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Eatwell Guide: modelling the dietary and cost implications of incorporating new sugar and fibre guidelines
  1. Peter Scarborough1,
  2. Asha Kaur1,
  3. Linda Cobiac1,2,
  4. Paul Owens3,
  5. Alexandr Parlesak3,
  6. Kate Sweeney4,
  7. Mike Rayner1
  1. 1Nuffield Department of Population Health, British Heart Foundation Centre on Population Approaches for Non-Communicable Disease Prevention, University of Oxford, Oxford, UK
  2. 2Department of Public Health, Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme, University of Otago, Wellington, New Zealand
  3. 3Global Nutrition and Health, Institute of Nutrition and Midwifery, Metropolitan University College, Copenhagen, Denmark
  4. 4Public Health England, Liverpool, UK
  1. Correspondence to Asha Kaur; asha.kaur{at}dph.ox.ac.uk

Abstract

Objectives To model food group consumption and price of diet associated with achieving UK dietary recommendations while deviating as little as possible from the current UK diet, in order to support the redevelopment of the UK food-based dietary guidelines (now called the Eatwell Guide).

Design Optimisation modelling, minimising an objective function of the difference between population mean modelled and current consumption of 125 food groups, and constraints of nutrient and food-based recommendations.

Setting The UK.

Population Adults aged 19 years and above from the National Diet and Nutrition Survey 2008–2011.

Main outcome measures Proportion of diet consisting of major foods groups and price of the optimised diet.

Results The optimised diet has an increase in consumption of ‘potatoes, bread, rice, pasta and other starchy carbohydrates’ (+69%) and ‘fruit and vegetables’ (+54%) and reductions in consumption of ‘beans, pulses, fish, eggs, meat and other proteins’ (−24%), ‘dairy and alternatives’ (−21%) and ‘foods high in fat and sugar’ (−53%). Results within food groups show considerable variety (eg, +90% for beans and pulses, −78% for red meat). The modelled diet would cost £5.99 (£5.93 to £6.05) per adult per day, very similar to the cost of the current diet: £6.02 (£5.96 to £6.08). The optimised diet would result in increased consumption of n-3 fatty acids and most micronutrients (including iron and folate), but decreased consumption of zinc and small decreases in consumption of calcium and riboflavin.

Conclusions To achieve the UK dietary recommendations would require large changes in the average diet of UK adults, including in food groups where current average consumption is well within the recommended range (eg, processed meat) or where there are no current recommendations (eg, dairy). These large changes in the diet will not lead to significant changes in the price of the diet.

  • diet
  • non-communicable disease scenario modelling
  • optimisation
  • food price
  • food-based dietary guidelines
  • non-linear programming

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Footnotes

  • Contributors PS and MR involved in conception and development of methods, analysis of data and writing the manuscript. AK and KS are responsible for the development of methods and analysis of data, and gave feedback on the manuscript. LC involved in the development of methods and analysis, and gave feedback on the manuscript. AP and PO are responsible for price data extraction and analyses, and feedback on the manuscript. Each author has seen and approved the contents of the submitted manuscript.

  • Funding This study was supported by Public Health England (6446884).

  • Competing interests  AK reports funding from Public Health England, during the conduct of the study; funding from European Commission: 7th EU Framework Programme Small Collaborative Project CLYMBOL (contract no. 311963), outside the submitted work. PS reports grants from Public Health England, grants from British Heart Foundation, during the conduct of the study. KS reports that she is an employee of Public Health England during the conduct of the study. MR reports grants from Public Health England, grants from British Heart Foundation and is the Chair of Trustees for Sustain, during the conduct of the study. This work was commissioned by Public Health England who provided data used and were involved in discussions around the methods and analyses.

  • Ethics approval This study used routinely collected publicly available data sets. As such ethics approval was not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Not additional data are available.

  • Transparency declaration The lead author (the manuscript's guarantor) affirms that this manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained. All authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. The raw consumption data used in this paper were taken from the National Diet and Nutrition Survey (NDNS) and are available to download from https://discover.ukdataservice.ac.uk/catalogue?sn=6533. The optimisation modelling spreadsheets, the associated price data and the eatwell plate allocations for individual food items are available on request from the corresponding author.

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