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
by Tanya HAFFNER | Jun 13, 2017 | Media in context
The study
A recent publication in the American Journal of clinical nutrition presents the results of a study on the dietary intake of cow’s milk and non-cow’s milk beverages in children aged 24-72 months. The authors conclude that non-cow’s milk consumption is associated with lower childhood height.
http://ajcn.nutrition.org/content/early/2017/06/07/ajcn.117.156877.abstract
Our review
There are multiple issues with the methodology used in this study that cast doubt on the value of its results and conclusions.
• The paper compares 4,632 cow’s milk drinkers with 643 non-cow’s milk drinkers. However, within these two groups there are 397 children consuming both cow and non-cow’s milk, meaning that only 4.8% (246) children in the study consume only non-cow’s milk.
o Additionally, data from the children consuming both cow’s and non-cow’s beverages are included in both groups and therefore the data are counted twice in the analysis.
• Non-cow’s milk is defined as any other type of milk not based on cow’s milk and included both plant and animal beverages e.g. goat’s milk, alongside soya and nut beverages which all have very different nutritional values. Additionally, many plant-based beverages are now fortified with vitamins and minerals. The authors therefore are completely unware of the nutritional values of the non-cow’s milk beverages and for the plant-based varieties, whether or not they were fortified nor can they make any connection between the groups for the quality and quantity of protein.
• The authors did not take other dietary factors into account. They propose that one of the key reasons why cow’s milk is important for height is achieving adequate protein intakes. Yet, without a full dietary analysis, they cannot be aware which children met their protein requirements and which did not. There are also many other protein sources in young children’s diets.
• The authors only adjusted data for maternal height but not for paternal height. The height of both parents should have been taken into account.
• The only dietary intake collected was how many 250ml cups of cow’s milk or non-cow’s milk was consumed per day. This was undertaken by questionnaire, which may be subject to measurement error or recall bias.
• It is not known when the children started consuming the non-cow’s milk drinks, or why they were consuming non-cow’s milk, both of which could have a significant effect on the results observed.
• The authors also recognise a potential height measurement error given the young age of the children.
• Finally, it is a cross-sectional study, not designed to look for causal effect, and thus the simplistic conclusion that height is effected by milk type cannot be drawn.
Our key take outs
Overall, the study is misleading and no conclusions can be drawn except that it is important for parents to be educated on children’s nutrition. Parents of children wishing or needing to avoid cow’s milk should seek dietetic advice to ensure that suitable alternatives are used and the nutritional quality of their overall diet is balanced. There is no reason why a healthy child following a balanced diet should not include calcium and vitamin fortified plant-based beverages. Additionally, soya beverages are similar to cow’s milk for protein quality and quantity.
About Nutrilicious
At Nutrilicious we help to change the way people eat for better health and planet. We do this by helping organisations and health influencers including the media with nutrition and health advice and support. We love good science and credible creative news and headlines. We get a little upset however when they mislead or cause confusion.
Our nutrition professionals are either Registered Dietitians or Registered Nutritionists with at least a bachelor’s degree in dietetic or nutrition science and extensive experience in public health nutrition. They are bound by the Association for Nutrition and the British Dietetic Association respectively to continue professional development and follow standards of ethics, conduct and performance. This means you can be assured that our advice will always be up to date with the latest recommended guidance and practice.
by Tanya HAFFNER | Dec 6, 2016 | Legal issues, Media in context, The Nation’s Health
How much is the UK public willing to pay for sweetened soft drinks?
The draft Finance Bill 2017 was published on Monday, 5th December. Not normally associated with health and nutrition news, this year, the introduction of the soft drinks levy has definitely hit the newspaper headlines. Still awaiting the finer details, the draft does provide further insight and confirms the details announced during the 2016 budget announcement. Out for comment, it will be interesting to see how industry reacts with many of the big players already making huge reformulation changes to ensure the few of their products are taxable.
So what is in the draft Finance bill?
All soft drinks which contain 5g or more of added sugars per 100ml will be in scope of the tax. This will also include alcoholic drinks of ABV up to 1.2%.
The exemptions:
• Smallest manufacturers and importers of the smallest producers abroad.
• Soft drinks containing less than 5g added sugars per 100ml or no added sugars drinks.
• Drinks classified as ‘Foods for Special Groups’ which includes baby foods and formulae.
• Sugar containing milk-based drinks with a minimum of 75ml of milk per 100ml.
• The new trend of plant-based milk alternatives is also exempt as long as they are a source of calcium.
• Alcohol substitute drinks.
Transition period until April 2018 – providing reformulation time for all industry.
The two sugar thresholds still remain:
Products with 5-8g added sugars will be taxed at a lower level than those providing 8g or more of added sugar per 100ml.
The exact tax level has yet to be defined, but according to the Guardian Monday 5 December headlines, the levy would increase the cost of a 1L bottle of soft drink containing 5g sugar per 100ml by 18p and those containing 8g and more of sugar per 100ml by 24p.
Policy objective is to reduce childhood obesity through the reduction of total calories by removing additionally calories consumed via added sugars within soft drinks. It hopes to raise in excess of £500 million in the first year which they have promised to invest in physical activity for children.
The government wants to encourage industry to reduce sugar levels by:
• Reformulation
• Reduction in portion size
• Import of lower sugars / reformulated drinks
Economic impact (Estimated by the Office for Budget Responsibility). Based on estimates made in 2016:
The levy will add a quarter of a percentage point to CPI growth in 2018 and 2019.
Health impact.
It is believed that the health of the nation will be significantly improved especially with a reduction of obesity related diseases e.g. diabetes type 2.
The main reason for the sugar focus is that it is seen as additional excess calories.
Impact on industry.
The government believes that 300 UK producers will need to register for the levy and the impact on their business should be negligible. However, the Coca Cola representative’s view at the All Party Parliamentary Group on Adult & Childhood Obesity Meeting on the 5th December, had a different opinion stating that the average cost per reformulation was in the range of £½million and that smaller manufacturers would not be able to absorb this cost.
Operational impact (HMRC costs): there will be a one-off capital costs to develop the system for tax collection and on-going resources costs for HMRC to implement this change and monitor compliance.
An additional comment made by at the All Party Parliamentary Group on Adult & Childhood Obesity Meeting on the 5th December, was that the government had yet to demonstrate clearly if this sugar tax will have a significant impact on obesity.
by Tanya HAFFNER | Sep 9, 2016 | Hot Topics in nutrition, The Nation’s Health
The latest NDNS survey is out today! The new survey (Years 5 and 6 – 2012/13-2013/14) will be met with disappointment and possibly frustration by many public health campaigners.
The Brits have done little to improve their intakes of essential nutrients despite significant government and NGO campaigns. We’re still eating too much sugar and saturated fat and seem to be unable to increase our fruit and vegetable, fibre and essential vitamin and mineral intakes. On a positive, and there was only one positive, we are reducing our intakes of red and processed meats. And at least our diets have not got worse. But the question remains, with little dietary improvements over the last 10 years, what really needs to be done to help the nation change their eating behaviour and nudge them into a healthier and happier life?
- Brits still struggling to meet their 5-a-day with no improvements in consumption compared to previous years:
- Just 8% of children and less than a third (27%) adults achieving their 5-a-day.
- Children’s average intake is less than 3 portions per day, whilst adults are so close to the recommendations at 4 portions a day.
- Heart healthy omega-3 and much needed vitamin D intakes cannot be expected to improve with oil-rich fish consumption continuing to fall short of the recommended 140g per day.
- Brits are only managing 62% of the recommendations at a max of 87g per day.
- The message is getting through about red and processed meat with reductions in intakes from previous years. However, men need to make further improvements as their intakes are significantly higher than women’s and the maximum recommendations of no more than 70g per day of red meat and avoidance of processed meat.
- Could the sugar reduction public health campaigns be making some small inroads to reducing added sugar intakes in children?
- Let’s not get too excited, but 4-10 year olds have reduced their intakes by 1% compared to previous years (13.4% of total energy intake vs. 14.4%).
- Unfortunately, teens and adults continue on their sweet ways with intakes remaining unchanged at 15.2% and 12.3% contribution to total energy intakes.
- Intakes are a long way from meeting the SACN recommendations of no more than 5%! Is sugar tax really going to be the solution?
- The attack on sweetened soft drinks seems to have made an impact on 4-10 year old’s intakes with a 23% reduction in amount consumed daily compared to previous years (100g vs 130g respectively).
- Unfortunately, adults and teens refuse to be told what to do and continue to struggle with the sweet nectar!
- Could the misleading media headlines ‘butter is good for you’ be responsible for the population continuing to exceed saturated fat intake recommendations (11% of total energy intake) and in fact have higher intakes than previous years.
- The latest data shows saturated fat to contribute to 12.7% of total energy intake, whilst in previous years it has been at 12.3-12.5%. A major contributor to elevated ‘bad’ cholesterol which afflicts over half the adult population.
- Fibre – another new government dietary recommendation doomed for failure! Although less publicity has been given to fibre, the SACN carbohydrate report did not only make new recommendations on sugar intakes but also recommended a significant increase in fibre intakes to 30g AOAC (23g non-starch polysaccharides NSP).
- The nation continues to struggle to meet the previous recommendations of 18g NSP per day with adults making no improvements to previous years at 13-14g NSP intakes daily.
- It would be great to see a public campaign for us to eat MORE of something rather than to deprive ourselves!
- Is it time for mandatory vitamin D fortification? The survey found around a fifth of adults with low vitamin D status and with an average level of 42-48nnmol/L.
- Few have the optimal status as recommended by many vitamin D experts of 50-70nnmol/L.
- Fatigue and tiredness in teenage girls and young women could be explained by continued poor iron intakes, with almost half of teenage girls and over a quarter (27%) of young women having iron intake below the lower reference nutrient intake.
https://www.gov.uk/government/collections/national-diet-and-nutrition-survey
by Tanya HAFFNER | Jun 12, 2016 | Hot Topics in nutrition, Thoughts, Media in context
The latest headlines have been fueled by the ill-advised national obesity forum publication ‘Eat fat, cut the carbs and avoid Snacking to reverse obesity and type 2 diabetes” (23rd May) and the findings from diabetes.co.uk survey of its 80,000 diabetic patients undertaking a 10-week low carb programme (31st May).
It is always important to challenge current thinking and explore new research. It is however, highly irresponsible to debate current thinking using studies that have already been discredited for methodological flaws. Add to which, in our opinion, it’s also unhelpful and damaging to design and direct a debate around controversial research findings for the consumer arena. Unless of course, we expect consumers to be totally adept at interpreting research findings into context of public health and able to fully understand and critique statistics and methodologies. This is unlikely when we consider that not all expert health professionals are able to correctly interpret research data into context nor have the skills to grasp appropriate selection criteria, dietary methodologies and limitations of study findings.
Low saturated fat debate – based on the same bad science
It was very disappointing to see the NOF cite the same studies that have been discredited in the past for methodological flaws and study selection bias. Their conclusions that lowering saturated fat intakes has no correlation to cholesterol levels or CVD outcome does not only go against the totality of scientific evidence but demonstrates their experts lack of knowledge in the critiquing of published data. Obvious factors such as the presence of trans fats from polyunsaturated margarines, the overall macronutrient profile of diets and which macronutrient replaced saturated fat reductions in the intervention groups were completely ignored in the studies cited by the NOF. These are very basic and undisputed factors that impact on CVD and serum cholesterol outcomes. An excellent explanation has been published by Dr Nita Forouhi from the University of Cambridge and covered by Prof. Bruce Griffin from University of Surrey during the Alpro Foundation symposium in March this year.
The totality of evidence points to:
• We should be talking about foods and diet and not individual nutrients.
o I.e. saturated fat sources from dairy do not adversely affect serum cholesterol levels compared to saturated fat from processed meat. Therefore, advice to consumers should be to eat less processed meats and not to eat less saturated fats.
• Lowering saturated fat intakes is important for reducing serum cholesterol levels, however, it isn’t enough. Which macronutrient replaces the saturated fat energy is important with polyunsaturated fats proving most effective whilst refined carbohydrates will show no benefit and in some cases negative effect.
• Whole diet approach should be encouraged where higher soluble fibre wholegrains, beans and peas, fruit and veg, oil rich fish and lean proteins are encouraged. It is the nutritional profile of the whole diet that will impact on CVD outcomes.
• Meta-analysis are not full proof and their conclusions should never be taken at face value. It is important to have a full understanding of the selection criteria used and potential contraindications that have been missed.
Low carbohydrate diets and type 2 diabetes
This has been fuelled by the patient led forum at diabetes.co.uk where it encourages its subscribers (over 120,000 patients with diabetes) to embark on a low carb 10-week programme. This has been championed by Dr Unwin, a GP from Southampton, who was frustrated at the lack of weight loss and poor glycaemic control of his type 2 DM patients following traditional dietary advice. He embarked on prescribing the low carb diet and has found that his patients are sticking to the dietary regimen, losing weight and significantly improving their HbA1c readings with significant financial savings to his practice. He has published two papers, one with 19 subjects and the other based on a case study. The low carb diet recommends anything from 0-130g of carbohydrates a day – normally no more than 100g – and a higher vegetable intake with lower fruit intake. To put it into context, 100g carbohydrate equates to 5 thick slices bread, 4½ medium bananas, 4 small servings (30g) of cornflakes OR 1¾ medium jacket potatoes. Carbohydrate calories are replaced, in the main, by unsaturated fats but also from proteins. Studies published on the success of this regimen are often small in number and over a short period of approx. 3 months. However, they are promising and seem to support the high protein satiety theory and better compliance to dietary restrictions. Ultimately, individuals on these regimens do consume significantly fewer calories. Although this dietary regimen can be successful for some patients, so have other regimens been proven to be as successful including higher wholegrain and low fat diets.
The primary goal for type 2 diabetes is weight loss to help optimise glucose control, therefore, dietary regimens should be matched to the individual patient’s needs. Different approaches will work for different individuals.
by Nutrilicious | Apr 25, 2016 | Food category comment
The growing trend for breakfasting on-the-go and at out of home establishments has been threatening breakfast cereal’s number one spot1. As well as a need for more convenience, breakfast cereals have been hit hard by the recent negative headlines with regard to their sugar content. But are the latest trends going to help improve or will they fuel the obesity epidemic?
What do the Brits fancy for breakfast?
Many surveys claim that up to 42% of us (and almost a quarter of school children) do not always have breakfast, stating time constraints are a major factor2,3. Kantar’s data however shows that only 7.7% of breakfast occasions were actually missed last year. This significant difference could be explained by the growing trend of eating ‘on-the-go’ or away from home which has grown by 10%4.
The UK seems to be slow to change its breakfast habits with the majority of breakfast occasions (84%) still taking place at home and breakfast cereals, toast and porridge remaining top favourites during the week whilst cooked breakfast continues to be popular at weekends2. The growing trend is for eating at catering establishments and portable on-the-go offerings with perceived health credentials such as breakfast biscuits, porridge pots and fruit and nut category, the latter seeing a 21.5% increase in 20152.
Breakfast cereals: UK’s no.1 choice with wholegrain cereals chosen by 37% of us during the week and still claiming over half the share of the market5,6. Many breakfast cereals have now significantly reduced their sugar levels, more ‘no-added-sugar’ variants are gaining shelf-space whilst a few indulgent variants still remain. According the to the latest National Diet and Nutrition Survey (NDNS), breakfast cereals account for just 5% of the added sugar intakes of adults and 6-8% of 4-10 year olds and teens.7 On the other hand, breakfast cereals (especially those that are fortified) do make a significant contribution to key vitamin and mineral intakes:
- B vitamins, in particular B1, B6 and folate.
6-9% of our vitamin D intake – vitamin D status is a growing concern in the UK6.
- Iron: 46% of teenage girls, and almost a quarter of women consume below the low reference nutrient intake (LRNI), which places them at high risk of deficiency. Cereals are a major source of iron contributing to 17% of teens, 23% of 4-10 year olds and 12% of adult intakes.
- Calcium: mainly due to the addition of milk but a handful are also fortified. Almost a fifth of teenage girls do not meet their LRNI placing them at higher osteoporosis risk in later life.
Looks like a hard act to follow, so how do other breakfast choices match up?
Porridge: Oats are making a come-back with 27% of us likely to make this choice in a week5. Porridge oats get a nutritional gold star from us, as they provide the gel-like fibre, beta-glucan, which has been proven to lower cholesterol levels – and boy almost 60% of us need to lower our cholesterol.8,9 However, how we serve them up is critical – piling on the sugar (even demerara sugar), drizzling with honey or syrup and making it with full cream milk converts this saint to a sinner. The porridge revival could be partly explained by the growing ‘on-the-go’ varieties which are now purchased by 9% of consumers4.
Toast continues to be popular for 32% of people during the week5. White toast provides calcium (accounting for 13% of teenagers’ intakes) whilst wholemeal and seeded breads provide fibre which, is highly relevant considering the 2015 new increased UK fibre recommendations6,10. Clearly, what we add to our toast is central to the nutritional quality, nut butters and unsaturated fat spreads providing healthy heart fats, whilst chocolate spreads (yes…that includes the favourite hazelnut and chocolate spread) and preserves are taking us on a sugar high.
Eggs: we can’t seem to get enough of them. Almost 3,000 million eggs are eaten at breakfast every year with one in five of us opting for an eggy breakfast at least once a week11. Eggs, originally classified as a complete nutrient food, provide protein, vitamin D, iron, phosphorus, iodine and selenium. In addition, it is reassuring to know that all the UK heart and health advisory bodies do not limit egg consumption (as the cholesterol found in food does not have a significant effect on blood cholesterol in most people)12. A gold star from us, if boiled or poached, however, the Brits favourite is a fried egg… oops, too much fat.
The growing convenience breakfast trends
Convenience, portability and time-saving options which also provide exceptional nutrition credentials are now in demand. A third of us are eating breakfast away of home at least once a week and 15% of us do so every day according to a Beacon 2015 survey13. In addition, gluten-free and high-protein health claims are also gaining traction4.
Out of home establishments:
- Greggs and MacDonald’s have a booming breakfast trade, however, the majority of options seem to include sausages and / or cheese which is a recipe for a heart attack with the hefty dose of saturated fat and salt levels. Some of the breakfast options providing up to 80% of daily saturated fat and over ¾ of daily salt recommendations. On the positive note, porridge oats are making an entry, however, for consumers to pick out the handful of healthier options amongst the sea of unhealthy options will be difficult. We feel a better balance and better promotion of healthier options are needed.
- Coffee shops: Coffees and other drinks on offer can be high in saturated fat and sugar laden, however, the options are there to opt for lower fat milks and sugar-free syrups. The mainstream coffee shops have improved their ‘healthier’ breakfast options with porridge, fruit salads, fruit and nuts and yogurt with granola on offer. However, the low fibre, higher fat and calorie croissants and muffins continue to be more popular.
- Cooked breakfasts: This is still a popular weekend choice, but with a whopping 800-1,000 calories for a classic fry-up, it has to have a thumbs down from us. Or does it? Making a few requests when ordering can bring this fat and calorie laden classic into healthy repute: poached eggs, beans, grilled lean bacon rasher, mushrooms, tomatoes, one sausage and toast instead of fried bread could almost half the calories whilst still providing fibre, protein as well as essential vitamins and minerals.
On-the-go options
Breakfast drinks, breakfast biscuits and fruit and nut bars have become widely available, albeit at a higher unit cost. All are portion controlled, the breakfast drinks use skimmed milk as the main ingredient and most provide a range of vitamins and minerals – many matching the nutrition profile of breakfast cereals.
Breakfast biscuits: 19% of consumers are opting for breakfast biscuits over cereal bars4. Nutritionally, they mimic cereals from macro and most micronutrients. Calcium and protein levels from the milk added to cereal are clearly lacking in the biscuits, but the leading brand provides clear advice on paring up the biscuits with yogurt and / or fresh fruit / fruit juice. An excellent option in our point of view.
Breakfast drinks: Definitely a very small but growing market that has failed to take off in the past. The Australian number one brand is definitely leading on this category. Many utilise key health slogans such as protein, energy and fibre whilst omitting to highlight their less than impressively sugar content. Nutritionally, they seem to match up with for fat and protein, however, sugar content varies between 18g and 20g per serving compared to cereal at 0-11g per serving. Interestingly, protein content can be exceptionally high and calcium levels per serving are 2 – 3½ fold greater than for most cereals served with milk. This may be advantageous if it appeals to the 19% of teenage girls and 12% of young women who have calcium intakes below the low reference nutrient intakes. Nutrilicious opinion: get that sugar down.
New opportunities
Recent government advice has highlighted the need to cut sugar levels (free sugars to less than 5% total energy intake) and increase fibre intake (to 30g AOAC per day for teens and adults)10. Considering this advice it would seem beneficial for any new breakfast foods to be based on wholegrains and / or provide soluble fibres such as beta-glucans and inulin and to be limited in free sugars as much as possible. The vitamin and mineral fortification of breakfast cereals significantly contributes to the nation’s micronutrient status, thus any new options must ensure that these essential nutrients are not lacking<sup>6</sup>. With on-the-go eating and eating at out of home establishments becoming more popular, it is paramount that options lower in sugar dominate. Sugar is now the big enemy under scrutiny by government, health organisations and pressure groups such as Action on Sugar14. This also applies to porridge pots and cereal pots as not all are low sugar and/or high in fibre. To add to the challenges for innovation, the consumer continuous to demand a great taste as well as a healthy nutrition quality.
Conclusion
When comparing different options, it is clear that healthier options are available whether breakfasting at home, catering establishment, coffee shop or eating on the go. However, the new trends need to focus more on providing a better balance and promoting more of the healthier options. The porridge, fruit and nut, lower fat and sugar free options at catering establishments are a good start, but the likelihood of the consumer choosing these amongst the overwhelming selection of higher fat, salt and sugar options is questionable. Breakfast cereals do contribute significantly to vitamin and mineral intakes especially iron and calcium – and there is a risk for vulnerable groups to become deficient if they begin to move away from these.
With all the above in mind, there are many opportunities to develop new innovative ways to create tasty, convenient, nutritious breakfasts that allow for people on the go to eat a greater variety of foods to help meet their nutritional requirements. Whilst time may be limited for many in the morning, Variety is King in helping consumers achieve adequate nutrient intake.
References
- Financial Times Oct 3 (2014). Daneshkhu S: Cereal sales go soggy as breakfast shrinks. http://www.ft.com/cms/s/0/771a89b2-4af2-11e4-839a-00144feab7de.html#axzz3zVYhDqes
- Agriculture and Horticulture Development Board (AHDB) for Cereals & Oilseeds Market News: Cereals and bread still breakfast mainstays. 14 January 2016. http://cereals.ahdb.org.uk/markets/market-news/2016/january/14/prospects-cereals-and-bread-still-breakfast-mainstays.aspx
- British Nutrition Foundation. National Pupil and Teacher Survey 2015 UK Survey Results. https://www.nutrition.org.uk/attachments/article/846/UK%20Pupil%20and%20Teacher%20Survey%20Results%202015.pdf
- Grocer March Guide to Breakfast.
- Shake Up Your Wake Up, Fun Breakfast Facts (2015). http://www.shakeupyourwakeup.com/why-is-breakfast-important/our-breakfast-foods/fun-breakfast-facts
- Bates B et al (2014). National Diet and Nutrition Survey: results from Years 1 to 4 (combined) of the rolling programme for 2008 and 2009 to 2011 and 2012. Available at https://www.gov.uk/government/statistics/national-diet-and-nutrition-survey-results-from-years-1-to-4-combined-of-the-rolling-programme-for-2008-and-2009-to-2011-and-2012
- Scientific Advisory Committee on Nutrition 2015. Draft Vitamin D and Health report. Scientific consultation: 22 July to 23 September 2015. Available at https://www.gov.uk/government/consultations/consultation-on-draft-sacn-vitamin-d-and-health-report
- Heart UK (2016). The Power of Oat Beta Glucan. http://heartuk.org.uk/images/uploads/healthylivingpdfs/HUK_factsheet_F09_OatBetaGlucanF.pdf
- Townsend N, Bhatnagar P, Wilkins E, Wickramasinghe K, Rayner M (2015). Cardiovascular disease statistics, 2015. British Heart Foundation: London. Available at https://www.bhf.org.uk/publications/statistics/cvd-stats-2015
- Scientific Advisory Committee on Nutrition (2015). Carbohydrates and Health Report. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/445503/SACN_Carbohydrates_and_Health.pdf
- Egg Info (2016). Industry Data. https://www.egginfo.co.uk/egg-facts-and-figures/industry-information/data
- Gray J and Griffin B (2009). Eggs and dietary cholesterol – dispelling the myth. Nutr Bull 36,199-211
- Beacon. Brits’ breakfast habits a big boost for the economy as people spend £76 million every day on eating out for breakfast. Survey 2015. Available at http://www.digitalnewsroom.co.uk/beacon/brits-breakfast-habits-a-big-boost-for-the-economy/
- Action on Sugar (2015). Breakfast Cereals Survey 2015. http://www.actiononsalt.org.uk/actiononsugar/Press%20Release%20/146900.pdf
