other information contained on product labels includes:

  • Fibre -  The Australian Dietary Guidelines recommend that foods such as breads and cereals have at least 3g or more of fibre per serve. In the food label example above, the product has 6.4g or fibre per serve which puts it well within the recommended guidelines.

  • Sodium (salt) - The Australian Dietary Guidelines recommend that foods with less than 400mg per 100g are good and ideally they should be 120mg per 100g. In food label examples above, the product has 215mg of sodium per 100g making it good but not ideal. 

In addition to product labels, the Australian and New Zealand Food Standards website provides a searchable database of a wide range of food and beverages (including fresh foods) and provides nutritional information about them.

The template for adapting the Australia Guide for Healthy Eating can aid clients in making informed food choices by allowing them to visualise how the foods that they eat fit into the five food groups and helps them to plan which foods they should be eating more or less of.

The blank sections of the pie-chart allow clients to write or draw the various food items that they plan to purchase and/or consume in a day or week. The different-sized sections provide a visual reminder of the portion sizes that should be observed for each food group. The condiments and discretionary foods sections at the bottom of the pie-chart only allow a small space for writing items as these foods should be consumed sparingly if at all.

An interactive version of this template is available here

Blank template of the Australiang Guide to Healthy Eating poster allowing clients to write or draw food items into the different sections

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Woman eating fruit salad