Q&A with innocent's nutritionist Vanessa Hattersley
To answer your questions on vitamins, smoothies and supplements, innocent's head nutritionist Vanessa Hattersley took part in a Q&A session in September 2011.
Vanessa worked in the NHS before her career as a nutritionist in the food industry, and joined innocent in March 2010.
snigger: Is it true that due to intensive farming methods and general devil-may-care food production standards that five-a-day nowadays is not worth five-a-day in years gone by? Should we technically be on seven-a-day?
Vanessa: Well, you could ask the second half of that question without even referring to intensive farming methods. The reason being that a number of countries already go beyond the five-a-day that's recommended in the UK. France for example recommend 10-a-day, in Denmark it's six and Australia say two fruit and five veg. It's all a bit inconsistent [hmm].
I think that the main point we shouldn't lose sight of is that in the UK it's at least five, ie five is the minimum we should be reaching for. Although there's research to suggest more would be beneficial, for a lot of people, aiming for five is a lot more realistic and achievable. Having said that, only a third of adults manage to reach five at the moment, so we've still got a long way to go.
It's difficult to say how farming methods might have changed the nutritional content of fruit and veg because I very much suspect that it will vary hugely depending on what fruit or veg you're looking at and what nutrient. And, of course, not all developments have a negative impact on nutrition. Being able to freeze fruit and veg, for example, helps to retain much more of the nutrients than you might otherwise get. Modern food production also means that you're able to enjoy a bigger variety of produce than you ever would have.
littlegit: Can you please tell me if you are going to start put pressure on the food industry to actively start removing aspartame from children's food and drinks? It's even in drinks which already have sugar in them! Sainsbury's seems to be at least removing it from their products.
Vanessa: I think that the only people who can really put pressure on the food industry to drive real change are you, the consumers. You're an incredibly powerful voice and working together you can vote with your feet. The industry soon realises if you're not happy with something, believe me. I think innocent's role is in leadership and showing that there is another way to think about our food.
In terms of aspartame specifically, I'm aware that the European Food Safety Authority is currently reviewing all the scientific studies ever published on it and they'll provide their opinion on its safety in due course. However, for the time being, it is considered completely safe and it obviously allows for the manufacture of products that have no sugar in them, which is very important for dental health and people trying to watch their calorie intake. Perhaps in a case like this, it's about providing you with plenty of choice and the necessary information to allow you to make the decision for yourself and your families?
Mumsy5: Are there any plans for more dairy-free (and egg-free) children's products? My son has multiple allergies and there are currently very few children's products that are allergy friendly.
Vanessa: I know that allergies can be a bit of a nightmare. I remember once when I was working in the NHS, I had to cross-check several lists from retailers to find products that were suitable for a patient who had multiple allergies. The problem was that they only produced one list per allergy. What a nightmare.
Of course as innocent's kids' products are all fruit-based, you won't find any sneaky dairy or egg in them. More broadly speaking though, unfortunately the reality of the situation is that the amount of product choice available will depend on consumer demand. So for example, as there are a larger number of people with coeliac disease than with multiple allergies, you'll find that the industry responds by making more gluten-free products available for this group. This is obviously not ideal for you or others in a similar boat.
You could try getting in touch with the Anaphylaxis Campaign who have very good links into industry and may be able to provide you with extra guidance and support.
ComradeJing: What constitutes portion sizes for different food groups for babies and children? If an apple is one portion for an adult, is it also one portion for a child, or is it half a portion?
Vanessa: Children's bodies are a bit mismatched, and their tummies are really quite small. At two years old, their stomach is about a quarter of the size of an adult's, yet in total they can need about three-quarters of the calories that adults do. This is because firstly, kids run around like they've got a rocket up their bum and secondly, because their bodies need to fuel growth and development. To get around this, they'll need smaller portion sizes than adults but will need to eat more often.
For fruit and veg, I'd say that at preschool age, you don't really need to be worrying what's what when it comes to five-a-day portion sizes. The most important thing is to give kids plenty of opportunities to squeeze in different types of fruit and veg throughout the day. At primary school age they can probably manage about half an adult portion and by secondary school, they should be eating proper grownup portions. And by adult portions, what we mean is roughly 80g.
Rather than go through all the different food groups here, I've provided a couple of links for you below, which should give you the information you're after.
For 5-a-day portions sizes, try the NHS website. Love Food Hate Waste has a really useful portion size guide on its website that's worth a look. And if you want a bit more detail, you can take a look on the Scottish Government's webpage (just scroll down to the portion size tables at the bottom).
BoSho: I am weaning my one year old on a vegetarian diet (and he's still having two or three breastfeeds a day) and would like to know whether meat substitutes and tofu are really important. We have great, balanced diet, and cook everything from scratch, but we don't eat tofu or meat substitutes at all. I read that there is a lot of oestrogen in tofu which can have adverse affects on young children, and Quorn just seems a bit synthetic. Should I get over this and introduce it into our diet or forget about it?
Also, is this combining protein business a load of rubbish, or is there something to it? If so can you please explain how do I do it because I can't for the life of me work it out.
Vanessa: Soya protein naturally contains phytoestrogens, which are basically plant versions of human oestrogens that are much less potent. There has been some concern over the consumption of phytoestrogens but this is primarily around the use of soya formula feeds in the first 6 months of life. This is because at this stage in the child's life, milk is relied on for the majority of the child's nutrition (or all, if weaning hasn't started) and as a result, the intake of phytoestrogens can be relatively high.
There seems to be less risk after the age of six months because the amount of phytoestrogens per kg body weight will be reduced and most of the infant's potentially vulnerable organs will have matured by this age. As such, there is no guidance to limit the intake of soya and soya proteins after this point and they can be important sources of nutrition for the vegetarian infant.
In answer to your question on protein combining, the short answer is don't waste any time worrying about this. I'll give you a bit of background though. Proteins are basically made up of building blocks called amino acids, of which there are 21 different kinds. These amino acids are present in foods in different quantities and in animal foods they are generally there in the right quantities humans need. However, in plant foods the proportions are not as well matched, so this idea of combining proteins to get the right balance was created. Classic examples of this are beans on toast, lentil curry and rice, tortillas and beans. But as long as you're getting a good variety of protein sources in your diet, there isn't a physiological need for you to get the right mix of amino acids each time you eat a protein meal. Life's too short, eh?
gazzalw: My friend has a 10-year old who isn't at all keen on dairy products (without having any allergy per se). I'm very conscious that it's important for girls, as they enter puberty, to ensure they have a calcium-rich diet. Do you have any good dietary tips to get around this?
Vanessa: Oh lordy, you're right about calcium being important going into puberty. Up to 60% of the bone mass your body lays down will happen during the pubertal growth spurt and so it's no wonder our calcium requirements are higher at this time of our lives than any other. The first thing to do is to look for direct substitutes (if she'll try them) like soya milk instead of cow's milk. It's important to check the label though to see if it's fortified with calcium because it's not naturally high in it like cow's milk. It's also worth knowing that organic soya milks can't be fortified with calcium.
Secondly, make use of other good calcium sources like fortified bread and breakfast cereals, baked beans (who'd have thought!), soya beans and kidney beans (a good reason to have a chilli). Although spinach contains quite a bit of calcium, Popeye wasn't aware that it's not very well absorbed.
Finally, she might find it possible to 'sneak' in some dairy products when cooking stuff up, like a bit of milk in soup (I do this with a lentil soup - tastes great), yoghurt in curries or cheese in mash, as just a few examples.
carriemumsnet: Any suggestions for healthy post-school snack that feels like a treat but isn't bad for teeth? My kids are pretty skinny so not so worried about calories but do have tricky teeth so muesli bars, which they like, have been vetoed. Someone also said crisps were bad all round - teeth and empty calories. They will have fruit but don't get very excited about it.
Vanessa: Ah, now there's a tricky question - I'd be a millionaire if I had the answer to it. I presume the snack is to fill them up and give them a bit of energy, if it's been a long time since they last ate? What about a small bowl of porridge with different toppings - a little bit of jam, chocolate spread (don't shoot me), dried fruit, apple etc? If you used one of those packet porridges they only take two minutes in the microwave.
Popcorn is also ok, if it's not covered in salt or sugar. You can make this at home in a few minutes and it's fun to watch it pop. The other thing is to try and make the fruit interesting. Like making a big, colourful fruit salad to keep in the fridge (to use over the next few days) and then put this and some yoghurt into a clear beaker to make a healthy knickerbockerglory-thingy. I'm sure some of the Mumsnetters will have loads of other ideas.
flimflammery: Can you confirm if the following is true or false? We live in abroad in a hot humid climate, and a neighbour told me her paediatrician said it's OK to give the kids plenty of salty food as they sweat so much they need more. Is this true? I don't mean putting salt in all their food, but having things like soy sauce, crisps, crackers, etc.
Vanessa: It may be that this advice was given for a specific reason for a particular child, so it's inappropriate for me to comment on an individual case. However, the Food Standards Agency has previously confirmed that this idea of having extra salt in hot climates is a myth.
Generally speaking, we're all having too much salt in our diets because we rely more heavily on convenience foods. And when we say convenience foods we're not just referring to canned soups and ready meals (although they obviously do contribute) but 'everyday' foods such as bread, cheese, breakfast cereals, processed meats etc. So as most people are already getting more than enough salt in their diets, it's unnecessary to go overboard with salty foods.
champagnesupernova: Help me. I am knackered. What can I eat to stop me getting every cold that's going and stop me feeling completely shattered?
Vanessa: There are so many nutrients involved in keeping your immune system in tiptop shape that it's almost impossible to pick out one or two and say that eating more of X will reduce the chances of you getting a cold and/or reduce the severity of it. Certain groups of the population are definitely at a greater risk of being deficient in nutrients and that will affect the strength of their immune system like smokers (active or passive), heavy drinkers, pregnant or lactating women, the elderly and people with eating disorders.
However, if you eat a varied diet, you should be getting all the nutrients you need. The only thing I'd add is that despite the common perception that taking vitamin C supplements reduces the chance of you developing a cold, reviews that look at all the data show that there isn't consistent evidence to support this. And in any case, with vitamin C, your body can't store it so you just wee out anything you don't need.
In answer to your other question, the best way to manage your energy levels through your diet is to try to keep to a regular meal pattern. Big gaps between meals can mean that your blood glucose (essentially the energy that is going around in your bloodstream) can drop and this can make you feel tired and lethargic. It can also be a good idea to pick foods and meals that are more slowly digested (sometimes referred to a low glycaemic index or GI).
In this way, your body will stay fuller for longer and get a more sustained supply of blood glucose to keep your energy levels up. Finally, caffeine (in tea, coffee, chocolate, energy drinks etc) can be a good pick-me-up, but you shouldn't rely on this as a substitute for regular meals.
skybluepearl: Does food influence acne? Can food help balance hormones? Does milk cause acne and is goats milk or soya milk a good alternative? Is there anything I can eat to help me have clear skin? Does water really flush toxins out of the system? Can specific foods delay age lines?
Vanessa: Unfortunately, there's very little scientific research that has been done in the arena of diet and its impact on acne. However, what we can gleam from the research we do have is that a low glycaemic load diet may have a positive impact.
If you haven't heard of glycaemic load before, it's very similar to glycaemic index that I mentioned in my answer to champagnesupernova's question. The only difference is that it places an equal emphasis on both the amount of carbohydrate as well as the type. If you want more information on this, I would suggest searching books by Nigel Denby, who is a registered dietitian who specialises in this area.
In answer to your other question about milk, only recently have we started to see research which has looked at the relationship between milk consumption and acne risk. At present, scientists believe that there is a link. However, as milk is a complex substance, there's lots of reasons why this could be the case.
It's important to remember that milk is very nutrient-rich and simply removing it from the diet could reduce the nutrients supplied. Alternatives could be plant-based milks like soya or rice milks but check that these are fortified with calcium, as they aren't naturally high in it like cows' milk.
On to your next question about water and toxins - your body is able to get rid of things it doesn't need or can't use through your stools and your wee. For this purpose though, it doesn't really matter where the fluid is coming from ie. plain water versus a cup of tea. It all contributes to your fluid intake and helps to keep you hydrated.
Finally, in terms of the overall health of your skin, there's no particular foods that are recommended. A varied diet should give you all the nutrients you need.
GemD81: What foods do you recommend eating regularly to avoid and prevent eczema, asthma, thrush and colds? I have been taking an acidophilus forte tablets for a couple of months and have not noticed any difference.
Vanessa: I'm afraid that there really isn't any strong scientific evidence to tell us whether avoiding or eating more of certain foods will reduce our risk of developing eczema or asthma. However, I did find research to suggest that probiotics do not make any difference with eczema, which would support what you seem to have found in your own experience. Take a look on my response to champagnesupernova for information on diet and immune system.
HipHopOpotomus: What effect does pasteurisation have on the nutritional value/content of shop bought juices and smoothies?
Vanessa: There are two different kinds of pasteurisation: ultra high temperature or UHT where a high temperature of around 135 degrees is used and gentle where a lower temperature around 80 to 90 degrees is used, for a shorter amount of time. At innocent we use gentle pasteurisation (like what is used with fresh milk) because it means that we can minimize any nutritional losses from the heat, whilst ensuring the drink tastes great and is safe to consume. We always test the nutritional content of our products at the end of their shelf life, so any nutritional information is based on what's in the bottle.
HattiFattner: Our infant school follows government guidelines for healthy eating. We have been getting mixed messages about fruit juices - on the one hand, we are encouraging kids to eat fruit at break time (and the school is supplied with fruit from the local authority for this purpose). We also supply a drink of fruit juice first thing (about 50ml only) as well as water.
However, we live in an area where many children have very poor dental health, and have been advised that they should not be eating high acid fruits and fruit juices due to acid erosion of teeth and dental decay caused by sugars in fruits. So, what would your recommendation be: fruit and juices for health vs dental decay?
Vanessa: This is a really good question. You've highlighted the only true downside to fruit and fruit juices, which is that the sugar found naturally in them and their acid content means that they're not great news for teeth. However, on the other hand, fruit and juices are really good for our overall health and an important source of nutrients.
The advice normally given is to dilute them and have fruit and juices with meals, whenever possible, as this reduces the number of times the teeth are exposed. Plus, if teeth are brushed twice a day with fluoride toothpaste, then this should help prevent any damage.
bemybebe: I love smoothies and make mostly my own from fresh and frozen fruit and freshly squeezed juices. However, innocent smoothies of any flavours that I have bought from time to time over the years give me the most awful acid stomach. Any thoughts of why?
Vanessa: People can get heartburn from different types of food and drink, so not everyone will suffer from it with fruit juices for example. However, I'm at a loss as to why you don't get it when the smoothies and juice are freshly made but you do with innocent products. After all, the only ingredients in them are the same things you would use at home ie fresh fruit and juice. Sorry I'm not much help with this one.
BoSho: Does my (11.5 month old) vegetarian son need to take any supplements? We take plant-based Omega 3 capsules, which he's getting via the breastmilk at the moment (and that'll stop soon) and he takes Vitamin D drops (we live in Holland and all kids take them here until they're 4 years old), but that's it.
All the vegetarian books I read say that I should also be giving him Vitamin A and C supplements and letting him drink juice to help him absorb iron-rich foods, but the health visitor and GP told me that extra vitamins aren't necessary, and I don't want to give my son a sweet tooth by giving him juice so I just give him water. Am I doing the right thing?
Vanessa: In the UK, the Department of Health recommends that all children whether vegetarian or not, take drops for vitamin A and D until the age of five. I would have thought though that if he's managing a varied diet, he should be OK on the drops he's on.
Vitamin C does help with the absorption of iron from plant-based foods and so it's not unusual to hear advice to drink juice with fortified breakfast cereal (as an example). However, because of dental health issues, it's important to dilute the juice down and keep it to mealtimes.
twipple2: I'm feeling quite under the weather and have lots of stress at the moment. What supplements should I be taking? I'm prone to cold sores and these tend to come out at times of stress.
Vanessa: Take a look my response to champagnesupernova for thoughts on diet and your immune system. I did take a look through the scientific literature to see if I could find anything for you on cold sores, but I'm afraid that there hasn't been much research done.
There seems to be a little bit on vitamins E and an amino acid-L-lysine. But most of this work is on animals rather than humans and there's nothing there to suggest you should be taking any particular supplements to prevent your cold sores. Bummer.
twipple2: My friend's daughter has been diagnosed with juvenile idiopathic arthritis. Can she take any vitamins or supplements to help this? It's not painful and is confined to one joint.
Vanessa: To my knowledge, there are no supplements that can help with this disease. With the arthritis being painless and localised there may be no dietary issues at all. But it's worth highlighting that sometimes the child's appetite can be affected and this will influence growth and development - one thing to keep an eye on. But otherwise, a healthy and varied diet is just the ticket.
mousymouse: In many other (northern) countries, it is recommended to give children high doses of vitamin D between October and March. What is your view on that?
Vanessa: Would you believe that the last time the dietary recommendations for vitamin D were amended was in 1994? The current recommendations are 8.5mg for 1 to 7 months, 7mcg for seven months to three year,s and 10mcg for pregnant and breastfeeding women and adults over 65. So, at the moment, there's no recommendation for anyone between the ages of three years to 65 years. This is because it is thought that this group can make sufficient vitamin D through the action of sunlight on the skin.
More recently, we've heard more reports that rickets may be on the rise and our Scientific Advisory Committee on Nutrition is currently looking at the scientific evidence available to see if these recommendations need changing.
We do know that in the UK from mid-October to the beginning of April, the UV light that reaches us is not of the correct wavelength to create vitamin D. And so, if you are at higher risk of vitamin D deficiency because you have covered up in the summer months or worn sunscreen, or have darker skin, if you're an ethnic minority, then additional vitamin D through either diet or supplements is important. Good dietary sources of vitamin D include oily fish and margarine or breakfast cereals (as these are fortified with it).
moondog: What's the purpose of asking people to knit all those little knitted hats for drinks?
Vanessa: Cute, aren't they? Those hats that you'll see gracing the tops of our innocent smoothies in Boots and Sainsburys stores are knitted by lovely people all over the country. Blink and you'll miss them though, because they only come out for three weeks from the 23 November. Innocent has a target of selling 650,000 bottles with hats on and as each bottle equals a donation of 25p to Age UK, if we meet out target, we'll all have raised over £160,000. If you want more information, visit our website.
CountessDracula: How do you feel about innocent being 58% owned by Coca Cola? Would you recommend, as a nutritionist, that children (or anyone) drink Coke?
Vanessa: Innocent went through a tricky time a few years ago when (without exaggeration) had it not been for Coke's investment, it would have had to shut down the business. And for me, that would be a terrible shame because there are very few food businesses out there that truly put healthy food and drink at the core of their vision. innocent's beliefs and values haven't changed as a result of the investment by Coca Cola and the extra cash has meant that more healthy food and drink could be made and sold all over Europe, which I only see as a good thing.