Category Archives: Dietitian Advice

Plant Waters – are they all goodness?

One of the trends for 2017 drinks is apparently going to be plant waters. Hyped to be full of goodness and said to be packed with health busting effects, I took a little look into them. 

Plant Waters - are they all goodness?

Birch water is one that has been around for a little while, making headlines in 2016 and is available in some supermarkets. It is meant to cleanse and detoxify the body, a claim that instantly makes me pull a face. How can a water possibly do a better job than the bodies own built in detoxification system – the liver and the kidneys do a pretty awesome job all by themselves. Even more maddening is the fact that this water is often flavoured and can have sugar added to it, but is then marketed as being a lower sugar alternative to coconut water. I’d reply that tap water is even lower in sugar content and a lot cheaper!  It contains 7.5kcals per 250ml serving and the nutrients manganese, potassium, zinc and xylitol. 

Maple Water comes from the sap that is usually boiled and made into Maple syrup. As you can imagine it is pretty sweet at 3-4 g sugar per 250ml serving. It does contain a large amount of phytochemicals and antioxidants, but the amount of these you will actually consume through a serving of the water is likely to be low. You would get more from the maple syrup itself as it is a concentrated form, but obviously your dentist and I would say it’s not a good idea to be having too much of that on a regular basis. There are a pile of interesting claims on maple water, based around it helping with exercise and being anti-inflammatory but these are just not substantiated.  

Dietitian UK: Plant Waters

Cactus Water is an intriguing one as it is not actually water. It is made from prickly pear concentrate, preickly pear extract and then water is added in. Not quite what I was expecting. The claim here is that is helps with hangovers! However this is based on a one-off small study. Catcus pulp contains betalains, an antioxidant  which has been shown to stop LDL oxidation involved in cholesterol levels, but no studies have been carried out on the water itself, so who knows how much of it you would need to drink to get an effect and how much that would cost. I would suggest  eating a good range of fruit and veggies is a better option.

Aloe Vera Water is another cheeky one as it  is sweetened with agave and a standard serving is 60-70kcals. There has always been a lot of chatter about aloe vera and it’s healing properties so I imagine this could become a popular one. However there is  no real research conducted on the water currently. 

Artichoke water is a yellow-green water made by squelching up whole artichokes! I’m not convinced it will taste good without sugar and flavouring added in. In does contains some vitamin A, B and C, magnesium and antioxidants and claims are that is can help lower cholesterol but we have no proof of this.

Watermelon Water is one I would like to try out and it would be great to see more studies conducted on it. It is made from the pulp of the watermelon and contains beta-carotene, potassium, vitamin C, lycopene and the amino acid L-Citrulline. In a few small  studies, watermelon extract has been found to reduce blood pressure, could the same be true for watermelon water? 

Coconut Water has been popular in the UK for some time now. It contains B and C vitamins, calcium, magnesium and potassium. If you like the taste then that is great but it does contain calories and sugar so when drunk regularly that can add up.  It doesn’t provide much more benefit to exercisers over water and a banana but it also won’t do any harm for those who prefer it. 

Photo by Max Lakutin
Photo by Max Lakutin

These waters all sound like a bit of a con to me, they have a hefty price tag and don’t deliver enough on the nutritional front. However if they help people to drink a bit more water and are an alternative to a soft drink then that is a good thing. Personally I will stick to filtered water.

Family Mealtime Mayhem.

Family meal times are in my house a whirlwind. In my mind we are all going to sit down, enjoy a tasty, hot meal, with some lovely conversation and in relative calmness. The reality is very different. At the time of writing this I have a 6 year old girl, a 3 year old boy and an 8 month old baby. You can probably imagine how an average mealtime goes, but I will give you a snapshot in the hope it nomalises the chaos that may also be in your home.

Dietitian UK: Family MealtimeMayhemTop Tips.

Mummy manages to find time to cook up a nutritious dinner, that in itself is no mean feat. Cooking at actual teatime  in our house is like navigating through a very choppy sea, on a pirate ship, with cannon balls being thrown at you. So when possible I try to cook straight after school or at lunchtime. I plan meals at least a day in advance otherwise my stress levels spiral upwards!

Mummy calls for someone to lay the table, usually meaning can my husband please come and do it. The reality is the 3 year old comes, upon prompting the 6 year old may join him. The table is quickly cleared by mummy (by cleared read – swept to one side or everything moved to the nearest worktop) and an assortment of cutlery is laid out. Certain people must have certain cutlery of course. Do not dare to give the 6 year old anything but a fork with a flower design on it!

Finally food gets to the table, some people sit down whilst it is hot, others straggle along later. Now comes the “How many times can we get mummy to get up from her seat” game. 

  1. There are no drinks.
  2. The table was laid with only forks and no knifes.
  3. The boy wants a different coloured plate.
  4. The baby has no bib.
  5. Someone wants pepper.
  6. A spillage needs a cloth.
  7. The cat needs putting out as he is trying to steal the babies meal.

 And so on…

The 6 year old refuses to sit with her legs round the front of her chair and sort of hangs off the side. The 3 year old refuses to eat with cutlery most of the time. Someone starts a song which leads to a both children singing different songs at increasing volumes until mummy shouts “No singing at the table”. The conversation darts all over the place from Daddy trying to pass on some business information, to what happened at school and what the boy’s dinosaur wants to do tomorrow. Throughout it all the baby sits there and cracks on with her meal, watching it all. 

 

Towards the end of his meal, my boy tends to need some encouragement with eating his vegetables, along with some feeding. Then he will find a free adult lap to climb into. The 6 year old takes her time, leaving her favourite bit of dinner until the end. After a while the baby will want a cuddle and feed so mummy can end up feeding whilst eating her dinner. By the end of the meal there are content children, a food covered baby and a lot of clearing up to be done.

So, even if you are a dietitian, mealtimes can be a negotiation process and far from perfect. That is family life. Family mealtimes are such an important time in our house though. A place where the family is all together, a time for sharing news, for role modelling manners, healthy eating, portion sizes, taking it in turns speaking and a time for fun as well. 

Here are my top tips for family mealtimes:

  1. Plan meals ahead of time. I do a rough plan for the week at the weekend but leave it flexible as life happens. My children get a bit of input into this, so I canvas opinions and try to cook things everyone likes.
  2. Set aside some food prep time. Chopping all the veggies in one hit for 3 meals can save you time on other days. I find it easier to chop a pile of carrots, butternut squash, peppers and pop them in a ziplock bag in the fridge to keep fresh.
  3. Getting the kids involved can feel like it takes more time and effort, but see it as a learning time for them. I have a boy who loves to help me cook and my girl is getting quite good at laying the table now. Find the jobs that they enjoy.
  4. Don’t expect perfect table manners. Do have some family rules. One of ours is “No phones at the table” (well you can take a quick instagram shot and that’s it).
  5. Role model healthy eating and portion control to your children, they will thank you for it later in life.
  6. Offer a range of different foods throughout the week. We sometimes talk about the food we are eating, where it came from, what it is made from and what it tastes like.
  7. Don’t force anyone to eat anything they don’t want to eat. 
  8. You may have to eat super early in order to fit with the children but I still think it is important to do this and it leaves you time for fruit and yoghurt later on.
  9. Enjoy the time you have together. It is precious. 
  10. Laugh in the face of chaos 😉

Detox the diet talk.

Diet and Detox.  These words can be destructive. They suggest that you need to lose weight, that you have been doing things wrong, that you are not good enough, that your body is full of toxins, that you need to change the way you look. I see a lot of broken people with broken thoughts about their bodies and eating. 

Diet:

a special course of food to which a person restricts themselves, either to lose weight or for medical reasons.
restrict oneself to small amounts or special kinds of food in order to lose weight.

Detox:

a process or period of time in which one abstains from or rids the body of toxic or unhealthy substances; detoxification.

So it’s all about restriction, abstaining and getting rid of the bad stuff.  NO! Thinking like this will lead to negative thoughts about yourself, lowered self esteem, negative body image and the feeling that you are not good.

Dietitian UK: detox-the-diet-talk

Now I’m not saying that there aren’t changes that people need to be making to their eating and their lifestyles. Some people need to gain weight for health reasons and others need to lose weight, some people need to have a healthier balance of foods in their days, others may need to be more active. What concerns me is the mindset and thought patterns around why these changes are made. Approaching it from a “I’m a bad person and need to change” mindset is not going to give long lasting positive results unless those thoughts are challenged along the way.

Use a Positive Mindset:

Have a longer term approach. What are your long term goals? Where do you want to be in 1 year and in 5 years? Think about how your health and body need to be in order to achieve those goals.

To be a nurse I need to be strong, fit and have a healthy relationship with food so I can eat around my shift patterns.

To have children I need to be a healthy weight for fertility, I need to be a healthy role model with my lifestyle and I need to be able to cook a good range of meals.

From here write yourself out a list of positive changes you can make to your eating and lifestyle. These are some of mine:

To eat an extra portion of vegetables every day.

To get outside in the fresh air for some form of exercise 5 days a week.

To cook a new recipe once a week.

To switch off technology, read more and get to bed early once a week.

To make healthy snacks ahead of time so I stay away from the biscuits.

It’s not about having a strict diet plan and then beating yourself up when you can’t stick to it.  It is about having a plan that is achievable and flexible. 

It’s not about cutting out food groups and thinking foods are bad. It is about moderation and balance.

It’s not about only making change for a few weeks. It is about the long term.

 

Be kind to you. Be achievable. Be true to you. 

 

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 I use Coconut Oil?

Coconut has been everywhere. As someone who isn’t that into having all my food taste of coconut I’ve felt a little left out of the latest craze, that was until I delved into the research.

Is there any research out there?

Hyped as a superfood (which is actually a marketing term not a scientific one) there are a myriad of claims but few are backed up by the science. Yes there are so studies that have been done but the problem is that often the evidence has been extrapolated. Studies conducted on animals or small scale human studies have then been used as the basis for a claim, but actually this is misleading. A good example of how articles can take a kernel of truth and blow it up into vat of popcorn. As of 2016 there are no large scale, good quality studies on humans. 

Is coconut nutritious?

Short answer =  Yes. It contains fibre, vitamins C, E, B vitamins, Iron, Selenium, Na, Calcium, Mg, Phosphorus, Potassium. Lactose free and suitable for vegans there are definite benefits to coconut.

It is also lower in carbohydrates and sugars thans some equivalent products so there are potential benefits for those needing a lower carbohydrate and sugar diet and needing to control their blood sugar levels. 

However, we hit a milestone with the fat content. Coconut is without a question high in saturated fat. Let’s look at coconut oil first. 

Should I use Coconut Oil?

As with any oil this is energy dense (over 800kcals per 100g) and high in fat.  It is the type of fats that interest me, take a look at this table and a watch of this video:

 

OilSaturated Fat
Coconut

92%

Olive

13%

Rapeseed

9%

Butter

49%

Lard

46%

Whoah! At 92% saturated fat that should stop you in your tracks. Just 2 tbsp = 20g SFA which is the recommended amount for a day. That’s without eating anything else. 

Yes there are polyphenols and micronutrients such as vitamins E and K  in there too. In VIRGIN coconut oil the polyphenols are high, these are equivalent to virgin olive oil, but without all the saturates.  The thing to keep in mind is that you only want to be using a small amount of any oil, so you are not really going to get a huge amount of all the micronutrients from it anyway. You are better off relying on your trusty fruit and veggies for your polyphenol dose. 

Fats:  Some say the saturated fats in coconut oil are not an issue due to the principle fatty acid (lauric acid) being a medium chain triglyceride (MCT). These MCT’s can have a beneficial affect on CVD risk however Lauric acid doesn’t act in this way. Instead it increases levels of HDL cholesterol (which is good) but then also it increases total and LDL cholesterol also increase so overall it is not thought to have a beneficial affect on CVD risk.

The take home message:

Coconut oil offers some polyphenols and micronutrients but also a hefty dose of saturated fat. For some dishes the coconut flavour works really well and enhances the meal. I particually like it in some Asian dishes. However a little goes a long way and it is someone to use sparingly. I would recommend not having coconut oil as the main oil in your kitchen, but certainly use it for those dishes that it adds that extra flavour to. 

 

How to prepare yourself for weaning.

I love the adventure of weaning. The excitement of seeing your baby try something for the first time. Their facial expressions when they taste. The determination they have in picking up a food. The mess they make as they feel the texture. Taking photos of them, it’s all rewarding and funny in my eyes. 

Dietitian UK: How to start weaning

However there can be a level of stress in it too. What do I feed them? How do I start them off? How do I minimise the mess? What do I do when out and about? Which foods are best to give them?

So here are my “mum of 3” tips of what you need to get started. 

What you need to start with:

Bibs: I like to have the ones that cover as much of their bodies as possible! Long sleeved as great. It saves a clothing change after eating. You need at least 5 if you can. 1 per meal and 1 in the wash plus 1 in the change bag. It saves hassle to have more bibs around. Although a muslin folded into a triangle can be tied around your little ones neck as a make shift bib. Be warned the food stains may not come out! 

A high chair with a table: I’ve started 2 of mine off in a Bumbo with the tray attached. I like it as they have sat on the table and there is less chance of throwing food onto the floor. However it didn’t work for my boy as he wasn’t safe in the Bumbo. 

Dietitian UK: How to prepare for weaning 2

I don’t think that is any need for an expensive high chair. The Ikea Antilop white one is our fav. Wipe clean with hardly any nooks or crannies for food to get stuck in it is also portable in the car as the legs come off. This highchair fits out table well, however I like it away from the table for the start of weaning so I can prevent baby throwing food in my dinner! It is also found in lots of cafe’s so when you eat out baby feels like it’s a home from home.

A mat: having a plastic sheet, shower curtain or washable mat under the highchair saves a whole heap of clearing up. You can then pick it up, shake the bits of food off outside and put the mat in the washing machine when wanted. I have this one which I take to people’s houses as well (saves apologising constantly about their cream carpets!).

Plastic Spoons: These can be picked up cheaply from any supermarket. These are specifically designed for fit a babies mouth and are shallower than other teaspoons. Metal spoons are not suitable as if baby bites on them or pushes them further into the back of their mouths they could harm themselves. 

Plastic Bowls: Again easily picked up in a supermarket or online. Safe in a dishwasher, microwave and unbreakable as they will get dropped on the floor.  Having some with lids is useful for storing and transporting foods.

weaning-bits

Cups: If you can use an open beaker then that is the best way to encourage baby to drink. It is messy however as they can pour it everywhere! I like to use a combination of different cups. My favourite open cup is the baby cup as it is so small it is easy to hold and there is not much liquid to be thrown around!  Safe, easy to clean and approved by dentists. I also like doidy cups.

 Wipes: We use washable wipes, they just get thrown in with the normal washing. I have a tub that sits on my table with damp wipes in it. Everyone ends up using them for messy hands and faces. I’ve found cheeky wipes really good as they trap all the bits and wash well. 

Patience: baby may not be that interested and eat that much initially, which can be stressful. It is almost best to ignore them and let them get on with it, whilst keeping a quiet eye out for safety. Let them play, let them eat with the family, let them make mess, let them try and feed themselves. 

A plan: Not necessarily a spreadsheet of foods to try out, but some vague plan of what you are cooking and how you can therefore adapt it for baby. I often find it easiest to save leftover from the day before and give that to baby for lunch the following day. You don’t need to cook different meals for baby, but it can also be useful to have bits of food saved up to offer them or spare meals in the freezer.

Good books: If you want to do some reading up then the Baby led weaning book and cookbook by Gill Rapley are good and for some great evidence based information try ”Easy Weaning” by Sara Patience.

Foods to have ready: As babies are used to sweetness in milk I find it good to start with a mixture of a few sweeter foods such as fruit but also plenty of vegetables and starchy foods. 

Examples:

Breakfast : 

Porridge fingers (porridge cooked and left to go hard! I often some to last several days. It is sticky but easy for little fingers to pick up.

Toast fingers with butter, scrambled egg or hummus.

Eggy bread with vegetable sticks.

Weetabix with mashed banana.

Lunch:

Pitta bread in fingers with cream cheese and avocado.

Large Pasta shapes with roasted carrot and courgette strips.

Savoury muffins with cheese and cucumber.

Pancakes with steamed green beans, mushrooms and trips of chicken.

Tea

Risotto with a no/low salt stock

Roast dinner with no gravy

Potato wedges with broccoli florets steamed, sweetcorn and fingers of fish.

 

If you want to stock up online here is a little list of my recommendations:

 

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? 

Where should I set my weight goal?

Where should my weight goal be?

Why does my body keep on gaining when I want it to stop?

Why have I reached a plateau?

If you were perfectly in tune with our bodies you would be able to eat when hungry, stop when full, even decide what to eat whilst thinking about the signals your body was sending out. This would likely result in your weight remaining relatively stable. Why? 

The theory is that the body has a genetically determined weight set point. This is the point where the body functions best. It will work to gain/lose weight back to this point. So with small losses and gains of weight your body will adapt it’s metabolism to bring your weight back. 

If you constantly ignore the bodies hunger/fullness signals you can override this system and push the body into a new “settling point”. Your body will work to get back towards it’s set point but external factors may mean this is not possible so it compromises. This can explain why you find it easy to gain/lose a little weight below your normal weight but then have to make bigger changes to alter your weight further. It also shows why a WEIGHT BAND is needed and not a single figure. 

Dietitian UK: set-point-theorywhere-should-i-set-my-weight-goal

Looking at the research on weight restoration after people have been at a low weight you find it takes time for them to get back to their healthy weight bands. For example simulation using the data from the Minnesota starvation study show it took over a year for the men’s bodies to resettle back to within 5% of their original body fat. 

In my practice of eating disorders I see similar results. Getting the body to regain weight back to it’s former set point is not as easy as you would imagine. There can be phases of regular weight gain and then plateau periods. It can take a few months for weight maintenance to be established. Almost as if the body is testing to make sure it is safe for it to settle into it’s groove again. Following a pattern of either bingeing and restricting or eating more and then compensating another day will make it harder for the body to normalise itself. Mindful eating, a regular pattern of meals and listening to your body’s signals is the key.

When you lose weight, below the set-point, your metabolism decreases. Your body uses less energy for jobs such as digesting food. Your overall energy expenditure decreases and your resting energy expenditure decreases. So you use less calories than you were using. As you start to weight restore your metabolism will at some point start to increase alongside this. This can result in a weight plateau, but it can also help you justify eating more.

How do your work out your set-point?

This is the tricky bit. There is no direct way to measure it and it can change over time. For some women pregnancy will change the set point. Ageing can have an affect. Medications and illness too. 

What we do know is it isn’t likely to be dead on a BMI of 20. BMI is a guide and a range it isn’t definitive. So you may have to continue gaining past BMI of 20 and listen to your physical health signals. Your energy levels, your menstrual cycle, your bone health, the condition of your hair and nails, your blood results. Ignore the numbers on the scales and think about your body as a whole.

General tips: look back over your weight history. If you have had a stable period when you ate normally and were moderately active then your weight at this time will be a huge clue. 

Look at the weight of siblings and parents. If you are female think about the weight when your menstrual cycle was occurring regularly, this is a huge clue. 

Remember, the body wants stability and to feel safe. So give it a routine and listen to what it is asking you for. 

If you need any advice then do get in touch for a Skype or face to face consultation.

 

References:

CCI: set point theory http://www.cci.health.wa.gov.au/docs/set%20point%20theory.pdf

Mirror-Mirror : Set Point Theory: http://www.mirror-mirror.org/set.htm 

Muller, JM et al (2010). Is there evidence for a set point that regulates human body weight? F1000 Med Rep. 2010; 2: 59. Accessed via PubMed.

Dear health bloggers, please be responsible.

Ok so a bit of a rant. However I am getting increasingly annoyed and saddened in my line of work  by the impact that so-called health bloggers are having. I am seeing a definite impact upon young girls who are either following these social media gurus or are hearing about their nutritional messages through other channels.  Sadly there is no regulation for these new nutrition types and yet with thousands of followers, their advice is wide reaching.

Restricting your dietary intake under hear-say or because someone else tried it out and it worked, or due to social media advising it really isn’t the way to go. 

Firstly it can lead to your diet becoming overly restricted and make it hard to find enough foods to eat.

Secondly it can leave you lacking essential nutrients. 

Thirdly this can spiral downwards leading to weight loss and disordered eating.

Some phrases I often hear are: 

“Carbohydrates are not good to be eating”

“Gluten is toxic”

“Dairy is full of fat and hormones”

“I only want to eat healthy fats”

So I spend a fair amount of my time with these clients, dispelling the myths and explaining the science. Some of these clients  I manage to catch early on, before things have gotten too far. For others though the damage has already started. What started as healthy eating has spiralled downwards into overly restricted eating. They are too scared to eat certain food groups and have continued to lose weight, taking their bodies into an unsafe area. Many of these clients then realise what has happened and actually become quite angry. Angry at the incorrect advice they have believed and the influence of the health instagrammers. Angry that they have been drawn into this culture. Angry that they now have many months of hard work ahead of them to turn things around. Angry at the impact on their minds and bodies.

Now I’m not saying that health bloggers are the reason for eating disorders. But I am saying that for some, the instagram health blogging world shows a world they want to be part of. The perfect body, the perfect diet, the perfect workout, the perfect food pictures. In my mind there is no perfect. At least not in this world. Instead we aim for balance with a healthy does of reality. However I am a 3o something year old, wife with 3 children. In my teens I too had issues with body image, I know I would have been easily influenced by the perfect diet and have followed the clean eating trend. Now with 2 daughters, I want to ensure they, and many others do not fall under this spell. 

health-bloggers-please-be-responsible

So, if you give nutrition advice, please spare a thought for how it could affect people. How it could be miscontrued. Think about whether it is correct, evidence based and sound.

How about we have the rise of the evidence based, trustable health bloggers? 

Please.

Eating Disorders: Prevention is better than cure

Eating disorders are a mean, cruel illness. Once seen to be a disease of affluence, there are now so many reasons an eating disorder can begin. The roots can be due to trauma, family issues, relationship problems, low self esteem, bullying, loneliness and wanting to fit in, a desire to be healthy, a need to achieve. Often there seems to be this air of mystery surrounding them and they can even be seen as a status. However, once you are in the cycle of truly trying to recover you will wish you had never become drawn into the disorder in the first place. 

Healthy eating taken to the extreme can seem like a good idea, but for some it can rapidly become an obsession. Counting calories, measuring portions, having the right balance of food groups can be positive. But when it lead to these measures being down to the nth degree, becoming obsessed with what your next meal will be and anxious if you have to eat something out of your plan, then there is a problem. 

When I meet someone who is low weight and wants to weight restore I always emphasis that it will not be easy. Not because I want to put them off, but I always find it is important to be honest and forewarn them. Recovery from an eating disorder is a cruel business. Why do I say that? Well if you have an eating disorder you have issues around food, often you are restricting your intake and eating high calorie foods causes anxiety. You don’t like feeling full, bloated or heavy and putting on weight around your tummy is not something you want to happen. Guess what? When you weight restore all these things happen. It is like everything you are scared of you have to go through, a bit like one of those awful challenges where they put you in a box full of spiders to get you past your fear of them (yes I’m scared of spiders). Someone weight restoring will have to:

  1. Eat more.
  2. Eat more calorie dense foods. 
  3. Increase the variety of foods they eat.
  4. Eat more carbohydrates, fats and sugars.
  5. Will feel bloated after a meal.
  6. Will have to continue eating when full, pushing past that feeling of wanting to stop.
  7. Will have anxiety around mealtimes.
  8. Will gain weight and this may initially go to their tummy but will then redistribute.

So you can see some reasons why it is so hard. All the things you fear are the things you have to go through. I wish I had a magic wand or an easy solution. However recovery is definitely possible and so so worth it. 

What I do know is:

Dietitian UK: Prevention is better than cure

 

AND

 

stories

 

Here is a quote from a  client talking about weight restoration to inspire you:

It seems like forever ago now and I can’t lie – I hated it at the time. I really struggled. I did the ISP after an admission and it was tough. I hated it at the time. I remember going through a folder of portion sizes with you and lying through my teeth. I couldn’t accept the help.  But I’ve been out of hospital for 3 years now. I’m small but not underweight. I had a lot of help and eventually knew how to use it. From there to now – I don’t think I could have got from there to where I am now without the support I received.

It hasn’t gone. It’s still there but I’ve got a lot to lose now (life, friends, family and definitely not weight) and I won’t give that up for anything. I never said thank you at the time because I couldn’t see that you were helping me. So I wanted to say thank you now. 

It is so good to be living again 😊