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Engaging with nutrition British Nutrition Foundation © Food – a fact of life 2010 Government recommendations Recommendation Why? Are we meeting it? F&V At least 5x80g/d risk some cancers, CVD and other chronic diseases 2.8x80g/d Oily fish At least 1x140g/wk risk CVD 0.3x140g/wk NMES < 11% en (~60g/d) risk dental caries Up to 19% en Fat Average 35% en risk CVD and energy density of diets Average 35% en Saturates Average 11% en risk CVD and energy density of diets Average 13% en NSP Average 18g/d To improve GI health Average ~13g/d Alcohol No more than 3-4 units/d (♂); 2-3 units/d (♀) Minimise risk of liver disease, CVD, cancers, injury from accidents and violence 60% (♂)exceed 44% (♀) exceed Salt Average 6g/d risk hypertension and CVD Average 8.6g/d Vitamins and minerals DRVs To promote optimum health and prevent deficiency Various Physical activity At least 5X30 mins moderate PA/wk risk CVD, DM, some cancers and body wt 35% (♂ ) & 24% (♀) Body weight BMI 18.5-25kg/m2 risk some cancers, CVD and other chronic diseases 66% (♂ ) & 53% (♀) over BMI 25 © Food – a fact of life 2010 Source: SACN 2007; FSA 2008 Hot topics Satiety: • Protein • Dietary fibre • Energy density • Wholegrains Functional foods: • Pre- and probiotics • Stanols/sterols • Polyphenols © Food – a fact of life 2010 Micronutrients: • Iron • Calcium • Magnesium • Vitamin A • Vitamin C Effect of food and drinks on satiety • • • • • Protein – often enhances satiety. Dietary fibre – particular types enhance satiety. Liquids – depends on mode of consumption. Alcohol – promotes passive overconsumption. Energy density – a major factor in determining satiating effect of foods. Energy density = kcal/g © Food – a fact of life 2010 Energy density A 200g B 400g Both portions of macaroni and cheese contain 330kcals. B has a lower energy density. B contains wholewheat pasta, skimmed milk and low-fat cheese. It also uses less butter and cheese and boosts its volume with vegetables, such as, spinach and tomatoes. © Food – a fact of life 2010 © Food – a fact of life 2010 www.nutrition.org.uk/nutritioninthenews/fuller/ feed-yourself-fuller-chart Eat more, lose weight leaflet © Food – a fact of life 2010 www.nutrition.org.uk/nutritioninthenews/fuller/ eat-more-lose-weight Eat more, lose weight leaflet Energy density: © Food – a fact of life 2010 1.54kcal/g 0.64kcal/g Wholegrains • Include all 3 parts of the grain kernel. • Commonly consumed grains consumed in the UK are wheat, corn, oats, barley, rye and rice. • Wholegrains should be eaten as part of the starchy foods, but there is no official recommendation. • Rich in various nutrients and have shown to provide health benefits, e.g. reduce risk of CHD. © Food – a fact of life 2010 Hot topics Satiety: • Protein • Dietary fibre • Energy density • Wholegrains Functional foods: • Pre- and probiotics • Stanols/sterols • Polyphenols © Food – a fact of life 2010 Micronutrients: • Iron • Calcium • Magnesium • Vitamin A • Vitamin C Probiotics Defined as: live microorganisms which when taken in adequate amounts confer health benefits. These are specific bacterial strains (mainly Lactobacillus and Bifidobacterium species), which may help with digestive health and immunity. Found in dairy products, such as yogurt and yogurt drinks. © Food – a fact of life 2010 Prebiotics Defined as: non-digestable food ingredient that can deliver beneficial effects on the host’s health by selectively stimulating the growth and/or activity of specific health-promoting bacteria in the colon. Occur naturally in foods (leeks, chicory, bananas, garlic, soybeans, oats) and added to foods. Most common types are fruto-oligosaccharides, e.g. inulin, and lacto-oligosaccharides, e.g. lactulose. Beneficial effects on immune function, mineral absorption (e.g. Calcium), gut health and reducing cholesterol. © Food – a fact of life 2010 Stanols and sterols Defined as: plant-derived lipids which have a similar structure to cholesterol. Help reduce heart disease risk by lowering blood cholesterol levels. Approved European Food Safety Authority (EFSA) health claim: the level of cholesterol in the blood can be reduced, on average by 7 to 10.5%, if a person consumes 1.5 to 2.4 grams of plant sterols or plant stanols every day . © Food – a fact of life 2010 Hot topics Satiety: • Protein • Dietary fibre • Energy density • Wholegrains Functional foods: • Pre- and probiotics • Stanols/sterols • Polyphenols © Food – a fact of life 2010 Micronutrients: • Iron • Calcium • Magnesium • Vitamin A • Vitamin C Micronutrients ‘As tiny as the amounts required are, the consequences of their absence are severe.’ WHO © Food – a fact of life 2010 Micronutrient intakes • Micronutrient intakes in the UK population are concerning. Low intake* Low status Iron Iron Riboflavin Riboflavin Vitamin A Vitamin B6 Calcium Vitamin B12 Magnesium Folate Potassium Thiamin Zinc Vitamin C Iodine Vitamin D *’Low’ defined as intakes less than the Lower Reference Nutrient Intake (LRNI) © Food – a fact of life 2010 Source: SACN (2008): The Nutritional Wellbeing of the British Population Vitamin & mineral intakes: % below LRNI % British males below LRNI Age (years) <4 4-6 7 - 10 11 - 14 15 - 18 19 - 34 35 - 64 65+ Riboflavin 0 0 4 6 6 7 1 2 Vitamin B6 4 4 7 1 1 0 1 1 Vitamin B12 0 0 0 0 0 1 0 0 Folate 0 0 0 1 0 2 0 0 Vitamin A 0 3 3 8 13 16 5 3 Iron 3 3 3 3 3 1 1 1 Calcium 2 3 3 13 9 2 2 2 Magnesium 4 3 2 28 11 9 7 8 © Food – a fact of life 2010 Source: National Diet and Nutrition Survey 2003 Vitamin & mineral intakes: % below LRNI % British females below LRNI Age (years) <4 4-6 7 - 10 11 - 14 15 - 18 19 - 34 35 - 64 65+ Riboflavin 0 0 1 22 21 12 5 9 Vitamin B6 1 5 0 1 5 7 1 2 Vitamin B12 0 0 1 1 2 1 1 1 Folate 0 1 2 3 4 3 2 5 Vitamin A 8 7 9 20 12 13 5 3 Iron 16 4 3 44 48 40 23 5 Calcium 1 2 5 24 19 7 5 9 Magnesium 0 2 5 51 53 21 9 23 © Food – a fact of life 2010 Source: National Diet and Nutrition Survey 2003 Micronutrient requirements: an ageing population • With age, the body becomes less efficient at absorbing micronutrients so it is important to make sure that there is plenty in the diet, maximising the chances of getting enough. • Older adults have reduced energy requirements. However, requirements for micronutrients (vitamins and minerals) are similar to other adults. • More nutrient dense foods need to be eaten to provide sufficient micronutrients. • Special attention needed to ensure that older adults do not develop nutritional deficiency disorders. © Food – a fact of life 2010 Micronutrients: Food types that contribute ≥ 10% of intake for those nutrients where there is low intake and/or status Food Type Contribution (%) of food types to average daily intake of specific nutrients Meat and meat products zinc (34%), vitamin B12 (30%), vitamin A (28%), vitamin B6 (21%), vitamin D (22%), thiamin (21%), iron (17%), potassium (15%), riboflavin (15%), magnesium (12%) Fish and fish dishes vitamin D (25%), vitamin B12 (18%), iodine (11%) Milk and milk products calcium (43%), iodine (38%), vitamin B12 (36%), riboflavin (33%), zinc (17%), vitamin A (14%), potassium (13%), magnesium (11%) Source: Henderson et al. (2003): 2000/01 National Diet and Nutrition Survey: adults aged 19-64 years © Food – a fact of life 2010 Micronutrients: Food types that contribute ≥ 10% of intake for those nutrients where there is low intake and/or status Food Type Contribution (%) of food types to average daily intake of specific nutrients Cereals and cereal products iron (44%), thiamin (34%), folate (33%), calcium (30%), magnesium (27%), zinc (25%), riboflavin (24%), vitamin B6 (21%), vitamin D (21%), potassium (13%), iodine (12%) (largely through fortification) Potatoes and savoury snacks vitamin B6 (19%), potassium (18%), vitamin C (15%), thiamin (13%), folate (12%), magnesium (10%) Vegetables (excluding potatoes) vitamin A (27%), vitamin C (22%), folate (15%), thiamin (15%), iron (10%), potassium (10%) Source: Henderson et al. (2003): 2000/01 National Diet and Nutrition Survey: adults aged 19-64 years © Food – a fact of life 2010 Micronutrients: Food types that contribute ≥ 10% of intake for those nutrients where there is low intake and/or status Food Type Contribution (%) of food types to average daily intake of specific nutrients Fruit (excluding fruit juice) vitamin C (19%) and nuts Drinks (including tea, coffee, fruit juice, alcoholic drinks) vitamin C (27%), folate (14%), vitamin B6 (11%), riboflavin (10%) Fat spreads vitamin D (17%), vitamin A (10%) Source: Henderson et al. (2003): 2000/01 National Diet and Nutrition Survey: adults aged 19-64 years © Food – a fact of life 2010 © Food – a fact of life 2010 Hot topics Satiety: • Protein • Dietary fibre • Energy density • Wholegrains Functional foods: • Pre- and probiotics • Stanols/sterols • Polyphenols © Food – a fact of life 2010 Micronutrients: • Iron • Calcium • Magnesium • Vitamin A • Vitamin C Design a day’s menu to account for all of these factors. Worked example: Breakfast ↓ cholesterol Protein Calcium Wholegrain ↓ cholesterol Magnesium Porridge made with fortified soya milk F&V (2 of 5) Glass of apple juice F&V (1 of 5) Fluid Banana Cup of tea/coffee © Food – a fact of life 2010 Fluid Pant based food (antioxidant) Worked example: Morning snack Calcium Improve gut health Fluid Not with a hot drink Drinking yogurt with pre- and pro-biotic bacteria Small bunch of grapes F&V (3 of 5) © Food – a fact of life 2010 Worked example: Lunch Fibre Protein Iron Fibre Magnesium Baked beans on jacket potato F&V (4 of 5) Vitamin C Kiwi fruit Glass of water Fluid © Food – a fact of life 2010 Worked example: Afternoon snack F&V (5 of 5) Vitamin A Calcium Magnesium Unsaturated fatty acids Vitamin E Calcium Selenium Protein Three dried apricots and a handful of mixed nuts (e.g. Brazil, almonds, walnuts) Cup of herbal or fruit tea No tannins © Food – a fact of life 2010 Worked example: Evening meal F&V (6,7) Calcium Vitamin C Long-chain omega-3 fatty acids Whole grains Poached salmon, broccoli and peas with brown rice or wholewheat pasta in reduced fat crème fraiche Slice of melon Polyphenols Calcium F&V (8) Vitamin C Small glass of red wine Whole grains © Food – a fact of life 2010 Two wholegrain crackers spread with low fat cheese Topped with six cherry tomatoes Calcium F&V (9) Vitamin A For more information visit www.nutrition.org.uk www.foodafactoflife.org.uk © Food – a fact of life 2010