New challenges, new opportunities

I’ve been a little quiet of late.

I’ve had to step away from The Food Whisperer a little bit as other aspects of life have taken over. My blog has suffered, but I’m pleased to say that we’re continuing to grow through social media. There’s a nice community building up on Facebook in the Food Whisperer Nutrition Hub, with lots of lovely people sharing recipes, talking nutrition and health, and asking questions – I’m always around to take part in the discussions!  

Whilst I’ve not been able to devote as much time to the Food Whisperer as I’d have liked, it has been for a good reason! First up, I changed jobs. This then necessitated a house move which, I’m glad to say, is now complete! In the sense that my husband and I are in the new house – we’re still surrounded by boxes J

The change in the day job has been a fantastic experience. I now specialise in weight management, an area of dietetics I am extremely passionate about.

I work with people whose BMI (body mass index) ranges from 35kg/m² up to and exceeding 100kg/m². Some of my patients will go on to have bariatric (weight loss) surgery. All of my patients – whether going forwards with surgery or not – will work hard at making positive lifestyle and dietary changes.

Patients come in despondent, hopeless, talking about themselves with disgust and despair. “Useless, rubbish, a failure…” I wonder how anyone can hope to muster the strength and determination to make sustainable, meaningful changes to an integral part of life when they have such low self-esteem and no self-belief.

Weight loss is hard-work. It takes years for the weight to come on, and it's hard to be realistic that it will take time - sometimes a lot of time - to lose it. And if it were as simple as eating less and moving more, then two-thirds of UK adults wouldn’t be overweight/obese. No one chooses to have a BMI of 60kg/m2. No one aspires to needing weight loss surgery. It’s a situation that most people sleep-walk into, and then struggle know how to change.

Much of the work I do is to help people to understand what has brought them to where they are now, and to identify the emotional and habitual aspects of their eating which – typically – are at the core of their weight gain. Eating is a behaviour, and not always one that we are consciously in control of. There is much, much more to weight than simply choosing the ‘wrong’ foods and being lazy. And this widely held, superficial ‘understanding’ is often part of the problem – if it sounds so simple, and yet is so hard to achieve, then how can a person value themselves and belief they are worth the effort to change?

I am in awe of the determination and hard-work that goes in to achieving the total life transformations that I have had the privilege of seeing and supporting, and over the next few weeks and months I’m hoping to write a series of posts about weight loss, bariatric surgery and explore the thoughts and behaviours that influence our food choices and eating behaviours.

If you have anything you’d like to me write about, please leave a comment below and/or come by the group or page on Facebook.

All the best,

Sarah

Adventures in Flapjackery - Part 1

Flapjacks.

Cheap, easy to make, versatile and (potentially) nutritious, flapjacks are often a go-to snack of choice, particularly for those engaging in sports.

They have the illusion of being a healthy treat - based on oats, it's easy to liken them to a bowl of porridge.
A traditional recipe for flapjacks, however, is loaded with added sugar and fat, and what seems to be a small snack can easily contribute significantly to your daily intake of calories and macronutrients.

Oats are an excellent source of slow-release carbohydrates, being low on the glycaemic index. They are also a useful source of protein and contain a form of soluble fibre that has been demonstrated to lower 'bad' LDL cholesterol.

So all in all, oats are good.

Back to flapjacks though, the added sugar and butter detract somewhat from the virtues of the oats. Whilst I very much hold the view that there is a place for everything in the diet (just so long as it's edible!) and moderation is key, I also enjoy a little bit of experimentation in the kitchen. A little bit of tweaking, some alternate ingredients, and flapjacks can be re-invented in a much more healthy fashion. And if you can make something healthier, then why not?

And to that end, I present some flapjack recipes.

The Recovery Flapjack

Containing a carbohydrate/protein ratio of 2 to 1, these flapjacks are ideal for a post-workout snack. The carbohydrates will replenish depleted glycogen stores, whilst the protein content will assist with muscle repair and synthesis.

They contain no added fats (the fat content comes from the peanut butter), and are much lower in added sugars than traditional flapjacks, as much of the sweetness comes from added fruit.

Allergy information:
This recipe contains peanuts, so is not suitable for nut allergy sufferers.
Use gluten-free oats to make them safe for coeliacs. 
Contains no egg or dairy.

Ingredients

175g crunchy peanut butter
5 tbsp golden syrup/honey
200g porridge oats
1 ripe banana, mashed
75g raisins

Method

1. Grease and line a 20cm square baking pan. Preheat the oven to 180C/Gas 4.
2. Place peanut butter and golden syrup/honey in a saucepan, and heat until melted.
3. Add the remaining ingredients and stir until combined.
4. Press into the prepared pan, and bake for 20-25 minutes (ovens will vary).
5. Leave to cool in the pan for 10 minutes before cutting into 12-16 pieces, depending on desired size.

Pizza Flapjack

A savoury option, because flapjacks don't have to be sweet.

It's a common complaint from people who take part in endurance sports - pretty much all of the shop-bought nutrition products are sweet. Gels, drinks, and bars tend to be based around glucose and are typically flavoured with chocolate, fruits or vanilla. Fair enough, but the sweetness can become cloying. For this reason people turn to alternate strategies, often opting for things like Marmite sandwiches or pork pies. This recipe is inspired by the good ol' pizza. In flapjack format.

This recipe is only marginally higher in fat than traditional flapjacks, but it is still worth bearing in mind that fats can cause gastric discomfort in susceptible people. Try in training and not for the first time on race day, if using as part of a fuelling strategy.

The carbohydrate/protein content is again a 2 to 1 ratio, so useful for recovery as well as general fuelling.
Nutritionally, the tomato puree, grated carrot and courgette provide useful vitamins, whilst the cheese content provides both protein and calcium.

Other vegetables - sweet potatoes, butternut squash, pumpkin, parsnip, etc. can be used as substitutes for the carrot or courgette if liked.

Allergy information:
Contains dairy and egg.
Can be made with gluten free oats. 
Contains no nuts. 

Ingredients

250g porridge oats
150g cheese
1 egg, beaten
1 carrot, grated
1 courgette, grated
50g butter
1 tbsp tomato puree
1 tsp mixed Italian herbs


Method


1. Grease and line a 20cm square baking pan. Preheat the oven to 180C/Gas 4.
2. Place butter, tomato puree, herbs and grated vegetables in a saucepan, and heat until melted.
3. Remove from the heat, and add the remaining ingredients - stir until combined.
4. Press into the prepared pan, and bake for 20-25 minutes (ovens will vary).
5. Leave to cool in the pan for 10 minutes before cutting into 12-16 pieces, depending on desired size.

Warning! Tastebuds will vary - but as far as I'm concerned, these are delicious!

Part 2 coming soon!

Bacon or death?

Processed meat linked to early death! 

Processed meat is a killer! 

Scary sausages? Suicide salami? Death by bacon? I can imagine worse ways to go. But then, I'm very easily seduced by a bacon sandwich. I jest, of course.

It's universally accepted that what we eat has an effect on our health, and the results of a study appearing in the news today have highlighted the risks associated with eating processed meat, which includes bacon, sausages, ham and other such meaty delights.

The research has spawned headlines proclaiming the dangers of eating processed meat, with findings indicating that people who consume more than 20g of processed meat per day have an increased risk of premature death from all causes, with particular risk for cardiovascular disease and cancer.

The study, involving 448,568 people from ten European countries, forms part of the European Prospective Investigation into Cancer and Nutrition (the EPIC study). The results published today look specifically at meat consumption and a preview draft can be found here.

What the results say:

• Eating 160g or more of processed meat each day increases your risk by 44% of dying, from any cause, when compared to people who eat 20g or less. 
• The risk of cardiovascular disease and cancer are raised more than other causes of death. 
• People who eat a lot of processed meats are also more likely to have other less healthy behaviours - smoking, high alcohol consumption, and low fruit and vegetable intake.
• Even when these other behaviours are taken into account, processed meat consumption was shown to increase risk of premature death. 

So how much meat are we talking about?

20g is a small portion - one small rasher of bacon, 1/5 of a McDonald's burger, two wafer thin slices of ham or a snack-sized Pepperami.

160g is a more robust portion - 2-3 sausages, half a can of Spam, four frankfurters, etc.

If you're a dedicated carnivore, it's easy for the total consumption of processed meats to add up over the course of a day or week. Bacon sandwiches for breakfast, ham rolls for lunch, sausage and mash for dinner - you can easily go over and above the 160g amount associated with significantly increased risk.

The current recommendation from the Department of Health is that we eat no more than 70g of red or processed meat per day. It is worth differentiating between the two of these, as they are most definitely not same thing.

What exactly is processed meat?

At the risk of stating the obvious, it's meat that has been subjected to some form of processing. This includes salting, curing, smoking and other process that preserve the meat, typically involving the addition of chemical preservatives.

Processed meat tends to be higher in fat than a cut of fresh meat, and also has additives such as nitrites, nitrates and salt, which in themselves can have a detrimental effect on health.

Mincing meat is not, in itself, sufficient for it to be considered as processed. Some additional preserving process is required, for example, adding preservatives, salt, etc.

And red meat?

The term red meat is used to describe meat that is (wait for it!) red when raw. Some people quibble over pork, but it is indeed classified as a red meat.

Red meat is nutritious. It's an excellent source of protein, vitamins and minerals, particularly zinc and iron and vitamin B12. Opt for lean cuts and low-fat cooking methods and there's no reason not to include it in your diet.

This study also looked at the consumption of white meat, which includes poultry and rabbit. No effect on mortality was identified.

Red meat may be processed, but not all processed meat is red. It is worth noting that any meat can be processed: a chicken nugget, for example, is most definitely a processed (white) meat.

The processed meat in this study however, was primarily processed red meat. Small amounts of processed white meats were included, but most consisted of processed beef, pork and lamb (and to a lesser extent, goat and horse. Probably more horse than was first thought...).

So what can we learn from this study?

Red and processed meats have, for some years, been associated with an increased risk of cancer development, particularly bowel cancer. The findings associating processed meat with cardiovascular disease is new.

How significant is this risk? Well the authors have stated that 3% of deaths within the participants of the study could have been prevented - that's 869 preventable deaths. If you extend that percentage to deaths in the UK (from all causes), then there's the potential for in the region of 15,000 deaths being prevented each year.

Processed meats tend to offer no nutritional benefit over meats in their natural form. Choose lean cuts of fresh/frozen red or white meat (check for additives and veer toward white meat more than red) and eat it in moderation, and you should have nothing to worry about.

If you do want to eat processed meats, do so. But accept that there is some risk involved, as there is with many things in life. A bacon sandwich is certainly enjoyable, but is it really worth a slightly hastened death?

Hence the (ever so slightly hyperbolic) title of this post - bacon or death? The choice is yours.

So hungry I could eat a... horse?

Horse meat. 

There's been a lot of talk about it in the media of late, and for good reason - horse meat has somehow found its way into processed meat products, and people have been unknowingly been eating it for months. 

In the general furore that's sprung forth from the discovery of horse meat in the food chain, there's something that's not particularly been touched on: all moral and cultural objections aside, is horse meat any good for you?

Horse meat is eaten in numerous countries throughout the world, being considered a delicacy on various European and Asian dinner tables. 

Horse is classified as a red meat, the same category to which pork and beef belong. For the purposes of comparison to meats we're more familiar with, let's look at the nutritional composition of horse vs. both beef and pork. 

Per 100g raw product, various cuts

Horse meat contains similar levels of protein to both beef and pork, and is considerably lower in both total and saturated fats.

For people watching their fat intake for the purposes of weight maintenance/weight loss, for concern over cardiovascular disease, or for any other reason, a lean meat such as horse actually makes a healthy choice. 

Horse meat contains significantly higher levels of iron than either beef (nearly double) or pork (nearly five times as much). Iron deficiency is a common problem, particularly in women of child-bearing age, and can lead to iron deficiency anaemia. Sufferers of which are troubled by symptoms of tiredness, fatigue, breathlessness and pallor (pale complexion). Sufficient dietary intake of iron can be difficult to achieve, and people are advised to eat foods rich in iron to ensure they meet their requirements. Horse clearly tops the table with the three red meats considered here, but other options include offal, fortified breakfast cereals (check the nutrition label!) and dark green leafy vegetables. 

Athletes are often recommended to eat high quality sources of protein, minimise excess fat (being active doesn't completely guard against all diet-related diseases!), and have adequate nutrients to support their bodies in coping with the demands their training places on it. Iron deficiency can be debilitating to an athlete, so it is essential that they consume sufficient iron to prevent he onset of a deficiency. Horse meat - high in protein and iron, and low in fat, fits quite nicely into this description. Something to think about. 

Looking beyond nutrition, there has been a well publicised concern over unregulated meat in our food - the issue of drug contamination.

Bute (also known as phenylbutazone) is a painkiller. It belongs to the family of drugs known as non steroidal anti-inflammatories (NSAIDs, he same group as ibuprofen). It is commonly used in horses and dogs, for the purposes of treating pain and reducing fevers. It was once commonly used in humans, and remains a prescribable drug for human use. It is not frequently used however due to serious side effects - the drug is known to cause damage to the blood, and can lead to bone marrow failure. Whilst rare, this serious side effect was enough for the drug to be withdrawn from common use - it is now only prescribed under close supervision and where all other options have failed. 

So clearly there is cause for concern if bute has contaminated the human food chain. 

But - and it's quite a big but - based on the results of testing carried out by the Foods Standards Agency, you would have to eat a rather large quantity of horse meat in order to consume the lowest known dose to cause an adverse reaction in a human. 

These are the figures:

The lowest known dose of bute to cause an adverse reaction in a human is 200mg of phenylbutazone, administered as a single dose. 

Of the sources tested thus far, the highest level of bute found in a horse carcass is 1.9mg per kg of weight. 

Taking the lowest dose - 200mg - as a baseline, you'd have to consumed 105kg of horse meat to take in 200mg of bute. 

And that would be an awful lot of burgers. About 920 quarter pounders in fact. 

So is eating horse meat something to be worried about?

From a nutritional point of view, no. Horse meat is lean, high in protein and provides a useful source of iron and calcium.

From a pharmaceutically contaminated point of view, perhaps. But where bute is concerned, probably not. 

As for ethically and morally... well, the choice is yours. 

Fasting, part 3 - Sustainability

Fasting - From Now Until..?

I've done a fair bit of reading about fasting diets. Both from research literature, popular texts (there are a few in the bookshops at the moment!), and also online. 

Lots of people have things to say about fasting, and it tends to take one of two forms. Fasting is either the best thing since sliced bread - take that Atkins! Or it's yet another example of a terrible fad diet, with claims that it can cause anything from bad breath to disordered eating. 

But there's something that, in general, is missing from all of these commentaries. And that's the focus of this post. 

In my first post on the topic, I hope I gave you a reasoned explanation of what the diet is and how it works. But there is one more thing I'd like you to consider before embarking on this, or indeed any other 'diet'. 

My question is this - how sustainable is intermittent fasting/calorie restriction? Can you honestly say that it's something you can keep up for life? Or, in fact, do you need to?

If you undertake a fasting diet as a means of weight loss, what happens once you've lost the desired amount of weight?

At the moment, there is a distinct lack of evidence on how these diets work in the long-term. Particularly so with regard to human studies. So anything you read about long-term sustainability and maintenance of weight loss is likely to be based on speculation.

And sustainability and maintenance of your new weight are rather important.

As with all diets, there is a fundamental issue that rears its ugly head: here’s the scenario – it may well be familiar.

You follow the plan, you obey the rules and lose the weight. Congratulations! But now what? You can stop following the diet, right? Go back to eating ‘normal’ food, every day?

And watch the weight pile back on.

This problem is common to an awful lot of diets. People in general are quite good at losing weight, but not so accomplished at keeping it off. This isn’t an issue specific to fasting diets, indeed we’ve already recognised a lack of long-term studies. But there’s a fairly logical thought progression that says fasting diets, as with other diet plans, if discontinued, will cease to be effective.

So how can you maintain the lost weight?

At the risk of sounding rather dull - it comes back to the fundamental concept that you need to eat a healthy, balanced diet.

The Eatwell Plate

That’s not to say don’t follow a diet, by all means, try it if you will and if it’s safe for you to do so. But learn from it.

Fasting diets can teach you several things.

Firstly, hunger is a natural sensation – it lets us know when we are actually in need of food. There’s nothing wrong with feeling hungry now and again. Embrace it, and learn to listen to the cues from your body.  

Secondly – and perhaps most importantly – the fasting days might put portion sizes into perspective. Portion sizes, more often than not, are the culprit in weight gain. Eating anything in excess, including fruit and vegetables, can lead to weight gain. By fasting you may come to realise that you don’t need to eat quite as much as you think you do, or are accustomed to.

Thirdly, be mindful when you are eating. It’s very easy to pop things into your mouth without thinking about it, or eat whilst distracted. And mindless eating is a guaranteed way of exceeding your energy requirements, thus leading to weight gain. Fasting days demand attention to your diet if you are to stay within your strict calorie allowance. If you are able to apply that same mindfulness to your eating behaviour in general, you are more likely to remain in control of your diet and with it, your weight.

Fats: the good, the bad and the ugly

Let’s face, fat has had a lot of bad press. We associated it with obesity and heart disease, and reducing fat in the diet has long been the standard advice for improving health. But does fat really deserve all of the blame that is attributed to it?

Not all fats are created equal - some are good, some bad and others, quite frankly, ugly. In terms of energy content, fat is fat. At 9 kcal per gram, it doesn't matter whether you eat butter, lard or olive oil - they all contain the same amount of calories. But energy content aside, the different fats have variable qualities and variable effects on the body - some are good for you, others not so good. 

Fat plays several essential roles in the body, from insulating us against the cold to regulating our hormone levels, we simply can’t maintain a healthy, functional body without fat. Fat is an essential fuel source for the working body, and whether you’re a first class athlete or sat on your bum all day, this is a simple fact – your body NEEDS fat.

But not too much. 

Balance and moderation, as always, are key. There are dangers associated both with having too much, or too little fat.

Too much fat:

• High fat diets are associated with excess body weight, an increased risk of cardiovascular disease, stroke and several cancers.
• An excess intake of fat can displace other nutrients – if we eat a high fat diet, we may find that our intake of carbohydrates and/or proteins drops. 
• When carbohydrate intake falls, our stores of glycogen are compromised. For athletes this can have serious consequences on training and competition. 
• Triglycerides (the smaller units that make up fats) are stored in the muscles, and are an important fuel source for sporting performance.

Too little fat:

• Fat is a good source of energy (9 kcal per gram), and a low intake can result in inadequate energy consumption. Fats are an important source of vitamins K, A, D and E. Eating a low fat diet can limit our intake of these essential nutrients.
• Low fat intake reduces the storage of triglycerides in the muscles, and so compromises this important fuel source.
• Fat is important in regulating several hormones, and a low fat diet can result in an altered menstrual cycle and can also effect fertility.

Current recommendations

<35% of total energy should come from fat.

For a 2000 kcal diet, this is 700 kcal/ 78g of fat

For a 2500 kcal diet, this is 875 kcal/ 97g of fat.

Saturated and trans fats should be kept to a minimum.

The good...

Some fats are essential - the clue is in the name: Essential Fatty Acids (EFAs). These cannot be synthesised in the body, so it's vital that they are eaten as part of the diet. EFAs are found in unsaturated fats - a family of fats that can be split further into mono- and polyunsaturated fatty acids (MUFAs and PUFAs). Both have the potential to lower 'bad' LDL (low density lipoprotein) cholesterol, whilst also raising levels of 'good' HDL (high density lipoprotein) cholesterol. 

MUFAs are found in oily fish, olive oil and spreads based on olive oil, nuts (including almonds, cashews, peanuts, pecans and pine nuts), sesame seeds and tahini, and avocados. 

PUFAs (which include Omega-3 and -6 EFAs) are found in oily fish (including salmon, mackerel, and sardines), oils based on vegetables and seeds (vegetable, sunflower, sesame and soy bean oil), and nuts and seeds. 


The bad...

Saturated fats are commonly referred to as 'bad fats'. They are solid at room temperature and found in animal products, including meat, milk (full fat), cheese and butter, as well as products that include these as ingredients. Saturated fats can also be found in some vegetable-based products, including coconut oil/milk/cream and palm oil. 

A high intake of saturated fats increases levels of LDL cholesterol in the blood, and is linked with increased risk of cardiovascular disease. 

The ugly... 

Trans and hydrogenated fats have a double whammy of effect, increasing both total and LDL cholesterol and lowering the good HDL cholesterol, thereby putting you at greater risk of heart disease. 

Some trans fats occur naturally in foods in very small amounts, and these include red meats (beef, lamb, veal) and in full fat dairy products. Most trans fats are found in artificial sources, such as those used in the manufacture of cakes, biscuits, pastries, and pies. 

Trans fats have no known benefit to health, and should ideally be avoided.

“But eating fat makes you fat, doesn't it?”

Actually, no. It is an excess of total energy that leads to weight gain – eating more than you use. In terms of weight gain, it doesn’t matter where these calories come from – fat, vegetables, carbs, protein… if it’s more energy than you need or use, your weight will increase.The main reason that people associate fat with weight gain is that fat is energy dense – it contains 9 kcal per gram, the highest energy content of the macronutrients (carbohydrates, proteins and fats). So it can be easy to over consume calories without an obvious increase in the amount of food you’re eating. It's hard to deny that it can play a role in gaining weight, but if accounted for within a healthy, balanced diet, there’s no reason to blame weight gain purely on eating fat.

So what's the take home message?


Enjoy the fat that you include in your diet!

•       It can taste nice – who doesn’t like a piece of hot buttered toast?
•       It’s enjoyable – see above! Hot buttered toast!
•       It adds variety to the diet – avoiding all sources of fat severely reduces our options when   

        choosing what we eat.
•       Fat contains essential vitamins and is a good source of energy.

But…

•       Moderation is key – stick to the guidelines on how much fat you eat, and account for it in 

        your daily intake to avoid weight gain.
•       If you’re trying to lose weight, reducing high fat foods can save you lots of calories.
•       Avoid saturated, trans and hydrogenated fats – they don’t confer any health benefits and 

        increase your risk of cardiovascular disease, stroke and several cancers. 

So that’s it. Fat shouldn’t be the pariah of the nutrient world – it can be good, it can be bad. But much of that depends on you and what you do with it…

Introducing The Food Whisperer...

It’s difficult to go anywhere without finding yourself surrounded by food options, cleverly marketed and often making all manner of health claims. And with information about diet and nutrition frequently in the news, it’s not surprising that it can be difficult to make sense of contradictory headlines, to pick through the advertising and to know what the truly healthy options are.



Everyone knows that diet and health are connected, with weight being the most obvious factor affected by what we eat. But did you know that your risk of type 2 diabetes, heart disease, certain cancers, stroke and osteoporosis are strongly influence by your diet? And that diet has a role to play in eye function, blood formation, mental health, healthy ageing, conception and achieving a healthy pregnancy?

It will probably come as no surprise that diet-related health problems are on the rise. More than a quarter of adults (26%) are classified as obese (having a body mass index (BMI) of 30kg/m2) in the UK, and rates of type 2 diabetes, heart disease and stroke are increasing too.



The good news is that in most cases all it takes to reduce your risk and protect yourself against these conditions it to make a few lifestyle changes, and The Food Whisperer is there to help you take those steps towards a long and healthy life.



The Food Whisperer takes a personalised approach, working with you, your likes and dislikes, and your lifestyle to find a way of helping you to achieve your goals. All advice given will be based on the highest standard of scientific evidence, whether you want a pro-active approach to dealing with a current concern or hints and tips to avoid future health problems.



In addition to general health and treating medical complaints, The Food Whisperer can also advise on all aspects of sports nutrition. Whatever your challenge, whether you’re aiming to complete your first half marathon, sculpt muscle or tackle an endurance challenge such as a marathon or an Ironman distance triathlon, knowing how to apply the science of nutrition to your training plan can enhance your performance, aid recovery and help you to achieve your best.

​

The Food Whisperer doesn’t advocate restrictive diets, promote the latest celebrity fad or ban foods. There’s nothing wrong with the occasional piece of cake or drink with friends! Instead the focus is on a balanced approach to eating and enjoying food.

Find The Food Whisperer on www.thefoodwhisperer.co.uk