Is it time to bring back the fat? 

In the last couple of days, there have been two media pieces that want us to ditch dietary guidelines, claiming that promoting ‘high carbohydrate, low fat diets’ is to blame for the ‘obesity epidemic’. The first is Channel 7’s news piece from ‘dietitian’ Christine Cronau (not actually a dietitian!) and The National Obesity Forum in Britain.
I have a lot to say but I’ll try to keep it to one or two (or four) points.

  1. These people are not using the best methods of looking at the science.
 Christine is using anecdotal evidence: ie, what works for her. We know that as long as you stick to a diet, you can lose weight for a few months. This includes very low carbohydrate diets like the Atkins diet. This is not news.
The National Obesity Forum looks a little more legit. It references studies! That’s scientific, right? The thing is when you look at individual studies, you can make claims about anything you like. The report looks at 43 studies, which sounds like a lot, but the dietary guidelines examine literally thousands of studies. These giant reviews are much more reliable.

  1. People aren’t following dietary guidelines.
 Less than 4% of adults in Australia are eating the recommended amount of vegetables. There is a great chart in this article. To claim the guidelines are to blame when practically no-one is following them is bizarre. Also, Australia’s Dietary Guidelines are moderate carbohydrate, not high!

  1. Weight is not a good measure of health.
To claim that all thin people are physically healthy and all fat people are not is ridiculous. What truly matters is health behaviours. And remember that there is more to health than physical health. Having a good social life and good mental health are extremely important, and if your way of eating is not helping your to see friends and be happy, it’s not healthy.

  1. There is not one diet that is the best diet for everyone.
 As I wrote in my take on high/medium/low carbohydrate diets, healthy diets do have common features: Lots of fruits and vegetables, high in fibre, has all the energy, vitamins, and minerals you need, and not dominated by highly refined grains, sugar or processed meats. Eat delicious food you love that makes your body feel good.

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We Are Being Lied To About Weight Loss

lies about weight loss

Nothing makes me quite as annoyed as the myths about weight loss. I went through some common ones on the science-side of things.

“It’s simple energy-in, energy-out.”

Our body isn’t an in-out energy machine. As soon as you start to eat less food than you need for your body and brain to work at their best, your brain starts to find ways to reduce your need for energy and increase how much you eat. Because it thinks you’re in a famine.

Things your body may do:

  • ramping up hunger (especially for high energy food)
  • reducing satiety (fullness) signals
  • reducing your metabolism (making you more tired)
  • increasing efficiency of muscles (so you use less energy doing everyday movement)
  • holding onto fat as much as it can
  • reducing adrenaline response (so you can’t run as fast in an emergency)

Which means that any efforts to lose weight by changing energy balance are counter-balanced by your body in an effort to maintain your weight.

“[insert fad diet of the week] is the answer”

Diet gurus try to claim that their diet is the best way to lose weight and keep it off: that somehow eating certain foods in just the right proportions, or cutting out the right food group will somehow overcome your body’s efforts to make sure you don’t starve.

A study found that of all the ‘named’ diets (think Atkins, Zone) worked pretty much exactly the same for weight loss at 12 months, as long as you can stick to them.

“If you fail at weight loss, you lack self-control”

Every single diet study shows that an overwhelming majority of people regain weight. Weight loss maxes out at six months and most is regained by 12 months. Less than 3% of people will have kept all their weight loss 5 years later, and most people will have regained at least 83% of the weight they lost. This is because as long as your body weight is lower, your body is putting in a lot of effort to get you back there. Being on a diet is a risk factor for weight gain. Diets are perceived by your body to be times of famine. And times of famine could come again, so your body stores fat to protect you.

“Diets don’t work, but lifestyle changes do”

This, of course, depends what you mean by ‘work’. Lifestyle changes can make you fitter, healthier and happier. They can also help you lose weight in the short term. However, the changes that your body makes to protect itself from weight loss still happen whether you call the changes a lifestyle change or a diet. It’s still less energy for your body to function.

“You can’t be ‘overweight’ and healthy”

So where does this leave us? Is it all a lost cause? Are we doomed to diet of obesity-related diseases? The answer is NO. Health and weight are not 100% linked. It is true that higher body weight seems to be associated with higher risks of certain disease – but this does NOT mean that they are caused by the weight itself.

Changing your lifestyle by increasing healthy behaviours will increase your wellbeing and increase the odds of living longer, regardless of your weight. Healthy behaviours include:

  • getting enough fruit and vegetables
  • doing some exercise
  • staying socially connected
  • seeing a doctor regularly
  • drinking moderately or not at all
  • not smoking

Good luck on your non weight-focused quest for health!

Connect with me on Facebook and Twitter.

 

Some sciencey reading if you’re interested in some facts behind all this:

Physiological defense of body weight.

All diets are the same.

Long-term weight loss.

Diets predict weight gain.

 

Is feminism useful in eating disorders recovery?

There has been recent argument on Twitter on whether Gloria Steinem’s talk on feminism and eating disorders at a treatment clinic was useful, scientifically correct, and/or marginalizing men who have EDs.

My first thoughts are related to the DSM-5 definition of anorexia nervosa:

  • Either an intense fear of gaining weight or of becoming fat, or persistent behaviour that interferes with weight gain (even though significantly low weight).
  • Disturbance in the way one’s body weight or shape is experienced, undue influence of body shape and weight on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight

and bulimia nervosa:

  • Self-evaluation is unduly influenced by body shape and weight.

So we can see that high evaluation of weight and shape is usually (not always) at least a part of many people’s eating disorders.

So how does feminism come into this?

Letting go of eating disorder beliefs, such as ‘I can only be happy while thin’ is difficult. What is more difficult, is when society, friends, media and celebrities say the same thing! If everything around you says there’s only one way to be beautiful, and implies that women can only be happy if they look like this, fighting the eating disorder is harder.

Feminism aims for equal rights for women, by reducing damaging gender roles and expectations for both men and women. These roles and expectations may be harmful to someone trying to fight the eating disorder thoughts. If this is the case feminism can help by:

  • Encouraging people to see themselves and others as being important because of who they are and what they do, not just as how they look.
  • Showing and appreciating bodies that come in all shapes and sizes, and removing pressure for men and women to look a certain way.

Society expects women to look one way and men to look another. Feminism fights these damaging expecations and helps to challenge eating disorders!

Feminism is often criticized for ignoring men’s troubles. While empowering women is the goal of feminism, narrow gender roles also hurt men. Tyler Kingkade explains how being mistaken as a girl fuelled his poor body image, and men often delay getting help for mental illnesses such as eating disorders, because men are expected to be strong and invulnerable.

Finally, because eating disorders are associated with women, they are seen to be associated with negative, traditionally female, traits, such as being vain, superficial, weak and irrational. Associating negative stereotypically ‘feminine’ traits with EDs prevents everyone getting treatment.

Feminism can help fight eating disorders, and we need all the tools we can get. It shouldn’t be dismissed as unrelated.

 

Enjoying the Silly Season


It’s easy to view the holiday season with great trepidation, forseeing many social occasions where we will eat and drink more than we intend, leaving an uncomfortable over-full feeling.

Why does this happen? I’ll try to cover a few big ones today.

We lose track of what we’ve eaten because the hor d’oeuvres keep circulating and the alcohol keeps getting magically refilled.

It’s proven that this way of eating reduces your ability to remember what you’ve eaten, and the memory of eating is a big part of satiety. Here are some tips to enhance your food memory:

  1. Get a little serviette or plate and decide how many times you’d like to fill it: maybe one or two, depending on your hunger and the size of the plates.
  2. Don’t let your alcohol glass be refilled until you’ve finished it, and alternate every second glass with water. It might be helpful to set a number of glasses that you’d like to drink.
  3. Really pay attention to the food you eat: how does it look, taste and feel? Would you like another one? How many have you had?
  4. Eat a few roving snacks, then wait half an hour to see if you’ve still got room.

There is such a lovely spread of food, we simply want to try everything.

  1. Look over the buffet or spread and choose which three or four things you really want to eat. This could be your favourites, something you’ve never had before, or a dish a loved one has gone to extra lengths to make special.
  2. Try the ‘1-2 plates full’ trick here as well. One savoury and one sweet plate is often enough.
  3. Once you’ve had enough to eat, get involved in the rest of the party. Get onto the dance floor, run around with the kids, or get into a really in depth conversation. Parties aren’t just for eating, and it’s the wonderful company that really makes it worthwhile, and that you’ll remember.

I wish you a very happy holidays – enjoy the delicious food (mindfully!) and the downtime.

Peace,

Jess

Carbohydrates: Good or Evil?

On Catalyst the other day was an episode about low carb diets. Naturally I watched it with great interest. I was sad to see that there were so few actual nutrition experts. Associate Professor Tim Crowe and Melanie Grice, APD, had some good, balanced comments. A lot of the other comments were riddled with errors (if you want you can read a list here http://davidgillespiesbigfatlies.com/catalyst-low-carb-story-shakedown-part-1/), but putting those aside I still think the ‘debate’ is missing the point.

There is not one ‘perfect’ way to eat. Diets vary so much around the world. Some of the longest-living people, the Sardinians and Japanese, have completely different diets. Yes, it is possible to eat a healthy ‘low carbohydrate’ diet, but it is also possible on a ‘moderate’ or ‘high’ carbohydrate diet. Carbohydrates are not evil – in fruit and wholegrain form they are amazingly good for us.

A healthy diet has a few important features:

  1. Lots of vegetables!
  2. Mostly whole foods
  3. Not too many processed carbohydrates and preserved meats
  4. Good fats
  5. Gets all your vitamins, minerals and proteins.
  6. Eating when hungry, not eating when full (except occasionally when the food is truly delicious)

Finding a ‘diet’ which fits these features, you enjoy, and is realistic and sustainable, is the key to health. If that mean low carb or high carb or somewhere in between, that’s totally ok. *

Remember, a ‘perfect’ diet is not realistic or necessary. Eating today involves a lot of cultural foods that may not be good for our bodies. Sure, we might all be healthier if we never ate these foods again, but it’s not sustainable, realistic, or fun.

Having a bit of chocolate, an ice-cream, chips or a piece of cake a couple of times a week is not going to ruin anyone’s health. Eating is more than getting nutrients and preventing chronic disease, it’s also about enjoying food, and enjoying life.

*If you have a medical condition, such as diabetes, advice from an Accredited Practising Dietitian will help you determine if you need a specialised diet.

Seasonal Veg of the Month: Cucumber – and how to use it


Cucumber: Crispy and refreshing, cucumber has heaps of vitamin C and K, as well as lots of water for hydration. I found 10 more to use it apart from a simple (though timeless!) garden salad.

  1. Tzatziki – Greek yoghurt and cucumber dip | SBS Food.
  2. Italian Style Tomato Onion and Cucumber Salad | Food Network
  3. Salmon and cucumber sandwiches – these look beautiful! | Yahoo Lifestyle
  4. Refrigerator pickles | Instructables
  5. Vietnamese Summer Rolls | Martha Stewart
  6. Sushi with avocado and cucumber | Je Suis Alimentageuse
  7. Thai Chilli and Cucumber Salad | Taste
  8. Cut into sticks and dip into hummus. (maybe even tzatziki for a double cucumber hit)
  9. Sunomono (Japanese Cucumber Salad) | Japanese Cooking 101
  10. Cucumber Salad with Mint and Basil | Good Food

Have a happy cucumber-filled November! xx

FAQ: what is the difference between a dietitian and a nutritionist?

This is a question I get a lot. I’m a dietitian AND a nutritionist, which I think is important.

Nutritionists know what food to eat to get all the nutrients we need to be healthy. It’s vitally important in my work that I know these things: knowing the basic facts behind what I’m recommending is the first step to helping someone find a healthy diet that works for them.

A dietitian is always a nutritionist, but a nutritionist is not always a dietitian. Dietitians have gone to uni to get a whole lot of extra knowledge: particularly important is nutrition counselling (helping people make the changes, not just giving instructions), and medical nutrition therapy (specialised diets for different medical conditions).

There’s also the Accredited Practicing Dietitian (APD) qualification. All dietitians in Australia who’ve studied an approved course can apply to the Dietitians Association of Australia, which gets them an APD qualification. Being a member of the DAA means you’re subject to professional codes of ethics, including continuous professional development. I’m pretty proud of my APD accreditation, as it says that I’m committed to ethical practice.

I hope this clears things up! xx

Why don’t diets work?

Today I’ve been reflecting on two pieces of information:
1. This article ‘Dieting must Die’ from Dr David Katz. “Dieting is a short-term, get-on-then-get-back-off approach to the permanent challenge of losing weight and finding health. It has been tested rather generously, and it does not work”

2. This spaghetti-like ‘obesity map’ explores the hundreds of factors that influence energy balance. Just look at it. It’s huge!

Diets are by definition restrictive. Restriction leads to weight loss, because reducing ‘energy in’ will cause weight loss. So as long as you keep that conscious ‘restrict restrict restrict’ mindset forever you’ll keep it off (Hooray…). Besides the fact that restriction is boring and psychologically damaging, it usually doesn’t work long-term. Studies show that most people on diets start to regain weight about the 6 month mark.

What diets fail to do is address the reasons WHY people have gained weight. Unless you remove the factors, or manage them, diets will not work.

The human body is quite well designed. We have excellent appetite signals – we get hungry when we need to eat, and we feel full when we do not. If we pay attention to these signals most of the time, we’d be right. The only exception is junk food- It’s hard for your appetite to keep up when you can inhale a large big mac meal (5000kJ – about 60% of your requirements for the day) in about 10 minutes.

Eating mostly whole, healthy foods to promote health, paying attention to appetite is not only a recipe for being a healthy and comfortable weight. It’s also an important part of a happy and calm life.

So why don’t people eat whole healthy foods? It varies for each person, but here are some factors I (and the spaghetti diagram) think are important:

  • cost and income
  • convenience
  • family preferences
  • personal preference
  • media pressure
  • peer group and social pressure
  • time restrictions
  • food literacy
  • habit

Why people eat when they’re not hungry, or keep going once they’re full?

  • Emotional eating
  • Habit
  • Social occasions
  • The food is just so delicious
  • Feeling deprived
  • Bored eating
  • Big portion sizes
  • Big plates
  • Eating too fast to register fullness
  • Not acknowledging hunger/satiety.
  • Pressure to finish everything on the plate / not wanting to waste food

So what can we do if we want to lose weight? It can be difficult to figure out what factors are having the biggest impact in your life. Taking time to consider WHY you are making certain food choices can be really helpful.

If you want to make a start, try asking yourself questions such as:

  1. Do I really want to eat this?
  2. Why do I want to eat this?
  3. Do I want to keep eating?

I hope you forgive some shameless self-promotion for dietitians here! A dietitian can help you figure out and manage your factors, and help with motivation and accountability.

Feel free to send me a message, or look for a dietitian in your area.

If you want to read book that address these topics, check out Don’t Go Hungry and Mindless Eating.

Review: Dr Libby’s Road to Sustainable Weight Loss

Last week I got together with the lovely people I did my Master of Nutrition and Dietetics with. We went to see Dr. Libby’s ‘Road to Sustainable Weight Loss’. I hadn’t heard of her before, but she’s a dietitian with quite a following in NZ.

Dr Libby is here in Australia promoting her books: the newest of which is ‘Calorie Fallacy‘. She’s a fantastic speaker, and she targeted her talk to individuals wanting to lose weight, but there was a lot for me to learn too!

As many people know, the ‘calorie-in/calorie-out’ equation does not always work.  One of my favourite phrases is ‘human bodies are such mysterious things!’ We definitely do not work like in/out machines. The human body is so complex, and there’s still so much to learn.

Dr Libby presents two basic ideas in her book:

  1. Toxin build up causes fat gain.
  2. Stress increases fat gain.

Dr Libby’s first theory is that our livers are overloaded from added sugar, trans fats, alcohol, caffeine and other toxins. She says that if there are just too many toxins, the liver will not be able to cope, and will dump excess toxins, which will have to be stored in fat cells.

While this does seem to make sense, I haven’t seen the research and cannot comment on the validity of this theory. Her solution to this is to consume less of what is bad for us: excess junk food, alcohol and caffeine. And more of what is good for us for optimum liver function: fruits and vegetables, and other whole, nutritious foods.

I think the label ‘toxins’ is interesting, because it’s all in the dose. Even things that we think of as harmless, such as cinnamon, can be toxic at higher doses.

So for alcohol and caffeine, I think to treat them as ‘to limit’ foods is a good idea.

Neither has been linked with weight gain, and moderate caffeine intake has been linked to weight loss. A moderate intake* of alcohol is linked with reduced mortality. If you think maybe caffeine intake is affecting your sleep, then it’s worth cutting down, to see if your wellbeing improves.

Her second theory is that stress causes fat gain: Having stress leads to high levels of cortisol, which messes with our metabolism. We do know that excessive cortisol causes weight gain – as in the case of Cushing’s Syndrome- although whether elevated cortisol plays a big factor in those without the syndrome remains to be seen.

Dr Libby recommends deep, slow breathing, such as meditation or tai chi, to reduce cortisol. There are many scientific studies that prove this. Reducing stress is good, whether it causes weight loss or not.

Although I haven’t seen all the evidence behind Dr Libby’s recommendations for weight loss, they are definitely good for health and wellbeing:

  • Eat whole foods.
  • Limit junk food, alcohol and caffeine.
  • Reduce stress.

 

*(no more than 1-2 standard drinks per day, and two alcohol free days per week)

 

References:

Better Health: Cushings Sydnrome

Buddhist Meditation reduces cortisol

Transcendental meditation reduces cortisol and CVD risk

The link between alcohol and weight is very confusing

Caffeine may in fact lead to lower body weight

Australian Alcohol Recommendations

IBS Management

Irritable Bowel Syndrome (IBS) affects one in seven Australians.

It is a condition marked by abdominal pain, bloating, and constipation and/or diarrhea. A diagnosis of IBS is only given after other causes are ruled out, such as coeliac disease or other serious conditions. IBS occasionally seems to occur after a serious infection, but otherwise the cause is unknown.

People with IBS have a significant reduction in quality of life. The good news, though, is that IBS does not seem to increase risk of any more serious diseases, such as cancer.

Basic first steps to take if you have IBS:
1. Make sure you’re getting 6-8 cups of water each day
2. Try a probiotic supplement.
3. Increasing your soluble fibre intake. Sources include supplements such a psyllium husks, or foods such as oats and oranges.

If those basic steps don’t seem to help, then have a look at your triggers – which are divided into stress/emotional and dietary.

If stress and anxiety make your IBS worse, try these relaxation exercises, or see your GP for a referral to a psychologist.

But if different foods seem to trigger your IBS, trying a low FODMAPS diet could have a significant impact. FODMAPS are parts of food that are more difficult to digest. A dietitian can help you plan a diet that meets all your nutritional needs, but avoids FODMAPS – which are often triggers for IBS. Then trial each different FODMAP to determine which are problems for you, and your tolerated dose.

I see clients for Low FODMAPS meal plans and re-introductions. If you’d like to book an appointment or would like to talk further, feel free to get in contact with me here.