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4363.0.55.001 - Australian Health Survey: Users' Guide, 2011-13  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 07/06/2013   
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Contents >> Health risk factors >> Dietary behaviours

DIETARY BEHAVIOURS

Definition

Depending upon the survey, this topic covers selected dietary indicators relating to the type of milk consumed, usual daily intake of fruit and vegetables and use of salt. It also covers broader dietary information on all food and drink consumed in the 24 hours prior to interview, and food avoidance behaviours. Information on type of diet currently on, collected in the NNPAS, can be found in the Body Mass and Physical Measurements topic.

Population

Information was collected for persons aged 2 years and over in the NHS and NNPAS.

Methodology

Information about dietary behaviours was collected in both the NHS and the NNPAS surveys. Information on dietary behaviours was first published in the First Results publication based on the NHS only sample of approximately 19,700 people aged 2 years and over. Updated results on dietary behaviours for the larger combined, core sample of approximately 32,000 people aged 2 years and over were published in the Updated Results publication. For comparison of dietary behaviours with NHS only items, the NHS file should be used and similarly for comparison with NNPAS only items, the NNPAS file should be used. However, for the most accurate information for dietary behaviours alone or comparison with other items collected in the core, the core file should be used. For more information on the structure of the AHS, see the Structure of the Australian Health Survey page of this Users' Guide.

Fruit and vegetables

Respondents were asked to report the number of serves of vegetables and fruit they usually ate each day. For the purposes of this survey the following definitions were used.

A serve of vegetables was defined as:

  • half a cup of cooked vegetables
  • one medium potato
  • one cup of salad vegetables - approximately equivalent to 75 grams.

All types of vegetables were included, but legumes were excluded. Tomatoes were included as a vegetable rather than a fruit.

A serve of fruit was defined as:
  • one medium piece or two small pieces of fruit
  • one cup of diced fruit
  • quarter of a cup of sultanas
  • four dried apricot halves - approximately 150 grams of fresh fruit or 50 grams of dried fruits.

Fruit and vegetable juices were excluded.

Prompt cards were used to assist respondents in understanding the concept of a serve, showing pictorial representations. One prompt card showed three pictorial examples of single serves of different vegetables and another card showed three pictorial examples of single serves of fruit. If respondents had difficulty in reporting, interviewers were encouraged to prompt in terms of asking respondents about their usual consumption of vegetables and fruit at breakfast, lunch and dinner, and for snacks.

Respondents in the NHS were also asked whether their vegetable and fruit consumption had increased, decreased or stayed the same since this time last year.

Whether vegetable and fruit consumption met the recommended guidelines was derived for respondents 4 years and over according to the following numbers of servings (based on recommendations from the National Health and Medical Research Councils Australian Dietary Guidelines (2003).

NHMRC Australian Dietary Guidelines (2003)

Age groups
Recommended daily serves of vegetables
Recommended daily serves of fruit

4-7 years
2
1
8-11 years
3
1
12-17 years
4
3
18 years and over
5
2


Note that the following modifications have been made to those presented in the Guidelines:
  • 18 year olds have been grouped with adults rather than the 12-17 year olds
  • pregnant or breastfeeding women have been applied the same cut-offs as adults.

Note that this section does not relate to calculations possible using foods reported as consumed in the 24-hour dietary recall in the NNPAS.

Salt

Respondents were asked whether salt was usually added to their meals during cooking, or to a meal at the table and whether the salt was iodised (i.e. containing iodine).

Respondents in the NNPAS were asked an additional question regarding type of salt added during cooking or at the table as part of the 24-hour dietary recall.

Milk

Respondents in the NHS were asked to report the main type of milk they usually drink:

  • cow's milk
  • soy milk
  • evaporated or sweetened condensed milk
  • other type of milk (specify)
  • don't drink milk.

The fat content of milk usually consumed (i.e. whole milk, reduced-fat, skim) was then reported for persons who drank milk. Categories included:
  • whole milk/regular/full cream (3% fat or more)
  • reduced fat e.g. Low/Lite/HiLo (around 1 or 2% fat)
  • skim e.g. Skinny/Shape/Fat Free (less than 1% fat).

Food avoidance

Respondents in the NNPAS were asked whether they had to avoid any particular foods because of food allergies or food intolerance. Foods included:
  • eggs
  • cow's milk/dairy
  • peanuts
  • fish
  • shellfish
  • tree nuts
  • soya
  • gluten (e.g. wheat, oats, barley and rye)
  • yeast
  • other.

More than one response was allowed. Some examples of ‘other’ foods included: spicy foods, specific fruit and vegetables, and foods containing preservatives.

Respondents were then asked whether they avoided any particular foods for cultural, religious or ethical reasons. Foods included:
  • meat
  • fish
  • poultry
  • pork
  • dairy
  • haram
  • beef
  • eggs
  • all animal products
  • other.

More than one response was allowed. Some examples of ‘other’ foods included: native animals, shellfish, red meat, and processed foods.

24-hour dietary recall

NNPAS respondents were asked to participate in a 24-hour dietary recall. This involved listing all the food and drink they had consumed in the last 24 hour period, from midnight to midnight the day prior to the interview. The aim of the 24-hour dietary recall is to estimate total intake of food, beverages, food energy, nutrients and non-nutrient food components consumed by the Australian population to assess dietary behaviours and the relationship between diet and health.

Where possible, approximately 9 days after the first interview, respondents were telephoned and asked to participate in a second 24-hour dietary recall.

More detailed information on the 24-hour dietary recall methodology and nutrient intake can be found in the Nutrition chapter of this Users' Guide.

Data items

The data items and related output categories for this topic are available in Excel spreadsheet format from the Downloads page of this product.

Interpretation

Points to be considered in interpreting data for this topic include the following:
  • Data recorded in the NHS on the type of milk usually consumed and the fat content of the main type of milk consumed is based on the information provided by respondents against a defined classification of milk type and fat content categories.
  • Questions on intake of fruit and vegetables are based on short questions used in the 1995 National Nutrition Survey (NNS). The questions are complex, as respondents needed to understand and apply the inclusions/exclusions, understand the concept of a serve and assess their consumption levels accordingly, and think about their total consumption in what would constitute a usual day. Interviewers were instructed to prompt/assist respondents in a standard way if necessary.
  • Inadequate fruit or vegetable consumption was derived in the 2011-12 surveys to assist users to determine whether vegetable and fruit consumption met the recommended guidelines. See: National Health and Medical Research Councils Australian Dietary Guidelines (2003). Respondents who did not meet the recommended guidelines for either fruit or vegetables were considered to have inadequate fruit or vegetable consumption.
  • The NHMRC Australian dietary Guidelines (2003) includes legumes as part of the daily recommended servings of vegetables, however the 2011-12 surveys excluded legumes.
  • There were a number of issues with data from the food avoidance due to allergy or intolerance question which has an impact on the accuracy of the data. Responses to the ‘other’ category indicated a high likelihood that the concept of allergy or intolerance was often not understood by respondents, and many respondents may have been recording foods avoided due to dislike for those foods rather than allergy or intolerance. This was despite interviewer training regard methods of probing to ensure the concepts were being correctly understood. During processing, obvious cases were removed. However many remain in the other category due to the possibility of legitimate responses. There were also a large number of unique responses recorded in the ‘other’ category for this item, more than any other fixed category and almost double those recorded in the next-most populous fixed category (fish). Caution should therefore be taken when examining this data, and in particular if analysing these responses in relation to data from the 24-hour dietary recall.
  • In 2013, the NHMRC released updated Australian Dietary Guidelines. The new guidelines have different recommended numbers of servings of fruit and vegetables. They have an additional age group of children aged two to three years, and more categories based on age and sex than the 2003 guidelines. Several age recommendations in the new guidelines also include half servings. For example, the recommended number of servings of fruit for boys aged 4-8 years is 1 .. Since questions in the 2011-12 surveys were developed before the release of these guidelines, they do not include half servings and therefore adherence to these new guidelines cannot be accurately assessed for some age groups. Note that the data item labelled 'Whether vegetable and fruit consumption met recommended guidelines' refers to the 2003 guidelines.

Comparability with 2007-08

Data for most common items are considered directly comparable between the 2011-12 and 2007-08 surveys. However when making comparisons the following should be noted:
  • The 2011-12 surveys collected information from persons aged 2 years and over, whereas in the 2007-08 NHS, information was collected for persons aged 5 years and over. Care should be taken to ensure that the correct population has been selected when making comparisons.
  • The 2007-08 NHS included legumes as part of the definition for a serve of vegetables, while the 2011-12 surveys excluded legumes.

The following items collected in 2011-12 surveys were not collected in 2007-08 survey:
  • salt added to food at cooking stage and whether iodised
  • salt added to food at table and whether iodised.

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