Diet and Healthy Eating

Dr Nurul ‘Ain Azizan

Ain.Azizan@nottingham.edu.my
 Learning outcomes

1 2 3 4 5
List the sources Describe the 5 List the 14 Describe the eat Be aware that
of energy in the food groups and Malaysia Dietary well plate and different
diet. list the principal Guidelines. name 5 foods countries have
nutrients that that would go different food-
each group into each section based guidelines.
provides. of the plate.
What is diet?

Oxford dictionary:

• “The kinds of food that a person, animal or community habitually eats”

• “A special course of food wo which a person restricts themselves, either to lose weight or for
medical reasons”

• Nutrition :a diet is the sum of food consumed by a person. It often implies the use of specific
intake of nutrition for health or weight management reasons. Although humans are omnivores,
each culture and person folds some food preferences of food taboos that restrict the types of
food that they consume
Nutrients for Health
A healthy diet is one where all of the necessary nutrients are
being supplied in the quantities that are required. It’s not just
about ‘calories’, the non-energy containing nutrients are also
needed for a healthy diet.

• Proteins
• Fats
• Carbohydrates
• Vitamins
• Minerals
• Trace elements
• Water
Proteins, Fats and Carbohydrates
• Proteins
Mostly in muscle and skin; important for hormones and enzymes; used as
an energy source during periods of starvation, least preferred energy source
• Fat
Widely distributed throughout the body in cells and are an essential
component of cell walls; they are carriers for fat soluble vitamins; easily
utilised energy source, stored in adipose tissue
• Carbohydrates
An important energy source; comes in simple and complex forms; those
that can, are converted to glucose which is used as a fuel source for all cells;
Excess glucose is stored as glycogen. Complex carbohydrates from fruit and
vegetables that are difficult to breakdown are called dietary fibre
 Vitamins, Minerals and Trace Elements
Vitamins
Diverse group, do not contain any energy; are needed in very small amounts for many process and most
can’t be made in the body

Fat Soluble - Vitamins A, D, E, K

Vitamin A – development of body tissues and for normal adaption of eyes to the dark; animal form –
retinol; plant form carotene

Vitamin D – involved in calcium absorption and affects bone; can be made from direct action of ultraviolet
light on skin, consider deficiencies

Vitamin E – acts as an antioxidant, deficiency is rare

Vitamin K – involved in blood coagulation (clotting) can be produced from bacteria in the gut, deficiency is
rare
Vitamins (contd)

Water soluble- Vitamins B and C

B Group vitamins – involved in energy metabolism and other metabolic processes.
Thiamin (Vit B1); Riboflavin (Vit B2); Niacin; Pyridoxine (Vit B 6); Vitamin B12 (Cobalamins);
Pantothenic acid; Biotin; Folate

Vitamin C – also known as ascorbic acid; is involved in many metabolic processes; is important in
iron absorption and can act as an antioxidant; deficiency is rare.
 Minerals and trace elements
Needed in small or trace amounts, but are essential for bodily
functions and structures.
Minerals needed in (mg) quantities Trace elements needed in (ug)
quantities
Calcium Copper

Phosphorus Chromium

Magnesium Manganese

Sodium Molybdenum

Potassium Selenium

Iron Iodine

Zinc

Fluorine (semi-essential)
 Calcium and Iron

• Calcium
99% found in teeth and bones to give rigidity; rest in cells involved in blood clotting, muscle
contraction and nerve function. Concerns re; low intakes and osteoporosis in later life.

• Iron
major role in oxygen transportation in haemoglobin and myoglobin. Involved in energy
metabolism.
Haem iron – from animal sources, more easily absorbed
Non-haem iron – from plant sources, less easily absorbed, inhibited by tea, eggs and other plant
components, Vit C can increase absorption
Food groups and principal nutrients
Food group Foods Principle nutrients
Starchy foods Bread, rice, pasta, potatoes, couscous, Carbohydrate energy
(mostly cereals) breakfast cereals, rolls, muffins, B vitamins
chapattis, pitta bread Dietary fibre
Fruit and All fruit- fresh, frozen, tinned or dried Vitamins and minerals
Vegetables All vegetables – fresh, frozen, tinned Dietary fibre
Fruit and fruit juices
Milk and Dairy Milk, cheese, yoghurt Protein, Fat & Fat soluble
vitamins (full fat only)
Calcium
Meat and Meat, poultry, offal, fish, cheese, eggs Protein, Fat, Iron (red meat)
alternatives Peas, beans, lentils, soya (tofu) Zinc, B vitamins
Textured vegetable protein (TVP)
Snack Foods Sugary and fatty snacks and drinks Fat
Salty snacks Sugar
Butter, margarine, spreads and cooking Alcohol
oils Salt
Alcohol
8 Guidelines for healthy eating

• Base meals on starchy foods

• Eat lots of fruit and vegetables (5 a day)
• Eat more fish (inc. 1 portion oily fish per week)
• Cut down on saturated fat and sugar
• Eat less salt (<6g/day)
• Get active, be a healthy weight
• Don’t get thirsty
• Don’t skip breakfast

https://www.nhs.uk/live-well/eat-well/how-to-eat-a-
balanced-diet/eight-tips-for-healthy-eating/
From Malaysia Food Pyramid to Healthy Plate
Malaysia Dietary Guidelines (2010)
1. Eat a variety of foods within your recommended intake
2. Maintain body weight in a healthy range
3. Be physically active every day
4. Eat adequate amount of rice, other cereal products (preferably whole
grain) and tubers
5. Eat plenty of fruits and vegetables daily
6. Consume moderate amounts of meat, poultry, egg, legumes and nuts
7. Consume adequate amounts of milk and milk products
 Malaysia Dietary Guidelines (2010) contd
8. Limit intake of foods high in fats and minimise fats and oils in food
preparation
9. Choose and prepare foods with less salt and sauces
10. Consume foods and beverages low in sugar
11. Drink plenty of water daily
12. Practise exclusive breast feeding from birth until 6 months and
continue to breastfeed until two years of age
13. Consume safe and clean foods ad beverages
14. Make effective use of nutrition information on fod labels
http://www2.moh.gov.my/images/gallery/Garispanduan/diet/introduction.pdf
https://nutrition.moh.gov.my/wp-content/
uploads/2021/07/Web%20MDG.pdf
https://www.moh.gov.my/moh/resources/auto%20download%20images/589d765c1b95f.pdf
Malaysia food pyramid 2010 and 2020
 Additional supporting healthy eating messages from MOH and
Department of Health

Bread, rice, potatoes, pasta and other starchy foods

Eat plenty, choose wholegrain varieties when you can

Fruit and vegetables

Eat plenty, at least five portions of a variety of fruit and vegetables a day

Milk and dairy foods

Eat some, choose lower fat alternatives whenever possible or eat higher fat
versions infrequently or in smaller amounts
 Additional supporting healthy eating messages from
Department of Health

Meat, fish, eggs, beans and other non-dairy sources of protein

Eat some, choose lower fat alternatives whenever possible. Eat more fish (at
least two portions of fish a week, including a portion of oily fish), eat eggs in
moderation (1 a day). Eat legumes daily

Foods and drinks high in fat and/or sugar

Eat just a small amount.
Try to choose options that are lower in salt when you can. Adults should
have no more than 5 grams of salt a day (new WHO guidelines).
How much to eat?!?
Food Group Portion size Portions per day
Cereals 1 slice of bread 2 tablespoons cooked At least 5 per day,
1 bowl of cereal rice more if active
1 medium potato 2 tablespoons cooked
1 medium chapatti pasta

Fruit and 1 piece of whole fruit 2 tablespoons cooked At least 5 per day
Vegetables 1 small salad veg

Milk and dairy 200ml milk 10og cottage cheese 2-3 per day
25g hard cheese 1 small pot yoghurt
50g half fat cheese

Meat and 75g cooked meat or 100g cooked fish 2 servings

alternatives poultry 125g cooked beans,
1-2 eggs lentils, dhal, quorn,
tofu
 Energy throughout the day
• Within a healthy balanced diet, women need on average 8,400kJ a day (2,000kcal),
while men need on average 10,500kJ a day (2,500kcal)

• A rough guide to how much energy contribution of meals and snacks:

• Breakfast: 20%
• Lunch: 30%
• Evening meal: 30%
• Drinks and snacks: 20%

• Drinks or snacks count towards your daily energy total. If you eat more for your
breakfast, lunch or evening meal, you may need to drop a snack later in the day to stay
on track

http://www.nhs.uk/Livewell/loseweight/Pages/surprising-100-calorie-snacks.aspx
Guidelines for Healthy Eating
KM1 - Eat a variety of foods within the recommended
servings

• How do we interpret the guidelines?

• What does this mean in practice?
KM2 – Achieve and maintain a
healthy body weight

• Do we know what an ideal body

weight is?
Get active and be a healthy weight

• Being overweight increases risk of heart disease, high blood

pressure and diabetes

• Being underweight could also affect your health

• Aim to lose 0.5-1kg (1-2 lb) per week

• Exercise (Adults)
• 2.5 hours per week and/or 75 mins moderate intensity
• >1.5 hours per day if weight loss is required
KM3 – Be physically active every day

• How active do I need

to be?
KM4 – Cook nutritious foods at home more often and
choose healthier options when eating out
KM5- Eat plenty of vegetables and fruits every day

• What is plenty?
• Which types of fruit and vegetable?
• Do fruit juices count?
• Is a potato counted as a vegetable?
• Do fries count?
• What about dried fruits (with sugar added)?
KM6 – Eat adequate amounts of rice, other
cereals, whole grain cereal-based product
and tubers

• What is adequate?
• Are all cereals equal?
• Does this include breakfast ‘cereals’?
KM7 – Consume moderate amounts of fish, meat, poultry,
egg, legumes and nuts

Do I need all these items every day?

What is moderate?
KM8 – Consume adequate amounts
of milk and milk products

• What is adequate?
• Do I have to take milk?
• I’m allergic to milk
• Can I take vegetable milk instead?
KM9 – Reduce intake of foods high in fat and
limit saturated fat intake

ARE LOW FAT WHICH OIL SHOULD DO I HAVE TO USE WHAT ABOUT
FOODS BETTER? I USE TO COOK? OLIVE OIL? CHOLESTEROL?
 Saturated fat

• Saturated fat increases blood cholesterol, which increases risk of

developing heart disease

• Saturated fat = Butter, cream, cheese, red meat, coconut oil, palm oil

• Unsaturated fat - vegetable oils- sunflower, rapeseed, olive oil; oily

fish, avocados, nuts, seeds

• Total fat – high = >20g/100g, low = 3g/100g

• Sat fat - high = >5g/100g, low=1.5g/100g
KM10 – Choose and prepare foods with less salt,
sauces and flavour enhancers

Will my food taste bland? Any idea what can be use to replace
salt, stock cube, flavour enhancer?
Salt
• Salt = (sodium chloride: ( 40% sodium and 60% chloride)
• Sodium controls fluid balance in our bodies and maintains
blood volume and blood pressure. Eating too much
sodium may raise blood pressure and cause fluid
retention.
• Main source of sodium – table salt.
• One teaspoon of table salt = 2.3g of sodium
• FDA recommends < 2.3g of sodium intake per day, and
that certain groups < 1.5g per day (adopted from Dietary
Guidelines for Americans)
• AHA recommends less than 2.3g sodium per day, ideally
1.5g sodium for most adults.
• WHO recommendation - less than 2g of sodium (or 5g of
salt) per day .
KM11 – Limit sugar intake in foods and
beverages

LIMIT TO WHAT? IS IT BETTER TO DRINK SHOULD I USE ARTIFICIAL

LOW CALORIE VERSIONS? SWEETENERS?
Sugar

• Sources- cakes, sweets, biscuits, breakfast

cereals, soft and fizzy drinks, coffee, tea, milo,
3-in-1, deserts, processed tin foods, sauces

• Look at the label –start with biggest ingredient

first

• Carbohydrate (of which sugars)

• High = >15g sugars/100g
• Low = 5g sugars or less per 100g
KM12 – Drink
plenty of water daily

• How much?
Water
 Essential – survival without water is impossible!
 Drink 6-8 glasses of water or other fluids (1.2L)
 Prevent dehydration – more is needed in hot weather
 Thirst is not a good sign of the need to drink- already dehydrated

Alcohol
Alcohol – women 2-3 units/day; men 3-4 units/day with 2-3 alcohol free days –
what are the current recommended safe units?

 Half a pint of standard strength (3.5% AVB) beer, cider or lager

 A pub measure of spirit
 Half a standard glass (175ml) of wine
 A pub measure of sherry, vermouth or liqueur

 Avoid binge drinking - what is considered binge drinking?

KM13 – Consume safe and clean foods and beverages

• Food hygiene
• Personal hygiene
• Food preparation
• Food storage
KM14 – Make effective use of nutrition information on food
labels
Traffic Light Criteria
 Exercise
15 minutes
Breakfast
I bowl of breakfast cereal (cornflakes) with sugar and full cream milk
2 slices of freshly cut white toast with butter and 1 teaspoon of sugar
I glass of orange juice
1 cup of tea with 2 tsp of sugar

Mid-morning
Coffee with milk (full fat) , 1 tsp sugar and 2-3 chocolate digestive biscuits

Lunchtime
Packed lunch brought from home : 2 scoop of rice + 1 pc grilled chicken+ steamed brocolli
1 red apple
Coffee with milk (full fat) and sugar

Mid-afternoon
Tea with milk (full fat) and sugar
5 pcs banana fritters

Evening meal approx 7pm

Chicken chop, steamed vegetables and mashed potato (eat outside)
Ice cream or slice of cake as dessert
Mocktails

Bedtime
Food Group Food in this group Number of portions Recommended
number of portions
Bread, potatoes, rice, cereals,
pasta & grains

Fruit and vegetables

Milk and dairy

Meat, fish and alternatives

Fatty and sugary food

Further reading

• Your guide to the EatWell Plate. Public Health England.

• https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-
labels/the-eatwell-guide/
• Harland et al., (2012). Achieving eatwell plate recommendations: is this
a route improving both sustainability and healthy eating? Nutrition
Bulletin. DOI: 10.1111/j.1467-3010.2012.01988.x
• Malaysian Dietary Guidelines 2020