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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Were iodine headlines scaremongering?

Were iodine headlines scaremongering?

According to headlines, iodine deficiency is the latest threat to our health in the UK. What’s more, the media says, poor iodine status is due to the rise of veganism and our increasing love for plant-based drinks as milk alternatives.

The headlines focused on the fact that dairy milk is our main source of dietary iodine, whilst plant-based drinks (with a few exceptions) do not contain iodine.

But is lack of iodine an issue? Could an increased consumption of plant-based drinks put people at risk of iodine deficiency?

It’s a complicated issue, but let’s look at the facts…

Is iodine important in the diet?

Yes. Iodine is essential. The body needs iodine to make thyroid hormones, which is fundamental for foetal and young children’s growth and brain development. Severe iodine deficiency in pregnant women can cause irreversible brain damage in their offspring. Population studies have also demonstrated a lower IQ score of around 13 points in severe iodine-deficient populations compared to iodine replete populations. The World Health Organisation (WHO) has stated that low iodine status is the single most preventable cause of brain damage in the world.

Adequate iodine status is especially critical for women of child-bearing age, during pregnancy and whilst breast feeding, to ensure optimal brain development in the foetus and young infant. Continued optimum intake in childhood and adolescence is fundamental as the brain continues to develop. It is important to note that folate, iron and long-chain omega-3 fats are also critical to brain development.

Severe iodine deficiency is rare in developed countries like the UK. However, there are significant numbers of women, especially of child-bearing age who are mild to moderately iodine deficient. A number of recent meta-analysis (including findings from UK population groups) indicate a high probability of compromised cognitive development in children whose mothers had mild to moderate iodine status during pregnancy. How significant these lower IQ scores are to cognitive ability in adulthood has yet to be established.

Measuring iodine status of a population
Median urinary iodine concentrations (UIC) are the best way to assess the iodine status of a population or large group. This is because the iodine content of foods is too variable to rely on dietary intakes as a measure of iodine status.

How the WHO classifies iodine deficiency.

For a healthy population 6 years and older For pregnant and breast feeding women
Median UIC is below 100mg/L AND

If 20% or more of that population has a median UIC of less than 50mcg/L.

Median UIC below 150mcg/L
Mild deficiency 50-99 mcg/L
Moderate deficiency 20-49 mcg/L
Severe deficiency <20 mcg/L

 

Does the UK have an iodine deficiency problem?

According to the latest National Diet and Nutrition Survey (NDNS) using WHO criteria, from an overall population perspective we’re actually not doing badly, with all age groups and sexes showing adequate iodine status.

However, severe to moderate deficiency (UIC <50mcg/L) still afflicts a significant number of our population:
• Approximately 1 in 10 children aged 4-18 years
• 14% of adults 19-64 years

Unfortunately, the NDNS does not currently perform UIC measures in pregnant women or the under 3s, the most susceptible population groups to low iodine status.

Women of child-bearing age (16-49 years) are classified as iodine replete, with a median UIC of 102mcg/L.

However, almost 70% of them would be classified as mildly to moderately iodine deficient if they were to become pregnant – i.e. UIC levels below 150mcg/L – when taking account for the increased demands of the foetus and young infant.

As a result, many are calling for the government to review the UK’s iodine initiatives, especially for women who are planning/are pregnant, or are breast feeding.

How does what we eat impact on our iodine levels?

The ocean is nature’s source of iodine, thus fish, seaweed and algae are rich sources. Additionally, coastal soil regions will acquire some iodine from coastal waters.

Therefore, higher intakes of seafood are paramount for adequate iodine status and studies have found seafood intakes to be positively correlated with iodine status.

In the UK, fish intakes are exceptionally poor. Few meet the government’s recommendation of two 140g servings per week. Average total fish weekly intakes in the UK:
• The majority of 4-18 year olds consume no more than 56g.
• The majority of adult women (19-64 years) consume 84g fish.
• The majority of adult men (19-64 years) consumer nearly 100g fish.

Iodine and dairy milk
In the UK, farming practices were changed in the 1930s to eradicate the high incidence of iodine deficiency. Animal feeds were fortified with iodine and the use of sterilizers containing iodine were introduced. This resulted in a significant increase in iodine levels of dairy milk and a consequent eradication of severe iodine deficiency.

Winter milk is significantly higher in iodine compared to summer milk, as dairy cattle are more likely to reared indoors with fortified feed in the winter months.

Thus the key source of iodine in the UK is indeed dairy milk – contributing to 34-40% iodine intakes in adults and 40-51% iodine intakes in 4-18 year olds.

Could plant-based drinks place the nation at risk of Iodine deficiency?
It is true that the majority of plant-based drinks do not contain iodine. However:
1. Incidence of mild to moderate iodine deficiency in pregnant women has actually been high in the UK since the 1990s, when milk intake was at its highest.

2. Despite the recent popularity of plant-based drinks, dairy milk intakes have seen little reduction. And plant-based drinks consumers also continue to drink dairy.

Since 2010, milk intakes have reduced by just 74mls per person per day (a 6.5% decrease), while plant-based drinks – although on a sharp incline – equate to just 45ml per person per day.

Therefore, plant-based drinks – whether they are or not fortified with iodine – are not the cause of the iodine deficiency that has been present for many decades.

Other considerations
• Cognition is affected by multiple environmental, psychological as well as dietary components e.g. pollutants, home environment, education level, various nutrients including vitamin D, iron, folate and iodine.
• Iodine is not highlighted in advice provided to expectant mothers, nor is it on the government agenda.
• No studies have indicated vegan populations, who exclude all dairy, to have lower IQ levels compared to omnivores.

There are also effective initiatives that have helped to eradicate severe iodine deficiency
• The WHO Iodized Salt programme has been adopted in many countries and proven to be successful.
• Iodine supplements have shown to be effective when given to women in the first or second trimester of pregnancy.

Takeaway messages

1. Many factors are at play when considering brain development of the foetus and young infant:
– Adequate intake of a number of nutrients, including iodine but also iron and folate
– Optimal environmental and psychological settings.
‘Fixing’ one aspect or one nutrient is not the answer to helping optimise cognition in the UK.

Saying this, iodine is one of the essential nutrients for brain development. That has been overlooked and needs to be addressed by the government, on a similar level to iron, folate and vitamin D – especially for expectant women and breast-feeding mothers. Monitoring iodine status needs to be instigated by the government for these groups and young children.

2. The increase in plant-based drinks’ popularity is not the cause of the sub-optimal iodine status in the UK, which has been prevalent in pregnant women for decades – way before plant-based drinks became mainstream.

Rather, the poor dietary patterns of the UK population need to be addressed, especially with regard to our less than optimal fish intake – the richest source of iodine.

Whenever we see the media headlines expounding the ‘benefits’ or ‘dangers’ of individual nutrients or foods, we worry. After 20 plus years in public health nutrition and communications, we believe there is a responsibility and an urgent need for all involved in this field to move away from doing this. In the majority of cases it’s not helpful and is more often scaremongering.

a. We need communications to focus on a balanced food intake. Focusing on a single nutrients in the media is dangerous and ignores all the bigger questions that need addressing: especially obesity and its many associated diseases and “how to” best help the nation enjoy a healthy balanced food intake for optimum health.

b. We need food and health communications that are not only healthy but also sustainable for our planet. Current scientific evidence repeatedly highlights the impact that our food choices have on the environment because of their significant contribution to greenhouse gas emissions, deforestation, biodiversity loss, and destruction of the ecosystem, use of fresh water and polluting of soil.

Beef and dairy cattle farming have been highlighted as the major dietary contributors, whereas plant-based drinks have been shown to be significantly more sustainable.

Leading experts have concurred that a balanced diet that is based predominantly on plant foods – including plant-based drinks – with lower intakes of meat and dairy, without having to exclude them altogether, is both sustainable and nutritious. Read our Sustainable Diets blog for more information.

It is incumbent upon all food and health influencers to incorporate these messages into all relevant food and health communications. Unfortunately, this is not yet being considered widely.

Sources:
1. Chambers L. Are plant-based milk alternatives putting people at risk of low iodine intake? Nutr Bulletin 2018;43:46-52
2. PHE. Results of the National Diet and Nutrition Survey (NDNS) rolling programme for 2014 to 2015 and 2015 to 2016. 2018 [cited 5/11/2018]
3. WHO-UNICEF. Assessment of iodine deficiency disorders and monitoring their elimination. Third Edition. 2008 [cited 9/25/2018]
4. Bath S, Rayman M. A review of the iodine status of UK pregnant women and its implications for the offspring. Environ Geochem Health 2015;37(4):619-29.
5. Levie D, Korevaar TIM, Bath SC et al. Association of maternal iodine status with child IQ: a meta-analysis of individual-participant data. J Clin Endocrinol Metab. 2019 Mar 28. [Epub ahead of print]
6. Dineva M, Rayman MP, Levie D et al. Similarities and differences of dietary and other determinants of iodine status in pregnant women from three European birth cohorts. Eur J Nutr. 2019 Feb 8. [Epub ahead of print]

 

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My first SMART SHOP ever!

My first SMART SHOP ever!

My first SMART SHOP 🛒 ever!
A taste of the future of grocery shopping! 🍏 🍊 🥛

Have you experienced it yet? If so how was it? This is my short story….May 2019!

“I can do this”…I told myself as I hear my forever forward thinking colleague Howard @see_research tell me that @Sainsburys @SainsburysNews have a new smart shop in Holborn – must be tried!

Forget ones inbuilt fear about new tasks I tell myself, especially new tech tasks….which is always a slow learn for me, where I normally have to do things 2-3 times before it clicks! Instead, need to muster all life skills accumulated over many years to overcome said fear, gain new experience, stay ahead & be more informed about retail advances!

Swapping 👠 for 👟 after our meeting I bounce over to the new store with curiosity & best enthusiasm possible for joining in…thankfully greeted by helpful friendly young millennial providing immediate, necessary, app set up assistance & source of calm!

After 10 mins setting up the store app on my 📱 (not as easy as I had hoped with millennial help but thankfully unlike the much slower paced android next to me 😢 ) I was finally ready to go & shop like I never shopped before & looking forward to experiencing no checkout & a speedy exit!

I watched & copied those before me! I test scanned an 🍏 . I scanned the bar code on the apple shelf, then picked up the apple & placed it in my bag. Easy! “Whoopee” I say when camera scans it immediately. I briefly remind myself of a talk at my sons school the week before which inspired me to embrace tech +++ + as our near future is artificial intelligence in every which way possible. Suddenly feeling more positive about my chances with that! What fun! 😀

Onto the next shelf I tried to scan the bar code on the shelf in front of a pack of mixed fresh beans. Error appears! 😆Oh dear. You have to fail before you really succeed, right?! I discover that for packaged goods you have to scan the bar code on the pack – not the shelf! A little awkward & challenging when holding the product & my shopping bag & in need of at least one whole hand to take the scan on the iPhone & another hand to hold the product. But must not be defeated!

I scan two more items successfully. I then suddenly think about my next meeting & the need to run. I smugly look at the long queue in front of me & start to proceed to check out & pay on the spot on my app & search for the QR code on the shop wall to indicate Im done & leaving. Only snag….my apple pay linked to the app doesn’t accept @Barclays @BarclaysUK debit cards yet ,which explains the difficulties that even my helpful millennial did not realise at set up!

A bit frustrating having to leave & not complete the new task- but having no time for the store queue the store manger kindly takes my items back.

I did however leave thankful to @Sainsburys overall for the new shopping experience. It was of course a faff to set up the app even for the millennial assisting me and it obviously has a teething problem with some banking cards. However, once set up & you know where to scan I can only imagine it becoming second nature to us all very quickly.

On the negative side I can see us having no human contact as we go out to shop which adds to my concerns about the deterioration in social skills as tech inevitably increases in our lives. A big responsibility for the big tech corporations & us all to address, I think.

On the positive side I can visualise all kinds of new nutrition tech supporting this app that may analyse our shop as we scan, potentially feedback to us as we shop & help nudge us towards healthier & more sustainable shopping baskets! How amazing would that be!

Watch this space… I have no doubt! If you have experienced smart shop or have any further thoughts Id love to hear! In the meantime happy 😃 healthy shopping everyone however you choose to do it right now! 🛒

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EAT-Lancet recommendations for health and planet

EAT-Lancet recommendations for health and planet

“The world’s diets must change dramatically,” said Harvard University’s Walter Willett, one of the leaders of the comprehensive EAT-Lancet report released this week researching healthy and sustainable diet.

The findings show we must drastically cut down on meat and dairy, and eat more plant foods.

Published after three years of reviewing extensive evidence from around the world, the message is similar to that of both the British Dietetic Association’s One Blue Dot campaign, the government Eatwell Guide, the World Health Organisation and recommendations made by various non-governmental health organisations, for example World Cancer Research Fund (WCRF) and the British Heart Foundation.


The EAT-Lancet recommended daily diet

Here’s an outline of the recommended daily diet to meet 2,500kcal and all micronutrients:

Average recommended intake*

Comment

Daily Weekly
Protein foods
Beef, lamb and pork 14g 98g ·  Less than a quarter pounder per week
·  Significantly below the WCRF recommendations of 350-500g per week
·  70-90% below current US & European intakes
Chicken and other poultry 29g 203g ·  Equivalent to around 1½ chicken breasts per week
·  EAT suggests that the poultry allowance can be exchanged for eggs, fish or plant proteins and vice versa
Eggs 13g 91g ·  Equivalent to around 1½ eggs per week
Fish 28g 196g ·  Around 1½ – 2 servings a week
·  Oil rich fish is strongly recommended as an omega-3 source
Legumes: dry lentils, beans, peas & soya foods 75g 525g ·  Equivalent to roughly 150g cooked / tinned beans daily
·  An allowance within the 75g recommendation for soya products is specified due to the association with lower breast cancer incidence and reduced cholesterol levels
Tree nuts & peanuts 50g 350g ·  Equivalent to 1½ handfuls daily
·  The report acknowledges that some nut and legume crops use intense water farming. However, the evidence for their associated reduced cardiovascular disease, cancer and total mortality risk justified this environmental trade off.
Dairy
Milk or equivalent in cheese / yogurt etc. 250g 1.75L ·  This is a significant reduction in dairy recommendations
Carbohydrates
Rice, wheat, corn and other, dry weight 232g 1.62kg ·  Whole grains advocated
·  Equivalent to 1 servings of rice or pasta, 40g serving of breakfast cereals & 2 large slices bread daily
Tubers or starchy vegetables 50g 350g ·  Equivalent to 1 egg-sized potato daily or 1½ baked potatoes weekly
Non-starchy vegetables
All vegetables 300g 2.1kg ·  Notably, more vegetables than fruit recommended
·  3-4 servings daily
All fruits 200g 1.4kg ·  2 servings daily
Added fats
Unsaturated oils 40g 280g ·  Equivalent to 4tbsp oil daily
Saturated oils ≤11.8g ≤83g ·  An allowance was made taking into consideration using all animal parts
·  Equivalent to a single butter pack
Added sugars – no more than 5% energy intake – approx. 30g or 7tsp per adult per day.

* EAT-Lancet recommended diet as well as an average daily intake, also provides a range of intakes.

Some of the notable findings are around red meat for iron and dairy for calcium:

  • Iron: There is a problem with deficiency for adolescents but encourages use of inexpensive supplements over consumption of red meat
  • Calcium: The United States and other countries over-estimate calcium needs. It is ubiquitous in the diet and there is little evidence that intakes above 500mg per day improve bone health.

The report looks how to change people’s choices to include less meat/dairy, through:
– making healthier foods more accessible and more cost effective
– reducing marketing and availability of unhealthy food.

It also tackles farming changes to a high degree – seen as being as important as, if not more than consumer change.

Conclusion? Change is needed, it’s going to be tough

We need to make big changes in our eating patterns if we’re going to protect our planet and health. It requires a multi-system combined effort approach to reduce food waste/losses, improve food production and encourage dietary shifts.

It is time for everyone to be involved in the urgently-needed transformation of our food system. We’ll be monitoring the impact the report has over time. Stay tuned…

 

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Fasts, Keto Diets and Pink Coconut Water

Fasts, Keto Diets and Pink Coconut Water

What’s hot in the wacky world of wellness in 2019

Historians believe that the practice of New Year resolutions originated in the Babylonian Kingdom, over 3,000 years ago. New Year intuitively brings time for pause, reflection and setting intentions for the year, and for many, that can centre on resetting what they eat, especially after indulging over the holidays.

In their annual round-up of the more bizarre fad diets for 2019, the BDA have suggested that the blood type diet, drinking your own pee (yes, really), detox teas/skinny coffee, slimming sachets and alkaline water, are some of the more bizarre regimes they’re coming up against.

Here’s a look at what else is hot in the wellness space, with some links to relevant, recent research that may help you in your daily communications or practice.

Lasting fasting

One thing that has remained popular as we come into the New Year, has been the idea of fasting and this month, Jurassic World actor Chris Pratt, announced to his 22.2 million followers that he’s doing the Daniel Fast.

If you haven’t heard of it, the Daniel Fast was created over a decade ago by Susan Gregory, according to the website, a ‘lay minister, businesswoman, coach for Christian living and wannabe techie’ and is a 21-day period of prayer and partial fasting practised by some Christians, based on the experience of the Prophet Daniel’s and Jewish fasting principles. According to the website, the permitted foods centre around vegan options, with some additional restrictions including all sweeteners (non-nutritive and nutritive), processed foods and solid fats.

Elsewhere and currently number 2 on Amazon.co.uk’s bestseller list for diet books, is Michael Mosley’s ‘The Fast 800’ (in fact it appears twice in the top-10 as a hardback and paperback). His latest offering since the popular 5:2 diet and 8-week Blood Sugar Diet (also still in the top-20), which centres on intermittent fasting/‘time-restricted eating’, is a low-carb, Mediterranean-style diet, based on only 800 calories.

For some recent papers on intermittent fasting in the past year, see the following links:

Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting

Intermittent Fasting: Is the Wait Worth the Weight?

Compensatory Mechanisms Activated with Intermittent Energy Restriction: a Randomized Control Trial

Intermittent Fasting and Cardiovascular Disease: Current Evidence and Unresolved Questions

Veto keto

Also vying for the top spot of popular diets in 2019 is the Ketogenic Diet. A quick check of Google search trends shows that after bubbling away for the past few years, interest in this diet is starting to soar and it was the most searched diet term in 2018:

Being low-carb, high fat, the ‘traditional’ Keto Diet may jar against principles of plant-based eating, with new research in The Lancet reaffirming the importance of fibre (from vegetables and wholegrains) in the diet. Keto fans looking for a vegan or vegetarian version of the diet may instead opt for the plant-based version; dubbed ketotarianism, reminiscent of the pegan (paleo-vegan) that was also popular in 2018.

For some helpful papers on ketogenic diets published in the past year, see the following links:

A Nutritional Perspective of Ketogenic Diet in Cancer: A Narrative Review

A Systematic Review of the Use of Ketogenic Diets in Adult Patients with Cancer

The Ketogenic Diet in Disease and Development

Ketogenic Diet for Treatment of Intractable Epilepsy in Adults: A Meta-analysis of Observational Studies

 

Wellness woo

The Times has also just published an interesting article (which is unfortunately behind a paywall) which to sum up, provides (rather alarming) insight into what’s on the cards for ‘wellness revolutionaries’ in 2019; citing pink coconut water, quartz crystals, salt lamps, MCT oil, edible coffee bars and tongue-scraping, amongst other endeavours, all seemingly in the pursuit of health.

On the other hand, continuing to get good traction is the interest in digestive health and the microbiome, and plant-based eating, with Pinterest’s list of 100 emerging trends for 2019, reporting that searches for oat milk increased in popularity by 186% last year.

It is probably unfair to drop all these increasingly popular approaches into a fad bucket. Some, such as intermittent fasting, have a promising and growing evidence to their name and others may have snippets of beneficial principles in them, such as being plant-based, Mediterranean-style eating or with a focus on minimally processed foods.

Others, however, lack any credibly with regards to the claims they are making; often having inflated what is otherwise an incomplete evidence-base or simply just making things up.

In this era of ‘nutrition folk wisdom’, now more than ever is expertise needed from qualified dietitians and nutrition professionals to make sense of what is becoming an increasingly confusing dietary minefield.

Are there other trends that other dietitians or registered nutritionists do find helpful? Do let us know your thoughts. Or if you are a company and an organisation planning what trends you should support we are always happy to discuss and advise. Call us for a hello on 020 8455 2126 or email hello@nutrilicious.co.uk

 

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The BDA’s ground-breaking One Blue Dot campaign for sustainable diets

The BDA’s ground-breaking One Blue Dot campaign for sustainable diets

We were delighted that a record number of people joined us for last weeks’ Sustainable Diets NutriWebinar. The effect our food choices are having on the environment – and what we can do about it – is clearly a topic that matters to you.

Today, many months of in-depth work on sustainable diets comes to fruition with the launch of the British Dietetic Association’s (BDA’s) One Blue Dot campaign, aiming to ensure that dietary guidance is synonymous with health and sustainable eating.


Putting together the One Blue Dot programme

Throughout 2018, we’ve been part of a working group collating and reviewing the latest evidence from around the world on environmentally sustainable and healthy eating patterns, drilling down to macronutrient level.

Supported by project partner Alpro, the ground-breaking results have been brought together into the new One Blue Dot reference guide and toolkit. It’s aimed at dietitians, health professionals and influencers – and really everyone involved in food provision in some way.

Indispensable reference guide and resources

Launching today at Food Matters Live in London, we hope One Blue Dot will become an essential read, guide and inspiration.

Polls show that where 50% of us are likely to consider dietary changes to reduce the impact on climate change, in reality there are significant barriers to changing behaviour for the majority of people.

One Blue Dot aims to tackle this problem. It provides both the latest evidence and a bank of practical resources, including menu swap suggestions for breakfast, lunch and dinner:

A nine-point plan includes:

  1. Reductions in red and processed meat to 70g per person per day (also recommended by the World Cancer Research Fund).
  2. Prioritising plant proteins such as beans, nuts, soya and tofu.
  3. Consuming fish from sustainable sources.
  4. Moderating dairy consumption and using fortified alternatives where needed.
  5. Focussing on wholegrain starchy foods.
  6. Opting for seasonal, locally sources vegetables/fruit. Avoiding air freighted, pre-packed and prepared vegetables/fruit.
  7. Reducing overconsumption of high fat, sugar, salt foods.
  8. Making tap water and unsweetened tea / coffee the choice for healthy hydration.
  9. Reducing food waste, especially of perishable fruit and veg by choosing tinned/frozen alongside seasonal fresh produce.

Each is covered in depth, from the point of view of both the effect on the planet and nutrition.

 

Dietitians can help lead the way

As dietitian and working group member Ursula Arens brilliantly sums it up, “Eating healthy is for you; environmentally sustainable eating is for your children and their children.”

And – as the guide itself says – dietitians are ‘perfectly placed’ to communicate national and international guidance to help the public understand what they need to do to improve their own health and that of the plant to help future generation. The toolkit will be a ‘live’ document, with regular updates and extra information as the science develops.

We’d love to hear your thoughts about the topic and the guide!

Members can download the reference guide and tools at https://www.bda.uk.com/onebluedot

For press enquiries, call 0800 048 1714

 

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