Table Of ContentNutrition:
A Handbook for
Community Nurses
JUDY BUTTRISS
SARA STANNER
AMANDA WYNNE
WHURR PUBLISHERS
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Nutrition
A Handbook for
Community Nurses
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Nutrition
A Handbook for
Community Nurses
JUDYBUTTRISSPhD, SRD, RPHNutr
Science Director, British Nutrition Foundation
AMANDAWYNNEBSc, MSc, PGDipDiet, SRD
and
SARASTANNERBSc(Hons), MSc, RPHNutr
Nutrition Scientist British Nutrition Foundation
SERIESEDITOR
MARILYNEDWARDSBSC(Hons), SRN, FETC
Specialist Practitioner, General Practice Nursing, Bilbrook Medical
Centre, Staffordshire
W
WHUR R PUBL ISHER S
LONDON AND P HILADELPHIA
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© 2001 Whurr Publishers Ltd
First published 2001
by Whurr Publishers Ltd
19b Compton Terrace
London N1 2UN England and
325 Chestnut Street, Philadelphia PA 19106 USA
All rights reserved. No part of this publication may be
reproduced, stored in a retrieval system, or transmitted in
any form or by any means, electronic, mechanical,
photocopying, recording or otherwise, without the prior
permission of Whurr Publishers Limited.
This publication is sold subject to the conditions that it
shall not, by way of trade or otherwise, be lent, resold,
hired out, or otherwise circulated without the publisher’s
prior consent in any form of binding or cover other than
that in which it is published and without a similar
condition including this condition being imposed upon
any subsequent purchaser.
British Library Cataloguing in Publication Data
A catalogue record for this book
is available from the British Library.
ISBN 1 86156 216 0
Printed and bound in the UK by Athenaeum Press Ltd,
Gateshead, Tyne & Wear.
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Contents
Series Preface vii
Introduction 1
Background 1
Current health targets – Saving Lives:Our Healthier Nation 2
Nutritional issues highlighted in Saving Lives:Our Healthier Nation 3
Contents 7
Chapter 1 A healthy diet 9
Dietary reference values 10
The components of a healthy diet 22
Food processing 28
Nutrition labelling 30
Functional foods 33
Chapter 2 Nutrients and health 35
Fibre 35
Sugar 36
Fat 36
Other nutrients and phytochemicals 40
Chapter 3 Nutrition through life 51
Nutrition and preconception 51
Nutrition and pregnancy 53
Nutrition and breast-feeding 61
Weaning 67
Nutrition and preschool children 77
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vi Nutrition: A Handbook for Community Nurses
Nutrition and primary schoolchildren 80
Nutrition and teenagers 87
Nutrition and women of child-bearing age 97
Nutrition and men 102
Nutrition and the menopause 107
Ethnic minority groups 109
Low-income groups: eating healthily on a tight budget 112
Nutrition and older people 118
Chapter 4 Nutrition and the prevention/treatment of diseases 127
Coronary heart disease (CHD) 128
Cancer 131
Obesity 132
Diabetes 138
Osteoporosis 140
Arthritis 141
Colds and flu 142
Vegetarianism 142
Allergy and intolerance 145
Special diets from the perspective of the community nurse 158
Chapter 5 Issues in the media 164
Dieting and weight loss 165
Women’s issues 168
Functional foods 171
Protective substances in food and their impact on health 175
Food safety 179
Chapter 6 Assessing the quality of nutritional information 186
Assessing the validity of new research 186
Who to approach for detailed professional nutritional advice 192
References 194
Useful addresses 200
Index 203
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Series Preface
This series of handbooks has been devised to help community nurses
answer commonly asked questions. Many of the questions are asked
by patients, others by colleagues. The books have been written by
specialists, and although they are not intended as full clinical texts,
they are fully referenced from current evidence to validate the
content. The purpose of each handbook is to provide ‘facts at the
fingertips’, so that trawling through textbooks is not needed. This is
achieved through the question and answer format, with cross refer-
encing between sections. Where further information may be
required, the reader is referred to specific texts. Many patients want
some control over their illnesses, and use the internet to access infor-
mation. The useful address sections include website addresses to
share with both patients and colleagues.
It is hoped that these handy reference books will answer most
everyday questions. If there are areas which you feel have been
neglected, please let us know for future editions.
Mandy Edwards
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Introduction
It has long been recognised that achieving optimal health involves
more than just preventing disease. To achieve optimal health status,
and reduce chances of early death and ill-health, it is important to
follow a healthy balanced diet, to stay fit and active, to avoid smok-
ing and to moderate alcohol consumption.
The government recognised, in Saving Lives: Our Healthier Nation
(Department of Health, 1999) (see page 2), that public health is an
important consideration and that nurses, midwives and health visi-
tors can play a crucial role in promoting good health. Relevant
aspects of this strategy paper are discussed below, and a strategy is
being developed, which will help develop the public health aspects of
the role of nurses (National Health Service Executive, 1999). There
is clearly a key role for nurses and other health professionals to
promote positive and practical dietary messages, to help people to
improve the balance of their nutritional intake and to implement a
regimen of physical activity, in order to optimise health and well-
being. In the future, there may also be a new role developed for
nurses, namely specialist in public health, i.e. equivalent to a
medically qualified consultant in terms of status.
Background
The importance of promoting good health through nutrition was
recognised in Government policy in 1992, when the Health of the
Nation White Paper (Department of Health, 1992) was launched.
This paper set out plans to ‘add life to years and years to life’. This
strategy was based on five priority areas: cancer; coronary heart
disease (CHD) and stroke; accidents; mental illness; and HIV/AIDS
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