MEASURING THE CONSUMPTION OF FOOD GROUPS FROM THE AUSTRALIAN DIETARY GUIDELINES

INTRODUCTION

The 2013 Australian Dietary Guidelines (ADG) provide evidence-based guidance for all Australians on the amounts and types of foods and dietary patterns required for optimal health and wellbeing.¹ Whilst the ADG consist of five Guidelines (see Appendix 1), the major focus of this publication was to analyse consumption of foods groups within Guideline 2, referred to as the ‘Five Food Groups’ comprising:

• Grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties
• Vegetables and legumes/beans
• Fruit
• Milk, yoghurt, cheese and/or other alternatives, mostly reduced fat
• Lean meats and poultry, fish, eggs, tofu, nuts and seeds and legumes/beans
  

In addition to the recommendations of servings from the Five Food Groups, the ADG recommend drinking plenty of water and include small allowances for unsaturated spreads and oils.

The 2013 Australian Dietary Guidelines noted a lack of data relating to dietary intakes of Aboriginal and Torres Strait Islander peoples. This publication aims to fill this need and provide evidence to support policies designed to reduce health inequalities between Aboriginal and Torres Strait Islander and non-Indigenous people.

Using 2012-13 NATSINPAS data, this publication presents the population mean (average) consumption from each of the five food groups on a given day. The mean daily consumption of each food group is presented alongside the ADG recommended minimum servings for each age and sex group. While this comparison gives relevant context, it does not provide an indication of the proportion of people who would usually consume above or below the recommended minimum serves. Such an analysis requires modelled usual intake distributions, which have not been produced for this survey (see Explanatory Note 5).

A further objective is to break 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.


METHODS

Because many foods recorded within the 2012-13 NATSINPAS were mixed foods (e.g. a lasagne may contain meat, vegetables, cereal and dairy foods), it was necessary to create a new database specifying the amounts of each of the Five Food Groups for each of the approximately 5,700 unique foods in the NATSINPAS. Development of the ADG database was undertaken by Food Standards Australia New Zealand (FSANZ) who designed the protocol and classification for assigning proportions of foods to food groups. This database complements the underlying nutrient database (known as AUSNUT 2011-13) and may be accessed along with the detailed explanatory notes from the FSANZ website.²

Treatment of discretionary foods

The ADG (Guideline 3 in particular) provides clear advice that Australians should limit their intake of discretionary foods which are characterised as nutrient-poor and energy-dense and are often high in saturated fat, salt or added sugars.¹ Therefore, in order to be consistent with the Guidelines only foods that were classified as non-discretionary³ were included when reporting intakes of ADG food groups (regardless of whether those discretionary foods have ingredients that would otherwise be considered as belonging to the Five Food Groups). However, the ADG database distributed all AUSNUT foods into the Five Food Groups irrespective of whether the food was classified as non-discretionary or discretionary, and this information is used for some supplementary analyses estimating how many extra serves were consumed if the Five Food Group components within discretionary food were counted.

Age standardising

The Aboriginal and Torres Strait Islander population has a significantly younger age structure than the non-Indigenous population, which means that comparisons of characteristics which are strongly age-related (such as health conditions) will be influenced by the differing age structures. While age standardisation is commonly used in comparisons of the two populations’ health status, it may not be appropriate to apply to characteristics that are less clearly age related such as dietary behaviours (see Explanatory Note 6).

Reporting for persons aged 71 years and over

While the Guidelines provide recommendations for males and females aged 71 years and over, estimates for this age group are not presented separately in this publication, due to the high sampling error associated with the limited number of Aboriginal and Torres Strait people in the 71 years and over age group. However, people this age contribute to all applicable totals in text and tables, including within the accompanying data cube.

Reporting for pregnant and breastfeeding women

Unlike the analysis conducted on the total population in the April 2016 release of Australian Health Survey: Consumption of food groups from the Australian Dietary Guidelines, this release does not exclude pregnant and breastfeeding women as this information was not collected in the 2012-13 NATSINPAS.

Under-reporting

Analysis of the 2012-13 NATSINPAS suggests that, like other nutrition surveys, the results are affected by under-reporting. Therefore, estimates of the amounts of food groups consumed in this publication may be an underestimate of the true amounts consumed.

In order to assist in the interpretation of data from the 2012-13 NATSINPAS, particularly in comparisons with non-Indigenous estimates from the 2011-12 National Nutrition and Physical Activity Survey (NNPAS), there are a few key points that should be noted.

• It is likely that under-reporting is present in both surveys.
• There appears to be a greater level of under-reporting in the NATSINPAS than in the NNPAS.
• The proportion of Aboriginal and Torres Strait Islander people who were classed as Low Energy Reporters (LERs) increased with Body Mass Index (BMI) for both males and females, with females more likely to be LERs than males.

Given the association of under-reporting with overweight/obesity and consciousness of socially acceptable/desirable dietary patterns, under-reporting is unlikely to affect data for all foods and nutrients equally. As a result, no adjustment to the estimates has been applied and the results within this publication will be affected by under-reporting to differing degrees. Therefore, care should be taken when interpreting results in this publication. For more information on under-reporting, please see the Australian Aboriginal and Torres Strait Islander Health Survey Users’ Guide.


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 27/10/2016

2. For more information see Assessing the 2011-13 AHS against the Australian Dietary Guidelines - Classification System and Database Development Explanatory notes, available from: http://www.foodstandards.gov.au/science/monitoringnutrients/ausnut/

3. For more information on the development of the discretionary foods classification see the 4363.0.55.001 - Australian Health Survey: Users' Guide, 2011-13 available from: https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.007~2011-12~Main%20Features~Discretionary%20foods~700