TIME TO QUESTION THE STANDARD NARRATIVE…..?
So whilst food is in abundance and new year's resolutions are on the cards.... let's talk about what constitutes a 'healthy' diet and how we could be far from optimising our health by following the outdated standard narrative of nutritional advice in the UK. In particular the EAT WELL guidelines as set out by the NHS.
Now don't get me wrong (and please remember that I used to be a Nurse) the NHS is bloody amazing and I'm very grateful to live in a country which provides a free health service (unless Trump has anything to do with it!). However, with a bit more emphasis on preventative health, we could ironically take much of the burden off the NHS and reduce the prevalence of chronic disease.
This all starts with nutrition and lifestyle advice, and the NHS nutritional guidelines are falling drastically short. Promoting the consumption of refined grains and vegetable oils is not the way to optimal health.
So let's take a look at their recommendations and what this actually means for our health:
1. 'Eat at least 5 portions of a variety of fruit and veg every day, which should make up just over a third of the food you eat each day'.
Their guidelines certainly start strong, with the importance of including plants in our diet being well known (just not always adhered to).
As an achievable goal, I recommend clients get at least 2-3 different source of fruit/veg at each meal, this will help to prevent vitamin and mineral deficiencies, provide optimal fibre for gut health and a source of antioxidants to reduce inflammation etc
When you start getting into the nitty gritty of plants you see many specific benefits such as including cruciferous vegetables to support detoxification of oestrogen in the liver.... and plenty of colourful fruit and veg as a source of bioflavonoids for optimal circulation etc.
Whilst they can't meet all our nutritional needs alone (B12, vitamin A and D etc), including plants as a staple of a healthy diet is certainly very beneficial.
2. 'Base meals on higher fibre starchy foods like potatoes, bread, rice and pasta.... starch should take up just over a third of everything you eat'
Including starchy foods like root veg, wild rice, oats, quinoa etc is a great way to meet your carbohydrate needs and provide soluble fibre to feed your gut bacteria. However, quantity and quality must be considered here:
QUANTITY - Now this is very bio-individual (varies from person to person), some clients may do well on a pretty even split of protein, fats and carbs which promotes metabolic flexibility (ability to switch between energy systems and use all 3 macronutrients for fuel), whilst others may have issues with blood sugar regulation and therefore do better on a lower carb, higher fat diet.
Now a third of your plate being from starchy carbs, may seem reasonable, but don't forget that fruit and vegetables are also predominantly carbohydrates, so the eatwell guidelines are essentially recommending that over two thirds of your plate is made up of carbohydrates/fibre.
Whilst this does not necessarily mean that your overall calories equate to 60% carbs (a third of a plate of kale is not going to break the bank in terms of carb intake), you can see how this could play havoc with your blood sugar and leave you deficient in fats and proteins if your plate resembled something like 35% mango, 35% cereal and then just 30% left for both fats and proteins.
Furthermore, for anyone with digestive issues this amount of FODMAPs (carbohydrates which are resistant to digestion) may be detrimental.
QUALITY - The Eatwell guideline recommends 'wholegrain or high fibre white bread', which for sure is better than white flour (which causes rapid spikes in blood sugar and is depleted in nutrients) but don't forget that most of these products have still been highly refined. If you look on the ingredients next time you are buying a loaf of bread you will see sugar, salt, preservatives and vegetable oils, just because it's 'whole grain' doesn't mean it's good for you.
Where possible stick with whole food sources of carbohydrates (eaten in moderation combined with good sources of fat and protein to stabilise your blood sugar) and be mindful of intolerances .
3. 'Have some dairy or dairy alternatives (such as soya drinks)'.
Again if you tolerate dairy, by all means include some full fat dairy from grass-fed cows. Dairy is a great source of many nutrients such as fat, protein, calcium, fat soluble vitamins (A, D, E and K), B vitamins etc.
However, soy is certainly not a good alternative. As well as being highly oestrogenic (high in plant oestrogens which mimic the hormone in the body, potentially contributing to oestrogen dominance), it's also a goitrogen. This means that it inhibits iodine uptake to the thyroid, down regulating thyroid function.
If you don't consume any dairy, instead look to other sources of calcium in particular such as bony fish (eg sardines), chia seeds, almonds, figs, leafy greens etc.
4. 'Eat some beans, pulses, fish, eggs, meat and other protein'
There are some great recommendations under this section such as 'eggs and fish are good sources of protein, and contain many vitamins and minerals. Oily fish is particularly rich in omega-3 fatty acids.'
However they also advise choosing 'lean cuts of meat and skinless poultry whenever possible to cut down on fat'. This scaremongering around consumption of fat is not acceptable and is completely outdated in relation to the evolution of nutritional science..... more on this in relation to their next recommendation.
In terms of overall protein intake, they recommend around 15% of overall calories from protein, and whilst 'high protein' is one of the latest fads (and probably excessive), this is not going to meet the needs of someone trying to build or maintain muscle mass (not that this is the only purpose of protein which is also involved in many other bodily functions such as hormones, enzymes, bone health etc!). Recommendations vary from person to person based on individual needs.
Here's an interesting study which delves into the optimal protein intake in aging:
https://academic.oup.com/advances/article/9/3/171/4964951
5. 'Choose unsaturated oils and spreads, and eat them in small amounts'
Now this is a really concerning recommendation. The most inflammatory forms of fat are polyunsaturated oils which have been exposed to a high heat. Yes you've got it....vegetable oils found in products such as margarine (as recommended by these guidelines) and most refined foods.
These include oils which were previously thought of as 'health foods' such as rapeseed and sunflower oil which are highly unstable, oxidising at a high heat.
The guidelines recommend that swapping to these 'unsaturated fats can help lower cholesterol', but wait.... what?! Where's the science behind this, apart from some poor studies which show correlation rather than causation?!
I'm not going to harp on about this (for fear of sounding like a broken record), but cholesterol is not the bad guy, cholesterol is the response to inflammation, not the cause (unless you have certain genetics that prevent efficient metabolism of saturated fats).
Most people will thrive on adequate sources of cholesterol in the diet. Here's some examples of it's role in the body:
- Cellular membrane function (cholesterol allows cells the flexibility/stiffness needed to function)
- Serotonin function (low levels of cholesterol are linked to increased risk of depression)
- Growth and development (it's found in high concentrations in breast milk)
- Fat digestion (without cholesterol your liver would not be able to make the bile salts needed to break down fats)
- Healthy gut lining (a deficiency in cholesterol can contribute to 'leaky' gut)
- Production of sex hormones (without cholesterol, we cannot make testosterone, oestrogen, progesterone, cortisol etc)
- Preventing heart disease and cancer (cholesterol is required to make corticosteroid hormones which prevent cancer and heart disease)
- Maintaining Vitamin D levels (without cholesterol, you cannot make vitamin D)
- Decreasing free radical damage (cholesterol is an antioxidant!)
Certainly important in terms of optimising health.
Finally onto their last recommendation....
6. 'Drink plenty of fluids (at least 6 to 8 glasses a day)'
A standard glass is around 250ml, so this would equate to around 1.5 - 2 litres of water/day. This recommendation is about right as an absolute minimum.
To give you more of an idea of the importance of hydration:
- Our bodies are made of 55-60% water
- We can only produce 8% of the water we need through metabolic processes, every other drop needs to come from what we consume.
- We are not camels, we can't store water long term, therefore we need to consume it daily.
- A 2% drop in our body's water levels will lead to fatigue
- A 10% drop leads to digestive, cardiovascular, immune and musculoskeletal problems
- Greater than 10% drop, is bad bad news and will lead to death if not treated.
Obviously water requirement will vary greatly dependent on climate, exercise levels and size. Here's a simple formula to work out how much water you should be drinking as a minimum:
Body weight (lbs) divided by 2 = Daily water requirement (ounces)
Eg 150lb /2 = 75 ounces (2130 ml)
Remember that not all liquid is created equal! Most of the drinks regularly consumed in the western world are diuretics meaning that they actually promote excretion of water and contribute to dehydration (drink too much coffee and your constantly going for a pee right?!).
Common diuretics include:
Alcohol
Coffee
Tea (especially caffeinated but also some herbal teas used to reduce bloating such as peppermint tea)
Fizzy drinks
Fruit juices
When you consume diuretics you will need to factor in extra hydration to counter this, 1.5 x the diuretic (this is on top of your daily requirement). Eg 300ml coffee = need for 450ml extra water.
And that's a breakdown of their 6 main guidelines.
So in summary.....
Certainly there are some good recommendations in terms of staying hydrated and building a healthy plate around plant foods which should be a staple at each meal, but as you can see these guidelines are misleading, particularly in terms of promoting the outdated 'high carb, low fat' diet.
So maybe it's time to question the standard narrative (if you haven't already) and start taking your health into your own hands, rather than relying on our NHS to pick up the pieces of preventable chronic disease.
Eat well, make smart choices and as always... listen to your body!
The content in this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding your health.