Food and Nutrition
Introduction
Eating a healthy, balanced diet is an important part of maintaining good health. This summary explores what food and nutrition means for Derbyshire. It highlights the different environmental and societal factors which affect the food we eat and why it is important to eat a healthy diet.
The government’s Eatwell Guide advocates for a healthy, balanced diet which is an important part of maintaining good health. It shows the five main food groups and the recommended proportions for a healthy diet. Eating a wide variety of foods in the right proportions and consuming the right amount of food and drink is key to maintain a healthy body weight.1 To have a balanced diet people should try to:
- eat at least 5 portions of a variety of fruit and vegetables every day2
- base meals on higher fibre starchy foods like potatoes, bread, rice or pasta
- have some dairy or dairy alternatives (such as soya drinks)
- eat some beans, pulses, fish, eggs, meat and other protein
- choose unsaturated oils and spreads, and eat them in small amounts
- drink plenty of fluids (at least 6 to 8 glasses a day)
Obesogenic Environment
The term ‘obesogenic environment’ refers to our surrounding environment which encourages people to eat unhealthy food. Our food choices are influenced by many factors including affordability, availability, convenience, and marketing. Many food and drink products available in supermarkets, restaurants, cafés and fast-food outlets are too high in saturated fat, sugar, and/or salt and are lacking in fruit and vegetables. Ultra-processed foods are readily available, heavily marketed, and are often cheaper than healthier alternatives. These factors make healthy food choices more difficult.
Accessibility
Factors such as poor transport links to affordable food retailers and the availability of affordable fresh food retailers can make eating healthy food difficult. Poor accessibility to affordable healthy foods increases the risk of food insecurity to people who are on low incomes.
The convenience of less healthy options such as fast-food can influence unhealthy choices. Across the UK, there is a greater density of fast-food outlets in more deprived areas, which makes healthy choices more difficult.3 Improving the balance between availability of healthy and unhealthy food and drink options is crucial to address food-related ill health.
Food Insecurity
Food insecurity is a growing problem in the UK and there has been a well-documented increase in food insecurity and demand for emergency food support in recent years.4 The cost of food is a contributing factor; healthier foods are more than twice as expensive per calorie than less healthy foods.5 To afford the government recommended healthy diet, the most deprived fifth of the population would need to spend 45% of their disposable income on food, rising to 70% for those households with children.6 Food is flexible item in the household budget and when very little money is available it is often the item that is reduced. This can result in households missing meals or opting for the cheaper, less nutritious foods.
There are additional costs to eating well including the affordability of appliances and their running costs. There are currently an estimated 1.9 million people in the UK living without a cooker, 2.8 million people without a freezer, and 900,000 people without a fridge.7 Fuel poverty can result in people either stop using or turn off cooking appliances, fridges and freezers to reduce energy bills and save money.
Climate Change
The food system is impacting on the climate and the natural environment. Farming processes contribute to carbon emissions, the production of greenhouse gas emissions, deforestation, and biodiversity loss. Direct impacts from climate change on health will mainly affect labour productivity among agricultural workers due to high temperatures for long periods of the year. Indirect impacts will include changes to crop and livestock productivity, soil fertility, impacts on pests and pollinators and disruptions to supply chains. Climate change is likely to have a global impact on the price of food, which will increase the risk to food security. This will have a greater impact on lower income households by making nutritious food increasingly unaffordable.8
Why is it important to Population Health?
A healthy, balanced diet has many societal and economic benefits, such as improved school attainment, increased employment, increased work productivity, reduced impact on health and social care, and reduced environmental impact. Eating a healthy diet is a large contributor to overall health and quality of life. Unhealthy diets are a primary driver of obesity and preventable diet-related disease including, tooth decay, diabetes, and hypertension. In the UK, obesity is the second most common preventable cause of death after smoking.9
Breastfeeding
The importance of good nutrition begins during pregnancy and in the early years. Breastfeeding is important to ensure the best start during the critical first 1001 days. It is a protective factor for the health of babies and mothers, which lasts well beyond the period of breastfeeding itself. Breastfeeding has been found to reduce a child’s current and future risk of overweight and obesity.10
Children
A healthy, balanced diet is essential for the physical and mental growth of a child. It is important that children get the right amount of nutrients and energy while they grow rapidly. Providing healthy, balance, and nutritious food creates positive eating habits early on, reducing the likelihood of obesity in adulthood and the associated risks to health.
Poor nutrition in childhood can cause both malnutrition and obesity which are significant risk factors for developing chronic illness in adulthood. Children are more at risk of developing tooth decay if they eat a poor diet. Frequently consuming a high level of sugary foods and drinks is a contributing factor toward poor oral health.
Adults
Obesity in adults can lead to cardiovascular disease, type 2 diabetes, cancer, liver and respiratory disease. It can also impact on mental health. It is associated with reduced life expectancy.
Older Adults
It is important for older adults to eat a healthy, balanced diet and to stay hydrated o maintain good health. As we age our sense of taste and smell can change which can affect our appetite and result in food becoming less appealing. Older adults are also at greater risk of dehydration, due to a decrease in our thirst sensation as we age.11
The Derbyshire Population Health Approach
The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.
When considering the topic of food and nutrition within The Derbyshire Population Health Approach:
• Prevention
Prevention strategies include providing access to nutritious food from an early age through interventions such as the Healthy Start Scheme, Free Schools Meals, and Derbyshire It’s About Me Holiday Activity and Food (HAF) programme. Educational programs for parents and caregivers and school-based initiatives ensure access to nutritious food.
Support people to adopt a healthy lifestyle is important. Local services such as Live Life Better Derbyshire provide support, help and advice to achieve a healthy weight.
Initiatives such as emergency food support and community pantries help to provide food to people who are struggling with low incomes. A Health in all policies approach ensures access to nutritious food and movement.
• Population
Food-related ill health disproportionately affects certain groups within the population. There is a strong relationship between eating healthy foods and deprivation. Communities living in more deprived areas are less able to eat healthy options. Children from the most deprived communities across the UK consume 20% less fruit and vegetables than the least deprived communities.12 Children across all income groups are consuming less than the recommended daily amount of healthy food groups, while at the same time overconsuming nutrients such as sugars and saturated fat.13
Nationally, nearly a third of children and young people are overweight or obese, rates are highest in children from the most deprived areas. Obesity prevalence for children living in the most deprived areas is more than double that of those living in the least deprived areas.14 This is reflected in Derbyshire, where local data shows that adults and children from lower-income households are more likely to be overweight or obese.
People on lower incomes are at increased vulnerability to food insecurity and facing greater barriers to eating a healthy diet and maintaining a healthy weight.
• Evidence
The National Food strategy, published in 2021, is a government commissioned independent review into the food system. It covers major issues facing the food system including health inequalities, diet-related disease, food security, climate change, biodiversity loss, land use, and trade. The strategy focuses around four strategic objectives:
- Escape the junk food cycle to protect the NHS
- Reduce diet-related inequality
- Make the best use of our land
- Create a long-term shift in our food culture
The strategy sets out 14 recommendations to improve health, protect the environment and build a better future for the next generation.
A whole systems approach is required to make changes to the food and drink environment, to make healthier choices easier whether we eat at home, eat out or eat on the go. A whole system approach epitomises a ‘Health in All Policies’ approach, involving stakeholders from across the local system, to help improve food and nutrition .15
• Causes
Addressing the causes of food-related ill health involves taking a whole system approach to influence changes to the food and drink environment. Understanding the underlying causes of poor nutrition, such as access and affordability of food, the built environment, education, and lifestyle factors is essential. Population health initiatives aim to address these root causes through policies, educational programs, and community-based interventions that promote healthy behaviours.
• Collaboration
Working in collaboration is essential to delivering a population health approach to food and nutrition. The development of a sustained ‘whole systems approach’ – health in all policies, actions across individual, environmental, and societal levels involving multiple sectors (including planning, housing, transport, children’s and adult’s services, business and health) is required to improve health.
By incorporating healthy and sustainable food policy into the population health approach model, population health practitioners can implement targeted prevention strategies, address the underlying causes of overweight and obesity, and foster collaboration to improve healthy weight and promote healthier communities.
The development of a Food Strategy will create an opportunity to work in collaboration with a wide range of partners and stakeholders to ensure everyone in Derbyshire has access to healthy, nutritious food which will achieve better health outcomes.
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