by Tanya HAFFNER | Jan 9, 2018 | Thoughts, Media in context, The Nation’s Health, Impactful health initiatives
Each week we analyse some of the hot headlines in health and nutrition news. This week we look at a new ‘Change4Life’ campaign on children’s snacks and the link between processed meats and breast cancer.
HEADLINE 1: LIMIT CHILDREN’S SNACKS TO 100 CALORIES
Popular in the news this week is the new campaign being launched to encourage healthier snacking in children. This has been reported widely, including the BBC, Sky News, The Telegraph, ITV News, the Sun and The Guardian.
Figures have shown that half the sugar consumed by children in England aged 4–10 comes from unhealthy snacks such as biscuits, cakes and sweets, as well and fizzy and juice drinks.
Public Health England (PHE) have launched a new ‘Change4Life’ campaign promoting children’s snacks which are no more than 100 calories. They also advise cutting number of snacks down to twice per day.
The campaign will run for eight weeks and offers money-off vouchers if parents sign up for lower-sugar snacks. Selected supermarkets including Tesco are supporting the campaign.
The Change4Life ‘Food Scanner’ app has also been updated and improved, showing parents the amount of sugar, salt and saturated fat in their food.
Behind the headlines: the Nutrilicious dietetic view
According to the latest National Diet & Nutrition Survey (NDNS), 4–10 year olds consume on average 53.5g free sugars daily – equivalent to 13 teaspoons. Unhealthy snacks and sweet drinks contribute to at least half this daily intake – equivalent to around 7 teaspoons per day.
We discussed the need for free sugars to be limited for children in a previous blog. Improvements must be made in this area and we sincerely hope this campaign can make a difference.
The scale of the problem
According to the new analysis by PHE, every year each 4–10 year old consumes on average 400 biscuits; more than 120 cakes, buns and pastries; around 100 portions of sweets; nearly 70 of both chocolate bars and ice creams; plus over 150 juice drink pouches and cans of fizzy drink.
As these products are predominantly energy dense with few nutrients on offer, looking at the total calorie contribution per year makes the latest findings even more alarming:
| PHE classified unhealthy snacks/drinks |
Energy contribution to children’s diet per year |
| Biscuits |
26,682 kcal |
| Buns, cakes, pastries |
26,682 kcal |
| Sugar confectionery |
5,366 kcal |
| Chocolate confectionery |
10,673 kcal |
| Ice-cream |
10,673 kcal |
| Sweetened soft drinks including sweetened fruit juices |
10,673 kcal |
| Total annual energy intake from unhealthy snacks and drinks |
90,749 kcal |
| Daily calorie equivalent |
249 kcal |
| Weekly calorie equivalent |
1,740 kcal |
The campaign to change habits
A simple ‘rule of thumb’ advice is being promoted by the campaign to help make it easier for busy families to reduce the intake: ‘look for 100 calorie snacks, two a day max’.
While 50kcal saving per day may not seem a lot, over a year that’s a saving of over 18,000 kcals.
It should be noted that the advice does not focus on fruit and vegetables. A variety of these should be encouraged, aiming for a minimum of five portions per day.
Examples of snacks that fall at or below 100 calories include:
- One Soreen malt mini lunchbox loaf (30g) – 95 calories
- One small pot of fruit fromage frais (42-85g) – 45-75 calories
- Snack pack of raisins (14g) – 38 calories
- One banana – 81 calories
- One apple – 51 calories
- One Hartley’s no added sugar jelly pot (115g) – 7 calories
- One packet skinny popcorn (17g) – 57 calories
- One packet Tesco’s lentil curls (20g) – 91 calories
(Source: Values obtained from Dietplan 7 and online supermarkets 2018)
The packaged snacks should also ideally show as greens and ambers on the ‘traffic light’ labelling system (indicating they are not too high in sugar, fat, saturated fat or salt). More information on food labelling is supplied by Change4Life.
It is also useful to check on the label that the portion consumed is what the label portion actually relates to. For example, a large pack of crisps may display the calories for 1/8 of the packet but it can be easy for a child to have more than this portion.
What’s missing from the advice
Although it is positive that action is being taken to promote healthier snacking, the campaign only focuses on the role of calories and may not necessarily teach parents about what makes up a healthy snack.
For example, a handful of nuts would contain more than 100 calories, yet nuts are a nutrient dense food and have many benefits to our health. Snacks can contain less than 100 calories but not contain any valuable nutrients, as in the case of many cereal bars. So, it is questionable how well this campaign will educate parents about healthy eating.
Nevertheless, if improvements can be made to the current eating habits in children it will be beneficial.
HEADLINE 2: EATING BACON, SAUSAGES AND OTHER PROCESSED MEATS INCREASES BREAST CANCER RISK IN OLDER WOMEN
Also in the news this week is the suggestion that eating processed meats will increase the chances of getting breast cancer. This was picked up by the Sun, the Daily Mail, the Evening Standard and the Independent.
The study involved 262,195 women aged 40–69, followed over a period of seven years. For this cohort, a 21% increased breast cancer risk was associated with women consuming more than 9g processed meat per day.
However, when the study was combined with another 10 cohort studies and a meta-analysis performed, the risk was significantly lower.
The meta-analysis found processed meat consumption to be associated with 9% increased risk of breast cancer in post-menopausal women only. No association was found in pre and peri-menopausal women, nor was an association found with red meat consumption.
Behind the headlines: the Nutrilicious dietetic view
The study looked at a variety of processed meats, but clearly the UK headlines are pulling at the Brits’ heart strings by focusing on bacon and sausages.
Firstly, what counts as processed meat? Processed meats are defined as meat which has been preserved through salting, curing, fermentation, smoking or other processes. Examples include sausages, bacon, ham, salami, chorizo, corned beef, hot dogs and pepperoni.
9g processed meat equates to:
- 1 and a bit sausages
- 2½ rashes of back bacon or medium slices ham
- 13 thin 5cm diameter slices of salami
- Almost 3 Peperamis
This study adds further supports to one of the key messages for cancer prevention to avoid processed meat and reduce overall intakes of red meat (no more than 500g per week) whilst focusing on a more plant-based diet.
In order to truly help women reduce their risk of breast cancer, messages like this, focusing on one food type, are not helpful. Study findings should be placed in context of overall dietary and lifestyle advice proven to lower risk as well as regular breast screening checks. This study only found correlation in post-menopausal women and only reported on processed and red meat findings.
With 50,000 new cases of breast cancer every year in the UK, 20,000 of which could be prevented through dietary and lifestyle modifications, there are far more pertinent actions women can take. The World Cancer Research Fund (WCRF) highlights the following as major risk factors for breast cancer:
- Gaining weight in adulthood
- Drinking alcohol
- Being physically inactive
- Not breastfeeding when you have a baby
- Being overweight or obese (for post-menopausal breast cancer)
Although this study further supports the evidence that processed meat isn’t great for women’s health (or, indeed men’s health), we need to stop scare-mongering and instead provide helpful advice to women concerned about the UK’s number one cancer. Scientific findings need to be put into context and then interpreted into practical and helpful advice for consumers.
As well as the lifestyle recommendations by WCRF, it is also important to continue encouraging women to regularly check their breasts for lumps and seek medical assistance if they have any concern as well as attend any breast cancer screening invitation from their health service.
For more tips and advice see World Cancer Research Fund UK and Cancer Research UK
by Tanya HAFFNER | Dec 22, 2017 | Hot Topics in nutrition, Thoughts, Media in context, The Nation’s Health
Each week we analyse some of the hot headlines in health and nutrition news. In our last round up for the year, we look at a ‘Mediterranean diet pill’, herbal remedies for stroke, and fruit juice in asthma.
HEADLINE 1: MEDITERRANEAN DIET IN A PILL COULD HELP BEAT HEART DISEASE
This week the Daily Mail, the Metro and the Express are reporting on the use of a Mediterranean diet pill to help prevent heart disease.
Scientists have issued a patency for a pill that is thought to replicate the Mediterranean diet. This is based on findings from Cambridge University that lycopene (the chemical that gives tomatoes and other fruits their red colouring) absorption is significantly increased by combining it with milk protein. Scientists believe that combining the two into a pill (a ‘Mediterranean diet pill’, as the headlines say) could have effects such as reducing furring of the arteries, helping to keep the heart healthy.
The pill is available over the counter and is called ‘Ateronon Heart.’
Behind the headlines: the Nutrilicious dietetic view
Although this pill is being referred to as a ‘Mediterranean diet pill’ and that lycopene may have potential benefits for the heart, there are many elements of the Mediterranean diet that have not been considered. The whole diet plays a key role in contributing to the health benefits attributed to it such as heart health. To highlight, traditionally, people in the Mediterranean have:
- Lots of fruit and vegetables
- Wholegrain breads and cereals, nuts, pulses (peas, beans and lentils) seeds and fish
- Less saturated fat from dairy and red meat sources
- Moderate alcohol consumption
- Higher levels of sunshine and more oily fish which results in good levels of vitamin D
As can be seen, it is not just as simple as amount of lycopene that may be contained within this diet (from tomatoes and other fruits and vegetables). There are so many factors that would mean the pill is not the necessarily going to give the same effects as having a Mediterranean diet. The reference to the product as a ‘Mediterranean diet pill’ as described by the headlines is thus somewhat misleading.
At this stage, no conclusions can be drawn with regard to any benefits the diet pill may have for heart disease. It is certainly not to be used as a substitute for a healthy diet. The Mediterranean diet, by use of real food, would indeed be encouraged for heart health. Exercise can also help reduce the risk of heart disease by helping with weight control, lowering cholesterol and blood pressure.
For more info: NHS and Heart UK’s Mediterranean Diet factsheet
HEADLINE 2: HERBAL REMEDY FOR STROKE RECOVERY?
The BBC and the Daily Mail have reported on the possibility of a herbal remedy for stroke recovery.
The trial involved 330 patients in China who had suffered an ischaemic stroke. The trial began within one week of the patients having the stroke. It was found that use of herbal supplement ‘ginkgo biloba’ alongside aspirin was linked with better cognitive skill scores on tests. Tests were taken at the start of the trial and then 12, 30, 90 and 180 days later, to assess any cognitive impairment.
More rapid improvements were also found with speech and muscle strength when ginkgo biloba was taken.
Behind the headlines: the Nutrilicious dietetic view
Firstly, let us understand more about what ginkgo actually is. Ginkgo biloba is a herbal supplement available without prescription that is sold in health food shops and some pharmacies in the UK (£4.99 for 30 tablets). It comes from the leaves of one of the oldest living tree species (the maidenhair tree).
Looking at an example packaging of ginkgo biloba from a high street retailer, the following is written as a description of the product: ‘Ginkgo helps the maintenance of good cognitive function and also contributes to normal blood circulation. Normal blood circulation is associated with brain performance and reactivity, and helps to maintain memory with age and preserve cognitive function.’ Although this sounds very beneficial, this has not been scientifically proven.
While the findings from this study are positive for use of ginkgo biloba, there are limitations of the research that must be noted. The study was relatively small and much larger, longer term studies are needed before any sound conclusions can be drawn. Furthermore, the study is subject to researcher bias, a point which has been recognised by Dr David Reynolds of Alzheimer’s Research UK who gave the following statement in response to the study: “The researchers were able to tell which participants received the ginkgo biloba extract and which didn’t – a set up that can strongly influence results.”
We therefore need much more comprehensive research into the field and cannot actively promote the use of ginkgo in stroke recovery from this research alone.
For more info: British Dietetic Association) and the original study
HEADLINE 3: CHILDREN WHO DRINK FRUIT JUICE HAVE A HIGHER RISK OF DEVELOPING ASTHMA
Also this week the Daily Mail, the Independent and the Express have picked up on a study linking fruit juice drinking in children with asthma.
This is based on a study of 1,068 mother and child pairs which found that children aged between 7 and 9 years were 79% more likely to have asthma if they regularly drank fruit juice (unsweetened 100% juice). It was also reported that the women who drank soda and sugary drinks whilst they were pregnant were 70% more likely to have their child to develop asthma by mid-childhood.
The original study discusses the different levels of fruit juice and sugary drink consumption from which the conclusions have been drawn.
Behind the headlines: the Nutrilicious dietetic view
Firstly, with regard to the fruit juice drinking being associated with childhood asthma, as with many dietary studies, we cannot prove that it is the fruit juice drinking causing the effects seen. There are many factors which could influence the results. For example, it could be that the fruit juice drinkers have an unhealthier diet and lifestyle, which could skew the results.
Also the study relied on the women to recall and provide information on fruit juice consumption for their children, for which the accuracy could be questioned.
Fruit juice can contribute to a ‘five a day’ portion and contains a good source of vitamins and minerals such as vitamin C. However, portion size is important and should be limited to a 150ml glass (a small glass). It can only ever count as a maximum of one portion of your five a day.
Fruit juice is a source of ‘free sugars’, which should be limited in our diet for health reasons such as leading to obesity and tooth decay. The Scientific Advisory Committee on Nutrition (SACN) currently advise that free sugar intake in the UK should account for no more than 5% of our daily energy intake. Advice for the different age groups is as follows:
- Children 4-6 years – no more than 19g free sugars per day (5 teaspoons)
- Children 7-10 years – no more than 24g free sugars per day (6 teaspoons)
- Children 11 years + and adults – no more than 30g free sugars per day (7 teaspoons)
We should be reminded in view of this study that there is a recognised link between a child being overweight or obese and developing asthma. Eating and drinking too much sugar (for which fruit juice is a concentrated source of) can contribute excess calorie intake. This contributes to being overweight and obese, which can in turn contribute to causing asthma. However, the study does not prove a direct link between fruit juice and asthma development.
As discussed above, this study also found that higher intakes of sugary drinks in mothers during pregnancy increased asthma prevalence in their children. Again, no causal relationship can be assumed here and the same limitations of the study apply to this finding.
However, it is important to eat a healthy diet during pregnancy for the health of both the mother and the baby. Having too many sugary drinks during pregnancy would contribute to excess calorie intake. This in turn increases the chances of putting on too much weight, which can cause complications such as gestational diabetes. The NHS provides advice on appropriate weight gain during pregnancy.
To conclude, this research does not prove that fruit juice drinking by children or that drinking of sugary drinks by expectant mothers causes childhood asthma. Sugary drinks and fruit juices are sources of free sugars and therefore excess calories and for this reason should be limited. However, fruit juice can help contribute to ‘five a day’ but it is important to control portion size to no more than 150ml per day for adults.
For more info: Asthma UK and SACN
by Tanya HAFFNER | Dec 18, 2017 | Hot Topics in nutrition, Thoughts, Media in context, The Nation’s Health
Each week we analyse some of the hot headlines in health and nutrition news. This week we look at wine glass size increase, NHS breastfeeding incentives and a man who claims a raw vegan diet cured his cancer.
HEADLINE 1: WINE GLASSES NOW SEVEN TIMES LARGER THAN IN GEORGIAN TIMES
This week the BBC, the Daily Mail, the Guardian, The Daily Telegraph and The Sun reported on the increasing size of wine glasses being served up.
New research from Cambridge University found that wine glasses are as much as seven times larger than they were 300 years ago. Measurements were taken of 411 glasses from 1700 until modern day.
Looking at sources including eBay, museums and department stores, it was found that wine glass capacity has increased from an average of 66ml in the 1700s to 417ml in the 2000s, and the average wine glass size in 2016-2017 was 449ml.
Behind the headlines: the Nutrilicious dietetic view
While these headlines may lead us to assume that an increase in wine glass size directly correlates to an increase in wine consumption, this has not been proven by the research. Nor can we assume that reducing wine glass size would lead to a decrease in alcohol consumption – although it has been found previously that large tableware increases food consumption, so the same may be true for glass sizes with drink.
Not only are glass sizes increasing as this research has shown, but the average strength of wine has also increased. This points towards a greater consumption of alcohol than in the past.
The adverse effects of drinking too much alcohol is well documented. It can increase the risk of least seven types of cancer, including bowel cancer and breast cancer, and is also linked with pancreatitis, liver disease, heart disease and diabetes.
Calories can sometimes be forgotten with alcohol but in fact it contains nearly as many calories per gram as fat does (7kcal per gram for alcohol and 9kcal per gram for fat). A 175ml glass of wine contains around 160 calories. For more information on alcohol and calories see Drinkaware’s handy Unit & Calorie Calculator.
With Christmas looming, it can be easy to overdo the alcohol consumption. The government recommends both men and women stick to no more than 14 units per week. To find out what constitutes a unit see Drinkaware. For wine, a 125ml glass of wine would be one unit, so it is a worry to think that a 449ml glass would contain over three units.
The take home message is to not exceed government guidelines for alcohol consumption and to be aware of glass size as this may well have a role in the amount of alcohol consumed.
For more info: British Medical Journal
HEADLINE 2: OFFER CASH INCENTIVES TO MOTHERS TO PROMOTE BREASTFEEDING
The Guardian, the Evening Standard, the BBC, The Daily Telegraph and the Daily Mail have reported on how shopping vouchers could potentially be used to help increases rates of breastfeeding in the UK.
This is based on a trial of 10,000 women in deprived areas which found that giving shopping vouchers to mothers resulted in a significant rise in breastfeeding rates.
The vouchers were worth £120 and were provided if the babies received breastmilk (including expressed) at two days, 10 days and six weeks old. If babies were still being breastfed at six months, a further £80 of vouchers were given to the mothers.
A 6% increase in rates of breastfeeding was found which the researchers concluded was a modest but statistically significant increase.
Behind the headlines: the Nutrilicious dietetic view
One limitation of this study is that we cannot be sure that the reported rates of breastfeeding are accurate. It relies on the honesty of the mother and potentially an economically struggling mother may report that she is breastfeeding when in reality she is not in order to obtain the vouchers. The data is therefore unreliable as no clinical test was used to confirm whether a mother was breastfeeding. We cannot say that by employing such a scheme on a larger scale in the UK would actually increase breastfeeding rates.
However, it is good that methods are being tested and investigated to help try and encourage breastfeeding, as it offers many benefits for both mother and baby. It is perfectly designed for the newborn baby, helps protect the baby from infections and diseases, provides health benefits for the mother, is free of cost and is ready whenever the baby needs it. It can also help with bonding.
In the UK breastfeeding rates are particularly low. The NHS advises exclusive breastfeeding for six months. The most recent UK Infant Feeding Survey highlighted that:
- 81% women initiated breastfeeding (69% exclusively)
- 69% breastfeeding at one week (46% exclusively)
- 55% breastfeeding at six weeks (23% exclusively)
- 35% breastfeeding at six months (1% exclusively)
So there is clearly huge room for improvement in this country.
Breastfeeding is not necessarily easy. The NHS acknowledges this and has provided advice on common breastfeeding problems. Identifying barriers to breastfeeding and providing plenty of support to mothers remains of key importance to help increase rates in the UK.
HEADLINE 3: MAN CLAIMS HE ‘CURED’ STAGE 4 CANCER BY SWITCHING TO VEGAN DIET
Also in the news this week is story about a man who claims to have cured his stage 4 cancer by following a vegan diet. This was picked up by the Metro (Man claims he ‘cured’ stage 4 cancer by switching to vegan diet), the Daily Mail (Father of two CURED cancer by going vegan), the Mirror (Brave cancer sufferer shares incredible story) and The Sun (Did vegan diet cure cancer?).
Rob Mooberry was diagnosed with stage 4 colorectal cancer in 2012 and believes his tumour shrank by 80% by following a raw vegan diet.
From the information we are given, it is understood Rob had undergone surgery, radiotherapy and chemotherapy (following which his cancer reduced to stage 3a). He took a break before his next course of treatment as he felt he could not undergo it and changed his diet to a raw vegan diet in November 2012. His following scan in early 2013 showed that the cancer had reduced by 80%. Rob’s cancer has now been in remission for five years and he has not received any further medical treatment.
Behind the headlines: the Nutrilicious dietetic view
The question on many people’s minds will be whether or not the raw vegan diet was responsible for ‘curing’ the cancer. We certainly cannot prove that the diet what was responsible for the reduction in tumour size. There is no scientific evidence to suggest this could be the case and Rob had previously undergone medical treatment. Also, this report is purely based on anecdotal evidence and does not necessarily mean the same could be applied to the next person with the same results.
Cancer Research UK provide advice on alternative diets and their role in cancer. They do not recommend using alternative therapies in place of medical treatment due to the lack of scientific evidence of their effectiveness. They also point out that unproven methods of alternative cancer treatment could make someone very ill. Supporting this further is Macmillan Cancer Support, who state on their website that ‘no alternative therapies have ever been proven to cure cancer or even to slow its growth’.
Following a raw vegan diet needs careful attention to ensure it is balanced. This diet was recently discussed by the British Dietetic Association as it has been considered one of the ‘top 5 worst celeb diets to avoid in 2018’.
To sum up, there is no evidence to suggest that a raw vegan diet can cure cancer and it is important to remember alternative therapies should not replace normal medical treatment. Alternative diets can cause various health problems and advice from specialists should always be sought before embarking on such dietary changes.
For more info: Cancer Research UK and Macmillan Cancer Support.
by Tanya HAFFNER | Dec 11, 2017 | Hot Topics in nutrition, Media in context, The Nation’s Health
Each week we analyse some of the hot headlines in health and nutrition news. This week we look at type 2 diabetes reversal through weight loss, the rise in childhood obesity and raw flour health risks.
HEADLINE 1: ‘I BEAT TYPE 2 DIABETES WITH 200-CALORIE DRINKS’
This week we have the BBC (‘I beat type 2 diabetes with 200-calorie drinks’), The Guardian (Radical diet can reverse type 2 diabetes new study shows), The Daily Mail (Three month diet reverse Type 2 diabetes), The Sun (Millions of diabetics could be cured by losing weight and eating healthier) and The Express (Type 2 diabetes symptoms diet reverse) reporting that it may be possible to reverse type 2 diabetes by following a ‘crash diet.’
The findings come from a study called DiRECT (Diabetes Remission Clinical Trial), where it was found that by following an intensive low-calorie diet for three to five months people could put their diabetes into remission. Nearly half of the study participants were in remission after one year. There was a close link found between amount of weight lost and remission of type 2 diabetes.
Here are the results for the percentages of people who were in remission after one year based on the amount of weight lost:
- 86% of people who had lost over 15kg (2.4 stone) in remission
- 57% of people who lost 10-15kg (1.6-2.4 stone) in remission
- 34% of people who lost 5-10kg (0.8-16 stone) in remission
There was also a control group who did not follow the low calorie diet, but were given the best diabetes care available and only 4% went into remission.
Behind the headlines: the Nutrilicious dietetic view
Firstly, it should be recognised what is meant by ‘putting diabetes into remission’. In this study being in ‘remission’ was defined as having a HbA1c level below 6.5% (48mmol/mol) after 12 months, with at least two months without diabetes medication. HbA1c is a measure of blood glucose levels over the past two to three months and can be used to diagnose diabetes. It should be noted that being in ‘remission’ does not necessarily mean the diabetes has gone completely and hence people still need regular check-ups.
This research backs up previous studies investigating the potential of reversing type 2 diabetes. This DiRECT study recruited many more participants (298 recruited vs 11 and 30 in the two previous studies), making it much more reliable, and testing was carried out over a much longer period.
Points to note
- While this is a very promising piece of research and extremely exciting for people with type 2 diabetes, it should be noted that the study is not over yet. It is unclear at this stage how long the remission will last for; whether it will reduce the risk of long term diabetes related complications; and whether this type of treatment could be feasible within the NHS.
- The people involved in the study had been diagnosed with type 2 diabetes for up to six years and so the findings may not apply to those have had the condition longer. Participants also were not included if they were taking insulin.
- The diet involved was intensive. Participants followed a daily diet of around 800kcal diet (made up of four soups or shakes fortified with vitamins and minerals) for between 8 and 20 weeks, followed by a long-term programme of weight loss maintenance. Certainly not an easy fix!
- The headlines alert us to the positive findings of the study but one person in fact developed severe abdominal pain, related to gallstones. This was thought to be possibly caused by the intervention. Further studies are required to ensure the diet is safe for widespread use.
- The weight management programme was delivered with medical supervision and dietitians were involved to help support long term weight management. While it may seem possible to put type 2 diabetes into remission, this type of diet should certainly not be undertaken alone and anyone attempting to do this should ask for help from a GP and dietitian.
The Deputy Head of Care at Diabetes UK provided this useful statement: “If you’re thinking about trying a low-calorie diet, it’s really important you speak to your GP and get referred to a dietitian. This is to make sure you get tailored advice and support.
“It’s also important to bear in mind that if you’re treating your Type 2 diabetes with certain medications, such as insulin or sulphonylurea, a low-calorie diet can make hypos more likely. So you’ll need support to make changes to your medications and check your blood sugar levels more often.”
For more information, go to Diabetes UK and the Newcastle University study
HEADLINE 2: ‘STARK’ INCREASE IN OVERWEIGHT YOUNGSTERS
We are being alerted by the BBC (‘Stark’ increase in overweight youngsters), The Times (A fifth of children are obese by 14) and the Daily Mail (Now one in three British teenagers is already overweight) of the increasing prevalence of obesity in children.
Data from the Millennium Cohort (a group of more than 10,000 children born between 2000-2001 who have been followed for years) revealed that 25% were overweight or obese at age 7, increasing to 35% by age 11. Little change was found between age 11 and 14 years.
There were notable differences found between different nations and there were links found between the mother’s education level, whether the child was breastfed and whether the parents owned their own home. Full results are discussed by the Institute of Education.
Behind the headlines: the Nutrilicious dietetic view
The headlines alert us to the growing problem of obesity in children and action clearly needs to be taken. The following risks are associated with it:
- Higher chance of premature death and disability in adulthood
- More likely to stay obese in adulthood and develop noncommicable diseases such as diabetes and cardiovascular disease at a younger age
- Muscoskeletal disorders in adulthood (e.g. osteoarthritis)
- Certain cancers in adulthood (endometrial, breast and colon)
Source: World Health Organisation
It is unclear from this research why there is such an increase in rates of obesity between ages 7 and 11, which then levels off. Children may start to make more of their own choices past 11 years and this is thought to potentially have a role.
In view of these recent findings, we should be reminded of the action that is planned to help combat obesity in the UK. These are discussed in full on the UK Government’s website. Key examples from this plan include:
- The Sugar Tax – The government plan to introduce a soft drinks levy to be enforced from April 2018. Producers and importers have been given two years to lower the sugar appropriately in their drinks to allow them to not face the levy. Our blog Draft Soft Drinks Levy – Objectives, Thresholds, Exemptions & Impact? discusses this further. This is a very encouraging and hopeful move considering that the latest National Diet and Nutrition Survey highlighted that soft drinks are a major contributor to sugar in children’s diets.
- Taking out 20% of sugar in products – firms have been called to cut sugar by 5% by the end of this year and by 20% by 2020. We discussed on last week’s blog the action that Kellogg’s have been taking on their top selling cereal products to cut the sugar.
There are also new rules due to be implemented on food advertising. Last month the BBC reported on how young children are being bombarded with adverts for high fat, high sugar foods, which is more than likely to be having a negative influence on food choices. The news rules are discussed in our blog New rules on food advertising to help tackle childhood obesity.
It is interesting to note that Amsterdam is the only European country that has successfully managed to reduce obesity rates in the last five years with a range of programmes, mainly through schools. Clearly, many measures will need to be employed to help combat childhood obesity in the UK. Let us hope that the actions due to be undertaken in UK will help improve the current rather desperate situation. Monitoring of the effectiveness of such actions will be of key importance in the future.
For more information, go to NHS and UCL
HEADLINE 3: ‘DON’T LICK THE MIXING BOWL!’
Also in the news this week is the warning over eating raw cookie dough. This was reported by The BBC, The Telegraph, The Evening Standard, The Sun and The Daily Mail.
The UK Foods Standards Agency have now provided guidance that we should not eat raw flour, including cookie dough. This is due to outbreaks in the US of food poisoning caused by E.Coli.
Behind the headlines: the Nutrilicious dietetic view
E.Coli is a type of bacteria that can cause diarrhoea, blood in faeces, stomach cramps, fever and vomiting. Before this guidance on raw flour, it was understood that E.Coli could be caught from infected foods such as raw leafy vegetables, undercooked meat or raw milk products.
We now must ensure we are aware of the potential risk associated with raw flour, including cookie dough and cake mixture for example. We may think we shouldn’t have a taster of these due to the raw egg. However, in October 2017, the Foods Standards Agency published advice that runny eggs are safe to eat for all, so long as they are stamped with the British Lion Code of Practice.
So now the reasoning behind avoiding having a taster of dough is down to the raw flour contained within it. It is also advised to wash hands thoroughly before and after using flour and to ensure worktops are wiped afterwards. Rest assured that cooking the flour will kill the bacteria that causes the infection.
It is important to be aware of this new advice from the Foods Standards Agency to reduce any complications caused E.Coli. Certain groups of people should take particular note of this new guidance, such as those with a weakened immune system and pregnant women, where food poisoning can cause harm to the unborn baby. When giving food safety advice to such groups, this latest advice on flour should be included.
For more information, go to NHS
by Tanya HAFFNER | Dec 4, 2017 | Retail, Food category comment, Media in context, The Nation’s Health, Surveys and insights
Each week we analyse some of the hot headlines in health and nutrition news. This week cheese; obesity & diabetes/cancer risk; and sugar reduction in Kellogg’s cereals.
HEADLINE 1: A piece of cheese a day keeps the doctor away
Picked up in the news this week by the Daily Mail, The Express, The Sun, The Independent and The Guardian is the suggestion that eating cheese could reduce the risk of heart attacks and strokes.
This is based on a meta-analysis of studies which concluded that consuming 40g of cheese per day reduced the risk of heart attack by 14% and stroke by 10%.
Behind the headlines: the Nutrilicious dietetic view
While cheese lovers are likely to have rejoiced, there are limitations to the research on which the headlines were based. The lack of randomised controlled trials included within the meta-analysis means that no causal relationship can be assumed between eating cheese and risk of heart disease. There are far too many factors which could interfere with the results.
Interestingly, there are previous large studies that have found no association between heart disease and eating cheese. Again, it can be hard to prove that it is the cheese eating that is causing the effects.
The harm that eating too much cheese can cause to health is well documented. Although it is a good source of protein, calcium, phosphorous and vitamin B12, it can also be high in saturated fats. Having too much saturated fat in the diet can increase levels of LDL cholesterol in the blood, which is an established risk factor for heart disease. A 30g portion of cheddar cheese (a matchbox size) contains 6.5g saturated fat (over a quarter of the reference intake for saturated fat – 20g). It can also be quite easy to go above this recommended portion size.
Some cheeses can be high in salt and there is a lot of evidence to show that too much salt can increase the risk of high blood pressure, another risk factor for cardiovascular disease.
Cheese can be enjoyed as part of a healthy diet if eaten in moderation and can provide a valuable source of various nutrients. Sticking to the recommended 30g portion size and opting for lower fat varieties such as lighter/reduced fat cheddars, cottage cheese and ricotta, can help ensure we don’t exceed our recommended maximum amount of saturated fat.
Moreover, foods such as low-fat yogurts and lower fat milks can also provide us with calcium and protein (two of the key nutrients found in cheese) but provide less saturated fats (as well as fewer calories, which would be helpful for those trying to lose weight).
For more information, go to British Heart Foundation and the NHS
HEADLINE 2: Diabetes is a key factor in WORLDWIDE cancer surge
The Express, The Sun and The Daily Mail reported on a finding that diabetes and obesity have been linked to causing cancer.
Researchers found that people with a high BMI (defined as above 25kg/m) who also had diabetes were behind 5.6% of new cancer cases globally, affecting 792,600 people in 2012. The method used was through assessing the increase in new cases of 18 cancers based on the prevalence of diabetes and high BMI in 175 countries (using data about BMI and diabetes in 2002 and cancers recorded in 2012).
Behind the headlines: the Nutrilicious dietetic view
This is an interesting study as it is the first study to have looked at the combined effect of having diabetes and obesity on cancer risk. Whilst the headlines alert us to the finding that over 5% of cancers were attributable to diabetes and cancer, there were significant differences between various groups of people, regions and types of cancer which should be noted. These are discussed in the original study. For example, cancers attributable to diabetes and being overweight were nearly twice as common in women (496,700 cases) as they were in men (295,900 cases).
It should be noted that there were limitations of the study. It is questionable whether the 10-year gap used between recording diabetes and high BMI to cancer incidence is entirely appropriate to enable conclusions to be drawn, as recognised by the researchers.
What we understand already is that obesity is certainly a risk factor for cancer. Analysis conducted by the World Cancer Research Fund has found that being overweight (BMI 25kg- 29.9/m) or obese (BMI 30kg/m and above) increases the risk of 11 types of cancer.
The Diabetes UK website outlines the link between diabetes and cancer. Some of the complications associated with diabetes can increase the risk of cancer. However, well-managed diabetes can help reduce the risk of any complications. Diabetes UK have given their thoughts on this study and stated that, “Diabetes doesn’t directly cause cancer, but this study adds to the evidence that having diabetes can increase the risk of certain types of cancer.”
The main message to take home from these headlines is that the increasing prevalence of obesity and diabetes may lead to an increase in risk of certain cancers. Maintaining a healthy weight, eating well, keeping physically active, not smoking, and not exceeding the government guidelines for alcohol consumption can all help lower the risk of diabetes and cancer.
For more information, go to Diabetes UK and WCRF
HEADLINE 3: Kellogg’s to cut sugar in kids’ cereals by up to 40%
Also in the news this week is the announcement that Kellogg’s will cut the sugar levels in children’s cereals by up to 40%. This was reported by the BBC, the Daily Mail, the Evening Standard, The Times and The Sun.
Kellogg’s have said they will reduce sugar levels by 20-40% by the middle of 2018 for Coco Pops, Rice Krispies and Rice Krispies Multi-Grain Shapes. They are also going to stop making Ricicles from January 2018, due to the amount of sugar in the cereal, and are putting a stop to on-pack promotions aimed at children on Frosties.
Behind the headlines: the Nutrilicious dietetic view
This is a very positive and encouraging move from Kellogg’s as the battle to reduce sugar consumption in the UK continues.
In March this year, officials at Public Health England called on food firms to cut sugar by 5% by the end of this year and by 20% by 2020. The Scientific Advisory Committee on Nutrition currently advise that free sugar intake in the UK should account for no more than 5% of our daily energy intake. Advice for the different age groups is as follows:
- Children 4-6 years – no more than 19g free sugars per day (5 teaspoons)
- Children 7-10 years – no more than 24g free sugars per day (6 teaspoons)
- Children 11 years + and adults – no more than 30g free sugars per day (7 teaspoons)
Although not the highest source of sugar in our diets, cereals do contribute to daily intake, with the most recent National Diet and Nutrition Survey highlighting that cereals are responsible for 5% of the added sugar intakes of adults and 6-8% of that of 4-10-year olds and teens. In our blog post last year A Health Check on New Breakfast Opportunities we discussed the need for more breakfast options to offer lower sugar choices and so this certainly is a positive step forward. With gradually a lesser number of options available that are high in sugar, it may be less overwhelming for consumers to make healthier choices.
Here is how much sugar is currently in the Kellogg’s products and how much they are to be reduced by:
- Coco Pops – 9g sugar per 30g serving. To be reduced to 5.1g per 30g serving (40% reduction, changing from about 2 teaspoons of sugar to just over 1 teaspoon).
- Rice Krispies – 3g sugar per 30g serving. To be reduced to 2.4g per 30g serving (20% reduction, changing from ¾ teaspoon of sugar to a little under 2/3 teaspoon of sugar).
- Rice Krispies Multi-Grain Shapes – 6.3g sugar per 30g serving. To be reduced to 4.5g per 30g serving (30% reduction, changing from about 1.5 teaspoons of sugar to just over 1 teaspoon)
A step forward to reduce the sugar content of any foods available on the market can only surely be a positive one.
For more information, go to Kellogg’s – Sugar and Breakfast Cereal and SACN 2015 – Carbohydrates and Health Report
by Tanya HAFFNER | Nov 24, 2017 | The Nation’s Health, Surveys and insights, Impactful health initiatives
The European Commission Group on Nutrition and Physical Activity is a high-level group covering all matters related to nutrition and physical activity for tackling obesity in children. They’re creating frameworks to address the health problems endemic in every country in the Western world. As health professionals, we’re delighted.
Government representatives from all EU countries, plus Norway and Switzerland, attend the group. The UK government is represented by the Department of Health.
The driver for the obesity problem to be taken seriously at last? The ever-growing drain on economies caused by obesity-related health problems: from the cost of healthcare provision to increasing numbers of sick days taken by workers.
Meeting at least three times a year, they share experiences and strategies for tackling obesity. To date, they have published an EU Action Plan on Childhood Obesity for 2014-2020, aiming to reduce exposure of foods with high saturated fat, sugars and salt (HFSS), as well as increasing exercise.
They’ve also set frameworks that can be taken up by any country on reformulation of commercial products, focusing on reductions in HFSS. Food categories currently under review are:
- Sugar-sweetened beverages
- Sweetened dairy and dairy imitates
- Breakfast cereals
- Bread and bread products
- Confectionary
- Bakery products (for example cakes and cookies)
- Ready meals (including ready to prepare products like dry soups, dried mashed potatoes, rice mixture)
- Savoury snacks
- Sauces (including ketchup)
- Sugars sweetened desserts, ice cream and topping
- Canned fruits and vegetables
- School food offer
- Catering meals
Interestingly, baby foods are not yet covered, although it would not be a surprise if this is the next step once Public Health England’s (PHE) sugar reduction strategy for this category gets under way end of this year.
The EU-specific Commercial Food Reformulation Framework for Added Sugars is set – and is really a reflection of the PHE’s sugar reduction strategy:
- They have proposed benchmarks for each of the above food categories.
- They have recommended that countries set an added sugars reduction benchmark of a minimum of 10% by 2020 (vs. 2015 baseline levels).
- They have used the same definition for ‘added sugars’ as PHE, including fruit juice, fruit juice concentrate and fruit purees.
The frameworks are guidelines with minimum requirements, rather than exact rules every country is bound to. This makes sense – countries can choose to apply them as appropriate, taking into consideration different consumer attitudes to food and nutrients.
So, for example, in the UK, the first nine food categories to come under the sugar reduction targets also used 2015 data as baseline, but we went to 5% reductions by year one and 20% reductions by year 2020.
The Group next meets at the end of the month, with an evolved nutrition labelling initiative one of the points on the agenda. Major multi-national companies are on board, including The Coca-Cola Company, Mars, Mondelez, Nestle, PepsiCo and Unilever.
Let’s hope that what comes out of it actually makes an impact, that it’s not just words no one follows up on. We’re certainly moving in the right direction.
