Guidelines Dietary - Eat For Health

Food intake, diet and nutritional statusThe available evidence suggests that, traditionally, Aboriginal and Torres Strait Islander peoples were fit andhealthy. The traditional diet appears to have been low in energy density but high in nutrient density – high inprotein, low in sugars, high in complex carbohydrate, and high in micronutrients. Energy expenditure appearsto have been high. 28,1002-1006With the transition from a traditional hunter-gatherer lifestyle to a settled Westernised existence, the diet ofAboriginal and Torres Strait Islander people has generally changed to an energy-dense diet that is high in fat andadded sugars. 311,1005,1006 The diet is also poor in fibre and certain nutrients including folate, retinol, vitamin E andother vitamins. 352In 2004–2005, 24% of Aboriginal and Torres Strait Islander people aged 15 years and over reported they ran outof food in the last 12 months, compared to 5% of non-Indigenous Australians. 988 While Aboriginal and Torres StraitIslander people living in remote areas were more likely to report having run out of food in the last 12 months(36%), this figure was also high for those in non-remote areas (20%) and ranged from 18% in New South Walesto 45% in the Northern Territory. 988 Women are at extra risk, partly because there is a cultural predispositionfor women to feed men and children before themselves. 961 Psychological suffering due to food insecurity canexacerbate feelings of exclusion, social disruption to family life and in some cases, anxiety about possible lossof custody of children. 1007There is very little recent dietary and nutrition data available for Aboriginal and Torres Strait Islander communities.Self-reported intakes of fruit and vegetables described in the 2004–05 NATSIHS are much higher than would beexpected from more reliable, objective data. 7,352,353,440Aboriginal people living in remote communitiesDietary intakes in remote Aboriginal communities have been consistently measured to be high in refinedcarbohydrates and low in fresh fruit and vegetables. 352,353,440 Foods with high energy density were associatedwith lower costs, contributing disproportionately to energy availability and limiting the capacity of people livingin these communities to attain a healthy diet. 353,1008 Food supply is an ongoing issue 1008 with people in rural andremote areas paying at least 30% more for basic nutritious foods than people living in urban and metropolitanareas. 317,1009-1014 Basic food items are less available in the more remote stores, as are fresh vegetables and fruitsand better nutritional choices. 317 The quality of dietary intake has been shown to vary in close association withthe income cycle in remote Aboriginal communities. 1015,1016In some communities purchased food intake is supplemented by procurement of traditional foods. In the 1994National Aboriginal and Torres Strait Islander Survey – the last time these questions were asked – 10% ofrespondents aged over 14 years reported spending more than 1 hour a week hunting or foraging for traditionalfoods and, of these, more than half reported spending more than 5 hours a week doing so. 983 Even thoughthe actual intake of traditional foods may be low in some areas, traditional foods are still popular and culturallyimportant for Aboriginal and Torres Strait Islander peoples. 7,1009,1017-1019Aboriginal and Torres Strait Islander people living in urban areasOnly limited dietary data are available for Aboriginal and Torres Strait Islander groups in urban areas. High foodcosts, poor access to nutritious foods, convenience of take-away foods, budgeting issues, overcrowding, andpoor knowledge and skills have been identified as barriers to healthy eating in these areas and can lead to foodinsecurity and overconsumption of energy-dense nutrient-poor foods and drinks. 1007,1020-1022Recommendations specific to Aboriginal and Torres Strait Islander peoplesThe general Australian dietary guidelines are relevant to Aboriginal and Torres Strait Islander peoples. 353,440,1023-1026In particular, increased consumption of vegetables and fruits could be expected to improve the health andnutritional status of Aboriginal and Torres Strait Islander people.Lactose intolerance after the age of 3–5 years may, however, be problematic in some areas or for someindividuals. 610,611 Alternative calcium sources such as chewing meat and fish bones, and consumption of small,soft fish bones (e.g. in tinned salmon), and low-lactose dairy foods (such as matured cheese and yoghurt) arerecommended in these cases.Consumption of traditional bush foods should be supported wherever possible, although intake of some highsaturated fat marine animal foods, such as dugong, should be limited, as was the case traditionally. 1027 In addition,there may be a problem with high levels of heavy metals in the organ meat of turtle and dugong. 1028106EAT FOR HEALTH – australian dietary guidelinesNational Health and Medical Research Council