Main

There was a time when a 'five-a-day man', or woman, was the common parlance for someone who was doing rather well in the process of cutting back on Player's Navy Cut or Will's Wiffs cigarettes. But in the brave new post-modern world it has a very different meaning as we struggle to get enough roughage on board and to encourage those around us to do likewise.

While for many of us, giving advice on quitting smoking seems to be a step too far into the personal lives of our patients, dietary advice has always seemed fair game, indeed been a part of the game. After all, the mouth is not only an organ directly affected by the quality of the diet it is also the portal for the foods and drinks that constitute whatever it is that makes up our calorific intake.

Of course we long ago gave up the over simplistic warning 'don't eat sweets'. However deliciously all-encompassing such a counsel of wisdom it might have seemed, especially in the days of sweet shops with grumpy owners, jars of boiled humbugs and alluring ceramic pots aching with brightly coloured lollipops and gob-stoppers, it now apparently deserves only to be accurately reproduced in BBC costume dramas of the 'period between the wars', and doubtlessly, in due course, to dental heritage theme parks.

The sophistication of the message has increased umpteen-fold since the discovery that it isn't only the quantity of sugar, sorry, refined carbohydrate that one ate, sorry, consumed, but also the frequency. Oh, and the consistency. Plus, I forgot to point out the order in which the fermentable (did I not previously mention fermentable? apologies) complex (and simple) carbohydrates were devoured. If the resultant messages seemed somewhat, how shall we say? less than consistent, then that was largely due to the impossible number of computations and permutations that were and were not, might and might not be safe, dangerous, low caries risk or high cariogenically inclined.

None of this has been helped by the constant nibbling away, the pun is entirely intended, of our already very tenuous authority in the matter by endless stories in the media. Not a day goes by or a news bulletin passes without further dubious wisdom being imparted by an 'expert' about the safety of this food, the dire consequences of over-eating that genre of vegetables, the inherently poisonous nature of some additive or another and the complete foolishness of eating anything other than pure unstrained yoghurt with any of it.

Now it may just have been possible to tiptoe a path through this minefield of nutritional mayhem had it not been for the intervention of the dieticians. Please don't misunderstand me, some of my best dinner party guests used to be dieticians, it's just that their stance on certain snack foods has not exactly made our jobs any easier. For example, hands up all those who used to feel moderately comfortable about suggesting crisps as a safe snack to substitute for 'sweets'. I thought so. Now, how many are not aware that the humble bag of cheese and onion has been given the thumbs down on the grounds of being suicidally stuffed with salt and fat? Not that various authorites haven't been expansive with suggestions for alternatives. Instead of a handful of salivatingly tasty salt and vinegar why not try a cream cracker? Get real. What adult, never mind a playground-bound child is likely to pull out a dry biscuit and taunt their chums with its yumminess?

...how is your preaching affecting the rest of your co-workers who are in regular earshot of your advice? Perhaps a peek inside the odd Tupper-wear box is taking the nutrition police too far...

Which in turn brings us to another quandary in daily practice, that of the substance of the dental team's respective lunchtime habits and lunchboxes. And, more particularly, our own. It hardly seems fair to be spending the morning eulogizing on the benefits of a healthy diet before repairing to the staff room for a bonanza of sausage rolls with mayonnaise topped off with blueberry cheesecake, or nipping down to the local take-away for a standing order of two saveloys and chips. (Well surely the pickle onion counts as one helping of vegetables?) And how is your preaching affecting the rest of your co-workers who are in regular earshot of your advice? Perhaps a peek inside the odd Tupper-wear box is taking the nutrition police too far but have a quick search through the post-lunch hour pedal bin. If you catch sight of a small mountain-range of confectionary bar packaging and Scotch egg wrappers the chances are that your patients aren't being swayed by your arguments either.

Which conveniently brings us back to the five-a-day stuff. Should we be regarding this as a huge boost to our dietary crusade or another nail in its terminally cholesterol-stenosed coffin? On one level it makes complete sense. It's natural, it's not adulterated and it's what our predecessors ate. Until, that is, some do-gooding historian points out that our predecessors died at a much younger age than we do now. On the other hand, it's what 'authority' says is good for us and we all know what that can mean. To be on the safe side the best advice still seems to be to eat a 'well balanced' diet full of all the nutrients, vitamins and trace elements required from each of the essential food groups needed for a healthy life style. And if your patient asks you to sum that all up in a few words relevant to today's way of life?

'Still don't eat sweets.'