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This study aimed to examine the dietary glycaemic index (GI) and glycaemic load (GL) of Australian children and adolescents, as well as the major food groups contributing to GL, in the recent 2011-2012 Australian Health Survey. Plausible food intake data from 1876 children and adolescents (51 % boys), collected using a multiple-pass 24-h recall, were analysed. The GI of foods was assigned based on a step-wise published method using values from common GI databases. Descriptive statistics were calculated for dietary GI, GL and contribution to GL by food groups, stratified by age group and sex. Linear regression was used to test for trends across age groups for BMI, dietary GI and GL, and intakes of energy, nutrients and food groups. Pearson's χ 2 test was used to test for differences between age groups for categorical subject characteristic variables. Mean dietary GI and GL of participants were 55·5 (sd 5·3) and 137·4 (sd 50·8), respectively. The main contributors to dietary GL were starchy foods: breads, cereal-based dishes, breakfast cereals, flours, grains and potatoes accounted for 41 % of total GL. Sweetened beverages, fruit and vegetable juices/drinks, cake-type desserts and sweet biscuits contributed 15 %. No significant difference (at P<0·001) was observed between sexes. In conclusion, Australian children and adolescents appear to consume diets with a lower GI than European children. Exchanging high-GI foods for low-GI alternatives within core and non-core foods may improve diet quality of Australian children and adolescents.
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Índice Glicêmico , Carga Glicêmica , Inquéritos Nutricionais , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Austrália , Índice de Massa Corporal , Criança , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Ingestão de Alimentos , Feminino , Humanos , MasculinoRESUMO
Non-alcoholic fatty liver disease (NAFLD) is closely associated with insulin resistance and obesity. Hence, carbohydrate quality could be of relevance to the risk of NAFLD, but prospective data are lacking. The aim of the present study was to investigate longitudinal associations between carbohydrate quality (including dietary glycaemic index (GI) and intakes of sugar, starch and fibre) and markers of liver function in an older Australian population. The analysis was based on 866 participants ( ≥ 49 years) of the Blue Mountains Eye Study with fasting blood specimens and dietary intake data at baseline and 5-year follow-up. Multi-level mixed regression analysis was used to relate dietary GI and sugar, starch and fibre intake to the liver enzymes alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT), as well as fasting TAG and HDL-cholesterol (HDL-C). After adjustment for potential confounding factors, a lower fibre intake was cross-sectionally related to higher GGT (P= 0.02) and fasting TAG (P= 0.002) levels, with fruit fibre being the most relevant fibre source (P= 0.095 for GGT; P= 0.003 for TAG). A higher dietary GI was associated with lower HDL-C (P= 0.046). Changes in carbohydrate quality during 5 years were not related to changes in ALT, GGT, TAG or HDL-C (P≥ 0.08). In conclusion, the absence of longitudinal associations between carbohydrate quality and liver enzymes and serum lipids in this older population does not support a major role of carbohydrate nutrition in liver function among the elderly.
Assuntos
HDL-Colesterol/sangue , Carboidratos da Dieta/classificação , Fígado/enzimologia , Triglicerídeos/sangue , Idoso , Consumo de Bebidas Alcoólicas , Estudos Transversais , Carboidratos da Dieta/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
In 2011, Barclay and Brand-Miller reported the observation that trends in refined sugar consumption in Australia were the inverse of trends in overweight and obesity (The Australian Paradox). Rikkers et al. claim that the Australian Paradox is based on incomplete data because the sources utilised did not incorporate estimates for imported processed foods. This assertion is incorrect. Indeed, national nutrition surveys, sugar consumption data from the United Nations Food and Agricultural Organisation, the Australian Bureau of Statistics and Australian beverage industry data all incorporated data on imported products.
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Comércio/tendências , Sacarose Alimentar/administração & dosagem , Sacarose Alimentar/provisão & distribuição , Abastecimento de Alimentos , Política Nutricional , Feminino , Humanos , MasculinoRESUMO
Background: Nutrient criteria underlying front-of-pack food labeling programs can play an important role in improving dietary intakes. Currently, no methodology for the development or update of nutrient criteria has been published, nor the methods used by food regulatory bodies. The scientific publication of methodology outlining the development and update of nutrient criteria underpinning front-of-pack food labeling programs highlighting healthier food choices is needed. Objective: To develop and provide a globally applicable and transparent methodology for researchers to follow when reviewing existing or developing new nutrient criteria for front-of-pack labeling. Methods: The Nutrient Criteria Methodology involved five phases: Phase I, the development of guiding principles; Phase II, collection of information for subsequent phases, including a pre-scope of the literature and selection of food composition database(s) for modeling; Phase III, literature review of all possible nutrients relevant to the nutrient criteria; Phase IV, database modeling to set quantitative limits for each selected nutrient; Phase V, assessment of the criteria against an established nutritional quality assessment tool. As an example, the methodology was applied to the update of the GI Symbol Product Eligibility and Nutrient Criteria (PENC). Results: A comprehensive and replicable methodology, based on best practice protocols and ensuring both scientific credibility and practicality of use by industry, was developed. Application of the five phases of the methodology to the GI Symbol PENC highlighted the ability of the methodology to uncover nutritional measures currently missing in many nutrient criteria for front-of-pack food labeling programs and other national food labeling systems, such as glycemic load and the unsaturated to saturated fat ratio. Foods achieving the PENC had a higher Health Star Rating than foods not achieving the PENC. Conclusion: Our Nutrient Criteria Methodology can be applied to the development and update of global nutrient criteria underpinning front-of-pack food labeling programs. Further research into the implementation of additional nutritional measures found to be important for human health is recommended, with the goal of the prevention of diet-related disease.
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Medical nutrition therapy is the first line of treatment for the prevention and management of type 2 diabetes and plays an essential part in the management of type 1 diabetes. Although traditionally advice was focused on carbohydrate quantification, it is now clear that both the amount and type of carbohydrate are important in predicting an individual's glycemic response to a meal. Diets based on carbohydrate foods that are more slowly digested, absorbed, and metabolized (i.e., low glycemic index [GI] diets) have been associated with a reduced risk of type 2 diabetes and cardiovascular disease, whereas intervention studies have shown improvements in insulin sensitivity and glycated hemoglobin concentrations in people with diabetes following a low GI diet. Research also suggests that low GI diets may assist with weight management through effects on satiety and fuel partitioning. These findings, together with the fact that there are no demonstrated negative effects of a low GI diet, suggest that the GI should be an important consideration in the dietary management and prevention of diabetes.
Assuntos
Dieta para Diabéticos , Carboidratos da Dieta/análise , Índice Glicêmico , Pressão Sanguínea , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/prevenção & controle , Humanos , Redução de PesoRESUMO
The glycaemic index (GI) is a food metric that ranks the acute impact of available (digestible) carbohydrates on blood glucose. At present, few countries regulate the inclusion of GI on food labels even though the information may assist consumers to manage blood glucose levels. Australia and New Zealand regulate GI claims as nutrition content claims and also recognize the GI Foundation's certified Low GI trademark as an endorsement. The GI Foundation of South Africa endorses foods with low, medium and high GI symbols. In Asia, Singapore's Healthier Choice Symbol has specific provisions for low GI claims. Low GI claims are also permitted on food labels in India. In China, there are no national regulations specific to GI; however, voluntary claims are permitted. In the USA, GI claims are not specifically regulated but are permitted, as they are deemed to fall under general food-labelling provisions. In Canada and the European Union, GI claims are not legal under current food law. Inconsistences in food regulation around the world undermine consumer and health professional confidence and call for harmonization. Global provisions for GI claims/endorsements in food standard codes would be in the best interests of people with diabetes and those at risk.
Assuntos
Dieta , Análise de Alimentos , Saúde Global , Índice Glicêmico , Rotulagem de Alimentos , HumanosRESUMO
BACKGROUND: Type 1 diabetes is primarily an autoimmune disease and type 2 diabetes is primarily a metabolic condition. However, medical nutrition therapy is an integral part of management for both types of diabetes to improve glycaemic control and reduce the risk of complications. OBJECTIVE: To outline the principles of dietary management in type 1 and type 2 diabetes and provide strategies to assist in overcoming common difficulties related to diet. DISCUSSION: All people with diabetes should be provided with quality professional education on medical nutrition therapy upon diagnosis, and at regular intervals thereafter. For children and adolescent patients with type 1 diabetes, the challenge is to maintain good glycaemic control while providing adequate energy for growth and development. Modification in dietary advice is required, depending on developmental stage. In type 2 diabetes, the initial challenge is to achieve weight loss of 5-10% body weight, normalise blood glucose and reduce cardiovascular risk factors. Specific strategies include a kilojoule controlled diet with reduced saturated fat, trans fat and sodium; moderate protein; and high in dietary fibre and low glycaemic index carbohydrates. Carbohydrates should be spread evenly throughout the day and matched to medication.
Assuntos
Diabetes Mellitus Tipo 1/dietoterapia , Diabetes Mellitus Tipo 2/dietoterapia , Adolescente , Austrália/epidemiologia , Glicemia , Peso Corporal , Criança , Pré-Escolar , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Carboidratos da Dieta , Gorduras na Dieta , Ingestão de Energia , Índice Glicêmico , Humanos , Insulina/administração & dosagem , Pessoa de Meia-Idade , Atividade Motora , Obesidade/complicações , Educação de Pacientes como AssuntoRESUMO
Dietary fibre is a generic term describing non-absorbed plant carbohydrates and small amounts of associated non-carbohydrate components. The main contributors of fibre to the diet are the cell walls of plant tissues, which are supramolecular polymer networks containing variable proportions of cellulose, hemicelluloses, pectic substances, and non-carbohydrate components, such as lignin. Other contributors of fibre are the intracellular storage oligosaccharides, such as fructans. A distinction needs to be made between intrinsic sources of dietary fibre and purified forms of fibre, given that the three-dimensional matrix of the plant cell wall confers benefits beyond fibre isolates. Movement through the digestive tract modifies the cell wall structure and may affect the interactions with the colonic microbes (e.g., small intestinally non-absorbed carbohydrates are broken down by bacteria to short-chain fatty acids, absorbed by colonocytes). These aspects, combined with the fibre associated components (e.g., micronutrients, polyphenols, phytosterols, and phytoestrogens), may contribute to the health outcomes seen with the consumption of dietary fibre. Therefore, where possible, processing should minimise the degradation of the plant cell wall structures to preserve some of its benefits. Food labelling should include dietary fibre values and distinguish between intrinsic and added fibre. Labelling may also help achieve the recommended intake of 14 g/1000 kcal/day.
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Consenso , Fibras na Dieta/normas , Qualidade dos Alimentos , Rotulagem de Alimentos , Humanos , Internacionalidade , OrganizaçõesRESUMO
BACKGROUND AND PURPOSE: It is unclear whether diets with high glycemic index (GI) and low cereal fiber (CF) are associated with greater risk of stroke. We aimed to assess the relationship between dietary GI and CF content, retinal microvasculature changes, and stroke-related mortality. METHODS: The study consisted of a population-based cohort, 49+ years, examined at baseline (1992 to 1994). At baseline, participants completed validated food frequency questionnaires. Mean GI was calculated using an Australian database. Retinal arteriolar and venular diameters were measured from photographs. Mortality data were derived using the Australian National Death Index. RESULTS: Over 13 years, 95 of 2897 participants (3.5%) died from stroke. Increasing GI (hazard ratio, 1.91; 95% CI, 1.01 to 3.47, highest versus lowest tertile) and decreasing CF (hazard ratio, 2.13; 95% CI, 1.19 to 3.80, lowest versus highest tertile) predicted greater risk of stroke death adjusting for multiple stroke risk factors. Persons consuming food in the highest GI tertile and lowest CF tertile had a 5-fold increased risk of stroke death (hazard ratio, 5.06; 95% CI, 1.67 to 15.22). Increasing GI and decreasing CF were also associated with retinal venular caliber widening (P(trend)<0.01). Adjustment for retinal venular caliber attenuated stroke death risk associated with high GI by 50% but did not affect the risk associated with low CF consumption. CONCLUSIONS: High-GI and low-CF diets predict greater stroke mortality and wider retinal venular caliber. The association between a high-GI diet and stroke death was partly explained by GI effects on retinal venular caliber, suggesting that a high-GI diet may produce deleterious anatomic changes in the microvasculature.
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Retinopatia Diabética/epidemiologia , Carboidratos da Dieta/efeitos adversos , Alimentos Formulados/efeitos adversos , Índice Glicêmico/fisiologia , Hiperglicemia/epidemiologia , Acidente Vascular Cerebral/mortalidade , Idoso , Austrália/epidemiologia , Estudos de Coortes , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/fisiopatologia , Retinopatia Diabética/sangue , Retinopatia Diabética/fisiopatologia , Carboidratos da Dieta/sangue , Feminino , Humanos , Hiperglicemia/sangue , Hiperglicemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Modelos de Riscos Proporcionais , Artéria Retiniana/patologia , Artéria Retiniana/fisiopatologia , Veia Retiniana/patologia , Veia Retiniana/fisiopatologia , Fatores de Risco , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/fisiopatologia , Inquéritos e QuestionáriosRESUMO
Hyperglycemia and insulin resistance are independent risk factors for cardiovascular disease (CVD). Postprandial glycemic "spikes" adversely affect vascular structure and function via multiple mechanisms including oxidative stress, inflammation, low-density lipoprotein oxidation, protein glycation, and procoagulant activity. Glycemic responses can be reliably predicted by considering both the quantity and quality of carbohydrate. The glycemic index (GI), a measure of carbohydrate quality, has provided insights that knowledge of the sugar or starch content has not. In prospective observational studies, dietary GI and/or glycemic load (GL; the product of the amount of carbohydrate and GI) independently predict CVD, with relative risk ratios of 1.2 to 1.9 comparing highest and lowest quartiles. In randomized controlled trials in overweight subjects, diets based on low GI carbohydrates have decreased plasminogen activator inhibitor-1 activity and other CVD risk factors over and above that of conventional low-fat diets. Taken together, the findings suggest that clinicians may be able to improve CVD outcomes by recommending the judicious use of low GI/GL foods.
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Glicemia/metabolismo , Índice Glicêmico/fisiologia , Trombina/biossíntese , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Dieta , Dieta para Diabéticos , Carboidratos da Dieta/metabolismo , Humanos , Hiperglicemia/complicações , Hiperglicemia/epidemiologia , Resistência à Insulina , Obesidade/epidemiologia , Prevalência , Trombose/epidemiologiaRESUMO
Published meta-analyses indicate significant but inconsistent incident type-2 diabetes(T2D)-dietary glycemic index (GI) and glycemic load (GL) risk ratios or risk relations (RR). It is nowover a decade ago that a published meta-analysis used a predefined standard to identify validstudies. Considering valid studies only, and using random effects dose-response meta-analysis(DRM) while withdrawing spurious results (p < 0.05), we ascertained whether these relationswould support nutrition guidance, specifically for an RR > 1.20 with a lower 95% confidence limit>1.10 across typical intakes (approximately 10th to 90th percentiles of population intakes). Thecombined T2D-GI RR was 1.27 (1.15-1.40) (p < 0.001, n = 10 studies) per 10 units GI, while that forthe T2D-GL RR was 1.26 (1.15-1.37) (p < 0.001, n = 15) per 80 g/d GL in a 2000 kcal (8400 kJ) diet.The corresponding global DRM using restricted cubic splines were 1.87 (1.56-2.25) (p < 0.001, n =10) and 1.89 (1.66-2.16) (p < 0.001, n = 15) from 47.6 to 76.1 units GI and 73 to 257 g/d GL in a 2000kcal diet, respectively. In conclusion, among adults initially in good health, diets higher in GI or GLwere robustly associated with incident T2D. Together with mechanistic and other data, thissupports that consideration should be given to these dietary risk factors in nutrition advice.Concerning the public health relevance at the global level, our evidence indicates that GI and GLare substantial food markers predicting the development of T2D worldwide, for persons ofEuropean ancestry and of East Asian ancestry.
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Glicemia/análise , Diabetes Mellitus Tipo 2/etiologia , Dieta/efeitos adversos , Índice Glicêmico , Carga Glicêmica , Adulto , Carboidratos da Dieta/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Prospectivos , Fatores de RiscoRESUMO
While dietary factors are important modifiable risk factors for type 2 diabetes (T2D), the causal role of carbohydrate quality in nutrition remains controversial. Dietary glycemic index (GI) and glycemic load (GL) have been examined in relation to the risk of T2D in multiple prospective cohort studies. Previous meta-analyses indicate significant relations but consideration of causality has been minimal. Here, the results of our recent meta-analyses of prospective cohort studies of 4 to 26-y follow-up are interpreted in the context of the nine Bradford-Hill criteria for causality, that is: (1) Strength of Association, (2) Consistency, (3) Specificity, (4) Temporality, (5) Biological Gradient, (6) Plausibility, (7) Experimental evidence, (8) Analogy, and (9) Coherence. These criteria necessitated referral to a body of literature wider than prospective cohort studies alone, especially in criteria 6 to 9. In this analysis, all nine of the Hill's criteria were met for GI and GL indicating that we can be confident of a role for GI and GL as causal factors contributing to incident T2D. In addition, neither dietary fiber nor cereal fiber nor wholegrain were found to be reliable or effective surrogate measures of GI or GL. Finally, our cost-benefit analysis suggests food and nutrition advice favors lower GI or GL and would produce significant potential cost savings in national healthcare budgets. The high confidence in causal associations for incident T2D is sufficient to consider inclusion of GI and GL in food and nutrient-based recommendations.
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Glicemia/metabolismo , Diabetes Mellitus Tipo 2/epidemiologia , Dieta/efeitos adversos , Índice Glicêmico , Carga Glicêmica , Animais , Biomarcadores/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/prevenção & controle , Humanos , Incidência , Prognóstico , Medição de Risco , Fatores de RiscoRESUMO
This study aims to examine whether there were changes between 1995â»2012 in the dietary glycaemic index (dGI) and glycaemic load (dGL) in Australian children (<16 years) according to three national surveys in 1995 (1995NS), 2007 (2007NS), and 2011â»2012 (2012NS). Glycaemic index (GI) values of foods were assigned using published methodology. Plausible 24-h recall data from the 1995NS, 2007NS and 2012NS (weighted n = 2475, 4373 and 1691 respectively) were compared for differences in dGI and dGL, and the contribution to dGL from different foods using one-way ANOVA with Bonferroni post hoc comparisons and linear regression. Decreasing trends across surveys were found in dGI and dGL (p < 0.001). Between 1995 and 2012, dGI and dGL per Megajoule (MJ) dropped by 2% and 6% respectively. The per capita dGL contribution from breads and bread rolls, fruit and vegetable juices, sweetened beverages and potatoes showed strong decreasing trends (R² > 0.7). Our findings suggest that dGI and dGL of Australian youths declined between 1995 to 2012, which may be due to increased awareness of the GI concept and healthy diet, widened food choices and immigrants with diverse dietary habits. This may lower the future risks of chronic degenerative diseases in Australian youths.
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Dieta/tendências , Índice Glicêmico , Carga Glicêmica , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Comportamento do Adolescente , Fatores Etários , Austrália , Criança , Comportamento Infantil , Fenômenos Fisiológicos da Nutrição Infantil , Pré-Escolar , Dieta/efeitos adversos , Inquéritos sobre Dietas , Comportamento Alimentar , Feminino , Humanos , Masculino , Estado Nutricional , Valor Nutritivo , Recomendações Nutricionais/tendências , Fatores de TempoRESUMO
BACKGROUND: Although dietary carbohydrates are thought to play a role in cataractogenesis, few epidemiologic studies have examined links between carbohydrate nutrition and cataract. OBJECTIVES: We investigated the associations between dietary glycemic index (GI), glycemic load (GL), total carbohydrate intake, and 10-y incident nuclear, cortical, and posterior subcapsular cataract. DESIGN: Of 3654 baseline participants in an Australian population aged >/=49 y (1992-1994), 933 were seen after 5 and/or 10 y, had completed a detailed semiquantitative food-frequency questionnaire, had no previous cataract surgery or baseline cataract, and had photographs taken to assess incident cataract with the Wisconsin Cataract Grading System. Dietary information was collected with a validated food questionnaire. GI was calculated from a customized database of Australian foods. GI, GL, and all other nutrients were energy adjusted. Hazard ratios (HRs) and 95% CIs were calculated with the use of discrete logistic models. RESULTS: After age, sex, diabetes, and other factors were controlled for, each SD increase in GI significantly predicted incident cortical cataract (HR: 1.19; 95% CI: 1.01, 1.39). Participants within the highest compared with the lowest quartile of GI were more likely to develop incident cortical cataract (HR: 1.77; 95% CI: 1.13, 2.78; P for trend = 0.035). These findings were similar after excluding participants with diabetes, although they were slightly attenuated and marginally nonsignificant (HR: 1.16; 95% CI: 0.98, 1.37, per SD increase in GI). No association was found between GI and nuclear or posterior subcapsular cataract and between GL or carbohydrate quantity and any cataract subtype. CONCLUSION: In an Australian cohort, poorer dietary carbohydrate quality, reflected by high GI, predicted incident cortical cataract.
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Catarata/epidemiologia , Carboidratos da Dieta/administração & dosagem , Índice Glicêmico , Idoso , Austrália/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Postprandial hyperglycemia is increasingly recognized as an independent risk factor for cardiovascular disease. Glycemic "spikes" may adversely affect vascular structure and function via multiple mechanisms, including (acutely and/or chronically) oxidative stress, inflammation, low-density lipoprotein oxidation, protein glycation, and procoagulant activity. Postprandial glycemia can be reliably predicted by considering both the amount and type of carbohydrate. In particular, the glycemic index (GI), a measure of postprandial glycemic potency weight for weight of carbohydrate, has provided insights that knowledge of the sugar or starch content has not. In prospective observational studies, dietary GI and/or glycemic load independently predict cardiovascular disease, with relative risk ratios of 1.2 to 1.7 comparing highest and lowest quintiles. In randomized controlled trials in overweight subjects, diets based on low-GI carbohydrates have produced better cardiovascular-related outcomes than conventional low-fat diets. Taken together, the findings suggest that health professionals may be able to improve cardiovascular outcomes by recommending the judicious use of low- GI/glycemic load foods.
Assuntos
Doenças Cardiovasculares/epidemiologia , Índice Glicêmico , Glicemia/fisiologia , Doenças Cardiovasculares/prevenção & controle , Dieta , Fibras na Dieta/administração & dosagem , Endotélio Vascular/fisiopatologia , Homeostase/fisiologia , Humanos , Hiperglicemia/fisiopatologia , Período Pós-Prandial/fisiologia , Medição de Risco , Fatores de Risco , Redução de Peso/fisiologiaRESUMO
Background: Reduced intakes of added sugars and sugar-sweetened beverages (SSBs) have been the main focus of efforts to stall obesity. Although obesity has risen steeply in Australia, some evidence suggests that added-sugars and SSB intakes have declined over the same time frame.Objective: We investigated recent trends in the availability of sugars and sweeteners and changes in intakes of total sugars, added sugars, and SSBs in Australia by using multiple, independent data sources.Design: The study was designed to compare relevant data published by the Food and Agriculture Organization of the United Nations [FAO Statistics Division Database (FAOSTAT)], the Australian government, academia, and the food industry.Results: With the use of the FAOSTAT food balance sheets for Australia, the per capita availability of added or refined sugars and sweeteners was shown to have fallen 16% from 152 g/d in 1980 to 127 g/d in 2011 (P-trend = 0.001). In national dietary surveys in 1995 and 2011-2012, added-sugars intake declined markedly in adult men (from 72 to 59 g/d; -18%) but not in women (44-42 g/d; NS). As a proportion of total energy, added-sugars intake fell 10% in adult men but nonsignificantly in adult women. Between 1995 and 2011-2012, the proportion of energy from SSBs (including 100% juice) declined 10% in adult men and 20% in women. More marked changes were observed in children aged 2-18 y. Data from national grocery sales indicated that per capita added-sugars intakes derived from carbonated soft drinks fell 26% between 1997 and 2011 (from 23 to 17 g/d) with similar trends for noncarbonated beverages.Conclusions: In Australia, 4 independent data sets confirmed shorter- and longer-term declines in the availability and intake of added sugars, including those contributed by SSBs. The findings challenge the widespread belief that energy from added sugars or sugars in solution are uniquely linked to the prevalence of obesity.
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Bebidas Gaseificadas , Dieta/tendências , Sacarose Alimentar/administração & dosagem , Comportamento Alimentar , Abastecimento de Alimentos , Obesidade/prevenção & controle , Edulcorantes/administração & dosagem , Adulto , Austrália , Criança , Comércio , Inquéritos sobre Dietas , Sacarose Alimentar/efeitos adversos , Ingestão de Energia , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Obesidade/etiologia , Fatores Sexuais , Edulcorantes/efeitos adversosRESUMO
Background: Australians have used the glycemic index (GI) since 1995; however, there are no data on changes in carbohydrate quality over time.Objectives: The aim was to compare average dietary GI and glycemic load (GL), and contributing carbohydrate foods, in the 2 most recent national dietary surveys.Design: Dietary data from adult participants of national nutrition surveys conducted in 1995 (the 1995 Australian National Nutrition Survey; n = 8703) and 2012 (the 2011-2012 National Nutrition and Physical Activity Survey; n = 6278), collected by a single 24-h recall, were analyzed. The differences in mean dietary GI and GL between surveys were compared by using 1-factor ANOVA. The main sources of dietary GL in the 2 surveys were also assessed. Multiple linear regression was performed to examine the contributions of the food groups to interindividual variations in dietary GI and GL.Results: Overall, dietary GI and GL decreased by 5% and 12%, respectively, from 1995 to 2012 (GI on glucose standard: 56.5 ± 6.2 compared with 53.9 ± 6.8, respectively; GL: 153.3 ± 62.1 compared with 135.4 ± 58.5, respectively; both P < 0.001). Breads were the main contributor to GL at both time points. Potatoes and sweetened beverages contributed less, whereas cereal-based dishes contributed more in 2012 than in 1995. The top 20 GL-contributing food groups explained less interindividual variation in dietary GI (R2: 0.376 compared with 0.290) and GL (R2: 0.825 compared with 0.770) in 2012 than in 1995.Conclusion: Although the average dietary GI and GL declined between 1995 and 2012, trends in specific carbohydrate foods suggest that Australians are avoiding potatoes and sugary beverages in favor of a greater variety of carbohydrate foods, particularly cereal products.
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Dieta/tendências , Carboidratos da Dieta , Comportamento Alimentar , Índice Glicêmico , Carga Glicêmica , Adulto , Idoso , Austrália , Bebidas , Glicemia/metabolismo , Carboidratos da Dieta/administração & dosagem , Carboidratos da Dieta/sangue , Grão Comestível , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Solanum tuberosum , Adulto JovemRESUMO
This study aimed to determine the major food groups contributing to dietary glycaemic load (GL). Plausible food intake data collected using a multiple-pass 24 hour recall from a weighted sample of 6326 adult respondents (52% male) of the 2011-2012 Australian Health Survey dataset (AHS) were analysed. The GI of foods was estimated based on a previously published step-wise method. Descriptive statistics were calculated for dietary glycaemic index (GI), GL and contribution to GL by major food groups, stratified by age and sex. Trends across age groups were assessed using linear regression. Pearson's χ2 was used to test for differences between age groups for categorical demographics variables. The mean (SD) dietary GI and GL was 54 (7) and 135 (59) respectively and the top 3 contributors to dietary GL were breads (14.4%), cereal-based dishes (10.3%) and breakfast cereals (ready to eat) (6.6%). There were small but significant differences in the GL contribution pattern between the sexes. The findings indicate that the average dietary GI of Australian adults is similar to that of other population groups, with a large proportion of starchy and energy-dense nutrient-poor foods that contribute to a high GL.