Transcript BNF Nutrition Update 5532 and Vitamin D

Nutrition Update
Nutrition Update
Sarah Coe, Nutrition Scientist
British Nutrition Foundation
15th November 2014
Sarah Coe, Nutrition Scientist
British Nutrition Foundation
15th November 2014
© 2014 The British Nutrition Foundation
© 2014 The British Nutrition Foundation
Outline
The ‘5532-a-day’ toddler
guide
Vitamin D
© 2014 The British Nutrition Foundation
Background
• No food-based guidance for
parents of toddlers (1-3 years)
available
• Guidance that children should
‘gradually move towards’
eating in line with the eatwell
plate is confusing
• Health professionals wanted
something age-specific
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Nutrient requirements of toddlers
• Naturally active and growing rapidly –
energy and nutrient requirements are high
• Nutrient-dense foods
• Regular drinks
• Establishing good dietary habits
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Nutrient requirements of toddlers
Group
Nutrients provided
Recommendation
Examples of foods
1. Potatoes, bread,
rice, pasta and
other starchy
foods
Energy, some
protein, fibre,
vitamins and
minerals
1 portion offered at
Breakfast cereals
each meal and at some Bread sticks
snack times
Rice cakes
2. Fruit and
vegetables
Vitamins and
minerals, fibre,
phytochemicals
Serve at each meal
and at some snack
times
Fresh/frozen/canned
/dried
3. Milk and dairy
foods
Energy, protein,
calcium, other
vitamins and
minerals
Serve 3 times a day
(whole milk/yogurt for
under 2’s)
Milk
Yogurt
Cheese
4. Meat, fish,
eggs, beans and
other non-dairy
sources of protein
Protein, energy,
omega 3 fats,
vitamins and
minerals
Serve 2-3 times a day
(3 times for vegetarian
toddlers)
Fish – twice a week
(one portion oil-rich)
Meat
Fish
Eggs
Nuts
Pulses
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Nutrient requirements of toddlers
Group
5. Foods high in
fat and/or sugar
Nutrients
provided
Recommendation
Energy, fat, vitamin Offered only in addition
A, E and D
to (not instead of) foods
from the other food
groups.
Sugary foods should be
kept to meal times and
no more than 4
occasions a day
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Examples of
foods
Butter, margarine
Cakes/biscuits
Sweets
Sweetened
drinks
Key nutritional issues in 1-3 year-olds
Not enough…
Iron
Zinc
Vitamin A
Vitamin D
1 in 5
overweight/obese
when start primary
school
Too much!
Saturated fat
Sugars
Salt
12% of
3 year-olds have
tooth decay
Type 2 diabetes
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Rickets
Developing the toddler guide
•
Set up an advisory group to develop ideas and review the research
•
Held focus groups with mums and health visitors
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Key Messages
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Surprise at
inclusion of
‘carbs’
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Not new but
useful
reminder
TOO MUCH!!
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Memorable
Helps reinforce the
breakdown of the food
groups
Needs careful
communication of
portion sizes
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Design Routes
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And the winner was…
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Dissemination
“I work with parents with young
children and they have been crying
out for this information re. portion
guidance”
Community & Health Coordinator,
Co.Tyrone
http://www.nutrition.org.uk/healthyliving/toddlers/5532
http://www.nutrition.org.uk/healthyliving/nutrition4baby
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Vitamin D
December 2014 www.blackwellpublishing.com/nbu
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Vitamin D
Review to explore vitamin D status and
intake in Europe
• Sources
• Vitamin D deficiency
• How much do we need?
• How much are we getting?
• Supplements and fortification
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Why do we need vitamin D?
• Help us absorb calcium and phosphorus
from the food we eat
• Healthy bones and teeth
• Severe lack of vitamin D =
rickets and osteomalacia
(soft and weak bones)
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Sources of vitamin D
Sunlight
Diet
Natural food
sources
Fortified foods
Supplements
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Sources of vitamin D
UK National Diet and Nutrition Survey (2008/09-2011/12)
Contribution of food groups to vitamin D intake in adults and children
Adults aged 19
years and over
Children aged 418 years
Children aged
1.5-3 years
Meat and meat
products
23-30%
25-35%
21%
Fat spreads
19%
20-21%
20%
Cereals and
cereal products
13%
17-20%
14%
Fish
17-23%
8-9%
8%
Milk and milk
products
5-6%
6-13%
24%
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Vitamin D deficiency
Increased risk if:
• Overuse sunscreen
• Have darker skin
• Low or no exposure to the sun
Other population groups at risk:
• Pregnant or breastfeeding
• Teenagers and young women
• Babies and children under 5 years
• Older people aged 65 years and over
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How much vitamin D do we need?
• Currently no agreement on what is the
optimal amount of vitamin D
• Recommended intakes across Europe vary
from 5-20 µg/day
• European average = 10 µg/day
• In the UK - there is no recommendation for
vitamin D for those aged 4-65 years
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How much vitamin D are we getting?
Average intake from food for adults does not
meet the recommendation:
4.8 μg/day (men), 3.3 μg/day (women)
Most countries = 2-4 μg/day
Lowest = Spain (<2 μg/day)
Highest = Scandinavian countries
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How much vitamin D are we getting?
Average daily vitamin D intakes (μg/day)
1.5-3y
4-10y
11-18y
19-64y
65+y
From food only
1.9
2.0
2.1
2.8
3.3
From food +
supplements
2.3
2.7
2.4
3.6
5.1
Source: NDNS 2008/09-2011/12
© 2014 The British Nutrition Foundation
How much vitamin D are we getting?
• In UK, vitamin D deficiency
is more common in winter
than in the summer (39%
vs. 8% adults)
• We can only make vitamin
D from the sun between
April and September
• Need to be out in the sun
for few minutes between
11-3pm
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How can vitamin D status be
improved?
• Supplements
• Fortification
• Improve population’s diet and lifestyle
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Supplements
Vitamin D supplements (10 µg/day)
• Pregnant and breastfeeding women
• More likely to be taken in Northern Europe and
by women
• UK – Healthy Start scheme (low uptake)
• Will only work if they are taken!
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Fortification
Varies throughout Europe
Milk and milk products
•
•
Finland (+ non-dairy
alternatives e.g. soy,
rice/oat drinks)
Sweden (low fat)
Breakfast cereals
Margarine and fat spreads
•
•
•
Finland (+ butter)
Sweden
UK (margarine)
Infant formula
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Summary
• Healthy eating over the life course is important
• Some health issues e.g. low vitamin D might be
more of a concern in some groups, but spans from
young children to older adults
• Important to get diet right from the start
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Thank you for listening
www.nutrition.org.uk
www.foodafactoflife.org.uk
© 2014 The British Nutrition Foundation