1

Questions and answerson theEating and Activity Guidelines for New Zealand Adults

More information about the Eating and Activity Guidelines can be found in the following factsheets that are located on Summary of Guidelines Statements and key related information; Topical Questions and Answers; What’s changed.

Context

  1. Who is the Guidelines document for? Will anything be developed for the public?

The Eating and Activity Guidelines for New Zealand Adultsis a document written for health practitioners and others who provide advice on nutrition and physical activity for New Zealand adults. The key messages from the Guidelines will be available for the public via the accompanying health education resources: Healthy Eating Active Living – food and physical activity advice for adults from 19–64 years; and Eat Healthy Food and Move More Everyday. These resources can be found on the Ministry of Health website ( and the health education resources website (

  1. Why has the Guidelinesdocument been produced?

The Guidelines document replaces the existing Food and Nutrition Guidelines for Healthy Adults (MOH 2003) and the Physical Activity Guidelines for Adults (SPARC & MOH 2007). The new Guidelines provide up-to-date, evidence based recommendations on nutrition and physical activity for New Zealand adults aged 19-64 years.

Evidence shows that diet, excess weight and physical inactivity are three major modifiable risk factors that contribute to early death, illness and disability in New Zealanders. By making positive changes to eating and activity patterns New Zealanders can not only improve their wellbeing but can also live longer, healthier lives.

  1. What are the key eating and activity messages for New Zealand adults?

The Eating and Activity Guidelines document provides eleven eating and activity related statements (the Guidelines Statements). These Statements are the evidence-based, population health key messages on nutrition and physical activity. They are designed to help New Zealanders meet nutrient needs; maintain a healthy body weight; be physically active; and decrease the risk of non-communicable diseases like cardiovascular disease and cancer. (See over page for Guidelines Statements.)

The Guidelines Statements are as follows:

Making good choices about what and how much you eat and drink, and being physically active are important for good health.
Eating Statements / Activity Statements
1. Enjoy a variety of nutritious foods every day including:
  • plenty of vegetables and fruit
  • grain foods, mostly whole grain and those naturally high in fibre
  • some milk and milk products, mostly low and reduced fat
  • some legumes*, nuts, seeds, fish and other seafood, eggs, poultry (eg, chicken) and/or red meat with the fat removed.
* Legumes include lentils, split peas, chickpeas and cooked dried beans (eg, kidney beans, baked beans) / 1. Sit less, move more! Break up long periods of sitting.
2. Choose and/or prepare foods and drinks:
  • with unsaturated fats (canola, olive, rice bran or vegetable oil, or margarine) instead of saturated fats (butter, cream, lard, dripping, coconut oil)
  • that are low in salt (sodium); if using salt, choose iodised salt
  • with little or no added sugar
  • that are mostly ‘whole’ and less processed.
/ 2. Do at least 2½ hours of moderate or 1¼ hours of vigorous physical activity spread throughout the week.
3. Make plain water your first choice over other drinks. / 3. For extra health benefits, aim for 5 hours of moderate or 2½ hours of vigorous physical activity spread throughout the week.
4. If you drink alcohol, keep your intake low.
Stop drinking alcohol if you could be pregnant, are pregnant or are trying to get pregnant. / 4. Do muscle strengthening activities on at least two days each week.
5. Buy or gather, prepare, cook and store food in ways that keep it safe to eat. / 5. Doing some physical activity is better than doing none.
Body Weight Statement
Making good choices about what you eat and drink and being physically active are also important to achieve and maintain a healthy body weight. Being a healthy weight:
  • helps you to stay active and well
  • reduces your risk of developing type 2 diabetes, heart disease and some cancers.
If you are struggling to maintain a healthy weight, see your doctor, a dietitian or your community health care provider.

Content

  1. What has changed?

For the first time the Guidelines document brings food and nutrition, and physical activity related guidance together in one place. The Eating Statements place more emphasis on having ‘whole’ and less processed foods, replacing saturated fats with unsaturated fats rather than decreasing total fat, and including more plant (such as legumes, nuts and seeds) and seafood based protein foods in the diet. The Activity Statements now include specific advice on reducing sitting time and the extra benefits of increasing activity levels. For more specific information on ‘What’s changed?’ go to

  1. Why does the Guidelines Statements/document now cover activity/exercise as well as food/nutrition?

Health practitioners and others with an interest in nutrition and physical activity suggested that as both subjects form the basis of a healthy lifestyle, putting population advice into the same document made sense. Both nutrition and physical activity are important for maintaining or achieving a healthy body weight.

  1. The Guidelines Statements now recommend people choose mostly ‘whole’ and less processed foods. What is meant by ‘whole’ and less processed foods?

‘Whole’ foods are those close to their natural state, but that may have been harvested, washed or cleaned ready for consumption or cooking. Examples of whole foods are fresh vegetables and fruit, raw legumes, raw nuts and seeds, eggs, fish, chicken and red meat (with visible fat removed).

Less processed foods are those that have undergone some processing, but have kept most or many of their physical and nutritional properties. This definition includes foods that have been processed with the aim of making the food:

  • safer – for example, pasteurised milk products
  • healthier – for example, low-fat milk, which contains less energy (kilojoules) and less saturated fat than full-fat milk
  • more convenient to use – for example:
  • whole grains that have had their inedibleouter husks removed but still have allof their edible parts
  • wholemeal flour ground from whole grains
  • frozen, packaged vegetables and fruit that may have been frozen quickly to keep their nutrient content
  • canned legumes, vegetables and fruit with no or minimal added sugar and/or salt, which have been prepared and cooked ready for use.

In comparison, highly processed foods, or the ingredients used to make them, have been heavily processed so they are usually very different from their natural states. Highly processed, ready-to-eat foods tend to be low in naturally occurring nutrients such as vitamins, minerals, fibre and other phytonutrients. They are often high in refined grains, energy (kilojoules), added saturated fat, sugar and/or salt (sodium).

  1. Why is choosing mostly ‘whole’ and less processed foods recommended?

Evidence shows dietary patterns that include vegetables and fruit, whole grains, legumes, nuts, dairy (including low-fat options) and seafood, but that are low in processed meat, refined grains, saturated fat, added sugar and salt are the healthiest. People who eat a lot of highly processed food with refined ingredients and added fat, salt and sugar are more likely to exceed their energy requirements and less likely to get the nutrients they need to remain healthy.

  1. What is the difference between prolonged sitting time (sedentary behaviour) and physical inactivity?

Sitting for long periods of time and being physically inactive are both separate risk factors for poor health. Physical inactivity is defined as doing less than 30 minutes of moderate physical activity over the entire week. However, it is possible to meet the physical activity recommendation of at least 2 ½ hours of physical activity per week, and still sit for long periods of time in between.

  1. I’ve got no chance of meeting the 2 ½ hours recommendation let alone the 5 hour one…so why bother trying to do anything?

The Ministry is aware that not everybody meets the Activity Statements. However, the evidence suggests that even small, sustained gradual increases in the time, duration or intensity of physical activity are good for health. Proportionally, a person who is less physically active to start with makes greater health gains when they increase their physical activity than a person who is already more physically active. Even if you cannot meet the recommended levels of activity, doing some activity is better than none.

  1. Why do you need to reduce sitting time if you are already physically active?

Even when adults are doing 2 ½ hours of moderate activity or equivalent a week, sitting for prolonged periods can affect your health.

Breaking up prolonged periods of sitting is important. Replacing sitting time with activities of daily living (such as hanging the washing out, gardening, washing the car or vacuuming) can have a positive effect on health. Those in sedentary jobs should try to stand and/or move for a few minutes each hour.

  1. Can all the Guidelines Statements be met through one type of activity?

Technically the Activity Statements could be met by doing one activity such as swimming or uphill running. However, the Ministry recommends doing a variety of activities that involve both the upper and lower limbs, improve aerobic fitness, agility and muscle strength.

  1. How do the revised guidelines compare with those used in other similar countries –eg, Australia's new food pyramid and physical activity guidelines?

The Guidelines Statements are based on the evidence that has been used to develop eating (dietary) and physical activity guidelines for a number of similar ‘developed’ countries. The Eating Statements are similar to guidelines from Australia, the United States of America (USA) (2010 and information used to prepare the 2015 edition), and the Nordic countries. The Activity Statements are similar to guidelines from Australia, the United Kingdom and the United States of America. All Statements are also consistent with advice from the World Health Organization and the World Cancer Research Fund.

Guidelines development

  1. Why did the Food and Nutrition Guidelines Series change to the Eating and Activity Guidelines Series (the Guidelines Series)?

The Guidelines Series were developed following an independent evaluation of the Food and Nutrition Guidelines in 2011. The evaluation showed the Food and Nutrition Guidelines are valued by many health practitioners, but some changes to their development process and format would strengthen them and make them more accessible to a wider audience. The Guidelines Series contain key features that were identified as important by a wide range of health practitioners during the evaluation. This includes creating one document that has both nutrition and physical activity population health advice; an external advisory group to work on the guidelines; and a more robust evidence base to support the advice.

The Guidelines Series aim to meet information needs of the health and activity sectors in the future.

  1. Who was consulted in the development of these Guidelines document?

Following extensive feedback from the sector (as part of the 2011 evaluation), on what the updated guidelines ideally would include,the Ministry undertook other key stakeholder consultation on the Guidelines document during different stages of the development process. Key stakeholders included:

  • nutrition and physical activity academics
  • health practitioners including individuals, national organisations such as Dietitians NZ and colleges such as Royal New Zealand College of General Practitioners (RNZCGP)
  • Māori and Pacific publichealth nutrition and physical activity organisations such as Toi Tangata and the Heart Foundation's Pacific Heartbeat
  • non-government organisations such as Cancer Society and Heart Foundation
  • physical activity and fitness organisations, such as the Exercise Association of New Zealand
  • food industry groupssuch asFood and Grocery Council, Grains and Legumes Nutrition Council, New Zealand Beef and Lamb, Fonterra and Unilever New Zealand
  • government agencies and crown entities including ACC, Ministry for Primary Industries, Sport NZ and the Health Promotion Agency
  • general public–specifically focus group testing of the Guidelines Statements included adult New Zealanders of Māori, Pacific, South Asian and New Zealand European ethnicities.

3. Who was on the Technical Advisory Group (TAG)?

Throughout the update and review of the Eating and Activity Guidelines, the Ministry has been guided by a Technical Advisory Group (TAG) of experts in nutrition and physical activity. The TAG consists of:

  • Professor Jim Mann (Chair) – Professor of Nutrition, University of Otago
  • Professor Murray Skeaff– Professor of Nutrition, University of Otago
  • Dr Ofa Dewes – Researcher in Pacific Health, University of Auckland
  • Dr ZirshaWharemate– Former Lecturer, Massey University
  • Dr Clare Wall – Associate Professor Nutrition, University of Auckland
  • Dr Pamela von Hurst – Senior Lecturer in Human Nutrition, Massey University
  • Delvina Gorton – Former Nutrition Advisor, New Zealand Heart Foundation
  • Dr Scott Duncan – Senior Lecturer Physical Activity / Associate Director of the Human Potential Centre, Auckland University of Technology
  • Dr Sandra Mandic– Senior Lecturer Physical Activity, University of Otago.
  1. How has the process used for the Guidelines made them technically more robust than previous Food and Nutrition Guidelines?

Previous Guideline documents have always considered a broad base of evidence via the literature review part of their development process, including key international evidence based documents and reports. However, the Ministry’s capacity for Guidelines development will never be as well-resourced as significantly larger and more populous countries such as Australia, the United States of America and the United Kingdom. The best option is for New Zealand to identify and consider the already completed international evidence or systematic reviews that underpin the dietary and physical activity guidelines of larger countries.

Links to other Government initiatives

  1. How does the Guidelines document contribute to and support the government’s work to address childhood obesity?

Although focused on adults, the Guidelines provide fundamental advice on healthy eating and regular physical activity that applies across the life-course. The Guidelines will support the Ministry’s work on childhood obesity, when used as the basis of healthy lifestyle advice for families and whānau.

  1. How does the Guidelines document link to the government’s Health Star Rating system?

The Guidelines recommend people choose a wide variety of foods that are mostly whole or less processed, and lower in saturated fat, sugar and sodium (salt). If choosing packaged foods, the Health Star Rating system allows consumers to quickly and easily compare the nutrition quality of similar foods, such as breakfast cereals. Foods lower in saturated fat, sugar or sodium (salt) and/or higher in fibre, protein, nut, legumes, fruit or vegetable content have more stars. The more stars the healthier the product.

Other

  1. Aren’t all people different? How can individuals usefully apply advice developed for a population?

These Guidelines Statements are population health advice that provides general information on nutrition, physical activity and achieving a healthy weight. This advice applies to most New Zealanders. However if more individualised advice is needed, such as when people have particular health issues, this specialised advice should come from health, nutrition and activity practitioners. These practitioners take into account the specific information and circumstances relating to an individual and interpret the Guidelines Statements appropriately.

  1. Will this Guidelines document lead to the development of a new food model for New Zealand?

Health promotion tools such as food models require up to date recommendations on what food to eat and how much is needed. While the Guidelines document provides updated advice on what to eat, further work to revise the quantitative aspects (the ‘how much’) is needed. The Ministry has begun a review of its current dietary serving size advice and is investigating how best to do quantitative food modelling. Both steps are required, as well as consumer and sector testing to create new user-friendly advice on what and how much of it to eat for New Zealanders. There is currently no time frame for the completion of this work.

General Qs &As – last edited 23 Oct 2015