Written evidence submitted by BANT to the Health Select Committee
Written evidence submitted by the British Associationfor Applied Nutrition and Nutritional Therapy (BANT)to the Health Select Committee of the House of Commons published 12 February, 2015.
The Eatwell Plate continues to receive criticism for its lack of validity in 2015 Britain. Government public health officials continue to claim that it provides appropriate advice for most people including people of all ethnic origins, and people who are of a healthy weight or overweight, as well as vegetarians. However, it is obvious looking at the waist size for the average Britton that the EatWell Plate model poses a number of problems.
What are the problems with the Eatwell Plate?
- It is applied not just to healthy weight people but also to those who are already overweight or obese.
- There is no evidence that any processed foods and drinks high in fat and sugar should be recommended as dietary advice. This is even more important for those who are overweight/obese and/or with impaired blood sugar control.
- All fruits and vegetables are not the equal.
- Milk and dairy foods: whilst these are important it is not clear why the products of one animal should constitute a ‘food group’ other than to reflect a food industry reality.
- There is no evidence that overweight/obese people should eat ‘plenty of bread, rice, potatoes and pasta’ even if it is wholegrain.
Further recommendations are that the 5 food groups should be consumed as follows:
- bread, rice, potatoes, pasta and other starchy foods - 33%
- fruit and vegetables - 33%
- milk and dairy foods - 15%
- meat, fish, eggs, beans and other non-dairy sources of protein - 12%
- foods and drinks high in fat and/or sugar - 8%
There is no reliable evidence that any individual should follow a diet with these percentages rather only potentially for national diet researchers to use these percentages to determine whether the nation, or populations, are eating healthily as a whole.
The problem with public health nutrition
Nutritional Therapy practice usually encompasses individual variability in the dietary response but BANT members also often work with groups and communities and as such two healthy eating plates supporting NT principles have recently been developed. The need for the tool development arose from a dissatisfaction with the current one-size-fits-all public health approach using the government’s 20-year old model of the Balance of Good Health represented by the ‘Eatwell’ Plate and ‘5-a-day’. BANT took the opportunity to take a critical look at the Eatwell Plate/dietary guidelines to address the inadequacies of theone-size-fits all approach, particularly with regard to its applicability to those who are overweight or obese.
Other models: the Harvard Plate and Pyramid
Over the past decade Harvard School of Public Health has developed and adapted its own plates and pyramids based on the prevailing science. These are free from food industry influence or lobbying and are a big improvement on the Eatwell Plate.
The BANT PLATES
What do we need from our diet?
Nutrients and other food components influence the function of the body, protect against disease, restore health, and determine people’s response to changes in the environment. BANT has developed two plates pulling together the latest dietary, and some lifestyle, advice for healthy living, including mental health. We need to eat to provide energy, vital nutrients and fibre, and bioactive components (nutrients and non-nutrients) for long-term genomic stability. Population reference values for micro-nutrients and non-nutrient bioactives are not able to encompass the full diversity of individuals or, in some cases, do not exist at all.
The two plates are intended for use by BANT members with groups and communities. They are not intended for use with individuals in anything other than as a starting position and reinforce why different initial conditions might require different programmes.
A public consultation on the Healthy Eating Puzzle Plates ran from 3 September to 24 October 2014. It received attention in social media and a good public response. The post-consultation versions of the plates will be launched in March 2015 along with a ‘Eat the Rainbow – 7 A Day’ (at least 2 portions of fruit and 5 of vegetables) poster.
Miguel Toribio-Mateas, Chairman, said: “the costs of obesity and diet-related disease (cardiovascular disease, some cancers, osteoporosis, mental health), both social and financial, demand that those working in the nutrition profession are up-to-date and appropriately qualified. Dietary intervention based on knowledge of nutritional requirement, nutritional status, and genotype (i.e., “personalised nutrition”) can be used to prevent, mitigate or cure chronic disease."
About BANT and Nutritional Therapy
BANT represents nutrition professionals whose practice is rooted in the post-genome understanding of the relationship between lifestyle and health status (and that health is a positive state not merely the absence of disease) and underpinned by a set of guiding principles, i.e.:
- Biochemical individuality: understanding and appreciating the importance of variations in metabolic function deriving from genetic, epigenetic and environmental differences among individuals.
- Dynamic balance of internal and external factors: understanding that resilient homeostasis (the buffering capacity to respond to a perturbation) is important for physiological equilibrium.
- Web-like interconnections: human physiology functions as an orchestrated network of interconnected systems, rather than individual systems functioning autonomously and without effect on each other.
- Promotion of organ reserve as the means to enhance health span by maintaining genomic stability and mitochondrial capacity so decreasing morbidity.
It is a truly holistic patient-centred model capable of adapting to meet individual and organisational requirements in modern healthcare.
NT is regulated by the Complementary and Natural Healthcare Council which is accredited by the Professional Standards Authority for Assured Regulator status. Because it is regulated by the CNHC, and for historic reasons, NT has been characterised as ‘complementary and alternative medicine’ although it might be better described as ‘alternative dietetics’: if ‘dietitian’ was not a protected term, NTs would have used the title for the last 20 or so years as a dietitian is someone ‘who applies the science of nutrition to the feeding and education of individuals or groups in health and disease”. BANT is currently in correspondence with the Health and Care Professions Council to open their Dietetics Register to full the scope of practice not simply as practised in the NHS and public health one-size-fits allmodel.
Nutritional therapy practitioners are delivering the modern agenda in diet-related disease: Predictive, Preventative, Participatory, Personalised.
You can see our full Health Select Committee evidence here: http://polho.me/1CYTfDU
