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Background: Water consumption as a vital component of the human diet is under-researched in dietary surveys and nutrition studies. Aim: To assess total water and fluid intakes and examine demographic, anthropometric, and dietary factors associated with water consumption in the Australian population. Methods: Dietary intake data from the 2011 to 2012 National Nutrition and Physical Activity Survey were used. Usual water, fluid and food and nutrient intakes were estimated from two days of dietary recalls. Total water includes plain drinking water and moisture from all food and beverage sources; total fluids include plain drinking water and other beverages, but not food moisture. Results: The mean (SD) daily total water intakes for children and adolescents aged 2–18 years were 1.7 (0.6) L for males and 1.5 (0.4) L for females, and for adults aged 19 years and over were 2.6 (0.9) L for males and 2.3 (0.7) L for females. The majority of the population failed to meet the Adequate Intake (AI) values for total water intake (82%) and total fluids intake (78%) with the elderly at highest risk (90%–95%). The contributions of plain drinking water, other beverages and food moisture to total water intake were 44%, 27%, and 29%, respectively, among children and adolescents, and 37%, 37% and 25% among adults. The main sources of other beverages were full-fat plain milk and regular soft drinks for children and adolescents, and tea, coffee, and alcoholic drinks for adults. For adults, higher total water intake was associated with lower percent energy from fat, saturated fat, and free sugars, lower sodium and energy-dense nutrient poor food intakes but higher dietary fibre, fruit, vegetable, caffeine, and alcohol intakes. No associations were found between total water consumption and body mass index (BMI) for adults and BMI z-score for children and adolescents. Conclusion: Reported water consumption was below

Considerable evidence has associated increasing portion sizes with elevated obesity prevalence. This study examines typical portion sizes of commonly consumed core and discretionary foods in Australian adults, and compares these data with the Australian Dietary Guidelines standard serves. Typical portion sizes are defined as the median amount of foods consumed per eating occasion. Sex- and age-specific median portion sizes of adults aged 19 years and over (n = 9341) were analysed using one day 24 hour recall data from the 2011–12 National Nutrition and Physical Activity Survey. A total of 152 food categories were examined. There were significant sex and age differences in typical portion sizes among a large proportion of food categories studied. Typical portion sizes of breads and cereals, meat and chicken cuts, and starchy vegetables were 30–160% larger than the standard serves, whereas, the portion sizes of dairy products, some fruits, and non-starchy vegetables were 30–90% smaller. Typical portion sizes for discretionary foods such as cakes, ice-cream, sausages, hamburgers, pizza, and alcoholic drinks exceeded the standard serves by 40–400%. The findings of the present study are particularly relevant for establishing Australian-specific reference portions for dietary assessment tools, refinement of nutrition labelling and public health policies.

Purpose To examine the intake and sources of added sugars (AS) of Australian children and adolescents, and compare their intake of free sugars (FS) to the recommended limit set by the World Health Organization (% energy from FS). Method Data of 4140 children and adolescents aged 2-16 years with plausible intakes based on 2 x 24 h recalls from the 2007 Australian National Children Nutrition and Physical Activity Survey were used. AS content of foods was estimated based on a published method. Intakes of AS and FS, as well as food sources of AS, were calculated. One-way ANOVA was used for comparisons between age groups and gender. Results The mean (SD) AS intake was 58.9 (35.1) g/day, representing 11.9 (5.6) % of daily energy intake and 46.9 (17.5) % of daily total sugars intake. More than 80 % of the subjects had % energy from FS > 10 %. Significant increasing trends for AS intake, % energy from AS, % energy from FS across age groups were observed. Sugar-sweetened beverages (19.6 %), cakes, biscuits, pastries and batter-based products (14.3 %), and sugar and sweet spreads (10.5 %) were the top three contributors of AS intake in the whole sample. Higher contribution of AS from sugar-sweetened beverages was observed in adolescents (p trend < 0.001). Conclusions A large proportion of Australian youths are consuming excessive amounts of energy from AS. Since the main sources of AS were energy-dense, nutrient-poor foods, interventions which target the reduction in these foods would reduce energy and AS intake with minimal impact to core nutrient intake.

Background/objectives: The effect of added sugar on health is a topical area of research. However, there is currently no analytical or other method to easily distinguish between added sugars and naturally occurring sugars in foods. This study aimed to develop a systematic methodology to estimate added sugar values on the basis of analytical data and ingredients of foods. Subjects/methods: A 10-step, stepwise protocol was developed, starting with objective measures (six steps) and followed by more subjective estimation (four steps) if insufficient objective data are available. The method developed was applied to an Australian food composition database (AUSNUT2007) as an example. Results: Out of the 3874 foods available in AUSNUT2007, 2977 foods (77%) were assigned an estimated value on the basis of objective measures (steps 1-6), and 897 (23%) were assigned a subjectively estimated value (steps 7-10). Repeatability analysis showed good repeatability for estimated values in this method. Conclusions: We propose that this method can be considered as a standardised approach for the estimation of added sugar content of foods to improve cross-study comparison.

The effects of habitual dairy consumption and the risk of 15-year cardiovascular disease (CVD) mortality in a cohort of older Australians were investigated. Participants (n = 2900) completed a validated 145-item semi-quantitative food frequency questionnaire. Cox proportional hazards regression models were used to investigate associations between tertiles of the dairy consumption, including low/reduced fat dairy, whole fat dairy and their ratio (ratioLF/WF), and risk of mortality from coronary heart disease (CHD), stroke or combined CVD. There were 548 recorded cases of CVD mortality in this cohort. For total dairy intake, a reduction in risk of CVD was only seen in tertile 2 (adjusted hazard ratio, AHR: 0.71; 95% CI: 0.55-0.93), and for CHD both tertile 2 and tertile 3 were associated with a reduced risk (both with AHR: 0.71). However there were no linear trends between total dairy consumption and any of the three outcomes. There were no associations or trends between low/reduced fat dairy or whole fat dairy consumption, or ratioLF/WF and any of the three outcomes in the fully adjusted model (all p > 0.05). This study found no consistent association between baseline consumption of dairy foods and the risk of CHD, stroke and combined CVD mortality.

Objective: To examine the association between intake of dairy products and indicators of diet quality among a sample of Australian children. Methods: Three 24-hour recalls were collected from 222 children aged 8–10 years living in western Sydney. Analysis of covariance was used to examine differences in mean intakes of foods and nutrients among 3 dairy consumption groups (<1 serve, 1–2 serves, ≥2 serves per day). The percentage of children meeting healthy eating guidelines for foods and estimated average requirements (EAR) for nutrients was also assessed. Results: Higher dairy consumption was associated with higher intakes of energy, protein, calcium, phosphorus, magnesium, potassium, zinc, vitamin A, riboflavin, and niacin as well as foods from the bread and cereal group but lower intakes of mono- and polyunsaturated fats, foods from the meat and alternatives group, and energy-dense, nutrient-poor foods. Children who consumed ≥2 serves of dairy products per day (38%) were more likely to meet food and nutrient recommendations. Body mass index z-score and waist circumference were not associated with dairy consumption. Milk intake was inversely associated with the intake of sugar-sweetened beverages, and children who did not meet their minimum dairy serve recommendations consumed higher quantities of sugar-sweetened beverages than milk. Conclusions: Adequate dairy consumption was associated with diets of higher nutritional quality but also higher intakes of energy, suggesting a potential benefit from shifting consumption from regular-fat to reduced-fat dairy products in line with current national recommendations.

Misreporting of energy intake (EI) is a common problem in national surveys. The aim of this study was to identify misreporters using a variety of criteria, examine the impact of misreporting on the association between EI and weight status, and to define the characteristics of misreporters in the 2007 Australian Children‟s Survey. Data from the 2007 Australian Children‟s Survey which included 4800 children aged 2–16 years were used to examine the extent of misreporting based on EI, physical activity level (PAL), age, gender, height and weight status. Three options for identifying misreporters using the Goldberg cut-offs were explored as was direct comparison of EI to energy expenditure (TEE) in a subset of children. Linear regression was used to determine the impact of misreporting on the association between EI and weight status. The prevalence of under-reporting among all children varied from 5.0% to 6.7%, and over-reporting from 1.6% to 3.0% depending on the option used. Direct comparison of EI to TEE revealed similar results. Regression analysis showed that excluding misreporters provided the best model to examine cross-sectional associations between EI and BMI. Characteristics associated with under-reporting included older age, female, higher BMI, higher PAL, living in an urban location, lower parental education level and feeling unwell on the survey day. Over-reporting was more common among children with a lower BMI and lower PAL. In conclusion, misreporting of EI is present among various subgroups of the 2007 Australian Children‟s Survey. The impact of misreporting on the association between EI and body weight should be recognised by users of this survey. Keywords: children; nutrition survey; energy intake; child nutritional physiological phenomena; Australia

The prevention of overweight and obesity, particularly among children, is a public health priority. A range of initiatives to address this problem have already been developed and implemented in NSW. However, a broader range of additional strategies are needed to effectively address this complex issue. The high consumption of soft drinks, i.e. sugarsweetened carbonated beverages, and other sugary drinks is one of an array of dietary behaviours which has been identified by a number of policy documents as an important, specific behaviour to address in the prevention and management of obesity.

High consumption of soft drinks and other sugary drinks are associated with a number of health problems, including overweight and obesity, type 2 diabetes, osteoporosis and dental caries. In Australia, soft drinks are the most commonly consumed sugary beverage and have been singled out for specific attention as a target of obesity prevention programs. Soft drinks are well-known, readily available and marketed extensively, especially to adolescents. They have no nutritional value other than sugar and fluid, and are identified in the Australian Guide to Healthy Eating as an ‘extra’ food – one that should be consumed only occasionally and in small amounts.

Consumers are interested in making healthier food choices but the mandatory nutrition information panel currently in use in Australia is not easily understood or interpreted by most consumers. A simple nutrition signpost would be valuable. This paper reviews two nutrition signposting systems currently being considered for adoption in Australia. The authors conclude that a system similar to the colour-coded Traffic Light System is likely to be most useful.

Monitoring key food habits of children is important for planning and improving health services in New South Wales. The NSW Health Department conducts the NSW Health survey program using Computer Assisted Telephone Interviews (CATI). This survey includes questions for monitoring food habits of children aged 0-16 years. In this report, we recommend survey questions to be used in the NSW Health survey for this purpose, which meet a range of criteria for good survey questions about nutrition and food habits.