10 th Seminar on. Background. Nutrition Labeling, Claims and Communication Strategies

Transcription

1 10 th Seminar on Nutrition Labeling, Claims and Communication Strategies August 28 29, 2018 Renaissance Hotel, Kuala Lumpur, Malaysia Issues on the definition of Whole Grains and dietary fibre: towards harmonisation in Southeast Asia Organizers Co-organizer In Collaboration With Dr Iain Brownlee CSIRO Nutrition & Health Program, Australia Newcastle Research and Innovation Institute Singapore Food Safety and Quality Division Ministry of Health Malaysia Overview Background to these challenges of harmonized definition Scientific hypothesis Chemical analysis Understanding (scientific and consumer) Findings from recent position paper on whole grains in Southeast Asia Regulations, Recommendations Research Background Next Steps

2 Dietary fibre and whole grains Dietary fibre and whole grains: Overview: Resulted in: SHARED HYPOTHESIS DEVELOPMENT? Eijkman et al., Burkitt et al., Cleave et al., Unpolished rice abated beriberi The isolation of vitamins Differential diet and disease risk in East Africans Wheat bran addition to diet alleviated constipation The fibre hypothesis Merritt & Tan (2011) Singapore Med J 59 Burkitt & Burkitt (1952) E Afr Med J 29 Cleave (1941) BMJ 1 HEALTH CLAIMS SUBSTANTIATION Panel consensus or meta-analyses? Intervention studies Randomised controlled studies Other randomised studies (non-controlled) Controlled, non-randomised studies Other intervention studies Observational studies Cohort studies Case-control studies Cross-sectional studies Other observational studies (e.g.: case reports) Other studies Animal and mechanistic studies Historical observation Weighting of evidence Dietary fibre definitions(s) Dietary fibre A diverse group of indigestible entities Mainly polymers ( 3/ 10 sub-units) Mainly carbohydrate Mainly from plant sources Structural components of plant-based foods tend to be classified as dietary fibre Cell wall structure Found in high amounts in grain caryopses Often presented as healthy yet inert

3 DALY per 100K Dietary fibre recommendations Area/Authority Adult target Additional content WHO >25 g/d From whole grains, fruits and vegetables : CVD, T2D Australia/New Zealand 30g/d M, 25g/d F Enjoy wholegrain/high fibre cereal [foods] : laxation, [CHOL]plasma, glycaemic control EFSA 25g/d bowel function Germany, Austria, Switzerland >30g/d obesity, T2D, BP, CHD, CRC Ireland - bowel disease Netherlands 14g/1000kcal/d Eat more plants, less animals T2D, CVD, CRC, breast cancer Nordic countries 30g/d M, 25g/d F CRC, CVD, T2D, breast cancer, obesity Spain >25 g/d Target based on 75 th %ile of intake UK 30g/d T2D, CVD, CRC USA, Canada 14g/1000kcal/d CVD, obesity, T2D, digestive health Buyken et al., (2018) EJCN Available online Fibre classification Dietary fibre supplemention n-value (P<0.05 wt loss) Alginate 2 (0) - α-cyclodextrin 2 (1) 6 g/d β-glucans 2 (1) 7 g/d Minimal dose for wt loss Chitosan 6 (3) 2.25 g/d FOS 1 (1) 30 g/d Inulin 2 (0) - Konjac g mannan 5 (2) 1.5 g/d Maltodextrin 1 (1) 34 g/d Psyllium 3 (0) - Fibre blends 5 (2) 3 g/d Chew & Brownlee(2018) Bioactive Carb Diet Fibre 14 Whole grains and health Whole grains Low whole grain intake appears to be one of the major modifiable risk factors for disease worldwide Global public health focus on increasing wholegrain food intake SEA, East Asia & Oceania Year Global Global Burden of Disease Data (2016)

4 Whole grains Graminacaea family members and some pseudo-grains Bran germ and endosperm present in natural proportions Intact or processed May include minimal losses Whole grain definitions(s) Wholegrain foods No current definition in most countries US definition: >51% by weight of whole grains Research reporting not consistent: can refer to servings of wholegrain food or mass of whole grains van der Kamp et al., (2014) Food Nutr Res 58 Ross et al., (2017) Adv Food Nutr 8 Whole grain recommendations Consistent observational evidence links wholegrain food intake to reduced disease risk 3 servings/d of wholegrain foods or c.48g/d of whole grains Food-based dietary guidelines vary Concept Example message Examples countries/regions Preferred source Eat adequate (preferably whole grains) UK, Malaysia, Philippines, Singapore Specific Eat 3 oz whole grains daily US, Denmark Staple option Staples such as corn, red rice Indonesia Source of fibre especially from wholegrain products Netherlands, Germany, Australia No mention - Many van der Kamp et al., (2014) Food Nutr Res 58; Seal et al., (2016) Brit J Nutr 115 Study Aims/Objectives Whole grains in ASEAN To assess current whole grain landscape in the ASEAN region Research Recommendations Regulations Data collection through: Systematic review Questionnaire Information for 6 countries available

5 National whole grain regulations Public health recommendations Country Include definition of whole grains/wholegrain foods? Minimum amount of whole grains in foods? Whole grain labelling requirements? Do the regulations allow content claims related to whole grains? Allowed health claims? Indonesia Y Y Y Y N Malaysia Y a Y Y a N N Philippines N N N N N Singapore Y N Y Y b Y b Thailand N N N N Y c Vietnam N N N Y c Y c a Draft regulations are currently under public consultation. b Claims can be made as long as other compositional requirements are met C uncertain if claims owould be regulated. Brownlee et al., (2018) Nutrients 10 Country Include whole grain recommendations? Suggest portion sizes/amount? Include rationale for whole grain intake? Use of specific tools to whole grain intake? Indonesia Y N N N Malaysia Y Y Y N Philippines Y Y Y Y Singapore Y Y Y Y Thailand N N N N Vietnam N N N N Brownlee et al., (2018) Nutrients 10 Country Recent (<10y) data? Wholegrain consumption data Adult whole grain intake data intake over time? % meeting recommendations Whole grain intake data - children Recent (<10y) data? intake over time? % meeting recommendations Market data on WG foods? Indonesia N N N N N N N Malaysia N N N a Y N N N Philippines Y N Y N Y Singapore Y Y Y Y N N Y b Thailand N N N N N N N Vietnam N N N N N N N a Previous studies have drawn comparisons with 48g WG/d cut-off b Only in children aged 6-12 years. Brownlee et al., (2018) Nutrients 10 Approaches to increasing intake Wholegrain public-private partnership in Denmark 2008: Mean intake = 36 g/d/10mj 6% of adults meet recommendation 7% of children meet recommendation 2014: Mean intake = 63 g/d/10mj 30% of adults meet recommendation 47% of children meet recommendation Appears to have successfully linked public, private and NGO sectors Greeve & Neess (2014) Available at

6 Summary ASEANwide intake of whole grains are currently low Positive moves in terms of regulations, recommendations and research Further data collection on whole grain intake is the next rational step Clear and consistent definitions for wholegrain foods are important regionally and globally Whole grains and dietary fibre are divergent groupings Plant-based foods form a major component of most ideal dietary templates Fibre supplement efficacy will depend on the fibre in question Added/supplemented fibre is not equivalent to integral fibre Cereal Partners Worldwide Dr Sinead Hopkins Ms Ece Durukan Dr Gabriel Masset Ms Zeina Maktabi Prof E-Siong Tee Acknowledgements Thank You