Today, the Department of Health published the combined results from the first three years of the National Diet and Nutrition Survey (NDNS) rolling programme (2008/09 -2010/11). These results supersede the results from the first two years of the survey combined, published in 2011 The NDNS rolling programme is a continuous cross-sectional survey, designed to assess the diet, nutrient intake and nutritional status of a representative sample of around 1000 people (500 adults and 500 children per year) from the general population aged 18 months upwards living in private households in the UK. The NDNS involves an interview, a four-day dietary diary and blood and urine samples. Results are used by government to develop policy and monitor progress on diet and nutrition and to assess whether the UK population is meeting expert recommendations on diet and nutrient intakes.
The NDNS is jointly funded by the Department of Health in England and the UK Food Standards Agency and carried out by a consortium of three organisations: National Centre for Social Research (NatCen Social Research) MRC Human Nutrition Research (HNR) and the University College London Medical School (UCL).
The findings in the years 1, 2 and 3 report (based on 3073 individuals who completed the dietary diary - 1491 adults, 1582 children) confirm those in the years 1 and 2 combined report published in 2011, which was based on a smaller sample size. They show that the overall picture of the diet and nutrition of the UK population is broadly similar to previous surveys in the NDNS series carried out between 1994 and 2001. The analyses presented in this report do not identify any new nutritional problems in the general population.
• Fruit and vegetables: Adults aged 19 to 64 years consumed on average 4.1 portions per day and older adults (i.e. those aged 65 years and over) consumed 4.4 portions. 31% of adults and 37% of older adults met the “5-a-day” recommendation.
• For children aged 11 to 18 years, boys consumed on average 3.0 portions per day and girls consumed on average 2.8 portions per day. 11% of boys and 8% of girls in this age group met the “5-a-day” recommendation.
• Oily Fish: Mean consumption of oily fish was well below the recommended one portion (140g) per week in all age groups. For example, mean consumption in adults aged 19 to 64 years was equivalent to 54g per week.
• Total fat: Mean total fat intake met the recommendation of no more than 35% food energy in all age/sex groups except for men and women aged 65 years and over, for whom, on average, total fat provided 36.9% and 35.4% food energy respectively.
• Saturated Fat: Mean intakes in all age groups exceeded the recommended level of no more than 11% food energy. For example, mean saturated fat intake for adults aged 19 to 64 years was 12.7% food energy.
• Trans fat: Mean intakes provided 0.7% of food energy for children and adults aged 19-64 years and 0.8% food energy in older adults aged 65 years and over, thus meeting the recommendation of no more than 2% food energy.
• Non-Milk Extrinsic Sugars (NMES): Mean intakes exceeded the recommendation of no more than 11% food energy for all age groups, most notably for children aged 11 to 18 years where mean intakes provided 15.3% food energy.
• Alcohol: 58% of adults aged 19 to 64 years and 52% of adults aged 65 years and over consumed alcohol during the four-day diary. Adults aged 19 to 64 years who consumed alcohol obtained 9% of energy intake from alcohol; older adult consumers obtained 7%.
• Iron: Mean iron intakes were below the recommendation for girls aged 11-18 years and women aged 19-64 years and 46% of girls and 23% of women had low intakes. There was evidence of both iron-deficiency anaemia (as indicated by low haemoglobin levels) and low iron stores (plasma ferritin) in 5.6% of girls and 3.3% of women.
• Vitamin D: There was evidence of low vitamin D status (as indicated by low 25-OHD concentrations) in all age groups reported : 18% of adults aged 19 to 64 years and 20% of children aged 11-18 years. This has implications for bone health including increased risk of rickets and osteomalacia.
• Blood Lipids: Nearly half of adults had elevated concentrations of serum total cholesterol associated with increasing risk of cardiovascular disease. This is well known and in line with findings from health surveys.
The full statistical release, including a summary, can be found on the DH website.
Notes to editors
The NDNS rolling programme has been commissioned to collect data over a four year period from 2008/09 to 2011/12 with an extension to a fifth year covering 2012/13. Prior to the rolling programme the NDNS comprised a series of cross-sectional surveys, each covering a different age group. The earlier programme was set up in the early 1990s and ended in 2000/01.
The report published today covers a range of topics including food consumption, intakes of energy, macronutrients and vitamins and minerals, nutritional status (see notes 11-14) and use of dietary supplements. The report also includes the heights, weights, blood pressure and socio-demographic characteristics of the participants. Results for food consumption and nutrient intake are presented for five age groups: 1½-3 years; 4-10 years; 11-18 years; 19-64 years; 65 years and over, split by sex in all except the youngest age group. Results for blood analytes are presented for children aged 11-18 years and adults 19-64 years. Fieldwork was carried out between 2008/09 and 2010/11 with an overall response rate of 52-55% each year. The analyses of food consumption and nutrient intake are based on 3073 individuals (1,491 adults and 1,582 children). The blood sample analyses are based on 582 adults aged 19-64 years and 256 children aged 11-18 years.
This report supersedes the report of the year 1 and 2 combined results and the supplementary report on blood analytes published in 2011 by the Department of Health. The statements made in these reports are supported and reinforced by the larger sample size of the combined data from years 1, 2 and 3.
Responsibility for nutrition policy in England and Wales transferred from FSA to Health Departments in 2010. Management of NDNS also transferred to the Department of Health in England at that time.
The Government recommends an intake of at least five portions of fruit or vegetables per person per day. The Health Survey for England (HSE) is used to monitor ‘five-a-day’ in England. HSE estimates of fruit and vegetable consumption are based on a recall of consumption over the previous 24 hours and are therefore different from NDNS estimates, which are based on a four-day diary. NDNS estimates are higher than HSE, at least in part, because NDNS captures the contribution from composite dishes containing fruit and vegetables.
The dietary recommendations or Dietary Reference Values are reported in Dietary Reference Values (DRVs) for Food Energy and Nutrients for the UK, Report of the Panel on DRVs of the Committee on Medical Aspects of Food Policy (COMA) 1991. The Stationery Office, London
Saturated fat is the kind of fat found in animal foods such as butter and lard, fatty cuts of meat, sausages and bacon, cheese and cream and foods containing them such as pies, cakes and biscuits. Consuming high levels of saturated fat can lead to raised blood cholesterol levels, which are associated with greater risk of developing heart disease.
Trans fats are formed when liquid vegetable oils are turned into solid or semi-solid fats through a process of hydrogenation. The main sources of trans fats in the diet are from partially hydrogenated vegetable oils (PHVOs), dairy and meat from ruminant animals. Hydrogenated Vegetable Oils can be used as ingredients in products such as biscuits, cakes and desserts and are also used as cooking and ingredient oils. Naturally occurring trans fats are found in dairy produce and the flesh of ruminant animals e.g. beef and lamb. Trans fats raise the levels of the type of cholesterol in the blood which may increase the risk of heart disease.
Non-Milk Extrinsic Sugars (NMES) are any sugars which are not contained within the cellular structure of the food, either because they have been added to a food in the form of table sugar, honey etc; or because the food has been processed which has released (otherwise intrinsic) sugars from the cell structure e.g. fruit juice. Intakes of NMES are of interest as they are implicated in tooth decay.
The recommended daily alcohol limits are no more than three to four units a day for men and no more than two to three units a day for women. There is not a recommended maximum percentage of energy from alcohol.
Nutritional status means the level of nutrients available to the body (after absorption) for use in metabolic processes. For some micronutrients, status can be assessed by directly measuring the level of the nutrient in blood, while for others it is assessed by a functional measure such as the activity of vitamin-dependent enzymes.
The report presents descriptive statistics on blood analytes for the following micronutrients: iron; vitamin C; vitamin B12; vitamin B1 (thiamin); vitamin B2 (riboflavin); vitamin B6; retinol; carotenoids; vitamin D; vitamin E; selenium; zinc. Results are also reported for blood lipids (eg cholesterol), homocysteine (a marker for some B vitamins) and C-reactive protein (a general marker for infection). These analytes are divided into the following main groups: a) haematology, including measures of iron status; b) water-soluble vitamins and total homocysteine; c) fat-soluble vitamins and carotenoids; d) blood lipids e) zinc and selenium. The percentage of participants with levels above or below an accepted threshold indicating low status is shown for those analytes for which threshold values have been proposed.
Severe vitamin D deficiency causes rickets in children and osteomalacia in adults, this is a condition characterised by pain, muscle weakness and bone fractures, Both conditions are rare in the UK although there is evidence of significant incidence in South Asian and Afro-Caribbean groups.