- Executive summary table 1 Summary of two most useful simulation scenarios to demonstrate both the achievement of the public health goal for red and red processed meat, and the worst-case scenario of no replacement
- Executive summary table 2 Summary of percentage of the population below the LRNI for key nutrients among children and young people aged 2 to 15 years living in Scotland at baseline (2024) and following a reduction in red and red processed meat to achieve a 20% or 35% reduction in the population average “total meat” intake for children and young people, together with a 20% reduction in dairy and no replacement
- Abbreviations table
- Table 1 Characteristics of children and young people aged 2 to 15 years living in Scotland who completed at least one dietary recall, 2024
- Table 2 Example of hierarchy of food groups evaluated for the food category, ‘milk and milk products’
- Table 3 Example of hierarchy of food groups evaluated for the food category, ‘meat and meat products’.
- Table 4 Most commonly reported meat-containing food items within the top five contributing sub food groups to meat consumption among children and young people aged 2 to 15 years living in Scotland, 2024.
- Table 5 Daily maximum intake of red and red processed meat required to achieve a 20% or 35% reduction in “total meat”, for the entire population of 2- to 15-year-olds and by age group.
- Table 6 Summary of simulation scenarios for reducing meat and dairy among children and young people aged 2 to 15 years in Scotland.
- Table 7 Definition of achieving Scottish Dietary Goals in children and young people aged 2 to 15 years living in Scotland.
- Table 8 Summary of percentage of the population below the LRNI for key nutrients among children and young people aged 2 to 15 years living in Scotland at baseline (2024) and following a reduction in red and red processed meat to achieve a 20% or 35% reduction in “total meat” together with a 20% reduction in dairy and no replacement.
- Table 9 Summary of percentage of the population below the threshold for biomarkers of nutritional status in NDNS, years 9-11 (2016/17-2018/19).
- Table 10 Summary of impacts of reducing meat and dairy on the achievement of the Scottish Dietary Goals among children and young people aged 2 to 15 years living in Scotland, 2024.
4. Simulation results
4.1. Energy and nutrient intake
Energy intake decreased across all scenarios (Annexe 4 and Annexe Tables 3). The average decrease ranged from 108kcal/d (~7% of baseline energy intake) when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy was reduced by 20%, with no replacement, to 15kcal/d (<1% of baseline energy intake) when “total meat” was reduced by 35% and was replaced with oily fish along with a 20% dairy reduction replaced with plant-based dairy alternatives. About two-thirds of the decrease in energy intake in the scenarios without replacement and a 20% decrease in both meat and dairy was attributed to dairy, and the rest (about one-third) to meat.
Protein intake decreased across all scenarios except when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and replaced with chicken (Annexe 4 and Annexe Tables 3). The average change ranged from a decrease of 9g/day (~15% of baseline protein intake) when “total meat” was reduced by 35% and dairy by 20% with no replacement, to an increase of 0.2g/day (<1% of baseline protein intake) when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and replaced with chicken. About half of the decrease in protein intake in the scenarios without replacement and a 20% decrease in both meat and dairy was attributed to dairy, and the rest (about half) to meat.
Despite these decreases, average protein intake remained above age-specific RNIs across all scenarios and the percentage of children aged 2 to 10 years below the RNI remained <3% (Annexe Tables 3). However, the percentage of young people aged 11 to 15 years below the RNI increased by 7-11 percentage points when “total meat” or red and red processed meat were reduced to achieve a 35% reduction in “total meat” and not replaced or replaced with vegetables or pulses and legumes.
There are two chemical forms of iron in our diets: haem iron and non-haem iron. Haem iron is found in meat and fish whereas non-haem iron is found in both animal and plant foods. Haem iron is more efficiently absorbed than non-haem iron.
The average change in iron intake ranged from a decrease of 0.4mg/day (~4% of baseline iron intake) when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy by 20% with no replacement, to an increase of 0.4mg/day (~4% of baseline iron intake) when “total meat” was reduced by 35% and replaced with egg, and dairy was reduced by 20% and replaced with plant-based dairy alternatives (Annexe 4 and Annexe Tables 3). However, most of this increase in iron is non-haem iron which is less efficiently absorbed than haem iron. Thus, for individuals with an increased need for iron, such as females of reproductive age, and individuals who have low iron intakes to begin with, further consideration of the chemical form of iron may be warranted. About 10% of the decrease in iron intake in the scenarios without replacement and a 20% decrease in both meat and dairy was attributed to dairy, and the rest (about 90%) to meat.
Average iron intake remained above age-specific RNIs across all scenarios for children aged 2 to 4 years and all scenarios except when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy by 20% with no replacement among children aged 5 to 10 years (Annexe Tables 3). The percentage of children aged 2 to 10 years below the LRNI was <5% across all scenarios (Figure 11 and Annexe Tables 3). However, at baseline, young people aged 11 to 15 years, on average, had iron intakes below the RNI and across all scenarios, even those in which iron increased, iron intakes in this age group remained below the RNI (Annexe Tables 3). At baseline, nearly one-third (31%) of young people aged 11 to 15 years were below the LRNI for iron. However, this percentage did not change substantially across any of the scenarios – ranging from an increase of 5 percentage points when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy by 20% with no replacement to a decrease of 3.5 percentage points when “total meat” was reduced by 35% and replaced with egg (Figure 11 and Annexe Tables 3).
Calcium intake decreased across all scenarios (Annexe 4 and Annexe Tables 3). The average change ranged from a decrease of 105mg/day (~13% of baseline calcium intake) when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy by 20% with no replacement, to a decrease of 29mg/day (~3% of baseline calcium intake) when meat and dairy were replaced with plant-based meat and dairy alternatives. More than 90% of the decrease in calcium intake in the scenarios without replacement and a 20% decrease in both meat and dairy was attributed to dairy, and the rest (less than 10%) to meat.
Average calcium intake was above the RNI among children aged 2 to 10 years across all scenarios (Annexe Tables 3). The percentage of children aged 2 to 10 years below the LRNI was <5% across all scenarios (Figure 12 and Annexe Tables 3). However, at baseline, young people aged 11 to 15 years, on average, had calcium intakes below the RNI and across all scenarios (Annexe Tables 3). At baseline, 15% of young people aged 11 to 15 years were below the LRNI for calcium, and this percentage did not change substantially across any of the scenarios – ranging from an increase of 0.6 percentage points when “total meat” was reduced by 35% and dairy by 20% and they were replaced with plant-based meat and dairy alternatives to an increase of 5 percentage points when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy by 20%, with no replacement (Figure 12 and Annexe Tables 3).
Iodine intake decreased across all scenarios (Annexe 4 and Annexe Tables 3). The average change ranged from a decrease of 19µg/day (~14% of baseline iodine intake) when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy by 20% with no replacement, to a decrease of 4.7µg/day (~3% of baseline iodine intake) when red and red processed meat was replaced with egg. More than 90% of the decrease in iodine intake in the scenarios without replacement and a 20% decrease in both meat and dairy was attributed to dairy, and the rest (less than 10%) to meat.
Average iodine intake was above the RNI among children aged 2 to 10 years across all scenarios (Annexe Tables 3). The percentage of children 2 to 10 years below the LRNI was 8-10% at baseline, and this percentage increased by 3-4 percentage points when “total meat” was reduced by 35% and dairy by 20% with no replacement (Figure 13 and Annexe Tables 3). However, it decreased by 1-3 percentage points when meat was replaced with egg. At baseline, young people aged 11 to 15 years, on average, had iodine intakes just at or below the RNI, and across all scenarios this dropped further below the RNI (Annexe Tables 3). At baseline, 24% of young people aged 11 to 15 years were below the LRNI for iodine, and this percentage increased by 8 percentage points when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy by 20% with no replacement (Figure 13 and Annexe Tables 3). In contrast, the percentage below the LRNI decreased by 6 percentage points when meat was replaced with egg.
Selenium intake decreased across all scenarios in which meat was not replaced or replaced with pulses and legumes, vegetables or plant-based meat alternatives, and increased when meat was replaced with egg, oily fish or chicken (Annexe 4 and Annexe Tables 3). The average change in selenium intake ranged from a decrease of 4µg/day (~11% of baseline selenium intake) when “total meat” was reduced by 35% and dairy by 20% with no replacement, to an increase of 2µg/day (~6% of baseline selenium intake) when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and replaced with egg. Slightly more than one-third of the decrease in selenium intake in the scenarios without replacement and a 20% decrease in both meat and dairy was attributed to dairy, and the rest (slightly more than two-thirds) to meat.
Average selenium intake remained above the RNI among children aged 2 to 10 years across all scenarios (Annexe Tables 3). The percentage of children 2 to 4 years below the LRNI was <1% at baseline and remained <2% across all scenarios (Figure 14 and Annexe Tables 3). The percentage of children 5 to 10 years below the LRNI was 2% at baseline and increased by 3 percentage points when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and not replaced or replaced with vegetables. At baseline, young people aged 11 to 15 years, on average, had selenium intakes below the RNI, and across all scenarios, even when selenium intake increased, it remained below the RNI (Annexe Tables 3). At baseline, 21% of young people aged 11 to 15 years were below the LRNI for selenium, and this percentage increased by 7 percentage points when “total meat” was reduced by 35% and not replaced or replaced with vegetables (Figure 14 and Annexe Tables 3). In contrast, the percentage below the LRNI decreased by 3 percentage points when meat was replaced with egg.
Zinc intake decreased across all scenarios except when meat was replaced with plant-based meat alternatives (Annexe 4 and Annexe Tables 3). The average change ranged from a decrease of 1mg/day (~15% of baseline zinc intake) when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy by 20% with no replacement, to an increase of 0.2mg/day (~3% of baseline zinc intake) when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and replaced with plant-based meat alternatives. About half of the decrease in zinc intake in the scenarios without replacement and a 20% decrease in both meat and dairy was attributed to dairy, and the rest (about half) to meat.
Average zinc intake was below the RNI across all age groups at baseline and remained below the RNI even in scenarios where zinc intake increased (Annexe Tables 3). The percentage of children aged 2 to 10 years below the LRNI was 9% at baseline and increased by up to 7 percentage points in children 2 to 4 years and 9.5 percentage points in children 5 to 10 years. At baseline, 26% of young people aged 11 to 15 years were below the LRNI and this increased by 14 percentage points when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy by 20% with no replacement (Figure 15 and Annexe Tables 3).
Vitamin B12 intake decreased in all scenarios except when meat was replaced with oily fish, but remained above the RNI across all age groups (Annexe 4 and Annexe Tables 3). The average change in vitamin B12 intake ranged from a decrease of 0.8µg/day (~19% of baseline vitamin B12 intake) when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy was reduced by 20% with no replacement, to an increase of 0.3µg/day (~7% of baseline vitamin B12 intake) when “total meat” was reduced by 35% and replaced with oily fish along with a 20% reduction in dairy replaced by plant-based dairy alternatives. About three-fourths of the decrease in vitamin B12 intake in the scenarios without replacement and a 20% decrease in both meat and dairy was attributed to dairy, and the rest (about one-fourth) to meat.
The percentage of children aged 2 to 10 years below the RNI remained <2% across all scenarios (Figure 16 and Annexe Tables 3). The percentage of young people aged 11 to 15 years below the RNI was 5% at baseline, and increased by a maximum of 3 percentage points when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy was reduced by 20% with no replacement.
Key messages: impact of reducing meat and dairy on energy and nutrient intake
- Under the most useful scenario to demonstrate both the achievement of the public health goal for red and red processed meat, and the worst-case scenario of no replacement, about 5-6 percentage points more of the population will fall below the LRNI for iodine and zinc, and about 1-2 percentage points more of the population will fall below the LRNI for iron, calcium, selenium, and vitamin B12 in reducing meat and dairy by 20%.
- Even under the most extreme scenarios, average intake of protein and vitamin B12 remained above the RNI for all age groups.
- Average iron and calcium intake remained above the RNI and the percentage of children below the LRNI was <5% across nearly all scenarios for children aged 2 to 10 years. However, at baseline, young people aged 11 to 15 years, on average, had iron and calcium intakes below the RNI and across all scenarios, iron and calcium intakes in this age group remained below the RNI.
- Average iodine intake was above the RNI among children aged 2 to 10 years across all scenarios but the percentage below the LRNI was 8-10% at baseline, and increased by 3-4 percentage points when ”total meat” was reduced by 35% and dairy was reduced by 20%, with no replacement. In young people aged 11 to 15 years, average iodine intake was just at or below the RNI, and across all scenarios this dropped further below the RNI, increasing the percentage below the LRNI by up to 8 percentage points when red and red processed meat was reduced to achieve a 35% reduction in “total meal” and dairy was reduced by 20%, with no replacement. Replacement of meat with egg attenuated some of these effects.
- Average selenium intake remained above the RNI among children aged 2 to 10 years and the percentage of children below the LRNI remained low (<10%) across all scenarios. However, among young people aged 11 to 15 years, average selenium intake was below the RNI at baseline and across all scenarios, even when selenium intake increased (which occurred when meat was replaced with egg, oily fish or chicken).
- At baseline and across all scenarios, average zinc intake was below the RNI. The percentage of children and young people below the LRNI increased by up to 7 percentage points in children 2 to 4 years, 9.5 percentage points in children 5 to 10 years, and 14 percentage points in young people 11 to 15 years when red and red processed meat was reduced to achieve a 35% reduction in “total meal” and dairy was reduced by 20%, with no replacement.
- When meat and dairy were both reduced and not replaced, most of the decreases in iron and selenium were attributed to reductions in meat whereas most of the decreases in calcium, iodine and vitamin B12 were attributed to reductions in dairy. The contribution of meat and dairy to decreases in protein and zinc in these scenarios was relatively equivalent.
4.2. Scottish Dietary Goals
The impact of the 27 simulations on the percentage of children and young people aged 2 to 15 years in Scotland who met the Scottish Dietary Goals (Table 7) was evaluated. We did not estimate the impact on oily fish given that this was assessed using a food frequency question instead of Intake24.
Table 7
Definition of achieving Scottish Dietary Goals in children and young people aged 2 to 15 years living in Scotland.
| Current Scottish Dietary Goal (13) | Definition for DISH survey | |
|---|---|---|
| Energy | Energy density of the diet to be ≤125 kcal/100g | Energy density of food and milk consumed to be ≤125 kcal/100g |
| Total fat | Total fat intake to be ≤35% of food energy | Total fat intake to be ≤35% of energy excluding ethanol |
| Saturated fat | Saturated fat intake to be ≤11% of food energy | Saturated fat intake to be ≤10% of energy excluding ethanol |
| Trans fat | Trans fat intake to be <1% of food energy | Trans fat intake to be <1% of energy excluding ethanol |
| Free sugars | Free sugars intake to be ≤5% of total energy | Free sugars intake to be ≤5% of energy excluding ethanol |
| Total carbohydrate | Total carbohydrate intake to be ~50% of total energy | Total carbohydrate intake to be 45-55% of energy excluding ethanol |
| Fibre | Fibre intake to be ≥30 g/day in adults and in line with Scientific Advisory Committee on Nutrition (SACN) recommendations in children: ≥15 g/day for 2-4y ≥20 g/day for 5-10y ≥25 g/day for 11-15y | Fibre intake to be: ≥15 g/day for 2-4y ≥20 g/day for 5-10y ≥25 g/day for 11-15y |
| Salt | Salt intake to be <6 g/day in adults | Salt intake to be: <2 g/day for 2-3y <3 g/day for 4-6y <5 g/day for 7-10y <6 g/day for 11-15y |
| Fruit and vegetables | Fruit and vegetable consumption to be >400 g/day in adults | Fruit and vegetable consumption to be >400 g/day in adults |
| Red and red processed meat | Red and red processed meat consumption to be ≤70 g/day in adults | Red and red processed meat consumption to be ≤70 g/day in adults |
All scenarios in which meat and dairy were replaced increased the percentage of children and young people meeting the goal for energy density (Annexe 5). The increase ranged from 0.7 percentage point when meat was replaced with oily fish to 5 percentage points when red and red processed meat was replaced with vegetables.
All scenarios increased the percentage of children and young people meeting the goal for total fat (Annexe 5). The increase ranged from 1 percentage point when meat was replaced with oily fish to 15 percentage points when red and red processed meat was replaced with chicken.
All scenarios increased the percentage of children meeting the goal for saturated fat (Annexe 5). The increase ranged from 6 percentage points when meat was replaced with eggs to 15 percentage points when red and red processed meat was replaced with chicken.
There was little impact in any of the scenarios on the percentage of children and young people meeting the Scottish Dietary Goal for trans fat: 99% of children and young people met the goal at baseline and in all scenarios (Annexe Tables 3).
All scenarios slightly decreased the percentage of children and young people meeting the goal for free sugars (Annexe 5). The decrease ranged from 1 percentage point when only dairy was reduced with no replacement to 4.5 percentage points when red and red processed meat was replaced with pulses and legumes (reminder: the replacement for pulses and legumes included baked beans which contained sugar, see Annexe 2).
All scenarios decreased the percentage of children and young people meeting the goal for total carbohydrates (Annexe 5). The decrease ranged from 1 percentage point when red and red processed meat was replaced with eggs to 10 percentage points when red and red processed meat was not replaced.
All scenarios in which meat and dairy were replaced increased the percentage of children and young people meeting the goal for fibre (Annexe 5). The increase ranged from 2 percentage point when red and red processed meat was replaced with egg to 7 percentage points when meat was replaced with plant-based meat alternatives.
All but one scenario – when “total meat” was reduced by 35% and replaced with plant-based meat alternatives – increased the percentage of children and young people meeting the goal for salt (Annexe 5). The increase ranged from 0.7 percentage point when “total meat” was reduced by 20% and replaced with plant-based meat alternatives to 8 percentage points when red and red processed meat was reduced and not replaced.
In scenarios wherein meat was replaced with pulses and legumes or vegetables, a slightly higher percentage (2-5 percentage points) of children and young people met the goal for fruit and vegetables (Annexe 5).
At baseline, 82% of children met the Scottish Dietary Goal for red and red processed meat (Annexe Tables 3). All scenarios that met a 20% or 35% reduction in “total meat” through reductions in red and red processed meat increased the percentage of children and young people meeting the goal for red and red processed meat to 100%. The scenarios with 20% or 35% reductions in “total meat” increased the percentage of children and young people meeting the goal for red and red processed meat to 88% and 93%, respectively.
Key messages: impact of reducing meat and dairy on adherence to the Scottish Dietary Goals
- All scenarios increased the percentage of children and young people meeting the goal for red and red processed meat.
- Replacing meat with pulses and legumes or vegetables slightly increased the percentage of children and young people meeting the goal for fruit and vegetables.
- Replacing meat and dairy with a variety of products, including pulses and legumes, vegetables, eggs, oily fish, plant-based alternatives, or chicken can increase the percentage of children and young people meeting the goals for energy density, total fat, saturated fat, fibre, and salt.
- Reducing meat and dairy may slightly reduce the percentage of children and young people meeting the goals for free sugars and total carbohydrates.
- Generally, the impacts were larger when red and red processed meat were reduced rather than “total meat”.
4.3. Greenhouse gas emissions
On average, in 2024, dietary greenhouse gas emissions among children and young people aged 2 to 15 years living in Scotland were 3.65 kgCO2e per day. Emissions were lowest for 2- to 4-year-olds (2.98 kgCO2e per day) and highest for 11- to 15-year-olds (4.00 kgCO2e per day). Dietary greenhouse gas emissions were significantly reduced in all scenarios except when meat was not reduced (i.e., ‘dairy only’ scenario) (Figure 17).
The average decrease ranged from 1.01 kgCO2e per day (~28% of baseline emissions) when red and red processed meat was reduced to achieve a 35% reduction in “total meat” and dairy was reduced by 20% with no replacement, to 0.17 kgCO2e per day (~5% of baseline emissions) when dairy was reduced by 20%.
Key messages: impact of reducing meat and dairy on greenhouse gas emissions
- On average, in 2024, dietary greenhouse gas emissions among children and young people aged 2 to 15 years living in Scotland were 3.65 kgCO2e per capita per day. This is slightly lower than the greenhouse gas emissions associated with adult (16+ years) diets in Scotland in 2021 (4.17 kgCO2e per capita per day).
- Dietary greenhouse gas emissions were significantly reduced in all scenarios except when meat was not reduced (i.e., ‘dairy only’ scenario).