Download 1 Diet-Avenue Medical Practice Neat Guideline Introduction

Diet-Avenue Medical Practice Neat Guideline
Introduction
Ensuring that you have a healthy, balanced diet is an important step towards good health. Good health
is essential for leading a full and active life.
The word 'diet' is often used to describe an eating plan that is intended to aid weight loss. However,
diet really refers to the food that a person eats during the course of a day or a week. The more
balanced and nutritious your diet is, the healthier you can expect to be.
A balanced diet
A balanced diet means eating the right amount of foods from all the food groups. No single food
contains everything the body needs, so it is important that your diet is varied. Eating a balanced diet
can:
1.
increase your life expectancy by keeping your heart and body healthy
2.
prevent many long-term illnesses
help maintain a healthy body weight
The food groups
There are five main food groups and each one contains essential nutrients. Nutrients are vitamins and
minerals that regulate the body's chemical processes and functions. Eating nutrients from the right
food groups helps keep your body fit and healthy.
The five main food groups are:
carbohydrates, which contain lots of energy and nutrients and are found in starchy foods, such as
bread, pasta and
potatoes
protein, which helps with growth and repair and is found in meat, fish, beans and eggs
fruit and vegetables
milk and dairy foods
foods that are high in fat and sugar
Carbohydrates should make up one-third of your daily diet, and fruit and vegetables should also make
up one-third. The remainder of your diet is split between protein and milk and dairy. Only a very small
amount of what you eat every day should consist of fats and sugars.
Alternative diets
People with certain medical conditions may need to follow a slightly different diet. For example,
pregnant women need to avoid eating certain foods, such as liver and some types of fish. People who
are recovering from a stroke may also have specific dietary advice to follow, such as a low-fat, highfibre diet.
Dietary advice for people over 60 and for children of various ages may also be different.
Health benefits
Eating a nutritious, balanced diet will help you improve your overall health. In particular, a balanced
diet can help you:
maintain a healthy weight
cut your risk of developing certain medical conditions, such as high blood pressure
(hypertension) and diabetes (a long-term condition caused by too much glucose in the blood)
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Being underweight
Being underweight can cause osteoporosis (brittle bones) and amenorrhoea (absent periods) in
women. Not eating enough can mean that you do not get vital vitamins and minerals, which you need
to maintain good health.
For example, not eating enough iron can cause anaemia (a reduced number of red blood cells), which
can cause tiredness and breathlessness.
Being overweight
There are approximately 25 million overweight or obese adults (over 16 years of age) in England. The
2008 Health Survey for England (HSE) found that 61% of adults are overweight or obese and that 27%
of children (between the ages of 2 and 10) are overweight or obese.
Being overweight or obese puts you at greater risk of developing a number of serious health
conditions, such as:
type 2 diabetes, a chronic (long-term) condition caused by too much glucose in the blood
most types of cancer, when the body's cells begin to grow and reproduce in an uncontrollable
way
heart disease, when your heart's blood supply is blocked
stroke, when the blood supply to the brain is interrupted
Avoiding health problems
Even if you are a healthy weight, it is important that your diet is balanced otherwise you may be at risk
of:
high blood pressure (hypertension)
high cholesterol, when a fatty substance, known as a lipid, builds up in your blood
Both of these conditions increase your chances of developing cardiovascular diseases (conditions that
can affect your blood circulation), such as heart attacks and strokes.
Making changes
You can maintain a healthy weight and avoid health problems by eating a balanced diet. To do this:
eat plenty of carbohydrates
eat at least five portions of fruit and vegetables every day
cut down on the amount of fat, sugar and salt in your diet
eat enough vitamins and minerals ▪
drink enough fluids
Food groups
Carbohydrates
Starchy foods (foods that contain carbohydrates) should make up one third of your diet. Carbohydrates
provide energy and contain nutrients, such as fibre, iron and B vitamins. Starchy foods include:
bread
▪ pasta ▪ potatoes ▪ cereals ▪ rice
Carbohydrates can be:
refined, such as white bread and sugary cereals that have had the fibre removed
unrefined, such as brown and wholemeal bread, pasta and rice
Choose unrefined carbohydrates whenever possible because these contain more fibre so are better for
you.
Some people think that starchy foods are fattening, but they contain less than half the calories of fat.
Fats that are added to them, such as butter and cheese, can make them unhealthy.
Avoid frying starchy foods and choose healthier alternatives, such as low-fat oven chips and fortified
bread and cereal. 'Fortified' indicates that the food has had vitamins or minerals added to it.
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Fruit and vegetables
Fruit and vegetables should make up one-third of your daily diet. Aim to eat at least five portions every
day. Fruit and vegetables can be:
fresh ▪ frozen ▪ tinned ▪ dried ▪ in juices
One portion of fruit or vegetables is equal to around 80g. It could be:
one medium-sized piece of fruit, such as an apple or banana
three heaped tablespoons of cooked vegetables
one 150ml glass of unsweetened 100% fruit or vegetable juice (juice only counts as one portion,
no matter how much you drink)
three heaped tablespoons of beans and pulses, such as baked beans or kidney beans (these
only count as one portion no matter how many different types or how much you eat)
Fruit and vegetables are rich in vitamins and minerals, which are essential for your body to function
properly. As well as keeping your skin and hair healthy, a diet that contains plenty of fruit and
vegetables can reduce your risk of getting heart disease and some types of cancer.
Fruit and vegetables are very low in fat and are helpful if you are trying to lose weight.
Milk and dairy
Milk and dairy products are a good source of calcium, which is very important for strong bones and
teeth. They also contain protein, vitamins and minerals. Milk and dairy products include:
cheese ▪ yoghurt ▪ soya alternatives that are fortified with calcium
Cream and butter are in the fats food group, and eggs count as protein.
Some dairy products contain a large amount of fat. It is best to choose lower-fat versions, such as
semi-skimmed milk, low-fat yoghurt and reduced-fat cheese.
Protein
Protein helps to build and repair your body. Sources of protein include:
meat ▪ fish ▪ eggs ▪ pulses ▪ seeds and nuts
If you are a vegetarian, you can get the protein you need from seeds, nuts, soya products and beans.
However, these do not provide as much zinc or vitamin B12 as meat or fish, unless they are fortified
(have had vitamins or minerals added to them).
Meat
Meat also contains vitamins and minerals, including:
iron ▪ selenium ▪ zinc ▪ B vitamins
However, meat can sometimes contain lots of fat. To keep it healthy:
buy lean joints of meat ▪ trim the fat from the meat ▪ remove the skin from chicken and
turkey
grill, roast or microwave meat, rather than frying it ▪ drain fat away after cooking
avoid eating too many meat products, such sausages or pies, because they usually contain more
fat
Fish
Fish also contains vitamins, such as niacin, and minerals, such as selenium and iodine. Oily fish that is
rich in omega-3 fatty acids helps prevent heart disease. Aim to eat at least two portions of fish a week,
one of which should be oily fish, such as:
salmon ▪ mackerel ▪ trout ▪ herring ▪ sardines
fresh tuna (not canned because the canning process removes the beneficial oils)
White fish, such as haddock, cod or plaice, are very low in fat. To keep it healthy, remove the skin
from the fish and grill, steam or bake it. Fried fish and fish in breadcrumbs are higher in fat.
Eggs
Eggs also contain vitamin D, vitamin A, vitamin B2 and iodine. To keep it healthy, poach, scramble or
boil your eggs. Fried eggs and eggs in flans or quiches will have a higher fat content.
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Pulses
Pulses are edible seeds that grow in pods. They contain fibre, vitamins and minerals, and iron. Three
heaped tablespoons of pulses count as one portion of vegetables, but eating any more than that, or
eating several different varieties, will not count as another portion. Pulses include:
peas, such as garden peas or black-eyed peas
beans, such as baked beans, kidney beans or butter beans
lentils, such as red, yellow or brown lentils
You can add pulses to soups or casseroles as an alternative to meat. This will make the meal cheaper
and lower in fat. Three heaped tablespoons of pulses counts as one portion of vegetables (you need to
eat at least five portions of fruit or vegetables every day).
Seeds and nuts
Seeds and nuts contain fibre and vitamins and minerals. They are also a good source of unsaturated
fat. Unsaturated fat helps to lower blood cholesterol and contains essential fatty acids that your body
needs to stay healthy. Examples of nuts and seeds include:
almonds ▪ brazil nuts ▪ cashews ▪ pumpkin seeds ▪ sesame seeds ▪ poppy seeds
Nuts and seeds are a healthy snack and you can add them to cereals or salads. Choose unsalted nuts
and do not eat too many. Nuts have a high fat content and eating too many is bad for you.
Fat, salt and sugar
Fats and sugars contain more energy than any other food group and should make up the smallest part
of your diet. Too much salt can lead to high blood pressure (hypertension).
Fats
Fats are divided into two groups:
Saturated fat: this type of fat can raise the cholesterol in your blood and increase your risk of
developing heart disease.
Unsaturated fat: eating a small amount of unsaturated fat will help keep your immune system healthy
and can reduce cholesterol levels.
Saturated fat is found in:
cream, crème fraiche and ice cream ▪ butter and margarine ▪ cheese ▪ mayonnaise
fried foods ▪ some savoury snacks, such as crisps ▪ some sweet snacks, such as chocolate
some fatty cuts of meat ▪ the meat that is used in sausages and pies
Unsaturated fat is found in:
sunflower, olive and vegetable oil ▪ spreads that are made from sunflower, olive and vegetable
oils
oily fish ▪ nuts and seeds ▪ avocados
A daily diet that contains too much fat may lead to obesity. Obesity is a serious health condition where
a person has an excessive amount of fat or body weight. It can lead to a number of further medical
conditions, including heart disease.
The average man should eat no more than 30g of saturated fat a day, and the average woman should
eat no more than 20g of saturated fat a day.
Salt
Eating too much salt can raise your blood pressure, increasing your risk of having a stroke or heart
attack. Adults should eat no more than 6g of salt a day and children much less than this (see box, left).
Around 75% of the salt in your diet is already in the food that you buy. As well as cutting down on the
salt that you use to season foods, check the labels on the food you buy. The following foods tend to
have a high salt content:
ham ▪ soy sauce ▪ salami ▪ gravy granules ▪ pizza ▪ mayonnaise and ketchup ▪ crisps
bread products, such as crumpets and bagels ▪ ready-made meals and sandwiches
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Choose foods with 'reduced salt' or 'no added salt', and avoid processed foods. Tinned fish, vegetables
and pulses are often in salted water, so it is a good idea to wash them before use. Try adding other
seasonings to flavour food instead of salt. For example, try adding herbs, spices, garlic or lemon juice.
Sugar
Some foods, such as fruit and milk, contain natural sugar and these are fine in your diet. Cut down on
products that have sugar added to them, such as:
soft drinks ▪ sweets and biscuits ▪ cakes and puddings ▪ jam ▪ ice cream
Sugary foods are bad for your teeth and can cause tooth decay. Tooth decay occurs when holes
(cavities) form in the outer layer of your tooth (enamel). The holes can spread into the centre of your
tooth where the nerves and blood vessels are. This can cause a very painful infection and, in severe
cases, your teeth can start to rot and may need to be removed altogether.
Sugary foods contain a lot of calories but few other nutrients. Eating too many calories can lead to
obesity. Therefore, eat sugary foods sparingly as a special treat.
Drink 1.2 litres of fluid every day
In the UK, you should aim to drink at least 1.2 litres of fluid a day (between 6-8 glasses). However,
you should drink more when the weather is hot, and during and after exercise because more fluid is
needed to replace what is lost from your body.
Ideally, the fluid you drink should be water, but it can also include other drinks, such as:
squash - as long as it does not contain lots of added sugar,
fruit juice - check the percentage of fruit juice it contains (100% is best), and
milk - which also contains vitamins and minerals, and calcium.
Avoid fizzy drinks because they contain lots of sugar.
Caffeine
Tea, coffee, and cola all contain caffeine. This acts as a diuretic, which means that it makes the body
produce more urine.
Drinks that contain caffeine are fine to drink as long as you also drink other fluids that do not contain
caffeine.
Fruit juice and smoothies
Fruit juice and smoothies contain lots of vitamins and may count as one portion of fruit (you need at
least five portions of fruit or vegetables every day). However, they also contain a type of sugar, called
fructose, which can cause tooth decay. Drink them with a meal, and chose juice with no added sugar.
Alcohol
If you drink alcohol, you should not exceed the maximum recommended daily intake. This is:
3-4 units of alcohol for men, and
2-3 units of alcohol for women.
One unit of alcohol is a single (25ml) measure of spirit, a 125ml (a small glass) of wine, or half a pint
of standard strength lager, cider, or bitter.
Drinking more than the recommended amount can have a negative effect on your health. Excess
drinking can increase your risk of developing some cancers, as well as heart and liver disease
Based on NHS Clinical Knowledge Summary, August 2010
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