Menopause and Diet.

The menopause is a time of life that can be distressing and cause symptoms that affect the quality of life significantly. However it is also a time of life that we neglect to talk about which makes it harder for women to know the evidence for treatments and where to get support. 

When does the menopause occur?

The average age is 51yrs, but there is a wide range. The menopause is defined as 12 months after your last menstrual period.  Women can be in the peri-menopausal stage where hormone levels are changing and symptoms are occuring for 4-5 years before the menopause occurs.

Symptoms can include hot flushes, night sweats, mood swings, disrupted sleep, brain fog, poor concentration, vaginal dryness and joint pains. For some these are mild and for others these are severe causing day to day life to be altered and upsetting. 

There are many supplements, pills and potions around that are said to help with the symptoms of the menopause. Sadly a lot of these have no real evidence behind them and end up being very expensive. Nutrition is something that plays a pivotal role in our health so it will come as no suprise that there are dietary changes that can be made to help offer some relief. There are also health issues that need ot be considered with the menopause approaching, which are covered below. 

Hot flushes:

These are one of the most common symptoms and one reason why HRT is recommended. Other lifestyle changes that can help incllude reducing the intake of alcohol, spicy food and caffeine. Weight loss can also help, a study has shown an improvement of 30% with 5kg weight loss.

Countries that eat more soya foods seem to have a lower incidence of hot flushes. This is thought to be due to the phytoestogens. Research suggests 2 x 200ml glasses of soya milk a day of 80g soya mince will give you this benefit. 

Bone Health

Bone loss is escalated in the menopause, so calcium is slowly lost from the bones. this is due to osteoclast cells that breakdown bone work harder than osteoblasts (cells that build bone). The recommended daily amount of calcium in the UK is 700mg/d if there is no risk of osteoporosis. However many women reach the menopause with low bone mineral density, in which case they will need to be having more like 1000-1200mg/d. Therefore it is important to focus on increasing calcium rich foods. Good examples include dairy, fortified plant milks, sesame seeds, dried figs, watercress and fortified bread. Weight bearing exercise will also help with bone health.

A note of caution is that excess vitamin A is associated with an increased risk of osteoporosis, so post-menopausal women should not exceed 600 micrograms a day. 

Heart Health:

Levels of total cholesterol can rise after the menopause whilst levels of HDL cholesterol tend to fall. This can, combined with weight gain and falling oestrogen (oestrogen is cardio-protective) can be a risk for heart health. 

Weight gain:

Metabolic rate slows down by about 10% after the menopause, this is why central weight gain can occur. Therefore staying active and eating a balanced diet is key. Resistance training using your body weight or light weights is a good alternative to high impact workouts. 

Top Tips:

  1. Reduce saturated fats and eat more polyunsaturated and monounsaturated fats, for example more nuts, avocado, olive oil and seeds. 
  2. Soluble fibre is good for heart health and cholesterol levels. Godo foods include oats, barley, nuts, seeds, beans, lentils, peas.
  3. Incorporate more soy based foods into your diet. Soya milk, yoghurt, soy mince and tofu.
  4. Ensure you are eating calcium containing foods – dairy, plant based fortified milks, green leafy veggies, tofu and tinned fish with bones. Also take a vitamin D supplement.
  5. Keep active and include weight bearing exercise in your week.

 

Environmentally Sustainable Diets – how to eat to save the planet.

This is going to be a hot topic. As a nation we have never had such access to food. Yet our diets are at their worst and the way we eat is unsustainable.

‘Sustainable Diets are those diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable; nutritionally adequate , safe and healthy while optimizing natural and human resources.’ FAO, 201031

Our food system is responsible for 15-30% of Greenhouse gas emissions (GGE’s) in the UK. This is due to all stages of food production from farm to fork. From using farm machinery, processing and packing food, the transportation and storage of it to how we cook it, then the waste and recycling afterwards. 

Foods that contribute the most to Greenhouse gas emissions are red meat, dairy and soft drinks, so consuming less of these will make a definite impact.

 

 

The production of food accounts for 70% of human water use, which is a huge amount. It is damaging our planet – through deforestation, pollution, a loss of biodiversity and damage to ecosystems.

In the UK we could make a huge difference to our planet just by focusing on not wasting as much food. An extra-ordinary 10 million tonnes of all food produced is spoiled or wasted in the UK every year. Whilst you may think restaurants and large scale catering is responsibly for this, actually the majority (71%) occurs in the home. 

So what can we do to help? This week one blue dot – a toolkit on environmentally sustainable diets has been released by British Dietetic Association with guidance and research on how we can eat sustainably.  Below I summarise the main points.

This imformation is undoubtedly going to raise the questions “So should we all go vegan?”  My answer would be –  Not unless you feel strongly about it or really want to. It’s about making swaps to some meals, eating less of some foods and having more plants in our diet. However also thinking about how and where we shop, what we do with food waste and packaging too.  

Top tips:

  • Reducing red meat intake to 70g or less a day. A lo Or commit to eating meat less times in your week. 50% of the UK population eat meat on a daily basis. 

A reduction in current UK consumption of total meat (108g per day)1 for adults to 50-99g would reduce our carbon foot print by around 22% whilst a further reduction to below 50g per day would result in a 39% reduction.

  • Switch to eating more beans, lentils and pulses, soya, tofu, mycoprotein, nuts and seeds. These are plant based swaps for meat. So a lentil bolognaise or using adding beans into a curry so that less meat is needed. 

 

  • Eat moderate amounts of dairy and include plantbased swaps. There is now a huge range of dairy alternatives, it is important to check these have added calcium in them.

 

  • Choose fish from sustainable sources. Over fishing and poor fishing practices have impacted on fishing stocks and the marine ecosystem has been damaged.

 

  •  Eat more wholegrains including tubers and potatoes.  
  • Go for seasonal fruit and veg or choose frozen and tinned  options.  

 

  • Tap water over soft drinks, tea and coffee. Soft drinks are a large contributor to our carbon footprint due to their processing and packaging. 

 

  • Reduce your food waste.  This is a huge area for us to all focus on. Shopping for only what you need, using all the leftovers and being savvy with portion sizes can all help.

Reference: https://www.bda.uk.com/professional/resources/environmentally_sustainable_diets_toolkit_-_one_blue_dot

Confessions of a dietitian. My kids eat doughnuts.

My children surprise me time and time again with their eating and their ability to hone in on their own needs and internal cues… if only I give them a chance. 

With my oldest turning 8 this week she is exposed to different foods in places outside our home. Sweets at youth club, biscuits for sale at school (yes really in the playground), cake at groups. Totally a time for her to put into practise all her intuitive eating skills and experiement away from me. 

With Miss K being my first child, she is also the one that I weaned first and did all the things wrong with first! Parenting is the hardest job for sure and there is no manual. So I was clear on limiting her biscuit intake and on keeping the sweets up high and on a pedestal. The sweet issue I had to totally back track on, explain I had dealt with this badly and it was time to try a new approach. The result is my kids eat sweets, regularly but they savour them and we have small amounts after a meal or as part of a snack. Today they have both had half an iced doughnut.  I don’t see restriction as the answer, I don’t want my children to grow up sugar-free or feeling cake is only for special occasions, but to appreciate all foods and know some things we eat less of.  I certainly don’t dish out cakes and sweets daily but I do have them around and part of life, Children need to learn how to eat and how to be around foods at home. Home is the training ground, the place to experiment, get things wrong and then try again. 

This weekend I was on a course and my parents looked after my kids. They all did a fabulous job at looking after each other. One thing I noticed was how well the mealtimes went. My mum was worried the smallest one especially had not eaten well and recounted the day to me, she had eaten well just not in what we would percieve to be a normal meal pattern. That’s toddlers! The kids had also convinced my mum to buy them doughnuts (grandparents prerogative) and where I would have cut these in half they had a whole one each…. my boy ate part of it and then gave it back when he had enough. Now this is the boy who I think could pretty much eat a whole chocolate cake – turns out I am wrong, again 😉 and very happy to be. 

So why am I writing all of this?  To show other parents that there is hope. That your children can be trusted around food, that they have an intuitive sense of what to have and how much. It may be that like me, you haven’t been perfect in your approach to food, well it’s not too late to change that and have a conversation with your children.

Here are 3 of my top tips:

  1. No foods are off limits or restricted. However as a parent you decide when to offer a food and what to offer. Your child decides what to eat from that selection and how much. If you have a cupboard of snacks like we do, then it is totally going to happen than you get asked for specific foods items from there, which could be totally fine but it’s working with your child to work out their hunger and what to put with their snack.
  2. Involve your children in the shopping and let them choose some of the foods, even if they are high sugar options you would prefer them not to have. It’s about learning how to have those foods safely, at home. 
  3. Let your children choose what to eat from a selection of food, without judgement. This is HARD. If you have provided a range of food then it is up to them to choose what to have and not up to you to tell them. Sometimes stepping back can allow your child to shine and show their independance off.

I’d love to hear your thoughts, experiences and problems. Do get in touch via social media, a blog comment or email.

The sugar summit and processed foods

Recently I was asked to speak on a panel at the Sugar Summit. This is a yearly meeting in Westminster aimed that brings together different stakeholders, from government, to charities, manufacturers, retailers, to talk about improving the the choices, policy and food environment around foods low in free sugars. This was an event organised by Sugar Wise who have a certification in place on processed foods. If you see this label on a food it is low in free sugars:

 

Being surrounded by food manufacturers one of the topics we discussed was processed foods.

1. Are all processed foods the same?

There seems to be a common misconception that processed foods are all bad and should all be avoided. Yet actually I don’t see that as true. Processed foods include frozen vegetables, fruit, tinned fish, cheese and bread. Food processing includes canning, freezing, baking and drying. So we really can’t get away from eating processed foods and we don’t actually need to. Food processing is something that has gone on since the start of the human race. There has always been a way of preserving foods. The issue now has become that some processed foods have become high fat, high sugar foods, foods to be eaten in smaller quantities and in moderation.

2. Should all processed foods be avoided?

Whilst the media/social media may give out the impression that processed foods are to be avoided at all costs, this is a very sweeping statement and pretty impossible to do. Tinned tomatoes, bread products, yoghurt and milk are all foods we eat regularly. Are they foods we need to avoid? Instead of avoiding processed foods, how about we see the processing of foods as essential and helpful. It makes food accessible and affordable. Suddenly vegetables can be kept in the freezer, out of season fruit is available all year round and a meal can be prepped in minutes out of the store cupboard. There are certainly some improvements that need to be made to some types of processed foods and this is where our focys needs to be. Working with food manufacturers, encouraging reformulation of sauces, biscuits, cereals and sweet foods is a great move.

3. Can processed foods actually be healthier?

Some processed foods are fortified with micronutrients that can improve their nutritional profile. Think breakfast cereals and plant based milks, margarines and flour. These foods can provide an important source of nutrients for people who may otherwise end up deficient. Frozen foods such as vegetables, fruit, beans and fish are processed and frozen fast, which means they can be better than the fresh versions which  may have travelling large distances and be stored for some time. 

All in all I think there is no way we can avoid all processed foods. Instead it is about being selective with the ones that we eat regularly. Check the label to see what has been added and compare to alternative brands. There are often reduced salt and sugar options that are better choices. 

I’d love to hear your views.

 

 

 

 

Mackerel Carbonara

Now this recipe, it’s not a combination that instantly springs to mind, in fact I remember Gregg being dubious when we cooked this on Eat Well for less. … however it works. This is a great way to get oily fish back on the menu for family meals.

Oily fish is such a important food to try and incorporate into your weekly meal planning due to the omega 3 content. Omega 3’s are a essential fatty acids that have anti-inflammatory effects, can help with brain health, cognitive function, heart health and even asthma.

I hope you enjoy the recipe – do make sure to turn off the heat before adding in the sauce of the yoghurt will curdle. 

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SMOKED MACKEREL CARBONARA

Ingredients

  • 450 g spaghetti
  • 2 tsp horseradish sauce
  • 400 g greek yoghurt
  • 4 eggs
  • 60 g parmesan cheese finely grated
  • 1 tsp sea salt
  • freshly ground black pepper
  • 1 tsp rapeseed oil
  • 2 medium courgettes grated
  • 350 g boneless smoked mackerel skin removed and flaked
  • 240 g baby spinach
  • 1 small bunch flat leaf parsley roughly chopped

Instructions

  1. Bring a large saucepan of salted water to the boil, add the spaghetti and stir well.  Simmer for 12-15 minutes until cooked.

  2. While the pasta cooks, prepare the sauce. Whisk together the horseradish sauce, yoghurt, eggs and parmesan. Season with black pepper.

  3. Heat a large pan until medium hot, add the oil and stir fry the courgette for 2 minutes until it has started to soften.

  4. Add the smoked mackerel, mix well then cook for another minute. Stir in the spinach and cook for a couple of minutes until wilted down.

  5. Turn the heat off (to prevent curdling), add the horseradish and yoghurt mixture into the pan. Stir really quickly until mixed throughout the courgettes and mackerel. 

  6. Drain the pasta and tip straight into the pan, with about 100ml of the cooking water, then stir until totally covered in the sauce.

  7. Serve straight away with the parsley scattered over the top.

Veggie Croquettes

After making these I was named the Empress of Veggies by the one and only Gregg Wallace, so I felt I had to share this recipe! It is a little messy to make (make sure you squeeze the fluid out of the veggies) but those dips combined with the croquettes = heaven. 

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Veggie Croquettes

Prep Time 20 minutes
Cook Time 25 minutes
Total Time 45 minutes
Servings 4
Author Eat Well for Less

Ingredients

  • 200 g cauliflower coarsely grated
  • 200 g sweet potato peeled and coarsely grated
  • 2 medium carrots peeled and coarsely grated (200g)
  • 1 medium courgette coarsely grated (200g)
  • ½ tsp sea salt
  • 1 red onion finely chopped
  • 1 small bunch parsley picked and roughly chopped
  • 1 tsp onion granules
  • 100 g fresh breadcrumbs
  • 2 eggs
  • freshly ground black pepper

Instructions

  1. Preheat the oven to 200C/fan 180C/gas mark 6. Line a large shallow baking tray with parchment paper.
  2. Place all the grated vegetables into a large bowl and mix together. Add the remaining ingredients and mix really well, squishing it all together until evenly mixed. Set aside to soften for 15 minutes.
  3. Mix once more then divide into 8 in the bowl, then take each portion and form into two little sausages. Place onto the lined baking tray then repeat with the remaining mixture to form 16 sausages.
  4. Place in the oven to bake for 25 minutes until the vegetables are tender and the croquette golden brown on the outside, .
  5. While the croquettes bake, prepare the dips.

 

 

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Pea guacamole

Author Eat Well for Less

Ingredients

  • 240 g frozen peas
  • 1 tsp ground cumin
  • 2 garlic cloves roughly chopped
  • 1 red chilli seeded and very roughly chopped
  • 1 lime zested and juiced
  • ½ small bunch coriander very roughly chopped
  • ¼ tsp sea salt
  • freshly ground black pepper

Instructions

  1. Place all the ingredients for the pea guacamole into a large food processor and pulse until just broken down, then scrape the sides of the processor down. Blitz until just beginning to get smooth - you want a little texture left. Tip into a serving bowl and taste
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Sweetcorn Salsa

Ingredients

  • 240 g tinned sweetcorn
  • 4 tomatoes chopped
  • 4 spring onions chopped
  • ½ small bunch coriander chopped
  • ½ lime juiced
  • 1 tbsp olive oil
  • ¼ tsp sea salt
  • freshly ground black pepper

Instructions

  1. Place all the ingredients for the sweetcorn salsa into bowl and mix well then tip into a serving bowl.

I hope you enjoy making these and it gets you eating more veggies! 

Diet and Depression

This is a topic I’ve been wanting to write about for ages and a media quote has spurred me on. I think we all know someone suffering from depression and the incidence seems to be on the rise. Depression is a multi-factorial disorder, something that was highlighted to me in a conversation to a journalist this week. I don’t believe that just changing one thing will be the cure. You can have the perfect diet but could still suffer, so instead it’s seeing diet as part of the picture and combining this with medication, therapy, sleep patterns, exercise and all round lifestyle.

Looking through some of the recent evidence on diet and depression an instant pattern emerges. Eating a balanced diet that relies less on processed convenience foods and more on eating from scratch is the answer. More fruit and veggies, wholegrains, olive oil, fish, low fat dairy is associated with a decreased risk of depression. 

An antidepressant food score was worked out by researchers, looking at the nutrient density of foods that have clinical evidence for helping in depression. The top foods were oyster, seafood, organ meats, leafy greens, lettuce, peppers and cruciferous vegetables. 

Top antidepressant nutrients (in no particular order):

Folate

Iron

Omega 3’s 

Magnesium

Potassium

Selenium

Thiamine

Vitamin A

Vitamin B6

Vitamin B12

Vitamin C

Zinc

Tryptophan

Fluid

Now it’s usually more helpful to think about nutrients in terms of foods, so here are some top ways you can boost your antidepressant nutrient intake.

  1. Eat regular meals – the brain needs glucose as fuel and eating regularly helps prevent blood sugars dropping too low which can give symptoms of fatigue, tiredness, lethargy.
  2. Include healthy fats in the diet  to nourish the brain. Oily fish, nuts, seeds, olive oil are all good ones. Aim for 2 portions of oily fish a week.
  3. Wholegrain foods are good sources of zinc, and B vitamins. Think wholegrain bread products, brown rice, brown pasta, grains.
  4. Ensure you eat protein regularly for tryptophan, iron and zinc. Tryptophan is thought to play a key role as it is a precursor for the neurotransmitter serotonin. Wholegrains, fish, poultry, eggs and seeds can help with this.
  5. Green leafy veggies contain folate, iron, potassium and magnesium plus vitamin C. Another reason to get crunching your veggies.
  6. Orange veggies such as sweet potatoes, orange peppers, carrots and apricots plus green leafy veggies are sources of vitamin A.
  7. Even slight dehydration can affect your mood. The brain is 78% water. Reducing caffeine and replacing with non caffeinated drinks, mainly water will help. Moderate intake of alcohol can be ok but watch the interactions with medications and too much alcohol can increase anxiety/depression.

Following a Mediterranean style of eating with a focus on fruit, vegetables, wholegrains, protein, oily fish and healthy fats is a great way to help combat depression. It may not be the cure but it is definitely a large part of the puzzle. 

Dietary patterns and depression risk: A meta-analysis. Psychiatry Research, July 2017

Diet quality and depression risk: A systematic review and dose-response meta-analysis of prospective studies. Journal of Affective Disorders, January 15, 2018

Antidepressant foods: An evidence-based nutrient profiling system for depression. World J Psychiatry. 2018 Sep 20;8(3):97-104 

 

There is no perfect way to eat

There is no perfect way to eat. The more I learn about nutrition the more I am convinced of this. The science of nutrition is continually evolving, growing and being researched. We are learning all the time and it’s a lot more complex than it looks on the surface, but also there are simple steps we can take to eat well.
 
Things are not always in your control. Our tastebuds, culture, finances and social circumstances are just somethings that can affect how we eat. The good news is there is no perfect way to eat. There are many, many ways to eat a nutritious diet. It’s not about striving to be perfect or have the best meals. It’s about eating as well as you can with what you have. No guilt. No shame. No judgment.
 
 
Our bodies change and need different things at different stages of life, often our bodies are able to adapt and help with this. As a baby, a mums breastmilk will change depending on what the baby needs.  Teenage bodies are able to absorb more calcium than at any other time of life. In pregnancy our bodies adapt and will absorb more of certain nutrients such as iron to provide for the baby and changes in the body. Isn’t the body amazing, it knows what we need better than we do. So one of my top tips is to focus on trusting your body, listening to your body and learning what your internal cues feel like. What does hunger feel like to you when you are very hungry, a little hungry and not hungry at all? What cues does your body give you about the foods it needs? Do you get cravings or suddenly feel you are drawn to certain foods? Sometimes this can be due to the nutrients in these. For example craving vegetables after a trip away when you have eaten differently, or craving salty foods when you haven’t had any salt for some time. 
 
My favoured approach in my eating disorder work is to focus on reaching a healthy state and not a healthy weight. On reconnecting with your body and not ignoring it’s signals. This can be very hard to do and a long journey. It’s not all about the numbers on the scales. Sometimes shifting the focus away from weight can make a huge difference.  There is no perfect way to eat or perfect way to recover from an eating disorder, but we do have amazing bodies that can help us discover the right way for us. 

If you need any help with this then do get in touch. 

Bacon, Chard and Rosemary Pasta

Swiss chard is such an easy veggie to grow and it gives you back time after time. Plant a few seeds, water and care for a few plants lovingly and you will find you always have bountiful supply. 

Some interesting chard facts.

  • Swiss chard was discovered by a Swiss botanist – hence it’s name.  
  • It is a member of the goosefoot family, called this due to the leaves looking like a goose foot.
  • Chard is packed with nutrition including vitamins A,C, K plus magnesium, potassium, iron and fibre.

So the question is what to do with it? The great news is it goes in virtually everything. I’ve added baby leaves to smoothies, savoury muffins and scones. Then use it like you would spinach in dhal, stir fry and omelette. Or wash it and freeze, I’m totally up for an easy life and don’t cook it before freezing. I find it works fine to add to casseroles and other meals where you add as it cooks.

One of the easy summer recipes I sometimes pull out the back of my mind when the chard patch and my mind are overflowing, and I need to cook but also need a break – this chard and pasta dish. It works so well. The rosemary gives it a warm lift and the bacon adds the saltiness, plus it means my children eat it. Now my boy isn’t a fan of his greens, but will eat this meal all up. It goes to show sometimes it is what a food is paired with that matters.

I let my children decide their own portions of this meal and eat according to appetite. My eldest girl after a busy day at school had seconds, my boy cleared his plate and was satisfied. My toddler ate off my plate too! 

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Bacon, Chard and Rosemary Pasta

Cook Time 20 minutes
Servings 4

Ingredients

  • 150 g bacon chopped into bite sized chunks
  • 1 tbsp fresh rosemary chopped
  • 2 cloves garlic crushed
  • 1 tin chopped tomatoes
  • 200 g chard leave it whole
  • 150 g mushrooms chopped
  • seasoning
  • 300 g pasta

Instructions

  1. Chop up the bacon, remove the fat and heat a non stick pan. Then cook the bacon for a few minutes.

  2. Add the rosemary and garlic, stir round to release the the flavours.

  3. Next add the chopped tomatoes and allow to come to a simmer.

  4. Cook the pasta.

  5. Wash the chard, chop any huge leaves. Place into the pan and allow it to wilt down.

  6. Chop the mushrooms and add these to the pan, allow the sauce to simmer for 5 minutes then turn off the heat and put the lid on. 

  7. When the pasta is ready mix the sauce in and serve.

Gingerbread energy balls

One of the questions I get asked a lot is for healthy snack ideas. Walking around the shops there is a plethora of snack items but so many of them are expensive items that you can make yourself in batches with a little knowhow and patience. Energy balls are one such item. Often sold for £1.50-£1 a portion, these can be made a lot cheaper at home. See my analysis below.  Whilst there are a lot of energy ball recipes out there on the internet this one is so delicious that I had to share it. I love having snacks  like these to hand for instant snacking and even better, these freeze well. My boy also loves making these with me.

Perfect mid morning snack for me between clients and an afternoon snack for the kids at a much better cost than buying from the shops.

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Gingernut Energy Balls

Ingredients

  • 100 g unsalted cashew nuts
  • 100 g dates
  • 25 5 oats
  • 1 tsp ginger
  • 1 tbsp sesame seeds (optional)

Recipe Notes

Blitz up the cashews, oats and dates in a food processor or grinder. I do this in batches as my grinder is smalll. You may need to stop grinding and stir it around a bit from time to time.

Put the mixture into a bowl, add in the ginger and stir.

Now roll into balls and roll in the sesame seeds (if wanted).

Store in a tin, the fridge or freeze.

 

Costing = £2.20 for 10 balls (5 portions for an adult)

100g cashews £1.10

100g dates 66p

25g oats 27p

1 tbsp sesame seeds 9p

1 tsp ginger 8p

 

Freelance Dietitian specialising in helping those with Eating Disorders and a Media Spokesperson for the profession.