16/09/15 – Scientific Advisory Committee Nutrition’s working group on carbohydrates (SCAN)

Speaker:  Prof. Ian Macdonald, Chair, Scientific Advisory Committee on Nutrition’s working group on carbohydrates (SCAN)

16th September 2015 – meeting notes

All-Party Parliamentary Group on a Fit and Healthy Childhood

Chair: Jim Fitzpatrick MP

The Chair opened the meeting, welcoming attendees and introducing the speaker.

Prof Ian Macdonald

In July of this year SCAN published the Carbohydrates and Health report which recommended that consideration of sugars include free sugars; glucose and honey and there should be no more than 5% in a diet. The old recommendations were 10%, so we are now seeing a halving of the free sugars requirement. However, lactose and the sugars in fruit and vegetables are not included.

Free sugars bring nothing but calories are associated with oral ill health and tooth decay, They are also associated with being overweight. There is also an association between the sugars in diet and drinks and body fat.

It is not all about sugars, we need to look at fibre as well. The British public eats less than recommended. Fibre protects against colorectal diseases, is associated with reduced cardio vascular events and reduced type 2 diabetes. Fibre is generally good for the body. There is some evidence that fibre has some benefits for children. This report, for the first time, gives fibre recommendations for children. This is a big difference and we need to educate the public on this. The food industry has a role to play to help the consumer to understand the issues around low sugar and high fibre. It is a policy area for Public Health England, which is developing a programme for this autumn. The Department of Health has also accepted the recommendations.

It should be noted that it took seven years to get to this point.

Questions and comments

The Department of Health and Nice have mislead the public and Parliament with ideas about exercise. The public need to understand the need to eat fewer calories. The press have still not cottoned on. It is about diet: eating less.

It is important to recognise the value of exercise itself, we need to be careful because it is generally good for the body.

Prof Ian Macdonald:  Exercise is right in terms of using calories. The British population needs to change its lifestyle and attitudes. The evidence shows that becoming active reduces the appetite.

To clarify the recommendations on fibre, what scale was used?

Prof Ian Macdonald The Fibre recommendations were scaled to energy.

Regarding calorific intake, how do we compare now with 30-40 years ago?

Prof Ian Macdonald We consumed less then. By the late 1950’s we reached the peak of the energy/intake balance.

We must remember that the amount of effort to lose weight is huge in comparison to eating less food. There needs to be guidance on how to change lifestyle. This is where the Department of Health and Public Health England can help.

The food industry has a role to play; for too long it has been supersizing products, This is not a way to encourage a healthy population.

How can we work more positively with the food industry to help make healthier choices easier? The MEND programme works well; can it be rolled out nationally? It is good to now have guidance on free-sugars.

Prof Ian Macdonald Currently teenagers, especially boys, have the highest intake of sugary drinks, 3-4 times the recommended levels. We need to get them to scale down and make it a treat.

I would support a roll out of the MEND programme if it is translatable and moveable; however that is a Public Health England issue.

The experience of talking to the food industry is good; they are taking it seriously. Three major companies have reduced sugar and there are strategies in place within the industry.

What role does social inequality play?

Prof Ian Macdonald: Free sugar consumption is slightly higher in low income groups.

Oral health and tooth extraction differences can be seen in the socio-economic groups. With more in lower social groups, this is also due to dental health issues.

Sugar is not the only cause of obesity; we must remember that calories-in and not enough calories-out plays a role. A reduction in free sugars will reduce overall consumption. The solution to obesity is not just about sugar.

We must remember that exercise has an important role to play in preventing obesity in the first place. Cars in residential areas limit children’s ability to access simple exercise.

Fruit juices are often labelled “this is 2 of your daily portion”.

Prof Ian Macdonald: This is one of the reasons to minimise and not stop the consumption of sugar-sweetened juice. There are other benefits in juice (as long as it is not additionally sweetened).

Another thing to consider is that we must be careful not to drop the fat levels of children’s diets. There should be no less than 30% of calories in their diet.

The language used by the media feels like a war on soft drink; how should we be working with the food industry?

Prof Ian Macdonald: There is a need to inform them and explain the meaning of the recommendations in reports like this report on Free Sugars. In my experience, companies that have been asked have made changes.

An adult portion of carbonated drink is 250ml – that is not available in shops. We told them to promote non carbonated drinks (because of the effects on enamel). Major manufacturers are behaving responsibly, just slowly. There could be a lot of research into how much sugar people need; like with the salt industry, which made changes over 10 years.

Will the message regarding fibre and good health be taken to schools and school meal providers and taken forward?

Prof Ian Macdonald: Public Health England will help spread the message.

School food is important; we will need to increase the fibre content in school meals.

When fibre is advertised in drinks we do not know how they compare with fibre from oats, rice, bran and vegetables. We need the evidence to see if these fibres (polydextrose-type fibre) are comparable with regular bran. Our bodies need 90 grams of fibre a day for dramatic effects. Public Health England needs to make it clear that these fibres are not to be advertised as equivalent.

The public are confused by all the changes of advice. We probably need people to go back to real food; there are 3 generations who don’t cook. We need to push the message of how to cook.

There are cook-less households, but it can be cheaper to go to a supermarket and buy meals rather than cook from scratch; which is the problem.

Should we emphasize satiety more?

Prof Ian Macdonald: That is a good point, food too rapidly eaten has no association with fullness, “satiety” is longer term, whilst “satiated” is short term fullness.

We need to combine talking about activity as well as stuff like sugar, it is all about prevention. It is important to fight the different corners and make sure that children are active in the school day.

The meeting closed.