Lifestyle

Diet and nutrition

The Eatwell Guide published by Public Health England outlines what constitutes a healthy and balanced diet. It includes fruit and vegetables (39%), starchy carbohydrates (37%), proteins (12%), dairy and alternatives (8%), oils and spreads (1%), and occasional foods (3%). Therefore, three quarters of a diet should encompass fruit, vegetables and starchy carbohydrates.

People living in the UK are advised to follow the 5-a-day campaign: being mindful of including five portions of fruit and vegetables in their diet each day. It is also advised that diets are low in sugar, salt and saturated fat. Following a healthy and balanced diet can avoid heart disease, stroke and bowel cancer cases.

In England, just over half of all adults (16+) meet the 5-a-day dietary recommendation (57.4%), with similar rates recorded locally in Derby (57.7%) by the Active Lives survey in 2017. This demonstrates that there is a large proportion of the local population who should make improvements to their diet to include five portions of fruit and vegetables each day and avoid foods containing excess sugar, salt and saturated fat.

Infants who are exclusively breastfed for the first six months of life are given the best nutrition. Exclusive breastfeeding avoids maternal and child health associated costs.

Physical activity

Physical inactivity is one of the top 10 causes of disease and disability in England (PHE, 2016). Taking part in regular physical activity can help lead to the prevention and management of over 20 chronic conditions and diseases, many of which are on the rise and affecting people at an earlier age. Regular exercise protects against diseases such as diabetes and particular cancers, and conditions such as obesity, hypertension and depression. Physical activity has wider reaching benefits as well, for instance brain development and educational attainment in children, better workplace productivity and reduced sickness absence, and a reduction in antisocial behaviour. 

By promoting and persuading inactive individuals (those doing less than 30 minutes per week) to become more active, it could prevent one in ten cases of stroke and heart disease in the UK and one in six deaths from any cause (Public Health England, 2016).

The Chief Medical Officer (CMO) recommends that all adults should be physically active for 150 minutes a week, and children and young people should be physically active for an hour each day. Alongside these physical activity guidelines, it is recommended that times of extended sedentary periods are also avoided.

Infographics detailing the recommendations can be found on GOV.UK - Start active, stay active: infographics on physical activity

Latest data from the Active Lives Survey (Sport England, 2018) indicates that nationally one in four adults (25.2%) did less than 30 minutes of physical activity a week, and therefore were classed as inactive. Similar rates were recorded locally in Derby, with 24.9% of the adult population recorded as inactive.

Nine in 10 UK children aged between two and four years do not achieve the physical activity guidelines (NHS Digital, 2016). Meanwhile, of young people aged between five and fifteen around 4 in 5 are not meeting the guidance (Public Health England, 2018). It’s important to develop healthy lifestyle behaviours from a young age because poor lifestyles developed in childhood are challenging to reverse in adulthood.

Essentially, more adults in Derby need to become physically active and strive towards regular physical activity at moderate level. More pressingly, children require the opportunity and encouragement to be physically active each and every day. Physical activity across generations is recommended in order to avoid the associated diseases such as diabetes and specific cancers, and conditions such as hypertension and depression.

Obesity

The rate of obesity in England has significantly increased since the 1990s. Now one in three children are overweight or obese, with rates of obesity increasing as children age. 10.1% of children in Derby begin primary school obese and this rises to 23.1% of children in Derby being obese when they leave (NHS Digital, 2017). In Derby, 65.1% of adults are overweight/obese (Public Health England, 2017). The levels of obesity are concerning because being overweight and obese is associated with health problems such as diabetes type 2, heart disease, stroke, hypertension and some cancers.

Ultimately, to reverse this obesity trend, individuals, families and communities need to move more, eat less and consume a healthy, nutritious diet.

Livewell Service

Livewell is Derby City Council’s wellbeing service which supports people to improve their lifestyles through losing weight, stopping smoking and getting physically active. In 2017/18 1,160 people were supported by Livewell to quit smoking, 936 NHS Health Checks were delivered and 1,891 children engaged in active schools.

Diabetes

Diabetes is a common life-long health condition and can increase the risk of other health conditions such as heart attack, stroke and amputation, and can even result in premature death.

There are just under 3.7 million people diagnosed with diabetes in the UK and an estimated 850,000 people who have the condition, but don’t know it (Diabetes UK, 2017).

There are two main types: Type 1 and Type 2.

Type 1: diabetes develops when the insulin-producing cells in the body have been destroyed and the body is unable to produce any insulin. This type is the most common found in childhood, and will usually appear before the age of 40. It can be treated with daily insulin injections, a healthy diet and regular physical exercise.

Type 2: diabetes develops when the insulin-producing cells in the body are unable to produce enough insulin, or when the insulin that is produced does not work properly. This type usually appears in people over the age of 40, though in South Asian people, who are at greater risk, it often appears from the age of 25.  

Around 90% of people have Type 2 diabetes, and around 10% have Type 1 diabetes. There are also rarer types like MODI, monogenic and gestational diabetes (Diabetes UK, 2017). Type 1 diabetes cannot be prevented. Type 2 however, whilst more complex, can often be prevented by leading a healthier lifestyle and being of a healthy weight.

To find out how at risk you are of developing Type 2 diabetes, take the Diabetes UK Risk Score Test. In the Southern Derbyshire Clinical Commissioning Group (CCG) area that covers Derby City, the prevalence of diagnosed diabetes among people aged 17 years and older is 7.1% (31,197 people in 2016/17) compared to 6.7% in similar CCGs (Public Health England, 2017).   

More details can be found in the Adult Diabetes Community Health Profile which can be downloaded below.

References

• Diabetes UK (2017). Position statements & reports – facts and figures [online]. Diabetes UK. [viewed 16/10/18]. Available from: Diabetes UK - Facts and Figures
• NHS Digital (2016). Health Survey for England 2015 [online]. NHS Digital. [viewed 15/10/18]. Available from: NHS  Digital - Health Survey for England, 2015 
• NHS Digital (2017). National Child Measurement Programme – England, 2016/17 [online]. NHS Digital. [viewed 16/10/18]. Available from: NHS  Digital - National Child Measurement Programme - England, 2016-17
• Public Health England (2016). Health matters: getting every adult active every day [online]. Public Health England. [viewed 26/07/18]. Available from: GOV.UK - Guidance: Health matters: getting every adult active every day
• Public Health England (2017). Public Health Profiles – Obesity [online]. Public Health England. [viewed 16/10/18]. Available from: Public Health England - Obesity 
• Public Health England (2018). Severe obesity in 10 to 11 year olds reaches record high [online]. Public Health England. [viewed 24/09/18]. Available from: GOV.UK - News story -Severe obesity in 10 to 11 year olds reaches record high
• Sport England (2018). Active Lives Adult Survey May 17/18 Report [online]. Download available from:
• Sport England website: Active lives adult survey May 17/18 report, Published October 2018