Guidelines Dietary - Eat For Health

Evidence statementBabies born to mothers who smoke during pregnancy are at an increased risk of development of overweight or obesity inadolescence and adulthood.GradeBGuideline 1Combined diet and physical activity interventions are associated with reduced risk of overweight and obesity in children.Combined diet and physical activity interventions are associated with reduced risk of overweight and obesity in adults.Consumption of vegetables is associated with reduced risk of weight gain.Consumption of fruit is associated with a reduced risk of obesity and weight gain.Hours spent watching television by children is associated with increased risk of development of overweight or obesity.In developed countries, a low family income or socioeconomic status is associated with increased risk of overweight or obesityduring childhood, adolescence, and young adulthood.Low socioeconomic status is associated with an increased risk of overweight or obesity.Interventions delivered in the school environment that are focused on eating and physical activity improve weight outcomesin children.CCCCCCCCNotes: Grades – A: convincing association, B: probable association, C: suggestive associationIncludes evidence statements and gradings from the Evidence Report (literature from years 2002–2009). Does not include evidence fromother sources, such as the 2003 edition of the dietary guidelines (in which individual studies were classified according to their design aslevel I, II or III but overall grades for relationships were not derived), although these sources have been used to inform these Guidelines.Grade C evidence statements showing no association and all Grade D statements can be found in Appendix E.1.2.1 Primary and secondary preventionFavourable outcomes have been consistently observed in interventions focusing on both reduced energy intakeand increased physical activity, supporting the evidence statements that combined interventions assist weightmanagement in children, adolescents and adults.• Adults: There is evidence that diet and physical activity interventions in adults can prevent overweight andobesity (Grade C; Evidence Report, Section 22.2). 171 Lifestyle interventions combining diet and physical activityinterventions are probably associated with reduced risk of developing type 2 diabetes in adults (Grade B;Evidence Report, Section 22.3). 171 For further information, see the NHMRC Management of overweight andobesity in adults, adolescents and children (NHMRC Overweight and Obesity Guidelines). 121• Children and adolescents: Recent reviews of combined diet and physical activity interventions for children andadolescents suggest that these can prevent overweight and obesity (Grade C; Evidence Report, Section 22.1). 172-175There is convincing evidence that behavioural interventions including diet and physical activity reduce the riskof obesity in overweight children – these interventions are more effective when they are family-based (GradeA; Evidence Report, Section 17.12). 176-179 Recent evidence suggests that interventions delivered in the schoolenvironment that focus on healthy eating and physical activity improve weight outcomes in children (Grade C;Evidence Report, Section 17.1). 180,181 There is a limited amount of quality data on specific components of thecombined programs in treating overweight and obesity; however, the results of combined programs indicatesignificant and clinically meaningful reductions in the level of overweight in obese children and adolescents. 182,1831.2.2 Dietary patterns and specific foods and drinksThere is increasing evidence that consumption of specific foods and food groups is associated with risk of excessweight gain, while other food types are associated with a reduced risk of weight gain.• Fat: The 2003 edition of the dietary guidelines and many international public health organisations, includingthe World Health Organization (WHO), 98 emphasised the major role of fat consumption in the development ofoverweight and obesity and of reducing fat intake as part of management. More recently, WHO has shiftedits emphasis, stating that there is convincing evidence that energy balance is critical to maintaining healthyweight and ensuring optimal nutrient intakes, regardless of macronutrient distribution. 184 Although no specificmacronutrient may be responsible for the development of obesity, the proportion of macronutrients in the dietdoes influence energy and nutrient intake, which may impinge on weight management and health outcomes.Achieve and maintain a healthy weightNational Health and Medical Research Council19