Guidelines Dietary - Eat For Health

Guideline 1• Sugar: No large long-term studies have measured the long-term development of overweight or obesityspecifically related to consumption of added sugars (Evidence Report, Section 14.3). However, recent evidenceindicates that it is probable that consumption of sugar-sweetened drinks (soft drinks) is associated withincreased risk of weight gain in adults and children (Grade B; Evidence Report, Section 15.1), 185-196 a findingconfirmed by a later longitudinal study. 197• Sugar-sweetened drinks: 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 increasedadiposity in children and moderate evidence that consumption of sugar-sweetened drinks is associated withincreased body weight in adults. 198 Most of the relevant research (see Section 3.3.2) was conducted in the USwhere, unlike Australia, corn syrup containing fructose is commonly used to sweeten soft drinks. Althoughthese sweeteners differ only slightly from those used commonly in Australia, this was taken into considerationin grading the relevant evidence statement.• Glycaemic index: The US review found strong and consistent evidence that glycaemic index and/or glycaemicload are not associated with body weight and that modifying either of these does not lead to greater weightloss or better weight management. 198 There is considerable variability in these indices, depending on inter-andintra-individual factors and the form of food (including the degree of processing, stage of ripeness, cooking andcooling times), which may limit practical application. 199 These factors were not included in the literature reviewto inform the revision of these Guidelines.• Vegetables and fruit: There is evidence suggesting that consumption of vegetables is associated with areduced risk of weight gain (Grade C; Evidence Report, Section 2.2). 200-203 The evidence also suggests thatconsuming fruit is associated with a reduced risk of obesity and weight gain (Grade C; Evidence Report,Section 1.3). 200-208 The US review found that the evidence for an association between increased fruit andvegetable intake and lower body weight is modest, but may be important in the long term. 198• Portion size: The US review found strong evidence of a positive relationship between portion size andbody weight. 198• Dairy foods: Recent evidence suggests that consumption of dairy foods is not associated with weight changeor risk of obesity (Grade C; Evidence Report, Section 5.8) 209-214 and that consuming milk is not associated withBMI or BMI change in childhood (Grade C; Evidence Report, Section 5.9). 209,215-219 These findings are consistentwith those of the US review, which found strong evidence that intake of milk and milk products do not have adistinct role in weight control. 198• Grains: There is evidence of a probable association between consumption of three to five serves per dayof grain (cereal) foods (mainly wholegrain) and a reduced risk of weight gain (Grade B; Evidence Report,Section 6.5). 215,220-229• Nuts: There is evidence to suggest that consuming nuts (65–110g per day) is not related to risk of weight gainin the short term (Grade C; Evidence Report, Section 8.1). 230-235• Fruit juice: The US review found that, for most children, there was limited evidence that intake of fruit juice isassociated with increased adiposity when consumed in amounts that are appropriate for the age and energyneeds of the child. However, increased intake of fruit juice was found to be associated with increased adiposityin children who were already overweight or obese. 198In seeking to achieve and maintain a healthy weight it is prudent to choose nutrient-dense foods of lower energydensity – that is, those low in total fat, particularly saturated fat, and added sugars (see Chapter 3) – in a total dietarypattern that seeks to control overall energy intake. 236 The US review found strong and consistent evidence that dietarypatterns that are relatively low in energy density improve weight loss and weight maintenance in young adults. 198Factors associated with risk of overweight and obesity• Breastfeeding: There is convincing evidence that breastfeeding infants, compared with formula feeding, isassociated with a reduced risk of becoming obese in childhood, adolescence and early adulthood (Grade A;Evidence Report, Section 17.2). 237• Birth weight: Increased birth weight, especially above 4,000g, is associated with increased risk of overweightor obesity in childhood, adolescence and later life (Grade A; Evidence Report, Section 17.1). 54,58,61,62,79,238,239There is a J- or U-shaped relationship between birth weight and increased risk of child or adult obesity, withboth low birth weight and high birth weight babies at increased risk. 24020EAT FOR HEALTH – australian dietary guidelinesNational Health and Medical Research Council