by Tanya HAFFNER | Nov 19, 2017 | Hot Topics in nutrition, Media in context
HEADLINE: ‘Emotional toll of diabetes ‘needs more recognition’
Link: http://www.bbc.co.uk/news/health-41970161
Same story also reported by
http://www.huffingtonpost.co.uk/entry/three-in-five-diabetes-patients-struggles-with-emotional-or-mental-health-issues_uk_5a0aab98e4b00a6eece3cecc
Nutrilicious Dietetic Comments – Take Home Messages
This news article highlighted that many people with diabetes are suffering from related emotional issues. A survey from Diabetes UK (involving 8,500 people with diabetes) found that three out of five said their condition made them feel down. Only three in ten felt they had control of their condition. Dietitians, alongside other healthcare professionals have an important role to play in educating people with diabetes. When people are diagnosed with diabetes, thoughts around food choices are often present and can persist. As shown in the news article, one survey participant stated ‘I am constantly thinking about food.” Dietitians Nutritionists and all involved in food and health communications have a role in helping those with Diabetes to feel like that they can take control of their food choices and it not become a big burden on their daily life. For both type 1 and type 2 diabetes, education programmes are offered which can help people manage their condition better. Whilst improvements are in need in terms of access to specialist healthcare professionals and other areas, we should be reminded of the Diabetes UK Checklist for the 15 healthcare essentials that people with diabetes should receive (see below).
Where to find useful information on the topic
Diabetes UK, https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/15-healthcare-essentials
Diabetes UK, Emotional Wellbeing https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/emotional-issues
HEADLINE: Tofu IS linked to prostate cancer, study reveals – but experts stress men shouldn’t cut it out of their diets just yet
Link: http://www.dailymail.co.uk/health/article-5080501/Tofu-s-effect-prostate-cancer-unclear.html
Nutrilicious Dietetic Comments – Take Home Messages
The study behind this headline involved 27,004 men and they found an association between dietary intake of isoflavones and an elevated risk of advanced prostate cancer. A food frequency questionnaire was used to establish dietary intake of isoflavones from soya sources. It should be noted that this is an association found, not a cause and effect relationship and in terms of the totality of the evidence to date we cannot draw the conclusion that tofu causes prostate cancer. To the contrary the American Institute of Cancer Research in their latest review of soya and cancer mentions that in some cases, research indicates that soya isoflavones may in fact lower the risk of prostate cancer. Some studies suggest that lifelong soya consumption and exposure to isoflavones – especially before and during puberty – may protect against the development of prostate cancer. Prostate Cancer UK have spoken about this new research and stated that ‘much more research is needed to measure the actual intake of isoflavones in people with varied eating habits.’ It is very difficult to draw solid conclusions from trials trying to isolate the impact of a single food type when we eat such a varied diet. The take home message is that we do not need to be cutting tofu out from our diet based on this study; much more research is needed. Tofu is a nutritious food and can indeed form part of a healthy diet; it is low in saturated fat (1g per 100g) and offers a good source of protein (12g per 100g).
Where to find useful information on the topic
Prostate UK, Diet, physical activity and your risk of prostate cancer https://prostatecanceruk.org/media/750831/diet-and-your-risk-leaflet-ifm.pdf
BDA Food Facts, soya https://www.bda.uk.com/foodfacts/soya_and_health.pdf
HEADLINE: Drinking coffee may help prevent liver cancer, study suggests
Link: https://www.theguardian.com/science/2017/may/25/drinking-coffee-may-help-prevent-liver-cancer-study-suggests
Same story also reported by
Daily Mail, ‘Drinking three cups of coffee each day could save your life: Beverage slashes the risk of fatal liver diseases by 70%, reveals review’ http://www.dailymail.co.uk/health/article-5089827/Three-cups-coffee-day-slashes-risk-liver-cancer.html
The Sun, Drinking three to five cups of coffee a day reduces risk of liver cancer, experts say https://www.thesun.co.uk/news/4932817/drinking-three-to-five-cups-of-coffee-a-day-reduces-risk-of-liver-cancer-experts-say/
The Express, ‘Drinking coffee can cut the risk of cancer’ https://www.express.co.uk/life-style/health/880570/Coffee-cancer-cirrhosis-liver-disease-science-research
Nutrilicious Dietetic Comments – Take Home Messages
This headline was based on the analysis of 26 studies (involving more than 2.25 million participants), which concluded that people who drink more coffee, including decaffeinated (to a lesser extent), were less likely to get liver cancer. Compared with non-coffee drinkers, those who drank one cup a day had a 20% lower risk of developing the most common form of liver cancer. Those who consumed two cups a day had a 35% reduced risk and for those who drank five cups, the risk was halved. However, the researchers judged the quality of the evidence they found using the GRADE criteria and deemed it be ‘very low’. One reason for this is the lack of randomised controlled trials (considered to be the gold standard within research). In this study, it is hard to be certain whether it was the coffee causing the outcome or other non-controlled for factors. E.g. do the coffee drinkers tend to have a healthier lifestyle in other ways which may confound the results? Nevertheless, this is an interesting study and moderate consumption of coffee is not a problem and can help towards our daily hydration needs. The EFSA advise that intakes up to 400mg of caffeine are safe for healthy adults in the general population. The exception lies with pregnant women who are advised to limit this to 200mg per day, the equivalent of two mugs of instant coffee.
NHS, pregnancy and caffeine https://www.nhs.uk/chq/pages/limit-caffeine-during-pregnancy.aspx?categoryid=54&subcategoryid=130
EFSA, Scientific opinion on the safety of caffeine http://onlinelibrary.wiley.com/doi/10.2903/j.efsa.2015.4102/epdf
by Tanya HAFFNER | Nov 15, 2017 | Legal issues, The Nation’s Health
Following a public consultation, strengthened rules controlling the advertisement of high fat, salt or sugar (HFSS) products to children came into force this summer. They’d been expected for a while and for many couldn’t come soon enough.
We think these rules can lead to a major reduction in the number of adverts for HFSS food and drinks seen by children. This will help in the fight against childhood obesity.
The new rules and their anticipated impact
The Committee of Advertising Practice (CAP) rules complement the existing Broadcast Committee of Advertising Practice (BCAP) rules. So what are the key points to note and what impact should they have on advertising HFSS products? Here’s a short rundown:
1. Age of a ‘child’ increased
A ‘child’ is now classified as anyone under 16, rather than under 12 as it was previously. Many of the rules apply to this wider age group.
Impact: A far greater number of young people will be protected from seeing the ads.
2. New restrictions based on audience
Adverts that promote an HFSS product, whether directly or indirectly (such as brand advertising using company logos or characters), cannot appear in children’s media or when children make up over 25 per cent of the audience.
Impact: The window of opportunity for advertising is more limited. It’s lovely to think that popular TV shows such as the X-Factor, which have a significant under-16 audience, will no longer be able to show adverts promoting products that are HFSS.
3. Celebrity endorsement prohibited for under-12 audience
Adverts for HFSS products that are likely to be seen as directly targeting under-12s cannot include promotions, licensed characters and celebrities popular with children.
Impact: Companies will no longer be able to use popular influencers such as footballers, Disney characters, etc. to help sell their products to children.
4. Reach extended, covering broadcast, print and online platforms
The rules now apply not just to broadcast media but also non-broadcast, such as print, cinema, digital and social media platforms.
Impact: Children are now protected across all platforms. The industry now has to factor in social media when it’s planning who and where to target its products.
5. Burden of proof shifted to advertisers
In order to determine whether a product is considered HFSS, advertisers must enter its nutritional content data into the Department of Health’s Nutrient Profiling Model. This model has been used to control TV advertising of food and drink products since January 2007.
Previously, all advertisers were required to submit a completed HFSS certificate to Clearcast before an advert could be aired on or around children’s programming. With the new rules, certificates do not need to be completed before an advert runs on non-broadcast media. However, as part of due diligence, businesses have an obligation to ensure they comply with the CAP code and hold the necessary documentation in-house.
If a complaint is made about an advert to the Advertising Standards Authority (ASA), measures will be taken to review it (which may involve a formal investigation) and non-compliant adverts will need amending or removing.
Impact: There’s a possible danger that as adverts are no longer pre-approved, more of them with inappropriate content will slip through the net – especially as the ASA admits it’s going to have a tough time enforcing the wider scope of application of its rules. However, the ASA will investigate any complaints seriously – even if it’s only one complaint against an advert. The complaint can come from anyone – likely to be competitors, pressure groups and parents. With the burden of responsibility for an appropriate ad more heavily weighing on the advertisers, we hope they will be careful to conduct their due diligence responsibly, to avoid costly amends or even the creation of a new campaign if they are forced to pull one.
Our overall assessment
The new CAP rules are very welcome. The wider remit, covering all platforms, presents both opportunities and challenges: the ASA will have its work cut out enforcing it. The more awareness there is amongst those interested in preventing HFSS products being advertised to children, the more likely it is that advertisers will be challenged if they flout the rules.
Change on the horizon for nutrient profiling
A decade has passed since the inception of the Department of Health’s HFSS nutrient profile. Nutrition science and dietary recommendations have moved on during that time – particularly in the area of sugar. The Government has announced its commitment to updating the nutrient profile as part of their Childhood Obesity Plan. So we expect that change is coming, which will mean companies will have to reevaluate their products and associated adverts.
Currently, products are scored on a points basis. You score negative points for elements that are damaging to health (sugar, saturated fat, salt, etc) and positive for those that are healthy (fibre, vitamins, etc). The benchmarks are going to change, in relation to total sugars and fibre levels. The amount of total sugars allowed will very likely be reduced (scoring proportionately more negative points) and you’ll probably have to have more fibre to score the positive points. Essentially, it will make it easier for products to be classified as HFSS.
Need help understanding or applying the rules?
The rules are complex, especially alongside European regulations that UK companies need to be aware of too. If you’re a food business affected by these new CAP rules, we can help support you in meeting your obligations. We’re also able to advise you on reformulation opportunities to improve nutrient profiling scores coming out of the HFSS categorisation, and to make sure your products are following the most up-to-date guidelines. We’d love to discuss your needs: email us today – email tanya@nutrilicious.co.uk
For more information visit the CAP website or download the Advertising Guidance: Identifying brand advertising that has effect of promoting HFSS product
by Tanya HAFFNER | Nov 12, 2017 | Media in context
Each week we analyse some of the hot headlines in health and nutrition news
HEADLINE 1: Could sugary diets fuel Alzheimer’s disease? Scientists discover link between high levels of glucose in the brain and memory loss symptoms
The story linking sugar to Alzheimer’s disease was reported in The Daily Mail, The Sun, The Express and Hello Magazine
Behind the headlines: the Nutrilicious dietetic view
This news was headline-grabbing indeed, with all the stories suggesting that diets high in sugar could be linked to Alzheimer’s disease.
The story is based on a study finding that there were significant abnormalities in glucose breakdown in patients with Alzheimer’s – resulting in high levels of brain glucose.
However, the actual reasons for these abnormalities remain unclear and cannot be drawn from this study. The study is still at an early stage and more research is needed to investigate whether genetic or perhaps environmental factors are the cause of such abnormalities. The headlines may lead people to think that high sugar diets cause Alzheimer’s. However, the study did not directly test this and no causal relationship can be assumed at all.
Nevertheless, as part of a healthy diet, sugar should be limited. SACN advise that less than 5% of daily energy should come from free sugars (which amounts to 30g per day for an average person over 11 years).
Where to find useful information on the topic
BDA Food Facts, Sugar
Alzheimer’s Society, Risk factors and Prevention
HEADLINE 2: Arthritis: Following THIS diet could help stave off the crippling condition
SWITCHING to a superfoods diet can help fight rheumatoid arthritis, research has found
The story in the Daily Express was also reported by:
NDTV: Scientists reveal the diet and superfoods that can beat arthritis
Daily Mail: Diet to beat arthritis
The Sun: Blueberries, ginger and olive oil offer pain relief to thousands of rheumatoid arthritis sufferers
Times Now: Rheumatoid arthritis: Indian scientists list foods that may help ease the condition
Behind the headlines: the Nutrilicious dietetic view
This headline is based on a list of ‘superfoods’ that has been produced following a review of journals publishing on the subject. The list of foods includes blueberries, olive oil, green tea, pomegranates, dried plums, ginger and more. Those who carried out the research also recommend avoiding meat and including probiotics.
Many studies seem to hit the headlines regarding so called ‘superfoods’ (a term for which there is no official definition). However, no single food can outweigh the impact of the rest of one’s diet and hence a whole diet approach is recommended.
What we know is that no single food can cure arthritis. Rather than following a list of ‘superfoods’ as this headline suggests, having a healthy balanced diet, Mediterranean style, with a variety of fruit and vegetables, whole grains, beans, fish and healthy fats would be advised.
The links given below discuss in more detail key aspects of a healthy diet for arthritis, the role of vegetarian diets and the potential role of supplements for the condition:
Arthritis UK, Diet and Arthritis
BDA Food Facts, Diet and Rheumatoid Arthritis
HEADLINE 3: Cheers! Red wine cuts diabetes risk in women: Moderate drinking found to reduce chance of the disease by 27%
The story in The Daily Mail was also reported by:
The Express: Type 2 diabetes symptoms: Drinking RED WINE could help LOWER risk of condition
Health Spectator: Drinking tea and red wine reduces type 2 diabetes risk
Behind the headlines: the Nutrilicious dietetic view
This study looked into the eating habits of women aged between 40 and 65 years old. Through a food questionnaire it concluded that a diet rich in antioxidants (foods including red wine, dark chocolate, tea, fruits, nuts and vegetables) will reduce the risk of type 2 diabetes by 27%.
From this type of research, it cannot be proven that a diet rich in antioxidants, or as the headlines specifically say drinking red wine, reduces diabetes risk; it is an association found and more studies are needed. Food questionnaires, as used in this study, have questionable accuracy and the study can only be applied to middle aged women. Whilst many of the foods listed in this study such as fruit and vegetables play an important part in the diet, alcohol can have detrimental effects to our health and should be limited (no more than 14 units per week).
Looking at the bigger picture, it is interesting to note that the WCRF recommend for reducing cancer risk as much as possible, we should not be drinking alcohol at all. For type 2 diabetes prevention, the most important lifestyle factors are to maintain a healthy weight, eat a balanced diet and be active.
For more information, go to:
NHS, Drinking and Alcohol
WCRF Alcohol and Cancer Risk
Diabetes UK, Preventing Type 2 Diabetes
by Tanya HAFFNER | Oct 20, 2017 | Hot Topics in nutrition, The Nation’s Health, Surveys and insights
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.
**Using data from Forestfield Software Ltd. Dietplan7 (2017)
***On-pack labelling of current leading brands on the market (October 2017)
by Tanya HAFFNER | Jun 19, 2017 | Hot Topics in nutrition, Healthcare
A new policy paper from the European Public Health Association (EUPHA) calls upon all European States to establish a statutory Sustainable Nutrition Task force to drive better integration of nutrition and sustainability food issues. This follows a report from the Food and Agriculture Organisation and the Food Climate Research Network in 2016, Plates, Pyramids, Planet that found very limited integration of these issues thus far, in the development of food-based dietary guidelines.
As an umbrella group for over 70 public health associations and institutions across Europe, EUPHA are calling upon public health professionals to advocate for healthy diets that are also sustainable in a wider sense – incorporating the three pillars of economy, society and environment.
This new paper from the leading Not-For-Profit public health group in Europe adds further weight and drives momentum towards sustainable nutrition, which is already high on the global political agenda – recently reflected in the 2030 Agenda for Sustainable Development resolution, accepted by the UN General Assembly in 2015.
Sustainable Diets
The report defines sustainable diets as those that “diets are nutritionally adequate, safe, and healthy, while having low environmental impact. They are also culturally acceptable, accessible, equitable, economically fair and affordable, contributing to food and nutrition security and to healthy lifestyles for present and future generations”.
In a practical sense this means a shift towards more plant-based diets and a concomitant reduction in the consumption of animal-origin foods. As well as the avoidance of processed foods with added fats (particularly saturated and trans fats), sugar and salt.
Sustainable Nutrition Taskforce
To achieve their policy aim, EUPHA would like to see the establishment of Sustainable Nutrition Taskforces with national agendas to reframe policies, strategies and implementation programmes towards sustainable diets, away from the current food system, which is described as “low cost food at high cost to the environment”.
EUPHA prefers that through appropriate regulation, “the food industry would be required to produce healthy, nutritious (minimally processed) foods in a sustainable manner, which contain low contents of sugars, salt and additives that could adversely affect health; production and marketing should be honest and transparent, with consumer-friendly food labelling, and with restrictions on the marketing of junk food and sweet beverages, especially to children”.
Key Take Outs
– Sustainable nutrition is moving ever-further up the global political and policy agendas
– Expect to see more alignment of the dual issues of nutrition and sustainability in Government dietary guidelines, policies and programmes
– Food businesses should be actively reviewing their product portfolios and marketing strategies to align with the core tenets of sustainable nutrition
EUPHA’s report – Healthy and Sustainable Diets for European Countries is available here: https://eupha.org/repository/advocacy/EUPHA_report_on_healthy_and_sustainable_diets_20-05-2017.pdf
