In relation to diet, the advice is to increase the consumption of wholegrains, vegetables and other foods high in dietary fibre. People should also be advised to drink at least six to eight glasses of water a day, reduce the total amount of fat in their diet by replacing foods high in saturated fat with versions high in unsaturated fat. NICE PH38 (2012) recommends the following:

• Choose skimmed or semi-skimmed milk and low-fat yoghurts, instead of cream and full-fat milk and dairy products
• Choose fish and lean meats instead of fatty and processed meat products (such as sausages and burgers)
• Grill, bake, poach or steam food instead of frying or roasting (e.g. choose a baked potato instead of chips)
• Avoid food high in fat such as mayonnaise, chips, crisps, pastries, poppadoms and samosas
• Choose fruit, unsalted nuts or low-fat yoghurt as snacks instead of cakes, biscuits, Bombay mix or crisps.

Goal setting is important  – a target of five to 10 per cent weight loss in the first year is a realistic initial target. Support should also be offered regarding smoking cessation and reduction of alcohol intake where applicable. The guidelines suggest no more than 14 units of alcohol per week for both men and women.