1. © Food – a fact of life 2010 Engaging with nutrition British Nutrition Foundation

2. © Food – a fact of life 2010 Government recommendations RecommendationWhy?Are we meeting it? F&VAt least 5x80g/d  risk some cancers, CVD and other chronic diseases 2.8x80g/d Oily fishAt least 1x140g/wk  risk CVD0.3x140g/wk NMES< 11% en (~60g/d)  risk dental cariesUp to 19% en FatAverage 35% en  risk CVD and  energy density of diets Average 35% en SaturatesAverage 11% en  risk CVD and  energy density of diets Average 13% en NSPAverage 18g/dTo improve GI healthAverage ~13g/d AlcoholNo 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 SaltAverage 6g/d  risk hypertension and CVDAverage 8.6g/d Vitamins and minerals DRVsTo promote optimum health and prevent deficiency Various Physical activityAt least 5X30 mins moderate PA/wk  risk CVD, DM, some cancers and body wt 35% (♂ ) & 24% (♀) Body weightBMI 18.5-25kg/m2  risk some cancers, CVD and other chronic diseases 66% (♂ ) & 53% (♀) over BMI 25 Source: SACN 2007; FSA 2008          

3. © Food – a fact of life 2010 Hot topics Satiety: Protein Dietary fibre Energy density Wholegrains Functional foods: Pre- and probiotics Stanols/sterols Polyphenols Micronutrients: Iron Calcium Magnesium Vitamin A Vitamin C

4. © Food – a fact of life 2010 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

5. © Food – a fact of life 2010 Energy density 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. 200g 400g AB

6. © Food – a fact of life 2010 www.nutrition.org.uk/nutritioninthenews/fuller/ feed-yourself-fuller-chart

7. © Food – a fact of life 2010 www.nutrition.org.uk/nutritioninthenews/fuller/ eat-more-lose-weight Eat more, lose weight leaflet

8. © Food – a fact of life 2010 Eat more, lose weight leaflet Energy density: 1.54kcal/g 0.64kcal/g

9. © Food – a fact of life 2010 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.

10. © Food – a fact of life 2010 Hot topics Satiety: Protein Dietary fibre Energy density Wholegrains Functional foods: Pre- and probiotics Stanols/sterols Polyphenols Micronutrients: Iron Calcium Magnesium Vitamin A Vitamin C

11. © Food – a fact of life 2010 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.

12. © 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.

13. © 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.

14. © Food – a fact of life 2010 Hot topics Satiety: Protein Dietary fibre Energy density Wholegrains Functional foods: Pre- and probiotics Stanols/sterols Polyphenols Micronutrients: Iron Calcium Magnesium Vitamin A Vitamin C

15. © Food – a fact of life 2010 Micronutrients ‘As tiny as the amounts required are, the consequences of their absence are severe.’ WHO

16. © Food – a fact of life 2010 Micronutrient intakes Micronutrient intakes in the UK population are concerning. Low intake*Low status Iron Riboflavin Vitamin AVitamin B 6 CalciumVitamin B 12 MagnesiumFolate PotassiumThiamin ZincVitamin C IodineVitamin D *’Low’ defined as intakes less than the Lower Reference Nutrient Intake (LRNI) Source: SACN (2008): The Nutritional Wellbeing of the British Population

17. © Food – a fact of life 2010 Age (years) % British males below LRNI < 44 - 67 - 1011 - 1415 - 1819 - 3435 - 6465+ Riboflavin00466712 Vitamin B 6 44711011 Vitamin B 12 00000100 Folate00010200 Vitamin A0338131653 Iron33333111 Calcium233139222 Magnesium4322811978 Vitamin & mineral intakes: % below LRNI Source: National Diet and Nutrition Survey 2003

18. © Food – a fact of life 2010 Age (years) % British females below LRNI < 44 - 67 - 1011 - 1415 - 1819 - 3435 - 6465+ Riboflavin00122211259 Vitamin B 6 15015712 Vitamin B 12 00112111 Folate01234325 Vitamin A87920121353 Iron1643444840235 Calcium1252419759 Magnesium025515321923 Source: National Diet and Nutrition Survey 2003 Vitamin & mineral intakes: % below LRNI

19. © Food – a fact of life 2010 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.

20. © 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 Source: Henderson et al. (2003): 2000/01 National Diet and Nutrition Survey: adults aged 19-64 years Food TypeContribution (%) of food types to average daily intake of specific nutrients Meat and meat products zinc (34%), vitamin B 12 (30%), vitamin A (28%), vitamin B 6 (21%), vitamin D (22%), thiamin (21%), iron (17%), potassium (15%), riboflavin (15%), magnesium (12%) Fish and fish dishesvitamin D (25%), vitamin B 12 (18%), iodine (11%) Milk and milk products calcium (43%), iodine (38%), vitamin B 12 (36%), riboflavin (33%), zinc (17%), vitamin A (14%), potassium (13%), magnesium (11%)

21. © Food – a fact of life 2010 Food TypeContribution (%) 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 B 6 (21%), vitamin D (21%), potassium (13%), iodine (12%) (largely through fortification) Potatoes and savoury snacks vitamin B 6 (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 Micronutrients: Food types that contribute ≥ 10% of intake for those nutrients where there is low intake and/or status

22. © 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 Source: Henderson et al. (2003): 2000/01 National Diet and Nutrition Survey: adults aged 19-64 years Food TypeContribution (%) of food types to average daily intake of specific nutrients Fruit (excluding fruit juice) and nuts vitamin C (19%) Drinks (including tea, coffee, fruit juice, alcoholic drinks) vitamin C (27%), folate (14%), vitamin B 6 (11%), riboflavin (10%) Fat spreadsvitamin D (17%), vitamin A (10%)

23. © Food – a fact of life 2010

24. Hot topics Satiety: Protein Dietary fibre Energy density Wholegrains Functional foods: Pre- and probiotics Stanols/sterols Polyphenols Micronutrients: Iron Calcium Magnesium Vitamin A Vitamin C Design a day’s menu to account for all of these factors.

25. © Food – a fact of life 2010 Worked example: Breakfast Porridge made with fortified soya milk Glass of apple juice Banana Cup of tea/coffee ↓ cholesterol Protein Calcium F&V (1 of 5) Fluid Wholegrain ↓ cholesterol Magnesium F&V (2 of 5) Fluid Pant based food (antioxidant)

26. © Food – a fact of life 2010 Worked example: Morning snack Drinking yogurt with pre- and pro-biotic bacteria Small bunch of grapes F&V (3 of 5) Calcium Improve gut health Fluid Not with a hot drink

27. © Food – a fact of life 2010 Worked example: Lunch Baked beans on jacket potato Kiwi fruit Glass of water Fibre Magnesium Fluid Fibre Protein Iron F&V (4 of 5) Vitamin C

28. © Food – a fact of life 2010 Worked example: Afternoon snack Three dried apricots and a handful of mixed nuts (e.g. Brazil, almonds, walnuts) Cup of herbal or fruit tea No tannins F&V (5 of 5) Vitamin A Calcium Magnesium Unsaturated fatty acids Vitamin E Calcium Selenium Protein

29. © Food – a fact of life 2010 Worked example: Evening meal Poached salmon, broccoli and peas with brown rice or wholewheat pasta in reduced fat crème fraiche Slice of melon Small glass of red wine Two wholegrain crackers spread with low fat cheese Topped with six cherry tomatoes F&V (6,7) Calcium Vitamin C Whole grains Long-chain omega-3 fatty acids F&V (9) Vitamin A F&V (8) Vitamin C Polyphenols Whole grains Calcium

30. © Food – a fact of life 2010 For more information visit www.nutrition.org.uk www.foodafactoflife.org.uk