Lisa Middleton On-The-Go Drink Health Interview

Lisa Middleton On-The-Go Drink Health Interview

A new report has uncovered the better and worse choices from a selection of on-the-go drinks, shedding new light on the category often criticised for its role in Australia's high level of obesity.

According to the Australian Institute of Health and Welfare (2016), diets low in fruit and vegetables and high in saturated fat, sodium and sweetened beverages are some of the biggest dietary risk factors contributing to the total burden of disease in this country. Based on the connection between diet and disease, the purpose of the -Nutritional Analysis of Select On-the-Go Drinks' study was to help consumers make better choices for their health when it comes to on-the-go drink options.

Nutritionist Dr Rebecca Reynolds and Ms Sophia Lin, researchers from UNSW's School of Public Health and Community Medicine, analysed a selection of 21 on-the-go drinks. This analysis included energy, macronutrients and seven micronutrients (including calcium, sodium and vitamins C and E). Each drink was assigned an Estimated Nutritional Quality (ENQ) score based on levels of these nutrients as well as approximated fruit and vegetable serves. This scoring system was based on certain assumptions (including assumptions about the ingredients contained where recipes were not available and is therefore to be used as a guide only).

The ENQ findings include:
From a total possible score of 40, the Boost Juice Two & Five (score 32), the Boost Protein Supreme (score 23) and the Super Nudie Green (score 22) were estimated to be the most nutritionally sound of all the drinks studied per 100mL. Both Boost Juice drinks contained blended fruit and/or vegetables as well as added micronutrient -boosters' which contributed to their high scores. The Nudie drink's high score was partly due to its fruit and vegetable ingredients
Drinks that contained high levels of added sugars and little beneficial nutrition received lower scores. Surprisingly, an iced tea drink was among the least nutritious drink (score 14). An energy drink (score 10) and a cola drink (score 11) scored the lowest out of the 21 drinks studied
Two Boost Juice drinks scored just over double that of a soft drink or energy drink and eight out of the nine Boost Juice drinks studied scored average or above average of all drinks tested

Dr Rebecca Reynolds advises that when choosing drinks on-the-go, consumers need to look at the total nutrition of a drink and not to just focus on one aspect like sugar, fat or energy. This is because drinks are never made up of just one nutrient such as fat or just have one nutritional characteristic such as energy.

'Not all on-the-go drinks are equal and some provide much more than just kilojoules. Even though excess weight is a prominent public health issue in this country and the kilojoule content of a drink portion is important, what's also important is whether a drink contains fruit and vegetables; especially blended vegetables."

'Blended fruits and vegetables provide numerous beneficial nutrients, including fibre which can help with appetite regulation," said Dr Reynolds.

'Other factors that contribute to our increasing obesity problem include a high intake of free sugars, especially added ones, and excessive portion sizes. This study highlights that when consumed in a way that suits individual energy needs, such as monitoring portion size and regularity of consumption, on-the-go drinks containing whole fruits and especially vegetables as blended ingredients - which aren't considered free sugars - can help supply valuable fibre and other healthy nutrients. Water, however, is the best way to hydrate, but in practice, people are going to choose non-water on-the-go drinks, and it's important to help them make better choices," added Dr Reynolds.

Additional findings per serve:
While higher in energy, one serve of some dairy-based on-the-go drinks, including the Boost Juice Protein Supreme (525mg/610mL) and the McDonalds Chocolate Thickshake (492mg/447mL) were found to deliver up to half the recommended calcium required each day – useful given 73% of females and half of all males in Australia do not meet recommended calcium intakes
The Boost Juice Protein Supreme (30.1g/610mL) and the Boost Juice Weekend Warrior (21.1g/610mL) contained the highest levels of protein per serve, up to half of the daily intake of 64g of protein recommended for men and 46g of protein recommended for women. Protein is necessary for tissue building and repair. Of the non-Boost Juice products, the McDonalds Chocolate Thickshake (11.9g/447mL) contained the most protein, followed by the Gloria Jeans large Caffe Latte (10.8g/423mL)

When choosing an on-the-go drink, Dr Reynolds recommends the following:
Opt for drinks with as many blended ingredients as possible, as these retain the fibre pulp, for example whole fruit and whole vegetables. Focus on vegetables as these are less energy-dense and less sugary
To protect teeth, choose drinks that are lower in sugar and acid. You can do this by choosing drinks with more vegetable and dairy ingredients
Choose reduced fat dairy ingredients, for example skimmed milk to decrease energy and saturated fat intake
Choose your drink type, portion size, regularity of consumption and use as a meal replacement to suit your lifestyle and to avoid excess energy intake

Eating whole fruits or vegetables and drinking water is the best advice
Avoid focusing on one particular nutrient or nutritional characteristic in ingredients lists and nutrition panels

The -Nutritional Analysis of Select On-the-Go Drinks' study by Dr Rebecca Reynolds and Ms Sophia Lin, researchers from UNSW's School of Public Health and Community Medicine, is an evidence-based analysis of a combination of laboratory testing for product nutrient content conducted by AgriFood Technology and publicly available ingredient lists and nutrition information panel data. The report was commissioned by Boost Juice in June 2016. A total of 21 products were selected for inclusion, including nine products from the current Boost Juice range. Energy, carbohydrate (total carbohydrate, sugars and dietary fibre), protein, fat (total fat and saturated fat), sodium, potassium, calcium and vitamins A, B12, C and E were analysed. Limitations of the study include bias in drink selection, differences in portion sizes, ingredient estimations where recipes were not available and the inability to determine the different fat and carbohydrate types accurately. The study authors do not endorse any of the products listed in the report.

The ENQ scoring matrix was devised to estimate the overall nutritional quality of each selected drink per 100mL. Each drink was scored from -2 (worst score) to 3 (best score) based on the levels of each of the following nutrients or criteria: energy, protein, saturated fat, sugars (natural free sugars vs. added free sugars), dietary fibre, vitamin A, vitamin B12, vitamin C, vitamin E, calcium, potassium, sodium and the study authors' own estimate of servings of fruit and vegetables. The report authors state that this scoring system is prone to substantial error and can be used as a guide only. See supporting fact sheet for more detail.

Fruit and vegetable serves were estimated as follows:
Fruit: fruit serves were estimated based on the Australian Dietary Guidelines (ADGs), which state that one fruit serve is equivalent to 350kJ and/or 150g and/or 150mL pure juice and/or 30g dried fruit, with no differentiation between juiced and blended. If nutrient information was available for more than one aspect (kJ, g and/or mL), then an average was taken.

Vegetables: the ADGs state that one vegetable serve is 75g or approximately 100-350kJ of solid food. They do not provide a recommended equivalent liquid amount as they do for fruit serves. In the present report, the median energy content (175kJ) and/or 75g was taken to be one serve. If nutrient information was available for kJ and g, then an average was taken. Herbs and spices (e.g. mint or ginger) were not calculated as part of vegetable serves, but liquidised vegetables were (with no differentiation between juiced and blended).

Not all recipes were available and therefore product ingredients were based on estimation only.

Interview with Lisa Middleton, Dietitian

Question: Can you talk us through the positives of on-the-go drinks, such as Boost Juices?

Lisa Middleton: A recent study by the University of NSW compared a range of on-the-go drinks and rated them according to overall nutritional quality (estimated nutritional quality – EQN). The drinks with the highest ENQ score were those that contained whole blended fruit and vegetables. So if you choose on-the-go drinks that contain whole blended fruit and vegetables or dairy, like many BOOST juice options, it increases the fibre and vitamin content. Many Australians don't consume enough fruit and vegetables, making a smoothie a convenient way to meet your daily 2 fruit and 5 vegetables serves.


Question: How can we combat the negatives associated with certain on-the-go drinks?

Lisa Middleton: It's important to consider the overall nutrition profile of on-the-go drinks rather than focusing on one nutrient only. On-the-go drinks are popular and available everywhere, and by choosing options that contain blended fruit and vegetables you can make a positive contribution to your daily nutrient intake, rather than going for drinks that are just sugar with no nutrient benefits. Smoothies with whole blended fruit and vegetables and protein can be filling and can be enjoyed as a snack or meal replacement for busy days.


Question: What should we be looking for in on-the-go drink options in terms of health?

Lisa Middleton: As per above, consider the overall nutrient value to provide nutrients such as fibre, vitamins, antioxidants, protein and calcium. Fibre and protein can help to fill you up, calcium is important for bone health and fibre for digestive health. All important nutrients found in blended fruit and vegetable drinks and smoothies.


Question: What should we take from the -nutritional analysis of select on-the-go drinks' report?

Lisa Middleton: Be informed about what is in the on-the-go drinks you choose. Some are more nutritious than others, and always consider your individual needs when it comes to the type and serving size.


Question: Can you talk about the scoring method (ENQ) used?

Lisa Middleton: A scoring system was devised by the study authors to estimate the overall nutritional quality of each selected drink per 100mL, resulting in an Estimated Nutritional Quality (ENQ) score. A number of nutrient criteria were considered, including the amount of kilojoules, macronutrients, micronutrients, plus servings of fruit and vegetables. Drinks were given a total score based on their overall nutrient profile.


Question: Which surprise drinks received the lowest scores per 100ml?

Lisa Middleton: I don't think there were too many surprises in the report when it came to lower scores, general the drinks that contained predominantly sugar and water with very little other nutritious ingredients.

Question: Which drinks were estimated to be the most nutritionally sound per 100ml?

Lisa Middleton: Boost Two and Five Juice
Boost Protein Supreme
Super Nudie Green


Question: How can we include vegetables, in our smoothies?

Lisa Middleton: It's easy to add green goodness to a smoothie by adding nutrient-dense vegetables such as spinach, kale, cucumber and herbs like basil and mint.


Interview by Brooke Hunter