Bringing in the Guidelines: The story so far….
AUSTRALIAN DIETARY GUIDELINES (ADG)
The ADG summarise the [scientific] evidence of the relationships between food and health. From the NHMRC (2013), the most recent release of the ADG:
The guidelines, together with the underlying evidence base, provide guidance on foods, food groups and dietary patterns that protect against chronic disease and provide the nutrients required for optimal health and wellbeing…
They [the ADG] are important tools that support broader strategies to improve nutrition outcomes….
The guidelines aim to promote the benefits of healthy eating, not only to reduce the risk of diet-related diseases but also to improve community health and wellbeing. The Guidelines are intended for people of all ages and backgrounds in the general healthy population, including people with common diet-related risk factors such as being overweight. (NHMRC, 2013, p. 2)
There have been five releases of the ADG; 1976, 1986, 1992, 2003, 2013.
The exact origin to the first appearance (1976) of dietary guidelines in Australia is unclear. However, it is reported by Dr Beverley Wood, the 1976 introduction and release of the dietary guidelines coincided with the International Confederation of Dietetics Associations (ICDA) conference of 1976 hosted in Sydney (Nash, 1989, pp. 41-45)
In his historical text on nutrition in Australia, Fredrick Clements writes:
The next development was the compilation of the ‘Dietary Guidelines’. This move began in the Scandinavian countries and the USA between 1968 and 1977.
In Australia in 1978 and 1979 a number of organisations, including the Australian Academy of Science, the Australian Association of Dietitians, and the Nutrition Society of Australia, established working parties to consider the need for changes in the Australian diet. This was because of the strongly held opinions of many medical persons, scientists, nutritionists and public health administrators that the high prevalence of such diseases as coronary heart disease, stroke, hypertension, and diabetes were due, in part at least, to the diets eaten by a sizeable portion of the Australian population. (Clements, 1986, pp. 218,219)
The first two releases (1976 and 1986) were introduced and disseminated by the Dietitians Association of Australia (DAA). The guidelines were a three-way folded colour pamphlet with headline: Stop and Think Before You Eat and Drink: Dietary Guidelines to Good Health.
There were nine guidelines unchanged across the two releases as:
- Eat a variety of foods each day.
- Prevent and control obesity.
- Limit the fat in your diet.
- Decrease your sugar consumption.
- Limit alcohol consumption.
- Enjoy water.
- Increase your intake of fruit, vegetables,
bread and cereals.
- Reduce salt intake.
- Encourage breastfeeding.
From the 1992 release onward, the guidelines became the responsibility of and published by the commonwealth government under the NHMRC. The 1992 publication was the first time reference to scientific studies were included in the report (NHMRC, 1992). The 1992 release followed the recommendations of the previous two releases (NHMRC, 1992)
- Eat a wide variety of nutritious foods.
- Eat plenty of breads and cereals (preferably wholegrain), vegetables (including legumes) and fruits.
- Eat a diet low in fat and, in particular, low in saturated fat.
- Maintain a healthy body weight by balancing physical activity and food intake.
- If you drink alcohol, limit your intake.
- Eat only a moderate amount of sugar and foods containing added sugar.
- Choose low salt foods and use salt sparingly.
- Encourage and support breastfeeding.
The 2003 release saw the introduction of food safety with “Care for your food, prepare and store it safely” (NHMRC, 2003). Special considerations were made for the nutrition of Aboriginal and Torres Strait Islander people, social status, nutrition and the cost of healthy eating, and sustainability of food systems (NHMRC, 2003, pp. 249, 265, 271).
The guidelines appeared to be aligned to the “five food groups”, including dairy, to become:
- Eat a wide variety of nutritious foods
- Eat plenty of vegetables, legumes and fruits
- Eat plenty of cereals (including breads, rice, pasta, and noodles) preferably wholegrain
- Include lean meat, fish, poultry, and/or alternatives
- Include milks, yogurts, cheese and/or alternatives
- Drink plenty of water
- Limit saturated fat and moderate total fat intake
- Choose food low in salt
- Limit your alcohol intake if you choose to drink
- Consume only moderate amounts of sugar and foods containing added sugars
- Prevent weight gain: be physically active and eat according to your energy needs
- Care for your food, prepare and store it safely
- Encourage and support breastfeeding
The most recent iteration of the guidelines is in 2013, at an estimated cost of $AUD2.1million (NHMRC, 2013).
 The predecessor to the dietary guidelines was the “Five Food Groups”. In his notes, Fredrick Clements writes: Up to the late 1950s most of the advice on food selection was of a general nature. It had not changed greatly from the 1940s. The emphasis was on liberal intakes of the ‘protective’ foods, milk, eggs, fruit and vegetables with the exercise of moderation in the amounts of carbohydrates and fats eaten. The first important change happened in the late 1950s, in America with the introduction of the ‘Four Basic Food Groups’. …..The Four Basic Food groups were adopted in Australia with appropriate modifications. The groupings were meats and meat substitutes (legumes), fruits and vegetables, dairy products (excluding butter) and grains and cereal products. The advice was expressed in the number of servings (size of which was specified for people of various ages) from each of the groups per day. The importance of this development was that the dietitian (nutritionist/health worker) could be specific – in light of experience since then, perhaps too specific. Pamphlets and posters were prepared and distributed, listing the items in each of the Basic Four Food Groups. In 1979 a fifth item was added to the Basic Four. This contained the high-energy – low nutrient foods such as butter and margarine and oils and sugar and sugar rich foods. The Five Food Groups received a mixed reception from nutritionists and dietitians as well as from school teachers. (Ball et al., 2015)
 Dr Beverly Wood is a dietitian and was the principle investigator for the Melbourne Working Party established by the NH&MRC in 1975. The Working Party was established to investigate the thiamin status of Australians, which was reported by the Working Party to be “at best borderline when compared with internationally accepted standards” (Clements, 1986, p. 216). Dr Wood is the author of Tucker in Australia which traces the history of and influences on dietary patterns in Australia (Clements, 1986, p. 204). Tucker in Australia was published by the DAA as part of the lead-up to the 1997 ICDA meeting in Sydney; offered as an adjunct revenue raising delight by the organizing committee of the 1977 ICDA (Wood, 1977). Dr Wood’s career is one of major intellectual and philosophical contribution to the profession of dietetics, yet to be discovered and accurately documented. Her approach and ideas in her role as Chief dietitian at St Vincent’s hospital in Melbourne demonstrates a level of insight and empathy, of operating “on the edge” of the conservative expectations of dietitians, to advocate for improved food-health for the disadvantaged of Melbourne.
 The 1976 release of the “Dietary Guidelines for Good Health” is pictured here – Kindly supplied by Dr Bev Wood 2015
 Under “limit the fat in your diet” included recommendation to limit use of cooking fats (butter, margarine, oil), and, to use low fat milk products, skim milk, low fat cheeses and low fat yoghurt.