Development of a methodology to assess the nutrient profile of popular UK meals

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1 NEWS AND VIEWS Development of a methodology to assess the nutrient profile of popular UK meals DOI: /nbu B. Benelam and S. Stanner British Nutrition Foundation, London, UK Abstract In order to characterise the nutrient profile of popular meals and to identify ways to improve this, a methodology was developed to assess the profile of meals by developing meal-based nutritional criteria for macronutrients, fibre, salt and selected food groups and comparing this with recipe analysis of both homemade and partly pre-made dishes (those using products such as cook-in sauces and frozen meal components). Meals were compared with the criteria per portion and with front-of-pack labelling guidelines per g. The results indicate that many popular UK meals, both homemade and partly pre-made, would benefit from changes to improve their nutritional profile. Generally, the dishes made with partly pre-made ingredients met criteria for total energy, total sugars and salt but often exceeded criteria for saturates and did not provide enough fibre or fruits and vegetables. Conversely, the comparable homemade dishes tended to meet the criteria for fibre and fruit and vegetables but were also more likely to exceed the criteria for saturates. A simple visual model, called the Nutrition Compass, for representing key results for each dish was developed. Relatively simple changes to dishes, such as adding extra vegetables and pulses, using wholegrains or potatoes with skins, using less salt or high salt ingredients and swapping higher fat dairy and meat ingredients for lower fat versions, could make significant improvements to the nutrient profile of many popular dishes. Such changes should be communicated to consumers, both by health professionals and by the food industry, in particular via recipes provided on pack or in other media for pre-prepared meal components. Keywords: healthy meals, meal patterns, nutrient profile, recipe analysis, salt, saturates Introduction The British Nutrition Foundation was commissioned to develop a methodology for analysing the nutritional profile of popular main meals in the UK. The aim of the analyses was to identify nutritional strengths and weaknesses in different meals and to identify ways to Correspondence: Sara Stanner, Science Director, British Nutrition Foundation, Imperial House, Kingsway, London WC2B 6UN, UK. s.stanner@nutrition.org.uk improve the nutrient profile of the meals. For each meal, both dishes cooked from scratch and those made from pre-prepared ingredients, such as jarred sauces and frozen meal components, were assessed using recipe analysis software. Criteria for a main meal were developed using established nutrition recommendations for macronutrients, fibre and salt, and also for some food groups, based on government food-based dietary guidelines. Recipes for each meal were assessed, both per portion and per g, and results compared with the criteria. Where meals did not conform to these criteria, potential ways to improve the recipes were highlighted 315

2 316 B. Benelam and S. Stanner (e.g. reducing the salt or saturates or increasing the fibre or vegetable content). Work was carried out between June 213 and July 214. Developing the criteria In order to develop criteria that were applicable to a single main meal for adults, the Food Standards Agency s (FSA) Nutrient and Food Based Guidelines for UK Institutions (FSA 27) were used as a template for planning the nutritional parameters of a main meal (lunch or evening meal). These guidelines assume that main meals provide approximately 3% of daily energy and macro- and micronutrient requirements. For nutrients that should be limited to avoid excess consumption, such as salt, saturates and sugars, it is made clear that 3% should be a maximum rather than a target. This guidance also covers micronutrients where there is concern about low intakes, but for the work described here it was not possible to include micronutrients as these data were not routinely available on the labels of pre-prepared ingredients. In setting the criteria, Dietary Reference Values (DRVs), Reference Nutrient Intakes (RNIs) (COMA 1991) and reference intakes (RIs) for adults (EFSA 29) were used. For energy, the RI of 2 kcal/day and RIs for carbohydrate, total sugars, total fat and saturates of 26, 9, 7 and 2 g per day respectively were used as the basis for calculating the criteria. For fibre, the adult DRV of 18 g non-starch polysaccharide (NSP) fibre per day was used but was converted to the Association of Official Analytical Chemists (AOAC) fibre, with a value of 24 g/day, as data on fibre from food labels were provided using AOAC methodology. The criterion for protein was based on the RNI for adult men of 55 g/day (COMA 1991). In this case, the RNI was selected as it was a higher value than the RI ( g), defined as being a level that is sufficient for 97.5% of the population, in order to ensure that protein levels were adequate. The criteria for salt were based on guidelines from the Scientific Advisory Committee on Nutrition (SACN) that salt intake should not exceed 6 g/day for adults (SACN 23). For each nutrient, the criteria were defined as 3% of the daily requirement, although for nutrients such as protein and fibre this was defined as a minimum while for others such as saturates, sugars and salt, it was given as a maximum that should not be exceeded. Note that, since the time this work was carried out, SACN has published new recommendations (SACN 215) that free sugars should make up no more than 5% of total dietary energy and that the fibre DRV for adults should increase to 3 g AOAC fibre per day. At the time of writing, these recommendations were being considered by the UK government and future work using this model may incorporate this. As well as nutrient criteria, requirements for particular food groups were also included to ensure that the meals were in line with UK food-based dietary guidelines. These were based on the eatwell plate and 8 Tips for Eating Well (PHE 214). For fruit and vegetables, the criteria were also set at 3% of the recommended daily intake of this group (from a daily recommendation of at least 4 g) equating to 12 g or g portions. For starchy foods, the criteria were set as one portion, to ensure that meals were based around this food group as suggested in the 8 Tips for Eating Well. It was also a requirement that the meal provide at least one portion from the meat, fish, eggs, beans and other non-dairy sources of protein group or from the milk and dairy foods group (or a total of one portion provided by foods from both groups based on the relative amounts of each in relation to the relevant acceptable portion size as described below). An acceptable portion from these was defined as any portion size that fell within the range provided by the average small to the average medium portion size using the Food Portion Sizes book (FSA 26). The criteria used for this work are shown in Table 1. Methodology Having established the criteria against which to measure the meals, popular recipes were identified using market research data from Taylor Nelson Sofres consumer and market insights. These data were collected in 21, using a representative sample of UK households and provided information on the most popular hot main meal types consumed. These results were used as the basis of the meal selections made for this work. For each meal type, a recipe from scratch (homemade) and a recipe made using a combination of pre-prepared items and home cooking (partly pre-made) were analysed. Table 2 shows the meal selections. The selections aimed to incorporate the most popular UK meal types yet provide a balance of dishes (i.e. with variations in, for example, type of sauce, main source of protein, type of starchy food). Recipe selection Homemade recipes were gathered using a Google Internet search to identify recipes from the BBC Good Food and BBC Food websites (sites that consistently appeared highest in Google searches) and selected meals that gave the highest placed search returns. Recipes were initially

3 Assessing the nutrient profile of popular UK meals 317 Table 1 Nutrient criteria developed for a main meal Total energy (kcal) Carbohydrate Protein Total sugars Total fat Saturates Starchy foods (No.) Protein/ dairy/both (No.) for contribution of main meal Max Min Min Max Max Max Min Max Min Min Min Notes on the basis of the criteria:total energy is based on RIs for an adult of 2 kcal/day (EFSA 29). Protein is based on the RNI of 55 g (for a man) per day (COMA 1991). Carbohydrate, total sugars, total fat and saturates are based on RIs of 26, 9, 7 and 2 g/day, respectively (EFSA 29). is based on the DRV of 18 g NSP fibre per day (COMA 1991), converted to 24 g AOAC fibre per day to allow comparison with data from food labels. is based on the SACN recommendation of 6 g/day (SACN 23)., fruit and vegetables. Table 2 Meal selections Meal Chicken korma with rice (made from scratch and using a cook-in sauce) Chicken Thai green curry with rice (made from scratch and using a cook-in sauce) Beef chilli con carne with rice (made from scratch and using a cook-in sauce) Chicken sweet and sour dish with rice (made from scratch and using a cook-in sauce) Mushroom risotto (made from scratch and using a ready-made packet) Beef spaghetti Bolognese (made from scratch and using a cook-in sauce) Bacon spaghetti carbonara (made from scratch and using a cook-in sauce) Beef lasagne (made from scratch and using cook-in sauces) Pasta with tomato sauce (made from scratch and using a stir-in sauce) Macaroni cheese (made from scratch and using a pasta bake sauce) Lamb shepherd s pie (made from scratch and using a dried shepherd s pie mix) Chicken roast dinner (made from scratch and using a pre-prepared roast chicken breast, frozen roast potatoes, vegetables and gravy granules) Beef casserole (made from scratch and using a cook-in sauce) Fish and chips with mushy peas (made from scratch and using frozen fish and chips and tinned mushy peas) Burger and potato wedges (made from scratch and using a ready-made burger and frozen potato wedges) Vegetarian (margherita) pizza (made from scratch and using a ready-made pizza) chosen based on a high rating or number of recommendations based on website data. Consideration was also given to the simplicity of the recipe, based on recipe descriptions (the level of difficulty described by the site) and ingredients lists (whether these tended to be store cupboard or easy to access ingredients, or more unusual), so if a highly rated recipe appeared difficult to prepare, a simpler recipe was chosen from lower rated recipes. For the partly pre-made dishes, market-leading products were selected and popular products were identified using ratings on supermarket shopping websites. Nutritional analysis methodology A stepwise process was used to analyse the recipes, which was done using CompEat nutrition analysis software (Nutrition Systems, Banbury). Ingredients were identified from the online recipe for homemade dishes, and from the cooking instructions on the packet for partly pre-made dishes. Where necessary, ingredients were added to the CompEat nutritional analysis software. On-pack nutritional information was used to enter the nutrient values for ready-made products. Recipes were adapted to take into account the percentage weight loss from cooking using weight loss values from the Composition of Foods tables (FSA 22). The weights of starchy food items (rice, pasta, potatoes and bread-based) were added using standard medium portions within the software, or were based on single units (pizza) or recipe or cooking instruction quantities as appropriate and the recipes were divided into portions using the information gathered from the recipe or packet. Recipes were analysed both per portion and per g. For the per portion analysis, nutrients were collated as follows: total energy in kcal; protein, carbohydrate, total sugars, fat, saturates, fibre and salt in grams. (AOAC) values were obtained by multiplying the fibre (Englyst) values by a conversion factor of 1.33, and salt values were obtained by multiplying the sodium content by 2.5. Food group data were collated by calculating the weight of fruit and vegetables provided in the recipes (either from the ingredients list in the online recipe or as described in preparation instructions) and comparing these to the recommended portion of 8 g. The number of portions of starchy foods, non-dairy protein foods and dairy foods were calculated based on the weights provided in the recipes and compared with portion sizes in the FSA s Food Portion Sizes book (FSA 26) as described previously. Data from each recipe were

4 318 B. Benelam and S. Stanner compared with the criteria to establish whether these were met in each case. Analysis was also conducted per g of the dish to account for any differences in portion weight between the dishes analysed. The criteria developed for a main meal were not applicable per g so the results of the recipe analysis per g were compared with the government s front-of-pack (FOP) labelling criteria per g (DH 213) to provide a comparison. Potential limitations Portion weights The analysis of recipes per portion used the portion weights provided in the recipe for each dish rather than standardising the portions, with the aim of making a more realistic comparison between dishes. This means that portion sizes and weights varied considerably between the different meals and this must be considered when interpreting the per portion results. As described, analysis per g of the dish, in addition to per portion, was undertaken to provide the opportunity to compare dishes using the same weight. Consumer behaviour Consumers do not always follow cooking instructions exactly in practice, and may make adaptations based on personal preference, availability of ingredients and household specifics. Hence, the portion sizes proposed by the recipes may not always be a reflection of actual consumption, with consumers potentially dividing a meal between more or fewer people than suggested. Consumers may also make additions to meals (e.g. adding vegetables or substituting ingredients). Our analysis is based only on the recipe and cooking instructions provided so consumers may, in reality, be consuming greater or smaller quantities of nutrients than those proposed. Additional meal components and consumption across the day The nutritional criteria are based on the premise that a single main meal (lunch or evening) provides 3% of an individual s nutrient intake for the day. Our analysis was performed taking the specified dish (always a savoury main course) as the only contributor to the eating occasion. In reality, people may have a beverage and a starter or dessert in addition to a main course. On this basis, the quantities of nutrients proposed do not reflect the additional quantities that could be provided by these additions, and a meal eaten with these additions may be closer or further away from the pragmatic 3% allocation of the day s nutrients and energy. It should also be recognised that the 3% allocation for a lunch or evening meal is based on the remaining 7% of energy and nutrients being consumed in the remaining meal and snacking occasions. It may be the case that more or less than 7% of energy and nutrients are consumed during the remaining eating occasions, and this could affect the proportion required at a meal occasion on that day. In the context of energy and nutrients to limit such as fat, saturates and salt, this allows for the potential inclusion of dishes classed as indulgent or special occasion meals in a healthy, balanced diet, so long as this occurrence is compensated for by eating less that day or over the following days. Nutrient requirements It should also be considered that all analyses are based on the nutritional requirements of an average adult (with the exception of protein, for which the value for males is used). Individuals and population groups differ in their specific nutritional requirements (e.g. males typically have a need for greater quantities of most nutrients compared with women, while young children typically have a need for smaller quantities). Hence, the nutrient values presented in this analysis are not reflective of the variance in requirements for individuals or population groups. In reality, a male member of the household may consume a larger portion of a dish, which could take him closer to his additional nutrient requirements, while a child may consume a smaller portion. However, our analysis is based on a dish being divided into equal servings. Results Results of recipe analysis of dishes per portion are shown in Table 3. Portion weight Portion weights varied considerably across dishes, ranging from 178 g for the homemade pizza to 636 g for the homemade roast dinner, a difference of more than 4 g. The pizza dishes and partly pre-made risotto were considerably smaller than other dishes. Homemade dishes tended to be larger in weight than partly pre-made dishes (an average of 43 g vs. 334 g), see Table 3. The variance in portion weights has an impact on the interpretation of the findings. Broadly speaking,

5 Assessing the nutrient profile of popular UK meals 319 Table 3 Results of recipe analysis of dishes per portion for total energy, total sugars, saturates, fibre, salt, and fruit and vegetables (). Values exceeding the criteria by 5% or less are in italics, values exceeding the criteria by more than 5% are in bold Portion weight Total energy (kcal) Total sugars Saturates Criteria Max Max Max Min Max Min Dish Chicken korma Chicken korma (jar) Chicken Thai green curry Chicken Thai green curry (jar) Chilli con carne Chilli con carne (jar) Chicken sweet and sour Chicken sweet and sour (jar) Mushroom risotto Mushroom risotto (packet) Spaghetti Bolognese Spaghetti Bolognese (jar) Spaghetti carbonara Spaghetti carbonara (jar) Lasagne Lasagne (jar) Tomato pasta Tomato pasta (pot) Macaroni cheese Macaroni cheese (jar) Shepherd s pie Shepherd s pie (packet) Roast dinner Roast dinner (pre-prepared) Beef casserole Beef casserole (jar) Fish and chips (fresh, fried) Fish and chips (pre-prepared, oven chips) Burger and wedges Burger and wedges (pre-prepared) Margherita pizza Margherita pizza (packet) the differences in the nutrient content of dishes are sometimes attenuated when analysis of the dish per g is considered, and in some cases the association between dishes and nutrient values no longer persists or is reversed. In the following sections, the results in relation to each of the criteria are discussed. Energy Based on the criteria adopted, the energy consumed per eating occasion should be no more than 3% of the daily RI of 2 kcal for a lunch or evening meal, which equates to 6 kcal. When performing analysis by portion, total energy was an average of 59 kcal per portion across all dishes, and so close to the criterion for energy. However, there was a wide variation in the amount of energy provided by dishes, with a difference of 5 kcal between the highest (homemade roast dinner 888 kcal) and lowest (partly pre-made pizza 333 kcal) dishes. Forty three per cent of dishes were over 6 kcal (see Table 3). When performing analysis per g, the dishes with the lowest energy per g were the casserole dishes and shepherd s pie dishes, the partly pre-made risotto and, conversely to the per portion findings, the homemade chilli, which all ranged from 97 to 125 kcal per

6 32 B. Benelam and S. Stanner g. This suggests that the high energy content of the homemade chilli per portion can be attributed to the large portion weight. The dishes with the highest energy density were the homemade pizza and spaghetti carbonara, the partly pre-made korma, and burger, both lasagne dishes and the fried fish and chips, which ranged from 183 to 217 kcal per g. This is a result of the use of fats, oils and higher fat versions of ingredients such as meat and dairy products, as well as lower amounts of vegetables and water, which effectively dilute the energy density of dishes. Conversely to the per portion findings, the energy content of the roast dinner dishes was not particularly high, and therefore their high energy content per portion is a reflection of their large portion size. Protein Based on the criterion adopted, the protein consumed per eating occasion should be at least 3% of the DRV of 55 g for a main meal, which equates to 17 g. In the per portion analysis, the risotto and pizza dishes were low in protein (particularly the partly premade dishes) and did not meet the criterion, alongside the partly pre-made spaghetti carbonara. This is likely to be due to the relatively small quantities of dairy foods included and lack of foods from the non-dairy protein group in these recipes. Some of the meat-based dishes were very high in protein (e.g. both roast dinners and both Thai chicken curries contained over g of protein per portion, more than three times the protein criterion). Excluding the vegetarian dishes, the average protein content of all dishes was over 35 g per portion, more than double the quantity set as the criterion. When performing analysis per g, the protein content of the risotto dishes remained low, although the two pizza dishes were no longer relatively low in protein, indicating that their low values per portion were due to small portion size. half of the quantity set by the criterion. The partly pre-made risotto failed to meet the criteria, which could be a result of a relatively small portion weight. Interestingly, in most cases (apart from the homemade roast dinner and the risotto, lasagne and pizza dishes, where portion sizes were not available for comparison), these dishes met the criterion for providing a portion of starchy food, which perhaps suggests that the use of small to average portions from this food group was not sufficient. The pizza, risotto and carbonara dishes were no longer relatively low in carbohydrate when analysed per g, suggesting that the low content per portion is a result of their relatively small portion weight. In fact, the homemade pizza had the highest carbohydrate content per g, at 33 g. The association between the homemade roast dinner and shepherd s pie dishes and low carbohydrate content persisted, with 1 g or less of carbohydrate per g. Total sugars Based on the criteria, the total sugars for a main meal should be no more than 3% of the RI of 9 g, which equates to 27 g. When analysed per portion, all meals were within the maximum limits of the criterion for total sugars, with content ranging from.1 g total sugars per portion (partly pre-made risotto) to 2 g per portion (partly pre-made sweet and sour chicken). Homemade dishes tended to be slightly higher in total sugars content compared with partly pre-made, although all dishes remained well within the limits of the criterion (see Table 3). When performing analysis per g, total sugars content was low for all dishes based on g analysis (receiving a low classification based on the FOP labelling criterion), with the exception of the partly pre-made sweet and sour dish, which contained a medium amount of sugar, at 5.6 g per g. Carbohydrate Based on the criterion used, the carbohydrate consumed per eating occasion (for a lunch or evening meal) should be at least 3% of the RI of 26 g, which equates to 75 g. In the per portion analysis, many of the dishes did not meet the carbohydrate criterion: the homemade roast dinner, and both the homemade and partly premade pizza, casserole, carbonara, lasagne and macaroni cheese dishes were low in carbohydrate, and in particular the two shepherd s pie dishes, which provided about Total fat and saturates Based on the criteria used, the total fat and saturates consumed per eating occasion should be no more than 3% of the respective RIs of 7 and 2 g for a lunch or evening meal, which equates to 21 and 6 g, respectively. Unsaturates do not form part of the nutritional criteria, but are discussed alongside total fat and saturates to give a picture of the fat profile of dishes. In the per portion analysis, many of the dishes exceeded the criterion for total fat, with homemade

7 Assessing the nutrient profile of popular UK meals 321 dishes more commonly being high in fat per portion. In particular, the homemade carbonara, burger, macaroni cheese, lasagne and fried fish and chips were high, at over 3 g total fat per portion, while the homemade roast dinner was exceptionally high at 52 g per portion. Most of the dishes exceeded the criterion for saturates per portion, with homemade dishes having a higher content than partly pre-made dishes (see Table 3). The homemade Thai curry, carbonara and roast dinner, and both lasagne dishes were particularly high, as was the homemade macaroni cheese, which was almost four times the criterion value. Many of the dishes that were high in fat and saturates were creamy or used non-low-fat minced beef, lamb or cheese; products that typically have a higher fat and saturates content. Unsaturates content in terms of the total contribution in weight per portion was higher in those dishes with a high total fat content (the fish and chips and burger dishes, and homemade roast dinner). As a proportion of total fat, the fish and chips dishes (the recipe for the homemade version used sunflower oil) had the highest quantity of unsaturates (over 2 g per portion) and the highest proportion of total fat as unsaturates (around 9% of total fat was unsaturated). When comparing dishes per g, all dishes were classified as medium in total fat applying the FOP labelling criteria per g. When looking at saturates content per g, only the homemade carbonara and homemade macaroni cheese were over 5 g per g and thus classified as high. Some of the dishes that appeared high in fat and saturates per portion were no longer particularly high when compared per g, including the homemade chilli and both shepherd s pie dishes, demonstrating that their high fat and saturates levels per portion were due to a large portion size., fruit and vegetables Based on the criteria used, the amount of fibre consumed per eating occasion should be at least 3% of the DRV (18 g NSP fibre or 24 g as determined by the AOAC method) for a main meal, which equates to 7.2 g. The meal should also contain at least 12 g (or 1.5 portions) of foods from the fruit and vegetables group. When performing analysis by portion, most of the dishes were below the criterion for fibre. Only the homemade chilli, both Bolognese dishes and both roast dinners contained adequate amounts, with a number of dishes providing less than % of the set criterion for fibre content (see Table 3). Many dishes lacked an adequate amount of fruit and vegetables, see Table 3. The dishes that fell short of fibre recommendations tended also to be relatively low in fruit and vegetables. However, the homemade korma, burger and sweet and sour chicken dishes had relatively high quantities of fruit and vegetables (between 1.3 and 2.1 servings of fruit and vegetables per portion) but still did not meet fibre requirements. In contrast, the partly pre-made Bolognese had less fruit and vegetables (1 serving per portion) but met fibre requirements. This may be a result of the types of vegetables used, or the fact that the starchy carbohydrate featuring in the Bolognese dish (spaghetti) has a somewhat higher fibre content than some of the other dishes. Based on the criteria, the salt consumed per main meal should be no more than 3% of the SACN recommendation of 6 g, which equates to 1.8 g. When performing analysis by portion, some dishes exceeded the nutritional criteria for salt, although the majority met the criterion (see Table 3). Where levels of salt were higher, this could often be attributed to the amount of cheese and stock/gravy used. Partly pre-made dishes tended to be higher in salt per portion, with half of the partly pre-made dishes assessed exceeding the criteria compared with one of the homemade dishes. However, it should be noted that many of the recipes include the instruction to season to taste, which means the amount of salt in these dishes may have been underestimated by the recipe analysis. Those partly pre-made dishes exceeding the criteria included dishes to which cheese was added (including lasagne, risotto and macaroni cheese), the Thai green curry, the roast dinner, fish and chips, burger and wedges and pizza dishes. When performing analysis per g, only a small number of dishes were classified as low in salt based on the FOP labelling criterion per g (the homemade korma, chilli, Bolognese, tomato pasta, roast dinner and burger dishes, and the partly pre-made sweet and sour and casserole dishes). All other dishes were classified as medium using the FOP labelling criterion per g. Food groups (starchy foods, non-dairy protein foods and dairy foods) It is recommended that all main meals are based on starchy foods; hence the criterion requires one portion from this group per eating occasion. The criteria also recommend at least one portion of non-dairy protein sources or at least one portion of dairy foods (or the

8 322 B. Benelam and S. Stanner equivalent provided by a combination of both food groups) per main meal. In each case, a portion was considered to fall within the range of an average small to average medium serving. When performing analysis by portion, all dishes analysed provided at least one small serving of items from the starchy foods group, with the exception of the homemade roast dinner, which, despite including potatoes, did not quite meet the required portion size for this food group. Despite this, a number of dishes did not meet the nutritional criterion for carbohydrate used (see Carbohydrate and total sugars section) and were comparatively low in carbohydrate when analysed per g. Many meals provided less than a small portion of non-dairy protein or dairy foods. In particular, the partly pre-made korma, sweet and sour chicken and carbonara dishes, and both risotto, tomato pasta and casserole dishes, did not meet this criteria, providing less than half a small portion of non-dairy protein or dairy foods. Despite this, most of the dishes met the nutrient criterion for protein (see Protein section), except the risottos and partly pre-made carbonara, owing to the protein contribution from other ingredients. The criteria required a minimum of one small portion of dairy foods or non-dairy protein foods per meal. However, the presence of a full portion or more of (non-low-fat) dairy foods in the homemade pizza, lasagne and macaroni dishes contributed to their high total fat and saturates levels relative to the risotto dishes and partly pre-made carbonara and macaroni cheese (which contain less than half a portion of dairy foods). Visually representing the results the Nutrition Compass In order to visually represent the key results of the analysis (from a public health point of view), a model was developed that compared the results using a Radar Diagram. This was termed the Nutrition Compass model. This comprised a comparison of the results for total energy, fibre, fruit and vegetables, total sugars, saturates and salt, with the criteria. On the visual scale, an optimal recipe should fulfil or exceed the criteria to the right of the model (fibre and fruit and vegetables) and should not exceed, and ideally be well within, the criteria to the left (salt and saturates). Improving the nutritional profile of a dish will therefore create a shift towards the right of the model. Energy, shown at the top of the model, should not be exceeded but it was not felt necessary to be significantly below the criteria hence this occupies a neutral position within the model. are potentially a nutrient of concern for public health because of the implications of high or frequent intakes in relation to energy intake and dental caries, respectively. However, because the analysis had already established that all of the meals in question were well within the total sugars criteria, this was also put into a neutral position at the bottom of the model in this particular analysis. For each recipe, Nutrition Compass diagrams were developed to allow such comparisons to be made and for ways to improve recipes to be identified. The examples of four dishes that are homemade and prepared using pre-made ingredients are shown in Figure 1. The model shows that the homemade korma is closer to the criterion for fruit and vegetables but well below the target for fibre. Although it is well within the criterion for salt, it is above that for saturates. The korma made using a jarred sauce is well below the criteria for both fruit and vegetables and fibre, within the criterion for salt and just over the criterion for saturates. In order to improve the nutritional profile, the model demonstrates that different approaches would need to be taken for each dish. In the case of the homemade korma, the vegetable content is close to the criterion but the fibre is low and the recipe could be improved by increasing the vegetable content and perhaps changing the balance of vegetables used and/or using some brown or wild rice in place of white to boost the fibre content. The ingredients of the dish would need to be modified to reduce the saturates content (e.g. reducing or taking out the double cream). In the case of the recipe using a jarred sauce, the vegetable content would need to be increased significantly, aiming for 1.5 portions per person. Vegetables with a higher fibre content should be selected in order to increase the fibre content and, as with the homemade version, wholegrains could substitute all, or part, of the white rice in the recipe. This should be communicated to the consumer via on pack recipe information or cooking instructions. Ideally, the saturates content of the sauce should be reduced to bring it within the criterion, but it is interesting to note that the saturates content is lower than that of the homemade version. For the chilli con carne, the homemade version performs very well against the fibre and fruit and vegetable criteria, exceeding the criteria in both cases. However, it significantly exceeds the criterion for saturates and so the recipe should be revised to reduce this (e.g. by using extra-lean minced beef). The dish is just within the criterion for salt but this could be reduced further by using a low-salt stock cube rather than the standard one

9 Assessing the nutrient profile of popular UK meals TE Roast dinner (homemade) 3 TE Roast dinner (pre-prepared) 2 TE Chicken korma (homemade) 2 TE Chicken korma (jar) TE Chilli con carne (homemade) 2 TE Chilli con carne (jar) TE 1 Spaghe Bolognese (homemade) 2 TE 1 Spaghe Bolognese (jar) Figure 1 Nutrition Compass comparison of two formats of chicken korma, chilli con carne, spaghetti Bolognese and roast dinner (homemade version and that made using pre-prepared ingredients). Note that the target criteria are all represented as % and the actual figures as a percentage of the target to allow consistent comparisons. TE, total energy;, fruit and vegetables;, saturates.

10 324 B. Benelam and S. Stanner suggested in the recipe. The chilli con carne made with a jarred sauce also exceeds the criterion for saturates, although to a lesser extent than the homemade version. Again, this could be addressed by signposting consumers to use extra-lean minced beef in the cooking instructions. This dish is well within the criterion for salt, but provides only % of the required amounts of fibre and fruit and vegetables. The dish could be improved by ensuring the cooking instructions suggest adding plenty of vegetables and beans, alongside the sauce and meat, although it should be noted that this adjustment may change other aspects of the nutritional profile. The Nutrition Compass diagrams also highlight differences between the two formats of spaghetti Bolognese, which both fit quite well with the criteria, although the version using the jarred sauce does not meet the criterion for fruits and vegetables. Both roast dinners exceed the criteria for total energy and saturates, with the homemade version having a very high saturates content. The version using partly pre-made ingredients also exceeded the criterion for salt. However, both versions exceeded the criteria for fibre and fruit and vegetables. Conclusions Based on the nutritional composition per portion and per g, characteristics of dishes that meet most of the criteria have emerged. These dishes tended to have a tomato-based sauce and/or have a relatively large proportion of fruit and vegetables either within the sauce or in addition to the sauce and tended to be less energy dense and higher in fibre. Dishes containing naturally leaner meat (i.e. skinless chicken) or fish, which did not have the addition of any cream or cheese, had better fat profiles than other dishes (i.e. had lower levels of saturates). The vegetarian dishes analysed in this report were not found to be relatively healthy, probably as a result of the amount of cheese and stock used and the low proportion of fruit and vegetables. Homemade dishes, particularly those without cheese, stock or processed meat, contained lower levels of salt. Dishes with a larger portion size were more likely to meet the fruit and vegetable and fibre criteria in this assessment, although the energy content also increased with portion size. In terms of ways in which the nutrition profile of popular meals could be improved, consumers should be encouraged to add plenty of fruit and vegetables to dishes, particularly when using pre-prepared ingredients. These could be added within the recipe or separately as an accompaniment. Pulses, such as beans, lentils or chickpeas, count as one portion of the recommended 5 A DAY for fruit and vegetables and will also increase fibre content if added to a dish. In addition to adding fruits and vegetables, consumers could use wholegrain options of starchy foods (e.g. wholewheat pasta) or potatoes with skins to improve the fibre content. Increasing the portion size and decreasing the energy density of partly pre-made dishes by making low calorie additions could potentially improve the satiating effects of the dishes (e.g. adding more vegetables), which could also help increase the fibre content as suggested above. A reduction in fat and saturates could be achieved by making a number of ingredient alterations or substitutions. For example, lower fat varieties of meat and dairy could be used (e.g. low-fat cheese, reduced fat coconut milk and lean or extra-lean versions of meat), and skinless poultry, fish or pulses could be used as the main source of protein, as they are typically lower in saturates than red or processed meat. A vegetarian source of non-dairy protein is recommended for vegetarian dishes to improve the protein content. Pulses, such as chickpeas and beans, soya products such as tofu, mycoprotein, eggs, nuts and seeds could be added to contribute towards protein requirements. Ingredient alterations or substitutions could be made to reduce the salt content of meals, particularly partly pre-made dishes. Examples include using reduced salt versions of products such as stock, soy sauce and fish sauce. Consumers can also check labels to select lower salt products. From the point of view of the food industry, it is important to consider the overall nutrient profile of the meals that are suggested in the cooking instructions provided on pack or in other media. To ensure that the product as consumed makes up a healthy meal, consumers should be encouraged to add plenty of vegetables, to choose higher fibre ingredients such as pulses, wholegrains or potatoes with skins, and to limit ingredients high in salt and saturates. While meals made with pre-prepared ingredients often performed better than the homemade equivalent in this analysis in relation to saturates content, they tended to have lower fruit and vegetable and fibre contents when prepared according to instructions. Much progress has been made by the food industry to reduce the salt content of foods. However, the results of our assessment of the dishes selected suggest that further reductions in salt in pre-prepared meal components should be considered in some cases. In our analysis, although 7% of all dishes overall met the criteria for salt per portion, the partly pre-made dishes tended to be

11 Assessing the nutrient profile of popular UK meals 325 higher than the homemade versions and it was more often the partly pre-made dishes that exceeded the salt criteria (e.g. dishes where cheese was added, the Thai green curry and the roast dinner). Reformulation of pre-prepared meal components to reduce saturates should also be considered, as meals exceeded the criterion for saturates in many cases, although the homemade dishes were almost always higher in saturates than the partly pre-made in our analysis and so strategies for consumers to reduce the saturates content of dishes cooked from scratch also need to be communicated. Overall, this analysis suggests that many popular UK meals would benefit from changes to improve their nutrient profile and that this could be helped by more consideration of cooking instructions for pre-prepared meal components and a greater focus on healthier ingredients in recipes. Homemade dishes tended to be higher in fruit and vegetables and in fibre, but were also higher in saturates. Relatively simple changes to the meals analysed, such as adding plenty of vegetables when cooking using a jarred sauce or swapping standard for lean mince when cooking a meat dish, could make a significant improvement to meals. Routes to communicate such simple changes to consumers should be used by retailers, manufacturers and caterers, and by health professionals wherever possible. Acknowledgement Thanks are due to Marie Murphy, who carried out much of the work described in this paper during her time at the Foundation. Conflict of interest The preparation of this paper and the work it describes were supported financially by Mars Food UK Ltd. Both the analytical work and the drafting of this paper were developed by BNF alone. References COMA (Committee on Medical Aspects of Food Policy) (1991) Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. The Stationery Office: London. DH (Department of Health) (213) Guide to creating a front of pack (FOP) label for pre-packed products sold through retail outlets. Available at: (accessed 11 May 215). EFSA (European Food Safety Authority) (29) Review of labelling reference intake values. The EFSA Journal 8: FSA (Food Standards Agency) (22) McCance and Widdowson s The Composition of Foods. Summary Edition (6th edition). Royal Society of Medicine. FSA (Food Standards Agency) (26) Food Portion Sizes. The Stationery Office: London. FSA (Food Standards Agency) (27) FSA Nutrient and Food Based Guidelines for UK Institutions. Available at: PHE (Public Health England) (214) Your guide to the eatwell plate. Helping you eat a healthier diet. Available at: (accessed 11 May 215). SACN (Scientific Advisory Committee on Nutrition) (23) and Health. The Stationery Office: London. SACN (Scientific Advisory Committee on Nutrition) (215) Carbohydrates and Health. The Stationery Office: London. Available at: attachment_data/file/4453/sacn_carbohydrates_and_health. pdf (accessed 17 July 215).