2018 - Innovations and policies in food and nutrition

What does 2018 have in store in terms of food and nutrition and what are the opportunities for new innovations? I’ve provided a few of my thoughts on this below, as well as a summary of some forthcoming developments in nutrition policy to look out for in early 2018.

Gut health – seeing the bigger picture

Interest in the importance of gut health is nothing new. Probiotics and prebiotics are now commonly associated with benefiting gut health and indeed much of the research so far has been on the bacterial gut microbiome – the good and bad bacteria in our digestive system. However, the gut is extremely complex and research is now providing us with a better understanding of the importance of not just the microbiome, but also the mycobiome, or fungal microbiota in the gut. It seems both bacteria and fungi play a key role in digestive health and their interactions can impact our health more generally.

As more research findings are published, we will have a better understanding of how different types of food and lifestyle impacts our gut health, and the impact our gut health has on our health in general. It’s an exciting area of research and an area to watch out for future food product innovation.

Focus on fibre and wholegrains

This is perhaps more wishful thinking from a nutritionist’s point of view, but I do hope that fibre and in particular wholegrains are given more attention this year. Fibre plays a vital role in our health, and we are generally not consuming enough of it! Most people in the UK consume on average, around 18g fibre a day, which falls far below the recommended 30g a day. A diet of fibre-rich foods, such as fruits, vegetables and wholegrains, reduces the risk of developing diabetes, heart disease and some cancers, as well as reducing obesity and improving digestive health. In actual fact, evidence shows that eating more fibre seems to lower mortality rate, whatever the cause (Yang Yang et al, 2015).

The benefits of eating wholegrains include improving gut health, lower body weight, reduced inflammation, reduced risk of cardiovascular disease, type-2 diabetes and many cancers. However, data from the National Diet and Nutrition Survey shows that 45% of the population eat less than one serving (16g) per day and almost 1 in 5 (18%) adults don’t eat any wholegrains at all! (Mann et al., 2015).

There are currently no quantified recommendation for intake of whole grains in the UK. The Governments Eatwell Guide advises that wholegrain options should be chosen whenever possible. Some countries such as the US, Canada, Australis and Denmark provide specific day recommendations which range from at least 48g per day (equal to at least 3 servings) in the US to 75g in Denmark.

Effective product development can lead to large increases in wholegrain intakes and the largest benefit could actually be achieved by shifting people who have low or no intake of wholegrains to an intake of just one serving (16g) per day (KyrØ and TjØnneland, 2016).

Plant based diets

Vegan food and drink options continue to increase and it would seem with the amount of new vegan food products and eateries in the UK that a large proportion of the population was turning vegan. However, to put this into context, the National Diet and Nutrition Survey from 2014 estimated that around 2% of the UK population is vegetarian and less than 1% follow a vegan diet. More recent research from GlobalData in the first quarter of 2017 reported 3% of the British population described themselves as vegan, compared with 0.8% in 2014.

For many people, adjusting to a vegan diet is very challenging, and a ‘flexitarian’ diet may be more achievable. A flexitarian, or semi-vegetarian diet is one that is mainly vegetarian with the occasional inclusion of meat and/or fish. Interestingly, a flexitarian diet is actually similar to the Mediterranean diet and the UK government’s Eatwell Guide.

Whatever the terminology, improvements in the population’s health are likely if more people adopt a more plant-based diet high in vegetables, fruits, legumes, nuts, beans, cereals, grains, fish and unsaturated fats, with low intake of meat and dairy – a ‘meat and three veg’ approach. The increase in plant based foods and animal protein alternatives is set to continue in 2018.

Nutrition for our aging population

In 2016, 18% of the UK population were aged 65 and over. This figure is estimated to increase to almost 24% (23.9%) by 2036 (ONS, 2017). As yet, I’ve not noticed many products developed specifically for this age group, and there is a lot of potential for it. A diet rich in micronutrients and high in fibre and protein can help lower the risk of health problems associated with later life. Key nutrients for older adults include long-chain omega-3 fatty acids, B vitamins, vitamin D and calcium, and zinc.

Protein is particularly important to help preserve skeletal muscle mass and strength as we age and to help prevent sarcopenia (muscle wasting). Evidence from studies conducted across the globe, reported a prevalence of sarcopenia from 1%-29% in community-dwelling adults aged 50+ years (Cruz-Jentoff et al, 2014). A small study in Scotland that I worked on, found high levels of sarcopenia and sarcopenic obesity among community-dwelling adults aged 65+ years (Jones et al, 2015). To maximise the beneficial impact of protein on muscle, adequate protein should be consumed throughout the day in each meal (Witard et al, 2016). Dairy proteins may be particularly beneficial due to their high leucine content – an amino acid that can help stimulate muscle growth and prevent muscle breakdown.

Forthcoming nutrition policies and developments

For the past several years there has been a lot of focus on specific nutrients (reformulation to reduce saturated fat, salt and most recently sugars). This will continue throughout 2018. The progress made by industry in terms of sugar reduction is currently being monitored by Public Health England (a progress report is due in March 2018); the publication of the SACN saturated fat review will put fat back in the spotlight (due out for consultation early 2018); and Public Health England will encourage further reductions in salt this year. SACN’s review of potassium-based sodium replacers published in November 2017, recommended that the government should consider encouraging food companies to explore the use of potassium-based sodium replacers to help reduce sodium levels in foods.

More broadly speaking, nutritional composition is being considered in a review by Public Health England. A review of the nutrient profiling model is due out for consultation in early 2018. The Nutrient Profiling Model was originally developed by the Food Standards Authority to provide Ofcom, the broadcaster regulator, with a tool to differentiate foods and drinks on the basis of their nutritional composition. This review aims to ensure the model reflects the latest dietary guidelines, and in particular the latest recommendations on sugars and fibre.

Public Health England will be launching a new campaign in March 2018 to raise awareness of ways to reduce calories consumed from breakfast, lunch and dinner. The simple rule of thumb will be to aim for 400, 600 and 600 calories for breakfast, lunch and dinner respectfully. As many additional calories are eaten outside of the home, Public Health England will be working with high street food chains to make healthier choices more accessible.

In Scotland, proposals for a range of actions to improve diet and weight is currently out for consultation until 31st January. The consultation document ‘A healthier future – action and ambitions on diet, activity and a healthy weight’ includes proposals on junk food advertising, food purchases for consumption outside the home and practical support for food manufacturers to reformulate and develop healthier products.

Scotland has also been urging action on the fortification of flour with folic acid. Back in 2006 and 2009 SACN, after reviewing the evidence, recommended mandatory fortification of flour with folic acid to be introduced along with voluntary fortification of foods with folic acid and guidance on supplement use. In July 2017, SACN published an update of evidence available since the previous reports. The recommendations from the previous reviews remained valid. Blood folate results show that 81%, 79%, 83% and 75% of women of childbearing age in Scotland, Wales, Northern Ireland and the UK as a whole respectively are below the threshold for increased risk of a neural tube defect affected pregnancy. After ruling out introducing mandatory fortification across Scotland only, due to cost and practical implications, Ministers from the Scottish and Welsh Governments wrote to Jeremy Hunt, UK Health Secretary, in December 2017 urging him to take action and introduce mandatory fortification of flour with folic acid on a UK wide basis. The response will hopefully come soon!

Finally, in Scotland, 2018 is the Year of the Young People. The attitudes and behaviours of young people in particular are driving many of the current and emerging food trends (e.g. free-from, vegan, and a preference for premium, small brands, local, online, sustainable, snackable and instagrammable food). Young people aged 7-16 years spend on average 3 hours a day online. There is a huge amount of nutrition information available on social media sites, with much of it opinion-based rather than evidence-based. Qualified Nutritionists (RNutr) and Dietitians (RDs) are needed to help re-balance the credibility of the information online. Making the title ‘Nutritionist’ a protected term and raising awareness among consumers and the media of where to seek reliable and trusted nutrition information would be very useful.

It looks set to be a very busy and #braw year!

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