1. Healthy Middle Years Gaynor Bussell RD, RPHNutr

2. What are the middle years? Around 45-65; known as ‘baby boomers’ in the States Around 45-65; known as ‘baby boomers’ in the States Probably still working and possibly with more responsibility than ever, yet may also have elderly parents and children that are still in full tome education (especially with the trend of having kids later) Probably still working and possibly with more responsibility than ever, yet may also have elderly parents and children that are still in full tome education (especially with the trend of having kids later) Can be stressful time, Can be stressful time, There is a desire to indulge in comfort, high quality food and drink (because you deserve it) There is a desire to indulge in comfort, high quality food and drink (because you deserve it) There is a market for such food, but it also may need to deliver health benefits There is a market for such food, but it also may need to deliver health benefits

3. Middle years and chronic disease Symptoms of chronic disease can start at this time Symptoms of chronic disease can start at this time But it’s not too late to prevent first symptoms developing into later long term disability and decreasing quality of life But it’s not too late to prevent first symptoms developing into later long term disability and decreasing quality of life Is there a role for food and supplement industry? Is there a role for food and supplement industry?

4. What are the health concerns of middle years? Cardiovascular. incl blood pressure, high cholesterol and metabolic syndrome Cardiovascular. incl blood pressure, high cholesterol and metabolic syndrome Diabetes Diabetes Cognitive function Cognitive function Gut health Gut health Weight gain- becoming ‘apple’ shaped Weight gain- becoming ‘apple’ shaped Physical fitness and muscle strength Physical fitness and muscle strength Skin and beauty Skin and beauty Joint and bone health Joint and bone health Menopause Menopause Cancers Cancers

5. Type 2 diabetes Used to be known as a disease of middle years Used to be known as a disease of middle years Caused by poor lifestyle factors such as overeating, not enough exercise Caused by poor lifestyle factors such as overeating, not enough exercise Usually preceded by insulin resistance Usually preceded by insulin resistance Lifestyle factors are the main cause, especially weight, activity levels and balance of diet Lifestyle factors are the main cause, especially weight, activity levels and balance of diet

6. What can offset this? “Healthy and achievable physical activity and dietary goals among older adults, including: “Healthy and achievable physical activity and dietary goals among older adults, including: moderate leisure-time activity and walking pace, moderate leisure-time activity and walking pace, higher intake of dietary fibre and polyunsaturated fat, and higher intake of dietary fibre and polyunsaturated fat, and lower intake of trans fat and easily digestible [high GI] carbohydrates.” lower intake of trans fat and easily digestible [high GI] carbohydrates.” April 27, 2009 issue of the Archives of Internal Medicine

7. Cardiovascular disease Diseases of the heart and circulatory system (cardiovascular disease or CVD) are the main cause of death in the UK Diseases of the heart and circulatory system (cardiovascular disease or CVD) are the main cause of death in the UK More than one in three deaths are from CVD each year. More than one in three deaths are from CVD each year. The main forms of CVD are coronary heart disease (CHD) and stroke. The main forms of CVD are coronary heart disease (CHD) and stroke. CHD, by itself, is the most common cause of premature death in the UK. About one fifth (19%) of premature deaths in men and one in ten (10%) premature deaths in women were from CHD CHD, by itself, is the most common cause of premature death in the UK. About one fifth (19%) of premature deaths in men and one in ten (10%) premature deaths in women were from CHD

8. Menopause Healthy diet and being physically active Healthy diet and being physically active Keep weight down Keep weight down Watch caffeine intake and alcohol Watch caffeine intake and alcohol Soya, calcium, vitamin D, vitamin E, EPO, LC omega 3s, probiotics, magnesium, Soya, calcium, vitamin D, vitamin E, EPO, LC omega 3s, probiotics, magnesium, But hard to make claims on foods and supplements for But hard to make claims on foods and supplements for menopause as not a disease disease

9. Bone health 1 in 3 women over 50 will experience osteoporotic fractures, as will 1 in 5 men 1 in 3 women over 50 will experience osteoporotic fractures, as will 1 in 5 men In women over 45 years of age, osteoporosis accounts for more days spent in hospital than many other diseases, including diabetes, myocardial infarction and breast cancer In women over 45 years of age, osteoporosis accounts for more days spent in hospital than many other diseases, including diabetes, myocardial infarction and breast cancer Up to 90 % of peak bone mass is acquired by age 18 in girls and age 20 in boys, which makes youth the best time to “invest” in bone health. Up to 90 % of peak bone mass is acquired by age 18 in girls and age 20 in boys, which makes youth the best time to “invest” in bone health. After around 30, bone is gradually lost at a rate of about 0.5% a year. In women this escalates to about 5% a year during the time of the menopause After around 30, bone is gradually lost at a rate of about 0.5% a year. In women this escalates to about 5% a year during the time of the menopause

10. What can be done? Calcium and vitamin D Calcium and vitamin D Balanced diet with plenty of fruit and veg Balanced diet with plenty of fruit and veg Weight bearing exercise Weight bearing exercise Moderate alcohol Moderate alcohol Other factors may be relevant; Other factors may be relevant; Vitamin K, magnesium, soya, antioxidants Vitamin K, magnesium, soya, antioxidants

11. Prostate cancer In UK, this cancer is the most common cancer in men and incidence rate is rising In UK, this cancer is the most common cancer in men and incidence rate is rising Lifestyle factors heavily involved Lifestyle factors heavily involved Lycopene, Vitamin D and soya may protect, high calcium diet are a probable cause Lycopene, Vitamin D and soya may protect, high calcium diet are a probable cause Selenium and vitamin E ruled out as protective and may actual increase it Selenium and vitamin E ruled out as protective and may actual increase it Again obesity and lack of physical activity may also promote Again obesity and lack of physical activity may also promote

12. Five main considerations in middle years as markers of health Smoking Smoking Weight-BMI and fat distribution Weight-BMI and fat distribution Alcohol intake-pattern and amount Alcohol intake-pattern and amount Exercise (minimum 5 times a week for 30 mins at moderate pace) Exercise (minimum 5 times a week for 30 mins at moderate pace) Amount of fruit and veg consumed Amount of fruit and veg consumed failing on the above can lead to ill health, whereas meeting the criteria for each of these leads to better health outcome

13. Evidence that middle years are ignoring health advice Getting fatter Getting fatter Drinking the same Drinking the same Not exercising as much Not exercising as much Not eating sufficient fruit and veg Not eating sufficient fruit and veg Why? “Middle years just want to have fun” Why? “Middle years just want to have fun” So need to keep taste and fun element of food, yet make it healthy So need to keep taste and fun element of food, yet make it healthy

15. Weight loss Does it matter how you do it? Does it matter how you do it? Satiety, e.g. GI, fibre Satiety, e.g. GI, fibre Protein factor Protein factor Portion size Portion size Energy density Energy density Tom Sanders will elaborate on weight loss later Tom Sanders will elaborate on weight loss later

16. Fluid Eat well plate does not show fluid. Eat well plate does not show fluid. Thirst mechanism decreases with age, so if you don' t think about drinking water, you may become dehydrated. Thirst mechanism decreases with age, so if you don' t think about drinking water, you may become dehydrated. Too much caffeine and alcohol can act as a diuretic Too much caffeine and alcohol can act as a diuretic

17. Exercise Vital and its never too old to start Vital and its never too old to start Strength, Stamina and suppleness should all be considered Strength, Stamina and suppleness should all be considered

18. Alcohol Alcohol units may have started to creep up, especially if life is stressful! Alcohol units may have started to creep up, especially if life is stressful! Alcohol is very calorific Alcohol is very calorific Too much causes a variety of Too much causes a variety of health problems including increase risk of several cancers Drinking within limits Drinking within limits shown to be protective, but not in women?

19. Health and well being market Biggest driver for NPD- seems so even due to recession Biggest driver for NPD- seems so even due to recession But, low fat/low sugar products only 6% of market and dieting in general is marginalised But, low fat/low sugar products only 6% of market and dieting in general is marginalised So what is in: functional ingredients supporting digestive health, immune support and mental functions So what is in: functional ingredients supporting digestive health, immune support and mental functions Anti-ageing and beauty ingredients are emerging trends Anti-ageing and beauty ingredients are emerging trends Positive on pack messaging is in! Positive on pack messaging is in!Mintel

20. What about functional foods and ingredients for healthy middle years? My starter for 10 for ingredients: folic acid, omega 3s, plant sterols and stanols, dietary fibre, pre and probiotics, soya, vitamin D, Co enzyme Q10, phytochemicals My starter for 10 for ingredients: folic acid, omega 3s, plant sterols and stanols, dietary fibre, pre and probiotics, soya, vitamin D, Co enzyme Q10, phytochemicals functional foods: low GI, high satiety foods, low energy dense, high protein, higher monosats, wholegrain functional foods: low GI, high satiety foods, low energy dense, high protein, higher monosats, wholegrain Over to speakers to qualify some of these Over to speakers to qualify some of these

21. What claims can be made? New health claims rules will mean populous nutrition as read in Daily Mail, will not be able to find itself on to our food and drink packages or adverts New health claims rules will mean populous nutrition as read in Daily Mail, will not be able to find itself on to our food and drink packages or adverts