Tag Archives: dietitian hampshire

Dietitian Advice, Family Meals, Intuitive Eating, Media, Nutrition Education

How do we know when we are hungry/full?

30 April, 2018 Priya Leave a comment

In a completely perfect world we would eat when hungry, stop when full and eat the foods our body tells us to eat. However few of us are that tuned into our bodies signals. We are bombarded with outside signals for example the media, advertising, other people, shops, restaurants – food is all around us.

You walk down the road and pass someone eating a burger, “hmmm I fancy one of those now”. Then you pass a billboard advertising ice-cream, “oh I could eat an ice-cream later”. Then someone in the office has a birthday so you have a slice of cake. Later on the radio is advertising a meal deal which makes you think of buying one for your lunch. In the shop you are standing waiting to pay and see a cereal bar so pick it up to nibble on. All those extra signals that are overriding your actual body signals. It’s all so easy to be overwhelmed by the external and takes a lot of quietening ourselves to hear the internal cues.

Many people I work with cannot actually initially pinpoint what hunger feels like. I ask how hungry they are and am met with a confused look. Hunger on the one hand is quite a simple idea, your body is hungry, it tells you, you eat. Other the other hand it is complex, so complex. There is head hunger, body hunger, stomach hunger, emotional hunger.

Here is my 7 year olds take on how she knows she is hungry. I think this is such an important conversation to have with children AND adults. So have a think this week, how do you feel hunger and how hungry are you before you eat?

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Dietitian Advice, Nutrition Education

The non-diet approach for children.

15 April, 2018 Priya 6 Comments

In a time when there is a focus on reducing sugar, countering obesity and improving the long term health of the nation, it can be hard to know how to approach these topics with your family. On the one hand we want children to be aware of what is in food but we don’t want them to be obsessing over it or feeling they need to go on a diet.

Personally I think that teaching children about nutrition, food preparation, healthy behaviours and their bodies early on is really important and can be part of the solution that our society needs. So as a mum I do my best to educate my children on a daily basis. Simple messages that we use are “There are no good of bad foods but some foods we eat less of as too much of them are helpful for our bodies”. We also talk about what is in a food and why it is good for us – often using “Funky Facts” such as the fibre in bread or the vitamin C in a kiwi. Top facts like this are things I find they store up and remember.

We may talk about dental health or how out tummy feels if you eat too much of certain foods. Both my older children (age 4 and 7 yrs) can associate with a time they have eaten sweet foods and felt unwell from it! I love talking to them about how their tummy feels and what do they feel it needs as well as what does it want!

I prefer to focus on these messages rather than focusing on weight/size/shape. Being a dietitian who works in the eating disorder field I am well aware of the issues that can occur when there is too much of a focus on weight, shape, size and how your body looks. Instead I like to focus on the enjoyment of food and on healthy behaviours such as being active, getting fresh sunlight, being outside and taking care of our teeth, hair, nails.

Here is a little video of my 7 year old explaining her thoughts on food:

I’d love to hear your thoughts!

Dietitian Advice, Nutrition Education

Teaching intuitive eating in family life

14 January, 2018 Priya Leave a comment

It seems a lot of you out there are interested in teaching your children about intuitive eating. Which is absolutely amazing! I’m over the moon. Absolutely loving the little experiments people are doing at home too.

After a few comments and questions about the last blog post I thought I’d do a post on how we talk about nutrition at home. Again this is not a perfect method and I don’t know it all but I am seeing the benefits in my children.

For example this week at lunch my boy aged 4

“Mummy why are we having grapes for lunch”

Me: “Because Miss E wanted them” (she is a grape-a-holic, though she hasn’t tried wine yet!).

J-boy: “We had grapes yesterday and the day before”

Me: “I know, is there a problem with that?”

J-boy: “Well we shouldn’t just eat the same foods we should have different colours and types”.

Me: in a flabbergasted tone “Ummmm yes exactly”

Is it just me who is amazed when their children actually listen and take on board what you say?

So here we go, how we chat about nutrition at home:

Take the relaxed road. Several people asked me how can I be sure the kids won’t over eat the food like sweets and biscuits? I guess I can’t ever be sure, but I also cannot be in control of their food intake for ever. I want them to listen to their inner signals and to have a good grasp of nutrition. The more I trust them and let go, the more they surprise me. So we talk about how sugary foods are absolutely delicious and all foods are great to eat but too many lollipops, cakes, biscuits, dried fruit can lead to tooth decay and tummy ache. On those occasions when the children do over-eat sweeter foods it is a great chance to talk about how that feels.

A recent example being Eton Mess, my girl had a serving, then came back to ask me if she could have more. I suggested she think about her tummy and decide herself. After another serving she felt a bit sickly and later on reflected on this being due to the sweet, creamy dessert.

Now if I had told her not to have another serving she would have just felt a bit disgruntled, whereas now she understands more about listening to her body.

Fullness and Hunger Cues. We talk about how it feels to be full and hungry. In the words of my children:

Fullness = my tummy has had enough, it feels uncomfortable, my mouth has eaten enough, I’m not empty. Hungry = rumbles and my tummy aches. Sometimes when I’m hungry I don’t have my energy.

Miss K has always been good at stopping when she is full. the J-boy is another kettle of fish. He will happily keep munching on foods such as biscuits unless you remind him to tune into his tummy. Distraction for him is a biggie. Yesterday in the car he had been given a pack of biscuits, he asked how many to have and I asked him to ask his tummy and see after 1 if he should have another or keep it for later. He happily munched his way through 2 and stopped. Now I’m pretty sure it would have been 3 or 4 biscuits if he had been watching TV whilst snacking or distracted.

Nutrition Facts. Now I’m not organised enough to sit down with them and give planned nutrition lessons, I find relaxed or undercover stealth like approach works best. So don’t feel you need to become a teacher to teach nutrition. When we eat a meal we tend to have a few facts about the food we are eating and talk about the meal. It could be where the meat comes from, how something is grown, the colours on the plate or why something is good for your body. My kids love a handy fact and they will then repeat things back at a later meal. This can prove amusing when someone else is eating a food that they know about.

Your language matters. How you talk about food is so important. Labelling foods as good/bad, healthy/unhealthy, treats or special foods put those foods up on a pedestal. If there are foods that you disapprove of your children will soon pick up on it. I feel like it is a daily occurance that I am having to challenge my own thinking on this and change my words/tone. It seems I am not alone, phew.

Eat using the Senses. Talk about how food tastes, smells and the texture. This can help them to zone in on what they are eating and to not eat it without noticing. One way we have done this recently is to talk about taste buds, where they are in the mouth and what you are tasting when you eat certain foods. My boy enjoys the noises that foods make and how they feel when he eats them with his fingers. Yes it may be not be good table manners but it is a way to get him to connect with his food and think about what he is eating. Later in life people spend lots of time getting back to mindful eating… our children can teach us alot about enjoying our food.

I’d love to know your thoughts. How do you talk about food at home?

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Media, Social Media for HCP's

The risk of social media.

11 December, 2017 Priya 3 Comments

Social media for me is essential. It brings me work, it brings me a virtual team and it enables me to stay up to date. I love it for personal and business reasons. It has connected me to a community of other nutrition professionals who I would probably never had met otherwise. I have daily chats with people about the current research, I can ask questions and support others, I can share resources and collaborate with them.

But at the same time social media can be a tough place to be. The nutrition world has become a crazy place. There are people with no training in nutrition publishing books and becoming the got-to for advice. There are highly qualified and respected experts getting caught up in social media wars. I can completely understand why some people stay away from it altogether.

Here are some things I am thankful for on social media:

Dietitian’s and registered nutritionists are trained to read the research and interpret it. That may sound simple but there can be many ways to interpret one piece of research. I’m thankful for people who share research, those who give an unbiased view, those who answer questions and help when others need a clearer answer or more research to back up a view.

A virtual community who are supportive, forward thinking and inspire me. Working as a freelancer I don’t actually see other dietitian’s that often. To all those who are on the cutting edge with popdcasts, videos, infographics – thankyou.

People who get in contact to just say nice things. Those who notice and say hi, those who comment on a blog post or a recipe. It is appreciated.

Things that I wish I could change on social media:

The sniping and fighting that goes on. There is not one perfect answer, or one perfect diet. So maybe sometimes we have to agree to disagree.

Promoting of books and money making schemes over the science. It can be all too easy to think that just because someone has a book contract it makes them an expert. There are too many arguments about who is the expert. Personally I would say look at someone’s qualifications. If they are talking about nutrition have they actually studied nutrition?

Black and white thinking. Social media only provides you with a small number of characters or a snapshot moment to present your point. This can mean that things become black or white, you end up having to take a side. Nutrition is a fairly new science and we are learning so much all of the time, with new research coming out tat is adding to our evidence. Therefore we do not have absolutes, what we do have is a base of science that we build upon.

If you are a nutrition professional I do think you need to be on social media, sharing accurate messages, supporting your profession and keeping up with the world on there. How we group together and fight these battles that go on is not something I can answer but I do know it needs to be co-ordinated and professional.

Dairy Free, Family Meals, Gluten Free, Recipes, Special Diets, Vegetarian, Weaning, Wheat Free

Lentil Lasagne and Lasagne made easy

8 September, 2017 Priya 3 Comments

Lasagne is one of those meals that is loved the whole family. Let’s face it, if you don’t love lasagne then you are very usual! Often seen as hard to make, time consuming and more comfort food than “healthy” I want to share my top tips for making it a standard weeknight family meal.

Pack in the veggies. Lasagne does not have to include meat! I rarely use mince to make lasagne these days. Instead I use lasagne as a way to pack in the veg. You can use lentils, beans or tofu or quorn to get protein in. There is nothing wrong with using the normal beef mince but if you are looking for more variety with meals or like us, are wanting to eat a greater range of plant based protein sources then it’s time to expand your lasagne repertoire.
Making your own sauce doesn’t have to be complicated. As much as I love a white sauce, if I’m in a rush it always goes lumpy or I burn the bottom of the pan. One of my hacks is to use cottage cheese. Add a little natural yoghurt to thin it down and pour it on the top of the lasagne, top with grated cheese and the jobs done. I wasn’t convinced this sauce would pass the lasagne police in my house but it did. Phew. The other easy alternative is to use a half fat creme fraiche, simple.
Embrace your freezer. I totally love my freezer, it saves me on a regular basis. Oh, and it needs defrosting, in case anyone fancies helping me with that. You can either make a double batch of the main filling and freeze it for another meal, or I like to make a whole lasagne and freeze it, makes me feel like a proper domestic goddess. Minus the tidy kitchen, mine is never tidy.
Make ahead. I often make lasagne in stages. so I will either get the main filling out of the freezer and leave to defrost, or make the filling up and leave it. Then later I get a child to help me put it together, layering the filling, pasta and sauce.
Use pre-bought lasagne sheets. I know most people don’t make their own fresh lasagne sheets, but I sometimes do, it makes the lasagne SO good, literally the best lasagne. But it takes more time that I just don’t have that often.

So why not transform your lasagne into sometime more inventive. It’s a forgiving dish. Here is a recipe for a wheat free, dairy free version I made this week:

Lentil Lasagne

2017-09-07 23:09:41

Serves 4

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Cook Time

45 min

Cook Time

45 min

Nutrition Facts

Serving Size

533g

Servings

Amount Per Serving

Calories 585

Calories from Fat 94

% Daily Value *

Total Fat 11g

16%

Saturated Fat 3g

16%

Trans Fat 0g

Polyunsaturated Fat 2g

Monounsaturated Fat 5g

Cholesterol 13mg

Sodium 221mg

Total Carbohydrates 89g

30%

Dietary Fiber 34g

136%

Sugars 14g

Protein 35g

Vitamin A

203%

Vitamin C

165%

Calcium

24%

Iron

49%

* Percent Daily Values are based on a 2,000 calorie diet. Your Daily Values may be higher or lower depending on your calorie needs.

Does this look wrong?

Ingredients

1 onion
2 garlic cloves
3 carrots
2 peppers
1 medium courgette
1 tsp olive oil
2 cups of dried lentils
1 tin chopped tomatoes
1 tbsp tomato puree
250ml stock (I used homemade chicken stock but you could use a stock cube and water)
1 bay leaf
Dried mixed herbs
1 small glug of balsamic vinegar
Lasagne sheets (wheat free if required)

White sauce

1 tbsp rapeseed oil
2 tbsp wheat free flour
Soya milk as needed, approx 250ml
250ml water (you may not need it)
Soya cheese or normal cheese

Instructions

Chop all the vegetables in a food processor (this saves time!) or chop finely by hand.
Saute in the oil for a few minutes, then add the lentils, chopped tomatoes, tomato puree, bay leaf, dried herbs, balsamic, stock and simmer for 20 minutes. This is your basic lasagne filling, You can now freeze this, keep it in the fridge for making up later, or use straight away.
Make up the lasagne with 1 layer of lentil mix, lasagne sheets, lentil mix and lasagne sheets.

White sauce

Pour the oil into a sauce pan and mix in the flour with a wooden spoon, it will make a thick paste. Mix in a little milk and stir to make a batter, now add in the rest of the milk place on a gentle heat and keep stirring to incorporate it all. The sauce will thicken, if it is too thick add some water. Keep stirring! Let it gently bubble but not too much. I like to let it cool a little and then pour on top of the lasagne.
Top with cheese and bake at gas mark 5 for 45 minutes.

By Priya Tew, Dietitian UK

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calories

585

fat

11g

protein

35g

carbs

89g

Dietitian UK https://www.dietitianuk.co.uk/

Dietitian Advice, Eating Disorders

Eating Disorders: Why can’t I recover?

9 July, 2017 Priya Leave a comment

Working in eating disorders as a dietitian is the very hardest part of my job. As a freelancer I cover a huge variety of roles. In my other world as a Pilates teacher and studio owner I have an altogether more energetic and flowing role. Yet it is working with eating disorder clients that uses the most of me, pushes me hardest, and pulls on my mind, spirit and emotions.

Some of my hardest work is with the “stuck” clients. Those who really want to change, really want to break free, really want help…. and yet they just can’t do it. It is so very hard for them as you can see they do want to get better. Imagine this – knowing how you are living is ultimately going to shorten your life, make your life difficult and lead to you not being able to do a lot of things and yet not being able to change it. Life with an eating disorder is a very hard life.

Often there is a specific weight that they cannot push past.

Sometimes there are behaviours such as exercising or purging that they cannot give up.

Change can be made, but only to a point.

So what causes this “stuckness”?

An association with a certain weight.

It is not uncommon for me to being working with someone who 100% agrees that they need to get their weight to xx kg. We put a plan in place, they are working towards it really well, everything seems to be on target and then the “stuckness” hits just before our weight goal. Why? It could be that when they were last at this weight they didn’t like their bodies/themselves, someone said something negative about them or that something traumatic happened at this weight. It could be they have never been that weight before, it is the highest weight they will have reached.

I like to work this through with people.

“What will it be like being this weight”

“How will it change your relationships and how you see yourself”

“What will be better and what will be worse?”

I also remind them that you really cannot predict how it will feel and be until you get there. Using the analogy of a night in a hotel. You can guess how it will be, you can imagine how you may spend the time with your partner, you can predict the layout of the room, the hotel and the menu. However you cannot really be sure what it will be like until you get there. Even if you have stayed there before, things change, things feel different at different stages of life.

2. Not wanting to move on.

Having an eating disorder can for some be a way of escaping. Escaping growing up, escaping emotions, escaping reality. So getting better means that you have to deal with all those tricky issues. You cannot run away any longer. You have to put on those big pants and be a grown up. It isn’t necessarily going to be fun, but in the long term it will be worth it.

I find using some motivational work can be beneficial here. Looking at the pros/cons of change. Planning out a vision board of where they want to be in 1 year, 5 years time. Talking through the real reasons they need to get better. For most people there is something driving the desire to make change. Examples are wanting to have a certain career that you can’t do at a low weight (nursing, law), wanting to have children, wanting to be able to go travelling.

3. Invested in the Eating Disorder.

This may seem like a strange one. If you have had an eating disorder for a long time it can be hard to imagine not have one. It becomes part of who you are. It becomes part of the way that other people see you, relate to you and care for you. If you no longer have an eating disorder there is an uncertainty, how will others see you, will they still care for you, will they still take time over you? If you no longer have an eating disorder who will you be? A huge part of this is all around knowing your identity. Spending time journalling can help with this. Thinking about who you used to be, who you would like to be. What are the things that make you come alive inside? Spend time doing those. What are your dreams and aspirations? What things are you good at? Asking someone close to you the question “What are my giftings or what are I good at?” can be very revealing and helpful. Once you have an idea of who you could be outside of your eating disorder you can push yourself to move past it.

Working on your relationship can also be helpful. If these are strong then you know that people will care for you always, with an eating disorder or not. Being in a sick role means you are seen in a very different way. Being recovered and healthy can expand and move your friendships and relationships to new levels.

Being stuck in your eating disorder recovery can be a very natural part of the recovery process. If you are in this place do seek some help. Do spend time journalling, talking, being creative and finding who YOU are. To look for a good therapist and dietitian near you in the UK the B-eat website is a good starting place. Or drop me an email as I work with people around the UK by video call.

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Dietitian Advice, Nutrition Education, Vegetarian

10 portions of fruit and veggies a day?

23 February, 2017 Priya 5 Comments

So today we woke up to the news that 10 portions of fruit and vegetables is the new 5 a day.

95 studies on fruit and vegetables have been analysed by researcher at the Imperial College of London. They found that the most benefit came from eating 800g per day, as 80g is a portion this equates to a whopping 10 portions a day.

Consuming 10 portions a day was associated with a 24% reduced risk of heart disease, a 33% lower risk of stroke, a 28% reduced risk of cardiovascular disease, a 13% reduced risk of cancer, and a 31% reduction in the risk of premature death. This may be due to the levels of antioxidants they contain as well as their fibre content. Eating 10 portions will also potentially mean that less processed foods are being consumed, so implies an overal healthier diet and lifestyle.

This isn’t to say that eating less is not worth doing however as there are still significant health benefits from eating any amounts of fruit and veggies. For example helping to reduce blood pressure and cholesterol levels.

Specifically apples and pears, citrus fruits, salads and green leafy vegetables (kale, spinach, lettuce), cruciferous vegetables (broccoli, cabbage and cauliflower) may help protect against heart disease, stroke, cardiovascular disease, and early death. Eating green vegetables, yellow vegetables and cruciferous vegetables could help protect against cancer risks.

Is it Achievable?

The problem is that in the UK many people are not even meeting the 5 a day target. Suddenly asking them to eat 10 portions a day is unrealistic and laughable for some. I myself currently eat 7-8 portions a day, having increased this from 5 a day. I could increase this further but I have a gut issue and personally I think I am on my limit.

For some people this level of fibre intake is not going to be a good plan. Those with digestive disorders such as diverticulitis, some people with IBS or Crohns disease or an inflamed gut.

So it is all about small increases and working towards eating more.

Sugar?

I’ve already heard the words “too much sugar” mentioned. Do not panic people. Put your sugar finger pointing fingers down. The sugar in fruit is not a “free sugar”. It is contained within a fibrous matrix and so it is not released into your blood stream as quickly as eating pure sugar or honey.

Having said this, I would still recommend you focus on eating more vegetables and not too much fruit. Remember dried fruit is a more concentrated form of sugar so watch your portion sizes of this. Juices and smoothies should be limited to maximum one a day. So really we are looking at upping the whole fruit and veg.

10 portions a day:

So what could it look like?

Breakfast: Cereal with 80g berries and 1 tbsp raisins. 2 portions

Snack: Banana and nuts. 1 portion

Lunch: 1/2 avocado on toast topped with tuna served with a side salad. 2 portions

Snack: 1 chopped carrot with 1 tbsp hummus. 1 portion

Dinner: Chicken casserole and rice with 2 portions of vegetables. 1 glass of fruit juice. 3 portions

Snack: Chopped apple and yoghurt 1 portion

My take home message:

JUST EAT MORE FRUIT AND VEGETABLES.

Focus on increasing it gradually. As with anything this is a habit that needs to be formed and it doesn’t happen overnight. Set yourself small goals like adding fruit to your breakfast or having a vegetable based snack each day and build on it.

I’d love to hear how many portions of fruit and veg you currently eat and how you plan to increase it.

Baking, Cooking with Kids, Snacks, Special Diets, Wheat Free

Pear Rock Cakes, no added sugar.

12 February, 2017 Priya Leave a comment

It’s been a week of pretty awful sleep. That saying about “They saved the best till last” is not true when it comes to sleeping babies. The third baby is the worse sleeper! However she also gives the best cuddles and is super cute with it, so I can’t be cross with her.

When I don’t sleep well I tend to :

Walk around in a bit of a brain fog, yet still be functional for work – how does that happen?
Want to poke out the eyes of anyone who has a baby that sleeps through the night.
Loose some of my words. My 6 year old is good at finding them for me. “I’m just making…..ummm, ummm” “Breakfast Mummy?” “Yes, that’s the one”.
Get creating in the kitchen. I’ve no idea how but cooking and baking helps restore my sanity.

So on a cold, fuzzy headed Sunday afternoon I was flicking through my recipe notebook and stumbled upon rockcakes. Rockcakes seem to be one of those recipes that people make in school or when they are learning to bake. I think they need a come-back. Super easy to make, which means the children can help, there is little that you can go wrong with and you are left with a mountain of tasty snacks for your week.

I’ve adapted the usual rock cake recipe by adding in fruit and upon tasty the mix I decided it was sweet enough for our palates. Try a bit of it before you add in the eggs and see what you think as you can always add in a little sugar to taste. Doing it this way will hopefully mean you don’t go OTT on the sugar content.

My kids were happy bunnies and rewarded me by playing nicely with minimal arguments all afternoon. I love the subtle pear hint in these. Perfect for tbe after school munchies, which happens to co-incide with my cuppa and snack time 🙂

Pear Rock Cakes

2017-02-12 22:23:44

Yields 20

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Prep Time

10 min

Prep Time

10 min

Nutrition Facts

Serving Size

45g

Yields

Amount Per Serving

Calories 116

Calories from Fat 41

% Daily Value *

Total Fat 5g

Saturated Fat 3g

14%

Trans Fat 0g

Polyunsaturated Fat 0g

Monounsaturated Fat 1g

Cholesterol 29mg

10%

Sodium 9mg

Total Carbohydrates 17g

Dietary Fiber 1g

Sugars 5g

Protein 2g

Vitamin A

Vitamin C

Calcium

Iron

* Percent Daily Values are based on a 2,000 calorie diet. Your Daily Values may be higher or lower depending on your calorie needs.

Does this look wrong?

Ingredients

100g butter at room temperature
250g flour (I used Doves Farm Plain Gluten Free Blend)
2 tsp baking powder
1 tsp mixed spice
1 soft large pear, peeled and chopped
1 soft ripe banana, mashed
100g raisins
2 eggs

Instructions

Rub the butter into the flour.
Now add the baking power and spice.
Add in the wet fruit. the pear should break down easily if you are using a stand mixer or food processor.
Now mix the raisins in gently.
Add in the eggs, one at a time.
Taste and add sugar if needed, I found it wasn't necessary.
Preheat the oven to Gas Mark 5, line and grease a baking tray.
You should end up with a soft dough.
Take dessert spoons of the mixture and gently shape into rounds.
Place onto a greased, lined baking tray.
Bake for 15-20 minutes until they are lightly browned on the top.

By Priya Tew, Dietitian UK

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calories

116

fat

protein

carbs

17g

Dietitian UK https://www.dietitianuk.co.uk/

Dietitian Advice, Nutrition Education

Detox the diet talk.

1 January, 2017 Priya 1 Comment

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.

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.

Nutrition Education

The low down on Fats. Are saturated fats really the villain?

26 January, 2016 Priya Leave a comment

Recently the world of fat had a shaking up. For 50 years saturated fat has been the bad guy, linked to coronary heart disease. But a systematic review and meta-analysis of the research looked at 32 worldwide cohort studies that reported finding a link between saturated fat (SFA) and coronary heart disease (CHD) and begged to differ.

The original landmark research that led to the development of our dietary guidelines was done by Ancel Keys, the Seven Countries study in the 1970s. He found links between CHD and cholesterol levels and linked this to saturated fats as we know saturated fats increase cholesterol. However this was not actually proven and no research was done to then prove the association or to look at the impact of the dietary guidelines.

The new analysis found that:

Saturated fat, omega 6 fatty acids, and monounsaturates (MUFA) were not linked to heart disease but instead they were neutrally related to the risk.
Trans fats were associated with a 16% increased risk of coronary events, a 34% increases in all cause mortality, 28% increase of CHD mortality and 21% increased in risk of CHD.
Omega 3’s led to a reduced risk.

The research analysed in these studies was carried out using diet history questionnaires and diet records and we know this is not always ultra-reliable. There is always the potential for bias and under/over-reporting. Different studies also used different views on fat categories so it confuses the results slightly.

What has happened: Some of the research looking at saturated fats compared extremes of intake. When you reduce saturated fats you increase polyunsaturated and monounsaturated fat, or you increase carbohydrates. The research often doesn’t tell us what foods were changed if saturated fat levels were altered.

What are Saturated Fats and how much should we eat?

The fats found in animal products: butter, cows milk,meat, salmon and egg yolks and in Plant products: chocolate, cocoa butter, palm oil.

Dietary guidelines are that saturated fats should be limited to <10% and trans fats to <1% of energy. These still stand.

What do you eat instead?

Research in 2005 showed us that replacing SFA with carbohydrates caused a small increased heart disease risk and instead should be replacing it with polyunsaturated fats (PUFA). Another study looks at the quality of carbohydrate, which I think is the key. It found replacing SFA with high glycemic index carbs led to a higher risk.

If you replace saturated fats with high glycaemic index carbohydrates, the “bad LDL cholesterol” increases. There is a direct association between LDL cholesterol and heart disease mortality. What we replace saturated fats with is important. Highly processed CHO are known not to be good for us due to their effect on blood sugars.

A 2% increase in energy from trans fats is associated with a 25% increase in risk of CHD and 3% increase in CHD mortality. So we don’t want to be eating more of those.

Current recommendations are that we replace SFA with PUFA and not with refined carbohydrates. So there is still am emphasis on lowering saturated fat but not going for very low fat diets. We all need some fats in our diet and very low fat diets are no longer recommended.

PUFA’s are found in:

High quality carbohydrates from fruit and veg and grains.

Nuts, seeds and plant oils.

Omega 3’s – 2 portions oily fish or vegetarian options such as linseed, hemp oil, walnuts and chia.

Can SFA’s be good for us?

Some foods that contain saturated fats also have other goods nutrients: vitamin A, D calcium and phosphorus are in dairy foods for example. Vitamin D is a nutrient that we are finding more people are deficient in so we do want people to be eating full fat dairy.

It’s a complex relationship to understand. There are so many confounding factors when we look at diet and heart disease, you cannot control them all.

We know now that dietary fats have different biological effects. Not all SFA’s behave in the same way. So it looks like excess lauric, myristic and palmitic acid are shown to decrease LDL cholesterol clearance which is not a good thing, but other length fatty acids are not associated with CVD risk.

All saturated fats are nutrients with very specific functions, we metabolise them differently and synthesise fatty acids when we eat sugars, alcohol and starch. So SFA is not the only thing responsible for heart disease risk.

It is more complex than we originally gave it credit for.

The concern is that is we remove one nutrient it gets replaced with something else that may not be as good.

So it’s not all about reducing SFA but more key is what we replace it with. It’s not the cutting down that is always key but what we increase and actually eat more of. Perhaps our dietary guidelines should look at what to EAT MORE of rather than the negative EAT LESS.

Individual changes to one nutrient have a knock on effect on another. WE want to see the bigger picture here and look at the balance of the whole diet. Maybe look at what you shold eat more of and not what to reduce. as you eat more fruit and ve you will eat less processed foods.

References:

BMJ 2015;351:h3978 SFA meta-analysis

http://www.ncbi.nlm.nih.gov/pubmed/19211817

http://www.ncbi.nlm.nih.gov/pubmed/20375186

The saturated Fat debate. Jenny Rosborough. Complete Nutrition Vol 7 (No2) June 2015

So what causes this “stuckness”?

An association with a certain weight.

2. Not wanting to move on.

3. Invested in the Eating Disorder.

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