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The London Nutritionist YouTube Channel

I’m now in earnest starting a YouTube channel!

I know. I’m a bit late to the party. But if you aren’t partied out, please come and have a look around and subscribe! Here’s my first video right now!

The London Nutritionist

Love Your Gut Week

Love Your Gut Week

The gut, or digestive tract, is an organ that digests our food in several stages. As part of digestion it takes all the useful parts from the food we eat and absorbs them so our bodies can make use of them in the constant act of staying alive. It links with other organs like the liver, and pancreas; and it protects from poisons; stores and transports nutrients; reabsorbs water and gets rid of the stuff we can’t use. It also plays host to many different species of bacteria that live in symbiosis with us. These bacteria have a constant source of food and in return they provide functions such as extracting nutrients, making vitamins and training our immune systems.

Because the gut is such a complex organ requiring lots of things to all work together, occasionally it can stop working as well as it should, and this can cause symptoms such as diarrhoea, constipation, nausea, pain, bloating and wind. These conditions can range from being mild to severe, but usually indicate that something isn’t quite right, so if you suffer persistently from any of them it’s really worth checking out. It’s important to realise that these symptoms may indicate some quite serious conditions like coeliac disease, Crohn’s disease or even bowel cancer so ignoring the problem could make things a lot worse.

The really good news is that so many people see real improvements in digestive complaints when they get treatment. However, a new survey carried out by Love Your Gut has found that 1 in 4 people delay going to see a health professional for over a month and of those people, nearly half were delaying because they are embarrassed. But as a dietitian I spend a great deal of time talking about bowel habits, and so does your GP. Health professionals are really used to talking about poo, because what your gut is doing plays an important role in so many health conditions. In hospital wards most patient’s notes have their own sheet devoted to poo – including what it looks like – so there is really no need to be embarrassed!

If you do feel a bit uncomfortable talking about this intimate part of your life below are a few phrases that are used in the medical profession that might help. Love Your Gut have also launched some new tools to help you assess your digestive health. Head over to their website www.loveyourgut.com to find the Digestive Health Assessment tool, a Food and Symptom Diary, a dedicated Love Your Gut Facebook Group and the launch of the annual ‘State of the Nation’s Gut’ report which this year looks further into this topic.

Helpful phrases

Bowels open – going for a poo
Constipation – difficulty in going for a poo
Stools – this is another word for poo
Wind – another term for farting
Loose stools – mushy and somewhat watery poo; diarrhoea
Faecal urgency – needing to go for a poo urgently
Abdominal cramps – tummy pain
Bristol stool chart – this chart that describes what your poo is like and what that can indicate


The London Nutritionist

Thinking about going on a diet?

 

Thinking of going on a diet? First ask yourself these 5 questions:

1. Why do I want to lose weight?

Do you want to lose weight because you don’t look like the models from the magazines? Do you feel like you are inadequate because of your weight? Is someone else pressuring you to lose weight? This is unusual coming from someone that works in the nutrition industry, but if you answered yes to any of these questions, then maybe you should rethink. We are living in a world that demonises people for not fitting into the “ideal”. If you are classed as “overweight” you may be subjected to fat-shaming or health-shaming. But this isn’t fair and I want to change this. Your weight has no bearing on your worth as a person. If you feel like your current weight is stopping you from doing the things you want to do, you are wrong. It’s you stopping you. If you love and want to go swimming but can’t because you don’t want to wear a swim suit, that is you stopping you, not your weight. If you go swimming regardless of how you think you look you will enjoy the swimming and get some exercise (which may even have the side effect of weight loss!) If this seems impossible then instead of a New Year’s resolution to lose weight, I recommend a resolution to seek out some therapy to help you to be able to do this. Be body confident no matter your shape (and it isn’t always people who have a high body-weight that lack body confidence).

2. Do I even need to lose weight?

A “need” is very different from a “want”. If you have surgery coming up and the operation requires you to lose weight then you “need” to lose weight. Apart from that, there are actually very few reasons why you need to lose weight. Any other medical or health reason is much more likely to be connected to eating well than to your weight itself. So, if you have type 2 diabetes then although it is correlated to BMI, actually eating well is going to be more beneficial than just losing weight. For example, eating well for type 2 diabetes would include reducing refined carbohydrates and replacing them with wholegrains. Eating well for high blood pressure would be reducing salt, which for some people would mean cutting down on high-salt, ready prepared, processed foods and eating more potassium-rich fruit and vegetables. Eating well for high cholesterol would mean reducing saturated fat and replacing it with mono- and polyunsaturated fats. As a side effect of eating well, weight loss often occurs causing a correlation with a reduction in symptoms. It’s not necessarily the weight loss that causes the reduction in symptoms, but the eating well.

3. What has happened when I have gone on a diet before?

Did you enjoy the diet? Did you feel satisfied by the food you ate? Did you get through without craving foods you weren’t allowed? Did you lose weight? Did you stick to it until you reached your goal? Did you keep the weight off? If you answered “no” to any of these questions then it might be time for a rethink. Most people hate diets and most people gain weight once they stop. Often weight loss is quick at first and then it levels off and people give up and regain the weight – sometimes more than was lost.

4. How will going on a diet benefit me?

Do you feel like everything will be better if you were just at a different weight? Do you blame your weight for you not having a good job or the right partner? Honestly, getting out of this mind-set is hard but you really should try. Not only is it probably not true, getting into the blame-game is really unhelpful.

Or perhaps it is for your health. This is a really tricky one for me as a dietitian. I constantly struggle with how to deliver a health message without making people feel bad about their weight. It is true that abdominal fat is linked to conditions like type 2 diabetes and I really want to help people be healthy and prevent disease, but dieting rarely works. As a “treatment” it has a ridiculously high fail-rate and has horrendous side-effects. If it were a medication it would never reach the stage where it would be allowed to be prescribed. If most people who took a pill had the side effects of negatively affects social life; leads to constant hunger; leads to feelings of inadequacy and failure; leads to rapid weight gain on stopping; results in chronic dissatisfaction in food intake, not one single person would want to take it. Yet millions of people embark on diets every day and never more so than in January.

5. Do I know what I’m doing?

Do you usually just buy the trending diet of the moment or do you go and get professional help? Fad diets are complex and hard to follow and although the may “work” in the short term, it’s usually because foods are restricted in some way and this is not very sustainable.

So if not dieting, then what?

Why not just start by making sure you give your body what it needs? Nutrients, pleasure, satisfaction. If you aren’t sure how to do this because you are bombarded with contradictory health messages then ideally find a dietitian (https://freelancedietitians.org) who will give you personalised advice – because not every piece of advice you might hear will be relevant to you – and support you with the things you need the most support with. Dietitians all have a degree in human nutrition and dietetics so are suitably qualified. If your budget won’t stretch to this then The Low-Fad Diet is a book that can help you understand the basics of eating well and show you how to get a balanced diet.

The Low-Fad DietJo Travers, The London Nutritionist and author of The Low-Fad Diet, is a Registered Dietitian with a First Class BSc (Hons) in Human Nutrition & Dietetics. She has been in private practice for five years, and in her media role has consulted for the BBC; Channel 4; and comments regularly in print and on radio (more often than not as the voice of reason when the latest outlandish food story hits the news).
She is also a spokesperson for the British Dietetic Association.

Men’s Health Week

Men’s Health Week

It’s Men’s Health Week this week and this year there is a specific focus on waistlines – or as it’s better known, belly fat (as the Men’s Health Forum quite rightly point out). As a dietitian, this is my bag! I love anything that highlights the problems with carrying extra weight around the middle, and there are a lot of problems with it. Heart disease, stroke, high blood pressure, type 2 diabetes, colo-rectal cancers and erectile dysfunction are all much more likely if your waist measurement is above 94cm (37 inches).

Losing some fat around the middle is one of the best ways (after giving up smoking) to reduce your risk of poor health and dying too young. However dieting is notoriously difficult and hardly ever works long term. I have written about this before here and more recently in my book The Low-Fad Diet. I honestly believe that making small changes, without “dieting” can make a huge difference and I see it in clinic all the time. It would obviously be healthier to eat only wholegrains and cut out the bacon completely but that isn’t how things work in real life. If you can just change the portion size or the frequency a bit, you will be making a positive change that is sustainable rather than trying to resist the smell of bacon for the rest of your life.

If you only do one thing to improve your diet, it should be at mealtimes fill half your plate with fruit and veg, a quarter with carbs and a quarter with protein. This could be as simple as switching the baguette for a sandwich and adding an apple. This simple guideline will help make sure you are getting the balance of nutrients right, not overdoing it on the carbs (which get stored as fat around the middle if eaten in large portions), and increasing fruit and vegetable intake.

While it’s really important, belly fat isn’t the only health issue men face. Brita (the water filter people) asked me to work with them on a campaign they were putting together for Men’s Health week highlighting the importance of hydration in men’s health. I talk a lot about hydration as it’s one of the easiest things to change but makes a huge difference to how we feel.

Men’s bodies are about 60% water so keeping properly hydrated is really important. Even mild dehydration can affect mood and energy levels. A European study showed that 72% of men were drinking less than the recommendation to drink 2.5l/d set out by the European Food Safety Agency.

Fluid losses increase when you sweat so when you exercise aim to drink 500ml a couple of hours before you start exercise and around another 200ml every 20mins during. Although you may drink more when you exercise because you are thirstier, you may need to drink double what you lose in sweat to replace these losses. So if you lose 500g in sweat when you exercise, you will need to drink a litre to prevent dehydration. Additionally, muscles are hydrophilic meaning they need a lot of water so if you are dehydrated it’s hard to build muscle. Take a bottle with you when you run, particularly if you are running for more than half an hour. I have a bottle for filtering tap water which I take to Zumba where I respire rather a lot!

If you don’t like the taste of water you can drink other drinks (watch the sugar though) or add sugar-free squash. Use water cooler at the gym or at work, or if you don’t have one, water filter jugs will soften and improve the taste of tap water if you live in a hard water area. Of course Brita have a range of products for just this purpose like the Fill & Go for taking to the gym.

Here’s the Men’s Health campaign from Brita:

Hit Your Hydration Goals
A recent study found that 72% of men drink less than the recommended daily amount. As men’s bodies are made up of around 60% water, it’s really important to make sure those levels are always topped up to increase productivity at work and performance in the gym.
Tip – the BRITA fill&go Active bottle is a great way to ensure you are hydrated on the go – whether it’s a Sunday stroll or you’re pounding the pavements, make sure you’re always hydrated.

You Are What You Eat
40% of men were found to eat less than three portions of fruit and veg a day, with fiber intake being less than two-thirds of the recommended daily allowance.
Tip – Increase fruit and veg to five handfuls a day and switch to wholemeal bread. Including oats and beans in your diet will support general health and digestive systems.

Get On You’re ‘A’ Game
It’s not commonly know that 50% of men have below the recommended daily intake of vitamin A.
Tip – Include plenty of dairy to help boost your immune system and get in key antioxidants

Balanced Body
Recent studies have found that 65% of men are overweight or obese which can lead to larger health problems.
Tip – To get the balance right, bulk out half your plate with vegetables and ensure carbs and proteins each cover a quarter of the plate

Mindfulness in Men
Mindfulness is important for everyone, but especially so for men as they often do not speak out with a study finding that 40% of men won’t talk to anyone about their health
Tip – small changes to your lifestyle such as reducing alcohol intake and increasing water intake, getting in some more exercise and eating a balanced diet will all aid this

References
Gazan, Rozenn et al. “Drinking Water Intake Is Associated with Higher Diet Quality among French Adults.” Nutrients 8.11 (2016): 689. PMC. Web. 8 June 2017.
EFSA Journal 2010; 8(3):1459, Scientific Opinion on Dietary Reference Values for water.
Bean A. (2009), The complete guide to sports nutrition. 6th. A&C Black Publishers: London
Position Statement from the American Dietetic Association (2000)

If you just need to lose a few kilos…

If you just need to lose a few kilos READ THIS!

A lot of the clients I see have been over-weight for a number of years and have tried losing weight on their own, often successfully at first, but always regained the weight and generally more than they lost. I hardly ever get clients that only need to lose a few kilos but I wish I did. Most wait until they are 10kg, 20kg or 30kg heavier than they want to be before booking an appointment.

And that’s the trouble with “dieting”: people generally gain more weight after dieting than they originally lost. It’s relatively easy for most people to lose weight by following a plan or instructions in a diet book, but keeping the weight off is incredibly difficult. In fact UCLA psychology graduate and researcher looking into the success rate of diets, Janet Tomiyama, reported that “Several studies indicate that dieting is actually a consistent predictor of future weight gain.”

lose a few kilos
Even if you are just into the overweight category, seeing a dietitian can mean the difference between getting to a good weight and staying there and gaining more weight than you lost.

So what is it about dieting that is so wrong? Weight loss is actually not too hard in the beginning. Dieting to reach a goal is challenging but quite a few of us actually relish the challenge (initially at least!) and having something to aim for provides focus and motivation at the start. It’s even rather exciting embarking on a new way of eating and can be refreshing, and some people even feel a sense of relief that they are now going to get to their desired weight. Then when weight begins to drop off and zipping up the trousers is a bit easier and going to the gym feels less daunting, confidence can grow and this can be hugely motivating.

But it’s hard work. At first you don’t mind because it’s fresh and novel, but after a while it can get boring and anti-social. It’s hard to resist temptation for the third or fourth week in a row when there’s birthday cake at the office. You carry on but it’s boring and miserable. And then weight loss slows down and it’s even harder to keep the motivation up. Even before the goal is reached (bear in mind also that it may be an unrealistic goal) the diet becomes less of a priority and before long weight is creeping back up.

And then it starts all over again and people become trapped in the yo-yo cycle, which by the way has been linked with increased risk of cardiovascular disease as well as feelings of failure and low self-esteem.

But carrying too much weight is unhealthy too, so we need to do something about it. First of all it’s important to realise that being over-weight is incremental. It starts off with being a very small amount over, and at this point no-one really notices. And in fact at this point you are unlikely to look any different from most other people as our idea of a “normal” weight may not actually be in tune with what a healthy weight is. Then a little more weight is added over Christmas or a holiday, and then a bit more is added the next year until you start buying clothes that are the next size up and you go on a diet.

My advice is to find out what a healthy weight for you is, and if you need to lose even a few kilos, go and see a dietitian. They will help you to lose the few kilos – which is very easy compared to 15kg, so the earlier the better – but they can also help you understand what a healthy way to eat is and to figure out why you gained the weight in the first place. They can help you to plan for the future so it doesn’t happen again, preventing the rebound weight gain after weight loss. And when you work with a dietitian you can pop back every so often to make sure you’re still doing well and if not they can support you through getting back on track.

So even if you have only a few kilos to lose, here’s my three-point plan:

1. Know what a healthy weight for you is. A good place to start is by finding out your body mass index. You can calculate it here: http://www.nhs.uk/Tools/Pages/Healthyweightcalculator.aspx

2. Ditch the “dieting”. We know from the research carried out by UCLA that diets don’t work for most people in the long-term. And do not pick up the latest fad-diet book whatever you do. They are even less successful long-term. However you could get yourself copy of The Low-Fad Diet, which is the opposite of a fad diet.

3. Even if you only have a small amount of weight to lose, see a dietitian to help you make a personalised plan that works for you and fits in with your lifestyle rather than you trying to work around a complicated, restrictive diet plan. And remember, it is so much harder and more daunting when you have double figures to shed.

Now get started! I’d wish you luck but if you have support from a professional, you won’t need it.

You can book your consultation with me either in my Harley Street or City clinics in London, or over Skype and FaceTime. Have a look at my Clinics & Availability pages for more information or please email me at [email protected]

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Revision Nutrition

It’s that time of year again! Studying for exams can be pretty consuming all-round and it’s easy to let food slip down the list of priorities, but giving your (or your young adult’s) body the right nutrients can mean the difference between a productive session and a bit of a washout. Here are the main revision nutrition players:

Iron

Iron carries oxygen around the body to all the organs including the brain. If too little is eaten it can cause tiredness, lethargy and “brain-fog” – the exact opposite of what you need for focused, alert revision sessions. It is one of the few micronutrient deficiencies that is common in the UK, and among teenagers, girls are most at risk. This is for two reasons: their requirements for iron are higher – double that of a teenaged boy – and girls also tend to eat less iron-rich foods. Iron comes from red meat, beans, pulses, dark green leafy vegetables and fortified foods such as white flour products and breakfast cereals.

Iron from meat is readily absorbed but iron from plant sources requires vitamin C to convert it to a useable form. Adding some fruit and vegetables alongside will aid this process. Iron absorption is hindered by tannins, which are found in tea, and also by calcium so it’s a good idea to separate dairy and iron-rich foods sometimes.

Carbs

The brain’s favourite energy source is glucose, so carbohydrates are revision nutrition essentials! As the body doesn’t keep large stores of carbs it’s necessary to get them from the diet at regular intervals. A teenager will need about five portions the size of their fist of carbohydrates every day, such as bread, rice, cereals, potatoes or pasta: some at each meal and the odd snack. This helps keep blood glucose levels nice and even, the brain alert, and hunger (and hunger-related mood swings) at bay.

Breakfast

After going all night without food the body needs some nutrients so breakfast is essential. Anything is better than nothing, but some slow-release carbohydrates such as in whole grain cereals and toast or porridge are ideal. Avoid anything with lots of sugar as this can contribute to irregular blood glucose levels. Adding some protein will keep them fuller for longer, eggs on granary toast is the breakfast of kings.

Hydration

The body depends on good hydration for blood volume and pressure; the delivery of nutrients; and removal of waste products, among other things, so even mild dehydration can cause all kinds of problems with concentration and energy levels. Sipping fluids regularly throughout the day is the most effective way of keeping hydrated, but very sugary drinks may have the opposite effect. Juice is not hydrating, as it tends to draw fluids into the digestive tract rather than the other way around. Thirst is actually not the first dehydration signal. Early signs of dehydration can be quite subtle and non-specific such as fatigue, a lack of concentration and headaches.

Caffeine

Caffeine can be great for sharpening up and giving a boost if the will to study is waning. However if caffeine use causes even a mild degree of insomnia and interrupts sleep patterns, then any benefit is massively outweighed by the sleep deprivation. Caffeine’s peak action occurs about 20 minutes after drinking but it has a very long half-life so it hangs around in the body for about two weeks. This means it is very easy for it to build up even with only two cups of coffee a day.

Snacks

Snacks are another opportunity to consume some nutrients and also provide a bit of respite in a busy timetable. Go for slow-release carbohydrates like whole grain bread or oatcakes topped with peanut butter, hoummous or cream cheese to boost the nutritional value. Vitamins and minerals found in fruits and vegetables are used as catalysts and co-factors in nearly every process in the body so snack time is a great time to squeeze in another portion. A lower-sugar cereal bar is great for keeping in a bag for revision sessions outside the house and is much better than a sugary chocolate bar from the café or vending machine.

Exam day

Nerves can play havoc with the digestive system and sometimes its difficult to face eating, so go for whatever you can manage. Try to stick to small meals and top up with snacks. Keep well hydrated and always take water into the exam room with you. When it’s over, you can cut loose and eat whatever you want, food is about celebration as well as nutrients!

Breastfeeding in Public

Breastfeeding in Public

So today the media is reporting that swanky hotel in London asked a mother who was breastfeeding in public to cover herself while she was having afternoon tea. Claridges apparently said this is their hotel policy. On top of this, Nigel Farage live on LBC suggested that it was “a matter of common sense” that women should “sit in a corner” if they are breastfeeding in public in case they upset someone who feels uncomfortable. Don’t worry about the poor mother – who wants to feed her baby in the best way possible – feeling uncomfortable. Perhaps she should just not leave the house?

The benefits of breastfeeding, as most people probably know, are massive, but in case Claridges and Mr Farage are reading this I’m going to list some of them (from the NHS website):

Breast milk is the only natural food designed for your baby.
Breastfeeding protects your baby from infections and diseases.
It’s free.
It’s available whenever and wherever [even Claridges] your baby needs a feed.
It’s the right temperature.
It can build a strong physical and emotional bond between mother and baby.
less chance of baby getting diarrhoea and vomiting and having to go to hospital as a result
fewer chest and ear infections for baby and having to go to hospital as a result
less chance of baby being constipated
less likelihood of becoming child obese and therefore developing type 2 diabetes and other illnesses later in life
less chance of child developing eczema
lowers mother’s risk of getting breast and ovarian cancer
naturally uses up to 500 calories a day
saves money – infant formula, the sterilising equipment and feeding equipment can be costly
can help to build a strong bond between mother and baby

Breastfeeding can be stressful enough as it is what with getting the latch right, cracked nipples, leaking boobs etc. Please let’s support new mums rather than make them wear a napkin!

I don’t know who these people are that feel uncomfortable about seeing someone doing what’s best for their baby while having a life (if I do know any of them they haven’t told me). I am always breastfeeding in public and I wish more mums would. The more of us that do, the more people will get used to it and the less we will need to have this kind of thing happen.

If you feel uncomfortable while seeing a woman breastfeed, I think it’s common sense really, just go and sit in the corner.

Drinking at your desk… I mean water, obviously.

Drinking at your desk… I mean water, obviously.

I do quite a few workplace nutrition seminars in my job so it was quite intriguing reading some research published today on which the healthiest and unhealthiest professions are. It looked at everything from average number of hours sleep to how many portions of fruit and veg is eaten in the average working day. But because the research was commissioned by BRITA (the water filter people: www.brita.co.uk) they also looked at hydration.

Hydration is essential for lots of processes in the body including getting rid of toxins and maintaining blood pressure, and don’t forget around half our body weight is made up of water so if we don’t drink enough this can have a significant impact on the way we feel and how our body works.

Dehydration is so common in the workplace, but I think that not everyone is aware of how it can affect the way we feel and our efficiency, and often people only have a drink of water when they’re thirsty. Actually there are plenty of other signs that you might be dehydrated that happen before that thirst signal kicks in. A slump in energy; a lack of concentration and headaches are also signs and typically when we feel like this we often want to reach for a sugary snack.

And this is just what the survey found. Four o’clock is when workers seem at their most vulnerable to this sweet snacking behaviour, but this can be counter-productive as it can cause a spike in blood sugar, which is then followed by a crash. When that afternoon lull happens just having a drink of water can perk you up no-end without that crash.

One of the reasons given for not staying properly hydrated at work was being too busy, but staying hydrated can increase productivity no end so taking a few seconds to have a drink could save time rather than waste it.

Another thing that people seem to be saying is that, particularly if they live in a hard water area, water doesn’t taste particularly nice and this is where a water filter can help.

But how much water do we really need? As a guide, in a clinical setting a dietitian would look to encourage around 35ml fluids per kg of body weight every day, but of course some of this will come from the food we eat such as fruit and veg or other foods high in water like soup. But even pasta and rice absorb water in the cooking process, which will all add up. As a recommendation sipping around 1.5L of fluids on top of a healthy diet will help keep your body nice and hydrated.

So off the back of this research, BRITA are hoping to get the nation’s workforce drinking water instead of reaching for those unhealthy snacks, with their “Pour O’Clock” campaign and of course they have a range of products to help people do that, whatever their job.

Unhealthiest and healthiest professions (1)