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Lifestyle & behaviour - Diet & nutrition
Diet as a determinant of health
Poor diet is a risk factor for malnutrition as well as three major UK killers - cancer, coronary heart disease and diabetes.
'Malnutrition' has traditionally referred to inadequate nutrients to maintain good health on a background of insufficient calories to
sustain an adequate body weight. Modern malnutrition however refers to a combination of obesity and an imbalance of nutrients resulting
from high intakes of fatty, salty and sweet foods with inadequate amounts of fibre from fruits, vegetables and whole grains. The WHO
have quantified the influence of diet and disease: poor diet is related to 30% of life years lost in early death and disability.
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What constitutes a healthy diet?
The government's dietary recommendations for England are outlined in Table 1. These are nutrient-based, whole population targets. Table 1
also summarises the population's progress toward achieving the targets, along with associated inequalities and the effect on health of
achieving the recommendations. More detailed food-based guidelines for individuals is set out in The Balance of Good Health. This tool
can be accessed via the British Nutrition Foundation website.
Click Here to view Dietry
Recommendations For England: Current Levels,Trends And Potential Impact On Health.
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Diet and inequalities
There are vast differences in food choices of Londoners due to socioeconomic, geographical and ethnic differences. Unsurprisingly,
inequalities in diet-related diseases exist. Poor diet and risk factors such as obesity and extreme underweight are on the causal
pathway between social deprivation and other co-morbidities such as hypertension, heart disease, diabetes, dental caries, osteoporosis,
cancers and low birth weight babies. In all age groups, people living on a low income have higher rates of diet related diseases than
other people.
Major barriers to healthy eating include:
- Low income,
- Food marketing,
- Lack of accessible and accurate information on what constitutes a healthy diet,
- Poor accessibility to affordable healthy foods,
- Lack of opportunity to experiment and to develop cooking skills (including poor literacy, reduced access to well
equipped kitchens, homelessness, poor educational attainment,)
- Sociocultural factors (i.e. family food norms, family resistance, lack of support and childcare demands can all inhibit
dietary change).
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Most data collected on food and nutrition is collected on a national scale. Small scale data are often collected locally but are
seldom adequate to extrapolate to whole boroughs. Also, individual studies at Primary Care Trust (PCT) level for example are often not
shared widely so there is no single place that holds all the data for similar smaller scale projects carried out around London.
Discussion is currently underway regarding the development of tools to estimate lifestyle factor statistics, including nutrition,
at a local level. Progress on these developments including using existing data of overweight and obesity and fruit and vegetable intake
in children to model obesity rates for different areas nationally, will be reported on this site as information emerges.
References to useful sources of food and nutrition data are listed below, indicating whether this information has been collected
for London, regionally or nationally.
The National Diet and Nutrition Survey Provides:
a comprehensive picture of the dietary habits and nutritional status of the population on such topics as:
- Children's drinking and eating habits,
- Food energy and nutrient intakes,
- Nutritional status of the population,
- Dietary behaviour,
- Infant feeding practice,
- Sociocultural factors (i.e. family food norms, family resistance, lack of support
and childcare demands can all inhibit dietary change).
Data level: Some national, some regional, some London (eg contributions of selected foods to nutrient intakes).
National Food Survey (Regional level)
National Food Survey Provides: data on
consumption of household food and drink. Data level: By government office region 1997-2000. National data predates this. Also national
data on nutritional value of household food.
Expenditure and Food Survey Is
a replacement for the National Food survey in 2001. Provides information on both household consumption and nutritional intake. Data
level: Government office region for 2001-2002 and 2002-2003
The Health Survey for England -
the health of ethnic minority groups Provides: information on the eating habits of ethnic minority groups Data level: National
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