EAT FOR HEALTH Australian Dietary Guidelines

EAT FOR HEALTH – AusTRALiAn diETARy guidELinEs

20

Guideline 1

•   Sugar: No large long-term studies have measured the long-term development of overweight or obesity

specifically related to consumption of added sugars (Evidence Report, Section 14.3). However, recent evidence

indicates that it is probable that consumption of sugar-sweetened drinks (soft drinks) is associated with

increased risk of weight gain in adults and children (Grade B; Evidence Report, Section 15.1),185-196 a finding

confirmed 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 increased

adiposity in children and moderate evidence that consumption of sugar-sweetened drinks is associated with

increased body weight in adults.^198 Most of the relevant research (see Section 3.3.2) was conducted in the uS

where, unlike Australia, corn syrup containing fructose is commonly used to sweeten soft drinks. Although

these sweeteners differ only slightly from those used commonly in Australia, this was taken into consideration

in grading the relevant evidence statement.

•   Glycaemic index: The uS review found strong and consistent evidence that glycaemic index and/or glycaemic

load are not associated with body weight and that modifying either of these does not lead to greater weight

loss or better weight management.^198 There is considerable variability in these indices, depending on inter-and

intra-individual factors and the form of food (including the degree of processing, stage of ripeness, cooking and

cooling times), which may limit practical application.^199 These factors were not included in the literature review

to inform the revision of these Guidelines.

•   Vegetables and fruit: There is evidence suggesting that consumption of vegetables is associated with a

reduced risk of weight gain (Grade C; Evidence Report, Section 2.2).200-203 The evidence also suggests that

consuming 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 and

vegetable 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 and

body weight.^198

•   Dairy foods: Recent evidence suggests that consumption of dairy foods is not associated with weight change

or risk of obesity (Grade C; Evidence Report, Section 5.8)209-214 and that consuming milk is not associated with

BMI or BMI change in childhood (Grade C; Evidence Report, Section 5.9).209,215-219 These findings are consistent

with those of the uS review, which found strong evidence that intake of milk and milk products do not have a

distinct role in weight control.^198

•   Grains: There is evidence of a probable association between consumption of three to five serves per day

of 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 gain

in 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 is

associated with increased adiposity when consumed in amounts that are appropriate for the age and energy

needs of the child. However, increased intake of fruit juice was found to be associated with increased adiposity

in children who were already overweight or obese.^198

In seeking to achieve and maintain a healthy weight it is prudent to choose nutrient-dense foods of lower energy

density – that is, those low in total fat, particularly saturated fat, and added sugars (see Chapter 3) – in a total dietary

pattern that seeks to control overall energy intake.^236 The uS review found strong and consistent evidence that dietary

patterns that are relatively low in energy density improve weight loss and weight maintenance in young adults.^198

Factors associated with risk of overweight and obesity

•   Breastfeeding: There is convincing evidence that breastfeeding infants, compared with formula feeding, is

associated 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 overweight

or obesity in childhood, adolescence and later life (Grade A; Evidence Report, Section 17.1).54,58,61,62,79,238,239

There is a J- or u-shaped relationship between birth weight and increased risk of child or adult obesity, with

both low birth weight and high birth weight babies at increased risk.^240