Less physical activity
In Scandinavia, as in most other industrialised countries, young people's everyday life is gradually mechanised and urbanised. More and more time is spent on indoor activities. As an example, 72 percent of all Norwegian teenage girls report that their favourite hobby is shopping. Young people's leisure time is spent in shopping malls, snack bars, in front of computergames, Internet chats, and television screens.
An average young man that graduate from highschool in the USA has spent 12000 hours at school and 19000 hours in front of a television/video screen. The distance between our different arenas is increasingly spent on wheels, lifts, and escalators. Many traditional physical activities are replaced by technical inventions. The New Scientist recently commented on the modern life style and its effect on people's health. As an example, the journal refers to English researchers who have calculated that the average use of a mobile phone saves us from walking 16 kilometers every year.
The normal situation of a Norwegian child at the end of the millennium is to enter kindergarten at the age of 3. The kindergarten offers little space for a variety of physical play. Much of the time is spent indoors on a flat floor, or on pillows, or on chairs. We have registered a setback in motor skills among pre-school children. In Scandinavia we also have a number of kindergartens where the kids spend all day out in the nature, in the woods, or at the seaside. These children have far better motor skills, they have better ability to concentrate, they observe visually better - which makes them safer along the roads, and generally they are in better health conditions. Even the teachers in these kindergartens are in better health than their colleagues in traditional kindergartens.
Traditionally, Norwegian school children walk to school every day. Only primary school pupils living more than 4 kilometers away from school are entitled to bus transportation. Today the situation is different. In most schools, about 50 percent of the pupils are taken regularly to and from school by car, either by parents or by neighbours. The percentage is higher among 6 year-olds, and lower among older pupils. This happens in spite of a major effort in many local communities to build separate roads for pedestrians and bikers, safe from the increasing car traffic.
Another aspect of this tendency is not to walk to school when the weather is cold, wet or windy. My own study indicates that students today are less tolerant to bad weather and have less ability to cope with physical strains than 10 to 15 years ago. Teachers taking students into woodlands and mountains complain about their lack of experience with outdoor life. They have far less knowledge about animals, plants, and nature in general than the students of the same age had a few years ago.
Traditionally, children and young people in Norway spent a lot of time on physical play, sports, and games. Today about 80 percent of all 10 to 11 year-old children in Norway take part in organised sport activities. The time spent on traditional physical play seems to be declining. At the age of 13, about 60 percent of the boys and 50 percent of the girls take part in organized sport activities. The figures go dramatically down as they grow older. The number of young people that never or very seldom play sports is increasing dramatically from the age of 15 to the age of 24. A recently published Norwegian study shows that only 47 percent of all young people aged 20 to 24 year-olds are doing physical training of any kind every 14 days or more.
A WHO study reveals that, among five-thousand 15 year-old students in Norway, 65 percent of the girls and 71 percent of the boys do physical exercise at least two times a week. However, the same study shows that 1 out of 5 is active in physical exercise of any kind less than an hour a week. The tendency is that one group of young people are especially active in sports and all other kinds of physical activities. On the other hand, we find an increasing number of young people that are almost completely physically inactive.
A statistics in the USA has reported that less than 10 percent of the US adult population engage in regular, vigorous physical activity more than 20 minutes per day, and 3 days per week. The tendency towards a more physically inactive lifestyle is very visible among students in the USA. In 1991 42 percent of students in grades 9 through 12 enrolled in daily physical education. In 1995 the similar figure was 25 percent. Among 9th grade students 80 percent of the boys and 62 percent of the girls reported of physical activities for 20 minutes or more at least 3 days a week. Among 12th graders the similar figures were 67 percent among boys and only 42 percent among girls. The American Healthy People 2010 aims to increase the proportion of physical actives at this level to at least 85 percent of all young people in grades 9 through 12.
In Norway military service is obligatory for all boys. To be enrolled in the military forces you have to keep up to a certain physical standard. Today 20 percent of Norwegian young boys are not taken into military service because of poor physical skills. An increasing number of young boys within the military service fail to pass certain physical tests. From the Norwegian University of Sport and Physical Education, it is reported that more and more students fail to enter because they do not pass the standard physical tests.
The decline in young people's physical activities happens at the same time as they are presented to extreme body ideals through television programmes like Baywatch, and through all kinds videos, movies and magazines. In stead of doing more physical exercise, many young people - especially girls - eat less. One result of this food phobia is high numbers of young people suffering from bulimia and anorexia. This is a serious health problem today in many countries. In spite of massive anti tobacco campaigns, 36 percent of all 18-year-old girls in Norway smoke. Many argue that it is better to smoke than to gain weight. Some girls even argue that they start smoking marihuana to lose appetite.
The modern physically lazy lifestyle has many unwanted consequences. Studies from all over Western Europe shows the same tendencies. In spite of a decrease in daily consume of calories, young people are gaining weight. The new lifestyle combined with a less healthy diet may create very high costs to the future society.
Increased physical activity may prevent high blood pressure. The risk of death due to heart disease has doubled among the physically inactive, even after adjustment for high blood pressure, high cholesterol levels and smoking has been done. In Scandinavia today we have more young people at risk for getting heart diseases than ever before. A result of the new life style is also an increase of certain types of cancer (e.g., Colon Cancer), and a dramatic increase in the number of diabetes II cases. Diabetes II is a disease normally associated with overweight elderly people. In Scandinavia today this disease is soon the most serious threat to people's health. Young people, even adolescents are getting diabetes II due to overweight and little physical exercise.
Studies show that as many as one out of five students in secondary school, and one out of ten in primary school need treatment because of pains in their neck, shoulders, and back. The reason for this suffering is normally too little physical activity. This kind of diseases costs the Norwegian society of 4 million people around 20 billion Norwegian kroner a year.
Norway has for many years had relatively high suicide rates among young people. From schools and clinics we regularly get reports of an increasing number of mentally depressed children and youths. Studies show that increased physical activity reduces the risk of depression.
Breakfast with bread, cheese and milk has a long been a tradition in Norwegian families. It has been looked upon as the most important meal of the day. Today we know that 1 out of 5 children go to school without eating any food in the morning. Many of them come from families where one hardly finds bread at home. This is a result of a busy and modern life-style that the family rarely eats breakfast, and many children do not bring food to school. Instead, they buy potato chips, chocolate, and sweet drinks.
At the age of 19, Norwegian young people in average eat fruit and vegetables only 3 times a week. Norwegian authorities recommend eating fruit and vegetables five times a day. We know that the more fruit and vegetables you eat as a child, the more you eat as an adult. The modern life-style among young people lead to more junk- food and fast food and less traditional and valuable food like fish, fruit and vegetables. We need a major change in the modern diet among children and youth to prevent a dramatic increase in heart diseases and a number of cancer varieties. Norwegian authorities recommend an increase to 65 percent in the average consumption of fruit and vegetables. That figure is also supported by the World Cancer Research Fund in their 1997 report "Food, Nutrition and the Prevention of Cancer: a global perspective." According to a Norwegian estimate, this change in nutrition would lead to a decrease of cancer on the lip, tongue, throat, oesophagus, and stomach with more than 50 percent, and a decrease of cancer in rectum and pancreas with 40 percent.
Modern families tend to skip common meals. Food is taken in a hurry in the kitchen, at a snack bar, or in the office. Regular meals, healthy food, and time spent at the table are important to our health and total well being. In many industrialised countries we find that the modern lifestyle is destroying what we have spent the whole century to build: Better nutrition and a healthy life for all.
The situation described above is typical for most industrialised countries. We even find it emerging among upper and middle class people in developing countries. It is necessary with extensive national and international programmes to promote a major change. Young people must learn about the consequences of a physically inactive lifestyle. We have to reintroduce physical activities in people's everyday lives. All students should have physical activities on their daily agenda, and we should promote everyday activities like biking instead of using the car, and taking the stairs instead of the lift. In urban planning we should always remember to leave space for playgrounds for children, for sport grounds and open areas for all young peoples unorganised outdoor activities.
It is necessary that public authorities carefully follow the development of young people's nutrition. Promotion of healthy food with more fruit and vegetables in schools is an important supplement to what many kids experience at home. Public campaigns should inspire the growing fast-food business to create meals of a higher nutritional value.
The human costs of not to intervene in these areas could be dramatic. The financial costs by having increasing numbers of dead and severely handicapped people because of an unwanted lifestyle will go beyond any imagination.
A healthy diet is one that helps to maintain or improve overall health. A healthy diet provides the body with essential nutrition: fluid, adequate amino acids from protein, essential fatty acids, vitamins, minerals, fibre and adequate calories.
The requirements for a healthy diet can be met from a variety of plant-based and animal-based foods, although a non-animal source of vitamin B12 is needed for those following a vegan diet. A healthy diet supports energy needs and provides for human nutrition without exposure to toxicity or excessive weight gain from consuming more calories than the body requires. A healthy diet, in addition to exercise, is thought to be important for lowering health risks, such as obesity, heart disease, type 2 diabetes, hypertension and cancer.
Various nutrition guides are published by medical and governmental institutions to educate individuals on what they should be eating to promote health. Nutrition facts labels are also mandatory in some countries to allow consumers to choose between foods based on the components relevant to health.
The idea of dietary therapy (using dietary choices to maintain health and improve poor health) is quite old and thus has both modern scientific forms (medical nutrition therapy) and prescientific forms (such as dietary therapy in traditional Chinese medicine).
World Health Organization
The World Health Organization (WHO) makes the following 5 recommendations with respect to both populations and individuals:
- Maintain a healthy weight by eating roughly the same number of calories that your body is using.
- Limit intake of fats. Not more than 30% of the total calories should come from fats. Prefer unsaturated fats to saturated fats. Avoid trans fats.
- Eat at least 400 grams of fruits and vegetables per day (potatoes, sweet potatoes, cassava and other starchy roots do not count). A healthy diet also contains legumes (e.g. lentils, beans), whole grains and nuts.
- Limit the intake of simple sugars to less than 10% of calorie (below 5% of calories or 25 grams may be even better)
- Limit salt / sodium from all sources and ensure that salt is iodized. Less than 5 grams of salt per day can reduce the risk of cardiovascular disease.
WHO stated that insufficient vegetables and fruit is the cause of 2.8% of deaths worldwide.
Other WHO recommendations include ensuring that foods chosen have sufficient vitamins and certain minerals, avoiding directly poisonous (e.g. heavy metals) and carcinogenic (e.g. benzene) substances, avoiding foods contaminated by human pathogens (e.g. E. coli, tapeworm eggs), and replacing saturated fats with polyunsaturated fats in the diet can reduce the risk of coronary artery disease and diabetes.
United States Department of Agriculture
Main article: History of USDA nutrition guides
Main article: MyPlate
The Dietary Guidelines for Americans by the United States Department of Agriculture (USDA) recommends three healthy patterns of diet, summarized in table below, for a 2000 kcal diet.
It emphasizes both health and environmental sustainability and a flexible approach: the committee that drafted it wrote: "The major findings regarding sustainable diets were that a diet higher in plant-based foods, such as vegetables, fruits, whole grains, legumes, nuts, and seeds, and lower in calories and animal-based foods is more health promoting and is associated with less environmental impact than is the current U.S. diet. This pattern of eating can be achieved through a variety of dietary patterns, including the “Healthy U.S.-style Pattern,” the “Healthy Vegetarian Pattern," and the "Healthy Mediterranean-style Pattern". Food group amounts are per day, unless noted per week.
|Food group/subgroup (units)||Healthy U.S. patterns||Healthy Vegetarian patterns||Healthy Med-style patterns|
|Fruits (cup eq)||2||2||2.5|
|Vegetables (cup eq)||2.5||2.5||2.5|
|Grains (oz eq)||6||6.5||6|
|Dairy (cup eq)||3||3||2|
|Protein Foods (oz eq)||5.5||3.5||6.5|
|Meat (red and processed)||12.5/wk||--||12.5/wk|
|Processed Soy (including tofu)||0.5/wk||8/wk||0.5/wk|
|Solid fats limit (grams)||18||21||17|
|Added sugars limit (grams)||30||36||29|
American Heart Association / World Cancer Research Fund / American Institute for Cancer Research
The American Heart Association, World Cancer Research Fund, and American Institute for Cancer Research recommend a diet that consists mostly of unprocessed plant foods, with emphasis a wide range of whole grains, legumes, and non-starchy vegetables and fruits. This healthy diet is full of a wide range of various non-starchy vegetables and fruits, that provide different colors including red, green, yellow, white, purple, and orange. They note that tomato cooked with oil, allium vegetables like garlic, and cruciferous vegetables like cauliflower, provide some protection against cancer. This healthy diet is low in energy density, which may protect against weight gain and associated diseases. Finally, limiting consumption of sugary drinks, limiting energy rich foods, including “fast foods” and red meat, and avoiding processed meats improves health and longevity. Overall, researchers and medical policy conclude that this healthy diet can reduce the risk of chronic disease and cancer.
In children, consuming less than 25 grams of added sugar (100 calories) is recommended per day. Other recommendations include no extra sugars in those under 2 years old and less than one soft drink per week. As of 2017, decreasing total fat is no longer recommended, but instead, the recommendation to lower risk of cardiovascular disease is to increase consumption of monounsaturated fats and polyunsaturated fats, while decreasing consumption of saturated fats.
Harvard School of Public Health
Further information: Healthy eating pyramid
The Nutrition Source of Harvard School of Public Health makes the following 10 recommendations for a healthy diet:
- Choose good carbohydrates: whole grains (the less processed the better), vegetables, fruits and beans. Avoid white bread, white rice, and the like as well as pastries, sugared sodas, and other highly processed food.
- Pay attention to the protein package: good choices include fish, poultry, nuts, and beans. Try to avoid red meat.
- Choose foods containing healthy fats. Plant oils, nuts, and fish are the best choices. Limit consumption of saturated fats, and avoid foods with trans fat.
- Choose a fiber-filled diet which includes whole grains, vegetables, and fruits.
- Eat more vegetables and fruits—the more colorful and varied, the better.
- Include adequate amounts of calcium in the diet; however, milk is not the best or only source. Good sources of calcium are collards, bok choy, fortified soy milk, baked beans, and supplements containing calcium and vitamin D.
- Prefer water over other beverages. Avoid sugary drinks, and limit intake of juices and milk. Coffee, tea, artificially-sweetened drinks, 100-percent fruit juices, low-fat milk and alcohol can fit into a healthy diet but are best consumed in moderation. Sports drinks are recommended only for people who exercise more than an hour at a stretch to replace substances lost in sweat.
- Limit salt intake. Choose more fresh foods, instead of processed ones.
- Drink alcohol in moderation. Doing so has health benefits, but is not recommended for everyone.
- Consider intake of daily multivitamin and extra vitamin D, as these have potential health benefits.
Other than nutrition, the guide recommends frequent physical exercise and maintaining a healthy body weight.
David L. Katz, who reviewed the most prevalent popular diets in 2014, noted:
The weight of evidence strongly supports a theme of healthful eating while allowing for variations on that theme. A diet of minimally processed foods close to nature, predominantly plants, is decisively associated with health promotion and disease prevention and is consistent with the salient components of seemingly distinct dietary approaches. Efforts to improve public health through diet are forestalled not for want of knowledge about the optimal feeding of Homo sapiens but for distractions associated with exaggerated claims, and our failure to convert what we reliably know into what we routinely do. Knowledge in this case is not, as of yet, power; would that it were so.
Marion Nestle expresses the mainstream view among scientists who study nutrition::10
The basic principles of good diets are so simple that I can summarize them in just ten words: eat less, move more, eat lots of fruits and vegetables. For additional clarification, a five-word modifier helps: go easy on junk foods. Follow these precepts and you will go a long way toward preventing the major diseases of our overfed society—coronary heart disease, certain cancers, diabetes, stroke, osteoporosis, and a host of others.... These precepts constitute the bottom line of what seem to be the far more complicated dietary recommendations of many health organizations and national and international governments—the forty-one “key recommendations” of the 2005 Dietary Guidelines, for example. ... Although you may feel as though advice about nutrition is constantly changing, the basic ideas behind my four precepts have not changed in half a century. And they leave plenty of room for enjoying the pleasures of food.:22
For specific conditions
In addition to dietary recommendations for the general population, there are many specific diets that have primarily been developed to promote better health in specific population groups, such as people with high blood pressure (as in low sodium diets or the more specific DASH diet), or people who are overweight or obese (in weight control diets). However, some of them may have more or less evidence for beneficial effects in normal people as well.
A low sodium diet is beneficial for people with high blood pressure. A Cochrane review published in 2008 concluded that a long term (more than 4 weeks) low sodium diet has a useful effect to reduce blood pressure, both in people with hypertension and in people with normal blood pressure.
The DASH diet (Dietary Approaches to Stop Hypertension) is a diet promoted by the National Heart, Lung, and Blood Institute (part of the NIH, a United States government organization) to control hypertension. A major feature of the plan is limiting intake of sodium, and the diet also generally encourages the consumption of nuts, whole grains, fish, poultry, fruits, and vegetables while lowering the consumption of red meats, sweets, and sugar. It is also "rich in potassium, magnesium, and calcium, as well as protein".
The Mediterranean diet, which includes limiting consumption of red meat and using olive oil in cooking, has also been shown to improve cardiovascular outcomes.
Further information: Dieting
Weight control diets aim to maintain a controlled weight. In most cases, those who are overweight or obese use dieting in combination with physical exercise to lose weight.
Diets to promote weight loss are divided into four categories: low-fat, low-carbohydrate, low-calorie, and very low calorie. A meta-analysis of six randomized controlled trials found no difference between the main diet types (low calorie, low carbohydrate, and low fat), with a 2–4 kilogram weight loss in all studies. At two years, all calorie-reduced diet types cause equal weight loss regardless of the macronutrients emphasized.
Reduced disease risk
Further information: Diet and cancer
There may be a relationship between lifestyle including food consumption and potentially lowering the risk of cancer or other chronic diseases. A diet high in fruits and vegetables appears to decrease the risk of cardiovascular disease and death but not cancer.
A healthy diet may consist mostly of whole plant foods, with limited consumption of energy dense foods, red meat, alcoholic drinks and salt while reducing consumption of sugary drinks, and processed meat. A healthy diet may contain non-starchy vegetables and fruits, including those with red, green, yellow, white, purple or orange pigments. Tomato cooked with oil, allium vegetables like garlic, and cruciferous vegetables like cauliflower "probably" contain compounds which are under research for their possible anti-cancer activity.
A healthy diet is low in energy density, lowering caloric content, thereby possibly inhibiting weight gain and lowering risk against chronic diseases. Chronic Western diseases are associated with pathologically increased IGF-1 levels. Findings in molecular biology and epidemiologic data suggest that milk consumption is a promoter of chronic diseases of Western nations, including atherosclerosis, carcinogenesis and neurodegenerative diseases.
The Western pattern diet which is typically eaten by Americans and increasingly adapted by people in the developing world as they leave poverty is unhealthy: it is "rich in red meat, dairy products, processed and artificially sweetened foods, and salt, with minimal intake of fruits, vegetables, fish, legumes, and whole grains."
An unhealthy diet is a major risk factor for a number of chronic diseases including: high blood pressure, diabetes, abnormal blood lipids, overweight/obesity, cardiovascular diseases, and cancer.
The WHO estimates that 2.7 million deaths are attributable to a diet low in fruits and vegetables every year. Globally it is estimated to cause about 19% of gastrointestinal cancer, 31% of ischaemic heart disease, and 11% of strokes, thus making it one of the leading preventable causes of death worldwide.
Popular diets, often referred to as fad diets, make promises of weight loss or other health advantages such as longer life without backing by solid science, and in many cases are characterized by highly restrictive or unusual food choices.:296 Celebrity endorsements (including celebrity doctors) are frequently associated with popular diets, and the individuals who develop and promote these programs often profit handsomely.:11–12
Fears of high cholesterol were frequently voiced up until the mid-1990s. However, more recent research has shown that the distinction between high- and low-density lipoprotein ('good' and 'bad' cholesterol, respectively) must be addressed when speaking of the potential ill effects of cholesterol. Different types of dietary fat have different effects on blood levels of cholesterol. For example, polyunsaturated fats tend to decrease both types of cholesterol; monounsaturated fats tend to lower LDL and raise HDL; saturated fats tend to either raise HDL, or raise both HDL and LDL; and trans fat tend to raise LDL and lower HDL.
While dietary cholesterol is only found in animal products such as meat, eggs, and dairy, studies have not found a link between eating cholesterol and blood levels of cholesterol.
Vending machines in particular have come under fire as being avenues of entry into schools for junk food promoters. However, there is little in the way of regulation and it is difficult for most people to properly analyze the real merits of a company referring to itself as "healthy." Recently, the Committee of Advertising Practice in the United Kingdom launched a proposal to limit media advertising for food and soft drink products high in fat, salt or sugar. The British Heart Foundation released its own government-funded advertisements, labeled "Food4Thought", which were targeted at children and adults to discourage unhealthy habits of consuming junk food.
From a psychological and cultural perspective, a healthier diet may be difficult to achieve for people with poor eating habits. This may be due to tastes acquired in childhood and preferences for sugary, salty and/or fatty foods.
Animals that are kept by humans also benefit from a healthy diet and the requirements of such diets may be very different from the ideal human diet.
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