Download Nutrition science - Food a fact of life

Nutrition science an update and
myth busting
British Nutrition Foundation 50th Anniversary Scottish Conference March 2017
Dr Stacey Lockyer RNutr ([email protected])
Nutrition Scientist, British Nutrition Foundation, London, UK
BSc (hons) Biology with Psychology
PhD - Olive leaf polyphenols & cardiovascular risk
MSc Nutrition and Food Science
Research Fellow – National
Clinical Guidelines Centre, Royal
College of Physicians
Research assistant
Nutrition Scientist, BNF
• Journal - Nutrition Bulletin
• Website - Information standard (NHS)
- New content
• Project work for member companies
• Media duty
• EU project – BACCHUS (www.bacchus-fp7.eu)
• CVD Task Force
• E-seminars
• Conference presentations
Nutrition science update
SACN Carbohydrates and Health
report (2015)
New dietary recommendations:
• Fibre intake should increase to 30 g/day in adults (previous rec. 23/24 g)
• For children, the recommended intakes are:
• 15g/day (age 2-5);
• 20g/day (age 5-11);
• 25g/day (age 11- 16);
• 30g/day (age 16-18).
• Free sugars intake should decrease to <5% energy from 2 years+
• The consumption of sugars-sweetened drinks should be minimised
The UK’s healthy eating model
↑
38%
↑
40%
•
•
•
Updated March 2016
More emphasis on plant-based diet
Sustainability messages
https://www.nutrition.org.uk/healthyliving/healthyeating/eatwellvideo.html
Methodology behind the Eatwell Guide
https://www.gov.uk/government/uploads/system/uploads/attac
hment_data/file/575623/eatwell_guide_report.pdf
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/57
5624/eatwell_guide_annex_1.pdf
•
An External Reference Group was established to provide
advice for methodologies for refreshing the Eatwell Plate.
•
Linear programming carried out to establish the segment sizes
- diet with least amount of change from current UK diet.
•
Qualitative research was undertaken to establish the best way
to communicate the updated messages to consumers (design,
images, messaging).
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/575625/eatwell_guide_annex_2.pdf
Impact of the Eatwell Guide
- Starchy carbohydrates +69%
- Fruit and vegetables +54%
- Foods high in fat and sugar −53%
- Increased consumption of n-3 fatty
acids and most micronutrients apart
from zinc, calcium and riboflavin
- £5.99/adult/day vs. current diet: £6.02
http://bmjopen.bmj.com/content/bmjopen/6/12/e013182.full.pdf
Research
spotlight
- Life expectancy would increase by 5.4
months for men and 4.0 months for
women
- 440,000 fewer new cases of diabetes
in men and 340,000 fewer cases in
women
- Fewer new cases of CVD, colon cancer,
stroke
http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0167859&type=printable
https://www.nutrition.org.uk/nutritionscience/researchspotlight/research-spotlight-january-2017.html
- Reducing the consumption of red and
processed meat and increasing intake
of fibre and fruit and vegetables has
greatest impact on health gains
Nutrition myths
1. Carbohydrates are fattening
Carbohydrate confusion
Sugars
Free sugars
Complex carbohydrates
‘Not free’ sugars
Starch
Fibre
We should:
-base meals on starchy carbohydrates
-increase our fibre intake by choosing wholegrain/high fibre versions of starchy
carbohydrates e.g. brown rice, wholewheat pasta, wholemeal bread, potatoes with
skin, plus include other foods such as nuts, seeds and pulses in our diet
-reduce our intake of free sugars
Perception of starchy carbohydrates
• 2014 Food and You Survey – FSA
• 475 interviews carried out in Scotland
• Only 26% rated consuming starchy foods as being very
important for a healthy lifestyle
• 68% did not place starchy foods in correct section of the
Eatwell Plate
• Our survey revealed a negative view of starchy
carbohydrates among UK practice nurses
http://onlinelibrary.wiley.com/doi/10.1111/nbu.12212/epdf
Carbohydrates and body weight
• SACN report: carbohydrates (wholegrain or higher
fibre versions where possible) should form about 50%
of daily energy intake
• Carbohydrate ~4 kcal/gram (fibre ~2kcal/gram)
vs. fat ~9 kcal/gram
• Some evidence that fibre can  satiety
• Hypothesis that diets high in total carbohydrate cause
weight gain is not supported by RCTs
https://youtu.be/a8Iy6
SYmQFI
https://www.nutrition.org.uk/healthyliving/basics/fibre.html
Consumer page –
healthy living
Nutrition science
https://www.youtube.com/watch?v=5NHdcsuX6Dg
http://onlinelibrary.wiley.com/doi/10.1111/nbu.12244/full
Health effects of
resistant starch
Quoted by media outlets worldwide:
• Time
• Medicalresearch
~3000
downloads
in
• Healthline
first month
• Nutraingredients
Nutrition myths
2. Saturated fat is nothing to
worry about any more
http://onlinelibrary.wiley.com/doi/10.1111/n
bu.12219/full
Controversy over
saturated fat
Recent meta-analyses of cohort (observational) studies - no significant
association between saturated fat intake and CVD in large populations.
This has led to debate about the current recommendation to limit saturated
fat intake.
Issues and complexities:
• Studies examined often compare diet at a distant time point with CVD
events/deaths when diet will have changed over time.
• Some older studies don’t represent current diets.
• Individual fatty acids have different effects on the body.
• We don’t eat individual fatty acids we eat foods.
• Reducing saturated fat in the diet without due attention to what
replaces it could have a negative impact on cardiovascular risk.
2015 Cochrane review of all
dietary studies that involved
a reduction in saturated fats
• 15 randomised controlled trials (≥2 years duration) 59,000 subjects
• 17% reduction in cardiovascular events observed in studies where
saturated fat was reduced
• 27% reduction in cardiovascular events observed in studies where
saturated fat was replaced with polyunsaturated fats
• Fewer published studies looking at replacement with
monounsaturated fat but more recent evidence suggest benefits
Hooper et al. (2015) http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011737/pdf
National and international dietary guidance to reduce saturated
fat in the diet and replace with small amounts of unsaturated
fatty acids remains
UK saturated fat intake:
National Diet and Nutrition Survey
rolling programme years 5-6
14
13.5
% food energy
13
12.5
12
11.5
11
10.5
Dietary
recommendation:
No more than 11%
food energy
10
4-10
years
11-18
years
19-64
years
Males
65+
year
4-10
years
11-18
years
19-64
years
65+
years
Females
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/551352/NDNS_Y5_6_UK_Main_Text.pdf
Nutrition myths
3. Coconut oil is good for you
Saturated Fat
Monounsaturated Fat
n-6 Polyunsaturated Fat
n-3 Polyunsaturated Fat
Coconut oil
Butter
Beef dripping
Palm oil
Lard (pork fat)
Fish oil (cod liver)
Peanut oil
Soya oil
Corn oil
Olive oil
Sunflower oil
Safflower oil
Rapeseed oil
Type of fatty acid
McCance and Widdowson fatty acids supplement
>26,000
downloads
since
March
136
http://onlinelibrary.wiley.com/doi
/10.1111/nbu.12188/epdf
Summary
• Consistent evidence that coconut oil raises blood
cholesterol
• No evidence that coconut oil can promote weight loss
• No evidence that coconut oil can alleviate symptoms
of Alzheimer’s or improve immunity.
UK saturated fat guidelines
Based on a 2,000 kcal diet (women) and 2,500 kcal diet (men):
• No more than 20 g saturated fat/day (women)
• No more than 30 g saturated fat/day (men)
2 tablespoons (~ 30 g) of coconut oil will exceed recommended daily
maximum intake for women and approaches the maximum value for men
Nutrition myths
4. Artificial sweeteners promote
weight gain
http://journals.plos.org/plosmedicine/article?i
d=10.1371/journal.pmed.1002195
https://www.nutrition.org.uk/nutritioninthene
ws/headlines/diet-drinks-make-you-fat.html
•
Opinion piece, not a systematic review
•
Based on observational studies – cannot demonstrate cause and effect
•
RCTs - low calorie drinks calorie intakes and body weight vs. sugars-sweetened drinks
•
Eatwell Guide says ‘Swap sugary soft drinks for diet, sugar-free or no added sugar varieties to
reduce your sugar intake in a simple step’
•
EFSA assess the safety of all additives including sweeteners
Overall, plain water is the best choice of drink but low calorie artificially sweetened drinks are a
good option for those who like the taste of sugar sweetened drinks
Nutrition myths
5. We are consuming too
much of everything
Energy balance
• Two thirds of adults (aged 16 and over) in Scotland are overweight
or obese
• A third of children aged 12-15 in Scotland are overweight or obese
Source: Scottish Health Survey 2015 http://www.gov.scot/Publications/2016/09/2764/downloads#res505810
Micronutrient status
Possible causes of micronutrient
deficiencies in teenagers
• Breakfast skipping/eating on the go
• More control over food choice
• Girls aged 11-18 years consume
least milk - concerns over
bodyweight/media influence?
Miller, R., Spiro, A. and Stanner, S. (2016), Micronutrient status and intake in the UK – where might we be in 10 years' time?. Nutr Bull, 41: 14–41
http://onlinelibrary.wiley.com/doi/10.1111/nbu.12187/pdf
A healthy, balanced diet should
align with the Eatwell Guide
Thank you!
For further information go to: www.nutrition.org.uk