Transcript Part 1 - A Better Start

Current recommendations
and advice:
Promoting a healthy diet
during pregnancy and the
early years
Dr Helen Crawley
March 2016
Where should we get
advice – and what are the
key things to consider?
• Who should we take advice
from?
• What are the key things we
should focus on to improve
nutrition from pre-conception
to five years?
• What works – and what
support is there out there for
you?
Maternal and child
nutrition
Implementing NICE guidance
2nd edition March
2012
NICE public health guidance 11
NICE Quality
Standards (98) 2015
• NICE quality standards are a
concise set of prioritised
statements designed to drive
measurable quality
improvements in the 3
dimensions of quality – patient
safety, patient experience and
clinical effectiveness – for a
particular area of health or care.
• https://www.nice.org.uk/guida
nce/qs98/chapter/List-ofquality-statements
Who do we listen to?
• There are global codes and
conventions which have
been set up to protect
women and children
What does this mean?
• This means that in public
health we work within the
WHO Code of marketing of
breastmilk substitutes and
relevant WHA resolutions and do not use any
materials, resources or
information produced by a
company which makes
breastmilk substitutes, or
markets food for infants
under 6 months.
Nutrition matters
• We are in a new era of
understanding about the
importance of nutrition in
determining intergenerational health.
•
@ www.oldi
• @ www.oldies.com/artistsongs/Barry-White/ringtones
• es.com/artist-songs/BarryWhite/ringtones
Unfit for pregnancy?
• Young women in the UK are the
most malnourished group of the
population
• They typically have low status of a
wide range of nutrients, some are
too thin and many too fat, most eat
too few fruits and vegetables and
dietary variety may be limited.
Young women in low income
households
• Studies show young women
in low income households:
• Have high fat, salt and sugar
intakes.
• 1/3 have very low intakes of
iron, zinc, potassium,
riboflavin.
• Intakes of vitamin A, calcium,
magnesium and iodine are
frequently very low.
• If they smoke diet is often
worse.
Does it matter?
• Children born to poorly nourished
parents are unlikely to reach their
full potential.
• Iodine deficiency disorders are
the commonest cause of learning
disabilities worldwide
• If a woman has little or no dairy
foods and does not eat fish it is
unlikely she will have adequate
iodine status in the UK – new
data suggests this is becoming a
significant problem among some
young women in particular.
• Low maternal iodine status was
associated with an increased risk of
suboptimum scores for verbal IQ at age 8
years, and reading accuracy,
comprehension and reading score at age 9
years
• Results suggested a worsening trend in
cognitive outcome with decreasing
maternal status
• Possible in-utero effect of sub-optimal
iodine status
2013;382:331-37
Folic acid and vitamin D
• An association between the
development of neural tube
defects (NTD) and folic acid was
first suggested more than 35
years ago – and has been
recommended for women
planning a pregnancy – and in
the first 12 weeks of pregnancy
since 1992.
• Recommendations that all
women should take vitamin D in
pregnancy and when
breastfeeding have been in place
since 2003 – and new
recommendations are due this
month to increase amount
suggested for some
Healthy Start
• The UK revised welfare food
scheme – revamped in 2006 to offer
vouchers to buy milk, vitamins and
fruit and vegetable to low income
families and women under 18 years.
• Food vouchers worth £3.10 a week,
£6.20 for infants in first year.
• Also free vitamins for pregnant and
nursing women and children 1-4
years.
• Universally free in some areas.
Finding out more
about Healthy Start