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Nutrition News July 2014 Mission Statement Kia whakareia te ōranga o ngā tāngata o Aotearoa ma te whakamana i ngā wawatā hei tohu kai hauora, kai reka, hei oranga kakama. To enhance the quality of life of New Zealanders by encouraging informed, healthy and enjoyable food choices, as part of an active lifestyle. SS – see STOP PRE ge for back pa ement announc 1 What is eaten and what is not eaten 2-4 A perspective on sugar 4 Update on Just Cook 2014 5 Behind the hype: Carbohydrates 6 Corporate Member Update - Freya’s lower Carb New Kellogg’s Products, & online hub for health professionals 7 New Zealand Nutrition Foundation pilots the Senior Chef programme 8 Update from National Heart Foundation New Zealand Food Reformulation work recognised on the global stage 9 Heart Foundation Tick 10 NZFAVA – Updated Resource The New Food Act 2014 11 Blogs we like 12 What’s on NZ Nutrition Foundation PO Box 331 366 Takapuna, Auckland 0740 Phone: 09 - 489 3417 Fax: 09 - 489 3174 Mobile: 021 640 995 Email: [email protected] 1 www.nutritionfoundation.org.nz What is eaten and what is not eaten For almost twenty years I have worked with the International Atomic Energy Agency (IAEA). A common misperception is that the IAEA is about nuclear weapons. The IAEA is part of the United Nations and the organisation won the Nobel Peace Prize in 2005 partly for their work to ensure nuclear energy for peaceful purposes is used in the safest way. Large sections of the IAEA are devoted to food and agriculture, human health, environment and water resources. I work with the Nutritional and Health-Related Environmental Studies (NAHRES). to ensure that the recipe includes 40 essential In the last two weeks I have attended two internutrients in adequate quantities for these national meetings in Vienna facilitated by the children, who are between -2 and -3 standard IAEA. The first was a small cooperative research deviations from the median weight for age of meeting about adolescent health and measurethe World Health Organisation child reference. ment of obesity in low to middle income counThere is a role for sugar, particularly making sure tries. The second was an International Sympothat the food will be eaten but it is a small part of sium on Understanding Moderate Malnutrition the picture. Added sugar is a in Children for Effective Interfeature of many ‘fake foods’, ventions attended by almost foods that do not provide In the 2014 Queens Birthday 400 country, NGO and nutrients we need. United Nations organisations Honours Elaine was awarded including the World Bank Membership of the New There was a call to talk about nutrition security, not food Zealand Order of Merit (MNZM). I had time to think at both security. Being large does these meetings about food Our congratulations and best not mean you are over-nourand nutrients; across the wishes go to Elaine from the ished. Malnutrition occurs spectrum of body size; from staff, Council, members and at all shapes and sizes and birth to later life and also the times of life. friends of the Foundation. We food supply and its nutrient are all delighted her passion, composition. Sugar, white We should take a look at the flour and white rice add commitment and achievements New Zealand food supply calories but not essential nuand see if we meet the nutri– so ably demonstrated in trients to the diet, yet they ent requirements, particularthis editorial - have been are dominant foods eaten in ly for growing children and acknowledged. most countries because they mothers. are cheaper and more easily Gabriela Mistral, a Chilean stored. Sugar has the added poet who received the Nobel negative in that it is strongly associated with Prize in literature in 1945, wrote: tooth decay and long term a diet high in sugar is associated with chronic disease. “Many things we need can wait. The child cannot. Now is the time his bones are formed, his mind The challenge to those in the area of nutrition is developed. To him we cannot say tomorrow, his to put whole foods and nutrients back into the name is today” food supply. In places where there is high risk of acute malnutrition (why is it called that when the Professor Elaine Rush, MNZM effects are life-long?) there is a drive to produce Scientific Director ready-to-use foods made from local ingredients and a system called linear programming is used New Zealand Nutrition Foundation www.nutritionfoundation.org.nz www.nutritionfoundation.org.nz 1 A perspective on While searching through our archives yesterday we came across the NZNF newsletter from May 1993. 21 years ago and guess what the feature article was…. SUGAR: THE MYTHS! As Jean Baptiste Karr said, “Plus ça change, plus c’est la même chose”, or loosely translated, the more things change the more they stay the same. The 1993 piece begins “Misinformation abounds in the community about many foods and nutrients, but perhaps more fallacious ‘information’ is spoken and written about sugar than any other food. We’ve all heard the expression ‘pure, white and deadly’ …….and many people in the community …… have come to believe it of sugar, particularly ordinary white table sugar”. Sound familiar? In this article we will look at the role of sugar in our every day diet and consider the implications of too much sugar on health and wellbeing. The information we have used is drawn largely from a comprehensive literature review – The role of sugar in the diet of New Zealanders – carried out for us last year by University of Auckland Health Science students Saphiya Zaza and Lauren Whitworth. Definitions Sugars or total sugars – all sugars including all mono and di-saccharides present in foods and drinks whether naturally occurring or added. Natural or intrinsic sugars – sugars naturally occurring and not added. These sugars are an integral part of the food such as fructose in fruit and lactose in milk. Added or extrinsic sugars – (also called free sugars) sugar added to food products during commercial or home food preparation, as well as sugars that are naturally present in honey, syrups, fruit juices and fruit concentrates. 2 Sugar or refined sugar – purified sucrose or sucrose, a di-saccharide made up of glucose and fructose. Includes all forms – white, brown, icing, caster, muscovado, demerara, golden syrup etc. Insulin: Insulin is secreted in response to increasing blood glucose concentrations. It plays important roles in both carbohydrate and lipid metabolism and is necessary for metabolism of glucose by many cells. The role of sugar Fructose Metabolism: The metabolism of fructose (the other breakdown product of sucrose) can lead to raised levels of uric acid. Studies have shown that uric acid stimulates the laying down of fat in the liver while fructose can be directly metabolised to form fat in the liver. Fatty liver is a risk factor for metabolic syndrome in susceptible individuals and studies have reported raised uric acid concentrations independently predict risk for obesity and diabetes. Sugar containing foods have moved from being a highly sought after over 200 years ago to a major source of calories in the food supply of every country. Food Production Preservation – sugar maintains both flavour and colour of fruits in jellies and jams and preserved fruit. By retaining water sugar also keeps products like breads fresher for longer, adding to shelf life. Texture – sugar can control the rate and extent of sugar crystallisation to create a wide variety of textures in foods. Sugar can vary in its degrees of viscosity, impacting the mouth feel of a food. Colour – when heated sugar caramelises, enhancing colour and flavour. Flavour – sugar is commonly used as a sweetener and to balance the tastes of salt, sour and bitter. Fermentation – sugar provides “fuel” for speedy growth of yeast in foods and alcoholic beverages. In our bodies As a carbohydrate, refined sugar or sucrose provides energy and has physiological effects on our bodies, including blood glucose and insulin metabolism, bile acid dehydroxylation and satiety. Energy: Glucose (a breakdown product of sucrose and starches) is the sole fuel used by the brain and its processes, except during prolonged starvation. Because the brain lacks fuel stores, the body maintains more or less a continuous supply of glucose to the brain. www.nutritionfoundation.org.nz Satiety: It is proposed sugar in large amounts induces leptin resistance and reduced satiety. Leptin is a hormone with a key role in regulating energy intake and expenditure. It has been described as the master regulator of appetite. How much do we consume? The most recent data on local intake come from the 2008/09 New Zealand Adult Nutrition Survey (ANS). The survey reported a median daily total sugar from all sources of 120g (males) and 96g (females). The median intake of sucrose was reported as 55g (males) and 42g (females). A limitation of dietary surveys is the temptation for respondents (or people) to under-report what they have eaten, so there may be many more people having larger amounts than this. Generally men consume more sugar and calories than women and younger people have a higher intake than older people. Interestingly, under 30s consume approximately 25% of their sugar in beverages. The main sources of total sugars in the New Zealand diet in decreasing order of magnitude are fruit, non-alcoholic drinks, sugar and sweets, milk and cakes and muffins. How much do we need? Both the American Heart Association (AHA) and the WHO have recently released guidelines around added sugar. AHA –6tsp / day women 9tsp / day men WHO Less than 10% of energy intake (based on the median energy intake data from the 2008/09 ANS this would be no more than 15tsp (males) and 11tsp (females). They also state there would be additional health benefits if we could go below 5%. These recommendations include honey, syrups and fruit juice but exclude other intrinsic sugars, tacitly acknowledging while fruit and milk are naturally high in sugars in the form of fructose and lactose respectively they are important core foods in a healthy diet. It is also postulated the form and the amounts in which they naturally occur can mean some of the adverse effects described below may not occur, for example: • In fruit, but not in fruit juice, the sugar is encapsulated in the cell wall, made of fibre, slowing the digestion and absorption. • You get much more sugar when you have fruit as fruit juice, even without added sugar, because you use more fruit for a juice serving than when you eat the whole fruit. What’s the problem? According to a review of literature some sugar as part of a healthy and balanced diet can pose little risk. However, the definition of a healthy and balanced diet can vary widely and the threshold and time of life at which sugar may have a negative health impact is unclear. Further muddying the water, there are many health conditions anecdotally linked to consumption of sugar and the threshold for which sugar has a negative impact is not the same for each condition. The literature review highlighted six health issues; diabetes, cardiovascular disease, obesity, oral health, ADHD and addiction. Diabetes The review of the literature showed a positive association between added sugar intake and the risk of type 2 diabetes. It was thought this was because of its effect on weight gain and insulin resistance but there is also a growing body of work looking at the role fructose may have in the development of metabolic syndrome and insulin resistance in susceptible individuals. Sugar added to drinks may also play a part. A review study based on 16,154 participants of which 12,403 had type 2 diabetes showed a daily intake of one (336ml) or more sugar sweetened beverages (SSBs) was associated with a 22% higher risk for type 2 diabetes compared with low consumers (< 1 glass / month). This association persisted after adjustment for BMI, indicating obesity may not be the main driver. Cardiovascular Disease In 2009 the American Heart Association recommended a significant reduction in added sugar intake, based on a positive association between added sugar and risk factors for cardiovascular disease. This is supported by a meta-analysis carried out at the University of Otago in 2013 (and published May 2014). The review found sugar adversely affected lipids and blood pressure suggesting sugar may be metabolised differently from other carbohydrates. Their conclusion: added sugar contributes to the risk of cardiovascular disease independent of the effect of sugar on body weight. This is supported by recently published results by Yang et al who showed a dose response of free sugars intake on cardiovascular mortality. Obesity There is strong evidence to suggest a positive association between added sugar intake and excess fat accumulation or obesity. However obesity is a complex metabolic issue and it is very unlikely sugar as a single food is the primary casual factor. Its role is thought to be that added sugar contributes to more energy-dense nutrient-poor diets, promoting positive energy balance. It is also thought SSBs may have a stronger association with weight gain due to their low satiety signals and the likelihood they will be consumed with other energy dense foods. Another meta-analysis carried out by the University of Otago concluded, “Intake of sugar is a determinant of body weight in free living people consuming ad libitum diets”. The data support the contribution of sugar to energy-dense diets, contributing to excess energy intake and therefore weight gain. This is in contrast to other views which include physiological and metabolic consequences of sugar intake as described earlier. Oral Health This is where the evidence is strongest and because it starts in childhood, affects life-long health. There is clearly a strong www.nutritionfoundation.org.nz association between the consumption of added sugar and the development of dental decay, the most prevalent chronic disease in New Zealand. Sugar in food and drinks is hydrolysed by amylase in saliva to produce substrates which provide a favourable environment for oral bacteria. The bacteria cause demineralisation and destruction of the hard protective surfaces of teeth. Once these surfaces breakdown caries or holes can form. This effect is compounded when acid is present as in fruit juices and cola drinks. The impact sugar on the development of dental caries is dependent not just on sugar consumed but also on oral hygiene, salivary function and fluoridation. Frequency of eating and / or drinking along with the amount consumed is also important, with studies showing a high frequency of consuming high sugar products is linked with an increase in the likelihood of developing dental caries. The amount of sugar consumed at one time is also important. Attention-Deficit Hyperactivity Disorder (ADHD) There are some cross-sectional studies showing a dose-responsive relationship between high sugar intake and behaviours like hyperactivity, lack of attention and aggression. Cross-sectional studies cannot show cause, but may point the way to further research. This is a controversial area close to the heart of many parents, with much ongoing research and we look forward to more definitive evidence. Sugar Addiction This is another highly controversial area with arguments both for and against sugar as an addictive substance. One limitation is many of the studies in support of addiction have been carried out in sugar-fed rats whose results do not always translate directly to humans. However they do point the way to on-going areas of research. In the ‘against’ corner some researchers have argued it’s not addiction to sugar that motivates us to consume sugar; rather, it is because sugar is found in almost all food products. Most of us choose foods such as ice-cream, soft drinks and sweets because of their taste and texture not their nutrition content. The idea behind sugar as a rewarding substance may shed some light - perhaps we associate reward with sweet food as a whole and not necessarily sugar. And perhaps some people are more susceptible to sugar ‘temptation’ than others. continued on page 4 3 continued from page 3 A closer look: Added sugar in 2 typical breakfasts A perspective on Conclusion and Recommendations Sugar alone is not responsible for all the ills of today. However, it undoubtedly plays a role in some conditions, including dental caries, obesity, cardiovascular disease and diabetes - some to a greater degree than others. Breakfast 1 Breakfast 2 Toasted muesli ½ cup14.5g Weetbix 2 biscuits 0.8g Wholegrain toast 2 slices 2.2g Wholegrain toast 2 slices 2.2g Jam 2 teaspoons 21.2g Marmite 1 teaspoon 0.7g Orange juice 1 cup 19.7g Water0.0g TOTAL69.7g TOTAL3.7g TOTAL kJ TOTAL kJ 1171kJ 62.2kJ So what does the NZNF recommend for consumers? % energy men 12.3% % energy men 0.7% 1.Eat food from all four food groups; • vegetables and fruits • cereals and grains (preferably wholegrain), • protein rich foods like legumes, beans, meat, fish, eggs and chicken • dairy products % energy women 15.6% % energy women 0.8% Also include foods rich in healthy fats like olive oil, avocado, oily fish and nuts. 2.Aim to have no more than 10% of energy from added sugars. This means no more than 50g / day or 12 teaspoons. Less is preferable. • Foods high in added sugar like sweets, muffins, cakes, muesli bars, biscuits and cakes should be regarded as treat foods and enjoyed in small portions. • Sugar sweetened beverages (SSBs) should be replaced with water, milk, or “diet” versions. foods with no added sugar are not included here foods with no added sugar are not included here Breakfast 1 seems to be a healthy breakfast, but closer inspection of the numbers shows it actually provides more than the recommended 10% of total daily energy from added sugar. By swapping the toasted muesli with Weetbix, replacing jam with marmite and exchanging the orange juice for water, the total sugar intake is reduced by more than 95%. NZNF thanks Saphiya Zaza and Lauren Whitworth for their work in preparing the literature review; The Role of Sugar in the Diet of New Zealanders. A list of references is available on request – email: [email protected] Update on Just Cook 2014 We are now in the final stages of preparing the My Food My Future teaching module developed with funding from the Youthtown Trust in partnership with the Liggins Institute and the National Institute of Health Innovation at the University of Auckland. Liggins Institute with their LENScience programme. Alongside more traditional methods like work sheets, the module uses fun new technology. Students can push a trolley through the virtual supermarket and fill it, just as you would in real life. It moves into the real world with activities including; • $2 lunch challenge • Design meals within a budget As described in earlier newsletters, the module uses a virtual • Design meal using lots of vegetables , ingredients which are on every Justday Cook supermarket as the springboardUpdate to talk about food2014 in season and ingredients that can stretch the budget choices and home meal preparation. For the Foundation, My We are now the final preparing the My Food My Future teaching module developed • Design meals according to Heartwith Foundation’s Simple Steps Food My in Future is partstages of theof JUST COOK programme. to Healthier Eating funding from the Youthtown Trust in partnership with the Liggins Institute and the National Institute My Food My Future sits within the years 7, 8 & 9 science costs of takeaways vs. home cooking of Health Innovation the University of Auckland. As choices described•in Comparing earlier newsletters the module curriculum and asksatstudents to consider how the food makesupermarket every day can as impact on their healthtoand usesthey a virtual the springboard talkwell-being. about everyday food choices and home meal information on food • Analyse and understand key nutrition The module students to eat from home labels.COOK programme. preparation. For encourages the Foundation My Food Mymore Future is part of the JUST and become more involved in food choices and preparation, We have attempted to future-proof the project by building in by not only talking nutrition but 7, also aboutcurriculum the My Food My Future sitsabout within the years 8 &talking 9 science and asks students the ability to add avatarsto at consider a later date. economics of food from home vs. takeaways or canteen food. howTeachers the foodwill choices they make everyday can impact on their health and well-being. The module have the option of turning on the app FoodSwitch Professional development will be key to the success of My Food encourages students to eat more from home and become more involved in food choices and to allow students to consider interpretive food labelling along My Future. We will be asking science teachers to apply to attend with the Nutrition Information preparation, by not only talking Panel. about nutrition but also talking about the training economics of food from during the holidays and a two day course in Auckland will also carry out one day sessions outside Auckland. home takeaways or canteen food. Teachers willMyhave the Wevschose the science curriculum as the place for Food Myoption of turning on the app Future because it isstudents compulsory study science in years food 7, 8 and All materials will be online through both the Nutrition FoodSwitch to allow to to consider interpretive labelling along with theavailable Nutrition 9 and we could build on a successful platform established by the Foundation and LENScience. Information Panel. We chose the science curriculum as the place for My Food My Future because it is compulsory to www.nutritionfoundation.org.nz 4 study science in years 7, 8 and 9 and we could build on a successful platform established by the Liggins Institute with their LENScience programme. Alongside more traditional methods like work Behind the hype: carbohydrates Because of the recent media focus on low carbohydrate diets and the vilification of sugar, the Health Promotion Agency has produced a resource on carbohydrates to support health and community workers without nutrition expertise to help clear up confusion about carbohydrates and sugar. This is a comprehensive resource covering what foods carbohydrates are found in, how to find them on a food label, dietary guidelines, why we need them and their role in weight loss. This is all important stuff to know when you are providing health support to the community, but people who do not have a nutrition background might find this resource a bit heavy going. Here is a summary of what you need to know: Carbohydrates are: Behind the hype: carbohydrates • Sugar in all its forms including fruitof the recent media focus on low carbohydrate diets and the Because sugars Promotion Agency has produced this resource on carbohydrates to su • Starchy foods such as pasta, rice, nutrition expertise to help clear up confusion about carbohyd without bread, cereals and oats This is a comprehensive resource covering what foods carbohydrates food label, dietary guidelines, why we need them and their role in we • Starchy vegetables like potatoes Having high amounts of carbohydrates in This is allhealth important stuff to know when you are providing health supp the form of sugar can have adverse users who don’t have nutrition background might find this resource a effects and it is recommended that intake is limited. This includes fruit juices and to know: what you need all so called ‘healthy’ sugars like coconut sugar, agave nectar and Carbohydrates honey. Much are: more detail is provided in our article, ‘A • Sugar in all its forms including fruit sugars perspective on sugar’ on page 2. • Starchy foods such as pasta, rice, bread, cereals and oats You can download the resource •hereStarchy vegetables like potatoes The graphic below appeared in the Having high amounts of carbohydrates in the form of sugar can have Huffington Post Lifestyles section in an recommended article about sugar, and with tongue in that intake is limited. This includes fruit juices and all ‘ agave nectar and honey. Much more detail is provided in our article, cheek we thought it was quite appropriate! You can download the Flyer here This graphic appeared in the Huffington Post Lifestyles section in an a was quite appropriate! www.nutritionfoundation.org.nz 5 Corporate Member Update Corporate Update - Goodman Fielder Freya’s lower Carb Goodman Fielder Freya’s lower Carb Consuming bread every day is an important part of a balanced healthy diet. The 2003 Food and Nutrition Guidelines recommend New Zealanders consume at least six serving per day from the Breads and Cereals food group, where one serve is one medium slice of bread or 1 medium rewena or ½ cup muesli etc. There are many important nutrients in this food group such as dietary fibre, protein, carbohydrates, and specific vitamins and minerals. Interestingly, according to the 2008-2009 Nutrition Survey in New Zealand, the Bread group was the largest single contributor of dietary fibre followed by vegetables. To encourage New Zealanders to consume foods from this food group, Freya’s has just launched its new Lower Carb range of breads! This range delivers on the same great quality and taste as Freya’s, but with 40% less carbohydrates than standard Multigrain breads*. This range is ideal for those New Zealanders seeking a lower carb alternative or those who just want delicious tasting bread! To achieve this new formulation, some of the wheat flour was replaced with a tasty mix of seeds and soy flour. There are three varieties in this range; these are Soy & Linseed, Toasted Sesame & Soy and 5 Seeds. In addition to being lower in carbohydrates, they provide an excellent source of fibre (25 - 28% of the recommended daily intake) and a good source of protein (23 - 28% of the recommended daily intake) in one serving, which is 2 slices of bread! Protein and fibre are both important nutrients and provide specific health benefits. Furthermore, thediet. The 2003 F Consuming bread everyday is an important part of a balanced healthy and Nutrition Guidelines recommend New Zealanders consume at least six serving per sodium content in this range is below from the Breads and Cereals food group, whereby one serve is one medium slice of br 1 medium rewena or ½ cup muesli etc. There are many important nutrients in this food 400g/100g. Freya’s Lower Carb range group such as dietary fibre, protein, carbohydrates, and specific vitamins and minerals. Interestingly, according to 2008-2009 Nutrition Survey in New Zealand, the Bread g can be found intheall major supermarkets. was the largest single contributor of dietary fibre followed by vegetables. For more information please visit http:// To encourage New Zealanders to consume foods from this food group, Freya’s has jus launched its new Lower Carb range of breads! This range delivers on the same great q freyas.co.nz/lower-carb/ and taste as Freya’s, but with 40% less carbohydrates than standard Multigrain breads This range is ideal for those New Zealanders seeking a lower carb alternative or those just want delicious tasting To achieve this new formulation, some of the wheat fl *The concise NZbread! Food Composition Table, was replaced with a tasty mix of seeds and soy flour. 9th Edition 2012 show the composite There are three varieties in this range; these are Soy & Linseed, Toasted Sesame & So value forIn addition, “Light multigrain bread” is an excellent so and 5 Seeds. to being lower in carbohydrates, they provide of fibre (25 - 28% of the recommended daily intake) and a good source of protein (23 40.7g/100g. of the recommended your daily intake) in one serving, which is 2 slices of bread! Prote and fibre are both important nutrients and provide specific health benefits. Furthermore sodium content in this range is below 400g/100g. Freya’s Lower Carb range can be fou all major super markets. For more information please visit http://freyas.co.nz/lower-carb New Kellogg’s Products, & online hub for health professionals *The concise NZ Food Composition Table, 9th Edition 2012 show the composite value f “Light multigrain bread” is 40.7g/100g. Kellogg’s is making changes for the better. This year the company has some exciting new launches starting with a recipe makeover as the first significant step. For the first time in almost 60 years, the Special K® flake has undergone a significant reformulation. Kellogg’s recognises consumers’ needs have changed and people are looking for a breakfast that is both nutritious and sustaining which still tastes great. The cereal is now made with three grains – rice, whole grain wheat and whole grain oats. The new recipe increases fibre content to 6.5g per 100g making Special K® not only one of the highest protein cereals but also now a source of whole grain and fibre. Plus, sodium is now down to 360 mg per 100g, 15% lower than the original Special K® flake. Also new to the Kellogg’s product range is All-Bran® High Fibre Muesli with 6.1g of fibre per serving from a blend of whole grain oats, fruit and pepita seeds - plus the signature wheat bran shreds helps promote regularity. Available in two flavours - Apricot & Almond or Cranberry & Pink Lady Apple, new All-Bran® High Fibre Muesli has the Heart Foundation Tick and is low GI. So what has stayed the same? Special K® Original remains 99% fat free and has only 5.8g sugar per serve. Protein content is steady at almost 20%, supporting satiety and it still contains eight essential vitamins and minerals including all-important iron. Additionally Kellogg’s has now launched a new online hub to help health professionals keep up-to-date. The health professionaldedicated site delivers access to the latest news, research and information about Kellogg’s products to help consumers make good choices for healthy living. The new flake is also used in other Special K® products including all Special K® snack bars as well as other Special K® cereal varieties. For more information head to http://www.kellogghealthprofessionalanz.com/ 6 www.nutritionfoundation.org.nz New Zealand Nutrition Foundation pilots the Senior Chef programme Senior Chef was established in 2004 in Christchurch as one of several projects initiated by the Canterbury DHB Healthy Eating, Healthy Ageing Project. This community based eightweek cooking programme provides older adults with the opportunity to improve their cooking skills and food and nutrition knowledge, and to socialise and share meals as a group. The overall goal of Senior Chef is to improve the nutritional wellbeing of community- living older people. From February to May this year, the Foundation piloted two Senior Chef courses on the North Shore to assess the feasibility of delivering the programme on a limited budget in a small organisation. Course venues needed to have suitable cooking equipment, space for up to twelve people per group and good access to public transport and parking. Glenfield Community Centre and Milford Baptist Church provided appropriate locations. In Canterbury, because of the demand for places, clients are now referred by a health professional, but in Auckland, as in the earlier years of the Canterbury programme, social networks and self-referrals were more effective. A total of 18 people graduated from the two courses. The majority of people undertaking the courses were male, some of whom lived alone or were caregivers in their own homes. Others were motivated to develop cooking skills as a pre-emptive measure. Each participant received a free cookbook that included recipes designed for one or two people and key nutrition, food safety and meal planning messages. Classes began with meeting and greeting and morning tea, followed by a nutrition or skills training session and finally, preparing and cooking a meal. An important component of the course was eating the meal together. This offered opportunity for discussion, reflection, questions and general fellowship. Participants were enthusiastic about interpreting instructions in a cookbook and wanted to take their cookbooks home so they could continue experimenting between sessions. Lively discussion took place about food gardening and ways of getting great results. Participants were asked to complete a pre- and post-course evaluation to identify what, if any, changes were made as a result of engaging in the course. Compared with the precourse evaluation, there was an increase in skill and confidence in cooking. Self-assessed knowledge of food and nutrition increased post- course. More participants were eating more servings of vegetables per day; intake of fruit had increased and consumption of dairy products had increased slightly. Some participants who were the cooks in their homes stated their increased confidence enabled them to include more fruit and vegetables and greater variety in their meals. A supermarket tour and assessment of food products as a group was an interesting learning experience for participants and sharing of useful food product knowledge between participants and course facilitator was valued. Knowledge of food safety had improved and more participants planned meals, used shopping lists, read food labels and felt more motivated and confident to cook meals. Where to from here? The Foundation was able to pilot the Senior Chef courses, thanks to a generous grant from the ASB Community Trust and with considerable help in setting up the programme from the Senior Chef team at Canterbury DHB. The Canterbury DHB courses are funded by the Ministry of Health and are free to participants. In the same spirit, the Auckland pilot courses were offered at no charge. Funding is increasingly difficult to secure and the Foundation needs longer term support if it is to set up the infrastructure to offer courses across the Auckland Region. The Nutrition Foundation is currently investigating options, alongside other plans in its Healthy Ageing portfolio. Other DHBs, Age Concern and Metlifecare have offered courses in other parts of the country, including Tauranga, Rotorua, Hawke’s Bay, Wellington/Kapiti, Blenheim, West Coast and Otago. Some DHBs have provided funding for Senior Chef courses, but only Canterbury is supported by specific Ministry of Health funding. The Ministry of Health does not currently have plans to support other programme providers across the country. There has been talk in the past about the Ministry licensing this programme and also taking over the resources so they are available free of charge, but these actions are not currently being actively considered. For more information about Senior Chef go to: http://www.seniorchef.org.nz The New Zealand Nutrition Foundation acknowledges the support of the ASB Community Trust www.nutritionfoundation.org.nz 7 Update from the National Heart Foundation The Heart Foundation’s Fuelled4life has launched a new Te Reo resource for Kōhanga Reo, “Toi te Kupu” (hold fast to our language). The Heart Foundation worked with Toi Tangata (formerly Te Hotu Manawa Māori) to develop the resource that is designed to foster Māori language and support healthy eating. The new resource has three parts: A mini Papa Kupu (dictionary) using many food, nutrition, health, and cooking terms, a sticker based language activity that allows the children to create an image of themselves and then apply food and nutrition sentences and a memory stick containing the dictionary, the 2014 Fuelled4life Buyers’ Guide, nutrition and catering information, recipes and menu planners. The resource pack will be distributed to over 1000 Kohanga Reo and early childhood education services around the country. For more information email fuelled4life@ heartfoundation.org.nz New Zealand Food Reformulation work recognised on the global stage The Heart Foundation’s Food Reformulation programme has recently been recognised on the global stage by the World Hypertension League. The ‘Notable achievement in salt reduction award’ recognises efforts to reduce dietary salt at a population level. The Heart Foundation facilitates an industry led voluntary salt reduction programme in New Zealand. Over the past 10 years a number of key manufacturers have led the way in their internal salt reduction programme and the HeartSAFE programme has worked in collaboration with food industry to bring on board smaller manufacturers and private labels particularly targeting high volume, low cost foods. These voluntary reformulation efforts from the food industry have removed around 210 tonnes of salt per annum from those food categories where targets have been set. Sodium targets have been set for bread, breakfast cereals, processed meats, soups and savoury pies. In the majority of the targeted food categories to date, 80 percent of 8 the volume market share has met the targets with high volume, low cost products being targeted. Work is currently underway to set sodium targets in butter and edible oil spreads, cheese, savoury snacks, cooking sauces and canned corned beef. Food companies who have initiated salt reduction should be congratulated for their efforts and this award recognises that the sodium removed from the New Zealand diet through reformulation is significant on a global scale. There is recognition however that there remains a significant amount of work still to be done to decrease the sodium intake of New Zealanders, who consume around twice the suggested dietary target. Sodium reduction needs to be a key issue on the radar of food providers right across the food supply, including food companies, food preparers, fast food companies and caterers. More information about the programme can be found here. www.nutritionfoundation.org.nz HeartSAFE Heart Foundation Tick The Heart Foundation Tick was introduced 21 years ago. Since then, it has become a trusted, independent symbol helping New Zealanders easily recognise healthier food choices within a specific food category. In April 2014, the Heart Foundation was proud to introduce the newest member of the Tick family, Two Ticks. Two Ticks was developed in response to what consumers told us they wanted and needed from the programme; to easily and quickly identify core foods that are the healthier products within a category (Tick) and to be able to identify the core foods for a healthy diet (Two Ticks). Two Ticks looks at foods as a whole (rather than just specific nutrients) and does not dictate frequency of consumption. It will include a sugar criterion for relevant categories including breakfast cereals and yoghurt. Due to its stricter criteria, there will be a limited number of food categories included in Two Ticks. For those categories within Two Ticks that do contain nutrient criteria, the criteria were developed taking the following in to consideration: • Current Tick programme criteria • The Australian and New Zealand Food Standards Code • Food Standards Australia New Zealand • Current Heart Foundation position statements. Last month, the Heart Foundation Tick had presence at the Wellington Food Show which was a great opportunity to introduce Two Ticks. The response from the public to Two Ticks was overwhelmingly positive. Visitors understood the purpose of the new tier and agreed that it would help them make healthy shopping decisions quickly and easily. While the original Tick logo will continue to help consumers identify healthier choices within a specific food category, Two Ticks will be on core foods for a healthy diet. The food categories within Two Ticks align with the NZ Food and Nutrition Guideline Statements for healthy adults and the four major food groups outlined by the Ministry of Health: • Eat plenty of vegetables and fruits The Tick is a trans-Tasman programme with criteria aligning for the majority of categories. Two Ticks is a New Zealand only initiative so will only be seen on products sold in New Zealand. Consumers will see a transition period and the gradual roll-out of products featuring the Two Ticks logo from mid-May 2014. For more information please contact Deb Sue, [email protected] or visit: heartfoundation.org.nz/twoticks • Eat plenty of breads and cereals, preferably whole grain • Have milk and milk products in your diet, preferably reduced or low-fat options • Include lean meat, poultry seafood, eggs or alternatives (nuts, seeds and legumes). few of Here are just a Fruit and Vegetables Vegetable juice Fruit bars Dried fruit Fruit juice & ts & Nuts Le es,, Nu mes gum Legu Se edss Seed Le es mes gum Legu Nu edss seed & se ts & Nuts Sp adss read Spre rs bars Nu ed ba seed & se Nutt & yo the categories Cereal Products Bread als Breakfast cere Pasta & noodles ts Savoury biscui Baked products Fa ls Oils & Oi ts & Fats e oils bl ta ls ge Ve Vegetable oiad readss spre Ed oill sp le oi ible Edib ts Ba fats ry fa kery Bake e And here are th Fruit and Vegetables Fresh & shelfstable fruit Fresh & shelfstable vegetables Cereal Products Wholegrain bread, pasta & noodles Breakfast cereals Whole grains www.nutritionfoundation.org.nz u may find Tick… Meat & Meat Alternatives Meat Poultry Small goods Seafood es Meat alternativ atives Dairy & Altern ilk m & Milk alternatives Yoghurt & dairy desserts Cheese tives Cream alterna Frozen desserts lsls eaea MM ss l kit eaea MM l kit lsls eaea y ymm adad ReRe ee cip ReRe cip ss tete tra enen ncnc coco tra eses chch wiwi ndnd SaSa ss upup SoSo ts Co ents imen ndim Cond uces sa e bl Ta Table saucesgs sings Sa essin dres lad dr Salad chut & ys s neys he utne lis Re & Relishes ch ks oc St Stocks es uces Co sauc ingg sa okin Cook may find Two Tic categories you Dairy & Alternatives Plain, low fat milk & milk alternatives Low-fat yoghurt ks… Meat & Meat Products Plain meat, poultry & seafood Legumes, Nuts & Seeds Dried & shelfstable legumes Plain nuts & seeds 9 NZFAVA – Updated Resource The NZ FAVA group have recently updated one of their resources, ’25 easy ways to get more fruit’ so that it more accurately reflects the latest New Zealand Food and Nutrition guidelines. The NZ Ministry of Health have always recognised that one 250ml glass of fruit juice per day can contribute towards one of the recommended five or more servings of fruit and vegetable per day. The guidelines for children further explain that juices should be diluted 50:50 with water or more for younger children. The updated NZ FAVA resource now includes an image of a diluted juice product as well as tips on the poster including drinking diluted juice with meals to boost iron absorption, mixing juices with sparkling water to make spritzers or swapping soft drinks for diluted juice. The NZ FAVA group feel it’s important to acknowledge that fruit juice is a source of added sugar and want to emphasize that diluted juice products are a more healthy option. Access the poster here The New Food Act 2014 In 2003 a Domestic Food Review documented problems with the current food regime – and this was the start of an elevenyear saga to review our food safety system and pass a New Food Bill which will replace the Food Act 1981 and the even more out-of-date Food Hygiene Regulations 1974. Finally, on May 27, 2014 the Food Bill had its third reading in Parliament and received Royal Assent on Friday June 6. The Food Act 2014 intends to make it easier and less costly for many food businesses, while ensuring the food produced is safe. It aims to give food businesses the tools to manage food safety themselves based on the level of risk associated with the kinds of food produced and in a way that suits their business. The new Act has four risk-based measures to ensure food safety risks in a wide range of food preparation activities can be controlled and monitored: • food control plans • national programmes • food handler guidance • monitoring programmes. For more information about these go to: http://www.foodsafety.govt.nz/policy-law/reform-nz-foodregulations/proposed-food-act/ Some provisions of the new Act are in force already. These are powers that are conferred on the Director-General, and that would typically be used in a food safety response situation. The key powers are: 10 s. 282 – direction to complete and supply a declaration s. 283 – direction to impose movement or related controls s. 284 – direction to recall food or a food-related accessory s. 286 – direction to publish a statement s. 289 – power to publish privileged statements s. 292 – power to require production of information The rest of the Act does not come into force until 1 March 2016 (or an earlier date set by Order in Council). Businesses do not need to make any immediate changes yet. Over the next 21 months, MPI will be developing regulations, tools and guidance. There will be extensive consultation during the development time giving people the opportunity to have their say on the detail of the new food safety system. The new Act provides a clear exemption to allow Kiwi traditions like fundraising sausage sizzles or home baking at school fairs to take place. The only rule will be that food that is sold must be safe. Growing food for personal use and sharing it with others, including ‘Bring a plate’ to a club committee meeting or a lunch for a visiting sports team or social group, is outside the scope of the Food Act. The Act only covers food that is sold or traded. For more information go to the MPI Food Safety website at: www.foodsafety.govt.nz/policy-law/reform-nz-food-regulations/ food-bill/questions-answers.htm The Food Act 2014 is available on the Legislation website http:// www.legislation.govt.nz/ www.nutritionfoundation.org.nz Blogs we like Over the past few years there has been a noticeable increase in the number of nutrition, food and public health blogs worth reading. The most useful to us offer analysis or insight into new research and emerging issues. Here’s a summary of some we like and follow regularly (in no particular order). The Sceptical Nutritionist http://scepticalnutritionist.com.au/ Bill Shrapnel is an Australian nutritionist with a CV including stints as a Dietitian in the health service and National Nutrition manager for the Australian National Heart Foundation. As a consultant for the past 19 years he has worked with major food companies and industry groups. He has an extensive list of publications including papers in Nutrition and Dietetics. Bill’s raison d’être is The Sceptical Nutritionist is my response to the dogma that has found its way into advice about healthy eating. Even well respected scientific organisations and nutritionists now weave ideological viewpoints into advice that is supposed to be evidence-based nutrition………My aim is to shine a light on current healthy eating advice and nutrition debates and attempt to sort the science from the dogma. Bill’s blogs typically review the available evidence and provide a digestible summary of the current state of play. Topics covered recently include; • Omega 6: good or bad for health (so much information here it has been divided into two parts) • Would taxing soft drinks lower rates of obesity? • Saturated fat: we still don’t get it. While we may not always agree with his conclusions, Bill’s posts are insightful and add to our knowledge. If I had a complaint it would be that Bill is not always a consistent blogger, some months it is every week and then others only once or twice a month. I guess like all of us trying to squeeze everything in! Highly recommended Public Health Expert https://blogs.otago.ac.nz/ pubhealthexpert/ At last a great New Zealand public health blog. Bought to you by public health experts under the banner of the University of Otago. The authors define their gig as; What could we do, and what should we not do, to improve public health? This Blog has postings from Tony Blakely, Nick Wilson and other public health experts on issues such as efficiency, equity, interventions, politics, cost effectiveness and much more. The blog addresses a wide range of issues with blogs often triggered by the publication of new evidence. The authors vary with experts in different areas of public health being called on as required. Topics covered recently include; • Minimum pricing of alcohol: what does the evidence say? • Antiviral stockpiles for pandemic preparedness: time for a careful rethink? • Reducing cardiovascular disease deaths from overweight and obesity: fortunately there are several options. While the wide range of topics means on paper not all will be relevant, the fact the topics are so… well, topical means almost all will be of interest. As a nutritionist antiviral stockpiles are not something I generally think about on a daily basis, but that was a subject that generated more discussion in my household than any directly related to my work. Where the blogs are relevant to nutrition they always provide a neat summary of evidence and a useful opinion. Essential reading The Scoop on Nutrition http://www.scoopnutrition.com/ Back to Australia for this one. Emma Stirling is a well-respected Australian Accredited Practising Dietitian (APD) based in Melbourne widely known for her social media work. Emma is a prolific communicator using all available channels but with an especial fondness for social media, in particular twitter, facebook and blogging. What Emma and her team at the Scoop on Nutrition offer is …. We’ll help you cut through nutrition confusion with credible expert news, advice and reviews. Emma’s blog is a little different from the two above as it focuses on food as well as science. This is evident looking at her category archives • Nutrition News - hot stories and breaking scientific articles. • Food Flash – category road tests and new product reviews. • Eco Eats - approaches to sustainability and green, clean eating. • Kitchen Klinic – lessons from our Eating Lab, recipes and how-to’s. • Cultured Cuisine – traditional diets from the Mediterranean to Okinawa. • Expert Examiner - FAQ section with leading guest dietitians and foodies. • Family Focus - your recipe for growing a healthy, happy home While her blogs, often authored by guest experts, are useful and provide a very neat summary of current hot issues, what I love about Emma’s blog is her work on food. After all, for dietitians and nutritionists this is where the rubber meets the road. Each month Emma takes part in a Recipe Redux Challenge where she and other dietitians post their take on a healthier version of a favourite recipe. The challenge always throws up some great ideas, good stories and often wonderful photos. Emma is also breaking new ground with Australasian dietitians, encouraging us to join live twitter chats as a way of swapping information and keeping up-to-date – not more geographical barriers for Emma! Her blog is fun, smart, informative and up to date, what more could you want. Highly recommended Sarah Hanrahan, NZNF Dietitian www.nutritionfoundation.org.nz 11 WHAT’S ON The 9th IANA (International Academy on Nutrition and Aging) meeting: Nutrition and Aging: From Cells to Body Systems and Populations Date: July 10-11, 2014 Venue: Albuquerque, USA For information: http://som.unm.edu/ cme/2014/IANA.html New Zealand Association of Gerontology Association Conference: The Age of Ageing Date: September 12-14, 2014 Venue: St. David Lecture Complex, University of Otago, Dunedin For information: www.events4you. co.nz/nzag2014.html Nutrition Society of Australia 2014 Annual Scientific Meeting: Nutrition: challenges and opportunities Date: November 26-28, 2014 Venue: Hotel Grand Chancellor Hobart, Tasmania For information: www.nsa.asn.au/index. php/2014_ASM/ Nutragenomics 2014: Enhanced Value for food through health benefits Date: August 27, 2014 Venue: Fisher & Paykel Healthcare Clinical Education Centre, Auckland City Hospital For information: http://scienceevents. co.nz/nutrigenomics2014/page/home/ NZ Population Health Congress: Connecting communities, policy and science Date: October 6-8, 2014 Venue: Aotea Centre, Auckland For information: http://www. pophealthcongress.org.nz/nzphc14 The FAO/WHO Second International Conference on Nutrition (ICN2) Date: November 19-21, 2014 Venue: FAO Headquarters, Rome, Italy For information: www.who.int/ mediacentre/events/meetings/2014/ international-conference-nutrition/en/ 2014 Nutrition Society of New Zealand Conference Date: August 28-29, 2014 Venue: Queenstown For information: http://www. queenstownresearchweek.org The 2014 American Institute for Cancer Research (AICR) Annual Research Conference on Food, Nutrition, Physical Activity and Cancer Date: October 29–31, 2014 Venue: Capital Hilton Hotel, Washington, DC For information: www.aicr.org/cancerresearch/conference/ Save the date! 30th October 2014 Food Not Nutrients Symposium We are excited to announce the keynote speaker for our Nutrition Week symposium, is world renowned preventative medicine specialist, Dr. David Katz. David Katz is the founding director of Yale University’s Prevention Research Centre, Editor-in-Chief of the journal Childhood Obesity and clinical instructor in medicine at the Yale School of Medicine. He’s also a prolific author with countless columns and now twelve books, the latest called Disease Proof. His views on food and health and ‘fad’ diets tie in well with the theme of Nutrition Week this year, “Food, not Nutrients”. If you would like to learn more about David Katz’s work you can go to his website here and we recommend reading a few of his blogs which are both entertaining and full of very sensible and scientifically sound information here Symposium details will be posted on our website www.nutritionfoundation.org.nz in due course. The views expressed in Nutrition News are those of the authors and do not necessarily reflect those of the New Zealand Nutrition Foundation 12 www.nutritionfoundation.org.nz