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The aim of this report is to analyze the relationship between poor diet and impaired mental well-being, particularly within the lower socio-economic groups, and how education and multi-agency partnerships can influence behavior change and promote positive holistic health.
Low Income
There are many factors that contribute to an individuals mental health, including nutrition, education, well-being, and income. While national guidance is in place to maintain and improve these, they may not be protecting the vulnerable. For example, the BBC reported that up to 3.7 million UK children live in homes struggling to afford enough meat, fruit, and vegetables to meet healthy eating advice (Sellgren, 2018). This research was carried out by the Food Foundation, which compared the weekly cost of following Public Health Guidelines with the average disposal income of poorer UK households. It found that following the guidelines would use 30% of a households income, compared to 12% for richer households. Critically, it also suggests that low-income households, earning less than £15,860 a year, would use nearly half their disposable income to afford the suggested foods (Sellgren, 2018). These categories cover more than 3.7 million children. Furthermore, as household income in the country decreases, it has been reported that households in receipt of statutory benefits consume fewer portions of fruit and vegetables than those in non-benefit households (Mental Health Foundation, 2017: 10). This inequality could severely affect the mental and physical development of these children. Linked with cognitive dysfunction, this could lead to a wider global impact as they develop and potentially fail to positively contribute to society impacting our economic future. The stigma associated with low income and the perceived knowledge of limited opportunities and exclusion from society could significantly affect stress levels and mental well-being.
Mental Health
Mental health plays a huge part in a familys lifestyle whether it is that of the child, the parent, or the family as a whole. Chronic stress, often linked with poor income, which is often related to poorer education, can lead to anxiety, irritability, and cognitive dysfunction. Stress in adults can also lead to increased caffeine or alcohol intake, both of which can greatly exacerbate anxiety levels, influencing the atmosphere in the family environment.
While there are multiple factors that contribute to an individuals overall health, mental well-being, and support networks can be significant motivators to improve welfare. According to the health belief model, a positive mindset is required to empower behavioral change. Therefore, an individual with poor mental health may find it difficult to consider change, such as improving their nutritional intake, due to their potential negative attitude. Poor mental health not only affects the individual, but it can also greatly affect their family, social networks, their employability, and ultimately impact their social class and income, which could in turn negatively affect global health.
Negative physical and mental health developments could impact the NHS too, ultimately costing the service avoidable time and money. One obvious conclusion would be that the government needs to collaborate with the food and health industries to make these guidelines achievable for all, regardless of income. This is supported by Luzzi and James (2008) who state that the inferior diet of the poor often relates to their lack of private or affordable public transport to out-of-town supermarkets, to the absence of an adequate range of cheap foods in city centers and to an unwillingness to experiment for fear of wasting food .
However, there is an argument that the guidelines are not the issue; misunderstanding nutrition is. According to Sellgren (2018), the chief nutritionist at Public Health England, Dr. Alison Tedstone, found that an adult following the Eatwell Guide would have an average daily spend of £6 per day. Tedstone believes this amount mirrors the current spending on unhealthy food, arguing that addressing the prolific promotion of unhealthy food and the abundance of fast food outlets is more significant to improving the nations diet.
Nutrition
A healthy diet contributes to a healthy brain, thus positive mental health. Healthy neurotransmitter activity is supported by consuming adequate amounts of vitamins and minerals, essential fats, and amino acids. When a brain is deficient in micronutrients, cognitive, motor, and socio-behavioral functions will likely be impaired, and several mental health problems can arise including concentration, memory problems, and depression, which can greatly affect all aspects of an individuals life, including their employability and social status.
A poor diet can also be related to poor sleep. Spiegel et al. (2004) found that reduced sleep can cause cravings for unhealthy food and reduce levels of leptin, a hormone that helps weight maintenance by regulating food intake and energy expenditure, thus creating a cyclical effect. Additionally, processed food, often used to address cravings, has been linked to poor mental health too. The Mental Health Foundation (2017) states that the change in food production techniques, such as processing, the use of additives and industrialized farming have all been directly attributed to serious physical health problems .
Combating this arguably requires further public education about processed food and poor nutrition, especially for those raising the next generation. A parents knowledge deficiency would impact their child, potentially leading to generations of poor diet techniques, yet the importance of good nutrition in early childhood cannot be understated. Early life nutrition may affect long-term cognitive and behavioral development throughout childhood into adult life, building a cognitive reserve. This reserve affects cognitive functioning during adulthood and may eventually determine the rate of cognitive decline during aging, while nutrition continues to impact these processes (Geissler and Powers, 2017: 472).
The study found a direct link between nutrition and cognition, stating that children who are undernourished are more apathetic and interact less with their caregivers and environment (Geissler and Powers, 2017: 472). Not only would this affect the childs mental growth, but it would also impact the parent, finding their child lethargic and needier, reporting a direct correlation between the increased malnourishment of the child and the amount their behavior differed to well-nourished children. This functional isolation would impact the childs development. Children gain many of their social skills from school, and if they are healthy, their attendance could potentially improve, increasing their odds of developing social interaction skills while improving their cognitive development as they mature.
Education
When it comes to public health education, such as advice on childhood nutrition, it is vital to consider that close to 60% of all adults access health information online, and over 25% access it through social media. Information on diet, nutrition, vitamins, and supplements is one of the most common reasons why people use the Internet. There has been a significant increase in the number of health-related social media accounts, with one nutritionist claiming Instagram is responsible for a rise in orthorexia diagnoses, an eating disorder concerning obsessional healthy eating (Rashid, 2019).
Health professionals question the validity and responsibility of these online experts, with the University of Glasgow finding that only one in nine of the most popular weight-management bloggers provide correct and reliable information. The study claimed that much of the information presented as fact actually didnt meet the national criteria. No blogger met the Public Health England nutritional guidelines, yet each blog had more than 80,000 followers. The report concluded: Popularity and impact of social media in the context of the obesity epidemic suggests all influencers should be required to meet accepted scientifically or medically justified criteria for the provision of weight management advice online (Forrest, 2019).
Online influencers frequently use similar empowerment techniques to social marketing, engaging the potential service user and appearing professional and trustworthy. If unregulated, irresponsible marketing claims, such as promoting fasting, providing ill-informed nutrition advice, or promising rapid physical transformations, could potentially cause the next global health epidemic.
While this call for regulation could add an argument to the growing mistrust of social media, it remains a powerful tool, with around 70,000 health-related searches on Google every minute (Murphy, 2019). Griffiths et al. (2008) argue that combining specialized health promotion and social marketing on an official government level could ensure that health improvement strategies and practice are as effective as they possibly can be . Initially, a typical social marketing campaign would use the biomedical model to influence preventative change leading to criticisms of self-blaming language (Jones and Douglas, 2012: 284). Recently, a more strategic approach has been employed, using the empowerment model to encourage self-development and motivate independent behavioral change.
Social media marketing should be considered alongside social marketing as a valuable health education tool. Used positively and responsibly, future and developing generations could be empowered through education to improve their nutritional health, and thus their mental well-being, for years to come.
Furthermore, the issue of accidental malnutrition, potentially caused by miseducation, needs to be prioritized by health experts across the world. Collaborative working is imperative to organizing policies and strategies to address this situation. As encouraged by WHO guidelines, this practice happens when multiple health workers from different professional backgrounds work together with patients, families, carers, and communities to deliver the highest quality of care (WHO, 2010: 7).
Each nations healthcare strategy should involve stimulating research, regulating care, and protecting disadvantaged groups and, arguably, there are already a vast number of health promotions, research projects, and directives across the globe. Some governments are already working alongside the food industry to monitor salt, fat, and sugar reduction, supported by legislation to reduce excessive intake. The United Kingdom has seen great changes so far, with Luzzi and James praising the efforts of public health professionals, claiming that in addition to improving medical services, immunization developments, and drug research, the factor impacting this century most has been diet improvements prompted by the increased variety and availability of ingredients and enhanced living conditions. They conclude these are great public health achievements which should not be overlooked by policymakers and indeed the public (Luzzi and James, 2008: 275).
However, as malnutrition is still a serious problem in many low-income families, even in high-income countries, the situation needs to be monitored and improved further. Further suggestions to improve and expand public health education include:
- Clarify food labeling to include natural vs processed ingredients, e.g., sugar;
- Promote the benefits of frozen food;
- Link nutritional intake to mental performance;
- Increase the cost of alcohol/cigarettes;
- Increase the sugar tax;
- Reduce the cost of exercise and improve access to facilities;
- Introduce stricter controls on social media regulation;
- Create marketing programs based on improving the well-being of those currently affected by poor income or ill health.
Conclusion
There is a definitive link between poor nutrition and poor mental health, which will have an impact not only on the general public but future generations too, thus adversely affecting the economy and environment. This report concludes income may not be as much a barrier to good health as a lack of knowledge or understanding, and all levels of intervention must understand this. According to the Mental Health Foundation, individuals, practitioners, and policymakers must make sense of the relationship between mental health and diet so we can make informed choices, not only about promoting and maintaining good mental health but also increasing awareness of the potential for poor nutrition to be a factor in stimulating or maintaining poor mental health. There is a need for further education about the impact of diet on mental health and academic performance. The current NHS guidelines are not being met by those who arguably need them most. Collaborative practice is required to revise these, to maintain momentum in the public to see the guidelines as positive and achievable, to understand the proposed benefits, and be empowered to make a behavioral change. Once empowered, each individual has the ability to educate and influence their community, leading to structural adjustment possibly new original legislation or policy changes to further improve our health. The achievability of these aims will depend on the availability and promotion of healthy eating and impactful messages directed by the health belief model.
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