That nutrition is important for health has been known for centuries. The Ancient
Egyptians knew the value of animal livers for preventing blindness and, from
the 15th century, scurvy was dreaded by seamen and explorers who were forced
to subsist for months on dried beef and biscuits. But it was not until the first
half of the 20th century that vitamins were identified and synthesised. These
discoveries resulted in the ability to cure many of the classic nutritional
deficiency diseases like scurvy and beriberi, and as the century progressed,
better diet and growing affluence were among the factors that led to increased
life expectancy and improved health. After the 1939-45 war, nutrition almost
began to take a back seat. By the 1960s, however, growing incidence of cardiovascular
disease was becoming a cause for concern and, as the links between heart disease,
cholesterol and diet became better known, nutrition again came into prominence.
The past 30 years have seen an enormous increase in the general public’s
interest in nutrition, but the plethora of dietary messages has too often spread
confusion, and with recent food and nutritional scares, confusion is rapidly
being replaced by scepticism. More than ever, the public needs a reliable source
of nutritional information, and pharmacists, as they always have been, are well
placed to provide it. Giving advice on medicines, responding to symptoms and
selling nutritional products often present opportunities for giving dietary
advice — as does the internet. The customer presenting with reams of information
from the web on a nutritional supplement needs help to interpret it.
Yes, the need is great. Research continues to show that 40 per cent of adults
are malnourished on admission to hospital. Over half the population is overweight
or obese, and results of recent national diet and nutritional surveys leave
no room for complacency. Average nutritional intakes in these surveys often
look fine, but a closer look at subgroups within the studied populations reveals
that the risk of deficiencies has not gone away. In addition, up to one third
of cancers are associated with poor diet, and the incidence of conditions such
as diabetes mellitus and osteoporosis, where again there is increasing evidence
for a role of good nutrition, are set to increase dramatically over the next
few years, placing an untenable demand on health services.
Pharmacists can do a great deal to encourage good nutrition in their communities,
both on a one-to-one basis within the pharmacy and through helping to ensure
that nutrition is taken seriously at a primary care group/ trust level through
the mechanisms of health improvement programmes and national service frameworks.
Prevention, of course, is always better than cure, but pharmacists have an opportunity
to help with both and, even with a limited amount of time, they can help to
ensure that nutrition is part of every patient’s care plan.
Continuing education, p720