I thank the Chairman for the invitation. I was invited as an independent nutritionist to discuss the consultation document published earlier this year by the Broadcasting Authority of Ireland.
By way of introduction, I hold a bachelor's degree and a Ph.D in nutrition. I am currently a lecturer in nutrition in the school of medicine in Trinity College and I am currently carrying out some research in the area of childhood obesity.
The brief I was given is such that I was asked to discuss the complete nutritional value of certain foods, in particular dairy products, particularly cheese, in light of the proposed methods for assessing the suitability of foods and drinks and possible restrictions on the advertising of those items to children. In terms of my presentation, I will briefly put all of that in context. I will talk through the proposed model. I will talk about the nutritional composition of dairy products such as milk and cheese. I will then go on to talk about the current dietary habits of children in Ireland, and will finish with the public health concerns children in Ireland face today.
I am sure no one in this room is unaware of the public health issue we face whereby one in four of our school-age children and one in five of our teenagers is either overweight or obese. Obesity is a risk factor for a number of diseases such as cardiovascular disease, type 2 diabetes and some cancers. Children throughout the world are exposed to the marketing of foods and drinks which are high in fat, salt and sugar. There is ample scientific evidence that suggests that television advertising of food and drink influences children's food preferences, their purchase requests and consumption patterns. I acknowledge that this is one of a range of factors that can influence children's health. There are a number of other factors such as environmental, social and individual, and all of those factors can interact to affect children's health.
Moving on to slide No. 3, the World Health Organization has published a number of reports over the years such as the one documented on the slide and those reports urge countries to take action to reduce the exposure to children of such marketing.
Moving on to my fourth slide, the proposed method for assessing the suitability of foods and drinks in the Irish context is called the nutrient profiling model. It is a scientific, rigorously validated tool that was developed in the United Kingdom for the purpose of broadcast regulation. I have outlined in the table how the model works but to explain briefly, we take 100g of a food or drink and based on its nutritional composition, that food is awarded a number of points or a score. A score is calculated and depending on that score, a food or drink is deemed to be either healthy or less healthy. That is how the model works but there are a number of points regarding that model to which I would like to draw members' attention.
First, the model assesses a food or a drink on its content of both less desirable nutrients and desirable nutrients. The model calls the desirable nutrients the C nutrients; they are listed on point No. 2 on my slide. Second, protein is one of the C nutrients or the desirable nutrients. Protein is included in the model because it is deemed to be an indicator or measure of how much iron, calcium or omega 3 fat, which is the good type of fat, might be found in a food or a drink. However, importantly, if a food or a drink achieves a score for its less desirable nutrients that is above a particular threshold, that is, it is packed with those undesirable nutrients, and scores lower than a particular threshold for the more desirable nutrients, the model is set up in such a way that we are prevented from using any of the points gained from protein, namely, the desirable nutrient in that food or drink. That protein restriction is in place to prevent foods that are high in calories, saturated fat, sugar and salt but high in protein from being classified as healthy. This is an important point and I will come back to it later in the context of dairy products, particularly, cheese.
On my next slide members will see I have set out the nutritional composition of milk. This is based on 100g of milk, which is about half a glass of milk. Members will see that on the slide I have three columns: whole milk, skimmed milk and semi-skimmed milk. Milk contains a mixture of nutrients and I have highlighted on the slide those nutrients that are used to assess milk using the model to determine if it is healthy or unhealthy. When one puts milk through the model, whether whole milk, semi-skimmed milk or skimmed milk, each category is classified as or deemed to be healthy. As with many other dairy products milk is a rich source of calcium, as I have highlighted on the slide, and calcium is an essential nutrient. It is important for growth, development of bone as well as several other functions such as blood clotting and neurotransmisison. It is of particular importance to children and especially children between nine and 18 years because that is a period of rapid growth and development.
The next slide shows the nutritional composition of hard cheese. We use 100g of cheese because the model works with 100g of a food or drink. The committee may be aware that an Irish child consumes a good deal less than 100g of cheese per day. I have highlighted these points on the slide but because cheese is so high in calories, saturated fat and salt, using the model I describe it is classified as a "less healthy" food. I refer to the point I made about protein. Although cheese contains protein, the points that come from protein cannot be used in the model because cheese does not contain enough of the other desirable nutrients. One might say this is an unfair assessment of cheese and to address this I ask the committee to examine the next slide. I am afraid it is a busy slide but I trust it highlights the point I am trying to make. The slide lists approximately 50 cheeses on sale in the United Kingdom, including cheddar and so on. I draw the committee's attention to the second column from the left, entitled "total score" from the current model. The committee will note that scores for all the cheeses, bar one, are well above the score of 4 and a score of 4 is the upper threshold for classifying a food or drink as being healthy. In addition, if the protein rule or restriction did not exist and if it were increased or completely removed, cheeses would still retain the classification of "less healthy" because of their calorie, saturated fat and salt contents. This raises an important question. If cheese is labelled "less healthy" and the marketing of cheese is restricted between 6 p.m. and 9 p.m., is this likely to be problematic to the health of children in Ireland with respect to their nutrient intake?
I refer to the composition of cheese. We have already stated that it is rich in calories, saturated fat and salt. I will not go through slide No. 9 in detail but it is evident from several scientific studies in Ireland that children in Ireland are already consuming enough, or too much, fat, sugar and salt as it stands. Therefore a reduction in the intake of any food or drink rich in fat, sugar or salt may have beneficial effects for children. Not only are children consuming too much fat, sugar and salt, but the inclusion in the diets of these less desirable nutrients, fat, sugar and salt, contributes to the fact that one in four of school-age children and one in five teenagers in Ireland is overweight or obese. In itself, this is a public health issue.
Let us consider calcium. As I remarked already, cheese is a rich source of calcium. Unlike the consumption of fat, sugar and salt, children in Ireland are not consuming enough calcium. The table on the right hand side of the slide on display highlights the recommendations with respect to calcium intake at different ages or life stages. I have drawn a highlight around the ages between nine through 13 years and 14 through 16 years. From nine to 18 years, the recommendations are that children should consume approximately 1,300 mg of calcium per day. The notes on the left hand side of the slide outline that children are consuming inadequate amounts of calcium in Ireland. Therefore the problem with restricting the advertising of cheese is that we may see less calcium being consumed by children than is the case currently, and the current intake of calcium is already lower than recommended.