"...all doctors should be able to diagnose and treat nutritional deficiencies."

Royal College of Physicians. Nutrition and Patients: A Doctor's Responsibility. London 2002

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This page has been printed from the www.stewartnutrition.co.uk web site.


Healthy Eating

Ensuring that the diet is adequate and healthy is a simple step in healthcare that is often overlooked. Many people accept that they may need to improve their diet but what are the benefits of healthy eating across the years of our lifetime?

  • Infants and Children – better growth, fewer infections and better educational performance
  • Adults – better nutrition can lower the risks of heart disease and cancer the two commonest medical causes of early death, and problems such as fatigue and mental health can also be influenced by diet quality
  • Mothers-to-be -- a healthy diet and normal weight in the mother means fewer complications in pregnancy with less chance of a newborn child being deformed or underdeveloped
  • Elderly – many of the disease of old age such as osteoporosis, dementia, severe infection and weakness can also be due, in part, to undernutrition.

One of the major lessons of the four National Diet and Nutrition Surveys is that though we are better off than countries in the developing world there is an unacceptably high prevalence of mild to moderate nutritional deficiency as well as poor dietary habits that affect both the quantity as well as quality of many people’s lives.

The advice that follows is similar to much that you may have read elsewhere but there is an emphasis on consuming nutritious foods that are inexpensive and widely available in the UK as a means of preventing both nutritional deficiencies as well as disease.

Simple Dietary Advice

  • Eat three regular meals per day and in particular make sure that you always have a good breakfast. Failure to do so makes adherence to a healthy eating plan or weight loss diet less likely
  • Make sure that your main meal does provide a good amount of protein from animal or vegetarian sources.
  • Eat green vegetables or green salad every day and try to eat spinach, kale, Savoy cabbage or Swiss chard at least twice per week.  These vegetables are all rich in carotenoids (relatives of vitamin A) which help to protect the eyes from macular degeneration.  A convenient green vegetable is frozen peas which are surprisingly nutritious.  All green vegetables are good sources of folic acid, magnesium and potassium.
  • Eat fresh fruit daily usually 2 or 3 portions and if you are taking a diuretic (water tablet) eat a banana or orange daily as they provide plenty of potassium.  If you cannot manage much fruit then have a glass of good quality fruit juice daily and try eating stewed fruit especially stewed (Bramley) apples as they are very high in vitamin C.
  • Your total intake of fruit and vegetable portions should be at least five per day made up from fresh fruit, fresh or quality frozen vegetables, dried fruit, fruit juice and beans.
  • Eat a good amount of dairy foods or dairy substitute with added calcium and vitamins.  Most people should consume about two portions of dairy foods per day.  (A portion is 200 mls of milk or non low-fat yoghurt or 55 g of cheese).  They provide protein, calcium, vitamins A and B as well as iodine.  These foods are particularly important for children and adolescents, those who are underweight and the elderly.  Those who are overweight or have an elevated cholesterol level may need to chose low-fat options of these foods.
  • Every day have at least one serving of nutritious complex carbohydrate in the form of:
     - potatoes with their skins e.g. jacket potato, boiled scrubbed new potatoes or wedgies
     - wholegrain foods e.g. whole wheat cereal, muesli, wholemeal, granary or heavy rye bread
     - brown rice
    they are a good source of fibre, potassium, magnesium, trace elements and vitamin B and are much more nutritious than pasta especially white pasta.
  • Eat fish twice per week at least one of which should be oily.  This will provide the specialised omega-3 series essential fatty acids EPA and DHA which help to control inflammation and reduce the risk of heart disease.  The best oily fish are salmon, mackerel, herring, sardines, pilchards and sprats.  Fresh, tinned and smoked are all acceptable.   Other fish that have a modest amount of these fats are plaice, sole, crabs and mussels.  Fish are also an important source of protein, vitamin B12 and iodine.
  • Have a variety of healthy oils and fat spreads based on olive oil, sunflower oil, rape seed oil and walnut oil.  Do not rely upon just one type of oil as this may mean that you do not have a good balance of essential fats in your diet.  If your blood cholesterol level is elevated or you are a diabetic then use small amounts of a polyunsaturated margarine derived from sunflower oil or olive oil and you may wish to choose one that has cholesterol lowering properties.
  • Limit intake of salt and salty foods.   Most people consume nearly twice as much salt as is considered to be healthy.  It is particularly important that those who have high blood pressure, heart failure or are prone to fluid retention cut down.  Eighty per cent of sodium salt comes in pre-salted foods and their intake usually needs to reduce.  This includes; crisps, other salty snacks, pot noodles, pies, bacon, sausages, prepared foods and some breakfast cereals e.g. corn flakes.  Bread and cheese are also quite salty and their intake may need to be limited. 
  • Eat an amount of food that is appropriate for your weight and activity level.  Lose weight if you are over weight especially if you are diabetic, have high blood pressure, heart disease or an elevated blood cholesterol level.  If you are underweight make sure that you eat adequately and that your diet contains adequate protein.  If you are losing or gaining weight unintentionally then you should consult your doctor.
  • If you have been found to be deficient then eat foods that are rich in the relevant nutrient and chose the types and forms that are also appropriate for your circumstances. See Food Sources of Essential Nutrients.
  • Do not drink alcohol excessively.  Limit yourself to a maximum of 21 units per week for men and 14 units per week for women.  Remember a bottle of wine is 9-10 units and a pint of beer is 2-3 units.  Older people, those with a lower body weight and those who are unwell or nutritionally deficient are likely to be less tolerant of alcohol.   The level of intake of alcohol that is optimum for health is likely to be half of these values for the majority of people. 
  • Do not consume sugar or sugary snacks excessively.  These can displace other nutritious foods from the diet and reduce its nutrient content.   Those who are overweight, have poorly controlled diabetes or have significant nutritional deficiencies should limit their intake of sugar, sweets, chocolate, cakes, biscuits and deserts.

For further advice on healthy eating see www.eatwell.gov.uk  



Copyright Dr. Alan Stewart M.B.B.S.M.R.C.P. (UK)M.F. Hom.
47 Priory Street, Lewes, East Sussex. BN7 1HJ
Tel 01273 487003 Fax: 01273 487576