1. Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications

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

3. What are we eating today?

4. 30% of calories from nutrient-poor foods and drinks Source: NDNS (2010) 19-64 years 30% of calories from treats, alcohol, soft drinks, chips and crisps

5. Similar picture in children 32% of calories from treats, soft drinks, chips and crisps Source: NDNS (2010) 11-18 years

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

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

8. 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?

9. 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

10. Evidence from the NDNS

11. Men and women

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

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

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

15. 25% of adults deficient in winter months Source: National Diet & Nutrition Surveys (2000, 2003) 25-hydroxy vitamin D <25 nanomoles/litre

16. Children and teens

17. Younger children doing better on average NDNS (2010) Children

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

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

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

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

22. Where are they going wrong? Food category g/day 4-10y11-18y Breakfast cereals2418 Bread6470 Milk164107 Fresh meat4658 Fish1917 Vegetables7477 Fruit10357 Soft drinks284417 NDNS (2010) Girls

23. 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

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

25. Hot nutrients for 2011 Vitamin D Selenium Omega 3 Flavonoids

26. Vitamin D – 90% from sunshine

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

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

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

30. Where do you get it?

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

32. Are we getting enough? Selenium intake μg/d UK rec 60-75 μg/d MAFF (1999), BNF (2001), Jackson et al (2003)

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

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

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

36. Flavonoids

37. 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

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

39. 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

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

41. 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