In advising about diet it is important to ensure that dietary change does not compromise other aspects of health. The inclusion of fruits, vegetables and wholegrain cereals is of particular importance as these are nutrient dense but low energy foods that have been shown to be protective to health.^19–23 In addition, it is important to consider reducing the risk of conditions such as anaemia and osteoporosis.

The Balance of Good Health is an educational tool which was produced to help consumers to understand more clearly the principals of a healthy diet.

The nutritional principles behind the model are that:

• Over half of our daily energy should be obtained from carbohydrates – primarily complex carbohydrates 
• Much less of our daily energy requirements should come from fat (<35%) 
• 15% of our daily energy requirements should come from protein 
• By eating a variety of foods from each food group, all micronutrient needs can be met

Food and meal choices need to be discussed in the context of the reality of daily living. It may take time for many people to put in place all of the changes that will improve the quality of their diet and, therefore, small achievable goals should be set at each review. Goals need to be specific as general guidelines such as ‘reduce fat’ or ‘increase fruit and veg’ have been shown to have little effect. Information gained from a brief diet history or food diary can form the basis of the discussion about what specifically to change e.g. suggesting that salad vegetables are added to a sandwich and that a lower calorie mayonnaise is used to increase vegetables and decrease fat, respectively.