U NIT 3 O UTCOME 2: PROMOTING HEALTH IN A USTRALIA The role of Australia’s government in promoting healthy eating through; The information provided by nutrition surveys and how it is used The purpose of the Nutrient Reference Values (NRV’s) The Australian Guide to Healthy Eating and Dietary Guidelines Legislation developed by Food Standards Australia New Zealand (FSANZ) governing the safety and quality of foods.

THE AUSTRALIAN GOVERNMENT’S ROLE IN PROMOTING HEALTHY EATING Public Health Nutrition is addressed in various ways by both the Government and Non-Government organisations via; Health promotion activities (relating to food consumption and guiding nutrient intake) Strategies related to recommendations for healthy eating (Dietary Guidelines) Policy Development and legislation (Food Standards; Nutrition Labelling; nutrient and health claims)

Government has a major role in making Australia a healthier nation through Educating (Health promotion) Providing accurate information regarding health issues to consumers Research issues relating to health Collect data relating to health issues Create strategies to improve health status Create policy and guidelines reflecting the information gathered and in response to Australia’s situation

Promotion of healthy eating is important as a Measure to ensure optimal health for all Australians As a response to the national obesity epidemic As a preventative measure for future health concerns The costs of healthcare and days lost off work, the pressure of physical health and risks of obesity all highlight how important the healthy eating message is for Australians. Aussie kids eating too much added sugar -

FOOD CONSUMPTION AND NUTRITION SURVEYS Aim: Monitor and assess food consumption and related behaviour within the Australian population by conducting surveys and providing obtained information for food and nutrition-related programs and policy development. Collection of survey data: Food diary and records (daily record of all food consumed) Food list recalls (questionnaire listing major food items, participant recalls all foods purchased in a determined time period) Inventory methods Food accounts Telephone surveys

Examples of surveys National Children’s Nutrition and Physical Activity Survey National Children’s Nutrition and Physical Activity Survey Food Consumption Survey National Nutrition Survey Healthy Food Basket Survey Kids Eat, Kids Play Survey Being Active Eating Well Survey – MacKillop 2010 ACTIVITY : Fill in the table using p table

USES Assessment of dietary intakes, dietary trends and food consumption economics Development of policies for food assistance, foods labelling and food safety programs Implementation of dietary guidance and nutrition education programs Comparing collected data with dietary guidelines evidence of current nutritional situations and dietary inadequacies are able to be concluded Benchmarks are able to be set for future measurements and comparison of changes in the food consumption of Australians overtime Progress of achievements towards improving healthy eating can be measured Conclusions can be made about the effectiveness of current healthy eating promotion strategies Highlight population groups that may have special requirements/ suffering inadequacies in particular areas of nutrition (used to assist development of response strategies)

LIMITATIONS Collected information can have limited use as an indicator of health status unless combined with collection of other data Many surveys only relate to a 24 hr or ‘snapshot’ period (not reflective of overall food consumption) Inaccuracies – people not correctly reporting (dishonesty) Limited representation of certain groups within the population

OVERALL OBJECTIVE: Provide food and nutrient data to assist with the implementation of Australia’s ‘Food and Nutrition Policy’

NUTRIENT REFERENCE VALUES

NRVS outline the levels of intake of essential nutrients considered to be adequate to meet the known nutritional needs of practically all HEALTHY PEOPLE. They provide information about the amounts of nutrients required on an average daily basis for adequate physiological function and prevention of deficiency disease or chronic disease prevention. For each nutrient the NRV’s indicate the Estimated Average requirement (EAR) for people of different ages and genders and the Recommended Dietary Intake (RDI) which takes into account differences in metabolism and absorption. Designed for use by NUTRITION PROFESSIONALS

USESLIMITATIONS Used by health professionals (i.e. dieticians and doctors) to assess the likelihood of inadequate intake in individuals of groups Used in areas of research Meal planning or large scale catering (i.e. hospitals, aged-care facilities) Setting food policy and legislation Used in the development of food choice guides/ food labeling Recommendations are for generally healthy people in the population; therefore may be some people (i.e. elderly, preterm infants or those with specific medical conditions) for whom these recommendations are unsuitable. Do not take into account additional needs of individuals on medication or whose lifestyle may affect nutrient absorption (i.e. smokers (increased loses of Vit C and Vit D), high alcohol intake (displaces nutrients).

AUSTRALIAN GUIDE TO HEALTHY EATING

AGHE provides a conceptual framework for understanding the relationship between foods and nutrients Based on the RDI’s and the Dietary Guidelines Presented in a diagram which includes illustrations of a range of multicultural sample foods divided into 5 groups based on nutrient content. Provides information about the amounts and kinds of food that an individual needs to eat daily in order to obtain essential nutrients. Additional information contained in the guide discusses the 5 food groups, serve sizes, nutritional requirements, sample serves and information based on the needs for different population groups. Developed to improve the knowledge and skills base necessary for Australian's to select a healthier diet. (Guide fulfills one objective of the Food and Nutrition policy (1992).

PURPOSE: Provide information to individuals regarding the appropriate foods to choose to eat each day. USES: Can be used as a tool for activities that can be used by health and education professionals and the food industry to promote good nutrition in their work Includes activities such as the development of educational and public health programs, promotional messages, nutrition resources and healthy menus Can be used for patient and client counseling To improve the knowledge and skill base necessary for Australians to select a healthy diet. Used by the general community as an education tool to get information about appropriate foods to eat each day in order to obtain enough nutrients needed for good health.

STRENGTHSLIMITATIONS Separates fruits and vegetables based on their differing nutrient profile Recognizes that nutrient needs vary with age, sex, pregnancy and lactation. Includes water and ‘extras’ Culturally versatile Contemporary Information on serving sizes is in a separate area to the food guide If foods are not chosen carefully, then high intakes of fat, salt, sugar and insufficient fibre can still occur.

DESCRIPTION: 1.Eat enough food from each of the five food groups everyday Main food groups in the guide; Bread, cereals, rice, pasta, noodles Vegetables, legumes Fruit Milk, yoghurt, cheese (or substitutes i.e. soy) Meat, fish, poultry, eggs, nuts, legumes Guide provides a recommended number of serves of these foods (p 233). N.B. requirements/ number of serves differ for different age groups, life stage groups, and between men and women) 2.Choose different varieties of foods from within each of the five food groups from day to day, week to week and at different times of the year. 3.Eat plenty of plant food (bread, cereal, rice, pasta, noodles, vegetables, legumes and fruit); moderate amounts of animal foods (milk, yoghurt, cheese, meat, fish, poultry, eggs) in the proportions shown in the guides; and small amounts of the ‘extra’ foods and margarines and oils Each pie segment = visual representation of the recommended proportion of the diet to choose from each group. 4.Drink plenty of water Refer to pg for in-depth discussion

DIETARY GUIDELINES FOR AUSTRALIANS

The 3 rd Ed of the Dietary Guidelines for Australians was published by the NHMRC in 2003 along with the Dietary Guidelines for Children and Adolescents in Australia. AIM: To promote the potential benefits of healthy eating to reduce the risk of diet related disease To improve the community’s health and well-being throughout the lifespan. Play an important role in supporting and influencing broader strategies to improve nutrition outcomes in Australia.

DIETARY GUIDELINES FOR AUSTRALIAN ADULTS AIMED: at healthy adults May be useful for health professionals wanting to develop suitable diets for adults in other health circumstances (N.B. remember guidelines are for healthy people so many not satisfy the specific nutritional requirements of people with a disease) Guidelines apply to the total diet and are not designed to be used to asses the healthiness of individual food items Individual guidelines are not designed to be considered in isolation Not ranked in order of importance and each one is relevant to an issue that is key to optimal health Guidelines been developed based on current knowledge about the relationship between diet and disease USES: Provides basic nutritional advice for individuals To assist on the development of food models Dietary Guidelines for Children and Adolescents in Australia = Different

Review of the guidelines

STRENGTHSLIMITATIONS Promotes the potential benefits of healthy eating to educe the risk of diet related diseases and improve health across the lifespan Identifies major features of the Australian diet that need attention - fat, sugar, salt, fibre, alcohol intake Includes information about safe food handling and the importance of breastfeeding Provides a basis for the development of food models No set serving suggestions – the guidelines are broad: plenty, moderate, limit May be difficult for people with poor literacy skills to understand

FOOD STANDARD AND QUALITY LEGISLATION: Federal Government has overall responsibility for ensuring Australia has a safe food supply. The Government body Food Standards Australia New Zealand (FSANZ) has the responsibility for the food standards developed in Australia which AIM to; Ensure equitable access for all Australians to safe, nutritious and acceptable food including labeling laws for nutrient and health claims on food products.

FSANZ GOAL: Provide a safe food supply and well-informed consumers FSANZ AIM: To develop food regulations to educate the population about food choices RESPONSIBILITIES OF FSANZ: Developing standards for food manufacturing, labelling, processing and primary production Providing information to consumers to enable better consumer choice (free from inaccurate or misleading information) Coordinating national food surveillance, enforcement and food recall Conducting consumer and industry research Giving consumers advice on food handling Conducting research on and supporting the Australian Quarantine and Inspection Service (AQIS) in the control of imported foods. Undertaking dietary exposure modelling and scientific risk assessments Providing risk assessment advice on imported food Develops food standards that apply to Australia that address food safety issues (i.e. setting the minimum safety standards for primary production of food)

Food safety in Australia is achieved by the development and implementation of the FOOD STANDARDS CODE (a code that sets out the prescribed requirements (standards) that must be met for a food to be sold) Developed with 3 objectives Protect public health and safety Provide adequate information to consumers To prevent misleading and deceptive conduct FSANZ develops these standards by conducting extensive consultation with other regulatory bodies, with primary food producers and processors, manufacturers, retailers consumer advocate groups, public health bodies and other stakeholder groups. Code contains a list of food groups (i.e. cereals, eggs, meat, fish) and special purpose foods, describing exactly what each food must contain and nothing else for that food to be sold. General standards are defined for foods covering: Identity or description of the food Composition Nutrient value Permitted microorganism levels Way to measure quantitative qualities of the food Additional labeling requirements

FOOD LABELLING Food Standards Code include specific labelling requirements for all foods available for sale in Australia According to The Food Standards Code, the following must be clearly visible to the consumer on the label of all food products for consumer purchase; Name of the food or a description of the food Name and address of the manufacturer Mandatory allergy warning and advice information Ingredient list Net weight Nutritional information panel Use by or best before date Country of origin Lot number Percentage labelling Food additives By law a label must tell the truth and not provide misleading information/ deceive consumers

NUTRIENT AND HEALTH CLAIMS ON FOOD LABELS In Australian NUTRIENT CLAIMS (a statement that sets out in general terms the nutritional consequences for good health of the intake of a nutrient) are ALLOWED to be printed on food labels and used in product advertising, however current regulations PROHIBIT the use of HEALTH CLAIMS (a direct connection between consuming a food product or nutrient found in the food and the decreased risk of a specific disease) PERMITTED NUTRIENT CLAIMS: Calcium is good for strong bones and teeth Absence of or low level of a nutrient in a product i.e. low in cholesterol Such claims are regulated and must meet specific criteria in order to makes such claims Criteria must also exist for how much energy, saturated fat, sodium, sugar, fibre and amounts of fruit there are in food Criteria must be met in order for any claims to be made on food labels

HEALTH CLAIMS – make a direct connection between the consumption of the food product and the potential decreased risk of a specific disease or health condition. At present the only health claim permitted in Australia is the benefit of FOLATE before and during pregnancy in the protection of neural tube defects such as spina bifida in babies.

N.B. VCAA: Unit 3 1.How much detail do we need to cover in relation to Nutrient Reference Values (NRV)? NRV are referred to in the key knowledge in Unit 3, Area of Study 2 in the context of the role of Australia’s governments in promoting healthy eating. In particular the key knowledge states: the purpose of the Nutrient Reference Values to guide dietary intake Teaching about the NRV should focus on: What are the NRV and what are they used for? Who uses the NRV? How are the NRV related to other nutritional tools such as those referred to in the subsequent points of the key knowledge, including the Australian Guide to Healthy Eating, Dietary Guidelines and food legislation such as food labelling? Teaching about the NRV should not focus on: Specific definitions of each of the individual measures that make up then NRV, such as EAR, RDI, AI etc. How individual nutrient requirements change across the lifespan. How the NRV are different from the previous RDI.

REFERENCE LIST: Australian Government Department of Health and Ageing, National Health and Medical Research Council (NHMRC). (2006). Nutrient Reference Values for Australia and New Zealand. Including Recommended Dietary Intakes. Canberra, Commonwealth of Australia. Retrieved from ns/synopses/_files/n36.pdf ns/synopses/_files/n36.pdf Goodacre, S. Collins, C. & Slattery, C. (2010). VCE Health and Human Development Units 3 & 4. New York, NY: Cambridge University Press.

PRACTICE EXAM QUESTIONS: Give one example of how nutrition survey statistics are used. How can the Dietary Reference Values be used to guide dietary intake? List the Dietary Guidelines for Australian Adults? Nutrient Reference Values are one tool used by the Federal Government to promote healthy eating. Identify the limitations in the use of the NRVs in determining nutritional status. Outline the vision and mission of FSANZ? Give an example of legislation developed by FSANZ to govern the safety of food in Australia.