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Nutrition Update Nutrition Update Sarah Coe, Nutrition Scientist British Nutrition Foundation 15th November 2014 Sarah Coe, Nutrition Scientist British Nutrition Foundation 15th November 2014 © 2014 The British Nutrition Foundation © 2014 The British Nutrition Foundation Outline The ‘5532-a-day’ toddler guide Vitamin D © 2014 The British Nutrition Foundation Background • No food-based guidance for parents of toddlers (1-3 years) available • Guidance that children should ‘gradually move towards’ eating in line with the eatwell plate is confusing • Health professionals wanted something age-specific © 2014 The British Nutrition Foundation Nutrient requirements of toddlers • Naturally active and growing rapidly – energy and nutrient requirements are high • Nutrient-dense foods • Regular drinks • Establishing good dietary habits © 2014 The British Nutrition Foundation Nutrient requirements of toddlers Group Nutrients provided Recommendation Examples of foods 1. Potatoes, bread, rice, pasta and other starchy foods Energy, some protein, fibre, vitamins and minerals 1 portion offered at Breakfast cereals each meal and at some Bread sticks snack times Rice cakes 2. Fruit and vegetables Vitamins and minerals, fibre, phytochemicals Serve at each meal and at some snack times Fresh/frozen/canned /dried 3. Milk and dairy foods Energy, protein, calcium, other vitamins and minerals Serve 3 times a day (whole milk/yogurt for under 2’s) Milk Yogurt Cheese 4. Meat, fish, eggs, beans and other non-dairy sources of protein Protein, energy, omega 3 fats, vitamins and minerals Serve 2-3 times a day (3 times for vegetarian toddlers) Fish – twice a week (one portion oil-rich) Meat Fish Eggs Nuts Pulses © 2014 The British Nutrition Foundation Nutrient requirements of toddlers Group 5. Foods high in fat and/or sugar Nutrients provided Recommendation Energy, fat, vitamin Offered only in addition A, E and D to (not instead of) foods from the other food groups. Sugary foods should be kept to meal times and no more than 4 occasions a day © 2014 The British Nutrition Foundation Examples of foods Butter, margarine Cakes/biscuits Sweets Sweetened drinks Key nutritional issues in 1-3 year-olds Not enough… Iron Zinc Vitamin A Vitamin D 1 in 5 overweight/obese when start primary school Too much! Saturated fat Sugars Salt 12% of 3 year-olds have tooth decay Type 2 diabetes © 2014 The British Nutrition Foundation Rickets Developing the toddler guide • Set up an advisory group to develop ideas and review the research • Held focus groups with mums and health visitors © 2014 The British Nutrition Foundation Key Messages © 2014 The British Nutrition Foundation Surprise at inclusion of ‘carbs’ © 2014 The British Nutrition Foundation Not new but useful reminder TOO MUCH!! © 2014 The British Nutrition Foundation Memorable Helps reinforce the breakdown of the food groups Needs careful communication of portion sizes © 2014 The British Nutrition Foundation Design Routes © 2014 The British Nutrition Foundation © 2014 The British Nutrition Foundation © 2014 The British Nutrition Foundation © 2014 The British Nutrition Foundation © 2014 The British Nutrition Foundation And the winner was… © 2014 The British Nutrition Foundation © 2014 The British Nutrition Foundation © 2014 The British Nutrition Foundation © 2014 The British Nutrition Foundation © 2014 The British Nutrition Foundation Dissemination “I work with parents with young children and they have been crying out for this information re. portion guidance” Community & Health Coordinator, Co.Tyrone http://www.nutrition.org.uk/healthyliving/toddlers/5532 http://www.nutrition.org.uk/healthyliving/nutrition4baby © 2014 The British Nutrition Foundation Vitamin D December 2014 www.blackwellpublishing.com/nbu © 2014 The British Nutrition Foundation Vitamin D Review to explore vitamin D status and intake in Europe • Sources • Vitamin D deficiency • How much do we need? • How much are we getting? • Supplements and fortification © 2014 The British Nutrition Foundation Why do we need vitamin D? • Help us absorb calcium and phosphorus from the food we eat • Healthy bones and teeth • Severe lack of vitamin D = rickets and osteomalacia (soft and weak bones) © 2014 The British Nutrition Foundation Sources of vitamin D Sunlight Diet Natural food sources Fortified foods Supplements © 2014 The British Nutrition Foundation Sources of vitamin D UK National Diet and Nutrition Survey (2008/09-2011/12) Contribution of food groups to vitamin D intake in adults and children Adults aged 19 years and over Children aged 418 years Children aged 1.5-3 years Meat and meat products 23-30% 25-35% 21% Fat spreads 19% 20-21% 20% Cereals and cereal products 13% 17-20% 14% Fish 17-23% 8-9% 8% Milk and milk products 5-6% 6-13% 24% © 2014 The British Nutrition Foundation Vitamin D deficiency Increased risk if: • Overuse sunscreen • Have darker skin • Low or no exposure to the sun Other population groups at risk: • Pregnant or breastfeeding • Teenagers and young women • Babies and children under 5 years • Older people aged 65 years and over © 2014 The British Nutrition Foundation How much vitamin D do we need? • Currently no agreement on what is the optimal amount of vitamin D • Recommended intakes across Europe vary from 5-20 µg/day • European average = 10 µg/day • In the UK - there is no recommendation for vitamin D for those aged 4-65 years © 2014 The British Nutrition Foundation How much vitamin D are we getting? Average intake from food for adults does not meet the recommendation: 4.8 μg/day (men), 3.3 μg/day (women) Most countries = 2-4 μg/day Lowest = Spain (<2 μg/day) Highest = Scandinavian countries © 2014 The British Nutrition Foundation How much vitamin D are we getting? Average daily vitamin D intakes (μg/day) 1.5-3y 4-10y 11-18y 19-64y 65+y From food only 1.9 2.0 2.1 2.8 3.3 From food + supplements 2.3 2.7 2.4 3.6 5.1 Source: NDNS 2008/09-2011/12 © 2014 The British Nutrition Foundation How much vitamin D are we getting? • In UK, vitamin D deficiency is more common in winter than in the summer (39% vs. 8% adults) • We can only make vitamin D from the sun between April and September • Need to be out in the sun for few minutes between 11-3pm © 2014 The British Nutrition Foundation How can vitamin D status be improved? • Supplements • Fortification • Improve population’s diet and lifestyle © 2014 The British Nutrition Foundation Supplements Vitamin D supplements (10 µg/day) • Pregnant and breastfeeding women • More likely to be taken in Northern Europe and by women • UK – Healthy Start scheme (low uptake) • Will only work if they are taken! © 2014 The British Nutrition Foundation Fortification Varies throughout Europe Milk and milk products • • Finland (+ non-dairy alternatives e.g. soy, rice/oat drinks) Sweden (low fat) Breakfast cereals Margarine and fat spreads • • • Finland (+ butter) Sweden UK (margarine) Infant formula © 2014 The British Nutrition Foundation Summary • Healthy eating over the life course is important • Some health issues e.g. low vitamin D might be more of a concern in some groups, but spans from young children to older adults • Important to get diet right from the start © 2014 The British Nutrition Foundation Thank you for listening www.nutrition.org.uk www.foodafactoflife.org.uk © 2014 The British Nutrition Foundation