Nutrition and Health Chris Seal Professor of Food & Human Nutrition School of Agriculture, Food & Rural Development, Newcastle University

Why is ‘nutrition’ important? Problems with poor nutrition - obesity What makes a healthy diet Fruit and vegetables Lecture Plan

Certainties in life DeathBirth Wellcome photo librarywww.roe.ac.uk

Nutrition is central in the progression from birth to death Affects growth rate (and final size) Affects reproduction (ability to have children and the number) Affects body function (ability to work/play) Affects risk of disease, resist infections, repair damage Affects life span

Changing focus of nutrition Recognising and resolving nutrient deficiencies Diet prescription and ensuring adequacy Use of foods and supplements to enhance ‘performance’

Healthy ageing (Centre for Life web site)

Is this ‘unhealthy ageing’? Probably not – more likely ‘unhealthy’ (or unnatural) activity during youth

Obesity is a focus for nutrition-related research

Obesity is a global problem Obesity is an independent risk factor for ill health Strongly associated with insulin resistance (leading to Type 2 diabetes), dyslipidaemia (blood lipid disorders) and hypertension (high blood pressure). Obese people are more likely to die prematurely from cancer & cardiovascular disease and, on average, life expectancy is reduced by 9 years.

Type 2 diabetes Coronary heart disease Cancer Osteoarthritis Gallstones Sleep apnoea Reproductive disorders Psychological problems, low esteem, social stigma £3.7billion annual cost to the UK economy on treating obesity; treating the effects of obesity, premature death and lost working time Complications of obesity

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1985 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1986 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1987 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1988 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1989 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1991 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14 15%–19%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1992 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14 15%–19%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1993 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14 15%–19%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1994 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14 15%–19%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14 15%–19%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1996 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14 15%–19%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1998 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 2001 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Source: CDC Behavioral Risk Factor Surveillance System. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) Obesity Trends* Among U.S. Adults BRFSS, 2002 No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Source: CDC Behavioral Risk Factor Surveillance System. Obesity Trends* Among U.S. Adults BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 2004 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 2005 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 2006 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 2007 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

In 1990, 10 states had a prevalence of obesity less than 10% and no states had prevalence equal to or greater than 15%. By 1999, no state had prevalence less than 10%, 18 states had a prevalence of obesity between 20-24%, and no state had prevalence equal to or greater than 25%. In 2008, only one state (Colorado) had a prevalence of obesity less than 20%. 32 states had a prevalence equal to or greater than 25%; six of these states had a prevalence of obesity equal to or greater than 30%. Obesity prevalence in the USA

Overweight and Obesity in Scotland

But is obesity a ‘nutrition’ problem? Obesity is caused by an imbalance between energy consumed and energy expended –The human body is VERY efficient at converting excess energy into stored energy = FAT The composition of the diet has (relatively) little impact on energy balance

How to stop obesity OR: Eat a healthy mixed diet and exercise more often

The Eatwell Plate Bread, rice, potatoes, pasta and other starchy foods Fruit and vegetables Milk & dairy products Meat, fish, eggs, beans & other non- dairy protein sources High fat, high sugar foods

8 tips for eating well 1. Base your meals on starchy foods 2. Eat lots of fruit and vegetables 3. Eat more fish 4. Cut down on saturated fat and sugar 5. Try to eat less salt - no more than 6g a day 6. Get active and try to be a healthy weight 7. Drink plenty of water 8. Don't skip breakfast

5 reasons to eat 5-A Day ! F&V taste good and there are a lot to choose from. They're a good source of vitamins and minerals, including folate, vitamin C and potassium. They're an excellent source of dietary fibre, which helps maintain a healthy gut and prevent constipation and other digestion problems. A diet high in fibre can also reduce your risk of bowel cancer. They can help reduce the risk of heart disease, stroke and some cancers. Overall, F&V contribute to a healthy and balanced diet.

1 medium apple 7 strawberries What is ‘5-A Day’? 5 portions = 400g 3 tablespoons of peas Medium (150mL) Glass fruit juice

Useful web sites NHS Choices Live Well NHS Choices 5-A Day Food Standards Agency Eat Well