Ask The Dietitian

Over the next four weeks, we'll be releasing advice from Ellie Gould, a qualified dietitian working in Guernsey's Health Promotion Unit, on all things diets, cooking and how to make sure your children are getting a nutritious lunch at school. 

Week 3 question and answers

1. How much water should I drink every day?

Most of us need 1.5-2 litres of fluid each day, unless we are very active/sweating we may need more. Water is the best drink. Try to make other drinks sugar-free.

2. What should I look for on a food label?

Look for the traffic lights to see how much fat, sugar and salt are in the meal. They should be on the front of the packaging; compare and choose products and go for mainly greens.

If you are buying a packaged meal, you can also check calories. I usually advise people who are trying to reduce their weight to go for products around 400kcal (calories) per portion and to add extra vegetables to their meal. 

If you are choosing a less healthy snack (eg crisps/chocolate), go for something around 100kcal.   

3. How can I find ideas for quick and healthy meals, especially working long days?

There are tons of websites that have healthy recipes.

I like BBC Good Food www.bbc.goodfood.com, Change4Life www.nhs.uk/Change4Life and British Heart Foundation www.bhf.org.uk.

All the recipes on these sites are nutritionally analysed, which means you know exactly how much fat, sugar, salt and calories are in them.

Batch cooking is really helpful when you have a busy week ahead – make 3+ times the amount you need and store it in portions in the freezer for when you need it. It's your own, healthy convenience meal!

4. How can I deal with stress eating?

Stress is a tricky one... it increases a hormone called cortisol which encourages fat storage, so trying to avoid eating during this time is best. 

The most helpful thing is to deal with whatever is causing the stress, and find ways of reducing it. If it’s work, speak to your boss. If it’s a relationship, speak to that person. Confide in someone you can talk to. Finding ways to relax or vent are also critical. Exercise is also amazing at making us feel better, reduces the desire to eat and gives you some ‘me time’. 

Remember that food won’t alleviate stress is also important – it only acts as a distraction; finding other distractions can also be helpful (e.g. watching a funny film). 

If you know that you stress eat in a particular place (such as at home), be pro-active and make sure your environment doesn’t support this behaviour – don’t buy the foods you would normally eat at this time to make it easier on yourself as will-power has its limits.

5.  What are the best fats to use when I cook?

Rapeseed oil is a healthy fat that is great for cooking. Co-op basic range vegetable oil is rapeseed and is a great choice and reasonably priced. If you cook with oil, aim to use about 1 teaspoon per person per meal.  

Week 2 question and answers

  1. Are you aware of any research pertaining to a meal supplement containing all of the vitamins, calories, fibre and minerals that one's mind and body would need?

There are many different meal replacement products on the market that provide ‘complete nutrition’. Most are aimed for weight reduction and can be helpful for some people, but they are often a short term solution and it’s important that a long-term plan is put in place for the reintroduction of food; otherwise weight can be regained quickly.

It's vital to understand how to calorie control meals and snacks for weight maintenance. One thing that we know, according to the evidence, is that it doesn’t really matter what type of ‘diet’ people follow; long-term results (e.g. 1-2 years later) are that people usually end up with a weight loss of 5-10%.  

2.  Fish, pork, chicken and beef - can you give me some advice on what amount I should consume of these in a week?

Fish:

  • Great source of omega 3 fats! 
  • We should aim for 1-2 portions a week, 1 of which should be oily (mackerel, sardines, pilchards, salmon).  Uncanned tuna is ‘oily’; tinned tuna counts as a white fish as the canning process destroys the good oils in this fish.
  • Can be tinned, fresh, frozen, smoked

Red meat: (beef, lamb, pork, goat)

  • Great source of protein, iron, zinc and B vitamins, but general national intake is high, and excess red meat in the diet has been linked to colorectal cancers
  • Maximum of 70g a day and have one meat-free day a week

Processed meat: (bacon, sausage, ham, salami, pastrami, corned beef, chicken slices, meat burgers)

  • All are high in nitrates and or salt, and are linked to an increased risk of colorectal cancer
  • Limit to 0-1 serving a week

Chicken/poultry:

  • No official guidance, good source of lean protein

Vegetarian options: (Quorn, soya, tofu, egg, beans, pulses, nuts & seeds)

  • Usually low fat and healthy option to choose!
  • Introduce these options for healthy alternatives to meat and processed meat products (eg sausages, burgers and sliced meat or bean pates/spreads for sandwiches)

3.  I am currently receiving HRT treatment and find it increasingly more difficult to lose weight plus get rid of bloating (even with drinking 2 litres of water a day). Do you have any suggestions?

During menopause, there is a reduction in muscle mass which lowers metabolic rate making it more difficult to manage weight.  It is therefore important to keep active to help preserve muscle mass, and aiming for 30-60 minutes of activity each day is desirable for weight management. 

Menopause can also lead to an increase in blood pressure, cholesterol levels and a weakening of bones. Therefore, it is also important to eat small amounts of healthy fats (see table a below), and reduce unhealthy fats to help manage cholesterol levels.  Don’t add salt to your diet and eat your ‘5 a day’. 

Finally, make sure you get 3 portions of dairy each day for an adequate calcium intake (1 portion = 200ml milk/150g yogurt/25g cheese). Aim for 20 minutes sun exposure a day to obtain your vitamin D, which is important for calcium absorption.      

Reducing unhealthy fats in your diet

  • Don’t cook with fat or cook with small amounts of healthy fats (e.g. 1 teaspoon per person)
  • Switch to lean cuts of meat or poultry/fish/vegetarian options
  • Switch to low-fat dairy
  • Swap butter for low-fat spread
  • Cut back on butter, ghee, coconut oil, lard, palm oil
  • Reduce cream and ice-cream
  • Reduce takeaways
  • Reduce pastry, pies, pizzas
  • Reduce cakes, biscuits, desserts
  • Reduce chocolate, crisps, flapjacks


With regards to bloating, it really depends on what is causing this. It is fluid? It is gas? f it is the latter, then it is important not to skip meals as this can make things worse.

You could try monitoring your diet for a while and see whether there are any foods you feel are triggering this. Certain foods that can cause irritable bowel symptoms include alcohol, caffeine, spices, fizzy drinks, fatty foods, chewing gum, sorbitol, and sometimes excess fibre (beans, pulses, cauliflower, sprouts, onions, etc). 

Exercise is also really helpful for reducing IBS symptoms. 

4.  Is it better to have 3 big meals or several small meals a day?

Whatever suits you. We would recommend at least 3 meals a day, starting with breakfast. If you would like snacks in between, choose up to 3, keep at least 2 of them healthy and keep any unhealthy snacks at a maximum of 100 calories. Avoid grazing.  People who graze or eat more than 6 times a day tend to struggle to manage their weight. 

5.  What are the absolute healthiest foods that you recommend eating daily?

Fibre-rich foods

Lean protein

Healthy fats

  • Fruits
  • Vegetables
  • Beans & pulses
  • Wholegrain bread
  • Oats
  • Wholegrain cereals (e.g. Weetabix, shredded wheat, natural muesli )
  • Ryvita or rice cakes
  • Wholegrain pasta
  • Wholegrain rice
  • Quinoa
  • Quorn
  • Soya or tofu
  • Egg
  • Chicken or turkey
  • Lean cuts of meat
  • Low-fat cream cheese
  • Low-fat hummus
  • Semi-skimmed/skimmed milk
  • Low fat, low-sugar yogurt/low-fat natural yogurt
  • Oily fish (e.g. mackerel, sardines, salmon, uncanned tuna)
  • Nuts and seeds
  • Avocado
  • Olive or rapeseed oil


6.  Low-fat vs. low-carb diet for weight loss?

We need to stop talking about 'diets' as all the evidence we have points to the fact that diets don’t work. We can’t stick to them, and why would we want to? That being said, there are positive and negative aspects to both options… Here's a summary: 

 

Pros

Cons

Low-fat diet

  • Eat less total and saturated fats: good for heart health 
  • Easy way to cut calorie intake
  • Could be low in healthy fats: bad for heart health
  • Less satisfying

Low-fat, high-carbohydrate diet

  • Eat less total and saturated fats: good for heart health

 

  • Could be low in healthy fats: bad for heart health 
  • High in carbohydrates: bad for heart health
  • Less satisfying

Low-carbohydrate diet

  • High in fat and protein: satisfying
  • Can eat lots of fat: bad for heart health
  • Can eat lots of meat and processed meats: bad for cholesterol levels and bowel health
  • Nutritionally deficient in fibre, vitamins and minerals: not good for general health long-term and often associated with constipation
  • Can cause headaches and poor concentration in first week due to insufficient carbohydrate intake
  • Too little carbohydrate can lead to more muscle wastage


Final thoughts

So what is the answer….? Eat to nourish and satisfy, ditch the diet, get off the sugar rollercoaster. Have less rules (that are there to be broken) and more of a healthy balance which means the ‘M’ word: everything in moderation! In reality, most people know what they need to do to improve their diet, and most of the time it is increasing healthier foods and reducing their intake of sugary and fatty foods and drinks.

Week one questions and answers

1. How can you have something that tastes good, but doesn't have all the 'hidden' sugars?

Cooking from scratch is a good way to know exactly what is in your meal.  Sauces can be flavoured with herbs and spices, puddings can be made without added sugar by either substituting with fruit or if you prefer, sweetener.  Over time you can train your taste buds to appreciate less sugary foods and drinks. 

If you are buying processed food, the only way to know what is in it is to read the label.  Look for a green traffic light next to the ‘sugar’ to find a product lower in sugar.  It’s important to know that even if one product is low in sugar, fat or salt; lots of processed products in one day can still push you over the daily recommendations. It’s therefore important to base your diet on wholesome, unprocessed foods as much as possible.

2. I constantly crave sugar even after I have eaten my regular meals. Am I lacking something in my diet?

We don’t need added sugar in our diets – but we are definitely programmed to like sugary foods!  Some people crave sugary foods more than others, and the problem is once we start it can be hard to stop.  It is so easy to have too much sugar, and we know that unfortunately this is linked with weight gain, diabetes, heart disease and dental caries. 

Habit can play a big role (e.g. if you always have chocolate after dinner, you will become to expect it as part of your routine) which can be difficult to break at first.  Sometimes we can also crave what is around us (e.g. biscuits in the office).  Other things that can affect our appetites include lack of sleep and fluctuating blood glucose control. 

To beat sugary cravings and stabilise your blood glucose, make sure you have regular meals (especially breakfast); eat plenty of fibre rich foods, some lean protein, and small amounts of healthy fats (see table a below).  These good quality foods will nourish your body whilst helping to regulate both blood glucose control and appetite.  Get some good sleep and exercise daily.

3. How can I snack healthily? Fruit & nuts are good, but I still look for something to munch afterwards!

There are so many healthy snack options.  If I’m not recommending fruit, then I usually advise people to choose wholesome snacks that provide great nutrition and curb hunger (e.g. 1-2 rice cakes with ½ avocado, or 2 tablespoons low-fat houmous + pepper and carrot sticks, 1 Weetabix with semi-skimmed milk and a handful of berries.  If you are wanting something less healthy such as crisps or chocolate, then I would advise choosing a product around 100 calories (e.g. a ‘light’ bag of crisps, or a fun-sized chocolate bar) –but  keep to the odd occasion as supposed to daily routine.

4.  How do you make lunches for an incredibly fussy 5 year old? Really want to balance out lunches and snacks for school but it's proving impossible as I can't find the variety or balance!

Younger children generally need 3 meals and 2-3 snacks each day.  At school, they will need a morning snack, a lunch, and an afternoon snack (if they don’t have this at home). 

Think about the ‘Eatwell Guide’, and try to have something from each section in their lunch box.  

For example this could be:

Morning break: apple slices, a small square of cheese and a cracker

Lunch: ½ - 1 tuna + sweetcorn sandwich

Afternoon snack: 1 rice cake with 2 tablespoons houmous and carrot sticks

Drink: Water

Try to include your child in the decision making process when feasible – give them options like “would you like sandwiches or pasta tomorrow?” or “what new vegetable shall we try this week?”  or “can you find a (e.g. red) fruit that our family can try in our packed lunches this week?” If you have the time, they could even get involved and help you prepare it?  Don’t give up offering foods you want them to eat.  Children need multiple exposures to foods before they accept them (up to 15 tastes!).  Offer a rainbow of fruits and vegetables to expose them to lots of flavours and different vitamins and minerals.  Sticker charts can be helpful for asking them to try new foods, give a sticker for each time they taste a new food, offer bigger rewards once they have tried 5 new foods (e.g. a trip to the park or beach).   Most importantly, eat the foods you want them to eat, make family packed lunches and all eat well together.   

Some helpful website for lunch box ideas:

Change4Life: https://www.nhs.uk/change4life-beta/recipes/healthier-lunchboxes#1BdeJTIKUkplUzkO.97

Carline Walker Trust: http://www.cwt.org.uk/wp-content/uploads/2015/02/CHEW-5-11-PACKEDLUNCHES.pdf

5.  With all the diets and health crazes around does it benefit to cut out things such as gluten/carbs etc or does this do more harm than good?

There is no science behind weight loss and gluten-free foods – it is a fad! In fact many gluten-free substitute foods are higher in calories!  Gluten-free is only needed if you have gluten intolerance, or if you have coeliac disease.  

There is no need to cut out carbohydrates for weight loss, however too much of anything will lead to weight gain.  Many people benefit from reducing their portion sizes generally as this reduces calorie intake which leads to weight loss.  Definitely switch mainly to wholegrain carbohydrates however, as they are more nutritious (great for heart and bowel health) and digested more slowly, keeping you fuller for longer.

If you chose to do a low-carbohydrate diet, this usually means cutting out starch, most fruits and some dairy and vegetables, which over-time would result in nutritional deficiencies and so are not recommended.