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1 Table Principles that meet the needs for health and the environment Principle Health benefits Climate change benefits Eat more plants Waste less food Eat less meat More fruit and vegetables known risk reduction for coronary heart disease and stroke Economic advantages. A healthy diet is perceived as expensive buying less of better nutritional quality could be achieved May reduce saturated fat intake, especially if processed meats. High intakes increase risk of certain cancers. Potential for detrimental reduction in iron intakes must be considered Replaces resource intensive animal production Reduce the 40% of food planted worldwide that is currently wasted Reduces resource intensive animal production Eat less processed foods Often high in fats, salt and sugars Resource intensive production, storage and distribution Choose certified foods No recognised health benefit Improved animal welfare, maintenance of stocks Manual of Dietetic Practice, Fifth Edition. Edited by Joan Gandy The British Dietetic Association. Published 2014 by John Wiley & Sons, Ltd. Companion Website:

2 Table Nutritional requirements at different life stages [source: Public Health Action Support Team (PHAST) (2008, Table 1). Reproduced with permission of Hannah Pheasant] Age Requirements Infants First 4 6 months of life (period of rapid growth and development) breast milk (or infant formula) contains all the nutrients required Between 6 12 months requirements for iron, protein, thiamine, niacin, vitamin B 6, vitamin B 12, magnesium, zinc, sodium and chloride increase Department of Health advice recommends exclusive breastfeeding until 6 months of age, with weaning introduced at 6 months 1 3 years Energy requirements increase (children are active and growing rapidly) Protein requirements increase slightly Vitamins requirements increase (except vitamin D) Mineral requirements decrease for calcium, phosphorus and iron, and increase for the remaining minerals (except for zinc) 4 6 years Requirements for energy, protein, all the vitamins and minerals increase, except vitamins C and D and iron 7 10 years Requirements for energy, protein, all vitamins and minerals increase, except thiamine and vitamins C and A years Requirements for energy continue to increase and protein requirements increase by approximately 50% By the age of 11, the vitamin and mineral requirements for boys and girls start to differ: Boys: increased requirement for all the vitamins and minerals Girls: no change in the requirement for thiamine, niacin and vitamin B 6, but there is an increased requirement for all the minerals. Girls have a much higher iron requirement than boys (once menstruation starts) years Boys: requirements for energy and protein continue to increase, as do the requirements for a number of vitamins and minerals (thiamine, riboflavin, niacin, vitamins B 6, B 12, C and A, magnesium, potassium, zinc, copper, selenium and iodine). Calcium requirements remain high as skeletal development is rapid Girls: requirements for energy, protein, thiamine, niacin, vitamins B 6, B 12 and C, phosphorus, magnesium, potassium, copper, selenium and iodine all increase Boys and girls have the same requirement for vitamin B 12, folate, vitamin C, magnesium, sodium, potassium, chloride and copper. Girls have a higher requirement than boys for iron (due to menstrual losses) but a lower requirement for zinc and calcium years Requirements for energy, calcium and phosphorus are lower for both men and women than in adolescents, and there is a reduced requirement in women for magnesium and in men for iron The requirements for protein and most of the vitamins and minerals remain virtually unchanged in comparison to adolescents (except for selenium in men which increases slightly) Pregnancy Lactation Increased requirements for some nutrients Women intending to become pregnant and for the first 12 weeks of pregnancy are advised to take supplements of folic acid Additional energy and thiamine are required only during the last 3 months of pregnancy Mineral requirements do not increase Increased requirement for energy, protein, all the vitamins (except B 6 ), calcium, phosphorus, magnesium, zinc, copper and selenium 50+ years Energy requirements decrease gradually after the age of 50 in women and after age 60 in men as typically become less active and with a reduced basal metabolic rate Protein requirements decrease for men but continue to increase slightly in women The requirements for vitamins and minerals remain virtually unchanged for both men and women After the menopause, women s requirement for iron is reduced to the same level as that for men After the age of 65, there is a reduction in energy needs but vitamins and minerals requirements remain unchanged. This means that the nutrient density of the diet is even more important

3 Table Summary of the dietary recommendations for the UK (adapted from Webster-Gandy 2011, table 2.1, p. 26. Reproduced with permission of Oxford University Press) Recommendation Population group Reason for recommendation Fruit and vegetables >5 80 g/day (400 g) Adults Risk of some cancers, CVD and other chronic conditions Oily fish >1 portion/week (140 g) Adults CVD risk Red and processed meat Consider intake All red meat consumers Cancer risk NMES <11% food energy* All NMES contribute to development of dental caries Fat <35% food energy All CVD risk, energy density of diet Saturated fat <11% food energy All CVD risk, energy density of diet Non-starch polysaccharide >18 g/day Adults Improves gastrointestinal health Alcohol <3 4 units/day men <2 3 units/day women Adults (>18 years) Risk liver disease, CVD, cancer, injury from violence or accidents Salt <6 g/day Adults Risk hypertension and CVD Vitamins and minerals DRVs All To prevent deficiencies and promote growth Dietary vitamin D DRV for young children, adults >65 years, pregnant and breastfeeding women Others with limited sun exposure also require dietary vitamin D Supplements** Vitamin D Older adults, housebound or living in institutions or who eat no meat or oily fish *Energy consumed as food and drink excluding alcohol. **Vitamin D supplements are also recommended for pregnant and lactating women. CVD, cardiovascular disease; DRVs, dietary reference values; NMES, non-milk extrinsic sugars. All To prevent deficiency To achieve adequate vitamin D status and risk of poor bone health Table Recommended maximum daily salt intakes Age Target for average salt intake (g/day) 0 6 months < months years years years years 6

4 Table Suggested proportions of the food groups on which the eatwell plate is based Food group Food Included Key messages Proportion to be eaten Amount to be eaten Main source of nutrients Bread, rice, potatoes, pasta and other starchy foods Bread, rolls, chapattis, pitta bread, naan bread, crispbread, muffins, scones, crumpets Breakfast cereals Pasta, rice, potatoes Fruit and vegetables All fresh, frozen, tinned, juiced, pulped and dried fruit and vegetables (except potatoes which are included as a starchy food because of the function they serve in the diet) Includes concentrates and smoothies Milk and dairy foods Milk, cheese, yogurt, fromage frais, crème fraiche Meat, fish, eggs, beans and other non-dairy sources of protein Foods and drinks high in fat and/or sugar Meat, poultry, fish, offal, processed meat and fish products Soya, tofu and mycoproteins (Quorn TM ) Pulses Nuts High in fat butters, margarines, vegetable fat spreads, oils. mayonnaise and dressings, cream/cheese/curry sauces and fatty gravy, pastry, savoury snacks High in sugar cakes, biscuits, puddings, ice cream, chocolate and other sweets, fizzy drinks Eat plenty, choose wholegrain varieties when you can Eat plenty, at least five portions of a variety of fruit and vegetables a day Eat some, choose lower fat alternatives whenever possible or eat higher fat versions infrequently or in smaller amounts Eat some, choose lower fat alternatives whenever possible or eat higher fat versions infrequently or in smaller amounts Aim for at least two portions of fish a week, including a portion of oily fish About 33% For most people this is between six and nine portions/day This is probably more than people commonly consume About 33% At least 400 g of a variety of fruit and vegetables Currently not achieved by many About 15% Two to three servings per day (a serving = 200 ml of milk, a small piece of cheese (40 g) or a small pot of yogurt About 12% Two servings per day Maximum of 70 g of red meat At least one portion of oily fish/week Commonly misunderstood as needing to be eaten in larger amounts Eat a small amount 8% Not a nutritional requirement but add variety and interest Most people eat too much Carbohydrate Fibre (particularly insoluble fibre) B vitamins Some calcium (added to bread products) and iron Vitamin C, carotenes, antioxidants Folate, soluble and insoluble fibre Potassium Calcium, protein, riboflavin, vitamins A and D (in full fat products only) Protein, iron, B vitamins, zinc, magnesium Some vitamins and essential fatty acids but usually combined with excess fat, sugar and/or salt

5 Table The eight tips for eating well (adapted from NHS Choices. Tip Details 1. Base meals on starchy foods 2. Eat lots of fruit and vegetables Starchy foods include potatoes, cereals, pasta, rice and bread Choose wholegrain varieties when possible; they contain more fibre and can make you feel full for longer. Starchy foods should make up around one-third of the foods you eat Most of us should eat more starchy foods: try to include at least one starchy food with each main meal. Some people think starchy foods are fattening, but gram for gram they contain fewer than half the calories of fat It is recommended that we eat at least five portions of different types of fruit and vegetables a day. This is easier than it sounds. A glass of 100% unsweetened fruit juice can count as one portion, and vegetables cooked into dishes also count. Why not chop a banana over your breakfast cereal or swap your usual mid-morning snack for some dried fruit? 3. Eat more fish Fish is a good source of protein and contains many vitamins and minerals. Aim for at least two portions a week, including at least one portion of oily fish. Oily fish is high in n-3 fats, which may help to prevent heart disease. You can choose from fresh, frozen and canned; but remember that canned and smoked fish can be high in salt Oily fish include salmon, mackerel, trout, herring, fresh tuna, sardines and pilchards Non-oily fish include haddock, plaice, coley, cod, tinned tuna, skate and hake Anyone who regularly eats a lot of fish should try to choose as wide a variety as possible 4. Cut down on saturated fat and sugar We all need some fat in our diet. But it is important to pay attention to the type of fat we are eating. There are two 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. Saturated fat is found in many foods, such as cakes, pies, biscuits, sausages, cream, butter, lard and hard cheese. Try to cut down on these, and choose foods that contain unsaturated rather than saturated fats, such as vegetable oils, oily fish and avocados Most people in the UK eat too much sugar. Sugary foods and drinks are often high in calories and can contribute to weight gain. They can also cause tooth decay, especially if eaten between meals. Cut down on sugary fizzy drinks, cakes, biscuits and pastries, which contain added sugars: this is the kind of sugar we should be cutting down on rather than sugars that are found naturally in foods such as fruit and milk. Food labels can help: use them to check how much sugar foods contain. More than 15 g of sugar/100 g means that the food is high in sugar 5. Try to eat less salt Even if you do not add salt to your food, you may still be eating too much. About three-quarters of the salt we eat is already in the food we buy, such as breakfast cereals, soups, breads and sauces. 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. Use food labels to help you cut down. More than 1.5 g of salt/100 g means the food is high in salt. Adults and children over 11 should eat no more than 6 g of salt/day. Younger children should have even less 6. Get active and try to be a healthy weight Eating well plays an important part in maintaining a healthy weight, which is an important part of overall good health. Being overweight can lead to health conditions such as high blood pressure, heart disease or diabetes. Being underweight could also affect your health. If you are trying to lose weight, healthy food choices will help: aim to cut down on foods that are high in fat and sugar, and eat plenty of fruits and vegetables. If you are worried about your weight, ask your GP or a dietitian for advice Physical activity can help you to maintain a healthy weight. Being active does not have to mean hours at the gym: you can find ways to fit more activity into your daily life. For example, try getting off the bus one stop early on the way home from work and walking 7. Drink plenty of water Try to drink about six to eight glasses (1.2 L) of water (or other fluids) a day to prevent dehydration. When the weather is warm or when you are active, you may need more. But avoid soft and fizzy drinks that are high in added sugars. Remember: When thinking about alcohol, there is nothing wrong with the occasional drink, but drinking too much can cause serious health problems. Alcohol is also high in calories, so cutting down could help you to control your weight 8. Do not skip breakfast Some people skip breakfast because they think it will help them lose weight. In fact, research shows that eating breakfast can help people control their weight. A healthy breakfast is an important part of a balanced diet, and provides some of the vitamins and minerals we need for good health. Wholemeal cereal with fruit sliced over the top is a tasty and nutritious breakfast

6 Table Key sources of knowledge and attitudes data related to healthy eating (adapted from NOO Reproduced with permission of Public Health England, Obesity Knowledge and Intelligence) Survey Adults Health Survey for England National Diet and Nutrition Survey Low Income Diet and Nutrition Survey British Social Attitudes Survey Food and You survey (FSA) Consumer Attitudes Survey Sodexo School Food Survey Change4life Tracking Survey Children Health Survey for England TellUs Sodexo School Food Survey National Diet and Nutrition Survey Low Income Diet and Nutrition Survey Take up of School Meals in England Details Attitudes to one s own weight; attitudes to healthy eating; knowledge about healthy eating; knowledge about healthy physical activity levels; attitudes to physical activity; self efficacy in relation to physical activity Eating habits and patterns; attitudes to one s eating habits; attitudes to one s own physical activity levels; attitudes to one s own weight; attitudes to dieting Attitudes to organic foods, knowledge of, and competency in, cooking; attitudes to appetite; attitudes to variety of foods consumed; attitudes to physical activity levels at work; weight status over time; attitudes to one s own weight status; influences on food choice; attitudes to one s current diet; attitudes to children s diet; knowledge of healthy eating; self efficacy in relation eating healthily Attitudes to eating and physical activity as a reliever of stress; attitudes to taking part in games or sports; attitudes to national culture relating to sport; attitudes to individual responsibility and health; attitudes to active transport Attitudes to importance of healthy eating; self efficacy with regards to cooking; attitudes to convenience foods; attitudes to eating healthily; attitudes to importance of healthy eating for children; knowledge of healthy eating; patterns of eating, including reduction and increase of consumption of certain foods; understanding of food labels; attitudes to food safety and hygiene; sources of information on healthy eating Parents attitudes to food provided by school; parental concerns about children s diets; parental attitudes to physical activity; parents motivation to exercise; parental opinion of own weight status; parental opinion of child s weight status. The latest available survey data are from the 2005 survey Attitudes to adopting a healthy lifestyle; attitudes to getting children to lead a healthy lifestyle, including healthy eating and being active; attitudes to overweight; knowledge of consequences of overweight; attitudes to changing physical activity and dietary habits; attitudes to changing physical activity and dietary habits of one s child; attitudes to breastfeeding; knowledge about healthy weaning. (Not in the public domain) Attitudes to one s own weight; attitudes to healthy eating; knowledge about healthy eating; knowledge about healthy physical activity; attitudes to physical activity; self efficacy in relation to physical activity Attitudes to advice on healthy foods; attitudes to how leisure time is spent; attitudes to provision of sports and leisure activities in the local area Attitudes to one s own diet; knowledge about healthy eating; motivation to eat healthily at school; healthy eating messages at school; attitudes to food provided in school; motivation to exercise outside school Eating habits and patterns; attitudes to one s own eating habits; attitudes to one s own physical activity levels; attitudes to one s own weight; attitudes to dieting School meal entitlement, school provision of food and cooking lessons; competency Annual survey of number of children eating a school meal, catering provision in schools and compliance with school food standards

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