Sorry, dietitians just aren’t sexy

wise words fresh from a dietitians mouth

Something that’s been weighing on my mind a bit lately is the disappointment that many people seem to have with dietitians and the reasons for this. Basically, it boils down to the fact that we’re not sexy. Nope, we can’t tell you the next great superfood you must buy daily (spoiler: there is no such thing as a “superfood”). We won’t recommend any breakthrough weight loss supplement; sorry, whatever Dr. Oz is selling we’re not buying. We won’t tell you “never eat these five foods“. And we won’t tell you that paleo, Atkins, low-carb, low-fat, gluten-free, vegan, <insert any trendy diet here>, is the best diet.

There are no shortcuts to health. There are no foods that you should never ever eat (I mean, obviously, there are some foods that should be consumed on an occasional basis, such as candy, and others on a regular one, such as vegetables)…

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“By failing to prepare, you are preparing to fail” (Benjamin Franklin)

Happy New Year readers! New year, New starts – but can we expect change overnight?

No one has ever said that losing weight is an easy task. For a lot of people being overweight is a result of years of bad habits, subconscious eating and a busy lifestyle… so change is not going to happen overnight. People attending my clinic often tell me a tale of “Yo-Yo dieting”, “slimming regimes” and diet after diet attempts – none of which have worked.

Firstly I don’t believe in “dieting” (Phew! I can hear you all say). The word ‘diet’ simply means what we eat on a day-to-day basis. Here is the bad news… there is no magic cure, just years of wrong-doing to right. If you want to lose weight you are embarking on a lifelong challenge to get healthy and more importantly stay healthy.

So how can you avoid falling into the “Yo-Yo dieting” trap? I believe it is all about making sustainable changes… Here is my guide on the preparation stages before you attempt weight loss. As Benjamin Franklin said, “By failing to prepare, you are preparing to fail.”

1. Are you ready to change? Embarking on a weight loss mission is a lot harder to achieve if you are running around like a headless chicken, stressed or going through a difficult time emotionally. Try re-evaluating the situation in 6-12 months time.

2. Identify why you want to lose weight, what are your motivations? Try using the method below to weigh up the pros and cons to change – this will help focus your thoughts.

3. Identify specific goals to help improve the overall quality of your diet. These should be tailored to you. Some examples include:

• Only drink alcohol on 3 days of the week
• Have 1 extra portion of fruit or vegetables per day
• Stop finishing off the kids dinners
• Drink a bottle of water whilst sorting the morning emails

Think about how you are going to achieve these goals e.g. take a piece of fruit to work as part of lunch. Keep track of your goals and achievements on the fridge door – if other people know of your goals they can help you out.

4. Be realistic. Only set 3 goals at once to work on. It takes between 2-8 months for a task to become routine (Lally et al., 2009). It doesn’t matter if you mess up every now and again, you’re in it for the long run, so don’t beat yourself up about it. Once the goal you have set has become routine, then pick another to work on, this way you won’t overload yourself. Don’t expect the weight to fall off – with a calorie controlled diet (1500kcal a day) you can expect to lose 1-2lb per week, but this takes dedication and planning.

If you would like specific advice or guidance please do not hesitate to contact me via email: sarah_carr456@hotmail.com where we can arrange a Skype or email consultation to meet your needs.

References

Lally, P., van Jaarsveld, C., Potts, H. and Wardle, J. (2010) How are habits formed: Modelling habit formation in the real world. European Journal of Social Psychology. (40) 998–1009.

Whoops we forgot to mention the alcohol… Christmas Blog #3

With many of us having a busy social calendar over the festive season we may find that our alcohol intake increases. Alcohol is a hidden source of calories with just 1g containing 7 calories (that’s more calories than 1g of protein and carbohydrate!)

 

In addition, spirits are often mixed with sugar containing drinks which adds more calories. Alcohol can also make you hungry (mostly through dehydration) leading you back to that inevitably unhealthy buffet for a second helping.

 

The table below shows some alcoholic drinks, how many calories they contain and what that means in real terms:

DRINK	CALORIES	EQUIVALENT TO
Large glass of wine (13%, 250ml)	228kcal	Cornetto ice cream
Small glass of wine (13%, 175ml)	116kcal	Slice of madeira cake
1 pint of larger (4%)	180kcal	Slice of pizza
1 pint of Cider (4.5%)	210kcal +	Medium bowl of cereal
1 pint of ale or stout (5%)	250kcal	Bagel
25ml measure of spirit (40%)	106kcal	Chocolate mousse
Bottle of alcopop (4%, 275ml)	171kcal	Hot chocolate with whipped cream

 Here are my tips on festive drinking:

• Always use sugar-free or diet mixers and soft drinks. These contain little to no calories.
• Avoid “rounds”. Rounds encourage you to drink more volume and faster – not a good combination… need I say more?!
• Try alternating between alcoholic and non-alcoholic drinks, this not only keeps you hydrated but adds up to less alcohol in total.
• Don’t let people top up your glass before you have finished, that way you can keep track of what you have drunk.
• Make sure you are well hydrated before you arrive at the party, this should help you drink the alcohol slower as it is for enjoyment rather than thirst.
• Set a drinking limit/guide before an event e.g. 3 glasses of wine. Let a friend know and learn to say no once you have reached this. Limits will help you to drink slower and stay in control.

This is the last blog post of 2014 so I’ll see you all in the New Year for some guidance on the “Detoxing”, “Dieting” and “New Year’s Resolutions”.

Christmas Blog #2 “The Main Event”

Christmas dinner may be healthier than you expected. It is those extra snacks and treats which result in excess calories, as written about in last week’s blog. However if you’re trying to watch your calories and fat intake over the festive period, read on to find out how you can trim off a few (hundred) calories from your dinner…

The Turkey: it’s naturally low in fat, lean and high in protein; so enjoy! Most of the turkey fat is found in/under the skin so removing it before eating will make it healthier. Meats such as pork, beef and lamb are naturally higher in fat.

Roast Potatoes: cutting these into larger chunks will mean they absorb less fat (which means fewer calories). Roast the potatoes with an unsaturated fat such as rapeseed oil or sunflower oil. These types of fats are better for your heart and cholesterol levels. Try brushing or spraying oil as you will add less this way, but still get good coverage.

Vegetables: aim to cover 1/3 of your plate in veg. Get the most of them by cooking for a shorter period of time so they retain their vitamins and minerals. Try steaming rather than boiling, this retains all the goodness. Avoid adding salt during cooking as this can contribute to high blood pressure. Instead of coating veg in butter, use sauces such as cranberry sauce or apple sauce to add flavour.

Gravy: Use the meat and vegetable juices to make your gravy. When using meat juice, let the fat to rise to the top then skim off reduce total fat levels.

Stuffing: swapping your stuffing from a meat based stuffing to a fruit based stuffing can save you a whopping 100kcal per portion. For a good recipe try cranberry, orange and chestnut stuffing.

Sauces:  A homemade bread sauce made with semi-skimmed milk is a lot healthier   than a pre-bought luxury sauce from the supermarket. When making your cranberry sauce, add the sugar bit by bit and taste as you go; you may need less that the recipe suggests.

Pigs in blankets: they’re hard to resist so minimise the damage by grilling rather than frying, this way you’ll avoid any un-necessary fat by draining off during the cooking.

Pudding: Christmas pudding is a fairly low fat pudding, jam packed full of nutritious fruit. By adding low fat custard rather than double cream or brandy butter can save you a massive 120kcal per portion.

Above all – enjoy!

Why not wrap up warm and go for a brisk post lunch walk to burn off those excess calories. One hours walking can burn 300kcal, enough to compensate for that extra pig in a blanket you snuck in whilst clearing up.

A Guilt Free Christmas (well nearly!) Part 1 of 3

* * * * * * *  Breakfast  * * * * * * * 

Breakfast is an essential start to the day; often missed over the festive season due to the imminent lunch or a heavy head from the night before. Breakfast kick starts your metabolism and is scientifically proven to make you snack less later on in the day. Why not try these seasonal options:

• Porridge made with low-fat milk and a festive sprinkling of cranberries or cinnamon.
• Smoked salmon on wholegrain toast – it’s a great source of essential fats and the wholegrains will ward off any mid morning temptations towards that tub of chocolates.
• Poached eggs, baked beans, grilled mushrooms and tomatoes on toast – get those “5 a day” in early with this filling and low-fat breakfast.
• Low fat yoghurt with stewed apples and raisins with a pinch of mixed spice.

* * * * * * *  “The Little Extras”  * * * * * * * 

Did you know that, on average people gain between 1-5lb (1-2.5kg) over Christmas? It is easy to over-indulge during this time with lots of tempting treats around. It tends to be those “little extras” that pile on the pounds. So here is how you can help to control your festive snacking:

• Keep chocolates, biscuits and sweets out of sight. Try putting a few in a bowl for everyone to share and then put the tub back in the cupboard. “Out of sight, Out of mind”
• Keep a large bowl of festive fruit to hand e.g. Satsuma’s, dried figs, dates or apricots, apples and pears.
• Try roasting some chestnuts: they are low in fat and a great source of essential vitamins and minerals.
• Other good snacks include unsalted nuts, plain popcorn, pretzels or raw veg and low-fat dips.
• Save items like mince pies and Christmas cake for a dessert rather than an extra to be eaten later on.

NEXT WEEK (16^th December) … we’ll talk about “The Main Event” and how you can make your Christmas dinner slightly healthier this year, with no compromise on taste!

Dementia and the Nutrition Nightmare

There are over 800,000 people with dementia in the UK, so many of us will know someone affected. It may be difficult seeing a loved one affected by dementia and it is often a big cause of family stress and worry.  Dementia can affect someone’s ability to eat and drink dramatically – especially in the latter stages. This blog post will discuss some of the effects dementia can have on eating and drinking and it will give you some tips on what you can do to help at meal times.

There are over 600 types of dementia and they all vary in how they affect people’s ability to carry out daily tasks. Different dementias will also progress at different rates. Some of the most common eating and drinking problems faced in people with dementia are:

• Forgetting to eat or forgetting that they have already eaten
• Not being able to distinguish food from non-food items
• Being distressed, confused or disorientated at meal times
• Loss of senses, appetite and desire to eat and drink
• Difficulties with swallowing and chewing
• Difficulties eating and drinking independently e.g. using a knife and fork
• Refusal of food and drink by not opening the mouth, turning away or spitting out food

The above problems arise because of physical damage caused to different parts of the brain. This damage may cause short-term memory loss, mood, personality or behaviour changes, anxiety, hallucinations or swallowing problems. It is useful to bare this in mind when caring for someone with dementia – try to identify why they might be acting as they are.

Food refusal can be a natural part of the progression of dementia and sometimes there is little you can do to prevent weight loss. However there are plenty of things you can do to help to make their nutrition and hydration as good as possible.

1. Ensure the eating area is well lit (to prevent hallucinations), clutter free, calm and free from distractions
2. Try placing a clock nearby to help with disorientation and eating pattern
3. Use coloured, un-patterned crockery as this helps people to distinguish where the food is and what items are food and non-food
4. Old photographs and music from their favourite decade can help to reduce anxiety and stress, improve mood and improve sense of self
5. Try traditional foods that are seasonal and familiar to the individual
6. If the individual is easily distracted or wanders about – try using finger foods that can be picked up on the go or can be snacked on through the day due to poor appetite
7. Pick high energy foods to help prevent weight loss e.g. meat/fish/eggs in a creamy sauce, mashed potato, full cream milk, milky puddings, sponge and custard, yoghurt, ice cream, pies, extra sauces such as mayonnaise, porridge with extra jam or honey and milky drinks
8. Be patient and if necessary adopt a little and often approach to eating and drinking
9. Try different flavours; tastes and preferences can change
10. Prompt people regularly and provide them with encouragement – people may need prompting to chew their food and then to swallow
11. Make sure teeth/dentures are in good condition and the mouth is kept clean and moist

If you are concerned that your family member/friend/patient/client is not getting enough nutrition or may be having problems with their swallowing you should visit your GP. They may be able to refer you to a dietitian or signpost you to a good support service. Please feel free to contact me for more information or personalised help via the “contact me” page.

Why not become a Dementia Friend at https://www.dementiafriends.org.uk/ to learn more about dementia and what you can do to help.

Carbohydrates – friend or foe?

I can’t count the number of times people have told me that carbs are “the devil”. It’s a common dietary myth which drives me up the wall.

Carbohydrates are the main source of energy for the body – vital for brain and muscle function. Picking the right carbohydrates can leave you feeling satisfied for hours and topped up with all the right vitamins and minerals. Picking the wrong carbohydrates can leave you with a “sugar crash”, feeling hungry within 30 minutes and with a waistline that makes you want to wear black from head to toe.

So how do we know which carbohydrates to choose? There are two main types of carbohydrates:

Simple: these are the more refined carbohydrates which get released quickly into the blood stream. They cause rapid spikes in blood sugar levels, leaving you hungry and craving unhealthy food. Simple carbohydrates are often described as “empty calories” as they contain little/no vitamins, minerals or fibre. These include: table sugar and the sugars used in baked products e.g. cakes, biscuits and chocolate.

Complex: these are the carbohydrates which contain starch/fibre, theyinclude: potato, pasta, bread, rice, breakfast cereals, oats and noodles. These carbohydrates are broken down into sugar slower than the simple carbohydrates, keeping you fuller for longer and preventing big spikes in blood sugar levels.

Why the bad press?

So if carbohydrates are essential, contain lots of vitamins and minerals and keep you feeling satisfied why do they get such a bad press? Why do people claim that they can’t lose weight unless they are on a low carb diet? Why are two of the most popular fad diets; the “Atkins diet” and the “Dukan diet” based on low carb principles? Surely all these people can’t be wrong…

I believe that carbohydrates are misunderstood. They are often over-eaten; so when people go on a ‘low carb diet’ they are simply bringing their carb consumption back to the recommended range. Carbohydrates have fewer calories that protein and fat. However when you add peanut butter to bread, cheese sauce to pasta or fry rice in oil, you add calories making the carbs appear fattening.

How to be friends with carbohydrates:

1) Try swapping to wholegrain versions of bread and pasta. These are low “GI” (Glycaemic Index) which means they release their energy slowly, keeping you fuller for longer.

2) Avoid adding creamy/cheesy sauces, oil or butter to your carbohydrates.

3) Use packets to help guide your portion sizes. Put the pan on the scales and pour in the correct amount of carbohydrate (this often looks like a small amount until it has been cooked – so trust the scales!). Healthy portion sizes are as follows:

• 75g of raw pasta/rice/noodles
• 2 slices of bread
• 3-4 egg sized potatoes or 1 baking potato
• 50g oats
• 30-40g of breakfast cereal

4) Try to only have 1 portion of carbohydrate per meal e.g. avoid having bread with pasta or naan with rice – go 50:50 if you want to try both but don’t have a whole portion of each.

5) Avoid snacking on the simple sugar foods, these often leave you with cravings. Instead try snacking on nuts, fruit or vegetable sticks for a healthier, more filling option with fewer calories.

6) Avoid drinks which contain simple sugars e.g. fizzy drinks, mixers, squashes and fruit juices. Opt for low-calorie/no-added-sugar varieties.

Use these simple swaps to reduce your cravings and snacking, bring your weight in check and improve your whole dietary balance.

Have we got the balance all wrong?

Ken Hom (Chinese Chef, author and tv presenter) brought this key questions into a new light for me at the weekend…

In Saturday 8th’s episode of the BBC documentary ‘Exploring China: A culinary adventure’ Ken Hom said that in China…“Meat is to garnish the veg’s. In the west; veg’s are a second thought; you have a big piece of meat and the veg’s come second.”  He believed that the west could learn a trick or two from eastern dietary practices.

In the UK we eat three times the amount of chicken per person than that in China. The National Diet and Nutrition Survey consistently shows that in the UK we exceed our protein intake – with meat being the main source of protein.

It is well known that meat is a good source of essential amino acids that are involved in thousands of important reactions in the body; it is also an excellent source of vitamins and minerals. However we also know that meat, especially red meat is high in fat, contributing to excess calories and obesity, and associated with an increased risk of certain cancers including colon cancer.

Confused by all the media coverage on meat? You are not alone…

Here are a few tips to help guide your shopping and eating habits, ensuring you achieve the right balance:

• Opt for lean or leaner versions of meat in the supermarket e.g. 5% fat minced beef. White meat e.g. chicken or turkey is naturally lower in fat.
• Cut off any visible fat from the meat and avoid frying or adding extra oil for cooking.
• Try halving the amount of meat and substituting it with beans or lentils. Going 50/50 on minced beef and lentils will significantly reduce the amount of fat and calories and provide a good source of fibre.
• To achieve the right balance, make your plate up to follow these proportions:

1/3 vegetables or salad        1/3 meat or fish        1/3 starchy carbohydrate (e.g. potato, pasta, rice)

If you’re trying to lose weight change these proportions to:

1/2 vegetables or salad        1/4 meat or fish        1/4 starchy carbohydrate (e.g. potato, pasta, rice)

• If you are feeling adventurous try going meat free for 1-2 days per week, it’s good for meat-sustainability and for your health! Check out websites like BBC GoodFood for ideas or try books like Hugh Fearnley-Whittingstall’s ‘River Cottage Veg Every Day’ for delicious recipes.

If you would like more information about meat, how much you should be eating, what types, recipe or shopping ideas please do not hesitate to contact me and we can arrange a skype or email exchange. I am a registered dietitian with the HCPC (http://www.hcpc-uk.org.uk/) and practice in an NHS hospital.

Look out for next weeks blog now we are up and running…