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Health Promotion: Eating

Eating well

There is a lot of nonsense and mis-information told about what food we must eat and what to avoid and the advice keeps changing. Dietary advice is a huge industry and as such the advice has to keep renewing itself - the same old stuff doesn't sell books or products. Yet mankind has been on this planet for 200,000 years without all this information! And the reality of healthy eating is quite simple. It is getting back to what has kept us on the planet these 200,000 years!

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A good diet looks like the graphic above (from The Doctor's Kitchen - see below). It should centre on fresh foods without the processing and packaging so many of us have got used to. The diet should be varied and plant-focussed.

Include fruit, a variety of differently coloured vegetables, fibrous starchy foods like potatoes, a little wholemeal rice, bread and pasta, some beans, pulses, eggs, fish, meat, nuts or other protein, dairy or substitute drinks and yoghurts (soya, almond, rice etc). It can be well favoured with herbs and spices. We don't need much, if any, meat: most vegetarians are perfectly healthy.

Unhealthy foods and drinks are high fat, high salt, high sugar, highly refined and processed should be taken only in small amounts, infrequently. Often, prepared meals and packaged foods have a lot of these unhealthy elements 'hidden' in their long lists of ingredients. And 'take-ways' do not list their ingredients at all!

Most people in the UK consume far too many calories, too much fat, sugar and salt and not enough vegetables, fibre and oily fish. Around 60% of adults are overweight and a better diet and more exercise would correct this for many.

A good diet is delicious, enjoyable, easy and cheap.

Food is not just fuel: it is part of our social life. We should enjoy eating and take pleasure in variety and new experiences. If we eat a good basic diet, a little of what you fancy is fine. It is not healthy to be over-worried about our diet and become fearful of foods. And it can be unhealthy to artificially restrict your diet and miss out on important nutrition. Fad diets can be damaging.

There are huge concerns about the food industry, production methods, additives, hygiene, preservatives, environmental degradation, animal welfare, food miles and so on. We really do need to get back to a more wholesome food industry and diet. We need to reconnect with food production, learn about food from the ground up and make choices based on knowledge and taste rather than the advertising hype or special offers.

Starchy carbohydrates should make up just over a third of the food you eat. They include potatoes, bread, rice, pasta and cereals.

Choose higher fibre or wholegrain varieties, such as wholewheat pasta, brown rice or potatoes with their skins on.
They contain more fibre than white or refined starchy carbohydrates and can help you feel full for longer.

Try to include at least 1 starchy food with each main meal. Some people think starchy foods are fattening, but gram for gram the carbohydrate they contain provides fewer than half the calories of fat.

Keep an eye on the fats you add when you're cooking or serving these types of foods because that's what increases the calorie content – for example, oil on chips, butter on bread and creamy sauces on pasta.

It's recommended that you eat at least 5 portions of a variety of fruit and veg every day. They can be fresh, frozen, canned, dried or juiced.

Getting your 5 A Day is easier than it sounds. Why not chop a banana over your breakfast cereal, or swap your usual mid-morning snack for a piece of fresh fruit?

A portion of fresh, canned or frozen fruit and vegetables is 80g. A portion of dried fruit (which should be kept to mealtimes) is 30g.

A 150ml glass of fruit juice, vegetable juice or smoothie also counts as 1 portion, but limit the amount you have to no more than 1 glass a day as these drinks are sugary and can damage your teeth.

Fish is a good source of protein and contains many vitamins and minerals.

Aim to eat at least 2 portions of fish a week, including at least 1 portion of oily fish.

Oily fish are high in omega-3 fats, which may help prevent heart disease.

Oily fish include: salmon, trout, herring, sardines, pilchards, mackerel
Non-oily fish include: haddock, plaice, coley, cod, tuna, skate, hake

You can choose from fresh, frozen and canned, but remember that canned and smoked fish can be high in salt.

Most people should be eating more fish, but there are recommended limits for some types of fish.

Find out more about fish and shellfish

Saturated fat
You need some fat in your diet, but it's important to pay attention to the amount and type of fat you're eating.

There are 2 main types of fat: saturated and unsaturated. Too much saturated fat can increase the amount of cholesterol in the blood, which increases your risk of developing heart disease.

On average, men should have no more than 30g of saturated fat a day. On average, women should have no more than 20g of saturated fat a day. Children under the age of 11 should have less saturated fat than adults, but a low-fat diet is not suitable for children under 5.

Saturated fat is found in many foods, such as: fatty cuts of meat, sausages, butter, hard cheese, cream, cakes, biscuits, lard, pies
Try to cut down on your saturated fat intake and choose foods that contain unsaturated fats instead, such as vegetable oils and spreads, oily fish and avocados.

For a healthier choice, use a small amount of vegetable or olive oil, or reduced-fat spread instead of butter, lard or ghee. When you're having meat, choose lean cuts and cut off any visible fat.

All types of fat are high in energy, so they should only be eaten in small amounts.

Sugar
Regularly consuming foods and drinks high in sugar increases your risk of obesity and tooth decay.

Sugary foods and drinks are often high in energy (measured in kilojoules or calories), and if consumed too often can contribute to weight gain. They can also cause tooth decay, especially if eaten between meals. Free sugars are any sugars added to foods or drinks, or found naturally in honey, syrups and unsweetened fruit juices and smoothies. This is the type of sugar you should be cutting down on, rather than the sugar found in fruit and milk.

Many packaged foods and drinks contain surprisingly high amounts of free sugars.

Free sugars are found in many foods, such as: sugary fizzy drinks, sugary breakfast cereals, cakes, biscuits, pastries and puddings, sweets and chocolate, alcoholic drinks

Food labels can help. Use them to check how much sugar foods contain. More than 22.5g of total sugars per 100g means the food is high in sugar, while 5g of total sugars or less per 100g means the food is low in sugar.

Get tips on cutting down on sugar in your diet

Eating too much salt can raise your blood pressure. People with high blood pressure are more likely to develop heart disease or have a stroke.

Even if you do not add salt to your food, you may still be eating too much.

About three-quarters of the salt you eat is already in the food when you buy it, such as breakfast cereals, soups, breads and sauces.

Use food labels to help you cut down. More than 1.5g of salt per 100g means the food is high in salt.

Adults and children aged 11 and over should eat no more than 6g of salt (about a teaspoonful) a day. Younger children should have even less.

Get tips on cutting down on salt in your diet

As well as eating healthily, regular exercise may help reduce your risk of getting serious health conditions. It's also important for your overall health and wellbeing.

Read more about the benefits of exercise and physical activity guidelines for adults.

Being overweight or obese can lead to health conditions, such as type 2 diabetes, certain cancers, heart disease and stroke. Being underweight could also affect your health.

Most adults need to lose weight by eating fewer calories.

If you're trying to lose weight, aim to eat less and be more active. Eating a healthy, balanced diet can help you maintain a healthy weight.

Check whether you're a healthy weight by using the BMI healthy weight calculator.

Start the NHS weight loss plan, a 12-week weight loss guide that combines advice on healthier eating and physical activity.

If you're underweight, see underweight adults. If you're worried about your weight, ask your GP or a dietitian for advice.

You need to drink plenty of fluids to stop you getting dehydrated. The government recommends drinking 6 to 8 glasses every day. This is in addition to the fluid you get from the food you eat.

All non-alcoholic drinks count, but water, lower fat milk and lower sugar drinks, including tea and coffee, are healthier choices.

Try to avoid sugary soft and fizzy drinks, as they're high in calories. They're also bad for your teeth.

Even unsweetened fruit juice and smoothies are high in free sugar.

Your combined total of drinks from fruit juice, vegetable juice and smoothies should not be more than 150ml a day, which is a small glass.

Remember to drink more fluids during hot weather or while exercising.

Some people skip breakfast because they think it'll help them lose weight.

But a healthy breakfast high in fibre and low in fat, sugar and salt can form part of a balanced diet, and can help you get the nutrients you need for good health.

A wholegrain lower sugar cereal with semi-skimmed milk and fruit sliced over the top is a tasty and healthier breakfast.


Check your Body Mass Index here

We normally do not need to buy extra vitamins and food supplements - we get more than we can use in a normal diet. There is, however, a tendency to vitamin D deficiency , especially during the winter months in the UK and if you work indoors and wear covered-up dress. All about vitamins and minerals

Get some good recipe books and websites to bring joy and creativity into our diets and stimulate our own imaginative juices to design our own recipes.

The NHS Eatwell Guide is a good starting point to discover the ins and outs of a good diet with recipes and ideas for changing your diet.

The Doctor's Kitchen is a great resource set up by an NHS GP, Dr Rupy Aujla. He has written a couple of really sensible books and a fascinating Podcast. His website has loads of free recipes which are delicious, nutritious and easy to cook.
Above all, he explains the basic requirements of a good diet and its relationship to health and illness.

The Plant Power Doctor is a another useful website. NHS GP, Dr Gemma Newman has written an excellent book of the same name. It is really comprehensive and describes the fundamentals of a whole food, plant-based diet for health. There are many recipes to get you started. Usefully it gives evidence based information - with the references - to back it all up. You don't have to buy the book of course as there is a lot of information on her website.

What do food labels mean?

You hear about the recommended "5-a-day" portions of fruit and vegetables - what makes up 5 a day?

Our portions are often too big - using a smaller plate, eating more slowly and concentrating on your food (not eating whilst watching TV or reading) can make it seem as though you are eating more then your reduce portion size.

Bloating and other gut problems? Here are tips for a happier digestive system.

The BBC Food Website also has useful information about different types of diet

What is the gut microbiome? We live in harmony with a surprising number and variety of organisms - bacteria, fungi and viruses. There are more of these together than pour own cells. There is a great deal still to be understood about they role they play in health and disease. It seems the gut microbiome is strongly affected by our diet and general lifestyle and the knock on effect on our health can be surprisingly powerful. This is an introductory article in the Guardian

IBS (Irritable Bowel Syndrome) and diet
IBS is very common and can be responsible for stomach cramps, bloating, diarrhoea and constipation. It may be lifelong, causing significant misery but can be improved by dietary changes. Other lifestyle adjustments can be helpful too.
This excellent 35 min video from a team of NHS dieticians covers many of the dietary issues about IBS based on the current best evidence and answering questions on all the current ideas and advice.
There is a good NHS guide to the Low FODMAP diet which can help many people with symptoms of IBS.

Feeling bloated, can't lose weight, always tired?
This advice from BANT (British Association for Nutrition and Lifestyle Medicine) may be worth trying:
Limit whole grains to their natural, unprocessed form eg. wild and brown rice, quinoa, millet etc.

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