© 2014 The British Nutrition Foundation Nutrition Update Sarah Coe, Nutrition Scientist British Nutrition Foundation 15 th November 2014

© 2014 The British Nutrition Foundation

Nutrition Update

Sarah Coe, Nutrition Scientist

British Nutrition Foundation

15th November 2014


Nutrition Update

Sarah Coe, Nutrition Scientist

British Nutrition Foundation

15th November 2014


OutlineThe ‘5532-a-day’ toddler

guide

Vitamin D


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


Nutrient requirements of toddlers

• Naturally active and growing rapidly – energy and nutrient requirements are high

• Nutrient-dense foods

• Regular drinks

• Establishing good dietary habits


Nutrient requirements of toddlersGroup 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 each meal and at some snack times

Breakfast cerealsBread sticksRice 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)

MilkYogurtCheese

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)

MeatFishEggsNutsPulses

Nutrient requirements of toddlers

Group Nutrients provided

Recommendation Examples of foods

5. Foods high in fat and/or sugar

Energy, fat, vitamin A, E and D

Offered only in addition 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

Butter, margarineCakes/biscuitsSweetsSweetened drinks



Key nutritional issues in 1-3 year-olds

1 in 5 overweight/obese when start primary

school

Type 2 diabetes

Not enough…IronZincVitamin AVitamin D

Too much!Saturated fatSugarsSalt

12% of3 year-olds have

tooth decay

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


Key Messages


Not new but useful

reminderSurprise at inclusion of

‘carbs’

TOO MUCH!!



Helps reinforce the breakdown of the food

groups

Memorable

Needs careful communication of

portion sizes


Design Routes






And the winner was…






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

http://www.nutrition.org.uk/healthyliving/toddlers/5532




Vitamin D

December 2014 www.blackwellpublishing.com/nbu

http://www.blackwellpublishing.com/nbu


Vitamin DReview 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


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)


Sources of vitamin D

SunlightNatural food

sourcesFortified foods

Diet

Supplements


UK National Diet and Nutrition Survey (2008/09-2011/12)

Sources of vitamin D

Contribution of food groups to vitamin D intake in adults and children

Adults aged 19 years and over

Children aged 4-18 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%


Vitamin D deficiencyIncreased 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


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


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



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


• 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


How can vitamin D status be improved?

• Supplements

• Fortification

• Improve population’s diet and lifestyle



Supplements

• 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!

Vitamin D supplements (10 µg/day)


FortificationVaries throughout Europe

Milk and milk products• Finland (+ non-dairy

alternatives e.g. soy, rice/oat drinks)

• Sweden (low fat)

Margarine and fat spreads•Finland (+ butter)•Sweden•UK (margarine)

Breakfast cereals Infant formula

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



Thank you for listeningwww.nutrition.org.uk

www.foodafactoflife.org.uk

Documents

© 2014 The British Nutrition Foundation Nutrition Update Sarah Coe, Nutrition Scientist British Nutrition Foundation 15 th November 2014