Nutrition A Handbook for Community Nurses pdf ebook

Nutritional Issues Highlighted in Saving Lives:
Our Healthier Nation The following are all areas highlighted by the Government in their
recent strategy document.

The Government has begun a series of meetings with the food
industry to explore ways of reducing the salt content of processed
foods. A number of major retailers have already taken action to
reduce the salt content of their own-brand products. Around 90%
of the salt we eat is derived from processed foods. Looking for lower
salt options in the supermarket, avoidance of adding salt during
cooking and use of alternative seasonings at the table can help to
reduce salt intake. It is important, however, to ensure that nutritional
messages are placed in context. It is recognised in the report
that salt is not the only factor that affects blood pressure. Reducing
excess alcohol intake and increasing physical activity are also highlighted
as being important.
Practical advice for those with high blood pressure should focus
on diet and lifestyle. Maintenance of a body weight within the desirable
range should be promoted, along with regular physical activity
and adherence to sensible drinking guidelines (no more than two to
three drinks a day for women and no more than three or four drinks
a day for men). In dietary terms, excess salt intake should be avoided
and consumption of fruit and vegetables encouraged to provide
potassium. Low-fat dairy products should also be promoted as a
useful source of calcium, which may also beneficially affect blood
pressure. For further information, see Q4.2.

There is no specific target given for tackling obesity in Saving Lives:
Our Healthier Nation. The targets set in the previous health strategy,
The Health of the Nation, to reduce obesity incidence to 6% of men and
8% of women, were very ambitious. The latest figures on obesity
(BMI > 30) show that it has now risen to 17% in men and 20% in
women in England (Department of Health, 1999). Altogether, 62%
of men and 53% of women can now be classed as overweight (BMI
> 25). The Government states in Saving Lives: Our Healthier Nation that
the provision of information on healthy eating and the importance of
physical activity will help prevent obesity. It may be, however, that a
more clearly defined strategy is needed to begin to tackle this problem.
A major review of obesity, published by the British Nutrition
Foundation (1999a), suggested key action for policy-makers. This
might include fundamental changes in legislation, e.g. new legislation
to clamp down on miracle weight-loss cures that undermine the
efforts of reputable healthcare professionals and new transport policies
that promote increased levels of physical activity.
The relationship between obesity and health is discussed more
fully in Q4.4–4.12. Specific issues relating to obesity are discussed
throughout the book and a Government framework for tackling
obesity at local level can be found in the National Service Framework
for CHD (Department of Health 2000c).

The benefits of breast-feeding are recognised by the Government,
which is aiming to increase the prevalence of breast-feeding, especially
in areas of the country where breast-feeding rates are lowest. For more
information see Q3.21–3.34. There are numerous benefits associated
with breast-feeding (see Q3.24). As well as being a complete nutrient
source, breast milk has anti-infective properties and contains a variety
of enzymes, growth factors, hormones, nutrient-binding proteins and
non-absorbable carbohydrates. Breast-feeding may also help in the
development of a warm mother/child relationship.

Importance of good nutrition for schoolchildren
High on the Government’s agenda is the need to focus on the health
of Britain’s schoolchildren. The implementation of good habits in
childhood is important for the future health of the population. Over
the last 50 years, there has been a change in emphasis in relation to
concerns about schoolchildren’s diets. Historically, the focus was on
the adequate provision of nutrients, but providing adequate dietary
balance is now viewed as the main priority. The National Diet and
Nutrition Survey of young people (aged 4–18 years) is the most
detailed survey yet to be undertaken in this age group in Britain
(Gregory et al., 2000). This survey demonstrates that, although vitamin
intakes are generally adequate, a sizeable proportion of
children, particularly older girls, may have inadequate intakes of
some minerals. Also, there is a high intake of saturated fatty acids,
non-milk extrinsic sugars and salt among many children. Moreover,
with the exception of the youngest children (4–6 years), young people
in Britain are largely inactive. Clearly, these findings are worthy of our
attention because poor eating and physical activity habits in childhood
can store up problems for later life, particularly in relation to
obesity, heart disease, diabetes, osteoporosis and cancer.
There is clear evidence from the survey to justify the Government’s
concern about the diets of children living in households
where there is relative poverty. In particular, boys in households in
receipt of benefits seem to have lower energy intakes and poorer-
quality diets (Gregory et al., 2000). The independent report to the
Government on health inequalities from Professor Acheson indicated
that one in three of Britain’s children lives in poverty and, in
1996, 2.2 million children in Britain were in families receiving
income support (Acheson, 1998). This report highlighted the important
role of education in influencing health inequalities and providing
children with practical and social skills, including budgeting and
cooking. The Government’s Healthy Schools programme is aimed at
creating a healthy ethos in schools. This remit includes promoting
good nutrition and the acquisition of cooking skills, as well as increased
levels of physical activity. There are also plans to re-establish national
nutritional standards for school meals, which came into force in
April 2001.
A number of initiatives are under way to improve the nutrition of
schoolchildren and their awareness of healthy eating, including
school breakfast schemes, ‘healthy’ tuck shops and the development
of ‘Wired for Health’ – a website for teachers providing health information
to support the National Curriculum. Pilots for a scheme to
provide 4–6 year olds with free fruit at school, are underway with a
view to implementation by 2004 (Department of Health 2000b). For
further information, see Q3.59–3.76. The government has also
published a sports strategy which aims to encourage physical activity
among children by providing after school activities for all pupils and
establishing school sport co-ordinators in communities of greatest
need (for further details see Sports England website

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