by Tanya HAFFNER | Nov 12, 2018 | Changing mindset, Impactful health initiatives
The facts are now mounting that our food choices not only impact our health but are also fast depleting the planet’s resources.
Taking into account every stage from production, distribution and delivery through to waste, we see the sizeable impact our food choices have on the environment. What we eat:
- Contributes 20-30% of total greenhouse gas (GHG) emissions
- Is the leading cause of deforestation, biodiversity loss and soil and water pollution
- Accounts for 70% of all human water use
- Is responsible for global inequality: current food production is adequate to meet the needs of the global population of 7 billion, however, 2 billion exceed their needs whilst 800 million suffer hunger
Additionally, 30–50% of all food produced is spoiled or wasted.
If we’re going to save our planet, we need to change the way we eat.
Choosing a sustainable diet
For the first time, the UK government’s most recent Eatwell Guide acknowledged the importance of eating to help sustain the planet, as well as for health.
It was modelled to ensure that all macro and micronutrient needs of people aged 5 and over are met, while the nation’s carbon footprint is reduced by almost one third.
- Supporting our planet
The Eatwell Guide recommends that 80% of food we consume should be of plant origin: the focus is on reducing meat – especially beef – and dairy, which have the most impact on the world’s resources.
– Livestock production is by far the most significant contributor to GHG emissions (methane, carbon dioxide and nitrous oxide) contributing to 14.5% of all GHG emissions.
– Cattle consume 40% of all grains produced. Over one third of arable land is dedicated to growing grains solely for animal feed production.
– Livestock is the main cause for deforestation, biodiversity loss, degradation and water pollution.
- Improving our health
The benefits come not only to the planet but also our health. As we discussed in our blog on the popularity of vegetarian and vegan diets, it is well established that diets higher in plant foods and lower in meat products result in a lower intake of both energy (calories) and saturated fat, while increasing fibre intake.
Those with a plant-based diet suffer significantly less from diseases such as obesity, type 2 diabetes, cancer and heart disease.
The barriers to change
With only 1% of the population adhering to the previous (and less plant-based) Eatwell plate, how can we now expect people to adopt a more environmentally-friendly diet?
The British Dietetic Association is committed to bringing sustainable diets to the top of the dietetic agenda. They’ve put together a new toolkit providing both scientific knowledge and the practical tools to empower dietitians and consumers to adopt a diet focussed on sustainability.
The advice follows extensive research into the science of sustainable eating and top barriers and motivators. These were identified as:
- Lack of practical knowledge and resources
- Perceptions that sustainable healthy eating requires more time, more money and taste has to be compromised.
- What’s on offer from retailers, restaurants, take-aways, etc. – with an imbalance toward unhealthy, plant-based foods versus health and affordable plant foods?
- Language needing to be tailored to the audience depending on culture, age group, socio-economic and education status
- Clarity over messaging, for example on fish and processed foods
- The misconception of sustainable only associated with vegetarian/vegan diets, and of them being nutritionally inadequate
Sound familiar? Have you been able to overcome the barriers and use successful motivators to increase your own sustainable eating, or that of a client?
Be first to benefit from the BDA’s Sustainable Diet toolkit
We are giving an exclusive preview of the toolkit along with an overview of the latest science on the upcoming FREE CPD NutriWebinar on Sustainable Diets, 14 November 8 to 9pm.
The toolkit will be formally launched at Food Matters Live on 20 November. Find out more and register now
by Tanya HAFFNER | Oct 23, 2018 | Workplace
Over the past few years, the issue of mental health has been increasingly in the spotlight. An estimated one in six people in the UK suffer from mental health issues. With research showing that food affects your mood as much as it does your physical health, what can we do to help people appreciate the link?– especially in the workplace where employees spend an estimated 1/3 of their lives and may not be able to eat well.
Link between nutrition and mental health
As highlighted in an article in the Guardian, ‘Eating junk food raises risk of depression’, the Journal of Molecular Psychiatry recently published findings from researchers in Britain, Spain and Australia who analysed 41 studies linking diet and depression.
They found that foods that are high in sugar, fat and processed foods cause inflammation not just in the gut but also the whole body, known as ‘systemic inflammation’. This can directly increase the risk for depression.
The findings support the recommendations offered by Public Health England, The Association of UK Dietitians (BDA) and mental health charity MIND, who all offer excellent information and advice about the links between eating well and mental health.
Food for good mood
The BDA outlines the types of foods that can promote better mental health in their ‘Depression and Diet’ fact sheet. Their advice includes:
– Eat regular meals to give your brain a steady supply of glucose
– Get the right balance of fats to keep your brain well nourished
– Choose more wholegrains, fruit and vegetables: They are rich in vitamins and minerals; digest slowly so control glucose supply to your brain and are rich in B vitamins and zinc, which recent evidence show are important in managing depression
– Include some protein at every meal: Protein helps to keep you feel full and therefore can prevent overeating. Tryptophan is also one of the building blocks of protein, which research shows may help with depression.
– Include oily fish: Researchers believe that two to three portions per week can help fight depression
– Drink enough fluid: A healthy brain contains up to 78% water and evidence shows that even slight dehydration may affect your mood. It’s important to drink 6-8 glasses of non-caffeinated drinks per day
MIND’s information support and ‘How to manage your mood with food’ short video also reminds us to try to avoid foods which make your blood sugar rise and fall rapidly, such as sweets, biscuits, sugary drinks and alcohol.
Positive action in the workplace
Despite the evidence, as Gillian Killiner RD points out in her blog The role of nutrition on mental health, “… diet still often remains a last resort when it comes to addressing ways to help improve or prevent the onset of mental health issues.”
The upcoming This Can Happen conference sets out to help companies who recognise that staff need support to deal with mental health issues affecting them, their colleagues or their families.
It was founded by Jonny Benjamin MBE and Neil Leybourn, the two strangers featured in Channel 4’s ‘Strangers on the bridge’ and passionate mental health campaigners after Neil talked Jonny out of taking his own life.
We’re attending to speak to attendees about helping staff to improve their diet alongside other ways to improve mental health. We’re interested to find out what – if anything – they do already, and to encourage sharing of best practice.
Do companies have policies and guidelines for healthy eating?
Do they provide healthy food and drinks to their staff?
Does the company environment nudge their employees towards eating well, or do they in fact nudge them towards an unhealthy way of eating?
Is nutrition included in any mental health advice they may provide? How can we help to make sure it is?
As mental health becomes tackled in an evermore-thorough way, we’re keen to explore these questions and ensure that wherever possible eating and drinking well are considered key components when addressing the topic.
by Tanya HAFFNER | Oct 8, 2018 | Hot Topics in nutrition, The Nation’s Health, Changing mindset
The most recent government guidelines on fibre intake recommend 30g per day for adults. Levels are currently at just 20g per day for adult men and 17.1g per day for women – that’s an average 68% increase in intake needed to meet recommendations.
And it’s not just adults: there’s a significant disparity between recommended and actual fibre intake across all age groups.
So why is fibre so important? And what can we do to help people meet the recommended intake levels?
Here’s a quick overview. To explore the topic in more detail, join our upcoming Fibre NutriWebinar, on Wednesday 7 November.
The benefits of fibre
Dietary fibre has long been recognised for its health benefits. But it’s only in recent years that our understanding and appreciation of it has significantly progressed.
Fibre’s health effects mainly result from two key factors – its physical properties (eg stool bulking, viscosity, binding ability) and its effect on the gut microbiota and luminal environment.
Amongst its many beneficial properties, clinical trials have proven that fibre:
- Decreases blood pressure
- Increases satiation
- Decreases glucose absorption
- Increases bacterial a faecal mass (commonly associated with health benefits including reduced risk of colon cancer)
- Exerts benefits through gut microbiota
Where are we getting our fibre from?
The main sources of fibre in the UK are cereals, vegetable and potatoes, contributing to 70% of total intake.
Interestingly, white bread and potato products prepared with fat (eg chips and crisps) are significant contributors. This is despite the fact that they have comparatively low fibre content, showing that consumption is high.
One of our challenges is to educate the public on healthier fibre sources – fruit, vegetables, whole grains and pulses, rather than broad recommendations on increasing cereals.
Understanding and helping consumers
We know that despite the convincing body of evidence for the role of dietary fibre in many chronic conditions, translating and achieving fibre recommendations in practice can be challenging.
Understanding the key barriers faced by the public and putting forward strategies to overcome these is key to facilitating better health for all.
Find out more about the FREE Fibre NutriWebinar with Dr Megan Rossi, RD and register now.
It’s one of our ongoing NutriWebinar series examining key nutrition topics with experts in the field.
by Tanya HAFFNER | Sep 12, 2018 | Hot Topics in nutrition, The Nation’s Health, Education, Changing mindset
The government recently announced new measures to halve rates of childhood obesity by 2030 and significantly reduce the health inequalities that persist – closing the gap in obesity rates between children from the most and least deprived areas.
This proposal builds upon the first chapter of the Childhood Obesity Plan, which was widely criticised at the time as lacking the breadth and depth of initiatives needed to effectively tackle such a widespread and entrenched issue.
Steve Brine, Public Health Minister has stated: “One in three children are now overweight or obese by the time they leave primary school. Overconsumption, combined with reduced activity, is having a catastrophic effect on our children’s health. As both a parent and minister, I am committed to driving today’s pledge of halving obesity over the next 12 years with bold new action.”
“Our updated plan will put parents in charge, providing more information and support. Our aim is to help families make healthier choices, which will in turn provide a better chance at a longer, healthier life for our children.”
Obesity – A systems issue
The financial burden of obesity is too great to ignore: it’s estimated that the NHS in England spent £6.1 billion on overweight and obesity-related ill-health in 2017/18, which, to put into context is more than was spent on the police, fire service and judicial system combined. The wider costs to society of these conditions are around £27 billion a year, if not higher.
Ever since the Foresight report was published over a decade ago, it has been recognised that obesity is a systems issue and one that therefore requires reform at many points, to deliver change. This idea and the fact that no plan to date has sought to address childhood obesity in a multi-sector way, was reiterated in the recent inquiry by the parliamentary Health and Social Care Committee into childhood obesity. Childhood Obesity: Time for Action argued for a change in narrative, making clear that obesity is everyone’s business and “an effective childhood obesity plan demands a holistic, joined-up, ‘whole systems’ approach with clear and effective leadership”.
How does the Childhood Obesity Strategy measure up?
This update to the Childhood Obesity Strategy is a welcome step forward. It contains a raft of proposed measures that seek to tackle the issue using a co-ordinated range of policy levers. What is also good to see is that this new plan takes a firm but fair approach in how it will deliver change: using voluntary measures in the first instance but being clear that a harder tact with the likes of regulatory and fiscal measures will be considered where progress is deemed insufficient, or where a level playing field is required.
Here at Nutrilicious, we’ve taken a closer look at what’s in store and benchmarked the new childhood obesity plan against the World Cancer Research Fund’s NOURISHING framework, as well as the recommendations from the Health and Social Care Committee’s report mentioned earlier.
The NOURISHING framework
The NOURISHING Framework sets out that policies are needed within three core areas to improve diets: the food environment, food system and behaviour change communication.
N – Nutrition label standards and regulations on the use of claims and implied claims on food
O – Offer healthy food and set standards in public institutions and other specific settings
U – Use economic tools to address food affordability and purchase incentives
R – Restrict food advertising and other forms of commercial promotion
I – Improve nutritional quality of the whole food supply
S – Set incentives and rules to create a healthy retail and food service environment
H – Harness food supply chain and actions across sectors to ensure coherence with health
I – Inform people about food and nutrition through public awareness
N – Nutrition advice and counselling in health care settings
G – Give nutrition education and skills
Bearing in mind that some policies and actions targeting childhood obesity were in place prior to this strategy update, overlaying the new measures show how broad their impact alone intends to be:
| New measures |
N |
O |
U |
R |
I |
S |
H |
I |
N |
G |
Nutrilicious notes |
| Improved food labelling to display ‘world-leading, simple nutritional information’ as well as information on origin and welfare standards following Brexit |
X |
|
|
|
|
|
|
|
|
|
|
| Strengthen School Food Standards to reduce sugar consumption |
|
X |
|
|
|
|
X |
|
|
|
We would like to see these universally applied and close the loophole that exists for some academies |
| Strengthen Government Buying Standards for Food and Catering Services* |
|
X |
|
|
|
|
X |
|
|
|
|
| Ban price promotions such as buy one get one free, multibuys or unlimited refills of unhealthy foods and drinks in the retail and out of home sector* |
|
|
|
|
|
X |
|
|
|
|
It is good to see a mandatory approach applied here, as this is what is undoubtedly needed when policies will impact businesses’ bottom line. |
| Ban the sale of energy drinks to children* |
|
|
|
|
|
X |
|
|
|
|
|
| Ban promotion of unhealthy food and drink by location e.g. positioning – checkouts, end of aisles and store entrances, in retail and out of home sector* |
|
|
|
|
|
X |
|
|
|
|
|
| Introduce a 9pm watershed on unhealthy food and drink advertising and similar protection online* |
|
|
|
X |
|
|
|
|
|
|
We would like to see similar controls applied to sports advertising |
| Review governance arrangements for advertising rules (currently overseen by the Committee of Advertising Practice and Advertising Standards Authority) |
|
|
|
X |
|
|
|
|
|
|
|
| Potentially bring ‘sugary milk drinks’ into the soft drinks levy if insufficient action on sugar reduction takes place |
|
|
X |
|
X |
|
|
|
|
|
|
| Introduce mandatory calorie labelling for out of home sector in England* |
X |
|
|
|
|
X |
|
|
|
|
|
| Sugar reduction plan for products aimed exclusively at babies and young children due in 2019* |
|
|
|
|
X |
|
|
|
|
|
|
| Calorie reduction plan due mid-2019* |
|
|
|
|
X |
|
|
|
|
|
|
| Develop trailblazer programme with local authority partners to highlight what can be done within existing powers |
|
|
|
|
|
X |
|
|
|
|
We would like to see greater powers for local authorities and health services |
| Develop plan to use Healthy Start vouchers to provide additional support to children from lower income families* |
|
|
X |
|
|
|
|
|
|
|
|
| Ofsted will review school curriculum to understand how it can better support healthy behaviours, including food choices |
|
|
|
|
|
|
X |
|
|
X |
We would like to see improved early years education for parents to support a healthy first 1000 days and compulsory home economics with healthy cooking skills at the core in both primary and secondary schools |
*Proposal for further consultation
Is it enough?
While we applaud this latest round of the childhood obesity plan, we would also draw attention to the fact that there is still some way to go.
By mapping the proposed policy options against the NOURISHING framework, we can see that in this latest iteration of the plan much more focus has been given to shaping an environment that enables and supports healthier choices, which is great to see.
However, what is noticeably absent is the ‘I’ in terms of improving food and health literacy of the population. In a ‘post truth’ world where consumers are increasingly sceptical of messages coming from the scientific community, and when social media influencers are capturing the hearts and minds of the masses with questionable dietary advice, never has it been more important to provide clear, simple and authoritative information and advice. As such, we’d like to the see the government step-up their efforts on social marketing and educational campaigns.
What is more, a number of recommendations made in the Health and Social Care Committee are notably absent, including:
- Establishing a Cabinet-level committee to review the implementation of the plan, ensuring it gets the high-level traction it requires
- Proposing further measures around early years and the first 1,000 days of life, including targets to improve rates of breastfeeding
- Banning the advertising and promotion of follow-on formula milk
- Providing local authorities with further powers to limit unhealthy food and drink advertising near schools (the only powers available to local authorities extend to the positioning of the billboards themselves, not the content of the advertising)
- Introducing services for children living with obesity
Finally, while this plan is overtly focussed on limiting unhealthy foods and drinks and making processed, packaged foods a little better through reformulation (lower in salt etc), we would also like to see equal attention given to measures that work improve the quantity and quality of foods that we do want people to eat more of. Changing the dietary landscape will require strong efforts to provide families with the tools and knowledge to instil these healthier behaviours in a sustainable way.
The full plan for action can be viewed here:
https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action
by Tanya HAFFNER | Aug 10, 2018 | The Nation’s Health
The final ‘Feeding in the First Year of Life’ report published by the Scientific Advisory Committee on Nutrition (SACN) supports current government recommendations including breast is best, introduction of allergenic foods from six months and the importance of variety and textures.
Covering infant feeding from birth to 12 months, it provides its recommendations to government based on the best available evidence for the short- and long-term health outcomes for infants and mothers.
The one note of significant difference to existing advice is the recommendation that vitamin A supplements for infants should be discontinued. This will cause some inconvenience as most infant vitamin drops, which were developed on government advice, include vitamin A.
What is the SACN recommending to government?
- More strategies and support to help mums breast feed exclusively for the first six months of the infant’s life and to continue breast feeding alongside weaning for the first year.
- Where breast feeding is not possible, infant formulae based on either cows’ or the more recent goats’ milk are the only suitable alternative options. Soya-based formulae should only be introduced under medical advice.
- Only breast milk, formula or water as a drink should be offered between six and 12 months.
- Solids should be introduced from around six months of age, ‘having achieved developmental readiness’. The SACN found no evidence for the critical window of opportunity (four-six months) for increased acceptance of solids.
- Reducing risk of ‘fussy eaters’. Based on the evidence available, it is recommended that perseverance with repeated exposure of a variety of textures and flavours should be encouraged.
- Introduction of textures is critical for the development of munching and chewing. Textures should be introduced incrementally depending on the infant’s individual development rate.
- Baby-led weaning: due to too few studies, the SACN could not make any recommendations. However, it did make the point that the limited evidence to date is promising for earlier self-feeding and less food fussiness.
- All allergenic foods should be introduced from six months in small quantities and one at a time. This is of course for infants not at high risk of or diagnosed with an allergy. It is particularly important for peanuts and hen’s eggs, where the evidence is strong that delayed introduction increases the risk of allergy later in life. Additionally, nuts such as peanuts should not be given whole until the age of five years to prevent choking risk.
- Vitamin D intakes remain a concern for infants who are being breast fed or on less than 500ml formula daily. The SACN acknowledges the poor update of vitamin drops for babies but continues to emphasise the importance of encouraging breast feeding mums to use vitamin D supplements from birth.
- Iron continues to be an issue beyond six months of age and greater emphasis should be placed on the introduction of iron rich foods, rather than supplements, from the start of weaning.
- Vitamin A supplementation should no longer be encouraged as risk of deficiency is low and advises the government to review its current baby vitamin drop recommendations.
- Energy intakes remain too high and infant weights exceed standard weight charts. There is a need to better monitor overweight and obesity in infants.
- Salt and sugars intakes remain high in infants, with commercial baby foods, especially fruit purees, being the main contributors.
- Throughout the report, the SACN make no distinction in their advice between commercial or home-made complementary foods – could this be a sign that reality and practicality has been taken into consideration?
The Public Health England (PHE) sugar reduction programme for complementary foods will be far more controversial than the new SACN recommendations.
We have heard this week that PHE have just finished their scoping work for their sugar reduction programme of complementary foods for infants and are preparing for discussions with industry, NGOs and other interested parties.
Setting sugar reduction targets for this category will be challenging, to say the least.
- The complementary foods’ regulation, which PHE cannot over-ride, permits significantly high levels of sugars: up to 20g total sugars per 100g for ‘fruit only’ products and up to 25g per 100g for desserts and puddings.
- There are huge discrepancies between PHE’s classification of ‘free sugars’ and regulatory and labelling classifications of ‘added sugars’. Sugars naturally present in fruit and vegetable purees are classified as ‘free sugars’ by PHE but not as ‘added sugars’ by foods or labelling regulations.
- Some will argue that pureed formats of fruit and vegetable are essential as first foods, especially by those from the ever-exploding pouch market, and as such should be excluded from the ‘free sugars’ classification. However, there should be a strong opposition from health experts and very active pressure groups:
- There is a growing consensus that fruit and sweet tastes should no longer be recommended as first foods in order to reduce the infants’ continued preference for sweetness.
- Additionally, with the SACN’s affirmation that complementary feeding should start around six months, purees are no longer essential. At that age the infant is ready, and should be encouraged, to develop their munching and chewing skills which means the need for textures. Pureed food on the other hand only rely on an infant’s innate skills of sucking and swallowing.
Interesting times…let’s wait and see.
Complementary foods regulation update – will this rock the boat?
The updated version of the 2006 regulation on processed cereal-based foods and baby foods for infants and young children has yet to be published. The revised regulation was rejected last year for numerous reasons, including pesticide and sugar upper limits being too high.
The next version should be with us this year and it will be interesting to see how it aligns with the SACN’s and PHE’s recommendations – especially with regard to sugars and when solid foods should be introduced. Currently, the regulation (and the failed 2017 revision) permitted solid food introduction from four months.
Welcoming the findings
Only recently, the BBC reported the potential benefits of feeding solids as early as three months, which is likely to have caused confusion for parents.
So we’re pleased that this new SACN report helps to give support for the current advice in the UK: babies should ideally be exclusively breastfed for six months, and solid foods should be introduced after this. Or, as Dr Alison Tedstone, Chief Nutritionist at Public Health England (PHE) put it: “SACN’s robust advice puts to bed any arguments about a beneficial effect of early introduction of solid foods.”
We do however notice the very precise wording of ‘around six months’.
There is some concern amongst dietetic paediatric experts that setting a specific time for solid food introduction is unrealistic, may place some infants at risk and is an added pressure for mums on top of guilt faced by those who do not wish to or cannot breast feed.
The important factor is that solid foods should only be introduced when an infant is developmentally ready: when they can sit with minimal support and hold their head steady; can co-ordinate eyes, hands and mouth; and are able to reach out to pick up food and bring it to their mouth. Some infants may be ready before six months; a few may not be ready yet at that stage.
It’s important government advice should ensure mums understand that there is flexibility ‘around’ the six months.
Further advice on early feeding and breastfeeding
In the UK we have some of the lowest breastfeeding rates in the world, so it is important to provide help and support to mothers wishing to breastfeed. The NHS gives information about where to get help.
See also:
by Tanya HAFFNER | Aug 1, 2018 | Hot Topics in nutrition, The Nation’s Health, Surveys and insights
An extensive detailed analysis of the current scientific evidence into omega-3 seems to have thrown a spanner in the works for heart health dietary advice.
Conducted by Cochrane, the review concludes that there is no correlation between cardiovascular health and intakes of the long chain omega-3 fats eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) over a one- to six-year period.
Long chain omega-3 fats have long been associated with reductions in blood triglycerides, blood pressure and thrombosis; producing anti-inflammatory and anti-arrhythmia effects as well as improving endothelial function and insulin sensitivity.
This most recent publication will raise many eyebrows within the heart health professional arena and likely to be taken up by media editors who seem to enjoy questioning the trustworthiness of public health guidelines. These recommend a diet including omega-3, especially found in oil-rich fish such as salmon, tuna and mackerel.
So, do we need to change dietary guidelines on the importance of omega-3 and oil-rich fish?
Before we jump the gun, it’s important to put things into context:
1. The shortcomings of the review
a. The studies investigated in this review predominantly used omega-3 supplements. Thus the outcomes cannot be related to oil-rich fish consumption which is the main dietary source of EPA and DHA.
b. The studies were also of one to six years’ duration, which is a relatively short period to assess disease and mortality risk. And conclusions cannot be reached for a lifetime consumption of foods rich in EPA or DHA.
c. Many of the studies may not have used adequate number pf subjects in the studies to elicit a result. This is especially the case for studies conducted in healthy individuals (and therefore low risk of heart disease), which would require very high numbers to demonstrate a difference in the omega-3 and non-omega-3 study groups.
d. Any studies conducted over the last two decades of people at risk of cardiovascular disease (CVD) will be in individuals already medicated with statins and other cardio-protective drugs, which may mask the effect, if any, of additional omega-3.
2. Omega-3 benefits go beyond heart health
Long chain omega-3 fats are critical for eye and brain development of the foetus and young children. Therefore, food sources should be included in a healthy balanced diet of children and adults planning for a family.
3. Oil-rich fish is not just omega-3. It offers so many health benefits.
a. Unlike omega-3 supplements, oil-rich fish is a rich source of not only the long chain omega-3 fats but also of selenium, zinc, vitamin D and iodine; woefully lacking in the UK diet.
b. Oil-rich fish has a healthier fat profile when compared to red meat and other animal proteins. Replacing saturated fat with unsaturated fat in the diet has been proven to have a positive effect on blood lipids and cardiovascular health (as confirmed by Cochrane’s 2015 review and the SACN’s & the WHO’s draft 2018 reports). See our saturated fat blog
Indeed, the authors themselves remind us of the other nutritional benefits of oil-rich fish and that this review does not negate public health advice that consuming oil-rich fish is beneficial to health.
The Nutrilicious view
Taking vitamin and mineral supplements as a substitute for eating a healthy balanced diet has never been encouraged by health professionals. However, dietitians recognise that when demands for specific nutrients are high, or when an individual’s nutritional intake is at proven risk of being compromised, supplements can play an important role. For example, pregnancy and folic acid; under-5 year olds and vitamins C and D; or sufferers of osteoporosis and calcium and vitamin D.
Therefore, these findings do not come as any surprise: omega-3 supplements are not a solution to better heart health. There are numerous dietary and lifestyle factors that impact on heart health. It should always be about food rather than the benefits of single nutrients.
As Linda Main, Dietitian and dietary advisor for cholesterol charity HEART UK, explains: “We continue to advise the lifelong consumption of a heart healthy diet centred around eating whole foods rather than the emphasis being on nutrients.
“Eating patterns such as the Mediterranean, DASH or the UCLP© diets result in the consumption of a nutritionally appropriate diet. This is characterised by eating plenty of vegetables, fruits, wholegrains, vegetable proteins such as nuts and soya, seeds, vegetable oils and spreads. In those who consume animal proteins, the inclusion of low fat dairy, lean and largely unprocessed meat and white and oily fish and seafood are recommended.
“Omega-3 supplements are not currently advised by HEART UK and would not be our first choice, except when prescribed by a recognised qualified health professional or when needed to safeguard the intake of the essentially fatty acid – alpha-linolenic acid.”
As oil-rich fish is an excellent low saturated fat protein source, and the main dietary source of long-chain omega-3 fats as well as other crucial nutrients, it should continue to be part of dietary guidelines.
Additionally, for those wishing to follow a more plant-based diet, it’s reassuring that the report finds consumption of the shorter chain omega-3 fats found in plant foods (like rapeseed and soya oil) has cardio-protective qualities. This supports findings from population studies that vegetarians and vegans have a lower incidence of cardiovascular events and mortality compared to non-vegetarians.
Current UK heart health dietary advice remains unchanged:
- Lower the amount of food eaten which is high in saturated fat and replace it with foods high in unsaturated fats (which Cochrane’s 2015 review supports, SACN 2017 Saturated fat draft guidance).
- Increase our intake of fibre (especially from beans, pulses, oats and barley), nuts.
- Consume at least five servings of fruit and vegetables daily.
- Reduce intakes of red meat and avoid/limit processed meat.
- Consume two portions of fish weekly – one of which should be oil rich.
- Increase intakes of leaner and plant-sources of protein.
- Use sterol or stanol fortified products (if blood cholesterol is raised after other dietary changes have been made).
It’s interesting to note that, unlike the US, the UK does not (and has never) recommended taking dietary supplements of omega-3 fish oil.
For up to date expert advice on heart health visit: heartuk.org.uk
Further references
Saturated fat and heart health reports
Supplements for specific groups
NHS UK: Vitamins for children; Vitamins, supplements and nutrition in pregnancy
Vegetarian and vegan diets and health outcomes
- Rizzo N, Jaceldo-Siegl K, Sabate J et al. Nutrient profiles of vegetarian and non-vegetarian dietary patterns. J Acad Nutr Diet.. 2013;113(12):1610-9.
- Sobiecki J, Appleby P, Bradbury K et al. High compliance with dietary recommendations in a cohort of meat eaters, fish eaters, vegetarians, and vegans: results from the European Prospective Investigation into Cancer and Nutrition-Oxford study. Nutr Res.. 2016;36(5):464-77.
- Springmann M, Godfray H, Rayner M et al. Analysis and valuation of the health and climate change cobenefits of dietary change. Proc Natl Acad Sci U S A.. 2016;113(15):4146-51.
- Clarys P, Deliens T, Huybrechts I et al. Comparison of nutritional quality of the vegan, vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diet. Nutrients.. 2014;6(3):1318-32.
Cochrane is an established body of researchers, health professionals and patients across the globe renowned for their high quality scientific reviews of nutrition and health evidence.
