MILK, YOGHURT, CHEESE AND ALTERNATIVES

Certain dairy products and their non-dairy alternatives are an essential component of a healthy diet. Milk, cheese and yoghurt are rich sources of calcium, protein, vitamins and minerals. The Australian Dietary Guidelines (ADG) recommends choosing low fat varieties for everyone over two years as full fat varieties can increase the saturated fat content of the diet and reduced fat varieties enable nutrient guidelines to be met without exceeding energy requirements. Full fat varieties are recommended for children under two.¹

Alternatives are available for those who avoid dairy. Products such as calcium-enriched soy or rice drinks count towards the serves in this food group. Other products high in calcium such as almonds, tofu, seafood, fish with bones and many plant foods may also be consumed as alternatives but are not included in this analysis for the milk, yoghurt, cheese and alternatives food group.²

A key finding from previous analysis of nutrition data from the Australian Health Survey was that nearly three quarters of females (73%) and half of all males (51%) aged two years and over did not meet usually meet their Estimated Average Requirements (EAR) for calcium from foods and beverages (see Australian Health Survey: Usual Nutrient Intakes, 2011 12, cat. no. 4364.0.55.008).

How much is a serve of milk, yoghurt, cheese and alternatives*?¹

A standard serve is (500-600 kJ) or:

• 1 cup (250 ml) fresh, UHT long life, reconstituted powdered milk or buttermilk
• ˝ cup (120 ml) evaporated milk
• 2 slices (40 g) of hard cheese, such as cheddar
• 3/4 cup yoghurt

*Choose mostly reduced fat


HOW MANY SERVES OF MILK, YOGHURT, CHEESE AND ALTERNATIVES WERE CONSUMED?

In 2011-12, Australians aged two years and over consumed an average 1.5 serves of dairy and/or alternatives per day, with children aged 2-3 years being the highest consumers (1.9 serves per day) and people aged 71 years and over consuming the least with an average 1.2 serves per day. Males generally consumed slightly more than females, although the only statistically significant difference was for 14-18 years and 19-50 years where males on average consumed an extra 0.3 and 0.4 serves respectively compared with females.

(a) Based on Day 1. See Glossary for definition.
(b) From non-discretionary sources.
Source: National Nutrition and Physical Activity Survey, 2011-12.

HOW MANY PEOPLE MET THE RECOMMENDED NUMBER OF MILK, YOGHURT, CHEESE AND ALTERNATIVES SERVES?

The ADG recommends greater amounts (3˝ serves) be consumed in adolescence (12-18 years) and also in older adulthood (3˝ serves for males 71 years and over and 4 serves for females aged 51 years and over).

A comparison of the usual number of serves consumed against the recommendations shows that around one in ten (10%) Australians consumed sufficient dairy products and/or alternatives to meet the recommendation. Children aged 2-8 years were most likely to meet the recommendation (43%) while 6.4% of people aged 9 years and over were able to do so, including less than 1% of people aged 71 years and over.

Age group (years)	Recommended minimum (a)		Median (b)		Proportion meeting recommendation (b)
	Serves		Serves		%
	Males	Females	Males	Females	Males	Females
2-3	1˝	1˝	1.9	1.7	70.0	60.3
4-8	2	1˝	1.5	1.3	26.3	40.2
9-11	2˝	3	1.5	1.5	12.0	3.9
12-13	3˝	3˝	1.7	1.4	3.9	1.8
14-18	3˝	3˝*	1.6	1.1	2.5	0.5
19-30	2˝	2˝*	1.6	1.3	13.9	6.0
51-70	2˝	4	1.2	1.2	5.4	0.1
71 +	3˝	4	1.2	1.2	0.5	0.1
(a) National Health and Medical Research Council, 2013, Australian Dietary Guidelines https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55_australian_dietary_guidelines_130530.pdf (b) From non-discretionary sources Source: National Nutrition and Physical Activity Survey, 2011-12 *For pregnant women up to 18 years of age the recommended usual intake of dairy is 3 ˝ serves and 4 serves for breastfeeding women of the same age. For pregnant and breastfeeding women 15-50 years, the recommended usual intake of dairy is 2˝ serves. However, both the pregnant and breastfeeding populations have been excluded from this analysis.

… Young children 2-8 years

Almost two-thirds (65%) of the 2-3 year olds consumed the recommended 1˝ serves of dairy and alternatives per day, including one in five who usually consumed 2˝ or more serves per day. Among the 35% who did not meet the recommendation, the majority (23%) were only half a serve or less below the guidelines. While the recommended number of serves for 4-8 years females is the same as the 2-3 year olds, the 4-8 year old females consumed half a serve or less on average than their younger counterparts, resulting in a minority (40%) who met the recommended minimum of 1˝ serves.

The recommendation for males aged 4-8 years is 2 serves per day (half a serve more than for the 2-3 years male age groups), yet they consumed slightly less (0.2 serves) on average, leaving just over one-quarter (26%) meeting the recommended 2 serves. However, a further 25% fell short by only half a serve or less than the recommended 2 serves.

(a) Usual intake. See Glossary for definition.
(b) From non-discretionary sources.
Source: National Nutrition and Physical Activity Survey, 2011-12.

… Children and adolescents 9-18 years

Less than 10% of children aged 9-11 years met the recommended 2˝ (for males) and 3 serves (females) per day. Half of the 9-11 year olds had less than 1˝ serves, including around one-quarter who usually had less than 1 serve per day.

The recommendation for adolescents aged 12-18 years is 3˝ serves per day. However, less than two percent consumed that amount, with the great majority (68% of males and 83% of females) usually having less than 2 serves per day and only the top 12% of consumers having 2˝ or more serves.

(a) Usual intake. See Glossary for definition.
(b) From non-discretionary sources.
Source: National Nutrition and Physical Activity Survey, 2011-12.

… Adults 19 years and over

Overall, 14% of males and 6% of females aged 19-50 years usually consumed the recommended 2˝ serves of milk, yoghurt, cheese or alternatives per day. Half of males and females this age usually had less than 1.6 and 1.3 serves respectively, and around one-fifth of males and one-third of females usually consumed less than 1 serve per day.

At age 51-70 years, the recommended serves for males and females is 2˝ and 4 serves per day respectively. Around 5% of the males and less than 1% of females consumed their respective recommended number of serves, with around two-thirds of both males and females getting less than 1˝ serves.

(a) Usual intake. See Glossary for definition.
(b) From non-discretionary sources.
Source: National Nutrition and Physical Activity Survey, 2011-12.

The ADG recommend that males and females aged 71 years and over consume 3˝ and 4 serves respectively. However, less than 1% of either males or females achieved the recommendation on a usual basis and half the male and female population aged 71 years males consumed less than one third of the recommendation, including around one third of males and females who usually consumed less than 1 serve per day.

(a) Usual intake. See Glossary for definition.
(b) From non-discretionary sources.
Source: National Nutrition and Physical Activity Survey, 2011-12.

AMOUNTS FROM MILK, YOGHURT CHEESE AND ALTERNATIVES

The greatest proportion of serves on average come from dairy milk with 62% or 0.9 serves to the total non-discretionary milk, yoghurt, cheese and alternatives consumed. This was followed by cheese (29%), yoghurt and dairy snacks (7.9%) with less than 2% from dairy alternatives (such as calcium enriched soy and rice drinks).

(a) Based on Day 1. See Glossary for definition.
(b) From non-discretionary sources.
(c) Includes dairy snacks such as custard and fromage frais.
Source: National Nutrition and Physical Activity Survey, 2011-12.

The majority (68%) of the milk consumed was in beverages (including 14% in café style coffee) with a further 26% was added to breakfast cereals.

The cheese contributing to the total non-discretionary milk, yoghurt, cheese and alternatives was most commonly consumed in sandwiches, rolls and on toast (42%). A further 12% was in (non-discretionary) pizza while 20% was consumed alone and not consumed as part of mixed dish or combined with other food, with the remainder being consumed in other mixed dishes and combinations.

… Higher, medium and lower fat varieties³

The ADG recommends choosing reduced fat varieties of milk, yoghurt, cheese and alternatives for everyone over two years on most occasions in order to ensure nutrient requirements are met without exceeding energy requirements. The lower fat sub-group (defined as including reduced fat milk and other products having less than 4 g of fat per serving)⁴ made up 29% of all non-discretionary serves of the milk, yoghurt, cheese and alternatives group, but was generally a higher proportion among females than males (34% compared with 25%). The contribution of the lower fat relative to medium and higher fat choices was also closely associated with age, with the young children having 15% (2-3 year olds) and 19% (4-8 year olds) lower fat varieties, compared with 36% and 39% among people aged 51-70 years and 71 years and over, respectively. This pattern reflects the tendency for people to increasingly choose reduced fat milk and yoghurts in older age groups. For example, around half (49%) of milk consumed by people aged 51 years and over was reduced fat compared with 16% and 23% for the 2-3 and 4-8 year olds, respectively.

(a) Based on Day 1. See Glossary for definition.
(b) From non-discretionary sources.
(c) Includes mostly cheese and yoghurt with fat content greater than 10 g per 100 g.
(d) Includes reduced fat milk and alternatives plus yoghurt and cheese with fat content between 4 g and 10 g per serve.
(e) Includes reduced fat milk and alternatives plus yoghurt and cheese with fat content less than 4 g per 100 g.
Source: National Nutrition and Physical Activity Survey, 2011-12.

Medium fat products (defined as regular fat milk plus other products with a fat level between 4 to 10 g per serve) made up the largest share with 43% of the milk, yoghurt, cheese and alternatives food group. The contribution from medium fat product sub-group changes with age and food consumption patterns, for example, for younger age groups the relatively high consumption of the medium fat product sub-group compared to other age groups results in a low percentage contribution from reduced fat products.

The Higher fat component of the milk, yoghurt, cheese and alternatives group is almost entirely (99%) made up of cheese and contributed 28% of all the non-discretionary milk, yoghurt, cheese and alternatives food group. The slightly higher contribution among 14-18 year olds (30%) in part reflects a relatively low contribution from medium and lower fat products (e.g. milk and yoghurt) as the absolute amount of cheese (0.45 serves) was not significantly higher than overall (0.42 serves).


DISCRETIONARY SOURCES

The ADG recommendations for serves of the milk, yoghurt, cheese and alternatives group does not include food sources flagged as discretionary, however, if such foods were counted as contributing to the ADG milk, yoghurt, cheese and alternatives group, the average number of serves would be boosted from 1.5 to 1.7.⁵ The age group with the highest potential contribution from discretionary sources of dairy and alternatives were children and adolescents 9-18 years, where the increase from discretionary sources would be from 1.5 to 2 serves.⁵

(a) Based on Day 1. See Glossary for definition.
Source: National Nutrition and Physical Activity Survey, 2011-12.

The most common discretionary sources of milk, yoghurt, cheese and alternatives were ice cream (24%), chocolate and chocolate-based confectionary (19%), high saturated fat pizza (9%) and cakes/ muffins/ scones and cake-type desserts (6%).
ENDNOTES

1. National Health and Medical Research Council, 2013, Australian Dietary Guidelines. Canberra: Australian Government. <https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55_australian_dietary_guidelines_130530.pdf >, Last accessed 05/05/2016
2. The ADGs also lists several foods that are likely to contain a similar amount of calcium as a serve of milk, yoghurt or cheese. However, as these alternatives are all classified elsewhere they have not been included within ‘dairy alternatives’. For more information, please see AHS ADG Classification system Explanatory Notes.
3. Lower fat products include reduced fat and skim milk, and yoghurt with less than 4g/100 g of fat. Higher fat dairy products include cheese and yoghurt with a fat content of greater than 10g/100 g. Medium fat products include cheese and yoghurt with a fat content between 4g and 10 g per 100 g. This group also includes regular fat milk, which although mostly has a fat level less than 4 g per 100 g, was included in medium fat to be consistent with the ADG modelling and recommendations. See AHS ADG Classification system Explanatory Notes.
4. National Health and Medical Research Council, 2011, A modelling system to inform the revision of the Australian guide to healthy eating, Canberra: Australian Government <https://www.eatforhealth.gov.au/sites/default/files/files/public_consultation/n55a_dietary_guidelines_food_modelling_111216.pdf>, Last accessed 05/05/2016
5. May not necessarily add to total due to rounding.