Making every calorie count

Abstract

We live in a world where people are living longer and overweight and obesity are widespread, linked with a calorie intake in excess of the requirements of a sedentary lifestyle. Obesity is known to increase the chance of developing type 2 diabetes and other chronic diseases. But is achieving energy balance the only challenge we face or is the scenario more complex? Evidence from dietary surveys indicates that calories should not be considered in isolation because poor diets are widespread, even in countries such as the UK. The National Diet and Nutrition Survey provides evidence of relatively low intakes of a number of essential vitamins and minerals among UK teenagers and young adults, in particular, and low intakes of fibre in all age groups, associated with low intakes of wholegrain foods, vegetables, fruit and pulses. Despite widespread familiarity with the 5 A DAY message, only 27% of adults eat five portions of fruit and vegetables a day and, on average, teenagers have particularly low intakes. The poor quality of many diets in Britain has been brought into sharp focus by publication of time trend data showing that micronutrient intakes have worsened over the past decade. However, going forward, dietary recommendations need to be considered in the context of delivering a global food supply that is both nutritious and also environmentally sustainable, and takes into account other factors such as equitable access, affordability and acceptability.

Proceedings of a roundtable event ‘Is communicating the concept of nutrient density important?’

“…Although public health policy and media coverage often focus on nutrients present in excess in diets, we also need to consider those that appear to be present in inadequate amounts in many people’s diets (Buttriss ). The 2015 report from the government’s Scientific Advisory Committee on Nutrition (SACN), Carbohydrates and Health , contains recommendations to increase fibre and reduce free sugars; yet, the message relating to fibre was largely lost among headlines focusing on sugar.…”

“…The Eatwell Guide outlines the relative proportions of the different food groups that best enables nutritional adequacy and reduced chronic disease risk. Yet, the NDNS demonstrates that, on average, diets in the UK are falling short of this guidance (see Buttriss for a discussion).…”

Vision for a National Food Strategy

“…Yet it is almost 75 years, since the 1947 Agriculture Act that focused on farming to improve productivity and produce more food domestically, that there has been a major review and reform of the UK food system. As discussed in the previous issue of Nutrition Bulletin , populations around the globe, including here in Britain, are facing an unprecedented series of food‐related challenges (Buttriss ). The world's population is growing rapidly and is set to reach close to 10 billion by 2050; diet‐related chronic diseases such as type 2 diabetes and cardiovascular disease are widespread, even in low‐ and middle‐income countries; and the impact of climate change on what can be grown in the future in different geographies means that it is high time that food systems are put under the microscope, to ensure everyone has access to nutritious and safe food and the environment is protected for future generations.…”

“…Good nutrition is as much about eating more of some things (such as pulses, vegetables and wholegrains) as it is about cutting back on others (such as free sugars, salt, saturated fat and energy dense foods low in essential nutrients). The integrated message of variety, balance and nutrient density – making every calorie count – needs to be reflected in food production right through to what we teach children in school about food (Buttriss ). Provision of food in the widest sense also acts as a social glue, creating community cohesion and contributing to the regeneration of socially deprived areas.…”

Diet and heart disease – what have we learnt over the last 15 years?

“…Research into the role of diet in CVD has historically assessed the role of single nutrients, but this strategy does not consider that meals are consumed as a combination of nutrients and foods that have the potential to interact with each other. As discussed in the paper by Professor Judy Buttriss, the importance of dietary patterns over individual nutrients is increasingly recognised, with remarkable consistency in associations between healthy dietary patterns and decreased disease risk (Buttriss ). This is important in the context of an ageing global population and the need to reduce risk of other conditions such as cancer and dementia.…”