Eating Disorders

Your weight
Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.

Many myths surround eating disorders - that they only affect young women, for example, or they're a modern phenomenon, but what are the realities?

Living with an eating disorder is a miserable, lonely experience. For most people, food is one of life's pleasures and an important social event. So if your feelings about food aren't relaxed, an important part of life becomes extremely stressed. This stress may add to other enormous stresses that may have led to the eating disorder in the first place.

When someone you know and love develops an eating disorder, it's easy to feel confused about what to do, and even threatened or angry.

Unfortunately, many health professionals are just as much at sea. Although eating disorders are increasing, we still know very little about their causes. Worse still, there aren't any quick or easy treatments.

A few things are clear. People with eating disorders aren't:

Bad or being defiant
Going through a 'teenage phase'
The result of poor or inadequate parenting
The product of modern stresses and obsession with weight
Able to snap out of it

What is known about eating disorders?
Many things about eating disorders aren't fully understood, but we do know the following:

Eating disorders have been around for centuries

Diets don't cause eating disorders, but research has shown young women who diet at a severe level are 18 times more likely to develop an eating disorder than those who don't and those who diet at a moderate level are five times more likely

Severe psychological problems, such as obsessive compulsive behaviour and depression, increase the risk of developing eating disorders

How common are they?

The most common form of disordered eating is obesity

Eating disorders include a range of different conditions where people have an abnormal attitude towards food, altered appetite control and unhealthy eating habits that affect their health and ability to function normally. The most common form of disordered eating is obesity, which affects more than one in ten people.

Bulimia nervosa, or binge eating and purging, is twice as common as anorexia.

Men and boys also have eating disorders, but less often than girls or women.

What are the causes?
Families often blame themselves, but they shouldn't. None of the research shows much difference between the ways that families of anorexics work compared with other families.

The causes of eating disorders are complex. They're probably the result of several factors, including:

A genetic tendency
Learned responses and habits, especially to stress
Cultural and social pressures, for example to be slim
Psychological factors, such as perfectionism and lack self-esteem, although it's not known whether this is a cause or effect of disorders

What can families do?

treating eating disorders usually involves years of hard work

The first thing is to accept that there's no quick fix - treating eating disorders usually involves years of hard work. During this time, there can be huge tension and communication can be terrible, but families can play a critical role in helping their relative through the worst.

Families need expert help for this, so talk to your doctor or contact one of the organisations given in our links.

How to help:

1. Help the person affected recognise they have a problem. Try to avoid head-to-head confrontation because it will only end in rebellion, tears and failure.

2. Be prepared to raid all your reserves of optimism and enthusiasm.

3. Try to remain sympathetic, no matter how bad the person's outer expression of their inner turmoil becomes.

4. Don't forget other members of the family and their needs, and don't let your own life, career and enjoyments become swamped or you'll become unable to give support.

5. Keep communication going with the patient and health professionals. What your loved one needs is a cohesive team supporting them.

It's a long road to recovery. After five years, about half of people with eating disorders have recovered, although many remain preoccupied with food, eating and their weight for many more years.

Advice and support
For information about national organisations, visit the Women's Health section on eating disorders.

Children's Weight

Your weight
Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.


In the UK, the number of obese children continues to rise. Currently, just under one in five children between the ages of two and ten is obese.

Obese children tend to become obese adults. This increases the risk of developing certain diseases, such as type 2 diabetes.

If you think your child might be overweight or obese, check with your GP. They'll be able to advise you on how to provide the right support for your child to help slow or halt their weight gain and allow them to grow into their weight.

Even if your child doesn't have a weight problem, it's important to establish healthy eating habits early on so they don't gain any excess weight.

Good nutrition in childhood is vital for growth and development. Establishing healthy eating and activity patterns while children are young can lead to life-long habits that will help to determine whether or not they're healthy as adults.

What's a healthy diet?
Children need a varied diet that provides enough energy and protein for growth and repair, and contains all the essential vitamins and minerals.

Encouraging by example
The best way to improve your child's diet is for them to see you enjoying healthy food options.

Introduce new foods from an early age. It's normal for children to reject new foods at first, but this doesn't mean they'll never like them. Research shows most children will eat them if you try again a few days later.

Don't pressure your child to clear their plate. Encouraging them to eat when they're not hungry can result in them eating more calorie-rich foods.

It may also lead weaken your child's innate ability to respond to signals of hunger or fullness, so that they overeat.

Small children need to eat regularly, but keep snacks to defined times rather than allowing continual grazing. Snack foods don't have to be sweets or biscuits. Try slices of fruit or vegetable sticks instead.

Portion size
Portion sizes have increased over the years, especially when it comes to ready meals and snacks. This means children have become used to eating more calories than they need.

High nutritional quality is more important than large quantities. Small children don't need as much food as adults. Think twice when serving meals and make sure theirs is smaller than a typical adult serving.

Avoid the supersize, kingsize and '25 per cent extra' foods. Seek out mini and fun-size foods instead.

Treats
Snacks during the day should be planned rather than spontaneous, so children can establish feelings of hunger and fullness.

Offering a sweet pudding as a reward when your child eats their greens reinforces the idea that vegetables are unpleasant and something to be endured, while desserts are a treat. Try offering non-food rewards, such as a story or trip to the park, instead.

Foods such as cakes, sweets, crisps and sugary drinks should be kept as party or holiday foods, not everyday items.

How many calories?
The following table shows the estimated average daily calorie requirements for young children. The figures assume the child is of average weight with reasonable physical activity levels. It should be used as a guide only.

Encouraging activity
Children are naturally active, so don't stop them tearing round the house even if you're craving a few minutes of peace and quiet.

Some sedentary behaviour, especially watching TV, is linked to increased intake of food, especially those high in fat, salt and sugar. If your child demands snack foods, try plain popcorn, vegetable sticks or slices of fruit instead.

Better still, turn off the TV or computer and get them out riding their bike, playing in the park or doing any physical activity they enjoy.

Maintaining a Healthy Weight

Your weight
Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.

Losing weight is half the battle, but keeping it off in the long term is a struggle for some people. Our advice, tools and strategies will help.

Maintaining your target weight
Lyndel Costain

For many people, losing weight isn't the really tricky part but keeping it off. Here are some tried and tested strategies for maintaining your weight.

Long-term change
If, once you've reached your realistic target weight, you go back to your old eating habits and activity levels, you'll put the weight back on. It's as simple as that.

This is usually the problem with quick-fix diets, they don't help you to make changes that you can maintain in the long term.

Stay realistic
Beware of 'how to be even skinnier' media messages that lure you into feeling dissatisfied. You have a life to live and enjoy, so hang on the satisfaction of being at a comfortable, healthy weight you can sustain.

Flexible restraint
Many slim people who stay that way by 'watching their weight', show flexible restraint, rather than following rigid all-or-nothing rules. They make healthy choices most of the time, but no foods are seen as forbidden.

This means enjoying small amounts of favourite foods without feeling guilty. And if you do over-indulge, or have a big night out, cut back a bit or do more exercise the next day to balance things out.

Eating healthily
Learn how to choose, prepare and enjoy a balanced diet. Low-fat cooking skills, understanding food labels and having the ability to judge portion sizes all help with this.

So does eating regular meals, taking time to really taste them and indulging yourself occasionally.

How to maintain weight loss
Continue to eat a balanced, lower fat diet with plenty of fruit and vegetables
Don't avoid any foods, just watch portion sizes and limit the amount of certain foods
Have three regular meals a day at regular times (starting with breakfast), and fewer snacks
Eat out occasionally, but limit fast food
Sit down to eat your meals, take time over them and pay attention to what you're eating
Keep 'self-monitoring' to stay conscious of your new eating and activity habits

Stay active
Getting regular physical activity is one of the strongest indicators of long-term success. Not only does it burn calories and increase metabolism-boosting muscle, it also boosts self-esteem and beats stress.

Studies show that just walking for 30 minutes or so each day, plus some other activities during the week, may be enough.

Learn to deal with stress
For many people, food is a quick and effective way to deal with stress. If this sounds like you, take some time to think about the stresses in your life and how you respond to them. A food and thoughts diary can be helpful.

Think about how you could manage stress differently. Things that help include regular exercise, breathing techniques and challenging negative self-talk that spirals into anxiety.

Finding The Time

Your weight
Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.


Ever feel there just aren't enough hours in the day to do everything you want, including being more active?

For many people, the same computer-based jobs that have taken the physical element out of work also take up so much time that exercise is the last thing they feel like doing when they get home. The key to finding time to exercise is to realise two things:

It doesnot have to take very long just half an hour a day, in ten-minute bursts if necessary.
It can be built into your day-to-day life - it doesn’t necessarily have to be found as additional time.

If you're in employment
Despite advances in technology, many of us still spend more - rather than less - time at work. However, there are ways in which you can be more active:

Go for a walk in your lunch break.
Try to find at least three different walks and vary them throughout the week. It might even be possible to find an indoor walking route, incorporating stair climbing, for those inevitable bad weather days.
Talk to your employers about promoting health at work. If they don't already, ask if it's possible to provide showers and cycle racks to encourage people to cycle to work. You might even be able to encourage them to provide subsidised membership at a local gym where you could go at lunchtime.
Walk to and from work. If you live too far away, park further from the office or get off the bus or train one stop earlier – even a ten-minute walk will help as long as it is hard enough to get you slightly out of breath.

If you look after children
Having children can change everything about your lifestyle. Some parents find their activity levels drop and their weight increases as going to the gym or playing sport become more difficult. Here are some positive steps you can take:

Exercise with your child.
Take them to the local swimming pool or play in the garden or local park.
Find out which local sports and leisure centres have crèche facilities, so you can exercise while your child is being looked after.

Walk your child to school.
Not only will this help you to be active, it will also help your child develop an early pattern of physical activity that might stay with them into adulthood.
Find out if there are activities available at your child's school for the local community. Many schools use their facilities for sports and exercise classes in the evenings and at weekends.

If you're based at home
Plan your week so you have to walk to the shops frequently. By going often you'll only have to carry light bags of shopping back.
Look at ways in which you can be more active in and around your home. Use the stairs to exercise, work in the garden or – if you have the space and can afford it - install some gym equipment, such as a mini trampoline or rowing machine, for example. Failing that, invest in a skipping rope.
Look for community-based activity programmes in your local area. These don't have to be fitness classes, just anything that gets you moving. Conservation groups can be a great way to get involved in improving your local environment and being active at the same time.

The early bird
If your normal day really doesn't let you incorporate exercise, one option is to get up earlier. If you normally set the alarm clock for 7.30am, set it for 7am instead and use the extra half-hour to go for a brisk walk or even a swim if you have a pool nearby. We all experience exercise differently at different times of the day because of our individual biological cycle, and you might not be a 'morning person', but it's worth a try as exercise first thing can really wake you up and leave you feeling invigorated for the day ahead.

Night owls
Alternatively, if you're not an early bird, consider looking at how you could use any free time you have in the evening to increase your activity patterns. Most of us spend a lot of time sitting watching TV in the evenings, but you could buy some home exercise equipment and work out while you're doing it.

Experiment to find a time for exercise that suits you best.

Maximise your exercise time
Make an appointment to exercise - and write it in your diary. You could also record what you did in your workout, so you can keep track of your achievements.
You can extend this idea by making a real appointment with a friend, colleague or relative to exercise together. If you've arranged to meet someone, you're a lot less likely to skip it.
Keep some exercise kit handy in the places you spend most of your time. This might mean leaving clothes at college, work, with friends or relatives, or in the boot of your car. By having the right clothes handy you can exercise whenever you get an unexpected free 15 minutes or a sudden burst of enthusiasm.
Consider taking active holidays such as a cycle tour or walking holiday. You still need to get your exercise five days a week, but getting in shape for your holiday might be a good incentive, and if you enjoy it enough it might inspire you to keep it going when you get home.
If you own a car, leave it at home as much as possible and walk or cycle to the shops for those small things such as milk or a newspaper.

Balanced Diet

Your weight
Balance of good healthExpert advice to help you maintain a healthy weight

Dissatisfied with your weight?

We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.

The Food Standards Agency has designed the 'eatwell plate' to help people get the appropriate balance of foods and nutrients in their daily diet.

Eat a healthy, balanced diet and stay active
The key to a healthy balanced diet is not to ban or omit any foods or food groups but to balance what you eat by consuming a variety of foods from each food group in the right proportions for good health.

The five food groups on the eatwell plate are:

Fruit and vegetables
These should make up about a third of your daily diet and can be eaten as part of every meal, as well as being the first choice for a snack.

You should eat at least five portions of fruit and vegetables each day. Research suggests this can help to protect against cancer, obesity and various chronic diseases such as heart disease. This is because of the unique package of nutrients and plant compounds they contain.

Bread, rice, potatoes and pasta
This food group should also make up about a third of your diet and contains the starchy carbohydrates that are the body's main source of energy.

When selecting products from this food group, choose unrefined carbohydrates over those that have been refined, as they will contain the whole of the grain. Wholegrain foods are rich in fibre and other nutrients that have many health benefits, and people who consume wholegrains seem to have a reduced risk of certain cancers, diabetes and coronary heart disease.

The final third of the eatwell plate is made up of three groups containing foods that need to be consumed in smaller proportions than the other two principal categories. These food groups also contain nutrients essential to our diet, so it's important not to leave them out altogether.

Milk and dairy foods
These should be eaten in moderation because of their high saturated fat content, but they're an important source of calcium, which is essential for healthy bones and teeth. Choose low-fat or reduced-fat versions.

Meat, fish, eggs and beans
This food group includes both animal and plant sources of protein, which is a major functional and structural component of all cells. Protein provides the body with between 10 and 15 per cent of its dietary energy, and is needed for growth and repair.

Foods and drinks high in fat and/or sugar
This group makes up the smallest section on the eatwell plate and includes foods that should only be eaten sparingly because, although they're an important energy source, they contain very few nutrients and are often known as 'empty calories'.

Foods from this group are high in unhealthy components such as saturated fat, trans fatty acids, sugar and salt - all of which are associated with an increased risk of developing certain diseases.

They should only be eaten as occasional treats, or to increase the palatability of other important foods (such as olive oil on salads, a scraping of spread on bread, or a sprinkling of sugar on some tart fruits).

How to eat a balanced diet
Eat a variety of foods to obtain all of the essential nutrients
Too much as well as too little can be bad for you – balance is required
Everyone's plate will look slightly different as we all have different requirements depending on our body’s shape and size, and our levels of activity.

Alternative Sources of Protein

Your weight
Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.

It's vital our diets contain protein, either from animal or plant sources.

Foods containing protein
Meat, poultry, fish, shellfish and eggs
Pulses, nuts and seeds
Soya products and vegetable protein foods

Why is protein important?
From hair to fingernails, protein is a major functional and structural component of all our cells. Protein provides the body with roughly 10 to 15 per cent of its dietary energy, and is needed for growth and repair.

Proteins are large molecules made up of long chains of amino acid subunits. Some of these amino acids are nutritionally essential as they cannot be made or stored within the body and so must come from foods in our daily diet.

Although all animal and plant cells contain some protein, the amount and quality of this protein can vary widely.

Animal protein
Protein from animal sources contains the full range of essential amino acids needed from an adult's diet. But red meat, in particular, should be eaten in limited amounts due to the high level of saturated fat it contains, which may raise blood levels of 'unhealthy' LDL cholesterol.

A high intake of saturated fat can lead to an increased risk of cardiovascular disease and other related disorders. As an alternative source of animal protein, choose poultry, fish and shellfish.

The 2007 World Cancer Research Fund report recommended meat eaters limit their consumption of red meat to no more than 500g a week, with very little processed meat, as these have both been linked to certain forms of cancer.

Fish is a good source of animal protein. Oil-rich fish such as salmon, mackerel, herring, tuna, trout and sardines are all rich in omega-3 fatty acids, which help to reduce the risk of developing cardiovascular disease.

Shellfish is also a good source of protein and is low in fat.

Aim to eat a couple of portions of fish every week, with at least one portion being an oily fish.

Advice for vegans and vegetarians
Vegetarians rely on plant sources for their daily protein. Plants don’t contain the full range of essential amino acids and so are not as high in nutritional value as animal protein. But by eating a well-balanced diet that contains a variety of different foods, it's possible to consume the required amino acids, regardless of the time of day they’re eaten or in what combinations within a meal.

Foods such as nuts, seeds, beans, pulses, vegetable protein foods and soya products all contain protein. There are also small amounts in grains and dairy products. Due to this variety of protein-rich foods available in the UK, protein deficiency is rare.

How much is enough?
Health professionals suggest men should eat 55.5g protein a day and women 45g. In practical terms, eating a moderate amount of protein - in one or two meals every day – should give you all the protein you need. Most people in the UK eat far more protein than they actually need.

Serving size
You should eat two to three servings of protein every day from both plant and animal sources. Here are some examples of one serving (about the size of a standard pack of playing cards):

100g boneless meat (eg lean beef, lamb or pork)
100g boneless poultry (eg chicken or turkey breast)
100g fish (eg salmon, sardines or tuna)
2 medium eggs
3 tablespoons of seeds (eg sunflower or pumpkin seeds)
3 tablespoons of nuts (eg almonds or walnuts)

Choosing the right protein
If you can, choose to eat low-fat protein foods as these will help to:

Keep your heart healthy
Keep cholesterol low
Minimise the risk of developing cardiovascular disease and other related disorders

Use this table to choose foods rich in protein but low in saturated fat.

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Protein and weight management
High-protein diets are sometimes popular with people wanting to lose weight, and there have been many studies looking at the effect of such diets on weight loss.

Regardless of the composition of the diet, weight loss will only occur if you expend more energy through activity than your body produces from food.

Protein-rich foods tend to make people feel fuller than foods rich in carbohydrates or fat. This can have a knock-on effect on appetite, minimising feelings of hunger, and helping to reduce overall energy intake.

Diets rich in protein at the expense of carbohydrates, for example, have been associated with slightly greater losses of weight in the short term compared with the recommended high-carbohydrate, low-fat eating plans. But after one year, studies have found there is no difference in weight loss between the two diets.

To control your weight it's important to find an eating pattern that suits your lifestyle and that you can sustain over a long period.

Caffeinated Drinks

Your Weight
Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.

Many popular drinks contain the stimulant caffeine. It has a bad reputation, but what effects does it really have and does it bring any health benefits?

Effects of caffeine
Caffeine acts as a stimulant to the heart and central nervous system, and is also known to increase blood pressure in the short term, although there's no conclusive evidence of long-term effects on blood pressure.

The effects on blood pressure are most likely when caffeine is taken in excessive quantities or by people who are highly sensitive to it. People who are hypertensive (have habitual high blood pressure) are advised to avoid caffeinated drinks, and pregnant women should limit their intake of caffeine to less than 300mg a day.

Food Caffeine content
Coffee (mg/cup)
Instant 61 to 70
Percolated ground 97 to 125
Tea (mg/cup) 15 to 75
Cocoa (mg/cup) 10 to 17
Chocolate bar 60 to 70
Cola drinks 43 to 65
(mg/12oz can)

Caffeine and weight loss
Caffeine has been shown to have very modest effects on increasing metabolism, and is sometimes added as an ingredient to weight loss pills. These pills often make claims about speeding metabolism to 'effortlessly melt' excess fat, but in reality the amount of calories that slimming pills containing caffeine would actually burn is very small.

Caffeine may also suppress appetite, but without making other changes to your diet and lifestyle caffeine is unlikely to make a significant difference to your weight.

Coffee
Coffee has been linked with a number of the risk factors for coronary heart disease, including increased blood pressure and raised blood cholesterol levels. But no relationship has been found between drinking coffee and the likelihood of developing coronary heart disease.

Coffee may be beneficial in some areas of health - for example, research has found it may reduce the risk of developing gallstones and kidney stones.

It's difficult to suggest a safe limit for coffee intake because of the huge variation in caffeine content across different brands and an individual's sensitivity to the drug. People with high blood pressure and pregnant women are advised to limit their caffeine consumption.

For the rest of the population, there's no evidence coffee does any long-term harm. Caffeine does have a very mild diuretic effect but, drunk in moderation, you don’t need to increase fluid intake to any significant degree as the loss of fluid is very minimal.

Tea
Tea contains some useful minerals such as zinc, manganese and potassium, and scientists are researching its potential to reduce the risk of coronary heart disease and some cancers.

Tea contains antioxidant substances called flavonoids, which have been shown to help slow or inhibit the chemical reactions thought to take place during the development of coronary heart disease.

Green tea
There's also a lot of interest in the health benefits of green tea, particularly in relation to cardiovascular health. Again, this is due to flavonoids, which are powerful antioxidants found in high concentrations in both green and black teas. The concentration of these compounds depends on how long the tea has been brewed, but can range from 125mg to 140mg.

Some studies have compared the concentration of these antioxidant compounds to that found in fruit and vegetables. Flavonoids bring potential benefits to heart health, as well as possible reductions in the risk of Alzheimer’s disease and other neurodegenerative conditions.

Caffeine and iron absorption
Both tea and coffee contain polyphenols that can bind to iron, making it difficult for our bodies to absorb. Avoiding tea and coffee during and around mealtimes is important for people at risk of iron deficiency.

The Digestive System

Your weight
Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.

When you eat, the food's journey through the body is governed by the digestive system.

What is digestion?
Digestion is the process of breaking down food so that it's small enough to be absorbed and used by the body for energy or in other bodily functions.

Digestion involves a number of different stages. The first phase is known as the cephalic (head) phase. It starts before food has even entered your mouth. The sight, smell, taste or even the thought of food will activate saliva in the mouth as well as digestive juices, which contain enzymes to break down food.

In the mouth
Once food is in the mouth, the tastebuds begin determining the chemicals within the food via their nerve endings, in order to give you the taste sensations of salt, sweet, sour or bitter. As your teeth chew and grind the food, breaking it down, it's mixed with saliva. This comprises many enzymes including salivary amylase, which begins to break down the long chains of starch found in foods such as bread, cereals, potatoes and pasta. Saliva also contains mucin, which moistens the food so it can pass easily through the digestive (gastrointestinal) tract.

The oesophagus
After the food has been swallowed, it's carried down the oesophagus (a muscular tube) towards the stomach. The oesophagus can contract and relax in order to propel the food onwards, and each mouthful of food takes about six seconds to reach the stomach once swallowed.

The stomach
The stomach is a sack made of muscle and, when it's empty, it has a volume of only 50ml but this can expand to hold up to 1.5 litres or more after a meal. The walls of the stomach are made of three different layers of muscle that allow it to churn food around and make sure it's mixed with the stomach's acidic digestive juices. The presence of hydrochloric acid in the stomach prevents the action of salivary amylase and helps to kill bacteria that might be present. The stomach also produces the enzyme pepsin, which breaks down proteins (mostly found in meat, fish, eggs and dairy products).

The hormone ghrelin is produced by cells lining the stomach. Ghrelin stimulates hunger and tends to increase before a meal and decrease after eating. This hormone forms part of the communication system between the gut and the part of the brain that controls hunger and satiety (how full you feel).

Food can stay in the stomach for a few minutes or several hours in the gastric phase where numerous acids and enzymes are released, including the hormone gastrin. When the food has been churned into a creamy mixture known as chyme, the pyloric sphincter (an opening controlled by muscle) opens and chyme passes gradually into the small intestine.

Prebiotics
These are mainly indigestible carbohydrates called oligosaccharides. On reaching the large intestine, they selectively stimulate the growth and/or activity of beneficial microorganisms already in the colon, such as bifidobacteria and lactobacilli.

The small intestine
About 3ml of chyme is squirted into the small intestine at short intervals as the pyloric sphincter opens. This is known as the intestinal phase and causes the secretion of many hormones, which all aid the digestive process. The sphincter is designed to open partially so that large particles are kept in the stomach for further mixing and breaking down.

Digestion and absorption of fats, protein and carbohydrates occurs in the small intestine. Three important organs are involved:

The gall bladder provides bile salts that help to make fats easier to absorb.
The pancreas provides bicarbonate to neutralise the acidic chyme from the stomach, and also produces further digestive enzymes.

The intestinal wall contains cells that make up the wall of the small intestine. These cells help to neutralise the acid and also produce enzymes to digest food.

The inner surface of the small intestine is folded into finger-like structures called villi, which greatly increase the surface area available for absorption - in fact the surface area of the villi is equivalent to that of a tennis court! Blood vessels receive the digested food from the villi where it's then transported through the blood stream to the liver via the hepatic portal vein.

Fat can take much longer to be broken down, with the process of fat digestion and absorption taking between three and five hours.

The unabsorbed residue of this process finally reaches the end of the small intestine and enters the large intestine.

Probiotics
Probiotics are live bacteria similar to the bacterial micro-organisms that live in the large intestine. They are often referred to as 'friendly bacteria', and come from food sources or dietary supplements. The mix of these 'friendly' bacteria and other gut microorganisms is important for good health, and many factors can alter this delicate balance, such as infection or use of antibiotics. Friendly bacteria are vital for proper development of the immune system, to protect against micro-organisms that could cause disease, and to aid the digestion and absorption of food and nutrients.

The large intestine
This is one of the most metabolically active organs in the body. It measures about 1.5 metres and contains over 400 different species of bacteria that break down and utilise the undigested residues of our food, mostly dietary fibres. As the watery contents move along the large intestine, water is absorbed and the final product - faeces - is formed, which is stored in the rectum before excretion from the body.

Attention Deficit Hyperactivity Disorder

Definition
ADHD is a problem with inattentiveness, over-activity, impulsivity, or some combination of these. For these problems to be diagnosed as ADHD, they must be out of the normal range for the child's age and development.

Overview, Causes, & Risk Factors

Is ADHD over-diagnosed? Under-diagnosed? Probably both -- and certainly real. ADHD affects children's school performance and their relationships with others. Parents who are wondering if their children have ADHD are often exhausted and frustrated.

Scientific studies, using advanced neuroimaging techniques of brain structure and function, show that the brains of children with ADHD are different from those of other children. These children handle neurotransmitters (including dopamine, serotonin, and adrenalin) differently from their peers.

ADHD is often genetic. Whatever the specific cause may be, it seems to be set in motion very early in life as the brain is developing. Other problems, such as depression, sleep deprivation, specific learning disabilities, tic disorders, and oppositional/aggressive behavior problems, may be confused with or appear along with ADHD. Every child suspected of having ADHD deserves a careful evaluation to sort out exactly what is contributing to his concerning behaviors.

Attention Deficit Disorder (ADD) is the most commonly diagnosed behavioral disorder of childhood, affecting an estimated 3 - 5% of school aged children. It is diagnosed much more often in boys than in girls.

Most children with ADHD also have at least one other developmental or behavioral problem. Every evaluation should include a search for possible additional conditions, including conduct disorder, oppositional defiant disorder, mood disorders, depression, anxiety, and learning disabilities.

Multiple Sclerosis or MS

Multiple sclerosis (abbreviated MS, also known as disseminated sclerosis or encephalomyelitis disseminata) is an autoimmune condition in which the immune system attacks the central nervous system, leading to demyelination. Disease onset usually occurs in young adults, and it is more common in women. It has a prevalence that ranges between 2 and 150 per 100,000. MS was first described in 1868 by Jean-Martin Charcot.

MS affects the areas of the brain and spinal cord known as the white matter, destroying a fatty layer called the myelin sheath, which wraps around nerve fibers and electrically insulates them. When myelin is lost, the axons of neurons can no longer effectively conduct action potentials. The name multiple sclerosis refers to the scars (scleroses – better known as plaques or lesions) in the white matter. Although much is known about the mechanisms involved in the disease process, the cause remains unknown. Theories include genetics or infections. Different environmental risk factors have also been found.

Almost any neurological symptom can appear with the disease, and often progresses to physical and cognitive disability. MS takes several forms, with new symptoms occurring either in discrete attacks (relapsing forms) or slowly accumulating over time (progressive forms). Between attacks, symptoms may go away completely, but permanent neurological problems often occur, especially as the disease advances.

There is no known cure for MS. Treatments attempt to return function after an attack, prevent new attacks, and prevent disability. MS medications can have adverse effects or be poorly tolerated, and many patients pursue alternative treatments, despite the lack of supporting scientific study. The prognosis is difficult to predict, it depends on the subtype of the disease, the individual patient’s disease characteristics, the initial symptoms and the degree of disability the person experiences as time advances. Life expectancy of patients is nearly the same as that of the unaffected population.

Importance Of Water Fluid

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Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.


Water or fluid is a vital component of our diets, even though it's not considered a specific nutrient.

Why do we need water?
Water makes up 50 to 70 per cent of an adult's total body weight and, without regular top-ups, our body's survival time is limited to a matter of days.

Water's essential for the body's growth and maintenance, as it's involved in a number of processes. For example, it helps get rid of waste and regulates temperature, and it provides a medium for biological reactions to occur in the body.

Water's lost from the body through urine and sweat, and must be replaced through the diet. If you don't consume enough you can become dehydrated, causing symptoms such as headaches, tiredness and loss of concentration. Chronic dehydration can contribute to a number of health problems such as constipation and kidney stones.

How much do we need?
The body gets its fluid from three sources:

Drinks, either plain water or as part of other beverages including tea, coffee and squash
Solid foods, especially fruit and vegetables (even foods such as bread and cheese provide small amounts of fluid)
As a by-product of chemical reactions within the body

Most healthy adults need between one and a half to three litres a day, so aim to drink six to eight medium glasses of fluid daily. Beverages such as tea, coffee and fruit juices count towards fluid intake, and may bring with them other nutrients or benefits.

You may require more fluid if you're very physically active or during periods of hot weather.

You can judge whether you're drinking enough by the colour of your urine. If it's a pale straw colour then your fluid intake is probably fine. If your urine is dark yellow, you probably need to drink more.

How to maintain fluid levels

Start as you mean to go on, with a glass of water when you wake.
Find time to make yourself regular drinks during the day - don't forget that tea, coffee and juices can count. Just watch out for the amount of sugar consumed in some soft drinks.
Keep a bottle of water in your bag, as it's a convenient way of providing fluid if you're travelling or exercising.
Get into the habit of having a glass of water with every meal.
The sensation of thirst is not triggered until you're already dehydrated, so it's important to drink before you get thirsty.
Increase your intake of fresh fruit and vegetables, as they have a high water content.
Bottled water
There are two types: spring water and mineral water.

Spring water is collected directly from the spring where it rises from the ground, and must be bottled at the source. UK sources of spring water must meet certain hygiene standards, and may be further treated so they meet pollution regulations.

Mineral water emerges from under the ground, then flows over rocks before it's collected, resulting in a higher content of various minerals. Unlike spring water, it can't be treated except to remove grit and dirt. Different brands of spring and mineral waters have differing amounts of minerals depending on their source.

Is it necessary to buy bottled water?
The drinking water available from UK taps is perfectly adequate to replenish fluid loss, and undergoes many processes to bring it up to the standards set out in the UK Water Supply Regulations.

In some areas tap water has fluoride added, which can reduce the risk of dental decay.

There are certainly no proven health benefits of bottled water over tap water. Although there are growing concerns about the sustainability of bottled water, ultimately it comes down to personal choice.

Bread, Cereals and Other Starchy Foods

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Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.


This food group is your body's main source of energy and contains bread, pasta, rice, potatoes, noodles, chapatti, cereals and other starchy carbohydrates.

Refined and unrefined grains
The foods listed above (apart from potatoes) are all produced from grains, such as wheat, corn or rice. They should be a part of all meals, filling about a third of your plate. They can come in two forms – refined or unrefined (often known as whole grains).

Refined grains have been stripped of their outer bran coating and inner germ during the milling process, leaving only the endosperm. They include white rice, white bread and white pasta.

In a whole grain the bran, germ and endosperm are all still present. The bran is an excellent source of fibre; the germ is a source of protein, vitamins and minerals; and the endosperm supplies most of the carbohydrates, mainly in the form of starch. Unrefined or whole grain forms provide far more nutrients than their unrefined counterparts.

Whole grains are rich in phytochemicals and antioxidants, which help to protect against coronary heart disease, certain cancers, and diabetes. Studies have shown people who eat more whole grains tend to have a healthier heart.

Most people get their whole grain from wholemeal bread or whole grain breakfast cereals such as porridge, muesli or whole wheat cereals. Choose a whole grain variety over processed or refined grains, and look out for added sugar or salt.

Other whole grains include:

Wheat
Oats
Maize
Barley
Rye
Millet
Quinoa
Wild rice

Fibre
Dietary fibre is found in plant foods (fruit, vegetables and whole grains) and is essential for maintaining a healthy digestive system. Fibre cannot be fully digested and is often called bulk or roughage. The two types of fibre found in food are soluble and insoluble.

Soluble fibre, which can dissolve in water, is found in beans, fruit and oat products, and can help to lower blood fats and maintain blood sugar.

Insoluble fibre cannot dissolve in water, so passes directly through the digestive system. It’s found in whole grain products and vegetables and it increases the rate at which food passes through the gut.

Evidence for health benefits of fibre
High-fibre foods take longer to digest, so keep you feeling fuller for longer. The slow and steady digestion of food through the gut helps control blood sugar and assists with weight maintenance
Fibre helps in the digestive process and can help lower blood cholesterol
Fibre promotes bowel regularity and keeping the gastrointestinal tract clean to help reduce the risk of developing diverticular disease and constipation
A high-fibre diet may reduce the risk of developing diabetes and colorectal cancer

To eat more fibre, try these healthy swaps:

Refined Swap Unrefined
Frosted flakes Bran flakes
White toast Porridge oats
Cereal bar Rice cakes
French bread Wholemeal bread
Normal pasta Wholewheat pasta
Breadstick Dark rye crispbread


How much is enough?
Bread, rice, potatoes, pasta and other starchy foods should make up about one third of your diet. Try these recipes from the BBC Food website:

Banana and Oat Smoothie
Wholemeal pizza baguettes
Ham and watercress sandwich on wholemeal bread
Creamy lentils and brown rice
Using wholemeal flour in baking, as in this Irish Soda Bread or half and half as in these Carrot and Pineapple Muffins

What about GI?
The glycaemic index (GI) is a way of ranking carbohydrate foods based on how quickly they increase blood sugar levels. Low GI foods are especially helpful for people with diabetes, who need to have more control over their blood sugar levels than the general population.

Ideally foods with a low GI, such as those rich in soluble fibre like oats and legumes, should be eaten more frequently than those with a high GI. But the texture, type of cooking or processing used, and the amount and type of sugars present can all affect the GI. Since foods are often consumed as part of a meal or snack, it can be difficult to calculate the GI. Focusing on unrefined, high-fibre, whole grain cereals and minimising rapidly absorbed, refined cereals and sugary foods will all help to lower the GI of your diet.

Importance Of Salt

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Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.


Salt, also known as sodium chloride, is made up of 40 per cent sodium and 60 per cent chloride. Found predominantly in pre-prepared foods, excessive salt consumption has been linked with high blood pressure and stomach cancer, and can exacerbate osteoporosis and asthma.

Why is it needed?
The sodium component of salt is vital for controlling the amount of water in the body, maintaining the normal pH of blood, transmitting nerve signals and helping muscular contraction. Salt is present in all foods in varying degrees, and almost all processed foods contain added salt.

Daily requirements
Sodium, unlike all other minerals, is generally overconsumed, with the dietary intake of salt in the UK being far in excess of the recommended daily requirement.

Adults are advised to consume no more than 6g salt per day (about one teaspoon). Current intake is about 9g per day – a third higher than is recommended for good health. Babies and children should have less salt than adults. High salt intake in babies can be especially dangerous, as their kidneys cannot cope with large amounts. Recommendations for babies and children are given below:


Age (years) Salt (g/day)
1 to 3 2 (0.8g sodium)
4 to 6 3 (1.2g sodium)
7 to 10 5 (2g sodium)
11 plus 6 (2.4g sodium)


Reducing salt intake
The government has set a target of reducing the average salt consumption of adults to 6g per day by 2010. This is a challenging but achievable goal, which will bring measurable improvements in health. A study published in the scientific journal Hypertension in 2003 estimated that a reduction in salt intake to 6g per day would lead to a 13 per cent reduction in stroke and a 10 per cent reduction in ischaemic heart disease.

People who have experienced heart problems or have high blood pressure should follow a low-salt diet and take advice from their health care professional. Reducing sodium has been proven to be one of the best ways of lowering high blood pressure, especially in combination with broader dietary changes.

Choosing Healthier Options

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Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.

More and more of us are eating out on a regular basis, whether it's for a business lunch, a girls' get together, or for a family meal.

The 2006 Family Food Survey found that households where the head of the household was under 30 years old were spending more than 40 per cent of their food budget on eating out.

Eating out usually means that we have little control over how the food is prepared or how large the portion is. Foods eaten out tend to be higher in fat and research has shown that those who eat out regularly generally have higher intakes of fat, salt and calories. Studies have also shown that eating with friends can tempt us to overeat. Meals with multiple courses eaten over longer periods and with alcohol are all associated with overindulgence. Large serving bowls and spoons increase the likelihood of piling more food on your plate than you usually eat.

Unlike packaged food, foods bought from cafes, restaurants etc don't have to carry nutritional information and so opting for the healthiest option might not always be obvious, or easy. However, with some knowledge and thought, eating out can be enjoyable and healthy!

General tips
If you're unsure as to what something is, or what it contains - ask! If the waiter/waitress doesn't know, then the chef will.
Think ahead, if you know you're eating out later and it could be a lavish affair, choose wisely earlier in the day to keep calories, fat, sugar and salt intakes under control.
Don't eat an extra course just to be polite.
Only order a sweet after the main course, and only if still hungry. Opt for sorbets, or fruit dishes to balance out a heavy main course.
Think about sharing a course with a companion if the portions look large.
Speak up about how you'd like a dish prepared eg ask for no mayonnaise, dressing on the side.
You're more likely to overeat at an 'all you can eat' style buffet.
Choose side orders of salad or vegetables to fill up on.
Cut off any visible fat from meat to keep saturated fat intake down.
Look out for smaller portions ie a main meal option as a starter size.
Opt for dishes which are grilled, baked, steamed, poached or cooked in own juice rather than fried.
Check the menu for dressings on salads and ask for it to be served separately. An otherwise healthy and nutritious salad could be drowned in a high fat sauce, bumping up its calorie content.
Avoid cheese, cream or butter-based sauces
If you're a cheese lover, think about sharing the cheese board option to keep saturated fat, salt and calorie intakes in check.

Fats and Sugar

These foods, although an important energy source, often contain few other nutrients, so it's healthier to limit their consumption.

What are they?
This group, which includes foods such as cakes, biscuits, sweets, sugar-sweetened drinks and crisps, makes up the smallest section of the Food Standards Agency's 'eatwell plate'.

Fat facts
Fat transports the fat-soluble vitamins A, D, E and K around the body
It can often improve the flavour and perception of foods, increasing their palatability
It supplies essential nutrients such as fat-soluble vitamins and essential fatty acids (EFAs)
EFAs must be supplied from the diet, and are thought to have a positive effect on heart health and the immune system
It has a key role in membrane structure
It cushions, and so protects, the internal organs
It's stored in adipose tissue (a thick layer of tissue under the skin) as a long-term fuel reserve. Excess fat may also accumulate around your organs, especially in the abdominal cavity

Fat is a concentrated source of energy. Just 1g provides nine calories - more than double the calories in 1g of protein or carbohydrate.

This means it's much easier to consume too many calories when eating high-fat foods. People trying to manage their weight should reduce fatty foods to help cut calories. We all need some fat in our diets, but small quantities of EFAs are the key to good health.

The two types of fat
Fat can be divided into two main groups - saturated and unsaturated.

Saturated fat is generally solid at room temperature and is usually from animal sources. It's found in lard, butter, hard margarine, cheese, whole milk and anything that contains these ingredients, such as cakes, chocolate, biscuits, pies and pastries. It's also the white fat you can see on red meat and underneath poultry skin.

How much saturated fat you eat is associated with increased blood cholesterol concentrations and an increased risk of heart disease. Eating less helps to minimise the risks it poses to heart health.

Unsaturated fat is usually liquid at room temperature and generally comes from vegetable sources. Monounsaturated and polyunsaturated fats are both included in this group.

Unsaturated vegetable oils are a healthier alternative to saturated fat and can be found in sesame, sunflower, soya and olive oil, soft margarine and in foods such as oily fish, including mackerel, sardines, pilchards and salmon. Where possible, you should ensure the fat you eat is unsaturated.

Did you know...?

A jam doughnut contains 10.9g fat
A slice of malt loaf contains 0.7g fat
A teaspoon of peanut butter contains 5.4g fat
A pint of whole milk contains 22.8 g fat
A handful of mixed nuts contains 21.6g fat

How much is enough?
Government guidelines recommend fats make up no more than 35 per cent of the energy in your diet, and that saturated fats should provide less than 11 per cent of total energy intake.

For the average woman, this means about 70g of total fat a day; for men, roughly 95g.

The latest National Diet and Nutrition Survey showed that, on average, UK adults consume about the right amount of fat, but that the intake of saturated fats is currently too high for good health (at present they provide about 13 per cent of total energy).

To reduce the amount of fat in your diet, try the following:

Look for alternatives to cakes, biscuits and savoury snacks, which are often high in fat - try fresh fruit, dried fruit and cereal-based products
Trim any visible fat off meat and poultry
Buy lean cuts of meat and reduced-fat minces
Poach, steam, grill or bake food rather than fry it
Swap whole milk for semi-skimmed or skimmed
Opt for low-fat dairy products
If you use lard, butter or hard margarine, switch to vegetable oil and low-fat spreads

Sugary foods
There are two types of sugar - those found naturally in fruit and milk (which are fine and don't need to be cut down) and those that are added to the diet.

These added sugars can be found in a variety of foods including confectionery, soft drinks, desserts and breakfast cereals. Added sugars are a great source of energy, but provide no other nutrients.

Sugary foods and drinks pose a threat to dental health, especially if consumed between meals.

Even the sugars in honey and fruit juices can cause tooth decay if good oral hygiene isn't followed and you consume a lot of these foods.

Only have sugary foods at mealtimes, when other dietary and oral factors can help to minimise the risk they pose to your teeth.

Sugary drinks have been identified as a possible cause of obesity. These drinks do not trigger the same sense of fullness as food with similar calories, increasing the risk of overeating.

How to reduce consumption of sugary foods
Swap sugary drinks for water, low-fat milk or artificially sweetened drinks to reduce your calorie intake
Try swapping sugary snacks for fruit or bread-based options such as fresh whole fruit or teacakes/malt loaf
Try to halve the amount of sugar you put in hot drinks, or cut it out completely
Buy reduced-sugar varieties of jam and marmalade
Choose tinned fruit in natural juice rather than syrup

Packing A Lunchbox

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Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.

Lunchbox tips
Planning ahead and packing a tasty and nutritious lunchbox can avoid reliance on the energy-dense, nutrient-poor options that often make up a quick meal on the move.

A nutritious lunch will help children and adults maintain energy levels and concentration through the afternoon.

Make your own lunch
If lunch is dictated by what's available - whether a sandwich bar, petrol station, corner shop or fast-food outlet - then choosing to make your own meal provides a nutritious and healthy alternative, and saves money.

Lunchboxes don't need to contain just a soggy sandwich and a packet of crisps. Ensuring the meal contains fruit and/or vegetables, a good helping of starchy carbohydrates and some dairy products will result in a nutritionally balanced lunch.

Healthy options
Avoid boredom setting in with some alternatives to sandwiches.

Try soup - a flask of warm vegetable soup can provide a portion of your five-a-day and boost fibre intake. Homemade versions can be tailored to personal taste, but shop-bought ones are fine, too (check the label to avoid those with a high salt content).
Rice, noodles, lentils, couscous, bulghur wheat and pasta can form the basis of salads, accompanied by chopped vegetables, fruit, seeds and nuts to boost vitamin and mineral intake. You can also add protein such as chicken, tuna, prawns and soya.
Leftovers from your meal the night before, such as homemade pizza, omelette or quiche, can all be eaten cold the next day, accompanied by a green salad.
Use different varieties of bread throughout the week, such as wholemeal, granary, oat-topped, seed-based, ciabatta, rye, bagels, wraps, pitta, baguettes and rolls. Choose wholemeal varieties for maximum nutrients (such as fibre, B vitamins, vitamin E and magnesium).

Accompaniments
Fill out your lunchbox with the following:

Fruit – include fruit such as apples, grapes, plums and berries. Chopped fruit, fruit salad or dried fruit such as apricots, raisins and dates can be easily handled and eaten by children. A fruit smoothie is also a healthy option.
Vegetables - chopped vegetables such as carrot, celery and cucumber can be included with dips such as hummus to provide a nutritious snack. Cherry tomatoes, sliced peppers, baby corn and sugar snap peas are great for adding colour and are easy for young children to eat.
Desserts - fruit can be added to low-sugar jelly, or mixed in with natural yoghurt for a tasty dessert. Yoghurt drinks or small pots of custard or rice pudding can top up calcium intake and provide an alternative to more sugary or fatty options. If you like cakes and biscuits, try varieties such as hot-cross buns, scones and malt loaf. Include your favourite cake once in a while, but keep the portion small.
Variety is key to keeping lunchboxes appetising and appealing. Sandwich fillings can be packed with salad to add colour and nutrients, and accompanied by low-fat nutritious options such as lean meat, fish, egg and low-fat cheese.
Adding a treat every now and then is fine - try fun-size chocolate bars, snack-sized packets of biscuits and sweets to keep portions small and the calorie, fat and sugar content low.
Drinks - use tap water, or mix it with low-sugar squash or some fruit juice to add flavour. Unsweetened fruit juice and smoothies count towards one of your five a day, but avoid too many sugary drinks which can add lots of extra calories. Milk-based drinks, without added sugar, are a healthier option for teeth than sugary alternatives.

Fruit and vegetables

Your weight
Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.

Fruit and vegetables are low in energy and packed with vitamins, minerals, protective plant compounds and fibre, so they're a great source of nutrients and vital for a healthy diet.

Five a day
Due to their nutritional and health benefits, it's recommended that fruit and vegetables form the basis of your diet, with a minimum intake of five portions each day - about a third of your daily food consumption. Currently the UK averages two to three portions a day, so we're falling well short of the benefits they can provide.

Fruit and vegetables should be incorporated into every meal, as well as being the first choice for a snack. Population studies have shown that people who eat a lot of fruit and vegetables may have a lower risk of chronic disease, such as heart disease and some cancers. Health benefits can be gained from fresh, tinned (in natural juice), frozen, cooked, juiced or dried versions. Potatoes don't count though, as they're a starchy food.

How much is a portion?
One piece of medium-sized fruit, such as an apple, peach, banana or orange
One slice of fruit, such as melon, mango or pineapple
One handful of grapes or two handfuls of cherries or berry fruits
One tablespoon of dried fruit
A glass (roughly 100ml) of fruit or vegetable juice
A small tin (roughly 200g) of fruit
3 tablespoons of fruit salad or stewed fruit
A side salad
A serving (roughly 80g) of vegetables, such as frozen or mushy peas, boiled carrots or stir-fried broccoli
Cooked dishes that contain significant amounts of vegetables may also count

So how do you ensure an intake of five portions a day? Here's a typical plan:

Glass of fresh orange juice or smoothie for breakfast = one portion
Small pack of dried apricots for mid-morning snack, instead of a chocolate bar or bag of crisps = 1 portion
Small pack of dried apricots for mid-morning snack = one portion
Side salad with lunch = one portion
Sugar snap peas and broccoli, served with main meal = one portion
Strawberries as dessert = one portion

Do remember that some fruits contain many of their nutrients just under the skin, so eating them with the skin on can provide greater nutritional benefits and the maximum amount of fibre compared with just drinking the juice of the same fruit.

Preconception and pregnancy

Your weight
Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.

When planning for a baby, a healthy diet will provide you and your partner with the nutrients needed to prepare your body for conception. When you become pregnant, what you eat is also vital for the development and well-being of your unborn baby and may affect its future health.

Body weight and fertility
Being a healthy body weight is important before pregnancy. If you're very underweight, it can be more difficult to conceive. Being obese may also cause problems with conceiving especially if you suffer from polycystic ovary syndrome. Women who are obese while pregnant also increase the risk of complications during pregnancy, delivery and in the few days after birth.

The ideal weight range is usually calculated using the body mass index (BMI). A BMI between 18.5 to 25 is a healthy weight for most people and associated with relatively low risks. For people with a BMI over 30, even a small weight loss can greatly increase your ability to conceive and have a healthy pregnancy. Take steps either to lose or gain weight in a sensible way before you become pregnant. Crash dieting is not good for your health, and limiting your range of foods may deplete your nutrient stores. If you're concerned about your weight, you may find it useful to speak to your doctor or practice nurse for further advice.

and your partner¦
Eating a healthy diet and being the right body weight is important for men who are hoping to become dads, too. There have been many studies looking at specific nutrients such as zinc and selenium and male sperm quality. However, the key messages for men are:

Aim to be the right weight for your height by eating sensibly and exercising on a regular basis
Follow the principles of healthy eating. Eating a variety of foods will help ensure you have all the nutrients you need such as zinc and selenium
Stick firmly within the alcohol limits. Do not exceed three to four units per day on a regular basis, preferably with some alcohol-free days each week

A balanced diet
With a few exceptions, you can continue to eat a normal, healthy diet before and during pregnancy. This includes regular meals and snacks, and a sensible healthy eating regime containing:

plenty of starchy carbohydrates - bread, rice, pasta, breakfast cereals, chapattis, couscous and potatoes
plenty of fruit and vegetables - at least five portions a day
low or reduced fat dairy products such as milk, yoghurt, fromage frais and pasteurised cheeses
lean sources of protein, such as meat, poultry, fish, eggs (well-cooked), beans and pulses
not too many fat-rich and sugary foods
at least eight medium glasses of fluid each day
very little or no alcohol

Generally, pregnancy can progress well with the need for only very small increases in protein, carbohydrate, fat, vitamins and minerals. The digestive system in pregnant women changes and becomes more efficient at absorbing certain nutrients. In fact, with only a few exceptions, most of the additional nutrient needs of pregnancy can be met by eating a well-balanced and varied diet. So the old adage 'eating for two' doesn't mean you should eat twice as much food.

Weight gain
Optimum weight gain in pregnancy depends on your pre-pregnant weight. The baby and amniotic fluid are only a small part of the weight gain, the rest is an increase in the mother's fat stores to provide an energy reserve for later breastfeeding. There are no specific recommendations for pregnancy weight gain in the UK. However in the USA, thinner women are encouraged to gain a little more weight, anywhere between 12.8kg and 18kg (28lb to 40lb), while women of an average weight should aim for between 11.5kg and 16kg (25lb to 35lb). Overweight and obese women should aim to gain less weight and this should be discussed with your midwife or health care provider.

Pre-school children

Your weight
Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?
We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?
Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.


Nutrition for children
Food and nutrients help to form strong teeth and bones, muscles and a healthy body. A good diet can also help to protect your child against illness now and in the future.

This is a critical time to complete the weaning process, reducing the amount of milk and establishing the foundations of your child’s diet. A young child's diet needs special care and planning - the need for energy and nutrients is high, but appetites are small and eating habits can be fussy. Their diet must be made up of small, regular, nutrient-dense meals.

Key nutrients and dietary sources
Suitable foods
Base your child's intake on the following food groups to help ensure they’re getting all the important nutrients. Remember pre-school children should be allowed to eat according to appetite, as there are no definitive recommendations on portion sizes for this age group. At this age, children are often good at regulating their appetite.

There's no need to rely on pre-prepared toddler foods. If the family diet is healthy, children can just have family food.

1. At least one kind of starchy carbohydrate, such as bread, rice, pasta, noodles, cereals or potatoes, should be served with all meals.

Young children have small appetites, so fibre-rich carbohydrates can be bulky and inhibit the absorption of some minerals. Gradually introduce higher fibre carbohydrate foods, such as wholewheat pasta and brown rice, so that by the time children are five, they're eating the same fibre-rich foods as the rest of the family.

2. Fruit and vegetables should be eaten often. Aim for at least five servings a day, where a serving is about a handful in size.

Use fruit in puddings and as snacks
Frozen and canned fruit and vegetables can be just as nutritious as fresh varieties
Vegetables can be eaten raw or cooked (serve crunchy rather than very soft to preserve the vitamins and minerals)
If vegetables aren't a favourite, try hiding them by pureeing in to soups, sauces, casseroles and pizza toppings

3. Milk and dairy foods are an important source of calcium. Your child should be having about one pint (500 to 600ml) of milk a day.

Use full-fat varieties; semi-skimmed may be given from the age of two if the overall diet contains enough energy and nutrients
Milk can be used on cereals or in drinks, puddings and sauces
Cheese, fromage frais or yoghurt can be given instead of some milk
Grated cheese, cheese spread or cheese portions can be used on sandwiches or toast
Try yoghurts as a pudding or snack between meals, served alone or with fruit

4. Meat, fish and alternatives should be eaten once or twice a day.

Minced beef, turkey, chicken and pork should be cooked slowly to ensure it's soft and tender
The Food Standards Agency recommends at least two servings of fish a week, one of which should be oily. But don't give your child more than four servings of oily fish a week for boys and two servings a week for girls. Shark, swordfish or marlin should also be avoided, as these contain high levels of mercury, which might affect a child's developing nervous system
Use eggs, either boiled, in sandwiches, as omelettes or scrambled
Try different beans and pulses, such as lentils, baked beans, peas and chickpeas

Adult's Diet

Your weight

Expert advice to help you maintain a healthy weight

Dissatisfied with your weight?

We're bombarded with scare stories about weight, from size zero to the obesity 'epidemic'. But a healthy weight is determined by different factors for each of us. Our expert advice is designed to help you achieve and maintain a healthy, life-enhancing weight.

Overweight or underweight?

Being the right weight has a positive effect on wellbeing but also on our health, as being the wrong weight can cause a range of medical problems.

Eating well and drinking sensibly are good investments for your immediate health.

Why good nutrition matters
By eating a nutritious diet and being physically active, you can maintain a healthy body weight and reduce your risk of developing diet-related illnesses, such as type 2 diabetes, heart disease and some types of cancer.

Some of the most important risk factors for premature death in adults are:

Smoking
Obesity
Physical inactivity
Raised blood cholesterol
Raised blood pressure
Excessive alcohol intake

With the exception of smoking, applying the principles of healthy eating and being more physically active can make a significant impact on all of these risk factors.

What is a healthy diet?
To understand how you can eat healthily, it's important to know which types of food to consume and why. Your body requires a well-balanced diet, with a good supply of carbohydrates, especially high-fibre foods, plenty of fruit and vegetables, some protein, low-fat dairy products and plenty of fluid. The best way to get the right balance is to follow the principles of healthy eating shown on the Food Standards Agency's 'eatwell plate'

Why don't we eat healthily?
A consumer survey carried out by the Food Standards Agency revealed that knowledge of what constitutes a healthy diet is actually quite high. Most of the adults surveyed knew which kinds of food they should be eating more of, such as fruit and vegetables, or less of, such as fat and salt.

But data from the National Diet and Nutrition Survey, published in 2003, shows that UK adults eat too much saturated fat, sugar and salt, not enough dietary fibre and, on average, their fruit and vegetable intake is fewer than three portions a day.

The rising number of people becoming overweight also tells us that, for a variety of reasons, this knowledge about diet is not being translated into positive action to achieve a healthier diet.

Some media coverage of healthy eating habits can make it seem as though a healthy diet will be incredibly difficult to achieve - either very expensive or not very tasty. But it's possible, with a few simple changes, to make your diet significantly healthier and reduce your risk of illness without it being an onerous task (see the Balance of good health article for details). There are lots of different things you can do, so approach the changes one at a time.

Everyone should be eating a variety of food to achieve a healthy diet, but some nutrition issues are more specific to men or women.

Nutrition issues for men
While both sexes need to maintain a healthy body weight, men in particular should be wary of excess weight. In men, extra pounds tend to be stored around the tummy. Sometimes referred to as abdominal fat, this increases the risk of developing heart disease and diabetes to a greater extent than fat stored on the hips and thighs, which is more typical for women.

This risk of abdominal obesity is even greater for men of Afro-Caribbean and Asian origin.