Dr Geraldine McNeill

1
Nutrition inequalities in Scottish school
children do they exist?

• Dr Geraldine McNeill

2
Food, Health and Income (1936)

• John Boyd Orr

The important aspect of the survey is the
inadequacy of the diets of the lower income
groups and especially of the children of these
groups, compared with that of the higher income
groups
3
Consumption of milk and spreads by income group
(n 1,152 HH)
4
Consumption of fruit, vegetables, jams and sugar
by income group (n 1,152 HH)
5
Adequacy of nutrient intake in relation to income
in 1935 (n 1,152 HH)
6
Eating habits in children 2-15y in Scottish
Health Survey 2003

• More frequent in lowest SIMD quintile
• Sweets chocolates
• Non-diet soft drinks
• Crisps/ savoury snacks
• Chips
• Meat products
• Salt added at table

• Less frequent in lowest SIMD quintile
• High fibre bread
• Potatoes/pasta/rice
• Poultry
• White and oily fish
• Low fat milk
• Diet supplements

7
Overweight and obesity in boys in Scottish Health
Survey 2003 (n 1,215)
of children
8
Overweight and obesity in girls in Scottish
Health Survey 2003 (n 1,223)
of children

9
Physical activity in boys in Scottish Health
Survey 2003 (n 1,465)
of children
at least 60 min. on all 7 days a week
10
Physical activity in girls in Scottish Health
Survey 2003 (n 1,468)
of children
at least 60 min. on all 7 days per week
11
Scottish Dietary Targets
12
Walker report (2004)
..there is no single existing survey currently
capable of assessing progress towards all the
Scottish Dietary Targets
Where data is currently lacking, as is the case
for non-milk extrinsic sugars, interim studies
may need to be set up
13
Scottish Collaborative Group FFQ
v
14
Survey of non-milk extrinsic sugars intake in
Scottish schoolchildren (2006)

Children aged 3-16y selected from Child Benefit
records (n 2,800)
Excluded by DWP (n 302)
Sent invitation to take part (n 2,498)
Opted out or wrong address (n 464)
Sent FFQ (n 2,034)
Interview completed (n 1,700)
FFQ returned (n 1,512)
FFQ incomplete (n 51)
FFQ energy lt2.5 or gt97.5 centile (n 70)
Dietary data analysed (n 1,391)
15
Intake of energy and fat ( energy) by SIMD
quintile (n 1,373)
of least deprived
p 0.018
p gt 0.05
p gt 0.05
16
Intake of sugars ( energy) by SIMD quintile (n
1,373)
of least deprived
p 0.703
p 0.003
p lt0.001
17
Intake of foods (g/d) among consumersby SIMD
quintile (n 1,373)
of least deprived
plt0.001
p lt 0.001
p 0.030
p 0.025
18
Intake of foods (g/d) among consumersby SIMD
quintile (n 1,373)
of least deprived
plt0.001
p lt 0.001
p lt0.001
p lt0.001
19
Overweight and obesity in boys and girls by SIMD
quintile (n 1,615)
of children
20
Summary of SHS and sugars surveys

• Scottish schoolchildren in more deprived families
  have
• Lower intake of fruit, fruit juice and vegetables
  
• Higher intake of processed meats, chips, crisps,
  sweets and soft drinks
• Slightly higher intake of energy, fat and sugar
• Similar intake of protein, fibre, iron and
  calcium
• Slightly higher levels of physical activity
• Similar levels of overweight and obesity

21
Pointers for action

• Need interventions to reduce the intake of
  processed and snack foods and soft drinks in
  children in low income households
• Important to engage parents as well as children
• Consider controlling marketing of snack foods
  (price promotions, multi-packs, school token
  schemes etc.)
• Ensure that labelling of processed and snack
  foods can be clearly understood by both children
  and adults in low income groups

22
A small bar of chocolate?
23
Or not so small!
1,300 kcal 77g fat 142 g sugar
2,080 kcal 123 g fat 228g sugar
24
Or not so small!
GDA One chunk contains 1.8 calories 3.9
sugar 2.7 fat
1,300 kcal 77g fat 142 g sugar
2,080 kcal 123 g fat 228g sugar
25
Or not so small!
1.59
1,300 kcal 77g fat 142 g sugar
BUT
1.95 or 2 for 2.20
2,080 kcal 123 g fat 228g sugar
26
Sugar content of foods (g/100g)
Source The Food Commission, cited in Sunday
Times 06/05/07
27
Acknowledgements

• University of Aberdeen / Rowett Research
  Institute
• Lindsey Masson, Leone Craig, Jennie Macdiarmid
• Scottish Centre for Social Research
• Christine Sheehy
• Kings College London
• Bridget Holmes, Michael Nelson
• Food Standards Agency Scotland
• Heather Peace, Gillian Dalgleish, Anne Milne