4364.0.55.009 - Australian Health Survey: Nutrition - State and Territory results, 2011-12  
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FURTHER INFORMATION

About this publication
This publication presents state and territory level nutrition results from the 2011-12 National Nutrition and Physical Activity Survey (NNPAS). It contains information on consumption of selected foods and nutrients. Data are presented by age and sex.

This release also contains both national and state and territory food security information.

About the survey
The 2011-12 National Nutrition and Physical Activity Survey (NNPAS) is a component of the 2011–12 Australian Health Survey (AHS), the largest and most comprehensive health survey ever conducted in Australia. The National Nutrition and Physical Activity Survey involved the collection of detailed information on dietary intake and foods consumed from over 12,000 participants across Australia. The nutrition component is the first national nutrition survey of adults and children (aged 2 years and over) conducted in over 15 years.

Information for the nutrition component of the NNPAS was gathered using a 24-hour dietary recall on all foods and beverages consumed on the day prior to the interview. Where possible, at least 8 days after the first interview, respondents were contacted to participate in a second 24-hour dietary recall via telephone interview. This publication presents results from the first interview, with information on food, beverages and dietary supplements, as well as some general information on dietary behaviours.

Acceptable Macronutrient Distribution Ranges
Reference ranges known as Acceptable Macronutrient Distribution Ranges (AMDR) form part of the recommendations for optimising diets to lower chronic disease risk while ensuring adequate micronutrient status.1

Age groups used in this publication
The terms 'children', 'boys' and 'girls' are for people aged 2-18 years, and 'adults', 'men' and 'women' refer to people aged 19 years and over.

Alcohol
In the 2011-12 National Nutrition and Physical Activity Survey (NNPAS), alcohol refers to pure alcohol (or ethanol), which, as a macronutrient, contributes 29 kJ per gram.

Alcohol intake - recommended
Alcohol can also contribute to dietary energy. Alcohol intakes below about 5% of dietary energy are recommended by the National Health and Medical Research Council.1

Alcoholic beverages
The 'Alcoholic beverages' food group includes beers, wines, spirits, cider and other alcoholic beverages.

Calcium
Calcium is a mineral required for the growth and maintenance of the bones and teeth, as well as the proper functioning of the muscular and cardiovascular systems. Low intake of calcium is associated with osteoporosis, a low bone density condition particularly affecting post-menopausal women.2

NHMRC, Estimated Average Requirements - Calcium

The National Health and Medical Research Council (NHMRC) describes the Estimated Average Requirements (EARs) for calcium, which are the daily levels of calcium estimated to meet the requirements of half the healthy individuals in a particular life stage and gender group.

Estimated Average Requirement

Males
Females
Age group (years)
mg/day
mg/day

2-3
360
360
4-8
520
520
9-11
800
800
12-18
1 050
1 050
19-50
840
840
51-70
840
1 100
71 years and over
1 100
1 100

Source: National Health and Medical Research Council 2006, Nutrient Reference Values for Australia and New Zealand, Canberra: National Health and Medical Research Council <http://www.nrv.gov.au/nutrients/calcium>

Dietary supplements
Intakes from supplements are not included in this publication or Australian Health Survey: Nutrition Second Results - Usual Nutrient Intakes (cat. no 4364.0.55.008). For information on selected supplements, see Australian Health Survey: Nutrition - Supplements (cat. no. 4364.0.55.010) for more information.

Discretionary foods
The 2013 Australian Dietary Guidelines describes discretionary foods as being: “foods and drinks not necessary to provide the nutrients the body needs, but that may add variety. However, many of these are high in saturated fats, sugars, salt and/or alcohol, and are therefore described as energy dense. They can be included sometimes in small amounts by those who are physically active, but are not a necessary part of the diet”.

The Australian Dietary Guidelines Summary lists examples of discretionary choices as including: "cakes, biscuits; confectionary, chocolate; pastries, pies; ice confections, butter, cream, and spreads which contain predominantly saturated fats; potato chips, crisps and other fatty or salty snack foods; sugar-sweetened soft drinks and cordials, sports and energy drinks and alcoholic drinks." Based on these definitions and the supporting documents which underpin the Australian Dietary Guidelines, foods reported within the NNPAS have been categorised as discretionary or non-discretionary. See User Guide section Discretionary Foods for more information.

Energy
Dietary energy is required by the body for metabolic processes, physiological functions, muscular activity, heat production and growth and development.3 Energy requirements vary with age, sex, body size and physical activity, so the amount of energy consumed would be expected to vary considerably throughout the population.

Energy and nutrient intakes in this publication are derived only from foods and beverages from the first 24-hour recall day. The nutrients from supplements are excluded from this analysis. No adjustment has been made to include information from the second 24-hour recall day to calculate usual intakes, see Australian Health Survey: Nutrition Second Results - Usual Nutrient Intakes (cat. no 4364.0.55.008) for more information.

Estimated Average Requirement
The Estimated Average Requirement (EAR) is a daily nutrient level estimated to meet the requirements of half the healthy individuals in a particular life stage and gender group. 3

Food avoidance
Food avoidance refers to people who avoid particular foods due to:
  • allergy or intolerance of food groups
  • cultural, religious or ethical reasons.

Food groups
Foods and beverages reported by respondents in the National Nutrition and Physical Activity Survey (NNPAS) were collected and coded at a detailed level, but for output purposes are categorised within a food classification with major, sub-major, and minor group levels. At the broadest level (the Major group) there are 24 groups. These groups were designed to categorise foods that share a major component or common feature. The classification was developed by Food Standards Australia New Zealand, along with the Nutrient Database, specifically for the Australian Health Survey.

Because many foods are in fact mixtures of different ingredients, the food groups will not exclusively contain the main food of that group. For example, a beef and vegetable casserole will belong within the major group of 'Meat, poultry and game products and dishes', yet will contain vegetables and sauce or gravy.

'Cereal-based products and dishes' is a particular example of a Major group where there may be a significant proportion of other (non-cereal) ingredients in the foods. While the common feature of this food group is cereal, the foods belonging to this group are very diverse and includes biscuits, cakes, pastries, mixed pasta or rice dishes, burgers, pizza and tacos. The 'Cereal-based products and dishes' should not be confused with 'Cereal and cereal products' which contains more basic foods such as bread, plain rice, plain pasta, breakfast cereals, oats and other grains.

For more information see Appendix 1: Example foods in Major food groups.Food security
Food security, according to the World Health Organisation definition, requires constant access to sufficient, safe, nutritious food to maintain a healthy and active life.

This topic collects information on the number of households that have experienced financial barriers in regards to purchasing food. Specifically, this topic focusses on:
  • running out of food and being unable to purchase more due to cost
  • having difficulty ensuring a constant food intake is sustained.

Recommended usual intake of fruit
In addition to collecting information about the foods actually consumed on the previous day, the AHS also asked respondents the usual number of serves of fruit consumed in a day.
A serve is equivalent to:
  • one medium piece
  • two small pieces of fruit
  • one cup of diced fruit pieces
  • one quarter of a cup of sultanas
  • four dried apricot halves
In this publication, data about recommended usual intake of fruit is derived from the Australian Health Survey 2011-13 ( 2011-12 Core component) as it provides a larger sample.


Recommended usual intake of fruit

The National Health and Medical Research Council (NHMRC) 2013 Australian Dietary Guidelines recommend a minimum number of serves of fruit each day, depending on age and sex, to ensure good nutrition and health. The table below outlines the recommended number of serves for children, adolescents and adults. Although the 2013 Australian Dietary Guidelines specify that fruit should mostly be eaten fresh and raw, other forms of fruit can count towards the daily serves occasionally. A serve is approximately 150 grams of fresh fruit, 125 ml of fruit juice (no added sugar) or 30 grams of dried fruit.*
RECOMMENDED DAILY SERVES OF FRUIT, by age**

Age group (years)
Fruit(serves)
Persons

2-3
1
4-8
1.5
9-11
2
12-13
2
14-18
2
19-50
2
51-70
2
71 years and over
2


*Note, while the NHMRC 2013 Australian Dietary Guidelines allow fruit juice to be used occasionally as one of the daily serves of fruit, the AHS only collected usual serves of fruit (excluding juice).
**The AHS collected whole serves which does not allow strict comparability for the 4-8 year olds, rounding the recommendation up to two serves provides an indication of the proportion who would meet the recommendation. A future Australian Health Survey product will provide further comparisons with the guidelines.Recommended usual intake of vegetables
In addition to collecting information about the foods actually consumed on the previous day, the 2011-12 AHS also asked people the usual number of serves of vegetables consumed in a day.
A serve is equivalent to:
  • half a cup of cooked vegetables
  • half a medium potato
  • 1 cup of salad vegetables
In this publication, data about recommended usual intake of vegetables is derived from the Australian Health Survey 2011-13 ( 2011-12 Core component) as it provides a larger sample.


Recommended usual intake of vegetables

The National Health and Medical Research Council (NHMRC) 2013 Australian Dietary Guidelines recommend a minimum number of serves of vegetables and legumes/beans each day, depending on age and sex, to ensure good nutrition and health. The table below outlines the recommended number of serves for children, adolescents and adults. A serve is approximately half a cup of cooked vegetables or legumes/beans or one cup of salad vegetables - equivalent to around 75 grams.*

RECOMMENDED DAILY SERVES OF VEGETABLES, by age***

Vegetable (Serves)

Age group (years)
Males
Females

2-3
2.5
2.5
4-8
4.5
4.5
9-11
5
5
12-13
5.5
5
14-18
5.5
5
19-50
6
5**
51-70
5.5
5
71 years and over
5
5

*Note, while the 2013 Australian Dietary Guidelines include servings of legumes and beans in the recommendations for vegetable intake, the AHS only collected serves of vegetables (excluding legumes).
**Note, the recommended usual intake of vegetables for breastfeeding women is 7.5 serves and pregnant women is 5 serves, however these population groups have not been separated from the nutrient data output for this data item.
***The AHS collected whole serves which does not allow strict comparability with the guidelines (in which some age/sex groups use half serves). The data presented have been derived by rounding the recommendation up to the whole number of serves, it is therefore likely that proportions who would meet the recommendation in particular categories are underestimates. A future Australian Health Survey product will provide further comparisons with the guidelines.
Salt
Sodium occurs in a number of different forms but is generally consumed as sodium chloride (commonly known as salt). Salt is a naturally occurring mineral needed to maintain adequate blood pressure and electrolyte balance4. It is commonly added to foods to enhance flavours and to act as a preservative. High salt intake can raise blood pressure, increasing the risk of cardiovascular disease, heart failure, kidney disease, oedema and osteoporosis4.

The amounts reported in this publication include sodium naturally present in foods as well as sodium added during processing, and exclude salt added by consumers either during cooking or at the table. For these reasons, these figures are likely to be an underestimate. See the Interpretation section of the Nutrient Intake chapter of the Australian Health Survey: User's Guide, 2011-13 (cat. no. 4363.0.55.001) for more information.



NHRMC, Sodium, Upper Level of Intake (UL)

The National Health and Medical Research Council (NHMRC) recommends a daily upper level of intake of 2,300mg of salt for adults and between 1,000mg and 2,300mg for children5.

Upper Level of Intake

Males
Females
Age group (years)
mg/day
mg/day

2-3
1,000
1,000
4-8
1,400
1,400
9-13
2,000
2,000
14-18
2,300
2,300
19-50
2,300
2,300
51-70
2,300
2,300
71 years and over
2,300
2,300

Source: National Health and Medical Research Council, Nutrient Reference Values for Australia and New Zealand, https://www.nrv.gov.au/nutrients/sodium


Selected micronutrients
The vitamins and minerals presented for each State and Territory (see Table 1.1 and Table 2.1 )are based on Day 1 intakes from foods only, (that is, not adjusted for usual intakes and exclusive of any amounts taken from dietary supplements). Although the data are presented alongside Nutrient Reference Values (NRVs) such as Estimated Average Requirements, (EARs), these are for context only and do not indicate the levels of nutrient deficiency/excess intake of the population group in relation to that NRV.

In order to make assessments about the proportion of the population who are at risk of inadequate intakes over the longer term, it is necessary to consider not only the mean or median intake but also the distribution of longer-term ‘usual’ intake in the population. Usual nutrient intakes are modelled estimates of the proportion of people who usually consume particular amounts of nutrients, as opposed to what they reported eating on the particular day they were surveyed in 2011-12. Usual nutrient intakes information is available in Australian Health Survey: Nutrition Second Results - Usual Nutrient Intakes (cat. no 4364.0.55.008).

Under-reporting
In order to assist in the interpretation of data from the 2011-12 NNPAS and particularly in comparisons with the 1995 National Nutrition Survey, there are a few key points that should be noted.
  • It is likely that under-reporting is present in both surveys.
  • There appears to be an increase in the level under-reporting for males between 1995 and 2011-12, especially for males aged 9 - 50.
  • The level of under-reporting by female respondents also appears to have increased, but to a lesser extent than for males.
Please see Australian Health Survey: User's Guide (cat. no. 4363.0.55.001) for more information.

Upper level of intake
The highest average daily nutrient intake level likely to pose no adverse health effects to almost all individuals in the general population. As intake increases above the UL, the potential risk of adverse effects increases.3

Usual intakes
Usual nutrient intakes are modelled estimates of the proportion of people who usually consume particular amounts of nutrients, as opposed to what they reported eating on the particular day they were surveyed in 2011-12. Usual nutrient intakes information is available in Australian Health Survey: Nutrition Second Results - Usual Nutrient Intakes (cat. no 4364.0.55.008).
APPENDIX 1: EXAMPLE FOODS IN MAJOR FOOD GROUPS

EXAMPLE FOODS IN MAJOR FOOD GROUPS
Major food groupExamples
Non-alcoholic beveragesTea, coffee, fruit juice, cordial, soft drink, water, electrolyte drink
Cereals and cereal productsBread, rice, noodles, pasta, breakfast cereal
Cereal based products and dishesSweet biscuits, savoury biscuits, cake, sweet pastry, savoury pastry, pizza, sandwiches, burgers
Fats and oilsButter, margarine, oils
Fish and seafood products and dishesFish, prawns, canned tuna, fish with pasta, fish with rice
Fruit products and dishesApples, pears, berries, oranges, peaches, bananas, melons, dried fruit, banana split, apple crumble
Egg products and dishesEggs, omelette, souffle, frittata
Meat, poultry and game products and dishesBeef, lamb, pork, veal, kangaroo, chicken, ham, dried meats, sausages, casseroles, curries
Milk products and dishesMilk, yoghurt, cream, cheese, ice cream, dairy desserts, cheesecake
Dairy & meat substitutesSoy beverages, almond milk, tofu, quorn, tofu stirfry
SoupCanned soup, homemade soup, dried soup mix
Seed and nut products and dishesPeanuts, peanut butter, pumpkin seeds, coconut milk
Savoury sauces and condimentsTomato sauce, chutney, salad dressings, mayonnaise, vinegar, dips
Vegetable products and dishesPotatoes, carrots, beans, tomato, corn, salads, potato bake
Legume and pulse products and dishesLentils, soy beans, chickpeas, kidney beans, falafel, dhal
Snack foodsPotato crisps, popcorn, corn chips, rice crisps, pretzels
Sugar products and dishesSugar, honey, jam, icing sugar, apple sauce, meringue
Confectionery and cereal/nut/fruit/seed barsChocolate, muesli bars, fruit bars, lollies, chewing gum
Alcoholic beveragesBeer, wine, spirits, cocktails, liqueurs
Special dietary foodsLiquid and powdered meal replacements, protein drinks and powders, oral supplement powder and beverages (excluding electrolyte drinks)
MiscellaneousYeast, salt, intense sweeteners, herbs, stock, essences, gelatine, spreadable yeast extract
Infant formulae and foodsToddler formula, rusks, infant cereals, infant fruit, infant custards, infant fruit juices
Dietary supplementsVitamins and mineral supplements, fish oil supplements, fibre supplements
Reptiles, amphibia and insectsCrocodile, turtle, goanna
ENDNOTE
1. National Health and Medical Research Council, 'Macronutrient Balance', Nutrient Reference Values for Australia and New Zealand, https://www.nrv.gov.au/chronic-disease/macronutrient-balance <last accessed 01/06/2015>
2. National Health and Medical Research Council, 'Calcium', Nutrient Reference Values for Australia and New Zealand, https://www.nrv.gov.au/nutrients/calcium <last accessed 01/06/2015>
3. National Health and Medical Research Council, 'Introduction', Nutrient Reference Values for Australia and New Zealand, https://www.nrv.gov.au/home/introduction <last accessed 01/06/2015>
4. Better Health Channel, Salt, http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Salt?open <last accessed 01/06/2015>
5. National Health and Medical Research Council, 'Sodium', Nutrient Reference Values for Australia and New Zealand, https://www.nrv.gov.au/nutrients/sodium <last accessed 01/06/2015>