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What this series is about As we age, keeping physically active is essential. It not only improves the appearance of the body, it also prevents the occurrence of health complications in the future. Join the discussion in this series as we research the various programs that can help maintain a healthy body.
Staying Young: Nutrition (b)
New national nutrition standards target chronic diseases
As indicated in the last issue of this newsletter (31 May 2006) the joint report of the Department of Health and Ageing and the National Health and Medical Research Council (NHMRC) of Australia and the New Zealand Ministry of Health offers a guide for dieticians, nutritionists and other health professionals to help accurately assess the dietary needs of individuals and groups.
According to Elizabeth Aitken (New Zealand Ministry of Health team leader and senior nutrition advisor) the new Nutrient Reference Values incorporate the previously used term Recommended Dietary Intakes (RDIs). The new recommendations cover more nutrients, set multiple levels and provide guidance on the dietary pattern required to reduce the risk of chronic disease, such as heart disease and diabetes.
For example, the new folate values include recommendations for prevention of deficiency and to reduce the risks of neural tube defects in babies. The recommendations provide a more comprehensive guide to the suggested intake of some 30 essential nutrients including protein, dietary fibre, essential fatty acids, and vitamins and minerals such as Vitamin A, folate, iron, calcium, iodine, selenium, and sodium.
For many people, meeting their recommended nutrient intake could be as simple as increasing the number of servings of vegetables, fruits and wholegrain cereals they eat. Eating reduced-fat dairy products, lean meats and a small amount of plant-based fats and oils is also the key. But it is important to note that the recommendations may not meet the specific nutritional requirements of individuals with health conditions or diseases, or for premature babies.
Copies of the Nutrient Reference Values for Australia & New Zealand are available at the New Zealand Ministry of Health at http://www.moh.govt.nz/publications, or the
Australian Department of Health and Ageing at
Questions and Answers
1. What are Nutrient Reference Values?
The Nutrient Reference Values outline the levels of intake of essential nutrients considered, on the basis of available scientific knowledge, to be adequate to meet the known nutritional needs of practically all healthy people to prevent deficiencies. For each nutrient, values are set for the estimated average requirement (EAR) for people in different age and gender groups as well as for pregnancy and lactation. A second figure called a Recommended Dietary Intake (RDI) is derived from the EAR, to take account of the variation in absorption and metabolism of nutrients, even within age/gender groups. The RDI covers the needs of nearly all people in that group. If there is not enough scientific evidence to set an EAR and RDI, an Adequate Intake (AI) figure is set either based on experimental data or median population intakes in an otherwise healthy population. An Upper Level of Intake (UL) is set, above which regular consumption could lead to adverse effects. For the first time, some guidance was also given for some nutrients in relation to reduction of chronic disease risk.
2. Who uses Nutrient Reference Values and what are they used for?
Nutrient Reference Values are used by health professionals such as dieticians and doctors to assess the likelihood of inadequate intake in individuals or groups of people; by universities and researchers; for meal planning or large scale catering in places such as hospitals, the armed services and aged care facilities; by food industry to develop and assess new food products; and by the government sector in setting food policy and legislation, such as in the development of food choice guides or food labelling to help the public make informed choices.
3. Why were the Recommended Dietary Intakes revised and who undertook the revision?
The previous Recommended Dietary Intakes, which are used both in Australia and New Zealand, were published in 1991. However, since then, scientific knowledge about nutrient needs has expanded greatly and new evidence on a range of nutrients has been found. Since chronic diseases now affect large sectors of the population, it was felt necessary to include additional information about levels of intake that may reduce risks of developing these diseases.
4. In Australia and New Zealand what nutrients are not consumed in sufficient quantities?
Nutrients which are thought to be particularly borderline in Australia and New Zealand include folate, calcium and iron for women, as well as iodine and selenium. However, up-to-date data on dietary intake in Australia are limited.
5. Is it really possible to get all those nutrients in a “normal” diet?
As part of the development process, a modelling exercise was undertaken to ensure that the recommendations were attainable with commonly eaten foods. The modelling showed that this was possible across a wide range of energy requirements (from 6000kj/day upwards). Flexibility of food choice increased as energy requirements increased, again emphasizing the importance of being physically active.
6. Do I have to take vitamin and mineral pills to get what I need?
No; dietary modelling showed that it is possible to get all the nutrients required from eating a variety of vegetables and fruits including some nuts and seeds, wholegrain cereal foods, reduced fat dairy foods and lean meats, fish (particularly those rich in omega-3 fats) or poultry as well as small amounts of poly or monounsaturated fats and oils.
Strict vegetarians who consume no animal foods may need supplements of vitamin B12 and omega-3 fats. They will need to take care that they eat sufficient iron and zinc-rich foods as these nutrients are less available from plant sources, so intake needs to be much higher than for non-vegetarians.
These recommendations are for generally healthy people in the population. However, there may be some other people such as the very elderly or those with specific medical conditions who may need supplements for medical reasons. Vitamin D supplements may also be needed by older people with little sun exposure and by veiled women.
7. Why do pregnant and lactating women need more nutrients than other women of the same age?
In pregnancy, there are increased needs for many (but not all) nutrients to cover additional needs of both the mother, whose own body increases in size during pregnancy, as well as for the foetus. Similarly, when a mother is breastfeeding, requirements are often increased to account for the amount ‘lost' in the breast milk. The increased needs can vary across nutrients as the mother's body can sometimes compensate for the additional needs, e.g. by increasing the absorption for a particular nutrient.
8. Why do older people need more of some nutrients than younger adults?
Older people often have higher nutritional requirements than younger adults because their bodies are not as efficient at absorbing the nutrients from food or processing the nutrient once it enters the body. However, the reverse is true for energy requirements as the body chemistry slows down with age and we are generally also less active. Thus it is particularly important that older adults have a high quality, nutrient rich diet.
9. Do these recommendations apply to every individual or are they for healthy people only?
The recommendations are for generally healthy people. Many people in the community do suffer from conditions such as diabetes, high blood pressure or heart disease. Generally speaking these recommendations would also be applicable to most people in these groups and for people with many other conditions. However requirements can be affected by a number of clinical conditions and some medications, so if in doubt, advice should be sought from health professionals, especially dieticians, in these special cases.
10. Would consumers achieve even greater benefit from consuming above the Upper Level of Intake?
No. The Upper Level of Intake has been set as the safe upper level for regular use above which there is a likelihood of adverse effects.
11. What should I eat to reduce my risk of chronic disease, such as heart disease?
For the first time the recommendations include advice about the type of dietary pattern to reduce the risk of chronic disease. To achieve this protection you need to follow the recommended Food and Nutrition Guidelines, in particular vegetables and fruit and more wholegrain breads and cereals. This benefit is only achieved by eating foods and not from dietary supplements.
12. Will food labels be changing and when?
Food Standards Australia New Zealand will commence a process to update the set of nutrient reference values currently listed in the Australia New Zealand Food Standards Code. After the Code is updated, some food labels may need to change. These changes will be timed to coincide where possible with changes to other labelling requirements.
Project Manager and Editor, Quality4life
21 June 2006