Poor diet is responsible for over half of all coronary heart disease (CHD) cases.

One of the main culprits is saturated fat which leads to high cholesterol.  What many people don't realise is that large amounts of fat are hidden in some of their favourite foods - foods such as cheese, savoury snacks, chips, biscuits, cakes and butter.

Excess saturated fat intake is one of the key indicators of poor diet among people in Britain.

  • 80% of adults in Great Britain are exceeding the maximum recommended intakes for saturated fat.  Less affluent households in Merseyside have higher levels of total blood cholesterol compared with the rest of England, which is indicative of a higher fat intake
  • Over 50% are exceeding the maximum recommended intakes for total fat (1). Less affluent households in Merseyside have a higher prevalence of obesity compared with the rest of England, which is indicative of poorer diets (2).  Around 50% consume more salt than the maximum recommended. Women in Merseyside have higher levels of hypertension compared with the rest of England (2)
  • Less than a sixth of respondents in the Greater Merseyside Lifestyle Study reported eating the recommended daily quota of fruit and vegetables.

Children's diets are equally poor.  In Great Britain children are eating:

  • 50% more saturated fat than the maximum recommended
  • 50% more sugar than is recommended
  • More than twice the maximum recommended salt intake
  • Only a quarter of the fruit and vegetables recommended (3)

Merseyside children's poor diets and the fact that they are getting worse, are reflected in local health trends. For example,

  • Between 1989 and 1998 the proportion of overweight and obese children under 5 in Wirral increased from 20% to 33% (4)
  • In some parts of Merseyside 65% of children under 5 have dental caries (5)
  • In some parts of Merseyside nearly 60% of boys are overweight (6).

Heart of Mersey launched the Greater Merseyside Food and Health Strategy in January 2005. The key aims of the strategy are to work strategically with partners to influence policies along the food chain, from production to consumption, which support the population to:

  • Reduce their saturated fat and total fat intakes
  • Reduce their salt and sugar intakes
  • Increase their consumption of fish, vegetable oils, grains,nuts and pulses
  • Increase their daily quota of fresh fruit and vegetables.

The strategy was developed with a wide range of partners, including NHS organisations and local authorities and is being implemented at three levels:

  • Local: working with local partners to support and add value to initiatives to improve access to healthy and nutritious food.
  • National: engaging with national partners to support and bring a local dimension to national campaigns and policy development
  • European: adding an independent local/sub-regional perspective to lobbying and advocacy for policy change at European Level. This is a key element because approximately 80% of food policies are developed by the European Union; many as a result of the Common Agricultural Policy, which is urgently in need of reform.

Children have been identified as a key priority for our interventions as dietary patterns are set early in life, and coronary heart disease originates in childhood.

The main elements of the food programme are:

1. Advocacy and communications

  • Produce responses to consultations at local, national and European level
  • Carry out research and produce reports on the impacts of implementing policies to support better nutrition
  • Develop campaigns on issues affecting local delivery
  • Produce briefing papers which analyse policies and suggest recommendations for action

2. Creating healthier environments

  • Promote and reward food service establishments that provide healthier options to the general public through the Greater Merseyside Food Charter Award
  • Work with the public sector bodies (such as hospitals) on Merseyside to improve the nutritional quality of food provided to staff, customers and patients to support the dietary goals; and to increase the amount of food that is sourced in a way that supports sustainable principles
  • Work with partners to identify areas where access to healthy food is poor among deprived communities, and introduce solutions to support improvements in access to healthy food in deprived communities
  • Work with local councils and health partners to support a change in cultural approaches to food.

3. Developing public health evidence

  • Pilot and evaluate interventions to support healthier eating, particularly among children
  • Undertake surveys and audits of the implementation of policies and practices which affect the population's diet.
  • Submit project bids to national and European funding streams to support the identification of good practice and development of recommendations for improving diet.

4. Building capacity

Lecturing & training input into key public health and nutrition programmes in the higher education and medical training sectors on Merseyside

5. Sharing good practice & networking

Develop networks and forums as well as stakeholder events to support the sharing of good practice.

References

1. Food Standards Agency. 2002. National Diet and Nutrition Survey: Adults Aged      16-64. Volume 1. London: Food Standards Agency

2. Capewell, Lloyd-Williams, Ireland. 2005.   In Sickness and In Health.  2003 Health Survey for Greater Merseyside

3.  National Heart Forum 2004. Nutrition and Food Poverty: A toolkit for those involved in developing or implementing a local food poverty and nutrition strategy. London: National Heart Forum

4. Bundred P, Kitchiner D, Buchan I 2001. Prevalence of overweight and obese children between 1989 and 1998: population based series of cross sectional studies. BMJ 322:1-4.

5.  The Dental Observatory. 2004. DMFT Data for Primary Care Trusts.