eNews Briefing button

Poor nutrition

Poor nutrition as a consequence of inadequate diet is a fundamental factor in the development of coronary heart disease. Research suggests that childhood nutrition and maternal diet during pregnancy have important long-term effects on health in later life.

Dietary surveys reveal that the average British diet is low in fruit and vegetables and high in fat, salt and sugar. The status of British children's diets  and the impact of poor nutrition on their health are causes for serious concern.

Fruit and vegetables

There is evidence that a diet that is rich in fruit and vegetable content is beneficial to heart health and can considerably reduce the risk of coronary heart disease. Exactly why this is so is still unclear but it is thought that antioxidants in fruit and vegetables act on low density lipoprotein (LDL) cholesterol in the blood.

The World Health Organisation's World Health Report 2002 estimated that 4% of the overall disease burden in the developed countries is caused by low fruit and vegetable consumption. While just under 30% of coronary heart disease in developed countries is due to fruit and vegetable consumption below e.g. per day.

Fruit and vegetable consumption in children is extremely low. The 2002 Health Survey for England measured self-reported intake by children between 2 and 15 years old and only 12% of boys and girls reported eating the recommended five portions per day, while 10% reported eating no fruit or vegetables at all the previous day.

Fresh fruit and vegetable intake is greater in higher income households. The UK 2002/03 Expenditure and Food Survey suggests that the volume of fruit consumed in the richest 20% of households is 20% higher than that consumed in the poorest 20% of households.

Salt

There is evidence to show that a diet high in salt content can lead to an increased occurrence of high blood pressure or hypertension. Since high blood pressure is a major risk factor for coronary heart disease (CHD), it is in our interest to keep consumption down to a reasonable level.

The National Diet and Nutrition Survey 2000/01 suggests that the average daily salt consumption for men is 11g and for women 8.1g, both significantly higher than the Scientific Advisory Committee on Nutrition target of no more than 6g per day for adults. This survey uses 24-hour urine samples to determine salt intake.

The Scientific Advisory Committee on Nutrition report confirms previous advice that reducing salt consumption by one-third - from an average of 9 grams a day down to 6 grams a day - would have significant public health benefits by reducing average population blood pressure levels. The government's target is 6g per day for adults by 2010.

For young adults, between 19-24 years old, their consumption is the highest with 98% of men and 83% of women consuming more than the recommended 6g of salt a day. This compares to 85% of men and  69% of women overall for all age groups. In the Salt and Health report of 2003, by the Scientific Advisory Committee on Nutrition introduced additional guidance on reducing salt intake for children. For the new recommendations for target levels of salt intake for children according to age see: http://www.sacn.gov.uk/

Trends in salt consumption are harder to gage than other foodstuffs and nutrients. The National Food Survey (2000) shows that salt added to cooking and used to sprinkled onto food has declined dramatically since 1960. However, 70% of salt intake in Britain comes through processed foods which are often high in salt. In fact UK consumption has increased in the last 15 years, according to the government's National Diet and Nutrition Surveys.

Salt reduction targets 2006

The Food Standards Agency (FSA) states that at least 26 million people in the UK eat too much salt. The FSA's new salt reduction targets announced in March 2006 will help progress towards bringing down the average UK salt intake to 6g a day.

The FSA has published these voluntary salt reduction targets for food manufacturers and retailers to further encourage a drop in salt levels in common processed foods.

The reduction targets apply to salt levels in the 85 food categories that contribute most to the amount of salt in our diet. These include everyday foods such as bread, meat products and cereal products, and convenience products like pizza, ready meals, savoury snacks and cakes and pastries. Processed foods contribute around 75% of salt to the diet.

Progress towards the maximum recommended salt intake of 6g a day by 2010 will be reviewed by the FSA in 2008 in light of independent assessments of the potential for salt reduction, ongoing research, and the results of urinary monitoring.

To view the Food Standard Agency's salt reduction targets see www.food.gov.uk/

Salt awareness and ethnicity

Consensus Action on Salt and Health (CASH) made the issue of salt and ethnic groups who are susceptible to the effects of salt - the main focus being on the African Caribbean population - their main campaign thrust in Salt Awareness Week 2006.

The long-term objectives of the campaign are reducing salt to 6g a day or less to cut the risk of stroke in black people by 45%, and heart attack by 35%. A CASH survey shows African and Caribbean foods are very high in salt so consumers need to be informed and manufactures need to rethink their formulation.

Fats

The 2000/01 National Diet and Nutrition Survey looks at food consumed in and outside the home (so includes meals in restaurants, cafes, workplaces and take-aways) suggests that the percentage of energy derived from total fat is 36% in men and 35% in women. While the amount gained from saturated fat is around 13% for both men and women. The Expenditure and Food Survey suggests even higher figures, in 2002/03 adults in the UK derived 36-37% of their energy from fat, and 14-15% from saturated fat.

Trends suggest that the percentage of food energy gained from fat in the British diet is falling gradually. The Expenditure and Food Survey shows that in 2002 the percentage of fat in the British diet was 37%, down from 41% in 1980.

Fat and saturated fat intake levels differ little between socio-economic groups or across UK regions.

Nutritional guidelines

A healthy, balanced diet (derived from the Committee on Medical Aspects of Food Policy [COMA] guidelines)[2] should:

Diet and other chronic conditions 

Poor nutrition not only contributes to CHD but to other chronic related conditions such as stroke, diabetes and cancer. For example, some researchers believe that the incidence of cancer could be reduced by up to one-third in the UK if we ate more healthily. According to charity Cancer Research UK diet is linked to the following cancers: bowel, stomach, breast, lung, prostate, pancreas, oesophagus and bladder.

Also see: Traffic-light food labelling in the Nutrition section

References

1. Salt and Health (2003) the Scientific Advisory Committee on Nutrition. The Stationery Office, London www.sacn.gov.uk/pdfs/
2. The National Diet and Nutrition Survey: adults aged 19 to 64 years, Office for National Statistics (2002) The Stationery Office, London.
3. The Expenditure and Food Survey (2002) Department of the Environment, Food and Rural Affairs, Office of National Statistics, London. http://www.defra.gov.uk/esg/publications
4. National Food Survey (2002) Department of the Environment, Food and Rural Affairs, Office of National Statistics, London. www.defra.gov.uk/esg/publications/efs/default.asp
5. The World Health Report (2002), World Health Organisation, Geneva.
6. Consensus Action on Salt and Health (CASH) 2006 http://www.actiononsalt.org.uk/
Related items
Most Recent items
Related publications