Summary of chronic disease
Recommendations to reduce chronic disease risk
Table 1. Suggested dietary targets (SDT) to reduce chronic disease risk
| Nutrient | Suggested dietary targeta (intake per day on average) |
Comments |
|---|---|---|
| Vitamin A |
Vitamin A: Men 1,500 µg Women 1,220 µg Carotenes: Men 5,800 µg Women 5,000 µg |
The suggested dietary target is equivalent to the 90th centile of intake in the Australian and New Zealand populations, to be attained by replacing nutrient-poor, energy-dense foods and drinks with plenty of red-yellow vegetables and fruits, moderate amounts of reduced-fat dairy foods and small amounts of vegetable oils. |
| Vitamin C |
Men 220 mg Women 190 mg |
Equivalent to the 90th centile of intake in the Australian and New Zealand populations, to be attained by replacing nutrient-poor, energy-dense foods and drinks with plenty of vegetables, legumes and fruit. |
| Vitamin E |
Men 19 mg Women 14 mg |
Equivalent to the 90th centile of intake in the Australian and New Zealand populations, to be attained by including some poly- or monounsaturated fats and oils and replacing nutrient-poor energy-dense foods and drinks with plenty of vegetables and moderate amounts of lean meat, poultry, fish, reduced-fat dairy foods and wholegrain cereals. |
| Selenium | No specific figure can be set. There is some evidence of potential benefit for certain cancers but adverse effects for others. | There are no available population intake data for Australia. New Zealand is a known low selenium area, thus recommendations based on centiles of population intakes are inappropriate. Selenium-rich foods include seafood, poultry and eggs and to a lesser extent, other muscle meats. The content in plant foods depends on the soil in which they were grown. |
| Folate | An additional 100–400 µg DFE over current intakes (ie a total of about 300–600 µg DFE), may be required to optimise homocysteine levels and reduce overall chronic disease risk and DNA damage. |
Current population intakes are well below the new recommended intakes. Increased consumption through replacement of nutrient-poor, energy-dense foods and drinks with folate-rich foods such as vegetables and fruits and wholegrain cereals is recommended as the primary strategy. Dairy foods can also help with folate absorption but reduced fat varieties should be chosen. It should be noted that fortified foods contain folic acid which has almost twice the potency of naturally occurring food folates. |
| Sodium (revised 2017)/ potassium |
Sodium (revised 2017): Men 2,000 mg 87 mmol Women 2,000 mg 87 mmol
Potassium: Men 4,700 mg 120 mmol
Women 4,700mg 120 mmol |
The Sodium SDT and UL for adults were reviewed in 2017. In this case, the SDT is the average intake of a nutrient that may help in the prevention of chronic disease. ‘Average’ refers to the median intake of the population.
The Sodium SDT was revised to 2,000 mg/day for adults. This is based on analysis of data indicating that if sodium intake at a population level were to decrease from the current average of about 3600mg/day to 2000mg/day, reductions in average population blood pressure could be achieved. It also aligns well with dietary modelling underpinning the Australian Dietary Guidelines (ADG) to support nutritional adequacy in the whole diet.
For the review of the sodium UL, the analysis of currently available data failed to determine an identifiable point at which the relationship between increasing sodium intake and increasing blood pressure did not occur in the range of tested data (between 1200 and 3300mg). In other words, increased sodium intake was associated with increased blood pressure at all measured levels of intake. The revised UL is thus ‘not determined’ reflecting the lack of an identifiable low risk level.
The 2006 Potassium NRVs have not been reviewed, as potassium was outside the scope of the 2017 review. As potassium can blunt the effect of sodium on blood pressure, intakes at the 90th centile of current population intake may help to mitigate the effects of sodium on blood pressure until intakes of sodium can be lowered. At the level of 4,700 mg/day for potassium there is also evidence of protection against renal stones. Increased potassium intake should be through greater consumption of fruits and vegetables. |
| Dietary fibre |
Men 38 g Women 28 g |
Upper level at 90th centile of intake for reduction in CHD risk. Increased intakes should be through replacement of nutrient-poor, energy-dense foods and drinks and plenty of vegetables, fruits and wholegrain cereals. |
|
LC n-3 fats (DHA:EPA:DPA) |
Men 610 mg Women 430 mg |
The suggested dietary target is equivalent to the 90th centile of intake in the Australian/New Zealand population to be attained by replacing energy-dense, low nutrient foods and drinks with LC n-3-rich foods such as fish such as tuna, salmon and mackerel, lean beef or low energy density, LC n-3-enriched foods. |
aFor most nutrients, unless otherwise noted, this is based on the 90th centile of current population intake. Average intake may be based on the mean or median depending on the nutrient and available data.
Table 2. Acceptable macronutrient distribution ranges for macronutrients to reduce chronic disease risk whilst still ensuring adequate micronutrient status
| Nutrient | Lower end of recommended intake range | Upper end of recommended intake range | Comments |
|---|---|---|---|
| Protein | 15% of energy | 25% of energy |
On average, only 10% of energy is required to cover physiological needs, but this level is insufficient to allow for EARs for micronutrients when consuming foods commonly eaten in Australia and New Zealand. Intakes in some highly active communities (eg hunter-gatherers, Arctic, pastoralists) are as high as 30% with no apparent adverse health. No predominantly sedentary western societies have intakes at this level from which to assess potential adverse outcomes. Thus, a prudent UL of 25% of energy has been set. |
| Fat | 20% of energy | 35% of energy | The lower end of the range is determined by the amount required to sustain body weight and to allow for intakes of EARs of micronutrients. Some communities, notably some Asian groups, have average fat intakes below this level, but members of these groups are often smaller in stature and their overall nutrient status is not always known. The upper level was set in relation to risk of obesity and CVD, bearing in mind that high fat diets are often high in saturated fat, a known risk factor for heart disease, and are also often energy dense, increasing a propensity to over-consumption of energy. Saturated and trans fats together should be limited to no more than 10% of energy. |
|
Linoleic acid (n-6 fat) |
As per relevant age/gender AI: Equates to 4-5% dietary energy |
90th centile of population intake: Equates to 10% of dietary energy. |
Based on intakes to help optimise chronic disease risk, notably CHD. There is some animal-based evidence that intakes up to 15% could be acceptable, but human evidence is limited. 10% as energy equates to about the 90th centile of current population intakes. |
|
a-linolenic acid (n-3 fat) |
As per relevant age/gender AI: Equates to |
90th centile of population intake: Equates to 1% dietary energy. |
Based on intakes to help optimise chronic disease risk, notably CHD. |
| Carbohydrate | 45% of energy (predominantly from low energy density and/or low glycaemic index foods) | 65%of energy (predominantly from low energy density and/or low glycaemic index food sources). | The upper bound carbohydrate recommendations were set so as to accommodate the essential requirements for fat (20%) and protein (15%). It is of importance to note that the types of carbohydrates consumed are of paramount importance in relation to their health effects. |