Tag Archives: media dietitian

The least sexy but vitally important nutrient

Facebook likes too ask “what’s on my mind” well actually right now it is fibre. An overlooked and neglected nutrient, maybe because bowel health just isn’t sexy. However to my mind, neither is constipation or piles. 
 
When the recommendations for fibre increased to 30g per day there were lots of posts out there about how hard it would be to achieve it and how to meet your fibre needs. At the time I remember thinking how hard this would be for many people to achieve. It’s all about making small changes one at a time and then building on these. In my clinic I see the extremes. Sometimes underweight people who are eating too much of the fibre rich foods (and I have to ask them to decrease these) but then also plenty of people who are just not having enough fibre which is causing some of their symptoms. 
 
(Disclaimer: this advice is not for those who are weight restoring from an eating disorder, too much fibre can be very filling and stop you from eating enough energy).
 
So why is fibre important? 
 
  • Bowels, bowels, bowels. As a student dietitian on the wards I remember having to swallow my embarrassment and loudly say to people “how are your bowels today”. These days I’m older, a lot harder to embarrass, mum to small kids and used to talking about bowels a lot… whether it be a clients, a child’s or a worms. Yes this week my girl wanted to chat about worms poo. Having enough insoluble fibre is important for bulking your stool. 

 

  • Soluble fibre forms a gel that slows digestion. This also means it helps stabilise blood sugars, lowers cholesterol and aids satiety, keeping you fuller for longer. Soluble fibre is found in oats, barley, psyllium, nuts, seeds, beans, lentils, peas, and some fruits/vegetables. 

 

  • The microbiome is a fascinating area. Research has shown that the largest influence on the gut microbiome comes from diet. Fibre feeds the gut bacteria so by eating your fibre you are helping ensure your gut stays happy and healthy.

So how much fibre is in your foods? Although I wouldn’t promote you analyse labels all the time it can be interesting to compare the fibre content of some of the foods you eat.

Some fibre rich foods that can help boost your intake are:

Lentils, Spilt peas, beans,  garden peas, nuts, seeds, wholegrain versions of pasta, rice, bread products, wholegrain cereals, grains such as oats, quinoa, cous cous, popcorn, fruit and veggies, potato skins.

Top tips to increase the fibre content of your meals: 

  • Add lentils, beans and pulses to your meals. A couple of handfuls of lentils goes well in casseroles, soups, salads, even stir fries. 
  • When possible opt for wholegrain versions of foods.
  • Add nuts and seeds into meals. I love them sprinkled on breakfast or my yoghurt, you could add to a salad or on top of a stirfry. Sprinkle some in your sandwich or add to baking.
  • Increase your portions of fruit and vegetables if you are not meeting the 5 a day target. 
  • Eating more plant based meals in your week. We aim to eat plant based meals 4-5 times a week in our house. 

Here are some meals where I’ve pimped the fibre:

Oats with fruit, seeds and nuts – 15g fibre. Plus the oats here are soluble fibre. 

  

2 x Rye bread with 1/2 avocado – 10-15g fibre, this particular bread is very high fibre, 10g for 2 slices.

If you used a different rye bread it would be lower, using my normal rye bread plus the avocado it would be 10g fibre.

Risotto made with pearl barley and broccoli – 12-15g fibre per portion. Pearl barley has a high fibre content and is a great grain to cook with. It takes slightly longer to cook than rice but can be used instead of rice, or added to soups and stews. 

Vegetable fajitas with chickpeas, peppers and sesame seeds, smashed avocado and seeded wraps – 10g fibre.

I totally encourage you to try increasing your fibre intake and help your gut bacteria, blood sugars and bowel health. Remember to also drink plenty of fluids to help that fibre move through your system.

 

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Diet Secrets – TV appearance clip Jan 2018.

When I was asked if I would take part in a documentary style show that was about myth busting and presenting the science behind dieting  I knew this was something I needed to get involved in. 

The show was of course a little controversial (or it wouldn’t make good TV) and I hadn’t realised celebs would be put on diets as part of it… but it made interesting viewing and had a great team of experts speaking. I love the fact that more and more times there are fully qualified, sensible talking actual experts talking about nutrition in the media.  More please! In fact I was working on a shoot recently and the food stylist was telling me about her time working with Gillian McKeith a few years ago and how times have changed so much since then.  A lot more credibility is now needed for most media outlets.

So here are some snippets of my on camera parts for the show, I hope you like it! A great facial expression to start 😉

 

 

Let the children lead the way

Ever get the feeling that the children in the house are in charge? Oh my days, I know I sometimes feel like I just run from child to child doing things for them! 

Letting them be in charge of some things can be empowering and really positive. When you think about it there isn’t that much that they are actually in charge of. That can be hard as these little people want a chance to grow their independence and show their preferences. Eating is one of the ways that they can do this. So from a very early age they can show which foods they like/dislike and how much they want to eat. As parents it is whether we take note of these signs or think we now better! I’m trying to raise my children as intuitive eaters but it is hard as often I think I know their tummies better than they do. I then have to sit back, breathe and let them lead. When you are in a rush or have other children to also look after it can be frustrating to do this but we are setting our children up for life. I want mine to know how to pause, think about how their bodies feel and then respond accordingly and not be rushed because I have a schedule.

I find toddlers fascinating as they are so in tune with their bodies. My 22 month old will literally refuse to eat when she doesn’t want to, there is no way I can force her. She now chooses what she wants to eat from a selection of foods and she tell me when she is hungry with “Eaaaaaa” or “Snaaaaa”.  A funny example this week was when I made a cake for Mothers Day and then we had some for pudding. However the toddler shunned it and ate a bowl of peas instead! 

As we grow up eating becomes more complicated. Foods plays more of a social role, there is an enjoyment factor and just seeing things that you fancy. Advertising, being around food, media and other peoples food choices also influence us. This is why I think it is SO important to encourage our children to build great relationships with food whilst they are young and to continually reinforce these principles:

 

  1. Listen to Hunger – eat when you are hungry, stop when you are full. Think about your hunger at the start, middle and end of mealtimes. I sometimes talk about hunger being a butterfly in your tummy that grows to a dinosaur. Where are you on that scale?
  2. Listen to Fullness – this can be fun with kids. My 4 yr old boy pokes his tummy and that can help him connect with how full he is. My 7 yr old girl just knows and will leave her food for later.
  3. Eat a balance –  I teach my kids that all foods are great but that our bodies need balance for energy, protein for building, fat to keep us warm and protect our organs and all the vitamins/minerals to keep it working properly. 
  4. There are no good/bad foods. I love this conversation with my children. We’ve used plastic foods to group them into food groups and then talked about what all the foods contain that is great for our bodies. Instead of foods being good/bad for us I talk about how we need to moderate foods that are higher in sugar due to our teeth and balance our snacks as biscuits don’t keep us full for long. 

I’d totally encourage you to let your children lead a bit more with food. If you want more tips on how we do this at home then do let me know. 

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Is eating gluten free healthier?

Gluten free eating has been bang on trend recently. Why? There is a thought that gluten affects weight, causes bloating and is commonly poorly digested. However, often it is not actually gluten that is the issue. There can be several other explanations, for example: large portions of carbohydrate foods can cause bloating, just because of the amount of food in one sitting. In those suffering from IBS, the issue is unlikely to be gluten, but that of FODMAPS, which include wheat, lactose, beans, pulses, plus certain fruits and vegetables. Another key reason can be the overall diet. Eating a diet that is high in packaged, processed foods can cause symptoms that then disappear when you remove gluten. Why? Because why gluten is removed, your whole diet changes. It is not gluten that is always the culprit, take a look at this clip from Food Truth or Scare for more.

Gluten free foods can be: 👉 lower in fibre. 👉 higher in fat. 👉higher in sugars 👉higher in calories. 👉lower in B vitamins. 👉lower in iron 👉often they are not wholegrain.

Therefore gluten free foods are not healthier!  Of course if you are gluten free for medical reasons you may need to have these foods but you can also use grains such as buckwheat and quinoa to provide your wholegrains. So it also doesn’t mean you can’t have a great healthy diet and be gluten free, it just require more planning and thought. Top advice: only go gluten-free if you absolutely need to.

 

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Gut Health on Air

I love media work and am of the opinion that dietitians and registered nutritionists need to be shouting the right nutrition messages out on the air waves and in the press. Not only so the public hear good nutrition advice, but also so the public know who to turn to for that advice. Google can bring up all kinds of wierd, wacky and dodgy advice. Social media is full of everyone and anyone shouting their nutrition messages out. Working with the media can be a way to push the experts to view. 

So therefore I was more than happy to pop in and chat to Sasha Twinings at BBC Radio Solent about nutrition and to answer some of her listeners questions live.

Here is a little snippet of our chat. We cover IBS and fermented foods.

 

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2017 Food Trends: the hot, the not and the ones to spot.

According to those in the know these are some of the food trends coming our way in 2017. In my cynical mind this usually means things to be wary of or foods that will become super expensive.  However there are also some interesting new foods on the horizon which I’m looking forward to trying.

Wellness Tonics 

Meaning any drink, juice, potion, shot or magical elixir that can boost your health. This year the money is on using alternative medicine’s roots, shoots and leaves. Products such as maca, holy basil, apple cider vinegar, medicinal mushrooms and kava are tipped to be added into the mix. 

Photo by Milo McDowell
Photo by Milo McDowell

Priya says: These alternative medicines are alternative as we don’t have enough research and evidence to prove their benefits. A lot of these drinks are unlikely to contain enough of these ingredients to have a benefit on the body and are likely to be a marketing ploy. There may be some good ones out there, but remember that water is always the best drink to be having, follow that up with plenty of fruit and veggies to pack yourself a wellness punch.

Using up the byproducts 

The waste from making products will be turned into new products. For example using the leftover water from chickpeas as an egg replacement or the left over whey from making Greek yoghurt to create a probiotic drink.

Priya says: I like this. We need to cut down on our food waste, using all the leftovers is a brilliant idea. It is what I try to do in my kitchen and we are all encouraged to do it, so why shouldn’t food manufacturers try too?

Coconut 

Yes the humble coconut is still hot to trot in 2017 with novel products continuing to come out. Tortilla wraps, butter, ice-creams, coconut flour and sugar are all set to be popular. I just hope there are enough coconuts being grown to support this craze.

Photo by Max Lakutin
Photo by Max Lakutin

Priya says: Whilst there is nothing wrong with coconut, in fact it is very nutritious, I do have an issue with it being over-used. We do not need to be having coconut versions of everything and adding coconut oil to foods when it is not needed. Coconut products such as sugar and flour do have some good features such as their low glycaemic index, however the coconut is high in saturated fat and so with all foods it is best to consume it in moderation and wisely.

All things Japanese 

Sushi has been popular for a while (it’s one of my children’s fav meals). Now in 2017 Japanese condiments, pickles and different types of seaweed are coming our way. Mirin, Miso, sesame oil and plum vinegar may not be unheard of in your kitchen but are set to be more popular in our store cupboards.

Photo by Leio Ohshima McLaren
Photo by Leio Ohshima McLaren

Nori is already available in the supermarkets, but more seaweeds such as kelp, wake and dulse are set to follow suit. I personally would love it if there was more of a trend for foraging these for ourselves. Now who wants to show me which seaweed I can pick up off the beach and how to use it?

Priya says: Savoury Japanese flavours such a matcha tea, green tea, azuki bean and mochi are likely to be popping up in recipes for cakes, desserts and breakfasts. All in all I’m excited about this one and look forward to trying new combinations out. 

Condiment Heaven 

Condiments look like they will be big news in 2017. With rare, traditional and new flavours of sauces and dips coming out. Apparently we have pomegranate molasses, beet salsa, mexican hot chocolate spread, plum jam with chia seeds and habanero jam. 

Photo by Ashim de Silva
Photo by Ashim de Silva

Priya says: These all sound exciting but may not fit with the current thinking on reducing sugar intake as many condiments are high in sugar content. Again it is all about how much of these products you have and how often you use them. They can certainly bring flavour and interest to a meal, just remember that a little can go a long way.

Alternative grain pasta 

Ancient and different grains have been increasing in popularity. Partially fuelled by the clean eating brigade, plant based eaters and the gluten free movement.  Quinoa, lentils, chickpeas flour are making popular noodles. Also spiralized veggies will continue to rise and seaweed noodles are set to make headlines. 

Priya says: It is great to have all this variety.  Using different grains is great at it brings more variety into the diet and with that, a broader way to get good quality nutrition into the diet. Although there is absolutely nothing wrong with wheat based pasta, using these other forms of noodles opens up things for people on vegetarian, gluten free and specialist diets plus it makes it more interesting when making meals. 

Purple Foods 

If you like purple then you are in for a treat as purple cauliflower,  black rice, asparagus, carrots, elderberries, beetroot, corn and potatoes are the foods to watch in 2017. 

 

Photot by Peter Hershey
Photo by Peter Hershey

Why purple? The colour indicates higher antioxidant content, it comes from anthocyanins which are action packed nutrients aiding in fighting ageing, cancer and chronic diseases. For example, purple potatoes are high in iron and antioxidants. 

Priya says: Purple foods are an interesting trend and very nutritious so I would certainly recommend eating them. Hopefully this trend may helps make fruit and vegetables more appealing to some people and increase their intake of these foods. Remember that we need to eat a range of fruit and vegetables so focus on eating a rainbow and not just purple foods.

 

What are your fav food trends?

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Should we label a food as good or bad?

The label of good and bad foods annoys me. It is one of those labels that I find hard to get away from when I am talking to people as it comes up constantly. I spend a lot of time trying to break that idea down in people’s minds. Google it and there are over 71,800,000 links talking about what foods are good/bad, what bad foods are really good, the best good foods to eat and so on. But do good and bad foods really exist?

Bad foods seem to be ones that are high in sugar, fats and calories. Foods that are “not healthy” and that exert a “bad” affect on the body. They can range from fast food, processed food and high fat/high calorie snack items to carbohydrates and dried fruit.

Dietitian UK: Should we label foods as good and bad?

We have a complex relationship with food. Trying to make it fit into just one camp is tricky. Look at the major food groups – carbohydrates, protein, fat, dairy, fruit and veggies. Then look at lentils. They are put in the protein group but they contain carbs and are a portion of veggies too. 

Let’s take it to a more philosophical level. Can a person be labelled as good or bad? Take an object like a razor blade. Is it good or bad? One the one hand it can be used to shave and on the other hand it could be used as a weapon. 

So by trying to label foods as good or bad we are over-simplifying it. Foods are really neutral. Labelling them automatically places them into one category. Let’s take chocolate as an example. On the one hand this is a high calorie, high fat food that is often laden with sugar, so could be classed as a “bad food”. However dark chocolate contains iron, magnesium and fibre. It has antioxidants including polyphenols, catchins and flavanols and may help lower blood pressure plus reduce LDL cholesterol levels. Some research suggests it may help with cognitive function too making it sound like a pretty amazing food to be eating. Even fruit and vegetables can have their negatives, too many carrots can turn the skin orange due to excessive beta carotene!

No single food is to my knowledge nutritionally complete. We need a combination of foods in order to provide the body with all the nutrients it needs. This includes the full range of essential fatty acids and some sugar too.

The old phrase “All things in moderation” is actually very true. Instead of looking at a food in isolation we need to think about how often we eat a food, how much or it we eat, combined with what else we are eating and adding to a food. Limiting or not allowing yourself to eat certain foods can actually lead to you craving them more and then over-eating them. Food is something to be enjoyed rather than denied, so a small amount of the things you like really can be good. 

So instead of labelling foods as good and bad, or healthy and not healthy, how about we change the way we view it. I let my children eat all foods, including cake, sweets and chocolate. However they know that some foods are best to eat in small amounts as they can lead to their bodies getting sick. A good example of this is a weekend recently where we had multiple parties, leading to a lot of party food being consumed. Both children had tummy aches and were slightly constipated! An excellent time to highlight that they had eaten more biscuits and cakes, less fruit and veggies and their bodies were complaining. We talked about how these foods are delicious (the words of my toddler boy) but if you eat too much of them they can make you feel unwell. 

How do you label food in your mind? 

Mediterranean Diet – the best diet to follow?

I love doing media work and this was especially fun as the radio crew came to me! We broadcast my part live from my lounge. Have a listen:

 

So normally I am not pro diets. However there is always an exception and this is it. The Mediterranean diet is the way I try to eat and drink. I prefer to call it an eating plan or a lifestyle rather than a diet. It is one of those diets that is good for your overall health and could have a great protective and preventative effect on chronic disease such as heart disease and type 2 diabetes.

There is some really good research on this way of eating. Large scale randomised trials conducted over a number of years with deent follow up. This is what we like. So the evidence shows that the Mediterranean diet definiately has good implicaitons for heart disease and type 2 diabetes. For overall health it is a very good way to be eating.

The PREDIMED study followed 7447 people aged 55-80yrs  who were at high risk of cardiovascular disease (CVD), for 5 years. They were randomised to:

  • Mediterranean diet with 1 litre of olive oil a week
  • Mediterranean diet with 30g/d nuts 
  • Low fat control group

The data has been analysed in a number of different studies. Here is my short summary.

Dietitian UK: Meditteranean diet olive-oil-1596417_1280

Cardiovascular Disease:

Estruch et al (2013) found the Mediterranean groups had a 

  • 30% reduction in the risk of death from CVD 
  • 39% reduction in stroke
  • These results were only significant in men and less than expected but still show the benefits of the Med diet for heart diease.

Metabolic Syndrome:

Salas-Salvado et al (2008) looked at the data from 1224 people after 1 year of the diet. 61.4% of people at the start had Metabolic syndrome (abdominal obesity, high blood pressure, raised blood sugar levels and blood lipid levels) and found:

  • 6.7% reduction in metabolic syndrome in the olive oil group
  • 13.7% reduction in the nuts group, which was statiscally significant. So a Med diet with nuts may have reveress metabolic syndrome.

Cholesterol:

Monteserrat et al (2007) looked at 372 of the subjects at the 3 month marker and found the levels of LDL cholesterol reduced in the Mediterranean diet groups. The high levels of antioxidants in the diet was concluded to the be cause of this. Olive oil, nuts, fruit, vegetables and legume intake was all increased in the Meditteranean diet groups and all these foods contain antioxidants.

Blood Sugars:

Blood sugars were looked at in 772 people at 3 months bu Estruch et al (2006). They found in the Med groups:

  • Blood sugars reduced
  • Systolic blood pressure reduced
  • Total:HDL cholesterol reduced
  • C reactive protein reduced (a marker of inflammation).

Looking at type 2 diabetes, Salas-Salvado (2011) found the risk was overall reduced by 52% in those on the Med diets. Only 10-11% of people on the Mediterrrean diets developed type 2 diabetes compared to 17.9% in the control group.

 

Lyon Heart Study:

The Lyon Heart Study is another good quality piece of research. 605 middle aged subjects who had already had a heart attack were followed for 4 years and were randomised to either:

  • Mediterranean diet with an omega-3 rich margarine
  • Western style diet

The results showed:

  • 72% reduction in death from heart disease
  • a reduced rate of recurrance of heart attacks

 

Weight Loss:

  • Esposito et al (2008) followed 180 patients with metabolic syndrome for 2.5 yrs. They were put on the Mediterranean diet or a low fat diet. At the end the Mediterranean group had lost more weight at 4.0kg compared to just 1.2kg in the low fat group. The Mediterranean diet group also had reduced the occurance of metabolic syndrome with only 44% of people still having it.
  • Shai et al (2008) looked at 322 obese people, putting them on a:
    • Low fat calorie controlled diet – weight loss of 2.9kg
    • Mediterranean calorie controlled diet – weight loss of 4.4kg
    • low carbohydrate diet that was not calorie controlled – weight loss of 4.7kg

So a Mediterranean diet may help with weight loss too. Here is a post on the Mediterranean diet explaining what it is and what foods to eat more of.

Taken with permission from: http://dietamediterranea.com/dietamed/piramide_INGLES.pdf
Taken with permission from: http://dietamediterranea.com/dietamed/piramide_INGLES.pdf

Other Sources:

Authority Nutrition: 5 studies on the Meditteranean Diet: Does it really work?

PENNutrition

Priya speaks out on the sugar in children’s drinks on Wave 105 radio

A Southampton dietitian has told Wave 105 how many parents are unaware of just how much sugar is in supposedly “healthy” fruit drinks for children.

Dietitian UK: Top 3 myths about sugar

Priya Tew is offering mums and dads advice on healthy alternatives to make sure their children are not exceeding their recommend daily intake (RDA) of sugar.

It comes as a new study shows many fruit drinks for children are “unacceptably high” in sugar.

The research, published in the journal BMJ Open 24th March 2016, found that 42% of fruit juices, juice drinks and smoothies surveyed contained at least 19g of sugars, 5 tsp, this is almost a child’s entire maximum recommended intake per day.

Action on Sugar is asking for a reformulation programme to reduce sugar in children’s drinks by 50% in 5 years and restrict them to 150ml serving sizes. Only 6 products surveyed were found in 150ml servings, meaning children are likely to be consuming more.

“The research doesn’t surprise me. Although it [fruit juice] is high is natural sugar, it’s a very accessible form of sugar.

“I do think parents are unaware of how much added sugar there is in fruit juice and smoothies, and they’re seen as a healthy option. I would beg to differ on that. I think a healthy option for a drink for a child is water or milk, perhaps some no added sugar squash.

“If you’re going to give your child fruit juice then my advice would be to water it down, make it half juice and half water, and only have that as an occassional treat rather than a daily option.”

When processed into fruit juice drinks, the sugars (fructose) in the fruit cell walls are released as ‘free sugars’ which damage your teeth and provide unnecessary calories; you take in more calories without feeling full (i.e. A 200ml glass of orange juice can contain 3 oranges).  

Co-author of the study Kawther Hashem, Registered Nutritionist and Researcher of Action on Sugar says: “It is highly concerning that many parents are still buying fruit juices and juice drinks for their children thinking they are choosing healthy products; children should be given as little juice as possible (maximum of 150ml/day).These juices rot children’s teeth and give children a ‘sweet tooth’ that will affect their general health in later life. 

“What is more concerning are the products with added sugar and glucose-fructose syrup. We call on all manufacturers to stop adding more sugars to already sweet juices, particularly in children’s products and to restrict children’s drinks to only 150ml bottles/cartons.

“Our advice is to eat the fruit, don’t drink the juice.  Juice should be an occasional treat, not an ‘everyday’ drink. These processed drinks are laden with sugars and calories and do not have the same nutritional benefits of fresh fruit and vegetables.” 

 

Priya stars on BBC1’s Food Truth or Scare.

So if you weren’t watching BBC1 on Thurs 25th Feb at 9.15am then where were you? 

Oh yes, probably at work or out living life 😉

Well you missed watching me talking about red meat with Chris Bavin on the TV…. but don’t worry because if you are in the UK you can watch it back for the next 28 days or so. So get on over to BBC iplayer and check it out.

Dietitian UK : Food truth or scare 2

 

Dietitian UK: Food truth or scare 1

I would love to know your thoughts so please do leave me a comment.

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