Transcript The NEEDNT Food List

The NEEDNT Foods List:
Non-Essential Energy Dense
Nutritionally Deficient Foods
Jane Elmslie, Ria Schroder
Doug Sellman, Frances Carter
What is the NEEDNT Foods
List?
• A list of 50 non-essential, energy dense,
nutritionally deficient foods
• Key money makers for the food industry
• Foods high in fats and added sugars,
which together with salt, are the food
components most commonly
associated with food addiction
Why was it developed?
• Need identified from :
– Clinician and consumer focus groups
– WW vs OA study
– Desire to test abstinence/moderation
paradigm without compromising
nutritional health
– Lack of movement on traffic light
labelling
Clinician and Consumer
Perspectives of Obesity
• Lifestyle change crucial
• Confusing/misinformation unhelpful
• Treatment must address the emotional
component of overeating
• Addictive component should be
acknowledged. A role for abstinence?
Weight Watchers vs Overeaters
Anonymous
Methodology
• 27 obese participants
• Attended 6 WW meetings and 6 OA
meetings
• Randomized order
• Asked what they thought of them?
• Asked what they thought about the
concept of “problem food”?
Weight Watchers vs Overeaters
Anonymous (n=27)
• Majority not satisfied with either
• WW – “too structured”, “too complex”,
“become obsessed by counting points”, “not
sustainable”, “too commercial – too much
hard sell of products”
• OA – “I’m not as bad as them”, “not
comfortable with the Higher Power”, “not
practical enough” “too touchy feely”
suggesting that differences between OA &
WW go beyond abstinence vs moderation
• All able to identify 3-4 problem foods
• Problem foods only part of the problem
What to do now?
• Simplify
• Clarify which foods contain
empty calories
• Encourage healthy eating
Medscape News July 19th 2011
• “Each day, the average American adult consumes
roughly 22 teaspoons, 90 g, or 355 calories, of
added sugars, well above health guidelines.
Caloric sweeteners in beverages are a key source
of excess calories.”
• “New U.S. dietary guidelines recommend drinking
water instead sugary drinks. Food and beverage
companies say they are being unfairly singled out.”
• “At various times, states and localities have
considered taxing sugary beverages to cover
obesity-related health costs.”
• In 2009 and 2010, as such proposals became more
frequent, the ABA, Coke and Pepsi collectively
spent $60 million on lobbying, up from $8 million in
2007 and 2008, according to data collected by the
Center for Responsive Politics' OpenSecrets.org.”
Nutrient composition of Griffins Toffee Pops
Component
Energy
Protein
Fat, Total
Fat - Saturated
Carbohydrate, Total
Carbohydrate - Sugar
Sodium
Qty Per 1 biscuit
340kJ
0.75g
3.9g
2.5g
10.8g
6.9g
45mg
Qty Per 100g
2000kJ
4.5g
22.8g
14.7g
63.4g
40.2g
270mg
Nutrient composition of Uncle Toby’s Chewy Muesli Bars
Component
Qty Per Serving (1 bar)
Energy
540kJ
Protein
1.8g
Fat, Total
4.2g
Fat - Saturated
1.4g
Carbohydrate, Total
19.6g
Carbohydrate - Sugar
6.6g
Dietary Fibre
2.1g
Sodium
5mg
Qty Per 100g
1710kJ
5.7g
13.4g
4.5g
62.7g
21g
6.6
15mg
Barriers to change in clinical
practice
• “But aren’t sugar and fat the
same thing?”
• “The citrus slice saga”
• “I’m having muesli bars now”
10
Developing the list
• Compiled using:
– National Heart Foundation and Diabetes New
Zealand “Foods to Avoid”, “Stop Eating” and
“Optional Foods” lists
– CDHB “Supermarket Shopping Guide”
– USDA population guidance on discretionary
calories.
• Foods and beverages were included if they:
–
–
–
–
–
contained alcohol,
saturated fat,
added sugar,
were prepared using a high fat cooking method
contained a large amount of energy relative to
their essential nutrient value.
NON-ESSENTIAL ENERGY-DENSE NUTRITIONALLY-DEFICIENT FOODS
NEEDNT FOOD
Alcoholic drinks
Biscuits
Butter, lard, dripping or similar fat (used as a
spread or in baking/cooking etc.)
Cakes
Chocolate
Coconut cream
Condensed milk
Cordial
Corn chips
Cream (including crème fraiche)
Crisps (including vegetable crisps)
Desserts/puddings
Doughnuts
Drinking Chocolate, Milo etc.
Energy drinks
Flavoured milk/milkshakes
Fruit tinned in syrup (even lite syrup!)
REPLACE WITH:
Water/diet soft drinks
*
Lite margarine or similar spread or omit
*
*
Lite coconut milk/coconut flavoured lite
evaporated milk
*
Sugar free cordial
*
Natural yoghurt (or flavoured yoghurt
depending on use)
*
*
*
Cocoa plus artificial sweetener
Water
Trim, Calcitrim or Lite Blue Milk
Fruit tinned in juice/artificially sweetened
NON-ESSENTIAL ENERGY-DENSE NUTRITIONALLY-DEFICIENT FOODS
NEEDNT FOOD
Fried food
Frozen yoghurt
Fruit juice (except tomato juice and
unsweetened blackcurrant juice)
Glucose
High fat crackers (≥ 10g fat per 100g)
Honey
Hot chips
Ice cream
Jam
Marmalade
Mayonnaise
Muesli bars
Muffins
Nuts roasted in fat or oil
Pastries
Pies
Popcorn with butter or oil
REPLACE WITH:
Boiled, grilled or baked food
Ordinary yoghurt
Fresh fruit (apple, orange, pear etc. + a
drink!)
Artificial sweetener
Lower fat crackers (≤ 10g fat per 110g)
*
*
*
*
*
Lite dressings/lite mayonnaise
*
*
Dry roasted or raw nuts (≤ 1 handful per
day)
*
*
Air popped popcorn
NON-ESSENTIAL ENERGY-DENSE NUTRITIONALLY-DEFICIENT FOODS
NEEDNT FOOD
Quiches
Reduced cream
Regular luncheon sausage
Regular powdered drinks (e.g. Raro)
Regular salami
Regular sausages
Regular soft drinks
Rollups
Sour cream
Sugar (added to anything including drinks,
baking, cooking etc.)
Sweets/lollies
Syrups such as golden syrup, treacle, maple
syrup
Toasted muesli and any other breakfast
cereal with ≥ 15g sugar per 100g cereal
Whole Milk
Yoghurt type products with ≥ 10g sugar per
100g yoghurt
REPLACE WITH:
Crust-less quiches
Natural yoghurt
Low fat luncheon sausage
Water/Diet/Sugar free powdered drinks
Low fat salami
Low fat sausages
Water/Diet soft drinks
Fresh fruit
Natural yoghurt
Artificial sweetener
*
Artificial sweetener
Breakfast cereal with <15g sugar per
100g cereal, > 6g fibre per 100g cereal
and <5g fat per 100g cereal (or <10 g fat
per 100g cereal if cereal contains nuts
and seeds)
Trim, Calcitrim or Lite Blue Milk
Yoghurt (not more than one a day)
Feedback to Date
• Current research participants
– Appreciate the clarity
– Have been surprised at some inclusions
– Useful as an individual guide to work out own most
problematic areas
– Useful to choose 5-10 most problematic NEEDNT
foods to stop eating completely or focus on
reducing significantly
– Gives additional focus beyond portion size
• Current patients
– Appreciate the clarity
– Have expressed the view that they are “addicted”
to some foods on the list
– Have used the list to prioritise non essential energy
dense food consumption.
– Have achieved their weight loss goals
Feedback to Date
• Colleagues working in obesity treatment
– Think the list is a valuable tool
– Would like to use it with their clients
– Agree with the items included on the list
• Medical Students
– Helps reduce confusion
– Makes sense
– Easy to use and talk about
• Members of Overeaters Anonymous
– What they would refer to as ‘top shelf’ food
– OA members in recovery would never eat any
of these foods
Where to from here
Obesity Treatment
– Simple tool to help health professionals initiate
conversations about food consumption
patterns which may promote and maintain
obesity
Research
– Abstinence vs. Moderation – appropriate list of
foods to test this paradigm
– Kia Akina – a new concept for participants to
contemplate/try in their weight loss journey
– NEEDNT Food List Moderation Guidelines
– NEEDNT Food List FFQ
Acknowledgements
• Ria Schroder
• Doug Sellman
• Frances Carter
• Jim Mann