Food groups

Understanding the different food groups and their importance to health and wellbeing.

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This food pyramid has been developed as an educational guide to support balanced, healthy eating messages. It is based on the REAL food pyramid (Recovery from Eating disorders for Life food pyramid (Hart et al 2018, adapted and used with kind permission).

The different sections of the food pyramid, and their importance to health and wellbeing are explained under the headings below:

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Food pyramid.JPG

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Diet foods and fillers

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What are diet foods and fillers?

Being at the top of the pyramid, this is the smallest section, and should be considered with the least importance when making food choices.

These include:

  • diet drinks e.g cola and energy drinks
  • diet or low fat yogurts
  • light or sugar free desserts
  • large servings of fruit and vegetables
  • increased amounts of condiments and sauces
  • artificial sweeteners.

Why are they important to consider?

If these make up a big part of meal and snack choices, your young person can end up filling up on these rather than more nutritious foods. This can mean it’s more difficult to get the full variety of nutrients needed for optimum health.

NB: energy drinks, and cola contain caffeine, which is linked with poor sleep, increased levels of anxiety and irritability. Young people are more sensitive to the effects of caffeine than adults, and so extra care should be taken.

Top tips about diet foods and fillers

During recovery we would advise you to work towards limiting or swapping the choices in this section, as they can slow progress with weight restoration.

Examples of swaps :

  • low fat yogurt → wholemilk yogurt
  • a sugar free Jelly → standard jelly
  • large servings of vegetables on a plate → vegetables making up only a third of a plate (see planning meal choices section for more information).

Social eating

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What is social eating?

Social eating includes having a meal or snack out with family and friends. It could also include eating lunch or snacks with friends at school or at work.

Why is it important to consider?

Social eating can be a fun and important part of supporting our health and wellbeing.

Making connections with others can support our mood and relationships, and enable your young person to practice flexible eating.

What's a good starting point

At the start of recovery journeys, we realise this may seem overwhelming for your young person to do. At a stage that you feel ready, encouraging social eating and connecting with others can be an excellent distraction, and provide a supportive reminder of what an eating disorder has taken them away from enjoying.

An example of a starting point with social eating could be inviting a friend over for the afternoon, and having a snack with them. It could also be visiting a family member and having a meal together. Planning ahead the details of what food or drink option will be had, will help your young person feel safer about taking this step. If planning to eat out, it can be helpful to have a plan A and a plan B food option, just in case your first choice isn’t available.

Dessert and snack foods with fats and sugars

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What foods are included in this group?

Some examples of desserts:

Some examples of snack foods:

Fruit crumble

Crisps

Sponge pudding

Biscuits

Cheese cake

Cake

Banoffe pie

Chocolate

Ice cream

Brownies

Trifle

Flapjack

Are these foods part of balanced eating?

Yes, they very much are part of balanced eating, together with a range of snack and dessert options from the other food groups. Whilst supporting our overall energy and nutritional needs, including foods from this group is also a key part of supporting your young person’s social and emotional wellbeing.

Being able to join in fully with social occasions involving foods from this group, and working towards eating without fear or feeling judged can bring the freedom, flexibility and enjoyment that food can bring to support emotional wellbeing.

Top tips on how to include these foods:

We would support you to plan an item from this group at least daily into your young person’s eating plan. This could be a packet of crisps or biscuits as a snack option or second course with a lunch type meal or planning in a dessert from this group after a main meal.

Take a look in the ‘planning meal and snack choices’ section for further information on balancing snack choices from the other food groups too.

Calcium foods

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Which foods are included in the calcium food group?

  • Milk
  • yoghurt
  • cheese
  • custard
  • milk-based puddigns e.g rice pudding
  • fortified non-dairy based alternatives e.g Sweetened soya milk, soya or coconut based yogurts
  • other useful non-dairy sources of calcium include nuts and seeds, tahini paste, beans, tofu, tinned fish (with bones), white bread.

Why do we need to include calcium foods?

Adolescence is a key life stage where bones grow significantly both in size and strength. Calcium is one of several vital nutrients for bone development, and young people have higher requirements for this nutrient than adults.

As well as Calcium, these foods are good sources of protein, certain B vitamins and iodine. They also make an important contribution towards achieving a balanced fat intake

Top tips with including calcium foods

Aim to include a food or drink portion from this group three times per day.

Calcium foods can be part of meals and/or snacks.

Some meal examples:

  • at breakfast, including milk with cereal or yogurt with granola.
  • at a meal time, including cheese with a jacket potato, or as part of a pasta bake, or in a sandwich. For a second course this could include having a yogurt, or custard pot or rice pudding pot.

Some snack examples:

  • a glass of milk, or milk shake or milk based hot chocolate
  • a pot of yogurt or custard pot or rice pudding pot
  • a bowl of cereal with milk or cheese cubes with an apple.

NB: Low fat versions, which include low fat or light yogurts, skimmed milk, almond or coconut milks, are not recommended during recovery.

Take a look in the ‘meal plan’ section for further ideas on including calcium food and drink options.

Protein

 

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Which foods are included in the protein food group?

Foods in this group include:

  • meat
  • chicken
  • fish
  • eggs
  • beans
  • lentils
  • nuts
  • Quorn based products
  • soya meat alternatives

Why are protein foods important for health?

Protein is a key nutrient in repairing and maintaining muscles and tissues. It also supports the body to build new cells, and hormones. Iron and Zinc are important minerals found in these foods, which support our bodies to function in a healthy way.

If young people are restricting their daily energy intake, then the body will use protein as an energy source. This leaves less available for these essential functions.

Top tips for including protein foods

Aim to include a protein food option at meal times at least 2-3 times a day. For more information, and specific meal ideas, look in the ‘meal plan’ section.

Aim for variety with different protein options, as this will ensure a good range of nutrients and a balanced fat intake.

Protein foods can also be good options for snacks e.g nuts or hummus with crackers or mini scotch eggs.

Oils and spreads

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What foods are included in the oils and spreads group?

These include:

 

  • oils (can be included as part of a sauce or salad dressing)
  • butter and margarine
  • mayonnaise
  • oil-based salad dressings e.g. Caesar, French dressing, honey and mustard
  • pesto
  • cream e.g. as part of a curry or risotto-type meal 

Are oils and spreads part of balanced eating?

Fats found in this group are an essential part of balanced eating. Although fats can  be linked in a negative way with health and body weight, restricting these too much can also put our health at risk.

Fats are essential to ensure our body and brain is able to functioin in a healthy way. Fats are crucial to our brain and the communication it has with the rest of the body via the nervous system. Fats support our brains to help us think  more clearly and logically, and provide energy to support concentration levels. 

Fats also help us to absorb fat soluble vitamins (A, D, E and K), build healthy cells, support the production of certain hormones, together with enabling us to achieve an adequate energy intake.

Fats add flavour to food, and allow a wide range of different meal choices to be available. Longer term in the recovery process, this can support eating to become a more enjoyable experience.

Top tips for including oils and spreads

In order to achieve an adequate intake of fats, we recommend an option from this group is added to each meal e.g breakfast, lunch and evening meal (see meal planning section for more information).

Achieving an adequate fat intake also means including calcium foods daily, a range of different protein foods, and foods from the ‘desserts and snacks foods with fats and sugars’.

Carbohydrate

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Which foods are included in the carbohydrate group?

Those linked more to meal times

Those linked more to snack times

Breakfast cereals

Cereal bars

Bread

Fruit bread

Wraps

Hot cross bun

Pitta

Crumpet

Bagels

Scotch pancakes

Rice

Crackers and oatcakes

Pasta

Pretzels

Noodles

Banana and malt loaf

Couscous

Popcorn

Potatoes e.g jacket, boiled, wedges, chips and sweet potato

 

Why are carbohydrate foods important to health ?

Carbohydrates are our body’s main energy source, and are broken down in the body to produce glucose. Glucose is an essential fuel that maintains our blood sugar levels and enables our bodies and brain to function in a healthy way.

Glucose plays a key role in supporting our brain function. It can help us to concentrate well; to think more clearly and logically;  to support us to manage our emotions, as well as our mood. Our brains don’t store glucose, and therefore need a regular supply from the foods that we eat.

Not eating enough carbohydrate foods or having long gaps between meals can lead to tiredness, reduced concentration, irritability and poor sleep.

Carbohydrate foods also give us essential B vitamins and fibre. Fibre supports a positive gut function, and healthy gut bacteria.

Top tips for including carbohydrate foods

At meal times: aim to include a carbohydrate portion with each meal. This includes breakfast, lunch and a main meal.  For more information please click the ‘meal plan’ and portion sizes section of the webpage.

At snack times: carbohydrate food options can also be a great snack to include between meals.

Fruit and vegetables

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What foods are included in the fruit and vegetables group?

These include:

  • fresh, frozen and tinned fruit and vegetables
  • avocado
  • butternut squash
  • dried fruit e.g. raisins and apricots
  • fruit juice
  • smoothies

Why are fruit and vegetables important to health ?

Including a variety of fruit and vegetables gives the body important vitamins and fibre to support our immune system and digestive health. 

Fibre supports a positive gut function, and healthy gut bacteria.

Top tips for including fruit and vegetables

Aim to include up to five portions, spread over a day.

Including a fruit or vegetable portion with at least each meal time will be a good step towards this.

Fruit can also be part of a snack choice, however due to the lower energy content of these foods, they usually need to be added to another food item to ensure energy needs are met. For example vegetable sticks with hummus or peanut butter, or fruit with a packet of popcorn. Refer to our snack list for more ideas, which can be found in the ‘food portion sizes’ section.

We do advise caution with young people eating increased quantities of fruit and vegetables when they’re trying to restore weight. This is because they are relatively low energy choices, and can be filling. This can make it more difficult to then achieve healthy food portions from the other food groups.

Fluids

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Which type of fluids count in this section ?

This includes fluid from:

  • water
  • squashes
  • milk
  • fruit juice
  • tea
  • coffee.

NB: Fizzy drinks are not recommended during the early stages of recovery as they can cause bloating, and increased levels of fullness.

Why are good hydration levels important to health?

Maintaining normal levels of hydration is essential to good health, supporting mood, energy levels and concentration.

Not drinking enough can lead to dehydration which can affect concentration levels, cause headaches, tiredness, dizziness and confusion.

Drinking too much can lead to over-hydration which can cause nausea, vomiting, headaches and confusion.

Seek support and advice from a health professional if you’re aware your young person is restricting fluids or drinking well above recommended levels as this can be dangerous to their health.

Top tips for maintaining good hydration levels

Normal levels of hydration for good health comes from including 6-8 glasses of fluid throughout the day.

A good way to fit this in is to include a drink with each meal and snack time. Taking a water bottle to school or work can be a helpful way to remember to drink regularly.

Recommended fluid intakes over a whole day are:

Young people aged 9-13 years

Girls: ~ 1500mls /day

Boys: ~1700mls/day

14+ years and adults

Women: 1600mls /day

Men: 2000mls /day

Reference: British Dietetic Association Fluids fact sheet 2017

 

NB: additional fluid is recommended to maintain hydration in hot weather and during exercise.

Nutritional advice to support you through family-based treatment