The Scottish Diet: An update Emma Schneider, Research Assistant, British Nutrition Foundation © 2014 The British Nutrition Foundation

© 2014 The British Nutrition Foundation In this presentation we will look at: The Scottish Dietary Goals; Scottish Health Survey; National Diet and Nutrition Survey; Using dietary information in the classroom. © 2014 The British Nutrition Foundation

Scottish Dietary Goals May 2013: http://www.scotland.gov.uk/Resource/0042/00421385.pdf © 2014 The British Nutrition Foundation Source: Scottish Dietary Goals, 2013

© 2014 The British Nutrition Foundation Source: Scottish Dietary Goals, 2013

© 2014 The British Nutrition Foundation Source: Scottish Dietary Goals, 2013

© 2014 The British Nutrition Foundation http://www.eatwellscotland.org/healthydiet/index.html © 2014 The British Nutrition Foundation

© 2014 The British Nutrition Foundation http://eatwelleveryday.org/ © 2014 The British Nutrition Foundation

Scottish Health Survey Provides a detailed picture of the health of the Scottish population 2008-2015, with a report being published each year of the survey. Key survey topics included in 2012 were: mental health and wellbeing; cardiovascular disease, hypertension and diabetes; eating habits, including fruit and vegetable consumption; smoking and drinking; physical activity; dental health; gambling behaviour. The Scottish Health Survey 2012 edition: http://www.scotland.gov.uk/Resource/0043/00434590.pdf Uses of the Scottish Health Survey video: http://youtu.be/vPUbuuVs9Kw © 2014 The British Nutrition Foundation

Children and physical activity The difference between genders is statistically significant - boys are more active than girls. Activity levels tend to decline with increasing age. © 2014 The British Nutrition Foundation Source: Scottish Health Survey 2012, 2013

© 2014 The British Nutrition Foundation Child obesity Total children 2-15 (%) Boys 2-15 (%) Girls 2-15 At risk of underweight 1.9 1.4 2.3 Healthy weight 67.5 64.9 70.3 At risk of overweight 13.8 13.9 13.7 At risk of obesity 16.8 19.7 © 2014 The British Nutrition Foundation Source: Scottish Health Survey 2012, 2013

© 2014 The British Nutrition Foundation Child obesity © 2014 The British Nutrition Foundation Source: Scottish Health Survey 2012, 2013

© 2014 The British Nutrition Foundation Adult obesity In 2012, almost two-thirds (64.3%) of adults were classified as overweight or obese (BMI ≥ 25 kg/m2). In 2012, mean BMI was 27.3 kg/m2. Men were more likely than women to be overweight including obese (68.2% compared with 60.4% of women). Prevalence of overweight including obese varied with age. © 2014 The British Nutrition Foundation Source: Scottish Health Survey 2012, 2013

Child fruit and vegetable consumption Average of 2.7 portions of fruit and vegetables per day Girls consumed an average of 0.4 portions more per day than boys (2.9 compared with 2.5 portions). Clear association with fruit and vegetable intake and age. © 2014 The British Nutrition Foundation Source: Scottish Health Survey 2012, 2013

© 2014 The British Nutrition Foundation National Diet and Nutrition Survey Rolling Programme (NDNS RP) Years 1-4 (combined) for Scotland Continuous programme of fieldwork designed to assess the diet, nutrient intake and nutritional status of the general population. Carried out on behalf of FSA Scotland and PHE Report covers a range of topics including food consumption, use of dietary supplements, intakes of energy, macronutrients, micronutrients and biochemical measures of nutrition status as well as BMI, blood pressure and blood cholesterol. First time representative data from NDNS RP has been available for Scotland. The results will support work to facilitate improvements to the diet and nutritional status of children and adults in Scotland. http://www.food.gov.uk/sites/default/files/ndns-scotland-full-report.pdf © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

Scotland NDNS and healthy eating recommendations Food/nutrient Recommendation Children (11-18) Adults (19-64) Older adults (65+) Fruit and veg At least 5 A DAY × Oily fish 1 portion/week Total fat No more than 35% food energy  Saturated fatty acids No more than 11% food energy Trans fatty acids No more than 1% food energy Non-milk extrinsic sugars Fibre (NSP) At least 18g/day © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

Comparisons between UK and Scotland NDNS RP survey years and age groups Scotland Years 1-4 combined UK Years 1-4 combined 1.5-3 4-10 11-18 19-64 65+ ‘5 a day portions’ (portions/d) - 2.7 3.8 4.4 2.9 4.1** 4.6 Fruit (g/d) 123 108 64 93 135 109 61 100 Vegetable (g/d) 65 78 161 172 72* 97** 112* 183** 186 Oil rich fish (g/d) 1 2 6 9 8 13* Red and processed meat (g/d) 31 48 59 72 63 30 45 60 71 73 Total fat % food energy 34.4 33.8 34 35 35.2 34.0 33.4 34.6 35.4 Saturated fatty acids % food energy 14.9 13.4 12.8 12.9 13.9 14.7 13.2 12.5 12.6 13.8 Trans fatty acids % food energy 0.7 0.6 0.8 0.7* NMES % food energy 12.0 14.8 15.4 11.5 11.9 15.6 12.1 NSP 8.3 10.5 13.0 8.2 11.1** 11.8 13.7** © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

© 2014 The British Nutrition Foundation 5 A DAY SDG - Average intake of a variety of fruit and vegetable intake to reach at least 5 portions/day (>400g) Children 11-18 years, mean consumption was 2.7 portions per day (10% meeting their 5 A DAY) Adults 19-64 years, mean consumption was 3.4 portions per day (25% meeting their 5 A DAY) Adults 65 and over, mean consumption was 4.4 portions per day (37% meeting their 5 A DAY) © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

© 2014 The British Nutrition Foundation Oily fish Oil rich fish consumption to increase to one portion (140g) per week © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

© 2014 The British Nutrition Foundation Saturated fatty acids Percentage contribution of food groups to average daily saturated fat intake (g) in 11-18 year olds in Scotland Buns, cakes, pastries and fruit pies Chicken, turkey and dishes Pasta, rice, pizza and other miscellaneous cereals Butter Biscuits 4% 4% 5% 5% 10% Sausages Beef, veal and dishes 4% Chocolate confectionary Cheese 4% 8% 7% Chips, fried and roast potatoes and potato products Meat pies and pastries Whole and semi skimmed milk 4% 4% 9% © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

Non starch-polysaccharides Percentage contribution of food groups to average non starch-polysaccharide intake (g) in 11-18 year olds in Scotland Vegetables (not raw) including vegetable dishes Pasta, rice, pizza and other miscellaneous cereals High fibre breakfast cereals Chips, fried and roast potatoes and potato products 5% 9% 11% 11% Other potatoes, potato salad and potato dishes Fruit White bread Savoury snacks 7% 12% 5% 5% © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

Micronutrient intakes and status This table shows nutrients of concern for some groups in Scotland, either because intakes are low or because of evidence of low status. Low intake* Low status** Folate Iron Riboflavin Vitamin D Calcium Magnesium Potassium Zinc Selenium Iodine * ‘Low intake’ is defined as intakes less than the Lower Reference Nutrient Intake (LRNI). Low intakes over a period of time may adversely affect health. ** ‘Low status’ of a micronutrient usually means that body stores or tissue levels are depleted and the individual is at greater risk of deficiency. © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

Population groups at risk of iron deficiency anaemia In Scotland, substantial numbers of girls aged 11-18 and women aged 19-64 have low iron intakes and so are at risk of iron deficiency anaemia. Evidence from blood tests indicate that 3.1% of girls 11-18 years, 3.0% of women 19-64 years and 5.2% of women 65 years and over have iron deficiency anaemia. © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

Population groups at risk of Vitamin D deficiency In Scotland, there was evidence of low vitamin D status in a proportion of participants in all reported age/sex groups, which was similar to the UK. For children aged 11 to 18 years, adults aged 19 to 64 years and adults aged 65 years and over, 26.1%, 32.5% and 29.4% respectively had a 25-hydroxyvitamin D (25-OHD) concentration below the current threshold indicating vitamin D adequacy (25nmol/L). © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

Estimated salt intakes NDNS age group RNI (mmol sodium per day) Maximum recommended salt intake (g per day) Estimated salt intake (g per day) 4 to 6 years 30 3 - 7 to 10 years 50 5 4.9 11 to 18 years 70 6 6.7 19 to 64 years Men – 9.4 Women – 7.0 65 years and over 7.3 At least 44% of the participants in each of the age groups excreted more sodium per day than the recommended maximum salt intake for their age group. © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

© 2014 The British Nutrition Foundation Sodium (salt) intakes Percentage contribution of food groups to sodium intake (g) in 11-18 year olds in Scotland. Sodium intake from the diet is underestimated in this survey as it only includes sodium in food and does not include the addition of salt during cooking or at the table. Bacon and ham Chicken, turkey and dishes Pasta, rice, pizza and other miscellaneous cereals White bread Cheese 13% 4% 6% 5% 11% Soup (manufactured/retail and homemade) Sausages Savoury sauces, pickles, gravies and condiments Savoury snacks 5% 4% 4% 4% © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

© 2014 The British Nutrition Foundation Dietary Inequalities For adults aged 19 to 64 years there was a pattern of ↓consumption of both fruit and vegetables, ↑ consumption of ‘soft drinks, non-diet’, ↓ NSP intake and ↑ percentage of energy from NMES with lower income and higher deprivation. For children aged 11 to 18 years, the pattern was similar with the exception of fruit consumption and percentage of energy from NMES which was not statistically significant. © 2014 The British Nutrition Foundation Source: NDNS RP (Scotland), 2014

Using the data in the classroom Research the nutrition and dietary issues in a certain population group Design a food product/meal focused on a particular nutrient concern (e.g. folate in 11-18 year old girls) Comparing their own diets with that of the Scottish population (e.g. class 5 A DAY survey) Creating posters/leaflets to help support the population in achieving the Scottish Dietary Goals (e.g. ways to reduce saturated fat intake) Comparing the diet of the Scottish population with other countries. © 2014 The British Nutrition Foundation

Links to further information Scottish Dietary Goals http://www.scotland.gov.uk/Topics/Health/Healthy-Living/Food-Health/DietaryGoalsScot Scottish Health Survey http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/scottish-health-survey FSA Scotland https://www.food.gov.uk/scotland eatwell everyday http://eatwelleveryday.org/ NDNS Report (Scotland) http://www.food.gov.uk/scotland/researchscot/scotlandresearch/ScotlandProjectList/n10036 NDNS Report (UK) 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 Food Standards Agency Scotland – Nutrition https://www.food.gov.uk/scotland/scotnut British Nutrition Foundation http://www.nutrition.org.uk/ © 2014 The British Nutrition Foundation

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