• Introduction
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Introduction

Ensuring that you have a healthy, balanced diet is an important step towards good health.  Good health is essential for leading a full and active life.

The word 'diet' is often used to describe an eating plan that is intended to aid weight loss. However, diet really refers to the food a person eats during the course of a day or week. The more balanced and nutritious your diet is, the healthier you  can expect to be.

A balanced diet

A balanced diet means eating the right amount of foods from all the food groups.  No single food contains everything the body needs so it is important that your diet is varied. Eating a balanced diet can:

• increase life expectancy by keeping your heart and body healthy
• prevent many long-term illnesses
• help maintain a healthy body weight.

The food groups

There are five main food groups and each one contains essential nutrients. Nutrients are vitamins and minerals that regulate the body's chemical processes and functions. Eating nutrients from the right food groups helps keep your body fit and healthy.

The five main food groups are:

• carbohydrates, which contain lots of energy and nutrients and are found in starchy foods, such as bread, pasta and potatoes
• protein, which helps with growth and repair and is found in meat, fish, beans and eggs
• fruit and vegetables
• milk and dairy foods
• foods that are high in fat and sugar

Carbohydrates should make up one-third of your daily diet, and fruit and vegetables should also make up one-third. The remainder of your diet is split between protein and milk and dairy. Only a very small amount of what you eat every day should consist of fats and sugars.

Alternative diets

People with certain medical conditions may need to follow a slightly different diet. For example, pregnant women need to avoid eating certain foods, such as liver and some types of fish. People who are recovering from a stroke may also have specific dietary advice to follow, such as a low-fat, high-fibre diet.

Dietary advice for people over 60 and for children of various ages may also be different.

Benefits

Health benefits of a balanced diet

Eating a nutritious, balanced diet will help you improve your overall health. In particular, a balanced diet can help you:

• maintain a healthy weight
• cut your risk of developing certain medical conditions, such as high blood pressure (hypertension) and diabetes (a long-term condition caused by too much glucose in the blood)

Being underweight

Being underweight can cause osteoporosis (brittle bones) and amenorrhoea (absent periods) in women. Not eating enough can mean that you do not get vital vitamins and minerals, which you need to maintain good health.

For example, not eating enough iron can cause anaemia(a reduced number of red blood cells), which can cause tiredness and breathlessness.

Being overweight

The most recent data from the Welsh Health Survey (2008) shows that over half of men (62%) and women (53%) are classified as overweight or obese, the proportions rising to 72% in men and 62% in women, among 45-64 year olds.
The Millennium Cohort Survey found that 22% of Welsh children aged three were overweight and just over 5% were obese.

Being overweight or obese puts you at greater risk of developing a number of serious health conditions, such as:

• type 2 diabetes, a chronic (long-term) condition caused by too much glucose in the blood
• most types of cancer, when the body's cells begin to grow and reproduce in an uncontrollable way
• heart disease, when your heart’s blood supply is blocked
• stroke, when the blood supply to the brain is interrupted

To find out if you are a healthy weight, check your BMI using the BMI Calculator.

Avoiding health problems

Even if you are a healthy weight, it is important that your diet is balanced, otherwise you may be at risk of:

• high blood pressure (hypertension)
• high cholesterol, when a fatty substance, known as a lipid, builds up in your blood

Both of these conditions increase your chances of developing cardiovascular diseases (conditions that can affect your blood circulation), such as heart attacks and strokes.

Making changes

You can maintain a healthy weight and avoid health problems by eating a balanced diet. To do this:

• eat plenty of carbohydrates
• eat at least five portions of fruit and vegetables every day
• cut down on the amount of fat, sugar and salt in your diet
• eat enough vitamins and minerals
• drink enough fluids

Body mass index

Use the BMI calculator to work out your body mass index (BMI):
If your BMI is less than 18.5, you are underweight for your height.
If your BMI is between 18.5 and 24.9, you are an ideal weight for your height.
If your BMI is between 25 and 29.9, you are over the ideal weight for your height.
If your BMI is between 30 and 39.9, you are obese.
If your BMI is over 40, you are very obese (known as ‘morbidly obese’).

Facts

The main food groups

Carbohydrates

Starchy foods (foods that contain carbohydrates) should make up one third of your diet. Carbohydrates provide energy and contain nutrients, such as fibre, iron and B vitamins. Starchy foods include:

• bread
• pasta
• potatoes
• cereals
• rice

Carbohydrates can be:

• refined, such as white bread and sugary cereals that have had the fibre removed
• unrefined, such as brown and wholemeal bread, pasta and rice

Choose unrefined carbohydrates whenever possible because these contain more fibre (see below), so are better for you.

Some people think that starchy foods are fattening, but they contain less than half the calories of fat. Fats that are added to them, such as butter and cheese, can make them unhealthy.

Avoid frying starchy foods and choose healthier alternatives, such as low-fat oven chips and fortified bread and cereal. ‘Fortified’ indicates that the food has had vitamins or minerals added to it.

Fruit and vegetables

Fruit and vegetables should make up one-third of your daily diet. Aim to eat at least five portions every day. Fruit and vegetables can be:

• fresh
• frozen
• tinned
• dried
• in juices

One portion of fruit or vegetables is equal to around 80g. It could be:

• one medium-sized piece of fruit, such as an apple or banana
• three heaped tablespoons of cooked vegetables
• one 150ml glass of unsweetened 100% fruit or vegetable juice (juice only counts as one portion, no matter how much you drink)
• three heaped tablespoons of beans and pulses, such as baked beans or kidney beans (these only count as one portion no matter how many different types or how much you eat)

Fruit and vegetables are rich in vitamins and minerals, which are essential for your body to function properly. As well as keeping your skin and hair healthy, a diet that contains plenty of fruit and vegetables can reduce your risk of getting heart disease and some types of cancer.

Fruit and vegetables are very low in fat and are helpful if you are trying to lose weight.

Milk and dairy

Milk and dairy products are a good source of calcium, which is very important for strong bones and teeth. They also contain protein, vitamins and minerals. Milk and dairy products include:

• cheese
• yoghurt
• soya alternatives that are fortified with calcium

Cream and butter are in the fats food group, and eggs count as protein.

Some dairy products contain a large amount of fat. It is best to choose lower-fat versions, such as semi-skimmed milk, low-fat yoghurt and reduced-fat cheese.

Protein

Protein helps to build and repair your body. Sources of protein include:

• meat
• fish
• eggs
• pulses
• seeds and nuts

If you are a vegetarian, you can get the protein you need from seeds, nuts, soya products and beans. However, these do not provide as much zinc or vitamin B12 as meat or fish, unless they are fortified (have had vitamins or minerals added to them). See Recommendations for information on vitamins and minerals.

Meat

Meat also contains vitamins and minerals, including:

• iron
• selenium
• zinc
• B vitamins

However, meat can sometimes contain lots of fat. To keep it healthy:

• buy lean joints of meat
• trim the fat from the meat
• remove the skin from chicken and turkey
• grill, roast or microwave meat, rather than frying it
• drain fat away after cooking
• avoid eating too many meat products, such sausages or pies, because they usually contain more fat

Fish

Fish also contains vitamins, such as niacin, and minerals, such as selenium and iodine. Oily fish that is rich in omega-3 fatty acids helps prevent heart disease. Aim to eat at least two portions of fish a week, one of which should be oily fish, such as:

• salmon
• mackerel
• trout
• herring
• sardines
• fresh tuna (not canned because the canning process removes the beneficial oils)

White fish, such as haddock, cod or plaice, are very low in fat. To keep it healthy, remove the skin from the fish and grill, steam or bake it. Fried fish and fish in breadcrumbs are higher in fat.

Eggs

Eggs also contain vitamin D, vitamin A, vitamin B2 and iodine. To keep it healthy, poach, scramble or boil your eggs. Fried eggs and eggs in flans or quiches will have a higher fat content.

Pulses

Pulses are edible seeds that grow in pods. They contain fibre, vitamins and minerals, and iron. Three heaped tablespoons of pulses count as one portion of vegetables, but eating any more than that, or eating several different varieties, will not count as another portion. Pulses include:

• peas, such as garden peas or black-eyed peas
• beans, such as baked beans, kidney beans or butter beans
• lentils, such as red, yellow or brown lentils

You can add pulses to soups or casseroles as an alternative to meat. This will make the meal cheaper and lower in fat. Three heaped tablespoons of pulses counts as one portion of vegetables (you need to eat at least five portions of fruit or vegetables every day).

Seeds and nuts

Seeds and nuts contain fibre and vitamins and minerals. They are also a good source of unsaturated fat. Unsaturated fat helps to lower blood cholesterol and contains essential fatty acids that your body needs to stay healthy. Examples of nuts and seeds include:

• almonds
• brazil nuts
• cashews
• pumpkin seeds
• sesame seeds
• poppy seeds

Nuts and seeds are a healthy snack and you can add them to cereals or salads. Choose unsalted nuts and do not eat too many. Nuts have a high fat content and eating too many is bad for you.

Fat, salt and sugar

Fats and sugars contain more energy than any other food group and should make up the smallest part of your diet. Too much salt can lead to high blood pressure (hypertension).

Fats

Fats are divided into two groups:

• Saturated fat: this type of fat can raise the cholesterol in your blood and increase your risk of developing heart disease.
• Unsaturated fat: eating a small amount of unsaturated fat will help keep your immune system healthy and can reduce cholesterol levels.

Saturated fat is found in:

• cream, crème fraiche and ice cream
• butter and margarine
• cheese
• mayonnaise
• fried foods
• some savoury snacks, such as crisps
• some sweet snacks, such as chocolate
• some fatty cuts of meat
• the meat that is used in sausages and pies

Unsaturated fat is found in:

• sunflower, olive and vegetable oil
• spreads that are made from sunflower, olive and vegetable oils
• oily fish
• nuts and seeds
• avocados

A daily diet that contains too much fat may lead to obesity. Obesity is a serious health condition where a person has an excessive amount of fat or body weight. It can lead to a number of further medical conditions, including heart disease.

The average man should eat no more than 30g of saturated fat a day, and the average woman should eat no more than 20g of saturated fat a day. See below  for advice about how to lower the amount of fat in your diet.

Salt

Eating too much salt can raise your blood pressure, increasing your risk of having a stroke or heart attack. Adults should eat no more than 6g of salt a day and children much less than this (see below).

Around 75% of the salt in your diet is already in the food that you buy. As well as cutting down on the salt that you use to season foods, check the labels on the food you buy. The following foods tend to have a high salt content:

• ham
• soy sauce
• salami
• gravy granules
• pizza
• mayonnaise and ketchup
• crisps
• bread products, such as crumpets and
• bagels
• ready-made meals and sandwiches

Choose foods with 'reduced salt' or 'no added salt', and avoid processed foods. Tinned fish, vegetables and pulses are often in salted water, so it is a good idea to wash them before use. Try adding other seasonings to flavour food instead of salt. For example, try adding herbs, spices, garlic or lemon juice.

Sugar

Some foods, such as fruit and milk, contain natural sugar and these are fine in your diet. Cut down on products that have sugar added to them, such as:

• soft drinks
• sweets and biscuits
• cakes and puddings
• jam
• ice cream

Sugary foods are bad for your teeth and can cause tooth decay. Tooth decay occurs when holes (cavities) form in the outer layer of your tooth (enamel). The holes can spread into the centre of your tooth where the nerves and blood vessels are. This can cause a very painful infection and, in severe cases, your teeth can start to rot and may need to be removed altogether.

Sugary foods contain a lot of calories but few other nutrients. Eating too many calories can lead to obesity. Therefore, eat sugary foods sparingly as a special treat.

Fibre

Many starchy foods contain fibre. Fibre is found in foods that come from plants, such as:

• grains (found in wholegrain bread)
• pulses (edible seeds that grow in a pod, such as peas, beans and lentils)
• oats (found in some breakfast cereals)
• fruit and vegetables

Fibre is very good for you because:

• it helps food and waste products to move through your gut, preventing constipation (when you are unable to empty your bowels)
• it is bulky, which means that it makes you feel full
• certain types may help to reduce the amount of cholesterol in your blood

Reducing fat and sugar

You can reduce the amount of fat and sugar in your diet by:

• choosing leaner cuts of meat
• choosing low-fat spread instead of butter
• using semi-skimmed milk instead of whole fat milk
• using an oil spray for cooking (you will use less oil)
• eating sugary foods only as a treat
• consuming sugary foods and drinks as part of a meal rather than on their own
• sweetening dishes with dried or fresh fruit instead of sugar
• drinking water or unsweetened fruit juice

Daily salt allowance

Below is the maximum amount of salt that different age groups should consume in one day. If possible, you and your children should eat less salt than this:

• babies: less than 1g of salt (0.4g of sodium) a day
• toddlers 1-3 years old: less than 2g of salt (0.8g of sodium) a day
• children 4-6 years old: less than 3g of salt (1.2g of sodium) a day
• children 7-10 years old: less than 5g of salt (2g of sodium) a day
• children 11 years of age and over and adults: less than 6g of salt (2.4g of sodium) a day

Food labels

Check food labels to see whether the food you are buying is high in saturated fat, sugar or salt. Below is an explanation of what constitutes high and low saturated fat, sugar and salt content:

• high in saturated fat: more than 5g of saturated fat for every 100g
• low in saturated fat: less than 1.5g of saturated fat for every 100g
• high in sugar: more than 15g of sugar for every 100g
• low in sugar: less than 5g of sugar for every 100g
• high in salt: more than 1.5g of salt (0.6g of sodium) for every 100g
• low in salt: less than 0.3g of salt (0.1g of sodium) for every 100g

Some products also use the traffic light system as part of their labelling to indicate whether they are high or low in fat or sugar:

• red light: high
• amber light: medium
• green light: low

Recommendations

Vitamins and minerals are essential to keep your body functioning. If you have a vitamin or mineral deficiency, it can lead to health problems. By eating a healthy, balanced diet, most people can get all the vitamins and minerals they need.

Below is some information about the vitamins that you need in your diet, including where to find them in your recommended daily allowance (RDA). For further information.

Unless otherwise stated, all RDAs shown are based on adults leading normal lifestyles.

The recommendations for other people, particularly pregnant women, are likely to be different. See the pregnancy topic for more information about your health and diet during pregnancy.

Vitamin A

• The UK RDA is 0.7 mg for men, 0.6 mg for women.
• Vitamin A is good for your eyesight, immune system, healthy skin and mucous membranes (moist linings, for example inside your nose).
• Good sources of vitamin A include cheese, eggs, oily fish, milk, fortified margarine and yoghurt.
• Too little vitamin A can weaken your immune system, so you may become ill more easily.

Vitamin B6

• Vitamin B6 is also known as pyridoxine.
• The UK RDA of vitamin B6 is 1.4 mg for men and 1.2 mg for women.
• Vitamin B6 is important for turning food into energy and making haemoglobin (the substance that carries oxygen round the body).
• Good sources of vitamin B6 include pork poultry, whole cereals (such as oatmeal and wheat germ), bread, cod, eggs, soya beans, milk, potatoes and peanuts.
• Too little vitamin B6 can lead to problems with your nerves and skin.

Vitamin B12

• The UK RDA of vitamin B12 is 0.0015 mg.
• Vitamin B12 is good for the nervous system (your nerves, brain and spinal cord), making red blood cells, turning food into energy and processing folic acid.
• Good sources of vitamin B12 include all meat products, salmon, cod, milk, cheese, eggs and yeast extract.
• Too little vitamin B12 can cause anaemia, which is a condition where not enough oxygen is carried in the blood due to a lack of red blood cells. Anaemia can make you tired, faint and breathless.

Vitamin C

• Vitamin C is also known as ascorbic acid.
• The UK RDA of vitamin C is 40 mg.
• Vitamin C is good for healthy cells and absorbing iron from food.
• Good sources of vitamin C include fruit and vegetables, particularly oranges, peppers, broccoli, and kiwi fruit.
• Too little vitamin C can lead to tiredness, bleeding gums, aching joints and loose teeth. Scurvy is a condition that occurs as a result of a severe vitamin C deficiency.

Vitamin D

• There is no RDA of vitamin D for people leading a normal lifestyle. 
• Vitamin D is good for regulating the calcium and phosphate in your body, to keep bones and teeth healthy.
• The main source of vitamin D is sunlight on your skin, but it is also found in oily fish and eggs.
• Too little vitamin D can lead to muscle weakness and aching and weakened bones. A severe vitamin D deficiency can cause rickets (a condition characterised by deformed bones).

Calcium

• The UK RDA of calcium is 700 mg.
• Calcium is good for building strong bones and teeth. It also helps muscles, including the heart, to function, and ensures that blood clots normally.
• Good sources of calcium include milk and dairy products, broccoli, cabbage, kale (a leafy green vegetable), dried fruit, soya beans, nuts and fish containing edible bones (for example, sardines or pilchards).
• Too little calcium can cause brittle bones or lead to tooth decay.

Folic acid/ folate

• Folic acid is also known as folate.
• The UK RDA is of folic acid is 0.2 mg. 
• Folic acid is good for making red blood cells and preventing birth defects.
• Good sources of folic acid include broccoli, brussels sprouts, peas, asparagus, chickpeas and brown rice.
• Too little folic acid can lead to anaemia or birth defects in unborn babies.

Iron

• The UK RDA of iron is 8.7 mg for men and14.8 mg for women.
• Iron is important for making red blood cells.
• Good sources of iron include liver, meat, beans, nuts, dried fruit, whole grains, watercress, and curly kale.
• Too little iron can lead to anaemia (see Anaemia: iron deficiency).

Magnesium

• The UK RDA of magnesium is 300 mg for men and 270 mg for women.
• Magnesium is important for hormones that make your bones healthy and for turning food into energy. 
• Good sources of magnesium include green, leafy vegetables (such as spinach), nuts, bread, fish meat and dairy products.
• Too little magnesium can lead to hypocalcaemia (too little calcium in the body), which may cause brittle bones or tooth decay.

Niacin

• Niacin is also known as vitamin B3.
• The UK RDA of niacin is 17 mg for men and 13 mg for women.
• Niacin is good for your nervous system, digestive system, and turning food into energy.
• Good sources of niacin include beef, pork, chicken, eggs, milk, wheat flour and maize flour.
• Too little niacin can lead to skin problems, dizziness, swelling of the tongue and vomiting.

Potassium

• The UK RDA of potassium is 3,500 mg.
• Potassium is good for lowering blood pressure and controlling the balance of fluids in the body.
• Good sources of potassium include fruit (particularly bananas), vegetables, pulses, nuts, seeds, milk, fish, beef, poultry and bread.
• Too little potassium can lead to an irregular heartbeat, irritability, nausea (feeling sick) and diarrhoea.

Riboflavin

• Riboflavin is also known as vitamin B2.
• The UK RDA of riboflavin is 1.3 mg for men and 1.1 mg for women.
• Riboflavin is good for your skin, eyesight, nervous system, helping the body absorb iron and making red blood cells and steroids (hormones).
• Good sources of riboflavin include mushrooms, rice, eggs and milk.

Thiamin

• Thiamin is also known as vitamin B1.
• The UK RDA of thaimin is 1 mg for men and 0.8 mg for women.
• Thiamin is good for your nerves and muscles, and for turning food into energy.
• Good sources of thiamin include peas and other vegetables, pork, milk, cheese, eggs, fresh and dried fruit, and wholegrain bread.
• Too little thiamine can lead to headaches and tiredness.

Zinc

• The UK RDA of zinc is 5.5 to 9.5 mg for men and 4 -7 mg for women.
• Zinc is good for wound healing, making new cells and enzymes (chemicals) and processing carbohydrates, fat and protein in the food you eat.
• Good sources of zinc include meat, shellfish, milk, cheese and wheat germ.
• Too little zinc can lead to hair loss, skin problems, diarrhoea and poor wound healing.

Fruit and vegetables

Fruit and vegetables contain most of the vitamins and minerals that are needed to maintain good health. Aim to eat at least five portions of fruit and vegetables every day.

Supplements

Eating a varied and balanced diet will usually provide you with all the vitamins and minerals that your body needs. Sometimes, if you do not get an adequate amount of a certain vitamin, for example due to a medical condition, you may benefit from taking a vitamin supplement. Your GP can advise you about this.

If you choose to take a multivitamin (a single tablet that contains several different vitamins or minerals) make sure that it does not contain high doses of any one particular vitamin or mineral. High doses may be unnecessary, and if they are higher than the RDA (recommended daily allowance) for that vitamin or mineral, they can be harmful.

This is because some of the vitamins and minerals that you need, such as iron and vitamin A, are stored in your body. Taking them in a daily supplement can cause a harmful build-up. For example:

• Too much vitamin A can lead to weakened bones in later life.
• Too much vitamin B6 can lead to a loss of feeling in your arms and legs.
• Too much vitamin C can cause stomach pain, diarrhoea and flatulence (wind).
• Too much iron can cause nausea (feeling sick), vomiting and stomach pain.
• Too much potassium can lead to stomach pain, nausea and diarrhoea.

Therefore, if you take supplements, stick to the recommended dose and do not take them for too long.  Always seek medical advice before taking supplements and remember that they are no substitute for having a balanced diet.

Fluids

Drinking enough fluids

Water makes up two thirds of an adult's total body weight. As water is lost through breathing, sweating, and passing urine, it is very important for you to keep your water levels topped up.

Dehydration (when the normal water content of your body is reduced) can lead to headaches, tiredness and irritability.

Drink 1.2 litres of fluid every day

In the UK, you should aim to drink at least 1.2 litres of fluid a day (between six to eight glasses). However, you should drink more when the weather is hot, and during and after exercise because more fluid is needed to replace what is lost from your body.

Ideally, the fluid you drink should be water, but it also includes other drinks, such as: 

• squash - as long as it does not contain lots of added sugar,
• fruit juice - check the percentage of fruit juice it contains (100% is best), and 
• milk - which also contains vitamins and minerals, and calcium.

Avoid fizzy drinks because they contain lots of sugar.

Caffeine

Tea, coffee, and cola all contain caffeine. This acts as a diuretic, which means that it makes the body produce more urine.

Drinks that contain caffeine are fine to drink as long as you also drink other fluids that do not contain caffeine.

Fruit juice and smoothies

Fruit juice and smoothies contain lots of vitamins and may count as one portion of fruit (you need at least five portions of fruit or vegetables every day). However, they also contain a type of sugar, called fructose, which can cause tooth decay. Drink them with a meal, and chose juice with no added sugar.

Alcohol

If you drink alcohol, you should not exceed the maximum recommended daily intake. This is:

• 3-4 units of alcohol for men, and
• 2-3 units of alcohol for women.

One unit of alcohol is a single (25ml) measure of spirit, a 125ml (a small glass) of wine, or half a pint of standard strength lager, cider or bitter.

Drinking more than the recommended amount can have a negative effect on your health.  Excess drinking can increase your risk of developing some cancers, as well as heart and liver disease.

Selected links

NHS Direct Wales Encyclopaedia links

Age UK: Healthy eating

Change4Life website provides advice and information about eating well, moving more and living longer for adults and children.

British Dietetic Association: Weight Wise

The British Dietetic Association: Teens Weight Wise

British Nutrition Foundation