Nutrition – a game changer in global healthcare

Fierce political debate rages on both sides of the Atlantic about the rising cost of healthcare and what should be done about it.

Spending on health services in the UK has more than doubled in cash terms in the last decade, growing from £53 billion in 2000-01 to £120 billion in 2010-11; this is equivalent to an increase of around 80 per cent in real terms (1).  In England, 22 per cent of total public spending is devoted to healthcare.

In the USA, more than $2.5 trillion is spent annually on medical care.  But as recently as 1950, Americans spent only about $8.4 billion ($70 billion in today’s dollars).  After adjusting for inflation, Americans now spend as much on health care every ten days as they did in the entire year of 1950 (2).  In the USA, medical spending now represents nearly 20 per cent of gross domestic product (GDP).

The cost of health insurance continues to climb for US companies and workers, with annual family premiums growing at a pace triple that of 2010 and outpacing wage increases (3). The chairman and CEO of Starbucks, Howard Schultz, is quoted as saying that his company spends more money on insurance for its employees than it spends on coffee (4).

New legislation, large-scale reorganisation of health services, changes in insurance schemes and budget cuts are all among the radical measures being taken by governments to address this issue.

There is much less press coverage though about the real game changer with respect to reducing healthcare costs – improving nutrition and lifestyle.

Chronic or non-communicable diseases are the top cause of death worldwide, killing more than 36 million people in 2008.  Cardiovascular diseases were responsible for 48 per cent of these deaths, cancers 21 per cent, chronic respiratory diseases 12 per cent, and diabetes 3 per cent (5).

In most middle- and high-income countries non-communicable diseases were responsible for more deaths than all other causes of death combined, with almost all high-income countries reporting more than 70 per cent of total deaths due to non-communicable diseases (6).

In the UK and the USA, non-communicable diseases account for over 80 per cent of all deaths (5).

Common, preventable risk factors underlie most of these non-communicable diseases.  These risk factors are a leading cause of the death and disability burden in nearly all countries, regardless of economic development.

The leading risk factor globally for mortality is raised blood pressure (responsible for 13 per cent of deaths globally), followed by tobacco use (9 per cent), raised blood glucose (6 per cent), physical inactivity (6 per cent), and overweight and obesity (5 per cent) (7).

If we were to stop overeating, stop eating unhealthy foods, stop smoking and stop living sedentary lives, these risk factors would reduce, the prevalence of these diseases would reduce, healthcare costs would reduce and we would enjoy a greater quality of life.

Simple changes to diet and lifestyle really can make a dramatic difference to your health and well-being (8).

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Works Cited

1. National Audit Office. Healthcare across the UK: A comparison of the NHS in England, Scotland, Wales and Northern Ireland. s.l. : National Audit Office, 2012.

2. Robbins, John and Robbins, Ocean. Beyond the Obamacare debate – why does healthcare cost so much? . s.l. : Fox News, 2012.

3. US Health Insurance Costs Rise. [Online] 27 September 2011. http://www.guardian.co.uk/world/2011/sep/27/us-health-insurance-costs-climb.

4. Businessweek. [Online] 21 November 2004. http://www.businessweek.com/stories/2004-11-21/online-extra-a-full-bodied-talk-with-mr-dot-starbucks.

5. World Health Organisation. Non-communicable diseases country profiles 2011.

6. —. Global status report on noncommunicable diseases 2010. . Geneva : s.n., 2011.

7. —. Global health risks: mortality and burden of disease attributable to selected major risks. . Geneva : s.n., 2009.

8. Willett, W.C. Eat, Drink and Be Healthy. New York : Free Press, 2001. ISBN 0 684 86337 5.

9. Parliamentary Office of Science and Technology. Health Behaviour. Postnote, May 2007, no. 283. 2007.

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How to lose weight

Many people resolve to go on a diet and adopt a healthier lifestyle, only to give up a few weeks later. Good intentions are often hard to put into practice and sustain. Here are a few suggestions to help you move towards and maintain a healthier weight:

1. Be realistic

Many people set themselves goals they find hard to achieve, such as fitting into a size 8 dress or a dinner jacket from 25 years ago. It is far better to begin by aiming to reduce your weight by 5 to 10 percent of your current weight. This may not turn you into a glamour model in a hurry, but it can lead to important improvements in weight-related conditions such as high blood pressure and diabetes. Once you have achieved this goal, you can always continue and aim to lose another 5 to 10 per cent until you are happy with your weight. Breaking the target down into manageable stages increases your chance of success.

2. Be gentle on yourself

Crash diets may work in the short-term but typically people regain all the weight they have lost and even add some more. Crash diets can also be dangerous. Not only this, but it is usually miserable being on a diet. Depriving yourself of food and feeling hungry sets up cravings which can lead to binge-eating followed by feelings of guilt. Neither deprivation nor hunger are necessary to lose weight if you are willing to take time and do the right things. If you cut out just 100 calories per day, the equivalent of a single can of fizzy drink or a bedtime snack, you could lose about 10 lb (4.5 kg) in a year. If you also added a brisk walk for half an hour a day five days per week, the weight loss could increase to 20 lb (9 Kg) in a year.

3. Keep moving

Next to not smoking, regular physical activity is arguably the best thing you can do for your health. It lowers the risk of heart disease, diabetes, stroke, high blood pressure, osteoporosis, and certain cancers, and can help to control stress and boost mood. Contrary to popular belief, the evidence for a simple relationship between physical activity and weight loss is equivocal, with some studies showing that exercise helps and others suggesting that it does not, possibly due to complex interactions between physical activity, diet and genes. If moderate to vigorous over an extended period, physical activity can help to maintain a healthy weight, provided you do not compensate by eating more as a self-reward. You would have to walk for 98 minutes to burn off the calories in one Mars Bar or swim for 45 minutes to burn off one slice of a pepperoni pizza, for example. For general health, any amount of exercise is better than none. The more you do, though, the better. This does not have to mean joining a gym or jogging. Many activities count as exercise: dancing, skating, gardening, cycling, scrubbing floors, washing the car by hand, or playing with children. Incorporate activity into your day by taking the stairs rather than the escalator, getting off the bus one stop before your destination and walking the rest, cycling to do errands rather than taking the car, and cutting back on watching television, playing computer games and other sedentary activities. Start slowly and gradually build up to more vigorous activity when your fitness increases.

4. Keep track

Many of us eat without thinking and have no idea how much we have consumed. Such lack of awareness can result in us eating and drinking more than we plan to. Try keeping a daily food diary for a while. List everything that you eat or drink, no matter how insignificant it seems. The calories can really add up, even just with drinks – one can of Coca Cola contains 142 calories, for example.

5. Eat food as nature intended

Research shows that people who eat at fast-food restaurants more than twice a week are more likely to gain weight and show early signs of diabetes than those who only occasionally eat fast food.

Our bodies were designed to consume food in the form that nature provides, with nothing added and nothing taken away.

Vegetables, fruit, nuts, seeds and whole grains all contain protein, carbohydrates, essential fats, vitamins, minerals and fibre. Fibre makes the food bulkier and less nutrient dense than highly processed food. This means that you have to eat a greater quantity of unprocessed food, like vegetables, to obtain the same amount of calories as highly processed foods, such as ice cream.

In the stomach and the gut, there are stretch receptors and nutrient receptors which signal to the body that it has enough food and to stop eating. If you eat highly processed foods, which are rich in calories but poor in vitamins, minerals and essential fats, such as white sugar and white bread, your body’s mechanism for signaling that it is full does not work properly – the gut is neither fully stretched nor receives the nutrients the body needs – so you carry on eating. This increases the chance of you consuming too many calories and becoming overweight, whilst not obtaining enough vitamins, minerals and essential fats.

The more unprocessed foods, like whole grains, vegetables, nuts and seeds, you include in your diet, the easier it is for your body to obtain the nutrients it needs without over-eating. Even if all you do is have porridge for breakfast instead of eating a sugary cereal or drinking strong coffee, you will find it easier to lose weight.

6. Keep your blood sugar stable

Another advantage of a food like porridge is that it has a gentle effect on blood sugar, or what’s called a low glycaemic index. When you eat porridge, glucose is released slowly and steadily into the bloodstream which helps to maintain energy levels over a longer period of time. This reduces hunger and cravings, so you tend to eat less. Other examples include whole grains such as brown rice (especially basmati), quinoa and whole-grain breads and pasta, as well as beans, nuts, fruits, and vegetables.

Eating foods that make your blood sugar and insulin levels shoot up and then crash may contribute to weight gain. Insulin tells the body to store surplus glucose as fat, so constantly excessive levels of glucose and insulin in the blood lead to weight gain. Such foods include white bread, white rice, and other highly processed grain products. So this is another good reason to increase the amount of unprocessed whole foods in your diet and reduce the amount of processed foods rich in calories.

7. Do not be afraid of good fats

Fat in a meal or in snacks such as nuts gives the food taste and helps you to feel full. Good fats, such as olive oil, have many benefits for health, including helping to improve your cholesterol levels when you eat them in place of saturated or trans fats or highly processed carbohydrates, like sugar and white flour products.

8. Drink water rather than fizzy drinks

Drinking juice or cans of sugary drinks can give you several hundred calories a day without even realising it. Several studies show that children and adults who consume sugar-sweetened beverages are more likely to gain weight than those who don’t, and that switching from these to water can reduce weight.

Using artificial sweeteners in soft drinks instead of sugar or high-fructose corn syrup seems like it would sidestep any problems with weight or diabetes. Artificial sweeteners deliver zero carbohydrates, fat, and protein, so they can’t directly influence calorie intake or blood sugar. Over the short term, switching from sugar-sweetened soft drinks to diet drinks cuts calories and leads to weight loss. Long-term use, though, may be a different story.

Some long-term studies show that regular consumption of artificially sweetened beverages reduces the intake of calories and promotes weight loss or maintenance. Others show no effect, while some show weight gain.

One concern about artificial sweeteners is that they uncouple sweetness and energy. Until recently, sweet taste meant sugar, and thus energy. Glucose is critical for the human brain to function, so the body has delicate feedback mechanisms involving the brain, stomach, nerves and hormones, to ensure that there is always a steady supply. When we eat something sweet, the human brain responds with signals – first with signals to eat more, and then with signals to slow down and stop eating. By providing a sweet taste without any calories, artificial sweeteners could confuse these intricate feedback loops. This could potentially throw off the body’s ability accurately to gauge how many calories are being taken in. Studies in rats support this idea. Researchers at Purdue University have shown that rats eating food sweetened with saccharin took in more calories and gained more weight than rats fed sugar-sweetened food. In addition, a long-term study of nearly 3,700 residents of San Antonio, Texas, showed that those who averaged three or more artificially sweetened beverages a day were more likely to have gained weight over an eight-year period than those who didn’t drink artificially sweetened beverages. At present, research findings are mixed, but there is a possibility that diet drinks may lead to weight gain in the longer term.

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References

Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. National Institutes of Health, National Heart, Lung, and Blood Institute, Obesity Education Initiative

Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007; 39:1423–34

Pronk NP, Wing RR. Physical activity and long-term maintenance of weight loss. Obes Res. 1994 Nov;2(6):587-99

Fogelhom M, Kukkonen-Harjula K. Does physical activity prevent weight gain – a systematic review Obesity Reviews, Volume 1, Issue 2, 95–111, October 2000

Pereira MA, Kartashov AI, Ebbeling CB, et al. Fast–food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet. 2005; 365:36–42

Bellisle F, Drewnowski A. Intense sweeteners, energy intake and the control of body weight. European Journal of Clinical Nutrition. 2007; 61:691-700

Swithers SE, Davidson TL. A role for sweet taste: calorie predictive relations in energy regulation by rats. Behavioral Neuroscience. 2008; 122:161-173

Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP. Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 2008; 16:1894-1900

Frank GK, Oberndorfer TA, Simmons AN, et al. Sucrose activates human taste pathways differently from artificial sweetener. Neuroimage. 2008; 39:1559-1569

Willett, W. Eat, drink and be healthy. Harvard Medical School Guide to Healthy Eating. The Free Press; Free Press Trade Pbk. Ed edition (April 2005). ISBN: 978-0743266420.

Lisle D, Goldhamer A. The Pleasure Trap – Mastering the Hidden Force that Undermines Health and Happiness.  Healthy Living Publications, 30 March 2006

Component of vegetable protein may reduce blood pressure

grains and pulsesResearchers examined dietary amino acids, the building blocks of protein, and their effect on blood pressure.

Glutamic acid is the most common amino acid and accounts for almost a quarter (23 percent) of the protein in vegetable protein and almost one fifth (18 percent) of animal protein.

They found that a 4.72 percent higher dietary intake of the amino acid glutamic acid as a percent of total dietary protein correlated with lower group average systolic blood pressure, lower by 1.5 to 3.0 millimeters of mercury (mm Hg). Group average diastolic blood pressure was lower by 1.0 to 1.6 mm Hg. 

Systolic blood pressure is the force when the heart beats; diastolic pressure is the pressure when the heart rests between beats. 

This average lower blood pressure seems small from an individual perspective. But, on a population scale, it represents a potentially important reduction, said Jeremiah Stamler, M.D., lead author of the study. 

“It is estimated that reducing a population’s average systolic blood pressure by 2 mm Hg could cut stroke death rates by 6 percent and reduce mortality from coronary heart disease by 4 percent,”

said Stamler, Professor Emeritus of the Department of Preventive Medicine in the Feinberg School of Medicine at Northwestern University in Chicago, Ill. 

Based on American Heart Association 2009 statistics, 6 percent of stroke deaths would be more than 8,600 people and four percent of coronary heart deaths represents about 17,800 lives saved per year. 

“High blood pressure is a major cardiovascular disease risk factor, and blood pressure tends to rise with age starting early in life so that the majority of the U.S. population age 35 and older is affected by pre-hypertension or hypertension,” he said. “We have a massive public health problem, and trying to address it by the strategy that has prevailed for years — diagnosis and drug treatment — is inadequate. While clinically useful, it fails as a long-term approach for ending this massive problem.” 

The only long-term approach is to prevent pre-hypertension and hypertension by improved lifestyle behaviours, Stamler said. This includes maintaining a healthy body weight, having a fruit and vegetable-rich eating pattern and participating in regular physical activity.  

Researchers analyzed data from the International Study on Macro/Micronutrients and Blood Pressure (INTERMAP), on 4,680 people ages 40-59 in 17 rural and urban populations in China, Japan, the United Kingdom and the United States. INTERMAP is a basic population study aiming to clarify the role of multiple nutrients in the etiology of unfavourable blood pressure patterns prevailing for most middle-aged and older individuals. Stamler and colleagues analyzed data from eight blood pressure tests, four diet recall surveys and two 24-hour urine collections for each participant.

“Although our research group and others earlier reported an association between higher consumption of vegetable protein and lower blood pressure, as far as we know this is the first paper on the relation of glutamic acid intake to blood pressure,”

said Ian J. Brown, Ph.D., co-author of the study and a research associate in the Department of Epidemiology and Public Health at Imperial College London.

Common sources of vegetable protein include beans, whole grains — including whole grain rice, pasta, breads and cereals — and soy products such as tofu. Durum wheat, which is used to make pasta, is also a good source of vegetable protein.

Stamler noted that there are no data on the possible effects of glutamic acid supplements and emphasized the importance of “improved habitual food intake for the prevention and control of hypertension, not popping pills.”

To learn how to cook with vegetable proteins and other whole foods, why not come along to a Cooking for Health course, held throughout the year in Somerset, UK.

Colon cancer, gut microbes and your diet

A typical Western diet, rich in meat and fats and low in complex carbohydrates, is a recipe for colon cancer, Professor Stephen O’Keefe from the University of Pittsburgh, USA, told the Society for General Microbiology meeting at Harrogate today (Tuesday 31 March). He described an expanding body of evidence to show that the composition of the diet directly influences the diversity of the microbes in the gut, providing the link between diet, colonic disease and colon cancer.

complexcarbs1

People eating a healthy diet containing high levels of complex carbohydrate (e.g., whole grains like wholewheat bread, brown rice, quinoa, millet, vegetables, fruit) had significant populations of micro-organisms in their gut called Firmicutes. These bacteria use the undigested residues of starch and proteins in the colon to manufacture short-chain fatty acids and vitamins such as folate and biotin that maintain colonic health. One of these fatty acids, butyrate, not only provides most of the energy to maintain a healthy gut wall, but it also regulates cell growth and differentiation. Both experimental and human studies support its role in reducing colon cancer risk.

However, gut microbes may also make toxic products from food residues. Diets high in meat will produce sulphur – this decreases the activity of ‘good’ bacteria that use methane and increases the production of hydrogen sulphide and other possible carcinogens by sulphur-reducing bacteria.

“Colon cancer is the second leading cause of cancer-related deaths in adults in Westernized communities.” said Professor O’Keefe, “Our results suggest that a diet that maintains the health of the colon wall is also one that maintains general body health and reduces heart disease”.

“A diet rich in fibre and resistant starch encourages the growth of good bacteria and increases production of short chain fatty acids which lessen the risk of cancer, while a high meat and fat diet reduces the numbers of these good bacteria.” Professor O’Keefe went on. “Our investigations to date have focused on a small number of bacterial species and have therefore revealed but the tip of the iceberg, our colons harbour over 800 bacterial species and 7,000 different strains. The characterization of their properties and metabolism can be expected to provide the key to colonic health and disease”

To learn more about which foods help to maintain the health of your gut and how to cook delicious recipes using them, please come along to a Cooking for Health course, held throughout the year in Somerset, UK.

Long term health is affected by maternal nutrition

This month, the British Medical Association (BMA) Board of Science has published a report on Early Life Nutrition and Lifelong Health.  The report reviews the evidence that the diets of women of reproductive age, and those of their foetuses and young children, are significant factors in influencing the risk of chronic diseases such as heart disease, diabetes, obesity, brittle bone disease and even some forms of cancer and mental illness, later in those children’s lives.

Lead author Professor Mark Hanson, director of the Centre for the Developmental Origins of Health and Disease at the University of Southampton, comments:

“Society and public health organisations need to pay much greater attention to these issues if the rising epidemic of these diseases is to be prevented. Tackling the diseases once children reach adulthood is often too late. By taking steps to improve maternal nutrition we could save many people from a lifetime of ill health.”

obese-kids1

Unbalanced nutrition can result from both inadequate and excessive dietary intakes, and both can exist at the same time in many populations. Moreover diets which lead to over-nutrition (e.g., excess calories) are often micronutrient poor.

There is strong evidence that undernutrition (stunting or wasting) during the first two years of life leads to impaired adult cognitive, physical and economic capacity, which cannot be repaired even if nutrition improves later in childhood.

Improved availability of energy-rich foods has however, enabled large numbers of people to escape from hunger. This has brought considerable benefits, but is already giving rise to obesity and obesity-related disease. Developing countries are reporting high rates of coronary heart disease (CHD) and type 2 diabetes that have appeared in one or two generations to become leading causes of morbidity and mortality. These epidemics are expected to intensify.  By the year 2030, the prevalence of diabetes is predicted to rise by over 100 per cent in India, China, sub-Saharan Africa, Latin America, the Caribbean and the Middle East; an increase far exceeding that in high-income countries (54%).

There is good evidence that an increased deposition of fat tissue in foetuses and babies is an outcome of both undernutrition and excessive nutrition.  Low birth weight babies born to underweight women in India have proportionately more fat than would be expected for their body weight.  Maternal obesity, another form of maternal malnutrition, also increases the fat tissue of the foetus and newborn baby. This phenomenon is exacerbated further if maternal obesity is complicated by gestational diabetes.

Extremes of maternal body composition, either excessive thinness or obesity, are associated with adverse patterns of foetal and infant development leading to poorer long-term health.

“It’s not only women who need to be careful about the quality of their food intake. Prospective fathers should also eat well and steps need to be taken to ensure that young people understand the importance of good nutrition as part of their lifestyle choices.”

The numbers of women who breastfeed their infants is still too low, with many women starting to breastfeed but then stopping too soon, and many infants being fed inappropriate foods at the weaning stage.  Breastfeeding rates in the UK are much lower than in many European countries. Less than1 per cent of mothers in the UK are exclusively breastfeeding at six months.

breastfeeding1

While there are gaps in the evidence about the long-term consequences of poor maternal and infant nutrition, and we do not as yet understand the mechanisms fully, it is clear that steps need to be taken to promote healthy diets in young women and their families, to encourage breastfeeding and the use of appropriate complementary foods.

More advice could be given to people with young children about the importance of a balanced diet for those children and more support could be given to women to help them start breastfeeding and to continue with it.

If you have enjoyed this post please leave your comments below.

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You can also join me on FacebookTwitterPinterest and LinkedIn, where I post interesting information which is not included in this blog.

Fruit and vegetable consumption low across the world

eating-burger_280_528732a1A new study to be published in the May edition of the American Journal of Preventive Medicine paints a depressing picture of the dietary habits of modern man across the globe.

National Diet and Nutrition Surveys in the UK have found that less than 15 per cent of the population eats the recommended 5 portions of fruit and vegetables per day; a similar situation exists in the USA.  It appears that the same is also true in developing countries, where traditional diets are threatened by the introduction of processed food.

A survey of over 200,000 people in developing countries showed that overall 77.6 per cent of men and 78.4 per cent of women consumed less than the suggested five daily servings of produce. 

“Low fruit and vegetable consumption is a risk factor for overweight and obesity, and adequate consumption decreases risk for developing several chronic diseases,” said lead author Spencer Moore. “The release of the 2002-2003 World Health Survey data provided a unique opportunity to examine global differences in low fruit and vegetable consumption in a way that has until now simply not been possible.”

There were wide variations among nations, ranging from 37 percent of men in Ghana who did not meet that standard – to 99 percent of Pakistani men. The researchers saw similar findings in women with the same two countries at the high and low ends of the spectrum.

The prevalence of low fruit and vegetable intake increased with age and decreased with income. This contrasts with findings from the UK where, on average, older people consume more fruit and vegetables than younger people.

family-eating-banana1

Epidemiological studies show that societies consuming high quantities of fruit, vegetables and whole grains are at lower risk of developing chronic diseases such as diabetes, heart disease and cancers than those that consume low quantities.  Such societies are often, but not exclusively, in less economically developed parts of the world.  As GDP per capita increases, countries opt for eating more meat, more processed food and less fruit, vegetables and whole grains.  This dietary shift leads to an epidemiological shift – away from infectious diseases and other diseases associated with lack of food, towards chronic noncommunicable diseases such as heart disease, stroke and cancer. 

The decline in consumption of fruit and vegetables in developing countries is disturbing as it is likely to give rise to an increase in the incidence of chronic diseases, leading to huge burdens on the healthcare systems of those countries, which may be ill-equipped to cope.

For information and practical tuition in how to create mouth-watering dishes with locally produced fruit and vegetables, come along to Cooking for Health courses held throughout the year in Somerset, UK.

If you are a caterer, or a professional responsible for encouraging healthier catering practices in your community, you will benefit from participating in a two-day training course on Healthier Catering.   By the end of the course, participants will: 

  • Understand the basic principles of nutrition
  • Be aware of the importance of food in the maintenance of health and well-being
  • Appreciate the role of lifestyles and culture in influencing diet
  • Recognise the potential benefits for both caterers and customers of providing a choice of healthier options
  • Know more about ingredient selection and methods of food production and processing that can be used to create healthier options, whilst being attractive and convenient to modern tastes and lifestyles
  • Be able to apply appropriate and relevant skills and knowledge when advising catering businesses or when planning, preparing, promoting and serving healthier foods

For further details about the course content and the course tutor, Dr Jane Philpott, please see http://cookingforhealth-uk.com/healthier-catering.php.

Reference

Hall JN, et al. Global variability in fruit and vegetable consumption. Am J Prev Med. 36(5), 2009.

Over-eating when eating out

Recently, I gave the menu of a well-known chain restaurant to a group of students and asked them to select what they would eat if they were dining there. 

 

They selected a starter (garlic bread with cheese), a main course (traditional lasagne with a salad), a dessert (ice cream) and a drink (a can of coke). 

 

Using the restaurant’s own nutritional information, they calculated the nutrient content of what they had chosen (Table 1).  The results left the students open-mouthed.

 

Their menu selection had provided:

 

n 106% of the guideline daily amount of calories (assuming 2000 kcal per day);

n 141-171% of the guideline daily amount of protein (depending on whether they were male or female);

n 61% of the guideline daily carbohydrate;

n 109% of the guideline daily amount of total fat;

n 192% of the guideline daily amount of saturated fat

n 52% of the guideline daily amount of salt. 

 

It is worth noting that the dietary reference value for salt in the UK is 6 g per day, compared with 2.3 g per day in the USA.

 

Thus, one meal out would have provided more than the entire day’s requirement for calories; enough protein to last for one and a half days; and enough saturated fat to last for two days.

 

Most people have no idea of the nutrient content of the food they are eating, nor of the potentially damaging effects on their health of a dietary excess of sugar, saturated fat and salt. 

 

Given that at least one–third of household expenditure on food and drink is spent on food eaten outside the home in the UK, food manufacturers and caterers have a real opportunity to contribute to an improvement in public health whilst also making a profit themselves. 

 

There is now convincing research evidence to suggest that increasing the amount of fruit, vegetables and whole grains in the diet, whilst decreasing the amount of sugar, saturated fat and salt, helps to protect the body from chronic conditions such as obesity, type 2 diabetes, heart disease and various cancers.

 

A two-day professional training course is offered, tailored to equip caterers, and those involved in encouraging healthier catering practices, with information and practical tools to achieve healthier eating in the population.

 

By the end of the course, participants will:

  • Understand the basic principles of nutrition
  • Be aware of the importance of food in the maintenance of health and well-being
  • Appreciate the role of lifestyles and culture in influencing diet
  • Recognise the potential benefits for both caterers and customers of providing a choice of healthier options
  • Know more about ingredient selection and methods of food production and processing that can be used to create healthier options, whilst being attractive and convenient to modern tastes and lifestyles
  • Be able to apply appropriate and relevant skills and knowledge when advising catering businesses or when planning, preparing, promoting and serving healthier foods

For further information on the course content and the course tutor, Dr Jane Philpott, please click http://cookingforhealth-uk.com/healthier-catering.php.

 

 

Table 1

Menu item

Calories per portion

Protein g per portion

Carbohydrate g per portion

Total fat g per portion

Saturated fat g per portion

Salt g per portion

 

Starter

 

568

 

29.8

 

35.6

 

34

 

16.5

 

1.15

 

Main course

 

934

 

 

42.2

 

74.4

 

33.1

 

14.6

 

1.84

 

Dessert

 

 

475

 

5.5

 

18.8

 

18.1

 

11.1

 

0.15

 

Drink

 

 

139

 

0

 

35

 

0

 

0

 

0

 

 

 

 

 

 

 

 

Total

 

 

2116

 

77.5

 

163.8

 

85.2

 

42.2

 

3.14

 

Gov guideline

 

 

2000 kcal

 

45 g/day (women)

55 g/day (men)

 

267 g per day

 

78 g per day

 

22 g per day

 

6 g per day

 

% of guidelines

 

 

106%

 

171% (women)

141% (men)

 

 

61%

 

109%

 

192%

 

52%