• Fewer than 0.1% of adults in the United Kingdom adhere to the U.K. Government’s Eatwell Guide for a healthy, balanced diet.
• Adults could add nearly 9 years of life expectancy by switching from an unhealthy diet to the diet outlined in the U.K.’s Eatwell Guide, a U.K. Biobank study has shown.
• Those who already follow the ‘median’ diet in the U.K., which only partially follows the Eatwell Guide recommendations, could gain around 3 years in life expectancy by making the full switch to a healthier diet.
• The study authors are calling for long-term action to be taken to enable more adults to eat healthily in order to reduce the burden of disease from poor diet.

Poor diet and lack of physical activity are “leading global risks to health,” according to the World Health Organization (WHO).

In order to improve diet globally, the WHO is working with countries to commit to a number of initiatives, including the elimination of trans fats, reducing salt intake and developing guidelines around food labelling and the use of artificial sweeteners.

The United Kingdom Government published its Eatwell Guide in 2016 to help people follow a healthy, balanced diet. It outlines the importance of eating at least five portions of fruit and vegetables a day, reducing salt and saturated fat intake, and promotes the consumption of whole grains and pulses, alongside suggestions for portion size and caloric intake.

Despite this guide being published to ensure policy in the U.K. is developed in line with these dietary aims, research published in BMJ Open suggests that less than 0.1% of the country’s population follows a diet that adheres to the guide’s recommendations.

How healthy diets impact longevity

The U.K. Biobank is a database set up in 2006 that tracks the health of half a million people, aged between 40 and 69 years, and living in the U.K. The Biobank collects data on the diets of participants, as well as on their overall health.

A recent study by a team of researchers based at the University of Bergen, Norway analysed U.K. Biobank data from over 465,000 participants to determine the impact of adherence to the diet outlined in the Eatwell Guide on their life expectancy. Its results appear in Nature Food.

Dietary patterns of participants were assessed, with intake of all food groups split into five quintiles, from lowest to highest. Dietary patterns associated with longevity were the quintiles for each food group with the lowest mortality risk.

Unhealthy dietary patterns were characterized by limited amounts of whole grains, vegetables and fruits, fish, and white meat, but a high intake of red and processed meats, eggs, refined grains and sugary drinks. Outcomes were also reported based on adherence to the dietary pattern recommended by the Eatwell Guide.

Researchers adjusted the data for factors including age, sex, area-based sociodemographic deprivation, smoking, alcohol consumption and physical activity level, and body mass index (BMI).

Their analysis indicated that a 40-year-old man changing his diet from an unhealthy diet to one following the Eatwell Guide dietary recommendations would add 8.9 years onto his life expectancy. For a woman of the same age, this change led to an 8.6-year increase in life expectancy.

For a 70-year-old man the change would correspond to a 4-year increase in life expectancy, and a 4.4-year increase for a woman of this age.

When these results were adjusted for BMI and energy consumption, the overall increase in life expectancy that could be attributed to improvements in diet dropped somewhat.

Meat consumption linked to higher death risk

Lead author Prof. Lars Fadnes of the University of Bergen, research group leader at Haukeland University Hospital, told Medical News Today:

“Our analyses and other research indicate that what we eat is linked to the risk of obesity, which again is a contributing risk factor to premature deaths. Our analyses could indicate that the risk for premature deaths related to overweight/obesity was about a quarter of the dietary increased risk from unhealthy eating and mortality.”

Researchers also looked at which foods had the greatest impact on decreasing the overall mortality risk.

They found that consuming more whole grains and nuts and less red meat and sugary drinks was associated with the biggest improvements in life expectancy.

Socioeconomic factors impact diet quality

As there were so few individuals who adhered to a healthy diet, these data provided the least amount of certainty, the study authors said.

“In our analyses, we do not only use groups that adhere to every aspect of the guidelines but rather compare all parts of the populations that adhere more or less to each of these recommendations, and then see how much health benefits each of the recommendations contribute to and how this can adds up together,“ Prof. Lars added.

“For some food groups, it is not possible to split evenly between five different ranges of intakes — what we label as quintiles. Thus, some intake categories can have fewer people than others. As more people within an intake level increases precision and certainty, fewer people will contribute to more uncertainty for these,” he noted.

Authors said their results supported long-term, multi-sector action to improve the diets of people in the U.K., including taxes on unhealthy food while reducing the cost of healthy foods.

Dr. Linia Patel, a dietician and British Dietetic Association spokesperson, who was not involved in the research, told MNT that her own research has shown that socioeconomic factors are the biggest determinant of whether patients can adhere to healthy diets — in this case, she studied the DASH diet, which is designed to lower blood pressure to reduce cardiovascular disease risk.

The results were not surprising, and the Eatwell Guide was supported by evidence that shows it supports a healthy diet, she said:

“We know that eating more whole grains, eating more legumes, eating more plant-based foods, they have all the plant goodness that is beneficial for us. So this is not necessarily new. What was nice is they’ve done a different model to actually quantify the number of years which is good to see.“

However, Dr. Patel also noted that the Eatwell Guide has attracted some criticism for not being inclusive of South Asian diets, and of diets typically followed by Black people in the U.K.

She also cautioned that the U.K. Biobank cohort may not be entirely representative of the country’s population.

“[I]f you look at U.K. Biobank data in general — even though at the moment I’m running a study on it myself — [it] is not very representative. […] [I]t tells the story, but it doesn’t tell necessarily the most representative story because the population group is […] predominantly Caucasian people, who actually are not from a low socioeconomic status. So it gives us a part of the story, but not the full story.”

She said that while data like these are helpful, they still do not indicate the best approach to designing policy so as to help people to eat better for their health.

Pointing to the low adherence to the Eatwell Guide, Dr. Patel said policy should ensure that the diet is achievable for people to adhere to. In addition to the policy suggestions made by the authors and others, she believes education is key to ensuring healthy nutrition.

“We know that beans and lentils are not necessarily that expensive, but for some reason people don’t use them. Why are people not using them? What are the barriers? The more questions like that I think need to be asked for us to fully understand how we can take something like research like this into the practical application of policy.”

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