New SACN report published on feeding children from 1 to 5

I recently attended the Nutrition Society Summer conference 2023 and I was fortunate enough to hear about the very new SACN report on feeding young children aged 1 to 5.

This follows on from the prior report on feeding infants from 0 to 1, published in 2018

First off, who is SACN?

SACN, the Scientific Advisory Committee on Nutrition, advises the Office for Health Improvements and Disparities and other UK government organisations. Their remit is focussed on

• Nutrient content of individual foods and on diet as a whole
• Nutritional status of people in the UK
• Nutritional issues affecting wider public health policy
• Nutrition of vulnerable groups and health inequality issues

This latest report that was published on 4th July 2023, is a comprehensive review of the scientific basis of current dietary recommendations for feeding young children aged 1 to 5 years.

SACN reports are primarily based on evidence from Systematic reviews – these are summaries of findings across a set of studies, all based on the same areas of research. So you can think of the SACN report as a summary of summaries.

This is one of the biggest reports produced by SACN, at 450 pages, with 600 pages of further appendices, and 5 years in the making.

So what were the key findings?

From the systematic reviews

1. Higher free sugar intake is associated with increased dental carries
2. Higher sugar sweetened beverage (SSB) consumption in children aged 1 to 5 is associated with a greater odds of overweight or obesity in childhood
3. Higher child BMI or weight status at age 1 to 5 is associated with higher adult BMI or risk of overweight or obesity

From the dietary surveys, young children are

1. consuming more than the recommended amounts of
   1. Calories
   2. Free sugars
   3. Saturated fats
   4. Protein
2. consuming less than the recommended amounts of
   1. Dietary fibre
3. eating too much salt
   1. 76% of 18-47 month old, and 47% of 48 to 60 month olds
4. may be at risk of not getting enough zinc, iron, vitamin A and D
   1. Specifically from lower socio-economic households and some ethnic groups

In addition, the report highlighted that when it comes to fruit and vegetable consumption, there are no agreed portion sizes so it is not possible to determine adequacy, but children across all age groups ate more fruit than vegetables and the consumption of both declined with increasing deprivation.

The report then highlighted the high levels of consumption across the whole age group of foods that are energy dense and high in saturated fat, salt or free sugars. This includes grain based deserts such as buns, cakes and pastries, dairy desserts, sweets, sweet spreads, crisps, savoury snacks, pizza, salted nuts, sugar sweetened beverages, flavoured milks, ice cream and high sugar breakfast cereals – all the kinds of foods that we know are very appealing to children and adults alike.

This group of foods contributed to as much as a third of total energy consumption, with the biggest contributor being buns, cakes and pastries.

Another concerning outcome was in relation to follow on milks. It was found that over a third of infants in the 12 to 18 month age group consumed follow on milks, and these contributed 50% of free sugar intake.

Consumption of sweetened drinks and fruit juices was found in 20-40% of children in the 1 to 5 age range, and fruit juices in particular were a large contributor of free sugars.

What does this mean for public health policy?

In the report, SACN conclude with a series of recommendations. These include:

1. Current UK dietary guidelines( as depicted in the Eatwell Guide) should now apply to children from age 2, wiht the following exceptions:
   1. Free sugar recommendation (<5% total energy) should apply from 1 year
   2. Milk and water should be the main contributor of drinks
   3. Semi-skimmed or whole milk can be given as main drink from age 1 year
   4. Sugar-sweetened beverages should not be given to children aged 1 to 5
2. Reiteration that formula milks are not required for children aged 1 to 5
3. Foods that are energy dense, high in saturated fats, salt or free sugars should be limited in children aged 1 to 5
4. Commercially manufactured foods and drinks marketed specifically for infants and young children are not needed to meet their nutritional requirements.
5. Promoting an energy appropriate and diverse diet that meets nutritional requirements
6. Consideration of strategies to reduce consumption of free sugars, excess protein, energy dense foods high in saturated fats, salt or free sugars, and sugar sweetened beverages

SACN also raise the need to develop age-appropriate portion sizing as this is currently lacking for this age group.

And to provide support to the parents and ongoing monitoring of children who follow a vegetarian, vegan or plant based diet.

Hopefully, a lot of this will filter through into policy changes, such as the example below, an excerpt from of a guide that Public Health England put together to help Early Years settings with meal planning, and in time will improve the health status of our youngest children and set them up for a more healthful future.