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Australian Health Survey: Nutrition - State and Territory results methodology

Reference period
2011 - 2012
Released
10/06/2015
Next release Unknown
First release

Explanatory notes

Introduction

1 This publication presents a selection of state and territory results from the 2011-12 National Nutrition and Physical Activity Survey (NNPAS), with the focus on foods and nutrients consumed and selected dietary behaviours.

2 The 2011-12 NNPAS was conducted throughout Australia from May 2011 to June 2012. The NNPAS was collected as one of a suite of surveys conducted from 2011-2013, called the Australian Health Survey (AHS).

3 The Australian Health Survey: Nutrition - State and Territory Results publication contains food and nutrient information from a 24-hour dietary recall and information on selected dietary behaviours by age groups and sex at the State and Territory level. Data are from the NNPAS with the exception of data relating to recommended usual daily serves of fruit and vegetables which is derived from the AHS 2011-13 (2011-12 Core component). This publication also includes selected nutrient comparisons with the 1995 National Nutrition Survey.

4 Data presented in this publication are only a selection of the information collected in the NNPAS. All statistics from the NNPAS are from the 24-hour dietary recall and are based on a single day's intake (Day 1). No adjustments have been made in this publication using the second day of 24-hour dietary recall information. For national level nutrition information refer to Australian Health Survey: Nutrition First Results - Foods and Nutrients (cat no. 4364.0.55.007) and Australian Health Survey: Usual Nutrient Intakes (cat. no. 4364.0.55.008). Further publications from the Australian Health Survey are outlined in the Release Schedule, while the list of data items currently available from the survey are available in the Australian Health Survey: Users' Guide (cat. no. 4363.0.55.001).

Scope of the survey

5 The National Nutrition and Physical Activity Survey contains a sample of approximately 9,500 private dwellings across Australia.

6 Urban and rural areas in all states and territories were included, while Very Remote areas of Australia and discrete Aboriginal and Torres Strait Islander communities (and the remainder of the Collection Districts in which these communities were located) were excluded. These exclusions are unlikely to affect national estimates, and will only have a minor effect on aggregate estimates produced for individual states and territories, excepting the Northern Territory where the population living in Very Remote areas accounts for around 23% of persons

7 Non-private dwellings such as hotels, motels, hospitals, nursing homes and short-stay caravan parks were excluded from the survey. This may affect estimates of the number of people with some chronic health conditions (for example, conditions which may require periods of hospitalisation).

8 Within each selected dwelling, one adult (aged 18 years and over) and, where possible, one child (aged 2 years and over) were randomly selected for inclusion in the survey. Sub-sampling within households enabled more information to be collected from each respondent than would have been possible had all usual residents of selected dwellings been included in the survey.

9 The following groups were excluded from the survey:

• certain diplomatic personnel of overseas governments, customarily excluded from the Census and estimated resident population
• persons whose usual place of residence was outside Australia
• members of non-Australian Defence Forces (and their dependents) stationed in Australia
• visitors to private dwellings.

Data collection

10 Trained ABS interviewers conducted personal interviews with selected residents in sampled dwellings. One person aged 18 years and over in each dwelling was selected and interviewed about their own health characteristics including a 24-hour dietary recall and a physical activity module. An adult, nominated by the household, was interviewed about one child (aged 2 years and over) in the household. Selected children aged 15-17 years may have been personally interviewed with parental consent. An adult, nominated by the household, was also asked to provide information about the household, such as the combined income of other household members. Children aged 6-14 years were encouraged to be involved in the survey, particularly for the 24-hour dietary recall and physical activity module. For further information, see Data Collection in the Australian Health Survey: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

11 All selected persons were required to have a follow-up phone interview at least 8 days after the face to face interview to collect a further 24-hour dietary recall. For those who participated, pedometer data was reported during this telephone interview.

Survey design

12 Dwellings were selected at random using a multistage area sample of private dwellings for the NNPAS.

The initial sample selected for the survey consisted of approximately 14,400 dwellings. This was reduced to approximately 12,400 dwellings after sample loss (for example, households selected in the survey which had no residents in scope of the survey, vacant or derelict buildings, buildings under construction). Of those remaining dwellings, 9,519 (or 77.0%) were fully or adequately responding, yielding a total sample for the survey of 12,153 persons (aged 2 years and over).

National Nutrition and Physical Activity Survey 2011-12, approached sample, final sample and response rates
NSWVicQldSAWATasNTACTAust
Households approached (after sample loss)2 2271 9831 9881 5511 5451 1559111 00612 366
Households in sample1 6661 3711 5251 2111 3341 0035928179 519
Response rate (%)74.869.176.778.186.386.865.081.277.0
Persons in sample2 1391 7491 9641 5261 7061 2457631 06112 153

13 Of the 12,153 people in the final sample, 98% provided dietary recall information for the day before the first interview (Day 1), with information for the missing 2% of Day 1 dietary recalls being imputed. The second 24-hour dietary recall (Day 2) had 7,735 participants (64% of the total). The Day 2 24-hour dietary recall participation was slightly higher among older respondents, and sex did not appear as a factor in participation.

14 More information on response rates and imputation is provided in the Australian Health Survey: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

15 To take account of possible seasonal effects on health and nutrition characteristics, the NNPAS sample was spread randomly across a 12-month enumeration period. Between August and September 2011, survey enumeration was suspended due to field work associated with the 2011 Census of Population and Housing.

Weighting, benchmarking and estimation

16 Weighting is a process of adjusting results from a sample survey to infer results for the in-scope total population. To do this, a weight is allocated to each sample unit; for example, a household or a person. The weight is a value which indicates how many population units are represented by the sample unit.

17 The first step in calculating weights for each person was to assign an initial weight, which was equal to the inverse of the probability of being selected in the survey. For example, if the probability of a person being selected in the survey was 1 in 600, then the person would have an initial weight of 600 (that is, they represent 600 others). An adjustment was then made to these initial weights to account for the time period in which a person was assigned to be enumerated.

18 The weights are calibrated to align with independent estimates of the population of interest, referred to as 'benchmarks', in designated categories of sex by age by area of usual residence. Weights calibrated against population benchmarks compensate for over or under-enumeration of particular categories of persons and ensure that the survey estimates conform to the independently estimated distribution of the population by age, sex and area of usual residence, rather than to the distribution within the sample itself.

19 The NNPAS was benchmarked to the estimated resident population living in private dwellings in non-Very Remote areas of Australia at 31 October 2011. Excluded from these benchmarks were persons living in discrete Aboriginal and Torres Strait Islander communities, as well as a small number of persons living within Collection Districts that include discrete Aboriginal and Torres Strait Islander communities. The benchmarks, and hence the estimates from the survey, do not (and are not intended to) match estimates of the total Australian resident population (which include persons living in Very Remote areas or in non-private dwellings, such as hotels) obtained from other sources. For the NNPAS, a seasonal adjustment was also incorporated into the person weights.

20 Survey estimates of counts of persons are obtained by summing the weights of persons with the characteristic of interest. Estimates of non-person counts (for example, number of organised physical activities) are obtained by multiplying the characteristic of interest with the weight of the reporting person and aggregating.

Reliability of estimates

21 All sample surveys are subject to sampling and non-sampling error.

22 Sampling error is the difference between estimates, derived from a sample of persons, and the value that would have been produced if all persons in scope of the survey had been included. For more information refer to the Technical note. Indications of the level of sampling error are given by the Relative Standard Error (RSE) and 95% Margin of Error (MoE).

23 In this publication, estimates with an RSE of 25% to 50% are preceded by an asterisk (e.g. *3.4) to indicate that the estimate has a high level of sampling error relative to the size of the estimate, and should be used with caution. Estimates with an RSE over 50% are indicated by a double asterisk (e.g. **0.6) and are generally considered too unreliable for most purposes. These estimates can be used to aggregate with other estimates to reduce the overall sampling error. Another factor, particular to the NNPAS, that may explain certain high RSEs are some of the food groupings that make up the Food Classification. That is, a relatively high variance would be expected where foods are combined that have very different amounts of consumption. For example, within the sub-major level food group of Herbs, spices, seasonings and stock cubes there are foods that have relatively small gram amounts of consumption (such as herbs and spices) grouped with foods that are consumed in substantially greater amounts (such as liquid stock). For more information on the Food classification see Food Intake in the Australian Health Survey: Users' Guide.

24 The MoEs are provided for all proportion and average estimates to assist users in assessing the reliability of these types of estimates. Users may find this measure is more convenient to use, rather than the RSE, in particular for small and large proportion estimates. The estimate combined with the MoE defines a range which is expected to include the true population value with a given level of confidence. This is known as the confidence interval. This range should be considered by users to inform decisions based on the estimate.

25 Non-sampling error may occur in any data collection, whether it is based on a sample or a full count such as a census. Non-sampling errors occur when survey processes work less effectively than intended. Sources of non-sampling error include non-response, errors in reporting by respondents or in recording of answers by interviewers, and occasional errors in coding and processing data.

26 Of particular importance to nutrition surveys is a widely observed tendency for people to under-report their food intake. This can include:

• actual changes in foods eaten because people know they will be participating in the survey
• misrepresentation (deliberate, unconscious or accidental), e.g. to make their diets appear more ‘healthy’ or be quicker to report.

Analysis of the results of the 1995 National Nutrition Survey (NNS) and the 2011-12 NNPAS suggests that, like other nutrition surveys, there has been some under-reporting of food intake by participants, and that patterns of under-reporting have changed over time. However, it is difficult from the available data, to accurately estimate levels of under-reporting that have occurred and therefore how much energy and nutrients might be missing from intakes reported by respondents. One method is to estimate the average amount of energy required for a population to achieve an Energy Intake: Basal Metabolic Rate ratio of 1.55 (i.e. the conservative minimum energy requirement for a normally active but sedentary population). Using this method, it is estimated that average energy intakes in the 2011-12 NNPAS may be under-reported by as much as 17% for males and 21% for females. The factor most closely associated with under-reporting was BMI, where overweight or obese people in the NNPAS were most likely to have lower than expected energy intakes. For more information see Under-reporting in Nutrition Surveys in the Australian Health Survey: Users' Guide, 2011-13.

27 Another factor affecting the accuracy of the 24-hour dietary recall data is that most young children are unable to recall their intakes. Similarly, parents/carers of school-aged children may not be aware of a child’s total food intake, which can lead to systematic under-reporting. Young children were encouraged to assist in answering the dietary recall questions. See the Interviews section of Data collection for more information.

28 Another non-sampling error specific to the NNPAS is the accuracy of the nutrient and measures database containing thousands of foods used to derive nutrient estimates. The databases used for the 2011-12 NNPAS were developed by Food Standards Australia New Zealand specifically for the survey. A complete nutrient profile of 44 nutrients was created based on FSANZ’s latest available data, however, not all data were based on directly analysed foods. Some data were borrowed from overseas food composition tables, food label information, imputed data from similar foods or data calculated using a recipe approach. See AUSNUT 2011-13 for more information.

29 Non-response occurs when people cannot or will not cooperate, or cannot be contacted for the purposes of a survey. Non-response can affect the reliability of results and can introduce bias. The magnitude of any bias depends on the rate of non-response and the extent of the difference between the characteristics of those people who responded to the survey and those who did not.

30 The following methods were adopted to reduce the level and impact of non-response:

• face-to-face interviews with respondents
• the use of interviewers, where possible, who could speak languages other than English
• follow-up of respondents if there was initially no response
• weighting to population benchmarks to reduce non-response bias.

31 By careful design and testing of the questionnaire, training of interviewers, and extensive editing and quality control procedures at all stages of data collection and processing, other non-sampling error has been minimised. However, information recorded in the survey is essentially 'as reported' by respondents, and hence may differ from information collected using different methodology.

Classifications

32 The Australian Health Survey food classification was produced by Food Standards Australia New Zealand. It is formed by grouping the 8-digit food codes into broader food groups comprising major, sub-major and minor groups, along with dietary supplements. The Australian Health Survey food classification is available as an Excel spreadsheet from the Data downloads section of the Australian Health Survey: Users' Guide, 2011-13.

Comparisons with the 1995 National Nutrition Survey

33 The 2011-12 NNPAS has not been collected in its current form before. However, the ABS has previously conducted nutrition surveys, the most recent being the 1995 National Nutrition Survey (1995 NNS). Published results from the 1995 NNS include:

34 While the 1995 NNS collected similar food and nutrition data to the NNPAS, some important changes in the food classification and methodology mean that care needs to be taken in making direct comparisons between surveys. See Comparisons with 1995 NNS in the Australian Health Survey: Users' Guide, 2011-13 for more details.

Confidentiality

35 The Census and Statistics Act, 1905 provides the authority for the ABS to collect statistical information, and requires that statistical output shall not be published or disseminated in a manner that is likely to enable the identification of a particular person or organisation. This requirement means that the ABS must take care and make assurances that any statistical information about individual respondents cannot be derived from published data.

36 Some techniques used to guard against identification or disclosure of confidential information in statistical tables are suppression of sensitive cells, random adjustments to cells with very small values, and aggregation of data. To protect confidentiality within this publication, some cell values may have been suppressed and are not available for publication but included in totals where applicable. As a result, sums of components may not add exactly to totals due to the confidentialisation of individual cells.

Rounding

37 Estimates presented in this publication have been rounded. As a result, sums of components may not add exactly to totals. Also note that due to rounding to one decimal place, estimates showing as 0.0 with a high RSE or MoE have a true figure being less than 0.05 but greater than 0.0.

38 Proportions presented in this publication are based on unrounded figures. Calculations using rounded figures may differ from those published.

Acknowledgements

39 ABS publications draw extensively on information provided freely by individuals, businesses, governments and other organisations. Their continued cooperation is very much appreciated; without it, the wide range of statistics published by the ABS would not be available. Information received by the ABS is treated in strict confidence as required by the Census and Statistics Act, 1905.

40 The ABS gratefully acknowledges and thanks the Agricultural Research Service of the USDA for giving permission to adapt and use their Dietary Intake Data System including the AMPM for collecting dietary intake information as well as other processing systems and associated materials.

41 Food Standards Australia New Zealand (FSANZ) was contracted to provide advice throughout the survey development, processing and collection phases of the 2011-12 NNPAS, and to provide a nutrient database for the coding of foods and supplements consumed. The ABS would like to acknowledge and thank FSANZ for their support, advice and expertise.

Products and services

42 Summary results from this survey are available in spreadsheet form from the 'Data downloads' section in this release.

43 For users who wish to undertake more detailed analysis of the survey data, Survey Table Builder is available. Survey Table Builder is an online tool for creating tables from ABS survey data, where variables can be selected for cross-tabulation. It has been developed to complement the existing suite of ABS microdata products and services including Census TableBuilder and CURFs. Further information about ABS microdata, including conditions of use, is available via the Microdata section on the ABS web site.

44 Special tabulations are available on request. Subject to confidentiality and sampling variability constraints, tabulations can be produced from the survey incorporating data items, populations and geographic areas selected to meet individual requirements. A list of currently available data items is available from the Australian Health Survey: Users' Guide (cat. no. 4363.0.55.001).

45 Current publications and other products released by the ABS are listed on the ABS website www.abs.gov.au. The ABS also issues a daily Release Advice on the website which details products to be released in the week ahead.

Technical note

Reliability of the estimates

1 Two types of error are possible in an estimate based on a sample survey: sampling error and non-sampling error. The sampling error is a measure of the variability that occurs by chance because a sample, rather than the entire population, is surveyed. Since the estimates in this publication are based on information obtained from occupants of a sample of dwellings they are subject to sampling variability; that is they may differ from the figures that would have been produced if all dwellings had been included in the survey. One measure of the likely difference is given by the standard error (SE). There are about two chances in three that a sample estimate will differ by less than one SE from the figure that would have been obtained if all dwellings had been included, and about 19 chances in 20 that the difference will be less than two SEs.

2 Another measure of the likely difference is the relative standard error (RSE), which is obtained by expressing the SE as a percentage of the estimate. The RSE is a useful measure in that it provides an immediate indication of the percentage errors likely to have occurred due to sampling, and thus avoids the need to refer also to the size of the estimate.

$$R S E\%=\left(\frac{S E}{estimate}\right) \times 100$$

3 RSEs for the published estimates and proportions are supplied in the Excel data tables, available via the page.

4 The smaller the estimate the higher is the RSE. Very small estimates are subject to such high SEs (relative to the size of the estimate) as to detract seriously from their value for most reasonable uses. In the tables in this publication, only estimates with RSEs less than 25% are considered sufficiently reliable for most purposes. However, estimates with larger RSEs, between 25% and less than 50% have been included and are preceded by an asterisk (e.g. *3.4) to indicate they are subject to high SEs and should be used with caution. Estimates with RSEs of 50% or more are preceded with a double asterisk (e.g. **0.6). Such estimates are considered unreliable for most purposes.

5 The imprecision due to sampling variability, which is measured by the SE, should not be confused with inaccuracies that may occur because of imperfections in reporting by interviewers and respondents and errors made in coding and processing of data. Inaccuracies of this kind are referred to as the non-sampling error, and they may occur in any enumeration, whether it be in a full count or only a sample. In practice, the potential for non-sampling error adds to the uncertainty of the estimates caused by sampling variability. However, it is not possible to quantify the non-sampling error.

Standard errors of proportions and percentages

6 Proportions and percentages formed from the ratio of two estimates are also subject to sampling errors. The size of the error depends on the accuracy of both the numerator and the denominator. For proportions where the denominator is an estimate of the number of persons in a group and the numerator is the number of persons in a sub-group of the denominator group, the formula to approximate the RSE is given below. The formula is only valid when x is a subset of y.

$$R S E\left(\frac{X}{Y}\right)=\sqrt{R S E(X)^{2}-R S E(Y)^{2}}$$

Comparison of estimates

7 Published estimates may also be used to calculate the difference between two survey estimates. Such an estimate is subject to sampling error. The sampling error of the difference between two estimates depends on their SEs and the relationship (correlation) between them. An approximate SE of the difference between two estimates (x-y) may be calculated by the following formula:

$$\mathrm{SE}(\mathrm{x}-\mathrm{y})=\sqrt{ [\mathrm{SE}(\mathrm{x})]^{2}+[\mathrm{SE}\left.(\mathrm{y})\right]^{2}}$$

8 While the above formula will be exact only for differences between separate and uncorrelated (unrelated) characteristics of sub-populations, it is expected that it will provide a reasonable approximation for all differences likely to be of interest in this publication.

9 Another measure is the Margin of Error (MoE), which describes the distance from the precision of the estimate at a given confidence level, and is specified at a given level of confidence. Confidence levels typically used are 90%, 95% and 99%. For example, at the 95% confidence level the MoE indicates that there are about 19 chances in 20 that the estimate will differ by less than the specified MoE from the population value (the figure obtained if all dwellings had been enumerated). The 95% MoE is calculated as 1.96 multiplied by the SE.

10 The 95% MoE can also be calculated from the RSE by:

$$MOE(y) \approx \frac{R S E(y) \times y}{100} \times 1.96$$

11 The MoEs in this publication are calculated at the 95% confidence level. This can easily be converted to a 90% confidence level by multiplying the MoE by

$$\LARGE \frac{1.645}{1.96}$$

or to a 99% confidence level by multiplying by a factor of

$$\LARGE \frac{2.576}{1.96}$$

12 A confidence interval expresses the sampling error as a range in which the population value is expected to lie at a given level of confidence. The confidence interval can easily be constructed from the MoE of the same level of confidence by taking the estimate plus or minus the MoE of the estimate.

Example of interpretation of sampling error

13 Standard errors can be calculated using the estimates and the corresponding RSEs. For example the estimate of the proportion of persons who ate a Stone fruit in Victoria on the day prior to interview is 10.3%. The RSE for this estimate is 8.3%, and the SE is calculated by:

\begin{aligned} SE \ of \ estimate &=\left(\frac{R S E}{100}\right) \times estimate \\ &=0.083 \times 10.3 \\ &=0.85 \end{aligned}

14 Standard errors can also be calculated using the MoE. The MoE for this estimate is +/- 1.7 percentage points. The SE is calculated by:

\begin{aligned} SE \ of \ estimate &=\left(\frac{MOE}{1.96}\right) \\ &=\left(\frac{1.7}{1.96}\right) \\ &=0.87 \end{aligned}

15 Note due to rounding the SE calculated from the RSE may be slightly different to the SE calculated from the MoE for the same estimate.

16 There are about 19 chances in 20 that the estimate of the proportion of Victorians who ate a Stone fruit on the day prior to interview is within +/- 1.7 percentage points from the population value.

17 Similarly, there are about 19 chances in 20 that the proportions of Victorians who ate a Stone fruit on the day prior to interview is within the confidence interval of 8.6% to 12%.

Significance testing

18 For comparing estimates between surveys or between populations within a survey it is useful to determine whether apparent differences are 'real' differences between the corresponding population characteristics or simply the product of differences between the survey samples. One way to examine this is to determine whether the difference between the estimates is statistically significant. This is done by calculating the standard error of the difference between two estimates (x and y) and using that to calculate the test statistic using the formula below:

$$\large \frac{|x-y|}{S E(x-y)}$$

19 If the value of the statistic is greater than 1.96 then we may say there is good evidence of a statistically significant difference at 95% confidence levels between the two populations with respect to that characteristic. Otherwise, it cannot be stated with confidence that there is a real difference between the populations.

Glossary

Show all

The definitions used in this survey are not necessarily identical to those used for similar items in other collections. Additional information is contained in the Australian Health Survey(AHS): Users' Guide (cat. no. 4363.0.55.001).

24-hour dietary recall

This was the methodology used to collect detailed information on food and nutrient intake. The 24-hour dietary recall collected a list of all foods, beverages and supplements consumed the previous day from midnight to midnight, and the amount consumed. For more information, see the 24-hour Dietary Recall of the AHS: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

Alcohol

The term 'alcohol' is commonly used to refer to alcoholic beverages. However, in the 2011-12 National Nutrition and Physical Activity Survey (NNPAS), alcohol refers to pure alcohol (or ethanol), which, as a macronutrient, contributes 29 kJ per gram.

Alcoholic beverages

The 'Alcoholic beverages' food group includes beers, wines, spirits, cider and other alcoholic beverages.

Alpha-Linolenic Acid (ALA)

Alpha-Linolenic Acid (ALA) is a plant-based omega-3 polyunsaturated fatty acid which is considered a small but important component of dietary intake in relation to helping reduce coronary heart disease risk.

AUSNUT 2011-13

See AUSNUT 2011-13 and also Nutrient Database

Australian Health Survey (AHS)

The Australian Health Survey 2011-13 is composed of three separate surveys:

• National Health Survey (NHS) 2011-12
• National Nutrition and Physical Activity Survey (NNPAS) 2011-12
• National Health Measures Survey (NHMS) 2011-12.

In addition to this, the AHS Survey contains a Core dataset, which is produced from questions that are common to both the NHS and NNPAS. See About the Australian Health Survey for details.

Basal Metabolic Rate (BMR)

Basal metabolic rate (BMR) is the amount of energy needed for a minimal set of functions necessary for life over a defined period of time. BMR is given in kilojoules (kJ) per 24 hours and is calculated using age, sex and weight (kg). For more information, see the Nutrient Intake chapter of the AHS: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

Body Mass Index (BMI)

Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to classify underweight, normal weight, overweight and obesity. It is calculated from height and weight information, using the formula weight (kg) divided by the square of height (m). To produce a measure of the prevalence of underweight, normal weight, overweight or obesity in adults, BMI values are grouped according to the table below which allows categories to be reported against both the World Health Organization (WHO) and National Health and Medical Research Council (NHMRC) guidelines.

CategoryRange
UnderweightLess than 18.50
Normal range18.50 - 24.99
Overweight25.00 - 29.99
Obese30.00 or more

Separate BMI classifications were produced for children. BMI scores were created in the same manner described above but also took into account the age and sex of the child. There are different cut-offs for BMI categories (underweight/normal combined, overweight or obese) for male and female children. These categories differ to the categories used in the adult BMI classification and follow the scale provided in Cole TJ, Bellizzi MC, Flegal KM and Dietz WH, Establishing a standard definition for child overweight and obesity worldwide: international survey, BMJ 2000; 320. For a detailed list of the cut-offs used to calculate BMI for children see the AHS: Users' Guide (cat. no. 4363.0.55.001) chapter on Body Mass and Physical Measurements and Appendix 4: Classification of BMI for children.

Calcium

Calcium is a mineral required for the growth and maintenance of the bones and teeth, as well as the proper functioning of the muscular and cardiovascular systems.

Carbohydrate

Carbohydrates usually provide the major part of energy in human diets. Carbohydrates are comprised of the elements of carbon, hydrogen and oxygen. Data for total carbohydrates include starch, sugars and related substances (sugar alcohols and oligosaccharides). Sugar alcohols and oligosaccharides are included in 'Total carbohydrates' but not in starch and sugar sub-totals. Therefore, total carbohydrate does not always equal the the sum of sugars and starch.

Cereal based products and dishes

The 'Cereal based products and dishes' food group contains biscuits, cakes, pastries, pies, dumplings, pizza, hamburgers, hot dogs, and pasta and rice mixed dishes.

Cereals and cereal products

The 'Cereals and Cereal Products' food group includes grains, flours, bread and bread rolls, plain pasta, noodles and rice, and breakfast cereals.

Combination code

Combination codes were used to indicate whether the food was combined with another food prior to consumption. One of the following combination codes was assigned to each food:

0. Not applicable
5. Sandwiches/wraps/rolls with fillings
6. Soup
7. Frozen meal
8. Ice cream/frozen yoghurt with additions
12. Meat, poultry, fish
14. Chips
99. Other mixtures

Confectionery and cereal/nut/fruit/seed bars

The 'Confectionery and cereal/nut/fruit/seed bars' food group includes chocolate, fruit, nut and seed bars and muesli or cereal style bars.

Consumer

A respondent who reported consumption of any non-zero amount (applies to foods or nutrients).

Day 1/Day 2 intake

Day 1 intake refers to information collected from the first 24-hour dietary recall, while Day 2 refers to information from the second 24-hour recall. In the 2011-12 NNPAS, Day 1 intake information was collected from all respondents, with a second 24-hour recall (Day 2) collected from around 64% of respondents. Nutrient intakes derived from 24-hour recall data do not represent the usual intake of a person because there is variation in day to day intakes. The second 24-hour recall is used to estimate and remove within-person variation in order to derive a usual nutrient intake distribution for the population. Usual nutrient intakes represent intakes over a long period of time.

Dairy & meat substitutes

The 'Dairy & meat substitutes' food group includes milk substitutes, cheese and meat substitutes, soy based ice cream and yoghurts and dishes where meat substitutes are the major components e.g. Tofu curry and Tofu and vegetable curry.

Dietary guidelines

The National Health and Medical Research Council (NHMRC) 2013 Australian Dietary Guidelines use the best available scientific evidence to provide information on the types and amounts of foods, food groups and dietary patterns that aim to:

• promote health and wellbeing
• reduce the risk of diet-related conditions
• reduce the risk of chronic disease.

The Guidelines are for use by health professionals, policy makers, educators, food manufacturers, food retailers and researchers.

The content of the Australian Dietary Guidelines applies to all healthy Australians, as well as those with common diet-related risk factors such as being overweight. They do not apply to people who need special dietary advice for a medical condition, or to the frail elderly.

Dietary supplement

For the purpose of the AHS, dietary supplements refer to products defined as Complementary Medicines under the Therapeutic Goods Regulations 1990 and that are not intended for inhalation or use on the skin. They include products containing ingredients that are nutrients, such as multivitamin or fish oil products.

Discretionary foods

The National Health and Medical Research Council (NHMRC) 2013 Australian Dietary Guidelines describes discretionary foods as being: “foods and drinks not necessary to provide the nutrients the body needs, but that may add variety. However, many of these are high in saturated fats, sugars, salt and/or alcohol, and are therefore described as energy dense. They can be included sometimes in small amounts by those who are physically active, but are not a necessary part of the diet”. For more information, see the Discretionary Foods chapter of the AHS: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

Discretionary salt

Discretionary salt is the salt added to food, either at the table or during the cooking/preparation. It does not include salt (or salt containing ingredients) added during manufacturing of processed foods or as required for chemical reasons, for example in bread baking.

Eating occasion

Respondents in the 24-hour dietary recall were asked to state what the eating occasion was for each food consumed, for example breakfast, afternoon tea, dinner.

Egg products and dishes

The 'Egg products and dishes' food group includes eggs and dishes where eggs are the major component e.g. omelettes, frittatas and souffles.

Energy

Energy, measured in kilojoules (kJ), is required by the body for metabolic processes, physiological functions, muscular activity, heat production and growth and development. All energy reported in the 2011-12 NNPAS is energy including that from dietary fibre.

Energy Intake to Basal Metabolic Rate Ratio (EI:BMR)

The ratio of energy intake to basal metabolic rate (BMR) is estimated on the basis of weight, age and sex. This ratio has been used to develop cut-off limits for implausibly low intakes. When energy intakes equal energy expenditure, EI:BMR approximates the physical activity level.

Estimated Average Requirement (EAR)

The Estimated Average Requirement (EAR) of a particular nutrient is the level of that nutrient estimated to meet the requirements of the average healthy individual in a particular life stage and gender group. See Nutrient Reference Values for Australia and New Zealand.

Fat

Fat provides a significant amount of dietary energy and is also a carrier for fat-soluble vitamins and the source of essential fatty acids. It is the most energy dense of the macronutrients. The three fatty acid subtotals do not add up to total fat because total fat includes a contribution from the non-fatty acid components.

Fats and oils

The 'Fats and Oils' group includes butters, dairy blends, margarines and other fats, such as animal-based fats.

Fatty acids

Fatty acids are units of carbon, hydrogen and oxygen which combine with glycerine to form fat. Most foods contain a mixture of monounsaturated, polyunsaturated and saturated fatty acids.

Fish and seafood products and dishes

The 'Fish and seafood products and dishes' food group includes fresh and tinned seafood, shellfish and mixed dishes with fish or seafood as the main component e.g. salmon mornay, fish curry and prawn cocktail.

Folate

In this publication, folate refers specifically to the naturally-occurring form of folate (tetrahydrofolate or THF).

Folate equivalents

Folate is a B group vitamin that is essential for healthy growth and development, which is important during pregnancy to help prevent the incidence of neural tube defects (such as spina bifida) in babies. Folate intake is measured in folate equivalents to take into account the higher bioavailability of folic acid (pteroyl glutamic acid, or PGA, the form used in food fortification and supplements) than natural folate (tetrahydrofolate, or THF, the form found in foods and in the body). Folate equivalents = 1.67*folic acid + natural folate.

Folate (total)

Total folate includes both folic acid (pteroyl glutamic acid, or PGA) and its derivatives (tetrahydrofolate, or THF, the naturally-occuring forms of folate), all of which have similar functions in the body. Total folate is calculated as the sum of folic acid and folate, without any adjustment for their differing bioavailabilities.

Folic acid

Folic acid (pteroyl glutamic acid, or PGA) is the form of folate used in supplements and for food fortification as it is more stable than the naturally-occurring forms in foods. It is more bioavailable than the naturally-occurring forms of folate. As of 2009, all wheat flour for baking (including all products baked commercially, such as English muffins, bread rolls, and bagels) is fortified with folic acid.

Food classification or food groups

Food and beverages reported by respondents in the 24-hour dietary recall were collected and coded at a detailed level, but for output purposes are categorised within a food classification with Major (2-digit), Sub-major (3-digit), and Minor group (5-digit) levels. The classification was developed by Food Standards Australia New Zealand, along with the Nutrient Database, specifically for the Australian Health Survey. At the broadest level (the Major group) there are 24 groups. These groups were designed to categorise foods that share a major component or common feature. Because many foods are in fact mixtures of different ingredients, the food groups will not exclusively contain the main food of that group.

Food security

Food security, according to the World Health Organisation definition, requires constant access to sufficient, safe, nutritious food to maintain a healthy and active life.

This topic collects information on the number of households that have experienced financial barriers in regards to purchasing food. Specifically, this topic focusses on:

• running out of food and being unable to purchase more due to cost
• having difficulty ensuring a constant food intake is sustained.

Fortification

Fortification refers to adding vitamins and minerals to food. When there is determined to be a significant public health need, food manufacturers may be required to add certain vitamins or minerals to specified foods (mandatory fortification). In Australia, mandatory fortification of foods includes iodised salt used in all bread, thiamin and folic acid added to wheat flour for baking bread, and vitamin D added to edible oil spreads such as margarine. See Food Standards Australia New Zealand: Fortification.

Fruit products and dishes

The 'Fruit products and dishes' food group includes fresh, dried and preserved fruit, as well as mixed dishes where fruit is the major component, for example apple crumble or banana split.

Haram

'Haram' was among the list of response options for respondents who said that they avoided particular foods due to cultural, religious or ethical reasons. In this context haram refers to foods which may be considered forbidden in Islam such as alcohol, pork or other non-halal foods.

Health risk factors

Specific lifestyle and related factors impacting on health, including:

• tobacco smoking
• physical activity
• body mass
• dietary behaviour
• blood pressure.

Intense sweetener

Intense sweeteners are added to food to provide sweetness without contributing significantly to the energy level (kilojoules). These food additives are substituted for sugar in some foods and beverages as a way to lower the kilojoule or carbohydrate level.

Iodine

Iodine is a nutrient essential for the production of thyroid hormones, which are essential for normal growth and development, particularly of the brain. Since October 2009, regulations have required that salt with added iodine (iodised salt) be used in all bread (except organic bread and bread mixes for making bread at home) in Australia.

Iron

Iron is a mineral essential for the oxygen carrying ability of red blood cells.

Infant formulae and foods

The 'Infant formulae and foods' food group includes infant formulae, and infant cereal, food and drink products

Linoleic acid

Linoleic acid is a particular type of omega-6 polyunsaturated fatty acid associated with blood lipid profiles seen as having a lower risk of coronary heart disease.

Legume and pulse products and dishes

The 'Legume and pulse products and dishes' food group includes legumes and pulses e.g. baked beans, chickpeas, split peas, lentils and dishes where legumes are the major component, for example dhal and falafel.

Major food group

The Major food group is the broadest level classification for food consumption data (i.e. 2-digit level). The food classification is available in Excel spreadsheet format in the Data downloads section of the AHS: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

Margin of Error (MoE)

Margin of Error describes the distance from the population value that the sample estimate is likely to be within, and is specified at a given level of confidence. Confidence levels typically used are 90%, 95% and 99%. For example, at the 95% confidence level the MoE indicates that there are about 19 chances in 20 that the estimate will differ by less than the specified MoE from the population value (the figure obtained if the entire population had been enumerated). In this publication, MoE has only been provided for the proportions and averages tables. For more information see the of this publication.

Mean

The mean is the sum of the value of each observation in a dataset divided by the number of observations. This is also known as the arithmetic average. The mean is a useful single statistic used in this publication because it summarises consumption on a per person basis (including non-consumers, i.e. zero amounts). It is most commonly used because mean amounts of individual foods can be aggregated, that is the individual means for each food within a group will sum to the higher (parent) level food group.

Meat, poultry and games products and dishes

The 'Meat, poultry and games products and dishes' food group includes beef, sheep, pork, poultry, sausages, processed meat (e.g. salami) and mixed dishes where meat or poultry is the major component e.g. casseroles, curried sausages and chicken stir-fry.

Median

The median is the middle value in distribution when the values are arranged in ascending or descending order. The median divides the distribution in half (there are 50% of observations on either side of the median value). In a distribution with an odd number of observations, the median value is the middle value. In contrast to means which tend to be skewed to the right due to small numbers of large consumers, the median is not influenced by large individual values beyond the middle of the distribution. These features make the median value most useful in this publication when comparing amounts eaten of different foods or the same food eaten by different population sub-groups. However, because medians are only relevant to consumers, it may also be useful to know what proportion of the population were consumers to give some prevalence context for the consumption.

Milk products and dishes

The 'Milk products and dishes' food group includes milk, yoghurt, cream, cheese, custards, ice cream, milk shakes, smoothies and dishes where milk is the major component e.g. cheesecake, rice pudding and creme brulee.

Minor food group

The minor food group is the most detailed level (5-digit level) group in the classification for food consumption data. The food classification is available in Excel spreadsheet format in the Data downloads section of of the AHS Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

Miscellaneous

The 'Miscellaneous' food group includes yeast, and spreadable yeast extract, intense sweeteners, herbs, spices and seasonings.

Monounsaturated fat

Monounsaturated fat or monounsaturated fatty acids are a type of fat predominantly found in plant-based foods, although there are exceptions.

National Nutrition and Physical Activity Survey (NNPAS)

The National Nutrition and Physical Activity Survey focused on collecting information on:

• dietary behaviour and food avoidance (including 24-hour dietary recall)
• selected medical conditions that had lasted, or were expected to last for six months or more
• cardiovascular and circulatory conditions
• diabetes and high sugar levels
• kidney disease

• blood pressure
• female life stages
• physical activity and sedentary behaviour (including 8 day pedometer component)
• use of tobacco
• physical measurements (height, weight and waist circumference).

Non-alcoholic beverages

The 'Non-alcoholic beverages' food group includes tea, coffee, juices, cordials, soft drinks, energy drinks and water.

Normal weight

See Body Mass Index (BMI).

Nutrient database

The Nutrient Database used to derive energy and nutrient estimates for the 24-hour dietary recall data was developed by Food Standards Australia New Zealand. See AUSNUT 2011-13

Obese

See Body Mass Index (BMI).

Overweight

See Body Mass Index (BMI).

Percentage contribution to energy intake

This refers to the proportion of energy that a food or macronutrient contributes to each person's total energy intake. The energy from each of these nutrients was estimated by multiplying each gram of a particular nutrient by a conversion factor to determine the kilojoules (kJ) of energy. For more information, see the Nutrient Intake chapter of the AHS: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

Polyunsaturated fat

Polyunsaturated fat or polyunsaturated fatty acids are a type of fat predominantly found in plant-based foods, although there are exceptions. Linoleic acid, alpha linolenic acid, long chain omega 3 fatty acids, and other polyunsaturated fatty acids are included in the polyunsaturated fatty acid total.

Preformed vitamin A

Preformed vitamin A or retinol is the form of vitamin A found in animal-derived food, such as meat, dairy products, and eggs.

Pro vitamin A

Pro vitamin A is the form of vitamin A found predominantly in dark green and orange vegetables. Where information on levels of carotenes other than beta carotene in foods was available, this has been included in the pro vitamin A total as beta carotene equivalents, according to the equation pro vitamin A = beta carotene + 0.5*alpha carotene + 0.5*cryptoxanthin. This equation takes into account the differing biological activities of the different forms of pro vitamin A.

Protein

Protein supplies essential amino acids and is also a source of energy. Protein can be supplied from animal or vegetable matter, though individual vegetable proteins do not contain all the essential amino acids required by the body. They may be limited in one of these essential amino acids.

The recommend levels of daily fruit intake to ensure good nutrition and health. Fruit intake has been grouped in the table below to allow results to be reported against the National Health and Medical Research Council (NHMRC) 2013 Australian Dietary Guidelines. A serve is approximately 150 grams of fresh fruit, half a cup of fruit juice (no added sugar) or 30 grams of dried fruit.*

Recommended daily serves of fruit, by age
AgeFruit (serves)
2-3 years1
4-8 years1.5
9-11 years2
12-13 years2
14-18 years2
19-50 years2
51-70 years2
70+ years2

*Note, while the NHMRC 2013 Australian Dietary Guidelines allow fruit juice to be used occasionally as one of the daily serves of fruit, the AHS only collected usual serves of fruit (excluding juice).

The recommend levels of daily vegetable intake to ensure good nutrition and health. Vegetable intake has been grouped in the table below to allow results to be reported against the National Health and Medical Research Council (NHMRC) 2013 Australian Dietary Guidelines. A serve is approximately half a cup of cooked vegetables or legumes/beans or one cup of salad vegetables - equivalent to around 75 grams.*

Recommended daily serves of vegetables, by age
AgeVegetables for malesVegetables for females
2-3 years2.52.5
4-8 years4.54.5
9-11 years55
12-13 years5.55
14-18 years5.55
19-50 years65**
51-70 years5.55
70+ years55

*Note, while the Australian Dietary Guidelines include servings of legumes and beans in the recommendations for vegetable intake, the AHS only collected usual serves of vegetables (excluding legumes).
**Note, the recommended usual intake of vegetables for breastfeeding women is 7.5 serves and for pregnant women is 5 serves, however these population groups have not been separated in the nutrient data output.

Relative Standard Error (RSE)

The standard error expressed as a percentage of the estimate. For more information see the in this publication.

Saturated fat

Saturated fat or saturated fatty acids are a type of fat predominantly found in animal-based foods, although there are exceptions. Saturated fat is the total of all saturated fatty acids, that is all fatty acids without any double bonds.

Savoury sauces and condiments

The 'Savoury sauces and condiments' food group includes gravies and sauces, pickles, chutneys and relishes, salad dressings, stuffings and dips.

Seed and nut products and dishes

The 'Seed and nut products and dishes' food group includes seeds and seed products, and nuts and nut products

Snack foods

The 'Snack foods' food group includes potato chips, popcorn, corn chips, cheese and bacon balls and pretzels.

Sodium

Sodium occurs in a number of different forms but is generally consumed as sodium chloride (commonly known as 'salt').

Soup

The 'Soup' food group includes homemade, dry and canned soups as well as soups purchased ready to eat.

Special dietary foods

The 'Special dietary foods' food group includes formula dietary foods e.g. protein powders, meal replacement shakes and meal replacement bars.

Sub-major food group

The Sub-major food group is the second level (i.e. 3-digit level) of the classification for the food consumption data. The food classification is available in Excel spreadsheet format in the Data downloads section of the AHS: Users' Guide, 2011-13 (cat. no. 4363.0.55.001).

Sugar products and dishes

The 'Sugar products and dishes' food group includes sugar, honey, syrups, jam, chocolate spreads and sauces and dishes and products other than confectionery where sugar is the major component e.g. pavlova and meringue.

Thiamin

Thiamin is a B group vitamin that helps the body to convert food to energy for the brain, nervous system and muscles. Wheat flour for bread making is fortified with thiamin in Australia.

Total long chain omega 3 fatty acids

Long chain omega 3 fatty acids are a particular type of omega 3 fatty acids (eicosapentaenoic acid, docosapentanoic acid, and docosahaexanoic acid) with cardiovascular and anti-inflammatory benefits. They are found in fatty fish such as salmon, sardines, mackerel, tuna and herring.

Under-reporting

Under-reporting refers to the tendency (bias) of respondents to underestimate their food intake in self-reported dietary surveys. It includes actual changes in foods eaten because people know they will be asked about them, and misrepresentation (deliberate, unconscious or accidental), e.g. to make their diets appear more ‘healthy’ or be quicker to report.

Underweight

See Body Mass Index (BMI).

Upper Level of Intake (UL)

The Upper Level of Intake (UL) of a nutrient is the highest average daily intake level that is likely to pose no adverse health effects. Nutrient intakes above the UL have a potentially increased risk of adverse effects. See Nutrient Reference Values for Australia and New Zealand.

Usual intakes

Usual intakes represent food and nutrient intake over a long period of time. For a single person, dietary intake varies day to day. A single 24-hour dietary recall does not represent the usual, or long term, intake of a person because of this variation. In the 2011-12 NNPAS, all respondents were asked for follow-up contact phone details in order to conduct a second 24-hour recall over the phone at least 8 days later. A second 24-hour recall was collected from about 64% of respondents. The second 24-hour recall is used to estimate and remove within-person variation in order to derive a usual nutrient intake distribution for the population.

Vegetable products and dishes

The 'Vegetable products and dishes' food group includes vegetables and dishes where vegetables are the major component. e.g. salad or vegetable casserole.

Vitamins

Vitamins are organic compounds required in small amounts from the diet for normal growth and metabolic processes.

Vitamin A retinol equivalent

Vitamin A is a fat soluble vitamin which helps maintain normal reproduction, vision, and immune function. Vitamin A intake is measured in retinol equivalents to reflect the contribution of pro vitamin A and preformed vitamin A, using the equation: vitamin A retinol equivalent = retinol + beta carotene/6 + alpha carotene/12 + cryptoxanthin/12. The equation takes into account the differing biological activities of the different forms of vitamin A.

Vitamin B12

Vitamin B12, also known as cobalamin, has a key role in the normal functioning of the brain and nervous system, and the formation of blood. Almost all vitamin B12 comes from animal foods, such as meat and dairy products, although some is added to some plant-based foods such as vegetarian meat replacements.

Abbreviations

Show all

The following symbols and abbreviations are used in this publication:

 . . not applicable ABS Australian Bureau of Statistics ACT Australian Capital Territory AHS Australian Health Survey ALA Alpha-linolenic acid AMDR Acceptable Macronutrient Distribution Ranges AMPM Automated Multiple-Pass Method AUSNUT Australian Food, Supplement and Nutrient Database BMI Body Mass Index BMR Basal Metabolic Rate CURF Confidentialised Unit Record File DNA Deoxyribonucleic acid EAR Estimated Average Requirement EI Energy intake FSANZ Food Standards Australia New Zealand kg kilogram kJ kilojoules mg milligram ml millilitre MoE Margin of Error na not available NATSIHS National Aboriginal and Torres Strait Islander Health Survey NATSINPAS National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey NHS National Health Survey NHMRC National Health and Medical Research Council NHMS National Health Measures Survey NNPAS National Nutrition and Physical Activity Survey NNS National Nutrition Survey NRV Nutrient Reference Values NSW New South Wales NT Northern Territory NTD Neural tube defects PGA pteroyl glutamic acid Qld Queensland RSE Relative standard error SA South Australia SE Standard error Tas Tasmania THF tetrahydrofolate µg microgram UL Upper Level of Intake USDA United States Department of Agriculture Vic Victoria WA Western Australia WHO World Health Organization