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Thursday, April 29, 2010

Dealing with emotional pain

Dealing with emotional pain has to be one of the most challenging things that human beings have to deal with during their lifetime. As Ian Thorpe once famously said when talking of the pain associated with swimming at a world championship level; “physical pain is nothing compared to emotional pain” – the pain that makes your heart ache and life no longer seem living. Whether it is a relationship breakup, a family loss, betrayal or extreme disappointment, at some point in our lives we all have to deal with it, and like everything, we can choose to do it well, or become victim to it.

The feeling of discomfort associated with intense emotional pain will often see us try and avoid the pain – drown it out with alcohol, sex, food, medication and people, which may give some temporary relief but ultimately means that we are actively avoiding the pain, and avoidance inevitably comes back to bite us. Although much more difficult, sitting with the pain, seeking some deeper understanding of the scenario and working towards making peace with the situation a crucial component of the healing process. Sure, we can do small things to make ourselves feel better; get a massage, cry with friends, listen to our favourite songs and wallow for a while but actually accepting that a degree of pain is a part of being human is a key component of Acceptance and Commitment Therapy (ACT).

In this model, rather than direct energy towards fighting an emotion such as hurt or pain or even behavioural changes such as eating less, ACT would encourage individuals to sit with the pain and look for the good that can come from working through it. Easier said than done admittedly, but knowing that growth generally does come from pain as well as the development of new personal resources to deal with pain better in the future does help somewhat. In addition to some good wine, good friends and some serious tears for a day or two to get it all out 

Tuesday, April 20, 2010

Butter or margarine?

Butter versus Margarine?

One of the most frequently asked questions I am asked about nutrition is whether one should use butter or margarine? As with most areas of nutrition, which you choose really comes down your own personal preference and there are definitely better options of each available given that there is 50+ different types of butter and margarine in the spreads section of the supermarket. So, to help you make your decision slightly easier before you get caught up in a world of polys, monos and saturated fats, plant sterols and sodium, here are some of the pros and cons of each.

Taking a step back from the question of butter or margarine to consider the role of added fat in the diet, it is important to remember that the average adult will require just 40-60g of fat in total each day. If we then consider that a serve of nuts, some oil in cooking as well as some oily fish will provide at least 2/3 of this amount we are really just considering where we need to get just 10-15g of total fat, or 2-3 teaspoons each day. For those of you who are now considering how much butter or margarine you smear on your toast, yes, you probably do need to cut back as we really do not need a lot of added fat in general.

So, of these 2-3 teaspoons which is best? Butter, while the spread of choice because of its more “natural” image is largely a saturated fat. A teaspoon of butter will give you almost 3g of saturated fat, the type of fat which we need to keep as low as possible in our diet as it is the type of fat most likely to store and clog our arteries. A teaspoon of margarine on the other hand; a formulated blend of different types of oils depending on the one you choose , will give <1g of saturated fat per serve.

The story then becomes a little more complicated when you then consider that many of the varieties of both butter and margarine are now blends of different oils, as food companies attempt to get rid of as much bad fat from both the butter and margarines they sell, while bumping up the good fats from monounsaturated and polyunsaturated sources. Light and extra light varieties of both butter and margarine mean that the total amounts of fat received from these sources can be as low as 2g of total fat per serve, which means that either used in moderation of just 1-2 serves each day can be incorporated into any nutritionally balanced eating plan.

Cholesterol lowering margarines offer another selling point to consumers, especially given there are also light varieties of such margarines which contain concentrated amounts of plant sterols which, when consumed in high enough volumes can significantly reduce blood cholesterol. What also needs to be considered though is that these spreads are very expensive, need to be used in the right amounts (3-4 serves a day) and the cholesterol lowering benefits are perhaps not as powerful as weight loss itself. Such formulated foods then suit individuals who do not need to lose weight, who eat a low fat diet in general and who still have elevated cholesterol levels.

So, have I answered the question about which is preferable? As a nutritionist, my focus is developing entire diet plans that tick a number of nutritional boxes. Dietary modeling will indicate that of all the types of fat in the average person’s diet, it is the long chain polyunsaturated fats that tend to be lacking in the diet. For this reason, when choosing spreads I generally suggest an extra light variety that offers a decent serve of polyunsaturated fat. As is the case with any added fat though, I would much prefer my clients get the fat in their diets from nuts, seeds, oily fish and good quality oil which means that there is really very little place for spreads in the diet in general.

Sunday, April 18, 2010

Don't let Easter get you off track

Traditionally it is the months that follow the Easter holiday period which see many of us go off track when it comes to our diet and lifestyle resolutions. Too much chocolate, too little activity and a couple of kgs of extra weight is often all that is needed to completely ditch ideal exercise regimes and dietary resolves of the year thus far. Unfortunately, the Winter hibernation that many of us readily embrace then sees an extra 5-10kgs on board by the time the flowers are opening come Spring. At this time of year, the best thing you can do it make an official declaration that this will not happen to you in 2010. It is time to immediately rid your home of all extra leftover Easter treats because basically, if they are in the house, you will eat them.

Sunday, April 11, 2010

Why can't I lose weight?

For many years, scientists, nutritionists and numerous other weight loss professionals have continually preached that weight loss comes down to a very simple equation – kilojoules in versus kilojoules out. While this principle is true to a certain extent, there are a number of increasingly common hormonal shifts that can occur that do alter this relationship. Insulin resistance, the clinical condition that precedes Type 2 diabetes is one such diagnosis. Individuals with insulin resistance will struggle to lose weight via traditional weight loss prescriptions simply because their body is not burning fuel the way it should be.

Insulin is a hormone secreted by the pancreas and used to digest carbohydrates. Carbohydrates are found in plant based foods including bread, rice, breakfast cereal, pasta, fruits and sugars. When carbohydrate rich foods are consumed, insulin is secreted by the pancreas to take glucose from the food to the muscles for energy. For a number of reasons, over time, insulin may fail to work as well as it should. Weight gain, where fat is clogging the cells is one such reason, as is a lack of physical activity. Your genetics can also pre dispose you to insulin resistance and Type 2 diabetes. The highly processed nature of our daily carbohydrate food choices including breads, breakfast cereal and snack foods, which require much higher amounts of insulin than less processed low glycaemic index carbohydrates is too thought to be a significant contributing factor to the increased incidence of insulin resistance.

Resistance to the hormone insulin builds up over time, with the body gradually producing more and more insulin in an attempt to get it to work better at taking glucose to the body’s cells for energy. As insulin is also a fat storing hormone, the more of it that is circulating in the body, the harder it becomes to actually burn body fat. High levels of insulin can also make you feel tired, bloated and craving sugar, as the body is not getting the fuel it needs to the cells as efficiently as it should be. Individuals with insulin resistance also tend to have distinct abdominal fat deposits, and carry much of their weight round their belly.

The good news is that once diagnosed by a physician or endocrinologist, insulin resistance can be managed and tight management can actually prevent the development of Type 2 diabetes. While some cases will warrant medication, the diet and exercise prescription does not change. Individuals with insulin resistance need a reduced carbohydrate, increased protein diet as developed by a dietitian who specialises in the area, as well as a highly specific training program that integrates high intensity cardio sessions in conjunction with a light resistance training program. Individuals with insulin resistance need to learn to become extremely fussy with their choice of carbohydrate foods. High GI, refined sources of carbs including juices, white breads and refined cereals need to be completely eliminated from the diet long term for the best weight loss outcomes long term.

Signs that you may have a degree of insulin resistance that may be worth investigating with your doctor include an inability to lose weight despite demonstrated diet and exercise compliance, distinct abdominal fat, feeling unusually fatigued, bloating and cravings sugar regularly. The benefits of identifying insulin resistance early and committing to a 6-12 months diet and exercise intervention will ultimately help you avoid getting diabetes.