The chimera of choice in UK food policy 1976-2018

Purpose This paper presents a critical discourse analysis of “choice” as it appears in UK policy documents relating to food and public health. A dominant policy approach to improving public health has been health promotion and health education with the intention to change behaviour and encourage healthier eating. Given the emphasis on evidence-based policy making within the UK, the continued abstraction of choice without definition or explanation provoked us to conduct this analysis, which focuses on 1976 to the present. Design/methodology/approach The technique of discourse analysis was used to analyse selected food policy documents and to trace any shifts in the discourses of choice across policy periods and their implications in terms of governance and the individualisation of responsibility. Findings We identified five dominant repertoires of choice in UK food policy over this period: as personal responsibility, as an instrument of change, as an editing tool, as a problem and freedom of choice. Underpinning these is a continued reliance on the rational actor model, which is consonant with neoliberal governance and its constructions of populations as body of self-governing individuals. The self-regulating, self-governing individual is obliged to choose as a condition of citizenship. Research limitations/implications This analysis highlights the need for a more sophisticated approach to understanding “choice” in the context of public health and food policy in order to improve diet outcomes in the UK and perhaps elsewhere

Iodine status in pre-school children prior to mandatory iodine fortification in Australia

The iodine status of children between the ages of 5 and 15 years has been routinely assessed in many countries, but few studies have examined iodine status in pre-school children. We conducted a cross-sectional study of pre-school children living in Adelaide, South Australia, between 2005 and 2007. Children 1–5 years old were identified using a unique sampling strategy to ensure that the study population was representative. A 3-day weighed diet record, a blood sample and a urine sample were obtained from each child. The median urinary iodine concentration (UIC) of the children (n = 279) was 129 µg L⁻¹, indicating iodine sufficiency (normal range: 100–199 µg L⁻¹), but 35% of the children had a UIC < 100 µg L−1. The median thyroglobulin concentration of children (n = 217) was 24 µg L⁻¹ and thyroglobulin concentration declined with increasing age (P = 0.024). The mean daily iodine intake was 76 µg. The intake of iodine was lower than expected and highlights difficulties in accurately assessing iodine intakes. Further studies are needed to monitor dietary changes and iodine status in this age group since the implementation of mandatory fortification of bread with iodised salt in Australia in 2009.Sheila Skeaff, Ying Zhao, Robert Gibson, Maria Makrides, Shao Jia Zho

Calcium to phosphorus ratio, essential elements and vitamin D content of infant foods in the UK: possible implications for bone health

Adequate intake of calcium and phosphorus in the appropriate ratio of 1–2:1 (Ca:P), in addition to magnesium and vitamin D, is vital for bone health and development of infants. In this feasibility study, the ratio of Ca:P in conjunction with vitamin D and other essential elements (Cu, Fe, K, Mg, Na, and Zn) in a range of commercial infant food products in the UK was investigated. The elemental analysis was carried out using inductively coupled plasma optical emission spectrometry, and vitamin D levels were determined using an enzyme-linked immunosorbent assay. The quantitative data were further evaluated, based on a standardised menu, to measure the total daily intake of an infant aged 7–12 months against the Reference Nutrient Intake. The results from the study show that the Ca:P ratio of the infant's total dietary intake was within the recommended range at 1.49:1. However, the level of intake for each of the nutrients analyzed, with the exception of sodium, was found to be above the Reference Nutrient Intake, which warrants further investigation in relation to both micronutrient interactions and in situations where the intake of fortified infant formula milk is compromised. Finally, as the study is the first to include consumption of infant snack products, the level of total calorie intake was also calculated in order to assess the total daily estimated energy intake; the results indicate that energy intakes exceed recommendations by 42%, which may have implications for obesity

A qualitative exploration of stakeholder perspectives on a school-based multi-component health promotion nutrition programme

Background:  Food for Fitness is an on-going multi-component health promotion programme, delivered in primary and secondary schools by community nutrition assistants. The programme uses nutritional interventions aimed at promoting healthier eating practices for children. This service evaluation investigated the receipt and delivery of the programme, as perceived by local stakeholders who had experienced and administered the service. Methods:  Semi-structured interviews and focus groups were carried out with three key stakeholder groups: health professionals (n = 9), school teachers (n = 10) and senior health officials (n = 3). Qualitative data were transcribed verbatim and received thematic analysis with deductive and inductive processes. Results:  Stakeholders reported that the programme contributed to the development of food education and healthy-eating practices of children in the local area. Stakeholders considered that the main concern was the limited capacity and size of the service. They described problems with long-term sustainability in supporting schools with maintaining nutritional interventions, highlighting issues regarding contact, planning and organisation of several interventions. Conclusions:  The findings of the service evaluation inform service management, organisation and ground-level delivery. The use of stakeholder opinion provided contextualised information on the factors that impact on the implementation of the programme. The richness of the qualitative results can guide future planning and provision for similar health promotion nutrition programmes delivered in the school environment

The decreased molar ratio of phytate:zinc improved zinc nutriture in South Koreans for the past 30 years (1969-1998)

For the assessment of representative and longitudinal Zn nutriture in South Koreans, Zn, phytate and Ca intakes were determined using four consecutive years of food consumption data taken from Korean National Nutrition Survey Report (KNNSR) every 10 years during 1969-1998. The nutrient intake data are presented for large city and rural areas. Zn intake of South Koreans in both large city and rural areas was low during 1969-1988 having values between 4.5-5.6 mg/d, after then increased to 7.4 (91% Estimated Average Requirements for Koreans, EAR = 8.1 mg/d) and 6.7 mg/d (74% EAR) in 1998 in large city and rural areas, respectively. In 1968, Zn intake was unexpectedly higher in rural areas due to higher grain consumption, but since then until 1988 Zn intake was decreased and increased back in 1998. Food sources for Zn have shifted from plants to a variety of animal products. Phytate intake of South Koreans during 1969-1978 was high mainly due to the consumption of grains and soy products which are major phytate sources, but decreased in 1998. The molar ratios of phytate:Zn and millimmolar ratio of phytate×Ca:Zn were decreased due to the decreased phytate intake in South Koreans, which implies higher zinc bioavailability. The study results suggest that Zn nutriture has improved by increased dietary Zn intakes and the decreased molar ratio of phytate:Zn in South Koreans in both large city and rural areas

Dietary assessment in minority ethnic groups: A systematic review of portion size estimation instruments relevant for the UK

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Nutrition Reviews following peer review. The version of record Almiron-Roig, E., Galloway, C., Aitken, A. & Ellahi., B. (2016). Dietary assessment in minority ethnic groups: A systematic review of portion size estimation instruments relevant for the UK. Nutrition Reviews, 75(3), 188-213. DOI: 10.1093/nutrit/nuw058 is available online at: https://academic.oup.com/nutritionreviews/article-lookup/doi/10.1093/nutrit/nuw058Context: Dietary assessment in minority ethnic groups is critical for surveillance programmes and for implementing effective interventions. A major challenge is the accurate estimation of portion sizes for traditional foods/dishes. Objective: To systematically review published records up to 2014 describing a portion size estimation element (PSEE) applicable to dietary assessment of UK-residing ethnic minorities. Data sources, selection, extraction: Electronic databases, internet sites, and theses repositories were searched generating 5683 titles from which 57 eligible full-text records were reviewed. Data analysis: Forty-two publications aimed at minority ethnic groups (n=20) or autochthonous populations (n=22) were included. The most common PSEE (47%) were combination tools (e.g. food models and portion size lists); followed by portion size lists in questionnaires/guides (19%); image-based and volumetric tools (17% each). Only 17% PSEE had been validated against weighed data. Conclusions: When developing ethnic-specific dietary assessment tools it is important to consider customary portion sizes by sex and age; traditional household utensil usage and population literacy levels. Combining multiple PSEE may increase accuracy but such tools need validating

Soil type influences crop mineral composition in Malawi

Food supply and composition data can be combined to estimate micronutrient intakes and deficiency risks among populations. These estimates can be improved by using local crop composition data that can capture environmental influences including soil type. This study aimed to provide spatially resolved crop composition data for Malawi, where information is currently limited. Six hundred and fifty-two plant samples, representing 97 edible food items, were sampled from N150 sites in Malawi between 2011 and 2013. Samples were analysed by ICP-MS for up to 58 elements, including the essential minerals calcium (Ca), copper (Cu), iron (Fe), magnesium (Mg), selenium (Se) and zinc (Zn). Maize grain Ca, Cu, Fe, Mg, Se and Zn concentrations were greater from plants grown on calcareous soils than those from the more widespread low-pH soils. Leafy vegetables from calcareous soils had elevated leaf Ca, Cu, Fe and Se concentrations, but lower Zn concentrations. Several foods were found to accumulate high levels of Se, including the leaves of Moringa, a crop not previously been reported in East African food composition data sets. New estimates of national dietary mineral supplies were obtained for non-calcareous and calcareous soils. High risks of Ca (100%), Se (100%) and Zn (57%) dietary deficiencies are likely on non-calcareous soils. Deficiency risks on calcareous soils are high for Ca (97%), but lower for Se (34%) and Zn (31%). Risks of Cu, Fe and Mg deficiencies appear to be low on the basis of dietary supply levels