Carbohydrates and health © Grain Chain 2016

Introduction to carbohydrate There are two types of carbohydrate that provide dietary energy - sugars and starch. Dietary fibre is also a type of carbohydrate found almost exclusively in plants, which helps keep the digestive system healthy. At least 50% of dietary energy should come from carbohydrate, mostly as starchy carbohydrates.

Function of carbohydrate Carbohydrate provides energy – 1g provides 3.75kcal/16kJ. Dietary fibre also provides a small amount of energy (2kcal/8.4kJ per g). A constant supply of energy (in the form of glucose) is needed as fuel for the body’s tissues, including the brain. Carbohydrate is the main source of glucose in the diet.

SACN report The Scientific Advisory Committee on Nutrition (SACN), a committee of independent experts that advises the Government on nutrition issues, published their report Carbohydrates and Health in July 2015. The Scientific Advisory Committee on Nutrition was requested by the government to provide clarification of the relationship between dietary carbohydrate and health and make public health recommendations. To achieve this they reviewed: the evidence for a role of dietary carbohydrate in colorectal health in adults and in childhood; the evidence on dietary carbohydrate and cardio-metabolic health (including cardiovascular disease, insulin resistance, glycaemic response and obesity); the evidence in respect to dietary carbohydrates and oral health; the terminology, classification and definitions of types of carbohydrates in the diet. To access the Carbohydrates and health report click here: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/445503/SACN_Carbohydrates_and_Health.pdf

Recommendations Total Carbohydrate The dietary reference value for total carbohydrate should be maintained at an average population intake of approximately 50% of total dietary energy.

Recommendations Sugars The definition for ‘free sugars’ be adopted in the UK. This comprises all monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and unsweetened fruit juices. Under this definition lactose when naturally present in milk and milk products is excluded. The average population intake of free sugars should not exceed 5% of total dietary energy for age groups from 2 years upwards. The consumption of sugars-sweetened drinks should be minimised in children and adults.

Recommendations PHE, 2015: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/446010/Why_5__-_The_Science_Behind_SACN.pdf

Sugars intake Evidence reviewed in the SACN report indicated higher consumption of sugars and sugars containing food is associated with a greater risk of tooth decay; increasing or decreasing total energy (calorie) intake from sugars leads to a corresponding increase or decrease in energy intake; consumption of sugars-sweetened drinks* results in greater weight gain and increases in BMI in children and adolescents; greater consumption of sugars-sweetened drinks is associated with increased risk of type 2 diabetes.

Sources of free sugars in 11-18 year olds

Sources of free sugars in 11-18 year olds

Recommendations Fibre SACN also recommended an increase in the population’s fibre intake to an average of 30g per day for adults. 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). The previous recommendation was equivalent to 23-24g/day AOAC fibre. No age group in the UK were able to meet the previous recommendation with average intakes in adults at around 18g AOAC fibre.

Fibre intake Evidence reviewed in the SACN report indicated diets rich in fibre (cereal fibre and wholegrains) are associated with: lower incidence of heart disease and stroke; type 2 diabetes; colorectal cancer. Trials have shown diets rich in fibre decrease intestinal transit times and increase faecal mass.

Sources of fibre in the UK diet Sources of fibre in the UK diet (Bates et al, 2014)

How can we meet the new recommendations? The British Nutrition Foundation undertook some simple dietary modelling to develop a 7-day menu plan. This illustrates, in practice, what a diet that meets the new recommendations of 5% free sugars and 30g AOAC fibre may look like for adults. The plan was also modelled to meet energy, other macronutrient and micronutrient recommendations over the week and all the current food-based guidelines, such as 5-A-Day and the inclusion of at least one portion of oil-rich fish over the week.

How can we meet the new recommendations? This modelling demonstrated the new SACN recommendations for dietary fibre and free sugars are achievable through a balanced, healthy diet featuring: meals based around starchy foods (mostly wholegrain varieties); around eight portions of fruit and vegetables daily; water, lower fat milk, unsweetened tea, coffee, herbal and fruit infusions and ‘no-calorie’, ‘diet’, ‘sugar-free’ or ‘no-added’ sugar carbonated drinks and squashes fibre-rich snacks (including nuts, seeds and dried fruits) occasional snacks/desserts with added sugars; very few foods high in fat and sugar (either as part of meals or as snacks); regular inclusion of lower salt options and use of unsaturated oils (such as rapeseed, olive or sunflower oil) for cooking and dressings; low fat spreads, high in unsaturated fats, and lower fat dairy products.

Sample 7 day menu plan For more information see: https://www.nutrition.org.uk/nutritioninthenews/headlines/letstakeanotherlookatsugar.html

For more information, go to: www.grainchain.com