Are vegetarian diets healthier? Amanda Johnson Jun 17


New research published earlier this month in JAMA Internal Medicine (3 June 2013) has found that vegetarian diets are associated with lower all-cause mortality.

A total of 96,469 Seventh-day Adventist men and women were recruited between 2002 and 2007, from which an analytic sample of 73,308 participants remained after exclusions. Study participants filled out a diet and lifestyle questionnaire at the start of the study, then every two years after that, filled out hospital history forms and listed any hospitalizations and diagnoses of cancers, stroke, heart attack and diabetes during the previous two years.

According to the researchers,

Research data showed a progressive weight increase from a total vegetarian diet toward a non-vegetarian diet. Additionally, levels of cholesterol, diabetes, high blood pressure, and the metabolic syndrome all had the same trend – the closer you are to being a vegetarian, the lower the health risk in these areas. In the case of type 2 diabetes, prevalence in vegans and lacto-ovo vegetarians was half that of non-vegetarians, even after controlling for socioeconomic and lifestyle factors.”

Compared to non-vegetarians, the vegetarians watched less television, slept more hours per night, consumed more fruits and vegetables, consumed less saturated fat, and typically ate foods with a low glycaemic index, such as beans, legumes and nuts.

The study has attracted some media interest, with headlines in the UK Daily Mail, for example, asking if vegetarianism is the secret to a longer life.

This type of research is nothing new. Almost 20 years ago the Oxford Vegetarian Study (Thorogood et al., 1994) found a significant reduction in mortality from cancer and overall mortality in non-meat eaters. There was also a lower rate of ischaemic heart disease among vegetarians. In this study though, it was difficult to disentangle which features of the vegetarian diet were responsible for the protective effect, and the authors concluded their data did not provide justification for encouraging omnivores to change to a vegetarian diet as there were several attributes of the vegetarian diet, apart from not eating meat, which might reduce risk

An editorial entitled Should we all be vegetarians?, by Dr Robert B Baron from the University of California, accompanies this latest study. Dr Baron points out that like all observational studies, this one provides associations and not cause and effect evidence.

As with many of these studies, the avoidance or limitation of meat may simply be a marker for a healthier diet and lifestyle. And, as Dr Baron comments, “although the authors use state-of-the-art approaches to adjust for potential confounders, one can never be sure that there are not other factors influencing the association between vegetarian diets and mortality”

Commenting to HeartWire, Dr Robert H Eckel from the University of Colorado agrees. “We need to put this study into perspective. Is a vegetarian diet heart healthy? Probably yes. Should people convert to a vegetarian diet based on this study? Absolutely not. I think they need to look at their overall diet and make sure it is consistent with what we know about diet and heart disease.”

I’d agree. I think the key is to have a healthy balanced diet and an active lifestyle, whether or not you eat meat. For those who do eat meat it’s important to stick to the appropriate portion sizes, and to have very lean cuts. For those who choose to follow a vegetarian or vegan eating pattern the most important consideration is to ensure the diet is balanced and, in particular, that the important nutrients that meat would have provided, such as iron, are provided by alternative foods, such as nuts, seeds, lentils, cooked dried beans and tofu.

To reduce risk of cardiovascular disease and cancer, include plenty of wholegrains, fruits and vegetables in the daily diet. It’s also important to consume foods that are low in total fat, saturated fats and trans fats. If meat is eaten it should be very lean. Poultry should be eaten without skin, and dairy products should be low-fat. In addition, a regular intake of fish (once or twice a week) will boost intakes of omega-3 fatty acids, and will help lower the risk heart disease, along with other dietary and lifestyle strategies.

Caffeine in the news again Amanda Johnson May 10

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The caffeine debate has been reignited again following the 3 May announcement by the US Food and Drug Administration (FDA) that they are planning to launch an investigation into the safety of caffeine in food products, particularly its effects on children and adolescents.

According to media reports, this latest review was prompted following the launch of a new caffeinated gum from Wrigley’s called Alert Energy, in the USA. Apparently a pack of gum is equivalent to ‘four cups of coffee in your pocket’. This had lead to concerns that children and young people may be exposed to excess caffeine intakes when the cumulative effects of all foods and drinks containing caffeine are taken into account. This week Wrigley’s has announced the withdrawal of the gum pending the investigation by the FDA.

News Reports here in New Zealand have picked up on the issue of caffeine intakes in children, with concerns expressed that caffeine intake is increasing in the general population, especially in the 13 to 19 age group.

According to the FDA, caffeine was first approved for use in colas in the 1950s, and the current proliferation of caffeine added to foods is “beyond anything they ever envisioned.”

In the USA, alongside energy drinks, caffeine is now found in jelly beans, marshmallows, sunflower seeds and other snacks, where it is added for its stimulant effect. However, I’m not aware of such foods being available in New Zealand. The main sources of caffeine for us are coffee, tea, cola, energy drinks and chocolate.

While the odd cup of coffee may be fine for adults, and might even be a good ‘perk-you-up’ in the afternoons, countering the post-lunch dip, the key concern with caffeine is the effect that excess intakes may have among children.

Caffeine is a psychoactive stimulant drug that acts on the central nervous system; adverse effects can include raised blood pressure, headaches, sleeplessness and gastric irritation. The latest Food and Nutrition Guidelines for Children and Young People, published last year by the New Zealand Ministry of Health, suggests that children may be more sensitive to the effects of caffeine that other groups of the population. An upper exposure of 2.5mg/kg body weight per day has been advised as a cautious toxicological upper limit, although this is based on limited evidence. To put that into context; a can of Diet Cola can contain as much as 49mg of caffeine per serve; and a V Drink 72mg/serve.

Currently in New Zealand, there are maximum permitted levels of caffeine allowed in cola-type drinks and energy drinks. Such products must also be labelled as ‘not suitable for young children, pregnant or lactating women and individuals sensitive to caffeine.’

It will be interesting to keep an eye on the results of the FDA review as this may well have an impact on New Zealand recommendations.


UK doctors unite to tackle obesity Amanda Johnson Feb 25

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A new report published last week in the UK has come up with some comprehensive recommendations on tackling obesity. The report, Measuring up: the medical profession’s prescription for the nation’s obesity crisis, follows a 6-month inquiry by a steering group with representatives from 20 of the Royal Medical Colleges and Faculties.

The report begins by describing the UK as the ‘fat man’ of Europe, with two thirds of adults overweight or obese. Unfortunately, In New Zealand, the obesity figures are similar, with one in three adults overweight (37.0%) and a further one in four obese (27.8%).

The report presents an action plan and sets out key recommendations for healthcare professionals, local and national government, industry and schools which it believes will help tackle the nation’s obesity crisis.

Recommendations include:

1. Education and training programmes for healthcare professionals.

2. Investing £100m (NZ$181m) in weight management services in each of the next three financial years to extend and increase provision of weight management services across the country, to mirror the provision of smoking cessation services.

3. Nutritional standards for food in hospitals.

4. Increasing support for new parents by ‘skilling up’ the early years workforce to deliver basic food preparation skills to new mothers and fathers.

5. Applying mandatory food- and nutrient-based standards to all schools in England.

6. Reducing proximity of fast food outlets to schools, colleges, leisure centres and other places where children gather.

7. Implementing a ban on advertising of foods high in saturated fats, sugar and salt before 9pm.

8. For an initial one year period, taxing all sugary soft drinks, increasing the price by at least 20%. This would be an experimental measure, looking at price elasticity, substitution effects, and to what extent it has an impact upon consumption patterns and producer/retailer responses.

9. Major food manufacturers and supermarkets should agree in the next year a unified system of traffic light food labelling and visible calorie indicators for restaurants, especially fast food outlets.

10. Public Health England should provide guidance to Directors of Public Health in working with local authorities to encourage active travel and protect or increase green spaces to make the healthy option the easy option.

Some of the recommendations have attracted controversy, with a report from the BBC highlighting taxing fizzy drinks and banning junk food ads

The argument against a ‘Nanny State often arises when this type of report is published; however, Professor Terence Stephenson, a paediatrician and chair of the Academy of Medical Royal Colleges, told the BBC that there was no “silver bullet” for tackling obesity, instead the entire culture around eating needed to change to make it easier to make healthy decisions.

“I choose what I eat or whether I smoke, what people have told us is they want help to swim with the tide rather than against the current to make the healthy choice the easy one,” he said.

The report avoids the ‘blame game’, stating that obesity is not the fault of any one government, organisation or individual. Instead, they say, “it is a problem that has crept up on us and must now be tackled urgently through collective action.”

A lot of the recommendations highlight issues that are very relevant to New Zealand, and we should take note and watch carefully to see whether these recommendations are implemented in the UK, and if so, what effect they have.

We certainly need to start taking obesity seriously in this country, and we need to support those who want to make changes to improve their health, by promoting healthy environments (especially for children), by investing in weight management services, and by making healthy choices easier for people.

Dodgy weight loss regimens Amanda Johnson Jan 07


Well, it’s that time again: after the indulgences of Christmas, many of us are starting to think about getting fit and healthy for the New Year. So, I was interested to see the Healthy Weight Network in the USA announce their Slim Chance awards at the end of 2012. These awards, they say, are aimed at

“exposing the widespread fraud and quackery in the weight loss field, and are aimed at helping people, especially girls and women, move on from chronic dieting to improving their lives in more positive and lasting ways”

Topping the list of award winners this year was Dr Oz who (according to the promoters of these awards) has recommended six dubious ‘miracle’ diet aids during 2012.

One is the raspberry ketone diet (which is available here in New Zealand). It seems there have been no human clinical trials on this product – it’s something that has only been tested in animal studies and on mammalian cell cultures. Apparently, the endorsement by Dr Oz resulted in this becoming a sell-out product in some countries.

Unfortunately, as we see time and time again, there are no magic bullets for weight loss. What’s required is a change in dietary habits and an increase in activity.

Another product targeted by the Slim Chance awards was QuickTrim. This product is listed by Fishpond in New Zealand, although they are currently out of stock. This is apparently supposed to detoxify and clean the body while burning calories. The Kardashian sisters, American reality TV star promoters of the diet, were last year slapped with a US$5 million lawsuit alleging that they, and the makers of the QuickTrim diet pills, falsely touted the product’s effectiveness for losing weight.

Another product under attack is the Ab Circle Pro, also promoted in New Zealand. In the infomercials marketing this product, claims were made that three minutes a day of exercise on this machine could melt inches and pounds, causing a weight loss of 10lbs in two weeks. (One’s Close Up did a great report on this a couple of years ago.) In August, marketers of Ab Circle Pro agreed to settlements with the USA’s Federal Trade Commission for consumer refunds of between US$15 million and US$25 million.

So how do you spot those diets that are just ‘fads’ and are best avoided? Well, there is some good information on the Dietitians New Zealand website

But just in summary, we should steer clear of any diet that:

  • Promises to solve your weight problem without having to change your lifestyle in any real way.
  • Offers unlicensed and untested products such as herbal concoctions or hormones.
  • Promises rapid weight loss of more than 1kg of body fat a week.
  • Suggests special fat-burning effects of foods or supplements.
  • Uses complex medical terminology and jargon to try and sound authentic and ‘scientifically proven’.
  • Promotes avoiding or severely limiting an entire food group, such as dairy products or a staple food such as wheat. It may also suggest substituting these foods with expensive doses of vitamin and mineral supplements.
  • Promotes eating mainly one type of food (eg, cabbage soup, lemons, baby food, liquid foods) or avoiding all cooked foods (the raw food diet).
  • Recommends eating foods only in particular combinations based on your genetic type or blood group.
  • Suggests being overweight is related to a food allergy or a yeast infection.
  • Recommends ‘detoxing’ or avoiding foods in certain combinations, such as fruit with meals.
  • Offers no supporting evidence apart from anecdotes from followers or celebrities with a personal success story to tell.

The fat tax debate is reignited again Amanda Johnson Dec 12

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The debate about fat tax has been reignited with the publication of a new paper today (12 December 2012) by New Zealand researchers. Taxes on soft drinks and foods high in saturated fats, and subsidies for fruit and vegetables, could lead to beneficial dietary changes and potentially improve health, say the authors of this latest research.

Helen Eyles and her colleagues from the University of Auckland and the University of Otago (Wellington) reviewed all relevant modelling studies that investigated the association between food pricing strategies, food consumption and chronic diseases. In their combined analysis of 32 studies, the authors’ model predicted a 0.02% fall in energy intake from saturated fat for each 1% price increase. Also, a 10% increase in the price of soft drinks could decrease consumption by 1% to as much as 24%.

In contrast, the authors found that a 10% decrease in the price of fruits and vegetables could increase consumption by between 2% to 8%. The results also indicated better health outcomes for those on lower incomes, suggesting that food pricing strategies have the potential to reduce inequalities in health.

The authors do note that the majority of included studies (25/32) were of low quality, with substantial variability in model structures, data inputs, and the types and magnitudes of food taxes and subsidies assessed. There is also evidence, for ‘compensatory purchasing’; for example, if carbonated drinks are taxed, then there are non-carbonated but equally ‘sweet’ drinks available to choose from.

We are in the grips of an obesity epidemic here inNew Zealand, with one in three adults now overweight and a further one in four obese. It is generally agreed that multiple strategies are needed to address the problem; but should a tax on fatty and sugary foods be implemented here in New Zealand?

Denmark last month scrapped its fat tax, which was implemented a year ago across-the-board on all foods with a saturated fat content above 2.3 percent. The hope was that consumption of unhealthy foods would be reduced. According to media reports, Danes simply began to do their grocery shopping internationally, heading to countries that didn’t levy a tax on fat. Although it has been suggested in a New Scientist article that the real reason for the repeal was to appease business interests.

Arguments in favour of a tax on unhealthy foods include the fact that a tax would provide funds to help towards the prevention of obesity (for example advertising campaigns to promote dietary improvements) and would also help fund future medical costs. It might also deter consumers from purchasing unhealthy foods and might encourage food manufacturers to alter the composition of their products to make them healthier. The results of this latest research would appear to support the introduction of a tax.

The authors of the research study suggest that “Based on modelling studies, taxes on carbonated drinks and saturated fat and subsidies on fruits and vegetables are associated with beneficial dietary change, with the potential for improved health.”

With obesity rates sky-rocketing in New Zealand, and given that obesity is associated with many diseases (including type 2 diabetes and cardiovascular disease) and with premature death, all aspects of addressing this problem need to be considered. Price certainly has an influence on food choice, and presenting healthier food options in a way that is more appetizing and appealing, as well as more affordable than the less healthy options, is likely to encourage their selection.

For more information about the research, which is freely available, follow this link to PLOS Medicine.

Baby-led weaning Amanda Johnson Nov 27


Baby-led weaning is an alternative method for introducing complementary foods to infants, where the infant feeds themselves hand-held foods instead of being spoon-fed pureed foods by an adult.

I first came across the concept of baby-led weaning just over a year ago when I was giving a talk to a group of new parents on starting solids. One or two mums in the group had tried the approach, so I asked how this had gone for them. Their reply was that they had had limited success; by way of an example, one mum said that her baby had just “gummed a chunk of meat around his mouth and had then spat it out”. No big surprise there really!

At the time, I think my main concerns were the risk of the baby choking on large chunks of food, and also the risk of the baby not getting enough nutrition.

I started to delve into this further and realised there is actually very little evidence-based research to back what seems to be a growing trend among some new parents, although it is certainly an area of growing interest among researchers.

A paper published earlier this year (February 2012) in BMJ open suggested that infants allowed to feed themselves with finger foods from the start of weaning (baby-led weaning) are likely to eat more healthily and be an appropriate weight as they get older than infants spoon-fed purees. The study was based on a parental questionnaire, and the researchers concluded by saying:

“Weaning style impacts on food preferences and health in early childhood. Our results suggest that infants weaned through the baby-led approach learn to regulate their food intake in a manner, which leads to a lower BMI and a preference for healthy foods like carbohydrates. This has implications for combating the well-documented rise of obesity in contemporary societies.”

But what about the nutritional adequacy of the diets of young infants? I ask this question since infants have incredibly high nutritional needs. For example a seven-month-old, on average, has a higher iron requirement (RDI 11mg/day) than an adult man (RDI 8mg/day). If a baby can not swallow the food as it is in a whole form (a chunk of steak) rather than in puree form, which is easier to swallow, what impact will this have on the child’s nutritional status?

A paper published earlier this month in the journal Nutrients by researchers at the University of Otago reviewed the evidence on baby-led weaning as an approach to infant feeding and discusses some of these concerns. If this is a topic of interest you, I’d recommend having a read of this very comprehensive review.

With regard to choking, a common concern among children of this age, the review reports that:

“We found in our recent qualitative study that 30% of parents reported one or more episodes of choking with baby-led weaning. However, all parents who reported choking also reported that the infant independently dealt with the choking by expelling the food from their mouth through coughing, and that parents did not have to intervene with first aid.”

So that’s good news. It’s always important to keep a close eye on infants of this age, though, when they are eating, whatever approach to feeding is being adopted.

From a nutritional perspective, there are concerns about intakes of nutrients such as iron, particularly given that foods such as fortified baby cereals and pureed meat are key contributors to iron intake and may not be provided to infants following a baby-led weaning approach. The review reports that:

“Parents following baby-led weaning may require clearer guidelines around the types and amounts of high iron foods to offer their infant in place of iron fortified infant cereal, both to ensure adequate intake, and to avoid choking. To date, no research has examined the food and nutrient intake of children following baby-led weaning to determine whether they are at increased risk of iron deficiency. The high iron requirements in this age group mean that baby-led weaning is not likely to be appropriate for children with delayed motor skills or oral motor function who would need to wait before they could self-feed effectively.”

There is also a concern that energy needs may be insufficient if foods are predominantly fruit and vegetable based.

The authors of this review summarise by saying that although most infants probably have the skills to self-feed safely at six months, more research is needed to determine whether nutrient intakes are adequate and whether more guidance is needed for parents to ensure appropriate foods are provided to ensure optimal nutritional status and to minimise any risk of choking.

Basically, there is really a need for some good quality research into this approach before firm guidelines and recommendations can be made to parents. But the good news is that a randomised-controlled trial is about to start in New Zealand. Results should be available in 2015.

Obesity prevention starts in the womb Amanda Johnson Oct 18

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The annual scientific meeting of the Australian and New Zealand Obesity Society starts today; the theme of the meeting is ‘For our children’s children‘, and a fascinating programme has been put together with some great speakers who will be presenting their research on this important topic.

One of the keynote speakers for today (18 October) will be Professor Wayne Cutfield, who is a Professor in Paediatirc Endocrinology and Director of The Liggins Institute. He will be discussing the foetal footprint. You can listen to Professor Cutfield’s key messages, along with those of some of the other key speakers, via a Science Media Centre briefing held in advance of the conference.

Professor Wayne Cutfield told the Science Media Centre briefing that early life events are critically important and can contribute to increased risk of adult obesity and diabetes.

According to Professor Cutfield, common variants in genes account for less than 10% of common diseases – the impact of genetics is fixed and small. The environment is therefore very important and it isn’t just genes that cause chronic disease.

It is important, he says, to prevent obesity early. Children born small for gestational age (1-3%); premature babies (3-5%); and post-term babies (2-4%) all have an increased risk of obesity, insulin resistance and/or diabetes. First born children (60%) also have an increased risk of insulin resistance and high daytime blood pressure.

A study by Redwood et al that has just been completed showed that 250 women going through IVF had a limited change in diet or lifestyle in the period leading up to pregnancy (alcohol was consumed by 51%; a small number smoked – 2%; caffeine was consumed by 87%; and folic acid intakes were low among 17%). There was a perception that pregnancy doesn’t count until you have a positive pregnancy test, but in fact the impact of early life events begin very early in pregnancy. Diets were also high in fat and saturated fats; and low in carbohydrate, calcium iron and folic acid.

His conclusion was that the optimal foetal environment is delicately poised. Deviation from the average (too early/late/small) increases risk of obesity, diabetes and cardiovascular disease. The foetal environment – particularly the nutritional environment during pregnancy right from just prior to conception is important for life-long health.

There has been some media coverage of this issue today in the New Zealand Herald and 3 News and on Stuff.

It is quite clear that we need to improve nutrition education in women of reproductive age in terms of promoting optimal food intakes during pregnancy. Education, suggests Professor Cutfield, should begin in the teenage years when girls are still at school.

By ensuring the right nutrients are consumed right from the time when pregnancy is being planned and certainly during pregnancy while the baby is growing in the womb, we can at least give our children the best possible start in life. All women of childbearing age need to have access to these important messages about nutrition and health, both for themselves and for their future children. This could have a significant impact on the health of the nation in the future.



Are organic foods healthier? Amanda Johnson Sep 07

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A new systematic review published in the Annals of Internal Medicine this week suggests not.

The authors of this latest research reviewed 17 human studies and 223 studies of nutrient and contaminant levels. They conclude that the published literature lacks strong evidence that organic foods are significantly more nutritious than conventional foods; although consumption of organic foods may reduce exposure to pesticide residues and antibiotic resistant bacteria.

So what is the difference between organic and conventionally produced food? Well, according to the NZFSA, organic agriculture is “a production system that avoids or largely excludes the use of synthetic fertilisers, pesticides, growth regulators and feed additives.”  

They go on to say that, “organic agricultural practices are premised on a philosophy of farming articulated through four basic principals – health, ecology, fairness and care. For consumers who purchase organic foods often health, taste and environmental benefits are important considerations in their food choice.”

This latest review paper found that organic produce had a 30% lower risk for contamination with any detectible pesticide residue than conventional produce. However, in New Zealand, the Ministry for Primary Industries state,

“The use of pesticides, herbicides, fertilisers, and veterinary medicines is strictly regulated in New Zealand, such that any residues present in food due to the use of these agricultural compounds are at levels that present notional zero risk to consumers. The term ‘notional zero risk’ is used to describe the risk associated with consuming levels of substances below the acceptable daily intake (ADI) which is the level at which a substance can be consumed every day for a whole lifetime without noticeable effect.”

From a nutritional perspective this latest review paper showed there is little difference between organic and conventionally produced food. There were no significant differences in vitamin content, and although phosphorous and total phenol content of organic foods were higher, the difference was of little clinical significance.

Organic produce can be considerably more expensive and the authors of this latest research conclude that despite the widespread perception that organically produced foods are more nutritious than conventional alternatives, they did not find any robust evidence to support this perception.

For anyone concerned about pesticide residues, consumption of conventionally produced fruits and vegetables has not been found to pose any risk to health – but washing and peeling fruits and vegetables will reduce exposure. For more information check out this Cancer Society information sheet.

The benefits of consuming fruits and vegetables certainly outweigh any risk, and we should all be consuming at least five portions a day of this important food group

Unhealthy weight control among New Zealand kids Amanda Johnson Aug 30

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A new study just published this month by researchers at the University of Auckland has highlighted concerns about weight control behaviours among New Zealand adolescents, and has identified a number of ‘red flags’ for unhealthy weight loss.

The new findings were published last week (21 August 2012) in the International Journal of Behavioural Nutrition and Physical Activity by Dr Jennifer Utter and colleagues from the School of Population Health, University of Auckland.

The researchers collected data as part of a national health and wellbeing survey of secondary school students in New Zealand in 2007. In total 9,107 students aged 13-18 agreed to participate. Results showed that among students who had attempted to lose weight (around half of the children surveyed) 90% were eating less fatty food and 52% were eating fewer sweets.

Of concern, however, was that a significant number of children were adopting unhealthy weight control behaviours in order to reduce their weight; for example vomiting (7.8%), diet pills (3.5%), smoking cigarettes (9%), fasting (12.5%) and skipping meals (31.4%). Students who adopted the more unhealthy weight control behaviours had significantly lower wellbeing scores and higher depression scores.

The authors of this research suggest that as skipping meals and fasting were the most common unhealthy weight control behaviours that routine assessment by clinicians should include screening for meal skipping and fasting.

This is an interesting study, especially in the light of the new Food and Nutrition Guidelines for Children and Young People published by the Ministry of Health earlier this month. The latest figures for the prevalence of obesity show that among 2-14 year olds 20.9% were overweight and a further 8.3% were obese; and among 15-19 year olds 22.1% were overweight and a further 12.6% were obese.

Weight issues are obviously affecting a significant number of New Zealand children and we need to make sure that good healthy strategies are put in place to help these children manage their weight effectively. Children need to be supported with advice based on the Ministry of Health Food and Nutrition Guidelines and Guidelines for Weight Management in Children and Young People. In terms of diet; a healthy diet should be encouraged that is low in saturated fats, sugar, and salt, includes a variety of foods, such as wholegrain cereals, rice, pasta, fruits, vegetables, and lean proteins. Water and milk should replace sugary drinks, and high-energy takeaway foods and snacks should be avoided. Children should also be encouraged to take part in regular moderate-intensity or vigorous physical activity for at least 60 minutes per day.

This approach should be promoted to all children with weight issues, however, following the publication of this research we all need to keep a particular eye out for ‘red flags’ such as fasting and meal skipping so we can intervene with appropriate help and support.

New nutrition guidelines for children out today Amanda Johnson Aug 06

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The Ministry of Health has today published the latest report in their series of Food and Nutrition Guidelines; this report is all about healthy children and young people from the ages of 2 to 18 years.

Children and young people in New Zealand represent a quarter of the population. Making sure our children follow a good healthy balanced diet will promote normal growth and development and will contribute to optimal health as they move through childhood and into adulthood.

The key recommendations in the report include consuming a balance of different foods from the four main food groups (wholegrain breads and cereals; vegetables and fruits; lean meat, poultry, fish, eggs, legumes and nuts; and low-fat milk and dairy foods). It also recommends the preparation of foods, snacks and drinks that are low in fat, salt and sugar. Children and young people should have plenty of fluids to drink during the day (water and lower-fat milks are the best choices; sugary drinks should be limited). Energy drinks are not recommended, and children under 13 should not drink coffee or tea. Older children should limit coffee and tea to one to two cups a day.

The report also advises encouraging children to get involved in shopping, growing food and cooking family meals.

Of course, physical activity is also very important for kids, and 60 minutes a day of activity is recommended while limiting sedentary pursuits to less than two hours a day.

I think it is interesting that the report highlights a number of concerns in relation to intake of food and nutrients among this age group. For example, children and young people in New Zealand are consuming foods high in fat, sugar and/or salt (HFSS foods) regularly. 85% of children consume potato chips, corn snacks or chips at least once a week, and nearly 50% of children consume chocolate, confectionary, fancy biscuits and soft drinks at least once a week. HFSS foods and drinks should not be thought of as ‘everyday’ foods and should be limited to less than once a week.

Intake of certain nutrients was found to be low in some children. Among children aged 5-14 years, prevalence of inadequate intake of folate was estimated to be 37%; among girls aged 9-14 years the figure was 64%. Calcium intakes were also a concern, with prevalence of inadequate intakes among children ages 5-14 years estimated to be 65%. Inadequate iron intakes were a concern among girls aged 15-18 years. An estimated 34% of girls in this age group had inadequate iron intakes, with a higher estimated prevalence of inadequate intakes among Maori (49%) and Pacific (40%) girls.

There is clearly a need to re-balance the diets of some children and young people. The publication of this report provides a timely opportunity for anyone involved with raising and caring for children in New Zealand to review the children’s eating habits and to promote the consumption of healthy, nutrient-dense foods, while limiting the intake of high-fat, high-sugar, high-salt ‘treat’ foods.

Practical guidelines for the public are also available with a new resource on healthy eating for children aged 2-12 years and one for teenagers (age 13 to 18 years).

The full report Food And Nutrition Guidelines For Healthy Children And Young People (Ages 2-18 Years) A background paper is now available on the Ministry of Health website. It’s an excellent and very comprehensive report and I would highly recommend it to anyone with involvement or interest in the food and nutrient consumption of New Zealand children.


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