Sarah Howe Specialist Dietitian Sarah is an experienced NHS Dietitian specialising in the fascinating area of Inherited Metabolic Disorders in adults. In her spare time she enjoys helping her work colleague and good friend, Louise Robertson run her blog 'Dietitian's Life'. She also loves fitness and spending time with her two girls. www. dietitianslife.com
SUGAR GUIDELINES: EASY TO ADVISE, BUT EASY TO FOLLOW? Sugar has been a hot topic in the news for a while now. Public Health England (PHE) set out sugar intake targets in 2015 . . . People over 11 years of age should now be having no more than 30g a day of added sugars. This is less for children ages seven to 10 years at 24g and even less for those ages four to six years, at 19g; 5% of our energy should come from added sugars. It is not just for the consumers, as PHE have also set targets for the food industry. By 2020, every sector of the food industry contributing to the top foods that provide children with the most sugar, need to reduce the sugar content by 20%. This may be via reformulation, reducing portion sizes, or shifting consumer purchase to low or no sugar options. These in theory are terrific and already, in my general practice, I am advising my patients to reduce their sugar intake. I’m full of ideas: switch to diet drinks, cook from scratch, less biscuits, cakes and sweets and Greek yoghurt instead of fruit yoghurt. Always easier said than done, but am I really practicing what I preach with my own children? Are these guidelines easy to advise on as dietitians, but harder to follow for parents? My eldest daughter is four and is, therefore, recommended to have 19g of sugar a day. She loves the cereal Raisin Wheats and a 45g portion of these is 8.1g straight away. I’m lucky she doesn’t have fizzy drinks or squashes and we don’t tend to use jars or ready meals, so this cuts it down a little. Unfortunately, she isn’t really a fruit lover and snack time becomes hard. She will eat bread sticks, yoghurt, cheese and nuts, but she also quite likes malt loaf. One-fifth of a loaf is 10g of sugar and she is almost at her limit before we add in the added sugar in fromage frais, or the chocolate she begs me for after her tea on some days.
I’m not going to lie; keeping recommended sugar levels is hard for me to always achieve with my daughter. We only have to attend a birthday party, with sweets as prizes, ice cream for pudding and a slice of cake in her party bag for her to have gone well over. One can argue this is only a one off, but they do add up and who wants to be that mean dietitian mum, sweating in the corner about the 19g-a-day sugar limit for their four-year-old? I’m educated and qualified. I read labels. I scrutinise my child’s food choices and I still struggle. What does it mean for someone who doesn’t understand nutrition? Someone who can’t afford to be picky, or hasn’t got time to sit and read the labels 30 times over on a food shop? The food industry has a massive role to play in this and recently, unfortunately, we have seen that they have failed to meet their 5% reduction target for the first year. This puts even more pressure on the consumer and for us as healthcare professionals. I am always conflicted when feeding my children, but I do feel this has helped me to tailor my advice more to my patients. I know I need to be more practical when it comes to helping others reduce their sugar intake. I need to be prescriptive when it comes to what foods to avoid and reduce. We all need to reduce our sugar consumption, but the food industry needs to play their part and, as healthcare professionals, we need to channel our own experiences into tailored, practical advice that can be followed. Guidelines are just that - until we bring real life and real families into our advice. I’ll just have to keep the chocolate hidden from my daughter in our house! www.NHDmag.com July 2018 - Issue 136
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