Food Standards Agency Nutrition Research

1. Food Standards Agency Nutrition Research Dr Andrew Wadge Chief Scientist Food Standards Agency June 2008

2. Diet related chronic disease in UK • Cardiovascular disease is the main cause of death: accounting for just under 238,000 deaths in 2002. • Cancer accounted for over 159,000 deaths in 2002. 1/3 all deaths attributed to diet

3. FSA 2005-2010 Strategic Targets for Nutrition Eating for Health and Wellbeing • Salt reduction (2010) • Saturated fat reduction (2010) • Energy balance targets (2006) • Micronutrient advice (2007) • Salt in 10 x foods contributing most to diet (2006) • Nutrition in institutions (2005) • Survey programme (2005) • Content labelling (2006) • Review food choice (2005) • Food vision • Whole school approach • Promotion of food to kids

4. Objectives of nutrition research • Objectives: • To improve dietary well-being and reduce diet related chronic disease by helping the consumer make healthier food choices. • To inform how to best influence people’s behaviour in order to help deliver dietary improvements to the nation. • To produce new, and refine existing, dietary recommendations.

5. Criteria for funded research We fund • pure and applied research in the nutritional and social sciences in humans Priority is given to • food based or nutrient studies in dose ranges found naturally in the diet • Randomised controlled trials We do not fund • Animal or test tube studies • Studies where the primary purpose is to understand mechanisms • Studies to develop novel or niche market foods

6. Current research portfolio • 7 programmes • 35 projects • Approx £6.7 million/year • National Diet and Nutrition Survey (NDNS) approx £2.5 million/year

7. 3 programmes inform dietary recommendations: • Diet and Cardiovascular Disease • Nutrition Status and Function • Diet and Colonic Health

8. EXAMPLE 1Impact of the amount and composition of dietary fat and carbohydrate on metabolic syndrome and cardiovascular disease (CVD) risk • Study design • Controlled, single blind, parallel study. Subjects (n=650) randomly assigned to one of 5 groups for a 24 week period (plus 4 week run in): 1) Control (high SFA/high GI) 2) High MUFA/High GI 3) High MUFA/Low GI 4) Low Fat/High GI 5) Low Fat/Low GI • Primary outcome = impact of dietary changes on insulin resistance • Measurements at baseline and 24 weeks • Insulin sensitivity, fasting lipid profile, markers of haemostatic and inflammatory function, dietary assessment

9. 2 programmes aim understand factors effecting food choice and to develop and test interventions to improve food choice • Food Acceptability and Choice • Food Choice and Inequalities

10. EXAMPLE 2Change in snacking habits and obesity over 20 years in children aged 11 to 12 years Secondary analysis of cross sectional data to evaluate changes in snacking patterns in children over 20 years 3 dietary surveys conducted in 1980, 1990 and 2000 in the same 7 schools (ASH11) Each survey had approx 400 children Methods across 3 surveys were the same Two definitions of meal and snack were used - following slides report application of uniform definition across all data sets.

11. 40 35 30 25 20 % of events 15 10 5 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Hour in day Meals 2000 Meals 1990 Meals 1980 Snacks 2000 Snacks 1990 Snacks 1980 Adamson, (2008)

12. EXAMPLE 3National Diet and Nutrition Survey (NDNS) • Cross-sectional survey of individuals • UK coverage – adults and children • Continuous fieldwork (rolling) began April 2008 Data collected: • Food consumption • Nutrient intake • Nutritional status • Lifestyle

13. NDNS aims to: • monitor the nutritional well being of the population • compare intakes with recommendations • describe characteristics of people with low (or high) intakes • model changes in diet or composition • monitor progress towards targets (saturated fat and salt) • form the basis of food chemical exposure assessment

14. Improve UK Diet and Health What Making healthier eating easier How Influencing products Influencing people Influencing the environment Providing healthier choices Making healthier choices easier Remove barriers to healthier choices Activity Reformulation Portion size Folate Labelling Information Access to products Promotion of food to kids Nutrient (DH lead) profiling Activity in schools (Ed deps lead) Legislation Skills/ Knowledge Campaigns Signposting Expert Advice Evaluation Surveys Nutrition & Social Research Evidence

15. Future Key issues: • Most existing evidence is from cohort studies which does not provide evidence of causality. • Increasing costs of research • limited resources

16. Future Options for the future: • More large scale interventions • Improvement in methods for assessing diet and nutritional status including new ‘omic’ technologies • More holistic interventions and multi-disciplinary approaches to address the evidence gap around how to improve diets and lifestyles.

17. FSA Nutrition Research Review Aim • To review the Agency’s nutrition research portfolio Timescale • External panel meeting – Autumn 2008 • Public consultation – Late 2008/early 2009 • Recommendation to FSA – Spring 2009