Draft Australian Dietary Guidelines (PDF, 3MB) - Eat For Health

and moderate (not high) in carbohydrate are consistent with reduced risk of excessive weight gain.Energy from drinks, in particular, may add to total energy intake without displacing energyconsumed in the form of solid food, and it is plausible that energy-dense drinks may contribute toexcessive energy intake through lack of impact on satiety [771]. The satiety value of foods mayalso be important in managing appetite and hunger. Evidence suggests that protein-rich foods anddietary patterns have a greater effect on satiety than foods and dietary patterns high in fat andcarbohydrate [805].Energy-dense dietary patterns are associated with higher consumption of grain-based foods, fatsand sweets and lower consumption of vegetables and fruit [806]. International data suggest thatthe major foods contributing to increased energy intake include sweetened drinks, snack foodsand fast food [803, 807, 808] and that increasing portion size is also an important contributor[143, 809, 810]. The low cost of energy-dense nutrient-poor food relative to nutrient-dense foodis also a major contributor to the obesity epidemic [803, 806].Positive outcomes have been described, at least in the short term, in clinical weight loss regimesthat include both dietary and physical activity interventions [811, 812].4.4 Practical considerations: Achieving andmaintaining a healthy weightAs is the case internationally [714], overweight, obesity and associated health problems place asignificant economic burden on the Australian health care system. The total direct, indirect andsocial cost has been estimated at $37.7–$58.6 billion [6, 813] with direct costs estimated at $8–$21 billion [6, 814]. It is predicted that by 2023, the projected health expenditure for diabetes willhave risen $1.4 billion to $7 billion per year, due mostly to increasing weight gain [11].Intentional weight loss in overweight and obese individuals reduces the risk factors for mortalityand morbidity, and alleviates the symptoms of many chronic conditions [811, 812]. It is notnecessary to lose large amounts of weight to achieve substantial health gains. For example, aweight loss of 5kg in all people who are overweight or obese is estimated to reduce the nationalprevalence of type 2 diabetes by 15% [815]. Improving nutrition and/or increasing physical activityalso benefits health in a number of areas beyond weight control, such as bone strength, mentalhealth and immune function [2, 816].There is a need to provide guidance for the population on promotion of healthy weight, primaryprevention of overweight and obesity, weight maintenance, weight loss, and management ofweight-related conditions, disorders and diseases. A stepped approach to obesity prevention andmanagement is recommended (see Table 4.4) [710].DRAFT Australian Dietary Guidelines- December 2011 120