DRAFT Australian Dietary Guidelines - Eat For Health

4.2.1 Primary prevention
Diet and physical activity: The evidence from recent reviews of combined diet and physical
activity interventions for children suggests that these can prevent overweight and obesity (Grade
C, Section 22.1 in Evidence Report [14]) [761-765].
The evidence from primary prevention diet and physical activity interventions in adults also
suggests that these can prevent overweight and obesity (Grade C, Section 22.2 in Evidence Report
[14]) [766]. Lifestyle interventions combining diet and physical activity interventions are probably
associated with reduced risk of developing type 2 diabetes in adults (Grade B, Section 22.3 in
Evidence Report [14]) [761-765].
Favourable outcomes were consistently observed in interventions focusing on both reduced
energy intake and increased physical activity, supporting the previous evidence statements that
combined interventions assist weight loss and weight control in both children and adults [767].
4.2.1.1 Dietary patterns and specific foods and drinks
Fat: The previous dietary guidelines and many international public health organisations, including
the World Health Organization [685], emphasised the major role of fat consumption in the
development of obesity and of reducing fat intake in the dietary management of obesity or
overweight. More recently, WHO has shifted its emphasis, saying there is convincing evidence that
energy balance is critical to maintaining healthy weight and ensuring optimal nutrient intakes,
regardless of macronutrient distribution and percentage of total fat [768].
Sugar: No large long-term studies have measured the long-term development of overweight or
obesity specifically related to sugar consumption (Section 14.3, Evidence Report [14]). However,
recent evidence shows it is probable that consumption of sugar-sweetened drinks (soft-drinks) is
associated with increased risk of weight gain in adults and children (Grade B, Section 15.1 in
Evidence Report [14]) [448-459]. A later longitudinal study adds confirmation [769].
The literature review to inform the revision of the Dietary Guidelines for Americans, 2010 found
strong evidence that greater intake of sugar-sweetened drinks is associated with increased
adiposity in children and moderate evidence that consumption of sugar-sweetened drinks is
associated with increased body weight in adults [143]. Most of the relevant research (see Chapter
3) was conducted in the United States where, unlike Australia, fructose/high fructose corn syrup is
commonly used to sweeten soft drinks. Although these sweeteners differ only slightly from those
used commonly in Australia, this was taken into consideration in the grading of the Evidence
Statement for this guideline.
The review for the US guidelines also found strong and consistent evidence that glycaemic index
and/or glycaemic load are not associated with body weight and do not lead to greater weight loss
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