1. Nutrition update Rebecca Haresign Research Assistant, British Nutrition Foundation

2. SACN Carbohydrates and Health report Nutrition claims Departments, agencies and public bodies Sources of information Overview

3. Scientific Advisory Committee on Nutrition SACN members are appointed as independent scientific experts SACN provides advice to UK Health Departments on matters relating to food, diet and health What is SACN? Examples of SACN working groups: Carbohydrates Working Group Vitamin D Working Group Military Energy DRVS Working Group Fats Working Group

4. SACN Carbohydrates and Health report Headlines based on evidence reviewed in SACN report: higher consumption of sugars and sugars containing food is associated with a greater risk of tooth decay; increasing or decreasing total energy (calorie) intake from sugars leads to a corresponding increase or decrease in energy intake;

5. SACN Carbohydrates and Health report Headlines based on evidence reviewed in SACN report: consumption of sugars-sweetened drinks* results in greater weight gain and increases in BMI in children and adolescents; greater consumption of sugars- sweetened drinks is associated with increased risk of type 2 diabetes. *sugars-sweetened drinks include non-diet carbonated drinks, coffee/tea containing sugar, squash, juice drinks, sport drinks, energy drinks.

6. This led to the following recommendations from SACN: Average intake across the UK population of free sugars should not exceed 5% of total dietary energy intake for age groups from 2 years upwards; The consumption of sugars-sweetened drinks should be minimised in children and adults. SACN Carbohydrates and Health report

8. What are free sugars? All sugars added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and unsweetened fruit juice. What sugars do not count as free sugar? Lactose (the sugar in milk) when naturally present in milk and milk products and the sugars contained within the cellular structure of foods (e.g. fruit and vegetables).

9. Comparison of the total and free sugars content of foods Portion size Total sugars (per portion) Free sugars (per portion) Comment Regular cola 330ml36.0g All of the sugars are present as free sugars Calorie- free cola 330ml0g No sugars present Semi- skimmed milk 200ml9.4g0gNone of the sugars are free sugars; all of the sugar is lactose from milk, which is excluded from the definition of free sugars Flavoured milk 200ml28.0g16.2gThe sugars are a mix of added ‘free sugars’ and lactose (from milk). Flavoured milk is permitted within the School Food Standards if it does not contain more than 5% added sugars Orange160g13.6g0gNone of the sugars are free sugars Orange juice 150ml12.9g All the sugars are classed as free sugars, released from the fruit during juicing Honey5g3.8g All of the sugars are classed as free sugars Source: Why 5%? An explanation of SACN’s recommendations about sugars and health. PHE 2015.

10. Sources of free sugars*: 11-18 year olds *sugars intakes measured as non-milk extrinsic sugars; data from the National Diet and Nutrition Survey Rolling Programme Results from Years 1-4 (combined) (2008/09-2011/12)

11. Sources of free sugars*: Adults *sugars intakes measured as non-milk extrinsic sugars; data from the National Diet and Nutrition Survey Rolling Programme Results from Years 1-4 (combined) (2008/09-2011/12)

12. Exploring sugars in the foods we buy http://bit.ly/1MYDUCD

13. Free sugars line up

14. Free sugars answers 0g 0.4g 2.7g 4g 11.25g 23.8g 36g Data taken from McCance and Widdowson, National Diet and Nutrition Survey dietary information and retail data 21.3g

15. SACN recommendations on fibre SACN also recommended an increase in the population’s fibre intake Previous recommendation for fibre was 18g NSP, measured using the Englyst method New recommendations from SACN use a different method – AOAC (Association of Official Analytical Chemists) 18g measured using the Englyst method is equivalent to 23/24g using the AOAC method

16. SACN recommendations on fibre SACN recommended an increase in the population’s fibre intake to an average of 30g per day for adults. For children, the recommended intakes are: 15g/day (age 2-5); 20g/day (age 5- 11); 25g/day (age 11- 16); 30g/day (age 16-18).

17. Why do we need to increase our fibre intake? Evidence from the SACN report indicated: diets rich in fibre (cereal fibre and wholegrains) are associated with lower incidence of CVD, type 2 diabetes & colorectal cancer diets rich in fibre decrease intestinal transit times and increase faecal mass.

18. What does 30g a day look like? https://www.nutrition.org.uk/attachments/article/881/SACN%20guidelines%20meal%20planner.pdf 7 day meal plan put together by BNF Meets the new fibre and free sugars advice Based on 2,000 calories a day Also meets the other guidelines for a healthy diet: Five portions of fruit and vegetables A portion of oil-rich fish Some low-fat dairy or dairy alternatives Lean, protein-rich foods Also follows the guidelines for salt, fat and saturates and supplies the recommended amounts of vitamins and minerals, such as calcium and iron.

19. Putting new recommendations into practice Averages of 4.9% free sugars, 33.2g fibre and 1989 kcal per day https://www.nutrition.org.uk/attachments/article/881/SACN%20guidelines%20meal%20planner.pdf

20. Fibre in the classroom

21. Nutrition claims Nutrition claims such as ‘source of’ and ‘high in’ are regulated by the European Commission. SOURCE OF FIBRE – claim may only be made where the product contains at least 3g of fibre per 100g or at least 1.5g of fibre per 100 kcal SOURCE OF PROTEIN - claim may only be made where at least 12% of the energy value of the food is provided by protein. HIGH PROTEIN - claim may only be made where at least 20% of the energy value of the food is provided by protein. http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32011R1169&from=EN

22. Nutrition claims SOURCE OF [VITAMIN/MINERAL] 15% of the nutrient reference values supplied by 100g or 100ml in the case of products other than beverages or per portion if the package contains only a single portion; HIGH [VITAMIN/MINERAL] at least twice the value of ‘source of [VITAMIN/MINERAL] (so 30% of the nutrient reference values supplied by 100g or 100ml in the case of products other than beverages or per portion if the package contains only a single portion) http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32011R1169&from=EN

23. Iron NRV for Iron=14mg, Source of Iron=2.1mg, High in Iron=4.2mg per 100g 8.8mg = High in iron 11.2mg = High in iron 2.7mg = Source of iron 3.9mg = Source of iron 1.6mg = Not a source

24. Government sources of information SourceRole Food Standards Scotland (FSS) http://www.foodstandards.gov.scot/ Public sector food body for Scotland. Ensures that information and advice on food safety and standards, nutrition and labelling, is independent, consistent evidence- based and consumer-focused. Scientific Advisory Committee on Nutrition (SACN) https://www.gov.uk/government/gro ups/scientific-advisory-committee- on-nutrition SACN members are appointed as independent scientific experts on the basis of their specific skills and knowledge. SACN provides advice to UK Health Departments on matters relating to food, diet and health. National Diet and Nutrition Survey (Scotland) (NDNS) http://www.foodstandards.gov.scot/n ational-diet-and-nutrition-survey- rolling-programme-results-years-1-4- combined-scotland-200809 http://www.foodstandards.gov.scot/n ational-diet-and-nutrition-survey- rolling-programme-results-years-1-4- combined-scotland-200809 This is a continuous programme which assesses the diet, nutrient intake and nutritional status of the general population aged 1.5 years and over, in the UK. Additional recruitment was sought for Years 1 to 4 (2008/9 to 2011/12) in order to enable comparisons to be made with UK results. The NDNS provides high quality data on the types and quantities of foods consumed by individuals, from which estimates of average nutrient intakes for the population can be derived. Family Food Survey https://www.gov.uk/government/upl oads/system/uploads/attachment_da ta/file/485982/familyfood- 2014report-17dec15.pdf The Family Food Survey is an annual survey of household purchases of food and drink, which also provides information on nutrient intakes from both household and eating out food and drink. There is a breakdown by UK regions, and in Scotland the statistics are used to monitor the health of the Scottish diet. As the survey has been conducted annually since the 1950s, it provides invaluable data on trends.

25. Sources of information Government (e.g. Food Standards Scotland) NHS Inform Charities/organisations with the Information Standard: British Nutrition Foundation, British Dietetic Association Health Professionals (e.g. Registered Dietitians, Registered Nutritionists)

26. Thank you! r.haresign@nutrition.org.uk