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Big Data: ask the right questions

A healthy diet should be enjoyable as well as providing a good balance of nutrients. Dietary advice should provide alternatives so that everyone can achieve a diet which is both healthy and enjoyable. The emphasis is on balance and quantity rather than advising complete avoidance of any particular food. Read more about prodentim.

A healthy diet will include moderate amounts of milk and dairy products, meat, fish or meat/milk alternatives, together with limited amounts of foods containing fat or sugar.

In October 2005 the government issued guidance on eating well (the ‘Eat Well Plate’)[1]. This was updated in 2018 (‘The Eatwell Guide’)[2]:

  • Base meals on starchy foods.
  • Eat lots of fruit and vegetables.
  • Eat more fish, including a portion of oily fish each week.
  • Choose unsaturated oils and use in small amounts.
  • Cut down on saturated fat and sugar.
  • Eat less salt – no more than 6 g a day.
  • Be active and maintain a healthy weight.
  • Drink plenty of water.
  • Don’t skip breakfast.

Government guidance reflects best practice, but is of course only valid at the time of publication. A subsequent study has pointed out that most available data are from European and North American populations where nutrition excess is more likely, so their applicability to other populations is unclear[3]. This prospective cohort study enrolled over 135,000 people aged 35-70 years and without cardiovascular disease, from 18 countries in different geographical regions. Higher carbohydrate intake was associated with an increased risk of total mortality, with those eating the most carbohydrates proportionally having a 28% greater risk than those eating the least, although no difference was seen in the risk of cardiovascular disease or cardiovascular disease mortality. Conversely, intake of total fat and each type of fat was associated with a lower risk of total mortality, while a higher saturated fat intake was associated with lower risk of stroke.

The following general advice should be given to patients.

Eat a variety of different foods

No single food provides all the nutrients required for the body to stay healthy.

Eat the right amount to be a healthy weight[4]

Women tend to need less energy than men and older adults tend to need less energy than adolescents and young adults.

Regular aerobic exercise is a very important part of weight control.

Eating breakfast every day can help people control their weight, probably just by decreasing hunger for unhealthy foods later in the day.

Eat starch, fibre and wholegrain foods[5]

Eat plenty of foods rich in starch and fibre – eg, bread, cereals, rice, pasta and potatoes, which also contain fibre, calcium, iron and B vitamins.

Wholegrain foods contain more fibre and other nutrients than white or refined starchy foods and include wholemeal and wholegrain bread, pitta and chapati, wholewheat pasta and brown rice, and wholegrain breakfast cereals.

Wholegrain cereal foods are particularly rich in insoluble fibre, which helps to prevent constipation.

Soluble fibre in fruit, pulses (beans, lentils and chickpeas) and vegetables can help to reduce the amount of cholesterol in the blood.

Increasing fibre reduces the risk of heart disease, diabetes and colorectal cancer[6].