A food modelling system for Australia

Lynne Cobiac, Peter Baghurst, Anthea Magarey, Annette Byron, Katrine Baghurst

For NHMRC

Overview• Background• Overview of methodology

– What nutrients?– What food groups?– What serve sizes– What NRVs?– Input from scientific reviews

• Foundation Diets• Total Diets• Where to from here?

Background• 1994 Core Food Groups• 1991 RDIs• 1992 Dietary Guidelines

for Australians• 1990 food composition• 1989-1990 Apparent

Consumption

• ?• 2006 NRVs (EAR, RDI, etc

• ? Dietary Guidelines• NUTTAB06, 09; AUSNUT07• 2007 ANCNPAS, 1995 NNS• Scientific Literature Reviews

Food groups for modelling created; serve size equivalents within groups determined

Composite food establishmentFor each group composite food devised using consumption relativities from NNS95 and NCNPA07 data. Created nutrient profiles and serve size for each food group for each age/gender

Modelling using composite foodsa. Foundation diet developed to provide overall numbers of serves of each of the major food groups using composite foods to cover RDI for 10 key nutrients within the least energy required for age/gender groups within constraints for chronic disease, social and environmental factorsb. Compared with nutrient standards, usual intakes, etc and remodelled as necessary.

Total Diet modelsa. Modelled variety of approaches to ‘total’ diets with composites building on foundation for each age/gender to reach various energy levelsb Compared with AMDR, UL, SDT and adjusted if necessary

Cross checkCompare with existing recommendations, intakes, and food supply

Modelling using simulated diets with individual foods Devised and assessed against nutrient standards (EARs), 100, 7-day diets per acceptable total diet pattern per age/gender group using real foods.Remodelled and retested if necessary

Draft foundation and total diet intake patterns

Final foundation and total diet intake patterns

Systematic Literature Reviews undertaken on chronic disease, social factors and environmental sustainability to establish model constraints re foods

Cross-checked current food groupings - CFG (1994) and AGTHE98 (1998) Recommendations examined with new composites using AUSNUT07

Consultation with NHMRC

Core outcomes…• Food patterns to provide nutrient

requirements over a week• Foundation Diets:

– Smallest/youngest children/oldest adult least active in all NRV age/gender groups

– ie aim to reach RDIs for the least energy requirements

– No discretionary or extra foods• Total Diets:

– Example diets for those with higher energy requirements (taller more active)

– Already achieved nutrients, so can add discretionary or extra foods

– Check against AMDR, SDTs etc

What nutrients?Energy and nutrients included as

drivers in modellinga Nutrients and food components to be assessed as outputs from

modelling, for information only

Energy Protein Thiamin Vitamin A as retinol equivalentsb Vitamin C b Folate as Dietary Folate equivalentsb Calcium Iodine Iron Magnesium Zinc

Nutrients with an AI only Linoleic acid Α-linolenic acid LC n3 fatty acidsb Dietary fibre Vitamin D Vitamin Eb Potassiumb Sodiumb Nutrients with EAR/RDI available in AUSNUT07 Riboflavin Niacin as Niacin Equivalents Phosphorus Nutrients with AMDR % energy as: protein, fat, carbohydrate, linoleic acid, α-linolenic acid

Nutrients with EAR/RDI available for key foods from NUTTAB09 Vitamin B6 Vitamin B12 Seleniumb Other nutrients and food components reported as outputs Starches Sugars Cholesterol Alcohol Used to examine P:M:S output Saturated fat Polyunsaturated fat Monounsaturated fat

a This group of nutrients was selected by NHMRC to drive the modelling (see next section); all have an EAR and RDIb Nutrients with a Suggested Dietary Target (SDT) for chronic disease prevention

Food group Minimum average daily serves

Maximum average daily serves

Comments

Cereals overall 4 6 Model all wholegrain(wg) ; all white and 50-50 wg-white (subsequently 2/3 wg to 1/3 refined ratio agreed as a result of modelling)

White rice unlimited unlimited 120g cooked rice = 1 serveCultural acceptability particularly for Asian cuisines

Wholegrain or brown rice

unlimited unlimited See cereals overall

Refined pasta unlimited unlimited 120g cooked pasta = 1 serveCultural acceptability particularly for some Mediterranean cuisines

Wholegrain pasta unlimited unlimited See cereals overall

Wholegrain or higher fibre bread

unlimited unlimited 40g bread equivalent = 1 serve

Refined or lower fibre bread

unlimited unlimited 40g bread = 1 serve

Oats unlimited 2 Serve =25g dry

Refined or lower fibre breakfast cereals

unlimited 2 serves Suggest sliding scale based on energy content (serve 30g)

Legumes unlimited unlimited Includes beans including baked beans, soybean, chickpeas, lentils, tofu

Green, brassica vegetables

1 2 Upper level was modelled on basis of cultural acceptability and variety as a large number of serves (e.g. 11-15/day) are chosen in an unrestrained model because of high nutrient density of this food category Serve =75g

Orange vegetables 1 2 As above

Starchy vegetables 1 4 Not to dominate vegetable group

Other vegetables 1 2 Includes tomatoes

Nuts and seeds unlimited 2 High kilojoules. Serve =30gSome varieties more beneficial re health and environment than others

NHMRC DGWC: Inputs from scientific evidence

NHMRC DGWC: Inputs from scientific reviews

Food group Minimumaverage dailyserves

MaximumAveragedaily serves

Comments

Meats, fish, seafood, poultry overall

unlimited 150g Global contraction and convergence framework – suggests contraction over decades among high consuming populations to mean of 90g meat/person/day for all people - allows room for low consuming populations to increase intake - based on principles of reducing green house gas emissions and reducing poor health from both over and undernutrition.

Lean red meats unlimited 65g See above.Good source of limiting nutrientsIncludes beef, lamb, veal, pork, venison, kangaroo. Pork included as epidemiological

evidence usually includes pork as red meat Current red meat consumption is high in men.Pasture-fed varieties may be more environmentally sustainable

Lean white meats unlimited 65g Includes chicken, turkey, duck, quail, crocodile

Fish and seafood 20g 40g Combine all categories for modelling purposes. At a 100g serve the daily range of 20-40g targeted for modelling of Foundation Diets would

equate to 1.4 to 2 serves a week. Some varieties may be more environmentally sustainable than others

Eggs Unlimited 1 egg

Fruit 2 4 Serve = 150g (edible portion) Exclude juice for modelling.

Total dairy foods Unlimited 4 Serve =250g milk equivGood source of limiting nutrientsSome non-lower fat dairy foods to be included for cultural acceptabilityAfter initial modelling, dairy foods were modelled on a mix of higher fat and lower fat options

for Foundation diets. Serve quantities were combined but with the proviso that most choices be lower fat. Some issues regarding environmental sustainability.

Higher fat dairy foods 0.5 0.5 Predominantly cheese. Good source of calcium and vitamin A and variety but limit re saturated fat content. Serve= 40g

Medium fat dairy foods 1 unlimited Includes full fat milks, yoghurts, some reduced fat cheese. Dairy food consumption declining in childrenServe= 250g milk equiv

Lower fat dairy foods unlimited unlimited Dairy food consumption declining in childrenServe= 250g milk equiv

Unsaturated fats and oils unlimited 0 or unlimited depending on modelling

Consider current culinary practices- include as an allowance as per previous CFG modelling

Inputs from scientific evidence (cont)

What foods?• Vegetables: 75g

– Starch– Green & brassica– Orange– Legumes– Other

• Nuts & Seeds:30g

• Cereals: 40g equivalent– Wholegrain/higher fibre– Refined/lower fibre

• Meats: 65-170g– Poultry/fish/seafood/eggs/legumes: 80-170g– Red meats: 65g

• Dairy foods: 250g equivalent

• Additional category: 7-10g equivalent– Unsaturated oils and spreads

• Vegetables– Starch– Green & brassica– Orange– Legumes– Other

• Nuts & Seeds

• Cereals– Wholegrain/higher fibre– Refined/lower fibre

• Meats– Poultry/fish/seafood/eggs/legumes– Red meats

• Dairy foods

• Additional category– Unsaturated oils and spreads– Discretionary choices or extras (600kJ equiv)

Foundation Diets: lowest energy Total Diets: higher energy

What NRVs to use?• Food selection guide used by individuals, so RDI is

basis for planning• Foundation Diets

– RDI benchmark for composite foods based on current consumption patterns

And– Cross-checked 100 x 7-day simulations against EAR with

individual food choices, with aim to get all diets >EAR• Total Diets

– Upper Limits (UL)– For those > 14 years

• Acceptable Macronutrient Distribution Ranges (AMDR)• Suggested Dietary Targets (SDT)

Summary of modelling resultsFor all age and genders (as per NRVs)• Foundation Diets: aim to reach RDI for 10 key nutrients for least E

• Omnivore, lacto-ovo-vegetarian, pasta-based, rice-based• Expressed as serves per week as some foods do not need to be eaten

every day• Major food groups plus allowance for unsaturated fats and oils (limit of 20-

40g/d marg or 7-28g/day oil) for adults)• Iron main limiting nutrient, especially pregnant women• ? Magnesium for older men

• Total Diets: includes additional serves of foods from: • Major food groups• Unsaturated fats and oils allowance (limit of 30-60g/d of marg or 20-45g/d

oil)• Discretionary or extras options – limited to 0-3 serves/day dependent on

EER• UL for sodium most often exceeded• Within AMDR, P:M:S

Omnivore Foundation Diets for men designed to attain RDI for the age group within energy needs of the smallest (160cm), very sedentary (PAL 1.4) in the group

OMNIVORE FOUNDATION DIETS MEN (modelled serves per week)

Composite food group Serve size

19-30 yrs 31-50 yrs 51-70 yrs 70+ yrs

Starchy vegetables 75g 7 7 7 5

Green & brassica vegetables 75g 7 7 7 7

Orange vegetables 75g 7 7 7 7

Legumes 75g 7 7 2 2

Nuts/seeds 30g 7 7 4 4

Other vegetables 75g 14 14 14 14

Fruit 150g 14 14 14 14

Wholegrain or higher fibre cereals/grains Equiv 40g bread 28 28 28 21

Refined or lower fibre cereals/grains* Equiv 40g bread 14 14 14 10

Meat and alts minus red Equiv 65g red meats 7 7 7 7

Red meats (beef, lamb, veal, pork) 65g 7 7 7 7

Dairy foods** Equiv 250g milk 17 17 17 24

Additional modelled allowance of unsaturated oils and spreads

Poly-unsaturated margarine *** 10g 28 28 28 14

* Refined or low fibre cereals were included as a group for cultural reasons; wholegrain or higher fibre cereals can replace these if preferred. ** Should be mostly low fat *** As proxy for unsaturated oils and spreads and could be replaced with PUS oil (7g/serve) or seeds (10g/serve)

Omnivore Foundation Diets for women designed to attain RDI for the age group within energy needs of the smallest (150cm), very sedentary (PAL 1.4) in group

OMNIVORE FOUNDATION DIETS WOMEN (modelled serves per week)

Composite food group Serve size Preg. Pr Lact. Lact.

19-30 yrs

31-50 yrs

51-70 yrs

70+yrs

19-30 yrs

31-50 yrs

19-30 yrs

31-50 yrs

Starchy vegetables 75g 5 5 5 3 5 5 7 7

Green & brassica vegetables 75g 7 7 7 7 7 7 7 7

Orange vegetables 75g 7 7 7 7 7 7 7 7

Legumes 75g 2 2 3 3 2 2 3 3

Nuts/seeds 30g 2 2 3 3 2 2 4 4

Other vegetables 75g 14 14 14 14 14 14 14 14

Fruit 150g 14 14 14 14 14 14 14 14

Wholegrain or higher fibre cereals/grains Equiv 40g bread 28 28 20 15 41 41 42 42

Refined or lower fibre cereals/grains* Equiv 40g bread 14 14 8 6 19 19 21 21

Meat and alts minus redEquiv 65g red meats 7 7 7 7 12 12 7 7

Red meats (beef, lamb, veal, pork) 65g 7 7 3 3 12 12 7 7

Dairy foods** Equiv 250g milk 17 17 28 28 17 17 17 17

Additional modelled allowance of unsaturated oils and spreads

Poly-unsaturated margarine *** 10g 14 14 14 14 14 14 14 14

* Refined or low fibre cereals were included as a group for cultural reasons; wholegrain or higher fibre cereals can replace these if preferred. ** Should be predominantly low fat *** As proxy for unsaturated oils and spreads and could be replaced with PUS oil (7g/serve) or seeds (10g/serve)

Food groups FOUNDATION TOTAL AGHE

Vegetables 31-50 years

31-50 years 19-60 years

-Starchy vegetables -Green and brassica vegetables -Orange vegetables -Legumes -Other vegetables

6 5-11 5-7

Nuts & Seeds

- nuts and seeds 1 1-2 (in meats/ alternatives)

Fruit - Total fruit 2 2-4 2-3.5 Cereals (40g equivalent) - Wholegrain or higher fibre cereals/grains - Refined or lower fibre cereals/grains*

6 6-9 9-13.5

Meats Poultry fish seafood eggs legumes 100g 100g 33-122g Red meats (beef, lamb, pork etc) 65g 65g 33-50g Dairy Foods Dairy foods** 2.5 2.5-3.5+ 2-4 Additional Categories Unsaturated oils and spreads*** 40g 40g+ 20-60g Discretionary choices (600kJ equivalents) -- 0-2.5 1.5

Omnivore Total Diets for men aged 31-50 yrs

*Can be wholegrain or higher fibre if preferred **Should be mostly low fat *** Poly-unsaturated margarine was used in modelling as a proxy for polyunsaturated oils and spreads

Where to from here?• NHMRC finalising inputs from public

consultation– Final report to be released later in 2010 – this will

define practice• Dietary Guideline writers:

– Translate the models into the new food selection guide

– Finalise the food groups, serve sizes, education messages