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4802.0 - National Nutrition Survey: Selected Highlights, Australia, 1995  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 22/12/1997  Ceased
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Introduction

Background

Food and nutrition have long been recognised as important contributors to health. However, food and nutrition affect more than just the physical aspects of our health and wellbeing. The buying, preparing and eating of food is part of everyday life. For many Australians, food is a focus for social interactions with family and friends. For some, it is also an economic concern.

As part of Australia's participation in the World Health Organisation (WHO) initiative 'Health for All by the Year 2000', a Better Health Commission was established to propose priority areas for preventive health programs and actions in Australia. The Commission decided to concentrate on three major areas, namely cardiovascular disease, nutrition and injury (Better Health Commission 1986).

The Commission's Nutrition Taskforce supported the existing Dietary guidelines for Australia and the Recommended Dietary Intakes for use in Australian (RDIs). The taskforce recommended that the dietary guidelines be reviewed regularly by the National Health and Medical Research Council (NHMRC). This has led to the most recent revisions:

  • Recommended dietary intakes for use in Australia (NHMRC 1991);
  • Dietary guidelines for Australians (NHMRC 1991); and
  • Dietary guidelines for children and adolescents (NHMRC 1995).
The need for a national dietary survey was identified in many forums, culminating in the conduct of the National Nutrition Survey (NNS) in 1995. The overall objective of this survey is the provision of food and nutrient data to assist with the implementation of Australia's 'Food and Nutrition Policy', future revisions of the RDIs and future revisions of National Health Goals and Targets. More specific objectives are to provide data on food intake for comparison with dietary guidelines and nutrient intake for comparison with RDIs — for Australians in general, and for those population groups at risk of health problems related to diet. The NNS also provides benchmark data against which future surveys can be compared to assess changes over time in the dietary status of Australians.


Survey features

The NNS was conducted during the period from February 1995 to March 1996.

Approximately 13,800 people aged two years or over from urban and rural areas in all States and Territories participated in the survey. The NNS was conducted on a sub-sample of respondents in the 1995 National Health Survey (NHS). The NNS was conducted under the Census and Statistics Act 1905, on a voluntary basis.

Two approaches were used in the NNS to collect data on food and beverage intake:
*The daily food consumption (24-hour recall) method was used as the main indicator of food intake. All participants were interviewed by trained nutritionists who sought detailed information on all foods and beverages consumed during the day prior to the interview (from midnight until midnight). Each food and beverage was described in sufficient detail to allow its nutrient composition to be determined. A sample of approximately 10% of the NNS participants provided intake data for a second 24-hour period.
  • A Food Frequency Questionnaire (FFQ) was used to assess usual frequency of intake for those aged 12 years or more. This self-completion form requested data on usual frequency of intake of selected foods, and vitamin and mineral supplements over the previous 12 months.

    In addition, the personal interviews collected information on:
  • Physical measurements. With participants' written consent, interviewers took the following measurements: height and weight, waist and hip circumferences, and blood pressure (from participants aged 16 years and over). Pregnant women were excluded from this component of the survey.
  • Eating habits and patterns. Participants were asked a series of questions on topics such as their usual type of diet, addition of salt to food and desired dietary changes.

Data interpretation

This publication reports food and beverage intake data collected by the daily food consumption (24-hour recall) method. Nutrient intakes are based on one day's food and beverage intake only. Data from the second 24-hour recall period will be incorporated into the nutrient analysis proposed for a later publication.

A classification of foods and beverages has been developed by HFS and the Australia and New Zealand Food Authority (ANZFA) for this survey. Two issues associated with this food classification are:
  • The classification of items as beverages was partly based on nutritional content considerations. For example, milk has not been classified as a beverage, but is included within 'milk products and dishes'.
  • Products and dishes were classified according to their major ingredient. For example, pizzas and commercial hamburgers are classified as 'cereal-based products'.

    Consequently, comparisons with the dietary guidelines need to be made with care as basic food groups referred to in the guidelines do not align closely with food groupings used in this classification.

    Although the target sample size was achieved, the response rate was low by ABS standards for household surveys due to the heavy response load in the survey and its voluntary nature. Characteristics of respondents and non-respondents have been compared, using information available from the NHS, and adjustments were made during estimation to reduce non-response bias. Notwithstanding, the results of the survey may be subject to higher errors than normally expected in household surveys and interpretation of the data should take this into account.


SELECTED HIGHLIGHTS

Introduction

The NHMRC Dietary guidelines for Australians (1991) provides advice to the general population about healthy food choices, for a diet that contributes to a healthy life style with minimal risk of developing diet-related diseases. In part, the guidelines encourage Australians to enjoy a wide variety of nutritious foods; eat plenty of breads, cereals, fruit and vegetables; eat a diet low in fat, particularly saturated fat; and maintain a healthy body weight. They also encourage Australians to eat foods containing two specific nutrients, calcium and iron.

In Australia a wide range of food is available in fresh, processed, mixed or prepared forms. Overall, the food supply is adequate to meet the nutritional needs of Australians, as assessed using the RDIs, see Apparent Consumption of Foodstuffs and Nutrients (ABS 1997a). Although the vast majority of Australians do have access to a wide range of food, there are regions in Australia where this is not the case. However, within the range of food available, the types and quantities of food consumed are an individual choice influenced by many factors, including culture, age, sex, income, health and dietary knowledge.

Over the years, health problems related to under-nutrition and deficiencies have decreased in Australia while those associated with over-nutrition and more sedentary lifestyles have become a major concern.

Food intake

The dietary guidelines recommend that Australians enjoy a wide variety of nutritious foods. During the day prior to the interview more than 90% of Australians reported consuming something from the cereal and cereal products, and the milk and milk products food groups. However, over half the males aged 12-44 years and approximately a third of children aged 4-11 years had not eaten fruit or fruit products. Further, more than 20% of children under 12 had not eaten vegetables or vegetable products on the day prior to interview.

On average, Australian males consumed a higher quantity of food and beverages than females in all age groups. Daily food and beverage consumption peaked at 4,240 g for males aged 19-24 years, and 3,320 g for females aged 25-44 years. Non-alcoholic and alcoholic beverages accounted for between 40% and 60% of total food and beverage intake, by weight. The percentage contribution of beverages initially increased with age up to 25-44 years and was generally higher for females than for males.



Average Nutrient Intake

Nutrient intake

The type and quantity of food eaten determines our daily nutrient intake. All Australians need the same range of nutrients. However, the quantities required depend on age, sex, physical size, state of health and activity levels.

The macronutrients (protein, fat, carbohydrate and alcohol) contained in foods eaten provide the energy needed for physical activity, and for keeping organs working, replacing cells, repairing damage and building tissue. Vitamins and minerals also play an important role in our health and well-being.

On the day prior to interview, average daily energy intake was 11,050 kJ for men, compared to 7,480 kJ for women. Energy intake increased sharply to a peak of 13,530 kJ for adolescent boys aged 16-18 years, and 8,690 kJ for girls aged 16-18 years and then declined with age.


Average energy intake

Carbohydrate contributed about 52% of daily energy intake for children aged 2-11 years, reducing to approximately 45% for Australian adults aged 45-64 years. Within carbohydrates, starch and sugar exhibited different patterns, with the percent contribution of sugar decreasing with age and the contribution of starch increasing slightly with age. Fat contributed between 32% and 34% of energy in all age groups. The proportion of energy from saturated fat was highest for children aged 2-3 years (16%), steadily decreasing to 12% for adults aged 45 years or more. The contribution of protein to energy intake steadily increased from 14% at age 2-3 years to 18% for adults aged 45 years or more.


Contribution of macronutrients to energy intake of adults


RDIs are the levels of intake of essential nutrients considered adequate to meet the nutritional needs of most healthy individuals. They are based on estimates of requirements for age/sex groups and, therefore, apply to group needs. As they incorporate generous factors to allow for variations in metabolism, absorption and individual needs, RDIs exceed the actual nutrient requirements for most healthy persons. Therefore they are not synonymous with requirements (NHMRC, 1991).

Australians' mean nutrient intake from food and beverages was very close to or exceeded the RDIs for most vitamins and minerals in all age groups. The exceptions were calcium for adolescent boys aged 12-15 years and females in most age groups except those aged 2-3 years and 16-18 years, zinc for females aged 12 years or more, and magnesium for adolescent girls aged 16-18 years.


Vitamin and mineral supplements

The NNS collected information on whether vitamin or mineral supplements were taken the day prior to interview, but did not obtain quantitative data. Australian adults reported taking a variety of supplements the previous day. A higher proportion of women (27%) reported taking a supplement, than men (15%). Vitamin C was the most common supplement taken by adults (10% of women and 7% of men). Other supplements frequently taken were vitamin B (8% of women and 4% of men), multivitamins (6% of women and 4% of men), calcium (7% of women) and vitamin E (5% of women).

Children aged 2 - 11 years

The childhood years are a time of growth and development. Boys and girls had reached an average height of almost 150 cm by the age of 11 years, being 55-60 cm taller than children aged 2. Body weight also increased substantially over the same period, from about 14 kg on average at age 2 to about 40 kg on average at age 11.

Food intake

The diet of Australian children changed considerably between the ages of 2-3 years and 8-11 years. During this time, the total food and beverage consumption increased by 30%, reaching 2,580 g, for boys and by 26% to 2,270 g for girls aged 8-11 years. Consumption increased with age in most food groups with the exception of milk and milk products, and fruit and fruit products, which both decreased. Nevertheless, milk and milk products still contributed significantly to average daily food intake, 430 g for boys and 360 g for girls aged 8-11 years.

Non-alcoholic beverage consumption increased to 1,120 g for girls and 1,210 g for boys aged 8-11 years, an increase of over 40% for both. Consumption of meats, poultry and game almost doubled between these ages while consumption of vegetables and legumes increased by approximately 65%, and cereals and cereal-based products increased by about 78% for boys and about 46% for girls.


Average intake from selected food groups, children 8-11 years


On the day prior to interview, more girls in all age groups consumed fruit and fruit products (between 63% and 75%) and vegetables and vegetable products (between 77% and 80%) than sugar products and dishes (between 56% and 64%) and confectionery (between 52% and 56%). Similar patterns were observed for boys with the exception that more 4-11 year old boys consumed sugar products and dishes than fruit products and dishes. However, the proportion consuming fruit and fruit products decreased noticeably into the adolescent years, particularly for boys.

Energy intake

Energy intake increased by 46% to 9,660 kJ for boys and by 37% to 8,310 kJ for girls between the ages of 2-3 years and 8-11 years. Although beverages accounted for between 42% and 50% of total food and beverages consumed by weight ,their contribution to energy intake was less than 11% for children in all age groups.

Across the food groups, cereals and cereal-based products were the major source of energy intake for boys (increasing from 30% to 39%) and girls (increasing from 32% to 36%). Although the contribution of milk and milk products to energy intake decreased with age, they remained the second most important source of energy for children (25% for children aged 2-3 years declining to 16% for children aged 8-11 years).

Carbohydrate made a greater contribution to energy intake for children (52%) than adults (46%), while the contribution of protein was lower for children, 14% compared to 18% for adults aged 45-64 years.

The contribution of total fat to energy intake remained constant at about 33% for children in all age groups. As age increased, the contribution of saturated fats declined while the percentage of monounsaturated and polyunsaturated fats increased for both boys and girls.

Eating patterns

Children tended to eat more frequently than either adolescents or adults, with almost 90% usually eating five or more times per day (see table 16). Approximately 30% of 2-3 year olds ate seven or more times per day, and this proportion decreased with age.

Over 90% of children usually ate breakfast five or more times per week, compared with 77% of adults.

Almost all children had eaten some food at home during the day before the interview. Foods consumed at home provided 75% of energy intake for children aged 2- 3 years but only 67% for children aged 8-11 years . As children reached school age they were more likely to eat food away from home that they had brought from home, with this pattern continuing until 12-15 years (see tables 12 and 13).


Adolescents aged 12 - 18 years

Growth and development continues through the adolescent years. By the age of 18, boys had reached an average height of 177 cm, while girls had reached an average height of 164 cm. Body weight had also increased substantially to an average of 75 kg for boys and 63 kg for girls.


Food intake

Food and beverage consumption for boys increased by 28% from 3,100 g for those aged 12-15 years to 3,960 g for those aged 16-18 years, compared to a 9% increase to 2,870 g for girls. The consumption in most food groups increased with age. The main exceptions were decreases in fruit and fruit products for both boys and girls and milk and milk products for girls.


Average intake from selected food groups, adolescents 16-18 years


The types of food consumed by adolescents differed from those reported by children. Fewer Australian adolescents reported consuming cereals and cereal-based products, fruit and fruit products, sugar products and dishes, confectionery, and fats and oils. In contrast, a higher proportion of adolescents reported consuming vegetables and vegetable products than children.

Energy intake

Energy intake for boys increased by 17%, from 11,590 kJ to 13,530 kJ, between the ages of 12-15 years and 16-18 years. In contrast energy intake reported by girls increased by only 2% to 8,690 kJ for those aged 16-18 years. Non-alcoholic beverages accounted for between 49% and 57% of total food and beverage consumed and contributed between 9% and 11% of energy intake.

Across the food groups, cereals and cereal-based products were the major source of energy for Australian adolescents, contributing between 34% to 37%. Milk and milk products also made a significant contribution to energy intake, from 13% for girls aged 16-18 years to 17% for boys aged 12-15 years.

Of the macronutrients, carbohydrate provided about half the energy intake for adolescent boys and girls, while fat accounted for about one-third of energy intake. The contribution of protein to energy intake was approximately 15% for Australian adolescents.

Eating patterns

Adolescent girls were more likely to be on a special diet than boys. By the age of 16-18 years almost 20% of girls reported being on some form of special diet, 5% were on a vegetarian diet, 6% were on a weight reduction diet and a further 8% were on some other form of diet.

Boys tended to eat more frequently than girls, with about 20% of 16-18 year old boys usually eating on seven or more occasions per day compared to 7% of girls the same age. In contrast 44% of girls aged 16-18 years reported eating on average only two to four times a day, compared to 31% of boys the same age.

Adolescent boys were more likely to regularly eat breakfast (5 days or more per week) than girls. At 12-15 years 87% of boys and 71% of girls regularly ate breakfast. However, this had dropped to 72% and 63% respectively at 16-18 years.

Take away and other pre-prepared foods are forming an increasing proportion of the diet. The NNS obtained information on where food and beverages were eaten but, for food eaten at home, did not distinguish between pre-prepared food and home prepared food. It did, however, identify whether food eaten away from home was obtained elsewhere or brought from home.

Adolescents aged 16-18 years were much more likely to obtain and consume food and beverages away from home (70% for boys and 68% for girls) than all younger age groups. The contribution to daily energy intake of food and beverages, obtained and consumed away from home, was higher for 16-18 year olds than for children and younger adolescents. In particular, the contribution recorded for girls aged 16-18 (37%) was higher than for females in any other age group (see tables 12 and 13). Generally, food and beverages obtained and eaten away from home had a higher relative fat content than those brought from home.

Adults aged 19 years and over

Food intake

Non-alcoholic and alcoholic beverages accounted for over 60% of total food and beverage intake, by weight, for adult Australians (2,460 g for men and 2,020 g for women). The contribution of beverages to the total weight of food and beverage intake may have been influenced by climate and was highest in the Northern Territory (74% for men) and one of the lowest in Tasmania (59% for men). The contribution of alcoholic beverages to food and beverage intake was higher for men (10%) than women (3%) (see tables 2 and 3)
Excluding beverages, cereals and cereal-based products contributed the greatest amount to food intake for men (400 g) and women (280 g). Cereals were followed by milk and milk products (320 g for men and 260 g for women) and vegetables and legumes (300 g and 240 g).


Average intake from selected food groups, adults


For men, consumption of fruit and fruit products increased with age, while daily intake of cereals and cereal-based products, milk and milk products, and meat poultry and game decreased. A similar pattern was observed for women.

Both the types and quantities of food and beverages consumed differed between the States and Territories. Adults in the Northern Territory reported consuming more meat, poultry, and game, and alcoholic and non-alcoholic beverages, and less fruit and vegetables than other Australians. Tasmanians had the lowest consumption of beverages and cereals.

Energy intake

Although beverages (alcoholic and non-alcoholic) contributed more than 60% of the total weight of food and beverages consumed, their contribution to energy intake was only 12% for men and 9% for women.

Across all food groups, cereals and cereal-based products were the major source of energy for both men and women (35% and 36% respectively). Men also obtained significant energy from meat, poultry and game (15%). Milk and milk products (11% for men and 12% for women) and vegetables and legumes (9%) were also major contributors to energy intake.


Contribution of selected food groups to energy intake, adults

For Australian adults the proportion of energy obtained from fruit and fruit products increased while energy intake from beverages decreased with age. The proportion of energy from cereals and cereal-based products also declined with age for men, while it remained constant for women.

Carbohydrate contributed the largest proportion of energy intake for men (45%) and women (46%). The contribution of fat to energy intake remained constant, at approximately 32% for men and women, in all age groups. However, the contribution of saturated fat continued to decrease with age. Protein contributed approximately 17% of energy intake for Australian adults.

Eating patterns

Women were more likely to report being on a special diet than men (42% compared to 29%). The proportion of people on a fat modified diet increased with age, with 26% of women and 23% of men aged 65 years or more reporting this type of diet. Almost 9% of women aged 25-64 years reported that their usual diet was a weight reduction diet.

Generally, for foods and beverages eaten away from home, those obtained elsewhere had a higher fat content than those brought from home. Women were less likely than men to purchase and consume food and beverages away from home (57% compared with 64%). When they did, however, this food had a higher fat content than food purchased by men (36 % compared with 34%). This difference may be partly explained by men's more frequent and higher consumption of alcoholic beverages which in general contribute energy but no fat to the diet. Consequently, food purchased and consumed away from home contributed a smaller proportion of total energy for women (22%) than men (26%).

Young adults aged 19-24 years were less likely to eat breakfast regularly than any other age group. Approximately 39% of young adults reported eating breakfast less than 5 days per week, with 15% reporting rarely or never eating breakfast. By the age of 65 years and more, 96% of both men and women ate breakfast five or more times per week.

Desired change in diet

When asked about desired changes to the types of foods consumed, over 90% of adults did not see a need to change the quantity of bread and cereals they ate. Approximately 30% of adults considered they should be eating more fruit and vegetables and about 25% of adults thought they should be eating less foods high in fat. Persons aged 19-24 years were most likely to report a desire to change their intake of selected foods, while those aged 65 years or more generally did not desire a change in their diet.

Ran out of food

Respondents aged 16 years or more were asked whether, during the previous 12 months, they had run out of food and had no money to buy more. Young men and women aged between 19 and 24 were most likely to have been in this situation with almost 10% reporting this to be the case. This corresponds to the age group most likely to buy food away from home. The proportion who had run out of food and had no money to buy more declined with age, with only 1% of people aged 65 and over reporting this to be the case.

Body mass index

Body Mass Index (BMI) (see Glossary) has been calculated for adults to assess the extent to which the Australian population is overweight or obese.

At every age, men are more likely than women to be overweight or obese. The proportion who were overweight or obese increased with age and peaked at 50-54 years for men and 60-64 years for women. Overall, 45% of men and 29% of women were considered to be overweight with a further 18% of both men and women being classified as obese. For people aged 45 and over, only about 25% of men and 35% of women were within an acceptable weight range for their height.


Overweight and obese adults

The 1995 National Health Survey (NHS) derived a BMI from respondents' self reported height and weight. This produced an estimate of the proportion of adults who were overweight or obese (45%) which was considerably lower than that from the NNS based on actual measurements (55% ) implying a tendency for respondents to understate weight and/or overstate height.

In general, excess weight is the outcome of a long-term imbalance between food and energy intake from food and energy expenditure for maintenance of normal physiological processes and for physical activity. The NNS does not provide any long-term data on food and energy intake. However, on the day before interview, the average energy intakes of men classified as overweight (10,850 kJ) or obese (10,390 kJ) was lower than that recorded for men whose weight was in the acceptable range (11,780 kJ). The same pattern was evident for women although the differences were smaller. A higher proportion of overweight and obese men and women were on special diets, both weight reduction and fat modified diets and this may be a contributing factor to the lower average energy intakes on the day before interview.


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