WHO EATS A HEALTHY DIET?

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A healthy diet therefore consists of high carbohydrate and low fat intake and links have been found between diet and both the onset of illnesses and their effective management. However, research indicates that many people across the world do not eat according to these recommendations. Research has explored the diets of children, adults and the elderly.

Children

Data on children’s diets in the Western world do not match the recom-
mendations for a healthy diet, and children have been shown to eat too much fat and too few fruit and vegetables (USDA 1999). Therefore, dietary recommendations aimed at the Western world in the main emphasize a reduction in food intake and the avoidance of
becoming overweight. For the majority of the developing world, however, undereating remains a problem resulting in physical and cognitive problems and poor resistance to illness due to lowered intakes of both energy and micronutrients. Recent data from the World Health Organization indicate that 174 million children under the age of 5 in the developing world are malnourished and show low weight for age and that 230 million are stunted in their growth. Further, the WHO estimates that 54 per cent of childhood mortality is caused by malnutrition, particularly related to a deficit of protein and energy consumption. Such malnutrition is the highest in South Asia which is estimated to be five times higher than in the Western hemisphere, followed by Africa then Latin America.

Adults

Research also explored the diets of young adults. One large scale study
carried out between 1989–90 and 1991–92 examined the eating behaviour of 16,000 male and female students aged between 18 and 24 from 21 European countries (Wardle et al. 1997). The results suggest that the prevalence of these fairly basic healthy eating practices was low in this large sample of young adults. In terms of gender differences the
results showed that the women in this sample reported more healthy eating practices than the men. The results also provided insights into the different dietary practice across the different European countries. Overall, there was most variability between countries in terms of eating fibre, red meat, fruit and salt. Fat consumption seemed to vary the least.
Countries such as Sweden, Norway, The Netherlands and Denmark ate the most fibre, whilst Italy, Hungary, Poland and Belgium ate the least. Mediterranean countries such as Italy, Portugal and Spain ate the most fruit and England and Scotland ate the least.
Further, Belgium and Portugal made least attempts to limit red meat whilst Greece, Austria, Norway and Iceland made more attempts. Finally, salt consumption was highest in Poland and Portugal and lowest in Sweden, Finland and Iceland.

The elderly

Research exploring the diets of the elderly indicate that although many
younger and non institutionalised members of this group have satisfactory diets many elderly people particularly the older elderly report diets which are deficient in vitamins, too low in energy and have poor nutrient content.EATING BEHAVIOUR 137 Research indicates that many people do not eat according to current recommenda- tions. Much research has explored why people eat what they do. This chapter will describe developmental models, cognitive models and the role of weight concern in
understanding eating behaviour.

Diet and illness onset

Diet effects health through an individual’s weight in terms of the development of eating disorders or obesity. Eating disorders are linked to physical problems such as heart irregularities, heart attacks, stunted growth, osteoporosis and reproduction. Obesity is linked to diabetes, heart disease and some forms of cancer (see Chapter 15). In addition, some research suggests a direct link between diet and illnesses such as heart disease, cancer and diabetes (see Chapters 14 and 15). Much research has addressed the role of diet in health and although at times controversial, studies suggest that foods such as fruits and vegetables, oily fish and oat fibre can be protective whilst salt and saturated fats can facilitate poor health.

Diet and treating illness

Diet also has a role to play in treating illness once diagnosed. Obese patients are mainly managed through dietary based interventions (see Chapter 15). Patients diagnosed with angina, heart disease or following a heart attack are also recommended to change their lifestyle with particular emphasis on stopping smoking, increasing their physical activity and adopting a healthy diet (see Chapter 15). Dietary change is also central to the management of both Type 1 and Type 2 diabetes. At times this aims to produce weight
loss as a 10 per cent decrease in weight has been shown to result in improved glucose metabolism (Blackburn and Kanders 1987; Wing et al. 1987). Dietary interventions are also used to improve the self-management of diabetes and aim to encourage diabetic patients to adhere to a more healthy diet.

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