30-Second Nutrition

30-SECOND
NUTRITION
R-NUTS_LVBK-001-005_UK.indd 1 29/05/2018 15:27

30-SECOND
NUTRITION
The 50 most signiﬁcant
nutrition-related facts, each
explained in half a minute
Editor
Julie A Lovegrove
Contributors
Margaret Ashwell Oonagh Markey
Luke Bell Elizabeth A Miles
Jenna Braddock D Joe Millward
Philip C Calder Brian Power
Rosalind Fallaize Hilary Powers
Glenn Gibson Judith Rodriguez
Ian Givens Carrie Ruxton
Bruce A Grifﬁn Jill Snyder
Kristen Hicks-Roof Katherine Stephens
Ditte Hobbs Jayne Woodside
Ian Macdonald Zhiping Yu
Illustrator
Steve Rawlings

First published in the UK in 2018 by
Ivy Press
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British Library Cataloguing-in-
Publication Data
A catalogue record for this
book is available from the
British Library.
ISBN: 978-1-78240-553-5
Digital edition: 978-1-78240-7-294

Hardcover edition: 978-1-78240-5-535
This book was conceived,
designed and produced by
Ivy Press
58 West Street, Brighton BN1 2RA, UK
Publisher Susan Kelly
Creative Director Michael Whitehead
Editorial Director Tom Kitch
Art Director James Lawrence
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Printed in China
10 9 8 7 6 5 4 3 2 1

CONTENTS 50 Foods & Health 112 Potential Bioactives & Health
52 GLOSSARY 114 GLOSSARY
54 Fruit & Vegetables 116 Flavonoids & Isoflavones
56 Fish 118 Nitrate & Nitrite
58 Milk & Dairy 120 Isothiocyanates
60 Eggs 122 Omega-3 Fatty Acids
62 Nuts 124 Profile: Hugh Macdonald Sinclair
6 Introduction 64 Grains & Gluten 126 Vitamin D & Calcium
66 Vegan & Vegetarianism 128 Probiotics & Prebiotics
10 Nutrients: Life’s Essentials 68 Mediterranean Diet
12 GLOSSARY 70 Profile: Ancel Keys 130 Food Processing &
14 Energy Production Systems
16 Protein 72 A Lifetime Of Nutrition 132 GLOSSARY
18 Carbohydrates 74 GLOSSARY 134 Cooking, Processing & Preserving
20 Fibre 76 Babies, Infants & Children 136 Refining
22 Fats 78 Adolescents 138 Additives
24 Minerals 80 Pregnancy & Lactation 140 Labels & Packaging
26 Fat-soluble Vitamins 82 Postmenopausal Women 142 Organic Foods
28 Water-soluble Vitamins 84 The Elderly 144 Free-range & Intensively
30 Profile: Sir Frederick 86 Overweight & Obesity Farmed Foods
Gowland Hopkins 88 Malnutrition 146 GM Foods
90 Profile: John Boyd Orr 148 Food Sustainability
32 Nutrients: Consumption 92 Changing Eating Habits 150 Profile: Charles Glen King
& Metabolism
34 GLOSSARY 94 Foods & Disease Risk 152 Appendices
36 Digestion & Absorption 96 GLOSSARY 154 Resources
38 Metabolism 98 Dietary Fats & Heart Disease 156 Notes on Contributors
40 Gut Microbiome 100 Food Allergies & Intolerances 158 Index
42 Nutrient–Gene Interactions 102 Profile: John Yudkin 160 Acknowledgements
44 Profile: Elsie Widdowson 104 Salt & Blood Pressure
46 Personalized versus Public 106 Sugars & Sugar Substitutes
Health Advice 108 Alcohol
48 Dietary Assessment 110 Red & Processed Meat

INTRODUCTION
Julie Lovegrove
Nutrition has been defined as ‘the process of

providing or obtaining food necessary for health and growth’ (Oxford
Dictionary), and is essential for sustaining all life on Earth. The word
‘nutrition’ originates from the sixteenth century, from late Latin nūtrītiō,
‘to nourish’. The quality of our diet influences our development and
well-being from the womb until death, and is, therefore, of relevance to
all. Our instinct to eat is principally for survival, but the selection of foods
is determined by the environment, genetics and numerous other factors.
Understanding the principles of nutrition and how different foods and
nutrients promote health and prevent disease empowers humans to make
an informed choice, optimizing their diet.
The Greek physician Hippocrates of Kos (460–370 BCE), known as the
‘Father of Medicine’, was one of the first to profess the importance of
nutrition, stating, ‘Let food be thy medicine and medicine be thy food.’
Hippocrates recognized the therapeutic significance of diet for the
maintenance of health, and developed one of the earliest nutritional
Hippocrates proposed recommendations that he called a ‘seasonal diet’. In the Tang dynasty
that a following a balanced (618–907 CE), Chinese physician Sun Simiao wrote what could be regarded
diet and avoiding excessive to be the first nutrition guidelines in his book Precious Prescriptions for
consumption were
Emergencies, which described the impacts of consuming grains, meat,
important for good health.
fruits and vegetables. It wasn’t until the twentieth century that formal
public health dietary recommendations came into effect for populations
across the world.
A landmark discovery in the history of nutritional science occurred
in the nineteenth century with the recognition of a causal link between
malnourishment and disease, and the first description of essential
micronutrients as ‘vitamines’ in 1912 by Casimir Funk. Following this,
Frederick Hopkins, an English biochemist, was awarded the Nobel Prize
in Physiology or Medicine for the discovery of the ‘growth-stimulating
vitamins’ in 1929. The identification of vitamins was viewed by many as
an endpoint to the study of nutrition, a short-sighted view given the
6 g Introduction

significant developments that were to follow. The increasing prevalence
of chronic degenerative diseases like heart disease and cancer as major
causes of premature death in the Western world in the late twentieth
century refocused attention on the importance of over-nutrition and the
role of macronutrients in disease development.
Sun Simiao advocated
Ongoing challenges in the field of nutritional science include:
the initial treatment of
developing more definitive measures of dietary intake; health status; diseases through dietary
and disease risk susceptibility in the early stages of life, when nutrition therapy, before trying
can be more effective in maintaining health and preventing disease. herbal remedies.
These challenges are being tackled by the
development of new analytical techniques,
identification of novel biological markers of
dietary intake and disease risk, and
innovations in food science and technology.
Progressions in nutritional science have
occurred in parallel with advances in genetic,
metabolic and behavioural sciences, that will
continue to improve tailored dietary advice
to specific characteristics of an individual to
motivate changes in diet for health.
The aims of 30-Second Nutrition are
to provide insight into the fundamental
importance of nutrition to life, and to
increase understanding of the principles of
nutrition, to help readers make informed
decisions about their diet and food choice.
Introduction g 7

About this book
30-Second Nutrition is your bitesize guide to food and its nutrients:
covering the science behind bodily functions that help us to digest and
absorb; through food groups and their impact on health; to how food
is grown and processed. Experts – nutritionists, dietitians, academics,
researchers – from around the globe share their knowledge and guide
us through the carefully selected topics, to ensure all fundamental bases
are covered, clearly and concisely. The gen on each topic is presented on
a single page, with an accompanying artwork on the opposite page to
encapsulate its essence. The main paragraph, the 30-Second Digest, is
complemented by the 3-Second Bite, which gives a quicker overview – the
key facts in a single sentence. And the 3-Minute Snack fleshes this out,
adding intriguing aspects of the subject. Each chapter also contains a
biography of a pioneer in the field – the men and women who contributed
to our understanding of modern nutrition. The book begins with an
overview of the main groups of nutrients in food and how our bodies
work to process and use these nutrients. It then delves into food groups
and their related health benefits, or otherwise. As nutritional demands
change through life, there is a chapter that takes you through the key
stages of the life cycle. Then it’s on to the potential hazards associated
with some food groups and the various risks they can pose to health, but
also looking at the ways in which we may be able to influence our diet
and health more positively. The final chapter takes a modern-day look at
food processing and production, helping us to evaluate the ever-widening
range of food-related choices on offer.
8 g Introduction

g
NUTRIENTS: LIFE’S ESSENTIALS

NUTRIENTS: LIFE’S ESSENTIALS
GLOSSARY
amino acids The building blocks of all eicosanoids Compounds responsible for
proteins, amino acids make up a large many of the beneficial effects of good fats;
proportion of cells, muscles and tissue, however, some are potentially harmful if
carrying out many important bodily excessive amounts build up in the body.
functions, such as giving cells their
structure. Also play a key role in the fatty acids The building blocks of fat in the
transport and storage of nutrients. body and in food. During digestion, the body
Essential amino acids need to be gained breaks down fats into fatty acids, which can
through diet rather than formed by the then be absorbed into the blood. Essential
body itself. fatty acids (EFAs) must be ingested because
the body requires them for good health but
anaemia Develops when the blood does cannot synthesize them. Those not essential
not contain enough healthy red blood cells are non-essential fatty acids.
or haemoglobin, important for carrying
oxygen around the body. There are many folate Also known as vitamin B9. Folate
types and causes, including iron deficiency. in the form of folic acid is advised for
Symptoms include lethargy, shortness of pregnant women (to prevent neural tube
breath, pale complexion and dry nails. defects in the developing foetus) and to
prevent a type of anaemia. Essential for DNA
cell signalling The communication of cells synthesis and metabolizing amino acids, it is a
by sending and receiving chemical signals, dietary requirement – an essential vitamin.
which allow the cells in your body to
coordinate their activities, such as free radicals Cells consist of molecules;
development, tissue repair and immunity. molecules consist of atoms joined by chemical
Errors in signalling contribute to diseases bonds. When a bond breaks, a free radical is
such as cancer, autoimmunity and diabetes. formed, which can set off a degenerative
process that damages the cell. Free radicals
disaccharides ‘Double sugar’ made of two can be formed during metabolism, by the
molecules of simple sugars linked to each immune system as a response to illness, by
other. Include sucrose, maltose and lactose. the ageing process, or due to environmental
factors such as pollution.
12 g Nutrients: Life’s Essentials

glycaemic index (GI) Rating system for polysaccharides Carbohydrate (for example
foods containing carbohydrates, showing starch, cellulose and glycogen) whose
how quickly each food affects your blood molecules consist of a number of sugar
sugar (glucose) level when consumed on its molecules bonded together. Serve as
own. Carbohydrate-rich foods, including short-term energy stores.
sugary foods and drinks, white bread and
potatoes, have a high GI rating. Low GI simple sugars Called ‘monosaccharides’;
foods include some fruit and vegetables, made up of single sugar molecules. Include
pulses and wholegrain foods. Low GI foods glucose and fructose. Present in natural and
are generally considered more healthy than processed foods. See also disaccharides.
high GI foods, although foods with a high
GI are not necessarily unhealthy and not all thiamin (vitamin B1) Water-soluble vitamin
foods with a low GI are healthy. that enables the body to use carbohydrates
as energy. Essential for glucose metabolism;
macronutrients Three main components plays a key role in nerve, muscle and heart
of the diet: fat, protein and carbohydrate. function.
All have their own specific functions in the
body, and all supply calories or energy. total energy expenditure (TEE) Depends
Required in relatively large amounts to on the rate at which the body expends
grow, develop and thrive. energy at rest (basal metabolic rate – BMR)
and our physical activity level (PAL), and
osteomalacia Rickets in adults; a this is expressed by the relationship:
softening of the bones caused by a lack TEE = PAL x BMR.
of vitamin D or calcium. Symptoms include
bone pain, difficulty in walking, easy triaclyglycerol (TAG) The major dietary fat,
fracturing of bones and a compressed made of a glycerol backbone and three fatty
vertebrae. acids (of which there are many different
types), with the main division being between
peptide bonds Covalent bond formed saturated and unsaturated types.
between two amino acids. Living organisms
use bonds to form long chains of amino
acids, known as proteins.
Glossary g 13

ENERGY
the 30-second digest
Our body uses energy to fuel
cellular metabolism, especially the major organs
like brain, heart, liver and gastrointestinal tract,
3-SECOND BITE and for physical activity. Carbohydrates and RELATED TOPICS
Macronutrients in food, proteins each provide 17 kJ/g of metabolizable See also
beverages and alcohol DIGESTION & ABSORPTION
energy intake, with fats and alcohol providing
fuel metabolism, organ page 36
function and physical
37 kJ/g and 29 kJ/g respectively. Our appetite
METABOLISM
activity, resulting in mechanism usually allows us to match energy page 38
consumption of oxygen intake to energy expenditure so that we
and production of heat OVERWEIGHT & OBESITY
maintain a healthy body weight, but when we page 86
and carbon dioxide (CO2).
overeat, the excess energy intake is stored as
fat. Overweight people should aim for an energy
3-MINUTE SNACK intake slightly less than their energy expenditure 3-SECOND BIOGRAPHIES
WILBUR OLIN ATWATER
There is obvious variation so that their energy deficit is met from their 1844–1907
between individuals in
body shape, yet everyone
body fat, helping them to achieve a lower, American chemist who
built the first whole body
conforms to the energy healthy body weight. Our total energy calorimeter to measure
energy expenditure.
balance principle that food expenditure (TEE) depends on the rate at
energy intake is balanced
which the body expends energy at rest (basal FRANCIS GANO BENEDICT
by energy expenditure plus 1870–1957
any gain or loss of body metabolic rate – BMR) and our physical activity Chemist who worked with
Atwater and invented a
energy stores, i.e. weight level (PAL), and this is expressed by the respirometer, to measure
change. Both food energy relationship: TEE = PAL x BMR. BMR can be human oxygen consumption.
intake and all components
predicted from body weight, sex and age, and DALE SCHOELLER
of energy expenditure
PAL varies with lifestyle from 1.35 in sedentary 1951–
are difficult to measure The first to measure energy
accurately and some people to 2.5 for the very active. At an average expenditure in humans using
commentators, especially isotopically-labelled water.
PAL of 1.63, men and women of average height
authors of dieting plans,
challenge the energy
need 11 MJ and 9 MJ of food energy each day for
balance principle. However, a healthy body weight. 30-SECOND TEXT
rigorous measurements D Joe Millward
show that energy balance
is always evident.
The amount of energy
a food contains per
gram is known as its
14 g Nutrients: Life’s Essentials energy density.

PROTEIN
Perhaps the ultimate building
block, protein provides all the functional and
structural components of the body: skin, bone,
3-SECOND BITE muscle, blood and all the organs. It consists of RELATED TOPICS
The human genome one or more long chains of amino acids linked See also
codes the sequences ENERGY
by peptide bonds. Essential in the diet, protein
of all 21 amino acids in page 14
19,000–20,000 proteins,
provides the amino acids that are reassembled
NUTS
determining all aspects to build new body tissue during growth, used page 62
of the structure and to maintain existing protein structures and to
function of the body. VEGAN & VEGETARIANISM
make smaller molecules like hormones and page 66
neurotransmitters. It can also serve as a fuel
3-MINUTE SNACK for the body – with the same energy density as
We need dietary amino carbohydrates (4 kal/17 kJ per gram). Protein is 3-SECOND BIOGRAPHIES
RUSSELL HENRY CHITTENDEN
acids to make new proteins present in all foods – animal and plant – but rich 1856–1943
during growth and to make
various other molecules,
sources include meats, dairy, fish, eggs, grains, Professor of physiological
chemistry at Yale who
such as hormones and legumes and nuts. The key is to eat a variety of revolutionized scientific
thought on human protein
neuro-transmitters. these foods, to make sure that we absorb the requirements, showing
Although all proteins are that health and athletic
right balance of the nine essential and the performance required only
continuously degraded and
replaced during protein non-essential amino acids. This can be done modest intakes of protein.
turnover, the amino acids with plant-based diets, as evident by the normal WILLIAM CUMMING ROSE
are mainly recycled, so 1887–1985
growth patterns of children in affluent vegan
turnover does not generate American biochemist and
much dietary demand.
communities. The minimum dietary requirement nutritionist who discovered
the amino acid threonine and
Apart from the needs of protein is for sufficient amino-acid nitrogen determined the amount of each
essential amino acid required
for new protein during and indispensable amino acids to meet the to maintain nitrogen balance.
childhood growth, demand for any growth, pregnancy or lactation
pregnancy and lactation,
our minimum dietary
and for body maintenance, balancing all
nitrogen losses mainly through urea excretion. 30-SECOND TEXT
amino-acid needs are
D Joe Millward
usually small, sufficient The minimum demand is usually small, and is
to make the various
easily met in most nutritionally complete diets. More protein is required
non-protein molecules.
for rehabilitation after
illness or after very
16 g Nutrients: Life’s Essentials strenuous exercise.

CARBOHYDRATES
Carbohydrates are one of the
three main components of the diet (the
macronutrients) and provide the major substrate
3-SECOND BITE for energy metabolism within the brain, kidney RELATED TOPICS
Carbohydrates are medulla and red blood cells. Carbohydrates are See also
essential for health, but ENERGY
also important for muscle function in high-
this does not mean that page 14
high-sugar foods are
intensity exercise. Whilst dietary carbohydrates
FIBRE
healthy. can range from molecules such as glucose and page 20
fructose (the simple sugars), through the
SUGAR & SUGAR SUBSTITUTES
disaccharides (sucrose, maltose, lactose) to the page 106
3-MINUTE SNACK
It is frequently stated
complex polymers of glucose found in starch, all
that carbohydrates are dietary forms are digested within the intestine
bad and ‘low carb’ diets so that the simple sugars are the molecules 3-SECOND BIOGRAPHIES
are healthier than higher CARL & GERTY CORI
that are absorbed into the body. Dietary 1896–1984 & 1896–1957
carbohydrate diets.
Much of this arises from
recommendations for healthy people suggest The Czech–American couple’s
research into carbohydrate
long-term prospective carbohydrates should provide between 45 and metabolism resulted in their
sharing the Nobel Prize.
cohort studies which 60% of dietary energy, depending on age,
ignore the type of
physical activity and body weight. High intakes PROFESSOR RUSSELL KEAST
carbohydrate consumed. Lead researcher from a team in
Clearly, high-sugars and of the simple sugars, sucrose or maltose, and Australia which showed that
there is a ‘sixth taste’ elicited
refined-grain diets are not even rapidly digested refined grains, are by other carbohydrates
advisable, but diets high in independent of sweet taste.
associated with risks to health, including tooth Those who are sensitive to the
fibre, wholegrain and low
glycaemic index foods are
decay and unintentional overconsumption of taste are thought to gravitate
to carb-rich foods.
not bad for you – in fact, energy (leading to weight gain). A healthy diet
the opposite is the case. should have most carbohydrate in the complex
form, particularly when contained in high-fibre 30-SECOND TEXT
Ian Macdonald
wholegrain cereals and vegetables. The idea
that carbohydrate is somehow toxic and that
low-carbohydrate diets should be eaten by all
is not backed up by research. When consumed in the
right foods, carbs are
important contributors
18 g Nutrients: Life’s Essentials to health.

FIBRE
Dietary fibre is the indigestible
component of foods and drinks which has a
bulking effect in the large intestine and provides
3-SECOND BITE a substrate for the colonic bacteria. Originally, RELATED TOPICS
Dietary fibre is an essential ‘fibre’ was limited to non-starch polysaccharides See also
component of our diet, DIGESTION & ABSORPTION
(such as cellulose) plus lignin from plants. In
improving cardiometabolic page 36
and gut health, and needs
recent years the definition of fibre has widened
GUT MICROBIOME
to be consumed in larger to include all food components that are not page 40
amounts than at present. digested and absorbed in the small intestine,
FRUIT & VEGETABLES
including the non-digestible oligosaccharides page 54
3-MINUTE SNACK
(which are between the simple sugars and the
Fibre is provided by starch polymers) and resistant starch. There
cereals, legumes and fruit is also an increasing use of novel, synthetic 3-SECOND BIOGRAPHIES
and vegetables. Reduced HUGH CAREY TROWELL
fibres in processed foods and drinks. Recent 1904–89
risk of cardiometabolic
disease and colorectal
research suggests that a high intake of dietary Identified dietary fibre as the
vitally healthy substance in
cancer is particularly linked fibre, particularly cereal fibre and whole plant foods missing from
industrialized Western diet.
to high intakes of cereal grains, is associated with a reduced risk of
fibre and wholegrain DENIS PARSONS BURKITT
cardiometabolic disease and colorectal cancer.
foods. However, simply 1911–93
consuming greater Higher intakes of some fibre components are Irish surgeon who compared
diseases in African hospitals
quantities of the novel also associated with reductions in serum with Western diseases,
synthetic fibres should cholesterol and triacylglycerols as well as blood concluding that many
not be encouraged unless Western diseases were the
clear beneficial effects
pressure. As a result, in recent years many result of diet and lifestyle.
can be demonstrated countries have raised the recommended intake

(for example, stool bulk, of dietary fibre to 30 grams (1 oz) or more for
appetite and reduction 30-SECOND TEXT
adults – almost twice the average present Ian Macdonald
in serum lipids such
as cholesterol). intake. The novel fibres, such as polydextrose,
are of potential benefit, but evidence is needed
to show that they have beneficial effects in the
people consuming them. Promotion of high-fibre
diets should be an
important part of
20 g Nutrients: Life’s Essentials health guidelines.

FATS
Fat is familiar to us as a substance
we eat in food and store in our body. Both
have the same chemical structure known
3-SECOND BITE as triaclyglycerol (TAG), which, when over- RELATED TOPICS
Fats are an energy-rich consumed in food, accumulates as body fat See also
component of the human METABOLISM
and increases body weight. The average 70-kg
diet, with important page 38
structural and functional
(155-lb) man has about 15 kg (33 lb) of body
DIETARY FATS &
roles in the body that make fat, which is equivalent to 140,000 calories or HEART DISEASE
them essential for life. 40 days of stored energy, but only 0.3 kg (10 oz) page 98
of stored carbohydrate (900 calories). The
3-MINUTE SNACK
physical and chemical properties of fats (TAG)
3-SECOND BIOGRAPHIES
Dietary fats are less filling in food are determined by differences in their WILLIAM PROUT
and provide more than component fatty acids (FAs), which differ in size 1785–1850
twice the energy per gram English physician and chemist
and number of carbon double bonds. Saturated who was one of the first to
than carbohydrates and recognize the importance of
proteins, properties that
fats are mainly derived from animal sources fat as a nutrient in our diet.
increase its potential to and are solid at room temperature due to
GEORGE BURR
increase body weight. a lack of double bonds (such as butter), 1896–1990
While most saturated
while monounsaturated fats have one, and American professor who,
fats come from animal along with his wife, Mildred,
products, one notable polyunsaturated fats have two or more double discovered the first dietary
FA that was essential for life,
exception is coconut oil, bonds, which turn these fats into liquid oils. linoleic acid.
which is a highly saturated, These oils can be extracted from plant seeds,
hard vegetable fat. KONRAD BLOCK
including flax, olive and sunflower. The human 1912–2000
body can make all but two FAs, namely linoleic Discovered, with Feodor Lynen,
the mechanism and regulation
acid and alpha-linolenic acid, so these fats must of cholesterol and FA
metabolism.
be acquired in our diet and are called ‘essential
fatty acids’. Fatty acids are used as building
blocks for cell membranes in the body and to 30-SECOND TEXT
Bruce A Griffin
make hormone-like compounds (eicosanoids)
that have metabolic effects essential for life. Coconut oil is high in
saturated fat (85%),
while butter is 50% and
22 g Nutrients: Life’s Essentials olive oil is 10%.

MINERALS
Minerals are inorganic substances
that are not made by living things. Found
in both soil and rocks, they are absorbed by
3-SECOND BITE plants that are then eaten. Minerals are RELATED TOPICS
Common food sources for largely classified as ‘major’ minerals or ‘trace’ See also
minerals are beans, peas, FRUIT & VEGETABLES
minerals. Major minerals are those that the
dairy, eggs, cereals, fruit, page 54
meat, poultry, vegetables,
body requires in amounts of at least 100 mg per
SALT & BLOOD PRESSURE
whole grains and seafood. day, and include sodium, potassium, calcium, page 104
magnesium, sulphur, phosphorus and chloride.
Trace minerals are needed in amounts of less
3-MINUTE SNACK
than 100 mg per day, and some, such as iron, 3-SECOND BIOGRAPHY
Iron deficiency anaemia HUMPHRY DAVY
is the most common fluoride, zinc and manganese, have established 1778–1829
mineral disorder in the recommended daily allowances (RDAs) or Cornish chemist and
inventor who was the first to
world. It is estimated that Adequate Intake (AI) limits to ensure adequacy. successfully isolate calcium in
over 30% of the world’s 1808, by electrolysing lime in
population are considered
A third classification, known as ‘ultra-trace’ mercury oxide.
anaemic, including 40% minerals, require less than 1 mg per day, and
of pre-school children include chromium, copper, iodine, molybdenum
in developing countries. 30-SECOND TEXT
and selenium. Minerals play a role in maintaining
Major health consequences Jill Snyder
include impaired physical a healthy immune system, bone and teeth
and cognitive development, health, muscle contraction, fluid balance
increased risk of morbidity and overall growth. A healthy diet of fruits,
in children and reduced
vegetables, whole grains and lean meats is
productivity in adults.
Iron-rich foods, fortification one way to ensure adequate intake of minerals;
and supplementation help supplementation is another way. While
to relieve symptoms. deficiencies may present detrimental health
conditions, it is important to be aware of intake
amounts when supplementing, to avoid toxicity
symptoms such as nausea and vomiting, which Minerals can compete
may occur with overconsumption. with each another in
the absorption process,
which takes place in the
24 g Nutrients: Life’s Essentials small intestine.

FAT-SOLUBLE
VITAMINS
Vitamins A, D, E and K comprise
a small group of fat-soluble vitamins of
disparate chemical composition which are
3-SECOND BITE essential for good health. Various processes are RELATED TOPICS
Fat-soluble vitamins are dependent on an adequate availability of these See also
essential to life, but too WATER-SOLUBLE VITAMINS
vitamins, including vision (vitamin A), growth
little or too much in our page 28
diet may have profound
and tissue differentiation (vitamins A and D),
MALNUTRITION
adverse health effects. bone and muscle function (vitamin D), immune page 88
function (vitamin A), protection against
VITAMIN D & CALCIUM
free radicals (vitamin E) and blood clotting page 126
3-MINUTE SNACK
(vitamin K). Although fat-soluble vitamins can
High-dose supplements
of some fat-soluble be stored in the body for use in times of dietary
vitamins can have severe scarcity, deficiencies do occur, with profound 3-SECOND BIOGRAPHIES
FREDERICK GOWLAND
adverse effects. High-dose consequences. In some regions of the world, HOPKINS
supplements of vitamin D 1861–1947
can actually increase
young children are at risk of becoming blind
British biochemist who
fracture risk and may cause because of inadequate vitamin A. Vitamin D demonstrated that
components in milk
damage to the heart and deficiency, which is common worldwide, may were essential for normal
kidneys. Vitamin A is toxic cause bowed legs and pelvic deformities of growth in rats, which paved
at high doses, causing the way to characterizing
serious birth defects and rickets in children and muscle weakness and individual vitamins.
possibly fractures. In bone pain of osteomalacia in adults. Foods HENRIK DAM

smokers, too much of animal origin tend to be good sources of 1895–1976
beta-carotene (a form Danish scientist who
fat-soluble vitamins, but red, yellow and discovered a dietary factor
of vitamin A) may even that promoted blood clotting.
increase the risk of death orange vegetables are an excellent source of This factor was vitamin K.
from lung cancer. carotenoids (a form of vitamin A), and vitamins E
and K are found in nuts and seeds. Vitamin D is
unusual as humans can synthesize it through 30-SECOND TEXT
Hilary Powers
sunlight on skin, which is important because
only a few foods are rich in vitamin D. Fat-soluble vitamins
are usually absorbed
in fat globules that
travel through the
26 g Nutrients: Life’s Essentials lymphatic system.

WATER-SOLUBLE
VITAMINS
Water-soluble vitamins perform
a wide range of important functions, including
the extraction of energy from food, cell
3-SECOND BITE signalling, synthesis of DNA and conduction RELATED TOPICS
Water-soluble vitamins of nerve impulses. Water-soluble vitamins See also
comprise a disparate group FAT-SOLUBLE VITAMINS
comprise nine compounds – vitamins B1, B2, B6,
of compounds needed page 26
in small amounts in the
B12, C, niacin, folate, biotin and pantothenic acid
METABOLISM
human diet, to carry out – distinguished by their chemistry and function. page 38
a wide range of essential They are required regularly in small amounts in
functions in the body. MALNUTRITION
the human diet as they are not stored in the page 88
body; excess intake is removed by the kidneys.
3-MINUTE SNACK Symptoms of deficiency may occur if a diet lacks
Claims that high-dose any one of these vitamins. For example, a diet 3-SECOND BIOGRAPHY
supplements of water- LUCY WILLS
lacking in vitamin C can lead to the development 1888–1964
soluble vitamins confer
special health benefits, of scurvy, characterized by impaired wound English medical scientist who
demonstrated that a factor in
or help us to live longer, healing, joint pain, tiredness and shortness of yeast extract cured pernicious
anaemia of pregnancy. This
are generally not breath; a diet lacking in vitamin B12 may lead to heralded the discovery of the
well-founded. Although vitamin folate.
anaemia and degeneration of the spinal cord. It
people with poor diets or
higher requirements may has proved difficult to know exactly how much
need vitamin supplements of each vitamin is required daily to stay healthy. 30-SECOND TEXT
to prevent symptoms of Early experiments (that would be considered Hilary Powers
deficiency, supplement use
is most common amongst
unethical today), systematically deprived human
healthy people consuming volunteers of vitamin C to determine how much
a varied and nutritious diet. of this vitamin reversed symptoms of scurvy.
Indeed, very high-dose
Such studies formed the basis of dietary
vitamin supplement use
may have adverse health reference values for water-soluble vitamins.
effects, including a A varied diet that includes fruit and vegetables,
possible increase in cereals, meat, fish and dairy products is likely
cancer risk. A regular supply of
to satisfy a person’s requirements. each water-soluble
vitamin is needed to
avoid developing
28 g Nutrients: Life’s Essentials deficiency disease.

20 June 1861 1894 1912
Born in Eastbourne, UK Graduates in Medicine Coins the word ‘vitamin’
from Guy’s Hospital, after conducting a series
London, and achieves of animal feeding
1878 his doctoral degree experiments
Graduates from school
in Enfield
1898 1914
Marries Jessie Anne Becomes Chair of
1883 Stevens, with whom Biochemistry at
Works at the Home he goes on to have Cambridge University,
Office as an assistant to two daughters the first person in
Sir Thomas Stevenson the country to hold
that position
1907
With Sir Walter Morley,
discovers the role of 1929
lactic acid in muscle Awarded the Nobel
contractions Prize in Physiology for
Medicine with Christiaan
Eijkman
16 May 1947
Dies in Cambridge and is
buried at the Parish of
the Ascension Burial
Ground
30 g Nutrients: Life’s Essentials

SIR FREDERICK GOWLAND HOPKINS
Fans of vitamins can thank Sir in the work that made his name. Sir Frederick’s
Frederick Hopkins for their early discovery. first success was to isolate the amino acid,
His vital research over the years shone a light tryptophan, from protein and prove that certain
on the ‘accessory food factors’, later named amino acids could not be manufactured by the
vitamins, which had an enormous impact on body. This led to the concept of ‘essential’
growth and function in living things, despite amino acids. Further research on laboratory
being present in tiny amounts in the diet. animals revealed that the prevalent view of a
Sir Frederick was born in Eastbourne in 1861 balanced diet – one that contained sufficient
where he was raised by his mother and uncle; proteins, fats, carbohydrates, minerals and
his bookseller father having died when Sir water – was lacking something vital. His papers
Frederick was a baby. Ten years later, the family in 1906 and 1912 are acknowledged as the
moved to Enfield in North London, where he first to develop the theory on the importance
excelled in science, particularly chemistry. of vitamins.
The first big break came in 1883, when Subsequently, after building on research by
Sir Frederick was offered a post at the Home Christiaan Eijkman, Sir Frederick discovered that
Office to work on poisons alongside Sir Thomas thiamin in unprocessed rice could reverse the
Stevenson. This led him to complete a BSc in deficiency disease beriberi. For this work, he
chemistry followed by a medical degree at and Eijkman were awarded the 1929 Nobel
Guy’s Hospital, London. After graduating, he Prize. Further research delved into the
continued at Guy’s to teach physiology and biochemistry of cells and enzymes, adding
toxicology, during which time he developed many useful findings to human knowledge.
research into what would become the new Honours rapidly followed: the Royal Medal
discipline of biochemistry. Early experiments of the Royal Society of London in 1918; a
revealed the workings of muscle before knighthood in 1925; and the Order of Merit in
Sir Frederick’s attention switched to nutrition, 1935. Until his death, Sir Frederick continued to
another under-developed topic. influence his peers and oversaw the flourishing
A move to Cambridge University in 1898 of the two disciplines that he had nurtured
began a period of intense research, culminating during his lifetime.
Carrie Ruxton
Sir Frederick Gowland Hopkins g 31

g
NUTRIENTS: CONSUMPTION & METABOLISM

NUTRIENTS: CONSUMPTION
& METABOLISM
GLOSSARY
amines Derivatives of ammonia; released fatty acids The building blocks of fat in the
by the breakdown of amino acids. Many body and in food. During digestion, the body
neurotransmitters are amines, including breaks down fats into fatty acids, which can
dopamine, serotonin and histamine. Can then be absorbed into the blood. Essential
be found in cheese, wine and chocolate, fatty acids (EFAs) must be ingested because
for example. the body requires them for good health but
cannot synthesize them. Those not essential
APOE gene Provides instructions for are non-essential fatty acids.
making a protein called apolipoprotein E.
APOE genotyping is sometimes used Human Genome Project International
to help in the diagnosis of late-onset research collaboration, from 1990 to 2003,
Alzheimer disease. to map and understand the genes of
human beings.
dextrin Common food additive, used
as a thickening and preservative agent. lipids Another word for ‘fats’. Contain
Produced by heating any starch in the carbon, hydrogen and oxygen. Along with
presence of either water or a dilute carbohydrates and proteins, lipids are the
hydrochloric acid. Not all forms are main constituents of cells and are easily
digestible; indigestible dextrin is stored in the body and used as a source
sometimes used in fibre supplements. of fuel.
enzymes Protein molecules in cells which maltose Also known as malt sugar. Made
work as catalysts, speeding up chemical out of two glucose molecules bound together,
reactions in the body. Essential to life. it’s created in seeds and other parts of plants.
Cereals, certain fruits and sweet potatoes
epidemiology The study of how often contain high amounts.
diseases occur in different populations
and why.
34 g Nutrients: Consumption
& Metabolism

metabolites Products of metabolism; obesity Significantly overweight, with excess
substances essential to the metabolism body fat; commonly measured using body
of a particular organism or to a particular mass index (BMI). Generally caused when
metabolic process. more calories are consumed than burned. The
excess energy is stored by the body as fat. Can
microbiome Gut microbiome is a vast lead to diabetes, heart disease, cancer, stroke
ecosystem of organisms such as bacteria, and depression.
yeasts, fungi, viruses and protozoans that
live in our digestive pipes. Many of these polymorphisms Discontinuous genetic
organisms are vital – breaking down food variation of a gene that may result in different
and toxins, making vitamins and training characteristics or disease risk among the
our immune systems. Currently subject to members of a single species.
significant research.
polyphenols Abundant substances found
nucleic acids Essential to all known in fruits, vegetables and nuts; evidence for
forms of life, nucleic acids are the main their role in the prevention of degenerative
information-carrying molecules of a cell diseases such as cancer and cardiovascular
and determine the inherited characteristics diseases is emerging.
of every living thing. The two main
classes deoxyribonucleic acid (DNA) and prebiotic Substrate that beneficially affects
ribonucleic acid (RNA). the host by targeting indigenous gut bacteria
thought to be positive. Currently, main
nutrigenetics The science of how prebiotic targets are bifidobacteria and
nutritional components in our diet interact lactobacilli.
with variations in our genes.
Glossary g 35

DIGESTION &
ABSORPTION
The oral cavity, or mouth, is
where food is initially broken up. Salivary
enzymes, such as amylases and microbiota, aid
3-SECOND BITE this process by breaking down some starches RELATED TOPICS
The gastrointestinal into maltose and dextrin, and thereby starting See also
tract (GIT) is comprised METABOLISM
the digestion process. In the stomach, a very
of anatomically distinct page 38
areas. The digestive system
low pH further degrades foods, and microbial
GUT MICROBIOME
starts in the oral cavity, populations are maintained at relatively low page 40
progressing through levels. Gastric juice in the stomach starts protein
the oesophagus to the
digestion. The small intestine is a very narrow
stomach and small and
tube with a large surface area and is the major 3-SECOND BIOGRAPHIES
large intestines. WILLIAM BEAUMONT
site of absorption in humans – in fact, 95% of 1785–1853
absorption of nutrients occurs here. Pancreatic US Army surgeon who became
known as the ‘Father of Gastric
3-MINUTE SNACK enzymes and bile aid the digestive process and Physiology’, constructing over
Bacteria in the human 200 experiments to provide
gastrointestinal tract,
microbial numbers begin to rise. Finally, the new information about gastric
transit time of the large intestine is very slow, physiology and the digestive
also called ‘gut flora’ or process in human beings.
‘microbiome’, help with with around 200 g of dietary contents entering
digestion. The total CLAUDE BERNARD
per day in an adult. The dietary contents are a 1813–78
number of microorganisms
present is about 1014, mixture of undigested carbohydrates, proteins, French physiologist who
verified that the small
with the overall vitamins and lipids. These help to fortify an intestine was the major
microbiome gene pool site of digestion and that
intensively colonized microbiota, which pancreatic secretions were
being approximately 100 important digestive agents.
times greater than the
contributes to digestion by metabolizing
human genome – by far these substrates into organic acids, gases and
the majority being colonic. nitrogenous compounds like ammonia, amines 30-SECOND TEXT
and phenols. Each of these may exert varying Katherine Stephens
& Glenn Gibson
influences upon health.
Starting in the mouth,

our food goes through
a lengthy process to be
36 g Nutrients: Consumption digested and absorbed.
& Metabolism

METABOLISM
Metabolism can be defined as
the chemical processes by which organisms
convert food into energy to maintain life,
3-SECOND BITE growth and to reproduce. These processes RELATED TOPICS
A popular misconception occur inside and outside of cells in the body See also
is that humans become ENERGY
and can be ‘destructive’ (catabolic) processes,
obese because they have page 14
slow metabolism, but
which release energy by breaking down large
CARBOHYDRATES
obese humans have a molecules into their constituent parts (dietary page 18
M
higher metabolic rate fats, carbohydrates and protein) to provide
than non-obese humans. FAT
the fuel for ‘constructive’ (anabolic) processes, page 22
which involve building large complex molecules
3-MINUTE SNACK for structural and functional roles in living
Eating less food energy organisms (proteins, fats and nucleic acids). 3-SECOND BIOGRAPHIES
HANS KREBS
and physical activity have These processes occur in a series of energy- 1900–81
marked and immediate
effects on metabolism,
dependent steps, whereby one molecule Professor of Biochemistry
at Oxford who shared a
which, if sustained, will such as glucose is broken down into smaller Nobel Prize for his part in
the discovery of a key
result in reduced body molecules to release energy, or, conversely, metabolic pathway that
weight over time. However, explains how energy is
molecules are built-up to make larger molecules. derived from carbohydrate,
there is no evidence that
specific foods or nutrients These series of transformative steps are called fats and proteins.
can accelerate or boost ‘metabolic pathways’ and are regulated by KONRAD BLOCH
metabolism to promote 1912–2000
enzymes (proteins that act as chemical catalysts)
weight loss. On the Professor of Biochemistry at
contrary, there is evidence
that promote reactions to convert substrates Harvard who won a Nobel Prize
for his part in the discovery of
for the existence of into products, which would not happen the mechanism and regulation
of cholesterol and fatty acid
differences in metabolism spontaneously. The activity of enzymes biosynthesis.
between groups of can be controlled in many different ways to
individuals, known as
‘metabotypes’, to which
regulate metabolism (rate or flux of molecule
transformations through the pathway). The rate 30-SECOND TEXT
dietary recommendations
Bruce A Griffin
can be specifically tailored of metabolism can be estimated by measuring
to improve benefits
the rate at which energy is used by an organism. The ‘resting metabolic
to health.
rate’ measures the
energy required to
38 g Nutrients: Consumption maintain the body.
& Metabolism

Acetyl-CoA
citrate
synthase
Citrate
Oxaloacetate
aconitase
malate
dehydrogenase
Malate cis-
Aconitate
aconitase
fumarase
Isocitrate
Fumarate
Isocitrate
succinate dehydrogenase
dehydrogenase
a-ketoglutarate
succinyl-CoA dehydrogenase
synthetase complex
Succinate
a-Ketoglutarate
Succinyl-CoA

GUT MICROBIOME
The gut microbiome is a vast
ecosystem of organisms such as bacteria,
yeasts, fungi and viruses that live in our
3-SECOND BITE digestive pipes. Many of these organisms are RELATED TOPICS
Diet provides the main vital – breaking down food and toxins, making See also
growth substrates for gut PROTEIN
vitamins and training our immune systems. Gut
microbiota, some of which page 16
are positive for health;
transit time and pH maintain gut microbiota
DIGESTION & ABSORPTION
others are pathogenic, and populations in the stomach and small intestine page 36
the remainder are neutral. at lower levels than in the large intestine, where
PROBIOTICS & PREBIOTICS
the vast majority of microbiota reside. Metabolic page 128
3-MINUTE SNACK
capacity of the microbiota is vast, with many
The human intestinal tract different end products being formed, including
is an intensively colonized short-chain fatty acids (SCFA). These are 3-SECOND BIOGRAPHY
area containing bacteria JOHN CRYAN
thought to exert energy generation, satiety Neuroscientist at the
that are health-positive University College of Cork,
and benign, as well as
and colonocyte regulation. Fermentable Ireland, who has investigated
pathogenic (causing carbohydrates like starch and fibres are the main how the gut microbiome
affects the mammalian brain
disease). In fact, there are substrates for SCFA generation. On the contrary, – with far-reaching public
far more bacterial cells in health implications.
protein and lipids can be metabolized by the
the human body than there
are mammalian ones. We microbiota, but these produce toxic compounds
are given our gut bugs such as ammonia and certain amines. Through 30-SECOND TEXT
during birth – the first, and the formation of metabolites, microbiota end Glenn Gibson
one of the most important,
presents of our life.
products can onset intolerance symptoms.
They then go on to play The indigenous microbiome can influence the
a major role in digestion immune response both positively and negatively.
and health. More positive components of gut microbiota
can be fortified: a prebiotic (such as
bifidobacteria and lactobacilli) is a substrate In terms of effect on
that beneficially affects the host by targeting health, our gut bugs
indigenous components thought to be positive. can be broadly
categorized into the
good, the bad and
40 g Nutrients: Consumption the indifferent.
& Metabolism

NUTRIENT-GENE
INTERACTIONS
Nutrigenetics is the science of
how nutritional components in our diet interact
with variations in our genes. People respond in
3-SECOND BITE different ways to eating certain kinds of foods, RELATED TOPICS
Nutrient-gene interactions and this is because we all possess versions and See also
have a significant impact METABOLISM
combinations of genes. Sometimes copies of
upon a person’s likelihood page 38
of developing diseases
genes don’t function or are damaged, which
OVERWEIGHT & OBESITY
such as cancer and can lead to obesity, metabolic diseases, or even page 86
cardiovascular disease cancer. Versions of genes (or polymorphisms)
in later life. DIETARY FATS &
involved with regulating our body weight, for HEART DISEASE
example, can lead to some people gaining page 98
3-MINUTE SNACK weight or becoming obese. Research has shown

Nutrigenomics aims that individuals with a lower body mass index
to understand how 3-SECOND BIOGRAPHY
tend to eat more legumes, fruit and fish; and JOSÉ M ORDOVÁS
nutrients ‘signal’ and 1956–
interact with genetic
it is not so much how many calories a person
A leading professor in the
variation. Differences consumes, but rather where those calories are field of nutrient-gene
interactions who has made
in genes, known as coming from. Vitamins and minerals also play a an outstanding contribution
‘polymorphisms’, can have
key role in regulating our body’s development to our understanding of the
significant impacts on a links between genetic variation
person’s health. These and growth. Having enough B vitamins and folic and dietary response.
‘genotypes’ give rise to a acid within the diet can determine aspects of
person’s ‘phenotype’, and our overall health, as well as affect our risks of
dictate how nutrients are 30-SECOND TEXT
metabolized and excreted
developing metabolic diseases. Consumption Luke Bell
on a molecular level. Some of certain foods can, however, decrease our risk
people possess versions of developing some diseases and improve our
of genes that allow their long-term health. Consuming polyphenols
cells to metabolize very
efficiently; in others
(found in fruits, vegetables and nuts) alters the
these genes might not expression of genes related to blood pressure,
function at all. improving cardiovascular function, for instance.
Understanding how
our genes interact with
nutrients could prevent
42 g Nutrients: Consumption some terminal diseases.
& Metabolism

21 October 1906 1940 1993
Born in Wallington, UK First edition of The Made a Companion of
Chemical Composition Honour (CH), an honour
of Foods published restricted to only 65
1928 Britons at any one time.
Receives Bachelor of Publication of biography,
Science in Chemistry from 1946 McCance and
Imperial College, London An Experimental Study of Widdowson: a Scientific
Rationing is published, Partnership of 60 years
although the results had (Ed: Margaret Ashwell).
1931 been made available to
Receives Doctorate from the British Government
University of London, during WWII 14 June 2000
having introduced Dies in Cambridge, UK
new methodology
for measuring the 1976
carbohydrate in apples Elected as a Fellow of the
Royal Society
1933
Enrols for a Dietetics 1977–80
diploma course at Elected President of the
King’s College, London. Nutrition Society
Historic meeting with
Robert McCance, her
lifelong scientific partner,
1979
at King’s College
Made a Commander of
Hospital.
the British Empire (CBE)
1938
Widdowson and McCance
move to the Department
of Experimental
Medicine, Cambridge
44 g Nutrients: Consumption
& Metabolism

ELSIE WIDDOWSON
Although best known for her themselves with solutions to judge the
pioneering work on the first British food tables absorption and excretion of minerals in the
with her scientific partner for more than 60 body. The photo of Elsie’s arm jammed full of
years, Robert McCance, Elsie Widdowson’s syringes never fails to wow today’s students.
influence on nutrition went much further Elsie considered the most important
than the chemical composition of foods. She unanswered question in nutrition to be the
made significant scientific discoveries in the influence of genetics on the way that the body
diverse worlds of mineral metabolism, body treats the nutrients delivered to it. She based
composition, the physiology of the newborn her belief on her research of the individual diets
and in normal and retarded growth, to name of children in the 1930s and 40s, which had
just a few. shown their vast range of energy and nutrient
In the citation for her Honorary Doctorate, requirements: ‘Similar individuals may differ
she was introduced as the woman who won enormously and unpredictably in their food
World War II on account of her research for the habits.’ These observations have paved the way
British food rations. ‘You can, if you have to, to the modern study of nutrigenetics, now
live on a very simple diet’, she said. She worked defined as the science of the effect of genetic
out that bread, cabbage and potatoes variation on dietary response.
contained all the nutrients for healthy survival Promoting the acceptance and
in the event that Britain could not import food. encouragement of women in science was Elsie’s
For three months in 1939–40, Widdowson, passion. On her death, the Imperial College
McCance and a number of their companions Elsie Widdowson Fellowship Award was set
ate nothing else. To demonstrate their fitness up to allow academic staff to concentrate fully
following this bleak regime, Elsie, McCance and on their research work upon returning from
two others completed a rigorous course of maternity, adoption, surrogacy and/or shared
cycling and mountain climbing in the English parental leave.
Lake District. Just like the secret codebreakers Elsie always retained her humility, her
of wartime Britain, Elsie was driven by Britain’s intuition and her sense of excitement for
desperate necessity to survive in wartime. discovery and debate. Her greatest satisfaction
Self-experimentation featured highly in Elsie’s was discovering how something she had said,
research. Widdowson and McCance even came written or done had helped someone else in
close to death once when they injected their career.
Margaret Ashwell
Elsie Widdowson g 45

PERSONALIZED
VERSUS PUBLIC
HEALTH ADVICE
Poor diet choices and lack of
physical activity are some of the key causes
of obesity, heart disease, diabetes and some
3-SECOND BITE cancers. Over the years, public health strategies RELATED TOPICS
Personalized nutrition, have attempted to improve diet through See also
tailored to an individual’s DIETARY ASSESSMENT
campaigns, which are typically delivered on
diet intake, physical page 48
characteristics and genetic
a population basis, using a ‘one size fits all’
CHANGING EATING HABITS
makeup has the potential approach. Guidelines may differ according to page 92
to revolutionize the gender, age, weight or specific conditions such
delivery of diet advice.
as pregnancy, and are unlikely to suit everybody.
In contrast, personalized nutrition seeks to tailor 3-SECOND BIOGRAPHY
JAMES WATSON
3-MINUTE SNACK dietary information according to individuals’ 1928–
A key challenge in characteristics, including diet intake and physical American molecular biologist
and geneticist who
improving public health health. The completion of the Human Genome co-discovered the structure
is motivating people of DNA in 1953 alongside
to change their dietary
Project in 2003 made it possible to tailor advice Francis Crick and Rosalind
based on genetic makeup. For example, research Franklin, and helped establish
behaviour. It is therefore the US arm of the Human
vital that nutrition advice has shown that people with specific variants of Genome Project.
is personally relevant and
the APOE gene respond better to a diet low in
easy to follow. In the
future, researchers aim saturated fat. Motivating individuals to change 30-SECOND TEXT
to harness technological their dietary behaviour is arguably one of the Rosalind Fallaize
advances, by combining greatest challenges in nutrition interventions,
complex personal data with
smartphone applications
and evidence suggests that an individualized
and wearable technology, approach – through a registered nutritionist/
to provide effective dietitian – helps people to follow a healthy
personalized nutrition diet more than ‘one size fits all’ public health
on a population-level.
guidance. However, public health guidance
remains a vital means of raising awareness of Personalized diet plans
important health issues in the population. anchored in genetics
could be the future
for fighting health
problems associated
46 g Nutrients: Consumption with poor nutrition.
& Metabolism

DIETARY
ASSESSMENT
Scientists, healthcare professionals
and, increasingly, members of the public are
seeking new and innovative ways of assessing
3-SECOND BITE dietary intake. Accurate dietary assessment is RELATED TOPICS
Dietary assessment forms vital, and forms an integral part of studies that See also
a vital part of nutritional PROFILE: ELSIE WIDDOWSON
focus on exploring the relationship between diet
science, and researchers page 44
are constantly exploring
and health. Traditional methods of assessment
new and innovative ways include: food frequency questionnaires and diet PERSONALIZED VERSUS
PUBLIC HEALTH ADVICE
of assessing energy and recalls, whereby individuals are required to page 46
nutrient intake.
remember the foods they have eaten over the
CHANGING EATING HABITS
past 24 hours to one year; and food diaries, page 92
3-MINUTE SNACK whereby individuals are asked to record what
Technological advances they eat in ‘real time’. These traditional methods
have enabled the 3-SECOND BIOGRAPHY
are often burdensome on both the individual ELSIE WIDDOWSON
development of mobile
dietary assessment
and the researcher. Furthermore, individuals 1906–2000
may under-report their food intake or change British dietitian who studied
instruments, which are nutritional deficiencies and
easily incorporated into their dietary behaviour, because they are aware helped to revolutionize the
the user’s lifestyle. way in which dietary intake
of being assessed. Several web-based tools have could be explored relative to
Additionally, biological disease risk.
markers are being been developed to improve the accuracy of
developed to assess traditional assessment methods. In parallel,
nutritional status and scientists are looking towards the use of 30-SECOND TEXT
recent dietary intake.
While biological markers
biological markers in hair, urine, blood and Rosalind Fallaize &
Oonagh Markey
are expensive and do not faeces to assess dietary exposure. Commercial
reflect multiple dimensions smartphone applications can help consumers to
of dietary intake, they have track their own dietary intake; however, further
the capacity to validate
and improve the accuracy
research is needed to assess the accuracy of
of self-reported dietary these applications and their effectiveness for Diet records provide
assessment tools. weight management. insight into food
habits and are used by
dietitians/nutritionists
to help individuals
48 g Nutrients: Consumption improve dietary intake.
& Metabolism

Network 1:27 PM 100%
intake/cal Burned/cal

R-NUTS_LVBK-050-071_U.indd 50 29/05/2018 15:39
g
FOODS & HEALTH
R-NUTS_LVBK-050-071_U.indd 51 29/05/2018 15:39

FOODS & HEALTH
GLOSSARY
allergy Damaging immune response by the cholesterol An animal sterol often classified
body to a substance, such as a food, to with dietary fats vital for normal functioning
which it has become hypersensitive. of the body. Mainly made by the liver, but
can also be found in some foods. Low
amino acids The building blocks of all density lipoprotein cholesterol (LDL-C) is
proteins, amino acids make up a large often referred to as ‘bad cholesterol’ because
proportion of cells, muscles and tissue, too much of it is unhealthy. High density
carrying out many important bodily lipoprotein cholesterol (HDL-C) is often
functions, such as giving cells their referred to as ‘good cholesterol’ because it
structure. Also play a key role in the is protective. Dietary cholesterol in an egg is
transport and storage of nutrients. not the same as the LDL-C that circulates in
Essential amino acids need to be gained blood and blocks arteries, and it is erroneous
through diet rather than formed by the to believe that dietary cholesterol simply
body itself. becomes LDL-C once it has been consumed.
bioactive compounds Extranutritional coeliac disease Autoimmune disorder from

constituents that typically occur in small eating gluten, which damages the small
quantities in foods. Usually linked with intestine. Symptoms include diarrhoea,
positive effects, and include carotenoids, abdominal pain and bloating.
antioxidants and flavonoids.
epidemiology The study of how often
bioavailability Extent to which nutrients diseases occur in different populations
are digested and absorbed. and why.
insulin Hormone made by the pancreas that

allows your body to use or store glucose from
carbohydrates in food for energy. Maintains
correct blood sugar level. When cells react
abnormally to insulin, this is known as insulin
resistance, which increases the risk of
developing type 2 diabetes and prediabetes.
52 g Foods & Health
R-NUTS_LVBK-050-071_U.indd 52 29/05/2018 15:39

gluten Mixture of two proteins, gliadin polychlorinated biphenyls Manmade
and glutenin, responsible for the elastic industrial chemicals that can be released into
texture of dough. the environment through waste and absorbed
through the food chain.
lactase Enzyme produced by many
organisms, located in the small intestine. probiotic bacteria Live bacteria promoted as
Essential to the digestion of milk and dairy having various health benefits, especially for
foods, as it breaks down lactose. the gut and relating to digestion. Added to
yoghurt or taken as supplements.
lactose Type of sugar mainly found in milk
and dairy products. salmonella Bacteria in contaminated food
that causes food poisoning. Symptoms
lipid profile Blood tests that measure include diarrhoea, stomach cramps, vomiting
levels of lipids (fats and fatty substances, and fever.
or cholesterols) in the bloodstream. Used
as part of a cardiac risk assessment. scurvy Severe vitamin C deficiency. Symptoms
include fatigue, weakness, severe joint or leg
mercury Metal found in the environment. pain, bleeding gums, red or blue spots on the
Eating a high quantity of foods skin, easy bruising.
contaminated with mercury can affect the
nervous system and a developing foetus. World Health Organization (WHO) Agency
of the United Nations tasked with building
micronutrients Vitamins and minerals; a better, healthier future for people all over
required in trace amounts for the healthy the world.
functioning of the body.
omega-3 Fatty acids found in fish,

especially fatty fish like salmon, tuna,
sardine and mackerel. Important for visual
and cognitive development and for heart,
cognitive and inflammatory health.
Glossary g 53
R-NUTS_LVBK-050-071_U.indd 53 29/05/2018 15:39

FRUIT &
VEGETABLES
Fruit and vegetables are a major
food group and are important components of a
healthy diet. Diets rich in fruit and vegetables
3-SECOND BITE have been linked to a reduced risk of chronic RELATED TOPICS
A high intake of fruits disease, whereas low fruit and vegetable See also
and vegetables has been WATER-SOLUBLE VITAMINS
consumption has been linked to poor health.
associated with reduced page 28
risk of a number of chronic
The World Health Organization (WHO) has
ORGANIC FOODS
diseases, including stated that, in 2013, an estimated 5.2 million page 142
cardiovascular disease deaths worldwide were attributable to lower
in particular.
than recommended fruit and vegetable
consumption. The evidence is strong for 3-SECOND BIOGRAPHY
JAMES LIND
3-MINUTE SNACK cardiovascular disease, relatively consistent 1716–94
Although the evidence for specific cancer sites and is weaker for both Scottish physician who first
demonstrated that scurvy
linking increased fruit diabetes and obesity. Fruit and vegetables could be remedied by eating
and vegetable intake to citrus fruit.
reduced risk of chronic
are micronutrient- and fibre-rich, as well as
disease is strong, it is containing a range of beneficial non-nutrient
difficult to measure fruit components, including plant sterols, flavonoids 30-SECOND TEXT
and vegetable intake
and other bioactives, which have a range of Jayne Woodside
accurately, and there
are some uncertainties potential health benefits, including antioxidant
regarding the importance and anti-inflammatory properties. Consuming
of variety, the optimum a variety of fruit and vegetables will help to
number of portions and
whether different types of
ensure an adequate intake of many of these
fruit and vegetables have essential nutrients. Fruit and vegetables are,
different health effects. therefore, recommended across all dietary
The effect of storage, guidelines. WHO suggests consuming more
processing and cooking
methods on nutrient
than 400 grams of fruits and vegetables per day
content and therefore to improve overall health and reduce the risk of
health benefits is certain non-communicable diseases. Consumption guidelines
also uncertain.
have been widely
translated as five
portions of fruit and
54 g Foods & Health vegetables per day.
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FISH
Fish is a very healthy food that
may be classed as white fish, fatty fish or
shellfish. Fish provides good quality protein
3-SECOND BITE and can be a source of many micronutrients, RELATED TOPICS
Fish is a good source of including selenium, iodine and vitamin D. Fish, See also
micronutrients and of FATS
especially fatty fish like salmon, tuna, sardine
omega-3 fatty acids. page 22
Yet, in many countries,
and mackerel, is the best source of the omega-3
DIETARY FATS &
people eat less fish than fatty acids that are important for visual and HEART DISEASE
recommended. cognitive development and for heart, cognitive page 98
and inflammatory health. Epidemiological OMEGA-3 FATTY ACIDS
3-MINUTE SNACK
studies have shown associations between page 122
Commercial fishing is a higher consumption of fish and reduced risk of

major global industry. It heart disease, stroke, some cancers, cognitive
3-SECOND BIOGRAPHY
can have an adverse impact decline, depression and several other non- MASAZUMI HARADA
on fish stocks and the 1934–2012
environment, and it is likely
communicable diseases. The protective effects
Japanese doctor and medical
that fishing in its current of fish are often ascribed to omega-3 fatty researcher who worked on the
effects of Minamata disease, a
form is unsustainable in acids, but it is likely that the other nutrients severe mercury poisoning that
some locations. Since fish
in fish also play a role. To obtain sufficient occurred in Minamata, Japan,
during the 1950s and 60s, as
are an important source of
protein, micronutrients and omega-3 fatty acids, it is recommended that a result of a petrochemical
company discharging heavy
omega-3 fatty acids, the people eat one or two servings of fatty fish metal waste into the sea.
lack of sustainability of each week. In many countries, fish consumption,
fishing is a challenge
to human health and
especially of fatty fish, is lower than
30-SECOND TEXT
well-being. Fish farming is recommended. Despite its clear health benefits, Philip C Calder
only a partial solution. fish can be a source of toxins such as mercury
and contaminants such as polychlorinated
biphenyls, which are harmful to health. These
compounds can become concentrated within
the marine food chain. For this reason, pregnant
women are advised not to eat certain fish. Low in fat, shellfish are
a source of omega-3,
protein, iron, zinc,
56 g Foods & Health copper and vitamin B12.
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MILK & DAIRY
Dairy foods are not essential in
our diet, but can contribute to over 40% of daily
intake of calcium, iodine, phosphorus and some
3-SECOND BITE B-vitamins in Europe and the USA. Dairy also RELATED TOPICS
Milk is a highly nutritious provides a higher quality of protein than meat. See also
food, with high absorbable FOOD ALLERGIES &
All dairy foods are made from milk that comes
calcium for bone health, INTOLERANCES
yet humans are the only
from ruminant animals such as cows, sheep, page 100
animals to drink milk goats and water buffalo and have been VITAMIN D & CALCIUM
throughout life. consumed for over 7,500 years in some page 126
European populations. There is a misconception PROBIOTICS & PREBIOTICS
3-MINUTE SNACK
that milk is a high-fat food, yet whole milk page 128
Milk is an excellent medium contains only 3.6% fat, semi-skimmed 1.7%

for bacterial growth, so to and skimmed 0%. Dairy foods are the main
prolong its shelf life and 3-SECOND BIOGRAPHY
contributor to saturated fat intake in many LOUIS PASTEUR
ensure it is safe to drink, 1822–95
milk can be heat-treated countries, but a high intake of dairy (excluding
French microbiologist who
by pasteurization. This butter and cream) is not generally associated was the first to conduct
pasteurization tests in 1862
process involves heating with heart disease risk. On the contrary, for milk preservation; credited
milk to 72°C (162°F) for
proteins, calcium, magnesium and probiotic with revolutionizing the safety
15–21 seconds, which of milk, enabling it to be stored
maintains its nutritive bacteria in dairy foods have been linked to some and distributed widely.
content, apart from a small beneficial effects on heart health, including
loss of vitamin B12. In the lowering blood pressure. While some individuals
production of cheese and 30-SECOND TEXT
yoghurt, added bacteria
develop an allergy to milk protein, others have Julie A Lovegrove
ferment lactose, producing lactose intolerance and are unable to digest
lactic acid, which thickens dairy sugar (lactose). Interestingly, adult lactose
the milk and gives intolerance is a normal condition in mammals.
cheese and yoghurt their
characteristic sour taste. However, most humans have a genetic mutation
that enables them to consume dairy products in
adulthood, due to the persistence of lactase, The commercial
required for lactose digestion. pasteurization of milk
was introduced in 1895,
and modern methods
58 g Foods & Health
are controlled by food
safety agencies.
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EGGS
Egg yolk contains all of the
essential ingredients to build a living organism
and provides a richer source of micronutrients
3-SECOND BITE than any other single food. Egg white contains RELATED TOPICS
There is no such thing as a protein that is superior to beef steak in See also
‘superfood’ for improving FATS
nutritional quality (content of essential amino
human health. But if there page 22
were, the egg must qualify
acids) and bioavailability. Eggs also boast the
DIETARY FATS &
as a major contender. highest ratio of nutrient to energy density than HEART DISEASE
any other food. So why have dietary guidelines page 98
restricted the intake of such a nutritious food? FREE-RANGE & INTENSIVELY
3-MINUTE SNACK
Eggs have always courted
An egg yolk provides the main source of dietary FARMED FOODS
page 144
controversy, with fears cholesterol (approximately 200 mg/egg), which
over the impact of their has been linked to coronary heart disease (CHD)
cholesterol on CHD, allergy by its association with ‘low density lipoprotein 3-SECOND BIOGRAPHIES
in response to their protein
and the risk of salmonella
cholesterol’ (LDL-C). However, the dietary DR ANCEL KEYS
1904–2004
infection, which is now cholesterol in an egg is not the same as the Keys stated that there was
mostly eradicated by mass LDL cholesterol that circulates in our blood and no evidence from studies in
humans to support the idea
vaccination programmes.
blocks arteries, and it is erroneous to believe that the amount of cholesterol
Nevertheless, the egg in the diet can influence the
prevails as a highly popular that dietary cholesterol simply becomes LDL level of blood cholesterol.
and versatile food that cholesterol in blood once it has been eaten. JOSEPH GOLDSTEIN &
is unmatched in its Eating an excessive amount of dietary MICHAEL BROWN
capacity to nourish 1940– & 1941–
humans throughout
cholesterol in eggs can increase blood LDL-
Discovered the LDL receptor
their life course. cholesterol – by reducing the ability of our cells pathway as the mechanism
that regulates cholesterol
to extract LDL-C from the blood – but for most metabolism.
healthy people, an egg a day will have no
significant effect in raising LDL-cholesterol,
30-SECOND TEXT
or risk of CHD, especially in comparison to the Bruce A Griffin
effects of eating too much saturated fat and
being overweight. A deepening knowledge
of cholesterol has led
to the relaxation of
60 g Foods & Health restrictions on eggs.
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NUTS
There has been increasing
interest in nuts and how they might improve
human health. Peanuts and tree nuts are foods
3-SECOND BITE that most commonly cause an allergic reaction, RELATED TOPICS
Eating more nuts will not but it has been demonstrated that consumption See also
cause weight gain, can PROTEIN
of a frequent peanut-containing snack by
improve other risk factors page 16
for heart disease and is
infants who are at high-risk of developing a
MEDITERRANEAN DIET
part of an overall healthy peanut allergy may prevent the development of page 68
diet pattern. allergy. Nuts are a varied food group, including,
FOOD ALLERGIES &
for example, tree nuts (almonds, hazelnuts, INTOLERANCES
3-MINUTE SNACK
walnuts, pistachios, Brazil nuts and cashews) page 100
Nuts are thought to reduce and legume seeds (peanuts). Nuts are nutrient-
the risk of heart disease. dense foods that are high in energy, but also
Whether different types of 3-SECOND BIOGRAPHY
with a favourable fatty acid (FA) profile (high in GIDEON LACK
nuts have different health
effects is not yet well
monounsaturated FAs and/or polyunsaturated Lead investigator on the LEAP
study, which was the first
studied, so mixed nuts – FAs) and contain a range of bioactive randomized trial to prevent
peanut allergy in a large cohort
unsalted and unroasted – compounds that also have proposed health of high-risk infants.
are recommended. People
benefits, such as vitamins, minerals and other
with poor dental health
may report difficulties antioxidants. Increasing nut intake has been
30-SECOND TEXT
eating nuts, and therefore demonstrated to reduce blood pressure, Jayne Woodside
the form of nuts consumed improve regulation of glucose, improve blood
(such as ground or sliced)
needs to be considered
vessel health, reduce inflammation and improve
in some population groups. lipid profile. Therefore, increasing intake could
reduce risk of heart disease, and nuts are a key
food group consumed within a Mediterranean
Diet, which has been proven to be heart-healthy.
Nuts have a high energy content, but
concerns about them being fattening are Increased consumption
largely unfounded. does not necessarily
lead to weight
gain, and nuts can
62 g Foods & Health increase satiety.
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GRAINS & GLUTEN
The edible seeds from plants of
the grass family are called ‘cereal grains’, or
‘cereals’. The general term for both the fruit
3-SECOND BITE (the seed or kernel) and the plant is ‘grain’. RELATED TOPICS
Gluten refers to proteins Major grain types worldwide are wheat, rice, See also
found in wheat, barley, FOOD ALLERGIES &
corn (maize), barley, sorghum, oats, rye and
rye and triticale, providing INTOLERANCES
baked products with
millet. Other important plants that are used as page 100
texture, moisture and grains but are not technically grains include wild REFINING
flavour; however, it rice, buckwheat, amaranth and quinoa. Wheat page 136
can cause an immune-
flour is the preferred flour for baking due to the
mediated reaction in the
small intestine. formation of gluten when the flour is mixed
3-SECOND BIOGRAPHY
with water and stirred or beaten, such as when WILLEM-KAREL DICKE
making a batter or kneading a dough. Gluten, 1905–62
3-MINUTE SNACK Dutch paediatrician who
a mixture of two proteins, gliadin and glutenin, was the first to develop
Gluten-free diets are a gluten-free diet for the
popular, and can benefit is responsible for the elastic texture of dough. treatment of coeliac disease.
those who experience Besides wheat, gluten can also be found in
adverse reactions and/or barley, rye and triticale. It gives baked goods
suffer from related 30-SECOND TEXT
soft, fluffy and moist qualities. Without it,
conditions such as coeliac Zhiping Yu
disease, wheat allergy bread would lose its shape, dry out and quickly
or non-coeliac gluten become stale. However, individuals with coeliac
sensitivity. However, disease (an autoimmune disorder that damages
there is little clinical
evidence to support the
the small intestine), wheat allergy (allergic
claim that a gluten-free reactions caused by gluten or other wheat
diet is a ‘healthier’ diet protein) or non-coeliac gluten sensitivity eat
directly related to improved naturally gluten-free diets or products made
health, weight loss or
increased energy. with gluten-free flours, such as those from corn,
rice, potato and soy, amongst others.
Corn is from a different
branch of the grain
family than the gluten
grains of wheat, barley
64 g Foods & Health and rye.
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VEGAN &
VEGETARIANISM
Between 1 and 10% of the
population in developed countries follow a
vegetarian diet. Many individuals and special
3-SECOND BITE interest groups claim that vegetarian diets can RELATED TOPICS
Following a well-balanced prolong life and promote health and vitality. See also
and varied vegetarian FRUIT & VEGETABLES
These claims are largely unsubstantiated in
or vegan diet may be page 54
associated with improved
terms of reliable scientific evidence. However,
BABIES, INFANTS & CHILDREN
health outcomes, populations following vegetarian diets do seem page 76
especially for heart to have reduced risk of heart disease and
disease and obesity. RED & PROCESSED MEATS
obesity. It is widely recognized, however, that page 110
over-reliance on one single food or food group
3-MINUTE SNACK will not provide the range of nutrients required
Whilst vegetarian and for optimum health and well-being. If a 3-SECOND BIOGRAPHY
PYTHAGORAS
vegan diets are potentially particular food or food group is not consumed c. 570 BCE
beneficial to health, if they
are well-balanced and
routinely, alternative nutrient sources must Greek philosopher and
mathematician who promoted
varied, such diet patterns be included; for example, instead of meat, benevolence among all species
and followed what could be
are highly heterogeneous plant-based protein sources such as legumes. described as a vegetarian diet.
in nature, which makes
Very restrictive or unbalanced vegetarian diets
thorough assessment of
their effects on health can result in nutrient deficiencies, particularly
30-SECOND TEXT
difficult. Furthermore, iron, calcium, zinc and vitamins B12 and D. Jayne Woodside
vegetarian lifestyles often This is especially the case for groups at risk
encompass other health
behaviours which can
of nutrient deficiency, including infants,
improve health, for children, menstruating and lactating women
example, being physically and athletes. Vegetarian and vegan diets can,
active, not smoking however, be balanced and healthy for all stages
and limiting alcohol
consumption; therefore,
of life, provided appropriate preparation and
the effect of the dietary planning are followed. Vegans may require
pattern per se is difficult supplementation if adequate intake of nutrients Any restrictive
to determine.
cannot be achieved. diet requires some
rebalancing of food
types and nutrients,
66 g Foods & Health for optimum health.
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MEDITERRANEAN
DIET
The Mediterranean Diet is a diet
pattern rich in fruit, vegetables, legumes, nuts,
fish and olive oil, and low in red meat and
3-SECOND BITE processed foods. There has always been RELATED TOPICS
Changing to a regional variation and, more recently, changes See also
Mediterranean Diet FRUIT & VEGETABLES
over time in the exact foods and how frequently
pattern is likely to reduce page 54
risk of heart disease and
they are consumed, but the traditional pattern
FISH
may benefit a range of is based on the typical diet of many regions in page 56
chronic diseases. Greece and southern Italy in the early 1960s.
DIETARY FATS &
The Mediterranean Diet has been rated as the HEART DISEASE
3-MINUTE SNACK
dietary pattern most likely, based on current page 98
The Mediterranean Diet knowledge, to offer protection against

has been proposed as an cardiovascular disease. This is supported by
alternative and palatable 3-SECOND BIOGRAPHIES
robust and consistent evidence from different ANCEL KEYS
lifestyle change that is
types of population studies, including trials 1904–2004
beneficial to health. What American physiologist
is not yet clear is whether where people have changed their diet and rates who explored whether
differences in diet could
non-Mediterranean of heart disease have been reduced. How the explain differences in rates
populations can adopt
diet protects the heart is not fully understood, of heart disease.
and maintain dietary
behaviours consistent with but those who follow it more closely seem to MICHEL DELORGERIL
1950–
a traditional Mediterranean have a healthier lipid profile, lower blood
French cardiologist who was
diet – because of the pressure, lower insulin resistance and less the first to demonstrate that
required changes in foods heart disease patients who
consumed, eating patterns
inflammation. Emerging evidence also suggests adhered to a Mediterranean
Diet reduced their chances
and food culture – and that following a Mediterranean Diet may have of a further heart attack.
there are concerns that additional benefits for overall longevity and
Mediterranean populations other chronic diseases, such as diabetes, cancer
are changing their diet 30-SECOND TEXT
habits towards a and Alzheimer’s disease. The health benefits
Jayne Woodside
Western-style diet. offered appear to be attributable to interactions
between different food components rather than There are concerns
the effects of single nutrients. that the modern-day
Mediterranean diet
is losing its unique
68 g Foods & Health components.
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26 January 1904 1936 1950
Born in Colorado Springs, Awarded second PhD Appointed Chair of
USA in Physiology, King’s the World Health
College, Cambridge Organization’s first Joint
Commission on Food &
1930 Agriculture, Rome
First PhD in 1937
Oceanography and Founds the Laboratory
Biology, UC Berkeley of Physiological Hygiene 1954
at the University of Establishes
Minnesota cardiovascular
1935 epidemiology as
Appointed Director of a new discipline
the International High 1941
Altitude Expedition Develops pocket-sized
to Chile ‘K-rations’ for the US 1961
military in WWII Nicknamed ‘Mr
Cholesterol’ on the front
page of Time magazine
1944
Initiates the Minnesota
Starvation Experiment 1970
First publication of Seven
Countries Study results
1947
Initiates the Minnesota
Business and Professional 1980
Men’s Study Publishes third book with
co-author wife – Eat
Well, Live Well
20 November 2004
Dies in Minnesota, USA,
at the age of 100
70 g Foods & Health
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ANCEL KEYS
Ancel Keys was a physiologist Westernized diet, and suggested that all of
and pioneer in cardiovascular epidemiology, these observations could be explained by a high
who established that a high intake of saturated intake of saturated fat raising the level of blood
fat increases the risk of coronary heart disease cholesterol. This theory was supported by his
(CHD) by raising the level of blood cholesterol. landmark Seven Countries Study, in which a
This discovery became known as the ‘diet-heart high incidence of death from CHD in men in
hypothesis’ and has been the cornerstone of Finland and the USA was contrasted with the
dietary guidelines to prevent CHD since the low incidence of CHD in Italy, Greece and Japan.
early 1980s. The results from this study were used to
Keys was a gifted and inquisitive child, but a formulate the ‘Keys equations’ for predicting
wayward teenager who had a series of menial the opposing effects of dietary saturated and
labouring jobs. He returned to higher education polyunsaturated fats on blood cholesterol,
in his late twenties, when he gained two which are still used in clinical practice today.
doctorates and a reputation for applying Ancel Keys was an advocate for the benefits
mathematics to quantify biological phenomena. of the Mediterranean diet in preventing CHD,
Keys’ first experience of fame was when he long before the impact of this diet was formally
founded the pocket-sized military ‘K-ration’ (an tested and shown to prevent death from CHD in
emergency, mobile source of food that could a randomly controlled trial called ‘PREDIMED’
provide soldiers with enough energy in the field in 2006. While Keys’ contribution to nutritional
for two weeks), before turning his attention at science has had an incalculable impact in
the end of the war to the effects of starvation preventing death from premature CHD, there
and how to rehabilitate malnourished post-war have been allegations that he manipulated his
survivors. This led to his curiosity over the results to concoct his theory about saturated
variation in incidence of CHD in different fat and CHD. Keys died before he could defend
countries, especially the low prevalence of CHD himself against these allegations, but,
in underfed European populations, contrasted fortunately, his reputation and monumental
with a high prevalence of CHD in affluent contribution to nutrition science have been
American businessmen. Keys was also redeemed by those who worked closely with
fascinated by the increased rate of CHD in him, in a White Paper commissioned by The
Japanese immigrants to the US who adopted a True Health Initiative in 2017.
Bruce A Griffin
Ancel Keys g 71
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g
A LIFETIME OF NUTRITION

A LIFETIME OF NUTRITION
GLOSSARY
adolescence Mental and cultural transition folate Also known as vitamin B9. Folate in
from childhood to adulthood; overlaps the form of folic acid is advised for pregnant
with puberty. women (to prevent neural tube defects in
the developing foetus) and to prevent a
anaemia Develops when the blood does type of anaemia. Essential for DNA synthesis
not contain enough healthy red blood cells and metabolizing amino acids, it is an
or haemoglobin, important for carrying essential vitamin.
oxygen around the body. There are many
types and causes, including iron deficiency. lactation Secretion of milk from the
Symptoms include lethargy, shortness of mammary glands; when a mother feeds her
breath, pale complexion and dry nails. baby. Suckling by the baby to the mother’s
breast stimulates the supply of milk, which
bariatric surgery Weight-loss surgery, provides essential nutrients and an array of
which might be recommended for very bioactive substances absorbed by the infant
obese people (BMI of over 35). Could for brain, immune and gut development.
include placement of a gastric band around
the stomach, a gastric bypass to join the malnutrition When a person doesn’t eat
top part of the stomach to the small enough, through illness, or when there is
intestine, or a sleeve gastrectomy, in insufficient amounts or quality of food,
which some of the stomach is removed. resulting in insufficient essential nutrients.
The consequence is reduced growth or weight
bifidobacteria Major type of bacteria loss. Symptoms can include a lack of interest
that make up the gut microbiome. Some in eating and drinking, chronic fatigue, feeling
bifidobacteria are used as probiotics. Found weak and a diminished immune system.
in foods such as live-culture yoghurt.
menopause When women stop menstruating
dementia Syndrome associated with and being able to conceive. Occurs between
an ongoing decline of brain functioning. 45 and 55 years of age, as a woman’s
Can affect memory, thinking speed, oestrogen and progesterone levels decline,
language, understanding, judgement, and typically lasts for four years. Symptoms
mood and movement. include hot flushes, vaginal dryness, trouble
sleeping and mood changes.
74 g A Lifetime of Nutrition

micronutrients Vitamins and minerals; Bacteria release toxins, and viruses damage
required in trace amounts for the healthy cells. White blood cells can ingest and destroy
functioning of the body. pathogens, which can be consumed through
contaminated food or drinks, resulting in
obesity Significantly overweight, with flu-like symptoms and nausea, vomiting,
excess body fat; commonly measured using diarrhoea or fever.
BMI (body mass index). Generally caused
when more calories – particularly those in progesterone Female sex hormones produced
fatty and sugary foods – are consumed by the ovaries and adrenal glands. Plays an
than burned (through physical activity). important role in sustaining pregnancy and
The excess energy is stored by the body regulating the menstrual cycle. High levels are
as fat. Can lead to diabetes, heart disease, thought to be responsible for symptoms of
cancer, stroke and depression. PMS (Pre-Menstrual Syndrome).
oestrogen Primary female sex hormone. puberty Physical changes that mature a
Secreted by the ovaries, it plays a key child’s body into an adult’s body capable of
role in puberty, the menstrual cycle and sexual reproduction. The brain sends hormonal
sex drive, and even in cognition, mental signals to the gonads – ovaries in girls, testes
health and binge eating. Declines in boys. The average age for girls to start this
after menopause. process is 11; for boys it’s 12, and it typically
takes four years. See also Adolescence.
osteoporosis Bone-weakening condition
that develops over several years until a sarcopenia Disease associated with the
fall or impact can cause a bone fracture. ageing process. Loss of muscle mass and
Postmenopausal women are at risk. A strength affects balance, gait and ability to
healthy diet (including foods rich in calcium perform daily tasks.
and vitamin D), regular exercise and
reducing alcohol consumption can help type 2 diabetes Llifelong condition that
prevent the condition. causes the level of sugar (glucose) in the
blood to become too high, as a result of the
pathogens Micro-organisms, such as insufficient production of insulin or the insulin
bacteria and viruses, that cause disease. being ineffective.
Glossary g 75

BABIES, INFANTS
& CHILDREN
The first 24 months of life are a
time of rapid growth and development. After
this, growth slows, but mental and social
3-SECOND BITE development continues apace. This is why RELATED TOPICS
Children are not little infants and children need good quality protein See also
adults – give them plenty PROTEIN
and sufficient vitamins and minerals to meet
of fruit, vegetables, high page 16
quality proteins and
their needs. Proteins support growth and
FAT-SOLUBLE VITAMINS
wholegrain carbs. Go easy development, especially muscle and bones. page 26
on the sugar and salt to Fibre is needed for digestive function and to
keep them healthy. MILK & DAIRY
prevent constipation, and can be found in fruit, page 58
vegetables and wholegrains. Calcium and
3-MINUTE SNACK vitamin D are vital for optimal bone health, as
It’s vital to get children’s bone density increases until its peak in young 3-SECOND BIOGRAPHIES
diets right. Firstly, early JANE WARDLE
adulthood. Iron is vital for red blood cells, which 1950–2015
eating habits track into
adulthood, so a healthy carry oxygen around the body. Studies show British health psychologist who
published influential work on
start will have a positive that young children and teenage girls have a children’s eating behaviour and
how it relates to risk of obesity.
lifelong influence on higher risk of low iron status, which can impact
food choice. Secondly,
on immune function and cognitive development. MARIA MAKRIDES
as diseases such as heart Australian researcher who
disease and type 2 diabetes Due to high nutritional needs and the fact that showed the importance of
omega-3 fatty acids to the
have their origins in fussy eating is common, several countries infant brain.
adolescence, a balanced recommend supplementation with vitamins A,
diet can help prevent LEANN BIRCH
future illness.
C and D from infanthood until school-age. A fish American professor who
demonstrated that young
oil supplement is useful if your child won’t eat children are uniquely able to
match their calorie intakes
oily fish. As children’s diets can influence future to requirements.
food preferences, and teeth are susceptible
to decay, sugary foods and drinks should be
limited. Salt should not be added to babies’ and 30-SECOND TEXT
Carrie Ruxton
toddlers’ meals as their underdeveloped kidneys
cannot process the extra sodium. Fresh fruit and
vegetables can be
introduced when a baby
76 g A Lifetime of Nutrition starts weaning.

ADOLESCENTS
Adolescence is the period of
growth and development that occurs during
the ages of 10 to 19. This period is characterized
3-SECOND BITE by physical changes, known as puberty, as well RELATED TOPICS
Adolescence is a period as social and emotional changes. The most See also
of significant growth and MINERALS
common and visible changes of puberty are
change in which good page 24
nutrition can play a key
related to sexual maturation, which begins
role in overall health. between ages 9 and 13 in girls and 11-and-a-half page 86
and 12 years in boys. Both genders will also
VITAMIN D & CALCIUM
experience significant growth in height and page 126
3-MINUTE SNACK
Appropriate parental
bone mass during this time period. Due to all
involvement in healthy these changes in a child’s physical appearance,
eating is vital during a greater self-awareness is often developed, 3-SECOND BIOGRAPHY
G STANLEY HALL
adolescence. It’s important and the child may be self-conscious for the 1846–1924
to provide opportunities
where teens can make their
first time. Relationships are also shifting as American psychologist
and educator who was the
own eating choices, but greater significance is placed on a child’s originator of the study of
adolescence with his seminal
also foster a positive, social relationships and less on their family work Adolescence, published
supportive environment in 1904.
relationships. An adolescent might also want
around healthy foods
such as fresh produce, to exert more independence in making their own
high-fibre foods and food choices. This presents a potential risk for 30-SECOND TEXT
proteins. Teens should choosing too many sugary and fat-dense foods Jenna Braddock
be encouraged to drink
water rather than
while not eating enough fresh produce and
sweetened beverages, high-fibre foods. The prevalence of adolescents
as well as to take regular being overweight or obese has significantly
physical activity. increased in recent years and these factors
are one of the underlying reasons. Other
nutrition-related concerns include adequate Adolescence is an
iron, vitamin D and calcium. important life stage for
kids to begin healthy
habits that will serve
them well the rest of
78 g A Lifetime of Nutrition their life.

PREGNANCY
& LACTATION
During pregnancy, maternal
physiology undergoes dramatic changes to
support the developing foetus. Changes include
3-SECOND BITE increases in blood volume and the size and RELATED TOPICS
Eating for two? Optimal function of major organs (heart, kidneys, See also
nutrition during pregnancy FAT-SOLUBLE VITAMINS
pituitary, thyroid, mammaries and uterus).
needs to support the page 26
maternal physiological
Maternal nutrient intake needs to support
WATER-SOLUBLE VITAMINS
changes required to ensure these changes as well as the developing child. page 28
successful pregnancy, Surprisingly, the additional energy requirements
foetal development BABIES, INFANTS & CHILDREN
(above those for a non-pregnant woman) are page 76
and lactation.
not substantial, estimated at about a further
10% during the last three months of pregnancy.
3-MINUTE SNACK Excessive calories before and during pregnancy 3-SECOND BIOGRAPHY
Nutritional support of DAVID BARKER
are associated with adverse outcomes for both 1938–2013
pregnancy is not just a
nine-month concern.
mother and baby and are a major concern for British Professor who first
proposed the theory of
It benefits the mother many populations. An appropriate supply of ‘Developmental Origins of
Health and Disease’ or ‘foetal
and ensures a healthier micronutrients is important for successful programming’, suggesting that
neonate, but has the early life environment of
pregnancy and lactation. During pregnancy, the foetus influenced lifelong
implications far beyond
this. David Barker first the tissue development of mother and baby patterns of health and disease.
published the idea requires a range of micronutrients, including

that influences on early those involved in cell, red blood cell and DNA
life development had 30-SECOND TEXT
lifelong consequences for
synthesis, such as folate and iron. The multiple Philip C Calder &
roles of micronutrients in the developing Elizabeth A Miles
offspring. He showed that
having a low birth weight foetus are complex, and an adequate supply
led to greater risk of dying during – and for some nutrients (such as folate)
from coronary heart
disease before the age
before – pregnancy is important. Micronutrient
of 65 years. requirements are partly dependent on the Optimal nutrient status
population and setting, which determine is key to maintaining
the maternal status. maternal health and
providing short- and
long-term health to
80 g A Lifetime of Nutrition the child.

POSTMENOPAUSAL
WOMEN
A postmenopausal woman has
ended her reproductive years, which is usually
in her late 40s or early 50s. This ageing process
3-SECOND BITE occurs as the ovaries no longer produce RELATED TOPICS
Postmenopausal women sufficient levels of oestrogen and progesterone, See also
suffer from a decrease FRUIT & VEGETABLES
causing the ovaries to stop releasing eggs.
in oestrogen production, page 54
affecting mineral
During menopause, oestrogen levels decline,
DIETARY FATS &
absorption and ultimately metabolism decreases and weight gain due to HEART DISEASE
increasing risk of heart poor dietary and lifestyle choices are at their page 98
disease and osteoporosis.
peak. Common menopausal symptoms, such VITAMIN D & CALCIUM
as hot flushes, night sweats and increased page 126
3-MINUTE SNACK irritability, may fade during the postmenopausal

Women can boost their period. During post-menopause, when
diet with increased 3-SECOND BIOGRAPHIES
oestrogen levels are significantly lower, women ADOLF BUTENANDT &
consumption of healthy
foods, such as fruits,
have an increased risk of heart disease and EDWARD ADELBERT DOISY
1903–95 & 1893–1986
vegetables, legumes, osteoporosis. Heart disease is one of the German and American
whole grains and nuts, leading causes of death in postmenopausal biochemists (respectively) who
both independently discovered
to decrease risk of heart
women due to increased body fat accumulation, oestrogen; however, only
disease and osteoporosis. Butenandt was awarded a
Adding daily physical the ageing process and changes in glucose Nobel Prize in Chemistry.
activity can also help to metabolism. Consuming a heart-healthy diet
increase heart and bone which is rich in fruits, vegetables, legumes,
strength. Including both 30-SECOND TEXT
aerobic exercises (walking,
whole grains and nuts may result in positive Kristen Hicks-Roof
running, cycling) and benefits. Osteoporosis may also occur as a
strength training result of reduced calcium, vitamin D and protein
exercises (lifting weights, intake, along with low levels of physical activity.
body weight exercises) can
contribute to an overall
To strengthen bones, it is important to consume
healthy lifestyle. calcium and vitamin D. Rich sources of vitamin D
include fatty fish and egg yolks; rich sources of Balanced nutrition
calcium include dairy and kale. and daily exercise are
vital components of
a comprehensive
82 g A Lifetime of Nutrition health programme.

THE ELDERLY
Ageing brings changes that
impact on dietary needs as well as health.
Muscle mass is harder to build and maintain,
3-SECOND BITE leading to the wasting condition sarcopenia. RELATED TOPICS
Healthier ageing can Nutrient absorption is reduced, especially See also
be achieved by choosing PROTEIN
for vitamin B12, folic acid, calcium, zinc and
nutrient-rich, high-fibre page 16
foods and eating
magnesium. Skin synthesis of vitamin D in
FIBRE
protein-containing foods response to sunlight also tails off. Another page 20
two to three times a day. important change is to gut bacteria: in young
OMGEA-3 FATTY ACIDS
people, these are diverse and skewed towards page 122
3-MINUTE SNACK
‘friendly’ species such as bifidobacteria; in
An ageing population, the elderly, both diversity and friendly species
coupled with unhealthy reduce, creating ideal conditions for pathogens. 3-SECOND BIOGRAPHIES
WILLIAM BOSWORTH CASTLE
Western diets and To keep healthy, elderly people should aim for 1897–1990
lifestyles, means that the
average person will spend
a high-protein, high-fibre diet that includes American physician who
discovered the gastric intrinsic
around a fifth of their nutrient-rich lean meat, poultry, eggs, oily fish factor, the absence of which
causes pernicious anaemia,
lifetime in poor health. and nuts, as well as fruit and vegetables, which particularly in the elderly.
A better quality of life in
are high in antioxidants such as vitamin A and C. MARTHA CLARE MORRIS
old age requires a shift
from low-fibre, high Portions can be small and frequent to overcome 1955–
American epidemiologist who
saturated-fat diets packed reduced appetite. Soft foods are useful where developed important research
with processed foods dental problems exist. Supplements of calcium linking oily fish consumption
towards nutrient-rich, to reduced dementia risk.
high-fibre diets, making
and vitamin D have been shown to help maintain
every calorie count. bone density and prevent falls, probably
through improved muscle function, while 30-SECOND TEXT
Carrie Ruxton
omega-3 fatty acids (from oily fish or fish oil
supplements) have been linked to a reduced
risk of dementia-type conditions. Additional
B vitamins may help to slow cognitive decline. Studies show that diet
can help to slow the
impact of ageing,
leading to a better
84 g A Lifetime of Nutrition quality of life.

OVERWEIGHT
& OBESITY
The World Health Organization
reports a ‘double burden’ across the world
where 1.9 billion adults are overweight or obese
3-SECOND BITE versus the 600 million who are starving. RELATED TOPICS
Despite overweightedness Overweightedness in children is rising 30% See also
affecting most adults and FATS
faster in developing countries, in line with
around a third of children, page 22
leading to increased risk
increasing affluence and adoption of Western
METABOLISM
of ill health, prevention dietary patterns. Overweight is defined clinically page 38
and treatment strategies as a body mass index over 25; obesity is a body
have remained largely REFINING
mass index over 30. In children, age-related page 136
ineffective.
weight for height is used. The physiological
causes of obesity are simple: an excess of
3-MINUTE SNACK dietary energy (calories) in relation to energy 3-SECOND BIOGRAPHIES
ADOLPHE QUETELET
Obesity has now expended. However, the societal and 1796–1874
become the norm in many
populations where 24/7
behavioural drivers are more complex and Belgian mathematician who
devised a way of expressing
access to affordable, include cheap, abundant energy-dense foods, weight for height in adults:
weight (kg) divided by height
palatable foods is seen marketing and low physical activity levels as (m²) – the Body Mass Index.
as a right, thanks to
a consequence of changes to work, travel, JOHN GARROW
persuasive advertising.
This presents an issue entertainment and domestic life. This means 1929–2006
Scottish-born nutritionist
for health legislators, as that obesity is difficult to prevent and treat. who was one of the first to
policies to restrict eating Obesity impacts adversely on disease risk see the approaching epidemic
habits and promote of obesity and tried to find
physical activity are often
(especially type 2 diabetes, cancer and solutions through meticulous
human research.
viewed as bossy and cardiovascular disease) and may reduce well-
intrusive. Yet there does being, increasing risk of depression and lower
remain a hankering after self-esteem. Efforts to reduce obesity have 30-SECOND TEXT
the unattainable thinness Carrie Ruxton
of celebrities and the
included population policies, such as limiting the
pursuance of faddy diets promotion of certain foods or applying sugar
that don’t work in the taxes, as well as individual actions, such as
long term.
professional advice, drugs or bariatric surgery. While the prevalence
has begun to slow, no
country has managed
86 g A Lifetime of Nutrition to reverse obesity.

MALNUTRITION
Malnutrition occurs when a
person doesn’t eat enough, through illness, or
when there is insufficient amounts or quality of
3-SECOND BITE food resulting in insufficient essential nutrients. RELATED TOPICS
Malnutrition usually The consequence is weight loss or reduced See also
implies inadequate DIETARY ASSESSMENT
growth of children. Symptoms include a lack of
amounts and poor quality page 48
food, resulting in weight
interest in eating and drinking, chronic fatigue
BABIES, INFANTS & CHILDREN
loss or poor childhood and a diminished immune system that increases page 76
growth, but it can include the likelihood of illness and slows recovery.
the wrong sort of food, OVERWEIGHT & OBESITY
Stunted childhood growth is the most common page 86
resulting in obesity.
outcome, resulting from multiple nutritional
deficiencies, especially protein, zinc, iodine
3-MINUTE SNACK and milk, which each influence height growth, 3-SECOND BIOGRAPHIES
JOHN WATERLOW
Malnutrition in adults is and an insanitary environment, with a lack of 1916–2010
identified by weight loss,
starting with a body mass
clean water and soap. Kwashiorkor – severe British scientist who identified
fatty liver disease in the
index of under 18.5 kg/m², malnutrition with oedema and often with fatty Caribbean and Africa, and
became a respected authority
which is associated with liver and skin changes – most likely reflects on childhood malnutrition.
increased risk of morbidity
tissue and organ damage caused by infections, ANN ASHWORTH
and mortality. This could
result from illness, so it or dietary toxins and a lack of protective 1939–
British nutritionist largely
is common in hospital micronutrients, minerals and essential fatty responsible for the
patients. For children, acids. It is often fatal without careful management regime for
growth failure or weight severely malnourished children
loss is assessed as a low
management, which involves antibiotics and WHO’s ‘10 steps’ approach
for inpatient treatment.
weight for age, either and cautious feeding with a low-protein feed,
through a low weight electrolytes and multivitamins. Public health
for height (wasting) or programmes focus on clean water and 30-SECOND TEXT
a low height for age D Joe Millward
(stunting). The latter
micronutrient supplementation. Obesity is a
condition is the most type of malnutrition in which overconsumption
prevalent, with about of energy-rich sugary or fatty foods accompany
25% of pre-school
an inactive lifestyle. The Malnutrition Task
children stunted globally.
Force works to prevent
and treat malnutrition
88 g A Lifetime of Nutrition in the developing world.

23 September 1880 1914–18 1940
Born in Kilmaurs, Serves as a medical Appointed an architect
Scotland, UK officer at the battles of national wartime food
of Somme, Ypres and policy development by
Passchendaele, where he Winston Churchill
1902–12 also improves the troops’
Gains degrees in Arts diet with local vegetables
(1902), Biological Science 1941
(1910) and Medicine (1912) Elected first President of
from Glasgow University 1919 UK Nutrition Society
Returns to the Institute,
which is renamed the
1914 Rowett Research Institute 1945
Appointed first Director in 1922 Appointed as the first
of Nutrition Research Director General of the
Institute in Aberdeen United Nations’ Food and
1932 Agriculture Organization
Elected Fellow of the
Royal Society for his
research on animal and 1948
human nutrition and Made Baron of Brechin
agriculture
1949
Awarded the Nobel
Peace Prize
1968
Made Companion
of Honour
25 June 1971
Dies in Edzell, Scotland
90 g A Lifetime of Nutrition

JOHN BOYD ORR
Nobel Laureate Baron John Boyd for a World Food Plan based on human needs
Orr, described by some as the ‘Scotsman of the and its publication of the first set of Human
twentieth century’, was a prodigiously gifted Nutritional Requirements.
scientist, administrator, champion of the poor During World War II, Orr advocated a wartime
and spellbinding broadcaster. diet based on government subsidies for
From a religious upbringing in Scotland, Orr essential foods, which eventually became
won a rare bursary to Kilmarnock Academy, government rationing policy for certain foods,
and went on to teach, learn book-keeping including bacon, butter and sugar, but not
and accountancy, and study and practise others such as bread, potatoes, vegetables,
medicine, before accepting a pivotal two-year fruit and fish; the use of 85% rather than 70%
research scholarship, which included work on extraction flour in bread making; and the
malnutrition and the energy expenditure of eventual provision of free cod liver oil, milk
military recruits in training. During World War 1, and orange juice to all pre-school children.
Orr developed his interest in military nutritional These wartime policies resulted in a US prize
and medical welfare, serving with the Infantry to the British Ministries of Food and Health,
and Navy. On return from the War, Orr which named Boyd Orr amongst those involved.
consolidated his work on the founding of the When the United Nations’ Food and Agriculture
Rowett Research Institute. Organization (FAO) was formed in 1945, Orr
Orr’s research was almost certainly was invited to be its first Director General,
responsible for the improved iodine status of even though he had just been elected as an
the UK population through his recognition of its MP and rector of Glasgow University. He
need in dairy cattle feed, which resulted in its took the post for two years and, although
presence in milk, which was eventually provided unsuccessful in organizing the means for
free or subsidized to school-children after the FAO to eliminate hunger and malnutrition,
Milk Marketing Board was established in 1933. he did set in place a strong international
Because of his writing and broadcasting on the organization. He retired from FAO in 1948, to
need for a national food policy, given that a assume the role of Chancellor of the University
third of the population were too poor to buy of Glasgow, to write and to travel the world
sufficient food, he became involved with the lecturing about food, agriculture, world unity
considerations of the League of Nations and peace.
D Joe Millward
John Boyd Orr g 91

CHANGING
EATING HABITS
As far as healthy food choices
are concerned, we largely know the drill: eat
more fish, fruit and vegetables, and less highly
3-SECOND BITE refined and processed foods. However, eating RELATED TOPICS
Developing new healthy habits are considered to play a key part in our See also
eating habits begins with PERSONALIZED VERSUS
food choices. The term ‘habit’ can be defined as
an effortful new eating PUBLIC HEALTH ADVICE
behaviour and gradually
an automatic behaviour, learned and repeated page 46
becomes effortless and over and over again. If you instinctively grab a DIETARY ASSESSMENT
automatic over time. banana to eat first thing each morning in the page 48
kitchen, you have a habit. So, how can we form
3-MINUTE SNACK
new healthy eating habits? Research tells us
Questions remain about that it’s a three-step process. Firstly, there is WILLIAM JAMES
the time it takes for people deliberate repetition of the new behaviour. 1842–1910
to take up and form new American philosopher and
Then there is a cue to trigger practising the new psychologist who is credited
eating habits. Research
shows that between 18 and
behaviour. A cue can include recurring places, with influencing current ideas
of habit in neuroscience.
254 days is the most likely times or people. Lastly, there is rewarding of
ANTHONY DICKINSON
time for people to form a the new eating behaviour. An example of this 1939–
new habit. This variation
three-step process might be: 1. A commitment British neuroscientist who has
depends on the person, the increased our understanding
behaviour and the given to begin eating porridge every morning of the difference between
habitual and goal-directed
situation. How long it (repetition); 2. Leaving your bowl and spoon out behaviour.
takes to form eating habits, in the kitchen the night before (cue); 3. Noting
therefore, appears to be an
individual matter.
down the energy and alertness that comes
30-SECOND TEXT
from eating porridge in the morning (reward).
Brian Power
Applying this three-step process increases the
likelihood that the new behaviour will become a
healthy eating habit. The new eating behaviour
also needs to be planned, relevant to an
individual’s personal circumstances and easy to Changing eating habits
perform, so that it can be practised repeatedly. takes time; persistence
is key, as is focusing on
the bigger picture of
92 g A Lifetime of Nutrition overall health.

g
FOODS & DISEASE RISK

FOODS & DISEASE RISK
GLOSSARY
acetaldehyde Toxic waste product of alcohol coronary heart disease (CHD) When the
that is a contributing cause of a hangover heart’s blood supply is blocked or interrupted
following alcohol consumption. by a build-up of fatty substances in the
coronary arteries. Symptoms include angina
anaphylaxis (anaphylactic shock) Severe and and heart attack.
potentially life-threatening allergic reaction
(see food allergies). coronary thrombosis Formation of a blood
clot inside a blood vessel of the heart, which
blood cholesterol Amount of cholesterol restricts blood flow. One of the causes of a
transported in the blood by different heart attack.
lipoproteins. Low density lipoprotein
cholesterol (LDL-C) is known as ‘bad ethanol The bulk of ethanol in the body is
cholesterol’ because it can contribute to broken down in the liver by an enzyme called
the blockage of arteries. ‘alcohol dehydrogenase’.
cardiovascular epidemiology The study of food allergies Involve an immune response

how often diseases of the cardiovascular to food and can be severe (anaphylaxis) and
system occur in populations and why. sometimes fatal. Common foods causing
allergy include cows’ milk, hens’ eggs, fish,
coeliac disease Specialized food allergy shellfish, nuts, peanuts, wheat and soy.
involving an immune response to gluten Symptoms can include vomiting, diarrhoea,
(found in wheat, barley, rye). The body’s rashes, breathing problems, faintness and
response damages the small intestine, causing loss of consciousness.
gastrointestinal symptoms and malabsorption
of nutrients. food intolerances Disorders of digestion;
an inability to break down or take up the food
congeners Substances other than ethanol in the normal way. Occur as a response to
produced during fermentation. Responsible common foods and are not life-threatening.
for some of the taste, aroma and colour of
alcoholic drinks. Associated with contributing fructose Fruit sugar; a simple sugar naturally
to hangovers; the greatest amounts of these occurring in fruit, honey, sucrose and
toxins are found in red wine and dark liquors. high-fructose corn syrup. Very sweet.
96 g Foods & Disease Risk

glucose A simple one-unit sugar, which is an polyphenols Abundant micronutrients found
important source of energy used by the body. in fruits, vegetables and nuts; evidence for
‘Blood sugar’ refers to the amount of glucose their role in the prevention of degenerative
in the blood. diseases such as cancer and cardiovascular
diseases is emerging.
hypertensive Having high blood pressure;
rarely has noticeable symptoms. If untreated, polyunsaturated fat Dietary fats in which the
it increases risk of serious problems such as constituent hydrocarbon chain consists of
heart attacks and strokes. two or more carbon-carbon double bonds.
Referred to as ‘good fats’ because they can
lactose Sugar found in milk. Broken down help lower LDL-cholesterol. Found in nuts,
into two parts by an enzyme called ‘lactase’. seeds and oily fish.
maltose Made out of two glucose molecules saturated fat Dietary fats in which the
bound together, it’s created in seeds and constituent hydrocarbon chain consists of
other parts of plants. Cereals, certain fruits single carbon–carbon bonds. Referred to as
and sweet potatoes contain high amounts. ‘bad fats’ as high intakes are linked to raised
LDL-cholesterol and risk of heart disease.
monounsaturated fat Dietary fats in which
the constituent hydrocarbon chain consists sodium nitrite Common additive to red meat,
of one carbon–carbon double bond. Often due to: inhibiting growth of disease-causing
referred to as ‘good fats’, along with micro-organisms; providing taste and colour;
polyunsaturated fats, because when and helping to prevent rancidity.
substituted for dietary saturated fats they
can help lower LDL-cholesterol. Found in starch Most abundant carbohydrate in the
avocados, olives, rapeseed oil and some nuts. human diet. Starchy foods include bread,
pasta, rice, couscous, potatoes, cereals, oats
normotensive Having normal blood pressure. and other grains like rye and barley.
phenylketonuria Results from the inability sucrose Most common dietary disaccharide,
to break down the amino acid phenylalanine containing one glucose and one fructose
(found in many dietary protein sources). sugar molecule. From sugar cane or beet.
Glossary g 97

DIETARY FATS &
HEART DISEASE
Saturated fats have been
implicated as one of the main dietary
contributors to heart disease. These fats do
3-SECOND BITE not block our arteries directly, but can raise the RELATED TOPICS
Reduction of dietary concentration of blood cholesterol, which can See also
saturated fats can help to FATS
form deposits inside arteries called ‘plaques’.
reduce heart disease, with page 22
greater effects if replaced
The plaques can then become unstable and
MILK & DAIRY
by unsaturated fats rather rupture, causing blood clot formation and a page 58
than simple carbohydrates. heart attack or stroke. For this reason, dietary
OMEGA-3 FATTY ACIDS
guidelines limit the amount of saturated fats we page 122
3-MINUTE SNACK
should eat. However, this recommendation has
In contrast to the effects been challenged because of a possible lack of
of eating less saturated evidence for a direct relationship between 3-SECOND BIOGRAPHIES
ANCEL KEYS
fats, consuming long-chain saturated fats and heart disease mortality, and 1904–2004
omega-3 polyunsaturated
fats, chiefly from oily
the complexity of the relationship between Suggested that hard animal
fats were more important in
fish, do not lower blood saturated fats and blood cholesterol. When influencing blood cholesterol
and risk of coronary heart
cholesterol, but are known we eat less saturated fats, the effect on blood disease.
as ‘heart healthy’ fats
cholesterol and other risk factors often depends
because they confer HUGH SINCLAIR
protection against heart on what the fats are replaced with. This can 1910–90
be another type of fat (polyunsaturated or First protagonist of the idea
disease, heart attacks and that deficiency of long-chain
strokes. These effects of monounsaturated fat) or carbohydrate, which omega-3 fatty acids from
long-chain omega-3 fats marine sources were involved
have been attributed to a
will lower blood cholesterol and heart disease in coronary thrombosis.
reduced tendency of the risk, with greater benefits from unsaturated

blood to clot, improved fats. Not all foods that contain saturated fats
function of blood vessels 30-SECOND TEXT
have the same effect on blood cholesterol, Bruce A Griffin &
and stabilization of an
irregular heartbeat. including dairy foods. Compared to butter, the Julie A Lovegrove
saturated fats in cheese are absorbed in the gut

to a lesser extent, which reduces the relative Diets low in saturated
potential of cheese to raise blood cholesterol. fats are recommended
to lower blood
cholesterol and reduce
98 g Foods & Disease Risk heart disease.

FOOD ALLERGIES
& INTOLERANCES
Food allergy and intolerance
are adverse reactions to foods, which are
dependent on the person rather than the food.
3-SECOND BITE Food allergies involve an immune response RELATED TOPICS
Food allergy and food to food and can be severe (anaphylaxis) and See also
intolerance differ NUTS
sometimes fatal. Common foods causing allergy
because intolerance does page 62
not involve the immune
include cows’ milk, hens’ eggs, fish, shellfish,
GRAINS & GLUTEN
system, whereas allergy nuts, peanuts, wheat and soy. After consuming page 64
is immune-mediated and the food, symptoms can develop rapidly or
potentially life-threatening. LABELS & PACKAGING
be delayed, and include vomiting, diarrhoea, page 140
rashes, breathing problems, faintness and loss
3-MINUTE SNACK of consciousness. Coeliac disease is a specialized
The immune system food allergy involving an immune response to 3-SECOND BIOGRAPHIES
protects against harmful CHARLES ROBERT RICHET
gluten (found in wheat, barley and rye). The 1850–1935
agents but must ignore
non-harmful agents or body’s response damages the small intestine, Awarded the Nobel Prize in
Medicine 1913 in recognition
substances (such as food, causing gastrointestinal symptoms and of his work on anaphylaxis or
‘anti-protection’.
non-harmful organisms). malabsorption of nutrients. Food intolerances
When the immune system
are disorders of digestion because of an inability SIR PETER BRIAN MEDAWAR
recognizes foods, a 1950–87
tolerant response must be to break down or take up the food in the normal Jointly awarded the Nobel
Prize in Medicine in 1960 with
generated to avoid causing way. They occur as a response to common foods Sir Frank Macfarlane Burnet
unnecessary damage. Food and are not life-threatening. Lactose intolerance for the discovery of acquired
allergy is not so much the immunological tolerance.
appearance of an immune
results from the reduced ability to break down
response to a food, but milk sugar. Commonly screened for at birth,
rather the lack of either the phenylketonuria is the result of an inability 30-SECOND TEXT
generation or maintenance Philip C Calder
to break down the amino acid phenylalanine & Elizabeth A Miles
of immune tolerance.
(found in many dietary protein sources).
Management of adverse reactions to food
usually requires a physician/dietitian-guided Reduced intake may be
reduction or avoidance of the food. the best management
for intolerance; lifelong
avoidance is often
100 g Foods & Disease Risk necessary for allergies.

8 August 1910 1933 1939–45
Born in London, UK Marries Milly Serves in the Medical
Himmelweit, a recent Corps and is posted to
emigre from Berlin, with Sierra Leone where he
1929 whom he has three sons researches riboflavin
Gains a degree from (vitamin B2) deficiency
Chelsea Polytechnic in soldiers
1935
Completes a PhD
1931 in Microbiology at 1945–54
Graduates with a degree the Department of Becomes Chair of
in Physiology and Biochemistry, Cambridge Physiology at Queen
Biochemistry from Elizabeth College in
Christ’s College, London, where he
Cambridge 1934–38 develops the first
While studying for his BSc and MSc degrees
PhD, qualifies as a in Nutrition
medical doctor and
begins research at
the Dunn Nutritional 1954–71
Laboratory, Cambridge Elevated to Emeritus
Professor of Nutrition at
Queen Elizabeth College
1993
Awarded an honorary
fellowship of the Hebrew
University, Jerusalem
12 July 1995
Dies in London, just four
months after the loss of
his wife

Risks

JOHN YUDKIN
The fact that a 1970s’ book on By the mid-1950s, Yukin’s concerns switched
sugar, entitled Pure, White and Deadly, still to obesity, which was at the start of its upward
resonates today is testament to the huge trajectory, and specifically the negative effects
impact that Professor John Yudkin had on of sugar (sucrose). It was Yudkin’s view, based
the theory and practice of nutrition. on analysis of population diets and disease
Born in the East End of London to Orthodox statistics, that rising intakes of sugar and
Russian Jewish parents, Yudkin and his four processed foods were driving the higher rates
brothers had a difficult upbringing marked by of obesity, dental decay and chronic diseases
poverty. Education was a way out, and the seen in wealthier countries. This opinion
young Yudkin quickly discovered how to use was consolidated by his success in reducing
his impressive intellect to climb the academic patients’ weight using low carbohydrate diets.
ladder, first at Chelsea Polytechnic in London As expert opinion at that time blamed
and later at Cambridge University. high intakes of dietary fat for cardiovascular
A PhD and medical degree followed in the diseases, Yudkin often swam against the tide.
mid-to-late 1930s. At that time, one had to However, his popular books, This Slimming
qualify as a medical doctor in order to become a Business and Pure, White and Deadly, first
nutritionist, as there were no specific nutrition published in 1972, resonated with the public,
courses. This was to change under Yudkin’s and are still read widely today.
leadership, when he took up his Chair at Queen Although Yudkin’s research into sugar
Elizabeth College, London. was later criticized for failing to account for
First, war intervened and took Yudkin to confounding variables, such as smoking and
Sierre Leone in West Africa, where he served poverty, the central theme – that lower intakes
in the Medical Core as a pathologist. On of carbohydrates and sugars could alleviate
seeing many soldiers with skin conditions, the risk of obesity and chronic disease – has
he discovered that the cause was a deficiency been vindicated in several contemporary,
of riboflavin (vitamin B2), not infection as randomized, controlled trials. For his brave
previously believed. Returning from World stance, and for championing the embryonic
War II, Yudkin developed his research interests nutrition profession, Professor John Yudkin
in a number of directions, including enzymes, deserves our recognition.
public health nutrition, diseases of affluence,
food choice and historical aspects of diet. Carrie Ruxton
John Yudkin g 103

SALT &
BLOOD PRESSURE
Once considered more valuable
than gold, salt has become a ubiquitous food
ingredient, much maligned by the health
3-SECOND BITE establishment yet eaten daily by millions of RELATED TOPICS
Salt intakes remain higher people across the world. Common salt (sodium See also
than recommendations, COOKING, PROCESSING
chloride) is obtained by evaporating brine, either
but while salt reduction & PRESERVING
lowers blood pressure,
in pressure vessels or in salt beds – a traditional page 134
there is a lack of evidence method mostly seen in hot, dry countries. In LABELS & PACKAGING
that health improvements ancient times, salt was highly valued and even page 140
follow for all.
used as a form of currency. Now it is produced
on industrial levels, mainly in China and the US.
3-SECOND BIOGRAPHY
3-MINUTE SNACK Salt is used not just to flavour foods but also LEWIS DAHL
Governments unanimously to preserve perishable goods such as meat, fish 1914–75
recommend wholesale salt American physician who used
and vegetables. This was one of the earliest a rat model to discover that
reduction, as we only need sodium-induced hypertension
around 1 gram daily for
food safety methods and is still used widely was related to genetics as
health. However, clear today. Excess salt intake has been associated well as salt intake, and noted
that hypertension was rarely
evidence that everyone with stomach cancer and raised blood pressure, seen in populations with low
would benefit is lacking, salt intake.
a risk factor for heart disease and stroke.
and there is a worrying
trend towards higher Controlled trials suggest that a fall in salt intake
cholesterol and to 5–6 grammes daily (typical intakes are around 30-SECOND TEXT
triacylglycerol levels on 8 grammes) significantly lowers systolic blood Carrie Ruxton
lower salt diets. More
consistent effects have
pressure. However, lower sodium intakes do
been seen for interventions not consistently translate into reduced mortality
such as the Dietary or cardiovascular problems. Black, Asian and
Approaches to Stop hypertensive people seem to benefit more from
Hypertension (DASH) diet,
which combine reduced
salt reduction than white normotensive people,
salt with healthy foods, in terms of blood pressure. It may be that
such as fish, nuts and some people are genetically responsive to salt It takes around three
plant foods.
reduction, while others are not. weeks for your taste
buds to become
accustomed to reduced
104 g Foods & Disease Risk amounts of salt.

SUGARS &
SUGAR SUBSTITUTES
Sweet foods and drinks are
perceived as pleasant and highly desirable
by the majority of people. In evolutionary
3-SECOND BITE terms, this preference was a survival benefit, RELATED TOPICS
Non-nutritive sweeteners as it enabled carbohydrate-rich foods, such See also
and bulk sugar substitutes CARBOHYDRATES
as fruit, to be identified and consumed,
could be of benefit in page 18
reducing the intake of
providing a metabolic substrate for the brain.
sugars and the risk of Unfortunately, the desirability of sweet foods page 86
tooth decay and energy can lead to overconsumption of sugars (glucose,
overconsumption. REFINING
fructose, sucrose, maltose) in food and drinks, page 136
which in turn can increase the risk of tooth
3-MINUTE SNACK decay, unintentional overconsumption of energy
Sugars intake should be and weight gain. While carbohydrate intake is 3-SECOND BIOGRAPHY
reduced to decrease the CONSTANTIN FAHLBERG
an essential component of the diet, there is no 1850–1910
risk of tooth decay and
cavities and of passive dietary requirement for sugars, as all of the German–American chemist who
discovered the first sweetener,
overconsumption of glucose needed by the brain and other tissues saccharin, after accidentally
tasting on his hands a food
energy. The sweetness can come from starch. Reducing the sucrose preservative compound he had
provided by sugars could just synthesized.
or high-fructose corn syrup content of the diet
be replaced by low-calorie
sweeteners, but there are is challenging if sweet foods and drinks, or
some concerns that this products such as cakes and biscuits (in which 30-SECOND TEXT
might perpetuate a desire sucrose has a functional role), are consumed, Ian Macdonald
for sweet foods and lead to
continued excessive energy
and so sugar substitutes have to be considered.
intakes. Concerns have The replacement of sweetness can be achieved
been expressed about with non-nutritive sweeteners, and reports
the safety of sweeteners, have shown the safety of these compounds.
but expert reports and
research do not support Replacing the bulk function has not yet been
the concerns. achieved satisfactorily. The removal from the
diet of unnecessary
sugars found in sweet
foods clearly presents
a challenge.

ALCOHOL
Whether or not to drink alcohol,
especially for ‘health purposes’, needs careful
balancing of the potential benefits with the
3-SECOND BITE potential harms. It appears that the difference RELATED TOPICS
Drinking no more than 14 in health effects lies largely in the dose and See also
units a week spread out PERSONALIZED VERSUS
patterns of drinking – how much you drink
over at least three days and PUBLIC HEALTH ADVICE
with meals may strike the
matters more than what you drink. Drinking page 46
right cancer/heart disease alcohol in moderation (half a standard glass DIETARY FATS &
balance in men and women. of wine a day) can generally be beneficial for HEART DISEASE
long-term heart health. On the other hand, page 98
3-MINUTE SNACK
when it comes to cancer risk, generally the more
Selling alcohol at a alcohol consumed, the higher the long-term risk 3-SECOND BIOGRAPHIES
minimum price or above it, (particularly breast cancer in women). Whether RHAZES
also known as ‘minimum 864–930 ce
it’s a sip of spirits, wine, liquor or beer, alcohol’s Pioneering doctor, author
unit alcohol pricing’, may
produce a variety of health
active ingredient is the same: ethanol. Alcohol and philosopher from Iran;
the first to adopt the use of
and safety benefits. The contains other substances, such as polyphenols alcohol for medical purposes.
basic idea is that minimum and congeners, but it’s the dose of ethanol that SERGE RENAUD
unit alcohol pricing can
plays the most important role in health effects. 1927–2012
reduce heavy drinking and French researcher who studied
the associated heart health The bulk of ethanol in the body is broken the role of alcohol in coronary
and cancer problems. down in the liver by an enzyme called ‘alcohol heart disease; close connection
to the French Paradox theory.
This can be achieved by dehydrogenase’. Excessive alcohol intake can
supermarkets targeting
cheap, high-strength
overwhelm the liver and inflict permanent and
tipple consumed by the serious damage, notably liver cirrhosis (scarring) 30-SECOND TEXT
Brian Power
highest-risk drinkers. and cancer. This is due in part, to a build-up
of toxic waste products such as acetaldehyde,
a contributing cause of hangover following
alcohol consumption. Fermentation causes
the chemical and
sensory properties
of wine to change, with
preservations of aroma
108 g Foods & Disease Risk and flavour.

RED &
PROCESSED MEAT
Red meat includes beef, lamb,
pork and venison, and is usually a good source
of important nutrients such as high-quality
3-SECOND BITE protein, iron, zinc and a number of B vitamins. RELATED TOPICS
Whilst red meat can be It is, however, very variable, notably in fat See also
nutritious, it should be DIETARY FATS &
content, which will depend on, for example, the
consumed in moderation; HEART DISEASE
a diet with little processed
source of the meat, the particular cut and the page 98
meat is even more age of the animal. Processed meat is an even NITRATE & NITRITE
important. more variable commodity as it is meat that has page 118
been transformed through a wide range of FREE-RANGE & INTENSIVELY
3-MINUTE SNACK
processes, and includes sausages, ham, bacon FARMED FOODS
page 144
Processing of meat has a and corned beef. Most processed meat contains
long history, with evidence beef or pork but can include other meats.
of salting and sun-drying There has been much publicity suggesting that 3-SECOND BIOGRAPHIES
in Ancient Egypt and
preservation using snow
consumption of red and processed meat can NICOLAS APPERT
1749–1841
and ice by early Romans. increase the risk of coronary heart disease, French inventor of airtight
Nowadays processing is type 2 diabetes and cancer of the large intestine food preservation who has
usually to preserve the been described as the ‘father
and rectum. The hard evidence is clear: the risk of canning’.
meat or change its taste
by methods including of these diseases from the consumption of CLARENCE BIRDSEYE II
salting, fermentation, processed meat is substantially greater than 1886–1956
smoking or the addition American inventor regarded
from red meat. For example, the risk of as the founder of food
of sodium nitrite. preservation by freezing,
intestinal cancer from processed meat is about especially fast freezing.
twice of that from red meat. It is, therefore,
important to maintain a low consumption of
processed meat. 30-SECOND TEXT
Ian Givens
WHO now labels

processed meats as
‘carcinogenic to humans’
and red meat as
110 g Foods & Disease Risk 'probably carcinogenic’.

g
POTENTIAL BIOACTIVES & HEALTH

POTENTIAL BIOACTIVES & HEALTH
GLOSSARY
alpha-linolenic acid Essential fatty acid fatty acids (FAs) The building blocks of fat
found in nuts and seeds; ; a metabolic in the body and in food. During digestion, the
precursor of long chain omega-3 fatty body breaks down fats into FAs, which can
acids, particularly eicosapentaenoic acid then be absorbed into the blood.
(EPA) and docosahexaenoic acid (DHA).
flavonoids Common chemical compounds
Alzheimer’s disease See dementia. that are present in many plant-based foods
and drinks, such as blueberries, tea, citrus
amines Derivatives of ammonia; released fruits, wine, onions and chocolate.
by the breakdown of amino acids. Many
neurotransmitters are amines, including glucosinolates Main phytochemical found
dopamine, serotonin and histamine. Can in cruciferous crops. Epidemiological and
be found in cheese, wine and chocolate. experimental data suggests they may act
as anti-carcinogenic agents.
atherosclerosis Build-up of material,
including cholesterol, inside arteries; hypertension High blood pressure; rarely
causes narrowing of the arteries, which, has noticeable symptoms. If untreated, it
when blocked by a blood clot (thrombus), increases risk of heart attacks and strokes.
causes heart attacks and strokes. Can be decreased by reducing salt, cutting
back on alcohol, losing weight and exercising.
bifidobacteria Major type of bacteria that
make up the gut microbiome. Some are isoflavones Class of flavonoids, which are
used as probiotics. Found in foods such as produced only by members of the bean family
live-culture yoghurt. of plants (Fabaceae).
dementia Syndrome associated with isothiocyanates Produced by Brassicales

an ongoing decline of brain functioning. plants to defend against pests and diseases.
Affects memory, thinking speed, language, When these plants are eaten, an enzyme
understanding, judgement, mood and converts glucosinolate molecules in the
movement. Alzheimer’s disease is the most plant tissues into isothiocyanates, creating
common cause. distinctive aromas and flavours. May be
effective against types of cancer.
114 g Potential Bioactives & Health

lactobacilli ‘Friendly’ bacteria that live in diseases such as cancer and cardiovascular
the digestive, urinary and genital systems diseases is emerging. Flavonoids and
without causing disease; associated with isoflavones belong to this compound class.
beneficial health effects. Also found in
some fermented foods like yoghurt and polyunsaturated fats Dietary fats in which
in dietary supplements. the constituent hydrocarbon chain consists
of two or more carbon-carbon double bonds.
microbiota Billions of bacteria living in Referred to as ‘good fats’ because they can
the large intestine. The bacteria live in a help lower LDL-cholesterol.
symbiotic relationship with their human
hosts, influencing a wide range of bodily prebiotics Indigestible components of food
processes – positively and negatively. that are able to reach the large intestine,
to feed beneficial bacteria and promote its
neurodegenerative Range of conditions growth and function.
which primarily affect the neurons in the
human brain. Diseases include Parkinson’s, probiotics Micro-organisms claimed to
Alzheimer’s and Huntington’s. provide health benefits (especially gut-related)
when consumed. Added to yoghurts or taken
nitric oxide Gas naturally produced in the as supplements; ‘good’ or ‘friendly’ bacteria.
body; used to communicate between cells;
cardio-protective. rickets Children’s skeletal disorder leading to
softening of the bones; caused by a lack of
osteomalacia Rickets in adults. vitamin D or calcium.
osteoporosis Bone-weakening condition sulforaphane Isothiocyanate found in

that develops over years until a fall broccoli and rocket; may be associated with
or impact causes a bone fracture. lower risk of prostrate cancer.
Postmenopausal women are at risk.
type 1 diabetes Failure of the pancreas to
polyphenols Abundant substances found produce insulin, which results in glucose
in fruits, vegetables and nuts; evidence for remaining in the blood rather than being
their role in the prevention of degenerative taken up by cells and used as fuel for energy.
Glossary g 115

FLAVONOIDS &
ISOFLAVONES
Flavonoids and isoflavones are
compounds produced by plants and fungi,
which can act as colour pigments in flowers, a
3-SECOND BITE defence against high UV light and as a chemical RELATED TOPICS
Flavonoids and defence against some plant diseases. Flavonoids See also
isoflavones are common GUT MICROBIOME
are present in many of the fruits and vegetables
chemical compounds that page 40
are present in many of
that we eat and drink, such as blueberries, green
FRUIT & VEGETABLES
the plant-based foods and black tea, citrus fruits, wine, onions and page 54
and drinks we consume cocoa. There is some evidence to suggest that
every day. POSTMENOPAUSAL WOMEN
consuming these compounds and their page 82
metabolites reduces the risk of developing
3-MINUTE SNACK conditions such as atherosclerosis, reduces
Flavonoids and blood pressure and improves vascular function. 3-SECOND BIOGRAPHIES
JUNJI TERAO
isoflavones belong to a Relatively recent research has shown that 1951–
class of compounds called
‘polyphenols’. This group
specific compounds may reduce cognitive World leader in the metabolic
effects of flavonoids and
also contains anthocyanins decline, which is linked with improvements isoflavones.
(present in grapes and red in vascular health, increased blood flow and JEREMY SPENCER
wine), catechins (found 1971–
maintaining synaptic connections in the brain.
in cocoa) and phenolic Leading researcher in the
acids (found in anything Isoflavones are similar to flavonoids, but are effects of polyphenols
on cognition.
from artichokes to wine). produced only by members of the bean family
These compounds are also of plants (Fabaceae) – soy, green beans and
thought to impart health
benefits in humans, though
peanuts. The health benefits of isoflavones 30-SECOND TEXT
the exact mechanisms by are not as well studied as flavonoids, but Luke Bell
which this happens are there are clinical indications that consumption
not always apparent. Gut decreases cancer risk in postmenopausal
microbial populations may
play an important role.
women and reduces some risk factors of
cardiovascular disease.
Isoflavones are present

in processed foods such
as tofu and miso soup
116 g Potential Bioactives & Health in high concentrations.

NITRATE & NITRITE
Nitrate was previously thought
to be an inert end product of body metabolism.
However, research over the last decade or so
3-SECOND BITE has revealed nitrate and nitrite to be important RELATED TOPICS
Vegetables rich in nitrate molecules for production of cardio-protective See also
have been shown to lower FRUIT & VEGETABLES
nitric oxide. Nitrate is found naturally in
blood pressure and improve page 54
exercise performance via
vegetables, particularly green leafy varieties
RED & PROCESSED MEAT
conversion to nitrite and and beetroot. Studies have shown that the page 110
the cardio-protective nitric consumption of dietary nitrate dramatically
oxide in blood vessels.
lowers blood pressure as well as improving
physical performance. These effects are 3-SECOND BIOGRAPHIES
ROBERT F FURCHGOTT &
3-MINUTE SNACK mediated by the conversion of nitrate to LOUIS J IGNARRO
Nitrate and nitrite are now nitrite by bacteria in the mouth, followed by 1916–2009 & 1941–
considered an important American biochemists who
conversion to nitric oxide in blood vessels. This discovered the role of nitric
alternative source of nitric oxide as an important
oxide in humans, rather causes the vessels to relax and dilate, increasing signalling molecule in the
than inert by-products blood flow and lowering blood pressure. In cardiovascular system.
of metabolism. Research contrast, the consumption of nitrate and nitrite
shows that daily
in processed meat has been associated with an 30-SECOND TEXT
consumption of nitrate-rich
beetroot juice lowers blood increased risk of colon cancer. Nitrate and nitrite Ditte Hobbs
pressure in people with are often added to processed meat to prevent
high blood pressure microbial spoilage and to preserve its red colour.
(hypertension), suggesting
a promising role for dietary
Yet, under the acidic environment of the
nitrate as a cost-effective stomach, nitrite may react with compounds
strategy for management called ‘amines’, found in meat to produce
of hypertension. nitrosamines – known carcinogens. However,
vegetables have low levels of amines, and
contain vitamin C and polyphenolic compounds Beetroot juice has
that favour the production of nitric oxide and been used to increase
reduce the formation of nitrosamines. performance in elite
athletes, as well as
helping the body cope
118 g Potential Bioactives & Health with high altitudes.

ISOTHIOCYANATES
Brassicales plants produce
isothiocyanates to defend themselves
against pests and diseases. They are the
3-SECOND BITE reason why cabbage smells sulfurous, why RELATED TOPICS
Isothiocyanates are mustard is hot and why you may hate the See also
important dietary NUTRIENT–GENE
taste of Brussels sprouts at Christmas. When
components for the INTERACTIONS
reduction in risk of certain
these plants are eaten, an enzyme converts page 42
chronic diseases and are glucosinolate molecules in the plant tissues into FRUIT & VEGETABLES
also responsible for the isothiocyanates, creating distinctive aromas page 54
flavours of foods such
and flavours. Some isothiocyanates also
as mustard and cabbage.
happen to be effective against types of cancer.
3-SECOND BIOGRAPHY
Sulforaphane is an isothiocyanate found in RICHARD MITHEN
3-MINUTE SNACK broccoli and rocket, and can help prevent and 1960–
With an ageing population, British professor who produced
slow the progression of prostate cancer. People the world’s first ‘super
diseases such as cancer and broccoli’ that has increased
dementia are becoming
who eat a greater proportion of Brassica-type amounts of the isothiocyanate
more prevalent in society. vegetables in their diets (kale, cabbage, broccoli) sulforaphane.
Eating vegetables that are at a lower risk of developing chronic
contain isothiocyanates
diseases such as cancer, heart disease and 30-SECOND TEXT
on a regular basis may be
associated with lowering neurodegenerative conditions. Cooking by Luke Bell
the risk of developing some boiling, steaming or microwaving is very bad
cancers and forms of for the enzyme that produces isothiocyanates,
neurodegeneration.
Isothiocyanate compounds
as it breaks down at temperatures above 60°C
interact with our genes and (140°F). Stir-frying helps to maintain the health
promote metabolism of benefits, and eating raw salads with watercress
cellular waste products and rocket is a good way to include them in the
in a less harmful way,
which protects our DNA
diet, without the need for cooking.
from damage.
Research strongly
suggests that we
should develop a
healthy love for
120 g Potential Bioactives & Health Brassica vegetables.

OMEGA-3
FATTY ACIDS
Omega-3 fatty acids are a class
of polyunsaturated fats. They are rarer in most
diets than saturated, monounsaturated and
3-SECOND BITE omega-6 polyunsaturated fats. Omega-3 fatty RELATED TOPICS
Omega-3 fatty acids are acids come from plants and animals. The main See also
important for maintaining FATS
plant omega-3 fatty acid is alpha-linolenic acid.
human health. The best page 22
source of the most
This cannot be made in animals and is an
FISH
important omega-3 fatty essential fatty acid. The main role of alpha- page 56
acids (EPA and DHA) is linolenic acid is as a metabolic precursor
fatty fish. DIETARY FATS &
of more complex omega-3 fatty acids, HEART DISEASE
particularly eicosapentaenoic acid (EPA) and page 98
3-MINUTE SNACK docosahexaenoic acid (DHA). However, this

EPA and DHA change cell metabolic conversion is relatively inefficient
membrane structure and 3-SECOND BIOGRAPHIES
and humans need preformed EPA and DHA to HANS OLAF BANG &
function, regulate the
chemical signals produced support cell function and to maintain health. JORN DYERBERG
Danish researchers who
by cells and control the The main dietary source of EPA and DHA is travelled to Greenland in the
1970s and early 1980s to study
genes that cells express. seafood, especially fatty fish (salmon, tuna, the diet and disease patterns
Through these actions, EPA
sardines, mackerel). If people do not eat fatty of the Inuit; demonstrated that
and DHA modify cell and the reported cardio protection
tissue behaviour and fish, their intake of EPA and DHA is likely to was most likely due to dietary
EPA and DHA.
responses in a way that be lower than recommended (around 200 to
optimizes function, thereby 500 mg of EPA plus DHA per day). Getting HUGH SINCLAIR
improving health and 1910–90
reducing disease risk. The
sufficient EPA and DHA is important for health. British researcher amongst the
DHA has key roles in the structure and function first to claim that diseases like
sustainability of fish as a heart disease were influenced
source of EPA and DHA is of the eye and brain and getting enough DHA by dietary fats.
not certain. early in life, when these organs are developing,
is vital. EPA and DHA are important for heart 30-SECOND TEXT
and cognitive health and for the control of Philip C Calder
inflammation. EPA and DHA are available in
supplements, often referred to as fish oils. Fittingly, ‘omega’
means ‘great O’
(ō mega, mega
122 g Potential Bioactives & Health meaning ‘great’).

4 February 1910 1933 1942–47 1967–68
Born in Edinburgh, UK Awarded the Gotch Director of the Oxford Master of the Worshipful
Memorial Prize Nutrition Survey Society of Apothecaries
1923
Studies at Stone House 1937 1945 1968
School then Winchester Receives the Radcliffe Awarded the Chevalier Awarded an Honorary DSc
College, where he Travelling Fellowship, of the Order of Oranje- from Baldwin-Wallace
is awarded the which allows Sinclair to Nassau by the Queen of College
Headmaster’s Natural make an extensive visit to the Netherlands for work
Science Prize (1928) many of the laboratories on the survey of the
and the Senior Science in the US and Canada Dutch population after 1976
Prize (1929) engaged in nutritional the Siege of Leningrad Joins the expedition of
research Drs Bang and Dyerberg in
northwest Greenland,
1946 renewing his interest in
Awarded Honorary the Inuit diet
Brigadier and,
subsequently, the US
Presidential Medal of 1979
Freedom with Silver Palm, Undergoes his infamous
for work on the Oxford ‘Eskimo diet’ study
Nutrition Survey
1983–1990
1951
President of the
Invited to give the Cutter McCarrison Society
Lecture at Harvard,
USA – a prestigious
lecture founded in 1912;
University Reader in 22 June 1990
Human Nutrition, Dies at the age of 80 in
Magdalen College, Oxford Oxford, UK
1
1956 1995
Publication of ‘Deficiency The Hugh Sinclair Unit of
of essential fatty acids Human Nutrition at the
and atherosclerosis, University of Reading is
etcetera’ in The Lancet founded, and Sinclair’s
archive is held in the
Museum of English Rural
Life (MERL)
124 g Potential Bioactives & Health

HUGH MACDONALD SINCLAIR
Hugh Macdonald Sinclair was a dietary long-chain omega-3 polyunsaturated

passionate nutritionist who dedicated his life fats, found in fish oils, in reducing blood
to investigating diet and chronic disease, and clotting and heart disease risk. This originated
enjoyed an illustrious career in terms of awards from a trip to Greenland to study snow
and accolades. Nevertheless, his major blindness, where Sinclair noticed that the Inuit
contributions to the field of human nutrition population did not seem to suffer from heart
were not fully recognized in his lifetime by his disease. In 1956 Sinclair published his famous
peers. Sinclair was born in Edinburgh, Scotland, paper, entitled ‘Deficiency of essential fatty
to Rosalie Sybil Jackson and Colonel Hugh acids and atherosclerosis, etcetera’, in The
Montgomerie Sinclair, a claimed descendent of Lancet, a prestigious medical journal, in which
Woldonius, the Viking monarch of Finland and he speculated on the links between long-chain
the St Clair cousins of William the Conqueror. omega-3 polyunsaturated fats and heart
After attaining a first-class degree in Animal disease and cancer. Unfortunately, his peers
Physiology from Oriel College Oxford and were sceptical, and Sinclair struggled to secure
Doctorate of Medicine from University College funding for his research to confirm these
London, amongst other degrees, he was elected speculations. This led to his famous ‘Eskimo
as University Demonstrator and Lecturer in diet’ study, when, at the age of 69, he ate
Biochemistry and as a Fellow of Magdalen nothing but seal meat, fish and water for
College Oxford. At the age of 31, the Ministry 100 days, while cutting his arm frequently to
of Health invited Sinclair to set up the Oxford measure the time it took for his blood to clot.
Nutrition Survey, to establish the health and Remarkably, this diet increased his blood
diet of the British population during World clotting time from 3 to 50 minutes and provided
War II. Between 1942 and 1947 Sinclair and his an elegant demonstration of how these fats
team of 24 staff conducted detailed surveys, reduce blood clots in arteries (thrombosis),
not only in the UK but also in Germany and thereby decreasing risk of a heart attack. This
the Netherlands. While this survey was an finding was confirmed by other studies, which
outstanding achievement, on which the British form the basis for the dietary recommendation
Government based its rationing strategy, the to increase intakes of these fats to reduce
results were, sadly, never published. heart disease.
Another landmark achievement in Sinclair’s
life was recognition of the importance of Julie A Lovegrove
Hugh Macdonald Sinclair g 125

VITAMIN D
& CALCIUM
Vitamin D is a vitamin in food
that becomes a hormone inside the body.
Sunlight supplies most requirements except in
3-SECOND BITE northern regions during winter, when dietary RELATED TOPICS
Vitamin D deficiency is sources become important, such as oily fish and See also
common in developed BABIES, INFANTS & CHILDREN
eggs. Calcium is a mineral found in dairy foods,
countries as year-round page 76
sunlight is scarce. Vitamin
green vegetables, nuts and seeds. Vitamin D
PREGNANCY & LACTATION
D works with calcium to supports bone health by boosting calcium page 80
maintain bone structure. absorption in the gut and promoting uptake
POSTMENOPAUSAL WOMEN
by the bone matrix. Low vitamin D can lead page 82
3-MINUTE SNACK
to rickets in children and osteomalacia and
Warnings about skin cancer osteoporosis in adults. Taking calcium with
could have inadvertently vitamin D improves bone density and lowers the 3-SECOND BIOGRAPHIES
ALFRED HESS
led to an epidemic in risk of fractures, particularly in postmenopausal 1875–1933
vitamin D deficiency, due
to sun avoidance or
women. There are hundreds of vitamin D American physician who
discovered that cod liver oil
potentially the use of sun receptors in the body, suggesting a wider and exposure to UV light could
cure rickets. He shared in the
block. Rickets is on the rise, influence. Studies have reported associations Nobel prize money awarded to
as is osteoporosis. An ideal Adolf Windaus for research
between low vitamin D status (blood levels) and into rickets.
balance is to get 15 to 20
minutes in the sun daily a higher risk of cancer or heart disease. Other
ELMER MCCOLLUM
during summer and to take research notes that children are at greater risk 1879–1967
a supplement in winter. of type 1 diabetes if their mothers were low in American scientist credited
with isolating vitamin D and
vitamin D during pregnancy. Further evidence creating the vitamin naming
system with Cornelia Kennedy.
is needed to confirm these findings. Vitamin D
deficiency is common in western and northern
countries, affecting 15 to 40% of the 30-SECOND TEXT
Carrie Ruxton
population. Those who are obese or have darker
skins are more at risk. Recommendations are
10–20 mg daily, and some countries advise daily The hard framework
supplementation as natural sources are limited. for bones (cortical)
and teeth (enamel) is
composed of calcium
126 g Potential Bioactives & Health phosphate.

PROBIOTICS
& PREBIOTICS
Gut health means more than
digestive health. The billions of bacteria
('microbiota') in the large intestine live in a
3-SECOND BITE symbiotic relationship with their human hosts, RELATED TOPICS
The millions of bacteria in influencing a wide range of bodily processes via See also
our guts can have positive GUT MICROBIOME
their proliferation and metabolic activities. In
or negative effects on our page 40
health depending on how
the case of potentially pathogenic bacteria, the
we treat them. impact on health can be negative. However, page 86
others such as bifidobacteria and lactobacilli
are associated with beneficial effects such as
3-MINUTE SNACK 3-SECOND BIOGRAPHIES
Studies on animals suggest
pathogen inhibition, rebalancing of immune
ELIE METCHNIKOFF
that certain gut bacteria function, blood lipid reduction and metabolic 1845–1916
promote obesity whereas changes that may assist control of weight. Russian scientist and Nobel
Prize winner who was the first
others help prevent it, Probiotics are live bacteria which, when to report that a fermented
possibly by boosting drink containing lactobacillus
satiety or limiting the
administered in adequate amounts, confer a bulgaricus helped to improve
health benefit; prebiotic fibres are selectively life expectancy in Bulgarian
amount of energy we villagers.
extract from our foods. fermented ingredients, for example inulin-type
While this sounds exciting, GLENN GIBSON &
fructans, galacto-oligosaccharide and lactulose, MARCEL ROBERFROID
it’s a long way off from the
highly complex situation that change the composition and/or activity of 1961– & 1938–
British microbiologist and
of human eating behaviour, the microbiota to deliver benefits. Do probiotics Belgian pharmacist who first
which is dominated by and prebiotics work? The literature has defined prebiotic fibres in 1995
and recognized their potential
desire, hunger, food
availability and societal
expanded rapidly and many studies have shown for working synergistically
with the gut microbiota to
cues. Therefore, a bacterial positive outcomes, particularly in relation to promote health.
cure for obesity is unlikely. infection control, mineral absorption and
metabolic effects, some inconsistencies in
30-SECOND TEXT
results are apparent. So, it’s a cautious ‘yes’. Carrie Ruxton
The large intestine is

home to billions of
different bacteria,
weighing in at 1–2 kg
128 g Potential Bioactives & Health (2.2–4.4 lb).

g
FOOD PROCESSING & PRODUCTION SYSTEMS

FOOD PROCESSING &
PRODUCTION SYSTEMS
GLOSSARY
additives Components added intentionally gene Basic physical and functional unit of
to a food to affect its characteristic, by heredity, a specific region of DNA that codes
improving look or appeal. for RNA, which make proteins.
ascorbic acid Micronutrient, also known as genetic modification or engineering

vitamin C, that also acts as a preservative, Genetically modified (GM) organisms are
antioxidant or colour stabilizer in foods. those whose genetic material (DNA) has been
altered in a way that doesn’t occur naturally
beta-lactoglobulin Specific protein in the through reproduction. Scientists introduce
whey component in milk that can initiate a new gene from a different organism, even
an allergy in some susceptible individuals. one unrelated to the modified species. Has
seen the rise of commercialized genetically
bioavailability Extent to which nutrients modified crops and livestock.
are digested and absorbed.
iodine Essential micronutrient in the diet,
endosperm Food reserve tissue inside involved in the production of thyroid
the seeds of most flowering plants that hormone. Present naturally in soil and
surrounds the embryo and provides seawater; found in dairy products and
nutrition in the form of starch. May also seafood. Symptoms of deficiency are related
contain oils and protein. to the thyroid.
enrichment Process that can reintroduce lycopene Naturally occurring carotenoid that
nutrients to refined foods, to improve is responsible for the red/pink colours seen in
the nutritional quality. tomatoes, pink grapefruit and other foods.
ethical omnivorism Philosophy and diet

that makes it essential only to consume
foods that come from animals that are
grass fed and free range; similarly, only
wild fish caught ethically or sustainably
farmed fish can be consumed.
132 g Food Processing

& Production Systems

nitrate Occurs in vegetables, grains scurvy Severe vitamin C deficiency. Symptoms
and drinking water; produced for use as include fatigue, weakness, severe joint or leg
fertilizers in agriculture. Scientific reviews pain, bleeding gums, red or blue spots on the
have reported that organic food crops can skin, easy bruising.
contain less nitrate than conventional
crops, the consumption of which has been selenium Essential mineral that increases
associated with both good and negative immunity, defends against free radical
effects on health. damage and inflammation and maintains
a healthy metabolism. Found in Brazil nuts,
polyunsaturated fats Dietary fats in which eggs, liver, tuna, cod, sunflower seeds,
the constituent hydrocarbon chain consists poultry and certain types of meat.
of two or more carbon–carbon double
bonds. Often referred to as ‘good fats’, World Health Organization (WHO) Agency
along with monounsaturated fats, because of the United Nations tasked with building
when substituted for dietary saturated fats a better, healthier future for people all over
they can help lower LDL-cholesterol. Found the world.
in nuts, seeds and oily fish.
refined foods Processed or altered foods

that are no longer in their natural state, a
process that results in a loss of beneficial
nutrients and fibre.
saturated fat Dietary fats in which the

constituent hydrocarbon chain consists
of only single carbon–carbon bonds.
Often referred to as ‘bad fats’ because
high intakes are linked to raised LDL-
cholesterol and increased risk of heart
disease events. Commonly found in
animal-derived products.
Glossary g 133

COOKING,
PROCESSING
& PRESERVING
Cooking, processing and
preserving have existed since humans began
to eat. Cooking makes foods softer, prolongs
3-SECOND BITE their life and combines foods to create RELATED TOPICS
Done properly, cooking specific dishes. It is a form of processing and See also
provides benefits related REFINING
preservation. The application of heat or an acid
to food preservation and page 136
nutrient availability, but
serves to deactivate naturally occurring enzymes
ADDITIVES
done improperly, as with that promote reactions such as browning or page 138
overcooking, it may ageing, and eventual spoilage. Processing
destroy other nutrients FOOD SUSTAINABILITY
transforms ingredients by physical or chemical page 148
and overly process foods.
means into other forms. It combines raw food
ingredients to produce products that are easily
3-MINUTE SNACK prepared and served. There are many methods, 3-SECOND BIOGRAPHY
NICOLAS APPERT
Although cooking is done including mincing and emulsifying. Preservation 1749–1841
primarily with the use of
heat or fire, microwaving is
prevents the growth of microorganisms such Looking for ways to feed
troops, Napoleon Bonaparte
a modern cooking process as yeasts, although some methods work by offered a prize for the
development of a process to
that is gaining global introducing benign bacteria or fungi to the food, preserve foods. Confectioner
popularity. Microwaves use and chef Appert rose to the
as well as slowing the oxidation of fats that challenge with canning, and
waves of energy that cause
molecules to vibrate, build cause rancidity. For all three processes, there are the rest is, as they say, history.
heat and cook the food. As pros and cons. Advantages include: less spoilage
less – or no – water can be by prolonging the life of the food; increased
used when cooking items 30-SECOND TEXT
such as vegetables, if not
availability of the foodstuff and increased Judith Rodriguez
overcooked, microwave bioavailability of some nutrients; reduced

cooking can help preserve food-borne diseases; convenience; enhancing
some nutrients. flavour and texture. Disadvantages include:
decreased levels of some nutrients (heat
destroys vitamin C); use of additives;
contamination risks; some methods have been The nutrients lost
linked to carcinogens; environmental concerns. during cooking varies
depending on the food
and the way in which
134 g Food Processing it is cooked.

REFINING
Refined foods are processed or
altered so that they are no longer in their
natural state, a process that results in a loss
3-SECOND BITE of beneficial nutrients and fibre. A whole grain RELATED TOPICS
Refined foods are contains an endosperm, germ and bran – all See also
highly processed grains, GRAINS & GLUTEN
nutrients remain intact. Automated milling using
sugars and oils that are page 64
stripped of a majority of
a roller mill is used as a process to create refined
SALT & BLOOD PRESSURE
their nutrients. grains, producing a finer texture and extending page 104
shelf life. This processing method improves the
SUGARS & SUGAR
digestibility of nutrients embedded within the SUBSTITUTES
3-MINUTE SNACK
grain; however, it strips the bran and germ from page 106
Refining grains were
initially created for two the grain to leave the endosperm – the nutrients
reasons: to enhance are no longer intact. A refined grain is missing
efficiency of grain several B vitamins, iron and dietary fibre, and OLIVER EVANS
processing; to reduce 1755–1819
rancidity of grain flour
numerous other nutrients are reduced. The
American inventor who
for travellers during long refined process occurs in foods beyond grains, developed the first automated
flour mill, to make grain
migrations. This process, commonly in sugars and oils. These products processing more efficient
now semi-counterbalanced
lack nutrients and minerals as compared to their without the assistance of
manual labour.
with enrichment, produces
a less nutritious grain wholesome counterparts. Foods that contain
JOHN STEVENS
product. It is advantageous refined products (white sugar, white flour, 1840–1920
for consumers to replace oils) include baked goods, confectionary and English inventor who
refined foods with whole developed the roller mill,
processed foods. A process called ‘enrichment’ widely used today, to extract
foods, to enhance the a grain’s endosperm.
nutritional quality of the can reintroduce nutrients, to improve the
foods they eat. nutritional quality of refined products. Refined
foods can be overeaten due to a poorer satiety 30-SECOND TEXT
index and, due to their lack of nutrition density, Kristen Hicks-Roof
should be replaced with whole foods that

maximize nutritional value. Replacing refined white
rice and pasta with
their ‘whole’ grain
counterpart will confer
136 g Food Processing many health benefits.

ADDITIVES
Usually when discussing
additives we are talking about components
added intentionally to a food to affect its
3-SECOND BITE characteristic. The purpose of intentional RELATED TOPICS
Intentional additives are additives is to improve the look or appeal of See also
components added to FOOD ALLERGIES
a food by modifying its flavour, colour, smell
foods for a variety of & INTOLERANCES
reasons and functions,
or texture, increasing its storage life, protecting page 100
such as to enhance flavour or increasing its nutrients, or improving COOKING, PROCESSING
or as a fat replacement. performance. There are many classes of & PRESERVING
additives, such as: preservatives, sweeteners, page 134
3-MINUTE SNACK
colouring agents, flavours and spices, flavour LABELS & PACKAGING
page 140
Use of additives is enhancers, fat replacers, nutrients, emulsifiers,
controversial. Some believe thickeners, stabilizers, texturizers, binders, acid
they should not be used at or alkalinity control agents, leaveners, anti- 3-SECOND BIOGRAPHY
all and others believe they
are appropriate to use.
caking agents, humectants, yeast nutrients, FREDERICK (OR FRIEDRICH)
ACCUM
While some additives’ dough conditioners or straighteners, firming 1769–1838
functions are not agents, enzymes and gases. Some additives may German chemist who published
considered essential and, Treatise on Adulteration of
provide more than one function; for example, Food, in which he denounced
therefore, should be the use of chemical additives
disallowed (such as ascorbic acid is a nutrient that also acts as a to food, causing considerable
colouring agents), some preservative, antioxidant or colour stabilizer. friction with food processors
and manufacturers.
additives provide functions The most common additives are sugar, salt, corn
that are beneficial to
a product (such as
syrup, citric acid, baking soda, mustard, pepper
preservation, so you can and colouring agents made from vegetables. 30-SECOND TEXT
Judith Rodriguez
keep your bread for a week Countries have their own lists of permitted
instead of a couple of days additives and review these lists periodically.
before it goes stale).
Additives do not pose a risk to health. However,
they can become an issue if someone with a
sensitivity to a particular additive consumes It has been suggested
them or if they are overconsumed. that some additives
may cause hyperactivity
and behavioural
138 g Food Processing problems in children.

LABELS &
PACKAGING
Modern food packaging has its
roots in the Napoleonic Wars (1803–15), when
the French government offered a 12,000-franc
3-SECOND BITE reward for the invention of a method of RELATED TOPICS
Nutritional information on providing transportable, stable and safe food to See also
food labels is considered SALT & BLOOD PRESSURE
soldiers in the field, which lead to the invention
an important strategy for page 104
encouraging consumers to
of food canning. Technological advances have
COOKING, PROCESSING
make informed and healthy allowed for the majority of foodstuffs to be & PRESERVING
diet choices. purchased pre-packaged. Nowadays, packaging page 134
protects food from the point it is processed to ADDITIVES
when it is purchased by the consumer, whilst page 138
3-MINUTE SNACK
Saturated fat, sugar and maintaining the product’s nutritional and
salt-rich processed foods sensory qualities. Packaging also provides
are major contributors product details, including a list of ingredients NICOLAS APPERT
to the global burden of 1749–1841
chronic diseases. It is vital
with allergens and additives identified, the
French chef, confectioner and
to provide consumers with ‘best before’ or ‘use by’ date and nutritional distiller, who was also known
as the ‘father of canning’ for
accurate and easy-to- information. The World Health Organization his pioneering work on airtight
understand nutritional
(WHO) advises that nutritional labelling of food preservation.
food labels, in line with
government dietary pre-packaged foods should be in line with ERIK WALLENBERG
1915–99
recommendations. Further international standards, including the Codex Swedish engineer who was
research is needed to Alimentarius – a ‘food code’ that ensures responsible for inventing the
examine links between Tetra Pak tetrahedron-shaped
consumer protection and fair trade. Since milk package.
nutrition knowledge,
food label usage and December 2016, back-of-pack labelling has
food intake; this will aid become a mandatory requirement of pre-
the development of 30-SECOND TEXT
packaged foods, under EU legislation. The Oonagh Markey
educational programmes
that promote healthier diet
WHO European Food and Nutrition Action
choices in less informed Plan 2015–20 calls for countries to develop
and/or educated consumer and implement front-of-pack labelling systems Nutrient profiling
groups.
for consumer-friendly nutritional information. systems, such as the
traffic light colour-
coding system, are
140 g Food Processing increasingly popular.

ORGANIC FOODS
The demand for organic foods
has increased, particularly in developed
countries. The motivation for choosing to buy
3-SECOND BITE organic food varies, but includes the beliefs that RELATED TOPICS
The classification of it is less environmentally damaging, contains no See also
organic food varies DIETARY FATS &
chemical residues and is associated with better
country to country, but HEART DISEASE
generally the focus is on
animal welfare than conventionally produced page 98
environmentally-conscious foods. Scientific reviews have reported that NITRATE & NITRITE
farming, without the use organic food crops can have higher antioxidant page 118
of synthetic pesticides
activity than conventional crops, which also FREE-RANGE & INTENSIVELY
or fertilizers.
contain more nitrate, the consumption of FARMED FOODS
page 144
which has been associated with both good
3-MINUTE SNACK and negative effects on health. There is also
Before World War II, foods evidence that organic milk and meat contain 3-SECOND BIOGRAPHIES
from crops and animals
were all organic, but not
higher amounts of omega-3 polyunsaturated WALTER JAMES
1896–1982
labelled so. In the 1940s, fats than conventional counterparts, but British agriculturalist who
an organic movement whilst the percentage increase often appears created the term ‘organic
farming’ and is regarded as
began due to worries
significant, since normal foods contain very little the ‘father’ of modern organic
about the increasing use agriculture.
of chemical fertilizers and of these fats, the higher values in the organic
products are not likely to impact the diet as a LADY EVELYN BALFOUR
pesticides in increasingly
1898–1990
industrialized agricultural whole. There is evidence that organic milk British organic farming pioneer
practices. Largely as a who graduated in 1918 with
result of environmental
contains less of some important nutrients, a diploma in agriculture from
awareness, popularity notably iodine and selenium, than conventional what is now the University
of Reading. Founded the Soil
grew, and standardized milk, which could contribute to an already Association in 1946.
certification procedures worryingly low intake of these nutrients in some
followed. Today, some
governments support
sections of the population. Overall, there is little
30-SECOND TEXT
organic farming through or no evidence that long-term consumption of Ian Givens
agricultural subsidy reform. organic foods will lower the risk of nutrition-
related ill health than eating conventional foods. Organic cows enjoy a
diet free from artificial
additives, chemicals
142 g Food Processing and GM ingredients.

FREE-RANGE &
INTENSIVELY
FARMED FOODS
Intensification of animal
production began in the 1950s to increase food
production. This involved more animals being
3-SECOND BITE kept indoors, particularly meat poultry, hens RELATED TOPICS
Currently – and perhaps and pigs that have diets based on cereals. There See also
surprisingly – there is no DIETARY FATS &
followed some increased housing of beef cattle
clear evidence that foods HEART DISEASE
from free-range animals
and dairy cows, and some supermarkets now page 98
are of superior nutritional demand that dairy cows have to graze outdoors ORGANIC FOODS
quality than those for a certain period per year. There has been page 142
produced more intensively.
increased demand for foods from animals in
free-range systems, likely due to perceived
3-MINUTE SNACK higher animal welfare and ethics of production. HIPPOCRATES OF KOS
So-called ‘ethical Whether foods produced by animals in free- c.460–c.370 BCE
omnivorism’ is a philosophy An influential Greek
range systems are nutritionally superior to those physician who also considered
and a diet that makes it food ethics, advising that,
essential only to consume produced from intensive systems has many ‘Food products yielded by
foods that come from similarities to the organic versus non-organic nature have to be improved
and refined.’
animals that are grass fed foods debate. As with organic foods, beef, lamb
and free range. Similarly, KARL MARX
only wild fish caught
and milk from outdoor grazing cattle have been 1818–83
ethically and sustainably shown to contain somewhat higher amounts German revolutionary socialist
who considered the ethics of
farmed fish can be of omega-3 polyunsaturated fats than those food production, saying that,
consumed. One aim is to from animals kept indoors. There is also similar ‘The food products generated
ensure that animals are by capitalism represent a basic
managed and slaughtered
evidence for free-range poultry meat, and eggs experience of estrangement
and alienation.’
according to ethical from free-range hens have been shown to have
principles, with the hope a higher vitamin D content than those that are
that more retailers and
battery farmed. However, milk from grazing 30-SECOND TEXT
restaurants will give Ian Givens
consumers the choice. cows is likely to contain less iodine and selenium
than from animals fed diets to which these
nutrients are added. Overall, no evidence yet
exists that free-range
produced foods are
healthier than those
144 g Food Processing from intensive systems.

GM FOODS
Genetically modified (GM)
organisms are those whose genetic material
(DNA) has been altered in a way that doesn’t
3-SECOND BITE occur naturally through reproduction. Scientists RELATED TOPICS
Genetically modified introduce a new gene from a different organism, See also
foods provide benefits NUTRIENT–GENE
even one unrelated to the modified species.
to food producers and INTERACTIONS
sometimes consumers,
DNA can be taken from plants, invertebrates page 42
but acceptability has or bacteria and inserted into the target species. FOOD ALLERGIES
remained low in many The main purpose is to enhance plant yield and & INTOLERANCES
developed countries. page 102
improve resistance to pests and diseases, but
some DNA crosses have resulted in strange FOOD SUSTAINABILITY
page 148
3-MINUTE SNACK outcomes, such as glow in the dark mice.
Farmers have been Examples of GM food applications include corn,
genetically modifying oilseed rape, sugar beet and soya, as well as 3-SECOND BIOGRAPHIES
plants and animals for
hundreds of years by
less allergenic milk from cows that have been GREGOR MENDEL
1822–84
selective breeding. GM engineered to express lower levels of beta- Augustinian friar and scientist
took this up a level by lactoglobulin. Regulation differs depending considered to be the founder
of genetics, thanks to
enabling a wider
on the country, and even if GM foods are not his meticulous research
genepool – even across in breeding different
different species – as well grown commercially, certain crops, such as characteristics in pea plants.
as shortening the time maize, soybean and sugar beet, might be HUGO DE VRIES
to create a desired imported. Concerns about GM organisms 1848–1935
characteristic. Depending Dutch botanist who postulated
include the potential for them to escape that the inheritance of specific
upon your viewpoint,
the potential of GM could and spread to wild populations, unintended traits was due to hereditary
carriers called ‘pangenes’,
be positive, heralding an consequences for other species of animals or shortened later to ‘genes’.
era of cheap nutritious insects, loss of biodiversity, increased use of
ingredients, or negative,
raising the possibility
pesticides, heightened allergenicity and safety
30-SECOND TEXT
of ‘Frankenstein’ or of GM foods. WHO has stated that GM foods Carrie Ruxton
unsafe foods. need to be assessed on a case-by-case basis.
WHO has stated that all
GM foods currently on
the market for human
146 g Food Processing consumption are safe.

FOOD
SUSTAINABILITY
The term ‘sustainability’ refers to
using a resource without depleting or damaging
the resource. There are five elements considered
3-SECOND BITE important in sustainable agriculture, all of RELATED TOPICS
Food sustainability can be which relate to food sustainability: water quality See also
promoted by emphasizing VEGAN & VEGETARIANISM
and supply; animal and plant biodiversity;
a diet with plant-based page 66
foods, shopping local and
energy production and use; plant and animal
ORGANIC FOODS
using recyclable bags, production; labour practices (as they relate page 142
while minimizing the use to social justice and equity). Sustainability,
of plastics, excessive GM FOODS
including food sustainability, is guided by the page 146
packaging and food waste.
underlying philosophy that as ‘stewards’ of the
Earth, we have a responsibility to care for it and
3-MINUTE SNACK benefit from its abundant resources, but not 3-SECOND BIOGRAPHIES
The Great Law of the MASANOBU FUKUOKA
deplete or destroy them in the process. This may 1913–2008
Iroquois (Native American)
Confederacy stated that
also guide some persons to emphasize, focus on Japanese farmer, philosopher
and author of the bestselling
deliberations must consider or select specific types of diets or food-related The One-Straw Revolution;
a leader in the worldwide
the impact on the seventh behaviours, such as vegetarianism or eating only sustainable agriculture
generation, approximately movement.
organic or free-trade foods. There are different
150 years into the future.
That has become a types of farming and scales (sizes of farms). WENDELL BERRY
1934–
basic principle underlying Whilst there is an assumption that small farms Renowned American
the concept of promote food sustainability and large farms sustainable food pioneer,
sustainability – often author and activist.
referred to as ‘Seventh
(agribusiness) does not, the type of process,
Generation Sustainability’. efficiency and impact on ecology and labourers
This philosophy is not should be the determinant of the sustainability 30-SECOND TEXT
unique to the Iroquois; Judith Rodriguez
of the practice. There is controversy concerning
many nations, tribes and
indigenous people around
the sustainability and impact of genetic
the world live by it. engineering. Nevertheless, focus on a plant-
based diet is generally regarded as being more Biodynamic farms
eco-friendly than an omnivorous diet. are managed as
self-sustaining whole
organisms, with
148 g Food Processing everything in balance.

22 October 1896 1923
Born in Entiat, Graduates from the
Washington, USA University of Pittsburgh
with an MSc and then
a PhD
1918
Attends Washington
State College, but studies 1931–32
are interrupted by WWI, Isolates vitamin C crystals
during which time King from lemon juice and,
serves with the 12th using an animal model,
Infantry Machine Gun identifies these as the
Company cure for scurvy
1919 1942
Marries Hilda Bainton, Becomes first Scientific
with whom he has one Director of the Nutrition
daughter and two sons Foundation
1950–53
President of the
International Union of
Nutrition Sciences (IUNS)
1951
Elected to the National
Academy of Sciences
1962
Retires from teaching
and becomes a consultant
to the Rockefeller
Foundation
23 January 1988
Dies in Pennsylvania, USA
150 g Food Processing


CHARLES GLEN KING
Although the Nobel Prize in 1937 spots, which typically affected sailors on long
for the discovery of vitamin C was awarded to voyages. Scientists were desperate to
Hungarian scientist Albert Szent-Györgyi, many understand exactly which chemical in citrus
believed that the honour should have been was responsible for the health benefits, leading
shared with Charles Glen King, an American to a global, yet unconnected, research effort.
pioneer of vitamin research. Working in laboratories in Hungary and
Known to his friends as Glen, King was born England, Szent-Györgyi detected an antioxidant
in 1896 on a homestead near a small town in compound in adrenal samples, which he named
Washington State. Having only a rudimentary ‘hexuronic acid’ in 1927. What he didn’t know at
local school, King was spurred on to attend the time was that he was looking at vitamin C.
university a year early, where he chose to On the other side of the Atlantic, King and his
pursue studies in Geology before switching to team were trying to isolate the anti-scurvy
Chemistry. Emerging later than usual from his factor from lemon juice using meticulous animal
undergraduate studies, due to the onset of feeding experiments. By April 1932, they were
World War I, King moved to Pittsburgh able to publish a report in Science describing
University. There, he enrolled in a Masters the isolation of the vitamin C crystal and, later
degree in Chemistry before beginning a PhD in that year, its chemical structure. However, a
Organic Chemistry. During this time, he married rival paper by Szent-Györgyi was published two
Hilda Bainton and settled in the Pittsburgh area weeks later, confirming that hexuronic acid and
to raise their children, making sure that the vitamin C were one and the same.
babies were given fresh orange juice daily, The awarding of the Nobel Prize to Szent-
even though he was yet to isolate the active Györgyi in 1937 for his work in discovering
ingredient, vitamin C. vitamin C was a disappointment to King.
It was already known by 1922 that citrus fruits While Szent-Györgyi was the first to note the
contained a vital component that could ward existence of hexuronic acid, there is doubt that
off scurvy, a serious condition characterized by he understood its biological significance until
weakness, joint pains, bleeding gums and blood King’s research had been completed.
Carrie Ruxton
Charles Glen King g 151

g
APPENDICES

RESOURCES
NUTRITION WEBSITES Scientific Advisory Committee on Nutrition

British Nutrition Foundation (BNF) www.gov.uk/government/groups/scientific-
www.nutrition.org.uk advisory-committee-on-nutrition
Impartial, evidence-based information Advises Public Health England on nutrition and
on food and nutrition. related health matters.
European Food Information Council (Eufic) Public Health England (PHE)

www.eufic.org www.gov.uk/government/organisations/
A non-profit organization that offers science- public-health-england
based information on food and health. Aims to protect and improve the nation’s health
and well-being, and reduce health inequalities.
Nutrition Society
www.nutritionsociety.org Institute of Food Science and Technology (IFST)
Advances the scientific study of nutrition www.ifst.org
and its application to health. Leading professional body for those involved in
all aspects of food science and technology.
Eatwell Guide UK
www.gov.uk/government/publications/ Nutrition.gov
the-eatwell-guide www.nutrition.gov
A policy tool used to define government Information to make healthy eating choices.
recommendations on eating healthily and
achieving a balanced diet. Academy of Nutrition and Dietetics
www.eatright.org
Association for Nutrition (AfN) Science-based food and nutrition information,
www.associationfornutrition.org a consumer site from the Academy.
Independent regulator for registered
nutritionists. United States Department of Agriculture
(USDA) Agricultural Research Service
British Dietetic Association (BDA) ndb.nal.usda.gov/ndb
www.bda.uk.com/foodfacts/home Food Composition databases.
The only body in the UK representing
the whole of the dietetic workforce. Nutrition Source
www.hsph.harvard.edu/nutritionsource
Harvard Public Health site for evidence-based
diet and nutrition information.
154 g Resources

Consumer Lab HEALTH/MEDICAL WEBSITES
www.consumerlab.com World Health Organization (WHO)
Test results and information to help www.who.int
consumers and healthcare professionals Includes publications, a Health Topics directory
evaluate related products. and Global Health Observatory (GHO) data.
Center for Science in the Public Interest The BMJ

cspinet.org www.bmj.com
Advice for a healthier food system. Host to research, education, news and views,
and campaigns information.
Canadian Nutrition Society/Société
Canadienne de Nutrition (CNS/SCN) Wikipedia
cns-scn.ca www.wikipedia.org
Provides all sectors with an interest Source of scientific information, along with
in nutrition access to evidence-based further reading suggestions.
information, resources and expertise.
NHS
Nutrition Australia www.nhs.uk/conditions
www.nutritionaustralia.org Up-to-date and easy to understand directory of
An independent, member organization illness and disease.
that promotes health and well-being.
WebMD
The Nutrition Society of Australia (NSA) www.webmd.com
nsa.asn.au Health and medical news and information.
Scientists and educators who aim to increase
and communicate the scientific value and Medline Plus
relevance of nutrition science in Australia. medlineplus.gov/nutrition.html
US National Institute of Health’s National
The Nutrition Society of New Zealand Library of Medicine website, for consumers.
www.nutritionsociety.ac.nz
Promotes the science of nutrition and its role
in growth and development, health and well-
being in humans and animals.
Resources g 155

NOTES ON CONTRIBUTORS
EDITOR Rosalind Fallaize is a Registered Dietitian and

Julie A Lovegrove is Professor of Human Research Fellow in Nutrition and Dietetics at the
Nutrition and Director of the Hugh Sinclair University of Hertfordshire and University of
Unit of Human Nutrition at the University Reading. Her research interests include dietary
of Reading, and a Registered Nutritionist. assessment, eating behaviour and e-health.
Her expertise is nutritional influences
on cardiometabolic risk, including nutrient- Glenn Gibson is Professor of Food Microbiology
gene interactions. and Head of Food Microbial Sciences at Reading
University, and is widely regarded as the UK’s
leading expert in this field.
CONTRIBUTORS Ian Givens is Professor of Food Chain Nutrition

Margaret Ashwell OBE was Senior Research at the University of Reading and Director of the
Scientist with the Medical Research Council, Institute of Food, Nutrition and Health. His key
Principal of the Good Housekeeping Institute interest is in human nutrition, and food chain
and Science Director of the British Nutrition nutrition in particular.
Foundation. She became President of the
Bruce A Griffin is Professor of Nutritional
Association for Nutrition in 2016.
Metabolism at the University of Surrey. He is a
Luke Bell is a Plant Biologist, Food Chemist Biomedical Scientist with research experience
and Nutritional Science Researcher from the in human lipid and lipoprotein metabolism,
University of Reading. nutrition and cardiovascular disease.
Jenna Braddock is a Certified Specialist Kristen Hicks-Roof is a Registered Dietitian

in Sports Dietetics and works primarily Nutritionist and Assistant Professor at the
with adolescent athletes. She is faculty at University of North Florida. Her passion is
the University of North Florida, writes at improving the health and wellness of the
MakeHealthyEasy.com and works with teen everyday individual by promoting realistic
athletes and their parents. dietary and lifestyle changes.
Philip C Calder is Professor of Nutritional Ditte Hobbs is a Research Fellow and Registered
Immunology within Medicine at the University Nutritionist at the University of Reading. Her
of Southampton. His work aims to understand research focuses on exploring the impact of
how nutrition affects the functioning of the nutrition on cardio-metabolic diseases, with
human body. interest in the effects of dietary nitrate.
156 g Notes on Contributors

Ian Macdonald is Professor at the School of Judith Rodriguez is a Registered Dietitian
Life Sciences at Nottingham University. His Nutritionist, Professor at the University of
main interests are obesity, diabetes, nutrition North Florida. She is a Past President of the
and exercise physiology. He chaired the SACN Academy of Nutrition and Dietetics. Her areas
Carbohydrates Working Group. of interest include nutrition education, food and
culture and health disparities.
Oonagh Markey is a Vice-Chancellor’s
Research Fellow at Loughborough University, Carrie Ruxton is a Registered Dietitian with
a Visiting Research Fellow at the University more than 20 years’ experience. Her PhD was in
of Reading and a Registered Nutritionist. Her child nutrition and she has written more than 50
work aims to understand how nutrients and peer-reviewed publications, as well as writing
diet influence cardiovascular disease risk. for consumer and professional magazines.
Elizabeth A Miles is a Nutritional Jill Snyder is a Registered Dietitian Nutritionist

Immunologist at the University of and Instructor at the University of North Florida,
Southampton, with expertise in allergology, counselling clients for medical nutrition therapy
nutrition and dietetics and immunology. and the benefits of a healthy diet, in addition to
teaching at UNF.
D Joe Millward is Emeritus Professor of
Human Nutrition at the University of Surrey, Katherine Stephens is a Research Fellow at the
and has served on several international University of Reading.
and national committees, advising on
requirements for protein and food energy. Jayne Woodside is Professor of Human
Nutrition within the Centre for Public Health at
Brian Power is a Lecturer at University Queen’s University Belfast, where she is also
College London and a Registered Dietitian. His Deputy Director of the Institute for Global Food
research interests include the development Security.
of behaviour change interventions.
Zhiping Yu, a Registered Dietitian Nutritionist
Hilary Powers is Professor Emerita in and Associate Professor at the University of
Nutritional Biochemistry at the University North Florida. Her research interests include
of Sheffield, UK. She has worked in the area prevention and treatment of eating disorders,
of micronutrient function for over thirty obesity and obesity-related chronic diseases.
years and her work has contributed to an
understanding of optimum nutrition, globally.
Notes on Contributors g 157

R

INDEX
A C E anaphylaxis 96, 100

absorption 36 calcium 13, 58, 76, 78, 82, eggs 60 food intolerances 58, 96, 100
acetaldehyde 96, 108 84, 126 cholesterol 52, 60 free radicals 12, 26
additives 34, 97, 132, 138 cancer 7, 20, 42, 54, 56, 68, 116, free-range 144 free-range foods 132, 144
Adequate Intake (AI) limits 24 120, 125 eicosanoids 12, 22 fructose 96
adolescence 74, 76, 78 alcohol and 108 eicosapentaenoic acid 122 fruit 24, 54, 116
ageing 75, 82, 84, 120 meat and 110, 118 Eijkman, Christiaan 31 Funk, Casimir 6
agriculture see farming obesity and 86 elderly people 84
alcohol 96, 108 salt and 104 endosperm 132, 136 G
allergies see food allergies Vitamin D and 126 energy 14, 62, 80, 86 gastrointestinal tract 36
alpha-linolenic acid 114 vitamin overdose and 26, 28 enrichment 132, 136 genes 34, 35, 36, 42, 46, 132
Alzheimer’s disease 34, 68, 114 carbohydrates 14, 16, 18, 103, enzymes 34, 36, 38, 53, 108 genetic modification 132, 148
amines 34, 114, 118 106 epidemiology 34, 52, 56, 96 GM foods 132, 146
amino acids 12, 16, 31, 52, 74, cardiometabolic disease 20 ethanol 96, 108 glucose 62, 97
100 cardiovascular disease 42, 54, ethical omnivorism 132, 144 glucosinolates 114
anabolic processes 38 68, 71, 86, 96, 103, 116 gluten 52, 53, 64, 96, 100
anaemia 12, 24, 28, 74 catabolic processes 38 F glycaemic index 13
anaphylaxis 96, 100 cell signalling 12, 28 farming 91 grains 64
APOE gene 34, 46 cereals see grains fish farming 56 refined 18, 136
ascorbic acid 132, 138 changing eating habits 92 free-range 144 whole 13, 18, 20, 24
atherosclerosis 114, 116, 125 children 16, 45, 66, 76, 86, 88 GM foods 132, 146, 148 see also gluten
cholesterol 20, 52 intensive 144 gut microbiome 35, 36, 40, 48,
B blood cholesterol 52, 60, 71, organic 142 114, 116, 126
B-vitamins 28, 42, 58, 96, 98, 104 sustainability 148
110, 136 dietary cholesterol 52, 60 fat-soluble vitamins 26 H
B1 (thiamin) 13, 31 eggs and 52, 60 fats 22, 103 health advice 46
B2 (riboflavin) 103 HDL 52, 60 dietary fats 98 heart disease 7, 56, 58, 76,
B9 (folate) 12, 28, 74, 80 LDL 52, 60, 96, 97, 115, 133 monounsaturated 22, 62, 97 120
B12 28, 58, 84 coconut oil 22 polyunsaturated 22, 62, 71, 97, birth weight 80
babies 76 coeliac disease 52, 64, 96, 100 115, 133 CHD 60, 71, 96
bariatric surgery 74, 86 congeners 96, 108 saturated 22, 46, 58, 71, 97, 98, cholesterol and 60, 71
Barker, David 80 cooking 120, 134 133 dietary fat and 98, 103
basal metabolic rate 13, 14 coronary heart disease 60, 71, fatty acids 12, 22, 34, 62, 84, Mediterranean diet 62, 68
beta-lactoglobulin 132 96, 110 114, 125 omega-3 and 125
bifidobacteria 40, 74, 84, 114, coronary thrombosis 96 essential 12, 22, 34, 114, 122 postmenopause 82
128 short-chain 40 salt and 104
bioactive compounds 52, 54, D see also omega-3 vegetarian diet and 66
62, 74 dairy foods 58, 98 fermentation 96 Vitamin D and 126
bioavailability 52, 132 dementia 74, 114, 120 fibre 16, 20, 54, 76, 136 Hippocrates of Kos 6
biodiversity 146, 148 dextrin 34, 36 fish 53, 56, 76, 98, 122, 132, Hopkins, Sir Frederick Gowland
birth weight 80 dietary assessment 48 144 6, 30–1
blood pressure 20, 104, 116, digestion 36 flavonoids 54, 114, 116 Human Genome Project 34,
118 disaccharides 12, 97 folate 12, 28, 74, 80 46
body mass index (BMI) 35, 42, DNA 12, 35, 74, 80, 120, 132, 146 food allergies 52, 60, 62, 64, hypertension 104, 114, 118
74, 86, 88 docosahexaenoic acid 122 96, 100 hypertensive 97, 104
158 g Index

I micronutrients 53, 75, 80, 88 polyphenols 35, 42, 97, 108, sulforaphane 115, 120
infants 66, 76 milk 58, 91 115, 116 Sun Simiao 6
insulin 52, 75 organic 142 polysaccharides 13 surgery for obesity 74, 86
iodine 58, 91, 132, 142, 144 minerals 24, 42, 58, 62, 88 polyunsaturated fats 22, 62, 71, sustainability 56, 144, 148
iron 24, 76, 78, 80, 110, 136 overconsumption 24 97, 115, 133 sweeteners 106
isoflavones 114, 116 monounsaturated fats 22, postmenopausal women 82, 115, Szent-Györgyi, Albert 151
isothiocyanates 114, 120 62, 97 116, 126
prebiotics 35, 40, 115, 128 T
K N pregnancy 16, 56, 74, 80, 126 thiamin 13, 31
K-rations 71 neurodegenerative 115, 120 preserving 104, 134, 138 total energy expenditure 13, 14
Keys, Ancel 70–1 nitrate 118, 133, 142 probiotics 53, 58, 74, 114, 115, 128 triaclyglycerol 13, 22
King, Charles Glen 150–1 nitric oxide 115, 118 processing 134 type 2 diabetes 52, 75, 76, 86,
Kwashiorkor 88 nitrite 118 meat 110, 118 110, 115, 126
normotensive 97 progesterone 74, 75, 82
L nucleic acids 35 proteins 14, 16, 56, 58, 60, V
labels 140 nutrient-gene interactions 42 66, 76 vegan diet 16, 66
lactase 53, 58, 97 nutrigenetics 35, 45 puberty 75, 78 vegetables 24, 54, 116, 118, 120
lactation 16, 66, 74, 80 nutrigenomics 42 public health 46, 88 vegetarian diet 66, 148
lactobacilli 40, 115, 128 nuts 26, 62 vitamin A 26, 76, 84
lactose 53, 58, 97, 100 R vitamin B see B-vitamins
lipid profile 53, 62, 68 O recommended daily allowances vitamin C 28, 53, 76, 118, 132,
lipids 34, 36, 40, 128 obesity 35, 38, 42, 66, 75, 78, (RDA) 24 134, 151
low carb diets 18, 103 88, 103 refined foods 133, 136 vitamin D 13, 26, 76, 78, 82, 84,
lycopene 132 bariatric surgery 74, 86 enrichment 132, 136 126, 144
oestrogen 74, 75, 82 riboflavin 103 vitamin E 26
M oils 22 rickets 13, 26, 115, 126 vitamin K 26
McCance, Robert 45 oligosaccharides 20 vitamins 42, 62
macronutrients 7, 13, 14 omega-3 53, 56, 84, 98, 122, S deficiency 13, 26, 28, 31, 53,
malnutrition 6, 71, 74, 88, 91 125, 142, 144 salmonella 53, 60 66, 103
maltose 34, 36, 97 organic foods 142, 144, 148 salt 76, 104 discovery of 6, 31
meat 24, 58, 60, 110 Orr, John Boyd 90–1 sarcopenia 75, 84 fat-soluble 26
cancer and 110, 118 osteomalacia 13, 26, 115, 126 saturated fats 22, 46, 58, 71, 97, overdose 26, 28
free-range 144 osteoporosis 75, 82, 115, 126 98, 133 supplements 26, 28, 66, 76, 126
organic 142 overweight 14, 78, 86 scurvy 28, 53, 133, 151 water-soluble 28
processed 110, 118 selenium 24, 133, 142, 144
red meat 110 P short-chain fatty acids 40 W
sodium nitrate 97, 110 packaging 140 Sinclair, Hugh Macdonald 124–5 weight see obesity; overweight
Mediterranean Diet 62, 68 pathogens 75, 84 smartphone applications 46, 48 Widdowson, Elsie 44–5
menopause 74, 82 peptide bonds 13, 16 sodium nitrate 97, 110 World Health Organization
mercury 53, 56 personalized nutrition 46 starch 20, 97 (WHO) 53, 54, 86, 133, 140, 146
metabolism 38 phenylketonuria 97, 100 stroke 56, 97, 98, 104 World War II 45, 91, 103, 125
metabolites 35, 116 physical activity level 13, 14 sucrose 97, 103
metabotypes 38 polychlorinated biphenyls 53, 56 sugar substitutes 106 Y
microbiome see gut microbiome polydextrose 20 sugars 18, 53, 76, 103, 106 Yudkin, John 102–3
microbiota 115, 128 polymorphisms 35, 42 simple sugars 13, 18, 96
Index g 159

ACKNOWLEDGEMENTS
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Copyright © 2018 Quarto Publishing plc

Digital edition: 978-1-78240-7-294

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Nutrition has been defined as ‘the process of

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12 g Nutrients: Life’s Essentials

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can be demonstrated countries have raised the recommended intake

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possibly fractures. In bone pain of osteomalacia in adults. Foods HENRIK DAM

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30 g Nutrients: Life’s Essentials

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Sir Frederick Gowland Hopkins g 31

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Starting in the mouth,

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3-MINUTE SNACK weight or becoming obese. Research has shown

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bioactive compounds Extranutritional coeliac disease Autoimmune disorder from

insulin Hormone made by the pancreas that

52 g Foods & Health

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omega-3 Fatty acids found in fish,

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Commercial fishing is a higher consumption of fish and reduced risk of

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Milk is an excellent medium contains only 3.6% fat, semi-skimmed 1.7%

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The Mediterranean Diet knowledge, to offer protection against

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70 g Foods & Health

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