Will European Group tackling obesity have any impact?

Will European Group tackling obesity have any impact?

The European Commission Group on Nutrition and Physical Activity is a high-level group covering all matters related to nutrition and physical activity for tackling obesity in children. They’re creating frameworks to address the health problems endemic in every country in the Western world. As health professionals, we’re delighted.

Government representatives from all EU countries, plus Norway and Switzerland, attend the group. The UK government is represented by the Department of Health.

The driver for the obesity problem to be taken seriously at last? The ever-growing drain on economies caused by obesity-related health problems: from the cost of healthcare provision to increasing numbers of sick days taken by workers.

Meeting at least three times a year, they share experiences and strategies for tackling obesity. To date, they have published an EU Action Plan on Childhood Obesity for 2014-2020, aiming to reduce exposure of foods with high saturated fat, sugars and salt (HFSS), as well as increasing exercise.

They’ve also set frameworks that can be taken up by any country on reformulation of commercial products, focusing on reductions in HFSS. Food categories currently under review are:

  • Sugar-sweetened beverages
  • Sweetened dairy and dairy imitates
  • Breakfast cereals
  • Bread and bread products
  • Confectionary
  • Bakery products (for example cakes and cookies)
  • Ready meals (including ready to prepare products like dry soups, dried mashed potatoes, rice mixture)
  • Savoury snacks
  • Sauces (including ketchup)
  • Sugars sweetened desserts, ice cream and topping
  • Canned fruits and vegetables
  • School food offer
  • Catering meals

Interestingly, baby foods are not yet covered, although it would not be a surprise if this is the next step once Public Health England’s (PHE) sugar reduction strategy for this category gets under way end of this year.

The EU-specific Commercial Food Reformulation Framework for Added Sugars is set – and is really a reflection of the PHE’s sugar reduction strategy:

  • They have proposed benchmarks for each of the above food categories.
  • They have recommended that countries set an added sugars reduction benchmark of a minimum of 10% by 2020 (vs. 2015 baseline levels).
  • They have used the same definition for ‘added sugars’ as PHE, including fruit juice, fruit juice concentrate and fruit purees.

The frameworks are guidelines with minimum requirements, rather than exact rules every country is bound to. This makes sense – countries can choose to apply them as appropriate, taking into consideration different consumer attitudes to food and nutrients.

So, for example, in the UK, the first nine food categories to come under the sugar reduction targets also used 2015 data as baseline, but we went to 5% reductions by year one and 20% reductions by year 2020.

The Group next meets at the end of the month, with an evolved nutrition labelling initiative one of the points on the agenda. Major multi-national companies are on board, including The Coca-Cola Company, Mars, Mondelez, Nestle, PepsiCo and Unilever.

Let’s hope that what comes out of it actually makes an impact, that it’s not just words no one follows up on. We’re certainly moving in the right direction.

Is coconut oil really good for you? A Nutrilicious health check

Is coconut oil really good for you? A Nutrilicious health check

Over the last few years, coconut products – in particular coconut oil – have become very trendy. Celebrities such as Gwyneth Paltrow and Angelina Jolie are enthusiastic consumers of the oil and one in 10 UK 16–24 year-olds currently buys it. Sales rose from around £1 million to £16.4 million in the three years up to 2016, according to the consumer research group Kantar Worldpanel.

The main driver? The popular belief that coconut oil or fat* is more nutritious than other types of fats.

But do the alleged health benefits stand up to scrutiny?

A summary of our assessment

Around 87% of coconut oil is saturated fat – more than in lard or butter. Despite what advocates of a ‘low carb, high fat’ diet suggest, scientific reviews and respected health organisations including the NHS and the British Nutrition Foundation concur that consuming too much saturated fat overall is bad for us.

As a result, the growing consumption of coconut products – especially coconut oil – is of great concern to those who work with scientific evidence-based nutrition. Coconut’s popularity is likely to add to the burden of obesity and heart disease, not reduce it.

So coconut products should be sold as an indulgent product, not a health food. Manufacturers, retailers and the media need to stop exploiting any health associations.

The scientific evidence on coconut oil

Coconut is bursting with cholesterol-raising saturated fats. Some companies marketing coconut products over-simplify what is a very complex topic. They assert that medium-chain length saturated fatty acids (MCTs) in coconut oil can actively protect heart health.

However, while some studies suggest some MCTs in isolation might have benefits, coconut oil contains a mix of fatty acids. Focusing on any benefits of a few MCTs while ignoring the detriments of the other fatty acids is at the least misleading and at worst very damaging for consumer health.

Saturated fats – a complex story

There are over 30 different types of saturated fatty acids. While there’s good evidence that some will have little, if any, effect on cholesterol, three in particular have been proven beyond a doubt to elevate cholesterol levels and are all contained in coconut oil in high amounts.

  • Lauric acid, an MCT, makes up 14% of coconut oil (and is also found in palm kernel oil and cow’s and goat’s milk).
  • Myristic acid, a long chain fatty acid (LCT), makes up 20% of coconut oil, and is in palm kernel oil and butter.
  • Palmitic acid, an LCT, is found mainly in palm kernel oil, meat and full cream dairy milk and products, but also makes up 8% of coconut oil.

Clinical studies have consistently demonstrated that coconut oil increases total and LDL cholesterol – directly linked to higher cardiovascular disease risk. Despite some (not all) studies also demonstrating an increase in HDL (‘good’) cholesterol through the consumption of coconut oil, this is common with other saturated fats and does not negate the effect on LDL cholesterol.

Coconut products – putting statistics into context**
  • Highest of all are the coconut oils and coconut butter, which are higher in saturated fat than any other commonly eaten food. Most coconut oils contain just short of nearly 90% saturated fat, compared with butter at 52%. Just 1½ tablespoons will provide the entire recommended daily intake of saturated fat.
  • Four 100% natural coconut yogurt alternatives are currently on the market as ‘healthy alternatives’. Three of these provide between 17% and 20.5% saturated fat; the other a more modest 4.2% – which is still higher than full cream dairy yogurt. So an average 125g serving of three out of the four coconut yogurts will provide 21.3g to 25.6g saturated fat. That’s up to 128% of the maximum saturated fat daily recommendation. Other yogurt alternatives with coconut added to ingredients such as soya may not be high in saturated fat. It’s important to check the label.
  • Creamed coconut (the block sort added to dishes like curries) is on average 58% saturated fat (some almost 70% saturated fats), which is more than butter (52%) and lard (44%)
  • Canned coconut milk (made with coconut extract and water) averages 14.6% saturated fat, with reduced fat coconut milk weighing in at a somewhat lower 6.3% (three times greater than full cream dairy milk).
  • Desiccated coconut is over 50% saturated fat and crops up increasingly in energy balls and similar products.
  • Coconut drinks are not of concern in terms of saturated fat. On average a 200ml glass of coconut drink contains only 1.5g saturated fat (7.5% of the Reference Intake). Coconut water contains no saturates at all, or only a tiny trace.***

What needs to be done differently?

We think more responsibility is needed

Chefs, celebrities, manufacturers, retailers and the media all share a responsibility in how coconut products are positioned and portrayed. In some cases, there is a genuine ignorance and misunderstanding of the science, which could perhaps be addressed through more public health messaging.

HEART UK, the British Heart Foundation and Department of Health already advise that coconut oil should be consumed only in small quantities and the Change4Life website lists coconut oil within a category of foods labelled ‘leave these on the shelf!’

But these messages need more reinforcement. Manufacturers see that the market for coconut products is a lucrative one, so they are harder to influence. However, given that the majority of coconut products are excessively high in saturated fat (with the exception of waters and drinks), we believe that responsible manufacturers should position the products of concern as an indulgence rather than something that provides any health benefits.

The products should have clear nutrition labels, ideally using the traffic light system. Consumers should look out to see which are classified as high, medium or low, to help them cut down on their intake. The classifications are:
High: More than 5g saturates per 100g. May be colour-coded red.
Medium: Between 1.5g and 5g saturates per 100g. May be colour-coded amber.
Low: 1.5g saturates or less per 100g. May be colour-coded green.

*’Coconut oil’ and ‘coconut fat’ are synonymous. A fat is usually called an oil when it’s liquid at room temperature.
**U
sing data from Forestfield Software Ltd. Dietplan7 (2017)
***On-pack labelling of current leading brands on the market (October 2017)

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