Instead, replacing some snack-type discretionary choices with less energy dense core foods is likely to be a more sustainable option to improve diet quality and reduce daily calorie intake without resulting in increased hunger.
These were the key findings of new research led by Dr Tom Wycherley from School of Health Sciences, University of South Australia, Adelaide, and presented at the European Association for the Study of Diabetes (EASD) meeting in Munich, Germany.
He noted that discretionary choices contributed to over a third of energy intake in Australia, displacing core foods such as fruit, vegetables, dairy, lean meats, and whole grains.
The study sought to assess the impact of reformulation and a reduction of consumption as strategies to tackle nutritional deficiency, obesity and other chronic diseases.
Food and nutrient intake data from 12,153 people who provided information to the 2011-13 Australian Health Survey was population weighted and combined into food categories. Data modelling was conducted to simulate a range of scenarios about the potential impact of key discrete strategies to reduce discretionary foods in the Australian population (identified from a previously conducted scoping review of the literature).
Portion size
The modelled scenarios included: reducing the quantity (portion size) of discretionary foods; substituting non-caloric beverages for water-based sugar sweetened beverages; decreasing the sugar content of discretionary foods; and decreasing the sodium content of discretionary foods. Modelling was conducted for the entire Australian population and a subset of people (4.7%) that self-reported having diabetes.
For the overall Australian population, a 25% reduction in the portion size of all discretionary foods reduced the average per person daily energy intake by 9% or 766kJ (184 calories) compared to the original diet.
To replace these discretionary foods with core foods would require an 8.3% increase in core foods and would result in a 310kJ (74 calories) (3.6%) lower energy intake, 2.1g (2.3%) greater protein intake, a 10.8g (20.6%) lower intake of added sugars and a 220mg (3.9%) lower sodium intake compared to the original diet.
Reducing sugar by 25% in discretionary foods within the food groups ‘biscuits’ (sweet and savoury) and ‘cakes/ muffins/ scones/ cake type desserts’ reduced total energy by just 0.4% or 36kJ (8.6 calories). Substituting water/non-caloric beverages to take the place of all SSBs reduced energy by 2.9% or 251kJ (60 calories) and added sugar by 14.3g (27.3%). Reformulation of grain-based discretionary foods to reduce sodium by 25% resulted in a 69mg (2.9%) lower sodium intake.
Head-to-head comparison
The sub-population of people with diabetes reported a lower intake of discretionary foods compared to the overall population (2515kJ, 604 calories).
The authors have not yet done a head-to-head comparison of different interventions, but one is planned for the future. However, they say “the effectiveness of a strategy will depend on how well it can be implemented and whether the appropriate sub-populations are targeted — for example high consumers of sugar sweetened beverages.”
They add: “Key discrete strategies, identified from the literature, to reformulate or reduce discretionary foods would in theory have small to moderate impacts on the diet quality of the overall Australian population and a subset of those who self-report having diabetes. The impact of these strategies in combination, or for sub-populations with proportionally higher discretionary food intake may be more substantial.”
They add that simply reducing food from the diet may result in nutrient deficits, and is usually not sustainable since people can experience hunger and subsequently reduce compliance.
“Replacing some discretionary choices with less energy dense core foods is likely to be a more sustainable option to improve diet quality and reduce daily calorie intake without resulting in increased hunger.”
They conclude: “The exception to this is calories obtained from sugar-sweetened beverages since we don’t tend to experience substantial changes in our feeling of fullness when we consume calories in the form of water-based sugar-sweetened, compared to consuming calories in solid or food form. Therefore, simply reducing consumption, for example by replacing them with water, may be a sustainable way to reduce calorie intake without affecting hunger.”