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Don’t believe everything you read
Those considering the recommendations should recognise that this report is largely an opinion piece and does not form the basis of any current recommended dietary messaging – so, whether we are thinking of our staff or service users, no menu or dietary changes should be made purely on the basis this report.
Consistent evidence based advice is key
Clear and consistent public advice should be based on the totality of robust and objective evidence. Suggesting people should, for example, cut out carbs conflicts with the broad evidence base and internationally agreed interpretations of it. The report from the Scientific Advisory Committee on Nutrition on carbohydrates was carried out over a number of years included around 600 peer-reviewed scientific reports. Despite the media storm, the advice remains that people should base meals on starchy carbohydrates, especially wholegrain.
Full fat dairy
There are some areas raised in this report though which are pertinent to the older care home population. There is a support for full fat dairy. In the care home situation, where maintaining or increasing the weight of service users at risk of malnutrition is one of the goals of their nutrition care, full fat dairy products can be useful. Dairy products, as a source of protein, calcium, potassium and iodine, play an important role in a healthy, balanced diet. Whilst they contribute to saturated fat intake, there is no clear evidence that eating dairy foods specifically is consistently associated with cardiovascular disease (CVD). In fact, other components in dairy may counteract the presence of saturated fat.
We should consider that for many service users, increasing calories is an objective. Adding, milk powder, full fat milk and cheese is a tool for fortifying foods, but consideration in respect of heart health could be given, by using unsaturated fats where possible e.g. unsaturated oils like olive or rapeseed oil, nut butters and sesame seed paste.
Small and often – snacks can be important
And, of course, regular readers of the blog will know about recommendations to include oily fish in the diet – again, sources of unsaturated fats. Oily fish pates and spreads can form part of a good snack, yet the NOF report is critical of snacking. For many older people eating small and often can be the most appropriate way to ensure adequate nutrition, particularly for those with reduced appetites.
Nutrition has an important influence on health. As such it should be treated as a serious science. Not everybody is an expert but the media have a tendency to report all views with equal credence. Opinion pieces get printed in the media with the same credibility as peer reviewed, systematic reviews and meta-analyses. The resultant confusion is unhelpful in the genuine need for consistent reviewed advice for healthy eating and physical activity that can make a difference to the health of the nation.
Ayela Spiro, British Nutrition Foundation – QCS Expert Nutrition Contributor