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Our guidance aims to help you address common eating difficulties for autistic people.

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Help from dietitians to help you get started

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As we approach the new year, many clients may be looking to make a plant-based diet one of their resolutions. Tiluka Bhanderi looks at how you can help them maintain a healthy approach.
Contrary to popular belief, vegan and plant-based are two different things. Vegan omits all animal products from the diet and lifestyle whereas plant-based refers to a diet that omits animal products and focuses on plant foods. ¹

Plant-based diets have been increasing in popularity with more people choosing to adopt this diet for a variety of reasons including ethical, sustainability and health concerns. The health benefits associated with a plant-based diet include a lower risk of heart disease, type 2 diabetes and certain types of cancers. ² It is important to make sure the diet is well planned to prevent deficiencies.

Vegan Eatwell Guide

The Vegan Eatwell Guide was produced by The Vegan Society and published in 2020 by Public Health England. ³ It was developed as guidance to help ensure a plant-based diet is balanced and food groups have been replaced with alternative substitutes. It outlines five key food groups:

1. Fruit and vegetables: fill at least half of your plate with a variety of fruit and vegetables - the more colours the better to ensure you're receiving an array of vitamins, minerals and antioxidants

2. Starchy foods: opt for wholegrain or high-fibre options of foods such as bread, rice and pasta whenever possible to maximise nutritional benefits. This food group provides energy, B vitamins, calcium and iron, and they are a good source of fibre

3. Protein: protein is essential for growth and repair. Sources include beans, peas and lentils. Well-known and versatile substitutes include tofu, tempeh, seitan, edamame, quinoa and Quorn (mycoprotein). Plant-based whole food protein sources are often high in iron, zinc and fibre. Additionally, they often count towards one of your 5 a day

4. Dairy alternatives: the range of plant-based cheeses, milks and yoghurts available in the UK is growing and, with more options available, it can be hard to know which ones to pick. Look for products fortified with calcium and vitamin D to help maintain bone health.

5. Healthy fats: these are essential in a balanced diet. Sources include avocados, olives, nuts such as walnuts and seeds like flax and chia. Fats are a source of essential fatty acids and they help the body absorb fat-soluble vitamins A, D, E and K.

Common concerns and how to address them

Nutrient deficiencies

B12 - commonly known as a vegan's deficiency, vitamin B12 cannot be obtained by plants alone. B12 is used to make red blood cells and it helps release energy from food. Sources of vitamin B12 include fortified dairy alternatives, nutritional yeast and fortified breakfast cereals. ⁴ Although it is possible to meet vitamin B12 requirements with diet alone, some may find it easier to take a supplement, especially whilst still learning about adjusting their diet.

Calcium - calcium is needed to build and maintain strong bones. It can be obtained from fortified plant-based milks e.g., soya, almond, oat, dried fruits including figs and prunes, leafy greens such as kale and broccoli, nuts such as Brazil nuts and almonds, and seeds such as sesame. ⁵ Vitamin D is needed to help the body absorb calcium. It is recommended that everyone in the UK takes a 10-microgram vitamin D supplement, especially during the winter months. Anti-nutrients such as oxalates and phytates found in foods such as spinach, seeds, legumes and nuts can affect the amount of calcium absorbed from whole-food plant-based sources as they bind to calcium and decrease its bioavailability, but soaking, sprouting or boiling foods has been found to help de-activate anti-nutrients. ⁶ It is still important to include these foods in your diet and obtain calcium from a wide range of whole-food and fortified sources to prevent deficiencies.

Iron - iron helps the body make healthy red blood cells. Sources include leafy greens, legumes, wholegrains, nuts and seeds. Consume vitamin C-rich foods such as berries, citrus fruits and bell peppers alongside iron-rich foods to increase absorption. ⁷

Iodine - needed to make thyroid hormones, iodine is an essential nutrient for following a plant-based diet. The amount of iodine contained in plant foods is dependent on the soil quality it was grown in. Sources include seaweed and fortified alternatives. It may be beneficial for some to take a supplement. ⁸

Abdominal discomfort such as bloating

This can be normal in the beginning when adjusting to a plant-based diet. Plant-based diets are higher in fibre, which can cause bloating as your body adjusts. Top tips to help manage bloating and gas include:

Drinking enough water: recommendations are to have 1.5-2L of fluid per day⁹ Building up slowly: increasing your fibre intake slowly allows your gut time to adjust

Eating mindfully: taking your time to eat reduces the chances of swallowing more air¹⁰

Being aware of cruciferous vegetables: vegetables such as cabbage, broccoli and cauliflower contain the sugar raffinose which contributes to bloating¹⁰

Soaking dried beans and lentils overnight before cooking.: this practice helps break down the oligosaccharides that causes bloating. Tinned beans are thought to cause less bloating but must still be drained and washed thoroughly.¹¹

Plant-based diet essentials

1. Find your why: think about your reasons for trying a plant-based diet and what you hope to get out of it. Whether it's to reduce your meat consumption, lose weight or have improved energy levels, set a clear intention to help keep you on track.

2. Monitor your 'all or nothing' mindset: perhaps try a few meat-free or dairy-free days in the week to experiment with a new way of eating and living.

3. Plan your meals: set aside some time each week to search for new recipe ideas; create a weekly meal guide and meal prep to help keep you on track.

4. Get creative in the kitchen: experiment with different flavours, spices and cooking methods and try to add a new fruit or vegetable to your meal at least once a day to increase your plant diversity.

5. Rally up support: get a friend or family member involved to help keep you accountable.

It's important to remember that adapting your diet requires patience, exploration, and a willingness to change. It's about progress, not perfection. Enjoy the process of discovering new flavours and nourishing your body with wholesome plant-based foods. As you embark on this path, you'll not only experience the benefits first-hand but also contribute to a healthier planet for generations to come.

Recommended resources
Free App: VeGuide
The Vegan Society has developed an app available on Android and iOS devices. Tailored to a UK audience, it contains useful videos, guides and recipes to help with adapting your diet. ¹²
Plant-based Health Professionals UK
Plant-based Health Professionals UK is dedicated to increase education around whole-food plant-based nutrition. Their website contains free resources and factsheets, and they provide a membership option for healthcare professionals to join with benefits including access to CPD-accredited webinars, online and in-person socials and events, regular journal and book clubs, and a listing in their health professional directory. ¹³

References

1. British Nutrition Foundation. Plant based diets. Accessed on: 18th May 2023 nutrition.org.uk/putting-it-into-practice/plantbased-diets/plant-based-diets/

2. British Dietetic Association. Vegetarian and Vegan Fact Sheet. Accessed on: 18th May 2023 bda.uk.com/resource/vegetarian-vegan-plant-based-diet.html

3. Vegan Society. Eatwell guide. Accessed 18th May 2023 vegansociety.com/sites/default/files/uploads/downloads/The%20Vegan%20Eatwell%20Guide_1.pdf

4. Vegan Society. Vitamin B12. Accessed on: 18th May 2023 vegansociety.com/resources/nutrition-and-health/nutrients/vitamin-b12

5. Vegan Society. Calcium. Accessed on: 18th May 2023 vegansociety.com/resources/nutrition-and-health/nutrients/calcium

6. Harvard T.H. Chan. Antinutrients. Accessed on: 18th May 2023 hsph.harvard.edu/nutritionsource/anti-nutrients/

7. British Dietetic Association (BDA). Iron Deficiency. Accessed on: 20th May 2023 bda.uk.com/resource/iron-rich-foods-iron-deficiency.html

8. Vegan Society. Iodine, Accessed on: 20th May 2023 vegansociety.com/sites/default/files/uploads/downloads/Iodine%20PDF_0.pdf

9. British Dietetic Association (BDA). Importance of Hydration. Accessed on 20th May 2023 bda.uk.com/resource/theimportance-of-hydration.html

10. Up To Date. Patient education: Gas and bloating (Beyond the Basics) 19th May 2023 uptodate.com/contents/gas-and-bloating-beyond-the-basics

11. International Journal of Food Sciences and Nutrition. Soaking and cooking modify the alpha-galacto-oligosaccharide and dietary fibre content in five Mediterranean legumes. Accessed on: 19th May 2023 tandfonline.com/doi/full/10.1080/09637486.2018.1544229

12. Vegan Society. VeGuide. Accessed on 1st June 2023 vegansociety.com/go-vegan/veguide

13. Plant-based Health Professionals. Accessed on: 1st June 2023 plantbasedhealthprofessionals.com/

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As we approach the new year, many clients may be looking to make a plant-based diet one of their resolutions. Tiluka Bhanderi looks at how you can help them maintain a healthy approach.

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If you are autistic, you may have difficulty with communication and social interactions with others. This Fact Sheet looks at the most common dietary problems affecting autistic people and how dietitians can help.

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Child and family healthy weight programme for families that live or are registered to a GP in Surrey.

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About Be Your Best

BYB can help all parents with online advice, but families who might need an extra hand to manage their child's weight can get further, personal support at home, plus learn more on online group sessions.

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About Be Your Best BYB can help all parents with online advice, but families who might need an extra hand to manage their child's weight can get further, personal support at home, plus learn more on online group sessions.

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Access the very best support for free to help you make healthy lifestyle changes and unlock sustainable weight loss!

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Free Surrey weight loss services for lasting health and wellbeing. Benefit from Health coach guidance and tailored nutrition and exercise plans.

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Lose weight with this free 12 week programme. Download the free app, access free recipes and menu plans

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Take steps to improve your health. Lose weight and feel better inside and out. Try our free NHS weight loss plan to get you started.

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Information from British Nutrition Foundation

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Arthritis and Nutrition | British Nutritional Foundation

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There is no special diet that can cure arthritis, but some people living with arthritis use dietary changes to

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Information from the British Nutrition Foundation

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Osteoporosis and Nutrition | British Nutritional Foundation

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Exercising, maintaining a healthy weight and eating a healthy, balanced diet, rich in vitamin D and calcium can help to keep your bones healthy.

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Information and guidance from the British Nutrition Foundation

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Obesity, Healthy Weight Loss and Nutrition

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In this section, you can read about about overweight and obesity, as well as some tips around diet and physical activity, for sensible weight management.

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Information from the British Nutrition Foundation

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Many common health complaints are linked to the gut. Our diet can play an important part in managing some of these conditions.

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Information from the British Nutrition Foundation

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Nutritional information about heart disease and stroke

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Heart disease and stroke are major causes of death worldwide and in the UK. Eating a healthy diet can help reduce your risk of heart disease and stroke.

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The Best and Worst Foods for High Blood Pressure

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The Best and Worst Foods for High Blood Pressure

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British Heart Foundation, Senior Dietitian Victoria Taylor explains how choosing to eat fruits, vegetables and wholegrains while avoiding salty, sugary treats and alcohol can help keep hypertension in check.

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The best and worst foods for high blood pressure

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BHF Senior Dietitian Victoria Taylor explains which foods can help and which foods to avoid if you have high blood pressure.

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If you, or someone in your family, has diabetes, you'll know that it can sometimes be difficult to know what to eat.

Start here for the key information you need to make healthy food choices for a balanced diet.

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If you, or someone in your family, has type 1, type 2 or another type of diabetes, you’ll know that it can sometimes be difficult to know what to eat. Start here for the key information you need to make healthy food choices for a balanced diet.

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Advice and guidance from Macmillan Cancer Support

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Healthy eating and cancer | Benefits of a healthy diet

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Healthier diets could help prevent up to one-third of cancers (30%) in the UK. Some foods may increase our risk of cancer, but others may protect us.

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Cancer Research UK explains the link between processed and red meat and cancer

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Does processed and red meat cause cancer?

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Processed and red meat are linked to bowel cancer. The less you eat, the lower your risk. Find out why from Cancer Research UK experts.

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Eating and Drinking Well with Dementia Toolkit

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Eating and Drinking Well with Dementia Toolkit

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Advice and guidance from Bournemouth University

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Winner of the 2019 CN Award for Nutrition Resource of the Year*Based on their findings, Professor Murphy, Dr Holmes and the team developed the toolkit to provide freely available resources (a film, workbook, leaflet and guide) to deliver person-centred nutritional care in the area of dementia. The toolkit has been used all over the UK and overseas, as far afield as Australia and is the winner of the 2019 CN Award for Nutrition Resource of the Year! For more information about the CN Awards, visit: nutrition2me.com/cn-awards

More information about these training resources can be found below.

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The Eating and Drinking Well with Dementia Toolkit

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Winner of the 2019 CN Award for Nutrition Resource of the Year*Based on their findings, Professor Murphy, Dr Holmes and the team developed the toolkit to provide freely available resources (a film, workbook, leaflet and guide) to deliver person-centred nutritional care in the area of dementia.

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Information and support

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Dementia UK is a charity that provides Admiral Nurses for families affected by dementia. Call our Dementia Helpline to find out how we can support you.

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Healthy eating advice from the NHS

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The Eatwell Guide shows how much of what we eat overall should come from each food group to achieve a healthy, balanced diet.
You do not need to achieve this balance with every meal, but try to get the balance right over a day or even a week.

Most of us still are not eating enough fruit and vegetables. They should make up just over a third of the food we eat each day.

Aim to eat at least 5 portions of a variety of fruit and veg each day. Choose from fresh, frozen, tinned, dried or juiced.

Remember that fruit juice and smoothies should be limited to no more than a combined total of 150ml a day.

Fruit and vegetables are a good source of vitamins, minerals and fibre.
Find out more about how to get your 5 A Day

Starchy food should make up just over a third of the food we eat. Choose higher fibre or wholegrain varieties, such as wholewheat pasta and brown rice, or simply leave the skins on potatoes.

There are also higher fibre versions of white bread and pasta.

Starchy foods are a good source of energy and the main source of a range of nutrients in our diet.
Find out more about starchy foods

These foods are good sources of protein, vitamins and minerals. Pulses, such as beans, peas and lentils, are good alternatives to meat because they're low in fat and they're a good source of fibre and protein, too.

Choose lean cuts of meat and mince, and eat less red and processed meat like bacon, ham and sausages.

Aim for at least 2 portions (2 x 140g) of fish every week, 1 of which should be oily, such as salmon, sardines or mackerel.

Find out about fish and meat.

Milk, cheese, yoghurt and fromage frais are good sources of protein and some vitamins, and they're also an important source of calcium, which helps keep our bones healthy.

Try to go for lower-fat and lower-sugar products where possible, like semi-skimmed, skimmed or 1% fat milk, reduced-fat cheese or plain low-fat yoghurt.
Find out more about milk and dairy foods

Unsaturated fats are healthier fats and include vegetable, rapeseed, olive and sunflower oils.

Remember all types of fat are high in energy and should be eaten in small amounts.
Find out more about the different types of fat in our diet

These foods include chocolate, cakes, biscuits, sugary soft drinks, butter, ghee and ice cream.

They're not needed in our diet, so should be eaten less often and in smaller amounts.
Get tips on cutting down on sugar

Water, lower-fat milks, lower-sugar or sugar-free drinks and tea and coffee all count.

Fruit juice and smoothies also count towards your fluid consumption, but they contain free sugars that can damage teeth, so limit these drinks to a combined total of 150ml a day.
Find out more about water, drinks and your health

How does the Eatwell Guide work?

The Eatwell Guide divides the foods and drinks we consume into 5 main food groups.

Try to choose a variety of different foods from each of the groups to help you get the wide range of nutrients your body needs to stay healthy.

It's important to get some fat in your diet, but foods that are high in fat, salt and sugar have been placed outside of the main Eatwell Guide as they're not necessary as part of a healthy, balanced diet and most of us need to cut down on these.

Unsaturated fats from plant sources (for example, vegetable oil or olive oil) are healthier types of fat.

But all types of fat are high in energy (calories), so they should only be eaten in small amounts.

On average, women should have around 2,000 calories a day (8,400 kilojoules) and men should have around 2,500 calories a day (10,500 kilojoules). We all need different amounts of energy (or calories) from food to be a healthy weight. How much you need depends on lots of things, including how active you are.

Find out how food labels can help you choose between foods and pick those lower in fat, saturated fat, sugar and salt.

Combination foods

Many foods, such as pizzas, casseroles, pasta dishes and sandwiches, are combinations of the food groups in the Eatwell Guide.

With these meals, check the ingredients and think about how these fit with the sections on the guide to help you achieve a balanced diet.

Does the Eatwell Guide apply to everyone?

The Eatwell Guide applies to most of us, whether we're a healthy weight or overweight, whether we eat meat or are vegetarian, and no matter what our ethnic origin.

Anyone with special dietary requirements or medical needs might want to check with a registered dietitian on how to adapt the Eatwell Guide to meet their individual needs.

Children under the age of 2

The Eatwell Guide does not apply to children under the age of 2 because they have different nutritional needs.

Between the ages of 2 and 5, children should gradually move to eating the same foods as the rest of the family in the proportions shown in the Eatwell Guide.

Read more about babies, toddlers and young children's nutritional needs in Your baby's first solid foods.

Download the Eatwell Guide booklet

For more information, including details of which foods are included in the food groups, download GOV.UK's The Eatwell Guide.

Healthy eating support

Food and diet advice on the NHS website includes:

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Read about the interactive Eatwell Guide, which shows how much of what we eat overall should come from each food group to achieve a healthy, balanced diet.

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Advice and recipes from the NHS

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Make a change today! Discover healthy recipes, food swaps, nutritional advice, and top tips and activities to help the whole family stay healthy.

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The six principles of healthy eating

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A healthy balanced diet | British Nutritional Foundation

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The key to a healthy eating is having a balance of different foods and nutrients in your diet. Although there is no ‘one size fits all’ healthy diet, there are six principles we recommend.

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Helpful tips to eat a plant based without spending too much

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Factsheets | Plant Based Health Professionals UK

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Factsheets providing information on plant-based diets, health & weight loss, pregnancy, children and health conditions.

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Choose from the many useful fact sheets, including helpful swaps to eat more plants

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Factsheets | Plant Based Health Professionals UK

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Factsheets providing information on plant-based diets, health & weight loss, pregnancy, children and health conditions.

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Visual guide to help you eat a balanced plant based diet

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Factsheets | Plant Based Health Professionals UK

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Factsheets providing information on plant-based diets, health & weight loss, pregnancy, children and health conditions.

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Find out how easy it is to get plenty of protein while eating plant based foods.

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Factsheets | Plant Based Health Professionals UK

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Factsheets providing information on plant-based diets, health & weight loss, pregnancy, children and health conditions.

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Help for families to manage behaviours and food choice

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Lots of children go through periods of eating. For many, this phase will pass as the child gradually learn s to accept new foods . F or autistic ch ildren and their families, overcoming eating challenges can be more difficult.
Over two third s of parents of autistic children report that their child is reluctant to try new food s¹ . Moreover, o ther behaviours such as eating or mouthing non-edible items , and extreme food selectivity can make providing sufficient nutrition hard.

Continue below for a range of resources for understanding, identifying and tackling eating challenges.

Understanding eating difficulties

89% of autistic children display some form of difficulty with eating². This can range from selective eating, to anorexia or ARFID (Avoidant/restrictive food intake disorder). Find out more about the common food disorders for autistic people.

Spotting the signs

There are many behavioural and physical signs that might indicate if a person is having issues around eating. This may indicate that they have an eating disorder or they may simply need some additional support. Find out more about what to look out for. Providing early support can be crucial and particularly in young people could help to reduce the impact on their education.

If you are concerned about your child's eating i t's important to talk with your child's GP, paediatrician or a dietitian. This will help to rule out any underlying causes such as gastrointestinal problems and allergies.

How to address eating difficulties

There are a number of things you can do to try and increase variety within a diet and promote healthy eating. Take a look at our resources below to find out what steps you could take.
A small ask...
If you have found any of the information in this section useful, please consider making a contribution to help us create more resources like this.

1. Rogers, L.G., Magill-Evans, J. & Rempel, G.R. Mothers' Challenges in Feeding their Children with Autism Spectrum Disorder-Managing More Than Just Picky Eating. J Dev Phys Disabil 24, 19-33 (2012).
2. Ledford, J. R., & Gast, D. L. (2006). Feeding problems in children with autism spectrum disorders a review. Focus on Autism and Other Developmental Disabilities, 21(3), 153-166

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Lots of children go through periods of eating. For many, this phase will pass as the child gradually learn s to accept new foods . F or autistic ch ildren and their families, overcoming eating challenges can be more difficult.

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Download a free a pack to help you understand how food and drink choices can affect your health and how to make small changes.

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We’ve created a pack to help you understand how food and drink choices can affect your health and how to make small changes.

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Learn more about what is in your food and how to cook it with a range of short courses

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Cookery and nutrition adult learning courses

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Nutrition courses, nutrition for menopause and range of practical cookery courses and workshops from learn to cook to mastering technical skills

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A short video from MIND

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How to manage your mood with food | 8 tips

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Tips To Help Eating Well After Critical Illness

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Tips To Help Eating Well After Critical Illness

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Supportive information from British Dietetic Association

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Tips to help with eating problems after critical illness

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It is common to find it difficult to eat after critical illness and to maintain a healthy weight. This information sheet tells you more about these problems and tips to help you.

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A short video from Headspace

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How Mindful Eating Improves Your Relationship with Food | Expert Videos

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Food Inequalities Experienced by People with Learning Disability

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Food Inequalities Experienced by People with Learning Disability

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A paper produced by The Food Foundation

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Food insecurity levels in the UK have reached unprecedented highs over the past few years, first in the face of the Covid-19 pandemic and now continuing through the cost of living crisis.

Disabled people have been particularly exposed to food insecurity, facing stark inequalities when it comes to accessing and affording the food that they need.

A quarter of the population, equating to 16 million people in the UK, including one in 10 children, are disabled - a proportion which has doubled in the last decade.

While improving access to food for disabled people requires a holistic, individualised approach, there are a numerous commonalities disabled people experience that policymakers must address to reduce food insecurity.

This briefing explores some of the common experiences of disabled people faced with food insecurity.

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Food insecurity and inequalities experienced by disabled people

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The Food Foundation's Food insecurity and inequalities experienced by disabled people report

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Information from the British Dietetic Society

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We all have good days and bad days; we all have foods we like more, or like less. But is there a connection between feeling fine and the foods we have eaten? Do some foods make us feel grumpy? Is it possible to plan a diet for a good mood?
Vitamins and minerals

When you don't eat enough nutrient-rich foods, your body may lack vital vitamins and minerals, which may affect your energy, mood and brain function. The table below shows how not getting enough of some vitamins/minerals can affect your mood, and what you can eat to replenish your body.

You should aim to get your vitamins and minerals from eating a healthy, balanced diet with plenty of fruit and vegetables.

In certain circumstances or for certain people, supplements may be beneficial e.g. folic acid for all women planning pregnancy; iron supplements for people diagnosed with anaemia; vitamin B12 for vegans and older adults, and vitamin D for everyone in winter months, and all pregnant and breastfeeding women, older adults, and people with dark skin.

Carbohydrate = Glucose = Brain Power

To be able to concentrate and focus your brain needs enough energy, which comes from blood glucose. In fact, the brain uses 20 per cent of all the energy your body needs.

Glucose is also vital to fuel muscles and maintain body temperature. The glucose in our blood comes from the carbohydrates we eat - including fruit, vegetables, cereals, bread, rice, potatoes, sugars and lactose in milk.

Eating breakfast and regular meals containing some carbohydrate helps you have enough glucose in your blood.

Healthier sources of carbohydrates include wholegrains, vegetables, fruits, legumes and lower fat dairy foods. These are important sources of other nutrients as well, such as calcium and B vitamins.

Not having enough glucose in your blood (hypoglycaemia) can make you feel weak, tired and 'fuzzy minded'. This may happen when you don't eat enough carbohydrate-containing food, and is a particular risk if you have diabetes or do extreme exercise or manual labour. It can also happen if you follow a very restrictive diet or have irregular eating patterns.

Although glucose ensures good concentration and focus, once your blood glucose is within the normal range, you cannot further boost your brain power or concentration by increasing your glucose levels. If you are eating some carbohydrate foods, additional sugary 'energy' drinks are not needed and not helpful.

Comfort eating

There is a messenger chemical in the brain called serotonin, which improves mood and how we feel. Serotonin is made with a part of protein from the diet (tryptophan), and eating carbohydrate-rich foods may help more of this get into your brain.

This suggestion has been used to explain 'carbohydrate craving' - eating sweet, comfort foods to boost mood. There is not enough research to show that eating lots of protein foods containing tryptophan or eating a lot of carbohydrates can really support mood improvement in humans. But it may be that not eating enough carbohydrate (for example through a high protein/high fat diet) leads to low moods.

You also may have heard the idea that eating chocolate can make you feel happier, and there are observations that people feeling down are more likely to eat chocolate. This is probably because chocolate is a well-known reward and comfort food, rather than due to any potent physiological effects particular to cocoa.

Caffeine and the 'drug-effect'

Caffeine, found in coffee, cola and energy drinks, is often called a drug: it acts as a stimulant and can increase feelings of alertness, and counter the effects of fatigue. However it may be that some of the effects of caffeine actually 'normalise' the lower levels of alertness felt by regular users who have not consumed enough caffeine that day.

Too much caffeine, particularly in people who are not used to it, may cause the adverse effects of irritability and headache. Such symptoms also occur with caffeine withdrawal in people used to lots of caffeine on a regular basis.

Vitamins and minerals - effect on mood and what foods can help

Iron

Not getting enough iron results in low levels of oxygen carrying haemoglobin in the blood, resulting in the condition anaemia.

Feeling weak, tired and lethargic all the time.

The risk of anaemia is reduced by eating enough iron, particularly from red meat, poultry and fish, beans and pulses, fortified cereals. Avoid drinking tea with meals.

Thiamin B1, Niacin B3 or Cobalamin B12 (all B vitamins)

Tiredness and feeling depressed or irritable.

Fortified foods including wholegrain cereals, animal protein foods such as meat, fish, eggs and dairy.

Increased chance of feeling depressed, particularly important in older people.

Folate is found in liver, green vegetables, oranges and other citrus fruits, beans and fortified foods such as yeast extract (marmite) and fortified breakfast cereals.

May increase the incidence of feeling depressed and other negative mood states.

Brazil nuts, meat, fish, seeds and wholemeal bread.

The gut-brain axis

There is some current interest in links between mood and the gut microbiome (the trillions of bacteria resident in the human colon). Consistent research outcomes are needed before any valid claims can be made about this.

Omega-3 fats

Long chain omega-3 fats (found in fatty fish) support the development of the foetus during pregnancy, particularly the brain. Some research suggests that diets containing omega-3 fats may help to reduce low mood states in adults.

So does food affect mood?

There are many ways that foods can affect how we feel, just as how we feel has an influence on what foods we choose. Some of the mood/food effects are due to nutrient content, but a lot of effects are due to existing associations of foods with pleasure and reward (chocolate) or diet and deprivation (plain foods).

Some foods also have religious, economic and cultural significance, which will influence how we feel when eating them.

Summary

Feeling good comes from a diet that has enough healthy choice carbohydrate at regular times to keep blood glucose levels stable, and eating breakfast is a sensible habit.

Diets should also contain a wide variety of protein and vitamin and mineral-containing foods to support the body's functions.

As a rule, plenty of fruits and vegetables and wholegrain cereal foods, with some protein foods, including oily fish, will support a good supply of nutrients for both good health and good mood.

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Is it possible to plan a diet for a good mood? This fact sheet includes healthy eating tips to improve your mental wellbeing.

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Spotting, preventing and treating malnutrition

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Malnutrition is a condition which happens when you don't get the correct amount of nutrients from your diet

Malnutrition is a major public health issue costing the NHS over £19 billion per year in England alone. There are approximately 3 million people in the UK who are malnourished or at risk of malnutrition; 93% are living in their own home, 5% are living in care homes and just 2% are in hospital. Consequences of malnutrition include:

increased risk of illness and infection

slower wound healing

increased risk of falls

low mood

reduced energy levels

reduced muscle strength

reduced quality of life

reduced independence and ability to carry out daily activities

This Food Fact Sheet will help you understand the signs of malnutrition and how to either stop it happening or to treat it.

Spotting malnutrition

Malnutrition can affect anyone, but it is more common for older people and those who are socially isolated. This can be because they can't get out much or because they have poor physical or mental health. It can happen over a long period of time which sometimes makes it difficult to spot. Common signs of malnutrition are:

unplanned weight loss - which can cause clothes, dentures, belts or jewellery to become loose

tiredness and lethargy

alterations in mood

loss of appetite

disinterest in food and/or fluids

loss of muscle strength

Stopping and treating malnutrition

A balanced diet is essential for health and wellbeing. When someone has a poor appetite and is malnourished, nutrient dense foods as well as drinks containing nutrition can help to improve energy intake without making portions too big to manage.

Protein, energy (calories) and vitamins and minerals are all important for people who are malnourished.
If you follow the points listed here, you can make sure you are eating well:

Eat 2-3 portions of high protein foods every day such as meat, fish, eggs, nuts, beans, pulses, soya, tofu and other meat-free protein foods.

Eat/drink 2-3 portions of dairy foods every day such as cheese, milk and yoghurt or non-dairy alternatives like soya, almond or coconut milk.

Eat a serving of starchy food at each meal (e.g. bread, cereals, potatoes, pasta or rice).

Eat some fruit and vegetables every day (fresh, frozen, tinned, dried or juiced).

If you enjoy fish, go for oily fish such as mackerel, salmon, herring, trout, pilchards or sardines as these are rich in omega-3 fatty acids. Aim for 2 portions a week (can be tinned or frozen for convenience).

Have at least 6-8 glasses/mugs of fluid every day, choosing drinks which contain some nutrition where possible such as milky drinks (malted drinks, hot chocolate, milky coffee, smoothies and milkshakes) which can provide energy, protein and vitamins and minerals or sugary drinks such as fruit juice, fizzy drinks or squash can provide extra energy.*

The following simple ideas will help you to increase the amount of energy and protein which you eat in a day:

Eat 'little and often' - try a small snack between meals and a dessert after lunch and evening meal.

Try not to have drinks just before meals to avoid feeling too full to eat.

Avoid low fat/diet versions of foods and drinks for example skimmed or semi-skimmed milk, low fat yoghurt, sugar free drinks etc, or watery soups.

Choose meals that you enjoy, are easy to prepare and eat, and are high in energy and protein. Items such as tinned fish or beans are easily stored and easy to prepare.

If you are preparing food for others, remember that as we get older, our taste buds change. Older people may prefer much sweeter tastes than they used to.

Add extra energy and protein to foods and fluid by adding high energy and protein ingredients - see above for ideas.

Add extra energy by adding high calorie ingredients to food and drinks - suggestions listed below:

Other high energy and protein foods include:*

cheese and crackers

thick and creamy yoghurt

Pot of custard or rice pudding

nuts and seeds

cereal bar or flapjack

Bombay mix

mini pork pie, sausage roll or scotch egg

chocolate

* If there are any health concerns which have previously required you to limit fat and sugar in your diet, e.g. diabetes or high cholesterol, you should discuss whether you still need to limit these with a health professional.
Ready meals, meal delivery services and online shopping

You may find that your energy levels change throughout the week and that on some days you feel better than others. Here are some suggestions to make preparing meals easier:

Make the most of the 'good days' by preparing extra meals which you can store in the fridge/freezer as individual portions for 'bad days'.

Buy a selection of fresh or frozen ready meals for times when you are not able to cook.

Make use of meal home delivery services such as Wiltshire Farm Foods and Oakhouse Foods - supermarkets also offer online shopping and home delivery services which may make shopping easier for you.

Swallowing difficulties

If you notice any of the following when eating or drinking you should seek advice from a healthcare professional such as your GP or practice nurse, who can refer you on to specialist speech and language therapist or a dietitian:

difficulty swallowing

choking or coughing

bringing food back up, sometimes through your nose

a sensation that food is stuck in your throat or chest

a change in the sound of your voice whilst/soon after eating i.e. your voice sounds 'wet'

Other things to consider:

Check dentures fit correctly - if not, visit your dentist.

If you have difficulty using cutlery or with coordination, try 'finger foods' such as toast, sandwiches, biscuits, chunks of meat, cheese, vegetables or fruit cut into pieces etc.

If you also suffer from constipation, try gradually increasing your fibre intake by consuming beans, lentils, fruit and vegetables and wholegrain foods whilst also increasing your fluid intake. You may need to fortify these foods as explained earlier.

Regular exercise may help increase your appetite and build up your strength - start with something easy for you and increase the intensity gradually.

If you have vision problems or for people with dementia, try using a coloured plate so that the food stands out from the plate.

Eating environment

Try to make sure that where you eat is as pleasant as possible and that meals and snacks look appealing. Eating with others often helps to encourage appetite.

Summary

Malnutrition is a common problem and if it is not spotted or treated it can make you very ill. The simple steps outlined above should help to identify and treat the condition. If these simple steps do not seem to help, seek advice from a healthcare professional.

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Malnutrition is a condition which happens when you don't get the correct amount of nutrients from your diet Malnutrition is a major public health issue costing the NHS over £19 billion per year in England alone.

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Information with a free booklet to download

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Care homes must ensure that all residents have enough to eat and drink and the help that people need to eat and drink when they need it. NICE Clinical Guidance 32 requires that all people in care homes should be screened on admission.

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Healthy eating tips for older adults

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All adults need a varied and balanced diet to ensure we get enough essential vitamins and minerals. We also need to make healthy choices when it comes to our lifestyles.

As we age, there are some elements of diet, nutrition and lifestyle we may need to change or pay more attention to. It is also common to become less interested in food. You may find that you are less hungry than you used to be, so it can be harder to get all the nutrients needed for good health.

Our sense of taste and smell can change as we age, which can affect our appetite and how much we like food. Make foods as tempting and tasty as possible so that eating stays enjoyable. Try varying colours and textures as much as possible or adding herbs and spices such as mint, rosemary, cinnamon or paprika.
Dr Stacey Lockyer, Senior Nutrition Scientist, British Nutrition Foundation

Eat plenty of fruit and vegetables

Fruit and vegetables contain many vitamins and minerals essential for good health. They are also generally low in fat and high in fibre. Many studies have shown that people who consume diets high in fruit and vegetables have a lower risk of heart disease, stroke, diabetes and some forms of cancer.

We should all be aiming for at least 5 portions of fruit and vegetables each day. This includes fresh, frozen, dried and canned fruit and vegetables, as well as smoothies and 100% fruit juices.

Did you know?

Beans and pulses, such as kidney beans, chickpeas, lentils and baked beans, can also count towards your 5 A DAY target

One portion is about 80g.

Choose healthier fats

There are two main kinds of fat: saturated and unsaturated. Eating a diet rich in saturated fat can raise your blood cholesterol level and increase your risk of heart disease. Reducing saturated fat and replacing some of it with unsaturated fat can reduce your risk of heart disease..

Butter, lard, ghee, palm oil and coconut oil contain a high proportion of saturated fat. Other foods with a relatively high saturated fat content include cakes, chocolate, biscuits, pies and pastries. The white fat you see on red meat and underneath poultry skin is also high in saturated fat.

Vegetable oils (such as rapeseed, olive, sunflower, soya, sesame oils) and fat spreads made from these oils are a healthier alternative to saturated fats. These are high in unsaturated fatty acids. Oily fish, including mackerel, sardines, pilchards and salmon, contain unsaturated fats called omega-3 fats, which can also help heart health.

It's easy to make small changes to cut back on saturated fat. Here's some examples of simple swaps you can make to reduce the amount of saturated fat you consume:

Include oily fish in your diet

All fish and shellfish provide us with a range of vitamins and minerals, but oily fish, such as herring, salmon and mackerel, are rich in omega-3 fats which may help protect against heart disease. For this reason, we are advised to eat at least two portions (140g cooked weight) of fish a week, one of which should be oily fish.

There is currently a lot of interest in the role of these fats on many other age-related conditions. For example, some research suggests they may help to alleviate some of the symptoms of rheumatoid arthritis. But because oily fish can contain contaminants you should not eat more than four portions per week (or one portion of swordfish as this may be high in mercury).

For more information on fish read this page on fish and shellfish from the NHS.

Healthy eating tips for older people

Get enough fibre

Eating plenty of fibre-rich foods, such as wholegrains (like wholegrain breads, wholegrain breakfast cereals, brown rice, wholemeal pasta), fruit, vegetables and pulses (like lentils, kidney beans and chickpeas), will improve digestive health and can help to protect against heart disease, diabetes and some cancers.

High-fibre foods may help you to stay fuller for longer so can be useful if you are watching your weight. It is also important to drink enough fluids or water when eating a diet high in fibre.

Stay well hydrated

Older people are at greater risk of dehydration than younger people. Our thirst sensation can decrease as we age so it is easy for dehydration to go unnoticed.

Early signs of dehydration include dizziness, tiredness and headaches. Long-term mild dehydration increases the risk of kidney stones, constipation and cholesterol problems.

Six to eight drinks are recommended each day to replace fluid that is lost from the body. Water is a great choice but tea, coffee and fruit juice all count. You will need to drink more if the weather is hot or humid or if you are physically active

Reduce your salt intake

Salt (sodium chloride) is the main source of sodium in our diet. While a small amount of sodium in the diet is necessary for health, it can raise blood pressure (raised blood pressure is a major risk factor for stroke and heart disease).

Adults should eat less than 6g (about a teaspoon) of salt per day. The food industry is reducing the amount of salt in many foods, but a lot of the salt we eat is already added to the foods we buy, and it is important to look at the labels to select lower salt options. For more information read our page on looking at labels.

Did you know?

A decreasing sense of taste as we age can encourage us to add more salt to meals for flavour.

Watch the amount you add at the table, and try to use herbs, spices and a variety of different foods or ingredients to flavour meals instead of adding salt.

Mind your micronutrients

We can't make (most) vitamins and minerals in our body so we must get them from our diet.

Boosting your B vitamins

B vitamins have a range of important functions in the body, including contributing to healthy red blood cells, releasing energy from the foods we eat, normal nerve function and vision, healthy skin, and reducing tiredness.

Sources of B vitamins in the diet include:

Folate/folic acid: Some green vegetables, and fortified grains and grain products

Vitamin B6: Fortified cereals, peanuts, pork, poultry, fish, milk and vegetables

Vitamin B12: Animal products (such as fish, meat, eggs, or dairy), fortified breakfast cereals and other fortified foods such as soya drink

Calcium-rich foods

Calcium is important to keep our bones healthy. After the menopause, women are at a higher risk of osteoporosis and reduced bone density. This is because the hormone oestrogen helps to reduce bone breakdown and after the menopause, less oestrogen is produced. So, it is particularly important that older women get plenty of calcium from their diet to minimise bone loss.

Milk, cheese and yogurt are rich in calcium, but other sources include fish with edible bones (such as canned salmon or sardines), some green leafy vegetables like kale, calcium fortified soy products (such as soya drink, tofu), white bread and fortified breakfast cereals.

You should be able to get all the calcium you need from your diet, but if you do take calcium supplements, be careful not to take too much - stick to less than 1500mg per day

Vitamin D supplements

Vitamin D plays a key role in bone health and muscle function. Low levels of vitamin D can increase the risk of falls and fracture.

The Government recommends that, all adults should consider taking a daily 10µg (micrograms) vitamin D supplement between October and March.

During the autumn and winter months, sunlight isn't strong enough to make enough vitamin D in our skin. It can be difficult for us to get enough vitamin D from our diet alone because it is only found in a limited number of foods including oily fish, eggs, and vitamin D fortified foods such as some breakfast cereals, fat spreads and dairy products.

People at higher risk of vitamin D deficiency should take a daily supplement containing 10µg of vitamin D throughout the year. For example, those living in a care home, housebound or who wear clothes that cover most of the skin while outside. People with darker skin are also at higher risk.

Supplements should not replace a healthy diet

There are some people that will be prescribed supplements, for example iron supplements for iron deficiency anaemia. Some people choose to take other supplements because they believe they will benefit their health, but we don't have strong evidence that taking supplements benefits our health.

If you do decide to take supplements, it's important to remember that supplements do not replace a balanced diet! It is also important to remember that supplements can be harmful if you take too much, so don't take more than it says on the label.

For example, according to some research, having more than an average of 1.5mg a day of vitamin A over many years may affect your bones, making them more likely to fracture. This is important for older people, especially women, who are at higher risk of osteoporosis (weak bones). If you take supplements containing vitamin A, make sure your daily intake from food and supplements is not more than 1.5 mg (1,500 µg). You often find vitamin A in multivitamins and in fish oil supplements. Also if you eat liver or liver pate more than once a week, you may get too much vitamin A.

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Nutrition for older people - British Nutrition Foundation

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As we age, there are some elements of diet, nutrition and lifestyle we may need to change or pay more attention to including dehydration and malnutrition.

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Best Foods For A Healthier Gut and Heart

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Best Foods For A Healthier Gut and Heart

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Did you know that poor gut health can also harm your heart? Gut health specialist dietitian Dr Megan Rossi (PhD) shares her expertise on this fascinating topic and offers some easy ways to make your diet more gut, and heart, friendly.

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Trillions of bacteria inside your gut could be playing a big role in your health, including heart health. Senior Dietitian Victoria Taylor hears from gut health experts Dr Megan Rossi.

Why does our gut matter?

There are three main reasons why we need to think about our gut health. Firstly, our intestinal tract (bowel) contains trillions of microbes. These are a hugely important part of our health: they produce different hormones and vitamins, and we couldn't survive without them.

Secondly, the majority of the cells that make up our immune system are found in our digestive tract. Having good gut health is linked to fewer sick days and lower risk of allergies and autoimmune conditions. Finally, even if you put the healthiest food into your body, if you don't have a healthy intestinal lining to digest it, you won't get all the benefits of what you are eating.

How do I know if I have a healthy gut?

There is no single way to tell if you have a healthy gut - it's a collection of factors. Constipation, diarrhoea or stomach cramps can be signs of an unhealthy gut. But just because you don't notice any symptoms, it doesn't mean you have good gut health. Other factors include:

how often you get sick

whether you are on a restrictive diet

what medications you take

What can I do to have a healthier gut?

Diet is one of the biggest influences on our gut health, because our microbes are reliant on what we feed them. This explains why even identical twins (who will have identical genetics) have different microbes. Things like sleep, stress and exercise can also change the microbes, so it's important to look at your lifestyle.

What should I eat to help my gut health?

One of the strategies I recommend is to eat 30 different plant foods every week. Diversity matters, because there are nearly 100 types of fibre and thousands of plant phytochemicals, which are thought to feed different bacteria. Thirty might sound intimidating, but it includes fruits and vegetables, wholegrains, legumes (such as chickpeas, lentils or kidney beans), nuts and seeds. It could be as simple as adding mixed seeds to whatever you are eating in the morning.

Make small switches, such as buying different colours of peppers instead of a single one, or a pack of mixed vegetables. Try not to have the same meals every day. Even if you love routine, have different fruit on different days, or if you eat porridge every day, vary the toppings - banana one day, berries another, along with nuts and seeds.

How could my gut health affect my heart?

A lot of research has been carried out in animals, but we need to wait for human studies before we know for sure. We do know, for example, that polyphenols (a type of antioxidant found in plants) are linked to heart and circulatory health, but 90 per cent of them can't be digested by human cells. Instead, we rely on the microbes in our gut to ferment them, so they can be absorbed into the body.

We also know that the Mediterranean diet is good for heart and circulatory health, as well as gut health. A core element is extra virgin olive oil, which is rich in polyphenols. But we also know that the Mediterranean diet will increase the diversity of our microbes, and it's this diversity that is linked to a lower risk of chronic conditions, including heart and circulatory diseases.
We also know that microbes love fibre, and that eating more fibre is linked to a lower risk of heart and circulatory diseases.
How long does it take for diet to make a difference?

Microbes in the gut can begin to change within days of changes to your diet, but the long-term benefits can take several years to show. Remember that if you go back to your old ways, you aren't going to get much of a benefit - it's about long-term changes.

Meet the expert

Dr Rossi is a Registered Dietitian with a PhD in gut health. She leads research at King's College London,
investigating nutrition-based therapies in gut health, and has recently published a book called Eat Yourself Healthy.

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Trillions of bacteria inside your gut could be playing a big role in your health, including heart health. Senior Dietitian Victoria Taylor hears from gut health experts Dr Megan Rossi. There are three main reasons why we need to think about our gut health. Firstly, our intestinal tract (bowel) contains trillions of microbes.

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Learn about how a healthy gut can influence your overall health

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What is the gut microbiota?

Your gut microbiota refers to all of the microorganisms (e.g. bacteria) that live within your gut. In fact, the largest population of microorganisms within the body live within the bowel.

The bacteria/microorganisms that live within your gut is completely unique to each individual. The human gut microbiota consists of over 100 trillion microorganisms, and weighs around 200g, around the same as an adult hamster!

Why is it so important?

Your microbiota has many functions, including defending against harmful microorganisms and digesting dietary fibre, that humans are unable to digest. Your microbiota also ease the absorption of some essential vitamins, and can even affect your mental health.

Early research suggests that some of the earliest changes that lead to Parkinson's disease may actually begin with the gut microbiota. This recent discovery only highlights just how much we're yet to discover about the microorganisms that occupy our gut, and the connection to our brain.

What influences your gut microbiota?

We can influence our gut microbiota, but only to an extent. There are many factors at play, and some begin before you even leave the womb.

Some factors we can influence:

Feeding methods, such as breast milk, artificial milk and introduction of solid food

Any medication such as antibiotics, acid suppressants and more

Dietary habits and the way food is cooked

Environment and lifestyle factors e.g. rural vs urban and exercise

Weight gain

Some factors we can't influence:

Genetics

Gestational age; whether you were born preterm vs. full-term

Delivery mode; vaginal delivery vs. C-section

What can I do to help my gut microbiota thrive?

The food you eat is the main fuel for your gut microbes. A review of the research literature suggests that diet can modify your microbes, this in turn has a profound impact on your overall health. Moreover, some studies have shown that gut microbiota composition is different in conditions such as type 2 diabetes, obesity, and inflammatory bowel diseases.

Some of the food that you eat does not absorb inside your body (fibre), but feeds the trillions of microorganisms that live in your gut. This part of the fibre that feeds these microbes is called a prebiotic (literally meaning 'before living organisms). If we consider our microbes as our gut garden, then the prebiotic is the fertiliser that helps to nourish our gut microbes.

Food sources of these prebiotics are plant foods. Some foods containing larger amount of prebiotics include: artichokes, asparagus, chicory, bananas, berries, tomatoes, garlic, onions, legumes, green vegetables and wholegrain cereals.

Fermented foods (frequently termed probiotics) are usually added to yoghurts, juices or taken as food supplements and are often described as 'good' bacteria. These foods are not harmful for most people with a healthy immune system, although the overall evidence that they are helpful in modifying the gut microbiome is inconclusive. If you have a digestive disease, you should talk to your doctor or dietitian before trying them.

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Introduction to Gut Bacteria - What is the gut microbiota? Your gut microbiota refers to all of the microorganisms (e.g. bacteria) that live within your gut. In fact, the largest

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Gut health is an important aspect of our overall health and wellbeing. Emerging research suggests a link with many other aspects of health, such as immunity, mental wellness and preventing some illnesses.

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Emerging research suggests a link between gut health and other aspects of health, such as immunity, mental wellness and preventing some illnesses.

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Improve Your Gut Health for Better Immunity

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Improve Your Gut Health for Better Immunity

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70% of our immune system is in the gut, achieving and maintaining a healthy gut can boost immunity

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How Gut Health Affects the Immune System and How To Boost It

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Research shows that a diverse gut microbiome is vital for a healthy immune system. And what you eat can play an important part.

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Screening for malnutrition for those in care in the community

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The ‘Malnutrition Universal Screening Tool’ (‘MUST’) was developed by the Malnutrition Advisory Group, a standing committee of BAPEN and it has been reviewed re

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These pages look at diet issues related to Parkinson’s and what you can do to manage them.

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If you have Parkinson’s there is no specific diet that you should follow. But you should find it helpful to maintain as healthy a diet as you can.

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Food and Wellbeing For Carers of Adults with a Learning Disability

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Food and Wellbeing For Carers of Adults with a Learning Disability

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This Making Every Contact Count training will focus on the impact of food on health and will address some of the challenges encountered by carers when trying to ensure the people they care for enjoy a healthy and nutritious diet.

The free online training is open to carers (paid and unpaid) and to support staff in community settings.

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MECC is an approach to behaviour change that uses interactions that organisations and individuals have with other people to support positive changes

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Diabetes is a condition where the amount of glucose (sugar) in your blood is too high because your body cannot use it properly.

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It's easy to overlook, but choosing healthier drinks is a key part of getting a balanced diet.
Many soft drinks, including instant powdered drinks and hot chocolate, are high in sugar.

Food and drinks that are high in sugar are often high in calories, and having too many calories can make you more likely to gain weight.

Some energy drinks are high in both sugar and caffeine. Checking the nutrition labels on soft drinks such as fruit juices and fizzy drinks can help you make healthier choices.

The Eatwell Guide says we should drink 6 to 8 cups or glasses of fluid a day. Water, lower-fat milk and sugar-free drinks, including tea and coffee, all count.
Find out more about food labels

Drink plenty of water

Water is a healthy and cheap choice for quenching your thirst at any time. It has no calories and contains no sugars that can damage teeth.

Plain tea, fruit tea and coffee (without added sugar) can also be healthy.

If you do not like the taste of plain water, try sparkling water or add a slice of lemon or lime.

Or heat the water and infuse a tea bag, some coffee or a slice of lemon.

You could also add some no-added-sugar squash or fruit juice for flavour.

Drink semi-skimmed, 1% fat or skimmed milk

Milk is a good source of calcium, a mineral that helps build and maintain healthy bones.

Milk also contains protein, vitamins and other minerals, and does not cause tooth decay.

For a healthier choice, choose semi-skimmed, 1% fat or skimmed milk.

Limit your intake of flavoured milks, milkshakes, condensed milk and milk-based energy or malt drinks. These contain added sugar, which is bad for teeth.

Milk is particularly important for young children. They should drink whole milk until they're 2 years old because they may not get the calories they need from lower-fat milks.

Cows' milk should not be given as a drink until a baby is 1 year old because it does not contain the balance of nutrients a baby needs.

From the age of 2, children can gradually move to semi-skimmed milk as a main drink as long as they're eating a varied and balanced diet and growing well.
Find out more about drinks for babies and young children

Juices, smoothies and 5 A Day

Fruit and vegetable juices and smoothies contain a variety of vitamins and minerals.

A 150ml glass of unsweetened fruit juice, vegetable juice or smoothie can count as a maximum of 1 portion of your recommended 5 daily portions of fruit and vegetables.

Limit the amount of fruit juice, vegetable juice or smoothie you have to no more than a combined total of 150ml a day (1 small glass).

Have other types of fruit and vegetables for the other 4 (or more) portions.

This is because the sugars in fruit and vegetables are released when they're juiced or blended, making them "free sugars".

Once released, these sugars can damage your teeth, especially if you drink juice or smoothies often.

The sugars found naturally in whole fruit and vegetables are less likely to cause tooth decay because the sugar is contained within the structure of the fruit.

It's best to drink juice or smoothies with a meal because this helps reduce harm to your teeth.

Fizzy drinks, flavoured waters, and squashes with added sugar

Fizzy drinks, squashes and juice drinks can contain lots of added sugar and very few nutrients, so keep them to a minimum. Children should avoid them completely.

Flavoured water drinks can also contain a surprisingly large amount of sugar, so check before you buy.

Also beware of "juice drinks" as they may not have enough fruit in them to count towards your 5 portions of fruit and vegetables a day.

A high sugar content means a drink is also high in calories, which can contribute towards you becoming overweight.

Cutting down on these drinks is a good way of reducing the number of calories you consume while not missing out on any nutrients.

Likewise, getting children to drink fewer sugary drinks is a good way of limiting the amount of sugar they consume.

Children who drink a lot of sugary drinks are more likely to become overweight.

The added sugar in these drinks also means they can damage teeth.

If you do have sugary or fizzy drinks, drinking them with meals can help reduce the damage to teeth.

The best drinks to give children are water and milk.

If you or your children like fizzy drinks, try diluting fruit juice with sparkling water instead.

Remember to dilute squashes well to reduce the sugar content in the drink.

Caffeinated drinks

Caffeine is a stimulant. Drinks containing caffeine can temporarily make us feel more alert or less drowsy.

Caffeine affects some people more than others, and the effect can depend on how much caffeine you normally consume.

Pregnant women should limit their intake of caffeinated drinks because of the caffeine content.

Caffeinated drinks are also unsuitable for toddlers and young children.

Drinks that contain high amounts of caffeine include coffee, tea, colas and energy drinks.

Tea and coffee

It's fine to drink tea and coffee as part of a balanced diet. Bear in mind, though, that caffeinated drinks can make the body produce urine more quickly.

Some people are more susceptible to this than others, but it also depends on how much caffeine you have and how often you have it.

If you have urinary incontinence, cutting down on caffeine by changing to low-caffeine tea and coffee, fruit or herbal teas, or other types of drinks can sometimes help.

If you drink tea or coffee with sugar or you have flavoured syrups in your coffee-shop drinks, you could be unwittingly damaging your teeth and adding unhelpful calories to your diet.

A wide variety of tablet or granular artificial sweeteners are available and are safe to consume in hot drinks.

But many people who choose to cut out sugar from their hot drinks soon become accustomed to the taste.

Energy drinks and caffeine

Energy drinks often contain high levels of caffeine and are often high in sugar (calories).

They may also contain other stimulants, and sometimes vitamins and minerals or herbal substances.

The caffeine levels in these drinks vary, but there's often around 80mg of caffeine in a small 250ml can.

This is the same as 2 cans of cola or a small mug of coffee.

Caffeine during pregnancy

Pregnant women should have no more than 200mg of caffeine a day.

One mug of instant coffee contains around 100mg of caffeine.

High levels of caffeine can result in babies having a low birthweight, which can increase the risk of health problems in later life.

High caffeine levels might also cause miscarriage.

Check the labels of energy drinks as they often say the drink is not suitable for children or pregnant women.

For more information about how much caffeine is safe during pregnancy, see foods to avoid in pregnancy.

Sports drinks

Sports drinks can be useful when you're doing high-level endurance sports and need an energy boost.

But they're no different from any other sugary soft drinks, which means they're high in calories and contribute to tooth decay.

Unless you're taking part in high-level endurance sports, water is the healthier choice and the best way to replace fluids lost through exercise.

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It's easy to overlook, but choosing healthier drinks is a key part of getting a balanced diet. Many soft drinks, including instant powdered drinks and hot chocolate, are high in sugar. Food and drinks that are high in sugar are often high in calories, and having too many calories can make you more likely to gain weight.

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Good hydration is one of the most important aspects of the diet - drinking enough liquids to keep the fluid levels in the body topped up helps to ensure that all bodily functions are able to take place as normal. Here, Johanna Hignett looks at how much we need to drink, what kind of drinks to choose and the signs of dehydration.
Why do we need fluids?

Water in the body is essential for many important processes to take place. From our blood system carrying essential glucose, oxygen and nutrients to cells, to the kidneys getting rid of waste products we no longer want, fluid in the body is vital to allow these to occur. It also lubricates our joints and eyes, helps our digestive system function and keeps our skin healthy.

We are uniquely designed to regulate our own body temperature, particularly in hot conditions, by losing more water through the skin (perspiration), which in turn acts to cool the body helping to maintain a stable temperature. The more water we lose through sweat, the more we need to replace, so those who live (or holiday) in a hot climate, or lose more fluid than normal doing sporting activities will need to drink more fluids more regularly to replace that lost through sweat.

Water levels in the body change as we age, with newborns having a higher body fluid level compared to adults. Elderly people have lower fluid levels still, but hydration is really important at all ages.

Why do we need to keep hydrated?

Fluid is so important in the body that even when levels drop only slightly, we begin to feel the consequences. Low levels of fluid in the body can cause headaches, feelings of dizziness, lethargy, poor concentration and a dry mouth. Over a longer term, dehydration can cause constipation and can be associated with urinary tract infections and the formation of kidney stones. Regular and adequate intakes of fluid can help to address these.

How much do I need?

Adults need to drink around 1.5-2 litres of fluid a day. A typical mug or glass is about 200 millilitres (ml) so this equates to 8-10 drinks a day. Children need slightly less and should aim for around 6-8 drinks a day, but once they reach teenage years their requirements are similar to adults. Don't forget that fluid needs can vary depending on various factors including level of physical activity and climate, so it is best to remember to drink regularly to keep thirst at bay. A few groups (listed in the box below) need to take particular care to make sure their fluid levels are kept topped up and these include:

Children: Often too busy to recognise the signs of thirst!

Pregnant and breastfeeding ladies: Fluid is critical for baby and breastmilk

Older people: Often don't drink enough

Athletes: Need regular fluid top ups as they lose more through sweat

How do I know I'm drinking enough?

Simply waiting for the sensation of thirst is not a good enough sign of a need to drink - by the time we feel thirsty our body is already dehydrated and potentially suffering some of the effects. Equally, simply drinking to eliminate the feeling of thirst does not fully hydrate the body.

The best indicator of good hydration is urine colour, a pale straw coloured urine being a reliable indicator of good hydration. Darker coloured urine is a sure sign that the body needs more fluid. Getting into the habit of drinking regularly is a great way of keeping hydrated.

What drinks count?

Simply, any drink will help to promote hydration. Water from the tap is a great choice, not least because it's readily available and free. Other drinks count towards our total fluid intake too; milk, fruit juice, tea, coffee and soft drinks are all over 85% water and can be included in total fluid intake.

Some drinks contain other nutrients in addition to fluid such as sugars, fats, vitamins and minerals. Fruit juice is one such drink with vitamins, minerals and sugars too. A glass does contribute to fluid intakes and also provides one of the recommended five portions of fruit and vegetables. Don't forget that the recommended portion is 150ml though, and only one glass of fruit juice counts each day. Regularly choosing drinks with higher levels of added sugars can cause dental problems and is also associated with an increased risk of developing Type 2 diabetes, but there are plenty of sugar free choices available today as alternatives. Finally, if you are
choosing sugary drinks try to have them at meal times to limit any problems with dental health.

Drinks with added cream and/or full fat milk provide more calories and higher fat intakes are not generally recommended within healthy eating guidelines, so drinks like creamy hot chocolates are best considered to be treats!

There has been confusion about coffee in particular, with some wrongly thinking it does not hydrate the body as it contains caffeine. Although caffeine is a mild diuretic, the fluid provided by a cup of coffee or tea far outweighs the mild dehydrating effect of caffeine and the fluid levels in the body are improved.

Most of the fluid we consume comes from drinks, but around 20-30% comes from foods. Many fruit and vegetables such as courgettes, cucumber, tomatoes and melon are over 90% water and make a valuable contribution to our overall fluid intake.

Sporty moves

An adequate fluid intake is critical for sports people, principally because their losses of fluid through sweat during activity are increased. It is well known
that performance in athletes can drop if fluid levels are not adequate. Athletes often choose isotonic sports drinks to replace both fluid and salts lost through sweat. In fact, regular drinking is as much part of their training as their diet and physical strength. However, most of us who enjoy occasional sport, gym classes, or recreational running don't need the more expensive sports drinks and are best choosing water to keep our levels of hydration up. Remember to take a bottle of water with you when you go for a walk, to the gym, for a run or game of football or rounders and drink a little every now and then!

Don't forget

Good hydration is critical to health and keeps our bodies performing at their best, not only in terms of all the processes that go on but also keeping our levels of concentration up. The best advice is to keep a bottle of water close by to top up fluid levels regularly and keep thirst away.

Author

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Good hydration is one of the most important aspects of the diet - drinking enough liquids to keep the fluid levels in the body topped up helps to ensure that all bodily functions are able to take place as normal.

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People with dementia can experience problems with drinking. These can include problems with staying hydrated or with alcohol.

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Hydration for kidney health - Kidney Research UK

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Why hydration is important for kidney health Drinking sufficient levels of fluid on a daily basis is an important part of kidney health. And it’s not just something we should be thinking about during the warmer summer months. We are at the greatest risk of dehydration when we are too hot or too dry, have…

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If you have been advised to reduce the amount of fluid you drink, it is important to also reduce the amount of salt in your diet. Read our guide to cutting down on salt and managing your fluid intake; ask your kidney team for support and personalised advice.

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Learning Disabilities and Weight Management

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Learning Disabilities and Weight Management

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Video, round table discussion with specialist learning disability dietitians

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BDA discussion: Learning disabilities and healthy weight management

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Managing Weight With A Learning Disability

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Managing Weight With A Learning Disability

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Advice from the NHS

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If you care for a person with a learning disability, they may need help and support to stay a healthy weight.
People with a learning disability are more likely to have problems with their weight.

Some people may be underweight because their disability means they have difficulties with eating or swallowing, for example.

Others may be overweight because they have a condition that increases their risk of obesity, such as Down's syndrome and Prader-Willi syndrome.

How to check someone's weight

Body mass index (BMI) is a useful measure of whether someone is a healthy weight for their height.

You can check the BMI of someone you care for by using our BMI healthy weight calculator.

If you're concerned about someone's weight

If you're concerned about the weight of the person you care for, try to help them understand the health risks of being either underweight or overweight.

A conversation that includes the person with learning disabilities, carers and support workers is a good way to begin making lifestyle changes.

A GP can also check for any medical issues that may be causing weight changes. Some medicines can affect your weight, for example.

Healthy eating for weight management

Shopping for food: support the person you care for to plan their meals a week in advance. Help them to make healthy choices using the Eatwell guide and write a shopping list together. Using pictures is helpful if they are shopping on their own and have trouble reading. Visit A Picture of Health or the Easyhealth website for pictures of healthy foods.

Between meals: encourage the person you care for to make healthier choices when buying snacks, for example, by swapping biscuits for fruit, or sugary drinks for sugar-free squash or water.

Out and about: if the person you care for eats out regularly in a canteen or at a day centre, encourage them to make healthy choices from the menu and ask staff to support them with this.

Portion size: if the person you support eats large portions at mealtimes, encourage them to reduce these slightly. Fill up to half their plate with vegetables or salad at mealtimes

Keep records: if you feel the person you care for is not eating properly, keep records of the food they eat and the foods they do not, to build up a picture of their eating habits.

If you need more support in helping the person you care for to manage their weight, go with them to see a GP. The GP can advise on physical activity and healthy eating.

There may also be community weight management programmes available that are suitable for people with learning disabilities - ask a GP for more information.

Annual Health Checks

If the person you look after is on the GP's learning disability register, they will be offered an Annual Health Check. This is a good opportunity to talk about any issues with weight.

Tips for gaining weight

If the person you look after needs to gain weight, increasing their portion sizes may help. Or try offering smaller meals and snacks throughout the day.

If they still cannot eat much, or their weight is low, you may need to offer special calorie-enriched foods or drinks, as well as their usual diet. These often contain extra vitamins and minerals, too.

A GP can advise you on calorie-enriched foods and supplements, and prescribe them if necessary. They can also refer the person you look after to a dietitian if they need more support.

Get more advice for underweight children and underweight adults.

Physical activity and learning disabilities

Exercise is key to managing weight. It helps burn calories for people who need to lose weight. It can also stimulate appetite for people who need to gain weight.

Ask the person you look after what activities they're interested in. Try to think of ones that will fit into their routine and that they enjoy.

If you can, organise some regular physical activity and support the person you care for to make sure it happens.

Mobile adults aged 19 to 64 are recommended to be active every day and do at least 30 minutes of moderate-intensity aerobic activity, such as cycling or fast walking, on at least 5 days a week.

This can be broken down into smaller amounts, for example, 3 short 10-minute walks.

Special Olympics Great Britain helps people with learning disabilities get involved in sports - see their Facebook page.

More information

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Managing weight with a learning disability

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If you care for a person with a learning disability, they may need help and support to stay a healthy weight. People with a learning disability are more likely to have problems with their weight. Some people may be underweight because their disability means they have difficulties with eating or swallowing, for example.

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Explains the differences between allergy and intolerance

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Food intolerances can be experienced in many different ways. If you’re looking to stay on top of your overall and heart health, it may be worth looking at the food you’re eating.

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Having to avoid certain foods in your diet can be difficult. But there are a few simple things you can do to help you manage your food allergies - allowing you to stay safe, continue to participate in fun activities and enjoy your food.
What is the difference between food allergy and food intolerance?

For some people, eating certain foods can lead to an unpleasant and sometimes dangerous physical reaction.

The term used to describe all types of reactions to foods is 'food hypersensitivity'. A 'food allergy' is a reaction involving the immune system (the body's defence against foreign bodies). Those that do not involve the immune system are often called a 'food intolerance'.

It is important to identify and manage foods that trigger any symptoms in an appropriate way.

Food allergy

Proteins within foods can trigger immediate (within two hours) or delayed symptoms (up to several days later).

Immediate food allergy (IgE mediated food allergy)

Immediate reactions to foods occur when your immune system reacts to a normally harmless protein in food, due to the creation of Immunoglobulin E (IgE).

This results in the release of chemicals (e.g. histamine) which trigger allergic symptoms. These symptoms are usually in the skin (itching/swelling), or gut (vomiting, diarrhoea).

Other symptoms can include breathing problems and in rare cases an extreme allergic reaction called anaphylaxis.

Delayed food allergy (non IgE mediated food allergy)

Delayed reactions to foods still involve your immune system, but there is a different type of immune reaction involved. Symptoms typically occur in the gut (vomiting, diarrhoea, constipation) and/or the skin (atopic eczema).

Which foods are involved?

The most common foods to be involved in children are:

1. cow's milk

2. hen's egg

3. peanuts

4. tree nuts e.g. hazelnuts, almonds, walnuts, Brazil nuts, cashew and pistachio nuts

5. wheat

6. soya

7. fish

8. shellfish, especially prawns

9. sesame

In adults, the most common type of food allergy is to raw fruits and raw vegetables. It is known as pollen food syndrome. Fish, shellfish, legumes and seeds are also common causes of allergy in adults.

Food allergy testing

If you think you have a food allergy, you will need specialist input to diagnose your allergy and help you manage it. For more information see the Food Allergy and Intolerance Testing fact sheet.

Food intolerance

There are many different types of 'food intolerance'. Food intolerances do not involve your immune system. Reactions often show a vast range of symptoms, and can be individual to you.

The onset of reactions could be immediate or delayed and the symptoms range in severity. If you think you have a food intolerance, you will need a detailed clinical history by an experienced healthcare professional to diagnose and help you manage these reactions.

Lactose intolerance

This is one of the most common food intolerances. It occurs when you have either too little or no lactase. This is the enzyme which helps to digest lactose, the sugar found in milk and dairy products from all types of animals (such as cow, goat and sheep).

If you are lactose intolerant you should avoid or reduce these foods. Replace them with lactose-free milk and dairy products or fortified plant-based alternatives.

Histamine intolerance

This is a reaction to certain naturally occurring substances in foods called vaso-active amines - such as histamine. Common trigger foods include red wine, strong and blue cheeses, tuna, mackerel, pork products, tomatoes and various other preserved foods.

Salicylate sensitivity

Salicylates are substances, chemically similar to aspirin, found in a wide variety of plant foods. Some fruits, vegetables, nuts, herbs and spices are high in salicylates. Most people can tolerate small amounts of these foods.

Other sensitivities

Some people can have reactions to caffeine or theobromine - found in chocolate.

There are also many reactions to foods with unknown mechanisms such as intolerance to food additives benzoate and sulphite, preservatives and monosodium glutamate.

In all these examples avoidance of foods or reduced intake may improve the symptoms. Often there can be other factors that also need to be considered.

Food labelling

Under UK law, food businesses must inform you if they use any of the 14 allergens as ingredients in the food and drink they provide. The 14 allergens are: celery, cereals containing gluten (such as rye, wheat, barley and oats), crustaceans (such as prawns, crabs and lobsters), eggs, fish, lupin, milk, molluscs (such as mussels and oysters), mustard, peanuts, sesame, soybeans, sulphur dioxide and sulphites and tree nuts (such as almonds, hazelnuts, walnuts, brazil nuts, cashews, pecans, pistachios and macadamia nuts).

Prepacked food - Allergens must be emphasised within the ingredients list of pre-packed food or drink, for example on tins you buy in the supermarket. This could be done by using bold, italic or coloured type.

Non-prepacked (loose) food - Food businesses such as a bakery, butchers or delicatessen, must provide you with allergen information for any loose item you buy that contains any of the 14 allergens.

Foods prepacked for direct sale (PPDS) - These are foods packed and prepared on the same site, such as in a café, sandwich shop, deli or food outlet preparing food in their own kitchen. From 1 October 2021, PPDS food must have a label that displays a full ingredients list. The 14 allergens must be emphasised within it.

Eating out - A restaurant or café must provide you with allergen information in writing. This could be allergen information on their menu or a written notice explaining how you can get this information. Ask a member of staff about the allergen content of a dish you wish to order.

Food delivery & takeaway food - If you are ordering food online or by phone, allergen information must be provided before purchase is completed and when the food is delivered (in writing or verbally). If ordering through a food delivery company you must contact the restaurant directly.

Precautionary allergen labelling - 'May contain' statements are often used on food packaging to state that a food may be contaminated with one of the common allergens. There is no law to say when these statements should be used. This type of labelling is used on many foods, so it is important to discuss the safest approach with your doctor or dietitian.

Top tips

When a food hypersensitivity reaction involves the immune system, it is called a 'food allergy'. If it does not involve the immune system, it is often called a 'food intolerance' or an 'adverse reaction'.

If you have to cut out complete food groups from your diet such as dairy or wheat, try to make sure the foods you replace them with have enough of the nutrients you need.

Look out for, and try, new 'free from' products as this will help add variety and enjoyment to your diet. These are clearly labelled and are common foods made without the standard ingredients.

Develop your cooking skills! Adapt your favourite recipes using suitable alternative ingredients.

Plan ahead. For special occasions or meals out, let your host or chef know your dietary requirements.

Prepare in advance for holidays abroad. This includes emergency medication, translation cards and making your airline and accommodation aware.

Be aware of the ingredients used in cuisines from different countries.

Know your level of food avoidance. Find out if you have to avoid tiny 'trace' amounts of food allergens or if you can have small amounts without triggering a reaction. Be aware of the risk of cross-contamination on surfaces and utensils.

Always carry the emergency medication recommended by your doctor. Make sure your family and friends know what to do in an emergency.

If you are unsure about which foods you can and can't eat and need further dietary advice, ask your doctor to refer you to a dietitian.

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Having to avoid certain foods in your diet can be difficult. But there are a few simple things you can do to help you manage your food allergies - allowing you to stay safe, continue to participate in fun activities and enjoy your food.

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Food Allergy | Allergy UK | National Charity

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Find out more about food allergies, including what the symptoms are, what can cause them and how they’re treated.

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A food intolerance is difficulty digesting certain foods and having an unpleasant physical reaction to them.

It causes symptoms, such as bloating and tummy pain, which usually happen a few hours after eating the food.

The number of people who believe they have a food intolerance has risen dramatically over recent years, but it's hard to know how many people are truly affected. Many people assume they have a food intolerance when the true cause of their symptoms is something else.

What are the symptoms of food intolerance?

In general, people who have a food intolerance tend to experience:

These symptoms usually happen a few hours after eating the food.

It can be difficult to know whether you have a food intolerance as these are general symptoms that are typical of many other conditions.

Is there a food intolerance test?

A number of companies produce food intolerance tests, but these tests are not based on scientific evidence and are not recommended by the British Dietary Association (BDA).

The best way of diagnosing a food intolerance is to monitor your symptoms and the foods you eat. See what happens when you cut out the suspected food for a while, and then reintroduce it into your diet.

Food diary

Try keeping a food diary, noting:

what foods you eat

any symptoms you have after eating these foods

when these symptoms happen

Trial elimination diet

Once you have an idea of which foods may be causing your symptoms, you can try excluding them from your diet 1 at a time and observing the effect this has.

Try cutting out the suspected food from your diet for 2 to 6 weeks and see if your symptoms improve.

Reintroduce the food to see if symptoms return. You may find you can tolerate a certain level and you only get symptoms if you have more than this amount.

Consider seeing a dietitian to make sure you're receiving all your recommended daily nutrients while you do this trial. Find a registered dietitian.

Never restrict your child's diet unless this has been advised by a dietitian or your doctor.

Could my symptoms be something else?

If you regularly have diarrhoea, bloating, tummy pain or skin rashes but you're not certain of the cause, see a GP.

A GP may be able to diagnose the cause from your symptoms and medical history. If necessary, they'll order tests, such as blood tests.

You can also do some research yourself. It may help to find out about other conditions that cause similar symptoms. For example, find out about:

The bowel is a sensitive organ and it's common to have bowel symptoms when you have been ill or feel run down or stressed.

Is it a food intolerance or food allergy?

A food intolerance is not the same as a food allergy. Here's how to tell the difference.

A food allergy:

is a reaction by your immune system (your body's defence against infection). Your immune system mistakenly treats proteins found in food as a threat

can trigger allergy symptoms, such as a rash, wheezing and itching, after eating just a small amount of the food (these symptoms usually happen quickly)

is often to particular foods. Common food allergies in adults include fish and shellfish and nut allergies. Common food allergies in children include milk, eggs, fish, peanuts and other nuts

can be life-threatening

A food intolerance:

does not involve your immune system - there is no allergic reaction, and it is never life-threatening

causes symptoms that happen gradually, often a few hours after eating the problem food

only results in symptoms if you eat a substantial amount of the food (unlike an allergy, where just traces can trigger a reaction)

can be caused by many different foods

Find out more about diagnosis of food allergies.

What causes a food intolerance?

It is often unclear why a person is sensitive to certain foods.

If your symptoms happen after eating dairy products, it's possible you may have lactose intolerance. This means your body cannot digest lactose, a natural sugar found in milk, yoghurt and soft cheeses. A GP can usually diagnose lactose intolerance by looking at your symptoms and medical history.

Some people have trouble digesting wheat and experience bloating, wind, diarrhoea, being sick and stomach pain after eating bread. Read more about wheat intolerance (also known as wheat sensitivity).

Otherwise, the culprit may be a food additive, chemical or contaminant, such as:

monosodium glutamate (MSG)

caffeine

alcohol

artificial sweeteners

histamine (found in Quorn, mushrooms, pickled and cured foods, and alcoholic drinks)

toxins, viruses, bacteria or parasites that have contaminated food

artificial food colours, preservatives or flavour enhancers

Gluten intolerance

Many people cut gluten from their diet thinking that they are intolerant to it, because they experience symptoms after eating wheat.

But it's hard to know whether these symptoms are because of an intolerance to gluten, an intolerance to something else in wheat, or nothing to do with wheat at all. It may help to read more about cutting out bread from your diet.

Very few people need to cut out gluten from their diet, although it's important to do so if you have coeliac disease (which is not an intolerance, nor an allergy, but an autoimmune condition).

How do I manage it?

If you're confident you are intolerant to a particular food, the only way to manage this is to stop eating the food for a while and then reintroduce small quantities while monitoring how much you can eat without causing symptoms.

Check food labels to see which sorts of foods to avoid.

If you think your child may have a food intolerance, check with a GP or dietitian before eliminating foods from their diet, as a restricted diet could affect their growth and development. Cows' milk, for example, is an important source of calcium, vitamin D and protein.

When do I need to see a specialist?

A GP may refer you to a specialist if they're not sure what's causing your symptoms and further tests are needed.

You may also be referred if your child has digestive symptoms (such as tummy pain and diarrhoea) and:

is not growing well

has not responded to any elimination diets that your healthcare professional recommended

has reacted suddenly or severely to a food

has a suspected food allergy

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A food intolerance is difficulty digesting certain foods and having an unpleasant physical reaction to them. It causes symptoms, such as bloating and tummy pain, which usually happen a few hours after eating the food. The number of people who believe they have a food intolerance has risen dramatically over recent years, but it's hard to know how many people are truly affected.

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Food Intolerance | Allergy UK | National Charity

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In this Factsheet you will find information about food intolerance, including the symptoms of food intolerances and resources to help identify and manage it.