What do consumers need to know about good nutrition

1
What do consumers need to know about good
nutrition?

Dr John Fletcher Nutrition Director PepsiCo
Europe
Ankara, October 2009
2
What is a consumer?
An individual who buys products or services for
personal use and not for manufacture or resale.
A consumer is someone who can make the decision
whether or not to purchase an item at the store
and someone who can be influenced by marketing
and advertisements. Any time someone goes to a
store and purchases a toy, shirt, beverage, or
anything else, they are making that decision as a
consumer.
InvestorWords 2008
3
A few facts about typical consumers, globally
and in Turkey.
They are young 20-40 Generally well fed and
healthy, they may expect to live to their 70s,
their children perhaps for longer Buying food
for a small family, with 2-3 children Often
buying in stores that may have 500 - 30,000
different food items They have a very short
time to buy food and to look at packaging Most
do not look at the nutrition label, most of those
that do Usually fail to understand it Only a
small minority know what is healthy eating, only
a minority of those choose foods on the basis of
healthy eating
4
What do consumers need to know?
What are the most important things that a
consumer should know about nutrition and health?

5
1. What do consumers need to know?
Number one What you eat and how much you eat
is very important for your health, and the
health of your family It will influence your
risk of disease and an early death
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What do consumers need to know?
Number one What you eat and how much you eat is
very important for your health, and the health
of your family. It will influence your risk of
disease and an early death
CVD is the number one cause of death now and the
coming decades- (CVD includes CHD, strokes
fibrillation)
Source Global Burden of Disease. Murray JL
Lopez AD 1996. WHO. Geneva
Est 2010
7
1. What do consumers need to know?
Number one What you eat and how much you eat is
very important for your health, and the health
of your family. It will influence your risk of
disease and an early death
8
What are the risk factors causing these deaths
Blood pressure Tobacco Blood Cholesterol Underweig
ht Unsafe sex Fruit and vegetable intake High
body mass index Physical inactivity Alcohol Unsafe
water, sanitation and hygiene Indoor smoke from
solid fuels Iron deficiency Urban air
pollution Zinc deficiency Vitamin A
deficiency Unsafe health care injections
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
0
Number of deaths (000s)
Source WHR 2002
9
What are the risk factors causing these deaths
Nutrition Related in developed countries

Blood pressure Tobacco Blood Cholesterol Underweig
ht Unsafe sex Fruit and vegetable intake High
body mass index Physical inactivity Alcohol Unsafe
water, sanitation and hygiene Indoor smoke from
solid fuels Iron deficiency Urban air
pollution Zinc deficiency Vitamin A
deficiency Unsafe health care injections





1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
0
Number of deaths (000s)
Source WHR 2002
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What do consumers need to know?
Number two You are at risk of becoming
overweight or obese. There are serious health
consequences of being overweight and obese. Too
much dietary fat and sugar may lead to positive
energy imbalance.
11
What do consumers need to know?
population over 15 yrs with body mass index gt 30
12

• Key Facts
• 1 billion people are obese or overweight
• Obesity is a leading cause of preventable death
• Accounts for up to 10 of health care costs

18
17
20
25
23
36
15
23
4
27
20
22
20
6
11
27
18
19
Source OECD / International Obesity Task Force
/ Euromonitor, June 2003
12
What do consumers need to know?
"Obesity is an epidemic peculiar to this century.
We must decide whether we address it today, or
pass it on to future generations. Comprehensive
changes to the way we live have led to this
problem, and we are all aware that action in the
field of health alone is not enough," said
Prime Minister Erdogan, 2006

• Turkey
• Estimates
• - 24 of women
• - 26 of men are overweight
• 25 of women
• - 14 of men are obese

13
What do consumers need to know?
Obesity the health risks Type 2 diabetes - 90
of Type 2 diabetics have a body mass index (BMI)
of gt25 kg/m2 Hypertension - 5 fold risk in
obesity Dyslipidaemia - progressively develops
as BMI increases from 21 kg/m2 Coronary artery
disease (CAD) and stroke - Obesity is a
contributing factor to cardiac failure in gt10 of
patients Respiratory effects - Neck circumference
of gt43 cm in men and gt40.5 cm in women is
associated with obstructive sleep apnoea, daytime
somnolence and development of pulmonary
hypertension Cancers - 10 of all cancer deaths
among non-smokers are related to obesity (30 of
endometrial cancers) Reproductive function - 6
of primary infertility in women is attributable
to obesity Impotency and infertility are
frequently associated with obesity in
men Osteoarthritis (OA) Frequent association in
the elderly with increasing body weight risk of
disability attributable to OA equal to heart
disease and greater than any other medical
disorder of the elderly
14
What do consumers need to know?
Obesity the health risks Type 2 diabetes - 90
of Type 2 diabetics have a body mass index (BMI)
of gt25 kg/m2
15
What do consumers need to know?
Number two you are at risk of becoming
overweight or obese and there are serious health
consequences of being overweight and obese. Too
much dietary fat and sugar may lead to positive
energy imbalance.
overweight
obese

16
What do consumers need to know?
Number two they are at risk of becoming
overweight or obese and there are serious health
consequences of being overweight and obese. Too
much dietary fat and sugar may lead to positive
energy imbalance

• Diabetes mellitus long term consequences
• Increases the risk of CVD
• Leads to blindness
• Leads to kidney failure
• Cause numbness and pain in feet or hands
• Cause impotence and gastrointestinal problem

17
3. What do consumers need to know?
Number three The major cause of premature
death in developed countries is cardiovascular
disease You can reduce the risk of
cardiovascular disease by eating less saturated
fat and less salt
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What do consumers need to know?
(Age adjusted, per 1000 men)
18
16
14
12
CHD Deaths
10
8
6
4
2
4mmol/l
5mmol/l
6mmol/l
7mmol/l
8mmol/l
0
140
160
180
200
220
240
260
280
300mg/dl
Blood cholesterol
Blood cholesterol

19
Cholesterol and CVD
Why is blood cholesterol important?
Open artery clogged artery
Open artery clogged artery

• High blood cholesterol Risk factor
• for clogging arteries ? heart attack

20
CVD risk factors
Serum lipid profile Total cholesterol
concentration (mmol/L) bad -
LDL-cholesterol concentration (mmol/L) bad
- HDL-cholesterol concentration (mmol/L)
good Total / HDL-cholesterol ratio high
bad Triacylglycerol concentration (mmol/L)
bad
21
What do consumers need to know?
Dietary recommendations for fat intake of
adults Country/ total fat SAFA
MUFA PUFA other Organisation   Eurodiet lt30en
lt10en - 4-8enn-6 200mg/d (2001) 2g/d
n-3 EPA/DHA   Austria, Germany 30en lt10en
gt10en 7-10en max 3en Switzerland (2000)
n-3   Netherlands 20-40en lt10en
- lt12en 200mg/d (2001) EPA/DHA   Belgium
(2000) lt30en lt10en - 3-7en -     UK
(1998) lt35en lt10en 12en 6-10en 200mg/d
EPA/DHA   USA (2000) lt35en lt10en
- - 1x/wk oily fish   
22
Sodium a problem mineral

• Function
• Maintains water balance in the body
• Needed for muscle and nerve activity
• When getting too much
• can lead to an increased blood pressure, an
  important risk factor for stroke.
• Sources
• Table salt (NaCl), baking soda, MSG etc
• Processed foods (80 of intake dev. world!)

• Salt Ideal and Real intakes
• recommended intake lt 6 g/day
• current intake 8-12 g/day

23
What do consumers need to know?
Turkey has the highest daily salt intake compared
to US, UK, Japan and China. Mean salt
consumption was found to be 18.0 g/day Women
were consuming 16.8 g/day Men were consuming
19.3 g/day
Turkey has a high prevalence of hypertension
age- and sex- adjusted prevalence was 31.8
27.5 for men 36.1 for women Altun B et
al. Journal of Hypertension, 2005 231817-1823
From Turkey Salt Action Summary Turkish Society
of Hypertension and Renal Diseases World
Hypertension Day 2008 Other Activities
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What do consumers need to know?
Number four Some food groups are
particularly healthy and should be a regular part
of everybodys diet These include fruits,
vegetables, wholegrains, fish and fibre.
25
What do consumers need to know?
Number four Some food groups are particularly
healthy and should be a regular part of
everybodys diet. These include fruits,
vegetables, wholegrains, fish and fibre.
The advantages of such a diet include - lower
risk of cardiovascular disease - lower risk of
dementia - lower risk of type 2 diabetes - lower
risk of age related blindness - lower risk of
cancer - lower risk of dieing early
26
Conclusions
Nutrition Science is complex, incomplete and its
conclusions sometimes change, but we know the
essentials of healthy eating The food industry
has a responsibility to change the composition of
foods to make them more healthy Universities,
medical authorities and the food industry have a
responsibility to communicate with consumers to
help them make wise choices The label on a
food is an important tool for communication
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Thank you and QUESTIONS
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Improving the composition of foods globally
Improving the type of fat - exclude
hydrogenated fat - lower saturated fat
content - higher MUFA, n-3 n-6 PUFA
Reducing the amount of sodium - gradual
reduction of salt content - substitution of
salt Reducing the amount of sugar - gradual
reduction in sugar content - substitution of
sugar with other sweeteners Increase of
fibre - high fibre raw materials - new types
of fibre New food types and formats with
vegetables, fruits, nuts and wholegrains
29
What do consumers need to know?
Number one What you eat and how much you eat
is very important for your health, and the
health of your family. It will influence your
risk and your childrens risk of disease and an
early death
Number two You are at risk of becoming
overweight or obese and there are serious
health consequences of being overweight and
obese. Too much dietary fat and sugar may lead to
positive energy imbalance
Number three The major cause of premature
death in developed countries is from
cardiovascular disease. You can reduce the risk
of cardiovascular disease by eating less
saturated fat and less salt
Number four Some food groups are particularly
healthy and should be a regular part of
everybodys diet. These include fruits,
vegetables, wholegrains, fish and fibre.
30
3. What do consumers need to know?
Number three The major cause of premature death
in developed countries is from cardiovascular
disease. You can reduce the risk of
cardiovascular disease by eating less saturated
fat and less salt
Effect on serum lipid profile Effect of
replacing 10 E carbohydrates by
SFA MUFA Trans PUFA Total cholesterol
concentration (mmol/L) 0.39 (- 0.03) - -
0.15 LDL-cholesterol concentration (mmol/L)
0.33 (- 0.06) 0.40 - 0.14 HDL-cholesterol
concentration (mmol/L) 0.12 0.09 (- 0.01)
0.07 Total chol/ HDL-cholesterol ratio (
0.03) - 0.26 0.021 - 0.32 From Mensink
(2003) Values between brackets are not
statistically significant. (-) no
information/data available