Many UK children still face poor diet and nutrition
Children in the UK are risking serious illnesses later in life because of poor diet and nutrition while they are young, an important new study just published on behalf of the Health Supplements Information Service (HSIS) has found.
Health experts are warning that all too many British youngsters face a ticking health time bomb because of high intakes of saturated fat, salt and sugar and inadequate amounts of essential vitamins and minerals and essential fatty acids from oil rich fish. While the researchers found that on average diets have improved in recent years, they say that there are still major nutritional problems that were cause for concern and need addressing urgently.
Proper nutrition in childhood is essential for growth, development and long-term health into adulthood. There is mounting evidence that problems with child nutrition can significantly contribute to chronic and degenerative diseases such as type 2 diabetes, cardiovascular disease and cancer.
In addition, poor diets and too little exercise have led to childhood obesity, with figures showing that one in 10 youngsters in school reception classes (aged 4 to 5) are obese, and this increases to 18% of those in year 6 (aged 10 to 11). Similarly, dental decay and even type 2 diabetes are becoming more of a problem in children.
To gauge the extent of the problem, the Health Supplement Information Service commissioned in-depth research into the quality of children’s diets. Independent dietitian and registered public health nutritionist Dr Carrie Ruxton and Dr Emma Derbyshire, senior lecturer in human nutrition at the Manchester Metropolitan University, analysed nearly 60 previously published papers and reports on the topic.
The research team found that all too frequently, intakes of essential nutrients fell badly short of recommended guidelines and similarly often exceeded the recommended allowances for saturated fat, sugar and salt. In particular, the researchers found that iron, calcium, magnesium, potassium and zinc are especially low in some groups. They also point to possible problems with intakes of fibre, omega-3 fatty acids and vitamin D as well as fruit and vegetable consumption.
Commenting on the research review study commissioned by HSIS, lead researcher Dr Carrie Ruxton says: “Even in the 21st century, it is not uncommon for British children to have an inadequate nutritional status. Thus, further improvements are needed. In the meantime, parents may consider giving children a daily multivitamin to ensure that micronutrient recommendations are achieved.”
Low vitamin D levels in childhood can lead to a greater risk of low bone mass and osteoporosis later in life. Inadequate intakes of certain nutrients such as iron, iodine, folate, zinc, vitamin B12 and long-chain omega-3 polyunsaturated fatty acids have also been linked with affecting children’s cognition and intellectual ability.
Much of the published research and data focuses on analysis of the UK National Diet and Nutrition Survey (NDNS), a rolling cross-sectional survey of food consumption, nutrient intakes and nutritional status of people aged 18 months and older in the UK. The first – and latest - report of the programme, funded by the Food Standards Agency and the Department of Health, includes in-depth data on food consumption and nutrient intakes for children aged 1.5 to 18 years taken between 2008 and 2009.
In the latest research for HSIS, the researchers highlight findings by the Scientific Advisory Committee on Nutrition - an advisory committee of independent experts that provides advice to the Food Standards Agency and Department of Health. The SACN report found that while children’s diets had improved over the last 15 years, with certain nutritional areas were still significantly lacking.
Supplementation levels
The data shows that vitamin and mineral supplements appear to make a significant contribution to overall nutrient intakes in children aged 2-17 years. Supplement use appears to vary between ethnic groups, with Asian or Afro-Caribbean children being most likely to take supplements, particularly cod liver oil. However, the researchers found that children most in need of supplements are often less likely to take them.
Among children aged 4-12 years, multivitamins were the most commonly-consumed supplement, although the researchers say that iron is also important as deficiency is common in UK children, especially in those who are vegetarian or have low meat intakes.
The researchers found that foods fortified with vitamins and minerals – such as some breakfast cereals - can be useful, but warned that there are potential problems in relying on them. Issues can include an insufficient level of fortification for good health, or the fortified food itself may be high in sugar, salt or saturated fat.
Another potential problem in the case of iron supplementation is that the fortified food may contain non-haem iron which is less bioavailable – not as easily used by the body - than the haem iron found in red meat. The researchers say that concerns about associations between processed meat intakes and the risk of colo-rectal cancer in adulthood have hindered the promotion of red meat for the maintenance of iron status, even though iron deficiency is common in UK children
Commenting further on the research review, Dr Ruxton notes: “Overall, there has been some progress in improving children’s diets, albeit slow. Intakes of fat have reduced to below dietary targets, while intakes of vitamins A and C, and calcium, have increased marginally. However, further improvements are needed. Children’s salt intakes are particularly high, exceeding the maximum recommendations set for adults.
“There remains a clear need to improve children’s diets to safeguard their future health. Despite some evidence showing beneficial changes to children’s diets over the years, certain population groups still fail to consume adequate levels of micronutrients, particularly iron, zinc, magnesium and potassium.
“Higher intakes of fruit, vegetables, oily fish and wholegrains would help children to meet dietary and nutrient targets. Fortified foods also contribute, although the macronutrient profile of some may make them less suitable for children. As a result, another option is supplementation, for instance multi-nutrient supplements and fish oil supplements, which can help children to meet nutrient targets while further dietary improvements are ongoing. This is especially vital for those children and teenagers who are fussy eaters and do not like oily fish for instance, which is are full of essential nutrients such as Omega 3.”
Fruit and vegetables
The research for HSIS shows that average consumption of fruit and veg was 170-190g/day in younger children, increasing to an average of 200g/day in 15-18 year olds. While there is no child-specific target for grams of fruit and vegetables, the adult guideline is 400g/day or more - children aged over 11 would be expected to need close to this. In addition, 20% of 4 -18 year olds consumed no fruit at all (excluding fruit juice) while 4% ate no vegetables. Other research indicated that among 11-18 year olds, boys had on average 3.4 portions of fruit and veg a day, and girls had on average 2.8. However, only 22% of boys and 7% of girls met the five-a-day target.
Oily fish / omega 3 essential fatty acids
Average intakes of oily fish ranged between 5-10g/week and 5-7g/week for males and females aged 4-18 years respectively, the equivalent of less than 0.1 of a portion per week, which is far lower than the recommended two portions per week.
Salt
Data shows that daily sodium intakes was around 2500mg in 7-14 year old boys and 2200mg in girls, which equates to salt levels of 6.4g and 5.6g respectively – high figures as the maximum salt target for this age group is 6g per day. Another study showed that 7-year old boys consumed higher levels of sodium (2.3g/d) compared with girls (2.2mg/d) - both equate to salt intakes in excess of 6g/day. It’s also thought that salt intakes may have been under-reported as studies have not taken into account salt added to cooking or at the table. One piece of research found that reducing salt intakes by 42% in children aged 8-16 years led to significant reductions in blood pressure.
Nutrients and minerals
The research shows that in young females, only 58% currently meet the reference nutrient intake (RNI) for iron, and previous studies have found that young vegetarian girls consuming fibre-rich diets are most at risk of iron deficiency. In addition, calcium, magnesium, zinc, potassium, iodine and folate deficiencies appear to be increasingly apparent, especially in children from low-income groups.
Vitamin D
There are increasing worries that many UK children are vitamin D deficient, and the research backs up this concern, particularly for children in low-income families. Data from this group shows that boys and girls consumed on average 2.2µg and 1.92µg vitamin D per day respectively - these intakes are less than half of the European Recommended Daily Allowance of 5µg. In one study of 12-15 year olds in Northern Ireland daily vitamin D intakes were just 1.7µg. Another study found that 36% of school-age children were defined as vitamin D deficient, rising to 46% during the winter because of limited sunshine. Vitamin D is essential required for normal bone growth and development during childhood and adolescence and the latest research has linked vitamin D deficiency with a host of serious health issues.
Sugar
Non-milk extrinsic sugars (NMES) provide about 15% of children’s food energy according to the latest data, though this is higher than the 11% maximum target, demonstrating that too much sugar is being consumed. In addition, sources of sugars have shifted away from table sugar towards soft drinks and fruit juices. One report showed that intakes of NMES from soft drinks doubled from 15g to 31g/day while intakes from cereals rose from 2g to 7g/day. Confectionary and soft drinks provided around 61% of NMES in children. While soft drinks can be a source of calories, they rarely provide micronutrients. High intakes of soft drinks were associated with higher energy intakes but lower intakes of milk, calcium and other nutrients.
