UPFRONT ALTERNATIVE SUGARS Greater Manchester schools and nurseries Coconut set to improve sugar dental care A £1.5 million pound action plan to improve children’s oral health in Oldham, Rochdale, Salford and Bolton Elaine Gardner, British Dietetic Association (BDA) has been launched. Spokesperson, discusses the sugar content in coconut The investment aims to reduce both sugar and provides related oral health advice. the number of children aged five and under affected by tooth decay and those needing a general anaesthetic to have their teeth taken out due to decay. Nearly all the cash will be spent on prevention work such as supervised tooth-brushing programmes, tooth- brush and toothpaste packs distributed via health visitors and dental practices and increased prevention messages. The announcement is being made by Greater Manchester Health and Social Care Partnership, the body overseeing the devolution of the £6 billion health and care budget in the city region. The wide-ranging three-year programme aims to: • Increase the number of children Name: Coconut (palm) sugar. Coconut sugar undergoes little processing under the age of five accessing dental so it retains some of the natural vitamins, care, with a focus on high-risk groups What is it? It is made from the sap of the minerals (notably iron, zinc, calcium and and under ones coconut palm tree and looks like brown, potassium), fibre (inulin) and antioxidants. • Expand supervised tooth brushing granulated sugar. Palm sugar is similar but The nutrients in coconut sugar are likely to in nurseries, schools and other early- made from a different type of palm tree. have a minimal effect unless you eat large years settings Jaggery is a concentrate of date, sugar cane amounts, when any benefit will be out- • Extend the provision of preventative juice and/or palm sap without separation weighed by all the sugar you’re eating. advice to families including through of the molasses. It has a fudge-like consist- Coconut sugar has the same number of training those working with children ency and is used extensively by the Asian calories as table sugar (16 calories per to share these messages. population (particularly those from India) to teaspoon). sweeten foods, breads and sweets. In Greater Manchester, approximately All these products are similar and are Oral health impact: All these products 36% of children aged five have tooth decay mainly composed of sucrose (table sugar) contain high levels of fermentable carbohy- compared with 25% across England. with smaller quantities of glucose and drates so are cariogenic. In 2015/6 treatment of preventable fructose. Coconut sugar can contain 70-80% tooth decay in children cost Greater sucrose and jaggery about 50% sucrose. Advice for patients: Treat these products Manchester circa £20 million. in the same way as table sugar and use Found in? Available from shops, health food sparingly. Oral hygiene needs to be main- stores and online. tained as they are harmful to teeth. Death Notice Effect on general health:Coconut palm It is with great sadness that we report sugar (and palm sugar and jaggery) is the death of Professor Jimmy Steele. essentially a fairly pure form of sugar and like Find out more about the British Dietetic Association at: A full obituary will follow in a ordinary sugar it can contribute to obesity, www.bda.uk.com. subsequent issue. © egal/iStock/Getty Images Plus; ©JannHuizenga/iStock/Gettydiabetes Images Plus and heart disease. Coming up: Lactose (milk sugar) BRITISH DENTAL JOURNAL | VOLUME 223 NO. 10 | NOVEMBER 24 2017 749 Official j ournal of the British Dental Associati on. .