J. Loe

Sustainable diets for the future: can we contribute to reducing greenhouse gas emissions by eating a healthy diet?

BACKGROUND Food systems account for 18-20% of UK annual greenhouse gas emissions (GHGEs). Recommendations for improving food choices to reduce GHGEs must be balanced against dietary requirements for health. OBJECTIVE We assessed whether a reduction in GHGEs can be achieved while meeting dietary requirements for health. DESIGN A database was created that linked nutrient composition and GHGE data for 82 food groups. Linear programming was used iteratively to produce a diet that met the dietary requirements of an adult woman (19-50 y old) while minimizing GHGEs. Acceptability constraints were added to the model to include foods commonly consumed in the United Kingdom in sensible quantities. A sample menu was created to ensure that the quantities and types of food generated from the model could be combined into a realistic 7-d diet. Reductions in GHGEs of the diets were set against 1990 emission values. RESULTS The first model, without any acceptability constraints, produced a 90% reduction in GHGEs but included only 7 food items, all in unrealistic quantities. The addition of acceptability constraints gave a more realistic diet with 52 foods but reduced GHGEs by a lesser amount of 36%. This diet included meat products but in smaller amounts than in the current diet. The retail cost of the diet was comparable to the average UK expenditure on food. CONCLUSION A sustainable diet that meets dietary requirements for health with lower GHGEs can be achieved without eliminating meat or dairy products or increasing the cost to the consumer.

Meal and snacking patterns of school-aged children in Scotland

Background:Current lifestyles and the choice and availability of foods may influence the eating patterns of children. The aim of this study was to investigate the meal and snacking patterns of school-aged children in Scotland.Methods:A sub-sample of 156 children (5–17 years) from the national Survey of Sugar Intake among Children in Scotland completed a 4-day non-weighed diet diary. Meals and snacks were defined using a food-based classification system based on ‘core’ and ‘non-core’ foods. The first eating event containing a solid food item up to and including 0900 hours (1100 hours on weekend days) was defined as breakfast. Frequency of meal and snack consumption was compared between age, sex, body mass index (BMI) and socio-economic sub-groups, between term-time and school holidays and between weekdays and weekend days. Intakes of total fat, saturated fatty acids (SFA) and non-milk extrinsic sugars (NMES) on these days were also compared.Results:Children ate a median of 3.3 meals plus 2.0 snacks per day, which did not vary between age and BMI groups. In all, 83% of children ate breakfast on all 4 days. Boys ate more meals than girls but the number of snacks was similar. Children from lower socio-economic groups tended to eat more meals and fewer snacks. Snacks accounted for 21% of the total daily energy intake, 22% of total fat, 24% of SFA and 39% of NMES intake. Daily intake of energy, total fat, SFA and NMES did not differ between term-time and holidays or weekdays and weekend days.Conclusions:Children tended to follow a traditional pattern of three meals a day, which was consistent between age and BMI subgroups and between school term-time and holidays.

It was an education in portion size. Experience of eating a healthy diet and barriers to long term dietary change.

The aim of the study was to explore the expectations and experience of actually eating a healthy diet and using this experience to identify barriers to healthy eating and sustainable dietary change. Fifty participants (19-63 yrs) were provided with a healthy diet (i.e. complied with dietary recommendations) for three consecutive days. Afterwards a semi-structured interview was carried out to explore expectations, experience and barriers to healthy eating. Using a thematic analysis approach eight dominant themes emerged from the interviews. Four related to expectations and experience of healthy eating; realisation of what are appropriate portion sizes, an expectation to feel hungry, surprise that healthy diets comprised normal food, the desire for sweet snacks (e.g. chocolate). This demonstrated there are some misconception about healthy eating and distorted views of portion size. Four more themes emerged relating to barriers to healthy eating; competing priorities, social, peer and time pressure, importance of value for money, a lack of desire to cook. Poor knowledge of healthy eating or a lack of cooking skills were the least common barrier, suggesting that future interventions and policy to improve dietary intakes need to focus on social, cultural and economic issues rather than on lack of knowledge or skills.

How many children meet dietary targets for both fat and sugar intake? A national survey of dietary intake of children in Scotland

Dietary targets are set for monitoring within the general population but they can provide a useful indication of the proportion of individuals meeting the dietary targets, as well as whether individuals are achieving a combination of the targets. The aim of the present study was to estimate the proportion of children in Scotland with intakes meeting the dietary targets of £ 35 % food energy from total fat, £ 11 % food energy from SFA and £ 10 % total energy ( £ 11 % food energy) from non-milk extrinsic sugar (NMES) as set out in the Scottish Diet Action Plan (1) . The Survey of Sugar Intake among Children in Scotland (2) conducted in 2006 assessed the dietary intake of a national sample of children across Scotland using a 140-item FFQ. The survey achieved a response rate of 67 %, with usable data for 1391 children aged 317 years. Dietary data were used to estimate the percentage of children meeting dietary targets for total fat, SFA and NMES intake. As a population these children achieved the dietary target for total fat, but approximately one-third of children had intakes > 35 % energy from total fat (see Table). Only 10 % of children met the targets for either SFA or NMES. There was no difference between boys and girls in the percentage meeting these targets. Younger children (3‐11years) were more likely than older children (12‐17 years) to meet targets for NMES (12.3% v. 7.2 %; P = 0.02) but less likely to meet targets for SFA (7.5% v. 14.3%; P < 0.001). Of the children 59 % met only one of the dietary targets and < 2 % of children met all three dietary targets. All the children that met the target for SFA also met the target for total fat intake, but only 15 % of those who met the total fat target also met the SFA target. A subsample of 156 children also completed a diet diary, which supported these findings and provided examples of the types of meals eaten across the day that achieved the targets.

Development of a tool to assess children's knowledge of non-milk extrinsic sugars, general nutrition, energy balance and physical activity

Children’s intakes of non-milk extrinsic sugars (NMES) are considerably higher than the recommended intake of less than 10 % of total energy (1) , with a recent survey showing the average intake of NMES for children in Scotland being 17.4 % of their food energy (2) . There is also increasing evidence to link intakes of NMES with weight gain (3) ; however, little is known about children’s current knowledge of NMES, physical activity and energy balance. The aim of this study was to design a questionnaire for children to assess their knowledge of these topics for use in an intervention. The questionnaire was developed in three stages with children aged 8–12 years and changes were made based on feedback from each stage. It was designed to appeal to children and teaspoons of sugar were used as a unit of measurement of NMES that the children could understand. Questions were included on maximum daily NMES recommendations, NMES content of a range of foods (using teaspoons of sugar), energy balance and general nutrition. Initially, the questionnaire was tested with 29 children to assess whether they understood the questions and could complete the questionnaire appropriately. The questionnaire was revised and retested in a separate group of 36 children who gave feedback; 75 % thought its difficulty was about right, and they all liked the layout. With further revisions, it was retested with a new sample of 38 children. From this stage, an item difficulty index was used to assess each item on the questionnaire with 20 of the 27 questions falling within the recommended boundaries (4) . Item discrimination (testing the ability of each question to discriminate between children with varying levels of knowledge) was assessed using an item-to-total score correlation which should not fall below 0.2 for any individual question (5) . The discrimination index ranged from - 0.19 to 0.59 (mean = 0.06). Although eight questions fell outside the discrimination or difficulty boundaries they were left in the final questionnaire as they were considered important for maintaining the appeal of the questionnaire to children. The internal consistency of the questionnaire was tested using Cronbach alpha (a). The whole questionnaire scored an a of 0.64. When the questionnaire was divided into different areas of knowledge, i.e. (i) NMES and nutrition, (ii) energy balance and physical activity, the a was 0.71 and 0.41, respectively. The questionnaire had a readability Flesh Kincaid grade level score (6) of 5.9, deeming it suitable for children aged 10 years and above. The results suggest that the final questionnaire is a useful tool to measure knowledge on NMES and energy balance in children, an increasingly important area of nutrition and health. The reliability testing suggests that it is perhaps a more suitable tool to measure knowledge of NMES and nutrition compared to physical activity and energy balance. With excessive intakes of NMES becoming an ever more prominent issue, it is both a useful and novel tool that can be used in education programmes to help test children’s knowledge on the subject.