Janis Baines Section Manager, Food Data Analysis, Food Standards Australia New Zealand. Paul Atyeo Assistant Director, ABS Health Section

Transcription

1 ILSI SEAR Australasia March 2015 Nutrition information from the Australian Health Survey Background and selected results Janis Baines Section Manager, Food Data Analysis, Food Standards Australia New Zealand Paul Atyeo Assistant Director, ABS Health Section

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3 Structure of the Australian Health Survey General population sample size = 26,000 households NATIONAL HEALTH SURVEY (NHS) 15,500 Households 1 Adult + 1 child = 20,500 persons Detailed conditions Medications and supplements Health related actions Days of reduced activity Social & emotional wellbeing (18 yrs +) Physical activity (15 yrs +) Private health insurance status (18 yrs +) Breastfeeding (0-3 yrs) Disability status Alcohol consumption (15 yrs +) Family stressors (15 yrs +) Personal income (15 yrs +) Financial stress NATIONAL NUTRITION AND PHYSICAL ACTIVITY CORE CONTENT SURVEY (NNPAS) 25,000 Households 9,500 Households 1 Adult + 1 child (2 yrs +) = 32,000 persons 1 Adult + 1 child (2 yrs +) = 12,000 persons Household information Demographics Self-assessed health status (15 yrs +) Smoking (15 yrs +) Physical measures (height, weight, waist and body mass index) Dietary behaviours Blood pressure (5 yrs +) Female life stage (10 yrs +) Selected conditions NNPAS Telephone follow-up 2 nd dietary recall 8-day pedometer (5 yrs +) 24 hr dietary recall Food security Food avoidance Physical activity NATIONAL HEALTH MEASURES SURVEY (NHMS) All survey participants (aged 5 yrs +) invited to VOLUNTEER persons Key blood tests (12yrs +) and urine tests (5yrs +) of nutritional status and chronic disease markers

4 Source of nutrition data 24 hr recall (x2) (detailed food consumption data and intakes for 44 nutrients) Biomedical indicators of nutritional status (Sodium, Potassium, Vitamin D, Folate, B12, Iodine, Iron)

5 National Health Measures Survey Types of tests Diabetes Fasting plasma glucose HbA1c Cardiovascular disease Blood lipids: total cholesterol, HDL, LDL, triglycerides Chronic kidney disease Urinary albumin creatinine ratio Estimated glomerular filtration rate (egfr) Liver damage Alanine aminotransferase (ALT) Gamma glutamyl transferase (GGT) Anaemia Haemoglobin Risk factors Serum cotinine Nutrition status Sodium, Potassium, Vitamin D, Folate, B12, Iodine, Iron

6 Diabetes % years and over Total with diabetes Known diabetes Source: Australian Health Survey , ABS

7 % Diabetes Aboriginal and Torres Strait Islander Non-Indigenous Source: Australian Health Survey , ABS

8 Source: Australian Health Survey , ABS Vitamin D all Australian adults

9 AHS Biomedical Results for Nutrients: Vitamin D % 35 Vitamin D deficiency by age, years and over Age groups (years) Source: Australian Health Survey , ABS

10 FSANZ use of AHS biomedical data Application to add Vit D to breakfast cereals Vitamin D intakes from fortified breakfast cereals estimated using national nutrition survey data (various intake scenarios) Estimated incremental increase in serum vitamin D from intake of fortified breakfast cereals using a dose-response relationship Added increment to the distributions of serum 25(OH)D from AHS for different age groups Calculated proportion population with low and high serum 25(OH)D values before and after fortification and for different types of consumers

11 FSANZ use of AHS biomedical data Application to add Vit D to breakfast cereals Based on best-case/ worst-case scenario modelling Predicted decrease in prevalence low vitamin D status (25(OH)D < 40 nm) Australian adults: baseline 13.4% to 1.6% New Zealand adults: baseline 20.9% to 1.5% Predicted increase in prevalence high vitamin D status (25(OH)D > 125 nm) Australian adults: baseline 1.3% to 7.5% New Zealand adults: baseline 1.4% to 5.5%

12 Nutrition First Results - Selected highlights

13 AHS Nutrition First Results Foods and Nutrients Proportion of consumers (day prior to interview) Non-alchoholic beverages Cereals & cereal products Milk products & dishes Vegetable products & dishes Cereal based products & dishes Meat & poultry products & dishes Fruit products & dishes Sugar products & dishes Fats & oils Savoury sauces & condiments Confectionery & cereal/nut/fruit bars Alcoholic beverages %

14 Food group contribution to energy Proportion of energy from selected food groups Seeds & nuts 1.6% Other 10% Confectionary 2.8% Fruit 4% Alcoholic beverages 5% Non-alcoholic beverages 6% Fish 2.3% Vegetable products & dishes 7% Milk products 11% Cereal based products & dishes 20% Meat & poultry products & dishes 14% Cereals & cereal products 18% Source: Table 8.1, AHS: Nutrition First Results Foods and Nutrients

15 AHS Nutrition First Results Foods 60 Soft drink consumption, % Males Females years and over Age groups (years)

16 % AHS Nutrition First Results Foods Cereal based products consumption biscuits Sweet biscuits Savoury biscuits and over Age Group (years)

17 AHS Nutrition First Results Foods % Cereal based products consumption pizza and burgers Pizza Burgers and over Age Group (years)

18 % AHS Nutrition First Results Foods Fruit & vegetable consumption Fruit Vegetables and veg. products and over Age Group (years)

19 Energy intake 12,000 Persons aged 2 years & over - Mean daily energy intake, kj 10,000 8,000 6,000 4,000 2,000 Males Females and over Age group (years)

20 Under-reporting Widely observed and documented that when people report on their food intakes in nutrition surveys, there is tendency to underestimate. This includes: actual changes in foods eaten because people know they will be asked about them, and misrepresentation (deliberate, unconscious or accidental), eg. to make their diets appear more healthy or be quicker to report.

21 Distribution Outlines for Energy Intake over Basal Metabolic Rate for All Ages: NNS95 and NNPAS11-12 EI/BMR 1.55: minimum average energy requirement for normally active but sedentary population (not sick, disabled or frail elderly) 0.9: Goldberg cut-off for a plausible report, i.e. lower 95% confidence limit for a single day for a single individual, allowing for day-to-day variation in energy intakes, and errors in calculation of EI:BMR

22 How much energy is missing?

23 Nutrients Macro Energy Moisture Macronutrients Protein Total Fat Saturated fat Monounsaturated fat Polyunsaturated fat Linoleic acid Alpha-Linolenic acid Omega 3 Cholesterol Trans fat Total Carbohydrate Total sugars Total starch Dietary Fibre Alcohol AUSNUT nutrient profiles for food, supplements Micro Vitamins Preformed Vitamin A Pro Vitamin A Vitamin A retinol equivalent Thiamin Riboflavin Niacin Niacin equivalent Folate Folic acid Total Folates Folate equivalent Vitamin B6 Vitamin B12 Vitamin C Vitamin E Minerals Calcium Iodine Iron Magnesium Phosphorus Potassium Selenium Sodium Zinc Caffeine

24 24 hr vs usual intake Usual intake Threshold amount 24 hr snapshot Nutrient amount

25 Calcium

26 Iron One in eight people aged two years and over had inadequate usual intakes of iron. Females were more likely than males to have inadequate iron intakes, with 23% not meeting the requirements compared with 3% of males.

27 FOCUS ON FOLATES, THIAMIN AND IODINE In Australia, most wheat flour for bread making is required to be fortified (enriched) with folic acid (a form of folate) and thiamin. If salt is used in bread making it is required to be iodised for the majority of bread types Approximately one in twelve (9%) adult females (aged 19 and over) did not meet their requirements for folate (dietary folate equivalents) based on their intakes from foods. Approximately 7% of males and 16% of females had inadequate thiamin intakes. This was consistently higher for females than for males across all age groups over 19 years. 2% of males and 8% of females did not meet their iodine requirements. Some young children exceeded the UL for iodine (13% of males and 6% of females aged 2-3 years).

28 Iodine Females aged 19 years and over were more than four times as likely as males to have inadequate intakes. Almost one in ten children aged 2-3 years (13% of males and 6% of females) had a usual intake from food exceeding the UL for iodine. Proportion of population with inadequate iodine intakes Age EAR (µg) Prevalence of inadequacy Males Females

29 Folate One in eleven (9%) adult females (aged 19 and over) did not meet their requirements for folate. Almost all males met their requirements for folate (2% with inadequate intakes). Proportion of population with inadequate folate intakes Age EAR (µg) Prevalence of inadequacy Males Females

30 Women of childbearing age % Vitamin B12, females years pmol/l

31 Comparisons with AHS biomedical results Folate/folic acid Based on NHMS, vast majority of women of childbearing age had sufficient folate. Less than 1% had a red cell folate level which indicates an increased risk of NTDs. Usual nutrient intakes: Approximately 9% adult females did not meet their requirements for folate Almost all males met their requirements for folate Iron NHMS did not publish any overall assessment of population iron status. Usual nutrient intakes: Females were much more likely to have inadequate iron intakes from foods than males, with 23% not meeting their requirements compared with 3% of males Vitamin B12 NHMS - Women of childbearing age had adequate levels of Vitamin B12, with an average well above the WHO cut-off for Vitamin B12 deficiency. Usual nutrient intakes: The proportion of females aged 14 years and over with inadequate usual intakes of vitamin B12 ranged from 5 to 8%. Almost all males met their requirements for B12

32 76% of males and 42% of females exceed the upper level of intake (UL) Males more likely than females to exceed the UL for every age group Children 2-8 years most likely to exceed UL >99% males 95% females Sodium

33 Salt usage How often salt is added, either in cooking or at the table, Not used 24% Very often 39% Rarely 12% Occasionally 25%

34 Interpretation Only food intakes used to model usual intakes. Supplements are not included. This may influence some findings Discretionary salt (salt added during cooking or at the table) not included. Sodium and iodine estimates will be impacted Underreporting, as described in Nutrition first results, will have some impact on results. Not all foods are impacted equally, so effects will vary across nutrients.

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36 AHS Nutrition THINGS TO COME Aboriginal and Torres Strait Islander peoples, Food and Nutrition 20 March 2015 State & territory tables April 2015 Guide to comparing with 1995 May 2015 Comparison with biomedical results late 2015 Comparison with Australian Dietary Guidelines early 2016

37 AHS Users Guide