The food industry and public health (part 1 & 2)

Question 1

Describe the impact of obesity

Answer 1

• Around 27% of the adult population are obese
• obesity can impact mental and physical health, increasing the risk of T2DM and CVD
• Obesity and T2DM cost the UK more than the police, fire service and judicial system combined in 2014-15
• in 2014-15 the NHS spent £6.1 billion on obesity-related illnesses

Question 2

Sugar: why the focus on sugar? Sugar reduction program and the sugar levy

Answer 2

• Focussing on sugar as SACN found that intakes of free sugar were double the recommendation of <5% of kcals. The main culprits were cereals (in children) and sugar-sweetened beverages (teens). This greatly increases risk of dental caries and obesity
• The sugar reduction program: reformulation program started by PHE with an aim to reduce sugars by 20% in worst offenders in children’s diets
• Sugar levy (soft drinks levy): no tax if sugar <5g per 100 mL, 18p if 5-8g per 100 mL, 24p if >8g per 100 mL
• since introduction of the sugar levy, there has been a reduction of 43.7% in sugars in soft drinks
• aiming for a 20% reduction in sugar in milk-based drinks by 2021
• aiming for a 5% reduction in juice drinks by 2021

Question 3

The calorie reduction program

Answer 3

• part of the wider PHE reformulation program

- reducing kcal by 20% by 2024 in 15 savoury food categories commonly consumed

Question 4

Other PHE strategies: encouraging activity, salt reduction, TV advertising, promotions

Answer 4

• Encouraging activity: Better Health, One You activity apps
• Salt: recommend less than 6g per day. Salt reduction program by 2024 (4/5 of our salt currently come from pre-packaged foods)
• No reports on saturated fat yet but SACN recommends <10% of kcals
• front of label packaging
• ending of BOGOF promotions on unhealthy foods
• junk food TV advertising watershed of 9pm

Question 5

Advice on fibre: guidance for age categories, % of TDEI from CHO, issues with fibre intake

Answer 5

• recommend that 2-5 year olds have 15g/day, 5-11 20g/day, 11-16 25g/day, 16+ 30g/day
• 50% of TDEI should be from CHO
• issues with fibre intake: <30% are currently getting their 5-a-day, not mandatory that there is a nutrient declaration for fibre

Question 6

Saturated fat and heart disease

Answer 6

• Media claim an attenuated link
• CVD deaths are falling due to advancement in medical science
• recommend <10% of kcals, currently at ~12% which has fallen from 16% in the 1980s

Question 7

Vitamins & minerals: general trends, vitamin D, iodine, folate, iron

Answer 7

• General trends: micronutrient levels are declining. Particularly in young women and in elderly populations,
• vitamin D: recommend 10ug/day, average is 2.9ug/day . Good food sources include oily fish, eggs and fortified foods
• Folate: helps NTD in pregnancy, need 400 ug 2 months pre-conception and 12 weeks into pregnancy. Food sources include wholewheat foods, vegetables, fortified foods. 89% of women of child-bearing age have a deficiency
• Iron: 49% of teen girls and 25% of women have Fe levels below LRNI. Food sources include red meats, fortified cereals. Iron-deficiency can cause poor pregnancy outcomes
• iodine: 28% of teen girls deficient. Essential for thyroid hormone production and in utero development. Main source is milk (34%), shellfish (10%)

Question 8

Other dietary recommendations: oily fish, red meat, fruit & veg

Answer 8

• oily fish: 140g/week (1-2 portions). Mean intake is 56g/week, low across all age groups
• red and processed meats: 350-500g per week (3x per week). Consume very little, if any processed meats
• 5-a-day: <30% consume 5 a day (400g). Average teen intake is ~180g/day which is that of a toddler

Question 9

Whole diet approach

Answer 9

• Aim for lower energy density to allow for larger portions of more wholesome foods
• think about simple swaps
• focus on diet quality

Question 10

Opportunities & challenges for the industry in improving nutrient density

Answer 10

• adding nutrients for fortification is difficult for dried foods
• reduction of sugars and fats: adds mouth-feel
• reduction of salt: it is a preservative
• reducing portion size may mean consumers feel they aren’t getting value for money
• Addition of composite foods i.e. vegetables

Question 11

Sustainable diets

Answer 11

• EAT-LANCET commission recommends: plant-based diets, fish from sustainable sources, reductions in food waste, improvements in the efficiency of food production
• The Carbon Trust found eating like the EatWell guide would lead to a 30% reduction in impact on climate
• It also costs less to eat like the EatWell plate
• But we still need to understand the impact of these food choices on health