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Dietary Guidelines are constantly changing: are they still relevant?

People often complain that nutrition science is constantly changing, and that Dietitians and Nutritionists can’t make up their minds about whether foods are ‘in vogue’ or ‘out’

This is understandable. After all, while foods like herbs, oils and honey have been used since ancient times to treat disease, advances in nutrition science and medical knowledge have only gained pace in the last century.

Science is constantly evolving, generating new recommendations to improve our health. However many people have eating habits that are bound to long- held beliefs, traditions and life-style which may matter more to them than longevity and so for them adaption may take longer.

Since the first NZ Dietitian registered in 1954 there have been huge changes in food technology, production and processing necessitating food legislation and standards on such things as food codes, claims, labelling and food safety, to protect the consumer.

There is also a greater appreciation now of how nutritional needs change with age, activity levels and health constraints, so when we think of setting up national food guidelines these things need to be considered. No one set of guidelines will remain in vogue indefinitely.

Guidelines also vary from country to country depending on the national health problems that may need solutions as well as the availability of local produce, religion, customs, and traditions.

For instance, the Norwegians1 use rye as their wholegrains and fish is plentiful and recommended to be eaten 2-3 times per week; while in Greece2 the Mediterranean diet relies heavily on olive oil, fresh vegetables, low fat dairy, fish and less red meat than currently eaten in NZ.

I was inspired by a recent webinar with Dietitian Dr Joanna McMillian3, that looked at the 2013 Australia food guidelines4 and what needed to change, to also consider New Zealand’s.

Our guidelines were updated in 2020 5 along with the food model (pictured) and aim to address many of the health concerns we have today, so let’s take a look at the guidelines summary.

What are the current trends within the five food groups?

  1. Eat a variety of nutritious foods each day

  • Plenty of vegetables– starchy vegetables (including corn and potato which can be milled so also fit the grain group) are an important source of carbohydrate.

Also, non -starchy vegetables, which although low in energy are nutrient rich.

  • Eat 2-3 pieces of fruit per day as these contain phytonutrients and polyphenols that protect the body from damage and build immunity and dietary fibre for gut health.
  • Choose wholegrains- breads and cereals with minimal processing as these are naturally high in B group vitamins for healthy nerves and brain function plus dietary fibre for a healthy gut
  • Milk and milk products. These are still a significant group even for those on a plant- based diet who may choose from a wide range of milks based on nuts and grains. While these milks are usually fortified with nutrients such as calcium and vitamins, (except for soy milk) their protein levels are quite low.Dairy products are still a significant source of calcium and protein and with fermented products such as yoghurt and kefir are maintaining/gaining popularity.Research is now focusing on the fat content of milk and even with heart disease early indications are that dairy, even full fat, may be better for cardiovascular health than none.6 As usual different groups of people have different needs.
  • Legumes, peas and beans do fit the grain and vegetables sections however as they are also important sources of protein especially in a plant- based diet, these are now included along with meat, fish and poultry.
    The NZ guidelines also mention removing visible fat from red meat and if choosing to eat red meat to limit this to less than 500g of cooked meat/week. This fits with the new Eat Lancet report7 which is encouraging everyone to eat a more environmentally sustainable diet by reducing red meat intake.

2. Choose or prepare foods and drinks

  • With unsaturated fat instead of saturated. So here evidence now supports high mono and polyunsaturated essential fatty acids found in vegetable oils, nuts, seeds and fatty fish that are natural antioxidant’s that help to build immunity and phytosterols which help to lower cholesterol 8
  • Low in salt (sodium)- if using salt use iodized (is aimed at reducing blood pressure, stroke and prevent goitre as our soils lack the trace element iodine important for thyroid function.
  • Little or no added sugar is designed to curb our girth and reduce diabetes
  • Mostly whole and less processed-

Interest is growing in the level of food processing9 as this can greatly affect our health.

Unprocessed or minimally processed are naturally whole e.g an apple or is slightly altered for preservation without reducing the nutritional components e.g freezing, drying or vacuum packing e.g the apple.

Processed culinary ingredients e.g.grinding, milling, pressing, refining makes many foods more useable.

-Processed foods any of the above plus the addition of salt, sugar or fat are often ready to eat with minimal food preparation.

Ultra-processed are processed foods to which colourings, flavourings, preservatives etc may be added to extend their shelf life, increase palatability, and make foods safer to eat. In many cases additives can make important ingredients such as protein more easily available in a busy family or where there are budgeting constraints. Often nutrients lost like Vitamin B and C lost in food processing are added back in.

However ultra-processing of foods such as e.g sugary drinks, cookies, crisps, breakfast cereals. crackers etc.may also lead to their overconsumption and obesity.

Many of the foods and snacks currently promoted as being vegan and vegetarian are in this category and may contain very high levels of sodium, added sugar and fat.

The golden rule is to learn to read food labels

3. Make plain water your first choice of drink

This is a commendable goal that could be extended to include the health advantages of also drinking tea a source of antioxidants that may reduce cancer, diabetes and heart disease10. Alongwith
coffee, which can reduce the feelings of exertion, and reduce the incidence of T2 diabetes, some cancers, Alzheimer’s and Parkinson’s disease.11

4. If drinking alcohol, keep intake low.

  • Stop drinking if pregnant or trying to get pregnant and when breastfeeding it is best to be alcohol free. Absolutely no argument.

5. Buy or gather, prepare, or cook food in ways to keep food safe to eat

and protect yourself from food borne illness especially if pregnant.

Now in the light of Covid 19 and other viruses in the community this guideline could be  strengthened with recommendations to wash hands before handling food or after blowing noses or using the toilet.

6. Encourage, support, and promote breastfeeding.

Also, no argument

To sum up..

The NZ Guidelines have been updated to include pregnant and breastfeeding women and they begin with a clear statement about the many things that influence our health such as social support, income, housing, family/whanau and work etc.

Not only do they offer summary statements on Eating but also Activity and Body weight with background papers and international evidence to back up claims.

Generally, these guidelines make interesting reading and offer information that is practical and relevant to our times

If you would like help to make personal dietary changes then contact me today

Other articles by Lea on similar topics:

Coffee concoctions

Alcohol and sport: Is it the best fit for you?

How to make the most of a plant-based diet

Snacking on a plant-based diet

What’s to drink?

References:

  1. The Norwegian Dietary Guidelines https://www.helsedirektoratet.no/brosjyrer/helsedirektoratets-kostrad-brosjyre-og-plakat/Helsedirektoratets%20kostråd%20-%20engelsk.pdf/_/attachment/inline/80f68126-68af-4cec-b2aa-d04069d02471:dcb8efdbe6b6129470ec4969f6639be21a8afd82/Helsedirektoratets%20kostråd%20-%20engelsk.pdf
  2. Food-based dietary guidelines- Greece http://www.fao.org/nutrition/education/food-dietaryguidelines/regions/greece/previous-versions-gre/en/
  3. Dr Joanne McMillan https://drjoanna.com.au
  4. The Australian Dietary Guidelines 2013 https://www.eatforhealth.gov.au/sites/default/files/content/The%20Guidelines/n55a_australian_dietary_guidelines_summary_131014_1.pdf
  5. Eating and activity guidelines https://www.health.govt.nz/our-work/eating-and-activity-guidelineshttps://www.health.govt.nz/system/files/documents/publications/eating-and-activity-statements-for-new-zealand-adults-summary-of-guidelines-statements-and-key-related-information-jan_21.pdf
  6. Astrup, A. et al Effects of full fat and fermented dairy products on cardiometabolic disease. Food id more than the sum of its part. Adv. Nut 2019:109245-9305.
  7. The EAT-Lancet Commission on Food, Plant, Health https://eatforum.org/eat-lancet-commission/
  8. Teasdale,S. How should we judge edible oils and fats? An umbrella review of health effects on nutrition and bioactive compounds found in edible oils and fats.
    Critical reviews in Food Science and Nutrition https://doi.org/10.1080/10408398 2021/882382
  9. Ultra processed foods, diet quality and health using the NOVA classification system FAO, Rome 2019 http://www.fao.org/3/ca5644en/ca5644en.pdf
  10. Gordon B, The health benefits of drinking tea.2020 Eatright Academy of Nutrition and Dietetics https://www.eatright.org/health/wellness/preventing-illness/the-health-benefits-of-tea
  11. Coffee: Harvard T.H.Chan School of public health https://www.hsph.harvard.edu/nutritionsource/food-features/coffee/

About the author View all

Lea Stening

Lea is one of New Zealand’s leading paediatric dietitians and also specialises in Sports Nutrition. She has specialised in Paediatric Nutrition for 31 years and in 1985 was the first paediatric dietitian to enter private practice in New Zealand. Lea helps families through her private consultations, public lectures, newspaper and magazine articles as well as television and radio interviews. Read more »

View all posts by Lea Stening »

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