The National Diet and Nutrition Survey (NDNS) is one of the best sources of information available in the United Kingdom (UK), helping to inform us about food habits, nutrient intakes and status and how these may be shifting with time.
This survey has been running since 2008 and now at the end of 2020 latest data has been released which captures new trends between 2016 and 2019 (Survey Years 9 to 11) and looks at overarching changes over the last 11 years.
This new report is particularly timely given the significance of ‘self-care’ in the light of the COVID-19 pandemic and urgent need to evaluate food in the context of its wider effects on planetary health. So, lets’ look at the latest data and see what has, or hasn’t been changing…
A Fall in Free Sugars. So, some positive news – intakes of ‘free sugars’ now show evidence of decline, particularly in older children aged 11-18 years.
Sugar confectionery intakes too seemed to have improved in 11 to 18 years olds, although the 65-to-74-year age group seem to have retained a sweet tooth.
Note: Definition of free sugars – Sugars added to foods and drinks by the manufacturer, or at home along with sugars naturally present in fruit, honey, syrups, vegetable juices, purees and pastes but excluding milk sugars in dairy-based drinks)
Fruit, Veg and Fibre at a sticking point. Mean fruit and vegetables intakes largely remain unchanged when compared with the 2014 to 2016 data set. Only women over the last 11 years seem to have marginally improved their fruit and vegetable intakes. Adults (19 to 64 years) eat, on average, 4.3 portions daily and children (11 to 18 years) just 2.9 portions daily.
This is somewhat surprising given shifts towards plant-based diets which, in theory, should be driving these up. Perhaps such shifts will be reflected in the next survey, or perhaps we are eating ‘plant-based’ meat substitutes but not necessarily using or eating these in their natural state.
There have been some improvements in fibre intakes in boys aged 4 to 10 and girls aged 11 to 18 years. Other than that, mean fibre intakes remain below recommendations across all age groups, again somewhat surprising given the emphasis towards plant-based diets.
The Concerning Fall of Folate and Iodine (in women of childbearing age). In the past, I have presented at several international conferences on the matter of folate. One of the main concerns is that folate shortfalls can result in neural tube defects (NTD – when the babies spinal cord does not form and close correctly in pregnancy). Women can, or course take supplements but, by and large these tend to be taken too late – once the spinal cord has already closed, a process that takes places in the incredibly early stages of pregnancy.
So, it is concerning to see that the populations folate status is declining whilst the mention of fortification seems to have gone somewhat quiet. Eating fortified breakfast cereals, pulses and green leafy veg can go some way towards improving these but clearly more needs to be done before more babies are born with spina bifida, cleft lip or palate.
Iodine is another nutrient of importance in pregnancy. Latest NDNS data again shows that this falls short in women of childbearing age (16-49 years) when compared against World Health Organization criteria for adequate iodine status.
Iron Intakes – A Paling Trend.
As in the last survey, mean intakes of iron remained to be discerningly low for girls (11 to 18 years) and women (19 to 64 years) alike with 49% and 25%, respectively having intakes below the Lower Reference Nutrient Intake (LRNI; level below which deficiency may occur).
Looking at blood biomarkers there is now evidence of iron-deficiency anaemia and low iron stores in one in ten older girls. Reductions in red meat intakes may have something to do with this, coupled with the failure to eat enough green leafy veg and fortified cereals. Novel interventions are needed before this problem becomes further exacerbated.
So, we have heard somewhat more about this vitamin over the last year, given confinements to the indoors in the wake of the COVID pandemic.
Sixteen per cent of adults (19 to 64 years), 13% of adults aged 65 years and over, and one in five children aged 11 to 18 years have low vitamin D status according to latest survey findings.
Vitamin D intakes were below dietary guidelines in all age groups. Supplementation led to some improvements, but recommended intakes were still largely not met.
It would be useful too to have a further breakdown of vitamin D intakes and status by ethnic group and body weight in further analyses of NDNS datasets.
So, much to think about and contemplate. Dr Emma Derbyshire the author of this Insight is the Founder of Nutritional Insight, a Scientific Consultancy providing expertise in Nutrition Research, Writing and Dissemination.
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