Table Of ContentThe Building Blocks of Life
Within the United Kindom (UK), most mainstream healthcare practitioners receive
little or no nutrition education during their years of training. As a consequence, the
understanding of nutrition amongst primary care practitioners such as general
practitioners, pharmacists, midwives, and practice nurses is limited and is largely
focused on energy consumption and obesity. There is little knowledge of the wealth
of micronutrients that underpin health, nor of the ticking timebomb of insufficient
intakes of those micronutrients amongst a significant proportion of the population
in the UK.
The Building Blocks of Life: A Nutrition Foundation for Healthcare Professionals is
a step towards redressing that balance. It sets out an informative and engaging
narrative on how and why nutrition is the basis for good health. It discusses UK-
specific issues with regard to diet and intakes of vitamins, minerals, essential fatty
acids and other micronutrients. It also raises concerns about the potential negative
health implications of the generally poor UK diet and suggests ways that healthcare
practitioners can support patients in improving their long-term health outlook.
Nutrition policy in the UK needs to be dragged into the 21st century and this book
sets out evidence-based arguments which challenge current public health myths
such as the idea that 10 micrograms of vitamin D is all anyone needs or the
messaging around the consumption of saturated fat vs highly processed seed oils or
that everyone can get all the nutrients they need from a varied and balanced diet.
Although The Building Blocks of Life: A Nutrition Foundation for Healthcare
Professionals focuses on concerns around poor diet and the consequent micronutrient
inadequacies in the UK, the nutritional detail is relevant no matter where you are in
the world. Everyone eats, all the time. It is time that mainstream medicine looked
towards food as both a cause and a solution to many of the chronic degenerative
conditions that plague modern life.
The Building Blocks
of Life
A Nutrition Foundation for
Healthcare Professionals
TC Callis
Designed cover image: Illustrator, Adam Speigl-James; Design Consultant: Rachael Mustoe
First edition published 2023
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ISBN: 978-1-032-27112-5 (hbk)
ISBN: 978-1-032-27111-8 (pbk)
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DOI: 10.1201/b22900
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Dedication
For my parents who enabled me to write this.
Thank you for telling me I could be anything I wanted to be.
I wish you could have been here for this.
Contents
Acknowledgements.................................................................................................xiii
Author......................................................................................................................xv
Introduction..............................................................................................................1
References............................................................................................3
Chapter 1 Nutrition Basics...................................................................................5
The Basics............................................................................................5
Macro- and Micronutrients Are Split up into Smaller and More
Complex Groups..................................................................................5
Macronutrients.....................................................................................5
Fats...............................................................................................5
Proteins........................................................................................6
Carbohydrates..............................................................................6
Fibre.............................................................................................7
Water............................................................................................7
Micronutrients......................................................................................7
Vitamins.......................................................................................8
Minerals.......................................................................................8
Omega-3 Fatty Acids..................................................................8
Phytonutrients..............................................................................8
Deficiency or Insufficiency.................................................................9
Nutrient Intakes – Terminology..........................................................9
National Diet and Nutrition Survey..................................................10
Government Guidelines.....................................................................10
There Is Nothing Simple about Nutrition.........................................11
References..........................................................................................12
Chapter 2 Malnutrition.......................................................................................15
What is Malnutrition?........................................................................15
Definitions..................................................................................15
Prevalence of Malnutrition in the UK..............................................15
The Difference between Macronutrient and Micronutrient
Malnutrition.......................................................................................16
Undernutrition Is Part of Malnutrition..............................................17
Vitamin D..................................................................................17
Omega-3 Fatty Acids................................................................18
What Are the Health Implications of These Nutrient Shortfalls?...18
Vitamin A..................................................................................18
vii
viii Contents
Vitamin D..................................................................................19
Riboflavin (Vitamin B2)............................................................19
Folate (Folic Acid)....................................................................19
Calcium......................................................................................20
Magnesium.................................................................................20
Iron.............................................................................................21
Iodine.........................................................................................21
Selenium....................................................................................21
Zinc............................................................................................22
Omega-3.....................................................................................22
Real Life............................................................................................23
Other Issues.......................................................................................23
Confusing Public Health Messages..................................................24
Solutions?...........................................................................................25
Education...........................................................................................25
Social Prescribing..............................................................................26
Clear Messages..................................................................................26
A Quick Fix?.....................................................................................26
References..........................................................................................27
Chapter 3 Digestion............................................................................................35
Digestion and Absorption..................................................................35
Fat Soluble Vitamins.................................................................37
Water Soluble Vitamins............................................................38
Minerals.....................................................................................38
Immunity............................................................................................40
The Microbiome................................................................................41
The Microbiome in the Mouth..................................................42
The Microbiome in the Gut......................................................42
Fibre...................................................................................................44
Short Chain Fatty Acids....................................................................45
Fermented Foods...............................................................................46
The Second Brain..............................................................................46
The Nervous Systems in the Gut..............................................48
Neurotransmitters.......................................................................49
Glutamate and GABA...............................................................49
The Centrality of the Gut to Health.................................................50
References..........................................................................................50
Chapter 4 Obesity...............................................................................................63
Obesity and Poverty..........................................................................64
Ultra-Processed Food........................................................................65
The Glycaemic Index........................................................................67
How Our Relationship with Food Impacts Obesity.........................68
Insulin and Carbohydrate..................................................................69
Contents ix
Hunger and Appetite.........................................................................70
Satiety Value......................................................................................71
Fat Is Not the Enemy........................................................................71
Saturated Fat – Really Not So Bad..................................................72
Trans Fats and Omega-3...................................................................73
Obesity and the Microbiome.............................................................76
There Is No Single “Best Way” to Lose Weight.............................78
References..........................................................................................79
Chapter 5 Immunity............................................................................................91
Immunity Requires Both Micronutrients and Macronutrients.........92
Nutrients Fund Immunity..........................................................93
Omega-3 and Omega-6.....................................................................93
Vitamins.............................................................................................95
Vitamin A..................................................................................95
Vitamin D..................................................................................96
Vitamin E...................................................................................97
The B Vitamins.........................................................................97
Vitamin C..................................................................................98
Minerals.............................................................................................99
Iron.............................................................................................99
Zinc..........................................................................................100
Selenium..................................................................................101
Calcium....................................................................................102
Other factors....................................................................................103
β-Glucans.................................................................................103
Flavonoids and Polyphenols....................................................103
The Microbiome and GALT...................................................104
References........................................................................................105
Chapter 6 Vitamin D........................................................................................115
Vitamin D from Food......................................................................115
Vitamin D from Sunlight................................................................116
Safety...............................................................................................118
Situation in the UK.........................................................................118
Vitamin D Deficiency Rates in the UK..........................................119
Bones................................................................................................119
Mental Health..................................................................................121
Immunity..........................................................................................121
Autoimmune Disease.......................................................................122
Multiple Sclerosis....................................................................123
Diabetes....................................................................................123
Inflammatory GI Diseases.......................................................124
Systemic Lupus Erythematosus (SLE) and Rheumatoid
Arthritis (RA)..........................................................................124
Some Cancers..................................................................................125
