We all know what we should eat, so why is one in three of us fat, asksSylvia Thompson in the first of a two-part series on diet
We have become obsessed with what we eat, yet we are increasingly confused about what foods are best for us. With one in three Irish adults now overweight, health professionals have never been more keenly aware of the importance of good nutrition. So, why are we getting it wrong? Why are the healthy eating messages not getting through? And why is one third of our population too fat?
In the last two years, 70 community dieticians have been assigned to health boards throughout the country to promote healthy eating.
In some areas, health-conscious options have been introduced in school canteens and restaurants in the workplace; basic nutrition and cookery courses are being run for parents in disadvantaged areas, and breakfast clubs provide food for children who arrive into school hungry.
"The emphasis is on improving knowledge and changing behaviour around food but it is difficult to encourage and motivate people to keep eating healthily," says Margaret O'Neill, community dietician in the Health Promotion Department of the South Western Area Health Board (SWAHB) of the Eastern Regional Health Authority.
Initiatives in which people are trained to run nutrition programmes in their locality have become popular, yet such schemes only run in geographical pockets while the rest of the community is left to rely on a few healthy eating leaflets stacked in health centres.
"There are a lot of barriers, and we are stretched in our resources if you consider that the SWAHB has a population of half a million people, so we decided to focus on the areas of greatest need which is the lower income groups."
The barriers O'Neill refers to include corner shops not selling fruit and vegetables (in Britain, fruit and vegetable vans now make door-to-door deliveries to some disadvantaged areas); the loss of cooking skills among parents, and the proliferation of convenience stores selling foods with a high fat content and low nutritional value.
Reliance on convenience and processed foods is not confined to disadvantaged areas, dietician and nutritional consultant Aveen Bannon points out. Having recently set up the Dublin Nutrition Centre (see panel) on Fitzwilliam Street, Dublin 2, Bannon advises a mix of young clients who want to make changes to their diets before they put their health at risk.
"I see young men who say: 'I know I drink too much and have too many fatty foods and I don't want to get heart disease, so give me a realistic way how I can improve the situation'. Then I see women who have tried all the fad diets and come to me for definitive dietary advice."
But why is it so difficult for people to eat healthily? "There is a lot of conflicting advice out there and I find some people just don't look at their diets logically," says Bannon. "For instance, there are those who tell me they avoid red meat and milk, yet have a bar of chocolate and a packet of crisps every day. Also, people should consider the whole idea of convenience foods. For example, it is convenient to eat fruit and yogurt.
"The problem also is there are a lot of mixed messages about food and people don't know what to believe. They hear one thing and go hell for leather into it. Everything is done excessively. For instance, people think olive oil is good for them and they use it abundantly in cooking and on salads. Whereas I'm saying, don't take too much of it. Use it instead of saturated fats, but buy a good quality non-stick pan and only use a small amount of it for frying. Remember that oil and fat have the same calories whether it's butter, margarine, lard or olive oil."
Less than honest marketing of some foods also doesn't help. Bannon points out that certain foods labelled cholesterol-free might never have cholesterol in them anyway, and other foods labelled low-fat can be high in sugar.
The forthcoming EU legislation on product labelling should put paid to such misleading claims which dupe the public into buying highly processed foods of low nutritional value, cleverly marketed as healthy choices.
However, some low-fat foods are genuinely healthy for you, and dieticians often recommend low-fat milk. Fortified foods can also help, for instance in "supermilk", where the fat-soluble vitamins A, D, E and K lost through the removal of cream to achieve low-fat milk, are replaced.
The core problem is still that the public has a poor knowledge of basic nutrition. Bannon agrees with retired paediatrician Niall O'Brien, who called for more comprehensive nutritional education in schools in a recent letter to The Irish Times.
"Home economics [in schools\] is favoured mainly for the possibility for easy points, but it should be revamped and redefined to add health economics and given the same priority as maths or physics. This is the only way that secondary-school pupils will develop an understanding and knowledge of health matters," says O'Brien.
Meanwhile, Irish adults could initiate healthier eating habits by copying the French. A recent study which compared French and American portion sizes found that the average in America is about 25 per cent larger.
Taking a little longer to eat your meals, waiting until you are hungry before you eat, and not eating too much are some of the simplest healthy eating messages.
Why wait for a National Healthy Eating Week campaign to spread this message?
Tomorrow, part 2: Can you prevent cancer, heart disease and other serious illnesses through dietary changes? Plus, children's eating habits and poor diets - a growing cause for concern.