A letter to my clients this Christmas

You know I love you all dearly – many of you I have seen for many months if not years and know you often as well as I know my own friends. I also often know your family as well as your friends who you have also sent to see me over the years so they too can learn to take control of their food, their body and their lives. I even feel great affection for those of you who skip your weigh in’s, who forget to text me your weight each week and even those who seem to come down with a cold every time the weekend eating and drinking became a little too much. I have seen you at your worst, often when you are most vulnerable and in general I feel privileged that you trust me to look after your weight and your diet.

But, I do have one request a mere few days before Christmas – please, please, please can you remember how hard we have worked together, how great our gains have been and not let it all go to waste?

Please don’t take this the wrong way; of course I want you to enjoy Christmas with your friends and family and indulge a little. Of course you are going to eat a little more than you should be eating and you are also likely to skip some of your training due to other commitments or family holidays.

You know what though? Such changes to your food and training schedules do not have to mean weight gain, at worst they should only result in no weight loss over the next couple of weeks.

If though you are viewing the holidays as an opportunity to throw all your hard work out the window, binge eat every morsel of food that crosses your path, opt to move your body as little as possible and see Christmas as a 4 week break rather than a special day or two, things are not looking great. Not only are you likely to regain significant amounts of weight as your body becomes overwhelmed by carbs, sugars and calories that it has been learning to live without but you are also likely to find it extremely difficult to lose this what all over again as your body’s cells start to tell you that they are sick and tired of these food games.

You know how good you feel when you are on track with your food and training, and you know how much better the start of a new year will be if you also start it feeling amazing. I promise I will be there for you all in January, helping to direct and motivate you for the year ahead but I need you to consider my needs to – and I need you to remember the foundations of what we have built together and give them the respect they deserve.

With Much Love and Kind Thoughts at Christmas

Your Devoted Dietitian

 

xx

 

 

Why did I write The Monday to Friday Diet?

Why on earth would a dietitian write a ‘diet’ book – we know that diets do not work. Well, for some of us they work initially but the research shows that strict diets do not work long term. Inevitably once we have cut back our calories for a few weeks and lost a few kg, unless we keep pretty focused, exercise for an hour a day and follow a 1300 calorie diet, most of the time, the weight always creeps back on – depressing isn’t it?

So, now I should clarify, The Monday to Friday Diet is not a ‘diet’ as such, but a way to approach our busy (and getting busier) working weeks so that we have some clear food and exercise rules with which to build strong lifestyle habits. Once we have these habits, taking control over our week and ultimately our food intake over the course of the week helps us to manage our calorie intake and commit to moving our bodies, for life. And that, put simply, is the secret to weight control.

Now this concept is not only relevant to the Monday to Friday working peeps out there – balancing food intake and exercise throughout any week can be challenging for working women, full time mums, shift workers, those juggling study and work, travel or life in general. We are all dealing with intense time demands, traffic, huge family and social commitments and an increasing need to move well and eat less. For this reason The Monday to Friday Diet offers you the specific strategies you need to deal with all of these demands and pressures. The Monday to Friday approach shows you how to adjust your calories on different days of the week, how to deal with your food and exercise when you travel, how to control your calories but still enjoy your weekend, how to get balance over your food, your body and your busy, busy week.

Ultimately we all want to eat tasty food and enjoy a busy fulfilling life, a big part of which is coming together over food with those closest to us. Unfortunately for many of us, our weight and our bodies become a victim to this lifestyle and so it is time to take control. The Monday to Friday Diet will show you how to do that – with food plans, recipes and plenty of tricks and tips, you will wonder how you ever got through the working week without it.

For the past 12 years I have spent much time with my clients helping them to work through the juggles and demands of their busy weeks, and develop strategies to continue to eat well and exercise no matter what their weeks look like. I have brought together these recipes, strategies and ideas to help you do the same. I look forward to hearing how the Monday to Friday Diet helps you to take charge of your week and ultimately your weight and health too.

 

The secret to getting and keeping motivation

 

If I knew the secret to getting every single individual motivated I would be in a very powerful position indeed, but unfortunately, as is the case with many human attributes, motivation is a complex and changeable state. For many, motivation, particularly when it comes to health and fitness routines is innate; we learnt to eat and behave in a certain way when were small and will continue to do so for the rest of our lives. For others, a health scare or realisation that you are 20kg heavier than you should be gives us the kick we need to change our daily habits and turn our lives around. Then there are those individuals who just seem to never get it and keep at it; they try one health and fitness craze after the other, never cementing a pattern of living that give their bodies and lives at better chance. As we edge closer to the warmer months and before all things weight loss become popular again perhaps it is worth trying to locate some of your own motivation. Some questions to ask yourself during this time as you try to find it include:

·         What are the benefits of keeping my body fit and healthy?

·         How would my life be better if I felt better about my body?

·         Am I the kind of healthy role model I would like to be for my children?

·         Can I physically do all the things I would like to with my body?

·         What am I really putting into my body each day?

·         If I was fit, healthy and happy what would I be eating and what training would I be doing each day?

·         If I knew I could keep my body disease free by eating well and moving, would I be more inclined to move more and eat less?

·         Who are the people in my life who would support me living like this?

·         What changes can I make to my lifestyle today that will help move me closer to my goal of living well and feeling healthy?

Remember, motivation starts with a single positive thought and is maintained with every small, single step you take in the right direction.

Supplements and schoolboy athletes

Teenage boys love them, parents tend to be concerned about them and teachers try and ban them – supplements. The mix of white powders, special drinks and potions packaged in brightly coloured, extra-large containers with the words ‘huge’, ‘ripped’ and ‘massive’ plastered across the front in large bold writing via which school boys see the body of a Super 15 or NRL player suddenly within their reach.

So should we be concerned with teenage athletes turning to various supplements to boost their protein and nutritional intake to support weight gain? As is the case with all areas of nutritional science, there are two sides to the story. Of course parents should be concerned or at least aware of what their teenage athletes are consuming but the first thing to know is that we cannot group all supplements into the same category. There is a wide range of nutritional and performance supplements available, which all do very different things. Sure, some may warrant concern with various suspicious ingredients and stimulants, but many, as is the case with most ‘protein’ supplements are simply a mix of concentrated milk protein and some carbohydrates for energy.

Now while the most common question that comes from parents is, ‘can’t they just get their nutrition from their food and drink some extra milk?’ is warranted, here are some of the number to consider. A busy teenage athlete, competing in 2-3 different sports at a relatively high level will be burning and as a result require several thousand calories a day – and this is just to grow and develop normally. If the athlete then has considerably athletic ability identified and his sport will benefit from him gaining 5-10 extra kg, unless he is drinking a litre of milk in a sitting to get the equivalent 30-40g of protein he can get from a protein shake or eating large serves of lean meat or eggs at every meal and mid-meal, it is going to prove challenging for him to get the amounts of carbohydrates, calories and protein he will require for muscle growth and recovery on a daily basis. This is not to say that it cannot be done, just that it will require a lot of attention and eating – something which teenage boys are not necessarily good at, or have time for.

So for this reason, as long as the supplement schoolboy athletes are choosing is pure – that means contains just carbohydrates and proteins without growth additives such as creatine, which we do not know are safe for teenagers at this stage, and comes from a reputable Australian brand such as BSc, I do use protein supplements with school boy athletes. Naturally we stress that more is not better, and supplements will only work in conjunction with a strong baseline diet, but they are an option. And surely as parents it is better to know what they are having, where it comes from and make sure they are taking it the right way, as opposed to them purchasing a dodgy supplement from overseas and taking it on the sly, because this is what tends to happen deep in private school dorms late at night anyway.

 

 

Eating for HSC Success

With the exam period upon us and hundreds of thousands of high school students completing their final exams, stress levels within the family home are likely to be at an all time high. Getting your teen to eat well during this intense period may be more challenging than usual, but is crucial to ensure they are at their best mentally and physical throughout the entire exam period.

Breakfast is the most important meal of the day for all of us but is of utmost importance on the day of a big exam. Unfortunately nerves and stress are both likely to impact on appetite the morning of exams. It is absolutely imperative that some sort of breakfast is eaten on exam days. Skipping breakfast has been proven to reduce the ability to concentrate and remain focused throughout the morning and hence must be seen as a priority. Ideally a breakfast option that combines both low GI carbohydrates and lean proteins will sustain your teen throughout the morning. Good choices include eggs on wholegrain toast or oats or muesli with yoghurt and fruit. If solid food is not an option, try a liquid meal breakfast drink or protein shake. For worst case scenarios, a couple of dry crackers with spread or a muesli bar will be better than skipping breakfast altogether.

A second dietary factor to consider for busy students is whether they, particularly the girls are getting enough iron. Many teenage girls will cut back on red meat in their later high school years, but lean red meat is the best source of readily absorbable iron and ideally needs to be consumed in small amounts 3-4 times each week. If your teen appears abnormally tired, it may be worth having a blood test to check their iron levels and try and get them to eat red meat regularly throughout the exam period.

Finally, pay particular attention to how much caffeine and other stimulants your teen is consuming. Energy drinks, coffee and caffeine tablets may provide a short term energy burst but they can also result in increased heart rate and anxiety, insomnia and fluctuating blood glucose levels – all less than ideal symptoms for already stressed teens. Encourage your teen to drink water and herbal tea, limit their coffee intake to just 1 to 2 cups each day and encourage them to get plenty of rest during this time. Remember that small regular protein rich snacks of nut bars, protein drinks or dairy food will help to keep them alert and better able to concentrate and a good night sleep is sometimes the best thing for a tired and stressed out brain.

 

When a drink becomes a problem

A disclaimer before I begin this piece, I enjoy a drink. A glass of wine with a friend or a few vodkas on a big night out is a part of my life, as enjoying a few drinks each week is a part of many people’s lives. This column is not about a drink or two enjoyed occasionally and socially. It is not even about enjoying a glass or two of wine each night over dinner. This column is about drinking habits that are negatively impacting on your relationships, your health and ultimately your life. And unfortunately this is the type of drinking that we see far too often in Australia – ½ a case or a bottle or more on a daily basis that is not helping you to relax and unwind like you are telling yourself it is, it is serving as a crutch and escape from the real issue.

From a health perspective, excessive alcohol consumption causes two main issues – the first is that alcohol is relatively high in calories and hence it is easy to gain weight when we drink too much. Individuals who drink too much alcohol over many years often develop an alcohol fat apron around the abdominal area – for women this can make them appear pregnant, while for men a hard packed solid mass which is exceptionally hard to budge. The other issue, which is perhaps the worse of the two, is that excessive alcohol consumption results in disinhibit ion and lethargy -  you do and say things you should not, far less gets done, mood is impeding and basically you function at a much lower level than you could be at any point in time. Occasionally this is no issue but on a daily basis, this pattern of behaviour starts to destroy lives.

You know the stories – couples fighting after one partner have drunk too much again, someone passed out in front of the television at 9pm, the aggressive  and non-personable behaviours that can almost be 100% attributed to drinking too much. And alcohol and the perception of escaping pain and stress that it offers becomes a habit very, very quickly. What started as a twice a week habit is now a nightly one, in double the amounts that you once consumed. As you are used to now drinking this much it seems normal to you, once it starts to affect your health, your daily performance and your relationships, it is a problem and a problem that needs to be looked at more closely.

Signs that alcohol may be an issue in your life are as follows – if you cannot go a night without a drink, if you regularly pass out after a few drinks or if you cannot remember the night before, it is time to take action. One option that works for many is a complete break from alcohol – sometimes all that we need is a period without the substance whether it be a particular food or in this case alcohol to remind us of how much we are actually consuming and have become reliant on. If though the issue is bigger than this it is time to get professional help, as our lives and relationships are far too precious to be lost over beers or a cheap bottle of wine.

Why you should see a dietitian for weight loss and dietary advice

 

One of the most common questions that you get asked as a dietitian is ‘what is the difference between a dietitian and a nutritionist? Admittedly it is confusing – if anything the term nutritionist sounds far more user friendly compared to the term ‘dietitian’ which tends to conjure up images of a practitioner in a white coat dictating what you should and should not be eating. This is as opposed to nutritionist in which case we tend to imagine holistic health imagery filled with fresh fruit, vegetables and wellbeing.

While a dietitian is always also a nutritionist, this is not the case for a nutritionist. A dietitian is someone who has completed tertiary training, usually with a Master’s Degree at university in the area of nutrition and dietetics – the applied science of nutrition and its application to dietary change in people. To be called an Accredited Practising Dietitian (similar to an accredited accountant) you not only need to have completed this university training but annually complete a certain number of continuing education activities to ensure that your practice is current and up to date with the latest scientific research and its application to humans. The scientific training of a dietitian involves studying biochemistry, physiology, disease states, psychology, supervised nutritional counseling and statistical analysis. Such in depth training not only takes many years but teaches dietitians to be able to interpret scientific data and medical results in order to develop individual client dietary prescriptions based on scientifically proven data ad research. On the whole, the profession is highly regulated to ensure that best practice is ensured for our clients.

Nutritionists on the other hand are managed a little less rigidly – actually anyone can call themselves a nutritionist, and while some people may have studied nutrition at a tertiary level and earned various qualifications, others may simply have completed a course at a private college or via an online course. And for this reason, it is imperative that consumers check the credentials of the health professional that they are seeing. Recommending that those consumers wanting dietary advice or weight loss advice see a dietitian is given not because a nutritionist is not likely to improve the diet quality of any client that they see, but rather because dietary intervention can be a little more complicated.

To demonstrate this, a client story of mine that I will share with you;

A couple of years ago I saw a 32 year old female for weight loss. The female was roughly 90kg and had been feeling exceptionally tired. She has already seen a GP and an endocrinologist who had blamed the fatigue on a poor diet and her insulin resistance. Since these consults, my patient’s symptoms had not improved and she had also see a nutritionist at her gym who suggested she stop consuming wheat and dairy. Initially my client had felt better with this advice but she was still not losing weight and a month later she was still tired. When I first saw her, I simply changed her macronutrient ratios (her carb, protein and fat levels) slightly but had that practitioner sixth sense that all was not well with this girl. I have seen too many other women for weight loss, over many years to know when something is not right. My client appeared grey, low in energy and mood and even with insulin resistance her fatigue was extreme. When I went home I discussed the patient online with some dietitian colleagues – as a profession there is support available from other practitioners online when you are a dietitian. One of my colleagues suggested another endocrinologist simply as this one specialist had much experience with clients presenting with fatigue. While I continued to see the client and managed to help her lose 3kg, she finally got into the new specialist and was diagnosed with thyroid cancer. She has since had it removed and is in full remission.

Now I do not share this story to show off or claim glory but rather to show that simple dietary presentations whether they are fatigue, bloating, irritable bowel, bad skin or unexplained weight gain can be masking significant health issues, health issues which do need practitioners with a certain level of training to deal with. If I was not a dietitian I would not be in close contact with other medical professionals, nor would I have access to a 2000 other practitioners to reflect and discuss cases and refer on when necessary. Luckily in this case we were able to have a patient diagnosed with cancer thanks to these professional interactions and as a result ultimately saved her life. In my 12 years of practice I have seen 5 cancer diagnoses, numerous cases of insulin resistance and PCOS, more than 20 pregnancies and 12 coeliacs diagnosed – and I can guarantee that it was my training as a dietitian that resulted in these outcomes.

Telling someone to eat more fresh fruit and vegetables is unlikely to do any harm but it is always useful to be aware of ones limitations in this space, and when it comes to many dietary issues and weight loss, a dietitian is the best practitioner to manage these.