Eating from the whole plate

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Adjunct Professor John G Kelly, AM

Group CEO, National Heart Foundation of Australia
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John joined the Heart Foundation in August 2016. Previous to that, he led sector reform for aged care as CEO of Aged and Community Services Australia. He has extensive clinical, management and consulting background in the health sector, including previous careers in law and in cardiac nursing and current academic appointments with the Sydney Nursing School and the University of Technology, Sydney.

The Heart Foundation’s updated healthy eating recommendations are a chance for Australians to look into our fridges and lunchboxes and make some choices about what to add to, or perhaps subtract from, our next shopping lists.

But more than that, they are an opportunity to think about ourselves, the people we want to be, and whether the way we eat is helping us. 

In a time of plenty, there is enormous concern among many Australians about how to make the best eating choices. When we launched our new guidelines last week, the news ran in more than 2000 media stories across print, online, radio and TV, and more than 40,000 people came to our website for further information.

Here is what we can tell them: Unflavoured, unsweetened full cream milk, cheese and yogurt are back on the table for most Australians. And we’ve also removed our previous limit on the number of eggs we advise most people to eat each week. At the same time, we’re advising Australians to limit their intake of red meat. I’ll drill down into all this shortly – as well as some important caveats for those with existing heart conditions, Type 2 diabetes or high cholesterol.

But first, I want to take a step back and focus for a moment on the big picture – the whole plate if you like.

 

As Australians, we belong to a nation where most (no, not all) of us have access to fresh, healthy, relatively affordable food. Yet more than a third of the average Australian’s diet is made up of junk food and takeaway. These high-kilojoule meals or snacks may provide quick energy fixes, but energy is not the same as nutrition. The saturated fat and salt in food such as chips, cakes and biscuits increase your risk of heart attack and stroke. Heart disease is Australia’s biggest killer, responsible for 51 deaths a day. Poor diet accounts for nearly three quarters of the global burden of heart disease based on years of life lost.

We know that diet is one of the most powerful ways in which we can manage and improve our overall health. But, like dietary guidelines, diet is a process, not a set prescription. And while recommendations about individual nutrients can help (a lot), in the end our heart health will be better served by embracing healthy eating habits that are sustained over time rather than by fretting over a list of dos and don’ts that most of us can only manage for a day or two before we lapse.

That said, the changes to the Heart Healthy Principles follow extensive and rigorous reviews of the available clinical and nutrition evidence on the health impacts of meat, dairy and eggs. The Heart Foundation examined the findings on dairy and eggs and commissioned the Sax Institute to do an external review into meat. This evidence was then scrutinised by an advisory panel of cardiology and nutrition experts – you can find more on our process here.

Among the key findings are that, for healthy Australians, eating either full-fat or low-fat milk, cheese and yoghurt has a neutral effect on risk of heart disease - so the choice is yours.  Similarly, there is no longer a strict limit on the number of eggs you should eat.  But too much red meat moderately increases your risk of heart disease and stroke.

As a result, we’ve made the following changes:

Dairy

We’ve dropped our restrictions on full fat milk, cheese and yoghurt except for people with high cholesterol or heart disease, who should continue to consume reduced-fat products. Either way, portion size still matters. We suggest two to four serves of milk, cheese or yogurt a day. And go easy on the double and triple cream Brie - cheeses with added cream or fat, cream, butter, ice-cream and other dairy-based desserts still contribute to heart disease and are not part of a heart healthy diet.

Eggs

There is now no limit on how many eggs you can eat a week, unless you have cardiovascular disease, high cholesterol or Type 2 diabetes, in which case stick to fewer than seven a week.

Red meat

Red meat – we’ve added a limit of 350 grams a week for unprocessed meats including beef, lamb and pork. What that looks like on the plate is up to three small serves of lean meat (think a small scotch fillet, medium veal/ pork loin steak or 2 lamb chops) a week. We also strongly encourage you to choose fish, plant-based proteins like tofu, chickpeas, lentils or beans or chicken on other days of the week. (We already recommend avoiding or restricting processed and deli meats, which are linked to a raised risk of heart disease and other chronic diseases.)

You can find the full guidelines here. For some, they will make little or no difference to your eating habits; for others it may mean broadening your horizons – looking at the whole plate.

On that plate we hope you’ll find a colourful mix of vegetables, fruit and wholegrains, healthy proteins such as fish, lentils, beans and nuts, smaller amounts of eggs and lean poultry, and if you choose, a few small serves of lean red meat a week.

And, yes, even the occasional treat.