Diet and nutrition. Professor Susan Jebb Nuffield Department of Primary Care Health Sciences Tuesday 12 April 2016

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1 Diet and nutrition Professor Susan Jebb Nuffield Department of Primary Care Health Sciences Tuesday 12 April 2016

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3 No shortage of opinion on what to eat A one-day cleanse from the alkaline diet Victoria Beckham and other celebrities love THE 5-FACTOR DIET: Eva Mendes is a huge fan of celebrity trainer Harley Pasternak's 5-Factor Diet. The program encourages dieters to cook with five ingredients or less and follow Pasternak's rigorous exercise regime. The M Plan: Mushroom-rich diet followed by Katy Perry and Kelly Osbourne can help women lose weight without shrinking their bust. Maple syrup, lemon juice and cayenne pepper: Naomi Campbell reveals the secret diet ingredients of her slimline figure Mother of six Angeline Jolie follows the ancient grains diet, adding grains, seeds, and nuts including quinoa, millet, chia seeds, spelt and buckwheat to her meals and snacks. Beauty benefits include glowing skin and shiny, healthy hair.

4 Nutritional principles for a healthy diet Achieve energy balance and a healthy weight Limit energy intake from total fats and shift fat consumption away from saturated fats to unsaturated fats and towards the elimination of trans-fatty acids Increase consumption of fruits and vegetables, and legumes, whole grains and nuts Limit the intake of free sugars Limit salt (sodium) consumption WHO Global Strategy on Diet, Physical Activity and Health

5 Dietary change is slow NDNS NDNS 2009/10 Targets Men Women Men Women % Fat % SFA % sugar (NMES) Portions of F&V

6 33,000 premature deaths per year averted in UK by achieving dietary recommendations Fruit & Veg Fibre Fats ( Chol) Fats ( BMI) Salt ( BP) Total Coronary Heart Disease Stroke Cancer * 6481 Total Scarborough, et al. J Epidemiol Comm Health 2012 May;66(5):420-6

7 Making dietary change happen

8 Resist Environments Change Environments

9 Signposting healthier choices through labelling 23 companies, representing two-thirds of pre-packaged food, have committed to adopt and implement a consistent Front of Pack nutrition labelling scheme

10 Reformulation by food manufacturers can reduce fat, saturated fat, sugar and salt 30% less sugar 25% reduction in salt 85% reduction in saturated fat 40% reduction in fat 50% decrease in salt 50% decrease in salt

11 Promoting public health nutrition through better public procurement of food April 13, 2016

12 Office Culture: help or hindrance for a healthy diet?

13 Helping people to help themselves Individual level: encourage and enable people to develop practical coping strategies Population level: change the environment to make the healthy choices, the easier choices

14 Obesity: the BIG problem 25% adults are obese and further 37% overweight 1 in 5 children aged 4/5y and 1 in 3 aged 10/11y are overweight Direct costs to NHS estimated at 5.1 billion/y Indirect costs to wider economy estimated at 16 billion/y

15 Supporting people to lose weight BI CP12 CP52 CP vs BI CP52 vs CP12 MAR * (-3.53, -0.89) -2.65* (-3.99, -1.32)

16 Changing what we eat can cut the incidence of type 2 diabetes by nearly half Incidence: 4.3 ( ) per 100 person y Incidence: 7.4 ( ) per 100 person y End of active intervention (reduce energy intake, decrease fat and SFA, increase fibre, increase activity) Lindstrom et al (2002). Lancet; 346:

17 Comprehensive action is needed to improve diet Shifting the balance of promotions e.g. marketing restrictions Places Creating a healthier environment e.g. schools, workplaces, local communities Promotions People Providing healthier options e.g. reformulation, portion control Products Making healthier choices easier e.g. campaigns, labelling

18 A personal evidence-informed recipe for a healthy diet 1. Think about foods not nutrients and choose a diverse range 2. Eat the right amount to achieve and maintain a healthy weight 3. Choose high fibre/wholegrain cereals and grains in place of refined varieties 4. Eat more vegetables 5. Eat less meat, especially processed meat, and more fish/legumes/nuts instead 6. Eat as little as you can manage of foods with little or no positive nutrition : biscuits, cakes, chocolate, confectionary, pastry 7. Eat some dairy and fruit 8. Drink water and minimise sugary drinks and alcohol 9. Don t add salt in cooking or at the table 10.Check the label on processed foods and choose products with less fat, saturated fat, sugar and salt