What are the health impacts of dietary risks?
Burden of disease is a measure of the years of healthy life lost from living with ill health or dying prematurely from disease and injury. A portion of this burden is due to modifiable risk factors. Burden of disease analysis estimates the contribution of these risk factors to this burden.
Dietary risk factors were the 3rd leading risk factor contributing to ill health and premature deaths after tobacco use, and overweight and obesity in Australia, in 2018 (AIHW 2021). Dietary risks factors include components where adequate amounts in the diet are required to prevent disease, as well as diets where excessive consumption contributes to disease development. The 12 individual dietary risk factors were:
- a diet low in: fruit and vegetables, milk, nuts and seeds, whole grains and high fibre cereals, legumes, polyunsaturated fat, and fish and seafood
- a diet high in: sodium, sugar-sweetened beverages, and red and processed meats.
Dietary risk factors combined were the 4th leading risk factor contributing to deaths – 15,802 deaths (9.9% of total deaths) in 2018 (AIHW 2021).
Dietary risk factors were linked to 16 diseases and contributed to:
- 50% of coronary heart disease total burden.
- 26% of bowel cancer burden.
- 26% of type 2 diabetes burden.
- 26% of stroke burden (AIHW 2021).
Males experience a greater amount of disease burden due to dietary risks factors than females in all ages up to age 84 (AIHW 2021). Total disease burden attributable to dietary risk factors is twice as high in the lowest (most disadvantaged) socioeconomic areas compared with the highest areas (least disadvantaged).
For more information on the disease burden due to dietary risks, see the Australian Burden of Disease Study 2018: Interactive data on risk factor burden.
The overall food and non-alcoholic drinks purchased from the food retail sector can be monitored over time to see how this profile changes. It represents foodstuff available for people to consume and does not account for foods that have been stored, wasted or not consumed (ABS 2022a). The measure is known as apparent food consumption.
The estimates include food and non-alcoholic drinks purchased from (ABS 2022a):
- Major supermarkets and fresh food markets.
- Convenience stores.
- Butchers and seafood shops.
- Bakeries and delis.
It does not include food purchases from fast food outlets, cafes and restaurants, and does not include foods that were obtained from foraging, hunting or fishing.
It is not possible using these data to determine the consumption patterns of individuals or groups such as consumption by age (ABS 2022a).
For further information, refer to the Apparent Consumption of Selected Foodstuffs, Australia methodology and the Technical notes.
Apparent Consumption of the 5 food groups
Between 2018–19 to 2020–21, the number of serves available per person from food purchased (apparent consumption) of the 5 food groups (ABS 2022a):
- Remained the same for fruit, dairy and alternatives and lean meats and alternatives; with 1.4 serves, 1.6 serves and 1.8 serves, respectively, across all three years.
- Remained steady for vegetables from 2.3 in 2018–19 to 2.4 serves in 2019–20, remaining at 2.4 serves in 2020–21.
- Decreased for grains and cereals, from an average of 4.0 serves in 2019–20 to 3.8 serves in 2020–21. This was a return similar to 2018–19.
Grains and cereals
Grains and cereals purchased in Australia were from the food types:
- grains (such as rice) (38%).
- breads (28%).
- flour (17%).
- oats (11%).
- breakfast cereal flakes (5.3%).
The Australian Dietary Guidelines recommend eating mainly wholegrain or high fibre foods, rather than low fibre or highly refined foods (NHMRC 2013b). The apparent consumption of grains and cereals from wholegrain or high fibre was 33.7% in 2020–21, similar to 2019–20 (33.2%). This was a decrease from 34.8% in 2018–19 (ABS 2022a).
Apparent consumption of discretionary food
Discretionary foods contributed to 38.1% of the available dietary energy per person from food purchased. This is a slight increase from 37.6% in 2018–19 and 37.7% in 2019–20 (ABS 2022a).
The top 3 contributors to discretionary food apparent consumption were (ABS 2022a):
- Cereal based products (21%) such as sweet and savoury biscuits, cakes, muffins and pastries.
- Confectionary (16%) such as chocolates, fruit, nut and seed-bars, and muesli bars.
- Non-alcoholic beverages (9.1%) such as soft drinks, cordial, and fruit and vegetable juices.
Apparent consumption of free sugar (including added sugar), saturated fat, and sodium
Dietary energy available per person from free sugar (sugar added to foods and sugar naturally present in juice and honey) and saturated fat in foods purchased are both higher than the recommended dietary intake for these nutrients, in 2020–21 (Table 5). The amount of sodium available per person (3,125 mg) from foods purchased is 56% higher than the recommended intake (Table 5) (ABS 2022a).
Of dietary energy available per person from food sold:
- Around 12% is from free sugar. Of the free sugar, 92% was added sugar (added to foods during processing and preparation).
- 15% is from saturated fat and 0.7% came from trans fatty acids. Discretionary and non-discretionary foods each contributed around half of the available saturated fat.
Table 5: Apparent consumption of added and free sugar, saturated fat, and sodium, 2020−21
|
Per person apparent consumption daily
|
% total dietary energy
|
Recommended intake
|
% that came from discretionary foods
|
Free sugar1
Added sugar
|
68.8 g
63.6 g
|
12.4
11.5
|
<10% of total energy intake2
|
88.7
|
Saturated fat
Trans fatty acid
|
36.4 g
1,659.2 mg
|
15.2
0.7
|
<10% of energy intake3
|
49.0
|
Sodium
|
3,125 mg4
|
n/a
|
2,000 mg per day5
|
58.3
|
Notes:
- Sugars naturally present in unrefined foods such as fruit and unflavoured milk are not considered free sugar.
- Recommendation from the World Health Organisation (WHO).
- Recommendation from the Nutrient Reference Values for Australia and New Zealand (NRVs).
- The apparent consumption of sodium does not take into account foods purchased from fast food outlets, takeaway and restaurants. Additionally, the proportion of salt purchased for non-food uses is not known so apparent consumption of sodium from sales of salt may be an overestimation (ref: ABS).
- The Suggested Dietary Target (SDT) recommends 2000 mg/day of sodium which is also consistent with the 2012 WHO guideline for sodium consumption which recommends less than 2000 mg/day for adults.
For more information, see the ABS Apparent Consumption of Selected Foodstuffs.
Impacts of COVID-19 on diet
Data are showing how public health measures put in place during the early stage of COVID-19 (for example, quarantine, the closure of non-essential services and restrictions on venue capacity) have impacted Australians’ dietary habits, as well as food purchasing behaviours.
Following the introduction of COVID-19 restrictions in March 2020, the response by Australian households to the highly uncertain circumstances was an increase in purchasing of household supplies from supermarkets (ABS 2022a). There was a greater weight of foods purchased in March 2020. Mean daily serves per person available increased most notably for grains in that month (ABS 2022a).
Some changes in dietary behaviour are observed in the first few months of lockdowns from April to June 2020, as seen in the data from the ABS Household Impacts of COVID-19:
- 29% of participants reported consuming less take-away and delivered meals in late April/early May 2020.
- 38% reported more cooking and baking in late April/early May 2020.
- Nearly 3 in 10 females (28%) and around 1 in 6 males (16%) reported eating more snack foods (for example, chips, lollies, biscuits), in June 2020, than what was usual prior to the implementation of public health measures in March 2020.
- In contrast, almost 2 in 10 (20%) people aged 18–64 reported that they reduced their consumption of soft drinks, cordials and energy drinks during the same time period (ABS 2022e).
Opportunity-induced eating and coping with negative emotions (such as stress) might also have an impact on unhealthy snacking behaviour (Verhoeven, et al. 2015). A study of poor appetite and overeating in 13, 829 Australian adults during the first month of COVID-19 restriction measures found that 54% were bothered by poor appetite or overeating. Over 1 in 10 (12%) reported poor appetite or overeating nearly every day (Owen, et al. 2020).
For more information on diet, see:
Visit Food & nutrition to see more on this topic.
Technical notes
About the Australian Bureau of Statistics National Health Surveys
This web report uses data from the following surveys from the Australian Bureau of Statistics:
- ABS 2011–12 National Nutrition and Physical activity Survey.
- ABS 2017–18 National Health Survey (NHS).
- ABS 2020–21 NHS.
- Apparent consumption of Selected Foodstuff.
The NHS is a series of surveys designed to collect a range of information about the health of Australians, including:
- prevalence of long-term health conditions.
- health risk factors such as smoking, fruit and vegetable consumption, alcohol consumption and exercise.
- use of health services such as consultations with health practitioners and actions people have recently taken for their health.
- demographic and socioeconomic characteristics.
The most recent 2020–21 NHS was conducted from August 2020 to June 2021. As it was conducted during the COVID-19 pandemic, to ensure the safety of interviewers and respondents, the survey was collected via online, self-completed forms (previous iterations of the NHS was conducted via face-to-face interviews).
Non-response is usually reduced through interviewer follow-up of households who have not responded. As this was not possible during lockdown periods, there were lower response rates than previous NHS cycles, which impacted sample representativeness for some sub-populations.
Additionally, the impact of COVID-19 and lockdowns might also have had direct or indirect impacts on people’s usual behaviour over the 2020–21 period. Due to these impacts and changes, the 2020–21 NHS is considered a break in series and should only be used for point-in-time analysis only. Comparisons with previous diet data over time are not recommended. Data on variations by populations groups and trends in dietary behaviour across time are presented up to 2017–18 only.
For more information, please refer to the ABS National Health Survey: First results methodology.
About the ABS Apparent Consumption of Selected Foodstuff
The primary data source used is the aggregated scanner data (SD) provided to the ABS from major supermarkets. The aggregated data are based on information compiled from barcode scanning at the point of sale. The major supermarkets that provide data to the ABS account for an estimated 82% of Food Retail sector.
The Household Expenditure Survey (HES) is undertaken every six years, with the most recent survey in 2015–16. The 2015–16 HES is used to help estimate and impute the value of purchases made at stores other than the major supermarkets in the SD.
For further information, refer to the Apparent Consumption of Selected Foodstuffs, Australia methodology.
Recommended number of serves of vegetable and fruit per day
Tables 6 and 7 summarise the minimum recommended number of serves of vegetable and fruit per day, by different age groups.
For more information on the dietary guidelines for other food groups, see the Australian Dietary Guidelines.
Table 6: Minimum recommended number of serves of vegetable per day, by age group
Age Group (years)
|
Male
|
Female
|
2–3
|
2.5
|
2.5
|
4–8
|
4.5
|
4.5
|
9–11
|
5
|
5
|
12–13
|
5.5
|
5
|
14–18
|
5.5
|
5
|
19–50
|
6
|
5
|
51–70
|
5.5
|
5
|
70+
|
5
|
5
|
Source: NHMRC 2013a.
Table 7: Minimum recommended number of serves of fruit per day, by age group
Age Group (years)
|
Male
|
Female
|
2–3
|
1
|
1
|
4–8
|
1.5
|
1.5
|
9–11
|
2
|
2
|
12–13
|
2
|
2
|
14–18
|
2
|
2
|
19–50
|
2
|
2
|
51–70
|
2
|
2
|
70+
|
2
|
2
|
Source: NHMRC 2013a.