Category Archives: Dietitian Advice

Dietitian Advice

Improve your Diet for 2019

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Whilst diets are flying everywhere and detoxes around every corner here is how to make long-term change your diet that will give you lasting health benefits for life.
 
How are you eat impacts your gut health and your long-term risk of diseases. So here are my top 5 food goals, which I’m taking onboard for myself too.
 
 
Increase your fruit and vegetable consumption by one portion.
It may not seem like much but if you manage to do this every day then it’s going to make a long-term change over the year.
 
Plan your meals.
Plan out what you’re going to eat incorporating a variety of foods across the week. Different colour vegetables for the different antioxidants and phytochemicals. Different grains, different protein sources (e.g chicken one day, red meat another, fish and lentils other times.
 
Eat more gut friendly foods.
This can be simply more fibre from whole grains and fruit/veggies and more probiotics from live yoghurt, sourdough bread, pickles or kefir.
 
Go plantbased where possible
Note this this does not mean you need to go vegan. Incorporating plantbased proteins is going to be an ever increasing trend. It’s definitely one to follow. Plant based meals are better in terms of sustainability and environmental impact plus they deliver a range of nutrients you may not get through a meat meal. More on this to come in my next blog posts.
 
Cook from scratch more.
This doesn’t have to mean every day but go for it if you can! Everyone is busy so try planning in times when you can bulk cook and stocking up the freezer. Cooking from scratch doesn’t have to be complicated or take that much time. I will be posting regular recipes on my social media to show what we eat. Trust me, I don’t have hours to cook.
 
However you start your new year try and keep your goals simple, achievable and remember that food is to be enjoyed! 
 
 
 
 

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Dietitian Advice, Nutrition Education

Nitrates, nitrites and eating sausages.

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There has been so much talk about red meat over the last few years. The guidelines from the WHO told us not to eat too much red meat and showed the link between red meat and colorectal cancer. This risk was higher with processed red meat. Today it’s been more news about processed meat causing cancer, so as a population we are still eating our bacon it seems.

The problem this time is nitrates (NO3) and nitrites (NO2). These are often added to processed meats as they help it keep its pink colour and are important in food safety – protecting against botulism. Nitrates are metabolised to nitrites in the body, these are all fine until they combine with protein to form Nitrosamines. These can be carcinogenic. There lies the problem.

However nitrates themselves can be beneficial, they can relax blood vessels, being beneficial for blood pressure. They can improve the blood flow to muscles in exercise and they are a cofactor for reactions in the body.

Nitrates are found in processed meats such as bacon, ham, salami and chorizo. Interestingly they don’t seem to be added into UK made sausages, which is a slight win. They are also found added into higher amounts in smoked fish, cured fish and beer (especially German beer). The levels in your piece of ham are small. Nitrates are also found in vegetables however these naturally occuring forms do not appear to react in the body in the same way as those added into meats.

The take home – eating less meat is a good thing for the planet and for our bodies, but there is no need to cut it out entirely. In my opinion cutting things out is generally not a helpful approach. Processed meat is not something to be eating daily but it is ok to eat it occasionally. You can find some processed meats now that are nitrate free, check the labels nitrate/nitrites, but remember that does not mean you can eat it regularly. As a population we all should be eating less meat and more plant based proteins when we can. So keep that bacon sandwich for a now and again brekkie. 

                              

 

 

Dietitian Advice, Nutrition Education

The benefits of Green Tea

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Green tea is made by the rapid steaming of freshly harvested leaves which stops the process of oxidation to black tea.
 
Green and black tea contain similar levels of total flavonoids but the difference in oxidation means there are differing types of flavanoids. Black tea has higher levels of theaflavins and thearubigins and green tea has 3.5 x the catechins levels. The main catechin in green tea is Epigallocatchin-3-gallate (EPCG).
 
Brewing time, the method to make your tea and the tea quality are all things that influence antioxidant status. Tea polyphenols are effective antioxidants and scavengers of free radicals. Studies show an increases in antioxidant levels in humans after drinking green tea. This is what is likely to provide any health benefits.
 
 
There is a misconception that green tea is caffeine free like a herbal tea. It is lower in caffeine but still contains some. Up to 400mg of caffeine a day is considered safe. That’s 8 cups of green tea! It may not be as hydrating as water but it does still provide hydration.
 
Black Tea : 40-70mg caffeine per cup
Coffee: 80-115mg caffeine per cup
Green Tea: 25mg caffine per cup
 
Most studies on tea are observational, are conducted on animals or in Asia where there is a different diet. Therefore it is an area we need clearer studies and research results.
 
Heart disease
Flavanoids in green tea has been shown to lower LDL cholesterol levels and decrease blood clotting. A meta-analysis of 13 research trials showed a decrease in systolic and diastolic blood pressure, total and LDL cholesterol, blood Triglyceride (fat) levels and overall stroke risks. So it does sound like there are benefits for your heart.
 
Weight loss
This is a an area that had a lot of interest. There is some mixed evidence here suggested green tea may stimulate thermogenesis and increase fat oxidation. This means you burn more calories when you digest your food and you use up more fat stores. Sounds good but the results were modest and so this won’t give you large weight loss. It’s certainly no magic cure but switching from a soft drink to green tea daily will reduce your calorie intake.
 
Cancer
There are very mixed results in the research so over there is no clear proof either way. Green tea is certainly packed with antioxidants so it could help and it won’t hinder.
 
Osteoporosis
Animal studies and studies on post menopausal women shows an association between tea consumption and better bone health due to the tea polyphenols. We have some emerging evidence for green tea improving muscle strength and bone health. An exciting area to focus on.
 
Brain Health
There is some research showing a link between green tea and brain health with it improving memory and brain power. Could be worth a green tea cuppa in the mornings.
 
 
Over all we need more studies to give us further information but it does seem that green tea is a good choice for your cuppa.

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Dietitian Advice, Nutrition Education

Menopause and Diet.

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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.

 

Dietitian Advice, Nutrition Education

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

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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

Dietitian Advice, Intuitive Eating, Kids Nutrition, Nutrition Education

Confessions of a dietitian. My kids eat doughnuts.

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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.

Dietitian Advice, Nutrition Education

The sugar summit and processed foods

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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.

 

 

 

 

Dietitian Advice, Nutrition Education

Diet and Depression

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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 

 

Dietitian Advice, Eating Disorders

There is no perfect way to eat

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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. 

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

Dietitian Advice, Media, Nutrition Education

Low Carb Diets

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Today has been all about carbohydrates as a new study was published in the Lancet. I’ve spoken on ITV new  and Wave 105 radio about it and  video/audio clips are at the end.

So what’s the low down?  This is a controversial topic as low carb diets have become popular. I’m not against this, but I do think it needs to be properly thought through and planned out. Low carb diets are used by some dietitians clinically for diabetes control, weight loss and for some metabolic disorders. However there is a way to do it right. Let’s break the latest study down:

👉 This was an observational study and it used food frequency questionnaires, so not the best data as this is self reported after the event. It is easy to forget what you eat or under/over-estimate. However the study  was followed over 25 yrs  with over 15,000 people taking part.

👉 A U-shaped relationship was found with increased mortality on a high carb or low carb diet. Low carb being <30% calories coming from carbohydrates. High carb being >60% calories coming from carbohydrates.

👉Eating moderate carbs (50-55% of total calories) was shown to be best. This is what our UK guidlines are based on so we already advise this. 

👉 Swapping carbs for plant based fats and proteins has better outcomes compared to animal products. So if you reduce your carbs it does matter what you replace them with.

👉 This study didn’t look at the type of carbs eaten. We want to be eating #wholegrains and reducing refined carbs (unless you have a medical reason to eat a low fibre diet).

👉 Eating lower carb may help weight loss and with diabetic control but it’s all about balance. Not overdoing it and taking all carbs out. Choose sensible sized portions of wholegrain carbs with meals.

👉 Everyone is individual. If you are more active you may need more carbs. If you are recovering from an eating disorder you may need more carbs. If you on a special diet you may need less carbs. If any of that applies to you then seek advice from a #Dietitan or #registerednutritionist.

One big issue that comes out of all of this is we keep on focusing on individual nutrients. It is not helpful to break food down and count the grams you are eating or the calories from each nutrient and could be triggering for an eating disorder. Food is complex, it is made up of many nutrients some of which we can’t even give a precise measure of. So once again we come back to common sense nutrition, eating sensible portions of balanced meals and listening to your internal cues of hunger/fullness.