Paula Mee

Family members, friends, clients and patients regularly share their experiences of meal-times, with ‘us’ dietitians. Some of what they go through is far from pleasurable. More like pure misery. People with gut disorder can be constantly edgy about what they eat and frequently anxious about bathroom facilities. Some avoid public transport and limit all travel in a bid to reduce embarrassing accidents. Their mistrust of food causes anxiety. Suspect foods are branded as ‘bloating’, meals described as ‘a bit of a lottery’ and eating out like ‘Russian roulette’.

Bowel conditions affect as many as one in five people. Irritable Bowel Syndrome (IBS) is particularly common in young women, in their 20s and 30s. Listening to their stories in clinic would make you feel wretched yourself. Their gut symptoms can have a profound effect, not only on their own quality of life but on their partners and other family members too.

Gut symptoms are reported as the second greatest cause of work and school absenteeism. Abdominal pain can be so bad that women say it is comparable to childbirth. Women can watch their stomach swell and distend over the course of the day, sometimes by as much as six inches.

While gut disorders like IBS are not life threatening, depression is common. I find it shocking to think that some patients who are severely affected by IBS have even considered suicide.

When I trained as a dietitian many years ago the management of gut disorders was poor and many people with IBS were told there was nothing wrong with them and that ‘it was all in their head’.

Today we know so much more about gut disorders. Evidenced based approaches like the low Fodmaps diet have transformed how we manage gut disorders such as IBS.

This approach can help more than those experiencing the symptoms of IBS. It has been shown to improve gut symptoms in more than half of patients with inflammatory bowel diseases (IBD) such as Ulcerative Colitis and Crohn’s Disease. In particular it helps, if you have endured ongoing gut symptoms despite having inactive IBD.

As a dietitian, I am specifically trained in this field and I regularly supervise people on the Low Fodmaps diet. Avoiding certain foods can be perplexing, especially if you tend to focus on all the things you can’t eat. Then there are the additional hassles of reading food labels, briefing a waiter or a friend when eating out, finding appropriate recipes and eating a wide variety of food groups important for our gut and overall health.

I wanted to write a book to help patients focus on the pretty impressive list of foods they CAN eat, even with bowel disorders. I wanted to supply patients not only with simple and relevant substitutions for the foods they had to remove but also to help them with specially adapted recipes to help them implement and follow the diet more easily.

Co-incidentally both myself and Lorraine Maher  (a dietitian I admire for her superb knowledge and commitment to her work) were independently collating recipes and meal suggestions for the Low Fodmaps diet. Over a cup of coffee and a long chat we decided to combine our expertise and write our book Gut Feeling.

We came up with over 100 recipes (various suggestions for breakfast, lunch, dinner, sauces and dips, desserts, snacks and beverages) which are free from possible trigger foods. Many of the recipes are designed with the family in mind. The idea being that they wont even realise the recipes are Low Fodmaps because they are so delicious!

We knew there were also many people who were diagnosed with IBS years before the Low Fodmap diet came into existence. Many of these people are living with long-established, yet poorly managed IBS and can greatly benefit from the Low Fodmap approach.

Gut Feeling is designed to complement the specifically tailored advice from a dietitian. But we also hope it will be a useful resource for consultants, GPs, practice nurses and family members supporting patients with gut symptoms.

Our book aims to help patients cook and enjoy a wide variety of foods to help minimise their symptoms. Once their problem foods are identified and their long term management plan is in place these recipes we hope will become long term firm favourites on the journey to better gut health.

 

From breakfast to dinner (and snacks in between) you’re entire day can be heart-healthy. A heart healthy diet doesn’t have to be bland or boring.

A Guide to Nutrients in Heart-Healthy Foods

Phytoestrogens are substances in plants, such as flaxseeds/linseeds, that have a weak estrogen-like action in the body. Studies suggest these plant components may help lower cholesterol and triglycerides levels and even your blood pressure.

Phytosterols are plant sterols that chemically resemble cholesterol. A diet high in these plant components appears to keep blood cholesterol levels in the normal range. All nuts and seeds, including wheat germ, contain phytosterols.

Carotenoids are heart-protective antioxidants in many colorful fruits and veggies. Alpha-carotene, beta-carotene, lutein, and lycopene are carotenoids.

Polyphenols are another set of antioxidants that help protect blood vessels, lower blood pressure and reduce LDL “bad” cholesterol. Flavonoid polyphenols include catechins, flavonones, flavonols, isoflavones, reservatrol, and anthocyanins. Non-flavonoid polyphenols include ellagic acid (found in all types of berries).

Omega-3 fatty acids (found in fatty fish like salmon) and alpha-linolenic fatty acids (found in plant foods like walnuts) may also play a part in keeping our hearts healthy. They help lower triglyceride levels, protect arteries from plaque buildup, are anti-inflammatory, and lower blood pressure.

B-complex vitamins, like Vitamin B-12 (folate) and vitamin B-6, protect against blood clots and atherosclerosis, or hardening of the arteries. Niacin (vitamin B-3) helps increase HDL “good” cholesterol.

Vitamins C and E are antioxidants that protect cells from free radical damage. Magnesium, potassium, and calcium help lower blood pressure.

Soluble-fibre rich foods help lower cholesterol levels too.

Approximately 10,000 people die each year from cardiovascular disease (CVD) – including coronary heart disease (CHD), stroke and other circulatory diseases. CVD is the most common cause of death in Ireland, accounting for 36% of all deaths. The largest number of these deaths relate to CHD – mainly heart attack – at 5,000. 22% of premature deaths (under age 65) are from CVD.

Source: Irish Heart Foundation website: www.irishheart.ie

                                                              Top Foods for your Heart

  1. Oats
  2. Oily fish e.g. salmon (fresh, frozen or tinned)
  3. Olive oil
  4. Unsalted nuts
  5. Seeds
  6. Avocado
  7. Legumes/pulses
  8. Berries
  9. Low fat dairy
  10. Spinach
  11. Soy and soy foods
  12. Brown rice
  13. Sweet potato
  14. Garlic/onions
  15. Dark chocolate

Celebrate Valentine’s Day by eating Red

  1. Tomatoes– lycopene rich.
  2. Tart cherries and juice – for recovery drink after training/sport.
  3. Strawberries –7-8 strawberries will give you the same amount of vitamin c as a medium orange. Use them in smoothies, salads etc.
  4. Red peppers – vitamin C
  5. Red onions -flavonoids
  6. Red grapefruit –b carotene
  7. Beetroot for blood pressure, sports nutrition etc.
  8. Red grapes – resversatrol
  9. Red wine – polyphenolic compounds

There are many red fruits and vegetables to choose from and they each bring something a little bit different to the table. Many red fruits and veggies are loaded with powerful, healthy antioxidants, such as lycopene and anthocyanins, that may help fight disease.

 Tomatoes

  • A tomato is full of vitamins and minerals (e.g. vitamin C, beta carotene) but is most renowned for its carotenoid called lycopene, which gives tomatoes their vivid red colour. Lycopene neutralises free radicals before they can cause damage to tissues.
  • Unusually, this is one case where processing can actually enhance the availability and absorption of nutrients, as lycopene is unharmed by cooking and food processing, which means that tomato-based products such as soups and sauces offer many of the same health benefits as the fresh fruit.
  • A recent study from Finland provided interesting results – this included just over 1,000 men aged 46 to 65 years in the Kuopio Ischaemic Heart Disease Risk Factor cohort. Researchers measured the level of lycopene in their blood when the study began and followed the men for about 12 years. During that time, 67 men had a stroke.
  • Men who had the highest levels of lycopene in their blood were 55% less likely to have a stroke, compared with men who had the lowest levels of the antioxidant in their blood (Karrpi et al., 2012).
  • The lowered risk was even greater for strokes caused by blood clots in the brain, called ischemic strokes. These are the most common type of stroke. Men who had the highest lycopene levels were 59% less likely to have this kind of stroke than men with the lowest levels. The findings appeared in the Oct. 9, 2012, issue of
  • This study adds to the evidence that a diet high in fruits and vegetables is associated with a lower risk of stroke. It’s important to note though, that the study just showed a link – it was not designed to say whether or not eating more tomatoes can lower stroke risk. The best ways to lower stroke risk is to eat a healthy diet that is rich in fruits and vegetables, and to exercise regularly.
  • Also good for the waist line – a medium tomato has only 14 kcals, 0g, 23% of your daily requirement for vitamin C, 7% of the RDA for potassium and 1g of fibre (4% of the recommended 25g).

Strawberries

  • Strawberries are fat free and only contain 30 calories in an average serving (8 strawberries). A great snack for those managing their weight.
  • A serving has more fibre than a slice of white bread (1.4g V’s 0.7g)
  • 8 strawberries provide the same amount of Vitamin C as a medium sized orange and 130% of the RDA for vitamin C.
  • A serving also provides 6% of the RDA for folate (folic acid).
  • Berries are a good source of polyphenols, especially anthocyanins, micronutrients, and fiber. In epidemiological and clinical studies, these constituents have been associated with improved cardiovascular risk profiles. Human intervention studies using cranberries, blueberries, and strawberries (either fresh, or as juice, or freeze-dried) have demonstrated significant improvements in LDL oxidation, lipid peroxidation, total plasma antioxidant capacity, dyslipidemia, and glucose metabolism (Basu et al., 2010).
  • Dip them in dark chocolate for Valentine’s day for a heart healthy treat .

Red peppers

  • Red peppers are high in vitamins A and C, which are antioxidant vitamins and good for heart health.
  • They are also a source of vitamin B6 which is essential for releasing energy from protein. To get the same amount of vitamin C as just half a red pepper, you would need to eat 2 oranges, 3 kiwis or 40 cherry tomatoes! Red peppers usually contain twice the vitamin C content of green peppers.
  • The level of lycopene can be up to nine times higher in red peppers compared to green peppers (the association between lycopene and heart disease has already been discussed in relation to tomatoes).
  • Red peppers are a good source of potassium (9% of the RDA in one pepper). Increasing potassium intake in the diet can help lower blood pressure, which is important for optimal heart health.
  • Peppers are also a source of cholesterol- lowering fibre (3.4g of fibre in one pepper = 14% of the GDA).
  • Chilli peppers contain a substance called capsaicin. Capsaicin in topical form is promoted mainly for pain caused by conditions such as arthritis and general muscle soreness but it is a potent inhibitor of a neuropeptide associated with inflammatory processes. It also acts as an antioxidant, protecting the cells of the body from damage by harmful molecules called free radicals.

Pink and Red Grapefruit

  • You want to go for color when you choose grapefruit, because pink and red grapefruit have higher levels of antioxidants, such as vitamin C, compared to white grapefruit.
  • They are also a good source of pectin, which helps lower cholesterol.
  • A good source of potassium, which can help control blood pressure and protect the heart – one grapefruit provides 10% of the RDA for potassium.
  • The pink and red fruits also sweeter in taste and a better option for anyone that doesn’t like the tangy white variety.
  • One grapefruit has 48 calories, almost 3g of fibre (12% of the GDA), basically 100% of the RDA for vitamin C (one grapefruit has 58mg vit C).

Red Grapes

  • Rich in antioxidants and fiber, red grapes are very heart-healthy. Some research studies suggest that red and purple grape juices may provide some of the same heart benefits of red wine.
  • Grapes are rich in health-protecting antioxidants, including resveratrol and flavonoids. These antioxidants are found mainly in the skin, stem, leaf and seeds of grapes, rather than in their pulp. The amount of antioxidants in grapes depends on many factors, including the kind of grape, its geographic origin and how it’s processed. Dark red and purple grapes tend to be higher in antioxidants than are white or green grapes. Likewise, the level of antioxidants such as resveratrol found in wine varies, with higher levels in red wine.
  • Red grapes have been shown to lower blood pressure, reduce inflammation, and reduce heart muscle damage related to a high-salt diet. They have also been shown to reduce blood triglyceride levels, LDL cholesterol levels, and improve blood vessel function.
  • Because purple grape juice does not contain ethanol, it has been suggested that its antiplatelet and antioxidant effects are due to flavonoids2 and increased intake of dietary flavonoids has been associated with a reduced risk of CHD events.

 

With the New Year well under way now many people are developing new habits and cementing patterns of eating for 2017. According to the US News and World report, the top three dietary patterns are 1. The Dash Diet, 2. The Mediterranean Diet and 3. The Mind Diet.

I’ll cover the Dash and Mind diets later this year and focus on the Mediterranean diet in today’s blog. Interestingly researchers have only recently discovered that people who stick with the Mediterranean diet appear to have less brain shrinkage, as they grow older. The team used MRI scans to test 401 people in a three-year period. Of course there are many other established health benefits which I will mention below.

So what does the traditional Mediterranean Diet look like? It’s certainly not symbolised by the white french bread stick or the choc-au-pain enjoyed by many with their breakfast coffee in Mediterranean counties today.

Culturally, despite the differences between Moroccans, French, Greek and others living around the Mediterranean basin, they shared a traditional diet with many common characteristics some seventy to eighty years ago.  There was an abundance of vegetables, fruits, spices, seafood, breads, cereal foods usually made from wheat, nuts, and olive oil, at mealtimes.

 ‘He is a shepherd or small farmer, a beekeeper or fisherman, or a tender of olives or vines. He walks to work daily and labors in the soft light of his Greek isle, midst the droning of crickets and the bray of distant donkeys, in the peace of his land. … His midday, main meal is of eggplant, with large livery mushrooms, crisp vegetables, and country bread dipped in the nectar that is golden Cretan olive oil. Once a week there is a bit of lamb, naturally spiced from grazing in thyme-filled pastures. Once a week there is chicken. Twice a week there is fish fresh from the sea. Other meals are hot dishes of legumes seasoned with meats and condiments. The main dish is followed by a tangy salad, then by dates, Turkish sweets, nuts, or succulent fresh fruits. A sharp local wine completes this varied and savory cuisine…….His is the lowest heart-attack risk, the lowest death rate, and the greatest life expectancy in the Western world’.

The description above of the ‘low-coronary-risk male’ living on the Isle of Crete, in the aftermath of  world war two, appeared in the Seven Countries Study, and focused the world’s attention on the traditional Mediterranean diet (MD).

To help us understand the protective component of the diet, isolated nutrients have frequently been studied in large, well-designed, randomised clinical trials, typically with null effects. It appears that this focus on nutrients rather than on foods is in fact counterproductive.

Compared to other Western diets, the traditional MD is considered somewhat of a paradox. Although fat consumption was high, the prevalence of cardiovascular disease, obesity and cancer was lower than other European countries. Rather than limiting total fat intake, the MD focused more on the enjoyment of healthier fats.

On the menu were monounsaturated fats found in olive oil, nuts, and avocados and polyunsaturated omega-3 fatty acids, found in oily fish. If you were to follow this diet today, limiting your intake of processed and packaged foods ensures a better balance of fats and a lower intake of the unhealthy saturated and trans fats.

In a meta-analysis published in the British Medical Journal, which collectively included more than 1.5 million participants, the researchers found that greater adherence to a MD resulted in significant improvements to health, including a 9% drop in overall mortality, a 9% drop in mortality from cardiovascular disease, 6% reduction in incidence of or mortality from neoplasm, and a 13% reduction in incidence of Parkinson’s disease and Alzheimer’s disease.

Unfortunately, the food and meal patterns of these Mediterranean countries have changed considerably over the last number of years. In Crete, for example, people consume less fruit and olive oil than they did historically. They also eat more meat, including processed meats today. With these dietary and lifestyle changes, low rates of heart disease are no longer prevalent.

A weekly Mediterranean-style shopping list has few processed foods, but is big on colour and flavour.

  • Shellfish: Clams, crab, lobster, mussels, scallops and shrimp.
  • Fish: anchovies, halibut, salmon, sardines, bream, sole, tilapia, trout, tuna and swordfish.
  • Fruits: citrus, berries, cherries, dates, figs, grapes, melons, apples, peaches, pears and pomegranates.
  • Vegetables: artichokes, asparagus, avocados, beets, bell peppers, broccoli, courgette, carrots, celery, corn, aubergines, fennel, green beans, green leafy vegetables, olives, onions, potatoes, radishes, squash and tomatoes.
  • Grains: barley, brown rice, buckwheat, bulgur, kamut, oatmeal, polenta, quinoa, wheat berries, whole grains, stone-ground breads, tortillas and pasta.
  • Nuts: almonds, cashews, hazelnuts, walnut, pecans, pine nuts and pistachios.
  • Seeds: sesame, sunflower, pumpkin and linseed.
  • Legumes: cannelloni beans, borlotti beans, fava beans, black-eyed peas, chickpeas (garbanzo beans), kidney beans, lentils, lima beans, split peas.
  • Herbs and spices (fresh or dried): basil, chilies, cinnamon, cloves, cumin, dill, garlic, ginger, fennel seed, marjoram, mint, nutmeg, oregano, parsley, pepper (black or red), rosemary, saffron, sage, tarragon, thyme,
  • Dairy products: Natural yoghurt, lower fat cheeses like feta, mozzarella, brie, camembert and goats.
  • Oils: rapeseed, extra-virgin olive, grapeseed, and sesame oil
  • Chicken and Eggs: chicken and duck eggs weekly
  • Balsamic vinegar
  • Red meat (only 1-3 times monthly)
  • And don’t forget the Wine!

Why you eat is just as important as what you eat.  I’ve started asking the why question earlier in consultations now. It offers a glimpse into a client’s internal environment. What is going on in the mind has a knock-on effect on how someone feels. Subsequently, how does that feeling shape their behaviour around food.

Sometimes the client has no idea why he or she under or over- eats. That’s ok. It can take time to unravel and clarify. And the why question can be explored long after they have left the building. An examination of the triggers might have little to do with a real physical hunger and more to do with an internal milieu of anxiety, stress, fatigue or boredom.

Ultimately awareness of these internal triggers is vital if someone’s behaviour or eating pattern is to change.  Some inner triggers are emotions we try and silence with food. Of course an emotional hunger will never be satisfied with any amount of food. The gratification is usually short-lived. ‘It diminishes at the same rate as the chocolates disappear. I can’t even taste them after a while but I will continue to eat until I’ve devoured the lot’ describes a very frustrated client. That ‘out-of-control’ rush, that self-loathing and hopelessness can follow for many.

Finding the time to reflect on an underlying root of your relationship with food takes time but it is very worthwhile. Knowing why you eat allows you to recognise your trigger as it begins to surface. Finding the space to pause and consider your choices is the real game changer. That time between the stimulus and your response is where unhealthy habits are broken and new one crystallise. The ability to name, claim and tame the trigger comes with practice.

Consciously pausing and slowing down before you reach for the packet of biscuits and asking yourself, is this the best way to care for myself right now, means that you are putting yourself in charge instead of mindlessly rushing to food and eating to escape. Focusing on food cannot fix anxiety.  By pausing before eating you are taking the reins back and taking charge of your needs. It’s a world apart from feeling out of control around food.

There are, of course, internal cues we need to cultivate and honour.  If ignored, hunger and fullness signals can be blunted. This can mean you end up eating whatever is placed in front of you, just because ‘it’s dinner time’. The urge to plough through your meal and overshoot the ‘satisfied’ mark can leave you feeling ‘stuffed’ when you’re not tuned into just how much is enough.

Listening to the body, instead of focusing on external cues, allows you to slow down and enjoy whatever it is you eat, be it a crunchy piece of crisp-bread or a creamy dessert. Eating consciously or mindfully is not about dieting. It’s actually anti-dieting. The Buddhist discipline of paying close attention to the sensation and purpose of each morsel may be a step too far for most, but savouring and relishing your food, getting more from less, checking in with the self are all practices that even big corporates like Google encourage in their health and wellness programs.

Your two environments, both inside and out, motivate why you eat what you eat. The principle of deliberately paying attention to what is going on inside (mentally, emotionally and physically) is powerful. Understanding how the outside or external environment influences you is crucial too. In his book ‘ Mindless eating, why we eat more than we think’  Professor Brian Wansink offers several practical solutions to help minimise the effect of outside triggers, such as using smaller dinner plates and taller glasses to facilitate serving smaller portions. Simple things like wrapping food in tinfoil rather than cling film can help you avoid facing tempting leftovers every time you open your fridge.

‘Mindfulness means paying attention in a particular way, on purpose, in the present moment, and nonjudgmentally’, according to Dr Jon Kabat-Zinn.  Several mindfulness based programs have adopted his mindfulness meditation model to help treat eating disorders such as binge-eating disorder, type 2 diabetes, and weight loss.

In one study, mindfulness based eating awareness therapy was used to target stress eating and cortisol levels. The outcome was that obese participants experienced significantly lower cortisol levels and decreased anxiety but had no changes in weight from baseline. The interesting thing was the control subjects gained a significant amount of weight during the study. Importantly those patients who reported the greatest reduction in stress also experienced the largest decreases in abdominal fat, which may be useful for lowering risks of disease over time. Food for thought.

 

  1. Think nourishment not punishment. Does the nutrient balance of your meals feel right? Forget about very extreme approaches. The ‘no- carb’ or ‘high protein’ or ‘fat free’ rigid diets are not sustainable. You can tweak your meals to restrict carbohydrates and include smaller amounts of high-fibre wholegrains if that approach suits you best. If hunger is your primary issue a modest increase in lean animal and plant proteins can improve satiety levels. The question is can you see yourself eating this way in ten years’ time? There are no quick fixes.
  1. Download apps. A gradual weight loss requires you to eat less calories than you are using up no matter what approach you take. This might be hard for you to gauge but free smartphone apps such as My Fitness Pal will help you estimate the number of calories you need versus the number you are eating. Adopting a Mediterranean type approach to include more seafood, seasonal vegetables and healthy fats is a long term sustainable and nutritionally balanced approach but too many calories even if they are healthy calories will not facilitate weight loss.
  1. Identify your obstacles. What is keeping you from achieving your health goals? If you work late most evenings, can you exercise three mornings a week before work or take a home cooked dinner from the freezer to work? Do you keep a gear bag in your car boot so you can grab the opportunity to exercise on the way to or the way from work if it arises? If you hate the gym, then lift your own body weight; do planks, jumping jacks and lunges as you watch the News or buy an exercise DVD and use it.
  1. Think differently about housework. It’s exercise too. Mopping your kitchen floor and raking the garden leaves burns calories. The more vigorous the better but don’t overestimate the number of calories exercise burns. One 20 minute walk burns up to 100 calories, so don’t reward yourself with calories when you’re done. The aim is to have a calorie deficit, not to break even!
  1. Check into your head space. Understand your emotional connections to food. Notice the internal barriers that keep you from meeting your weight loss goal. Do you reach for a hug in a wrapper whenever there’s an argument or tension at home or in work? Find a way to work out any emotional stress the right way, rather than through food. Food will never mollify an emotional hunger. It might be a pleasurable distraction but it won’t solve anything.
  1. Remind yourself to slow down. When you eat, make a big effort to savour and enjoy your food at a more relaxed pace. Don’t gobble food. You can only taste food in the mouth. Your stomach doesn’t have taste-buds or teeth, so don’t shovel it through the pleasure zone. Digestion starts in the mouth. It generally takes 20 minutes for your brain to get the message that your stomach is full.
  1. Dump your scales. There is far too much focus on numbers and not enough on your feelings of fitness and resilience as you change your exercise and food patterns. A body composition analysis will demonstrate more about your muscle and fat stores and how they are changing than the bathroom scales. If you really have must weigh yourself, do it once a week in similar clothing and around the same time of day. But find other ways of measuring your success. Use the waist bands of clothes and how snugly they fit as your “scale.” Monitor improvements to your blood pressure and cholesterol levels after a three month period.
  1. Make breakfast a priority. Greek, fruit and natural yoghurts, fruit, oats, seeds and eggs are great foods to kick-start the day. If you find oats boring on their own, try different whole grains like oats with quinoa, millet or bulgur. Add your favourite toppings for extra nutrition: chopped banana, crushed nuts, berries etc.
  1. Double check portion sizes. Use digital scales and look up the nutrition content of the per-serving information. You might be surprised by how many calories your bowl of cereal has if you are too heavy handed. Add more fiber and blend in linseeds to bump up fibre, healthy fats and texture. It will also make it more satisfying so you’re not tempted to snack throughout the morning.
  1. Snack smart. When a sweet craving hits at work distract yourself. It will pass. Head for the water cooler or grab a cup of tea instead. If a piece of fruit just does not hit the mark, chew some sugar free gum or suck a frozen grape (most work mini freezers are un-used). Try a more satisfying protein (as opposed to carbohydrate) rich snack like a small handful of wasabi peas, roasted edamame beans or your favourite unsalted nuts. But control portion size and calories. Buy smaller snack packs or measure out a portion.
  1. Lighten your lunches. Skip creamy salad dressings. Add fresh chunky salsa or Pico de Gallo (tomatoes, onion, jalapeno peppers, lime juice and fresh coriander) to top your prawn or chicken and salad greens. Adding green or red chilies, which contain capsaicin, might not boost the metabolism to any significant extent but more importantly they can add great flavour to a winter salad.
  1. Din Dins. If possible allocate one weekend afternoon to batch cooking healthy eats for the week. This way you can grab and go Monday through Friday. Think bean and lentil veggie soups and protein-rich frittatas. Think Mediterranean too – lots of colour, fresh vegetables, seafood, olive oil and moderate servings of alcohol if any in January. If you stick to oily fish and seafood two nights a week, go for lean meat another two or three evenings – not processed meats with hidden fat such as chorizo, salami etc.
  1. Meatless Mondays. Go veggie for one main meal a week if possible. This helps support the planet, your waist line and even your bank account. Plant proteins such as peas, beans and lentils offer great fibre, phytonutrients, vitamins and minerals while containing fewer calories. Use plenty of fresh herbs and spices with vegetarian dishes and you won’t feel like you are missing out.
  2. Add green power to your plate. Aim to eat one green vegetable a day. Toss spinach, kale or leafy greens into your salad for a flavour and nutrition punch. The mustardy peppery flavour of leafy greens can spice up a boring sandwich too. Eating too many cruciferous vegetables (such as broccoli, cabbage, Brussels sprouts, and cauliflower) when you are not used to them can cause excess wind. An average serving is 80g.
  3. Good things come in small packs. And on smaller plates, slimmer taller glasses and petite cereal bowls. Scientists have also found certain colours, like blue, suppress the appetite. As few foods in nature are physically blue, our brains turn off the signal to eat. Would a smaller blue plate work for you? Try whatever you like.
  1. Experiment while cooking. Buy a good recipe book this January not a fad diet book. Cutting even one tablespoon of oil from a recipe can save you 120 calories. Cutting a tablespoon of sugar from a recipe can save you approx. 60 calories. Adapt recipes. They are usually versatile.
  1. Cook smart. The idea is that for every main meal that you cook, you will get a smart leftover meal from it the following day, saving you preparation and cooking time and expense.  Store the extra leftover as your lunch or second dinner straight away so that it does not tempt you to ‘seconds’ on the same evening.
  1. Use your extras. Roast lamb with rosemary and garlic can become a leftover lamb and couscous salad. Oven roasted whole chicken with garlic, orange and rosemary can transform into an oven baked chicken and broccoli casserole. Extra roast vegetables and boiled potato from Sunday’s dinner can be reinvigorated in an eggy frittata the following day.
  2. Manage your freezer. After a thorough clear out but some freezer labels and bags for storing those extra meals cooked on batch day. Fill the rest of your freezer space with frozen berries, pure fruit ice lollies, fish and seafood, meat, bread, frozen yoghurt and any suitable freezer food. You can even freeze grapes and energy balls for snacks.
  3. Have a Blood Test now in January. Many hundreds of Irish people have high cholesterol, high blood pressure and diabetes but are unaware they have these conditions. It is recommended in some countries that everyone over the age of 40 be tested for diabetes every three years. If you experience symptoms such as excessive thirst and urination, weakness and fatigue, blurred vision or foot numbness, get a blood test now.
  1. Hit the Hay. Try going to bed and getting up at roughly the same time every day, even on weekends. Your body likes routine, so you’re likely to get a better night’s sleep. This is the time when the body repairs and regenerates tissues. Sleep is important for the immune system. Research shows that poor long-term sleeping patterns are associated with increased risk of weight gain and obesity.
  1. Connect with friends. Make these non-food and alcohol social occasions over the week-end, if that helps. Commit to meeting friends for walks and hikes and bike rides followed by a cup of coffee, rather than meeting them at the local. If you are going to the cinema, bring your own coffee or sugar free mints.
  1. Choose a vice. When you are making so many great changes allow yourself one small taste of wickedness. Maybe it is one glass of wine or two large squares of dark chocolate on Saturday and Sunday evening. The important thing here is that you don’t need to completely deprive yourself of everything you love in order to be a more comfortable weight for your height. So find one thing that will be weekend indulgence, and really relish it.
  1. Don’t forget liquid calories. Start a fluids diary. List everything you drink for seven days. Remember to record everything from your morning smoothie to that café mocha grande at eleven. How many soft drinks and juice creep in over the week Make changes if you need to after evaluating your drinking pattern. Juice has no fibre and you are better to eat the entire fruit if possible. The machine does the work of your body when you make a smoothie. They can be a good way to include greens but be aware of the calories in these drinks.
  1. Drink enough water. If you are partially dehydrated you won’t be able to concentrate or work to the best of your ability. Increase your water intake so that the colour of your urine is very pale in colour. Add slices of lemon or fresh cucumber cubes and sprigs of fresh mint to water for a cool and refreshing twist. Too much alcohol can dehydrate us. It contains a substantial number of calories too. A small 125ml glass of red wine has about 95 calories and white wine 85. Excess alcohol can cause high blood pressure, irritation of the gastrointestinal lining, depression and anxiety, and more. Maybe ask yourself could you do without it for the first few weeks of the New Year?

 

Are you making big, bold resolutions to “eat right” in 2017?

Personally I’ve found writing out my goals clarifies them, but planning to succeed requires more than just hoping and wishing for change. When clients tell me they want ‘to get to a more comfortable weight’, I usually reply ‘Good! Now what are you prepared to do to get there?’

Committing a plan to paper forces us to really think about what we want to change. More importantly, it helps us make really concrete decisions about how we are going to do it. It may mean writing out your own meal plan, a shopping list or an activity plan.

It takes time to ‘eat an elephant’ but if you have a large number of intolerance genes like me, you can tie yourself up in ‘all or nothing’ thinking. This either creates a huge amount of anxiety if you don’t get on with the business of change efficiently and quickly, or a huge amount of fear which paralyses you before you begin.

The changes we need to make are so great and so arduous that when we look at the extent of the change necessary, it is simply overwhelming. This can mean we either never start the change or that circumstances just sabotage us. Life gets in the way, that great old excuse.

It’s worth reviewing the steps to change described by the late psychologist Dr. Joyce Brothers.

Step 1:  Accept that change involves. . .change! Habits die hard. We construct neural pathways that mostly serve us well and make life easier and more efficient for us. That’s a good thing. But when we try to change our habits or neural pathways, the brain resists. We need to take this normal resistance seriously, admit it exists, and use powerful strategies to install new habits. If not, old habits return eventually.

Step 2:  Be exact about the change you want. Wishing and hoping to “do better” won’t cut it. Decide precisely what you want, what it will look like, and how you will measure your progress. Skipping the few minutes it takes to do this thoroughly is a setup for failure.

Step 3:  Lists the penalties of not changing. What will it cost you over a lifetime to continue your old habit? Will your health suffer ? Will you die younger? Will you be more frustrated or unhappy with yourself? Again, there are important and vital reasons you want to change, so committ them to paper.

Step 4:  List the rewards of making the change you want. How will you and those closest to you benefit from this change? Will you be healthier, live longer or with more congruence? Will you be more fulfilled? What are the real, tangible benefits from making this change? List them.

Step 5:  Decide the change is worth it! Make the commitment. Design systems and strategies for success. What are your supports? Think it through and be very clear. Desiring or longing for change is not enough. Assess the costs and advantages, then set your resolve.

Step 6:  Be accountable. Tell people about the change you are making and ask them to monitor your progress. Ask family to be your allies. Record your pattern of eating, drinking, sleeping or activity with a diary or smartphone app. Get a coach. Fitness is easier if your friend, partner, or an entire team is waiting for you at the gym.

Step 7:  Map your progress. Post your changing body composition on your bathroom mirror . Use graphs and pictures to mark your progress and get feedback from people who care about your success.

There are few common habits amongst the 6000 participants on the US National Weight Control Registry. Not only did these people successfully lose weight, they also prevented the weight from returning again. Common behaviours included reducing their calorific intake, weekly self- monitoring, participation in a high level of physical activity and eating breakfast almost every day. This suggests that the simple habit of starting your day with breakfast is an important strategy for losing weight and keeping it off.

Start the day well.

Skipping breakfast is counterproductive as your body stays in its “hoard mode”, thinking it’s starving because you’re fasting for a very long period of time without food. Breaking the fast, helps to boost your metabolism and your energy levels.

If the family is missing out on a good breakfast, set the table the night before and get everyone out of bed 5 minutes earlier. A quick nutritious breakfast of a high fibre cereal topped with low fat milk and some seeds and chopped fruit will do. You can relax at weekends, introducing a wider range or breakfast foods such as eggs, beans, grilled tomatoes or wholemeal pancakes filled with yoghurt and berries.

Make the environment work with you, not against you.

Stimulus control involves learning what social or environmental cues seem to encourage undesired eating, and then changing those cues. On reflection, you may learn from self-monitoring that you’re more likely to overeat while watching television, or whenever the box of sweets are on display in the office, or when you eat with a certain friend or in a certain place.

You might then try to sever the association of eating with the cue (don’t eat while watching television), avoid or eliminate the cue (leave the sweets on some-one else’s desk), or change the circumstances surrounding the cue (plan to meet with your friend for a walk). In general, visible and accessible food items are often cues for unplanned eating and unhealthy chain reactions.

Losing weight ultimately involves eating less calories. Choosing smaller glasses and plates all help to limit portion sizes, as does changing the pace at which you eat. Putting less each fork full and chewing more, helps us focus on how satiated we are, so we can stop before we feel  stuffed.

The fibre filler

Eighty percent of us are not getting enough fibre. The greatest quantities of fibre are found in foods such vegetables, beans, lentils, fruit, nuts and grains.

Studies indicate that people who eat a high fibre diet find it easier to control their weight than those who don’t. Fibre contributes to weight control by increasing the time taken to chew foods; it adds bulk to the diet and helps us to feel fuller for longer. Certain types of fibre can help lower cholesterol too. People with high fibre diets are one third less likely to develop Type 2 diabetes.

The Protein Filler

 For many, finding time to eat a healthy lunch at work or at home may be even more challenging than finding five minutes for breakfast.  And even if you’re not physically active, the brain also needs to be fed.

Like all balanced meals it’s important to try and eat a variety of foods which will give you: carbohydrate for brain fuel, protein for alertness and satiety, some good fat to provide us with fat-soluble vitamins and essential fatty acids.

What you eat for lunch can either boost energy levels or leave you feeling sleepy and easily distracted. Protein-rich foods such as seafood, lean meats or eggs at lunch keep us alert and focused in the afternoon. Protein-rich foods also trigger the sensation of fullness faster than fatty foods. Sandwiches and salads exclusively made from salad leaves and bulky low calorie vegetables are light but probably insufficient in protein. Always include a lean protein at lunch and at your evening meal.

  • Carrot, orange and hummus: Coarsely grate 1 carrot and mix with zest of ½ an orange and 1 tablespoon of reduced fat hummus in a wrap.
  • Egg and cress: Mash a hard-boiled egg with 1 teaspoon of low-fat mayonnaise. Add finely chopped chives and cress and stuff into a wholemeal pitta.
  • Apple and cheese Slaw: Grate a small apple, 1 stick of celery and mix with 25g of your favourite low fat cheese like brie. Stir in chopped spring onions and 2 teaspoons of natural yogurt and pile onto your bread of choice.
  • Steak Sarnie: Layer leftover beef (chicken or turkey also work well), red onion, rocket and 2 teaspoons of Dijon Mustard on a small crusty ciabatta.
  • TLT (turkey, lettuce and tomato): Chop up sliced turkey breast, lettuce and cherry tomatoes and mix with tiny bit of low fat mayo. Pile into a pitta pocket or wholegrain Bap
  • Roast pepper and brie: Spread matchbox size of lower-fat brie on your bread of choice, top with roasted red peppers. Add smoked salmon for a treat.

And remember if you’re not hungry, why are you eating? Tuning into your body’s needs over time, will lead to establishing mindful eating patterns. Practice doesn’t make perfect, it makes permanent!

 

analysedappleXX.pngThis week I met 4000 young Transition Students at the inaugural ‘HealthFest 2016.’  Organised by the National Dairy Council and Safefood, the event has been developed to provide knowledge and motivation for Transition Year students about healthy eating and physical activity in an engaging way. The Zumba really did look fun.

I spoke about snacking. In my time there was no such thing as snacking. There wasn’t a snacking industry. We more of less had a routine; three meals a day, maybe a cereal or some toast for supper if we were hungry or very active.

When we went to school, they were no vending machines, no tuck shops. There was no corner shops selling fried fast foods, the petrol stations only sold diesel and petrol.

Today we eat on average 2-3 snacks here in Ireland and in the UK according to Bord Bia research.

The students at Healthfest (16 years plus) are the highest consumers overall. Many of them make their own decisions about what to snack on and when. They choose and buy snacks themselves frequently. It’s possibly convenient (not requiring much preparation if any) and they’re portable or hand held.

But lots of snacking takes place at home too. We don’t just eat ‘on the go’ or ‘on impulse’. In fact 7 out of 10 snacks are purchased at the supermarket as part of a larger or weekly shop. Deliberately purchased, these make up part of the family shop.

Our snacking occurs relatively evenly throughout the day with a slight peak at mid afternoon – about the time school finishes. Research highlights the most favourite snacks are 1. confectionary (21%), 2. crisps (15%) and 3. fruit (only 12%).

Interestingly – we don’t really consider ‘drinks’ to be snacks. Yet the research shows us that 42% of all snacks are accompanied by a drink.

Bord Bia’s research estimates we spend about 2 euro on a snack, so if the 4000 students at Healthfest had on average 2 snacks a day the market value would be close to 6 million euro for the year. Think of what the size of the market would be for the island of Ireland! Now hopefully some entrepreneurs out there might be thinking – Hmmmmm now there’s an opportunity! And that’s quite true. We need more innovation and competition for sure, in healthier snack ranges.

Snacks of course are separate to meals. If you snack smart and make clever choices you can boost your energy levels and enhance your nutrition and health.

On the other hand snacks can be something we grab and can be eaten purely out of habit. If we eat too many indulgent sugary and fatty snacks we displace or knock out essential nutrition from meals and become overweight and unhealthy. Snacks replace the nourishment necessary to grow to our full height and reach our full potential both in terms of our studies and our favourite sport.

Unfortunately bad snacking choices can have both short and long term consequences. You don’t need to eat a perfect diet all of the time but its good to know how much sugar you eat vs how much you really need.

A teenage girl or a pretty sedentary boy needs about 2000kcals. Only 5% of which should be added sugar according to the World Health Organisation. This is about 6 teaspoons sugar (25g). I’m afraid this is not a lot and many teenagers exceed it.

Why? Because sugar is added to so many foods. It’s estimated that added sugar is found in approx. 80% of processed foods in the US. However companies won’t make foods we don’t eat so this trend is reversible but it requires us all to really think about our food choices and to choose better snack options in supermarkets and when we’re out and about.

Sugar is found not just in foods. It’s also in drinks. Do you know how much sugar is in your favourite drink? A 500ml serving of some of these drinks can contain twice the recommended sugar for the day.

Water is calorie and sugar free. A 200ml glass of milk contains about 10g sugar but this is not the sugar the WHO wants us to cut out. This natural sugar found in milk and dairy (called lactose) is not the issue. Your glass of milk can be enjoyed as one of your three –five dairy a day as it contains protein and calcium, phosphorous and some B vitamins. It’s a matrix of nutrients important for bone health. Remember 90% of the adult skeleton is formed by age 18.

Orange juice has more sugar and in general the recommended intake of juice is only 100ml (tiny) as there may be some vitamins but there is no fibre in juice. Other juice drinks are largely water and sugar mixes. The soft drinks come in larger 500ml servings so it’s easy to see how the teaspoons of sugar add up.

And then there is the latest trend in drinks – energy drinks. This drinks section has exploded with formulas enticing you with promises of ‘Monster Energy’. Even though there is no agreed definition of what an energy drink is, ‘they are soft drinks with a high percentage of sugar, caffeine or other stimulants, typically consumed as a way of over coming tiredness’ according to a recent Safe food report. It seems they contain a ridiculous amount of sugar. For example the Monster Energy drink contains twice as much as the daily recommended intake and has the same amount of stimulant as not one but two espressos? Who on earth needs that at 16 years old?

Of course there’s nothing wrong with some sugar now and then. It’s how much we eat that’s the issue. Choosing mini treats occasionally is fine but the sugar habit can grow and unhealthy levels are bad for the body and brain. Down size don’t supersize.

We are all aware of the rising obesity levels but the brain too can be affected by too much sugar. When we reward ourselves with sugary foods and drinks the pleasure centre of the brain lights up and dopamine is released.

If you want to know what a dopamine rush feels like just close your eyes and think about someone you love, it may be a pet, or a tasty food, or the day you won that cup – anything else that leaves you feeling warm and fuzzy. When you really get lost in the detail, you may even start smiling. That’s because your recollection and memory triggered a dopamine rush in your brain!

Our sugar habit can become hardwired in the brain so that we repeat the behaviour that gives us the dopamine rush but with awareness we have the choice to change. We can make conscious decisions that can change our habits and our rewards systems.

But we need to be awake to change our habits, we need to be aware and not on automatic pilot.

We also need to note – who is selling us what? There are multi-million dollar businesses out there promoting products, even thoughts/beliefs and lifestyles – deliberately.

Learning to think for your self is a hugely important life skill when you’re young, and it’s more of a challenge now than ever before to shift through and determine what is real and worthwhile and what isn’t.

Social Media is NOT real life. It can mislead. Essena O’Neill, a model on Instagram, recently quit and talked about the unhealthy aspect of Instagram. How ‘it is a lie’. She described the hundreds of photos she had to take daily in trying to choose the one for Instagram. She wouldn’t eat for two days before a shoot just to get the best shot. The more she focused on looking good, the more unhealthy she became.  So question the fad diets , the supplements, the tonics and take it all with a pinch of salt. Try to establish who the real experts when it comes to advice about what you put into your body and brain.

Safefood and the INDI are two trusted bodies providing evidence based advice when it comes to food – what sort of snack boost your energy, prevents fatigue on the pitch, helps you recover after training. You’ll find plenty of information and ideas on snacking on both websites.

What you eat can make a huge difference to your mind and body.

Put some power on your plate students and get the nutrients you need, to help you;

  • reach your full height.
  • develop strong and healthy bones.
  • develop your muscle mass.
  • keep your teeth strong and healthy.
  • be the right weight for your height.
  • keep your skin, hair and nails healthy.
  • perform to your full potential at sport

Eat well, look well, feel well! 

 

Your mIddle yearsI’m taking some MENO-LEAVE at the moment.

It’s a makey-up word but so what! It’s just one day (Monday) each week OFF until the end of September this year! I’m so excited about this. It dawned on me after a 3 day mindfulness course that I deserve some time out.

As I walked along the beach I realised that the last time I had a decent spate of time off work was when I was on maternity leave nearly 21 years ago. I took what was on offer in those days (three months) plus my holiday leave – four months in total. Since then I’ve been working fulltime, only taking 2 week holidays at a time.

So I’ve decided to give myself some meno-leave now that Your Middle Years is published and on the book shelves since its launch – March the 8th.

I’ve no clue how I’ll get on this Summer but for the moment I am stopping my clinic work. Instead I am focusing on my corporate work Tuesday to Friday. That’s the plan. I intend to come back refreshed and updated. Time out will give me time to reflect and think about my work, but also to do some other stuff too. How good is that!

I will be posting weekly on Paula Mee Your Middle Years Facebook page. You can set up your notifications to direct you there, where you can share and discuss issues with other liked minded women.

Incidentally you can buy the book on line but because it’s such a tome the envelope and postage comes to €8 euro so the price is €25.00 from the website as opposed to €17.00 in bookstores.

Your Middle Years, Love them, Live them, Own them! Published by Gill books

I found no road map for the transition through menopause, no exact starting point or finishing point. There is also a stark lack of practical information on menopause and the middle years. Even more concerning is the notable absence of positive outlooks on ageing.

I firmly believe however that with the right diet and lifestyle, we can look, be and feel our best through the menopausal years and well beyond. I wanted to write Your Middle Years with Kate O Brien to help women anticipate the natural physiologic and metabolic changes they will go through, to offer advice and useful solutions to help them feel strong, resilient and more in control of their destiny.

Many of my friends are at the same stage in life and have similar symptoms. Whilst we might joke about foggy brains and dry punanis we rarely get into serious discussions about the menopause. And while scientists are still deciphering the roles of individual hormones, it’s becoming clear that excess body fat, especially abdominal fat, disrupts the normal balance and functioning of hormones.

So I wanted to focus on preventing the accumulation of visceral fat around the middle in this book. It used to be pretty easy to drop a few pounds when in the 30s and early 40s, but now it seems to take a great deal more effort and time to achieve even minimal change.

Your Middle Years explains how to eat well to avoid a build-up of visceral fat, yet maintain a healthy muscle mass; how to destress (through exercise, mindfulness and meditation) so as not to cause further hormonal disruption; and gives tips about how to handle some of the symptoms.

I’ve heard many women’s personal accounts of their menopausal journey from a focus group we carried out and it seems there is plenty of scope for more discussion on the topic.

Your Middle Years is designed so you can dip in and out of it when necessary. It will hopefully arm women with concrete lifestyle strategies prior to the menopause, from the early 40’s onwards. It’s a book to help women anticipate the natural symptoms and changes they will go through. Personally I would have liked to have known more about menopause at an earlier stage – what to expect before I experienced symptoms and how best to manage them.

I believe it’s important to empower ourselves before, during, and after menopause to live healthier lives. While we can’t avoid the raging hormones, and a certain amount of weight gain, loss of bone and muscle mass and digestive issues, we can still manage and minimise their risk of adverse effects and disease as they age.

There are chapters on symptoms, weight, heart health, bone health, immune health, exercise, sleep, beauty, alternatives and sex. There are a number of fast facts throughout the chapters like the ones below.

Fast facts

  • By 2020, more than 50 million women will be older than 51 years, the average age of menopause.
  • Close to three quarters of women experience menopausal symptoms.
  • There are up to 40 different symptoms.
  • Common symptoms include hot flashes and night sweats, mood changes, sleep problems, difficulty concentrating, short-term memory lapses, loss of productivity that accompany these vasomotor symptoms.
  • Symptoms can significantly decrease women’s quality of life and lead to higher healthcare costs.
  • Yet many women go unevaluated and untreated and unhelped.
  • Knowing the likely symptoms and accepting that they may be part of your journey, can be helpful.
  • Close to 20% of women in early menopause could benefit from hormone therapy because they experience moderate to severe vasomotor symptoms and lack contraindications to therapy.

I really hope you enjoy the read and please feel free to feedback what you liked and didn’t like about the book. Enjoy Your Middle Years!