A How-To Guide to a Balanced Diet.

by Judith Willis
Q. Just what exactly is a balanced diet?
A. In the broadest sense, eating a balanced diet means eating a wide variety of foods. A
traditional way of getting a balanced diet has been to eat a certain number of portions from
certain food groups, as defined by the U.S. Department of Agriculture. At one time, there were
as many as 11 groups. In recent years, USDA defined four basic groups. In their latest
publication on the subject, they added a fifth group.
Q. What are these groups?
A. The four basic groups are vegetables and fruit; bread and cereal; milk and cheese; and meat,
poultry, fish and legumes such as garbanzos, kidney beans and lima beans.
It's from these groups that you need a certain number of servings each day. For example, it's
recommended that you have four servings from the fruit and vegetable group [a serving equals
one-half cup--or a typical portion such as an apple or half a grapefruit]. And you should include
one good source of vitamin C each day, such as citrus fruit, and a good source of vitamin A,
usually deep-yellow or dark-green vegetables. From the bread and cereal group, it is
recommended that you get four basic servings [a serving would be one slice of bread; one-half to
three-fourths of a cup of cooked cereal, pasta, or rice; or one ounce of ready-to-eat cereal]
including some whole-grain bread or cereals. The recommended servings from the milk and
cheese group vary with age, with the highest recommendations for teens and nursing mothers
(four servings). Two basic servings from the meat, poultry, fish and beans group are
recommended.
Then there's that new fifth group: fats, sweets and alcohol. It's a group that you want to avo...

Millions of people in Britain take food supplements, adding up to an industry worth around 350
million a year. These consumers believe their purchases are helping to protect their health. But
are they right - or are they merely suckers who have swallowed some skilful marketing?
The debate about the value of vitamin and mineral supplementation shows no sign of abating. On
one side are food scientists and dieticians who insist that a balanced diet offers all the nutrients
we need, that serious vitamin and mineral deficiency is rare in the developed world and that the
answer to bad eating habits is not a jar of pills.

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Ranged against them are nutritionists who claim that many of us are not consuming a balanced
diet and that even if we were, higher doses of certain vitamins and minerals than can be obtained
through food give us an extra boost and protect against disease.
"In principle, people in this country do not need to take supplements, provided they are healthy
and have a normal balanced diet," says Dr Sin Astley, research scientist at the Institute of Food
Research. "However, most people would probably say they are not as healthy as they might be
and that their diet is lacking in some respects.
"You no longer see deficiency diseases like scurvy in the Western world, but some people are
walking around with less than optimal levels of certain nutrients. For example, teenage girls have
an inadequate intake of iron. The problem is that much of the data is about avoiding deficiency
rather than achieving optimal nutrition, with the result that we have very little idea what we do
and don't need as individuals."
Ann Walker, senior lecturer in human nutrition at the University of Reading, has found evidence
in the British National Diet and Nutrition Surveys that a sizeable proportion of the population is
not getting the Reference Nutrient Intake - the recommended minimum amount - of several
vitamins and minerals, including iron, magnesium, calcium, zinc, vitamin A and vitamin D.
"More than 50 per cent of women aged 15 to 18 are not reaching the target for calcium and this
is worrying because that is the age when we lay down bone. This could have serious implications
for osteoporosis levels in the future," says Dr Walker. "Around 80 per cent of women do not
make the magnesium targets. A deficiency can lead to migraines, cramps, palpitations and heart
arrhythmias. It is unlikely that a GP would pick up a magnesium deficiency as the cause of these
problems, but I know from my clinical practice that people respond very well to
supplementation."
Dr Walker blames poor diets for these deficiencies. "Certain foods, such as fats and sugar, dilute
the impact of nutrients. Surveys show that our overall energy intake has diminished and our
micronutrient intake will also be reduced. The fact that the average adult eats fewer than three
portions of fruit and vegetable a day - compared with the recommended five - also has an
impact."
But is supplementation the answer to our nutritional shortcomings? In some cases, yes. Folic acid
has been found to reduce neural tube defects in babies: the necessary dose cannot always be
obtained from food, so women planning a family have been advised by the Government to take a
supplement. Those at risk of osteoporosis are prescribed calcium and vitamin D. Women with
heavy periods and teenage girls may need extra iron. Older people are less efficient at extracting
the B vitamins from their food and may benefit from supplementation.
But why stop there? There are many who swear that high doses of vitamin C can prevent colds,
that B6 can alleviate pre-menstrual symptoms, and that the antioxidant vitamins A, C and E can
mop up the free radicals that lead to cancer, heart disease and illnesses associated with ageing.
They believe it is only a matter of time before nutritional supplements are widely used in
therapeutic doses as an alternative to pharmaceuticals.

So far, research has produced conflicting results. Some trials suggest that people leading healthy
lifestyles who also take antioxidant supplements are at lower risk of developing heart disease
than those who do not take supplements. However, a review of seven high-quality trials
published last year in The Lancet showed that antioxidant supplementation actually increased
death rates from gastrointestinal cancers.
"We know that if you eat a diet high in vegetables, fruit, wholegrains and plant-derived fats you
have significantly less chance of developing the diseases associated with ageing," says Dr
Astley. "But we do not see the same effect when we isolate the antioxidant compounds in a
supplement. When you consume nutrients in a diet, they seem to work synergistically, in
harmony, like the instruments in an orchestra."
Taking a handful of pills will not change a bad diet into a good one, says dietician Lyndel
Costain. "Helping people to achieve a better diet can improve their health in many ways and help
to tackle obesity, diabetes, high blood pressure and heart disease. Arguably, vitamin pills are
peripheral to the big issues: they appeal to the worried well."
Costain accepts that a daily multivitamin is appropriate for anybody on a restricted diet,
including older people, slimmers, those with specific food allergies and teenage vegetarians.
When 231 young adult prisoners - whose diets are known to be poor - were given food
supplements in a double-blind, placebo-controlled trial, their behaviour improved dramatically.
Dieticians and food scientists are concerned about the high-dose tablets recommended by some
nutritionists.
"We cannot make the assumption that because vitamins and minerals are naturally occurring
food products, they are safe or that because a little of a nutrient is good, more will necessarily be
better," says Dr Astley. "Aspirin is a natural substance that can help in limited doses, but too
much will kill you. That is another reason why it is better to change your diet: you cannot
overdose on nutrients consumed as food."
The Government's Expert Group on Vitamins and Minerals, whose job it was to decide on safe
upper limits for a wide range of nutrients, has warned against taking more than 1,000mg a day of
vitamin C, 1,500mg of calcium or 17mg of iron and against long-term use of high doses of B6.
However, one expert in nutritional therapies has described the group's recommendations as
"excessively and inappropriately restrictive". The debate looks set to run for many years yet.