Issue 134 News

NEWS

Emma Coates Editor Emma has been a registered dietitian for 12 years, with experience of adult and paediatric dietetics.

NEW DYSPHAGIA GUIDELINES - DRIVE TO ADOPT AND IMPLEMENT IDDSI In August 2017, the BDA and the RCSLT surveyed members of their organisations to gain insights in to whether the adoption of the International Dysphagia Diet Standardisation Initiative (IDDSI) would be beneficial. Both surveys concluded that they would support the new framework.

IDDSI is the international standardised terminology and definitions for texture modified foods and thickened liquids for people with dysphagia. The framework consists of a continuum of eight levels (0-7) and includes descriptors, testing methods and evidence for both liquid thickness and food texture levels.

Since October 2017, both the BDA and RCSLT have been working to raise awareness of the new framework with a view to adoption and implementation between April 2018 and April 2019. The new framework promotes the use of IDDSI compliant products, foods and labels from April 2018, meaning manufacturers are currently revising their products to align with the framework.

Training and guidance for healthcare professionals and carers will be required to ensure correct implementation of the new framework, with ongoing support to ensure competency continues.

More information can be found at iddsi.org/ or www.bda.uk.com/professional/practice/international_dysphagia_diet_ standardisation_initiative_framework

NICE PUBLISHES UPDATED GUIDANCE FOR ADHD IN CHILDREN, YOUNG PEOPLE AND ADULTS It's thought that around 2-5% of school- raising awareness to bring about aged children may have ADHD.1 It can positive change and inclusion in mental be a challenging condition to manage health, education and employment. for many families, educational staff and The ADHD Foundation welcomes healthcare professionals. the NICE guideline published in The ADHD Foundation2 is a March: Attention deficit hyperactivity registered UK charity working ‘in disorder: diagnosis and management partnership with individuals, families, [NG87]. doctors, teachers and other agencies This guideline covers recognising, to improving emotional wellbeing, diagnosing and managing ADHD in educational attainment, behaviour children, young people and adults. and life chances through better The aim of the guidance is to improve understanding and self-management recognition and diagnosis, as well as the of ADHD, ASD and related learning quality of care and support for people difficulties such as dyslexia, dyspraxia, with ADHD. The guidance includes a Irlen’s Syndrome, dyscalculia and section on dietary advice (1.6 Dietary Tourette’s Syndrome’. They also provide advice), which is concise but helpful. The training for GPs, Teachers, Social Care full guideline can be found at www.nice. agencies and other professionals, org.uk/guidance/ng8 1 NHS Choices. 2018. Attention deficit hyperactivity disorder (ADHD). [online] Available at: www.nhs.uk/conditions/attentiondeficit-hyperactivity-disorder-adhd/. [Accessed 15 April 2018] 2 www.adhdfoundation.org.uk/

STAY WITH US . . . the Data Protection Law is changing. To continue to receive communications from NHD, update your details here . . .

6

www.NHDmag.com May 2018 - Issue 134

NEWS HIGH OMEGA-6 LEVELS CAN PROTECT AGAINST PREMATURE DEATH A recent study1 published in The American When the researchers divided the study Journal of Clinical Nutrition asked the question, participants into five different groups based on ‘Could omega-6 fatty acids protect you against their blood linoleic acid level, they discovered premature death?’. The answer was ‘yes’. The that the risk of premature death was 43% lower in study, conducted by the University of Eastern the group with the highest level, when compared Finland, also found that while protecting to the group with the lowest level. A more against premature death, omega-6 fatty acids detailed analysis of the causes of death showed also help to reduce cardiovascular disease. that a similar association exists for death due to Professor Jyrki Virtanen from the University of cardiovascular diseases, as well as for death due to Eastern Finland, explains that, “Linoleic acid some other reason than cardiovascular diseases or is the most common polyunsaturated omega-6 cancer. However, no association was observed for fatty acid. We discovered that the higher the death due to cancer. Another significant finding blood linoleic acid level, the smaller the risk of of the study is that the outcome is very similar premature death.” regardless of whether the study participants The Kuopio Ischaemic Heart Disease Risk suffered from cardiovascular diseases, cancer or Factor Study, KIHD, determined the blood diabetes at the onset of the study. fatty acid levels of 2480 men between the ages The blood linoleic acid level is determined of 42 and 60 at the onset of the study, in 1984- by a person’s diet, and the main sources of 1989. During an average follow-up of 22 years, linoleic acid are vegetable oils, plant-based 1143 men died of disease-related causes and spreads, nuts and seeds. However, a person’s deaths due to an accident or other reasons were diet will affect his or her blood arachidonic acid excluded from the study. level only a little.

1 Virtanen, Jyrki K, et al, 2018. Serum n-6 polyunsaturated fatty acids and risk of death: the Kuopio Ischaemic Heart Disease Risk Factor Study. The American Journal of Clinical Nutrition, Volume 107, Issue 3, Pages 427

Fibre Figures (adult intake recommendation) LATEST NDNS SURVEY: FIBRE INTAKES (AOAC FIGURES) DRV report SACN report 1991 2015 In March this year, the latest dietary survey figures for the UK population were published (NDNS results NSP analysis 18g About 23g from Years 7-8 (combined) for the Rolling Programme method 2014/15-2015/16). For the first time, UK data on fibre AOAC analysis About 23g 30g intakes is presented as AOAC figures. method There is some scope for confusion, because there has been a ‘double change’ since the last reporting of fibre intakes in the UK diet. The first change is the method of analysis, which was previously done by the Englyst method, which capture Non-Starch Polysaccharide (NSP). The current fibre figures are those measured by American Association of Analytical Chemists (AOAC), and these additionally included resistant starch and lignin, so nearly always result in a higher figure. The second change is an increase in the actual fibre intake recommendations.

The previous recommendation for fibre intakes set by the 1991 Dietary Reference Values report, was for an NSP intake of 18g/day for adults: this is about 23g g/day as an AOAC figure. However in 2015 the Scientific Advisory Committee on Nutrition (SACN) produced a report on carbohydrates in the diet, and recommended a further increase to intakes of 30g/day for adults. So the headline change in figures for adult fibre intake recommendations in the UK (18g to 30g), reflect the double change in fibre analysis methods and increased target recommendations.

So, how much fibre are we consuming? For adults (those aged 19 to 64 years) average intakes were 19g/day. Although men were three times more likely than women to achieve the 30g/day recommendation (13% versus 4%), women had similar or greater intakes of fibre per 1000/kcals, so fibre-density in the diets of women is similar or better. The message of more fruit and vegetables and wholegrain breads and cereals in the diet remains unchanged. For more on fibre intake see p 26. www.NHDmag.com May 2018 - Issue 134

7

NEWS FASTING DIETS REDUCE IMPORTANT RISK FACTOR FOR CARDIOVASCULAR DISEASE

A new study1 in The British Journal of Nutrition has reported intermittent energy restriction diets, such as the 5:2 diet, clears fat from the blood quicker after eating meals than daily calorie restriction diets, reducing an important risk factor for cardiovascular disease.

In the first study of its kind, researchers from the University of Surrey examined the impact of the 5:2 diet on the body’s ability to metabolise, as well as clear fat and glucose after a meal and compared it to the effects of weight-loss achieved by a more conventional daily calorie restriction diet. Previous studies in this field have predominantly focused on blood risk markers taken in the fasted state, which only tend to be, in for the minority of the time, overnight.

During the study, overweight participants were assigned to either the 5:2 diet or a daily calorie restriction diet and were required to lose 5% of their weight. Those on the 5:2 diet ate normally for five days and for their two fasting days, consumed 600 calories, using LighterLife Fast Foodpacks, whilst those on the daily diet were advised to eat 600 calories less per day than their estimated requirements for weight maintenance (in the study women ate approximately 1400 calories, men ate approximately 1900 calories/day).

Under the expert guidance of the team, those on the 5:2 diet achieved 5% weight-loss in 59 days compared to those on the daily calorie restriction diet who achieved their goal in 73 days. 27 participants completed the study, with approximately 20% of participants in both groups dropping out because they either could not tolerate the diet or were unable to attain their 5% weight-loss target.

8

www.NHDmag.com May 2018 - Issue 134

PRODUCT / INDUSTRY NEWS JUVELA GLUTEN-FREE STARTER PACK SERVICE To ease the transition onto a gluten-free diet, Juvela are delighted to offer your newly diagnosed coeliac patients a Juvela starter pack.

Containing a range of staple gluten-free foods to try before setting up a gluten-free prescription, the pack will help your patients make the right food choices to suit their dietary preferences.

Click here to order NEW Juvela starter pack request cards.

To book your Company's product news for the next issue of NHD call 01342 824 073 Researchers found that participants who followed the 5:2 diet cleared the fat (triglyceride) from a meal given to them more efficiently than those who undertook the daily diet. Although there were no differences in post-meal glucose handling, researchers were surprised to find variations between the diets in c-peptide (a marker of insulin secretion from the pancreas) following the meal, the significance of which will need further investigation.

The study also found a greater reduction in systolic blood pressure (the pressure in your blood vessels when your heart beats) in participants on the 5:2 diet. Systolic blood pressure was reduced by 9% of following the 5:2, compared to a small 2% increase among those on the daily diet. A reduction in systolic blood pressure reduces pressure on arteries, potentially lessening incidences of heart attacks and strokes.

Further studies will be need to confirm the findings, as well as to understand the underlying mechanisms and to improve the tolerability of the 5:2 diet.