Will SACN report put an end to the saturated fat debate?

Will SACN report put an end to the saturated fat debate?

At long last, the Scientific Advisory Committee on Nutrition (SACN) report on saturated fats and health was published this month. The conclusion? Nothing new: saturated fat leads to heart disease and we should limit it to 10% of our calorie intake. So will it finally put an end to the irresponsible advice that abounds suggesting saturated fat isn’t so bad for you?

It’s taken over a year from the draft report to final version because of the number of comments, criticisms and questions as to why certain studies were or weren’t included as part of the overall evidence into sat fats.

The SACN committee has investigated and answered each one, including only the highest quality evidence available. The studies that came to the wrong conclusions about saturated fat were shown to be flawed.

They’re open about certain limitations to the evidence: for example, whether replacing saturated fat intake with carbohydrate can be beneficial. None of the studies look specifically at ‘good’ carbs (for example wholegrain cereals), just at carbs overall. Further research still needs to be done into this.

But the overall conclusion was inescapable: to reduce cardiovascular disease we should lower our intake of saturated fat.

So will high profile influencers like Dr Michael Mosley or Joe Wicks take note and stop promoting ingredients like coconut oil, which is shown to have higher saturated fat than butter and lard?

Sadly, we think it’s unlikely. For one reason or another they seem to have too much invested in it.

But if you’re reading this and feel as strongly as we do about the need to stop the irresponsible advice, join us in canvassing the influencers to open their eyes to the dangers of what they’re suggesting – rather than just thinking about their commercial interests or looking for the next great headline. #saynotosatfat

Go to the British Nutrition Foundation website for a summary of the SACN report findings

 

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Making healthier shopping baskets a reality for lower income households

Making healthier shopping baskets a reality for lower income households

We’re excited to be involved in a new initiative to help tackle the critical problem of poor diet amongst lower income households: Shop Well – Eat Well. It’s a collaboration between the British Dietetic Association (BDA), Alpro and the Southwark Hub, with the aim of a multi-angled approach to have a real and lasting impact.

Launched last month, we brought together experts to give their insights into key topics. Here’s a summary of some of the key points, followed by links to each of the presentations, which we highly recommend you take the time to watch!

People on lower incomes have a worse diet and shorter life expectancy
There is a direct correlation between diet and income, in turn affecting health. The lower your income, the more likely it is you will:

  • Eat more sugar, processed foods, fat and sodium
  • Eat less fibre, vitamin A and folate
  • Be less likely to meet iron, folate and calcium recommendations
  • Eat less oil-rich fish
  • Eat more take-aways
  • Cook less at home from scratch

People in lower income groups in the UK have a significantly shorter life expectancy than the average: by nine years for women and seven for men.

They have double the rates of cardiovascular disease, lifestyle-related cancers, type 2 diabetes and total mortality compared to the national average. Obesity prevalence of the most deprived 10% of children is approximately twice that of the least deprived 10%.

This is not new news. Countless attempts have been made to try to address the problem and encourage people on lower incomes to eat more healthily, thereby increasing their quality of life and life expectancy.

But when it comes to eating habits, behaviour change is very difficult to achieve.

Barriers to healthy eating are multiple, complex and interlinked – psychological, financial, environmental, conscious and unconscious. Among lower income households they include:

  • Financial barriers – For low income families, a big barrier to buying new foods or going to a new food shop is not knowing how much the food will cost, or assuming that it will all be expensive. Parents want to know exactly how much their shopping basket is before they reach the checkout.
  • Social barriers – Food habits get passed down the generations as young people grow up and become parents themselves. What children see their parents and families doing is what they grow up thinking of as ‘normal’.
  • Preparation space – Cooking from scratch relies on kitchen equipment, confidence in cooking skills, time to prepare food and pleasant surroundings – not the case for many on low income.
  • Limited bandwidth – The cognitive burden of living under financial strain and other modern day life stresses reduce parents‘ mental bandwidth; brainpower that would otherwise go to planning ahead and problem-solving.[1] Families in this situation look for quick and easy ways to eat, and takeaway and convenience foods provide an in-the-moment solution to feeding children quickly, affordably and safely.
  • Advertising and shop layouts – Cues such as special offers, advertising for takeaways, attractive packaging and child-height shelving nudge families towards less healthy foods in shops.
  • It’s not always a lack of knowledge or cost that’s a problem, it’s translating knowledge to practice.

In fact, most eating behaviour is driven by unconscious, habitual processes. These are largely immune to education when it comes to behaviour change. Yet this has been our predominant approach to changing dietary behaviour!

Breaking the habits of a lifetime
Multiple collaborative strategies are needed to succeed in changing behaviour: from government, local authority, industry and all food providers, alongside continuing to help individuals overcome their personal barriers.

We need to making healthy eating

  • easy,
  • habitual, and
  • normal

As behavioural psychologist Dr. Paul Chadwick says, it’s not sustainable for people to have to think about every food choice that they make. Healthy eating has to become the default option.

A new initiative for change
Behavioural science shows the importance of interactions between the individual and their physical and social environment when it comes to habit forming and breaking.

It’s time the food environment changed to make healthy eating as easy to attain as possible for all, including low affluent groups.

It’s also time for families and individuals to be supported in overcoming barriers to breaking the unhealthy habits.

We’re excited to be part of the new initiative, Shop Well – Eat Well, to help enable this – especially targeting those on a low income.

Starting as a year-long pilot in Southwark, South London, it’s kicking off in June. Community charities and volunteers will join to create peer and professional-led healthy eating seminars and workshops tailored to the young, old and families.

At the launch, Kate Arthur, UK External Scientific Affairs & Nutrition Manager at Alpro, explained: “We wanted to find interventions that would encourage people to think about their food choices differently.

“Going directly into the community to find out what will work for people is the logical thing to do. We’ll be working on different engaging activities such peer led cookery workshops and drop in seminars, with help from the BDA Let’s get Cooking and an advisory committee of experts, always with an eye on the main barriers.

“Ultimately, we’ll be assessing to see what really makes a difference over the next year of the campaign and we’ll share any success stories widely with local communities nationwide and the dietetic community as a whole.”

Caroline Bovey, Chair of the British Dietetic Association added: “By partnering on this project, and working with the food manufacturers and shops that people are accessing daily, we’re excited to directly tackle some of the wider barriers to healthy habits in a local area. The BDA is delighted to be working with Alpro and the Southwark wellbeing hub to help people who often have to prioritise the other demands of daily life over their food choices.”

Take advantage of insightful presentations and useful resources
At our launch, five leading experts presented the latest evidence and initiatives to help overcome barriers to healthy shopping baskets and healthy eating. The presentations are available on the Shop Well – Eat Well website. Make yourself a cup of tea, watch, learn and be inspired:
– Dr Paul Chadwick, behaviour change leading expert: A scientific approach to behaviour change
– Sue Baic, Registered Dietitian: Affordable, healthy and sustainable eating in practice
– Duncan Brown, Development Director at charity Shift design: How does affluence impact on food choices?
– Kate Arthur, Alpro UK’s External Scientific Affairs & Nutrition Manager: Changing behaviour in the community
– Nilani Sritharan, Company Nutritionist at Sainsbury’s Supermarkets Ltd: Making healthy shopping easier

You’ll also find practical and engaging resources to help consumers overcome their barriers to healthy eating.

#shopwelleatwell @SouthwarkHub @BDA_Dietitians @Alpro

 

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Choose a sustainable diet: for the planet, for your health

Choose a sustainable diet: for the planet, for your health

The facts are now mounting that our food choices not only impact our health but are also fast depleting the planet’s resources.

Taking into account every stage from production, distribution and delivery through to waste, we see the sizeable impact our food choices have on the environment. What we eat:

  • Contributes 20-30% of total greenhouse gas (GHG) emissions
  • Is the leading cause of deforestation, biodiversity loss and soil and water pollution
  • Accounts for 70% of all human water use
  • Is responsible for global inequality: current food production is adequate to meet the needs of the global population of 7 billion, however, 2 billion exceed their needs whilst 800 million suffer hunger

Additionally, 30–50% of all food produced is spoiled or wasted.

If we’re going to save our planet, we need to change the way we eat.

 

Choosing a sustainable diet

For the first time, the UK government’s most recent Eatwell Guide acknowledged the importance of eating to help sustain the planet, as well as for health.

It was modelled to ensure that all macro and micronutrient needs of people aged 5 and over are met, while the nation’s carbon footprint is reduced by almost one third.

  1. Supporting our planet

The Eatwell Guide recommends that 80% of food we consume should be of plant origin: the focus is on reducing meat – especially beef – and dairy, which have the most impact on the world’s resources.

– Livestock production is by far the most significant contributor to GHG emissions (methane, carbon dioxide and nitrous oxide) contributing to 14.5% of all GHG emissions.

– Cattle consume 40% of all grains produced. Over one third of arable land is dedicated to growing grains solely for animal feed production.

– Livestock is the main cause for deforestation, biodiversity loss, degradation and water pollution.

  1. Improving our health

The benefits come not only to the planet but also our health. As we discussed in our blog on the popularity of vegetarian and vegan diets, it is well established that diets higher in plant foods and lower in meat products result in a lower intake of both energy (calories) and saturated fat, while increasing fibre intake.

Those with a plant-based diet suffer significantly less from diseases such as obesity, type 2 diabetes, cancer and heart disease.


The barriers to change

With only 1% of the population adhering to the previous (and less plant-based) Eatwell plate, how can we now expect people to adopt a more environmentally-friendly diet?

The British Dietetic Association is committed to bringing sustainable diets to the top of the dietetic agenda. They’ve put together a new toolkit providing both scientific knowledge and the practical tools to empower dietitians and consumers to adopt a diet focussed on sustainability.

The advice follows extensive research into the science of sustainable eating and top barriers and motivators. These were identified as:

  1. Lack of practical knowledge and resources
  2. Perceptions that sustainable healthy eating requires more time, more money and taste has to be compromised.
  3. What’s on offer from retailers, restaurants, take-aways, etc. – with an imbalance toward unhealthy, plant-based foods versus health and affordable plant foods?
  4. Language needing to be tailored to the audience depending on culture, age group, socio-economic and education status
  5. Clarity over messaging, for example on fish and processed foods
  6. The misconception of sustainable only associated with vegetarian/vegan diets, and of them being nutritionally inadequate

Sound familiar? Have you been able to overcome the barriers and use successful motivators to increase your own sustainable eating, or that of a client?

Be first to benefit from the BDA’s Sustainable Diet toolkit

We are giving an exclusive preview of the toolkit along with an overview of the latest science on the upcoming FREE CPD NutriWebinar on Sustainable Diets, 14 November 8 to 9pm.

The toolkit will be formally launched at Food Matters Live on 20 November. Find out more and register now

 

 

 

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Increasing fibre intakes is key to improving the nation’s health

Increasing fibre intakes is key to improving the nation’s health

The most recent government guidelines on fibre intake recommend 30g per day for adults. Levels are currently at just 20g per day for adult men and 17.1g per day for women – that’s an average 68% increase in intake needed to meet recommendations.

And it’s not just adults: there’s a significant disparity between recommended and actual fibre intake across all age groups.

So why is fibre so important? And what can we do to help people meet the recommended intake levels?

Here’s a quick overview. To explore the topic in more detail, join our upcoming Fibre NutriWebinar, on Wednesday 7 November.

The benefits of fibre 

Dietary fibre has long been recognised for its health benefits. But it’s only in recent years that our understanding and appreciation of it has significantly progressed.

Fibre’s health effects mainly result from two key factors – its physical properties (eg stool bulking, viscosity, binding ability) and its effect on the gut microbiota and luminal environment.

Amongst its many beneficial properties, clinical trials have proven that fibre:

  • Decreases blood pressure
  • Increases satiation
  • Decreases glucose absorption
  • Increases bacterial a faecal mass (commonly associated with health benefits including reduced risk of colon cancer)
  • Exerts benefits through gut microbiota

Where are we getting our fibre from?

The main sources of fibre in the UK are cereals, vegetable and potatoes, contributing to 70% of total intake.

Interestingly, white bread and potato products prepared with fat (eg chips and crisps) are significant contributors. This is despite the fact that they have comparatively low fibre content, showing that consumption is high.

One of our challenges is to educate the public on healthier fibre sources – fruit, vegetables, whole grains and pulses, rather than broad recommendations on increasing cereals.

Understanding and helping consumers

We know that despite the convincing body of evidence for the role of dietary fibre in many chronic conditions, translating and achieving fibre recommendations in practice can be challenging.

Understanding the key barriers faced by the public and putting forward strategies to overcome these is key to facilitating better health for all.

Find out more about the FREE Fibre NutriWebinar with Dr Megan Rossi, RD and register now.

It’s one of our ongoing NutriWebinar series examining key nutrition topics with experts in the field.

 

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Updated childhood obesity plan: But how does it measure up?

Updated childhood obesity plan: But how does it measure up?

The government recently announced new measures to halve rates of childhood obesity by 2030 and significantly reduce the health inequalities that persist – closing the gap in obesity rates between children from the most and least deprived areas.

This proposal builds upon the first chapter of the Childhood Obesity Plan, which was widely criticised at the time as lacking the breadth and depth of initiatives needed to effectively tackle such a widespread and entrenched issue.

Steve Brine, Public Health Minister has stated: “One in three children are now overweight or obese by the time they leave primary school. Overconsumption, combined with reduced activity, is having a catastrophic effect on our children’s health. As both a parent and minister, I am committed to driving today’s pledge of halving obesity over the next 12 years with bold new action.”

“Our updated plan will put parents in charge, providing more information and support. Our aim is to help families make healthier choices, which will in turn provide a better chance at a longer, healthier life for our children.”

Obesity – A systems issue

The financial burden of obesity is too great to ignore: it’s estimated that the NHS in England spent £6.1 billion on overweight and obesity-related ill-health in 2017/18, which, to put into context is more than was spent on the police, fire service and judicial system combined. The wider costs to society of these conditions are around £27 billion a year, if not higher.

Ever since the Foresight report was published over a decade ago, it has been recognised that obesity is a systems issue and one that therefore requires reform at many points, to deliver change. This idea and the fact that no plan to date has sought to address childhood obesity in a multi-sector way, was reiterated in the recent inquiry by the parliamentary Health and Social Care Committee into childhood obesity. Childhood Obesity: Time for Action argued for a change in narrative, making clear that obesity is everyone’s business and “an effective childhood obesity plan demands a holistic, joined-up, ‘whole systems’ approach with clear and effective leadership”.

How does the Childhood Obesity Strategy measure up?

This update to the Childhood Obesity Strategy is a welcome step forward. It contains a raft of proposed measures that seek to tackle the issue using a co-ordinated range of policy levers. What is also good to see is that this new plan takes a firm but fair approach in how it will deliver change: using voluntary measures in the first instance but being clear that a harder tact with the likes of regulatory and fiscal measures will be considered where progress is deemed insufficient, or where a level playing field is required.

Here at Nutrilicious, we’ve taken a closer look at what’s in store and benchmarked the new childhood obesity plan against the World Cancer Research Fund’s NOURISHING framework, as well as the recommendations from the Health and Social Care Committee’s report mentioned earlier.

The NOURISHING framework

The NOURISHING Framework sets out that policies are needed within three core areas to improve diets: the food environment, food system and behaviour change communication.

N – Nutrition label standards and regulations on the use of claims and implied claims on food
O – Offer healthy food and set standards in public institutions and other specific settings
U – Use economic tools to address food affordability and purchase incentives
R – Restrict food advertising and other forms of commercial promotion
I – Improve nutritional quality of the whole food supply
S – Set incentives and rules to create a healthy retail and food service environment
H – Harness food supply chain and actions across sectors to ensure coherence with health
I – Inform people about food and nutrition through public awareness
N – Nutrition advice and counselling in health care settings
G – Give nutrition education and skills

Bearing in mind that some policies and actions targeting childhood obesity were in place prior to this strategy update, overlaying the new measures show how broad their impact alone intends to be:

New measures N O U R I S H I N G Nutrilicious notes
Improved food labelling to display ‘world-leading, simple nutritional information’ as well as information on origin and welfare standards following Brexit X
Strengthen School Food Standards to reduce sugar consumption X X We would like to see these universally applied and close the loophole that exists for some academies
Strengthen Government Buying Standards for Food and Catering Services* X X
Ban price promotions such as buy one get one free, multibuys or unlimited refills of unhealthy foods and drinks in the retail and out of home sector* X It is good to see a mandatory approach applied here, as this is what is undoubtedly needed when policies will impact businesses’ bottom line.
Ban the sale of energy drinks to children* X
Ban promotion of unhealthy food and drink by location e.g. positioning – checkouts, end of aisles and store entrances, in retail and out of home sector* X
Introduce a 9pm watershed on unhealthy food and drink advertising and similar protection online* X We would like to see similar controls applied to sports advertising
Review governance arrangements for advertising rules (currently overseen by the Committee of Advertising Practice and Advertising Standards Authority) X
Potentially bring ‘sugary milk drinks’ into the soft drinks levy if insufficient action on sugar reduction takes place X X
Introduce mandatory calorie labelling for out of home sector in England* X X
Sugar reduction plan for products aimed exclusively at babies and young children due in 2019* X
Calorie reduction plan due mid-2019* X
Develop trailblazer programme with local authority partners to highlight what can be done within existing powers X We would like to see greater powers for local authorities and health services
Develop plan to use Healthy Start vouchers to provide additional support to children from lower income families* X
Ofsted will review school curriculum to understand how it can better support healthy behaviours, including food choices X X We would like to see improved early years education for parents to support a healthy first 1000 days and compulsory home economics with healthy cooking skills at the core in both primary and secondary schools

*Proposal for further consultation

Is it enough?

While we applaud this latest round of the childhood obesity plan, we would also draw attention to the fact that there is still some way to go.

By mapping the proposed policy options against the NOURISHING framework, we can see that in this latest iteration of the plan much more focus has been given to shaping an environment that enables and supports healthier choices, which is great to see.

However, what is noticeably absent is the ‘I’ in terms of improving food and health literacy of the population. In a ‘post truth’ world where consumers are increasingly sceptical of messages coming from the scientific community, and when social media influencers are capturing the hearts and minds of the masses with questionable dietary advice, never has it been more important to provide clear, simple and authoritative information and advice. As such, we’d like to the see the government step-up their efforts on social marketing and educational campaigns.

What is more, a number of recommendations made in the Health and Social Care Committee are notably absent, including:

  • Establishing a Cabinet-level committee to review the implementation of the plan, ensuring it gets the high-level traction it requires
  • Proposing further measures around early years and the first 1,000 days of life, including targets to improve rates of breastfeeding
  • Banning the advertising and promotion of follow-on formula milk
  • Providing local authorities with further powers to limit unhealthy food and drink advertising near schools (the only powers available to local authorities extend to the positioning of the billboards themselves, not the content of the advertising)
  • Introducing services for children living with obesity

Finally, while this plan is overtly focussed on limiting unhealthy foods and drinks and making processed, packaged foods a little better through reformulation (lower in salt etc), we would also like to see equal attention given to measures that work improve the quantity and quality of foods that we do want people to eat more of. Changing the dietary landscape will require strong efforts to provide families with the tools and knowledge to instil these healthier behaviours in a sustainable way.

The full plan for action can be viewed here:

https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action

 

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Joining the fight against high cholesterol

Joining the fight against high cholesterol

Currently 2.3 million people in the UK are living with heart disease, at an annual cost of £953m to the NHS. We’re involved in an on-going battle to try to reduce it.

For those in the health industry, the link between high cholesterol and heart disease is well known. Meta-analyses, genetic studies and randomised controlled trials totalling more than 2 million participants, 20 million person-years of follow up and 150,000 cardiovascular events demonstrate a close correlation between cardiovascular disease (CVD) and high levels of low-density lipoprotein cholesterol (LDL-C).

What’s less known is the impact plant stanol esters can have on lowering cholesterol.

 

Changing behaviours of those at risk of heart disease

GPs and practice nurses are key influencers when it comes to persuading people to change their lifestyle to improve their health. So it’s vital to make sure these healthcare professionals (HCPs) have the facts – and materials – they need to support this.

In a survey we undertook this year of HCPs on behalf of Benecol, we found that persuading patients to improve their diet change is a key priority when it comes to reducing cholesterol – along with cutting smoking and increasing physical exercise.

We discovered that while the HCPs are well aware of the importance of cutting saturated fat and sugar, and want to communicate about healthier eating to patients, they are less likely to know the impact plant stanol esters can have on lowering cholesterol.

Plant stanols and sterols can reduce cholesterol by up to 10% in two to three weeks.

Over 70 clinical studies have demonstrated that plant stanols effectively lower cholesterol.

How do they work?

Consumption of foods with added plant stanols or sterols (1.5 – 2.4g/day) should take place at meal times. Mixing with food and digestive juices results in the displacement of dietary and biliary cholesterol in the fat absorption pathways in the gut.

Cholesterol absorption is reduced by about 50% and studies have shown a dose-dependent reduction in circulating LDL-C of 7 – 10% on average.

Cholesterol begins to lower immediately. With continued use full reduction is achieved within 2 – 3 weeks and is sustained over the longer term. What’s more, if used alongside statin therapy, plant stanols lower LDL-C by an additional 10% – an effect greater than doubling the statin dose, which, at best, only provides a 6% additional LDL-C reduction.

Plant stanols provide an easy diet-based solution to all hypercholesterolaemic patients, including those with mildly elevated serum cholesterol level. They would also be especially recommended for those averse to taking statins, anxious to keep statin doses low, or at higher risk from potential statin-related side effects.

They are recommended by a number of prevention and treatment guidelines as part of a cholesterol-lowering diet, including the European Society of Cardiology, the Atherosclerosis Society, UK JBS3 guidelines and the World Health Organisation.

 

Our holistic communications approach to help reduce cholesterol

As a result of our research, we created a holistic communications approach in association with HEART UK – the Cholesterol Charity and leading heart health dietary specialists – to support practice nurses and GPs, and their patients.

  1. We created information sheets for the healthcare professionals with full information about dietary changes patients can make to lower LDL-C levels. Included in this was the latest evidence not only on plant stanols but on all dietary recommendations for lowering LDL-C.
  2. Alongside this were fact sheets for patients, clearly explaining the problem of high cholesterol and the lifestyle changes that would have a significant impact on their health.

We highlighted the key motivators for patients – the fact that a small change would bring quick results.

Companies are accused of only being interested in their profits – and of course, they are ultimately accountable to stakeholders, so money is always going to come into it.

But what we found with Benecol’s approach is that they are genuinely determined to help combat the huge problem of heart disease that exists. Reaching out to health professionals they wanted to understand issues fully and how best to communicate lifestyle change – not just dietary, which would help promote the message of plant stanols, but also more widely, include all dietary matters as well as smoking and exercise.

The materials tell the whole story, educating the professionals and patients and then leaving it in their hands how to act.

Health professionals responsible for communicating heart health cholesterol lowering advice can order these packs by calling the Benecol Helpline 0800 018 4010 and asking for your health professional Benecol Toolkit ‘Small Change, Big Results’ pack.

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Email: hello@nutrilicious.co.uk

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