The recently released draft report recommends the following changes in the Estimated Average Requirement (EAR):

• Teenage boys ( increase by up to 9%)
• Teenage girls ( increase by up to 15%)
• All adults ( increase by up to 16%).

SACN has conducted a thorough evaluation of the latest evidence – there are 785 references to other scientific papers! So although the report has been released in draft and will be subject to consultation it is virtually certain that the recommendations will be ratified.

The most significant finding is that the previous evaluation conducted by SACN’s predecessor COMA (Committee on Medical Aspects of Food Policy) underestimated the levels of activity. Because the level of activity is a critical determinant of the energy requirement it follows that the recommendation in the 1991 COMA report were too low and therefore will need to be increased.

The official recommendation for energy intake has enormous implications for food and nutrition policies.

First of all,  the Healthy Eating Guidelines for nutrients such as fat and sugar are expressed in terms of the energy intake.

Secondly, energy intake is a key factor in the provision of information for the public such as the Guideline Daily Amounts (GDAs).  The Traffic Lights will be thrown into chaos. Some foods currently classed as red may no longer meet the criteria and will now be amber.

Thirdly, regulations such as those which relate to the Nutrient Standards for School lunches are completely undermined because the foundations on which they are based have been shattered.

The SACN report recognises that physical activity plays an important role in the maintenance of good health and that if people are active their energy requirement will have to increase.

Recent experience has demonstrated that when information on Healthy Eating is conveyed to the public in terms of nutrients the result is invariably chaos and confusion.

If we really are to make progress in this area then the approach must be provide the advice in terms that are easily understood by most people.

Essentially this means the emphasis must be on foods NOT nutrients.

In fact there never has been a ‘’rapid rise’’ in child obesity. Official figures for the changes in the BMI values for school children are shown in the table below.

It is immediately obvious from these data that the BMI values for children aged 15 has remained essentially steady over the period 1995-2007.

Presumably the current DoH position is based on the conclusions in ‘’Tackling Obesities : Future  Choices – Project Report ‘’. This was commissioned by the Chief Scientific Adviser to the government and prepared  by the Foresight Group. It was  published in October 2007.

This report suggested that by 2050, 55% of girls would be overweight or obese , with only 30% in the healthy Body Mass Index (BMI) range. For boys the values were 55% overweight or obese and 45%in the healthy range.

Most of the results which I have quoted above would have been available when the Foresight Report was being prepared.  It would appear that those who contributed to this report were either unaware of this information or chose to ignore it.

The conventional wisdom is that the general health of children is poor and getting worse. In a previous blog http://vernerwheelock.com/?p=33f where I have provided convincing evidence based on the National Health Survey of England which shows that for boys aged 1-15 the percentage whose health was classified as ‘good/very good’  increased from 90 to 95 between 1995 and 2007. For girls the values were 92 and 94.

There is absolutely no indication that the health of children is deteriorating. The reality is that for the vast majority of children, health is perfectly satisfactory.

Of course a small proportion children may have health problems. However efforts should be directed at those who are at risk.

AN ENORMOUS AMOUNT OF MONEY IS BEING SPENT ON PUBLIC HEALTH PROGRAMMES  SO IT IS INCUMBENT ON THE GOVERNMENT TO ENSURE THAT THE STRATEGIES ARE BASED ON A DETAILED AND THOROUGH EVALUATION OF ALL THE RELEVANT EVIDENCE.

Although it has been established that diet is related to health it is difficult to devise guidelines which can be used for the population as a whole. This is because there is such a wide variation between individuals in their genetic make-up and in their food consumption patterns. Nevertheless there are compelling reasons to advise people generally to eat plenty of fruit and vegetables and to limit the intake of salt, which is largely present in processed foods. An analysis conducted by the Food Standards Agency has concluded that implementing various healthy eating strategies would save almost 70,000 lives. However 90% of these were linked to increasing consumption of fruit and vegetables to Five-a-Day (42,200)and reducing salt to the recommended level (20,000).  The remaining 10% was attributed to reducing sugar and saturated fat.

Unfortunately there is a tendency for health professionals to be very much more prescriptive than is justified when providing advice on how to construct a healthy diet. There is not a shred of evidence to indicate that an occasional slice of cake does anyone any harm whatsoever. In fact, a slice of cake every day is probably a valuable source of calories for active children. It can also contribute to the variety of a diet. I can do no better than to re-iterate the old cliché that ‘’there are no bad foods …only bad diets!’’ It is perfectly OK to eat a bar of chocolate, a bag of crisps or a pork pie but do not go overboard on these. Foods should not be demonised. Children (and everyone else) need to understand how to construct a balanced diet.

It seems to be the conventional wisdom that the current diet is absolutely awful and is therefore responsible for more and more obesity which results in increasing incidence of the degenerative diseases such as heart attacks and cancers.  The rationale behind the Jamie Oliver campaign on school meals is that the diet of children to-day is so bad that they will have a shorter life span than their parents.

So let us take a look at the facts:

1. The mortality of children has fallen steadily for the past 50 years. In the last 10 years the mortality of boys aged 10-13 has come down by 37%.
2. The National Health Survey of England has found that the health of boys aged 1-15 considered  ‘good/very good ‘  has increased from 90 to 95% between1995 and 2007. There was also an improvement in the health of the girls.
3. The same Survey showed that fruit and vegetable consumption had increased by 25% between 2001  and 2007. Those eating Five-a-Day had increased from 11 to 21%.
4. Although the incidence of obesity in the population as a whole is supposed to be increasing life expectancy  has improved significantly. During the 25-year period ending in 2007, it increased from 77 to 82 in women and from 71 to 77 in men.
5. This apparent paradox can be explained by the results of high quality research conducted in the USA and in Canada. These studies show conclusively that people considered  ‘overweight’ actually live longer than those of ‘normal weight’. In fact there is also evidence to suggest that those in the ‘mildly obese’ category have a longer life than those of normal weight. These results have been totally ignored by the public health authorities in the UK which continue to advocate weight reduction as a means of improving health.

I certainly do not wish to downplay the importance of a nutritious diet as part of a healthy lifestyle and I have been advocating Healthy Eating for the last 30 years. However that is no reason to ignore the facts and distort the evidence.

There are people who are seriously obese and this may well have adverse effects on their health but this should not be used as a justification for developing policies aimed at everyone. It is just as important to consider those who are underweight  –a condition which is linked to poor health and a reduced life expectancy.  Similarly there are some groups of children who are malnourished : hence policies and strategies should be directed specifically towards those at risk. It is not only counter-productive but a waste of valuable resources to develop policies such as the legislation on school meals  which are directed at all children, when over 90% are perfectly healthy. I have been highly critical of this legislation and my views can be found at http://www.healthyeatinginschools.co.uk/

A version of this article was also published in The Yorkshire Post Newspaper 21st Oct 2009and can be seen at http://www.yorkshirepost.co.uk/opinion/Verner-Wheelock-Let-our-children.5750800.jp

• ‘’Britain is in the grip of an epidemic.  Almost 2/3 of adults and 1/3 of children are either overweight or obese’’
• ‘’We are facing a public health problem the experts have told us is comparable to climate change in both its scale and complexity…’’
• ‘’…….there has been a clear rise in obesity rates, probably accelerating in the late 1980s and early 1990s…’’
• ‘……severely obese individuals are likely to die on average 11 years earlier…..than those of a healthy weight’’

In his campaign on school meals Jamie Oliver claimed that to-day’s school children would have a much shorter lifespan than their parents unless they improved the nutritional quality of the food that they eat.

All in all things seem to pretty bad. Given that there has apparently been a steady deterioration in the diet over the last 30-40 years it is instructive to examine how public heath has changed .So the information presented is likely to be of interest.

Over the past 25 years or so life expectancy has steadily increased and there is no suggestion that there is any fall off in the rate of increase. It is because of this improvement that the country is faced with a Pensions Time Bomb.

This figure shows why the life expectancy has improved. In the early part of the 20^th Century the infectious diseases were virtually eliminated as a major cause of death. There has also been significant progress with the respiratory diseases. The death rate from cancers has remained reasonably constant, although there was a  slight rise in the 1980s but more recently the rate is coming down.

The big success has been with the circulatory diseases, which include strokes and heart attacks. Over the last 50 years the death rate has been reduced by over 50%.

This figure shows that the good news also applies to children.

Furthermore when we look at what has happened in the last decade there have been very significant improvements in the death rates of children of all ages.

Results from the Health Survey ,England confirm that in England there has been a steady improvement in the health of school children.

It is a great pity that those providing advice to the Government did not bother to study the relevant data on public health before making their dire predictions about our health in the future.

It is blindingly obvious that although people have been getting heavier, public health has been improving significantly.  So if it follows that the dangers to health of being overweight or obese have probably been exaggerated.

Dough used to make cookies has been found to have E.coli contamination.  As a consequence at least 69 people in 29 different states have been infected, 34 of these required hospital treatment.

The dough was prepared at a Nestle plant in Virginia.  It has just emerged that when it was inspected by FDA officials in September 2001, a number of deficiencies were noted.  More worryingly, the inspectors were refused access to important food safety related documents.

These include :

·         Complaints records

·         Pest control records

·         HACCP information

It is clear from this that the powers available to the authorities in the U.S. have serious limitations.

Furthermore it is absolutely incredulous that the attitude of food safety in a plant owned by one of the biggest food manufacturers in the world is to put it mildly “Cavalier”.  The damage to the brand caused by this incident must be enormous.

Finally all purchasers of ingredients must take steps to ensure the safety of their supplies.  This example demonstrates that you cannot always rely on major international companies.

If you would like to find out more about this, then go to: www.foodhaccp.com/memberonly/newsletter357.html.

Recently there was a major outbreak in the U.S.A. which was caused by peanuts contaminated by Salmonella.  At least 9 people died and an estimated 25,000 became ill.

The peanuts were from a factory in Georgia owned by the Peanut Corporation of America (PCA).  Investigations have shown that the company repeatedly re-tested product until negative results for Salmonella were obtained, distributed product that it knew was contaminated and failed to act on FDA recommendations.

Bill Master, the attorney who specialises in food safety has estimated the costs that are likely to be incurred.  These include :

Settlement of compensation claims for those who died and suffered illness         $30-35 million

Recalling contaminated food products                                                                     $500 million

Kellogg’s estimated that their recall costs would be                                                  $75 million

Loss of sales and product ion to the peanut industry                                                   $1 billion

We should not kid ourselves that the standards in the U.K. are higher than they are in the U.S.A.  The recent Pennington report on the E. coli outbreak in South Wales demonstrates a rather uncanny parallel with what happened in America.

(You can read my resume on the Pennington report at http://www.vwa.co.uk/penn.htm).

Above all, the U.S. outbreak demonstrates very clearly the damage that an outbreak of food poisoning can do to the various businesses involved. 

Furthermore it just shows how important it is to have confidence in the safety of the ingredients which are sourced from other suppliers.

Unfortunately a number of small companies, which probably had perfectly good standards in their own premises were wiped out because they failed to ensure the peanut products purchased were safe!

If you would like to get some idea of the large number of products involved in the recall have a look at the relevant part of the U.S. Food and Drug Administration (FDA) which can be accessed at:

http://www.accessdata.fda.gov/scripts/peanutbutterrecall/index.cfm

The Scientific Advisory Committee on Nutrition (SACN) has recently released a report on “Iron and Health”.  The World Cancer Research Fund (WCRF) advocates that the intake of red meat should be restricted to 500g per week and that very little if any, should be processed.  This advice is based on an evaluation of the scientific evidence which was published in the Expert Report “Food Nutrition and Physical Activity and the Prevention of Cancer: a Global perspective in 2007”.

However the SACN report has done a separate evaluation of the evidence and is rather more cautious in its conclusions. In particular it draws attention to limitations and weaknesses in the various studies on this subject.  Key points made include the following:

There are a number of methodological inconsistencies between the different studies which make comparisons difficult. These include: adequacy of the dietary assessment methods to obtain reliable estimates of red and processed meat intake; lack of consistency in the categorisation of red and processed meat; and variability in the reporting of quantities of red and processed meat intake.

In most studies red meat and processed meat intake is based on a single dietary assessment at the start of the study. This does not take account of changes in dietary patterns over a number of years and could therefore be an unreliable estimate of intake over the specified follow-up period. The relevant period between dietary intake and development of cancer is also uncertain and dietary intakes estimated at baseline may not be the relevant period for dietary assessment in relation to cancer risk.

There are also considerable inconsistencies between studies in categorisation and definition of red and processed meat. Some studies have collected detailed information of the foods included under the red and processed meat categories, while others have used very broad classifications (e.g., beef, pork, lamb). In addition, some studies have separated red and processed meat categories and have only included fresh or untreated red meat in the red meat category while other studies have also included processed meat under the red meat category.

Another difficulty is the variability in reporting quantities of red and processed meat intake. While most studies compared highest versus lowest red and processed meat intake in grams per day/week/month, some studies reported intake as g/1000 kcal, frequency of intake per week/month or servings/day. There are also large differences in the quantiles of intake between different studies so that the amounts in lowest quantiles described in some studies are higher than the top quantiles in other studies.

Although results from prospective studies of dietary fibre and colorectal cancer are inconsistent, it has been suggested that higher intakes of foods containing fibre may protect against colorectal cancer risk. However only 8 out of the 21 studies on red meat intake and colorectal cancer risk and 5 out of the 14 studies on processed meat intake and colorectal cancer risk adjusted for fibre intake.

There are also a number of other factors that have been associated with colorectal cancer risk. These include genetic predisposition, high total fat intake, low fruit and vegetable intake, low fibre intake, low physical activity, and meat preparation and cooking methods. Studies have varied in the adjustments made for all these factors, so the effects of confounding cannot be excluded.

Taking all these factors into consideration it is very difficult to extrapolate form these findings a firm recommendation on the amount of red meat or processed meat intake that is associated with the risk of colorectal cancer

The SACN report reaches a rather more tentative conclusion on the consumption of red and processed meat than the WCRF. SACN states that

‘’Meat, particularly red meat, is the main source of haem iron. Epidemiological studies suggest an increased risk for colorectal cancer in association with increasing intakes of red and processed meat. Although the increased risk is not statistically significant in most studies, this may be due to lack of statistical power to detect an association. Overall, the available evidence suggests that red and processed meat intake is probably associated with increased colorectal cancer risk. However, since the evidence is based on prospective observational studies, the effects of confounding by other factors associated with increased colorectal cancer risk cannot be excluded. It is not possible to identify if there is a dose response or a threshold level of red or processed meat associated with increased colorectal cancer risk because of a number of limitations in the available data, including lack of consistency in categorisation and in reporting quantities of red and processed meat intake.’’

It concludes that lower consumption of red and processed meat would probably reduce the risk of colorectal cancer, and that although the evidence is not conclusive, as a precaution, it may be advisable for intakes of red and processed meat not to increase above the current average (70 g/d) and for high consumers of red and processed meat (100 g/d or more) to reduce their intakes.