diet and nutritiondiet and nutrition professor susan jebb nuffield department of primary care health...

Diet and nutrition

Professor Susan Jebb Nuffield Department of Primary Care Health Sciences susan.jebb@phc.ox.ac.uk

Tuesday 12 April 2016

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.

A one-day cleanse from the alkaline diet Victoria Beckham and other celebrities love

The M Plan: Mushroom-rich diet followed by Katy Perry and Kelly Osbourne can help women lose weight without shrinking their bust.

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.

Maple syrup, lemon juice and cayenne pepper: Naomi Campbell reveals the secret diet ingredients of her slimline figure

No shortage of opinion on what to eat …

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

Dietary change is slow

NDNS 2000-2001 NDNS 2009/10 Targets

Men Women Men Women

% Fat 35.5 34.7 35.2 34.4 35

% SFA 13.3 13.1 12.9 12.6 11

% sugar (NMES) 13.5 12 12.9 12.2 5

Portions of F&V 2.7 2.9 3 3.1 5

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

7053 3661 4605 1544 3937 20800

Stroke 3383 -538 623 2408 5876

Cancer 4741 535 1205* 6481

Total 15177 3661 4067 2702 7550 33157

Scarborough, et al. J Epidemiol Comm Health 2012 May;66(5):420-6

Making dietary change happen

Resist Environments Change Environments

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

Reformulation by food manufacturers can reduce fat, saturated fat, sugar and salt

85% reduction in saturated fat

25% reduction in salt

40% reduction in fat 50% decrease in salt 50% decrease in salt

30% less sugar

April 13, 2016

Promoting public health nutrition through better public procurement of food

Office Culture: help or hindrance for a healthy diet?

Individual level: encourage and enable people to develop practical coping strategies

Population level: change the environment to make the

healthy choices, the easier choices

Helping people to help themselves

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

Obesity: the BIG problem

Supporting people to lose weight

BI CP12 CP52 CP vs BI CP52 vs CP12

MAR -3.71 -4.91 -7.23 -2.21*

(-3.53, -0.89)

-2.65* (-3.99, -1.32)

Changing what we eat can cut the incidence of type 2 diabetes by nearly half

End of active intervention (reduce energy intake, decrease fat and SFA, increase fibre, increase activity)

Lindstrom et al (2002). Lancet; 346: 393-403

Incidence:

7.4 (6.1 – 8.9) per 100 person y

Incidence:

4.3 (3.4 – 5.4)

per 100 person y

Comprehensive action is needed to improve diet

Products

Promotions People

Creating a healthier environment e.g. schools, workplaces, local communities

Making healthier choices easier e.g. campaigns, labelling

Providing healthier options e.g. reformulation, portion control

Places

Shifting the balance of promotions e.g. marketing restrictions

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