towards a healthier britain dr carrie ruxton registered dietitian nutrition communications
TRANSCRIPT
![Page 1: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/1.jpg)
Towards a healthier Britain
Dr Carrie Ruxton
Registered Dietitian
Nutrition Communications
![Page 2: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/2.jpg)
Plan of talk
• What are we eating today?
• Evidence from the NDNS
• Hot nutrients for 2011
• Role of fortified products and supplements
![Page 3: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/3.jpg)
What are we eating today?
![Page 4: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/4.jpg)
30% of calories from nutrient-poor foods and drinks
Source: NDNS (2010) 19-64 years
30% of calories from treats, alcohol, soft drinks, chips and crisps
![Page 5: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/5.jpg)
Similar picture in children
0 5 10 15 20
Bread
RTEC
Milk
Chips/crisps
Soft drinks
Meat/fish
Treats
% of daily calories
32% of calories from treats, soft drinks, chips and crisps
Source: NDNS (2010) 11-18 years
![Page 6: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/6.jpg)
Fruit and vegetable intake improving in adults but not in children
0
5
10
15
20
25
30
35
40
2001 2002 2003 2004 2005 2006 2010
% achieving 5-a-day
Men Women Children
Source: NDNS (2010) and SACN reports
![Page 7: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/7.jpg)
Deficiency amongst plenty?
Half of adults overweight or obese1 in 5 children overweight
![Page 8: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/8.jpg)
Half of adults overweight or obese1 in 5 children overweight
Half of women have inadequate selenium intakes1 in 5 pre-schoolers have low iron stores
Why does only one side of equation get our attention?
![Page 9: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/9.jpg)
Proven role of nutrients in health
Calcium, magnesium, Vit D
Normal bones and teeth
Vit B12, zinc Normal immune function
Vit A Normal vision
Niacin Normal nervous system
Iron, zinc Normal cognitive function
Folate Normal tissue growth during pregnancy
DHA/EPA Maintenance of normal blood pressure and normal serum triglycerides
Source: EFSA opinions on Article 13 claims, 2010
![Page 10: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/10.jpg)
Evidence from the NDNS
![Page 11: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/11.jpg)
Men and women
![Page 12: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/12.jpg)
Average intakes of vitamins and minerals seem OK, probably influenced by fortified foods
0 50 100 150 200 250 300
Vit A
Folate
Vit C
Iron
Calcium
Magnesium
Potassium
Zinc
Iodine
Selenium
%RNI
Women
Men
NDNS (2010) Adults
![Page 13: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/13.jpg)
But averages mask adults with poor intakes
Source: NDNS (2010) Adults
0 10 20 30 40 50 60
Vit A
Folate
Vit C
Iron
Calcium
Magnesium
Potassium
Zinc
Iodine
Selenium
% adults < LRNI
Women
Men
NDNS (2010) Adults
![Page 14: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/14.jpg)
Most adults have low vitamin D intakes
0
2
4
6
8
10
12
14
16
18
20
>0.5 0.5 to 1 1 to 1.5 1.5 to 2 2 to 2.5 2.5 to 3 3 to 3.5 3.5 to 5 5 to 7 7 to 7.5 7.5 to 9 >9
Intake (micrograms per day)
% w
ith in
take
s in
rang
e
Men
Women
EU RDA for adults < 50 years71% men + 78% of women below RDA
NDNS (2003) Adults
![Page 15: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/15.jpg)
0
5
10
15
20
25
30
35
40
% d
efic
ien
t
15-18 19-24 25-34 35-49 50-64 Instit
Age (years)
Men
Women
25% of adults deficient in winter months
Source: National Diet & Nutrition Surveys (2000, 2003)
25-hydroxy vitamin D <25 nanomoles/litre
![Page 16: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/16.jpg)
Children and teens
![Page 17: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/17.jpg)
Younger children doing better on average
NDNS (2010) Children
0 50 100 150 200 250 300
Vit A
Folate
Vit C
Iron
Calcium
Magnesium
Potassium
Zinc
Iodine
Selenium
% RNI
11-18 yr
4-11 yr
![Page 18: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/18.jpg)
But closer examination reveals the issues
0 10 20 30 40
Vit A
Folate
Vit C
Iron
Calcium
Magnesium
Potassium
Zinc
Iodine
Selenium
% children < LRNI
11-18 yr
4-11 yr
Intakes of iron, magnesium and selenium particularly worrying
NDNS (2010) Children
![Page 19: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/19.jpg)
0
5
10
15
20
25
30
35
40
45
50
% g
irls
11-1
8yr
< L
RN
ITeenage girls most at risk from deficiency
NDNS (2010) Children
![Page 20: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/20.jpg)
Most children have low vitamin D intakes
94% boys + 97% of girls below EU RDA of 5 micrograms/day
0
5
10
15
20
25
30
35
<0.5 0.5 to 1 1 to 1.5 1.5 to 2 2 to 3 3 to 5 >5
Intake (micrograms per day)
% w
ith in
take
s in
ra
ng
e
Boys
Girls
Source: NDNS (2000) Children
![Page 21: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/21.jpg)
Diets have improved little over the years
50
100
150
1997 2008/9
%R
NI
BoysGirls
0
50
100
1997 2008/9
%R
NI
BoysGirls
Folate
Vitamin D*
* EU labelling RDA of 5 micrograms used
50
100
1997 2008/9
%R
NI
Iron
50
100
1997 2008/9
%R
NI
Calcium
![Page 22: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/22.jpg)
Where are they going wrong?
Food category g/day
4-10y 11-18y
Breakfast cereals 24 18
Bread 64 70
Milk 164 107
Fresh meat 46 58
Fish 19 17
Vegetables 74 77
Fruit 103 57
Soft drinks 284 417
NDNS (2010) Girls
![Page 23: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/23.jpg)
Key nutrients
Men•Selenium•Potassium•Magnesium•Zinc•Vitamin A•Vitamin D
Women•Selenium•Potassium•Magnesium•Iron•Calcium•Vitamin D
Children•Selenium•Potassium•Magnesium•Iron•Calcium•Vitamin D•Zinc•Folate•Iodine
![Page 24: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/24.jpg)
What are we missing?
Vitamin D
Selenium
Vitamin A
Zinc
Magnesium
Potassium
Calcium
Iron
Iodine
Folate
![Page 25: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/25.jpg)
Hot nutrients for 2011
• Vitamin D
• Selenium
• Omega 3
• Flavonoids
![Page 26: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/26.jpg)
Vitamin D – 90% from sunshine
![Page 27: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/27.jpg)
But diet plays a role
5 to 22 mcg/portion0.02 to 1 mcg/egg
5 to 10 mcg/tsp
![Page 28: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/28.jpg)
Mortality
Bone health
Immune function
Cell aging
Heart disease
Cancer
Cognitive function
Diabetes
Why are we interested?
Infection
Good Moderate Emerging
![Page 29: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/29.jpg)
Selenium
• Essential trace element (Se)
• Antioxidant
• Stored in the body but topped up by our diet
![Page 30: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/30.jpg)
Where do you get it?
![Page 31: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/31.jpg)
Why are we interested?
Se
Supports fertility
Antioxidant
Immune function
Mood?
Anti-ageing
Heart health
![Page 32: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/32.jpg)
Are we getting enough?
Selenium intake μg/d
UK rec60-75 μg/d
MAFF (1999), BNF (2001), Jackson et al (2003)
![Page 33: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/33.jpg)
Omega-3s – still current
• Marine foods or supplements remain the best sources of EPA/DHA
• Vegetable omega-3s ‘don’t count’
![Page 34: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/34.jpg)
Why are we interested?
Omega-3Heart health already known
IQ in children
Stress relief
Anti-ageing
Less depression?
Immune function
![Page 35: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/35.jpg)
Omega-3 and the lifecycle
DHAEPA
Higher IQLess allergy Brain function
Better behaviour?Less stressMaintain brain function
![Page 36: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/36.jpg)
Flavonoids
![Page 37: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/37.jpg)
Flavonoid subclass
Examples Sources
Flavonols Kaempferol, quercetin Onions, kale, broccoli, tea, red wine
Flavones Apigenin, luteolin Parsley & leafy herbs
Flavanones Hesperetin, naringenin Citrus fruits
Isoflavones Daidzein, genistein Soybeans, legumes
Flavan-3-ols Catechin, epicatechin, epigallocatechin, EGCG
Tea, red wine, cocoa
Anthocyanidins Cyanidin, delphinidin, malvidin
Blueberries, black grapes, leafy veg
![Page 38: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/38.jpg)
Heart disease Weight management
Blood pressure
Stroke Cognitive function
Diabetes
Why are we interested?
Good Moderate Emerging
Cancer
Oral health
![Page 39: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/39.jpg)
The issue
• 30% of calories are from foods that tend to be low in micronutrients
• Significant groups of adults and children are low in key nutrients, risking deficiency
• Some nutrients, e.g. omega-3s, vitamin D, iron and selenium are only present in limited numbers of foods
![Page 40: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/40.jpg)
Only some consumers are motivated to change their diets
managersdisciples investorshealers strugglers unmotivateds
health involved unmotivated
Source: Design Bridge
health involved unmotivated
![Page 41: Towards a healthier Britain Dr Carrie Ruxton Registered Dietitian Nutrition Communications](https://reader036.vdocument.in/reader036/viewer/2022062417/551a25e3550346cb358b4c70/html5/thumbnails/41.jpg)
Role of fortified products and supplements
• Boost what consumers already like to eat or find acceptable
• Take care to fortify where appropriate (chocolate bars with vitamin D!)
• Supplements only taken by 25% of consumers – room for improvement
• Consumers prefer ‘natural’ sources of nutrients