Nutrition update Rebecca Haresign Research Assistant British Nutrition

Nutrition update Rebecca Haresign Research Assistant, British Nutrition Foundation

Overview • • SACN Carbohydrates and Health report Nutrition claims Departments, agencies and public bodies Sources of information

What is SACN? • Scientific Advisory Committee on Nutrition • SACN members are appointed as independent scientific experts • SACN provides advice to UK Health Departments on matters relating to food, diet and health Examples of SACN working groups: • Carbohydrates Working Group • Vitamin D Working Group • Military Energy DRVS Working Group • Fats Working Group

SACN Carbohydrates and Health report Headlines based on evidence reviewed in SACN report: • higher consumption of sugars and sugars containing food is associated with a greater risk of tooth decay; • increasing or decreasing total energy (calorie) intake from sugars leads to a corresponding increase or decrease in energy intake;

SACN Carbohydrates and Health report Headlines based on evidence reviewed in SACN report: • consumption of sugars-sweetened drinks* results in greater weight gain and increases in BMI in children and adolescents; • greater consumption of sugarssweetened drinks is associated with increased risk of type 2 diabetes. *sugars-sweetened drinks include non-diet carbonated drinks, coffee/tea containing sugar, squash, juice drinks, sport drinks, energy drinks.

SACN Carbohydrates and Health report This led to the following recommendations from SACN: • Average intake across the UK population of free sugars should not exceed 5% of total dietary energy intake for age groups from 2 years upwards; • The consumption of sugars-sweetened drinks should be minimised in children and adults.

SACN Carbohydrates and Health report

What are free sugars? All sugars added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and unsweetened fruit juice. What sugars do not count as free sugar? Lactose (the sugar in milk) when naturally present in milk and milk products and the sugars contained within the cellular structure of foods (e. g. fruit and vegetables).

Comparison of the total and free sugars content of foods Portion size Total sugars (per portion) Free sugars (per portion) Comment Regular cola 330 ml 36. 0 g Caloriefree cola 330 ml 0 g 0 g No sugars present Semiskimmed milk 200 ml 9. 4 g 0 g None of the sugars are free sugars; all of the sugar is lactose from milk, which is excluded from the definition of free sugars Flavoured milk 200 ml 28. 0 g 16. 2 g Orange 160 g 13. 6 g 0 g Orange juice 150 ml 12. 9 g All the sugars are classed as free sugars, released from the fruit during juicing Honey 5 g 3. 8 g All of the sugars are classed as free sugars All of the sugars are present as free sugars The sugars are a mix of added ‘free sugars’ and lactose (from milk). Flavoured milk is permitted within the School Food Standards if it does not contain more than 5% added sugars None of the sugars are free sugars Source: Why 5%? An explanation of SACN’s recommendations about sugars and health. PHE 2015.

Sources of free sugars*: 11 -18 year olds *sugars intakes measured as non-milk extrinsic sugars; data from the National Diet and Nutrition Survey Rolling Programme Results from Years 1 -4 (combined) (2008/09 -2011/12)

Sources of free sugars*: Adults *sugars intakes measured as non-milk extrinsic sugars; data from the National Diet and Nutrition Survey Rolling Programme Results from Years 1 -4 (combined) (2008/09 -2011/12)

Exploring sugars in the foods we buy http: //bit. ly/1 MYDUCD

Free sugars line up

Free sugars answers 0. 4 g 2. 7 g 4 g 11. 25 g 21. 3 g 23. 8 g 36 g 0 g Data taken from Mc. Cance and Widdowson, National Diet and Nutrition Survey dietary information and retail data

SACN recommendations on fibre • SACN also recommended an increase in the population’s fibre intake • Previous recommendation for fibre was 18 g NSP, measured using the Englyst method • New recommendations from SACN use a different method – AOAC (Association of Official Analytical Chemists) • 18 g measured using the Englyst method is equivalent to 23/24 g using the AOAC method

SACN recommendations on fibre SACN recommended an increase in the population’s fibre intake to an average of 30 g per day for adults. For children, the recommended intakes are: 15 g/day (age 2 -5); 20 g/day (age 511); 25 g/day (age 11 - 16); 30 g/day (age 16 -18).

Why do we need to increase our fibre intake? Evidence from the SACN report indicated: • diets rich in fibre (cereal fibre and wholegrains) are associated with lower incidence of CVD, type 2 diabetes & colorectal cancer • diets rich in fibre decrease intestinal transit times and increase faecal mass.

What does 30 g a day look like? 7 day meal plan put together by BNF Meets the new fibre and free sugars advice Based on 2, 000 calories a day Also meets the other guidelines for a healthy diet: • Five portions of fruit and vegetables • A portion of oil-rich fish • Some low-fat dairy or dairy alternatives • Lean, protein-rich foods • Also follows the guidelines for salt, fat and saturates and supplies the recommended amounts of vitamins and minerals, such as calcium and iron. • • https: //www. nutrition. org. uk/attachments/article/881/SACN%20 guidelines%20 meal%20 planner. pdf

Putting new recommendations into practice Averages of 4. 9% free sugars, 33. 2 g fibre and 1989 kcal per day https: //www. nutrition. org. uk/attachments/article/881/SACN%20 guidelines%20 meal%20 planner. pdf

Fibre in the classroom

Nutrition claims such as ‘source of’ and ‘high in’ are regulated by the European Commission. SOURCE OF FIBRE – claim may only be made where the product contains at least 3 g of fibre per 100 g or at least 1. 5 g of fibre per 100 kcal SOURCE OF PROTEIN - claim may only be made where at least 12% of the energy value of the food is provided by protein. HIGH PROTEIN - claim may only be made where at least 20% of the energy value of the food is provided by protein. http: //eur-lex. europa. eu/legal-content/EN/TXT/PDF/? uri=CELEX: 32011 R 1169&from=EN

Nutrition claims SOURCE OF [VITAMIN/MINERAL] 15% of the nutrient reference values supplied by 100 g or 100 ml in the case of products other than beverages or per portion if the package contains only a single portion; HIGH [VITAMIN/MINERAL] at least twice the value of ‘source of [VITAMIN/MINERAL] (so 30% of the nutrient reference values supplied by 100 g or 100 ml in the case of products other than beverages or per portion if the package contains only a single http: //eur-lex. europa. eu/legal-content/EN/TXT/PDF/? uri=CELEX: 32011 R 1169&from=EN portion)

Iron NRV for Iron=14 mg, Source of Iron=2. 1 mg, High in Iron=4. 2 mg per 100 g c our s ot a N g =. 6 m n ro in i h e ig = H g m 8. 8 1. 6 = mg ot a N e c our = S g. 7 m 2 1 n iro of e urc o = S on e urc so 11 ir in h Hig = g. 2 m n iro of g m 3. 9

Government sources of information Source Role Food Standards Scotland (FSS) Public sector food body for Scotland. Ensures that information and advice on food safety and standards, nutrition and labelling, is independent, consistent evidencebased and consumer-focused. Scientific Advisory Committee on Nutrition (SACN) SACN members are appointed as independent scientific experts on the basis of their specific skills and knowledge. SACN provides advice to UK Health Departments on matters relating to food, diet and health. National Diet and Nutrition Survey (Scotland) (NDNS) This is a continuous programme which assesses the diet, nutrient intake and nutritional status of the general population aged 1. 5 years and over, in the UK. Additional recruitment was sought for Years 1 to 4 (2008/9 to 2011/12) in order to enable comparisons to be made with UK results. The NDNS provides high quality data on the types and quantities of foods consumed by individuals, from which estimates of average nutrient intakes for the population can be derived. Family Food Survey The Family Food Survey is an annual survey of household purchases of food and drink, which also provides information on nutrient intakes from both household and eating out food and drink. There is a breakdown by UK regions, and in Scotland the statistics are used to monitor the health of the Scottish diet. As the survey has been conducted annually since the 1950 s, it provides invaluable data on trends. http: //www. foodstandards. gov. scot/ https: //www. gov. uk/government/gro ups/scientific-advisory-committee-on -nutrition http: //www. foodstandards. gov. scot/ national-diet-and-nutrition-surveyrolling-programme-results-years-1 -4 combined-scotland-200809 https: //www. gov. uk/government/upl oads/system/uploads/attachment_da ta/file/485982/familyfood 2014 report-17 dec 15. pdf

Sources of information • Government (e. g. Food Standards Scotland) • NHS Inform • Charities/organisations with the Information Standard: British Nutrition Foundation, British Dietetic Association • Health Professionals (e. g. Registered Dietitians, Registered Nutritionists)

Thank you! r. haresign@nutrition. org. uk