Food and Drink Industry Ireland Estimating the impact of reformulation and the introduction of low and no cal beverage products by FDII members on the Irish population Supplementary Report to the FDII/Creme Global Reformulation Project Report
Contents 1. Executive Summary 4 2. Introduction 8 3. Methodology 10 3.1 Food Consumption Surveys 10 3.2 IUNA Beverage Category 11 3.3 FDII Member Data 11 3.4 Market Share Data 12 3.5 Two Methods 12 3.6 Levels of Nutrients Sold (in Tonnes and Kilocalories) 13 3.7 Average Daily Intakes of Energy and Sugar for Irish Pre-Schoolers, 15 Children, Teenagers and Adults 3.7.1 FDII Member Data 15 3.7.2 Calculating Daily Nutrient Intakes 15 3.7.3 Calculating Levels of Significance for Nutrient Mean Intakes, Baseline and Follow-Up 18 4. Results 20 4.1 Levels of Nutrients Sold (in Kilocalories and Tonnes) 20 4.1.1 Energy 20 4.1.2 Sugar 20 4.2 Average Daily Intakes of Nutrients for Irish Pre-Schoolers, Children, Teenagers and Adults 21 4.2.1 Adults (n = 1500, 18 90 years) 23 4.2.2 Teenagers (n = 414, 13-17 years) 25 4.2.3 Children (n = 594, 5-12 years) 27 4.2.4 Pre-Schoolers (n = 500, 1-4 years) 29 5. References 31 1
List of Figures Figure 1: Diagrammatic description of Method 1 and Method 2 12 Figure 2: Calculation utilised to calculate the difference in tonnes/kilocalories sold of the two nutrients 13 between baseline and follow-up time points Figure 3: Example Calculation used to determine quantities of sugar sold for Beverage X between 14 baseline and follow-up time period (Method 1) Figure 4: Example Calculation used to determine quantities of sugar sold for Beverage X between 14 baseline and follow-up period (Method 2) Figure 5: Illustration of the development of the beverage consumption model using FDII nutrient and 16 sales data with IUNA consumption data Figure 6: Description of intake statistics used in the present investigation 17 Figure 7: Difference between the two sets of analyses run and the results produced 22 List of Tables Table 1: P-Value results from statistical analysis of mean intakes. Significant reductions between 6 baseline and follow-up period (with 99.9% confidence) are shown in highlighted cells Table 2: Irish national food consumption surveys utilised to investigate total dietary intakes within 10 four Irish populations Table 3: List of IUNA sub-categories contained in the Beverages category and range of number 11 of IUNA codes per sub-category (with variation per survey) Table 4: Data supplied by the 4 FDII beverage members 11 Table 5: Categorisation of beverages based on FDII member data 15 Table 6: Total energy and sugar sold from FDII reformulated beverages (and equivalent) at baseline 20 and at follow-up period for Method 1, with absolute and relative change Table 7: Total energy and sugar sold from FDII reformulated beverages (and equivalent) at baseline 20 and at follow-up period for Method 2, with absolute and relative change Table 8: Percentage of FDII beverage sales break down of regular and low/no cal beverage 21 sub-categories at baseline and follow-up time periods based on litres sold Table 9: Method 1 - Daily nutrient intakes of energy and sugar for Irish adult consumers of FDII 24 member beverages (and equivalent), at baseline and follow-up period Table 10: Method 2 - Daily nutrient intakes of energy and sugar for Irish adult consumers of FDII 24 member beverages (and equivalent), at baseline and follow-up period Table 11: Method 1 - Daily nutrient intakes of energy and sugar for Irish teenage consumers of FDII 26 member beverages (and equivalent), at baseline and follow-up period Table 12: Method 2 - Daily nutrient intakes of energy and sugar for Irish teenage consumers of FDII 26 member beverages (and equivalent), at baseline and follow-up period Table 13: Method 1 - Daily nutrient intakes of energy and sugar for Irish children consumers of FDII 28 member beverages (and equivalent), at baseline and follow-up period Table 14: Method 2 - Daily nutrient intakes of energy and sugar for Irish children consumers of FDII 28 member beverages (and equivalent), at baseline and follow-up period Table 15: Method 1 - Daily nutrient intakes of energy and sugar for Irish pre-schoolers consumers 30 of FDII member beverages (and equivalent), at baseline and follow-up period Table 16: Method 2 - Daily nutrient intakes of energy and sugar for Irish pre-schoolers consumers 30 of FDII member beverages (and equivalent), at baseline and follow-up period 2
1 Executive Summary 3
1. Executive Summary 1. Executive Summary (FDII) beverage members* have recorded a decrease in sales of regular drinks and an increase in sales of low/no cal drinks within the last decade. This has coupled with FDII reformulation efforts which focused on the reduction of energy and sugar for a number of these beverages, have impacted upon energy and sugar intakes of consumers. The current project was divided into two sections: (a) investigating quantities of energy and sugar sold via the FDII members beverages at baseline and follow-up period, and (b) calculating the daily nutrient intakes in Irish populations of energy and sugar from these beverages, at baseline and follow-up periods. Two methods are presented per section. Method 1 included regular and low/no cal beverages (including new products introduced to the market between baseline and follow up period) and assumes no reformulation has occurred between baseline and the follow up period. This method analysed the shift in sales/consumption between regular and low/no cal in isolation. Method 2 included the same regular and low/no cal beverages and new products to market, but also products that have been reformulated between baseline and follow-up period. A summary of the impact on quantities of energy and sugar sold between baseline and follow-up period (based on the two methods) are outlined below: Method 2 has the greatest impact on tonnes/kcals sold due to a combination of shift in sales from regular to low/no cal beverages and reformulation efforts by the FDII. Energy This reduction ranged from ~7% in Method 1 - ~12% in Method 2 The absolute drop in energy sold was 8.8 x 10 9 Kcal and 1.3x 10 10 Kcal, for Method 1 and Method 2 respectively Sugar The reduction ranged from ~9% - ~13% The absolute reduction in sugar sold was ~2,500 tonnes and ~3,400 tonnes, for Method 1 and Method 2 respectively * This refers to the beverage manufacturers that are among the 14 FDII member companies who participated in the FDII/Creme Global Reformulation Project. See main report for full details. 4
A summary of the impact on daily nutrient intakes of energy and sugar for Irish adults, children, preschoolers and teenagers between baseline and follow-up period, (based on the two methods) is outlined below: Method 2 (shift in market trends with FDII reformulation efforts) exerted the greatest impact in terms of reducing levels of energy and sugar consumed by Irish populations 1. Executive Summary Teenagers experienced the greatest levels of energy reductions among all the populations, with a 49kcal/ day reduction for high consumers (P97.5 intakes) using Method 2, followed by 36kcal/day in children, 22kcal/ day in pre-schoolers and 14kcal/day in adults Differences in mean intakes between baseline and follow up period for all populations were statistically significant. This was true for both Method 1 and Method 2 (see Table 1 below) Energy Reductions in mean intakes ranged from ~8% (Method 1 for Pre-Schoolers and Children) to ~22% (Method 2 for Pre-Schoolers) for consumers of FDII beverages only Reductions in mean intakes from the total diet ranged from ~0.1% (Method 1 for Adults/Pre- Schoolers) to ~0.6% (Method 2 for Children) for all consumers Sugar Reductions in mean intakes ranged from ~8% (Method 1 for Children) to ~23% (Method 2 for Pre- Schoolers) for consumers of FDII beverages only Reductions in mean intakes from the total diet ranged from 0.48% (Method 1 for Pre-Schoolers) to 2.32% (Method 2 for Children) for all consumers 5
1. Executive Summary Table 1: P- Value results from statistical analysis of mean intakes. Significant reductions between baseline and follow-up period (with 99.9% confidence) are shown in highlighted cells Method 1 Adults Teens Children Pre-Schoolers FDII Beverages (and equivalent): Consumers Only Sugar <0.001 <0.001 <0.001 <0.001 Energy <0.001 <0.001 <0.001 <0.001 Method 2 Sugar <0.001 <0.001 <0.001 <0.001 Energy <0.001 <0.001 <0.001 <0.001 Total Diet (including FDII Beverages): All Consumers Method 1 Method 2 Sugar <0.001 <0.001 <0.001 <0.001 Energy <0.001 <0.002 <0.002 <0.002 Sugar <0.001 <0.001 <0.001 <0.001 Energy <0.001 <0.002 <0.002 <0.002 6
2 Introduction 7
2. Introduction The Irish beverage market has experienced significant changes in recent years. These changes have primarily evolved around the beverage companies striving to improve the nutritional well-being of consumers. A primary example of such endeavours by the beverage companies is the development of low/no calorie/sugar alternatives for the majority of leading soft drinks, cordials, squashes, fruit juice drinks and sports drinks. Furthermore, beverage companies have also reformulated the nutritional content of regular products to reduce levels of energy and sugar. From this point forward, the term regular beverage refers to a beverage identified as containing sugar and no sweeteners of lower calorific values than sugar. The term low/no cal refers to drinks that contain (a) sweetener(s) with a lower calorific value than sugar, or those that claim to have no added sugar. 2. Introduction This project compares two time points on the Irish market (baseline and follow up) and investigates how (1) the shift in market sales for regular and low/no cal beverages, and (2) the reformulation of beverages, have had an impact on Irish consumers. This analysis will focus on the impact in terms of energy and sugar production quantities and consumption. 8
3 Methodology 9
3. Methodology 3.1 Food Consumption Surveys The Irish Universities Nutrition Alliance (IUNA) conducts the national dietary surveys in Ireland. This organisation comprises four academic nutrition units (University College Dublin (UCD), University College Cork (UCC), Trinity College Dublin (TCD) and University of Ulster (UU)). Over the past decade, IUNA have recorded the habitual consumption patterns of various Irish populations, including pre-schoolers, children, teenagers and adults. Four such surveys were included in the present analyses to investigate levels of energy and sugar sold and consumed via FDII member beverages. Details of the four surveys included in the present analyses are highlighted in Table 2. Table 2: Irish national food consumption surveys utilised to investigate total dietary intakes within four Irish populations Survey Year of Survey Age Group Number of Participants Methodology National Pre- School Nutrition Survey (NPNS) National Children s Food Survey (NCFS) National Teens Food Survey (NTFS) National Adult Nutrition Survey (NANS) 2010-2011 1 4 Years N = 500 4-day weighed food record 2003-2004 5 12 Years N = 594 7-day weighed food diary 2005-2006 13 17 Years N = 441 7-day semiweighed food diary 2008-2010 18 90 Years N = 1500 4-day weighed food diary 3. Methodology All four surveys recorded amounts and types of all foods and beverages consumed during the survey period, with nutrient composition data obtained from the 5th and 6th editions of McCance & Widdowson s The Composition of Foods (Food Standards Agency, UK) 1,2. Detailed descriptions of all four surveys can be found at www.iuna.net 3. IUNA data is considered as a gold standard when analysing Irish consumption patterns - the surveys are nationally representative and use 4- and 7-day, weighed and semi-weighed food diaries, which record all consumption events in great detail. The representative nature of the surveys with the detailed level of data recorded for each consumption event is ideal for an analysis of this kind. 10
3.2 IUNA Beverage Category All national food surveys conducted by IUNA allocated each food consumed by survey participants to a specific food category. 77 food categories were developed for the NPNS, 68 were developed for NANS and 62 were developed for the NCFS and the NTFS. A list of these food categories are available elsewhere 4. A number of these categories captured various types of beverages consumed by Irish populations. Based on these IUNA food categories, a Beverage group as a whole was created for the present analysis. This category is based on the IUNA grouping system and is described below in Table 3: Table 3: List of IUNA sub-categories contained in the Beverages category and range of number of IUNA codes per sub-category (with variation per survey) Beverages Carbonated beverages (n= 11-28) Diet carbonated beverages (n = 2-7) Squashes, cordials & fruit juice drinks (n = 22-39) Every beverage consumed in the IUNA food surveys was recorded with a unique code. Some of these codes were generic (e.g. Orange drink - undiluted ), but some describe considerable details about the beverages, such as actual brand name, specific flavour of beverage, etc. Such detail in the coding system meant the appropriate beverage codes were included in the present analysis. 3.3 FDII Member Data In order to investigate the true effect that shifts in market sales of regular vs low/no cal beverages had, coupled with the reformulation efforts, sales and nutrient data was required for the beverage products. This data was forwarded by a number of FDII members (n = 4). These companies include some of the largest beverage manufacturers currently on the Irish market. Each FDII member involved in the current project was requested to complete a template which would provide the required data (Table 4). Data was obtained for 127 beverages in total, with 32 of these being reformulated beverages. Data was provided for two points on the Irish market: baseline (between 2005 2010) and follow-up period (2012). This allowed comparisons to be made between the two points against which the levels of impact could be assessed. Table 4: Data supplied by the 4 FDII beverage members 3. Methodology Data supplied by FDII beverage members Company & product name Description of product (i.e. descriptive name) Sales in litres for baseline & follow-up periods Energy content (kcal) for 100mls at baseline and follow-up period Sugar content (g) for 100mls at baseline and follow-up period 11
3.4 Market Share Data FDII members provided the project with sales data (in litres) for every product included in the present analysis. This enabled the analysis to quantify the ratio of sales for regular beverages and low/no cal beverages. To assess the weighting and proportion the FDII members (and the brands associated with each member) held within the overall Irish beverage market, sales data for each FDII brand and total beverages market was sourced from Kantar Worldpanel (http://www.kantarworldpanel.com/ie). This is an independent company that calculate market share data of individual companies and products within a larger, pre-defined food grouping system. 3.5 Two Methods The results generated for this project were based on two distinct data methods (Figure 1). Method 1: Low/No Calorie Sugar Products Only Data included in this method were from the 4 FDII beverage members. This data included information on all products produced by the 4 members, these products being a mix of both regular and low/no cal drinks. Sales data for all products in turn captured the shift in consumer purchasing trends for regular vs. low/no calorie/sugar beverages. This method does not consider reformulation efforts. Un-reformulated product nutrient data was applied at both baseline and follow-up time periods, thereby assuming these products did not change nutritionally since the baseline year. In summary, the differences noted in results between the two time points for this method were due to changes and shifts in sales of low/no cal products alone (i.e. based on consumer preferences). Method 2: Low/No Calorie Sugar Products with Reformulated Products 3. Methodology This method incorporated the shift in sales of low/no cal products between both time points, as was the case in Method 1. In addition to this, it took into account the reformulation efforts by the 4 FDII members. The differences noted in results between the two time points for this method will be down to two factors: (1) changes and shifts in sales, and (2) reduction in levels of nutrients for reformulated products. Results from Method 2 will provide a more thorough picture of the impact changes in the beverage industry have had on Irish beverage consumers. Figure 1: Diagrammatic description of Method 1 and Method 2 Follow up Baseline Method 1 Method 2 Regular drinks Low/no cal drinks Reformulated regular drinks Reformulated low/no cal drinks New-to-market drinks Follow up 12
3.6 Levels of Nutrients Sold (in Tonnes and Kilocalories) The first stage of this project investigated the quantities of energy and sugar sold at baseline and follow-up time points, based on kilocalories/tonnes reduced in all products between the two time periods (Figure 2). Figure 2: Calculation utilised to calculate the difference in tonnes/kilocalories sold of the two nutrients between baseline and follow-up time points Nutrient level: Baseline Kcal or g per 100mls x Litres Sold = Nutrient level in kilocalories or tonnes (1) Nutrient level: Follow-Up Kcal or g per 100mls x Litres Sold = Nutrient level Nutrient level (1) (2) = Nutrient level in kilocalories or tonnes (2) Nutrient reduction in volume (% of original nutrient level) Firstly, the level of the nutrient (per 100mls) in a specific branded beverage was multiplied by the litres sold in the baseline year for that particular food (in terms of 100mls), resulting in the actual level of nutrient sold from that food at baseline. This formula was followed again for the nutrient levels and litres sold at the follow-up period and the two outcomes were compared to one another. This highlighted the difference in levels of energy and sugar sold (in kilocalories and tonnes) between the two time points (in absolute and percentage terms). Based on the descriptions outlined in Section 3.5 above, two sets of results will be generated based on the two methods: Method 1: Quantities of Nutrients Sold for Low/No Calorie Sugar Products Only Example: Beverage X contained 11g of sugar (per 100mls) and sold 8,975,702 litres at baseline. Therefore, Beverage X sold 987,327,220mls (or 987.33 tonnes) of sugar at this time point. At the follow up period, Beverage X still contained 11g of sugar (per 100mls) and sold 7,236,102 litres. Therefore, product X sold 795,971,220mls (or 795.97 tonnes) of sugar at this time period. This illustrates the impact that the reduction in sales of this particular beverage had on levels of sugar entering the Irish market (i.e. reformulation was not a factor). This example is depicted in Figure 3. 3. Methodology 13
Figure 3: Example Calculation used to determine quantities of sugar sold for Beverage X between baseline and follow-up time period (Method 1) Baseline: Beverage X 11g of sugar (per 100mls) x 8,975,702 litres = 987.33 tonnes of sugar sold (Baseline) Follow-Up: Beverage X 7,236,102 11g sugar (per 100mls) x litres = Nutrient level Nutrient level in tonnes (1) in tonnes (2) = 795.97 tonnes of sugar sold (Follow-Up) 191.33 tonnes reduction (19.4% Reduction) Method 2: Quantities of Nutrients Sold for Low/No Calorie Sugar Products with Reformulated Products Example: Beverage X contained 11g of sugar (per 100mls) and sold 8,975,702 litres at baseline. Therefore, Beverage X sold 987,327,220mls (or 987.33 tonnes) of sugar at this time point. At the follow up period, Beverage X contained 10.6g of sugar (per 100mls) and sold 7,236,102 litres. Therefore, product X sold 767,026,812mls (or 767.03 tonnes) of sugar at this time period. This illustrates the impact that both the reduction in sales of this particular beverage and reformulation had on levels of sugar entering the Irish market (i.e. both factors considered). This example is depicted in Figure 4. Figure 4: Example Calculation used to determine quantities of sugar sold for Beverage X between baseline and follow-up period (Method 2) 3. Methodology Baseline: Beverage X 11g of sugar (per 100mls) x 8,975,702 litres = Follow-Up: Beverage X 7,236,102 10.6g sugar (per 100mls) x litres = Nutrient level Nutrient level in tonnes (1) in tonnes (2) = 987.33 tonnes of sugar sold (Baseline) 767.02 tonnes of sugar sold (Follow-Up) 220.31 tonnes reduction (22.3% reduction) These formulas were conducted for each individual product recorded in the Beverage category. The level of each nutrient produced from each beverage was combined within the category, for both the baseline and follow-up time periods. When all levels were combined within the category, total levels of energy and sugar were calculated for both methods. These levels were then converted from grams to tonnes for sugar. The absolute and percentage change between the two times periods were then calculated. 14
3.7 Average Daily Intakes of Energy and Sugar for Irish Pre-Schoolers, Children, Teenagers and Adults The second part of this project investigated the average daily nutrient intakes of energy and sugar from beverages available on the Irish market among Irish pre-schoolers, children, teenagers and adults. 3.7.1 FDII Member Data Sections 3.3 and 3.4 above describe the data from FDII members and Kantar that was utilised in the present investigation. The proportion of the total Irish beverage market that each of the FDII members hold was calculated by using both the FDII litres sold data and the Kantar market share data for the FDII brands. By using the litres sold data for each individual product, the impact of reduced sales of regular beverages and the increased sales of low/no cal beverages is also captured. This shift in sales is primarily captured in the results from Method 1. Furthermore, reformulation data was then also added to the data from Method 1, thereby investigating the impact of both the sales reduction of regular beverages and the increase in low/no cal drinks, but also the impact of reformulated beverages. 3.7.2 Calculating Daily Nutrient Intakes Total dietary intakes of both nutrients were calculated using data from the four Irish national dietary surveys saved within the Creme Nutrition model. The intake assessments calculate daily intakes based on distributions of intakes for each individual in the survey. The concentration levels of the FDII beverages (at both baseline and follow-up) were applied to appropriate food codes within the four dietary surveys. 3.7.2.1 Creating a beverage consumption model The consumption patterns of regular beverages and low/no cal beverages have changed in recent years. Based on the sales data from FDII members, it is clear that sales of regular beverages have reduced, while the sales of low/no cal beverages have increased. Consumption data from the IUNA surveys do not reflect this trend, as these surveys were conducted at one time point. This model allows for the shift in the market to be analysed by using FDII beverage data from two different time points (Figure 5). A number of steps were followed to create the beverage consumption model and are outlined below: All similar beverages (i.e. beverages with similar nutritional content) were grouped together. This resulted in ten sub-categories of beverages, listed in Table 5. 3. Methodology Beverages within these 10 categories were matched to appropriate IUNA codes (i.e. beverages consumed in the IUNA surveys). These IUNA codes represent a mix of both regular beverages and low/no cal beverages. By combining both types of beverages per category, it provides a picture of consumption for that category as a whole (e.g. cola beverage consumption). It eradicates the original trend captured in the IUNA surveys. The FDII sales data was then plugged into the beverage consumption model. This sales data will in turn transform the consumption model to reflect the changes in the market over the past number of years (i.e. low/no cal beverages are now consumed more than regular beverages in certain categories). Based on the sales data provided by FDII members, the shift in the market with regards to the sales of regular and low/no cal beverages is captured in the consumption model. 15
Once the consumption model was created depicting current beverage consumption trends, FDII member nutrient composition data was applied. Therefore, when a person consumes a cola drink in an IUNA survey, for example, the market share determines the probability of that cola drink being regular or low/no cal. Figure 5: Illustration of the development of the beverage consumption model using FDII nutrient and sales data with IUNA consumption data IUNA Beverage group Concentrations Generic Identifiable as drinks produced by FDII members Identifiable as drinks produced by FDII members Changed to: Remain as they appear in IUNA survey FDII nutrient concentrations MS of FDII low/no cal Beverages MS of FDII regular Beverages Rest of Market regular Low/no cal IUNA nutrient concentrations Where available the IUNA concentration values of group appropriate generic drinks, for Regular and Low/No Cal respectively, were used. Table 5: Categorisation of beverages based on FDII member data 1. Colas 3. Methodology 2. Carbonated Tropical Fruit Flavoured Beverages 3. Carbonated Orange Flavoured Beverages 4. Lemonades 5. Tonic & Soda Waters 6. Berry Cordials/Squashes 7. Orange & Tropical Fruit Cordial/Squashes 8. Lemon or Lime Cordials/Squashes 9. Ready-To-Drink Fruit Juices/Flavoured Waters 10. Sports Drinks 16
3.7.2.2 Applying Nutrient Values with Market Shares Nutrient data, with the brand appropriate market share data, was applied using discrete distributions. These distributions allowed the model to not only incorporate the nutrient concentration level(s) of each particular beverage into the intake assessments, but also the market share value of the brand(s) attached to the individual IUNA codes. By applying discrete distributions, the analysis, in turn, recognises the variability in nutrient concentration levels per code, but also the variability in market share that each brand holds within the overall market for the appropriate food category. The distributions capture: The nutrient values of the individual FDII beverages with the appropriate market share. For the remainder of the market, nutrient values based on the original IUNA nutrient values are included, thereby representing the unknown part of the market (i.e. non-fdii beverages). This remainder is applied for both regular beverages and low/no cal beverages based on a ratio calculated from the FDII sales figures (i.e. still capturing the most recent consumption trends on the Irish market) and the remaining market share of the individual categories. 3.7.2.3 Intake Model Used Creme Nutrition is a scientific, cloud based software service used to estimate dietary intakes of foods, chemicals and nutrients in populations of consumers. Creme Nutrition achieves this by linking food consumption data to the appropriate food composition and chemical concentration data using a number of validated and published models. The system supports both deterministic and probabilistic input data. Probabilistic data can be represented by parametric or empirical data; these data sets are then combined in the Creme Nutrition model using Monte Carlo simulation. Method calculation types include daily average intakes, acute exposures, as well any required population statistics, standard errors and confidence intervals 4. For the present nutrient intake assessments, Creme Nutrition considered all eating events in order to determine the daily intake levels in each individual survey. Results are presented for daily intakes baseline and post-reformulation and per food categories specifically designed for the purposes of this project. Intake statistics analysed for this project are described in Figure 6. Figure 6: Description of intake statistics used in the present investigation Mean: Mean Error: 97.5th Percentile (P97.5): The average of all intake values calculated for individuals within the target population Standard deviation of the distribution of mean intake values. The distributions of mean intake values are calculated using bootstrapping. The value of intake below which 97.5% of the analysed population falls P97.5 Error: Standard deviation of the distribution of P97.5 intake values. The distributions of P97.5 intake values are calculated using bootstrapping. 3. Methodology In Creme Nutrition, standard errors of statistics are calculated using a resampling technique called bootstrapping. For example, a mean value can be estimated from the collected sample data which is assumed to be representative of the total population. Using the bootstrap method allows a distribution of the mean values to be generated and used to assess the accuracy of the estimated statistic (in this case, the mean value). This is performed by sampling with replacement from the data set in question a number of times, generating a number of different estimates of each statistic. The standard error of the mean is then the standard deviation of the mean values obtained from the large number of bootstrap samples. 17
Mathematically, the true standard error of a statistic can be estimated as: with with where N is the number of bootstrap samples (usually large, N=1000 by default in Creme Nutrition ) is the parameter estimate based on the bootstrap sample is the mean of all parameters estimated on N bootstrap samples 3.7.3 Calculating Levels of Significance for Nutrient Mean Intakes, Baseline and Follow-Up Nutrient intakes generated for baseline and follow up time periods were compared and the difference assessed by means of statistical tests. In the present investigation, the difference in intakes between the two time points was assessed with a paired Wilcoxon test, a non-parametric test used to assess if the difference in intakes between pairs of subjects is statistically significant. This test is used in place of a Student s t-test when the condition of normality of the data is not met. 3. Methodology The p-value returned by a statistical test is evaluated in relation to a specified significance level; the lower the significance level, the more stringent is the criteria to conclude that the observed difference between intake values is statistically significant. In this analysis the significance level that was chosen is 0.001, which corresponds to a 99.9% confidence level. A p-value that is less than the significance level of 0.001 was regarded as providing evidence against the null hypothesis, which states that there is no difference between the two sets of values. If a less stringent significance level of 0.05 was chosen, a p-value lower than 0.05 would indicate that the observed difference between paired values is significant with 95% confidence. The more stringent significance level of 0.001 used in this investigation requires p-values to be smaller than 0.001 to conclude that the observed difference is significant with 99.9% confidence. The tables included in the following sections report the p-values of the paired Wilcoxon tests performed over the observed intakes for energy and sugar at baseline and follow-up time periods. The p-values <0.001 indicate that nutrient intakes differ significantly between the two time points for the population under analysis with 99.9% confidence. 18
4 Results 19
4. Results 4.1 Levels of Nutrients Sold (in Kilocalories and Tonnes) Reductions were observed for energy and sugar for both methods. 4.1.1 Energy Levels of energy sold in beverages between the two time points reduced for both Method 1 and 2; the reduction in intakes in Method 1 being solely due to shift in the market while the reductions in Method 2 are a combination of both a shift in the market with reformulation efforts. This suggests that both reduced sales and reformulation play complementary roles in reducing quantities sold, as expected. This reduction ranged from ~7% - ~12% (Table 6 and Table 7). 4.1.2 Sugar Levels of sugar sold in beverages between the two time points also reduced in both Methods, proving that both reduced sales and reformulation play a role in reducing levels of sugar sold. This reduction ranged from ~9% - ~13% (Table 6 and Table 7). Table 6: Total energy and sugar sold from FDII reformulated beverages (and equivalent) at baseline and at follow-up period for Method 1, with absolute and relative change METHOD 1 Energy (Kcal) Food Category Quantities sold at Baseline Quantities sold at Follow-Up Absolute Change % Change Beverages (excluding Milk) 1.2x 10 11 Kcal 1.1x 10 11 Kcal 8.8 x 10 9 Kcal 7.09% Reduction Food Category Quantities sold at Baseline Sugar (Tonnes) Quantities sold at Baseline Absolute Change % Change Beverages (excluding Milk) 28,983.67 Tonnes 26,481.88 Tonnes 2,501.79 Tonnes 8.63% Reduction Table 7: Total energy and sugar sold from FDII reformulated beverages (and equivalent) at baseline and at follow-up period for Method 2, with absolute and relative change METHOD 2 Energy (Kcal) 4. Results Food Category Beverages (excluding Milk) Food Category Beverages (excluding Milk) Quantities sold at Baseline Quantities sold at Follow-Up Absolute Change % Change 1.1 x 10 11 Kcal 1.0 x 10 11 Kcal 1.3x 10 10 Kcal 11.78% Reduction Quantities sold at Baseline 26,186.60 Tonnes Sugar (Tonnes) Quantities sold at Baseline Absolute Change % Change 22,802.06 Tonnes 3,384.53 Tonnes 12.92% Reduction 20
4.2 Average Daily Intakes of Nutrients for Irish Pre-Schoolers, Children, Teenagers and Adults Analysing the sales data provided by FDII members, the shift in the market with regards to the sales of regular and low/no cal beverages between baseline and the follow-up period is apparent. This shift in the market is detailed in Table 8. Table 8: Percentage of FDII beverage sales break down of regular and low/no cal beverage sub-categories at baseline and follow-up time periods based on litres sold % Regular Sales Baseline % Low/no cal Sales % Regular Sales Follow-Up % Low/no cal Sales Colas 70.87 29.13 65.63 34.37 Carbonated Tropical Fruit Flavoured Beverages Carbonated Orange Flavoured Beverages 94.14 5.86 99.19 0.81 93.73 6.27 92.85 7.15 Lemonades 98.44 1.56 83.39 16.61 Tonics and Soda Waters 76.98 23.02 73.59 26.41 Berry Cordials/Squashes 41.75 58.25 25.71 74.29 Orange & Tropical Fruit Cordials/ Squashes 31.16 68.84 23.55 76.45 Lemon or Lime Cordials/Squashes 100 0 100 0 Ready-To-Drink Fruit Juices and Flavoured Waters 99.61 0.39 100 0 Sports Drinks 100 0 99.66 0.34 These figures were incorporated into the beverage consumption model and are therefore intrinsically linked to the average daily nutrient intake results (Method 1 and Method 2) presented in this section. Dietary intakes for energy and sugar were calculated for the following Irish populations and will be presented as such: Section 4.2.1: Adults (18 90 years) Section 4.2.2: Teenagers (13 17 years) Section 4.2.3: Children (5 12 years) Section 4.2.4: Pre-School Children (1 4 years) All intakes will be presented for Method 1 (Regular and low/no cal beverages, no reformulated beverages) and Method 2 (Regular and low/no cal beverages, with reformulated beverages). 4. Results 21
Intakes are presented as: Daily nutrient intakes from FDII member beverages, at baseline and at follow up: FDII beverage consumers These daily intake calculations only considered the consumers of one or more of the FDII member beverages. Mean and P97.5 (high consumers of FDII beverages) nutrient intakes (with corresponding error values) are presented for both baseline and follow-up time periods. Daily nutrient intakes of consumers from the total diet, at baseline and post-reformulation Results for the daily intakes were based on the consumption of the FDII beverages, but also include the remainder of food and beverages that fall outside this group, such as fruits, vegetables, fresh meat, non-fdii beverages (i.e. the total diet) This output looked at all, consumers and non-consumers, within each survey. Mean and P97.5 intakes (with corresponding error values) are presented for both baseline and follow-up period consumption. Figure 7 below summarises the differences between the two intake calculations. Figure 7: Difference between the two sets of analyses run and the results produced Nutrient Intakes from FDII Beverages (and equivalent beverages): FDII beverage consumers these mean and P97.5 intake values relate only to consumers of one or more FDII beverages (and equivalent) per subpopulation. These nutrient intakes are presented as: FDII reformulated beverages (and equivalent beverages) Consumers of foods reformulated by FDII members (e.g. FDII Brand X Cola) plus equivalent foods (e.g. other colas, applying original IUNA nutrient values). Nutrient Intakes from the Total Diet These mean and P97.5 nutrient intakes relate to all consumer and nonconsumers of all foods consumed by the sub-population. These nutrient intake results include FDII beverages, with foods and beverages outside the scope of this analysis (i.e. red meat, bread, non-fdii beverages). The original IUNA nutrient levels were maintained for these foods and beverages. 4. Results 22
4.2.1 Adults (n = 1500, 18 90 years) Table 9 presents mean and P97.5 intakes of energy and sugar for Irish adult consumers of FDII beverages (and equivalent) and as part of the Total Diet, at both baseline and follow-up period for Method 1. Table 10 presents the same results in terms of Method 2. P-values are also presented in both tables to present whether changes in mean intakes of energy and sugar are statistically significant. An overall decrease was recorded for both nutrients for both methods. Energy Mean intakes reduced by ~10% for consumers of FDII beverages only and by 0.1% within the total diet for Method 1 (i.e. reduction based on shift in market only). Intakes reduced further for Method 2 (i.e. shift in market with reformulation efforts), with consumers only recording a reduction of ~15% and a 0.2% reduction with total diet. Sugar Mean intakes reduced by ~9% for consumers of FDII beverages only and by 0.67% within the total diet for Method 1 (i.e. reduction based on shift in market only). Intakes reduced further for Method 2 (i.e. shift in market with reformulation efforts), with consumers only recording a reduction of ~15% and a ~1% reduction with total diet. 4. Results 23
4. Results Table 9: Method 1 - Daily nutrient intakes of energy and sugar for Irish adult consumers of FDII member beverages (and equivalent), at baseline and follow-up period Mean (Mean Error) P97.5 (P97.5 Error) Baseline Follow-Up Absolute Change % Change P-Value Baseline Follow-Up Absolute Change % Change FDII Beverages (and equivalent): Consumers Only, n = 624 Energy (kcal) 66.73 (2.44) 60.14 (2.19) 6.59 9.88 Reduction <0.001 244.60 (12.73) 225.99 (10.86) 18.62 7.61 Reduction Sugar (g) 15.92 (0.59) 14.47 (0.55) 1.45 9.10 Reduction <0.001 58.51 (3.47) 56.94 (2.81) 1.58 2.69 Reduction Total Diet (including FDII Beverages): All Consumers, n = 1500 Energy (kcal) 2015.28 (16.83) 2012.60 (16.79) 2.68 0.13 Reduction <0.001 3476.02 (68.33) 3464.33 (71.34) 11.69 0.34 Reduction Sugar (g) 90.73 (1.08) 90.12 (1.08) 0.61 0.67 Reduction <0.001 190.48 (4.87) 188.69 (5.03) 1.79 0.94 Reduction P-Value <0.001 denotes significant difference in mean intakes with 99.9% confidence Table 10: Method 2 - Daily nutrient intakes of energy and sugar for Irish adult consumers of FDII member beverages (and equivalent), at baseline and follow-up period Mean (Mean Error) P97.5 (P97.5 Error) Baseline Follow-Up Absolute Change % Change P-Value Baseline Follow-Up Absolute Change % Change FDII Beverages (and equivalent): Consumers Only, n = 624 Energy (kcal) 66.73 (2.44) 56.97 (2.10) 9.76 14.63 Reduction <0.001 244.60 (12.73) 210.53 (9.45) 34.07 13.93 Reduction Sugar (g) 15.92 (0.59) 13.61 (0.53) 2.31 14.53 Reduction <0.001 58.51 (3.47) 53.38 (2.50) 5.14 8.78 Reduction Total Diet (including FDII Beverages): All Consumers, n = 1500 Energy (kcal) 2015.28 (16.83) 2011.26 (16.78) 4.02 0.20 Reduction <0.001 3476.02 (68.33) 3464.62 (71.64) 11.40 0.33 Reduction Sugar (g) 90.73 (1.08) 89.74 (1.07) 0.99 1.09 Reduction <0.001 190.48 (4.87) 188.69 (4.97) 1.79 0.94 Reduction P-Value <0.001 denotes significant difference in mean intakes with 99.9% confidence 24
4.2.2 Teenagers (n = 414, 13-17 years) Table 11 presents mean and P97.5 intakes of energy and sugar for teenage consumers of FDII beverages (and equivalent) and as part of the Total Diet, at both baseline and follow-up period for Method 1. Table 12 presents the same results in terms of Method 2. P-values are also presented in both tables to present whether changes in mean intakes of energy and sugar are statistically significant. An overall decrease was recorded for both nutrients for both methods. Energy Mean intakes reduced by ~11% for consumers of FDII beverages only and by ~0.4% within the total diet for Method 1 (i.e. reduction based on shift in market only). Intakes reduced further for Method 2 (i.e. shift in market with reformulation efforts), with consumers only recording a reduction of ~15% and a 0.5% reduction with total diet. Sugar Mean intakes reduced by ~10% for consumers of FDII beverages only and by 1.42% within the total diet for Method 1 (i.e. reduction based on shift in market only). Intakes reduced further for Method 2 (i.e. shift in market with reformulation efforts), with consumers only recording a reduction of ~14% and a 2.10% reduction with total diet. 4. Results 25
4. Results Table 11: Method 1 - Daily nutrient intakes of energy and sugar for Irish teenage consumers of FDII member beverages (and equivalent), at baseline and follow-up period Mean (Mean Error) P97.5 (P97.5 Error) Baseline Follow-Up Absolute Change % Change P-Value Baseline Follow-Up Absolute Change % Change FDII Beverages (and equivalent): Consumers Only, n = 377 Energy (kcal) 78.62 (3.56) 70.19 (3.20) 8.43 10.72 Reduction <0.001 274.44 (12.80) 229.66 (13.14) 44.78 16.32 Reduction Sugar (g) 18.79 (0.81) 16.94 (0.77) 1.84 9.80 Reduction <0.001 60.54 (2.86) 54.07 (2.90) 6.46 10.68 Reduction Total Diet (including FDII Beverages): All Consumers, n = 441 Energy (kcal) 1979.12 (28.16) 1971.88 (28.10) 7.24 0.37 Reduction <0.001 3303.55 (111.07) 3302.88 (114.86) 0.67 0.02 Reduction Sugar (g) 106.03 (2.01) 104.52 (1.99) 1.51 1.42 Reduction <0.001 199.90 (8.58) 194.59 (8.49) 5.30 2.65 Reduction P-Value <0.001 denotes significant difference in mean intakes with 99.9% confidence Table 12: Method 2 - Daily nutrient intakes of energy and sugar for Irish teenage consumers of FDII member beverages (and equivalent), at baseline and follow-up period Mean (Mean Error) P97.5 (P97.5 Error) Baseline Follow-Up Absolute Change % Change P-Value Baseline Follow-Up Absolute Change % Change FDII Beverages (and equivalent): Consumers Only, n = 377 Energy (kcal) 78.62 (3.56) 66.94 (3.11) 11.68 14.85 Reduction <0.001 274.44 (12.80) 225.42 (15.31) 49.03 17.86 Reduction Sugar (g) 18.79 (0.81) 16.11 (0.74) 2.67 14.22 Reduction <0.001 60.54 (2.86) 52.95 (2.81) 7.58 12.53 Reduction Total Diet (including FDII Beverages): All Consumers, n = 441 Energy (kcal) 1979.12 (28.16) 1969.02 (28.07) 10.10 0.51 Reduction <0.001 3303.55 (111.07) 3284.20 (113.02) 19.35 0.59 Reduction Sugar (g) 106.03 (2.01) 103.80 (1.98) 2.23 2.10 Reduction <0.001 199.90 (8.58) 194.28 (8.31) 5.62 2.81 Reduction P-Value <0.001 denotes significant difference in mean intakes with 99.9% confidence 26
4.2.3 Children (n = 594, 5-12 years) Table 13 presents mean and P97.5 intakes of energy and sugar for children consumers of FDII beverages (and equivalent) and as part of the Total Diet, at both baseline and follow-up period for Method 1. Table 14 presents the same results in terms of Method 2. P-values are also presented in both tables to present whether changes in mean intakes of energy and sugar are statistically significant. An overall decrease was recorded for both nutrients for both methods. Energy Mean intakes reduced by ~8% for consumers of FDII beverages only and by ~0.3% within the total diet for Method 1 (i.e. reduction based on shift in market only). Intakes reduced further for Method 2 (i.e. shift in market with reformulation efforts), with consumers only recording a reduction of ~16% and a 0.6% reduction with total diet. Sugar Mean intakes reduced by ~8% for consumers of FDII beverages only and by 0.29% within the total diet for Method 1 (i.e. reduction based on shift in market only). Intakes reduced further for Method 2 (i.e. shift in market with reformulation efforts), with consumers only recording a reduction of ~17% and a ~2% reduction with total diet. 4. Results 27
4. Results Table 13: Method 1 - Daily nutrient intakes of energy and sugar for Irish children consumers of FDII member beverages (and equivalent), at baseline and follow-up period Mean (Mean Error) P97.5 (P97.5 Error) Baseline Follow-Up Absolute Change % Change P-Value Baseline Follow-Up Absolute Change % Change FDII Beverages (and equivalent): Consumers Only, n = 548 Energy (kcal) 65.75 (2.48) 60.60 (2.32) 5.16 7.84 Reduction <0.001 217.14 (15.60) 194.65 (16.79) 22.49 10.36 Reduction Sugar (g) 15.78 (0.58) 14.57 (0.56) 1.21 7.67 Reduction <0.001 49.15 (3.61) 44.98 (3.17) 4.17 8.49 Reduction Total Diet (including FDII Beverages): All Consumers, n = 594 Energy (kcal) 1666.03 (14.17) 1661.22 (14.10) 4.81 0.29 Reduction <0.001 2437.01 (41.37) 2423.40 (40.94) 13.61 0.56 Reduction Sugar (g) 103.95 (1.31) 102.90 (1.29) 1.05 1.01 Reduction <0.001 179.34 (5.85) 176.57 (5.78) 2.77 1.54 Reduction P-Value <0.001 denotes significant difference in mean intakes with 99.9% confidence Table 14: Method 2 - Daily nutrient intakes of energy and sugar for Irish children consumers of FDII member beverages (and equivalent), at baseline and follow-up period Mean (Mean Error) P97.5 (P97.5 Error) Baseline Follow-Up Absolute Change % Change P-Value Baseline Follow-Up Absolute Change % Change FDII Beverages (and equivalent): Consumers Only, n = 548 Energy (kcal) 65.75 (2.48) 54.96 (2.17) 10.80 16.42 Reduction <0.001 217.14 (15.60) 181.29 (16.11) 35.86 16.51 Reduction Sugar (g) 15.78 (0.58) 13.13 (0.52) 2.65 16.80 Reduction <0.001 49.15 (3.61) 41.27 (3.31) 7.89 16.04 Reduction Total Diet (including FDII Beverages): All Consumers, n = 594 Energy (kcal) 1666.03 (14.17) 1655.99 (14.07) 10.04 0.60 Reduction <0.001 2437.01 (41.37) 2421.85 (40.73) 15.16 0.62 Reduction Sugar (g) 103.95 (1.31) 101.54 (1.28) 2.41 2.32 Reduction <0.001 179.34 (5.85) 175.15 (5.99) 4.19 2.34 Reduction P-Value <0.001 denotes significant difference in mean intakes with 99.9% confidence 28
4.2.4 Pre-schoolers (n = 500, 1-4 years) Table 15 presents mean and P97.5 intakes of energy and sugar for pre-school consumers of FDII beverages (and equivalent) and as part of the Total Diet, at both baseline and follow-up period for Method 1. Table 16 presents the same results in terms of Method 2. P-values are also presented in both tables to present whether changes in mean intakes of energy and sugar are statistically significant. An overall decrease was recorded for both nutrients for both methods, with the exception of sugar P97.5 intakes. Energy Mean intakes reduced by ~8% for consumers of FDII beverages only and by ~0.13% within the total diet for Method 1 (i.e. reduction based on shift in market only). Intakes reduced further for Method 2 (i.e. shift in market with reformulation efforts), with consumers only recording a reduction of ~22% and a 0.42% reduction with total diet. Sugar Mean intakes reduced by 10% for consumers of FDII beverages only and by 0.48% within the total diet for Method 1 (i.e. reduction based on shift in market only). Intakes reduced further for Method 2 (i.e. shift in market with reformulation efforts), with consumers only recording a reduction of ~23% and a ~1.5% reduction with total diet. 4. Results 29
4. Results Table 15: Method 1 - Daily nutrient intakes of energy and sugar for Irish pre-schoolers consumers of FDII member beverages (and equivalent), at baseline and follow-up period Mean (Mean Error) P97.5 (P97.5 Error) Baseline Follow-Up Absolute Change % Change P-Value Baseline Follow-Up Absolute Change % Change FDII Beverages (and equivalent): Consumers Only, n = 297 Energy (kcal) 36.03 (2.42) 33.25 (2.15) 2.77 7.70 Reduction <0.001 132.36 (16.44) 126.41 (12.49) 5.94 4.49 Decline Sugar (g) 8.96 (0.60) 8.06 (0.51) 0.90 10.00 Reduction <0.001 33.23 (2.94) 32.02 (3.40) 1.21 3.64 Decline Total Diet (including FDII Beverages): All Consumers, n = 500 Energy (kcal) 1139.74 (11.30) 1138.22 (11.27) 1.52 0.13 Reduction <0.001 1772.45 (52.56) 1760.00 (53.20) 12.45 0.70 Reduction Sugar (g) 78.26 (1.02) 77.88 (1.01) 0.38 0.48 Reduction <0.001 129.16 (4.53) 129.93 (4.75) 0.77 0.59 Increase P-Value <0.001 denotes significant difference in mean intakes with 99.9% confidence Table 16: Method 2 - Daily nutrient intakes of energy and sugar for Irish pre-schoolers consumers of FDII member beverages (and equivalent), at baseline and follow-up period Mean (Mean Error) P97.5 (P97.5 Error) Baseline Follow-Up Absolute Change % Change P-Value Baseline Follow-Up Absolute Change % Change FDII Beverages (and equivalent): Consumers Only, n = 297 Energy (kcal) 36.07 (2.33) 27.98 (1.97) 8.09 22.43 Reduction <0.001 132.36 (16.44) 110.84 (11.49) 21.52 16.26 Reduction Sugar (g) 8.69 (0.54) 6.66 (0.46) 2.03 23.32 Reduction <0.001 33.23 (2.94) 27.25 (3.16) 5.98 17.98 Reduction Total Diet (including FDII Beverages): All Consumers, n = 500 Energy (kcal) 1139.74 (11.30) 1134.94 (11.25) 4.80 0.42 Reduction <0.001 1772.45 (52.56) 1756.00 (51.76) 16.45 0.93 Reduction Sugar (g) 78.26 (1.02) 77.08 (1.00) 1.18 1.51 Reduction <0.001 129.16 (4.53) 127.84 (5.03) 1.33 1.03 Reduction P-Value <0.001 denotes significant difference in mean intakes with 99.9% confidence 30