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.

Component of vegetable protein may reduce blood pressure

Researchers 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.

Alzheimer’s Disease, metabolic disorders and the role of diet

Accumulating evidence for the role of metabolic disorders such as insulin resistance, diabetes, obesity and hypertension in increasing the risk of Alzheimer’s disease and vascular dementia, is reviewed in a new paper published this month in the Archives of Neurology.

In the same journal, compelling evidence is presented that higher pre-diagnosis total cholesterol, low-density lipoprotein cholesterol, and diabetes are associated with faster cognitive decline in patients with incident Alzheimer’s disease.

A cohort of 156 patients with incident Alzheimer’s Disease (mean age 83 years) were followed for up to 10 years.  Changes in a composite score of cognitive ability were monitored from diagnosis onwards.

“These findings indicate that controlling vascular conditions may be one way to delay the course of Alzheimer’s, which would be a major development in the treatment of this devastating disease as currently there are few treatments available to slow its progression,”

said Yaakov Stern, Ph.D., a professor at the Taub Institute for the Research on Alzheimer’s Disease and the Aging Brain and director of the Cognitive Neuroscience Division of the Gertrude H. Sergievsky Center at Columbia University Medical Center, and senior author of the paper.

“Preventing heart disease, stroke and diabetes – or making sure these conditions are well managed in patients diagnosed with them – can potentially slow the disease progression of Alzheimer’s,” said Dr. Stern.

Diets high in fruit, vegetables, fibre and unsaturated fats, and low in sugar, salt and saturated fat are known to reduce the risk of a range of chronic conditions, such as diabetes, heart disease and stroke.  This means eating more plant-based foods and less processed and animal-based foods.

Stabilising blood sugar is crucial.  This may be done by eating a diet with a low glycaemic load, that is, one that includes moderate quantities of complex carbohydrates which release glucose slowly into the bloodstream.  Whole grains, such as whole-wheat bread, brown rice, quinoa, millet and buckwheat are valuable for helping to ensure smooth regulation of blood sugar.  In contrast, highly refined carbohydrates, such as white bread, white rice, white pasta and table sugar, create a roller-coaster of blood sugar highs and lows, which if left unchecked, can ultimately give rise to insulin resistance and eventually to diabetes.  Potatoes release sugar into the bloodstream almost as fast as table sugar and thus should be eaten sparingly, unless you are lean and exercise regularly.  Consuming protein with carbohydrates at every meal has also been found to help regulation of blood sugar.

Increasing the quantity of vegetables and fruit in the diet is also vital.  Blood sugar levels are easier to maintain if vegetables are emphasized more than fruit, as some fruit contains a lot of sugar.  A minimum of 5 portions of fruit and vegetables per day is recommended.  For easy tips for increasing the amount of fruit and vegetables in your diet please click here.

Unsaturated fats found in plant oils, such as olive oil and the oils of nuts and seeds, and in oily fish, are beneficial for preventing heart disease and other vascular health conditions.  For practical suggestions for ways to incorporate more healthy unsaturated fats in your diet please click here.

For information and practical tuition in how to put all these recommendations together to create fabulous food that protects you from diabetes, heart disease and Alzheimer’s Disease, please come to a Cooking for Health course, run by nutrition expert, Dr Jane Philpott.

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.”

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.

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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Fruit and vegetable consumption low across the world

A 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.

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%

 

 

 

Cinnamon – spice up your health

Cinnamon comes from the inner bark of evergreen trees (Cinnamomum verum, C. zeylandicum, C. aromaticum), native to Sri Lanka and other Asian countries.  The bark is peeled away from the tree and curls up into tubes, called quills, as it dries.

 

 

In addition to its use as a spice, cinnamon or its oil is used as a flavouring agent in pharmaceutical, personal health and cosmetic products.

Cinnamon is one of the oldest spices known.  It was imported to Egypt from China as early as 2000 BC, where it was used as a medicinal herb, a flavouring for drinks and as an embalming agent.  At one time it was considered to be even more valuable than gold.  Cinnamon is also mentioned in the Bible.

Moses was commanded:

“Take thou also unto thee principal spices, of pure myrrh five hundred shekels, and of sweet cinnamon half so much, even two hundred and fifty shekels, and of sweet calamus two hundred and fifty shekels” (Exodus 30:23)

 

In Proverbs, the lover says:

“I have perfumed my bed with myrrh, aloes, and cinnamon” (Proverbs 7:17)

And Solomon describes the beauty of his beloved as

“Spikenard and saffron; calamus and cinnamon, with all trees of frankincense; myrrh and aloes, with all the chief spices” (Song of Solomon 4:14)

The Roman Emperor Nero is said to have burned a year’s supply of cinnamon at the funeral for his wife Poppaea Sabina in 65 AD, to express the depth of his loss.

As its popularity grew, cinnamon was one of the first spices to be traded regularly between Europe and the Near East.

 

Cinnamon has many medicinal uses.  It is reported to be beneficial in the treatment of arthritis, asthma, cancer, diarrhoea, fever, heart problems, insomnia, menstrual problems, peptic ulcers, psoriasis, and spastic muscles.  Some of the confirmed effects of cinnamon are as a sedative for smooth muscle, circulatory stimulant, digestive aid, antibiotic, anticonvulsant, diuretic and antiulcerative.

Some studies suggest that cinnamon may be useful for people with diabetes.  In one trial, 1 to 6 grams of cinnamon taken daily for forty days reduced fasting blood glucose by 18 to 29 per cent, triglycerides by 23 to 30 per cent, LDL cholesterol by 7 to 27 per cent, and total cholesterol by 12 to 26 per cent.  In contrast, there were no clear changes for the subjects who did not take cinnamon[1].

Another trial showed that a cinnamon extract had a moderate effect in reducing fasting plasma glucose concentrations in diabetic patients with poor glycaemic control[2].

Other research has shown that a substance in cinnamon called methylhydroxychalcone acts as an insulin mimetic; it stimulated glucose uptake and glycogen synthesis to a similar level as insulin[3].

Cinnamon may thus be useful for helping to treat insulin resistance and type 2 diabetes, conditions that are becoming increasingly more common in the UK and elsewhere.

Statistics published in the Journal of Epidemiology and Community Health in February 2009 indicate that the incidence of diabetes in the UK climbed 74 per cent between 1997 and 2003.  By 2005, over 4 per cent of the population were classified as having some type of diabetes.  The majority of new cases are type 2 diabetes, linked to diet and growing obesity rates. A research team from Spain and Sweden analysed the results, and made it clear that the trend was not due to more screening tests or an ageing population.

Ideas for incorporating cinnamon into your diet

• Add 1 tsp ground cinnamon to oat porridge at breakfast
• Drizzle flaxseed oil over whole-wheat toast and then sprinkle with cinnamon and a little rice malt syrup
• Simmer a cinnamon stick with 1 cup rice milk  for a delicious warm drink
• Add a cinnamon stick to home-made squash soup to make a warming lunchtime meal
• When poaching fish, add cinnamon sticks to the poaching liquid
• Add ground cinnamon when preparing curries or spicy Middle Eastern dishes using chickpeas
• Add ground cinnamon to stewed apple and mix with ground almonds for a creamy dessert

 

For recipe ideas, tips and information about following a plant-based diet please sign up for my free newsletter and check out my website.

You can also find me on Facebook, Twitter and LinkedIn.

 

References

[1] Khan et al. Cinnamon Improves Glucose and Lipids of People With Type 2 Diabetes.  Diabetes Care 26:3215-3218, 2003

[2] Mang et al. Effects of a cinnamon extract on plasma glucose, HbA_1c, and serum lipids in diabetes mellitus type 2 European Journal of Clinical Investigation:Volume 36(5)May 2006p 340-344

[3] Jarvill-Taylor et al.  A Hydroxychalcone Derived from Cinnamon Functions as a Mimetic for Insulin in 3T3-L1 Adipocytes. Journal of the American College of Nutrition, Vol. 20, No. 4, 327-336 (2001)

Farmer’s markets help to increase consumption of fresh fruit and vegetables

A new Farmer’s Market was started last November in Brownsville, Texas, in an effort to make locally grown produce more available and affordable to local residents, to increase the awareness of chronic diseases associated with obesity and to educate consumers on the importance of nutrition. Certain communities in this region have twice the US national average of diabetes, which is associated with obesity. The project is the brainchild of Belinda Reininger, Dr.P.H., associate professor of behavioural sciences at the University of Texas School of Public Health.

“A significant portion of the obesity problem here is because local diets are high in carbohydrates and include very few vegetables and fruits,” said Rose Gowen, M.D., medical director of the Clinical Research Unit at the University of Texas School of Public Health and chair of the market’s board of directors. “Many of the diabetes cases are related to the problem of obesity, which is beginning in childhood and adolescence years.”

More than 400 residents shop weekly at the Saturday market and surveys have found 80 percent of them are now eating more fruits and vegetables and 78 percent reported eating a wider variety of fruits and vegetables. Surveys also revealed that 84 percent of shoppers find the quality of the produce at the market exceeds the quality of produce offered elsewhere.

Market shoppers also have access to health screenings and on-site nutrition, obesity and diabetes information provided by the UT School of Public Health, Texas Department of State Health Services (DSHS) and other organizations.

In common with the UK government, the U.S. Department of Agriculture recommends eating five servings of fruits and vegetables a day, which provide vitamins, minerals and phytonutrients that help maintain and improve overall health, as well as protect against chronic diseases such as diabetes. The 2000 Texas Healthy People Report revealed that only 23.4 percent of Texans were consuming five or more servings of fruits and vegetables per day.  In the UK, average fruit and vegetable consumption is less than three portions per day.

Low-income families can receive US$10 in vouchers to purchase fresh fruits and vegetables, which goes quite a long way at the market.

“Last week I bought four cucumbers, six grapefruits, a dozen farm eggs, fresh cilantro and dill, all for $10,” said Gowen, a long-time local resident and a driving force behind the market.

The market is in its final stage of a certification process to become a state-recognized farmer’s market. Once certified, organizers hope to allow families to use their Women, Infants and Children (WIC) card and food stamps to purchase fresh produce.  The committee also wants to provide cookery classes for attendees to learn healthier cooking options for their fresh produce.

If you would like ideas and practical tuition in how to include more fresh vegetables and fruits into your diet, why not come along to a Cooking for Health course, held throughout the year in Somerset, UK.