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Overindulged over Christmas? Then read on…


Question: After overindulging, how can I cut back without feeling I am wearing a hair shirt!

If you have overindulged, you are not alone. And you are also not alone in starting the year wanting to get back on track. However, a lot of people give up and often it’s because they try to do too much at once which can feel like torture. One way to see it through is to get a plan…

Breakfast
Start the day with something filling that will keep you going and won’t leave you feeling deprived. For some a bowl of porridge is the ultimate comfort food. Made with skimmed milk and with a handful of raisins or prunes thrown in for sweetness. For others, this is nothing but a punishment! For those who love it, you carry on. This is a great breakfast and will do you no end of good.

If however you would have to force down porridge, then fear not there are other great breakfasts that are not too calorific and will do a good job at keeping you full. A couple of boiled eggs and a slice of granary toast (easy on the butter) is often a breakfast reserved for lazy weekend brunch, but try making time for it before work. Eggs are full of protein and important vitamins and minerals, plus evidence shows that people who eat two eggs for breakfast eat fewer calories throughout the day.

If you don’t think either of these will work for you, stick to high-fibre cereals such as bran flakes, shredded wheat, Weetabix or fruit & fibre. Top with skimmed or semi-skimmed milk and add some sliced or dried fruit. If toast is your thing, have a scraping of spread and have a topping such as marmite or a little peanut butter.

Lunch
Lunch can be a killer if you have to buy it work every day. A simple cheese and onion sandwich can contain up to 600kcals depending where you get it. From a supermarket you can check the labels but if you go to a café or restaurant you are at their mercy. Soup is a great lunch. It’s filling, comes in hundreds of flavours, is readily available in supermarkets and can fit nicely into your calorie budget. Beware of the cream-of versions though. If possible buy your soup from somewhere that lets you know what is in it and how many calories it contains. It’s super easy to make a big batch at home and freeze in portions to take into work to heat in the microwave, and there are literally a million recipes to be found online.

If soup doesn’t hit your comfort spot though you could try sushi; filling whole-grain salads such as couscous, barley, quinoa or bean; pitta pockets with low calorie fillings like tuna or salad (easy on the mayo and dressings).

Evening meal
It’s easy to get into bad habits over Christmas and New Year like drinking every day and eating your way through the left over chocolate. Try and have a couple of days off the sauce each week, preferably consecutive days. If you have been drinking over the festive season, the chances are your liver has a back-log to get through and if you don’t give it time to clear it, the alcohol can cause scarring i.e. cirrhosis.

In terms of eating, planning ahead is the best way to make sure you have easy, healthy options for dinner and don’t reach for the takeaway menu. Plan what you’re going to eat on each day before you go to the supermarket. Go for things that are filling but not too calorific: chicken, fish, lean meat, beans, lentils, pulses, vegetables, rice, pasta and potatoes. Try to stay away from full-fat creamy or cheesy sauces and go for tomato based ones instead. If you’re buying ready-made, check the labels to see which are best. If you cook from scratch, limit the oil or fat to one teaspoon per person for the whole meal (whatever the recipe says!). If you’re a pudding person, try looking for the lower-calorie options. Instead of ice-cream, try frozen yogurt or sorbet; fruit salad; meringue and berries; baked apple; low-calorie chocolate mousse. Instead of cream try half-fat crème fraiche or fat free Greek yogurt.

Between meals
For snacks throughout the day, try to limit them to about 100 kcals such as a muesli bar, a pot of low-calorie yogurt, a piece of fruit, a portion of light cheese and a couple of oat biscuits, a small bag of baked crisps.

To figure out roughly how many calories you need to keep your weight the same, there is a nifty calculator on the Dudley NHS website: Calorie requirement calculator
But remember, if you want to lose any weight you have gained over Christmas, you’ll need to take off a few hundred calories from your calorie requirements, but don’t go below 1200kcals a day without the supervision of a specialist. Also remember that slow & steady wins the race: gradual weight loss is more sustainable than rapid.

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Diet & Arthritis


Question from Jenny Watts:

I have problems with arthritis and suffer in cold damp weather, what could I eat to help ?

Arthritis is a condition that causes inflammation of the joints so make sure you are getting enough fish oils (omega 3s) which are anti-inflammatory. You should be having about two portions of oily fish per week such as sardines, mackerel, fresh tuna, salmon, herrings.

Additionally cutting down on saturated fats (mainly found in animal products such as meat & full-fat dairy) may help the pain as these fats can add to the inflammation. Cutting down on saturated fat is also good for another reason: sufferers of arthritis are at increased risk of other inflammatory conditions such as heart disease, and cutting down on saturated fats can lower your cholesterol, reducing your risk of developing cardiovascular problems.

Eating a ‘Mediterranean Style’ diet has been shown to benefit people with rheumatoid arthritis, particularly lessening stiffness in the joints in the morning. This style diet means eating about 6 portions of fruit & veg every day; include nuts and seeds; choose fish rather than meat; eat plenty of wholegrain foods such as wholemeal bread & pasta and brown rice; and use oils such as olive oil rather than butter.

Getting enough calcium is also important so make sure you have plenty of low-fat dairy dairy in your diet and taking a vitamin D supplement will help your body absorb the calcium. There is also some evidence that vitamin D works as an anti-inflammatory – so a double-whammy!

Also, making sure you are the right weight for your height will mean that your joints won’t be under any unnecessary pressure – particularly important if you get pain in your hips, knees and ankles.

You could also try moving somewhere hot & dry!

I hope this helps,

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Vegetarian sources of iron for your baby


Unlike the thing that stands in the laundry room next to a huge stack of washing, the iron in your blood is your friend! Iron carries oxygen around the body to the brain and other organs. Mums supply their babies with a good store of iron when pregnant, but this will start to run low at around six months old. It is important to give your baby iron-containing foods from this age so their body and brain can get on with growing into a walking, talking, little person. Your baby will need about 8mg of iron each day from when they are seven months up to a year old.

Types of Iron
There are two types of iron that come from food. Both do the same job but the way they find their way into the blood is slightly different:
The first is called haem iron and this comes from animal sources like meat and fish and eggs. This type of iron gets separated from food and is absorbed directly so can be put straight to work;
Non-haem iron comes from non-animal sources such as fruit, vegetables, legumes and pulses. This type of iron needs some odds and ends doing to it before it can be put to good use, which means it a little less efficient than it’s cousin.

Food sources
The best vegetable sources of iron are beans and pulses like lentils (6mg per 50g) and the best fruits, are dried ones such as dried apricots (3mg per 50g). Dark-green leafy vegetables are all generally pretty good too like spinach as well as kale and broccoli. Cooked spinach has just under 1mg for every 50g.

Maximize the Benefits
Another thing to know about veggies is that they tend to have a lot less iron than animal sources but never fear, there are one or two tricks to keep up your sleeve to get maximum benefit.

Some foods interfere with the absorption of iron. Phytates are found in whole grains and their products such as wholemeal bread, brown rice, nuts and seeds. Now there’s nothing wrong with these healthy and tasty tidbits and they are a great addition to your little one’s dinner plate, but to make sure she’s getting enough iron, give them at different times to iron-foods most of the time.

Calcium containing foods such as milk and cheese are also a bit pesky when it comes to iron absorption. So again, if you are worried your child might not be getting enough iron, give these foods at different mealtimes. Tea is another one so it is best to avoid giving this as a drink.
You can help baby absorb non-haem iron by giving them foods that contain vitamin C alongside. Bell peppers, tomatoes, citrus fruit (or orange juice diluted 1:10 with water) are all perfect for this job.

References
The Composition of Foods; McCance & Widdowson
Advanced Nutrition and Human Metabolism 5th Ed; Wadsworth
British Nutrition Foundation: feeding your baby

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Gift Vouchers

Buy a nutrition gift voucher

By popular demand, you can now (finally!) buy London Nutritionist gift vouchers which are particularly good – as pointed out more than 30 times by Maddie – for mums-to-be to use for the workhops. Thank you Maddie! Choose your amount from the drop-down menu below. This feature is now at the bottom of each page below the twitter feed.

Vouchers will be emailed to you for you to print out and give to the intended recipient.






Questions & answers

Eggs are good for you!


Thanks for the tweet @HangingModifier. Please find the answer below!

“@LDNnutritionist Glad to see you recommend eggs. There was a story about eggs being as bad as smoking. Junk science and/or junk journalism?”

Eggs have been in and out of favour and plagued by controversy over the last few decades. A recent article in the Daily Mail insinuated that eggs may be two thirds as bad as smoking if you are at risk of heart disease. This came from a single study that was not conclusive and not appropriate for extrapolation to the entire population in any way.

Much of the controversy about eggs is down to the level of cholesterol in their yolks. A high blood-cholesterol level is a risk factor for cardiovascular disease (among many others such as age, sex, smoking, lack of exercise etc.) but this is not the same as a high cholesterol consumption. Consumption of cholesterol has less effect on blood cholesterol than total fat intake. Additionally, owing to changes in chicken feed in the UK, eggs are lower in cholesterol these days than they used to be.

So eggs are lower in cholesterol, fat, saturated fat and calories than in the 1980s and, because of their amino-acid profile, they are one of the best sources of protein for a human. They are one of the few foods to naturally contain vitamin D and they provide folate, iodine and several antioxidants. They also contain selenium, a nutrient that is limited in plant foods by the levels in the soil they grow in. It is therefore difficult to predict the content of selenium in many foods.

Because high-protein foods promote satiety, people who eat eggs for breakfast have been shown to consume fewer calories throughout the day which is helpful if you are trying to watch your weight (adding butter and cream to scrambled versions notwithstanding).

What’s bad about eggs? Almost nothing really. And, unless you have quite a rare form of high cholesterol (familial hypercholesterolaemia – check with your doctor), there is no reason to limit your egg intake at all: fill your cups.

So in answer to your question: junk journalism. The Daily Mail (apologies in advance for this) has eggsaggerated the study and over-egged the pudding.

References

NHS Choices Health News; Eating egg yolks as ‘bad as smoking’. available at: http://www.nhs.uk/news/2012/08august/Pages/Eating-egg-yolks-as-bad-as-smoking.aspx [Accessed 10/9/12]

Carrie Ruxten; Eggs with benefits. Dietetics today, September 2012

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Beauty and the Feast?


Can what we eat affect the way we look?

I was recently asked to provide nutrition advice for a beauty bar on Oxford Street and it made me realise that some people really are interested in how food impacts of their body (beyond being able to do up their trousers). So here’s a little bit of insider knowledge.

Most body cells don’t live very long. Not when you consider that the average human in the UK lives for about 80 years. The most longevity you can expect from any of your cells is, of course, a lifetime, and some neurons do live up to this expectation, but most have a transient existence compared to ‘us’.

Some of the most rapid cell turnover comes from the lining of our mouths and stomach; our blood; and from our skin, hair and nails. Our cells are always dying off without us ever really noticing – your body carries on helpfully replacing those that have come to the end of their road. You eat that delicious lunch, your body digests it, disassembles the components, chucks out the waste and recycles the useful bits to power our functions and make new cells. By trying not to align myself with a certain TV – and I use this in the flimsiest sense of the word – “nutritionist”, I have gone a rather roundabout way to say: you actually are what you eat.

Our skin, hair and nails are made of cells consisting of things such as proteins, fats, carbohydrates and water. Different types of cells are made in different ways and require different nutrients for the process to work. Hair and nails are largely made of a protein called keratin, which requires vitamin A for its formation. Skin contains a protein called collagen that provides strength to the structure of cells. The body cannot produce collagen unless there is sufficient vitamin C on hand, and if you have heard of scurvy, then you’ll know what the effects of long-term vitamin C depletion are. Fortunately, scurvy is not common in the UK.

Let’s have a look at a few key players:

Vitamin C:
Many face creams, shampoos, hair treatments and manicures promise you that putting a bit of this and that on your skin will make your skin/hair/nails this that and the other. It is worth noting that the dermis of your skin consists of several layers which the chosen topical ointment will need to battle through before it reaches anything that is in the business of producing new skin cells. So, although vitamin C is in a lot of cosmetics and marketed as “collagen-boosting” it is unlikely to be as effective as getting enough through your diet. It’s also worth noting that, unlike your skin (which is an organ and one of only two that can self-repair – the other is the liver), by the time your hair and nails become visible they are pretty much past it and their constituent cells are certainly beyond improvement. That is why shampoo manufacturers only say that their products will give you “healthy-looking” hair and not “healthy” hair, because dead things can’t ever be considered healthy and advertising regulations (thankfully) prohibit misleading claims.

Vitamin C is also an antioxidant, meaning that it helps neutralise free radicals. Free radicals are the by-products of various processes in the body and they are known to attack DNA and cell membranes. Some people believe that getting enough antioxidants can offer a bit of protection against the ageing process and preserve youthful, wrinkle-free skin, but others disagree completely so the jury is still out on that one.

Vitamin A:
Vitamin A is important in the growth of epithelial cells (a type of cell found in skin, among many other places) and for the production of keratin. One of the symptoms of vitamin A deficiency is rough, bumpy skin around the hair follicles. A word of caution though: too much vitamin A is toxic and large intakes while pregnant can cause miscarriage.

Vitamin B complex:
Riboflavin (B2) and niacin (B3) have both been classified by the European Food Safety Authority as being physiologically effective in the maintenance of normal skin as has biotin on the maintenance of hair and nails.

Folate:
Folate (or folic acid as it is know in its synthetic state) is central to the process of cell division. Actively dividing cells need plenty of this stuff to divide properly – your skin cells are dividing all the time.

Zinc
Zinc is a mineral that is sometimes known for its purported aphrodisiac qualities but less often for its role, alongside vitamin C, in collagen production.

So can what we eat really affect the way we look? Well yes it can, but let’s not get carried away. The vitamins and minerals we’ve discussed here are abundant in the diets of the average person in the UK and deficiencies are rarely found here.

Should you take supplements? You probably don’t need to take supplements of these vitamins, with the exception perhaps of folic acid if you are female and of childbearing age as adequate quantities protect against neural tube defects such as spina bifida. Eating a balanced diet is usually better for the average citizen. Take a look at the list of foods below to see the best sources of these micronutrients. You should consult your doctor before taking any supplements, particularly if you are taking any medication or if you are – or are trying to become – pregnant.

Food sources
Vitamin A: Liver, whole milk, cheese, butter, fish, fortified margarine, carrots, watermelon, tomatoes
Vitamin B complex: Whole grains, fortified cereals, meat (B3) liver (biotin), egg yolk (biotin). Biotin is also produced by the body.
Vitamin C: Asparagus, papaya, citrus fruit and their juices, cauliflower, broccoli, green peppers
Folate: Mushrooms, green leafy vegetables, beans, legumes, oranges, liver
Zinc: Red meat, oysters, dairy products, whole grains, leafy vegetables

References
Advanced Nutrition and Human Metabolism 5th Ed. Wadsworth
National Diet and Nutrition Survey
European Food Safety Authority
UK Office for National Statistics

Research

Educated mothers are turning their backs on health visitors

Educated mothers are turning their backs on health visitors

The biggest UK survey of its kind has revealed that middle-class mothers disregard advice given to them by health visitors about feeding their babies.

A pdf version of this press release is available here: Educated mothers are turning their backs on health visitors Aug 2012 Press Release

PRESS RELEASE

Mothers are turning their backs on professional advice given to them about feeding their babies. Results just released from research carried out by nutritionist Jo Travers earlier this year show that many mothers were sceptical of state-sponsored guidance from health visitors, preferring to access advice from the Internet.

The majority of mothers involved in the survey were educated to degree level or higher and had a household income of above £41,000pa. Many of the sample felt that they were being given inaccurate or contradictory information and this led to a general mistrust of advice from health visitors.

The aim of the study was to explore the importance placed on various influences on complementary-feeding practices. Quantitative data taken from the largest nationwide survey ever undertaken into the degree that influencing factors affect complementary-feeding decisions shows that almost 60% of mothers did not value advice from health visitors rating it as “not very important” or “not important at all”.

Health visitors are provided by the state to every mother following the birth of their baby. The Department of Health in its 2010 white paper Healthy lives, Healthy people has committed to increase the number of health visitors by an extra 4,200 by April 2015 at an estimated cost of £577m. With mothers discounting their advice however, this raises the question, is it worth it?

Babies of complementary-feeding age are in a critical stage of development yet most mothers act against official recommendations.

“I received quite a bit of contradictory advice from health visitors, who did not themselves seem to know the guidelines.” – p131

“Generally the health professional[s] in primary care don’t seem very well informed, unfortunately, and their advice seems to be based on personal experience rather than research” – p109

“Health visitors had very outdated and unflexible [sic] knowledge […] so when I was introducing solids I didn’t even ask for advice” – p124

Jo Travers says: “We found that many people felt that they were being given inaccurate information from health care professionals, which damaged their credibility and led to a lack of confidence in advice from official sources. This ultimately drove these educated mothers towards potentially unreliable information from books and the Internet.”

Notes for editors:
Jo Travers is a practising, evidence-based registered Dietitian with a First Class BSc (Hons) degree in Human Nutrition & Dietetics from London Metropolitan University. Her experience in the field includes time working in the NHS throughout London as well as four years in private practice. She is the author of two recipe books and is available for interview.

Jo can be contacted via 07540 305699 or jo@staging.thelondonnutritionist.co.uk or @LDNnutritionist or staging.thelondonnutritionist.co.uk

Methodology: The survey, a specific electronic questionnaire, was completed by 133 participants who had been recruited via a well-known online parenting forum. A second arm of the survey, with 10 participants, was conducted face-to-face at a baby clinic in southeast London. Frequency tables and chi-squared tests were used to analyse categorical data, and thematic analysis was carried out on qualitative data. A Likert scale was used when canvassing opinions. Ethics approval was granted by London Metropolitan University. Please contact Jo Travers to read the entire paper.

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Research

New mothers distrust advice from their mother-in-law about baby…

New mothers distrust advice from their mother-in-law about baby feeding

The biggest UK study of its kind has found that mothers do not rate advice from their partner’s mother when making decisions about feeding their baby

A pdf version of this press release is available here: New mothers distrust advice from mother-in-law about baby feeding Aug 2012 press release

PRESS RELEASE

It’s not just men who ignore their other half’s family. According to nutritionist Jo Travers, mothers are also highly likely to ignore advice from their mother-in-law (or partner’s mother). In a major study she carried out in the UK earlier this year, the results of which have just been collated, she discovered that mums prefer to take feeding cues from their newborn than listen to advice from its paternal grandmother.

The aim of the study was to explore the importance placed on various influences on complementary-feeding practices. Quantitative data taken from the largest nationwide survey ever undertaken into the degree that influencing factors affect complementary-feeding decisions shows that almost two thirds of mothers did not value advice from their partner’s mother: 66% of mums rated advice from their in-laws (or equivalent) as “not very important” or “not important at all”.

Other factors that rated badly included advice from other family members, such as their own mothers; advice from friends; and labels on food packaging. Another significant finding was that advice from health visitors was also rated as “less than important” by nearly 60% of respondents.

Babies of complementary-feeding age are in a critical stage of development yet most mothers act against official (and family) recommendations. The mothers who introduced complementary foods before 26 weeks – the age recommended by the Department of Health – said that they did so because they felt that the baby was precocious and “ready”.

Jo Travers says: “We found that mothers did not regard advice from their partner’s mother as valuable when it came to feeding their baby. The paternal grandmothers were rated about the same as healthcare professionals, which was not as highly as it might sound.”

The survey found that new mums mentioned these sources most as trustworthy, in decreasing order:

1. Their own feelings about what was right (91%);
2. Whether the baby was interested in solid food (86%);
3. Their baby reaching a certain age (82%);
4. Printed advice other than food labelling (70%); and
5. Previous experience (67%)
6. Advice from health car professionals other than health visitors (60%)
7. Advice from friends/other mothers (49%)
8. Advice from health visitors (41%)
9. The impression that the baby needed more nutrients (41%)
10. The baby seemed hungrier (39%)

Notes for editors:
Jo Travers is a practising, evidence-based registered Dietitian with a First Class BSc (Hons) degree in Human Nutrition & Dietetics from London Metropolitan University. Her experience in the field includes time working in the NHS throughout London as well as four years in private practice. She is the author of two recipe books and is available for interview.

Jo can be contacted via 07540 305699 or jo@staging.thelondonnutritionist.co.uk or @LDNnutritionist or staging.thelondonnutritionist.co.uk

Methodology: The survey, a specific electronic questionnaire, was completed by 133 participants who had been recruited via a well-known online parenting forum. A second arm of the survey, with 10 participants, was conducted face-to-face at a baby clinic in southeast London. Frequency tables and chi-squared tests were used to analyse categorical data, and thematic analysis was carried out on qualitative data. A Likert scale was used when canvassing opinions. Ethics approval was granted by London Metropolitan University. Please contact Jo Travers to read the entire paper.

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