Food and Nutrition Guidelines for Healthy Adults

Food and Nutrition Guidelines for Healthy Adults:A Background Paper
(full text version)
page 1 of 8
Date of publication: October 2003
ISBN 0-478-25839-9 (Book)
ISBN 0-478-25840-2 (Internet)
HP 3712

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Contents

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Part III: Nutrition and Health Outcomes

12 Obesity
Background
What causes overweight and obesity?
Definitions of overweight and obesity
Obesity in New Zealand
Financial burden of obesity
Obesity and disease
Principles of prevention and management of obesity
Priority groups
Practical advice

13 Coronary heart disease
Background
Coronary heart disease in New Zealand
Alcohol and coronary heart disease
Physical activity
Practical advice

14 Hypertension
Background
Hypertension in New Zealand
Factors associated with hypertension
Practical advice

15 Diabetes mellitus
Background
The burden of type 2 diabetes in New Zealand
Dietary and lifestyle prevention strategies for type 2 diabetes
Practical advice

16 Cancer
Background
Obesity and cancer
Physical activity and colon cancer
Food and nutrients and colorectal cancer
Vegetable and fruit intake and cancer
Dietary fibre and cancer
Alcohol and cancer
Summary
Practical advice

17 Osteoporosis
Background
Dietary and lifestyle factors
Practical advice

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Part IV: Physical Activity – A Partner To Nutrition

18 Physical activity
Background
Dimensions of physical activity
Extent of physical activity in New Zealand
Strategies for increasing levels of physical activity
Recommendations for levels of activity

Part V: Nutrition and Health in Maori and Pacific Peoples

19 Maori
Background
Maori models of health
Traditional foods and practices
The burden of disease
Effective interventions
Current and future work

20 Pacific peoples
Background
Nutrition strategies

Part VI: Other Issues

21 Food security
Background
Health consequences of food insecurity
Issues for women
Food skills
Socioeconomic disadvantage

22 Supplementation and fortification
Supplementation
Fortification

23 Food safety
Background
Foodborne illness notification and trends
Commercial food safety
Domestic food safety
Food safety promotion
Food safety information

Appendix 1: Serving sizes of the four food groups and samples of two types of three-day meal plans
Meal plan 1 with some luxury foods
Meal plan 2 with basic foods

Appendix 2: National Nutrition Survey 1997

Appendix 3: Australian Recommended Dietary Intakes

Appendix 4: Dietary Reference Intakes in the publications of the Institute of Medicine, United States

Appendix 5: United Kingdom Dietary Reference Values

Appendix 6: Policy Statement on Physical Activity: Minister of Sport, Fitness & Leisure & the Minister of Health

Glossary and Abbreviations

Glossary

Name abbreviations

References

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Foreword

Good nutrition, physical activity and maintaining a healthy body weight are fundamental to health and to the prevention of disease and disability.

Food not only is a means of maintaining and improving physical health but has a valued place in our society. It is a catalyst for social interaction and has a significant part in most celebrations.
The cultural and psychological functions of food cannot be overemphasised.

Over recent years there has been a rapid rise in health conditions for which poor nutrition and inadequate physical activity are key risk factors. This trend is particularly evident in the current obesity epidemic. The Ministry of Health recognises the need for sound, up-to-date technical information to support health professionals, health educators and teachers in the practice of healthy nutrition.

This background paper supports three of the key priorities of the New Zealand Health Strategy. It brings together the latest evidence and advice on food and nutrition, physical activity and obesity relevant to the health of adult New Zealanders. In addition, it provides information on important nutrition-related health disorders, food safety and quality issues. It will assist health professionals and educators with the implementation of the Healthy Eating – Healthy Action Strategy, which was launched in March 2003.

Key population groups in New Zealand, including Maori and Pacific peoples, are at particular risk of compromised health due to poor nutritional status. For this reason, one part of this paper is devoted to nutrition issues relating to the health of these groups.

These guidelines are an important part of the Ministry’s Food and Nutrition Guideline series for New Zealanders. This paper provides background material for health education resources for the general public. It is envisaged that Food and Nutrition Guidelines for Healthy Adults: A background paper will provide sound and practical advice on food and nutrition for health professionals and educators to use in their daily work.

Don Matheson (Dr)

Deputy Director-General
Public Health

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Acknowledgements

The Ministry of Health would like to thank all those who have contributed to the development of this document. In particular thanks go to Crown Public Health, the members of the former Food and Nutrition Advisory Committee, and the staff of the Department of Human Nutrition, University of Otago.

The peer reviewers who dedicated time and energy to reviewing this document at various stages are acknowledged. The National Heart Foundation and the Cancer Society of New Zealand are also thanked for their comments.

The many individuals and groups who gave feedback as part of the public consultation process and the specialists who commented on the final draft have shaped this final document significantly. The Ministry of Health appreciates the assistance of the many people who have had input during the process.

This document has been produced by the Public Health Policy Group.

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Introduction

Food and Nutrition Guidelines for Healthy Adults: A background paper is the technical background paper that supports the Food and Nutrition Guideline statements. There are seven background papers in the series. This adult background paper is the most comprehensive of the series and follows the format of all the other papers. In addition to underpinning the Food and Nutrition Guideline statements, it has been written to support health professionals including dietitians and nutritionists, teachers and health educators in the practice of healthy nutrition.

This document has been divided into six parts.

Part I: The New Zealand Food and Nutrition Guidelines presents the Food and Nutrition Guideline statements and the background as to why they were adopted.

Part II: Nutrients, food and drinks considers the role that energy and each of the major nutrients play in health. It discusses current and recommended dietary intakes in New Zealand, identifies sources of the nutrient in the New Zealand diet and summarises the evidence available on the topics covered. Where appropriate, it makes suggestions that can form the basis for nutrition advice to healthy adult New Zealanders. These suggestions are intended as a guide only, as the nutritional needs of individuals are dependent on many factors.

Part III: Nutrition and health outcomes discusses the most important non-communicable diseases where food and nutrition are significant risk factors. These include obesity, type 2 diabetes, coronary heart disease, hypertension, cancer and osteoporosis. These guidelines are not intended as treatment guidelines but rather emphasise reducing the risk of developing these diseases.

The document goes on to consider other factors that sit alongside nutrition in contributing to good health.

Part IV: Physical activity – a partner to nutrition considers the complementary role of physical activity in reducing the risk of the diseases considered in Part III.

Part V: Nutrition and health in Maori and Pacific peoples considers the cultural approaches to nutrition by Maori and Pacific peoples. It discusses the differential burden of disease these populations carry that can be influenced by nutrition.

Part VI: Other issues examines factors that can influence people’s ability to access good nutrition in terms of food security, fortification, supplementation and food safety.

This document weaves the relevance of nutritional issues for Maori throughout the document. Specific issues for Maori as a population group are described separately in Part V. However, Maori health must be understood in the wider context of their social, economic, cultural and political position. Integral to working with Maori is a need to understand the special relationship between iwi and the Crown, and the Treaty of Waitangi. The Crown recognises the three guiding principles of the Treaty of Waitangi as the basis of any health strategies for Maori.
The three principles are:

partnership – working together with iwi, hapu, whanau and Maori communities to develop strategies for Maori health gain and appropriate health and disability services

participation – involving Maori at all levels of the sector, in decision-making, planning, development and delivery of health and disability services

protection and improvement of Maori wellbeing – working to ensure Maori have at least the same level of health as non-Maori and safeguarding Maori cultural concepts, values and practices (Minister of Health and Associate Minister of Health 2002).

This background paper draws on an enormous body of national and international literature.

For the major nutrients this information is translated into food-based suggestions at the end of each chapter. Food serving sizes and samples of two sets of three-day meal plans have been provided in Appendix 1.

In 1999 the Ministry of Health released NZ Food, NZ People: Key results of the 1997 National Nutrition Survey (Ministry of Health 1999c) and this survey is described in Appendix 2. The results of this survey are used throughout to document current intakes, eating patterns and nutrition-related risk factors of New Zealand adults.

In 1991 New Zealand adopted, where practical, the Australian Recommended Dietary Intakes pending a comprehensive review of all the recommended levels by Australia or jointly with New Zealand. Throughout this text, where RDIs are detailed, they refer to the Australian value unless otherwise stated.

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