Over the years I've watched family members and numerous patients go through fad diets, do well for a certain amount of time, only to completely give up, go back to unhealthy habits and feel like they've failed yet again. So how do we tackle such an important yet often tricky subject? After all, sometimes it feels like there's an overwhelming amount of, sometimes conflicting, information on what we should and shouldn't be eating... whether fats are terrible (as we may previously have been lead to believe) or whether we should all go Keto and even whether going vegan/veggie is more healthy than eating animal produce (especially with the new Netflix documentary, Game Changers, being a talking point).
I'm not a nutritionist and will always refer patients on if I feel they have specific nutritional needs to consider. However, over the last few years I have developed a growing interest in looking into the research and new information on how food can affect everything from our energy and concentration levels, to conditions such as depression, diabetes and even Alzheimer's. The new research out there is super exciting and growing constantly!
So I wanted to put together some simple, sustainable, healthy yet enjoyable general advice for patients. This has been tried and tested by myself over three years as I've added/taken away certain foods from my own diet and felt the benefits in terms of not only energy levels day to day but also my previous IBS (irritable bowel syndrome) symptoms. (Again, I'm not saying this will alleviate everyone's IBS as again this sometimes needs specific help from a Nutritionist in terms of bringing in things like a low FODMAP diet).
For me, this has been a three year journey for so far, not 3 days or 3 weeks! This is not to say I didn't start feeling the benefits sooner but I'm trying to emphasize the fact that it sometimes should be seen as marathon not a sprint when making things sustainable. How about instead of 'crash dieting' every year, we develop habits that will last a lifetime and get us to a healthy sustainable weight as an individual (without feeling like your punishing yourself on a sudden super strict diet)? Let's look at food for it's exciting numerous health benefits, not just for weight loss alone!
First, the basics- fat, carbs, sugar, salt and more...
Let's dive into the main diet components and the basic understanding of each...
FATS- when we look as fat it has previously been demonized as it contains more calories per gram compared to carbohydrates or protein (9 per gram vs 4 per gram). But fat is important in many human functions including hormone function, as is cholesterol. Certain fats can help reduce inflammation and fat helps us absorb vitamins A, D, E and K. There are different types of fats:
Saturated fats- mainly found in dairy (cheese, butter), meat like sausages and bacon, and coconut oil. Ideally the NHS says that we shouldn't have more than 11% of our daily food intake in saturated fat. These are a bit harder to break down in the body than unsaturated fats.
Trans fats may be found in ultra-processed foods and are not good for us.
Mono-unsaturated fats- like avocados, extra virgin olive oil, nuts and sesame oil.
Poly-unsaturated fats- contain omega-3s. ALA is found in vegetable products such as flaxseed oil. EPA and DHA is found in animal products such as oily fish/eggs and has been linked to improved heart and brain function.
Cholesterol- is a fat that is vital for the body. It is made in the liver and carried in the blood as lipoproteins. HDL is our good cholesterol, which carries fat to the liver. LDL is our not so good cholesterol, which carries fat to the cells. LDL is often found in saturated fats and can accumulate in our artery walls causing cardiovascular disease.
CARBS- the NHS recommends around 50% of our daily intake should come from carbohydrates (although again this may vary depending on individuals). Carbs provide us with energy, help the central nervous system and brain function. Carbohydrates are not just found in pasta and bread ('refined' carbs) but also in fruits and vegetables. Carbohydrates are broken down into...
SUGAR- this comes in different forms. 'Added' sugars are found in things like fruit juice and soft drinks, ketchup and cooking sauces and shouldn't be more than 5% of your daily intake. Fruits and vegetables contain different natural sugars, fructose and glucose. Dairy contains lactose. Sugar can raise our blood glucose levels and therefore our insulin levels and therefore has been shown to play a role in certain conditions such as diabetes. However, fruit and vegetables contain fibre, which can affect how quickly those sugars are released and is also extremely important in the gut microbiome, satiety and weight loss. Fruits with a peel on often have more fibre in them and a lower GI (glycemic index, indicating blood sugar rise), as do berries which also contain beneficial antioxidants.
PROTEIN- contains amino acids which are the building blocks for muscle mass, as well as helping with metabolism, hormone production and immune system function. Building muscle mass burns more calories and therefore also helps with weight loss. Protein can be found in animal produce such as meat, fish and eggs and plants such as beans, pulses, nuts and seeds.
SALT- again, this is worse when in processed foods (adding a little bit to home made cooking is okay and is needed to maintain healthy blood pressure). The NHS currently recommends no more than 6g a day but this may drop to 3g soon.
All in all we need a balance of these macronutrients in breakfast, lunch and dinner. Try and fill 1/2 of your plate with plant foods, 1/4 with protein and 1/4 with carbs (obviously there is overlap between some foods but the main aim is to eat mainly plant based where possible and get a variety of macronutrients in each meal).
Are all calories not the same when it comes to weight loss?
There's no doubt that calories in vs calories out is important to manage and be aware of with weight loss. However, take 100 calories of sweetcorn vs 100 calories of ground corn a.k.a flour... we do not absorb the full 100 calories of sweetcorn, yet we absorb much more when it's in a different form. Fruit and vegetables contain fibre which isn't as easily broken down in the digestive tract. So often it's ideally about more than just thinking about calories in vs out, it's about thinking of the nutrient value of the food we're eating too.
So, here's my top foods to gradually eliminate and top foods to gradually add in:
To decrease:
- Foods with roughly more than 5 ingredients on the label of the packet
- Fried foods, take aways, ready meals
- Fizzy/sugary drinks
- Too much caffeine (especially after midday- we cover this when we talk about sleep in another Blog post too).
- Alcohol.
- White refined carbohydrates- bread/pasta/rice.
- Some cereals.
- Sweets/cakes/chocolate.
- Vegetable oil, margarine.
To increase:
- 8 glasses (roughly 2 litres) water per day.
- At least 5 fruits/vegetables per day. More vegetables than fruit (1-2 portions of fruit ideally). The more variety the better- eat the rainbow! (Top points if you eat 30 different plant foods a week!).
- Leafy green vegetables in particular (broccoli, spinach, kale…).
- Dark berries.
- Protein: lean meat, fish, eggs, chickpeas, lentils, yoghurt, milk.
- Carbohydrates: sweet potatoes, oats, brown rice/pasta, lentils, quinoa.
- Healthy fats: olive oil, butter, coconut oil, avocado (omega-3 rich)...
- Nuts and seeds.
- Oily fish ('SMASH' fish- salmon, mackerel, anchovies, sardines, herring), 2-3x/week.
- Green tea.
- Dark chocolate (over 80% cocoa, low sugar).
This links in with what we'd call an 'Anti-inflammatory' diet, eating food to decrease our bodies inflammation levels (which can add to many chronic health conditions such as cardiovascular disease, diabetes, arthritis, Alzheimer's and even depression).
Other considerations:
For some people gluten and/or dairy may cause issues.
For some patients with arthritis/psoriasis a group of foods called the Nightshade plants (white potatoes, aubergine, peppers, tomatoes) may increase symptoms.
Additional supplements may be recommended for some people, such as Vitamin D, magnesium, probiotics or more.
Personally, I stick to the 80:20 rule. Or basically, I eat very well on 'work days' and allow myself more freedom, if I feel I want it, at weekends (depending on how much I'm craving Lindor chocolate!). Intuitive/mindful eating is key. Often we get into habits of having a glass of wine or bag of crisps after work without actually stopping and thinking 'do I really feel like this?'. Working out our eating triggers is important, whether that's lack of sleep, stress, or emotional upset. Then it's a case of planning in ways of substituting the unhealthy eating habits either with a healthier alternative e.g. even swapping milk chocolate for >80% dark chocolate to start... or substituting it with a different habit altogether e.g. putting on your favourite song and doing some deep breathing for 2 minutes.
So try decreasing/increasing one thing at a time and see how you go.
Why not try a food, bowel and mood diary to see how food may affect you?
For more information from some of my top, sustainable nutrition advocates I follow:
https://ameliafreer.com/about/ - some great blog posts and books
https://drchatterjee.com/blog/category/food/ - doctor I follow a lot, I'd highly recommend his book, The Four Pillar Plan.
https://clairesambolino.com/healthy-eating-guidelines-2/ - my cousin, a nutritionist. Great e-book and regular helpful social media content.
Southcote Proactive Healthcare Nutritionists: Patricia and Tara https://www.southcote.com/nutrition