In the internet age, the public has unfettered access to a wealth of nutrition and lifestyle information. Unfortunately, due to the ‘Wild West-like’ nature of the online space, what they are often likely to discover is conflicting opinion, confusion, and potentially harmful advice.
Given this climate of confusion, it is perhaps more important than ever that personable, trusted sources are able to provide accurate information to the public. Pharmacists are ideally situated to offer evidence-based advice, as public trust in healthcare professionals (including pharmacists) is high, as indicated by national polls.
Although specific dietary advice for medical conditions remains the remit of doctors and dietitians, there may be opportunities for pharmacists to provide general lifestyle and nutrition information to concerned individuals. A healthy diet as part of a healthy overall lifestyle can have a significant impact on reducing the risk of diseases like cardiovascular disease, type 2 diabetes and some cancers and may also be helpful for people with different medical conditions, alongside their medication.
In the UK, the Eatwell Guide presents a practical, visual representation of what current evidence suggests is a healthy dietary pattern. The Eatwell guide contains 5 main food groups, including fruit and vegetables, starchy carbohydrates, proteins, dairy and alternatives, and a much smaller segment for oil & spreads.
Each of these groups can contribute a range of nutrients. For example, wholegrain varieties of starchy carbohydrates can contribute to fibre intake. Most adults only consume around 19 grams of fibre per day, far less than the recommended 30 grams. Adequate fibre and fluid intake can be valuable tools to combat constipation, which may be a common issue raised at the pharmacy counter.
Foods high in fat, salt and sugars sit outside the main image of the Guide to show that these are not needed as part of a healthy diet and, if they are eaten, this should be in small amounts and less often.
The messages presented in the Guide might seem obvious, but large swathes of the UK population do not meet the current recommendations.
If a balanced and varied diet is followed, most key nutrients will be obtained through the diet. Whole foods contain a mixture of nutrients, fibre and other natural bioactive compounds that may not be present in a supplement. A recent study has indicated that general supplementation may be less effective than consuming equivalent nutrients from the diet and the wide range of compounds found in foods may partially explain this finding.
However, this does not mean that supplementation cannot be useful if an individual has sub-optimal status for a nutrient, which can be due to a medical condition or an excessively restricted diet in one or more areas. In these particular cases, supplements might be useful to fill a specific requirement gap.
There are some specific occasions where supplementation is more broadly encouraged:
- Between October and March, everyone in the UK should consider taking a 10µg vitamin D supplement, due to its rarity in the diet and the lack of sunlight in these months.
- Children between the ages of 6 months and 4 years should take vitamin A, C and D supplements and babies from 0-6 months who are breastfed or having less than 500ml of infant formula a day should be given a vitamin D supplement.
- Vegans and strict vegetarians may need supplementary vitamin B12, as it is predominantly found in animal products. Vegans mayalso require other supplements, particularly iodine, though they should discuss this with a doctor or dietician first.
- Pregnant women are advised to take folic acid supplements, both before and during the first 12 weeks of pregnancy. Vitamin D supplements should also be considered during pregnancy but supplements containing vitamin A (retinol) should be avoided.
Alongside healthy eating, lifestyle factors such as smoking and drinking above the recommended intake of alcohol can exacerbate health issues and contribute towards new ones. Physical exercise is also something that you might wish to discuss when asked for health-related advice. UK guidelines recommend 150 minutes per week, but there is scientific evidence that even small amounts (e.g. 10 minutes at a time) are better than none. Aim to encourage small changes in physical activity, such as walking briskly or taking up a new social sport.
While there can be a lot of confusion surrounding diet and health, the evidence-based Eatwell Guide model, alongside other Government advice on nutrition provide a solid platform for giving practical advice on diet that can have a real impact on people’s health.
The communications team at British Nutrition Foundation contributed to this piece which also appears in the July issue of Pharmacy Business.