Summary

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/
potassium

Sodium:

Men 1,600 mg

70 mmol

Women 1,600 mg

70 mmol


 

Potassium:

Men 4,700 mg

120 mmol

 

Women 4,700mg

120 mmol

Whilst a UL of 2,300 mg (100 mmol)/day was set for the general population; it is recognised that additional preventive health benefits (in terms of maintaining optimal blood pressure over the lifespan and thus reducing stroke and heart disease) may accrue if sodium intakes are further reduced to about 1,600 mg/day (70 mmol) in line with WHO recommendations. Reducing intakes to this level may also bring immediate benefit to older and overweight members of the community with pre-existing hypertension.

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.

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
0.4–0.5% dietary energy

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.