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BBC Good Food Eat Well Show

The BBC Good Food Eat Well Show – The Diet Consultant

Posted by | Fat loss, Fitness, Food for thought, Healthy Eating, Uncategorized | No Comments

It’s an exciting weekend ahead for foodies and health enthusiasts, with The BBC Good Food Eat Well Show being held at Kensington Olympia, London. I’m excited to be there on Friday 27th to hold a FREE drop in clinic alongside other specialist Dietitians. Here, we will get to meet with members of the public, just like you, within 20 minute appointment slots. Our aim is to help as many people as possible by providing dietary advice on how they might be able to improve their health, performance and quality of life and achieve their specific dietary goals. The Dietitians Clinic, can be found at stand no: F62, placed by the British Dietetic Association.

BBC GOOD FOOD

BDA new logo

As well as receiving dietary advice whatever your goal or health concern, you are sure to have a great weekend with many other health experts, celebrities and professional chefs there to tickle your taste buds and keep you healthily informed.

If you are keen to come along, tickets are just £15 and you can pick them up here. It would be great to see you on Friday morning, so come along and say hi! 

 

Allergy-or-Intolerance-2small

A Food Allergy or Intolerance

Posted by | Food for thought, Healthy Eating | No Comments

Do you have a food allergy or intolerance? Victoria Bittle has kindly offered to write this blog post, to help to distinguish between each diagnosis, to describe how you might be tested and what you should do if you think you have one.
Thank you Victoria :)

If I had a dollar for every time I heard ‘I don’t tolerate that’ I’d be rich by now! Each year visits to GP’s for reported gut, skin or respiratory symptoms increase. Is food allergy and intolerance becoming more of an epidemic or are we just becoming better at recognising and treating it??  Many people often get confused about the differences between allergy and food intolerance and often they can present in similar ways, which can be confusing.

So what are the differences between allergy and intolerance?

Surprisingly, true food allergy is rare; affecting approximately 2% of the adult UK population and 8% of children (www.allergyuk.org).  Food allergy involves the immune system, where the body sees the food as a foreign body and makes specific antibodies (IgE) to fight off the potential harmful allergen. This results in a release of histamine and it’s the release of this, and other chemicals that cause the symptoms, we recognise as an ‘allergic reaction’. This reaction tends to happen relatively quickly following exposure to the allergen (the particular food) making it slightly easier to identify the cause. Common symptoms include wheezing, difficulties breathing, a running nose, vomiting, diarrhoea, skin rash, itching or swelling.
Most Common Food Allergens

Food intolerance is a little ‘wooly’ and not as clear cut as a food allergy.

Food intolerance reactions do not involve the immune system and reactions tend to be more delayed occurring hours to days after exposure. Symptoms vary however, more commonly associated with gut (bloating, constipation, diarrhea) and skin problems such as eczema.

Lactose Intolerance

People often talk about being intolerant to lactose/wheat or that they may be sensitive to caffeine or natural occurring histamine foods such as cheese, wine, or pickled foods . Having primary lactose intolerance is actually rare; this is when you lack the enzyme lactase meaning they are unable to break down the natural sugar within milk (lactose). More commonly seen is secondary lactose intolerance, which tends to be more temporary and can occur post gastrointestinal bugs/antibiotics. A simple lactose free diet (exclusion) for 6-8 weeks with re-introduction period tends to restore tolerance again.
Unlike with a true allergy, a positive lifestyle change such as exercise, a regular meal pattern, a nutrient dense diet and a reduced amount of fatty and processed foods can significantly impact your food tolerance.

It’s therefore important you look at making positive changes to your diet and lifestyle first before you start eliminating foods unnecessarily.

How do I find out if I’m allergic?

If you suspect an allergy based on the above information it is recommended that you visit your GP who can refer you onto the appropriate service for specific testing and dietetic input, should it be necessary. Tests that help to confirm an allergy include, a Skin Prick Test; which involves pricking the skin with an allergen, this may cause a localised response (i.e. redness, swelling). A Specific IgE blood test (previously known as RAST) is another way to test an allergy, it measures the amount of IgE, an antibody that increases in the blood in response to a (suspected) food. The results are not always reliable in both examples; therefore an oral food challenge remains the gold standard for allergy testing. These can be preformed either at home if appropriate or in the hospital setting under supervision from a specialist medical team and dietitian.

How do I find out if I am intolerant?

Unfortunately there aren’t many validated tests that can confirm intolerances, therefore for that reason the gold standard is to exclude the specific food for a period of time and then re-introduce it to see if symptoms reappear/worsen. A food and symptom dairy can be an extremely useful tool to help you to identify culprit foods and a dietitian can provide a tailored elimination diet to suit your needs. Dietitians are important during elimination diets to help advise you on a nutritionally complete diet including meals and snacks and special ‘free from products’ to ensure you can still enjoy, as well as stick to your diet.

In Summary

Food allergies and intolerances do appear to be all around us, so If you suspect an allergy or intolerance, make sure you go down the right channels in order to get the correct diagnosis and support you need. Speak to a qualified health professional; e.g. your GP and be skeptical of any ‘allergy’ test that’s either different from those described above and/or offered by a non-medic/doctor. Restricting your diet without supervision from a qualified dietitian may be difficult but also very dangerous if your diet isn’t nutritionally adequate, a dietitian can support you in finding replacement ‘free-from’ foods to prevent this from happening.

Top Tips

- Keep a food and symptom diary
- Alter your diet and lifestyle to ensure it is balanced and healthy
- Once you see notice patterns in your food diary, visit the GP who can advise and refer you on to a specialist if needed
- See a dietitian if you are excluding a number of foods for expert advice and to ensure you aren’t missing out on the key nutrients your body needs to stay healthy.
For more information on allergy and food intolerances visit Allergy UK.

 

Victoria Bittle

Paediatric Allergy Dietitian

 

The Author

Victoria is an experienced Dietitian, specialising in paediatric allergies and weight loss working predominantly within the NHS. In her spare time she try’s and reviews ‘free from’ products on the website Allergy Angle and works privately with the Diet Angels too. Victoria’s skills help assess, educate and treat nutritional related problems and her friendly, practical and professional approach aids motivation to achieve the desired goals and outcome.

www.allergyangle.co.uk                 www.dietangels.co.uk            Follow her on Twitter

The Weight Loss Surgery Roller Coaster

The Weight Loss Surgery Roller Coaster

Posted by | Fat loss, Food for thought, Healthy Eating, Uncategorized | No Comments

In essence, weight loss surgery is one of the toughest roads you could ever choose to go down; emotionally, physically and socially.

Over the past 6 years I have been in the incredibly privileged position of working alongside hundreds of people going through the process of weight loss surgery. To be there throughout the entire process from assessment to post surgery discharge was indeed, a rollercoaster. I shared the highs and the lows, felt the frustrations and the liberation, I felt the despair and the sheer happiness, and usually all in one afternoon! Because weight loss surgery is like that; about as far from a smooth and steady journey as you can possibly imagine.

More and more individuals are being offered weight loss surgery and this, I am certain, is only going to increase.
Why?

Because it works.

But let me rephrase that slightly, because it can work and can work brilliantly. However, it can also be a complete disaster. It can be the hardest, most traumatic, heart breakingly disappointing procedure. It can shatter dreams and hope, wreaking havoc with an existing, rock bottom self-esteem.

So what have I learnt about navigating weight loss surgery to make sure it works and works brilliantly?

You can never be 100% certain that it will work. Despite high motivation levels and a good level of understanding, there will always be people for whom weight loss surgery will never work. The reasons for this are multiple and complex and I doubt even that individual will really understand what is holding them back from success.

Timing is everything. The vast majority of people will come for an assessment hoping to be put forward immediately and, in an ideal world, have their surgery within weeks. This would be a disaster. I have learnt so much about the importance of providing people with at least 6 months of  pre-surgery preparation. This time is SO important to start accepting the reality of weight loss surgery, to realize the changes that you will need to make and to reflect on the harsh reality of the hard work required to succeed. For some 6 months is enough and for others a period of 18 months works perfectly – everyone is different.

Weight loss surgery is no magic wand. Weight loss surgery or no weight loss surgery…

In order to lose weight you need to make significant, sustainable and positive changes to your diet and lifestyle.

To lose weight with weight loss surgery you need to reduce portions, cut out or reduce the empty calories, concentrate on plenty of fruit and vegetables, lean protein and complex carbs. Just as you need to do without the surgery. It is not a way of eating what you like and still losing weight. You have to work at it.

The complete team is so important. Having a multidisciplinary team with a dietitian, psychologist, pharmacist, specialist nurse, endocrinologist, surgeon, anesthetist and a radiologist is crucial. The team need to communicate effectively and have sufficient funding to offer appropriate levels of care to patients. This is a big one and fairly political at the moment but nonetheless very true.

There is no one-size-fits-all surgery option. I have seen people succeed and fail with all types of weight loss surgery and the choice of surgery needs to be a joint decision, informed, considered and chosen for the right reasons. Many people have seen friends or family fail or succeed with a certain type of surgery and then choose to avoid or select it accordingly. Be open and consider all types.

Accept that after the sunshine comes the storm. The hardest part for many is accepting that post surgery weight loss is slowing and then stopping and then worse, they start to gain weight. This is normal. It happens to everyone and is part of the process. Just as normal weight loss without surgery will come in waves; you lose, you maintain, you gain, you lose….and the cycle continues. Relapse and weight gain is a normal part of the process so expect it at some point, embrace it and use it as a valuable learning opportunity. Look at why it has happened? Which habits have crept slowly back in? (this happens to everyone!) Learn from it and decide how you plan to avoid it happening again? Your weight loss curve will look more or less like a rollercoaster – expect this and you won’t be as disappointed.

What success looks like

 

To all those who have had surgery – ignore everyone who puts you down, thinking that you have chosen the easy option. Hold your head high, know that deep down you are mustering the same strength, determination and resilience that anyone else trying to lose weight without the surgery, has to do. Criticism is often borne out of resentment and jealousy. Try to rise above it however hard this might be. There is a growing number who realise how hard you are working – focus on these individuals.

Surgery can change the way that you eat forever. Sometimes surgery can have unpredictable effects and you might end up unable to tolerate or digest certain types of food. This can be hugely restrictive and impact on every aspect of your life. Sadly this is a risk, one of the many that those undergoing surgery will have to take. However, be mindful of the choices that you make in terms of foods. Some foods will be easier to eat, however this although tempting is not the way forwards. A good working relationship with your dietitian is the best way to avoid falling into this trap.

apple on a plate

Choosing to undergo weight loss surgery is a brave option and it is often the last option available for people. A last resort after years of struggling. Summoning up enough courage to attend an initial appointment is a huge achievement, it takes so much strength to face up to discussing food and eating and these individuals deserve a truck load of respect. I admire each and every patient with whom I have worked. I learn from them every day and I never cease to be amazed by the commitment that they show.

Losing weight might not make you as happy as you think it will. For many, weight loss surgery carries a heavy burden or responsibility – it is supposed to make you happier, improve your relationship, help you to get a job or be better at the one you do, be a better friend, have more confidence, make you do more exercise and so on. A long list of responsibilities for any one ‘thing’ to bear. Unfortunately, the harsh reality of weight loss surgery is that it often fails to deliver on one or all counts. I think this is something that everyone needs to think about. It is all too easy to live in the ‘if only’ land. ‘Life would be better if only I was thinner’, I would have a job if only I was thinner, I would have a relationship if only I was thinner….believe me when I say, that losing weight is not a guaranteed for ‘happily ever after’. In fact, it can have the opposite effect. It can be hard to adjust and you need to be aware of this, if you find yourself in this situation. You are responsible for your own happiness, and that starts from within, not from a gastric band. So reset the expectations that you may have about your slimmer self, when you go for surgery or about others who are doing so. Don’t feel entitled to a new mindset.

That’s not to say you can’t be happier, of course you can but that is down to you and the choices that you make and not a piece of silicone or a few stitches.

I hope that his article makes you think, perhaps about judgments that you have made or about choices that you might make in the future if you are thinking of weight loss surgery as an option. It can be a truly wonderful and life changing tool, but it is just that, a tool, and without the team, the personal commitment and the necessary resilience within your tool kit, the surgery alone is a very small part of a large and complex jigsaw.

Faith Toogood

Faith Toogood

 About the Author 

Faith Toogood is an experienced Dietitian, specialising in weight management and weight loss  surgery.  She has a breadth of experience spanning the NHS and the private sector.  In addition to  running a busy private practice, she is a regular on our TV screens, appearing on ITV’s ‘The Biggest  Loser’ and other weight loss shows. Faith is passionate about helping everyone to feel empowered  around food and cooking, and is well  known for her practical, no-nonsense and warm approach in  helping others to drastically improve  their diets through simple, sustainable and affordable  changes.
Connect with Faith here: FaithToogood.com, on Twitter and on Pinterest 

 

Faith is a fantastic dietitian and one of the nicest people I have had the pleasure of working with so check her out, on her website and social media links above. A huge thank you for writing this guest blog post Faith, it really highlights the highs and lows of the weight loss surgery journey for the patient and that its not the plain sailing procedure, as its often perceived.

Have you or anyone you know embarked on weight loss surgery?

We would love to hear about your experiences?

Do you have any advice for others considering weight loss surgery?

Optimized-top-10-tips-to-avoid-weight-gain-in-the-USA

How to avoid (too much) weight gain on ‘vacation’ in the USA

Posted by | Dining, Fat loss, Fitness, Healthy Eating, Uncategorized | 2 Comments

Having just returned from a well-deserved and thoroughly enjoyable break in the USA, I was pleased to find out that I’d only gained 1.5 lbs in weight.  I normally assess my weight by how my clothes fit and since they were a little tight, I was curious to know.  Now, one of the reasons I wanted to do this trip was because of the amazing and authentic food on offer; from deep pan pizza in Chicago, Buffalo wings in Buffalo, cheesecake in New York to Cheesesteaks in Philly, this trip was a foodies dream!  Therefore, I absolutely expected to gain some weight, and having been to the US before I knew exactly what I was in for when it came to; portion sizes, hidden calories and the not so hidden calories in the form of ranch dressing and cheese drenching a perfectly healthy balanced salad!

Icecream

So how can you reduce the weight gained while away in the US?  Here are my top 10 tips for minimizing weight gain whilst holidaying in America.

1. Sharing is Caring

Portions in the US of A are just huge, in many places I feel ‘quantity’ takes precedence over quality.  Luckily, I had some equally health conscious friends (one being another dietitian @perryncarrol) with me who were happy to share the load.  So one meal became 2 or sometimes even 3, there was no need to worry about whether there would be enough, we were always left feeling full to the brim!

Deep pan Pizza

2. Think Small

Starters and sides are often as big as a main course meal here in Britain, we were always so surprised when they arrived that we couldn’t hide our shock even after 2 weeks! Ordering a starter as your meal will help to reduce the total amount of food you eat, plus tips one and two undoubtedly helps you to save the dollars too!

3. Be Specific

The USA are a service-centric nation and so making requests at the start of your meal, no matter how much bother it seems to you, really isn’t to them.  Us Brits, don’t like to make a fuss I know, but if you ask for grilled instead of fried, and cheese/dressing on the side it really won’t be too much trouble.  In fact, I suggest this is one of the main ways slim Americans stay that way.  If I had eaten the food given to me in the way it’s normally served, I’m sure I’d be sat here writing this an extra 3 lbs heavier!

4. Eat In

We travelled around the North East and stayed in hostels, hotels and Air B&B apartments.  This was great as all but the one hostel had a refrigerator, plates and cutlery for us to make some of our own meals.  I personally feel that eating out all of the time can get a bit much, its a financial drain but most of all it’s pretty time consuming! Having the fridge was perfect, because we could buy fresh milk, yoghurt, fruit and cereal to whip up a nice healthy (and familiar) brekkie.

5. Drink Well

I mean water, of course.  As expected, it was pretty hot and humid over there.  This, combined with the continuous flow of the AC conditioned air is enough to dehydrate a cactus!  Its common to feel hungry when in fact you are thirsty.  Therefore, I would suggest drinking more than you would normally and especially at meals to help fill you up, replenish salts lost through sweat and restore hydration.

6. Drink Light!

By this I DON’T mean ‘light’ beers; these are often reduced in alcohol but not in calories – so don’t be fooled!  I mean, go for light drinks nothing to thick, heavy or creamy. I realise that this tip is extremely generalised, but when you fancy a boozy beverage you don’t really want to think too long and hard about calories.  So simply think; ‘drink light’; prosecco over white wine and white wine over red.  Lager over ale, stout or Guinness and vodka/gin instead of whisky, brandy or liqueurs.  Always try to mix with a low/zero calorie mixer and add plenty of ice, and while it’s tempting to indulge on the way home – remember that what you eat at the end of boozy night will more than likely be stored as fat (if you are in a calorie surplus), since your body is already working hard to metabolise each unit of alcohol you have effortlessly sunk and not the calories from the burger and fries.

7. Joyful Jogging

I take my trainers with me everytime I go away!  I find running through exciting locations the best way to get your bearings and explore new holiday hot spots. I tend to head out first thing to avoid the midday heat.  From Central Park to Saugatuck (on Lake Michigan) I pounded the pavements and felt great for it!  I know many of my clients don’t like to exercise when they’re away, but there were so many people doing the same thing.  Why wouldn’t you? It wakes you up, snaps you out of your heat induced coma and burns calories, plus it was the first time I felt like a local – which is pretty cool!

Running

Training like Rocky!

8. Cultural Ride

Everywhere we went, there were bikes available to hire, again its a pleasant (calorie burning) and cooling way to explore.  We took the bikes out in Chicago and Saugatuck and on both occasions got to see way more than we could on foot.  Just remember to ride on the ‘wrong’ side of the road when you aren’t on cycle paths but don’t cycle in NYC (unless you are only in Central Park) its far too dangerous on the roads and this is coming from a London based cyclist!!

The Cloud Chicago

9. Count your Steps

We walked sooo much, from the Freedom trail in Boston, the Constitutional walk in Philadelphia to the Brooklyn Bridge and just about the whole of Manhattan in NYC.  I didn’t realise that my comfiest Havaianas could give me blisters, but they did!  Our friend had bought a pedometer at the start of our trip and it was quite rewarding as well as encouraging to find out how many steps we had clocked by the end of the day.

10. Enjoy it!

We had an amazing trip and while I followed all of these tips to minimise weight gain, I didn’t feel restricted.  I still ate what I wanted to eat and enjoyed every mouthful! So what if I gained a lb or 2, now I’m home and back to eating my normal healthy diet and exercising regularly, I’ll return to my previous weight in a few weeks, which is absolutely

Genos            Buffalo wings Optimized-4th July cake

In short, life and all it contains is here to be enjoyed.  So, do just that, eat a New York Cheesecake but just make sure you’ve packed your trainers to run it off in Central Park afterwards!

 

Triathlete

Nutrition to Fuel your Triathlon

Posted by | Fitness, Healthy Eating, Sport Nutrition, Uncategorized | No Comments

Training for a triathlon, from a sprint distance to an Ironman requires a lot of extra time and grit, putting in the hard graft a train for 3 disciplines (swim, run and cycle).  A disciplined attitude towards nutrition is also useful, since training alone will only get you so far.   Specifically, amateur and elite triathletes should be aware of their own carbohydrate needs and intake, ensuring they are consuming enough to optimise their training performance and ensure that carbs are distributed over the day to fuel before a workout and aid recovery following.  If you are serious and you want to do well, then fuelling your training with a healthy nutritious diet and one that provides an adequate amount of carbohydrate should be one of the things at the top of your list.

Carbs to Go!


Carbohydrates are your body’s main and preferred source of fuel especially during an endurance sport such as triathlon.  Carb food sources such as bread, potato, pasta and rice are digested and stored in your muscle and liver as glycogen, ready to use as energy, as and when we need it.  The problem is however, that we can only store approximately 2000 kilocalories from carbohydrate.  Which sounds like a lot, but if you imagine a half – ironman triathlon requires approximately 4500 calories to complete, the energy stored doesn’t even meet half of the energy required.   That’s why a regular intake of carbs is required during the event as well as during your triathlon training. To put it simply, a higher muscle glycogen level will allow you to train harder for longer and a low muscle glycogen will result in early fatigue and a lower training threshold.
Take home message A regular intake of carbs in your diet can help you to train harder and perform better.

Calibre of Carbs


You may have heard of the glycaemic index (GI). It’s basically the value at which carbohydrate food and drinks affect blood glucose levels. High GI foods and drinks cause a higher blood glucose response and low to medium GI foods cause a lower blood glucose response.   It’s recommended that we consume carbohydrate foods that are considered low to medium GI most of the time.  However, in reality a mixed meal, which contains carbs, fats and protein, will reduce digestion time and thus the rate at which a high GI carb (like a jacket potato!) affects the blood glucose level anyway.  Plus high GI sources are particularly important during exercise (greater than 1 hour), since they supply a rapid uptake of glucose to sustain energy production and performance.
The amount (which I’ll come on to) and ‘quality’ of the carbohydrate food appears to be more important for health and energy levels.  By ‘quality’ carbohydrate I mean, carbs that are unrefined, e.g. wholegrain breads and cereals, fruits and vegetables as well as dairy; foods that provide many other nutrients and physiological benefits besides energy alone.  Sweets and sugar (are also carbohydrate) do just that and have been unfairly demonised of late.  While they shouldn’t be consumed regularly, an infrequent intake will cause you no harm.  Plus, we are only human – who doesn’t like the odd biscuit or sprinkle of sugar!
Take home message :Eat nutritious unrefined carbohydrate sources most of the time and save sweet foods and those with added sugar to occasional treats or for during exercise lasting more than 1 hour.  

Carb counting – how much?

We all need carbohydrates as part of a healthy balanced diet but regular exercisers and triathletes need more than inactive, sedentary individuals. The amount of carbs you require is very much dependent on how active you are, and specifically how many hours per week you spend training.  Carb requirements are calculated on an individual basis using total body weight (in kgs) multiplied by carbs (in grams), which increases proportionately with time spent training.

Carb req vs Training needsTake Home Message: To estimate your carbohydrate needs, use the information in the table to establish the amount of hours you typically train each week and calculate the suggested carbs in grams by your weight in kilograms.

Carb Guide

This is probably all gibberish if you do not know the carb content of your fav’ foods!  So to help, see our Carb Food Guide below; which shows you a variety of different carb rich foods and the amount that provides around 50g of carbohydrate.  I would suggest keeping a food diary for a few days, being sure to note accurate weights or servings sizes.  Once complete, cross-refer with the Carb Food Guide to estimate your current carbohydrate intake, comparing it to your calculated requirements.  It may be that you consume more carbs than you need or that you do not consume enough to support your triathlon training.  Either way, adjusting your intake should help you to meet your carb needs and ultimately support your triathlon training and performance.
Take Home Message: Different foods contain varying amounts of carbs, getting to grips with your current carb intake and making appropriate adjustments to the amount and ‘quality’ you consume, will help you to meet your energy needs whilst fuelling your sport and supporting your health.

Please note: that I have included a variety of foods within this table to help show their carb content.  Foods such as sugary cereals, chips, white bread and biscuits should be consumed in moderation – think ‘quality’ unrefined, whole foods.

Carb guide table

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

50g exhange Carb guide

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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