July Paper of the Month

The Paper of the Month for July is from the British Journal of Nutrition and is entitled 'Prospective association between adherence to UK dietary guidelines in school-age children and cardiometabolic risk markers in adolescence/early adulthood in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort' by Genevieve Buckland, Caroline M. Taylor, Pauline M. Emmett and Kate Northstone.

The Eatwell Guide (EWG) was developed by the UK Health Security Agency (UKHSA) in partnership with the Scientific Advisory Committee on Nutrition. It aims to help inform people living in the UK on how to meet government dietary recommendations and has been a part of nutrition education in the UK for many years. Assessing what proportion of the population are failing to meet the dietary recommendations for foods and nutrients within the EWG can help identify important gaps between actual and recommended intakes. It’s also important to understand the specific health benefits of following government dietary recommendations.

In this paper, we assessed whether school-age children within a large UK cohort study were meeting or failing to meet key EWG dietary recommendations. We then analysed the relationship between meeting these dietary recommendations during childhood and future cardiometabolic health. The data come from approximately 2,000 participants taking part in the world-renowned health study, the Avon Longitudinal Study of Parents and Children, ALSPAC. We calculated an EWG score for each participant when they were 7, 10 and 13 years old. This score ranged from 0 to 9 and reflected how many of the nine EWG dietary recommendations they met. We then assessed their cardiometabolic health at 17 and 24 years using a cardiometabolic (heart/diabetes) risk score. This took into account the participant’s blood levels of certain fats, and their blood pressure, insulin resistance and body fat.

Were the children in this study meeting the EWG dietary recommendations?

Unfortunately, most children in the study didn’t meet the dietary guidelines for many key foods and nutrients, because their diets contained too much saturated fat, free sugars and salt, and not enough fruit and vegetables, fibre and fish, particularly oily fish. We also found that about 10% of the children in the study didn’t meet any of the nine EWG dietary recommendations we studied, about 25% only met one and on average 65% met fewer than three EWG recommendations.

Although the study is based on children’s diets about 15-20 years ago, recent national diet surveys show that children’s average daily intakes for most of the foods and nutrients we focused on in our study were similar to the amounts eaten by children today, with the exception of free sugars and salt intake, which encouragingly have now gone down slightly.

Was meeting EWG dietary recommendations in childhood linked to overall cardiometabolic health?

Yes, the children with diets that were more in line with UK guidelines had better cardiometabolic health when they were young adults. For example, children who met three or more EWG recommendations at 7 years had a significantly lower cardiometabolic risk score at 24 years compared with those who didn’t meet any dietary recommendations. This reduction was mainly due to them having lower body fat, cholesterol, blood pressure and insulin resistance.

The large gap between what school-age children in the study were actually eating and what they should have been eating, according to Government dietary guidelines, suggests that a huge amount of work still needs to be done to help UK children adopt healthier eating habits. Our research adds to the evidence on the health benefits of following UK dietary recommendations and shows that it’s important to develop healthy dietary habits from childhood to maintain future cardiovascular health.  

Genevieve Buckland, Kate Northstone, Pauline M. Emmett and Caroline M. Taylor