DIETARY BEHAVIOURS

Definition

The 2014-15 NHS collected data on the following dietary indicators:

• Main type of milk usually consumed
• Fat content of main type of milk usually consumed
• Usual daily serves of vegetables
• Vegetable consumption increased or decreased since same time last year
• Usual daily serves of fruit
• Fruit consumption increased or decreased since same time last year
• How often salt is used in household for cooking or preparing food
• Whether salt used in cooking or preparing food is iodised
• How often salt is added to food at table
• Whether salt added to meal at table is iodised.

Population

Information was obtained for persons aged 2 years and over in the 2014-15 NHS.

Methodology

Information about dietary behaviours was published in the National Health Survey: First Results, 2014-15 based on a sample of 18,594 people aged 2 years and over.

Milk

Respondents were asked to report the main type of milk they usually drink (shown on a prompt card):

• Cow's milk
• Soy milk
• Evaporated or sweetened condensed milk
• Other type of milk - specify.

Persons who drank milk were then asked the fat content off the milk they usually consume. Categories included (shown on a prompt card):

• Whole milk/regular/full cream (3% or more)
• Reduced fat e.g. Low/Lite/HiLo (around 1 or 2%)
• Skim e.g. Skinny/Shape/Fat Free (less than 1% )

Vegetables and Fruit

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

Definition

A serve of vegetables was defined as about 75 grams or (shown on a prompt card):

• 1/2 cup cooked green or orange vegetables (for example, broccoli, spinach, carrots or pumpkin) - including frozen or tinned
• 1/2 cup cooked dried or canned beans, peas or lentils
• 1 cup green leafy or raw salad vegetables
• 1/2 cup sweet corn - including frozen or tinned
• 1/2 medium potato or other starchy vegetables (sweet potato, taro or cassava).

All types of vegetables were included, e.g. potatoes, salads, stir-fried vegetables, as well as prepared (cooked) legumes such as kidney beans. Tomatoes were included as a vegetable rather than a fruit.. Baked beans were excluded.

A serve of fruit was defined as about 150 grams or shown on a prompt card):

• 1 medium apple, banana, orange or pear
• 2 small apricots, kiwi fruits or plums
• 1 cup of diced or canned fruit
• 30g dried fruit (for example, 4 dried apricot halves, 1 1/2 tablespoons sultanas)

All types of fruit were included, e.g. fresh, dried, frozen and tinned.

Fruit and vegetable drinks or beverages were excluded.

Prompt cards were used to assist respondents in understanding the concept of a serve (these may be downloaded from the Downloads tab). 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 were also asked whether their usual vegetable and fruit consumption had increased, decreased or stayed the same since this time last year.

Whether Vegetable and Fruit Consumption Met 2013 National Health and Medical Research Council (NHMRC) Australian Dietary Guidelines

Whether vegetable and fruit consumption met the recommended guidelines was derived for respondents aged 2 years and over according to the following numbers of servings (based on recommendations from the National Health and Medical Research Council's (NHMRC) Australian Dietary Guidelines (2013)).

	Age group (years)
Recommended serves per day	2-3	4-8	9-11	12-13	14-18	19-50	51-70	71 years and over
Fruit
nnnn Males	1	1.5	2	2	2	2	2	2
nnnn Females	1	1.5	2	2	2	2	2	2
Vegetables
nnnn Males	2.5	4.5	5	5.5	5.5	6	5.5	5
nnnn Females	2.5	4.5	5	5	5	5	5	5
Interpretation of Half Serves in the Australian Dietary Guidelines Several age recommendations in the 2013 guidelines also include half servings. For example, the recommended number of servings of fruit for boys aged 4-8 years is 1 ½.. However, as the 2014-15 NHS collected usual daily serves in whole serves, in the National Health Survey: First Results, 2014-15, half serves were rounded up to the nearest whole serve for published data. For example, for a 4-8 year old boy to meet the recommended daily intake of fruit, he would need to eat 2 serves of fruit. The data items affected by this include: Whether vegetable consumption met recommended guidelines (2013 NHMRC guidelines) Whether fruit consumption met recommended guidelines (2013 NHMRC guidelines) Whether fruit and vegetable consumption met recommended guidelines (2013 NHMRC guidelines). For the age/sex groups which include half serves in the 2013 recommendation, analysis is presented below to demonstrate the effect of rounding half serves up or down on the proportion who would meet the 2013 fruit and vegetable guidelines. There were greater differences for vegetable consumption than for fruit consumption. The difference was more apparent among children under the age of 8 years, for whom half serves made up a significant proportion of the total recommended daily serves. The effect was similar for both males and females. PROPORTION WHO MET THE 2013 VEGETABLE GUIDELINES Age group (years) Half serves rounded up (as published) (%) Half serves rounded down (%) Males 2-3 19.1 42.5 4-8 2.7 8.5 12-13 1.0 3.6 14-18 2.6 4.9 51-70 3.5 9.7 Females 2-3 20.7 45.8 4-8 4.5 10.2 Persons 2-3 20.0 44.8 4-8 3.3 8.8 PROPORTION OF CHILDREN AGED 4-8 YEARS WHO MET THE 2013 FRUIT GUIDELINES Half serves rounded up (as published) (%) Half serves rounded down (%) Males 72.9 95.6 Females 73.8 97.2 Persons 73.1 96.8 Whether Vegetable and Fruit consumption Met 2013 National Health and Medical Research Council (NHMRC) Australian Dietary Guidelines

Whether vegetable and fruit consumption met the National Health and Medical Research Council's (NHMRC) Australian Dietary Guidelines (2003) was also derived on the 2014-15 NHS (although not published) for respondents 4 years and over according to the following numbers of servings.

	Age group (years)
Recommended serves per day	4-7	8-11	12-17	18+
Fruit
nnnn Males	1	1	3	2
nnnn Females	1	1	3	2
Vegetables
nnnn Males	2	3	4	5
nnnn Females	2	3	4	5

Comparison Between Self Reported and Actual (Based on 2 Day Dietary Recall) Vegetable and Fruit Intake

Analysis of the 2011-12 National Nutrition and Physical Activity Survey (NNPAS) was conducted to determine the relationship between respondents' self reported usual intake of fruit and vegetables, and their actual intake based on a two day average of a 24 hour dietary recall. Overall, there was a moderate correlation between the variables indicating that respondents who reported usually consuming a greater number of serves were more likely to also have actually consumed a greater number based on the average of their two 24 hour recall intakes. On average, people who reported that their usual daily vegetable consumption was two serves or less tended to underestimate their intake, with their actual consumption serves being higher. On the other hand, people who reported a usual daily vegetable consumption of 3 serves or more tended to overestimate their intake, with their consumption being lower. Women tended to overestimate their usual daily vegetable consumption more than men. Similarly usual daily vegetable consumption by children and young people aged 2-18 years tended to be overestimated more than that of adults.

People who reported a usual daily fruit consumption of less than one, or one serve tended to accurately estimate their intake, with their actual serves being just under or just over one serve. People who reported they usually consumed 2 or more serves of fruit per day tended to overestimate their intake, with their actual serves being lower. Women tended to overestimate their usual daily fruit consumption more than men. The relative degree of overestimation of daily fruit consumption was similar across all age groups.



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).

Data items

The questionnaire, data items and related output categories for this topic are available in pdf/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 2014-15 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 2014-15 NHS to assist users to determine whether vegetable and fruit consumption met the recommended guidelines. See: National Health and Medical Research Council's Australian Dietary Guidelines (2013). Respondents who did not meet the recommended guidelines for either fruit or vegetables were considered to have inadequate fruit or vegetable consumption.

Comparability with 2011-12

When making comparisons between 2014-15 and 2011-12 data it is recommended that:

• Where possible, comparisons are made using the Australian Health Survey: Updated Results, 2011-12 (cat. no. 4364.0.55.003) and Microdata: Australian Health Survey, Core Content - Risk Factors and Selected Health Conditions, 2011-12 (cat. no. 4324.0.55.003) for the most accurate information.
• For comparison of 2014-15 data with items which were only collected in the 2011-12 NHS, the Australian Health Survey: First Results, 2011-12 (cat. no. 4364.0.55.001) and Microdata: Australian Health Survey, National Health Survey, 2011-12 (cat. no. 4324.0.55.001) are used.

When making comparisons the following should be noted:

• There were significant differences between the prompt cards used in 2014-15 and 2011-13 AHS to assist respondents in determining the size of a serve of fruit or vegetables. This may have had some impact on the comparability of the data.
• The 2014-15 NHS included prepared (cooked) legumes such as kidney beans (but excluded baked beans) as part of the definition for a serve of vegetables, while the 2011-13 AHS excluded legumes such as baked beans and kidney beans.

New items derived for the 2014-15 NHS included:

• Whether vegetable consumption met recommended guidelines (2013 NHMRC guidelines)
• Whether fruit consumption met recommended guidelines (2013 NHMRC guidelines)
• Whether fruit and vegetable consumption met recommended guidelines (2013 NHMRC guidelines),

These items are not comparable with the estimates published in Australian Health Survey: Updated Results, 2011-12 (cat. no. 4364.0.55.003) because the 2014-15 items are based on the 2013 guidelines, whereas the 2011-13 AHS uses the 2003 guidelines.

Consumption of Food Groups from the Australian Dietary Guidelines

In May 2016, the ABS released the Australian Health Survey: Consumption of Food Groups from the Australian Dietary Guidelines, 2011-12 (cat. no. 4364.0.55.012). This publication uses the 2011-12 National Nutrition and Physical Activity Survey (NNPAS) to present data showing the population’s usual consumption from each of the food groups and make comparisons with the recommended servings in the ADG for each age and sex group. A further objective is to break down the Five Food Groups into sub-groups to examine the relative contribution of those groups and also look at the form in which the foods were consumed.