An unhealthy diet is a major risk factor for chronic diseases and general poorer health. Many international organisations and researchers, including the World Health Organisation, have recognised the importance of improving diet in both developed and developing nations. The prevalence of over eating, and consumption of nutrient-poor, calorie dense foods has led to a global epidemic of obesity: in the last decade the prevalence of obesity has passed that of malnutrition as the primary source diet-related morbidity.
Pillar 4 focuses on the role that diet plays in self-care, maintaining health and reducing the risk of diet-related non-communicable disease.
- Diet is considered one of the two primary risk-factors for non-communicable disease, alongside physical activity. Maintaining a healthy diet has been repeatedly shown to have preventative benefits, reducing the risk of many non-communicable diseases. In every country for which data is available, in both developed and developing nations, the determinants of non-communicable disease are largely the same: improving diet and exercise and quitting tobacco use could prevent up to 80% of non-communicable disease.
Evidence shows that people can remain healthy into their seventh, eighth and ninth decades, when a range of health-promoting behaviours, including healthy diets, are followed (WHO).
- Dietary changes are also used in the treatment of established illnesses, in a similar way to physical activity.
Of particular importance is the need for health eating in children and adolescents; childhood obesity is one of the most serious public health challenges of the 21st century. The problem of childhood obesity is highlighted in that overweight and obese children are likely to stay obese into adulthood and then tend to develop non-communicable diseases like diabetes and cardiovascular diseases at a younger age than non-obese children.
However, as with exercise, it is never too late for an individual to improve their diet and work on eating healthily; the benefits gained from improved diet are both immediately apparent and life-long.
- Poor nutrition and over-eating has been shown to cause obesity, cardiovascular disease, diabetes, several forms of cancer and a host of other non-communicable diseases. Overall, mortality rates directly increase with increasing degrees of overweight, as measured by body mass index. The World Health Organisation has estimated that 2.8 million people die as a result of obesity each year.
- The reasons behind this risk are complex, but in essence, elevated consumption of energy-dense, nutrient-poor foods that are high in fat, sugar and salt results in increased blood pressure, increased cholesterol levels, obesity and overweight, micronutrient deficiencies and a range of other related health problems, such as dental caries. These are all risk factors for non-communicable disease and early, preventable mortality.
As a result of unhealthy eating, the prevalence of obesity has risen exponentially worldwide in the last two decades. This is seen in developed nations, developing nations, in in adults and in children. In 2008, 35% of adults aged over 20 years were overweight. Globally, in 2010, the number of overweight children under the age of five is estimated to be over 42 million.
The World Health Organisation’s recommendations of health eating are set out in the “Global strategy on diet, exercise and health”, 2004. These recommendations recognise that changes in patterns of diet and physical activity at a population level will be gradual, and national and organisational strategies will need a clear plan for long-term and sustained disease-prevention measures. However, individual reductions in risk factors and in non-communicable diseases can occur quite quickly when effective changes are made and then sustained.
For a healthy diet, recommendations for individuals include the following:
·Achieve an energy balance and a healthy weight
·Increase consumption of fruits and vegetables, and legumes, whole grains and nuts
·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
·Limit the intake of simple sugars
·Limit salt (sodium) consumption from all sources and ensure that the majority of salt consumed is iodized