Who do you rely on for healthy food choices? Part 2

Most of the UK is Nutritionally Deficient

Nutrition-related risk factors are linked to both acute and chronic disease, contributing significantly to a large burden of preventable non-communicable diseases and increasing the risk of premature death.  According to a 2020 study, malnutrition is estimated to cost the UK around £26bn a year – 20% of the entire NHS and social care bill:  illness caused by undernutrition or nutrition deficiencies costs around £20bn a year, and obesity costs around £6bn a year.

In 2022 the UK Health and Food Supplements Information Service (HSIS) issued a report – Immune Health: Micronutrients Under the Microscope – detailing how the UK ‘urgently needs a nutrition reset to get immune health back on track’.  The report found that the nutrients most lacking are vitamins A, C, D and all B vitamins, iron, zinc and omega-3 fatty acids.

Processed food is the main culprit

An Imperial College study tracked 200,000 British people over 12 years (2009-2021) and found that half or more of the everyday British diet is made up of NOVA classified ultra-processed “foods” – the great majority of packaged foods including infant formula and baby foods, which retain hardly a trace of the whole foods from which they were extracted.  These are industrially derived food substances and food additives put through a sequence of extensive industrial processes – resulting in a nutrient-free human equivalent of canned dog food, engineered to taste so good that you are likely to eat too much of it, and even become addicted to it.  

Substantial research has proven that there is a direct link between ultra-processed food consumption and degenerative diseases such as arthritis, cancer, diabetes, heart disease, cognitive decline and more, and that a healthy diet can not only greatly improve disease outcomes but also very significantly outweigh genetic risk factors.  

NHS considers dietary supplementation ‘unnecessary’ in most cases.

In 2018, NHS England stated that vitamins and minerals – whilst essential nutrients – should not be routinely prescribed in primary care because most people can and should get them from eating a healthy, varied and balanced diet.  They consider that ‘In most cases, dietary supplementation is unnecessary’. NHS guidelines strictly limit the testing of vitamin and mineral levels, and the prescription of vitamins and minerals, to cases of malnutrition or nutrient depletion caused by certain categories of acute or long-term chronic illness, medical procedures and/or pharmaceutical drugs.

But most people in the UK do not eat a healthy, varied and balanced diet, and widespread unrecognised food intolerances and allergies (to the ubiquitous wheat, gluten, dairy, eggs, soy etc) can greatly deplete nutrient absorption and assimilation.

Do nutrient deficiencies get diagnosed and treated by medical doctors?

In the UK our general practitioners give us most of the personalised advice we receive on nutrition.  But the NHS Long Term Plan of 2019 stated that many medical school curricula provide at most a total of 8 hours of nutrition training per medical student over five or six years, and it recognised the urgent need to ‘ensure nutrition has a greater place in (medical) professional education’. 

And in a 2020 UK study (Time for nutrition in medical education) published in the BMJ, some medical doctors reported having received less than 2 hours nutrition training.  Only 26% of the 853 doctors in the study were confident in their nutrition knowledge and 74% gave nutritional advice less than once a month, citing lack of knowledge (75%), time (64%) and confidence (62%) as the main barriers. 

So where can you find a nutrition expert?

Dieticians can work unsupervised with patients to devise eating plans for the management or treatment of their medical condition and/or specialise in the provision of the therapeutic diets required within a hospital environment.  

Nutritionists provide evidence-based nutrition information and guidance to people at an individual, group or population level or to animals and their carers. They cannot treat an individual’s medical condition unless closely supervised by a medical doctor or dietitian.

Nutritional Therapists assess and identify potential nutritional imbalances based on how these imbalances can contribute to an individual’s specific symptoms.  They remedy nutritional imbalances by prescribing both highly nutritious food and nutritional supplements, thus supporting the patient in regaining and maintaining good health.  They work in collaboration with medical professionals.

The following doctors are experts in the use of nutrition and lifestyle in treating disease, have written books and created websites dedicated to their specialist subjects:

Dr Dean Ornish (cardiac, prostate cancer), Professor Robert Thomas (cancer) Dr Aseem Malhotra (cardiac) Dr Rangan Chatterjee (general, stress) and Dr David Unwin (diabetes).