Adherence to the Eatwell Guide and population and planetary health: A Rank Prize Forum report
Corresponding Author
Oliver M. Shannon
Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
Correspondence
Oliver M. Shannon, Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
Email: [email protected]
Search for more papers by this authorRebecca Townsend
School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Newcastle Upon Tyne, UK
Search for more papers by this authorFiona C. Malcomson
Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
Search for more papers by this authorJamie Matu
School of Health, Leeds Beckett University, Leeds, UK
Search for more papers by this authorAlex Griffiths
School of Health, Leeds Beckett University, Leeds, UK
Search for more papers by this authorAmy Jennings
School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
Search for more papers by this authorNicola Ward
School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
Search for more papers by this authorKeren Papier
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
Search for more papers by this authorNicola Best
Department of Health Professions, Manchester Metropolitan University, Manchester, UK
Search for more papers by this authorChloe French
School of Health Sciences, University of Manchester, Manchester, UK
Search for more papers by this authorPauline Scheelbeek
Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
Search for more papers by this authorCurie Kim
Basic and Clinical Neuroscience, School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Search for more papers by this authorBertha Ochieng
Centre for Primary Care Research, De Montfort University, Leicester, UK
Search for more papers by this authorKaydee Shepherd
School of Health, Leeds Beckett University, Leeds, UK
Search for more papers by this authorBernard Corfe
Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
Search for more papers by this authorAndrea Fairley
School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Newcastle Upon Tyne, UK
Search for more papers by this authorClaire T. McEvoy
School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
Search for more papers by this authorAnne-Marie Minihane
Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
Search for more papers by this authorYi Jia Sim
School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Newcastle Upon Tyne, UK
Search for more papers by this authorEmma Stevenson
Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Newcastle Upon Tyne, UK
Search for more papers by this authorSarah Gregory
Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
Search for more papers by this authorCorresponding Author
Oliver M. Shannon
Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
Correspondence
Oliver M. Shannon, Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
Email: [email protected]
Search for more papers by this authorRebecca Townsend
School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Newcastle Upon Tyne, UK
Search for more papers by this authorFiona C. Malcomson
Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
Search for more papers by this authorJamie Matu
School of Health, Leeds Beckett University, Leeds, UK
Search for more papers by this authorAlex Griffiths
School of Health, Leeds Beckett University, Leeds, UK
Search for more papers by this authorAmy Jennings
School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
Search for more papers by this authorNicola Ward
School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
Search for more papers by this authorKeren Papier
Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
Search for more papers by this authorNicola Best
Department of Health Professions, Manchester Metropolitan University, Manchester, UK
Search for more papers by this authorChloe French
School of Health Sciences, University of Manchester, Manchester, UK
Search for more papers by this authorPauline Scheelbeek
Centre on Climate Change & Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
Search for more papers by this authorCurie Kim
Basic and Clinical Neuroscience, School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Search for more papers by this authorBertha Ochieng
Centre for Primary Care Research, De Montfort University, Leicester, UK
Search for more papers by this authorKaydee Shepherd
School of Health, Leeds Beckett University, Leeds, UK
Search for more papers by this authorBernard Corfe
Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
Search for more papers by this authorAndrea Fairley
School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Newcastle Upon Tyne, UK
Search for more papers by this authorClaire T. McEvoy
School of Biological Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
Search for more papers by this authorAnne-Marie Minihane
Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
Search for more papers by this authorYi Jia Sim
School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Newcastle Upon Tyne, UK
Search for more papers by this authorEmma Stevenson
Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Newcastle Upon Tyne, UK
Search for more papers by this authorSarah Gregory
Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
Search for more papers by this authorOliver M. Shannon and Rebecca Townsend shared first author.
Abstract
This report summarises a Forum conducted in June 2023 to explore the current state of the knowledge around the Eatwell Guide, which is the UK government's healthy eating tool, in relation to population and planetary health. The 1.5-day Forum highlighted the limited, albeit promising evidence linking higher adherence to the Eatwell Guide with favourable health outcomes, including reduced overall mortality risk, lower abdominal obesity in post-menopausal women and improved cardiometabolic health markers. Similarly, evidence was presented to suggest that higher adherence to the Eatwell Guide is associated with reduced greenhouse gas emissions. Presentations were given around cultural adaptations of the Eatwell Guide, including African Heritage and South Asian versions, which are designed to increase the acceptability and uptake of the Eatwell Guide in these communities in the United Kingdom. Presentations highlighted ongoing work relevant to the applications of the Eatwell Guide in randomised controlled trials and public health settings, including the development of a screening tool to quantify Eatwell Guide adherence. The Forum ended with a World Café-style event, in which the strengths and limitations of the Eatwell Guide were discussed, and directions for future research were identified. This Forum report serves as a primer on the current state of the knowledge on the Eatwell Guide and population and planetary health and will be of interest to researchers, healthcare professionals and public health officials.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflicts of interest.
Open Research
DATA AVAILABILITY STATEMENT
Data sharing not applicable.
REFERENCES
- Abrishami, D. (2018) The need for cultural competency in health care. Radiologic Technology, 89(5), 441–448.
- Aune, D., Giovannucci, E., Boffetta, P., Fadnes, L.T., Keum, N., Norat, T. et al. (2017) Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies. International Journal of Epidemiology, 46, 1029–1056.
- Bach-Faig, A., Berry, E.M., Lairon, D., Reguant, J., Trichopoulou, A., Dernini, S. et al. (2011) Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutrition, 14, 2274–2284.
- Bakre, A.T., Chen, R., Khutan, R., Wei, L., Smith, T., Qin, G. et al. (2018) Association between fish consumption and risk of dementia: a new study from China and a systematic literature review and meta-analysis. Public Health Nutrition, 21, 1921–1932.
- Best, N. & Flannery, O. (2023) Association between adherence to the Mediterranean diet and the Eatwell guide and changes in weight and waist circumference in post-menopausal women in the UK Women's cohort study. Post Reproductive Health, 29, 25–32.
- Blood Pressure UK. (2022) A South Asian guide to controlling your blood pressure. https://www.bloodpressureuk.org/media/bpuk/docs/South-Asian-2022_web.pdf
- Brottman, M.R., Char, D.M., Hattori, R.A., Heeb, R. & Taff, S.D. (2020) Toward cultural competency in health care: a scoping review of the diversity and inclusion education literature. Academic Medicine, 95, 803–813.
- Buckland, G., Taylor, C.M., Emmett, P.M. & Northstone, K. (2023) Prospective association between adherence to UK dietary guidelines in school-age children and cardiometabolic risk markers in adolescence/early adulthood in the Avon longitudinal study of parents and children (ALSPAC) cohort. British Journal of Nutrition, 17, 1–13.
- Carter, J., Mathers, J., Fairweather-Tait, S., Jebb, S., Sattar, N., Jennings, A. et al. (2021) Medical research council hot topic workshop report: planning a UK nutrition and healthy life expectancy trial. Nutrition Bulletin, 46, 395–408.
- Clegg, M.E. & Williams, E.A. (2018) Optimizing nutrition in older people. Maturitas, 112, 34–38.
- Cobiac, L.J., Scarborough, P., Kaur, A. & Rayner, M. (2016) The Eatwell Guide: modelling the health implications of incorporating new sugar and fibre guidelines. PLoS One, 11, e0167859.
- Dalile, B., Kim, C., Challinor, A., Geurts, L., Gibney, E.R., Galdos, M.V. et al. (2022) The EAT–lancet reference diet and cognitive function across the life course. The Lancet Planetary Health, 6, 749–759.
- DHSC (Department of Health and Social Care). (2016) The national diet and nutrition survey. https://www.gov.uk/government/collections/national-diet-and-nutrition-survey
- Farvid, M.S., Sidahmed, E., Spence, N.D., Mante Angua, K., Rosner, B.A. & Barnett, J.B. (2021) Consumption of red meat and processed meat and cancer incidence: a systematic review and meta-analysis of prospective studies. European Journal of Epidemiology, 36, 937–951.
- Felando, M., Rasmussen, H., Karmally, W. & Guyton, J.R. (2020) JCL roundtable: healthy ethnic diets. Journal of Clinical Lipidology, 14, 274–281.
- Frankowska, A., Jeswani, H.K. & Azapagic, A. (2019) Environmental impacts of vegetables consumption in the UK. Science of the Total Environment, 682, 80–105.
- Galante, J., Adamska, L., Young, A., Young, H., Littlejohns, T.J., Gallacher, J. et al. (2016) The acceptability of repeat internet-based hybrid diet assessment of previous 24-h dietary intake: administration of the Oxford WebQ in UK Biobank. The British Journal of Nutrition, 115, 681–686.
- Gan, Y., Liang, C., Chai, Q., Lemke, R.L., Campbell, C.A. & Zentner, R.P. (2014) Improving farming practices reduces the carbon footprint of spring wheat production. Nature Communications, 5, 5012.
- Green, R., Scheelbeek, P., Bentham, J., Cuevas, S., Smith, P. & Dangour, A.D. (2022) Growing health: global linkages between patterns of food supply, sustainability, and vulnerability to climate change. The Lancet. Planetary Health, 6, 901–908.
10.1016/S2542-5196(22)00223-6 Google Scholar
- Gregory, S., Griffiths, A., Jennings, A., Malcomson, F.C., Matu, J., Minihane, A.M. et al. (2023) Adherence to the Eatwell Guide and cardiometabolic, cognitive and neuroimaging parameters: an analysis from the PREVENT dementia study. medXriv https://doi.org/10.1101/2023.05.09.23289734
10.1101/2023.05.09.23289734 Google Scholar
- Ho, F.K., Gray, S.R., Welsh, P., Gill, J.M.R., Sattar, N., Pell, J.P. et al. (2022) Ethnic differences in cardiovascular risk: examining differential exposure and susceptibility to risk factors. BMC Medicine, 20, 149.
- Johnson, K.O., Shannon, O.M., Matu, J., Holliday, A., Ispoglou, T. & Deighton, K. (2020) Differences in circulating appetite-related hormone concentrations between younger and older adults: a systematic review and meta-analysis. Aging Clinical and Experimental Research, 32, 1233–1244.
- Kapoor, E., Collazo-Clavell, M.L. & Faubion, S.S. (2017) Weight gain in women at midlife: a concise review of the pathophysiology and strategies for management. Mayo Clinic Proceedings, 92, 1552–1558.
- Liu, B., Young, H., Crowe, F.L., Benson, V.S., Spencer, E.A., Key, T. et al. (2011) Development and evaluation of the Oxford WebQ, a low-cost, web-based method for assessment of previous 24 h dietary intakes in large-scale prospective studies. Public Health Nutrition, 14, 1998–2005.
- Lubin, F., Lusky, A., Chetrit, A. & Dankner, R. (2003) Lifestyle and ethnicity play a role in all-cause mortality. The Journal of Nutrition, 133, 1180–1185.
- Miller, V., Webb, P., Micha, R. & Mozaffarian, D. (2020) Defining diet quality: a synthesis of dietary quality metrics and their validity for the double burden of malnutrition. The Lancet Planetary Health, 4, 352–370.
- Nair, L. & Adetayo, O.A. (2019) Cultural competence and ethnic diversity in healthcare. Plastic and Reconstructive Surgery. Global Open, 7, 2219.
- NHS (National Health Service). (2021) NHS equality and diversity council. https://www.england.nhs.uk/about/equality/equality-hub/patient-equalities-programme/edc/
- NHS Forth Valley. (2022) Multicultural nutrition. https://nhsforthvalley.com/health-services/health-promotion/nutrition/multi-cultural-nutrition/
- NHS South East London. (2022) Tasty recipes when you have gestational diabetes. https://selondonccg.nhs.uk/wp-content/uploads/2022/03/Recipe-Book-compressed.pdf
- NICE (National Institute for Health and Care Excellence). (2021) Patient experience in adult NHS services: improving the experience of care for people using adult NHS services. https://www.nice.org.uk/guidance/cg138/chapter/1-guidance
- Nour, M., Chen, J. & Allman-Farinelli, M. (2016) Efficacy and external validity of electronic and mobile phone-based interventions promoting vegetable intake in young adults: systematic review and meta-analysis. Journal of Medical Internet Research, 18, 58.
- Ochieng, B.M.N. (2020) Healthy weight maintenance strategy in early childhood: the views of black African migrant parents and health visitors. Health & Social Care in the Community, 28, 1551–1559.
- Ochieng, L., Amaugo, L. & Ochieng, B.M.N. (2021) Developing healthy weight maintenance through co-creation: a partnership with black African migrant community in east midlands. European Journal of Public Health, 31, 487–493.
- OHID (Office for Health Improvement and Disparities). (2023) Overweight adults. https://www.ethnicity-facts-figures.service.gov.uk/health/diet-and-exercise/overweight-adults/latest
- Ojo, A.S., Nnyanzi, L.A., Giles, E.L., Ells, L.J., Awolaran, O., Okeke, S.R. et al. (2023) Perceptions of dietary intake amongst black, Asian and other minority ethnic groups in high-income countries: a systematic review of qualitative literature. BMC Nutrition, 9, 85.
- ONS (Office for National Statistics). (2023) Cost of living insights: Food. https://www.ons.gov.uk/economy/inflationandpriceindices/articles/costoflivinginsights/food
- PHE (Public Health England). (2016a) From plate to guide: What, why and how for the eatwell model. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/579388/eatwell_model_guide_report.pdf
- PHE (Public Health England). (2016b) Government Dietary Recommendations. Government recommendations for energy and nutrients for males and females aged 1–18 years and 19+ years. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/618167/government_dietary_recommendations.pdf
- PHE (Public Health England). (2016c) The Eatwell Guide. https://assets.publishing.service.gov.uk/media/5a75564fed915d6faf2b2375/Eatwell_guide_colour.pdf
- PHE (Public Health England). (2016d) The Eatwell Guide: How does it differ to the Eatwell Plate and Why? https://assets.publishing.service.gov.uk/media/5a8099a240f0b62305b8c183/Eatwell_guide_whats_changed_and_why.pdf
- Raleigh, V. & Holmes, J. (2021) The health of people from ethnic minority groups in England. Kings Fund. https://www.kingsfund.org.uk/publications/health-people-ethnic-minority-groups-england
- Rong, S., Liao, Y., Zhou, J., Yang, W. & Yang, Y. (2021) Comparison of dietary guidelines among 96 countries worldwide. Trends in Food Science & Technology, 109, 219–229.
- Sacks, F.M., Svetkey, L.P., Vollmer, W.M., Appel, L.J., Bray, G.A., Harsha, D. et al. (2001) Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. DASH-sodium collaborative research group. The New England Journal of Medicine, 344, 3–10.
- SACN (Scientific Advisory Committee on Nutrition). (2003) Salt and health report. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/338782/SACN_Salt_and_Health_report.pdf
- SACN (Scientific Advisory Committee on Nutrition). (2010) Iron and health. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/339309/SACN_Iron_and_Health_Report.pdf
- SACN (Scientific Advisory Committee on Nutrition). (2011) Dietary reference values for energy. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/339317/SACN_Dietary_Reference_Values_for_Energy.pdf
- SACN (Scientific Advisory Committee on Nutrition). (2015) Carbohydrate and health. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/445503/SACN_Carbohydrates_and_Health.pdf
- Scarborough, P., Kaur, A., Cobiac, L., Owens, P., Parlesak, A., Sweeney, K. et al. (2016) Eatwell Guide: modelling the dietary and cost implications of incorporating new sugar and fibre guidelines. BMJ Open, 6, 013182.
- Scheelbeek, P., Green, R., Papier, K., Knuppel, A., Alae-Carew, C., Balkwill, A. et al. (2020) Health impacts and environmental footprints of diets that meet the Eatwell Guide recommendations: analyses of multiple UK studies. BMJ Open, 10, 037554.
- Schröder, H., Fitó, M., Estruch, R., Martínez-González, M.A., Corella, D., Salas-Salvadó, J. et al. (2011) A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. The Journal of Nutrition, 141, 1140–1145.
- Shannon, O.M., Ashor, A.W., Scialo, F., Saretzki, G., Martin-Ruiz, C., Lara, J. et al. (2021) Mediterranean diet and the hallmarks of ageing. European Journal of Clinical Nutrition, 75, 1176–1192.
- Shannon, O.M., Lee, V., Bundy, R., Gillings, R., Jennings, A., Stephan, B. et al. (2021) Feasibility and acceptability of a multi-domain intervention to increase Mediterranean diet adherence and physical activity in older UK adults at risk of dementia: protocol for the MedEx-UK randomised controlled trial. BMJ Open, 11, 042823.
- Siervo, M., Shannon, O.M., Llewellyn, D.J., Stephan, B.C. & Fontana, L. (2021) Mediterranean diet and cognitive function: from methodology to mechanisms of action. Free Radical Biology & Medicine, 176, 105–117.
- The Carbon Trust. (2016) The Eatwell Guide: a more sustainable diet. https://www.carbontrust.com/resources/reports/advice/sustainable-diets
- The Food Foundation. (2019) The Broken Plate 2019. https://www.foodfoundation.org.uk/sites/default/files/2021-10/The-Broken-Plate.pdf
- West, J.H., Belvedere, L.M., Andreasen, R., Frandsen, C., Hall, P.C. & Crookston, B.T. (2017) Controlling your “app”etite: how diet and nutrition-related Mobile apps lead to behavior change. JMIR mHealth and uHealth, 5, e95.
- Willett, W., Rockström, J., Loken, B., Springmann, M., Lang, T., Vermeulen, S. et al. (2019) Food in the Anthropocene: the EAT-lancet commission on healthy diets from sustainable food systems. Lancet, 393, 447–492.
Citing Literature
