FAD or FAB?! – Collagen supplementation for athletes

Collagen is the most abundant protein in the human body and is largely responsible for providing structure and strength to our connective tissues. Most people who are involved in sports will at some time experience injury to such tissues – whether it be to their tendons, ligaments or even to their bones or cartilage. Tendons, fascia and ligaments in particular can be very slow in healing, causing much frustration and subsequent injury when the athlete returns to high training loads without adequate rehab or healing time.

connective tissue injury

Been  there…done that…too many times…

This article looks at the most recent evidence on whether ingesting additional collagen, notably through supplementation with gelatin or hydrolyzed collagen supplements will help with the healing, stabilization and strengthening of these collagen-rich connective tissues with the ultimate aim of preventing injury in the first place.

Before I delve into the nitty gritty, the simple, unavoidable truth first:

There are many micronutrients involved in collagen formation and any additional free amino acids or peptides from supplementation will not be effectively used for collagen production if you are lacking in Vitamin C, E, A, sulphur and lysine in particular. Adequate amounts of these nutrients along with good hydration, sleep, regular exercise and avoidance of alcohol and smoking will do far more for collagen production and creating healthy bodily tissues then popping a few gummies or tablespoons of powdered collagen every day and neglecting these other elements.

 

SO, WHAT DOES THE RESEARCH SAY?

There are three key amino acids in particular that make up collagen: Proline, glycine and hydroxyproline. Research into supplementing with these amino acids have shown promise in increasing recovery rates on connective tissue(1), reducing muscle loss in the elderly(2) and in the treatment of osteoarthritis(3).

Supplementation is becoming of increasing interest to athletes as it’s recently been shown that taking 15g gelatin with around 50mg of Vitamin C, 30-60mins prior to targeted training such as jumping rope, will double the collagen production after those sessions compared to undertaking the session without such nutritional support.(4) Collagen intake has also been showed to improve function, instability and pain perception in ligament and joint damage – with the most significant and conclusive studies being undertaken on the ankles and knees.(5-8)

targeted exercise

Sounds good yes?

Sure, but such studies have to be interpreted with care with substantial weaknesses being:

  • Studies in this relatively new area are not common and most are sponsored by the supplement industry. This affects some studies referenced above but they have nonetheless been carefully included in my analysis as the institutions they worked with to undertake their research are so highly regarded in terms of their quality, methodology and ethics. There are plenty of others (all showing positive findings of course) which I omitted for being of questionable quality.
  • Most researchers unfortunately compared collagen supplements or gelatin to a non-amino containing placebo only. It would have been far more meaningful to have an additional group taking an equivalent amount of whey protein for example – to identify how much of the positive result was attributed to the specific collagen-related amino acid mix. (Ie – the research doesn’t necessarily answer the question: Are collagen supplements just a tarted up, overpriced protein supplement?)

It’s important to acknowledge that collagen supplementation is still a very new, evolving area of study and there is still insufficient data to be truly conclusive about the efficacy, dosage and application. This includes that most positive studies on improving injury healing rates and injury prevention have very small sample sizes and therefore further, more comprehensive research is needed.

Crucially, the studies that produced positive results combined supplementation with targeted tendon/joint exercises or resistance training.

The theory is that the additional availability of the key amino acids required for collagen production allows the tissues to strengthen in the direction and for the purpose of the targeted activity to which they are being subjected in that active period of uber collagen peptide availability. Popping collagen pills or powers without complementary exercises is unlikely to have any effect on injury healing or the prevention of injury.

So, if you’re tempted to give it a go – based on the reviewed research, a reasonable regimen that you may want to try for the targeting of specific collagen-rich tissues is to:

  • Take 10-15g gelatin or collagen peptide supplement with at least 50mg Vit C, 30-60mins prior to 10 minutes of individually-designed targeted connective tissue exercises.
  • For injury prevention: 2-3 sessions/week with ideally a 6 hr window between other sessions
  • More sessions maybe required if you are addressing a specific acute or chronically occurring injury. Discuss this with your physio.

Gelatin vs Supplements:

So, you might want to ask your Nanna to fire up her repertoire of wobbly gelatin-filled delights (or if you prefer, there are all sorts of recipes that abound on the internet that will contain far less custard, cream, sugar and painful cheek pinching). On the other hand, if you want to get fancier, throw a bit of $$ around but arguably it’ll be more convenient, there are an increasing number and range of new collagen supplements on the shelves these days. Many of these supplements contain the hydrolyzed form of collagen as these are arguably better absorbed by the body and therefore more bio-available after digestion for collagen production.

gelatin

Photo by Mateus Campos Felipe on Unsplash

Additionally, supplementation with non-animal based collagen is of course really the only effective way for vegetarians or vegans to get additional exogenous amounts of these amino acids in any notable amounts without the ingestion of animal tissues. Such vegetarian and vegan collagen supplements (though hard to find!) are usually synthesized from modified yeast and bacteria.

Of course, you can also generally increase these key amino acids in your diet naturally by slow cooking or making bone broth with animal bones, cartilage and other connective tissues such as ligaments/tendons. It would be hard however to quantify dosage and eat such a dose in the context of the regimen suggested above.

A cautionary note: Concerns with heavy metal contamination have been raised with animal-based collagen supplements and/or high intakes of bone broth/similar dishes. I’d certainly avoid any such collagen-enhanced regimen for children or pregnant women.

Likewise, the outmost care must be taken to select a reputable brand of supplements. I’m far from expert in this area – so after writing this article, I sought advice from Phil (my supplement guru at Fit Empire and Wellness – Townsville). To be clear at this point – there’s no kickbacks for him or me (I just know a lot of you may appreciate a starting point!) He recommended ‘Gelita’ as a brand – both in terms of quality and purity. The Gelita staff are certainly lovely and take a lot of pride in their company, many thanks to Natalie took a lot of time to explain to me the ins and outs of some of their products.

 

TARGETED EXERCISES – AN ESSENTIAL, NOT AN OPTIONAL COMPONENT!

I won’t go into depth with the different sorts of training/exercises that can be done as I’m certainly not a physio by any means and each sport and different injuries and individual athletes need to be professionally treated with a tailored program.

However, targeted exercises are an essential ingredient in the athletic context; so for your interest and consideration:

There are specific types of training that can stimulate collagen production in these connective tissues in different ways. The good news is that compared to muscular and cardiovascular adaptations that can benefit from hours of training, stimulus to strengthen the connective tissues largely turns off after 10 minutes – so no need to worry about how you’re going to fit in any more big blocks of training time into your day!

These mini-sessions are best done minimally 6 hours apart from each other or from other training – so timing is important. Generally 2-3 sessions/week are recommended for injury prevention and up to 2 or even 3 times/day to address and rehab an acute injury.(9)

  • Fast, plyometric type of exercises improve strength and speed – the interlinking of collagen proteins within the muscle and at the muscle end of the tendon are built up under this sort of loading.
  • Jarring exercises can be used to strength bone which is also a collagen-rich tissue. For example; a useful exercise for runners for the prevention of lower limb stress fractures is 5-10 minutes of skip rope jumping 3-4 times/week.
  • Of particular use for tendon injury treatment or prevention is training with slow reps and heavy weights including exercises with eccentric loading or isometric holds.(7) This type of training will still increase the interlinking of the collagen proteins within the muscle but not so much at the muscle end of the tendon, reducing stiffness at those locations, thereby reducing risk of injury.
    • Eccentric loading – where your muscle lengthens at the same time it’s being contracted – think of the downwards rather than the upwards part of a bicep curl
    • Isometric holds – static holds where a muscle is under load but without lengthening/contracting of that limb – eg a static tricep extension against a solid surface such as a wall all or even the dreaded plank

Again, I stress with emphasis – the types of exercises you need and frequency should be tailored by a physio to suit your sport and to correctly target your area of likely (or current) injury.

 

CONCLUSION

Research is not yet at the point where we can positively define the dose-response effect of collagen supplementation or to separate out the effects of supplementing with specific collagen peptides vs standard amino acid supplements as unfortunately most of the research was merely comparing collagen vs placebo. Some more truly independent research would also be a valuable addition to this discussion.

However, it’s a promising new area for injury prevention and treatment in the athletic context with few reported side-effects – the most common being slight digestive upset (possibly more due to the ‘eeww’ factor of thinking what collagen is made from rather than any true physiological response).

The key take away points if you are considering jumping on the collagen train for injury treatment or prevention is that:

  • Most successful studies used around 10-15g hydrolyzed collagen or gelatin with supplemental 50mg Vitamin C
  • Dosage taken 30-60 mins prior to targeted exercise sessions
  • Sessions were short and comprised of specifically-designed, exercises on key target tissues or areas. See your physio for a program that suits your priorities
  • Supplementation will be ineffectual if other micronutrients required for collagen synthesis are lacking (namely Vitamin C, E, A, sulphur and lysine)

Again, for emphasis – do not fall into the trap of thinking that you’ve popped a supplement therefore will automatically reap the benefits. Timing, frequency, targeted activity and general overall good health and nutrition is also essential.

Side note to this article that some of my clients have been asking about:

Much of the hype within the general population around collagen supplementation at the moment is as it’s role in the ‘beauty’ connective tissues such as in your nails,(10) skin and hair.(5) It’s important to note that from that many of the positive studies in this area were found to have substantial conflicts of interest (ie funded by the supplement makers) and the outcomes were self-reported – sooo….not exactly top science! Additionally, most beauty collagen supplements contain really small amounts of collagen so are unlikely to be effective to any great degree.

However, despite this – there is a small amount of genuine positive evidence to support supplementation for the improvement of these tissues, but the findings have been insufficiently consistent to ascertain effective dosage-response levels(11). Extrapolating from what we’ve learned in the athletic context, the lack of obvious, measurable and consistent response in these aesthetic tissues to supplementation, could be due to the absence of a particular, specific stimulus in those specific tissues. Ie – the additional amino acids in the blood stream may well be used to form other bodily proteins or used for other functions entirely.

So, if you want to grasp onto your youthful looks for as long as possible (don’t we all?!), you really should get your head out of the Jelly Jar and focus on establishing well-balanced dietary and healthy lifestyle habits – no groundbreaking news here!

 

REFERENCES

 

  1. Lopez HL, Ziegenfuss TN, Park J. Evaluation of the Effects of BioCell Collagen, a Novel Cartilage Extract, on Connective Tissue Support and Functional Recovery From Exercise. Integr Med (Encinitas). 2015;14(3):30-8.
  2. Hays NP, Kim H, Wells AM, Kajkenova O, Evans WJ. Effects of whey and fortified collagen hydrolysate protein supplements on nitrogen balance and body composition in older women. J Am Diet Assoc. 2009;109(6):1082-7.
  3. Garcia-Coronado JM, Martinez-Olvera L, Elizondo-Omana RE, Acosta-Olivo CA, Vilchez-Cavazos F, Simental-Mendia LE, et al. Effect of collagen supplementation on osteoarthritis symptoms: a meta-analysis of randomized placebo-controlled trials. Int Orthop. 2019;43(3):531-8.
  4. Shaw G, Lee-Barthel A, Ross ML, Wang B, Baar K. Vitamin C-enriched gelatin supplementation before intermittent activity augments collagen synthesis. Am J Clin Nutr. 2017;105(1):136-43.
  5. Czajka A, Kania EM, Genovese L, Corbo A, Merone G, Luci C, et al. Daily oral supplementation with collagen peptides combined with vitamins and other bioactive compounds improves skin elasticity and has a beneficial effect on joint and general wellbeing. Nutr Res. 2018;57:97-108.
  6. Dressler P, Gehring D, Zdzieblik D, Oesser S, Gollhofer A, Konig D. Improvement of Functional Ankle Properties Following Supplementation with Specific Collagen Peptides in Athletes with Chronic Ankle Instability. J Sports Sci Med. 2018;17(2):298-304.
  7. Praet SFE, Purdam CR, Welvaert M, Vlahovich N, Lovell G, Burke LM, et al. Oral Supplementation of Specific Collagen Peptides Combined with Calf-Strengthening Exercises Enhances Function and Reduces Pain in Achilles Tendinopathy Patients. Nutrients. 2019;11(1).
  8. Zdzieblik D, Oesser S, Gollhofer A, Konig D. Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides. Appl Physiol Nutr Metab. 2017;42(6):588-95.
  9. Jeukendrup A. Using gelatin to improve performance prevent injury and accelerate return to play 2017. Available from: http://www.mysportscience.com/single-post/2017/03/15/Using-gelatin-to-improve-performance-prevent-injury-and-accelerate-return-to-play.
  10. Hexsel D, Zague V, Schunck M, Siega C, Camozzato FO, Oesser S. Oral supplementation with specific bioactive collagen peptides improves nail growth and reduces symptoms of brittle nails. J Cosmet Dermatol. 2017;16(4):520-6.
  11. Choi FD, Sung CT, Juhasz ML, Mesinkovsk NA. Oral Collagen Supplementation: A Systematic Review of Dermatological Applications. J Drugs Dermatol. 2019;18(1):9-16.

 

Many thanks to my friend and colleague Rachel Eagleton who kindly reviewed this article and provided me with invaluable insight and input. Rachel’s Balmain-based consultancy specialises in tailored, individual solutions for her clients – head over to her website for some fabulous resources and contact details.

Lets lunch, 2018!

And so the school year begins with hundreds of lunches laid out in front of you to pack one by one. So what’s on the menu for the little tackers in 2018?

Some of you reading this article are no doubt all over this packed lunch business, prepping them like the pro you are and perhaps only keeping your eye out for a few new ideas. Others may need a mini-refresher course about the essential building blocks that make up a nutritious, balanced meal.

Note also – that though this article is aimed at parents making lunches for their kids, much of the advice holds true for adults making their own lunches – plenty of room for improvement in many an adult lunch!

So what should your kid’s ideal lunchbox look like?

Well unfortunately these days with time-poor parents and the proliferation of packaged food – it probably shouldn’t look like their mate’s sitting next to them! LCM bars, tiny teddies, juice poppers, chips, refined carbohydrates in the form of white bread or crackers and sugary muesli bars abound in lunches these days. So, it can be really hard for your child to be excited about their healthy food when they’re comparing it to that of their BFF.

Personally, I find it helpful if my kids lunches are as fun and as attractive as possible to minimise this sense of ‘losing out’ and it can take but a few extra minutes and a few simple tools like a potato peeler and a few cookie cutters. But there is also real life to get on with and it’s unrealistic to expect that you should be able to #lunchboxboss every day!

Sometimes you may have the time and motivation to spend mucking around making their lunch cutesy – and sometimes you simply don’t and would rather take the star cutter to your eyeball. Striving for perfection will only send you crazy – and that goes for both content and aesthetics!

Let’s look at what their lunchbox should (..ideally…when the stars align….) contain

Well, in a nutshell (actually…don’t put nuts in – you could kill someone) – your childs lunch should contain something from each of the following categories – not neccessarily in seperate, neat portions – they could having a party together in a frittata, muffins or some leftovers! You are limited only by your imagination, prepping time and what your child is likely to eat. Remember too that mini Thermos flasks can be great to keep leftovers piping hot and safe to consume if they won’t eat them cold.

Adjust the portion sizes noted below based on your child’s age, activity level and hunger – this is just a rough guide for an ‘average’ primary-aged child and to indicate healthy ratios of the different types of food – wild variations in absolute quantities can occur

1) DRINK – WATER

Juices and flavoured milks are unnecessary and should only appear as a ‘treat’ on a rare occasion.drink bottle

One juicebox contains around 5 tsp of sugar. This is pretty much your child’s recommended daily total.

 

2) VEGETABLES – min one half of a std cupveg

  • Carrot
  • Cucumber
  • Capsicum
  • Cherry tomatoes (yes..technically a fruit..)
  • Beans – green or canned
  • Snow peas
  • Corn
  • Broccoli (if your kids are hard-core!)

Basically, work with whatever your child will happily eat!

 

3) FRUIT – 1 medium piece, two smaller pieces or ½ cup fruit saladfruit

  • Apple, Pear, Banana, Mandarin
  • Berries, grapes, kiwi
  • Apricot/peach/nectarine
  • Melon, Avocado, olives
  • Again – whichever they’ll eat!

2-3 pieces of dried fruit or a small serve of sultanas is a fun alternative occasionally. It should not replace fresh fruit as an everyday option.

4) PROTEIN AND/OR DAIRY or dairy alternative – around 1/2 cup 

  • A few chunks of cheese
  • 100g yoghurt – try to get one where sugar and protein contents are both within 5-10g/100g
  • Cream cheese (eg to dip veggie sticks in)
  • Boiled eggs
  • Marinated tofu (try it on them…you maybe surprised)
  • Legumes
  • Tuna or smoked fish
  • Meats – in their wholegrain, or wrapped around their veggies.

Processed meats really aren’t great for you or your kids – but lets face it, they’re convenient. Try to strike a balance between ‘ideal nutrition’ and functionality, mix up your proteins as much as possible.

5) GRAINS – 1-2 serves 

Grain sources should be as high fibre and as with as much wholegrain content as possible. A good trick to know is that the total carbohydrate/10 <<fibre content on the label

For younger kids and/or if you are including the full range of the categories above – you often don’t need a whole sandwich – half is often sufficient.

  • Wholewheat or grainy bread or wraps
  • Crackers – Ryvita, vitaweat or Tucker’s wholegrain are great
  • Sushi – brown rice if possible
  • Noodles
  • Leftover pasta, quinoa, cous cous or rice meals or salads can be good to change things up

 

Above all – remember the key division of responsibility that you need to govern the realm of nutrition with peace between you and your child:

1) Parent: Your responsibility and power is to provide what you want your children to eat and in the quantities that you’re happy for them to eat that particular food in

2) Children: Their responsibility and choice is what to eat and how much of each food they want to eat from your offerings.

If over time you notice that your children are not eating a proper balance between the food groups and consistently coming home with (typically) their veggies – try lowering the portions of the other foods so that you encourage consumption of their ‘less valued’ options – it may be a simple issue of having too much food in their lunch and that’s the last cab off the rank. Or better still ask them what veggies they’d like to see – or if there’s ways you can make it easier or more fun to eat.

Kids love having power over their food – especially as they get older – so giving them the power of choice within the options you have available or are happy to source and getting them more involved in their lunchbox shopping and preperation gives them increased ownership and tends to increase their acceptance of what’s on offer.

So I hope this gives you a bit more info to help you navigate the field of school lunches in 2018!

Below is a recap of a few of my kids lunchboxes from over the last year or two to give you a few ideas to try out on your kids this year – noting as always the disclaimer that they are not all as attractive as these ones and they’re all certainly not ‘perfect’ nutritionally!

You’ll see that they’re all presented in ‘Yumboxes’ which are a favourite of mine as they don’t leak between compartments, reduce waste and make lunches look fun. In using the Yumbox, there’s a bit of a tradeoff between taking a bit more ‘fiddly’ time to cut things down to fit compartments vs having to find a million seperate containers in the tupperware drawer, then having to wash them all – wondering on which bit of the playground were half the lids left?

Heads up! Exciting news for those of us in Townsville – These Yumboxes are now going stocked in Elle J’s boutique, Domain Central – so you can see them and the different colours/options before you buy. For those elsewhere – my favourite online shop for all things Bento is Little Bento World.

(No paid affiliation with either company – just adding info pre-empting the common question about where you can get these boxes!)

 

 

Would you like extra carbs with that?!

So you’re at your local pub when “I’m Carbo-loading” is slurred at a particularly loud volume straight in your face, complete with some complimentary chicken salted spittle to your eyeball.

Despite being epically un-original, this one liner reliably earns a few giggles due to the irony of generally being stated so proudly by those least likely to have any plans to burn off their enhanced muscle glycogen tomorrow – or indeed at any stage in the short, medium or long term future! But taking this term outside of the pub context – what exactly does Carbo-loading mean and if you are preparing for an endurance race should you embrace this beast?

It just so happens that I’m pondering this very question right now as I prepare for my first ever 50km trail run next week in the Blue Mountains. Let’s be honest: I’m a complete novice, as green as they come and I use the words ‘prepare’ and ‘run’ very generously given that my preparation has been woeful (injury after injury) and therefore very little running is actually forecast for the big day.

So, in my desperate search for anything that is going to increase my likelihood of survival, let alone avoiding a ‘DNF’ being written beside my name – reading that research has found that carbo-loading can delay fatigue by 20% in races longer than 90 minutes is naturally piquing my interest somewhat!(1)

Basically, ‘carbo-loading’ is the process of elevating your muscle glycogen stores in the hope that you will be able to go faster and/or longer and is generally of particular interest to those competing in endurance events (those races longer than 60-90 minutes). 

For those – not quite in ‘the know’ – glycogen is basically your body’s way of storing carbohydrates as fuel for movement or activity, and the average humanoid has around 500g of it distributed around their body, mostly in the muscular tissue (with an additional 90 odd grams in the liver).  Therefore, the amount of glycogen which is stored in the body is logically dependent on two main factors – how much muscular tissue you have and whether your diet is high or low in carbohydrate. For women, where you are with your menstrual cycle will also be a factor: it’s been shown that in the luteal phase you’ll store more.(2, 3) When combined with the glucose in your blood, this means that for most – generally, the body will store around 2000 Calories worth of carbohydrate fuel.

Side note: for every 1g of glycogen, your body will hold around 3ml of water – hence why when you go on a really low energy/carbohydrate diet you’ll miraculously lose 2-3kg in the first week….but then why of course that just comes straight back when you eat normally.(4)

Bodily fat is also an important fuel for endurance events, especially for ultra-endurance events that are conducted at a lower intensity (lower heart rate), but fat is generally not as easily broken down for energy.(5, 6) There are many practices that athletes employ to try to maximise training adaptations or fat-burning efficiency to improve this rate and/or reduce their reliance on consuming carbohydrates during their races (who doesn’t want less weight to carry, less chance of gastrointestinal upset and to save time and effort in not having to physically consume as much carbohydrate during the race?!)(7, 8)

These are summarised in the figure below but in it’s most basic form, this can involve training in the morning before breakfast to more elaborate training/nutrition sequencing and with the extreme end of the spectrum being to train and live in a ketogenic state.

train-low.png

Source: From Asker Jeukendrup at http://www.mysportscience.com/single-post/2015/07/13/6-Ways-to-trainlow

However, given that the vast majority of research still supports that fatigue will be reduced and performance maximised with initially high glycogen levels and continued carbohydrate absorption during the event, maximising glycogen stores prior to a big event is still a highly recommended practice for endurance athletes.

But what does carbohydrate loading actually entail?

Back in the 60’s, a week prior to competition, a final training session would be undertaken to severely deplete the body of all of it’s glycogen stores. The athlete would then cease training and eat very little carbohydrate for 2-3 days before then eating a very high amount of carbohydrate in the 3 days prior whilst still not training.(9-11) This was very effective in maximising the glycogen stores with a ‘supercompensation’ effect – but it was seen to have too many negative side effects. This included that for the 2-3 days of carbohydrate restriction, athletes who were not used to having a high-fat diet experienced gastrointestinal upset and there were questions about the impact on recovery and the immune system by restricting carbohydrates after an intense final session. Many athletes also reported feeling mentally frustrated or anxious about not being able to train at all for the full week prior to the event.

This protocol has become increasingly moderate in nature over the last 50 years or so where a taper in training for the week leading up the event with a gradually increasing carbohydrate intake has been found to increase the glycogen sufficiently (though not to the same super-compensatory effects of the original protocol).(12) However, athletes report feeling happier with the process as it’s less arduous and restrictive, they feel less mentally stressed and research now supports a protocol of having 1-2 days of increased carbohydrate and that this is sufficient to achieve a good glycogen level – especially in the more trained individuals (unfortunately, lesser so for schleppers like me!).(12, 13)

Interestingly though, these carbo-loading practices are believed to be less effective for increasing glycogen and improving performance in women as compared to men though debate among researchers continues.(3, 14) Notably for both genders, the more elevated your initial glycogen level is, the quicker the rate that your glycogen will be used with little difference in glycogen levels being observed by the 60-90minute mark in tests where subjects had either high or very high glycogen levels to start with.

So really, how relevant is undertaking a ‘super-carbo load’ for events of 4, 8 or 12+hours if there’s little difference in glycogen levels after 1-2hours? Ie – is it worth undergoing full ‘carbo-loading’ to achieve the very maximum glycogen level that you can, or is a moderate increase good enough with the difference being made up by consuming carbos during the race?

In answering this – lets see what you’re getting yourself into if you undertake a proper carbo-load. ‘High intake’ of carbohydrate is in the context of this process is 9-12g of carbohydrate per kg of body mass per day. So consider a 65kg person and using 10g/kg of carbohydrate each day, the following meal plan example was written keeping the other macronutrients relatively low so that total calorie intake is not blown up to astronomical proportions:

Carbo loading meal plan example*
Notes – based on a 65kg person and 10g carbo/kg of BM per day
This meal example shows what a very high carbohydrate intake looks like with a lowered % of fat/protein and especially in the last day or so, researchers also recommend to lower fibre further also* Not to be used outside this endurance carbo-loading context as not balanced or designed as a diet for long term health
Breakfast Carbo (g) kJ Cal
Café Latte with 1 sugar and Fat-free (cows) milk – 250ml 17 439 105
2 tip top white english muffins 55 1289 307
Peanut butter (1 tablespoon) 4 400 95
Honey (2 tablespoons) 34 502 120
Mixed berries (1 cup) 17 293 70
SUBTOTAL: 127 2923 696
Morning snack
2 uncle toby’s muesli bars 40 920 219
V8 juice, tropical blend (400ml) 30 500 119
SUBTOTAL: 70 1420 338
Lunch
Breaka choc milk (250) 27.8 833 198
2 Pieces of bread (white in last 2 days) 44 1004 239
shredded chicken (100g) 0 554 132
Cup of salad 3 60 14
Mustard 0 0 0
Cup of mashed potato, no butter (a little milk) 36 750 179
SUBTOTAL: 110.8 3201 762
Afternoon snack
Yoghurt, yoplait – low fat, flavoured (100ml) 14 400 95
Low-fat fruit granola (1 cup) 80 160 38
Banana (1) 27 439 105
SUBTOTAL: 121 999 238
Dinner
Tuna in springwater (150) 0 686 163
2 Helgas white wraps 70 1699 405
2 Cups of salad 6 120 29
Mayonnaise, light (2 tablespoons) 2 385 92
Apple juice 41 790 188
SUBTOTAL: 119 3680 876
Evening snack
Honey (2 tablespoons) 34 502 120
Mixed berries (1 cup) 17 293 70
Low-fat fruit granola (1/2 cup) 40 795 189
Yoghurt, yoplait – low fat, flavoured (150ml) 14 400 95
SUBTOTAL: 105 1990 474
DAILY TOTAL 652.8 14213 3384

 

Whhaaa……!? This is an insane amount of food!

I don’t know about the average 65kg person out there – but even if I lowered the intake of fat, protein and fibre further – on a personal note – I’d totally struggle to consume that volume of food and it’d most likely make me feel awfully heavy, bloated and blergh – not to mention having to ride that blood glucose rollercoaster that comes with such quickly absorbed carbohydrate sources! If you decide nonetheless to carbo-load and also doubt whether you could comfortably eat that much, it’s worth noting that these days there is a much wider and more readily available range of proprietary, specialised products that can deliver a high amount of carbohydrate in a lower bulk package than ‘standard food’ does.

Of likely concern for many healthy athletes out there, is this sort of an eating plan is likely to be such an astronomical change from their regular diets and this comes with risk of serious gastrointestinal upset – notably, a lowered fibre intake could spell huge issues in the #2 department! Who wants to contend with that in the lead up to and during a race?!

So, despite being desperate for anything to help me to get to the finish line I found myself questioning how well carbo-loading works in reality and whether it’s commonly undertaken. I reached out to some of my more trained up running friends, including many who are heading for the UTA next week. Though I’m usually the first to point out that the plural of anecdotes is not data – it was interesting to see that very few consider themselves to carbo load and who only a token pasta added here or there in the days prior. Far more importance for the regular athlete out there was placed on not changing up your regular eating habits too much so that you don’t experience unusual GI reactions but certainly to ensure that you eat a good lunch and dinner the day prior and on making sure some decent breakfast is consumed before to the race.

As Sam Steadman who heads up Outer Limits here in Townsville and is incredibly experienced in a range of endurance events indicated “if you expect to race off the start line, push your body to the limits and run on minimal intake of carb to save weight and time, you might need to increase your glycogen stores for up to 3 days before” – otherwise, don’t really change your diet or nutrition or clothing or anything really before the race.” In other words – for the vast majority of us out there it’s probably best to stick with what you know and what you’re used to!

The other key focus from my unofficial focus group, especially from those in the longer distance events (where already by half way through, without replenishment their original muscular glycogen stash would have burnt out, regardless of any carbo-loading) – was put on figuring out what carbohydrate intake/hr is appropriate to support their exertion over such a long time. It was stressed that it must be palatable, easily eaten and well-absorbed on the run. Too much intake could mean GI upset, not enough would mean that your energy levels are low and you fatigue or ‘bonk out’.

Certainly research, including a recent systematic review confirms the importance of consuming carbohydrates during endurance events.(15) For those events longer than 2 hours, most studies used a rate of 1-1.5g/kg of ingested carbohydrate per body weight/hr or at or above 90g of carbohydrate per hour.(10, 15) Additionally, there is evidence to support using multiple transporters by adding fructose to the mix rather than having just a glucose-based blend which will enhance absorption but that this may be athlete-dependent as fructose is not always well tolerated.(15)

So, in conclusion – taking on board all this theoretical and practical advice: carbo-loading for 1-3 days in accordance with the recommendation of consuming 9-12g of carbohydrate per kg of body mass per day may give you that edge if you’re an elite, professional racer looking to make the podium and if (and only if!) you’ve actively practiced your carbo-loading during training. Otherwise it seems to offer more risk than reward.

Personally, for me, next week will be a ‘normal’ diet, plus a few extra carbo serves in the days prior to the race and making sure there’s plenty of room in my pack for snacks and magical unicorn tear essence-infused carbohydrate/electrolyte containing powders……then I’m going to pray with all my might that there are still hot chips at the van at checkpoint two by the time I get there and mix that fantasy with a giant dose of naivety, stubbornness, bluster and cross fingers that I can faff my way to the end somehow!

Wish me luck!

 

  1. Hawley JA, Schabort EJ, Noakes TD, Dennis SC. Carbohydrate-loading and exercise performance. An update. Sports Med. 1997;24(2):73-81.
  2. Hackney AC. Effects of the menstrual cycle on resting muscle glycogen content. Horm Metab Res. 1990;22(12):647.
  3. Walker JL, Heigenhauser GJ, Hultman E, Spriet LL. Dietary carbohydrate, muscle glycogen content, and endurance performance in well-trained women. J Appl Physiol (1985). 2000;88(6):2151-8.
  4. Astrup A, Meinert Larsen T, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet. 2004;364(9437):897-9.
  5. Achten J, Venables MC, Jeukendrup AE. Fat oxidation rates are higher during running compared with cycling over a wide range of intensities. Metabolism. 2003;52(6):747-52.
  6. Sahlin K, Harris RC. Control of lipid oxidation during exercise: role of energy state and mitochondrial factors. Acta Physiol (Oxf). 2008;194(4):283-91.
  7. Hawley JA, Burke LM. Carbohydrate availability and training adaptation: effects on cell metabolism. Exerc Sport Sci Rev. 2010;38(4):152-60.
  8. Psilander N, Frank P, Flockhart M, Sahlin K. Exercise with low glycogen increases PGC-1alpha gene expression in human skeletal muscle. Eur J Appl Physiol. 2013;113(4):951-63.
  9. Ahlborg B, Bergstom, J., Brohult, J., Eklelund, L. G., Hultman, E., & Maschio, G. Human muscle glycogen content and capacity for prolonged exercise after different diets. Forsvarsmedicin. 1967;3:85-99.
  10. Burke LM, Hawley JA, Wong SH, Jeukendrup AE. Carbohydrates for training and competition. J Sports Sci. 2011;29 Suppl 1:S17-27.
  11. Karlsson J, Saltin B. Diet, muscle glycogen, and endurance performance. J Appl Physiol. 1971;31(2):203-6.
  12. Bussau VA, Fairchild TJ, Rao A, Steele P, Fournier PA. Carbohydrate loading in human muscle: an improved 1 day protocol. Eur J Appl Physiol. 2002;87(3):290-5.
  13. Sherman WM, Costill DL, Fink WJ, Miller JM. Effect of exercise-diet manipulation on muscle glycogen and its subsequent utilization during performance. Int J Sports Med. 1981;2(2):114-8.
  14. James AP, Lorraine M, Cullen D, Goodman C, Dawson B, Palmer TN, et al. Muscle glycogen supercompensation: absence of a gender-related difference. Eur J Appl Physiol. 2001;85(6):533-8.
  15. Stellingwerff T, Cox GR. Systematic review: Carbohydrate supplementation on exercise performance or capacity of varying durations. Appl Physiol Nutr Metab. 2014;39(9):998-1011.

 

Having some trouble negotiating with your #2’s?

So…..constipation. Charming word, Charming problem.

Few people will casually bring up constipation as a conversational topic over coffee or at a social dinner party – unless of course you happen to have someone like myself present who doesn’t mind talking crap. Then it’s all out there about not being able to get it outta there.

So, lets pause and just clarify – constipation is a condition (which can either be acute or chronic) where you move your number 2’s less often than ‘usual’ and/or when these stools are hard, dry, pebbly and often painful and tricky to get out. There are so many reasons why you can become constipated including drugs, supplements, medications or dehydration. Other common factors include ignoring the urge to go or a sudden change in diet or even in timezone – an especially problematic combination during travel!

constipation-meme

Trouble is that what is ‘usual’ for somebody is unusual for somebody else, so it’s difficult to put a timeframe in this definition – but on average it’s when your number twos are taking more than 2-3 days to get out (or 3-4 for kids) – then you are perhaps constipated. Being very constipated can make you feel very blergh – including being nauseous, loss of appetite, abdominal pain and it is linked to increased risk of urinary tract infection.

Acute, severe constipation can be serious – so please don’t ignore it. If left untreated it can result in hernia, bowel obstruction or septicaemia – all of which can be very detrimental to your health. If you have blood in your stools or acute, severe pain in the abdomen – seek immediate medical attention.

Chronic constipation which does not respond to improvements in your diet – primarily including plenty of water and fibre (naturally from fruit, vegetables, legumes and wholegrains – not relying on fibre supplements or laxatives) and despite being reasonably active may be indicative of further health issues. These could include colorectal cancer, diabetes, low thyroid function, diverticulosis, kidney failure, hypercalcemia (high levels of calcium in the blood) and Parkinson’s. If you believe you have chronic constipation – please don’t delay seeking further medical advice.

There are many products out there to treat constipation – some which add bulk and soften the stool (bran, psyllium), others which are designed to draw water into the bowel, others which work on the action of the bowel etc! But in this article I’m going to discuss Magnesium sulphate in particular as it’s a ‘oldie but a goodie’ and for most – it’ll have very few side effects and has a much lower risk of dependency than some of the other solutions.

Magnesium sulphate is a mineral more commonly known as Epson salt – usually used to relax muscles in a bath after a hard workout! However, taking anywhere between a teaspoon to a tablespoon of this with 300ml of water 1-3 times a day (depending on the severity of what you’re dealing with!) – is generally a very successful approach for dealing with occasional constipation. Many believe that the standard Epson salts are fine to consume orally though you can buy Epsom salts that have been specifically manufactured for oral administration and these supposedly manufactured under more regulated hygiene conditions and with fewer impurities (they are of course more expensive) – it’s your choice at the end of the day, but ask your pharmacist for help and for guidance with your appropriate dosage – especially if it’s for your children, noting that it is not appropriate to administer this to kids under 2years.

Hot tip: Epsom salts can be hard to dissolve – so stir a bit into 50ml hot water until dissolved, then add 250-300ml cold water and ice. You may find you need to add a bit of juice or cordial as it tastes pretty awful – sink it all down in one go! Generally your bowel movement will occur between 30mins-5 hours after administration. 

Magnesium Sulphate draws water into your intestines while at the same time replacing magnesium in the body which can be low depending on your diet, alcoholism or when your blood calcium levels are particularly high – added bonus! Low magnesium levels are associated with fatigue, cramping, convulsions, low concentration and irritability and magnesium also plays a role in carbohydrate metabolism. A whole swag of mental and physical functions need magnesium so correcting any deficiency is certainly important.

However, magnesium sulphate may not be the solution for everybody – especially those who are breastfeeding, pregnant (do not take this without medical supervision and guidance if pregnant!), under 2 years old, those with a kidney or other digestive organ disorder, those who have a bowel obstruction or perforated bowel or heart disease/irregular heartbeat. If this is you – ask your doctor or pharmacist for a more appropriate approach and let them know if you are on medication or supplements (especially antibiotics) in case there are any potential harmful interactions. Similarly, if you are undergoing any medical procedure or starting any new medications – advise your medical team if you are regularly taking magnesium sulphate.

Common side effects may include diarrhoea, upset stomach and rare but potential more serious side effects can include allergic reaction, dizziness/sweating or fatigue and muscle weakness.

So, hopefully you will not need this advice much – or better still – ever, but it’s certainly one of the better solutions out there to deal with acute or chronic constipation if the need ever arises.

The Silly Season is coming – Yeehaa!

Question: Lead the stampede to the buffet or ‘behave’ yourself in case Santa is watching and to avoid an awkward encounter with your friendly neighbourhood nutritionist – with a Cheezel on each of your fingers and a mouth stuffed with chorizo?

dear-santa

The tsunami of food, champagne and beer is relentless and goes on – not just for the 12 days before Christmas – but for at least a month prior and a good few weeks of ‘hair of the dog’ afterwards. And as we all know from years of experience, gorging ourselves doesn’t come without a price!

champers

At first it’s the bloated stomach which sees you heading to the bathroom mid-function to undo a few notches on your belt, then soon you stop wearing your favourite clothes. Waistlines creep out and you suddenly develop a double boob in your favourite bra, and this starts to affect how you feel in your coconut.

Guilt perhaps? Regret? Sadness? Shame? Anger? Will you reach a desperate conclusion that since you’ve let the dogs out, you’re just going to continue madly surfing this food wave and do something about it when you pop yourself through to the other side like some sort of experimental human champagne cork …. Perhaps that may happen sometime in the New Year…?

Now, I don’t want to be a killjoy as Christmas is also my favourite time of year! But I feel it would be negligent of me to not point out that most weight gain over the Christmas period doesn’t magically dissolve in January when the lights are taken down and the tree packed away. It’s unfortunately the present that you can’t re-gift to nanna for her birthday or hide at the back of your cupboard.

Sadly, most of that weight gain will stick with you and worse still – it will accumulate over the years. This is despite your best sweaty attempts to bootcamp it away, despite the fact that you’ve just spent $1000 on a gym membership that you will not use after Australia day, despite swapping real food for powdered algae, Amazonian berries and unicorn tears, despite having coffee and a hose inserted in your derriere to ‘clean you out’ (whaaaa…?!). The inflammation in your entire digestive tract and the awful reality that your excrement now does actually smell of Rosé – will not magically resolve when you swap your Moët for organic kombucha.

So what is a party animal like you to do?

hangoverI could write you a scientifically-based list of strategies to help you ‘control’ yourself – drink water between drinks, don’t go to a party hungry, stay away from fried foods… <insert yawn>. But as much as I like to science – I know that after your second vino, you’ll essentially use that list to clean up the wasabi mayonnaise that just dripped from your canape onto your new top.

Instead – here’s just 3 key things to keep in mind that occasionally turn over in my brain

Concept One – Ditch the concept of ‘New Years Resolutions’ – they rarely work and cost a bomb – $ that you often don’t have after spending it on shoes and cocktails…I mean after spending it on Lego and Shopkins for the kids. Having this idea in your head that you’ll ‘fix it all’ in January and become some nutritional Mother Theresa who discovers that she does actually love kale after all and is going to ride her bike to work instead of driving – makes the animal inside you go rabid.

oreo
Planning to draconically restrict all lemon tart, beer, carbos, fried food and work out for 2 or even maybe 3 hours a day in the New Year to shed your newfound muffin top and regain your health will only make yourself indulge further now and totally abandon any attempt to maintain your fitness.

Put simply, the reaction to fearing hunger and deprivation in the future is to over-consume and binge now.

Concept Two – Pick your moments – Don’t go nuts at every party, choose one a week that you really want to cut loose at and go ahead and dance on top of the bar. However, consider driving to (and from!) the others, returning before midnight before you turn into a pumpkin. Not having your beer brain on and scheduling a workout early the next morning will also usually result in you making far better food decisions.

Bonus: designated drivers should score points towards good pressies under the tree for this selfless act! Make sure to point that out to your boozehound friends – BEFORE they start on the tequila shots because the Sav Plonk ran out.

Similarly – you already know that there will be far too much overconsumption with friends, family and work mates during this Silly Season – so this is probably the most important time of the year to have your own fridge stocked with fruits, veg, wholegrains and quality proteins. Try to stay organised with making your own nourishing and balanced meals/snacks in those interval periods between parties. Slipping in the odd meat pie or pub lunch any other time of the year because you couldn’t be bothered to take your own lunch to work is not a problem, but in December/January – it’s just adding fuel to the fire.

Concept Three – Next year, don’t create so many random, rigid ‘diet’ rules and restrictions for yourself.  Christmas shouldn’t be the only the time of the year that you’re allowed to splurge and be human. Throughout the year, go for a 90:10 or even 80:20 approach with your eating and exercising habits. Perfection is impossible and aside from sending yourself mental, striving for it will only lead to some pretty wild behaviour during next year’s Silly Season – and so the cycle will continue!

So enjoy the coming weeks and I hope that you find my above thoughts to be more simple, realistic and useful that the random lists of ‘Top 10 Strategies to Stop Weight Gain this Holiday Season’ that will soon be flooding your inboxes and Facebook feeds.

Merry Christmas!

christmas-table

Understanding the basics of the Health Star Rating System.

You may have noticed during your shopping trips that some products have badges on them advertising how many stars their product has out of a possible 5 – but what does it all really mean?

This system, which is currently voluntary and being rolled out here in Australia is supposed to help consumers better identify which products are ‘healthier’ than others. It ultimately endeavors to indicate how well a product does in limiting energy, saturated fat, sodium and total sugars while giving credit for any fruit and vegetable content and in some cases also dietary fibre and protein content.

However, no system is perfect and unfortunately this one is far from it.

For starters, the manufacturers themselves are trusted to determine their product ratings themselves using an algorithim that considers the above-mentioned nutritional criteria. Logically, some manufacturers will work within (read: manipulate) this system to maximize their star rating, not to mention that there is potential for downright dishonesty in entering false nutritional data to manipulate the end result.

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One such perfect example of working the system is Milo which if analyzed through the calculator on it’s own would only get 1.5 stars. So, how does it get a 4.5 star rating on its tin!?  Apparently because you mix one level tablespoon into 200ml skim milk – who does this!? More like 2-3 heaped tablespoons to 200ml milk! You can see though how a 4.5 star rating could lead people to believe that Milo itself is a healthy product.

Furthermore, products are analyzed within ‘categories’ and though a product may achieve a 5 star rating compared to it’s competitors – this still doesn’t mean it’s necessarily healthy.

Examples:

  • In the ‘Beverages other than dairy’ category, a sugar-free apple juice scores 5 stars when you compare it to other beverages such as coke or ‘fruit drinks’ that have added sugar, but this 5 stars is quite misleading and should not be taken to mean that apple juice is a ‘healthy’ product or one to be consumed daily.
    • It’s long been known that consuming juice is totally unnecessary for a healthy diet and in fact, can be quite the opposite.
    • Juice is considered a ‘free sugar’, just as in coke or confectionary – it should therefore be limited and only had on occasion.
  • Some butters or margarines will appear to be ‘healthier’ under this star rating than Extra-Virgin Olive Oil as olive oil is extremely energy-dense which brings its ratings down. This is of course terribly misleading as there is no way that margarine can be considered healthier than olive oil when you look deeper into the nutrient profile of these products!

 

CONCLUSIONS:

So, by all means use the star system to guide your purchases – but please understand that like all systems, there are approximations, simplifications and compromises that have been made to attain a uniform and workable rating system.

The key thing to remember:  5 stars does not necessarily indicate that the product is healthy – but that it is healthier than the other products in that category – noting that even this is sometimes not quite true!

This mini-article was adapted from Life Nutrition’s ‘Healthy Choices Supermarket Tour’ resource book (30+ pages of valuable info!). So, if you’ve enjoyed this mini-article, please book a tour with us!

Milk Alternatives – A quick review

There are many reasons these days why you may be unable or don’t want to drink cow’s milk – noting that contrary to the baloney spouted by many a ‘health and wellness guru’ – dairy does not cause inflammation in the vast majority of us!

So, which of the ‘milk’ substitutes may be best for you? Almond milk, coconut milk, soy, oat or rice milk – Are any of these better even than cow’s milk itself?

The short answer in terms of overall nutrition is no, as a stand alone liquid – cow’s milk is overall the most nutritious milk followed by soy. The main highlights in the nutrient profile of cow’s milk includes a good amount of quality protein, calcium, vitamin A, D, B vitamins (but notably B2, B12) and Zinc.

An important note on calcium – On average, adult and adolescent intake of calcium in Australia is below our recommended daily intake, and calcium is absolutely critical for bone health.  For most people, 60% of their calcium will come from dairy products and it is largely for this reason that it is recommended that adults should be consuming mimimally 2.5 serves per day of milk, other dairy or dairy substitutes and this rises to 3.5 for men over 70 and to 4 for post-menopausal women.

Some of these milk alternatives will add calcium phosphate, calcium citrate or calcium carbonate into their formulations to address the natural lack of calcium in these ingredients and this added calcium is generally around 10% less bioavailable than the naturally occurring calcium in cow’s milk. Not such a big deal. However, studies have found that these salts often settle towards the bottom of the container and are subsequently disproportionally discarded in the ‘dregs’.

*Note that if you have irritable bowel syndrome or tend to be susceptible to digestive issues such as bloating or gas – ensure you choose a substitute that is fortified with calcium citrate as this will tend to cause fewer side effects than the others.

So, without question, if you are going to drink these alternatives often or as a substitute to cow’s milk – you must make sure that your preferred brand is fortified to contain minimally 275-300mg calcium per 250ml and that you shake your container regularly (and drink those dregs!). (Note that the Oat and Soy milk considered below are not fortified)

Let’s get onto a quick snapshot comparison of the key nutrient values between unsweetened, fortified store-bought formulations of each – and against a reduced and full fat cows milk. This is not to say that other brands or your own homemade versions won’t have different nutrient profiles, but these are just the 7 randomly chosen ‘off the shelf’ milks that I chose to review today.

Products chosen (all unsweetened and options 3-7 are lactose free):

  1. Paul’s Smarter White
  2. Paul’s Full Cream Milk
  3. PureHarvest Oat Milk – note that this product contains gluten
  4. Vitasoy Coconut Milk
  5. PureHarvest Rice Milk
  6. PureHarvest Soy Milk (malt-free)
  7. Sanitarium, So-Good Almond Milk

 

table

Note: I have not attempted to score ‘taste’ as this is so personal – but perhaps you could all comment at the end of the article or share on facebook which of the substitutes you’ve found is best for different applications (Is one better for coffee, another for smoothies – are any of them any good at all in baking?)

If you are considering moving away from dairy for whatever reason – there are pros and cons of each milk type and aside from taste, and ensuring that your milk is calcium-enriched – your choice may depend on what key features you’re looking for or what eating plan you maybe following (check your brand as there maybe considerable differences between each!):

  1. Low-energy: Coconut or almond
  2. Low-sodium: Coconut or soy milks
  3. Low-fat: Rice Milk then almond milk
  4. Low-carb/low-sugar: Almond Milk then coconut milk
  5. Higher protein: Soy then oat milk
  6. Other: There maybe allergy or other reasons that you cannot consume soy or nut milks and this may restrict your choice. Note also that oat milk contains gluten

As each of these milks has specific nutritional highlights, often the best approach when substituting a nutritionally well-rounded product with less-nutritious substitutes is to mix it up so that they complement one another. Some of these features include:

  1. Almond milk has heart-healthy fats
  2. Rice milk tends to be the best milk for those with many allergies/suspected allergies
  3. Oat milk has beta-glucan with helps lower cholesterol
  4. Soy milk contains isoflavones or a type of phytoestrogens that may play a role in protecting against some cancers. However, there are certain medical situations where you may be advised to limit your soy intake (eg women with oestrogen-dependent breast cancer)

So, hope you enjoyed this mini-review and if you drink any such substitutes – don’t forget to go and check that you have a fortified version (min 275-300mg calcium/250ml) and try not to get stuck on the one option, but change it up for better rounded nutrition.

Are we there yet? Why are we not there yet?

As you start making nutritional and behavioural changes you expect to see results right?!

Like – bam! Because you’re doing everything asked of you and you’re a super focused machine!

However, it didn’t take you a few days or weeks to put on the weight you’re wanting to lose or to have depleted your body of the micronutrients it needs to function at it’s peak. Many of your negative behaviours or attitudes around food are also a product of your life to date – many starting right back in your childhood. So, logically – it’s going to take time to see any nutritional improvements to be reflected in you. As for the formation or breaking of any habit – behavioural change also takes time and it is often this which is the hardest to address.

glitterGenerally, by the time most people come to see a nutritionist – they have figured out (often via the hard and expensive way) that there are no ‘silver bullets’ and that there is no fairy dust that anybody can sprinkle on you to turn you into the woman, man or unicorn of your dreams overnight.

 

Many ‘diets’, 12 week challenges or shake programs may well provide quick weight loss results in the short term, but can leave you feeling exhausted and awful with downright weird and unnatural attitudes towards food. Unfortunately, the quick weight loss is more often than not associated with quick rebound – where often more weight is gained than originally lost. Few of these programs teach you anything worthwhile about nutrition for long-term health. There’s a host of reasons for this – aside from it being really good business to have the steady stream of return customers, but I won’t start ranting on that now.

In short – Be realistic about your expectations – true results will gradually come and they will be far longer lasting and enrich your life far more than ‘weight loss’ results alone.

For long term improvements of health and improved weight management, you need to:

food-babe1. Learn basic nutritional principles – You wouldn’t ask your mechanic to teach you the principles of neurosurgery, so don’t get your nutrition advice from celebrities or wellness bloggers – they are true fountains of nutritional liquid excrement!

Invest in yourself by making a few appointments with a reputable nutritionist to really learn about nutrition – knowledge that will benefit not only you but your family and friends around you. As seeing a personal trainer once won’t transform your beer keg into a 6-pack, don’t expect to walk away from one appointment with all the knowledge and skills you need for real change.

2. Prioritise your nutrition – organization is key and you must make time in your week to shop and prepare food properly – see our article ‘How to meal-prep like a boss’ for some ideas. You may even have to learn to cook if you don’t already know how – otherwise, you’ll have to work hard at becoming the most skilled shopper and evaluator of processed foods/take-out meals. However, without controlling or undertaking most of the cooking yourself, most will find it exceedingly hard to reach their goals.

3. Be prepared to ‘win some and lose some’ – ride the ups and downs, be flexible and indulge in moderation without guilt of shame – as food is there to be enjoyed and life is there to live. While not losing sight of your long-term goals, appreciate and enjoy special moments with a cheese platter or a mud cake without transforming into a humanoid demolition derby!

4. Listen to your body – this will take time and practice – but tune into your hunger and satiation cues, learn to use food as fuel – not as a stopgap for boredom or to deal with emotion. Start counteracting external cues with strategies – such as those suggested in ‘The Dreaded After-Dinner Munchies’.

It takes consistent attention to what you’re doing to make lasting change and some are lucky enough that over time, good decisions and eating appropriate diversity and quantities of food become second nature and they never have to think about what they’re eating (or not eating) again – good nutrition has simply become part of their lifestyle. Others though will have to maintain more vigilance and consistently or periodically monitor what they’re eating and how they are using food in their life.

So if the scales aren’t budging yet or weight-loss is not the primary goal – How do we know what we’re doing is working? Assuming you are not monitoring your glucose or are on a first-name basis with your local pathologist who is periodically monitoring your bloods for inflammation markets, lipid profiles or micronutrient status, you may notice signs of beneficial changes reflected in:

  • Improved satiation. One of the first signs when you improve your diet quality and hydration is that you feel more satiated. You may find that even though you are consuming less energy per day than before – you no longer feel hungry!
  • Reduced cravings – we all tend to want more of whatever we’re eating – this certainly goes for dopamine-inducing alcohol, sugar-sweetened beverages, chocolate, or those optimally-designed processed foods that are deliberately formulated to provoke embarrassing public drooling. Put simply, the more you have, the more you  will want. So when these are reduced in the diet, the desire to track down these foods like paleolithic hunter looking for a Big Mac also usually falls. There is also research to suggest that micronutrient deficiencies increase the likelihood and strength of ‘cravings’, so these get fewer/easier as your diet becomes better rounded nutritionally.
  • Better moods – you’re now smiling more than you are scowling – goodbye resting b**ch-face! Both improved nutrition and your new direction and positive focus on change will improve your brain chemical balance, hormonal balance and outlook on life.
  • pony-tailMore energy and strength! You actually feel like getting out of bed and starting the day, you’re pumping out your workouts (or for the first time in ages – you actually feel like doing and are enjoying a workout) and you find you have enough energy at the end of the day to actually do your dinner dishes and not leave them until tomorrow! Winning!
  • Better sleep – poor nutrition can affect sleep patterns – notably caffeine, sugar or alcohol ingestion, especially late in the day will certainly interfere with your zzzzz’s. Also having dinners that are too heavy can also negatively affect sleep. Poor nutrition and lack of the right proteins and micronutrients can negatively affect hormone production and functions which are required for a restful night.
  • Better fitting clothes – So your ‘weight in kgs’ may not have budged at all – but you may start noticing that your waistband is a bit looser. This is as your body composition is changing and you maybe losing fat while increasing your muscle and perhaps even increasing your bone mass – or if you have lowered your sodium intake, you may have found that you are bloating less. Periodic body composition monitoring is far more useful to illustrate these changes than weight scales.

So whenever you may be feeling worried that the scale is not moving yet – please reflect on the above and assess when you have started to make progress as real progress is so much more than just a number.

 

How to meal prep like a boss

Made time to go to the supermarket and have a shopping trolley full of fruit, veggies, wholegrains and good quality proteins? Tick!

Managed not to scream like a banshee at your kids trying to slip chocolate bars into the trolley at the checkout? Tick! ….. Managed to slip your own chocolate bar into the trolley at the checkout? Double tick!

And look at you getting all your shopping bags from the car to the house in record minimal trips – complete with resulting ligature marks across your forearms to show both how tough and super-efficient… (umm…lazy)….you are? Aren’t we just winning today!

Best thing to do now is to stick the kids in front of a movie, unpack and go have a lie down with a glass of wine – um…what I mean to say is – stick the kids in front of a movie, unpack the rest of your shopping and go a good round with your veggies in a meal-prep session!

fridge-ingredientsIt is very likely that at this point it’s the last thing you feel like doing – but as we all know, if you unpack a load of vegetables straight into the fridge – the prospect of coming home after work, or after child-wrangling, study, managing the house, squeezing in a workout or social session and having to start each meal from scratch is so completely unattractive!

So much so that despite your good intentions, it often doesn’t happen and results in takeout or ready-made meals and veggie drawers being full of sad, moldy vegetables at the end of the week. In danger of stating the obvious – this is far from ideal, from both a health, financial and environmental perspective – but we’ve all done it and the best (and only) way really to avoid it is to meal prep

Now, when the term ‘meal prep’ is boring-meal-prepmentioned – many of you may picture rows of bland, identical meals in throw away containers and this prospect of eating the same reheated lunch and dinner for 5 days straight as just as horrifying as having to scrape out end-of-the-week slushy zucchini from the bottom of the veg drawer. And that’s not even taking into account the inevitable sniping and moaning from the kids (big and small) from the back bench.

So in this article I’m aiming to give you just a few examples of how you can hit that middle ground – where in just one initial 30-45min ‘veg prep’ session, you can seriously cut your cooking (and cleaning up!) time during the week but still have real, fresh varied meals each day.  Being a mother predominately in charge of the cooking at home – the aim is not to be gourmet but simple, quick and kid-friendly – all these dishes go down well at our house, so I hope you have the same luck!

Many can also be done up in advance and simmer away in a slow cooker if that works in better with school runs, fitting in extracurricular activities etc. If you are a Jedi-master or an ultimate multi-tasker, while you’re doing this veg-prep, pop the oven on to do a batch of roasted pumpkin for salads or roasted antipasto-Mediterranean veg and boil 6-8 eggs on the stove for breakfasts/instant snacks.

A quick note on sauces: ‘I’m a passionate foodie and I’d just give anything to have enough time to make my own sauces’ – said me never. If I had more free ‘alone time’, you’d probably find me climbing hills or meeting friends for coffee and cake instead of stirring a vat of tomato puree and sterilizing bottles to store it. My philosophy is that if the bulk of your meal is based around vegetables, wholegrains and quality protein sources – then you’re already winning. If you need to use purchased sauces or marinades to keep it real and get a meal on the table that your family actually wants to eat – go for it.

Just be very aware of course, that most sauces are high in salt and often in sugar too – so choose the reduced sodium varieties where available. Use these sauces sparingly, complementing the dishes with garlic, citrus juices or herbs as flavourings instead of simply using more sauce. Also consider elongating your dishes to reduce the amount of sauce in each serve – ie: if a sachet of sauce says to ‘add an onion and 500g of the meat of your choice’ – then also throw in 2-4 cups of chopped vegetables as well, thereby lowering the concentration of both the sauce and calorie density in your meal and scoring extra veggie points.

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So let’s get started – Clear some bench space, wash all your vegetables, get out your airtight containers and all chopping toys and tools. Make sure you’ve also extracted any savable veggies out of the fridge and compost/dispose of any poor souls which didn’t make it. Vegetables we always have on the chopping block are onions, carrots, capsicum, zucchini, leek, cucumber, broccoli, beans or snowpeas and celery.

Be sure to include whatever others rock your boat – but noting that some softer options like tomatoes, mushrooms and avocados don’t fare too well for more than a day or so!

Cut vegetables into appropriate gadget-friendly sizes and lengths and either dice them using a knife (slow), manual cutter as that shown above (faster with seriously OCD-compliant results) or with a slicing blade on a processer (fastest, but can be annoying with big random chunks being left behind).Cutting rather than macerating the vegetables in a processer with a coarse grating attachment is preferable in terms of longevity and texture (though the coarse grater is super-quick for a one-off meal prep!).

Some things to watch out for in your food prep:

  • Don’t finely dice too much celery, unless you’re planning to use it in the first day or two – it goes brown faster than the other veg
  • Cucumber seeds don’t like sitting around in plastic containers for a few days – cut out the bulk of these with a v-shaped notch before dicing
  • Moisture should be drained out of these containers before storing them to maximize longevity/quality of the veggies inside. As you complete each container, line 2-3 layers of paper towel across the tops of the containers, put the lids on and let them rest upside down for at least 10 minutes. Upright and remove towel before storing in fridge
  • Cut some veggie sticks as you go – these are great for dips or snacks.

So what can we create out of this for the next few days?

There are multitudes of options, I’ve only included a few of our family favourites – and I’d love to hear yours! You may notice that I have included the salad-based dishes first, this is as logically – precut veg are going to start to lose their best textures by day 3-4 and so they’re better off getting thrown into sauces/soups by then! Additionally, this is when lettuce or bags of salad mix are going to be at their best after coming home from the supermarket.

You may note that my quantities generally provide around 8 serves. We do this so that there are leftovers for lunches or to freeze half a batch of the cooked component for a future crazy busy/lazy day. Adjust your quantities as required

1) Lunch or light dinner – Salad cups, 5-10 minutes prep time

Wash 2 heads of cos lettuce and strip off the best medium-sized leaves. Fill with your choice of veggies, avocado, nuts and protein – eg shredded chicken/pork/beef, smoked salmon, tuna, tofu, legumes (or you can keep the cups veggie-only and serve as an accompaniment to your protein). Season with pepper, citrus juice and drizzle with dressing or mayo. A good looking dish to bring to BBQ’s too!

 

2) Lunch or light dinner – Chicken/fish wraps, 10-15 minutes prep/cook time

(and I’ve noted a few other options if you have a bit more time!)

Create a platter of cut veggies for the family to choose from and set it out perhaps with some grated cheese, avocado, protein of your choice and some salad leaves. You may choose to grill some chicken (marinade can add interest), or shred a roast chicken/get canned tuna or salmon if you’re particularly pressed for time. A super-easy favourite of ours is to get the supermarket to put 2-3 pieces of salmon into an ovenbag with just one squirt of the sweet chilli and this only takes 15 minutes to cook in a preheated oven – no standing over the stove worrying about drying it out, no fish smell in the house or having to clean fish splatter off the splashback! Choose a good quality wholegrain or multigrain wrap such as ‘better for U’ barley wraps rather than white tortillas.

Also as photographed below – wraps also work really well with pulled pork or slow-cooked lamb if you remember to put your cut into the slowcooker in the morning or by lunch, noting that you already have diced cucumber that can make a great tzatziki when paired with a quality yoghurt, some lemon juice, garlic and mint. Cut corners and bring some variety and even more colour onto your salad platter by heating up a bowl of frozen corn in the microwave. Bonus: left over meats can be used in lunches, in sauces/soup over the next 2-3 days.

If you have 20 minutes of cooking time – wraps are always winning when served a la Mexicana! Before you start preparing your salad platter, fry off ¾ cup of your pre-prepared onion and 800-1000g of minced beef or chicken/beef strips. Add 2-3 cups of vegetables, a 400g can of diced tomatoes, a drained can of red kidney beans and 2 sachets of taco, burrito or fajita seasoning. While this is simmering away for 10-15 minutes – prepare your salad platter (don’t forget to pop some jalapenos on there!) and substitute sour cream for plain greek low/no-fat Chobani yoghurt – it’s a swap nobody will notice and is a much healthier choice!

*Hot tip, especially for the kids or the unco’s among us – Hold the wrap with it’s base half way down a 15cm length of foil, fold the foil over the base and wrap the edges around the sides – so much easier to eat!

3) Random mid-week lunches and snacks

Having all your veggies pre-cut is so handy in enabling you to create a salad in less than 5 minutes for work or to have at home – simply add your choice of leaves, protein, nuts and dressing to a few good scoops of your veggie mix. Also great for preparing a snack for yourself or for the kids at school.

 

4) Dinner – San Choy Bao, 15 minutes prep/cook time

While you are microwaving a cup of brown rice with 2 cups of water (15 mins), start by washing/separating out your iceberg or cos lettuce leaves – laying them out on paper towels to dry – if you’re a bit OCD, you might like to trim them down into neat bowls – I have neither the time or motivation! Then stirfry 800-1000g of minced pork, turkey or chicken with a drizzle of oil, some garlic paste and a cup of your pre-prepared leek or onion.

Add in 3-4 cups of veggies, cook through for a few minutes and add 2 sachets of San Choy Bao sauce and simmer until done or until rice is ready. This recipe works really well with some chopped water chestnuts, bean sprouts or bamboo shoots but don’t stress if you don’t have them. Let your rice and San Choy Bao mix cool a little before spooning into lettuce cups

*Hot tip: run the base of the lettuce under cool water as you peel the cups off from starting at the base – this helps them separate without ripping. Cos lettuce is the far better choice though if you are short on time or patience (and it’s easier to handle than iceberg, especially for kids!)

5) Dinner – Pasta – 20mins prep/cook time

Pasta, sausages or meatballs are true potty words in many nutritional circles. However, with my Italian background – an occasional pasta for me is non-negotiable and my kids and partner love sausages – let’s be honest, they can be really tasty. I figure why not include this family favourite into this article as it’s truly delicious and what is food if it’s not there to be enjoyed?

It’s a good reminder not to get caught up in the puritanical obsession over food and to demonise foods to the extent you are too scared to enjoy them in moderation.

So – get the pasta water boiling straight away and throw in 1-1.5 packets of pasta when it’s at full boil. (Many like to salt the pasta water – that’s beneficial for flavour, not so great for your health – your choice!) Then fry off 800-1000kg of mince/meatballs or bite-sized sausage pieces (pork or chicken) with some garlic paste and around a cup of your pre-cut onions. When meat is browned, add in 3-4 cups of diced vegetables, a stock cube/gel that complements your meat chosen and some tomatoes (a combination of your choice from fresh tomatoes, diced tomatoes or passata (tomato puree).

Now to boost flavour – I highly recommend adding 3 heaped teaspoons of Sacla chilli pesto or a jar of their arrabiata sauce (see *disclosure below!), herbs of your choice – such as bay leaves, rosemary, basil and add chopped parsley towards the end of cooking. Another great way to add flavour is to throw in the rind from your parmesan cheese and remove before serving (never throw these rinds away, there’s a million culinary-genius uses for them!).

As for most pasta sauces – though it can be eaten after the meat and vegetables are cooked through – more cooking time will certainly improve the sauce and intensify the flavours – whether this is an extra 10 minutes that you may have at night or whether you manage to get it into a slow cooker in the morning/during the day. Drain pasta when cooked, drizzle with extra-virgin olive oil and immediately stir through a few large serving spoons of sauce as this lowers the amount of olive oil you have to add to stop the pasta from sticking together as it cools. Serve with grated parmesan.

*Disclosure – In the interests of full transparency – please note that I have familial associations with the Sacla and Val Verde products featured here. You can use other brands for sure – but in a totally biased, but still true statement – these are the best!

6) Dinner – Shepherd’s pie – 1hr prep/cook time

So this one many not be one for a ‘school night’ for many as it does take a bit longer to prep and cook than the other dishes – despite me taking plenty of shortcuts on the traditional shepherd’s pie (and changing it up to make it more nutritious!).

Set the oven to 160 degrees. In a deep, ovensafe pan – fry up a cup of your diced onion with 1kg of lean lamb mince (or kangaroo/beef if you can’t find lamb or if you want a leaner dish as lamb can be inherently a bit fattier!). Add 4 cups of diced veggies and/or frozen peas/corn and after a 2-3 minutes of cooking stir in 4-5 tablespoons of plain flour. After a further 2 minutes of cooking, add 4 bay leaves, 500ml beef stock, 3-4 tablespoons of Worstershire sauce and 2 tablespoons of concentrated tomato paste. (In the session when this photo was taken I didn’t have the paste – so just used 400ml diced tomatoes and just boil it off a bit more – it still worked!). Bring the mixture to a boil on the stove and then transfer to the oven to reduce.

Pop a large pot of water on the stove to bring it to the boil while you start peeling/chopping your root veggies. Traditionally the topping for this pie is white potato, but you can make this a lower GI dish (with fewer calories) if you change it up a bit by replacing or combining this white potato with sweet potato, pumpkin or cauliflower instead – all manner of combinations/substitutes work well.

When these veggies are soft, drain and mash – whether you add milk, salt, butter or cream is ultimately entirely up to you – this pie can be as healthy or as decadent as you like – including if you’d like to add a pastry base/sides, but from a nutritionist’s point of view, if it’s going to feature regularly on your weekly menu – then try add these ingredients in a half-reasonable fashion! Take the mixture out of the oven and increase the temperature to 220 degrees then either pop this mash straight on top of the mixture if there’s room in your pan – or layer a new casserole dish with the mixture and then the mash (and if you like, top with a bit of grated tasty or parmesan cheese!). Return to the oven for 10 minutes to brown off the top and melt the cheese.

 

7) Dinner – End of week – ‘Mongrel but Delicious’ Soup – 10 minutes prep time, 30 minutes to 1 hour simmer time.

So you’ve made it to the end of the week (hopefully without too much general carnage and wine intake along the way!). This is when I bring out the biggest pot I have, fry off the remaining onion and leek with some garlic and then pretty much dump all my remaining diced vegetables (except cucumber – that’d just be weird!) and any remaining loners from the veg drawer with a chunk of pumpkin, a sweet potato or two and perhaps some legumes or barley from the pantry.

For flavour: Add some rosemary, bay leaf, diced tomatoes or half a bottle of passata, any left-over meat from a previous roast or slow-cooker meal or a ham or bacon hock (parmesan rind is good here too!). Cover the lot with salt-reduced stock, bring to the boil and simmer on medium heat for at least 30 minutes and until all veggies are soft – around an hour is ideal.

Extract the ham/bacon bone if you added one of these and shred off the meat, throwing out the bone/skin/fatty bits. Add this meat back into the soup and serve chunky ‘minestrone’ style with some parsley, grated parmesan and if you would like some extra carbohydrates – perhaps add some cooked pasta pieces, brown rice or put some wholemeal/multigrain bread on the side. Otherwise (as this tends to be more kid friendly!) take out the hard bayleaves/sticks from the rosemary and pulverise with a stick blender until really lovely and smooth.

To Conclude: I hope this article (albeit a long one to get through!) has given you a few ideas about how you may become your own ‘Meal prep boss’. As always, if you’ve enjoyed the read – the greatest compliment would be to share it and recommend Life Nutrition to your family and friends, your support is always appreciated!

The Dreaded After-Dinner Munchies

You’ve finished dinner. You’re not hungry, but ……nom nom nom….So, every night without fail, shortly after what technically should be your final meal of the day – why do you find yourself pulling open the fridge door? Cookies, cake, icecream – anything – you don’t really care – you’ve got the munchies as badly as a stoned teen who’s scored a ride to 7-Eleven!

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Over time – this habit can result in weight gain as it contributes surplus energy daily needs – or otherwise it seriously dents your efforts to have eaten well during the rest of the day. So lets nip this in the bud in a very matter of fact way! Try thinking of ‘post-dinner snacking’ in the way that you would deal with any risk.

Simplistically – a risk assessment may consider:

  • Identification and source of the risk 
  • Ascertaining the likelihood and consequences of that risk
  • Managing that risk – eliminate/avoid, reduce/mitigate or accept it
  • Monitoring that risk – periodically evaluate how you’re doing

With this in mind, therefore most important aspect to first ascertain is why are you snacking? What is the cause or what is the likely trigger? You may have to take a little diary over a few days to record your moods, any dramas which have passed over the day and what you’ve eaten that day – a trend might just start to emerge.

  • Have you restricted your intake during the day too much – either, that you literally haven’t eaten enough or have you become nutrition’s Mother Teresa and eaten nothing but kale and kombucha which has left you feeling unfilled and wholly unsatisfied with the world?
  • Are you bored and it’s just something to do?
  • Are you using food to comfort you (Bridget Jones style!), as a stress relief, to reward yourself or because you’re angry at somebody, your workplace, a rotten spell of luck (or are you angry at yourself?).

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It’s usually one or a combination of the above 3 reasons and once you’ve figured this out – you can start to address this habit at the root of its cause. Either starting to eat properly during the day will diminish this drive and/or you may have to work to put in place other means to deal with your emotions or boredom. This may require some trial and error and you may need to assess your sleeping habits, stress levels or work on identifying the ‘negative influences’ in your life and either reducing those or learning different ways in how to manage them.

 

STRATEGIES TO COMBAT THE MUNCHIES

Unfortunately, despite this being a common issue and a key source of extra energy for many – there has not been much research done into effective strategies to lower the drive for post-dinner snacks. However, I have reviewed a lot of evidence-based research around food behavior and eating environments as well as anecdotal evidence to formulate the following ideas for you to try.

  • Immediately brushing your teeth after dinner – Potentially works as: it’s a good psychological trick – the action/taste of mint informs your inner food-god that offerings have ceased for the day, you maybe too lazy to have to brush again – or perhaps as food can just simply taste weird after toothpaste – so whichever theory rocks your boat – this simple strategy may just result in you avoiding further food.
  • Make a household rule that there is no eating on the couch or in front of the TV or ask others who are munching after dinner to eat elsewhere – or remove yourself. Potentially works as: your environment/company hugely affects what you eat and your behaviour around food and as eating in front of the TV, computer or ipad has been shown to increase the quantity of high-calorie, low nutrient-density food consumed.

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  • Savour a large cup of flavoured herbal tea or decaffinated tea – Potentially works as: it maybe a good substitute for ‘going through the motions’ – many find that a large cuppa, lightly sweetened if desired can do the trick with the bonus of additional hydration.
  • Do something productive or join some social sports, clubs or go for a walk after dinner – Potentially works as: it changes up your normal ‘high-risk’ snacking environment and replaces potential boredom with a positive task which may strengthen or fulfill you both physically, emotionally and mentally.
  • Consider removing all of your ‘vices’ out of the house and clean out the pantry and fridge of all temptation. Potentially works as: limiting visual exposure and access to food decreases consumption and wanting of that food. At the minimum, remove your ‘danger’ snacking foods from eye-height and make them difficult to get to – the effort just may not be worth it – if you are inherently lazy, use this to your advantage!

 

OR AFTER TRYING A FEW OF THESE, IF THEY ARE NOT WORKING…

…. DO YOU SIMPLY EMBRACE THE MUNCHIES AND BE AT PEACE WITH THE LITTLE BUGGERS?

Even once these issues are identified and addressed and you’ve tried a few strategies from above, the feeling of ‘enjoying something sweet’ after dinner can remain and this is where you can either continue to fight it – or acknowledge that it’s an aspect of your day which you actually enjoy and which you don’t want to eliminate completely.

If this is you (this is me!) – then I suggest planning this inevitable post-dinner snack into your day so that it doesn’t become surplus to your daily energy and nutrient needs. You may find it useful to set yourself some guidelines to work within and they may include the following:

  • Energy value of an ‘everyday’ post-dinner snack should be 100Cal or less – this generally requires an overhaul of what you consider a ‘normal serving’ size to be. Take a look at your favourite post-dinner snacks and see how small a serving size of 100Cal actually is – of course, 100Cal worth sometimes just won’t cut it – but endeavor to establish that as your serving for most days.
  • Accommodate for this snack by decreasing your dinner size – think of the post-dinner snack as a slightly delayed part of your dinner – not as an additional extension. Stop eating your dinner at 80% full, so that this snack is not consumed on a full stomach.
  • Try to make most days at least semi-nutritious! – a handful of berries, a few tablespoons of good quality yoghurt with a 2-3 teaspoons of granola, some quality dark chocolate or a bowl of strawberries with a teaspoon of honey are far better choices (even if fruit/honey maybe a bit high on the sugar side) than a Tim Tam or some Ben and Jerrys.

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If you can’t beat the munchies entirely – then join them, but make them play by your rules!

“You don’t win friends with salad, you don’t win friends with salad”

 

Those of us who were watching too much TV in the 90’s may remember Bart and Homer parading around their living room singing these lines which have since become quite a soundbite, particularly with you men out there! Well, whether that is true or not – many people have this idea that to eat better or lose weight that they have to forgo all the foods that they love and exist on ‘rabbit food’.

However, this is simply not the case and the following suggestions are just a few seriously simple ways for you to swap just one or two ingredients in your favorite dishes and cut their energy content by a third or even sometimes up to a half, while not compromising (or compromising much!) on taste and usually adding more veg – always a bonus!

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Lasagna – This is one of my favourites but between the high carbo load and the decadent béchamel sauce – it can certainly pack a good punch in the calorie stakes! Swap: Some or all of the lasagna sheets for slices of pumpkin or zucchini (about 1cm thick works quite well), add extra vegetables to the bolognese sauce and if you’re really serious – go for a lighter version of the béchamel sauce – such as this one from Epicurious. (Note if entertaining though – this will not plate up as easily as traditional lasagna)

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Shepherd’s pie – What better on a winter’s night?! Swap: The buttery mashed potato that after a few bowls is sure to spike your blood sugar with some blended sweet potato and cauliflower. Also, in the interests of both health and laziness, why not serve it straight from the oven tray and skip the pastry? – Of course, while you’re at it, up the vegetable content of the filling too!

Macaroni and cheese – a hit with the kids (both with the small and overgrown kids alike!). Swap: The creamy cheesy sauce for some cauliflower or pumpkin sauce (trust me…) Basically just cover a few cups of your vegetable of choice in some vegetable stock and boil. When soft put the vegetable in a blender (retain the stock though!) and blend it up really well with some garlic that has been gently fried in a touch of butter. Add a little stock, 2-3 tablespoons of greek yoghurt and even a bit of milk as required to get a nice smooth consistency. Then add only a small handful of tasty cheese like parmesan or mature cheddar and stir through your cooked pasta.

Steak and chips – Though we are generally eating too much meat (both for health and environmentally!), steak holds a special place on many a dinner plate. However, if you are looking to both cut your saturated fat/energy intake and positively impact the environment, the consider a swap to kangaroo meat. Kangaroos produce far less methane and require far less resources compared to traditional livestock farming. Additionally, per 100g, compared to beef – kangaroo meat has approximately a third less energy, 15% of the total fat, slightly more protein, 2-3 times more iron (though half the zinc) and higher levels of Omega-3 fatty acids than grain-fed beef. Finally, swap the fried chips with crunchy baked sweet potato wedges.

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Note that if you don’t like the more ‘gamey’ taste of kangaroo or very patriotically can’t bear to eat our coat of arms and you’re going to continue eating the beef – it’s worth sourcing grass-fed beef as this has a far better fat profile than grain-fed, though it requires higher resources to farm – so you’ll have to weigh up your priorities here! Kangaroo mince can also now be bought in most supermarkets – so try it in your bolognese, lasagna, shepherds pie, meat balls, hamburger patties etc.

berry pieBerry tarts – If you’re looking for a healthier (and superquick!) option on the rich, glazed berry tart (or even a cheesecake type of desert) – then simply brown off your shortcrust pastry shell (or mini-shells will plate up much neater!) and let the shell cool completely. Swap: the traditional filling with a thick, quality, honey flavoured or lightly sweetened greek yoghurt – Chobani or Mundella are good ones, but it’s up to your taste preferences really as this is dessert after all – taste is a top priority! Top this with fresh berries and serve – with an extra drizzle of honey over the top of you’d like. This swap will still taste really creamy and sweet but will have half the energy of a traditional tart.

Hope this article has given you a few ideas on some easy swaps you can make to still allow you to enjoy your favourite dishes but in a lighter, more nutritious way.

 

Holy cow! Why is everybody getting inflamed over dairy these days?

Creamy, decadent icecream, milkshakes, cheese – both pungent and delightful, morning yoghurt. Hearing mention of these foods make some of us drift off to our happy place while others recoil in horror at the thought of being anywhere near all this (alleged) inflammation-inducing, stomach cramping, skin breakout-causing dairy.

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Is it time that we rethink dairy as a ‘staple’ in our diets, even putting aside the often-touted but totally irrelevant catchphrase that ‘cow’s milk is meant for calves, not humans’ – or is dairy totally fine to consume and too many people are getting all whipped up over nothing?

Firstly – what is inflammation and why do we care?

Inflammation is basically a response from your immune system to counteract an attack, injury and heal the affected tissues and restore normal functionality. Acute inflammation (think when you’ve fallen off the bar while dancing spectacularly and twisted your ankle) has a rapid onset and often can be quite severe and at times visually very impressive – snapchat that! However, chronic or low-grade inflammation may not be quite so dramatic or visible but can nonetheless contribute to the progression of many auto-immune conditions such as rheumatoid arthritis, lupus and also some cancers, type 2 diabetes and atherosclerosis (build up of plague in your arteries – not good).

So very logically – we want to reduce chronic inflammation and avoid anything that may contribute to this long-term, destructive process in our bodies and as such, dairy is in the sights of many as a highly suspected culprit. However, in my research for this article, I have failed to find an explanation as to why or how dairy is supposed to inflame your body – most anti-dairy articles just state it as a fact without any backup research and then proceed to talk about milk intolerance or allergy – which are different issues entirely. Certainly, if you have a milk allergy and consume dairy – inflammation will result – as it would for the ingestion or exposure to any allergen that you happen to be allergic to (thanks Captain Obvious!). Similarly, the vast majority of milk intolerance is caused by having insufficient lactase (the enzyme required to break down lactose) – and this will result all manner of unpleasant side-effects upon dairy consumption – but the incidence of this in a caucasian population is only about 1 in 20 – noting that it is higher in those with Asian, Africa, Middle Easter or Indigenous backgrounds.

This would indicate that for the vast majority of us who do not have a milk allergy or milk intolerance, dairy will not cause inflammation. This is confirmed by the vast body of research, including a really indepth systematic review (Bordoni et Al) of 52 clinical trials which found no evidence (other than those with allergies) that either full or low-fat dairy was inflammatory and in fact concluded that it was quite the opposite and that it was beneficial for inflammation, especially in those with metabolic disorders (including obesity) for whom low-grade inflammation is particularly concerning.

Additionally, there is overwhelming evidence that has consistently shown dairy consumption to be beneficial for cardiovascular health, type 2 diabetes risk, weight loss and control, bone health and for hypertension (or high blood pressure).

So, if you don’t like dairy, convinced that it doesn’t make you feel good, are against it for ethical or environmental reasons – then by all means feel free not to consume it as there are many other brilliant foods out there that can provide the calcium, potassium, Vitamin D, protein etc that are in dairy. But please please – just don’t let the ‘wellness gurus’ or scaremongers use the feared ‘inflammation’ argument to convince you to put down your latte or flat white ‘just the way you like it’ as it can certainly still be considered a ‘staple’ in the diet of most.

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If you choose to include dairy in your diet, serving suggestions for adults is generally 2.5 serves/day or up to 4 in some older age groups or teenagers.

yogurt with superfood granola and blueberries

Milk over wholegrain cereal with fruit and nuts

 

A serving could be:

  • 250ml glass of milk
  • 200g tub of yoghurt
  • 40g (2 slices) of cheese

 

 

To conclude: if you are worried about low-grade inflammation – you’d be far better off putting down the smokes, being less of a boozehound, getting moving with some regular exercise, losing excess weight safely and including the over-all quality of your diet with more fruits, vegetables, whole grains, and Omega-3 rich foods including fish.

 

All this talk of dairy – I may just go off now and make myself a good smoothie!

Hypothyroidism and weight management

As we age and our resting metabolic rate naturally slows, it can become increasingly difficult to maintain a healthy weight. This unfortunate aspect of aging is compounded for those struggling with an underactive thyroid as this slows the metabolism further and causes fatigue, lowering energy expenditure – bugger right?

However, for optimal weight management, the following key strategies can be implemented and reviewed on a regular basis and those with an underactive thyroid may benefit further from one-one nutritional and physical activity planning.

Firstly – a quick overview of hypothyroidism for those not in ‘the know’

The thyroid is a small gland on the front of your throat which in response to thyroid-stimulating-hormone (TSH) will release Triiodothyronine (T3) and Thyroxine (T4) – hormones which help to regulate metabolism. It is estimated that approximately 8-10% of western populations have some issue with this thyroid gland (most involving hypothyroidism or underactive thyroid function) and that women are 10 times more likely than men to be affected with risk increasing with age. The reasons for hypothyroidism can vary, but it is commonly associated with an autoimmune condition – whereby, the immune system mistakenly attacks your own thyroid gland…not so clever…

Hypothyroidism is associated with weight gain, fatigue, depression, memory issues, hair loss, decreased libido and poor cold tolerance – though not all of these symptoms have to be present and one person’s symptoms and severity of symptoms can differ greatly from another’s. In severe cases, if left untreated, the thyroid gland can become enlarged and form a goiter, risk for other autoimmune conditions including rheumatoid arthritis can increase and rarely, but potentially, it can result in severe life-threatening depression, heart failure, or coma.

Strategy 1: Make sure your medication is right for you, both with respect to type and dosage

This will have the greatest effect on your weight management as, without question – it will have the most significant impact at the root of your problem by essentially correcting your hormone levels. Many don’t like the idea of having to take medication daily and indefinitely, but at this stage – such treatment is the only and best solution for hypothyroidism. So the first priority is certainly to make regular (initially monthly and then progressing to annual) appointments with your GP to get your thyroid-stimulating hormone (TSH) and perhaps also your thyroxine (T4) levels checked to determine what medication and dosage is suitable for you. Then of course it is essential that you take it correctly (this is definitely a ‘do as I say, not as I do’ as I’m the worst at this with mine!) – it needs to be taken daily, on an empty stomach and at least 30mins prior to food or as otherwise detailed by your GP or as detailed in your medication leaflet.

Some advocate taking thyroid support medications or supplements, funnily enough – especially those companies trying to make money out of you or ‘nutritional consultants’ who so happen to have such fabulous potions behind their counters! Though some people report that at least initially, this can improve energy levels – there is no significant clinical data published that show that any of these are of any long-term benefit when correct thyroid medication is taken with an adequately nutritious diet. So, bypass those selling ‘dreams in a pill’ (spend that extra money on a nice pair of shoes or something) and focus instead on optimising your diet and modifying your food intake.

Strategy 2: Aim to increase the nutrient density of all of your meals and snacks.

Hypothyroidism is often associated with other autoimmune conditions and these commonly and negatively affect nutrient absorption with increased likelihood of micronutrient deficiency. Prioritise a wide range of vegetables and fruits (especially those with high fibre) and good quality proteins and wholegrains while minimising refined carbohydrates and sugars. Generally, for those with hypothyroidism, your plate should be about 50% salad/veg (excluding potato), 25% protein (or a ‘palm sized’ serve) and 25% or even slightly less high quality carbohydrate – depending on how active you are.

Protein is a really satiating macronutrient which often helps with weight loss, controlling appetite and also with maintaining muscle mass during weight loss. You will also note further down, that meats, legumes, nuts, seafood and dairy also contain the key micronutrients required for optimal thyroid function. Also, please note, that I am not advocating to go ‘low-carb’ – there is absolutely nothing wrong with high quality carbohydrates and these can provide excellent fuel and can have great nutritious value, but refined (white) flours and sugars provide nothing but short-term bursts of energy, blood-sugar spikes and are often quite devoid of any nutritional value (despite being so extremely yummy when in the form of cakes or cookies!) – so it’s best to learn to only eat these foods occasionally.soda-pop

Generally, my primary recommendation is to first significantly reduce the soft drinks, ice teas, high-calorie sports drinks and juices in your diet as these provide a load of empty calories which you will not then compensate for, leading directly to weight gain. To stop me ranting further about that here, if you’re interested in more on this – see my article The Great Sugar-Tax Debate for more detail and information about why these really have no place in any healthy diet, but particularly for those who are trying to lose weight.

Next areas to tackle are usually alcohol and pre-packaged or baked goods (think cookies, sugary cereals and museli bars, cakes, muffins, refined-flour breads etc). One by one, I recommend to go through any of these tempting morsels which you commonly eat and consciously reduce your intake and/or replace them with alternatives – though noting that many of the ‘healthy’ options will contain just as much sugar and energy. Please watch out for an article that I’m working on that will detail more actionable and practical strategies on how to change your food behaviours and reduce your reliance and ‘cravings’ for such foods – in the meantime, start experimenting with what works for you as everybody’s vices and solutions in dealing with them can differ markedly!

So, there are specific nutrients that support the thyroid to keep in mind and of course, the healthier your thyroid, the better it will function and the easier your weight management will be:

  1. Iodine – Over the last few decades, iodine deficiency used to be very rare in Australia – but deficiency rates are rising in certain sectors of the population and in particular, women over 50 years, who are also one of the most likely groups to suffer from thyroid issues. Post-menopausal women are consuming on average slightly lower than the Recommended Daily Intake (RDI) which is not a problem for most without thyroid issues, but could be for those with an underactive thyroid as it is required for thyroid hormone production. Rich dietary sources include: using iodised salt instead of regular salt, dried seaweed (nori), cod, baked potato (skin on) and milk. However, just to throw a spanner in the works, consuming too much iodine can also exacerbate hypothyroidism and cause a range of other health issues, so stay away from supplements (unless you’re pregnant) and as for most of my dietary advice, never go overboard on any one particular food or food-group.
  2. Zinc – In Australia, most adult women consume their RDI, so for most – your diet should already be adequate. This is really good news as it is essential in the regulation of TSH. However, if you are concerned about your Zinc levels, increase your intake of seafood (especially oysters and shellfish), legumes/nuts/seeds, beef and I just have to add in here – cocoa powder and dark baking chocolate is also very high in Zinc – huzzah!
  3. Selenium – On average, consumption of selenium in Australian adults is above RDI which again, is excellent news as it is a mineral which helps recycle iodine. Still, it’s best to ensure that adequate selenium levels are maintained by eating foods such as Brazil nuts, seafood, wholewheat bread, sunflower seeds, pork and other meats.

Strategy 3 Increase your physical activity – both cardio and weightbearing

Unless you’re doing some really impressive sweat sessions, exercise does not contribute as much as you may think to weight management, which is why dietary control is key, especially for those with compromised metabolisms such as is the case with hypothyroidism. However, it does still certainly contribute to energy expenditure, especially if you have the time and motivation to really push yourself and by increasing your muscle mass, you will increase your resting metabolic rate – which means when you’re watching your fourth hour of Game of Thrones, you’ll be burning more calories merely sitting there on the couch than you would have without sporting your new buns and guns.

However, the benefit of exercise goes well beyond weight management and is instrumental in maintaining bone and cardiovascular health, blood glucose control, strength, balance and mobility and exercise is incredible for depression and memory – mental health issues commonly associated with hypothyroidism.

So wherever your currently fitness level is now, aim to improve it gradually through both cardio and weight-bearing activity and set goals to strive for – eventually it’d be great to be doing at least an hour of activity on at least 5 days of the week. You may benefit from working with a personal trainer or getting a health check and clearance from a GP, especially if you haven’t undertaken exercise for a while, and it can definitely be easier to set new habits if you have a good support team around you. The most important thing is that you find something that you enjoy to do and often enjoyment and motivation for your activity is raised considerably when you have good company to do it – and a promise of coffee at the end – so rope in some of your friends! I believe most people would agree that physical activity needs to fit into your lifestyle and that you look forward to it as special time that you’re investing in you – as otherwise it’ll just be a drag and be unsustainable – and we can’t have that!

bike ride

 

Strategy 4: Maximise sleep and minimize stress

The relationship between poor sleep and weight gain is well established and so ensuring that you prioritize sleep is paramount.

Things to try if you’re not a great sleeper:

  1. Regulate the time you go to bed/wake up and implement a consistent sleep preparation routine (may include a shower, listening to music, reading)
  2. Turn off all electrical equipment including phones, ipads, TV’s at least 1 hour prior to bed – experts say up to 2 hours, but let’s be realistic!
  3. Restrict nicotine, caffeine and alcohol – especially in the afternoon and evening as this wrecks havoc with your sleep. Likewise do not go to be either hungry or overly full.
  4. Ensure that you get adequate natural light during the day and minimize light sources at night – this will keep your circadian rhythm regular and ensure that your melatonin levels are increased at nighttime, making you sleepy.
  5. Ensure that your bed and pillows are suitable for you and that your room is a comfortable, cool temperature.
  6. Exercise is great for sleep!

sleeping

Stress will also interfere with good sleep, so avoid confrontation or doing or thinking about your work or other problems at night. Stress also has the effect of releasing cortisol which encourages the consumption and storage of energy (to replace that which you theoretically expended when running away in an adrenaline-fueled panic from some frightening predator). Additionally, the brain seeks to reduce tension by releasing pleasure-inducing chemicals and what better way to do this than through seeking pleasurable, dopamine-inducing foods such as cake, chocolate or hot chips? This is problematic in today’s modern world as our stress is unfortunately not associated with any great energy expenditure and such foods are readily available 24/7 so over time, if this adrenaline/cortisol cycle becomes chronic – stress will inevitably result in weight gain.

But, how to control stress is of course the million dollar question and ultimately many of us feel we have limited control over the source of our stress (work, family, finances, dogs chewing the irrigation – again!) – but this is certainly the first port of call as the rest is just treating the symptoms. Where possible, tackle, eliminate or outsource stressful tasks – or better still, where applicable – ‘reassign’ them to the people who should be doing them anyway (Question: How did that issue suddenly become yours in the first place?!) Where possible, learn not to stress about things you can’t change or control and create distance between you and people who are causing you undue stress and pressure, even if you are only able to temporarily remove yourself from the situation. It’s an ongoing process to learn to live fully in the moment and not spend time in regretting or resenting the past or dreading what may come the future – but working towards this is a key for many in reducing stress and living better today.

Aside from eliminating stress at its source – do your best to find your zen and what works for you in helping to deal with it (and no, eating icecream straight out of the tub until you’re in a food coma is not a suitable solution…sorry). This will ideally require a multi-level strategy – starting with good sleep, good food and taking time out of your busy life to prioritize exercise and also some other quality time just for you. Yup, your family will survive for an hour (they are capable of making their own lunch!) and your mountain of work will still be there if you were to catch up with a friend for a yarn or simply relax somewhere with a book for an hour.

time out

Some like to practice meditation – unfortunately, I have no patience for that, I figured I mastered breathing a while back and I’m too skittish to sit still for that long – perhaps I’ve just identified one of my key problems! However, I do try to practice mindfulness, both to ensure that I’m fully enjoying the stress-free moments, and this includes when eating so that I don’t blankly guzzle down food and not even taste or enjoy it. Main point again is that it has to be something that works for you.

A quick parting note on hypothyroidism, gluten and goitrogens

Though not directly related to the main topic of weight management – I’m anticipating that there maybe a few questions on the relationship between hypothyroidism and gluten or goitrogens – so here are the quick answers:

Gluten: There are suggestions that as many cases of hypothyroidism arise due to Hashimoto’s  (autoimmune condition), and given that other autoimmune conditions commonly also present can be exacerbated by gluten ingestion, that there maybe a link between hypothyroidism and gluten intake. However, the research on this to date is not conclusive and there are still many grey areas that are unclear or not fully understood. My recommendation at this point is that it is not necessary for all those suffering from hypothyroidism to go ‘gluten free’, such a link is far from clear – but if there is a family history of gluten intolerance, coeliac disease or if your symptoms have not improved despite implementing all the above strategies, then it would be harmless and perhaps beneficial to try going gluten-free for a while and seeing how this many affect how you feel.

Goitrogens: are substances that are found in cruciferous vegetables such as kale, broccoli, cabbage and cauliflower and if consumed in sufficiently super-large doses, can negatively affect the thyroid’s function. As goitrogen levels are greatly reduced during the cooking process – unless you are juicing ridiculous quantities green smoothieof these vegetables raw (as in basically living on the conconction and little else!) – the presence of these goitrogens should not be of concern as the sheer quantity required to negatively affect your thyroid is next to impossible to consume. The benefits of these nutrient-dense vegetables far outweigh the very low goitrogen risk. So feel free to enjoy your green blend – your thyroid will not shrivel up and die in horror!

Thanks for reading! I hope you’ve enjoyed reading this article on weight management for those with hypothyroidism and please share it with anybody you know who is or who may be suffering with an underactive thyroid and stay tuned for that article I promised above for practical tips and strategies for changing ‘food behaviours’ and restructuring your eating habits.

Blending vs Juicing – does either live up to the hype?

Recently, blending and juicing have been very popular with many believing that the pulverizing or extraction processes better ‘release’ the micronutrients from your fruits, vegetables or nuts to allow more efficient absorption. Others believe that such liquids – especially when green and containing expensive ‘superfood’ powders or herbs – become magical concoctions which can ‘detox’ you and aid in weight loss.

However, what is the truth in all this and if you are keen to give it a try – is blending or juicing better?

Firstly, allow me to deal with the ‘detox’ claims as that’s fairly straightforward and our recent article To detox or not to detox? deals with this question in depth. However, in summary – no, there is no scientific basis or clinical evidence that nutritional ‘detoxing’ is required or effective.  The best way to maximise the function of your natural detoxification system, is to provide your body with optimal nutrition in the long-term. Most detox diets are low in proteins or amino acids, fibre, probiotics and ‘good fats’ – unfortunately, some of the key nutrients that our main ‘detoxing’ organs need to be fully functional. This can lead to impaired organ function and actually allow more toxins to accumulate.

So, assuming you don’t intend to use blending or juicing as a ‘detox’ approach – why else might you want to occasionally blend or juice?

Such drinks are easy to consume ‘on the go’ – much quicker than juicesitting down to eat a salad or dealing with the mess of trying to peel a mandarin on the way into a work conference! Many people report that they don’t like consuming solids first thing in the morning, but on the other hand, they don’t want to leave for their day with nothing in their systems – a nutritious liquid that ticks off a few fruit and vegetable serves early in the day could be a good compromise. Kids who turn their noses up at fruits or vegetables may be convinced to drink some ‘monster juice’ – my little one went through a fussy patch at around 3 years old, and green blends were a very effective way at upping her fruit and vegetable intake. And some may simply like the taste – though I’ve seen some horrendous green goop recipes doing the rounds!

At Life Nutrition, we strongly believe that if you do not enjoy what you’re eating and drinking – then aside from not being sustainable from a dietary perspective – you are not truly enjoying life in the meantime. We can’t have that!

One of the key concerns when dietary intake is restricted – either to lose weight, or due to poor eating habits, is the possible development of micronutrient (vitamin and mineral) deficiency. Synthetic vitamins/supplements have been shown to be generally acceptable in raising vitamin status in cases of deficiency, but they are not the best way to ensure safe, adequate intake as your body doesn’t fully absorb them and they’re often present in different forms to that occurring naturally in food. Excess in one supplemented vitamin or mineral can have unintended, unpleasant and at times dangerous side-effects or have detrimental interactions with medications. So unless totally necessary, I highly recommend that you refrain from taking supplements and instead work on obtaining adequate micronutrients from real, whole foods.

For me, juicing – where only the liquid of the fruit and vegetables is kept, just doesn’t cut it and doesn’t meet the definition of consuming fruit-juice‘whole foods’. Lack of fibre is the main reason for my opinion. Insoluble fibre from the plant’s stucture – eg from the skins or stalks, is great for bowel health and soluble fibre slows the rate of gastric emptying of all these nutrients/energy. This is excellent for blood cholesterol levels, blood glucose control (reduces sugar ‘spikes’), satiation, better nutrient absorption and is strongly associated with reduced cancer and heart disease risk. However, sadly all of this beautiful fibre is thrown out in juicing!

Negligible fibre in juice means that all the sugars will be absorbed far quicker with low satiation which can lead to over-consumption of energy and weight gain. If you juice too often and your fruit content is very high, your liver may not be able to keep up with fructose metabolism, leading to fat being stored around your organs and in the liver itself. It is this fat is the main contributor to metabolic dysfunction. Additionally, often antioxidants found in the skins, pulp and seeds of fruits and vegetables are left behind in the juicing process.

However, doing a blend occasionally (maximally one/day), where whole fruits and vegetables get both annihilated and consumed, does fit in with our ethos and can certainly be a handy top up to your micronutrient and fibre intake. So long as you don’t use too much fruit, you can get a really good nutrient intake for your ‘calorific buck’. Note though: unless you like drinking gritty salad purees, you’ll definitely need a high speed quality blender!

With blending, one lesser-known thing to watch out for though is that the acidity, natural sugars and colours in these blends can be very detrimental to your dental health and can cause staining if you blend too much over a long period of time, so minimise contact of the liquid with the teeth by using a straw, drinking your blend within a short time and then rinse your mouth and teeth with water after finishing.

So, if you are interested in blending, please see our Recipe page for some of my favourite recipes and blending tips – please give them a try and let me know if they hit the spot for you too –  otherwise I’d love to hear yours!

 

The Great Sugar-Tax Debate

Obesity is a complex, multifaceted metabolic disease with many environmental, genetic, social and economic factors,1 but one direct contributor is high intake of Sugar-Sweetened-Beverages or ‘SSB’.2-4 Would implementing a tax on these drinks actually reduce consumption and lower obesity rates or would this tax be just another revenue-raising scheme by a government who is arguably becoming more patronising and increasingly involved in our personal lives? This divisive debate has been reignited in Australia after the UK recently approved such a tax.

What’s not in dispute is that overweight and obesity rates have reached critical levels in Australia, and that these are major risk factors for the development of diabetes, cardiovascular diseases and some cancers.1, 5-9 The total annual economic cost of overweight and obesity in Australia is estimated at $41billion in 2008, and it now affects 63% of adults and 25% of children.10, 11 Many argue that if the public purse pays for a significant proportion of the consequences of diet-related disease, than those in charge of public health need to accept more responsibility and be more proactive in changing the Australian dietary landscape.

The debate of personal choice vs public interest is hotly contested.

For the purposes of the following discussion, soda-popsugar-sweetened-beverages or SSB’s include soft, energy, sports or vitamin drinks, iced-teas or other water-based drinks which contain sugar or other energy-containing sweeteners (collectively termed ‘sugar’), but exclude 100% fruit juices or flavoured milks.4, 12 The calories in these drinks have little satiating effect and contain few if any nutrients and this is not compensated for by reducing calories from solid food or non-SSBs, increasing the likelihood of these consumers becoming overweight and obese.4, 13, 14

Life Nutrition has undertaken in-depth research on this topic and for this article and from the best evidence available, we believe that there is a very strong, consistent case made that increasing the end-price of SSB’s by an average of 20% would decrease daily energy intake, especially for key at-risk subgroups like the young and disadvantaged. Doing so could encourage manufacturers to reformulate drinks, healthier options should become cheaper and population obesity rates should drop, corresponding to significant health expenditure savings. Furthermore, revenue raised from this tax could  be directed into other obesity-prevention programs.

Why do we need to limit SSB’s and will a tax actually work?

The sugary nature of these drinks triggers dopamine reactions in the brain, similar to other substance addictions and encourages further consumption.15, 16 Therefore, it is perhaps unsurprising that young males in particular over-consume SSBs with 51% of 14-18year olds and 44% of 19-30year olds consuming them the day prior the latest Australian Health Survey interviews.17 Those from low socio-economic groups, indigenous communities and children are also very high consumers.18, 19 Aside from the relationship between weight gain and SSBs, there are also strong associations with poor mental health, diabetes mellitus, dental caries and asthma.20-23

SSB’s provide no nutritional benefits, can be harmful red bullwhen consumed in excess and certainly contribute to weight-gain and subsequent metabolic disease.3, 16, 22-25 Therefore, Life Nutrition believes that they are not only unnecessary, but potentially damaging dietary items and can reasonably be compared to tobacco or alcohol, where taxation initiatives helped to discourage consumption.26, 27

The success of taxation in discouraging purchases of a consumable product is largely dependent on its ‘Price Elasticity’, or the responsiveness of purchasing behaviour to price change.12, 28, 29  To explain this in simple terms – when there are no alternatives or the product is a basic necessity, the price is considered to be inelastic and price increases will not greatly change purchasing behaviour. However, SSB’s have been shown to be quite elastic with a research finding that an increase in price of 10% will reduce consumption by about 8-13%.12, 28 This effect is comparable or even higher than that of tobacco, indicating that as per the decline in cigarette use, this taxation strategy is likely to be very effective in reducing SSB consumption.27, 30

After reviewing this evidence and the likelihood of beneficial outcomes, Life Nutrition advocates for this ‘top-down’ public health approach as small-scale interventions and education programs have been largely ineffective, with fewer than 7% of the population heeding the current Australian Dietary Guidelines.17 Notably, despite these advising that the consumption of SSBs should be ‘limited’, around 2% of an average adult’s daily energy intake currently comes from soft drink and flavoured mineral waters alone.17, 31, 32 However, we believe that this tax should be implemented as just one aspect of a multi-directional approach to combatting the many causes of obesity, other valuable approaches including; continued education, changes to the built environment and addressing food insecurity for some vulnerable subgroups.33

Unfortunately, as there is little evaluation available yet from SSB taxes applied recently to free-living populations in France, Hungary and Mexico, the support for this initiative still largely comes from extensive modelling and cohort studies. However, indications from the Mexican tax introduced in 2014 is that consumption has fallen by 12%.34 Evidence from significant South African, UK, American, Indian and Irish models concur that being elastic, as the SSB end-price rises, energy intake and weight will increasingly lower.12, 35-37

Though limitations include little Australian-specific analysis, varying target groups, different tax strategies and model inputs/outputs, these models generally agree that with an end-price increase of 20%, the prevalence of obesity such populations should fall by 3.8% in men and 2.4% in women.36, 38 Extrapolating these findings to our population, 78,014 Australian men and 47,655 Australian women would no longer being categorised as obese and this would have far-reaching health and economic benefits.11

So why hasn’t this yet been done?

Essentially, there hasn’t been enough vocal push or demand from the public for the tax and the large multi-nationals behind many of these SSB’s yield too much power in political spheres. However, there are many valid concerns with the application of a tax to SSB’s, many which you may personally hold or have heard in discussions concerning this tax – some of these are noted and debated below:

  1. SSB taxes are regressive taxes – Those who can least afford it will be disproportionately and negatively affected.12, 39
    • SSBs are non-essential dietary items – as low-income earners are more sensitive to price rises on elastic consumables, the likely response is decreased purchases.28, 29 Often being high-consumers, this will particularly benefit their health, reducing private expenditure on diet-related disease.12, 40
    • Public health programs that maybe funded with the revenue collected from this tax are generally most beneficial those most disadvantaged.41 Such revenue could be used to subsidise healthier alternatives – as consumers will purchase these if they are less expensive than unhealthy choices. 42, 43 or to establish education and school-based programs including kitchen gardens.44, 45 They could also be used to improve the built environment, including accessibility to healthy foods, water-fountains, reducing social inequity and increasing physical activity opportunities.46

 

  1. Consuming SSB is a personal choice and the government should not interfere with an individual’s behaviour or with the ‘free market’.
    • Life Nutrition believes that one of the government’s roles is to maximise public health and obesity is increasingly a top-ranking health, social and economic issue that requires more action.10, 11 As tax-payer funded health expenditure is rising and diverting funds from other sectors, we believe that this outweighs the commercial interests of a few and over-rides our individual ‘right’ to over-consume non-essential, potentially damaging dietary liquids.
    • Many government initiatives already control or change personal and commercial behaviours in the interests of public health including; tobacco and alcohol restrictions, mandating vaccinations and the wearing of seatbelts.26, 30, 47 Some may argue, that as Australian governmental policies have contributed to the current obesogenic environment, it is up to them to develop new policies and strategies to reverse this.48sugar
    • ‘Personal choice’ implies informed and free choice. However, due to age, education or literacy issues, many SSB consumers are unaware of the sugar content and/or understand the implications for health. ‘Free choice’ has also been manipulated and compromised by aggressive marketing techniques.49-51

 

  1. This tax is unfair to moderate consumers and as SSBs are not the sole cause of obesity.
    • The SSB tax will have negligible effect on moderate consumers and is far outweighed by the large beneficial impacts expected for the high-consumers.
    • True, Life Nutrition acknowledges that obesity is a multi-faceted disease and not caused by SSBs alone,48 but we believe that it’s a good starting point for real action as reducing a non-essential beverage which is contributing 2% of energy to the average Australian adult diet, will certainly help with weight management and population obesity rates.17
    • Revenue from this tax could help fund a multi-strategy and multi-level approach to obesity prevention and help with associated obesity-related health costs, reducing the burden for all taxpayers – including those moderate SSB consumers.12, 52

So – thank you for reading this article and we hope that we have provoked thought and imparted knowledge which you may not have held prior. Please let us know your thoughts as we’d love to hear what you think.

Do you agree with our analysis and conclusions and support a tax (if so, please share this article!) or do you resent the idea of further governmental control?

If you don’t think a tax is a good solution, on what actions or projects do you think the government should focus their efforts to address Australian overweight and obesity rates?

soft drink cans

 

 

REFERENCES

 

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  3. L. Lim, C. Banwell, C. Bain, E. Banks, S. A. Seubsman, M. Kelly, V. Yiengprugsawan and A. Sleigh, PLoS One, 2014, 9, e95309.
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Is food sustainability on the menu?

Worldwide 2 billion people are hungry or malnourished and in Australia food insecurity affects our most disadvantaged including 15% of young Australians.(1, 2) Do our current dietary choices and expectations, high volume of wastage and pursuit of packaged, convenience-foods jeopardise food security for the next generation? Are we essentially eating our children’s food and leaving them with a broken food system?

Food system activities are interdependent and multi-directional activities which include food production, processing and packaging, distribution, retail and marketing, access, consumption and disposal.(3).There is a growing body of research confirming that how we manage these activities worldwide is unsustainable and that they are negatively impacted by powerful, interrelating environmental, social and great barrier reefcommercial factors.(3, 4) Such factors include climate change, food and water wastage, population growth, urbanisation, economic effects of industrial farming and global trade agreements.(2-5) In Queensland, unsustainable food system activities degrade the environment increasing the salinity of agricultural lands and placing our Great Barrier Reef under threat from runoff, a reef already currently experiencing an acute, unprecedented bleaching event.(6-9) Elsewhere forests are being razed and burnt to grow oil palms so our processed foods and personal care products can be made more cheaply.

Food-intake patterns in Australia see an increased consumption of resource-intensive animal-products, with processed, packaged foods being favoured over whole fruits, vegetables or minimally processed wholegrain products.(10) Few Australian adults consume the recommended quantity of fruits and vegetables and only 3.45% of 19-25year olds eat sufficient quantity and diversity when measured against the Dietary Guidelines 2013.(11, 12) Though for many, this is attributable to poor personal dietary management, others suffer from limited access or availability to sufficient, safe, nutritious, and culturally-appropriate foods. Reasons may include significant physical or economical barriers in accessing or purchasing nutritious foods or that their preparation and cooking skills or equipment may be lacking.

Such poor dietary intake significantly contributes to the extremely high rate of diet-related disease with 63.4% of Australians being overweight or obese, 4% having Type 2 Diabetes Mellitus and 21.5% with hypertension.(13) These are all significant risk factors for circulatory diseases which account for 29.9% of the deaths in Australia,(14, 15) conservatively estimated to cost Australians $5billion/year.(16)

However, despite the dire environmental and health consequences, food sustainability is still not at the forefront of public discussion, often only being considered within or as supplementary to environmental or public health publications or research.(5, 16, 17) At Life Nutrition, we value food sustainability and endeavour to consider this in all of our nutritional recommendations.

But we’re all just individuals, what can we really do about it?

It is really difficult to fathom that your personal choices or behaviour could make a difference, and I will also be the first to admit that there’s a lot more our family could do to generally become more ‘eco-friendly’. So I don’t intend to preach from the moral highground, or lecture to you from any righteous standpoint – but instead provide the following suggestions more as a prompt for all of us to assess more closely what we do in our personal or working environments.

  • Consider more carefully what food you are purchasing and from where. Where possible, purchase local, seasonal produce and products with sustainably sourced palm oils or fish – though unfortunately our lax labeling requirements don’t always make this very easy to determine. Please don’t continually bypass the uglier fruit or vegetables in the supermarket in search of ‘perfection’– they deserve to be loved to!
  • Eat fewer animal products – an estimated lifestock60-80% of agricultural emissions are linked to the livestock (including dairy) sectors(18). Animal products are rich sources of proteins, vitamins and minerals and are valuable additions to the diets of many. However in general, Australians consume well above that considered reasonable for health – try incrementally introducing more meat-free meals into your week.
  • Minimise wastage with more careful meal planning, being creative with leftovers and better storage approaches.
  • Though tempting from a convenience perspective, buying food and drinks in a more ‘bulk’ form that is not already portioned will save packaging and money. For example, buying a 1kg block of cheddar may only cost you $12 compared to buying individually-wrapped cheese that can cost $50 or $60/kg – you could instead be eating smoked salmon instead for that price!
  • Can you grow your own produce? I’m personally herb gardenhopeless at growing things, and everything I touch dies – a true Grim Reaper in the garden. However, for those with green thumbs – growing and picking herbs or citrus fruits in particular, will save you time, money, packaging and your produce has only had to travel a few metres by foot to your door.
  • If your garden is suited to a compost, this will save your raw fruit and vegetable offcuts from rotting in landfill and can in turn can enrich your garden’s soils.
  • If keen, you could also undertake the Food Sustainability Spring Clean Test – see how you score!
  • Teach your children about food sustainability so that it becomes a natural consideration for them.

As a busy mother, I totally understand that life is busy and that packaged or convenience-foods can be ‘lifesavers’ during a busy week, with few of us having time to create every meal from scratch. However, even just writing this article has been a good reminder for me to review what our family is doing in terms of influencing food systems and the environment in general. I hope you feel the same and that I’ve given you some ‘food for thought’.

 

REFERENCES

  1. Nolan M, Williams M, Rikard-Bell G, Mohsin M. Food insecurity in three socially disadvantaged localities in Sydney, Australia. Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals. 2006;17(3):247-54.
  2. Friel S. Climate change, food insecurity and chronic diseases: sustainable and healthy policy opportunities for Australia. New South Wales public health bulletin. 2010;21(5-6):129-33.
  3. Garnett T. Food sustainability: problems, perspectives and solutions. The Proceedings of the Nutrition Society. 2013;72(1):29-39.
  4. Premanandh J. Factors affecting food security and contribution of modern technologies in food sustainability. Journal of the science of food and agriculture. 2011;91(15):2707-14.
  5. Australian Bureau of Statistics. 4626.0.55.001 – Environmental view and behaviour, 2011-12 [Accessed: 2/4/2015]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/4626.0.55.001.
  6. Albert S, O’Neil JM, Udy JW, Ahern KS, O’Sullivan CM, Dennison WC. Blooms of the cyanobacterium Lyngbya majuscula in coastal Queensland, Australia: disparate sites, common factors. Marine pollution bulletin. 2005;51(1-4):428-37.
  7. Bui EN. ENVIRONMENTAL AUDITING: Risk Assessment in the Face of Controversy: Tree Clearing and Salinization in North Queensland. Environmental management. 2000;26(4):447-56.
  8. Rayment GE. Water quality in sugar catchments of Queensland. Water science and technology : a journal of the International Association on Water Pollution Research. 2003;48(7):35-47.
  9. National Land and Water Resources Audit. Dryland Salinity in Australia. 2000.
  10. Australian Bureau of Statstics. Nutrition First Results – Foods and Nutrients, 2011-2012. Report 4364.0.55.007 [Accessed: 31/3/2015]. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0072011-12?OpenDocument.
  11. Australian Bureau of Statistics. 4338.0 Profiles of Health, Australia, 2011-2013 2012 [Accessed: 31/3/2015]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4338.0main+features222011-13.
  12. Australian Bureau of Statistics. 1301.0 – Year Book Australia, 2012 [Accessed: 2/4/2015]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/1301.0~2012~Main%20Features~Home%20page~1.
  13. Australian Bureau of Statistics. Australian Bureau of Statistics – Key Findings 2011, 2012. Report 4364.0.55.001 [Accessed: 31/3/15]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4364.0.55.001Chapter1002011-12.
  14. Australian Bureau of Statistics. 3303.0 – Causes of Death, Australian 2012 [Accessed: 31/3/2015]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0~2012~Main%20Features~Contents~1.
  15. Landini L. Modification of Lifestyle Factors are Needed to Improve the Metabolic Health of Patients with Cardiovascular Disease Risk. Current pharmaceutical design. 2014.
  16. National Health and Medical Research Council (Australia). Eat for Health Australian Dietary Guidelines 2013 [Accessed: 31/3/2015]. Available from: http://www.eatforhealth.gov.au/.
  17. Trevena H, Kaldor JC, Downs SM. ‘Sustainability does not quite get the attention it deserves’: synergies and tensions in the sustainability frames of Australian food policy actors. Public health nutrition. 2014:1-10.
  18. Friel S, Dangour AD, Garnett T, Lock K, Chalabi Z, Roberts I, et al. Public health benefits of strategies to reduce greenhouse-gas emissions: food and agriculture. Lancet. 2009;374(9706):2016-25.

To detox or not to detox?

Detoxing is huge news at the moment – today, a Google search for ‘detox’ alone brought up over 76 million hits. So there is much excitement (and billions being made) out there by alternative therapists who are offering to ‘cleanse’ your body and detox you of all sorts of nasty chemicals and ‘toxins’ – but does the human body even need help detoxing?!

Approaches to detoxing can include colonic irrigation, homeopathic remedies, teas or use of electromagnetic devices. And then there are of course a whole suite of detox diets – often celebrity-endorsed and involving copious amounts of green juices and exotic, expensive Amazonian berries, exclusive herbs or mysterious root extracts. It is the efficacy of these which are going to be addressed in this article.

So, if your definition of ‘detoxing’ is a few days or weeks of easing off chocolate or alcohol, cutting back on processed foods and doing a bit more exercise in the interests of improving your health, then by all means – go for your life. Doing so will improve your intestinal microbiome, blood glucose levels and give your liver and gastrointestinal system some ‘breathing space’ to adjust, especially after a period of over-indulging.(1-3) However, undertaking such temporary ‘detoxing’ unfortunately barely begins to make up for long-term dietary abuse (sorry!). You’re far better off aiming for long-term lifestyle and dietary improvements for optimal health and nutrition.

So, lets discuss detoxing in the context of ‘toxins’.

By definition, toxins are small molecules, peptides or proteins that, though medically useful in some cases – may in sufficient doses potentially contribute to the development of disease through contact with or via absorption of body tissues. Most toxins that cause issues in humans are actually of bacterial origin, including those which cause tetanus, toxic shock, cholera or Botulinum neurotoxins – the toxins responsible for the potentially fatal food poisoning disease botulism (possible culprits – raw honey, poorly canned food).(4, 5) No amount of green blends, juices, herbs, superfoods or celebrity ‘detoxing’ program is going to remotely deal with such toxins. Needless to say, if you are suffering toxicity from any of these – please go see your doctor immediately and I also strongly encourage you to take preventative steps by accessing the wide range of potentially life-saving vaccines available.

On the other hand, toxins can be found in our environment, including heavy metals, pesticides, phthalates, VOC’s (Volatile Organic Compounds), dioxins or asbestos and these should certainly be minimised through product choices and optimising your living or working environments.(6-10) High levels or over-exposure of environmental toxins in humans has been linked to increased cancer risk, endocrine disorders, skin issues, liver damage, headaches and a host of other adverse medical consequences.(6, 10) Toxins can even be found lurking naturally in our food supply – whoever would have suspected the humble, unassuming broccoli of containing the potentially deadly mitochondrial toxin cyanide?!(11) However, don’t panic and clear out your vegetable drawer of this wonderful vegetable – there are no reports of anyone who has managed to achieve cyanide poisoning by munching their way through daily mountains of raw broccoli. In fact, in small amounts, this cyanide in broccoli (and other cruciferous vegetables) has actually be shown to be beneficial for some enzyme functions in the liver.

So, toxicity hugely depends on the toxin itself, the dosage and the human body’s ability to do with it. Anything is toxic in the right amount – even oxygen or water. The mode of exposure as well as the gender, genetics, age, general health and nutritional status of the exposed individual will all affect whether accumulation of a toxin occurs and whether that will cause health issues.(12) It is more than worthwhile noting that symptoms of toxicity from heavy metals or pesticides do not include generally feeling a little blergh or getting a few extra pimples. They can involve heart palpitations, breathing difficulties and loss of muscular control – so if you have these – again, we highly suggest you get yourself off to your hospital for immediate treatment (possibly involving dimercaprol chelation and atropine but certainly not involving ‘Ultra-slimming, Quick-cleanse lemon-coconut-detox’).

Our body’s detoxification organs work 24/7 and include the liver, kidneys, skin, lungs, gastrointestinal tract and lymphatic system.(7, 12) These are constantly breaking down toxins into other forms which we can then excrete via urine, faeces, sweat or via our respiratory system. Most of the time, for the vast majority of us, our body can handle the typical toxin load and accumulation will not result. Therefore, the best way to ensure that this natural detoxification system is working at optimal levels, is to provide your body with optimal nutrition to support the function of these organs.

Most detox diets or juice cleanses are low in proteins or amino acids, fibre, probiotics and ‘good fats’ – unfortunately, these are many of the key nutrients that our organs need to be fully juicefunctional. This can lead to impaired organ function and actually allow more toxins to accumulate causing many adverse and potentially dangerous side effects.(12, 13) Additionally, those detoxes that involve high volumes of juices can cause dangerous blood sugar swings which could also be potentially very dangerous for diabetics.(14, 15) Also, what many people may not realise – the manufacture of these products is very unregulated and there is no true review or control over the inclusion or quantity of many of the ingredients which result in a range of unintended interactions with medications and adverse, potentially dangerous side effects.

Though lots of fruits and vegetables are undoubtedly good for you, pulverising kilograms of raw fruits and vegetables over several days or weeks may actually stress organs which suddenly have to deal with a huge quantity of oxalates, nitrates and ironically your exposure to pesticides could increase during such a ‘detox’. The headaches commonly reported during detoxes, have nothing to do with the clearance of any toxins, but more to do with energy restriction, electrolyte imbalances, possible withdrawal from caffeine and potentially also nitrate overload (as nitrates promote vasodilation).(16) Also, there are compounds called goitrogens in raw green vegetables which if consumed in great quantities can also negatively affect thyroid function in some susceptible people.(17) None of this is usually a problem for fruit and vegetables consumed within a normal, healthy dietary context – but can become significant problems when over-consumed in a detox or juice ‘cleansing’ context.

Therefore, in conclusion – no, there is no scientific basis or consistent, reputable clinical evidence that nutritional ‘detoxing’ is required or effective in removing ‘toxins’ from the body.(12, 13) If you’re feeling generally unwell or run down – it is far more likely to be due to poor diet, fatigue, stress or a general virus or infection.

Other reasons people may want to go on a ‘detox’ diet, has nothing to do with ridding their bodies of toxins, but has more to do with the weight loss that some celebrity experienced while doing it. Restricting calories significantly (as is usually the case on a detox diet), will cause a very rapid ‘weight’ loss of around 2-3kg within the first few days or week which seems fantastic on paper. However, hold back your excitement as most of this is merely the 500g or so of glycogen in your muscles and 1.5kg of associated water which your body has had to use up in the absence of sufficient caloric intake.  It will come straight back as soon as you start eating normally again.

Detoxes can lead to disordered eating and will only contribute to the mindframe of yo-yo dieting – there is nothing logical about the idea of taking a ‘week’s holiday’ from long-term poor lifestyle and imbalanced dietary intake. Additionally, if you continue detox diets for more than a few days, you risk the development of micronutrient deficiencies and you will also start to lose muscle mass which is detrimental to long-term weight loss. Life Nutrition is able to show you much better strategies to enhance your health, maximise your natural detoxing abilities and lose weight safely and keep it off.

Please do not resort to celebrity detox diets or purchase expensive magic herbs and restrict dietary groups to cleanse your liver and colon – the only thing that will be detoxed and lightened is your wallet.

 

References

  1. Corfe BM, Harden CJ, Bull M, Garaiova I. The multifactorial interplay of diet, the microbiome and appetite control: current knowledge and future challenges. Proc Nutr Soc. 2015;74(3):235-44.
  2. David LA, Maurice CF, Carmody RN, Gootenberg DB, Button JE, Wolfe BE, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014;505(7484):559-63.
  3. Schaubeck M, Haller D. Reciprocal interaction of diet and microbiome in inflammatory bowel diseases. Curr Opin Gastroenterol. 2015;31(6):464-70.
  4. Fujinaga Y. Transport of bacterial toxins into target cells: pathways followed by cholera toxin and botulinum progenitor toxin. J Biochem. 2006;140(2):155-60.
  5. Grover SS, Negi SS, Singh S, Ray K. Significance of circulating toxin and antitoxin in unimmunized tetanus cases of neonates and infants. Biologicals. 2012;40(4):262-5.
  6. Kim HS, Kim YJ, Seo YR. An Overview of Carcinogenic Heavy Metal: Molecular Toxicity Mechanism and Prevention. J Cancer Prev. 2015;20(4):232-40.
  7. Lin X, Gu Y, Zhou Q, Mao G, Zou B, Zhao J. Combined toxicity of heavy metal mixtures in liver cells. J Appl Toxicol. 2016.
  8. Manoukian A, Buiron D, Temime-Roussel B, Wortham H, Quivet E. Measurements of VOC/SVOC emission factors from burning incenses in an environmental test chamber: influence of temperature, relative humidity, and air exchange rate. Environ Sci Pollut Res Int. 2016;23(7):6300-11.
  9. Tchounwou PB, Yedjou CG, Patlolla AK, Sutton DJ. Heavy metal toxicity and the environment. EXS. 2012;101:133-64.
  10. Yoshida T, Ogawa M, Goto H, Ohshita A, Kurose N, Yokosawa F, et al. [Clinical findings of the patients with sick building syndrome and the results of environmental measurement]. Sangyo Eiseigaku Zasshi. 2011;53(2):25-32.
  11. Tanii H, Takayasu T, Higashi T, Leng S, Saijoh K. Allylnitrile: generation from cruciferous vegetables and behavioral effects on mice of repeated exposure. Food Chem Toxicol. 2004;42(3):453-8.
  12. Klein AV, Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. J Hum Nutr Diet. 2015;28(6):675-86.
  13. Ernst E. Alternative detox. Br Med Bull. 2012;101:33-8.
  14. Murphy R, Thornley S, de Zoysa J, Stamp LK, Dalbeth N, Merriman TR. Sugar Sweetened Beverage Consumption among Adults with Gout or Type 2 Diabetes. PLoS One. 2015;10(5):e0125543.
  15. Xi B, Li S, Liu Z, Tian H, Yin X, Huai P, et al. Intake of fruit juice and incidence of type 2 diabetes: a systematic review and meta-analysis. PLoS One. 2014;9(3):e93471.
  16. Nossaman VE, Nossaman BD, Kadowitz PJ. Nitrates and nitrites in the treatment of ischemic cardiac disease. Cardiol Rev. 2010;18(4):190-7.
  17. Cho YA, Kim J. Dietary Factors Affecting Thyroid Cancer Risk: A Meta-Analysis. Nutr Cancer. 2015;67(5):811-7.