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To GI or not to GI - that is the question
The Best Way to Build a Healthy Body - A focus on nutrition and activity for kids!
The pros and cons of the glycaemic index diet
Children’s Diets
Preparing for a Healthier Older Age
Prevention and treatment of type 2 diabetes
Nutrition for the boys
Festive Healthy Eating!
The Health Professional’s Role in the Treatment and Prevention of Obesity
Pregnancy and the first postnatal year - Part 2 - After the birth
Scotland’s Dental Dilemma – Dietary Implications for Oral Health
Pregnancy and the first postnatal year - Pre-pregnancy and pregnancy
Smiling for Scotland – how to keep your teeth for life
Healthy Eating in the 21st Century
When Irish teeth are Smiling – how to keep your teeth for life
Weight Management and Fad Diets
Dietary prevention and treatment of type 2 diabetes - Scotland
Coronary heart disease - Ireland
Weight management – a big challenge...
Dietary prevention and treatment of type 2 diabetes - Ireland
Eating for a Healthy Active Lifestyle
What do we know about...Nutrition and older people?
What do we know about...Eating for a healthy active lifestyle?
What do we know about...Childhood Obesity?
What do we know about...Diabetes & obesity in adults & children?
What do we know about...Diet and Coronary Heart Disease?
What do we know about...Oral health for families?
Weight management in primary care: The Counterweight Project
Smiling through the ages – how to keep your teeth for life
Vegetarian and Vegan Diets
Coronary heart disease - Scotland
Exercise for children
Fluid Thoughts
The Importance of Carbohydrates in the Diet
Osteoporosis Prevention: Building Stronger Bones
Advice on Unhealthy Diets
Dental decay and the case for fluoride
Nutrition and the Elderly
The importance of physical activity for health
Caring for teeth in later life
Undernutrition in the elderly: a problem on the rise
Oral Health of the Young
Diet and Coronary Heart Disease
Coronary Heart Disease in Ireland
Wearing thin
Dietary Counselling for Caries Prevention
To GI or not to GI - that is the question
Right! Another magic diet eh! All you have to do is eat slow carbohydrates. No, it doesn’t make you slow, it is supposed to make you full - without eating too much. It slightly more complicated than Granma’s advice to eat lots of potatoes and bread (or Yorkshire pudding if you like that sort of thing). It’s not quite the same as the “F Plan Diet��? either, but the idea is much the same. Somehow the body’s delicate sense of when it is being cheated of calories is supposed to be turned off, just by eating bagels instead of bread. Hard to believe? Then you can’t have been reading the hype on GI.
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The Best Way to Build a Healthy Body - A focus on nutrition and activity for kids!
Why should children be active? Or more importantly, should we be encouraging our children to be more active? From a health standpoint the answer is a resounding yes. The benefits are not only physical, but psychological and social as well. In the Department of Health report (2004) the Chief Medical Officer recommends that children and young people take part in at least 60 minutes of moderate intensity exercise every day, including activities that increase muscle strength and flexibility and improve bone strength, at least two days a week. Unfortunately, this recommendation is not being met by four out of 10 boys and six out of 10 girls in England.
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The pros and cons of the glycaemic index diet
The low glycaemic index (GI) diet has featured a great deal in the media. It seems to have taken over from Atkins as the diet of choice. So, is the GI diet a useful tool for weight loss, and can it reduce the risk of diabetes and coronary heart disease? Or is it just another diet fad?
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Children’s Diets
Eating well and being physically active are essential for any child’s health and development. As children are active and grow rapidly they have a high energy requirement relative to their body size - per kilo of body weight children need more calories than adults. However, younger children may have a small appetite due to the small size of their stomachs, so the frequent consumption of energy and nutrient-rich foods in small amounts is essential to ensure that their nutrient requirements are met.
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Preparing for a Healthier Older Age
Ageing well has never been more important as life expectancy continues to grow – from just 47 years at the start of the last century to 79 years by 2004 (1). Estimates are that by 2031 there will be 36,000 centenarians in the UK (people over 100 years old) compared to just 300 in 1951. In short, more people are living longer, which means that either people are enjoying many years of a healthy and active third age or they are experiencing years of ill health. Middle age is assumed by many to be the time when the cracks begin to show, but this need not be the case. Improving life choices now can reap huge rewards for the years ahead and may be easier to achieve than many people believe.
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Prevention and treatment of type 2 diabetes
Recently, several landmark studies have demonstrated significant benefits of intensive lifestyle interventions in both prevention and treatment of diabetes. Alternatively, low-carbohydrate high-fat diets (including the Atkins diet) have been proposed as a substitute for challenging modifications in lifestyle and established hypocaloric low-fat diets. This review presents a summary of lifestyle modification strategies along with practical guidance about how these can be implemented in routine clinical practice.
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Nutrition for the boys
Men not only have different energy and nutrient requirements from women but they also have a greater risk of succumbing to many life-threatening diseases such as coronary heart disease and bowel cancer.
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Festive Healthy Eating!
Did you know that the average Christmas menu can contain a whopping 6,000 calories? December is the one time of the year that even the healthiest of eaters tends to let go a little. The build up to December 25th can also play havoc on diet and calorie intake. With all those Christmas parties to go to, the after work drinks, and no free time to go to the gym with all that present shopping to do, it’s no wonder that the average person gains weight during December. So how can you and your patients limit the damage over the festive season, without missing out on all the fun? Simple, follow some golden rules and plan ahead a little.
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The Health Professional’s Role in the Treatment and Prevention of Obesity
With the increasing prevalence of obesity in the UK, there is an increasing demand for health professionals to offer advice on successful weight loss strategies. Over the last 25 years, obesity levels have trebled and they are continuing to rise. One of the largest diet and nutrition surveys carried out in 2001(1) indicated that over half of all men and women were overweight and 25% men and 20% women were clinically obese. Worryingly, the increase in obesity is occurring across all age groups including young school children and adolescents.
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Pregnancy and the first postnatal year - Part 2 - After the birth
Amongst all their other tasks, health visitors, midwives and community nurses have the challenge of communicating clear and correct messages about food-related issues. The purpose of this article is to give a broad overview of the main issues for mothers and their infants during the first year after birth. There is a list of sources of other information and further reading at the end.
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Scotland’s Dental Dilemma – Dietary Implications for Oral Health
The Scottish diet has been subjected to criticism for long enough. The urban myth of the deep-fried Mars Bar caught the imagination of detractors. If we are fair, in the past and no doubt even now, there remains room for improvement. The nursing profession is very well aware that there have been great efforts to remedy the situation and great change is on the way. Public awareness of dietary matters has never been higher. It is difficult to pick up any popular publication and not read an explanation of some nutritional angle. In the very nature of things, because change takes time, it will be a while before we will see the gains coming through in the epidemiology. Like other lifestyle related problems, the potential for dramatic improvement is there but may be slow to materialise. Dental disease, notably dental decay (caries), is no exception to this rule. Nor is it exempt from the scrutiny of researchers stimulated by interest in the Scottish diet.
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Pregnancy and the first postnatal year - Pre-pregnancy and pregnancy
Amongst all their other tasks, health visitors, midwives and community nurses have the challenge of communicating clear and correct messages about food-related issues and pregnancy. The purpose of this article is to give a broad overview of the main issues. There is a list of sources of other information and further reading at the end.
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Smiling for Scotland – how to keep your teeth for life
Sometimes Scotland is unfairly targeted as having particularly poor oral health. This is a simplistic view. Throughout the UK it has become clear that dental decay (caries) has become a socially mediated disease. Prevalence patterns match closely those of socio-economic deprivation. Where Scotland differs is the very large variations between different areas. Dental caries prevalence is usually measured by counting the average number of decayed, missing and filled teeth at survey. This is known as the dmft for primary teeth and DMFT for permanent teeth.
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Healthy Eating in the 21st Century
Nutrition and healthy eating have featured highly on health priorities since the mid eighties, but the recent tidal wave of obesity that is sweeping the country has placed a new emphasis on developing focused and effective strategies to tackle this epidemic in public health effectively. Alongside this, nutrition also features highly in the media, which plays a dual role in educating readers regarding health and well-being, while simultaneously perpetuating diet myths and the latest fads such as the Atkins mania of the early 2000s. Both Scotland and Ireland have Food and Nutrition Strategies in place and nurses play a front line role in implementation of these, with daily opportunities to work with patients to improve their diets for both themselves and their families.
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When Irish teeth are Smiling – how to keep your teeth for life
There is a bittersweet picture of dental health in Ireland. The contrast between the North and the fluoridated regions in the Republic show dramatically how dental decay can be cut by 50% with water fluoridation. Not all of the Republic of Ireland (RoI) is fluoridated and the contrasts are highlighted by the Eastern seaboard which boasts the lowest decay rates for the whole of Europe. This benefit persists through the ages. Fifteen year olds in the South have half the level of tooth decay of their counterparts in Northern Ireland.
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Weight Management and Fad Diets
Obesity and overweight are global concerns and the world has a weight problem. Ireland is no exception and obesity is emerging as one of its most serious health problems. In 2003, it was reported that 42% males and 27% females were overweight and 14% males and 12% females were obese (1). Paradoxically the proliferation of diet books and the sheer volume of commercial diets and access to nutrition information have never been greater. However, are fad diets effective for weight loss, is their information scientifically sound and do they reduce the risk for chronic disease?
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Dietary prevention and treatment of type 2 diabetes - Scotland
Diabetes mellitus presents a serious health challenge for Scotland. It is estimated that 122,900 (1 in 40) people have been diagnosed with diabetes and a further 87,100 are, as yet, undiagnosed in Scotland (Scottish Intercollegiate Guidelines Network (SIGN), 2001). It is predicted that the number of people developing diabetes may double in the next 10-15 years to well in excess of 200,000 people in Scotland (Scottish Diabetes Framework, 2002).
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Coronary heart disease - Ireland
Despite a continued fall in deaths from coronary heart disease (CHD), it still remains the biggest killer in both Northern Ireland and Eire. In 2001, CHD accounted for 14% of all deaths in those aged less than 65 years (1). In Northern Ireland alone, 2948 deaths were due solely to CHD in 2002. However, the good news is that mortality rates from CHD have consistently fallen over recent years. The Irish government is committed to the reduction of levels of heart disease as set out in its 'Cardiovascular Health Strategy - Building Healthier Hearts' published in 1999 (2).
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Weight management – a big challenge...
It seems fairly simple; all you have to do to maintain a healthy weight is balance the amount of calories consumed with the amount of energy expended. For centuries the vast majority of people have managed to do this effortlessly, but in recent times the number of overweight or obese people has escalated dramatically (1). So why are so many people finding it hard to control their weight, and what help and advice can be offered for a leaner, fitter future population?
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Dietary prevention and treatment of type 2 diabetes - Ireland
Diabetes is a growing epidemic and is one of the most common non-communicable diseases in the world. Currently in Southern Ireland it is estimated that 200,000 people have diabetes and that 50% of those are unaware they have the condition (population 4 million) (Diabetes Service Development Group, 2002). In Northern Ireland, 49,000 people are diagnosed and another 25,000 undiagnosed (population 1.7 million) (Diabetes UK, 2003). The incidence of diabetes is expected to double by 2010 as unhealthy diets, obesity and sedentary lifestyles exact their toll on aging populations.
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Eating for a Healthy Active Lifestyle
It seems we are told two key things with regards to our health - eat a healthy balanced diet and take part in regular exercise. These two things are however not separate - you can’t keep up a regular exercise programme without fuelling it with the right diet. And, if we wanted to take it a stage further and rank one above the other - there is an increasing amount of scientific evidence pointing towards exercise as being the most important component to enhance life quality and expectancy. So why is exercise so important for health? And how can we best fuel a healthy active lifestyle?
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What do we know about...Nutrition and older people?
Nutrition is important to the health and functioning of elderly people. This paper summarises the evidence that many old people suffer from undernutrition and outlines the insidious effects of this form of malnutrition. It discusses the physiological and practical difficulties elderly people face in achieving good nutrition, and the challenge this poses to health workers. Given the UK’s ageing population, undernutrition in older people is a significant public health issue as well as one that should concern all health professionals involved in individual or group contacts with elderly clients.
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What do we know about...Eating for a healthy active lifestyle?
Increasing evidence points to the key role of exercise in enhancing the quality of life and life expectancy. In this article a registered sport and exercise nutritionist examines the nutritional aspects of fuelling physical activity, including the importance of a balanced diet and of taking carbohydrates before and after exercise.
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What do we know about...Childhood Obesity?
The incidence of obesity among children in the UK has been increasing since the 1980s and is a “hot topic" among health professionals, Government, the media and some parents. It is an emotive subject which often attracts instant opinions and hasty solutions. To provide sound, balanced advice it is important that health professionals are aware of current evidence about the prevention and management of obesity in children, and differences between child and adult obesity. This article summarises the evidence and offers some practical tips. It also considers child obesity in the context of the family.
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What do we know about...Diabetes & obesity in adults & children?
The increased incidence of diabetes is linked with the rising incidence of obesity in adults and children in the UK. The National Framework for diabetes has identified obesity as the most significantly modifiable risk factor for type 2 diabetes. In this article, two specialist dietitians and a specialist nurse discuss exercise and diet in the prevention and management of diabetes in adults and children, with particular reference to obesity and type 2 diabetes.
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What do we know about...Diet and Coronary Heart Disease?
Coronary heart disease (CHD), together with stroke and peripheral vascular disease, make up the main cardiovascular diseases, which are diseases of the heart and circulatory system. Cardiovascular diseases, especially CHD, are major causes of morbidity and mortality in the UK.
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What do we know about...Oral health for families?
The author outlines improvements in Britain’s dental health and summarises practical advice to pass on to families with young children and adults of all ages. The importance of fluoride and moderating the frequency of snacks is emphasised. Current thinking on diet and dental decay is discussed, including new developments in our understanding of the part played by carbohydrates, which is less simplistic than previously thought.
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Weight management in primary care: The Counterweight Project
Obesity is a serious public health problem in the UK and needs to be tackled both at an environmental and an individual patient level. The Counterweight Project is a structured general practice programme and the first largescale practice nurse-led intervention aimed at improving the management of obesity in primary care. Preliminary results suggest 40% of patients completing the weight management aspect of the programme achieve and maintain a 5% loss of initial body weight at 12 months. The project is led by a board of consultants from across the UK, is facilitated by dietitians and involves 80 general practices.
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Smiling through the ages – how to keep your teeth for life
The key aspects of dental health in babies and children, teenagers, adults and the elderly are outlined, including tips for prevention of dental disease.
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Vegetarian and Vegan Diets
Although there are many interpretations of the word vegetarian, the Vegetarian Society describes a vegetarian as "someone living on a diet of grains, pulses, nuts, seeds, vegetables and fruits with or without the use of dairy products and eggs (preferably free-range). A vegetarian does not eat any meat, poultry, game, fish, shellfish or crustacea, or slaughter by-products such as gelatine or animal fats"
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Coronary heart disease - Scotland
It is estimated that half a million Scots have coronary heart disease (CHD), of whom 180,000 require treatment for symptomatic disease. Despite a continued fall in deaths from CHD, it still remains the biggest killer in Scotland. In 2001, CHD accounted for 11,914 deaths in Scotland, which was the highest mortality rate from CHD in Europe (1). However, the good news is that mortality rates from CHD have consistently fallen over recent years (Figure 1). The Scottish Executive is committed to the reduction of levels of heart disease. In the public health white paper 'Towards a Healthier Scotland', it declared that one of the aims is to reduce the number of deaths from heart disease of those aged less than 75 years by 50%, from the year 1995 to 2010. The Scottish Executive's 'Coronary Heart Disease and Stroke Strategy for Scotland' was published in September 2002 (2).
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Exercise for children
Statistics indicate that 39% of boys and 58% of girls aged 7-18 do not achieve the recommended levels of exercise, eg spending at least one hour each day in a physical activity of at least moderate intensity. This paper summarises the physical and psychological health benefits of exercise for children and young people and emphasises that the promotion of exercise and healthy food choices should go hand in hand. Practical tips for young people on exercise and nutrition are suggested.
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Fluid Thoughts
We are all now more aware that it's vital to drink plenty of fluids to stay fully hydrated. But how much do we need? In essence, we need to drink enough to replace what is lost - in urine, sweat and even our breath. This varies from person to person - a lot depending on age, climate, and physical activity levels. But, the general recommendation is that we need to drink about 2-3 litres of fluids a day - about half of this normally comes from food and half from drinks.
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The Importance of Carbohydrates in the Diet
Cancer and heart disease are the two main causes of death in Scotland and, when combined, accounted for more than 30,000 lives lost in 1999 (1). It is estimated that one in three Scots are at risk of getting cancer at some point in their life (2). These figures exclude deaths resulting from other non-communicable diseases and poor health (1). Strategies implemented in the past couple of years to improve health have impacted positively on heart disease and it is estimated that mortality rates fell by four percent in 2001, compared to 2000 (2). On the other hand, obesity is increasing, with 17 percent of men and 21 percent of women in the UK currently obese and more than half the adult population classified as being overweight (3).
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Osteoporosis Prevention: Building Stronger Bones
Osteoporosis is a major world-wide public health concern, causing substantial pain, disability and death. Prevention centres around improving diet and increasing physical activity. Here, Dr Samantha Stear looks at the importance of nutrition and activity in preventing this disabling condition.
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Advice on Unhealthy Diets
Many magazines and health books for lay people extol the virtues of diets that produce weight loss, often rapidly and using unconventional regimes. In this article a dietitian summarises the basic physiology of weight loss and discusses three such types of diet: food-combining; "detox"; and the Atkins or high-protein, low carbohydrate diet, including their physiological flaws and possible adverse effects.
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Dental decay and the case for fluoride
A former Chief Dental Officer explains the use of fluoride in preventing dental caries. He discusses the causes and process of dental caries and the basic health education messages to communicate to the public. Although the incidence of dental caries has reduced in the UK, mainly due to greater use of fluoride, decay remains prevalent among socially and economically disadvantaged groups. Dental health promotion is also needed for young parents who, having good teeth themselves, do not always realise that their children are still at risk of caries. Parents are not always aware of how to prevent dental caries in their children.
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Nutrition and the Elderly
A healthy balanced diet is vital for the elderly as it can help stave off disease and aid recovery from illness. Health promotion is a major role of the primary care nurse, and as the proportion of the population living to over 65 increases, it is crucial to encourage healthy eating.
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The importance of physical activity for health
Physical inactivity is recognised as a significant, common and preventable risk factor for heart disease, obesity, type II diabetes and osteoporosis. Regular physical activity helps avoid weight gain and plays a part in increasing wellbeing by reducing stress, anxiety and feelings of depression. The author outlines some of the specific health effects of exercise and explains the significance of diet, especially carbohydrates. The article includes some practical health education tips.
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Caring for teeth in later life
There are substantial changes occurring in the oral health status of older people with increasing numbers of people having some natural teeth. However, we are still some way from a prosthesis-free world, as many older people rely on either part dentures or a complete denture opposed by a natural dentition for function. Obviously, these changes in oral health status bring with them differing needs in terms of personal oral health care and attitudes to oral health.
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Undernutrition in the elderly: a problem on the rise
Older people are vulnerable to malnutrition, increasing the likelihood of ill-health and negatively affecting functional ability (1-3). Indeed, 3% of older men and 6% of older women are underweight, and these figures rise to 16% and 15% respectively in care homes (4). By 2025, 21.5% of the population will be elderly; and of these, 29.1% will be greater than 80 (5)
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Oral Health of the Young
With the deadline for the Oral Health Strategy quickly approaching, Brian Mouatt CBE looks at the targets set in 1994 for raising the standard of the oral health of the nation’s youth and looks at what changes have occurred to help us reach them.
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Diet and Coronary Heart Disease
Coronary Heart Disease (CHD) is one of the leading causes of death in Scotland. The premature death rate for CHD in men living in Scotland is over 50% higher than in East Anglia and over 80% higher for women (1), and the cost to the NHS of treating CHD is enormous. Drugs alone were estimated to cost over £175 million in Scotland in 2001 and accounted for a staggering 23% of the total drugs budget (2). These damning statistics make grim reading and highlight the importance of strategies to improve the heart health of people in Scotland.
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Coronary Heart Disease in Ireland
Cardiovascular disease (CVD) (including coronary heart disease (CHD), stroke and circulatory disorders) is the highest cause of mortality in Ireland (> 40%) and a major cause of premature mortality. Within the cardiovascular group of diseases, CHD accounts for more than half of the mortality rate and is the cause of almost one quarter of all deaths at all ages. Over 1,800 people in Ireland died prematurely from CVD in 1997 (Annual Report of the Chief Medical Officer, 1999).
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Wearing thin
It is perhaps a sad indication of life, but as you grow older your teeth wear away. For most people the process is slow and the changes do not affect appearance or function of teeth. But in some, the process is more aggressive and the results can affect people’s quality of life.
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Dietary Counselling for Caries Prevention
The English philosopher and mathematician Alfred North Whitehead (1861-1947) remarked: ‘A science which hesitates to forget its founders is lost’. This saying often crosses my mind when I think about the relationship between diet and dental caries.
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