Guidelines for preventive activities in general practice



      1. Nutrition

Metabolic | Nutrition

Diet is the most important behavioural risk factor that can significantly impact health.1 The quality and quantity of foods and beverages we consume affects the health and wellbeing of individuals, society and the environment. Therefore, improving nutrition has the potential to improve individual and public health while reducing healthcare costs.1 Optimal nutrition is vital for the normal growth and physical and cognitive development of infants and children. Nutrition plays an important role in maintaining a healthy weight, enhancing quality of life and wellbeing, strengthening resistance to infections and safeguarding against chronic diseases and premature death in all Australians.1 Conversely, inadequate nutrition is linked to ill health.1

Numerous chronic diseases related to diet, such as cardiovascular disease, type 2 diabetes and certain forms of cancer, are major causes of death and disability among Australians, and over one-third of all premature deaths in Australia are from preventable chronic diseases.1 Many of these conditions are closely associated with being overweight or obese.1 For specific information on overweight and obesity, refer to the Overweight and obesity chapter.

Generally, Australians of all ages do not eat enough of the five food groups (vegetables, fruit, grains, meat and alternatives, and dairy products and alternatives) and eat too much sugar, saturated fat, sodium and food that is high in energy and low in nutrients (‘discretionary food’).2

Preventive activities and advice

Recommendation Grade How often References
Patients should be encouraged and supported to follow the Australian dietary recommendations which includes eating five serves of vegetables (or more, depending on age and life stage) and two serves of fruit per day.  Recommended (strong) Opportunistically. 1
Choose a variety of nutritious foods from these five groups every day:
  • plenty of vegetables, including different types and colours, and legumes/beans
  • fruit
  • grain (cereal) foods, mostly wholegrain and/or varieties high in cereal fibre, such as bread, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley
  • lean meats and poultry, fish, eggs, tofu, nuts/seeds and legumes/beans
  • milk, yoghurt, cheese and/or their alternatives, mostly reduced fat (reduced fat milks are not suitable for children under two years of age).
Limit the intake of foods and drinks containing saturated fat, added salt, added sugars and alcohol. See Box 1.

Care for food; prepare and store it safely.
Practice point Opportunistically.  1
Encourage, support and promote breastfeeding. Recommended (strong) Discuss antenatally and 12 months of age and beyond, for as long as the mother and child desire. 1,3,4

Infants should be exclusively breastfed until around six months of age, when solid foods are introduced (texture appropriate, in any order, as long as iron-rich foods are included) and at a rate that suits the infant’s development4 (for further information, refer to the Eat for Health Infant feeding guidelines). Breastfeeding in Australia has a high initiation rate at 96%, but this drops off quickly and only a small percentage of women meet the current recommendation of exclusive breastfeeding until around six months of age.4 Iron-fortified cereals, pureed meat, vegetables, fruit and other nutritious foods will provide a variety of tastes and textures that should be encouraged. Breastfeeding should continue while solid foods are introduced until 12 months of age and beyond, for as long as the mother and child desire.4 The benefits of breastfeeding include reduced risks of sudden infant death, necrotising enterocolitis, gastrointestinal, respiratory and middle ear infections, being overweight and obese, type 1 and type 2 diabetes and dental issues and improved cognitive development.5 For babies whose mothers cannot breastfeed or who discontinue breastfeeding early, infant formulas will need to be used up to the age of 12 months, at which time cows’ milk (full fat up to the age of two years), combined with an adequate diet, will provide the required nutrients and energy.

Reducing sugar intake will assist in reducing weight gain and dental decay.6

Because of the importance of the health outcomes that are determined by these nutritional issues, assessment and the education of parents and carers regarding children’s nutrition can be of great benefit.
For further information about good nutritional advice in children, please see the Eat for Health guidelines.

Box 1. Foods that adults should limit1

Adults should:

  • limit the intake of foods high in saturated fat, such as many biscuits, cakes, pastries, pies, processed meats, commercial burgers, pizza, fried foods, potato chips, crisps and other savoury snacks
  • replace high-fat foods, which contain predominantly saturated fats such as butter, cream, cooking margarine, coconut and palm oil, with foods that contain predominantly polyunsaturated and monounsaturated fats, such as oils, spreads, nut butters/pastes and avocado
  • limit the intake of foods and drinks containing added salt
  • read labels to choose lower-sodium options among similar foods (do not add salt to foods in cooking or at the table)
  • limit the intake of foods and drinks containing added sugars such as confectionary, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and sports drinks.

For specific recommendations for Aboriginal and Torres Strait Islander people, please refer to the Growth failure section in the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people. Visit the Eat for Health website for Aboriginal and Torres Strait Islander information sheets, brochures and posters to assist implementing the Australian dietary guidelines.

Pregnancy and lactation bring nutritional risks due to increased nutrient requirements. It is important to note that a mother's nutritional status significantly impacts the wellbeing of both the fetus and the infant.1 

For people who are at high risk of cardiovascular disease, following a Mediterranean diet can reduce their risk.7 For people with hypertension, following a DASH (Dietary Approaches to Stop Hypertension) diet can prevent and control hypertension.7 For specific information, refer to the Cardiovascular disease risk chapter.

For up-to-date advice, including the Australian dietary guidelines and the Infant feeding guidelinesEat for Health website

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