133 Molesworth Street
PO Box 5013
Wellington 6140
New Zealand
T+64 4 496 2000
3 September 2024
J Bruning
By email: [FYI request #27933 email]
Ref:
H2024048401
Tēnā koe J Bruning
Response to your request for official information Thank you for your request under the Official Information Act 1982 (the Act) to the Ministry of
Health – Manatū Hauora (the Ministry) on 6 August 2024 for information regarding the Ministry’s
Eating and Activity Guidelines (EAGs). Please find a response to each part of your request
below:
In which month were the 2020 Ministry of Health guidelines published?
The EAGs for New Zealand Adults were first published in October 2015 and updated in
November 2020 to include advice for pregnant and breastfeeding women. The update in 2020
only looked at pregnant and breastfeeding women and did not include review of the general
advice for adults.
Did the Ministry of Health guideline authors (who cited the Hooper 2015 review) consider
the May 2020 Cochrane review led by Lee Hooper, and discuss the findings that there
was no effect from saturated fat intake across a wide spectrum of health conditions?
The main author of the Ministry’s guidelines no longer works at the Ministry, so we are unable to
confirm. However, given that the May 2020 Cochrane review occurred after the publication of
the 1st edition in October 2015, and the 2020 EAG update focused on pregnant and
breastfeeding women, it is unlikely that it was considered as part of the limited 2020 revision.
The findings of the May 2020 Cochrane Review (Hooper et al) are consistent with the Eating
and Activity Guidelines, Eating Statement 2 (page 47) relating to saturated fat intake. The May
2020 review found that reducing dietary saturated fat reduced the risk of combined
cardiovascular events, with greater reductions in saturated fat resulting in greater reductions in
cardiovascular disease events. The May 2020 review also noted that for most other outcomes
studied there was low or very low-quality evidence. The authors also reported no evidence of
harmful effects of reducing saturated fat intakes.
Please provide all citations based on your recommendation for ages 2-18 - used to justify
the claim that 'saturated fat and trans fatty acids increase total and LDL cholesterol
(increasing the risk of cardiovascular disease)' which underpin the recommendation that
children aged 2-18 years should lower saturated fat intake.
The Food and Nutrition Guidelines for Healthy Children and Young People (Aged 2-18 years): A
background paper was originally published in July 2012. There was a partial revision in
February 2015 to incorporate minor editorial changes. This paper can be found at:
www.health.govt.nz/publication/food-and-nutrition-guidelines-healthy-children-and-young-
people-aged-2-18-years-background-paper.
The Ministry continues to recommend that New Zealanders lower their saturated fat intake and
eat unsaturated (particularly polyunsaturated) fats instead. In practice this means, using
polyunsaturated fats such as plant-based oils and spreads instead of butter if needed for
cooking and spreading. The vast majority of evidence from around the world supports this
advice for population health.
The updated advice in the EAGs is based on recent large international evidence reviews that
were used to develop dietary guidelines for Australia, the United States and the Nordic
countries. This multi-sourced evidence consistently describes a healthy eating pattern that is
high in vegetables and fruit; includes whole grain cereals; low-fat milk products; legumes and
nuts; fish and other seafood; and unsaturated oils. This eating pattern is low in processed
meats, saturated fat, sodium (salt) and sugar-sweetened foods and drinks. The evidence shows
that this way of eating is associated with a lower risk of heart disease, stroke and other health
conditions.
The EAGs advice is also closely linked to evidence-based recommendations from the World
Health Organization and the World Cancer Research Fund.
The link between saturated fat consumption, blood cholesterol levels and heart disease are well
established, with evidence building over the past 60 years. Recent research continues to add to
this evidence base. A Cochrane Collaboration review published in 2015 (Hooper et al 2015)
found that reducing saturated fat intake and partially replacing it with unsaturated fats,
particularly polyunsaturated fats, is linked with a decreased risk of cardiovascular disease. A
follow-up Cochrane Collaboration Review (Hooper et al, 2020) also found that reducing
saturated fat reduced serum cholesterol, and when saturated fat is reduced for at least two
years, results in a potentially important reduction in combined cardiovascular events.
High saturated fat diets have been highlighted in the media periodically. The few recent studies
that endorse high saturated fat diets are not sufficient to refute the wealth of counterevidence.
New nutrition related research continues to be published and the Ministry’s monitors findings
from research produced worldwide. Any new research is considered in the context of the
already existing body of evidence. As part of the EAGs process, the Ministry worked closely with
experts in nutrition and physical activity who provided guidance on interpreting current
evidence.
Has the Ministry of Health ever reviewed the evidence that partial substitution of
carbohydrate with either protein and fats can lower blood pressure, improve lipid levels,
reduce estimated cardiovascular risk and reduce pre-diabetes and diabetes incidence?
The Ministry undertook a review of popular diets in 2017 including paleo and very low
carbohydrate diets. The information in this review has now been transferred to Health New
Zealand – Te Whatu Ora and can be found on their website at:
https://info.health.nz/keeping-
healthy/popular-diets-review.
Does the Ministry of Health plan to review this evidence?
The guidelines for children and young people are the next set of guidelines scheduled for
review. The commencement of the review is on hold and subject to prioritisation and available
resource being identified.
Has the Ministry of Health reviewed evidence that current dietary guidelines relating to
current recommended levels of breads and cereals in the diet may have potential to
increase serum lipids and contribute to the development of pre-diabetes and diabetes? - Pre-schoolers: at least 4 servings
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- Children: at least 5 servings - Young people: at least 6 servings
The Ministry’s current serving size advice which was updated in 2020 can be found on Health
New Zealand’s website at:
www.tewhatuora.govt.nz/assets/Health-services-and-
programmes/Nutrition/new-serving-size-advice-dec20-v3.pdf. The document outlines the
process for the new serving sizes and rationale for aligning with Australia.
I trust this information fulfils your request. If you wish to discuss any aspect of your request with
us, including this decision, please feel free to contact the OIA Services Team on:
[email address].
Under section 28(3) of the Act, you have the right to ask the Ombudsman to review any
decisions made under this request. The Ombudsman may be contacted by email at:
[email address] or by calling 0800 802 602.
Please note that this response, with your personal details removed, may be published on the
Manatū Hauora website at:
www.health.govt.nz/about-ministry/information-releases/responses-
official-information-act-requests. Nāku noa, nā
Dr Nicholas Jones
Director of Public Health
Public Health Agency | Te Pou Hauora Tūmatanu
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