Dried fruit and public health - what does the evidence tell us?

A scientific workshop held in the UK explored the potential contribution of traditional dried fruits to public health, identified gaps in the evidence and addressed priorities for research. Presentations considered the categorisation and composition of dried fruits; dried fruit and gastrointestinal health; the polyphenol content of dried fruits and their potential contribution to health; dried fruit and appetite in relation to the psychology of snacking and obesity; dried fruit and dental health including its role as a snack; and conflicts in public health advice for dried fruits. A round table discussion explored the contribution of dried fruit to "five a day" fruit and vegetable intake and fibre intake, whether dried fruits have equivalence with fresh in terms of dietary advice, advice on snacking in relation to dental health and appetite control, informing the public about different types of dried fruits and avoiding consumer confusion, and future research requirements.

A review of economic evaluations for beneficial health outcomes of micronutrient and long-chain omega-3 fatty acid supplementation.

A comprehensive review of the literature identified 13 papers exploring economic evaluations of supplementation with micronutrients or long-chain omega-3 fatty acids in developed countries. Evidence of efficacy included single-study-based estimates and estimates based on published meta-analyses or data synthesis. Results suggest that supplementation with specific micronutrients or long-chain omega-3 fatty acids for specific health outcomes, and targeted at particular population groups, may be cost-effective or deliver cost savings for health care providers. While the quality of the analyses was variable and some authors reported considerable uncertainty of the results, the approaches adopted were in the main conservative. This suggests that investigating the potential economic impact of supplementation, particularly where there is good evidence of efficacy and predicted clinical benefit, is informative. Economic evaluations may also be useful to assess whether further nutritional research into particular health outcomes is a good investment of funds.

Dried fruit and dental health.

A comprehensive review of the literature has found that the common perceptions that dried fruits are "sticky", adhere to teeth, and are detrimental to dental health on account of their sugar content are based on weak evidence. There is a lack of good quality scientific data to support restrictive advice for dried fruit intake on the basis of dental health parameters and further research is required. A number of potentially positive attributes for dental health, such as the need to chew dried fruits which encourages salivary flow, and the presence of anti-microbial compounds and of sorbitol, also require investigation to establish the extent of their effects and whether they balance against any potentially negative attributes of dried fruit. Advice on dried fruit consumption should also take account of the nutritional benefits of dried fruit, being high in fibre, low in fat and containing useful levels of micronutrients.

Sugar-fat seesaw: a systematic review of the evidence.

Further to reports of a reciprocal relationship between sugar and fat intakes, this review aimed to provide an in-depth analysis and to determine the likely influence of this relationship on the achievement of population dietary guidelines. Using systematic methods, relevant literature was selected according to preset criteria. A strong and consistent inverse association was found between total sugars and total fat intakes expressed as percentage energy. Fewer studies considered absolute intakes and these reported a positive relationship, which may be influenced by confounding with energy intakes. Evidence for an inverse relationship between percentage energy from fat and extrinsic sugars was weaker and less consistent than for fat and total sugars. Reciprocal relationships were also observed for sugar-saturated fat, sugar-protein, sugar-alcohol, and sugar-starch expressed as percentage energy. Under-reporting of dietary intakes had no major influence on the findings. This review confirms the existence of the sugar-fat seesaw on a percentage energy basis and concludes that it is most likely explained by a combination of mathematical and food compositional effects. This finding is relevant because dietary guidelines are expressed as percentage energy and implies that at the population level multiple guidelines may be difficult to achieve in practice.