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Experts urge overhaul of nutritional guidelines as kids skip fruit and vegies – Sydney Morning Herald

7 minutes, 39 seconds Read

Natalie Stapleton, a dietitian and mother of two young children, says there’s no one-size-fits-all approach to feeding kids. And she is one of many experts who say the country’s nutritional guidelines are in desperate need of a review to reflect that.

“Every child will have unique nutrition needs. Nutrition intake for kids over the week varies,” says Stapleton, general manager of policy and advocacy at Dietitians Australia and mother to Riley, 3, and Liam, 18 months.

Natalie Stapleton of Dietitians Australia with her children Riley (aged 3, on the left) and Liam, 18 months.

“At home, I focus on teaching my kids to recognise how eating food nourishes their bodies and minds, with the intention of helping them establish a positive relationship with food to guide them through life.”

“For breakfast this morning, we had oat porridge, baked beans and some fruit. It’s not uncommon for us to serve up leftover family dinner for the kids’ lunch the next day.”

Stapleton is among several child health experts calling for an overhaul of Australia’s 32-year-old food and nutrition policy, as children’s diets continue to fall short of national guidelines.

The latest data shows growing numbers of young people are skipping fruit and vegetables and falling outside normal weight ranges. Large numbers of youth are experiencing long-term conditions such as depression, anxiety, autism and allergies, prompting researchers to delve into potential links to diet.

Good nutrition promotes physical and mental health and is especially important for children.

Good nutrition promotes physical and mental health and is especially important for children.Credit: Aresna Villanueva

Dietitians Australia says poor diets are “driven predominantly by food environments that promote and continually encourage unhealthy eating”. Excessive screen time, online fast-food orders, poverty and higher prices for healthy foods outside capital cities contribute to the challenge.

Stapleton says Australia’s food and nutrition policy – now under review by the Department of Health – doesn’t reflect the growth in highly marketed and ultra-processed foods, as well as the shift away from seasonal, locally grown food. “Our food system has changed dramatically since 1992,” she says.

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Dietitians Australia says an updated nutrition policy could include new taxes and marketing bans on unhealthy products, improved food labelling, help for schools to provide healthy foods, and the establishment of an independent statutory health promotion agency.

But change won’t come fast. The health department says an updated food and nutrition policy won’t be released until 2026. This includes changes to dietary guidelines, which currently advise Australians to be physically active; eat vegetables, fruit, grains, meat and dairy, and drink plenty of water; limit salt, sugars and alcohol; support breastfeeding; and store and prepare food safely.

HOW DO CHILDREN’S DIETS FARE?

Research by Dr Miaobing Zheng, a National Health Medical Research Council (NHMRC) early career research fellow, has found that children develop unhealthy lifestyle patterns, such as consuming an energy-dense and nutrient-poor diet, as early as 18 months. She says there’s also a strong link between parents and their children’s health and behaviours – children show higher-risk of obesity and developing unhealthy lifestyle patterns when their parents have higher body weight and unhealthy lifestyle behaviours.

Similarly, children in families who enjoy a variety of nutritious food from the five food groups are more likely to make their own healthy choices as they get older, the NHMRC says.

Dr Miaobing Zheng, a National Health Medical Research Council (NHMRC) early career research fellow in Melbourne.

Dr Miaobing Zheng, a National Health Medical Research Council (NHMRC) early career research fellow in Melbourne.Credit: Luis Enrique Ascui

The latest Australian Bureau of Statistics (ABS) figures show the proportion of children who do not usually eat fruit daily has doubled over the last decade (from 2.8 per cent in 2011–12 to 5.8 per cent in 2022). Similarly, the proportion of children who do not usually eat vegetables daily has tripled, from 1.5 per cent compared to 4.5 per cent.

Growing proportions of children are underweight or overweight, the ABS says. Just 64.6 per cent of young people aged 5 to 17 were in the normal weight range in 2022, with 7.6 per cent underweight and 27.7 per cent classified as overweight or obese. In 2011–12, 69.1 per cent of that age group were in the normal weight range.

A 2021 survey of primary-school-aged children’s lunchboxes found discretionary food – food that is not needed to meet nutrient requirements, but contributes to the enjoyment of eating – accounted for 44 per cent of energy intake, and most children consumed less than one serve of vegetables, meat and alternatives, or milk and alternatives during school hours.

Teens eat the most discretionary food of any age group. At seven daily serves, discretionary food accounted for 41 per cent of the energy consumed by teens aged 14 to 18, compared with about a third for adults.

ROLE OF DIET IN COMMON CONDITIONS

Research shows a pregnant woman’s diet affects her offspring, and children develop lifestyle patterns fast. So, what is the role of diet in the development and severity of common childhood conditions, particularly depression, anxiety disorders, autism and allergies?

Associate Professor Yasmine Probst of the University of Wollongong’s School of Medical, Indigenous and Health Sciences says the evidence for diet and its relationship to other conditions is “highly variable and influenced by a number of factors that are not specific to what a person consumes.

“There may be relationships between food and the management of childhood conditions, though the evidence for these relationships is growing and heavily dependent in the condition of focus,” Probst says.

Professor Adrienne O’Neil, of Deakin University’s Food and Mood Centre, says dietary intake in early life has been associated with a “host of mental and brain health and behavioural outcomes in children including cognition, attention and neuro-development more generally”.

As large proportions of young people report feeling depressed and anxious, the relatively new field of nutritional psychiatry is gaining traction.

DEPRESSION AND ANXIETY

O’Neil says a decade ago she could only find 12 studies looking at the associations between dietary intake and mental health in children and adolescents. Now she says there are 17 experimental studies that show that “dietary programs, particularly those that involve the whole family, may be effective in helping adolescents with depression improve their mental health”.

“An interesting study from last year showed that children who ate a dietary pattern with whole grains and dairy during school years had larger brain volumes two years later, while those consuming a Western-like dietary pattern [more snacks, processed foods and sugar] in infancy and school age was associated with lower global brain volume,” O’Neil said.

ALLERGIES

Australia has one of the highest rates of allergies in the world, with food allergy affecting 10 per cent of 12-month-olds and 5 per cent of school students aged 10 to 14 in Melbourne.

Support group Allergy and Anaphylaxis Australia says there are nine foods which cause 90 per cent of food allergic reactions: peanuts; tree nuts such as cashews and almonds; egg; milk; fish; wheat; soy; sesame; and shellfish such as prawn and lobster.

Nine foods cause 90 per cent of food allergic reactions in Australia.

Nine foods cause 90 per cent of food allergic reactions in Australia.Credit: Aresna Villanueva

Dr Vicki McWilliam, allergy researcher and dietitian at the Murdoch Children’s Research Institute, says the exact cause of Australia’s rise in food allergy is unknown. She says allergies can be hereditary – recent research led by the institute finds infants with a family history of food allergy and parents born in East Asia were more likely to develop cow’s milk allergy.

Allergy and Anaphylaxis Australia says a child whose parent has an allergy has a 30 per cent chance of inheriting the allergic gene. If both parents have a history of some allergic condition, this rises to 40 to 60 per cent.

McWilliam says 30 per cent of peanut allergy and 90 per cent of egg allergy naturally resolves by age six, while allergies to peanuts, tree nuts, sesame seeds and seafood persist in 70 to 90 per cent of children affected.

Environmental factors, such as delays in feeding potentially allergenic food to babies, dry skin and low exposure to dirt, could contribute to the prevalence of food allergy. McWilliam says research is underway to look at the role of low vitamin D and a lack of exposure to pets in food allergy.

“We now have good evidence that introducing common allergenic foods into the infant’s diet in the first year of life, such as smooth peanut butter or well-cooked egg, decreases the risk of infants developing allergy to these foods,” she says.

ASTHMA

Asthma prevalence has increased in recent decades as Western diets became more pervasive, with overweight and obese children at “higher risk of developing asthma than normal-weight youths”, according to a 2020 American study.

Increased fruit and vegetable consumption, and decreased saturated fat and dairy intake are associated with reduced asthma risk and better asthma control, the study finds.

“Recommendations to increase fruit and vegetable consumption, while decreasing saturated fat and dairy intake, are supported by the current literature. Mediterranean and vegan diets emphasising the consumption of fruits, vegetables, grains, and legumes, while reducing or eliminating animal products, might reduce the risk of asthma development and exacerbation,” it says.

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