In recent years, there have been reports suggesting a high prevalence of low vitamin D intakes and vitamin D deficiency or inadequate vitamin D status in Europe. Coupled with growing concern about the health risks associated with low vitamin D status, this has resulted in increased interest in the topic of vitamin D from healthcare professionals, the media and the public. Adequate vitamin D status has a key role in skeletal health. Prevention of the well-described vitamin D deficiency disorders of rickets and osteomalacia are clearly important, but there may also be an implication of low vitamin D status in bone loss, muscle weakness and falls and fragility fractures in older people, and these are highly significant public health issues in terms of morbidity, quality of life and costs to health services in Europe.Although there is no agreement on optimal plasma levels of vitamin D, it is apparent that blood 25-hydroxyvitamin D [25(OH)D] levels are often below recommended ranges for the general population and are particularly low in some subgroups of the population, such as those in institutions or who are housebound and non-Western immigrants. Reported estimates of vitamin D status within different European countries show large variation. However, comparison of studies across Europe is limited by their use of different methodologies. The prevalence of vitamin D deficiency [often defined as plasma 25(OH)D <25 nmol/l] may be more common in populations with a higher proportion of at-risk groups, and/or that have low consumption of foods rich in vitamin D (naturally rich or fortified) and low use of vitamin D supplements.The definition of an adequate or optimal vitamin D status is key in determining recommendations for a vitamin D intake that will enable satisfactory status to be maintained all year round, including the winter months. In most European countries, there seems to be a shortfall in achieving current vitamin D recommendations. An exception is Finland, where dietary survey data indicate that recent national policies that include fortification and supplementation, coupled with a high habitual intake of oil-rich fish, have resulted in an increase in vitamin D intakes, but this may not be a suitable strategy for all European populations. The ongoing standardisation of measurements in vitamin D research will facilitate a stronger evidence base on which policies can be determined. These policies may include promotion of dietary recommendations, food fortification, vitamin D supplementation and judicious sun exposure, but should take into account national, cultural and dietary habits. For European nations with supplementation policies, it is important that relevant parties ensure satisfactory uptake of these particularly in the most vulnerable groups of the population.

Yogurt is a nutrient‐dense food within the milk and dairy products food group. The nutritional content of yogurt varies depending on the processing method and ingredients used. Like milk, it is a good source of protein and calcium, and can be a source of iodine, potassium, phosphorus and the B vitamins – riboflavin (B2) and vitamin B12 (depending on type). Some yogurt products are also fortified with vitamin D. The nutritional value of dairy products (milk, cheese and yogurt) and the importance of the nutrients they provide for bone health are well recognised. These foods are collected together as one of the four main food groups within the UK's eatwell plate model that illustrates a healthy, balanced diet. Studies exploring the nutritional and health attributes of yogurt are limited but some research has suggested benefits in relation to bone mineral content, weight management, type 2 diabetes and metabolic profile. Yogurt consumption has also been associated with diet quality. The aim of this paper is to use national survey data to examine yogurt consumption in the UK and consider its contribution to nutrient intakes at different life stages within the context of nutritional challenges in each age group. The contribution of yogurt to energy and nutrient intakes across the life course was calculated via secondary analysis of data from the Diet and Nutrition Survey of Infants and Young Children (2011) and the National Diet and Nutrition Survey (2008/2009–2010/2011). The products categorised within the ‘yogurt group’ included all yogurt, fromage frais and dairy desserts, and fortified products. Comparisons were also made between specific sub‐categories of yogurt, namely ‘yogurt’, ‘fromage frais’ and ‘dairy desserts’. Nutrients included in the analyses were energy; the macronutrients; micronutrients that yogurt can be defined as a ‘source of’; micronutrients that may be of concern in the UK population; and vitamin D for fortified products. A simple dietary modelling exercise was also undertaken to investigate the potential impact of including an additional pot of yogurt per day on the nutrient intakes of adolescents. Children aged 3 years and under had the highest intakes of yogurt [mean intake 43.8 g/day (SD 39.7 g) in 4–18 month‐olds; 46.7 g/day (SD 39.1 g) in 1.5–3 year‐olds], and adolescents (11–18 years) consumed the least [21 g/day (SD 38.0 g)]. In adults, highest mean consumption [35.7 g/day (SD 55.0 g)] was during middle age (50–64 years), equivalent to less than a third of a standard 125 g pot. Around 80% of young children (aged 3 years and under) but only a third of teenagers and young adults had consumed any yogurt product during the survey period of 4 days. Average yogurt consumption was twice as high in women as men among older adults (65 years and over), while gender differences in consumption were less apparent in children. Fromage frais and fortified yogurt products were most commonly consumed by younger children, as were dairy desserts in those aged 4–18 years. Among adults, yogurt per se ...

The Scientific Advisory Committee on Nutrition (SACN) recently published its draft report on Carbohydrates and Health, in which new recommended intakes for fibre were proposed for children and adults, following an in-depth review of the scientific evidence base. The recommendation for the adult population of 30 g/day, measured by the Association of Official Analytical Chemists' (AOAC) method, is somewhat higher than current recommendation and, according to intakes reported in the recent National Diet and Nutrition Survey, would require men to increase their fibre intakes by around 50% and women by 75%. This paper discusses current fibre intakes in the UK and describes the main contributors of fibre to the diet. Simple dietary modelling was carried out to investigate the feasibility of the recommendation by SACN in the context of other nutrient recommendations and food-based guidelines. This demonstrated that it is possible to consume 30 g of AOAC fibre a day in the context of a healthy diet that meets other dietary recommendations if all meals are based on starchy foods (including mainly wholegrain options and potatoes with their skins), high fibre snacks are selected and the diet is rich in fruit and vegetables (around 8 portions daily).

The recent report on Carbohydrates and Health by the Scientific Advisory Committee on Nutrition concluded that a high fibre intake is associated with reduced risk of a number of significant chronic diseases in the UK, although further studies are needed to fully elucidate the precise mechanisms involved. New recommendations have been set for adults and younger people but dietary surveys suggest that intakes are currently well below these targets, reflecting low consumption of fibre-containing foods such as fruit, vegetables, nuts and seeds and high-fibre/wholegrain starchy foods. A wide number of interrelated barriers to increasing intakes have been purported. These include a lack of awareness of the health benefits of fibre; relatively little interest amongst the media compared with other nutrients (e.g. sugars); perceived high cost of fruit and vegetables; perceptions of starchy carbohydrates as unhealthy; taste preferences for refined grains; lack of a specific dietary recommendation or national awareness campaign for fibre or wholegrain intake; no general permitted (European Food Safety Authority approved) health claims for fibre and wholegrain; and a lack of mandatory labelling of fibre values on packaging. Health professionals have an important role in giving dietary advice, including the promotion of dietary fibre. However, as well as limited time during appointments to discuss diet and lifestyle issues, the level of confidence and competency in delivering such advice may be lacking amongst some health professionals. Current knowledge and awareness of the key messages around dietary fibre amongst health professionals have been poorly studied. A small online survey of UK practice nurses (n = 50) recently commissioned by the British Nutrition Foundation suggested that, although the benefits of dietary fibre intake in relation to cardiovascular disease, type 2 diabetes and colorectal cancer are largely acknowledged, the perceived importance of fibre for patient health is lower than other nutrients such as fat and sugars. One in five nurses reported not having adequate skills or knowledge to offer dietary advice and one in four said they sometimes lacked the confidence to give dietary advice to their patients. In view of the evidence for the health benefits for dietary fibre, there is a need to increase the importance that health professionals place on communicating ways to boost intakes amongst their

Bread has been a widely consumed traditional staple food in the UK for centuries, although there has been a decrease in consumption over the past 50 years. This may reflect the increased availability and popularity of other starchy foods such as pasta and rice and potentially negative misconceptions around bread and health (e.g. weight gain and gastrointestinal symptoms). On average, in the UK, bread provides 11-12% of energy, 16-20% of carbohydrate, 10-12% of protein and 17-21% of fibre intakes across all age groups and is a key contributor to micronutrient intakes (9-14% of folate, 15-17% of iron, 12-17% of calcium, 12-13% of magnesium and 10-11% of zinc). White bread is the largest contributor to salt intakes in the UK, though average salt content has been declining, largely as a result of the government reformulation programme with the food industry, including the setting of salt reduction targets. The mandatory fortification of flour with folic acid, a strategy used successfully in >60 other countries as a means of reducing neural tube defects (NTDs), is currently being considered and may be an important public health initiative. The variety of fibre types in bread such as arabinoxylan, oligosaccharides and resistant starch, as well as other bioactives including polyphenols, are an area of emerging interest in relation to nutrition and health. This paper gives an overview of the current contribution of bread to nutrient intakes and considers trends which may change the role of bread in our diet going forward.

Interesterification rearranges the position of fatty acids within triacylglycerols, the main component of dietary fat, altering physical properties such as the melting point and providing suitable functionality for use in a range of food applications. Interesterified (IE) fats are one of a number of alternatives which have been adopted to reformulate products to remove fats containing trans fatty acids generated during partial hydrogenation, which are known to be detrimental to cardiovascular health. The use of IE fats can also reduce the saturated fatty acid (SFA) content of the final product (e.g. up to 20% in spreads), while maintaining suitable physical properties (e.g. melt profile). A novel analysis was presented during the roundtable which combined data from the UK National Diet and Nutrition Survey (2012/2013–2013/2014) with expert industry knowledge of the IE fats typically used in food products, to provide the first known estimate of population intakes of IE fats among UK children and adults. IE fats were found to contribute approximately 1% of daily energy across all ages. The major contributors to overall IE fat intakes were fat spreads (~54%) and bakery products (~22%), as well as biscuits (~8%), dairy cream alternatives (~6%) and confectionery (~6%). Increasing use of IE fats could contribute towards reducing total SFA intakes in the population, but would depend on which food products were reformulated and their frequency of consumption among sub‐groups of the population. Studies comparing the effect of IE and non‐IE fats on markers of lipid metabolism have not shown any consistent differences, either in the fasted or in the postprandial state, suggesting a neutral effect of IE fats on cardiovascular disease risk. However, these studies did not use the type of IE fats present in the food supply. This issue has been addressed in two studies by King's College London, which measured the postprandial response to a commercially relevant palm stearin/palm kernel (80:20) IE ‘hard stock’, although again no consistent effects of the IE fat on markers of lipid metabolism were found. Another study is currently investigating the same IE hard stock, consumed as a fat spread (blended with vegetable oil), and will measure a broader range of postprandial cardiometabolic risk factors. However, further long‐term trials using commercially relevant IE fats are needed. Subsequent to the roundtable, a consumer survey of UK adults (n = 2062; aged 18+ years) suggested that there is confusion about the health effects of dietary fats/fatty acids, including trans fats and partially hydrogenated fats. This may indicate that providing evidence‐based information to the public on dietary fats and health could be helpful, including the reformulation efforts of food producers and retailers to improve the fatty acid profile of some commonly consumed foods.

Poor dietary choices not only manifest in obesity, which is currently the main public health focus in the UK, but can also lead to inadequate micronutrient intakes, with implications for health. Recent dietary survey data and measurements of status biomarkers have highlighted folate, vitamin D, calcium, iron and iodine to be amongst the micronutrients of most concern for particular subgroups of the UK population. Those most vulnerable to inadequate intakes of these micronutrients include adolescents, ethnic minorities and lower socioeconomic groups. Teenage girls and women of childbearing age are of particular concern because of their high requirements for some micronutrients and the impact poor micronutrient intakes can have on the health of their offspring. Yet, compared to other food concerns, relatively little importance seems to be given by consumers to the micronutrient density of foods. This review explores different factors that may influence micronutrient intakes and status over the following decade and beyond. Over the next few years, it is likely that the micronutrients of concern remain similar, although continuation of dietary trends could result in further decreases in iron and calcium intakes. In an obesogenic and sedentary environment, where many people are being encouraged to reduce their energy intakes, increasing the micronutrient density of the diet is essential to prevent a concurrent decrease in micronutrient intake. Investment in fortification policies/practices or sustained government programmes aimed at raising awareness of micronutrients of most concern or encouraging supplementation, for example focusing on folate and vitamin D, could considerably improve population micronutrient intakes. Over the longer term, with sufficient investment in research and support from healthcare professionals and the food industry, adequate micronutrient intakes could be achieved across the UK population. However, global food security issues, including retaining food supply in response to an increase in demand for food, energy and water, and changing climate, could potentially hamper these efforts.

The continuing global increase in the prevalence of overweight and obesity, particularly amongst children, attracts widespread public and political attention. Obesity is a complex condition, with multi‐faceted determinants, and prevention strategies require consideration of dietary and lifestyle patterns alongside a range of environmental factors. Reduction in intake of sugar‐sweetened beverages and foods is advised around the world as part of healthier dietary patterns to help reduce energy intakes, obesity risk and obesity‐related disorders. Current intakes indicate that this is challenging and will likely require a concerted approach with a broad range of interventions including fiscal measures. In recent years, after some notable success with salt and trans fats, there has been considerable focus on food reformulation to support the reduction in population intakes of free sugars from manufactured foods, often without need for consumer behaviour change. In some products, particularly sugar‐sweetened beverages, reformulation is relatively easy and has been widely achieved, as the sweetness of sugars can be replaced with low‐calorie sweeteners. However, other products, in which sugar delivers a variety of functional properties, are more challenging to reformulate to maintain consumer acceptance and achieve a reduction in energy, alongside sugar, content. This paper will look at current definitions and recommendations for free (or added) sugars, as well as key dietary sources and trends in intakes, and explore various strategies to promote population reductions in intake of sugars for public health, including the opportunities and challenges presented by reformulation using low‐calorie sweeteners. Ultimately strategies to promote sugar reduction, including reformulation, should adopt a holistic approach that considers wider dietary recommendations.