Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications

Plan of talk What are we eating today? Evidence from the NDNS Hot nutrients for 2011 Role of fortified products and supplements

What are we eating today?

30% of calories from nutrient-poor foods and drinks Source: NDNS (2010) years 30% of calories from treats, alcohol, soft drinks, chips and crisps

Similar picture in children 32% of calories from treats, soft drinks, chips and crisps Source: NDNS (2010) years

Fruit and vegetable intake improving in adults but not in children Source: NDNS (2010) and SACN reports

Deficiency amongst plenty? Half of adults overweight or obese 1 in 5 children overweight

Half of adults overweight or obese 1 in 5 children overweight Half of women have inadequate selenium intakes 1 in 5 pre-schoolers have low iron stores Why does only one side of equation get our attention?

Proven role of nutrients in health Calcium, magnesium, Vit D Normal bones and teeth Vit B12, zincNormal immune function Vit ANormal vision NiacinNormal nervous system Iron, zincNormal cognitive function FolateNormal tissue growth during pregnancy DHA/EPAMaintenance of normal blood pressure and normal serum triglycerides Source: EFSA opinions on Article 13 claims, 2010

Evidence from the NDNS

Men and women

Average intakes of vitamins and minerals seem OK, probably influenced by fortified foods NDNS (2010) Adults

But averages mask adults with poor intakes Source: NDNS (2010) AdultsNDNS (2010) Adults

Most adults have low vitamin D intakes EU RDA for adults < 50 years 71% men + 78% of women below RDA NDNS (2003) Adults

25% of adults deficient in winter months Source: National Diet & Nutrition Surveys (2000, 2003) 25-hydroxy vitamin D <25 nanomoles/litre

Children and teens

Younger children doing better on average NDNS (2010) Children

But closer examination reveals the issues Intakes of iron, magnesium and selenium particularly worrying NDNS (2010) Children

Teenage girls most at risk from deficiency NDNS (2010) Children

Most children have low vitamin D intakes 94% boys + 97% of girls below EU RDA of 5 micrograms/day Source: NDNS (2000) Children

Diets have improved little over the years Folate Vitamin D* * EU labelling RDA of 5 micrograms used Iron Calcium

Where are they going wrong? Food category g/day 4-10y11-18y Breakfast cereals2418 Bread6470 Milk Fresh meat4658 Fish1917 Vegetables7477 Fruit10357 Soft drinks NDNS (2010) Girls

Key nutrients Men Selenium Potassium Magnesium Zinc Vitamin A Vitamin D Women Selenium Potassium Magnesium Iron Calcium Vitamin D Children Selenium Potassium Magnesium Iron Calcium Vitamin D Zinc Folate Iodine

What are we missing? Vitamin D Selenium Vitamin A Zinc Magnesium Potassium Calcium Iron Iodine Folate

Hot nutrients for 2011 Vitamin D Selenium Omega 3 Flavonoids

Vitamin D – 90% from sunshine

But diet plays a role 5 to 22 mcg/portion 0.02 to 1 mcg/egg 5 to 10 mcg/tsp

Mortality Bone health Immune function Cell aging Heart disease Cancer Cognitive function Diabetes Why are we interested? Infection GoodModerateEmerging

Selenium Essential trace element (Se) Antioxidant Stored in the body but topped up by our diet

Where do you get it?

Why are we interested? Se Supports fertility Antioxidant Immune function Mood? Anti-ageing Heart health

Are we getting enough? Selenium intake μg/d UK rec μg/d MAFF (1999), BNF (2001), Jackson et al (2003)

Omega-3s – still current Marine foods or supplements remain the best sources of EPA/DHA Vegetable omega-3s dont count

Why are we interested? Omega-3 Heart health already known IQ in children Stress relief Anti-ageing Less depression? Immune function

Omega-3 and the lifecycle DHA EPA Higher IQ Less allergy Brain function Better behaviour? Less stressMaintain brain function

Flavonoids

Flavonoid subclass ExamplesSources FlavonolsKaempferol, quercetinOnions, kale, broccoli, tea, red wine FlavonesApigenin, luteolinParsley & leafy herbs FlavanonesHesperetin, naringeninCitrus fruits IsoflavonesDaidzein, genisteinSoybeans, legumes Flavan-3-olsCatechin, epicatechin, epigallocatechin, EGCG Tea, red wine, cocoa AnthocyanidinsCyanidin, delphinidin, malvidin Blueberries, black grapes, leafy veg

Heart disease Weight management Blood pressure Stroke Cognitive function Diabetes Why are we interested? GoodModerateEmerging Cancer Oral health

The issue 30% of calories are from foods that tend to be low in micronutrients Significant groups of adults and children are low in key nutrients, risking deficiency Some nutrients, e.g. omega-3s, vitamin D, iron and selenium are only present in limited numbers of foods

Only some consumers are motivated to change their diets managersdisciplesinvestorshealersstrugglersunmotivateds health involvedunmotivated Source: Design Bridge health involvedunmotivated

Role of fortified products and supplements Boost what consumers already like to eat or find acceptable Take care to fortify where appropriate (chocolate bars with vitamin D!) Supplements only taken by 25% of consumers – room for improvement Consumers prefer natural sources of nutrients