Download National Diet and Nutrition Survey Dietary results: Years 1 to 4

National Diet and Nutrition Survey
Dietary results: Years 1 to 4
Dr Toni Steer
Public Health Nutritionist
MRC Human Nutrition Research, Cambridge, UK
MRC Human Nutrition Research
Conduct nutrition research and surveillance to
improve the health of the population with a
focus on cardiometabolic risk and obesity,
musculoskeletal health, intestinal function and
nutritional vulnerabilities.
The National Diet and Nutrition Survey (NDNS)
• A national survey of the dietary habits and nutritional status of
the UK population
• Dietary habits:
• the foods people eat
• the nutrients they take in in their food
• Nutritional status
• physical measures (in blood, urine or anthropometry) that
reflect how well (or badly) nourished people are in relation
to the nutrients in the diet
How are NDNS data used?
• Monitor diet and nutritional status of the UK population
• Tool for monitoring progress towards public health objectives,
e.g. salt, saturated fat, fruit and vegetables
• Provides the evidence base to support development of public
health nutrition policy
• Public Health Responsibility Deal, Change4Life
• Food consumption data used by FSA for food safety risk
assessments
Who pays?
• Public Health England (PHE) for the
core UK NDNS survey
• With the boost samples funded by:
• The Food Standards Agency in
Scotland
• The Food Standards Agency in
Northern Ireland
• The Welsh Assembly
Who undertakes the NDNS?
National Centre for Social
Research, London
MRC Human Nutrition Research
Department of Epidemiology
and Public Health, University
College, London
Previous NDNS surveys
NDNS programme:
• Children aged 1.5 - 4.5 years - fieldwork 1992-3
• People aged 65 + years - fieldwork 1994-5
• Young people aged 4-18 years - fieldwork 1997
• Adults aged 19-64 years - fieldwork 2000-1
• NDNS Rolling Programme 2008-17
NDNS Timeline – Years 1-5
April - July 2007
Comparison study fieldwork
Feb - March 2008
Run-in to main study
April 2008 - March 2009
Main study Year 1
April 2009 – March 2010
Main study Year 2
April 2010 – March 2011
Main study Year 3
April 2011 – March 2012
Main study Year 4
April 2012 – March 2013
Main study Year 5
May 2014
Years 1-4 UK report published
NDNS – Coverage
• 1000 people per year (in the core sample) - enables trend data
every 2-3 years
• All ages from 1½ years upwards
• Private households representative of UK
• England, Scotland, Wales, Northern Ireland
• Excluding:
• Pregnant and lactating
• Those in institutions
• children’s homes, prisons, residential homes
NDNS – Components
• Face to face interview – dietary habits, socio-demographic data,
lifestyle
• 4 day prospective estimated (unweighed) diary, including
both weekend days
• Tracer water on sub-sample – Years 1, 3, 6 and 7
• Physical measures: height, weight, waist hip, mid upper arm
circumference (Y1-5 only), demispan and infant length
• Blood pressure
• Fasting blood sample
• 24 hour urine (part of the main survey for Years 1-5 only
and as a single time point boost study for adults during Y69)
• Physical activity – questionnaire age 16 years +, Actigraph 4-15
years (Y1-4 only)
What is the blood sample analysed for?
•
•
•
•
•
•
•
•
•
Full blood count
Lipid profile
(triglycerides; total, HDL- and LDL cholesterol)
C-reactive protein
Creatinine
Homocysteine
Vitamins – A, B1, B2, B6, B12, C, D, E, folate, carotenoids
Iron status – Hb, ferritin, transferrin receptor
Minerals – selenium, zinc
Age groups:
Glucose and HbA1c – funded by Diabetes UK
16 + yrs – 35 ml
7-15 yrs – 19 ml
1.5-6 yrs – 10 ml
What is the 24 hour urine sample analysed for?
•
Measure of nutrient intake:
•
•
•
•
Sodium
(salt)
Potassium
Urea, nitrogen
(protein, adults only)
Other measures
•
•
Creatinine
(kidney function)
Para-aminobenzoic acid (completeness of collection)
NDNS Years 1, 2, 3 and 4 (NDNS Y1-4) UK
report
Prepared by: (Editors) Beverley Bates, Alison Lennox, Ann
Prentice, Chris Bates, Polly Page, Sonja Nicholson and Gillian Swan
NDNS Y1-4 UK report – dietary data
• Food consumption
• Consumption of foods and food groups for 1.5-3y, 410y, 11-18y, 19-64y, 65+y
• Fruit and vegetable portions compared with 5-a-day
– not toddlers or young children
• Nutrient Intakes
• Intakes of macronutrients, selected minerals and
vitamins for 1.5-3y, 4-10y, 11-18y, 19-64y, 65+y
• Comparisons with government recommendations.
NDNS Y1-4 UK report – dietary data
• Comparisons in the UK Y1-4 report for dietary data:
• New age splits (16–24y, 25–49y, 50–64y)
• Equivalised income quintiles
• Y1&2 versus Y3&4
• With previous surveys.
Diet In Nutrients Out (DINO)
•
Dietary data is coded using Diet In Nutrients Out (DINO) a dietary
assessment system developed at MRC Human Nutrition Research,
incorporating the NDNS food composition databank
•
Information used for DINO:
• Manufactured product information
• Standard recipes from McCance
and Widdowson’s “The
Composition of Foods”
• Homemade recipes from
respondents’ food diaries
Total Energy intake kcal/d
NDNS Y1-4 compared to previous NDNS
2500
2308
2111
Total Energy intake kcal/d
2131
1972
2000
1907
1935
1613
1684
1573
16631569
1635
15091489
1510
1420
F 4-10y F 11-18y F 19-64y
F 65+
1500
1000
500
0
M 4-10y M 11-18y M 19-64y
M 65+
1994/95,1997,2000/01
2008/12
Sources of total energy – NDNS Y1-4
100
Cereals and cereal
products
Milk and milk
products
90
80
70
31
Meat and meat
products
Vegetables,
potatoes
Sugar, preserves,
confectionery
31
50
9
40
25
9
12
15
17
17
30
15
13
11
11
11
6
5
10
9
10
8
4
Alcoholic beverages
31
60
20
Non-alcoholic
beverages
35
36
0
4
6
0
0
1
1.5-3y
4-10y
11-18y
% contribution to
energy intake
6
4
19-64y
65+y
Sources of total energy NDNS – adults 19-64y
1986/87 vs 2000/01 vs 2008/12
100
Cereals and cereal
products
Milk and milk
products
90
80
70
Meat and meat
products
Vegetables,
potatoes
Sugar, preserves,
confectionery
Non-alcoholic
beverages
Alcoholic beverages
30
31
31
11
10
9
16
15
17
20
12
13
11
10
6
6
5
3
4
7
7
6
1986/87
2000/01
2008/12
60
50
40
30
0
2
% contribution to
energy intake
Macronutrient recommendations
Nutrient
Population Average
(% of food energy)
Total Fat
Not more than 35%
Of which
Saturated fat
Trans fat
Total Carbohydrate
Not more than 11%
Not more than 2%
At least 50%
Of which
Starch & sugars in milk & fruit*
Added sugars**
Fibre***
*Intrinsic and milk sugars (IMS)
**Non-milk extrinsic milk sugars (NMES)
***Non-starch polysaccharides (NSP)
At least 39%
Not more than 11%
18g per day
Fat intake % food energy NDNS Y1-4 compared
with previous surveys
Total fat intake (% food energy) by
equivalised income quintiles – NDNS Y1-4
Women 19 to 64 years
36.5
36
35.5
35
34.5
34
*
*
33.5
33
32.5
32
q1
* p<0.05
q2
q3
q4
q5
Sources of total fat – NDNS Y1-4
Saturated fatty acids (% food energy) NDNS Y1-4
Saturated fat intake (% of food energy) by
equivalised income quintiles
**
**
*
* ** ** *
* p<0.05, ** p<0.01
**
Sources of saturated fatty acids, NDNS Y1-4
Fat and saturated intake % food energy
(combined) – NDNS y1-4
NMES intake in NDNS Y1-4 vs earlier NDNS
surveys
NMES intake by equivalised income quintiles –
NDNS Y1-4
*
**
** *
**
*
* p<0.05, ** p<0.01
Sources of NMES – NDNS Y1-4
Non starch polysaccharides (NSP) by income
quintiles NDNS Y1-4
**
*
**
**
**
* ** *
*
NDNS Year 1 to 4 sodium intake (24 hr urinary
analysis)
10
9
8
7
6
5
4
3
2
1
0
males
females
4 to 6 years
7 to 10 years
11 to 18 years
Maximum recommended salt intake per day
19 to 64 years*
65 years and
over
*
Dietary sources of sodium – NDNS Y1-4
Dietary sources of sodium – cereals and cereal
products
Pasta, rice, misc
cereals
40
35
White bread
7
30
10
7
6
Wholemeal,
brown, granary
bread
Breakfast cereals
25
20
10
13
10
4
5
Buns, cakes,
pastries, fruit pies
11
15
6
Biscuits
10
11
0
3
2
1.5-3y
8
5
4
4
6
4
3
3
2
2
2
4
2
2
4-10y
11-18y
19-64y
% contribution to
sodium intake
3
4
Micronutrient intake as % of Reference Nutrient
Intake by age group
100% of RNI
Vitamin A
Folate
Iron
Calcium
1.5-3y
Zinc
4-10y
11-18y
Magnesium
19-64y
65y+
Potassium
Copper
Iodine
0
50
100
150
200
250
Intakes of thiamin, niacin, vitamin B6, vitamin B12, and vitamin C are not presented in this graph but were
>100% of Reference Nutrient Intake for all age groups
Mean iron intake by equivalised income – NDNS
Y1-4
Women 19 to 64 years
11
10.5
10
**
9.5
9
**
**
8.5
8
7.5
q1
** P<0.01
q2
q3
q4
q5
RNI: 14.8mg for 19–50 years 50+ years 8.7mg
NDNS Years 1-4 (combined): Fruit and vegetable
intake (disaggregated)
% achieving 5-a-day
100
80
60
41
40
40
20
30
30
10
7
0
Boys 11-18
Men 19-64
Men 65+
Girls 11-18
Women 19-64
Women 65+
‘5-a-day’ portions by income quintiles – NDNS
Y1-4
**
**
*
** p<0.01 *P<0.05
*
**
**
**
**
** **
NDNS Year 1 – 4 summary: 1
19-64 years
Males
NDNS
NDNS
NDNS
2000/1
35 ↓
35.8
34.8
34.9
34.5
Saturated fat
11 ↓
13.4
12.6
13.2
12.6
Trans fat
2↓
1.2
0.7
1.2
0.7
50 ↑
47.7
47.8
48.5
48.2
39 ↑
34.9
35.1
37.0
36.6
11 ↓
13.6
12.7
11.9
11.6
18 ↑
15.2
14.7
12.6
12.8
Total carbohydrate
Starch & sugars in milk and
fruit*
Non-milk extrinsic sugars
Dietary fibre (g/day)
Intrinsic and milk sugars and starch
2008/12 2000/1
NDNS
Target
Total fat
*
Females
2008/12
NDNS Years 1 to 4 summary: 2
• Total fat intake meets population recommendations, but saturated
fat, NMES and salt remain above recommended levels. Whilst fruit
and vegetables, fibre and oily fish are generally below
recommendations.
• Some age groups are consistently not meeting dietary
recommendations. Children aged 11 to 18 years in particular
consumed the fewest portions of fruit and vegetables, had the
highest percentage of food energy from NMES and substantial
proportions of this age group fell below the LRNI for some vitamins
and most minerals
• Some differences observed in food consumption and energy and
nutrient intakes by equivalised household income quintile,
particularly for fruit and vegetable consumption, particularly for
adult females. Differences were clearest between the lowest and
highest income quintile but were not seen in all age/sex groups.
• NDNS report:
https://www.gov.uk/government/publications/national-diet-and-nutritionsurvey-results-from-years-1-to-4-combined-of-the-rolling-programme-for2008-and-2009-to-2011-and-2012
• NDNS data Years 1 to 4 available in
UK Data archive shortly:
http://www.data-archive.ac.uk/
• NDNS Rolling Programme 2008-17
NDNS Timeline – Years 6-9
April 2013 - March 2014
Main study Year 6
April 2014 – March 2015
Main study Year 7
April 2015 – March 2016
Main study Year 8
April 2016 – March 2017
Main study Year 9
Dates to be confirmed
Possibly a Years 5&6 report
MRC Human Nutrition Research
Cambridge, UK
[email protected]