Hancock Sarah, Zinn Caryn, Schofield Grant, Thornley Simon
The Human Potential Centre, Auckland University of Technology, Auckland.
Section of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland.
N Z Med J. 2020 Feb 7;133(1509):65-72.
Dental caries is the most common chronic childhood disease in New Zealand. Concurrently, obesity and related chronic metabolic diseases are the most challenging public health problems of modern times. There is considerable evidence that a common dietary behaviour-high frequency consumption of sugar- and starch-containing foods-is the principal aetiological factor for both dental caries, and presentation of children and young people with increased adiposity or obesity. Conversely, consumption of full-fat dairy products by children and young people is associated with reduced risks of dental caries and obesity. Government-endorsed dietary guidelines for young people correctly provide recommendations to decrease intake of high-sugar foods. However, recommendations are provided to increase the frequency of consumption of sugar- and starch-containing foods as children age, and to choose low-fat dairy produce. We contend that this advice directly contradicts evidence of the dietary causes of both dental caries and obesity. This advice also does not reflect evidence regarding observed associations between the consumption of full-fat dairy produce and reduced dental caries and obesity. We present evidence to support our contention that important elements of New Zealand's dietary guidelines have been established without due consideration of the entirety of the evidence, including that which is updated, recent or evolutionarily. Given the epidemics of dental caries and metabolic disease are ongoing public health challenges in New Zealand and share common dietary causes, guidelines for healthy eating should limit refined sugar- and starch-containing foods and encourage intake of full-fat dairy items.
龋齿是新西兰最常见的儿童慢性疾病。与此同时，肥胖及相关慢性代谢疾病是当代最具挑战性的公共卫生问题。有大量证据表明，一种常见的饮食行为——高频食用含糖和淀粉的食物——是导致龋齿以及儿童和青少年肥胖或超重的主要病因。相反，儿童和青少年食用全脂乳制品与降低龋齿和肥胖风险相关。政府认可的青少年饮食指南正确地建议减少高糖食物的摄入量。然而，该指南还建议随着儿童年龄增长增加含糖和淀粉食物的食用频率，并选择低脂乳制品。我们认为，这一建议与龋齿和肥胖的饮食成因证据直接相悖。该建议也没有反映关于食用全脂乳制品与降低龋齿和肥胖之间关联的证据。我们提供证据支持我们的观点，即新西兰饮食指南的重要内容在制定时没有充分考虑全部证据，包括最新的、近期的或不断演变的证据。鉴于龋齿和代谢疾病的流行在新西兰仍是持续的公共卫生挑战，且有着共同的饮食成因，健康饮食指南应限制精制糖和含淀粉食物的摄入，并鼓励食用全脂乳制品。
