An assessment of nutritional information in oral health education leaflets.

INTRODUCTION: Dental caries prevalence in UK children remains high and obesity, closely linked to Type 2 diabetes, is rising. Literature suggests that dentists may not give dietary advice due to a lack of clear and consistent guidelines. OBJECTIVE: The aim of the study was to determine whether oral health education leaflets with a food and nutritional focus conform to existing UK national nutritional guidelines from the Department of Health (DoH), the Food Standards Agency (FSA) and the Committee on Medical Aspects of Food and Nutrition Policy (COMA). METHOD: A sample of 30 information leaflets, aimed at parents and children aged 3-16 years, was sourced during the winter of 2005-2006. A qualitative content analysis was carried out to identify key recommendations on type, frequency and quantity of food and drink and general diet-related health advice. RESULTS: Most leaflets (21) promoted milk and water in agreement with nutritional guidelines. Timing of sugary food and drink to mealtimes (25) and decreasing frequency of 'sugary' e.g. non-milk extrinsic (NME) sugar containing foods (22) and drinks (25) reflected guidelines. Inconsistencies were, however, recorded in the leaflets. Five leaflets advised that frequency of consumption rather than the amount of sugary food or drink was important for oral health. This conflicts with nutritional guidelines, aimed at tackling obesity, to decrease both amount and frequency. There was conflicting advice on healthy snacks. Crisps were presented as 'healthy' by two leaflets; another two advised against snacking on dried fruit, conflicting with FSA guidelines that dried fruit contributes to "5 a day". Sixteen leaflets promoted cheese as 'healthy' with no limits on portion size; this could conflict with nutritional guidelines associated with percentage energy contribution of saturated fat to the diet. CONCLUSION: While there was agreement between leaflet content and nutritional guidelines, there were inconsistencies. Dental professionals should acknowledge these when selecting leaflets for lay dissemination.

Knowledge of and attitudes to sports drinks of adolescents living in South Wales, UK.

Background The UK sports drinks market has a turnover in excess of £200 million. Adolescents consume 15.6% of total energy as free sugars, much higher than the recommended 5%. Sugar sweetened beverages, including sports drinks, account for 30% of total free sugar intake for those aged 11-18 years.Objective To investigate children's knowledge and attitudes surrounding sports drinks.Method One hundred and eighty-three self-complete questionnaires were distributed to four schools in South Wales. Children aged 12-14 were recruited to take part. Questions focussed on knowledge of who sports drinks are aimed at; the role of sports drinks in physical activity; and the possible detrimental effects to oral health. Recognition of brand logo and sports ambassadors and the relationship of knowledge to respondents' consumption of sports drinks were assessed.Results There was an 87% (160) response rate and 89.4% (143) claimed to drink sports drinks. 45.9% thought that sports drinks were aimed at everyone; approximately a third (50) viewed teenagers as the target group. Over two thirds recognised the brand logos, yet less than a third could identify brand ambassadors. About half were aware that dental erosion may result from consumption and approximately two thirds knew that they were linked to dental caries and energy provision. Despite this the majority claimed to drink them. As previously reported most of those drinking sports drinks did so because of the taste.Conclusion Whilst most of the respondents had some understanding of the detrimental effects on health the majority of them were drinking them regularly despite this knowledge. Work is therefore needed at a macro level, with soft drink manufacturers, to consider marketing and reformulation of products for adolescent consumers who appear to enjoy them.

A survey of sports drinks consumption among adolescents.

Background Sports drinks intended to improve performance and hydrate athletes taking part in endurance sport are being marketed to children, for whom these products are not intended. Popularity among children has grown exponentially. Worryingly they consume them socially, as well as during physical activity. Sports drinks are high in sugar and are acidic. Product marketing ignores the potential harmful effects of dental caries and erosion.Objective To investigate the use of sports drinks by children.Method One hundred and eighty-three self-complete questionnaires were distributed to four schools in South Wales. Children in high school years 8 and 9 (aged 12-14) were recruited to take part. Questions focused on use of sports drinks, type consumed, frequency of and reason for consumption and where drinks were purchased.Results One hundred and sixty children responded (87% response rate): 89.4% (143) claimed to drink sports drinks, half drinking them at least twice a week. Lucozade Sport(™) was the most popular brand. The main reason for consuming the drinks was attributed to the 'nice taste' (90%, 129/143). Most respondents purchased the drinks from local shops (80.4%, 115) or supermarkets (54.5%, 78). More boys claimed to drink sports drinks during physical activity (77.9% versus 48.6% girls, P <0.001). Whereas more girls claimed to drink them socially (51.4% versus 48.5% boys, NS).Conclusion A high proportion of children consumed sports drinks regularly and outside of sporting activity. Dental health professionals should be aware of the popularity of sports drinks with children when giving health education advice or designing health promotion initiatives.

Food references in UK children's magazines - an oral health perspective.

OBJECTIVE: Children's magazines are popular in the United Kingdom, but their content is poorly regulated. Consequently, food and beverages high in fat, salt and sugar (HFSS), detrimental to oral and wider health, make unrestricted appearances. The study aim was to assess the amount of HFSS food and drink children are exposed to while reading magazines; with particular focus on foods containing free sugars due to their known cariogenic properties, and foods with low pH due to their erosive potential. DESIGN: Eleven of the most popular UK children's magazines were selected and purchased at four separate time points in 2012. These 44 magazines were examined using content analysis; any references to food/beverages (in advertisements, free gifts, editorial and general content) were recorded. RESULTS: Of the 508 food references observed, 73.6% (374/508) were for foods detrimental to oral health owing to their high sugar and/or acid content. 5.9% (30/508) were considered 'unhealthy' due to their fat or salt content. 20.5% of references were for 'healthy' foods (104/508). The most common food categories referenced were baked goods (181/508) and sweets (86/508). Over a third (36.4%, 16/44) of magazines came with free sweets. In terms of positioning, the food/drink references were predominantly found in the general content of the magazines, including the editorial spreads. Direct advertisements for food/drink only accounted for 9.6% (36/374) of the total number of references counted. CONCLUSION: Food references within children's magazines are biased towards unhealthy foods especially those detrimental to oral health; these permeate throughout the general and editorial content and are not restricted to direct advertisements. Magazine editors, journalists and illustrators are responsible for the editorial and general content of magazines. Without regulation, subliminal placement of advertisements within editorial and general content leads to 'advertorials' which are known to confuse children and parents alike. This study concludes that regulation may therefore need to cover more than just the direct advertisements. Dental professionals need to be aware of current trends in children's media when giving health education advice or designing health promotion initiatives.

A comparison of the nutritional knowledge of dental, dietetic and nutrition students.

Conflicts in dietary messages remain widespread. Such conflicts can have negative effects on the behaviour, motivation and attitudes of individuals. Inconsistencies in dietary advice may be linked to inadequate training of professionals. Literature suggests that the nutrition training of dentists and oral health training of dietitians and nutritionists is limited. This study was designed to provide information on the nutritional knowledge of dental, dietetic and nutrition students and how this conforms to national nutritional guidelines, identifying differences between professional groups and conflicts in undergraduate training. Self-administered questionnaires were completed by 124 dental, dietetic and nutrition students at Cardiff University and the University of Wales Institute, Cardiff (UWIC). Significant inter-group differences (p <0.05) were observed in relation to recommendations concerning the between-mealtime consumption of a wide range of snacks and drinks. Dental students were mainly concerned with oral health problems (for example, acid erosion), while dietetic and nutrition students were mainly concerned with general health problems (for example, obesity). Just over a third of dental students felt that they had received sufficient training in the dietary management of patients. In conclusion, a common risk-factor approach and consistent nutrition guidelines are essential to improve health. In addition, recommendations should be made to incorporate oral health into the training of nutritionists and general health into the training of dentists.

A new breakfast cereal containing guar gum reduces postprandial plasma glucose and insulin concentrations in normal-weight human subjects.

A new guar-containing wheatflake product was developed to assess its effect on carbohydrate tolerance in normal-weight, healthy subjects. The extruded wheatflake breakfast cereals containing 0 (control) or approximately 90 g guar gum/kg DM were fed to ten fasting, normal-weight, healthy subjects using a repeated measures design. The meals were similar in energy (approximately 1.8 MJ), available carbohydrate (78 g), protein (15 g) and fat (5.4 g) content. The guar gum content of the test meals was 6.3 g. Venous blood samples were taken fasting and at 15, 30, 45, 60, 90, 120, 150 and 240 min after commencing each breakfast and analysed for plasma glucose, insulin and C-peptide. The guar wheatflake meal produced a significant main effect for glucose and insulin at 0-60 min and 0-240 min time intervals respectively, but not for the C-peptide levels compared with the control meal. Significant reductions in postprandial glucose and insulin responses were seen following the guar wheatflake meal compared with the control meal at 15 and 60 min (glucose) and 15, 60, 90 and 120 min (insulin). The 60 and 120 min areas under the curve for glucose and insulin were significantly reduced by the guar gum meal, as was the 240 min area under the curve for insulin. Thus, it can be concluded that the use of a severe method of heat extrusion to produce guar wheatflakes does not diminish the physiological activity of the guar gum.