Unit 19 – Nutritional Health
Understand concepts of nutritional health
Healthy eating and a balanced diet
The National Diet and Nutrition Survey, published in May 2014, showed that, on average, the population of the UK is still consuming too much
saturated fat, added sugars, salt, and not enough fruit, vegetables, oily fish, and fibre. Dietary advice has been available to people in the UK
for many decades. During the Second World War the government issued leaflets with recipes for nourishing meals, alongside healthier
lifestyles, and dietary advice. Current advice has been designed to be easy to understand and hopefully, more likely to be followed.
Eatwell plate and main food groups
The Eatwell plate is a visual representation of the proportions of each different type of food you should consume. The Eatwell plate illustrates
food in groups as this is a simple way of categorising foods. The five main food groups are:
fruit and vegetables (33 per cent)
bread, other cereals, and potatoes (33 per cent)
milk and dairy products (15 per cent)
foods containing fat and foods containing sugar (7 per cent)
meat, fish, and alternatives (12 per cent).
It is easier for people to plan a healthy diet if advice is not too complicated. Even children can usually understand these food groups. Anyone
on a special diet may need help from a dietician to adapt this to their dietary restrictions.
Malnutrition, including under-nutrition and obesity
You might think of malnutrition as a condition in which people are not getting enough to eat, however, malnutrition is any condition in which
the body does not receive sufficient nutrients to function properly. Malnutrition can include both under-nutrition and over-nutrition.
Under-nutrition
Under-nutrition is a deficiency of calories, or of one or more essential nutrients, and results from having insufficient food, or a person having a
condition where they are unable to digest nutrients from the diet. This might include conditions such as ulcerative colitis, when food passes
through the digestive tract very quickly before the nutrients can be absorbed into the bloodstream. The Department of Health considers a
person with a body mass index of less than 18.5 to be underweight.
Overweight and obesity
The World Health Organization defines:
Overweight as having a body mass index greater than or equal to 25.
Being overweight increases the risk of arthritis, type 2 diabetes, and high blood pressure.
Obesity as having a body mass index greater than or equal to 30.
The National Audit Office warns that being obese can take up to nine years off your lifespan.
In addition to the health problems linked to being overweight, people who are obese are far more likely to develop health problems such as
cancer, heart disease, stroke, infertility, and depression.
Effects of food processing methods
In recent years warnings have been given about eating too much processed food.
Foods that are processed have been altered in some way, sometimes to make them last longer, or for convenience.
Table 19.1 shows the various methods that food manufacturers use to prevent food from deteriorating. Some methods have a detrimental
effect on the nutritional value of foods.
,Effect of food preparation methods
The nutritional value of food can be affected by the way food is prepared.
Fresh vegetables served raw have a high nutritional value, as long as they are fresh.
Cooking vegetables destroys some of the vitamins, but some cooking methods cause less damage than others.
When vegetables are boiled, the vitamins are lost into the water, and the longer they are boiled the more vitamins are lost.
However, studies have shown that cooked tomatoes contain more lycopene, an antioxidant that reduces the risk of heart disease and some
types of cancers.
If you use the water from boiling your vegetables to make gravy, you can save some of the vitamins. Or you can steam them instead, to retain
much of their nutritional value.
Stir-frying is also a good cooking method for retaining vitamins, and only requires a minimal amount of fat.
Cooking vegetables in a casserole with meat retains the goodness in the gravy, and roasting vegetables also releases more nutrients than
steaming or stir-frying.
Frying food is quick, and retains nutrients, but adds calories to a meal, unless dry frying, frying without adding fat to the pan, is used.
Grilling is also quick and has the added advantage of allowing fat to drip away from the food during the cooking process.
The nutritional value of food is reduced by keeping food hot, so whenever possible food should be served as soon as it is cooked.
Current nutritional issues and effects on health
The food industry is constantly developing. Research results are often summarised in the media, informing us about recent discoveries of
harm or benefits from different foods, or substances used in food processing.
More efficient methods are discovered to make food production more cost effective.
Self-prescribed health supplements
According to the Food Supplements (England) (Amendment) Regulations 2007, food supplements are sold in dose form and are intended to
add to, not replace, the normal diet.
Examples include vitamin and mineral tablets.
A well-balanced diet should include all the nutrients needed to keep you well.
However, some people struggle to consume sufficient amounts of important vitamins and minerals.
This includes fussy eaters and those unable to eat certain foods for medical reasons.
It also includes people with conditions leading to poor absorption, or who experience frequent diarrhoea.
Food supplements can also benefit people who need to consume high quantities of particular substances, for example a woman who suffers
from heavy periods may benefit from iron supplements to help replace the iron lost during her period.
Genetically modified foods
According to the World Health Organization, foods are genetically modified (GM) if the DNA of the cells making up that food has been altered.
Genetic modification may be done for several reasons.
One is to produce higher yields of crops, which could be vital to avert starvation in developing countries in a world where the population
continues to rise.
Crops may be modified to make them poisonous to pests that damage the crop, removing the need to use pesticides.
This is better for the environment and reduces the exposure of the farm workers to pesticides.
Some crops are modified to make them more nutritious.
For example, a strain of rice has been developed that is richer in vitamin A, a nutrient that can be lacking in some Asian diets.
A further advantage of GM foods is that they last longer before starting to deteriorate, GM tomatoes, bananas and pineapples have all been
produced to last longer
, Nutritional measures and recommended dietary intakes
A good understanding of the function of different components of food is useful for care workers, who may need to advise individuals about
dietary changes required to improve health.
Balancing energy requirements for protein, fat, carbohydrate (kilocalories and kilojoules) The body needs energy to function.
Even when you are resting, your body uses energy for all the processes going on inside, such as respiration, temperature control, digestion
and cell repair.
This is known as the basal metabolic rate.
The amount of energy you need for this depends on your age, gender, size, and the climate you live in.
It also depends on your lifestyle.
If you have a strenuous job or do a lot of exercise, your energy needs will be greater.
It is important to balance the amount of energy being used and the number of calories eaten.
Too many calories will lead to weight gain, and too few, to weight loss.
Of course, it is not just calories that you need to think about, but the type of foods you eat. Energy comes from the carbohydrate, fat, and
protein in your diet.
Nutritional balance means having just the right proportion of different types of food.
If you look at the labels on packaged food, you will notice that energy is measured in two different units, kilocalories, and kilojoules.
Kilocalories are the units normally referred to as calories, and are the ones normally used to measure and control intake when people are
trying to lose or gain weight. Kilojoules are a different measure, mainly used by scientists, 1 kilocalorie equals 4.2 kilojoules.
Measuring body mass index (BMI)
The body mass index is used to decide whether people are the right weight for their height.
The ideal BMI is between 18.5 and 24.9.
In recent years, the value of BMI as a tool to identify obesity has been questioned as it does not consider overall percentages of body fat and
muscle.
Muscle weighs more than fat, so individuals with a higher percentage of muscle will weigh more.
Some practitioners now recommend that waist size is a better predictor of risk to health.
Ideally, the waist measurement should not exceed half that of the height.
Weight for height and gender
When monitoring people’s weight, it is important to consider their height and gender.
A person who weighs 80 kg (12 stone 7 lbs) would be very overweight if they were 1.45 m (4 ft 9 ins) tall but would be normal weight if they
measured 1.9 m (6 ft 2 ins).
Men are slightly heavier than women of the same height because they usually have more muscle.
Using growth charts to monitor weight gain
Babies and young children should have their weight regularly monitored, and this is usually done at a special clinic in the local health centre.
This is to monitor their weight gain, so that action can be taken if they are not putting weight on or putting weight on too quickly.
Their weight is recorded on a chart, which also records their birth weight.
There are lines printed on the chart showing the range of weights for children according to their age, so babies can be compared to others of
the same age.
The normal range is quite large.
The most important thing is the rate of increase, and just because a baby is within the normal range for their age does not mean all is well.
For example, you may be worried if a baby at the top end of the scale stops putting on weight.