EAT FOR HEALTH Australian Dietary Guidelines

EAT FOR HEALTH – AusTRALiAn diETARy guidELinEs

24

Guideline 1

Taller and/or more active adults in each age and sex group can choose additional serves of foods from the five

food groups and/or unsaturated spreads and oils and/or discretionary foods to increase energy intake to meet

energy requirements (that is, to comprise Total Diets),^9 but they need to monitor weight or waist circumference

to ensure energy intake does not exceed expenditure. If energy requirements are exceeded by energy intake on

a regular basis, weight gain will occur.

There is wide variation in individual energy needs, so to prevent weight gain (or inappropriate weight loss) at an

individual level, weight (and waist circumference) should be measured regularly (e.g. every 2–3 months) and the

amount and/or quality of dietary intake and physical activity levels adjusted accordingly.^9

As a basic principle when adjusting dietary patterns, the first steps are to choose nutritious foods from the

five food groups and the unsaturated fat allowance in amounts consistent with Foundation Diets and to limit

discretionary (energy-dense, nutrient-poor) choices. If further restrictions are required, rather than eliminating

one category of food from the five food groups, smaller serves should be chosen.^9

Recommended quantities of specific food groups to suit those preferring different dietary patterns are included

in the Foundation Diets for adults set out in the Food Modelling System.^9

1.4.2 Weight loss in adults who are overweight

These Guidelines do not encourage inappropriate food restriction. However, they do discourage consumption of

energy-dense, nutrient-poor discretionary foods and drinks.

In dietary patterns to achieve a healthy weight and assist weight loss, the recommendations of types and

quantities of foods outlined in the Foundation Diets, outlined throughout this document and in the companion

resources should not be exceeded. Adhering to Foundation Diets only, without discretionary foods or additional

serves of the five food groups, could represent a daily reduction in energy intake of 1,850 kilojoules for women

and 2,700 kilojoules for men who are average height for their age and sex group. This could result in a satisfactory

amount of weight loss, even if physical activity levels are not increased.

A combination of increased physical activity and energy restriction is more effective than energy restriction alone

for weight loss and maintenance of weight loss. Physical activity can affect body composition favourably during

weight loss by preserving or increasing lean mass while promoting fat loss. Physical activity affects the rate of

weight loss in a dose-response manner, based on its frequency, intensity and duration.

Weight loss will not be achieved unless energy intake is lower than total energy expenditure. lifestyle

improvements, through cognitive and behaviour change, to increase physical activity and improve dietary intake

is fundamental to weight management. Such education, training and support may be provided to individuals or

groups.^121 Weight loss is most likely to be maintained where dietary and physical activity habits are acceptable

and sustainable. In this regard, regular weight loss of initially around 1.0 to 4.0 kg per month, reaching 10% loss

of initial weight in the medium term and 10–20% loss of initial weight over 1–5 years, is likely to be most effective

and sustained.121,281

Individuals who are overweight or obese and have associated cardiovascular disease or type 2 diabetes risk

factors should seek clinical advice about the range of available treatment options.^121

1.4.3 Pregnant and breastfeeding women

Obesity in pregnancy is one of the most common, and potentially modifiable, risk factors for adverse pregnancy

outcomes^282 and longer term adverse outcomes for mothers^283 and children.^284 Since about one-third of pregnant

women in Australia are overweight or obese,^285 preventing excess gestational weight gain is an urgent health priority.

Appropriate maternal weight gain during pregnancy (see Tables 1.2 and 1.3) is important for the health of the infant:

•   too little weight gain during pregnancy increases the risk of a low birth weight infant

•   excess weight gain during pregnancy increases the risk of macrosomia and gestational diabetes and is also

associated with increased risk of obesity and metabolic syndrome in infants later in life.286,287

Evidence supports recommendations to manage pregnancy to reduce the risk of excess weight gain and

gestational diabetes.288,289