Don't be evil......

Occasionally there is a tag line or quote that has a powerful impact and the ‘google’ motto, ‘Don’t be evil’, made public in the documentary film ‘Google; Behind the Scenes’ did that for me. To me these simple words did an excellent job of summarizing what we all bring to this world, as individuals or as corporations in the sense of whether we are contributing positively or negative to the global energy system. And this morning, after spending some time reflecting on the contents of the new Coca Cola advertisement which aired in Australian prime time last night, again the concept of ‘Don’t be evil’ echoed in my ears.

As a health professional, when I go to sleep at night, my goal is to feel that I have contributed positively to this world. Sure there are perks associated with working in the media but in general I see my role as a dietitian in contributing positively to the health and well-being of my clients. Indeed, there is nothing more gratifying than to see a client achieve their food and weight related goals in conjunction with my guidance and I am never as happy as when I have had a successful day seeing lots of clients who are on track health wise.

I imagine this would be the same for a number of professionals – teachers, parents, doctors’ even most lawyers J  whose focus is to not only make money to live a comfortable life but to also put good energy, skills and resources back into the universe.

When I consider big multinational food companies who pump millions of sugar and fat based calories into the universe every day, I struggle to see the positive contribution. Sure, on one hand these groups create thousands of jobs, service a consumer want for these food types and give back to the community via various feel good initiatives, but should these groups still be rewarded when you argue that at least some parts of their business are a little bit evil in terms of what they are selling, developing and marketing?

These were the feelings I experienced when viewing the Coca Cola advertisement highlighting their commitment to smaller serving sizes of sugar based drinks; clearer caloric labeling and programs to support disadvantaged children get more active. Sure, it is great to see a company acknowledging that sugar based drinks are a contributing factor to obesity and also their commitment to do what they can to help but is it not a little bit hypocritical? Would those advertising dollars not be better spent on actually helping the managing obesity, at grass roots? Is it still a good thing when the underlying business model is to sell more and more liquid calories?

There is not one cause of obesity and successful obesity prevention and management requires numerous strategies and initiatives from individuals and as well as the public and private sectors. I do wonder though, if the executives of these big food companies rest easy at night? Whether, if they actually saw the impact of obesity at a grass roots level, would they continue to do what they do? And do they really believe that they are ‘doing no evil’ as they work towards plugging more and more high fat and sugar calories into the universe? What I do know is that I couldn’t do it, and while these groups are still around, the health professionals like me will have plenty of work to do, hopefully funded by Coca Cola or Pepsico in the future.

 

 

Are grandparents making their grandkids fat?

School holidays – 2 or 3 weeks in which working parents juggle the demands of their career with child care and keeping busy, energetic children stimulated for an extra 6-8 hours a day. For some this will mean extra child care, or time off work and then there are the growing number of grandparents who are taking the role of secondary caregivers for more and more busy, working parents. While this may appear the perfect scenario for families, recent research published by the University of Helsinki has found that children who are cared for my grandparents are more likely to be overweight than children cared for by parents.

 

The study which was published in the journal Evolutionary Psychology examined the weight status of 9000 children living in the UK and found that on average 23% of children were overweight and 26% of children cared for by grandparents were overweight. Researchers concluded that the benefits associated with grandparents caring for children from a historical perspective may not hold in modern life in which sedentary entertainment, high calorie food choices and long working hours tend to dominate family life.

 

And every single day, we see this. Children spending hours if not days sitting in front of screens, food treats a regular daily occurrence and schedules being based on the child’s wants, interests and desires – long gone of the days where Michael spent the day pottering with Nan in the garden and a treat was a glass of milk and a homemade biscuit.

 

So what does this mean for parents and grandparents who naturally want to do the best by their children, at least from a health perspective long term? It means that we need to start saying no – no to purchasing food away from the home; no to the TV, video games and i-pad’s and no to spending more and more money on entertainment in place of simple activities such as playing in the park or heaven forbid in the garden with friends. Not only does saying no help to empower any caregiver to be in charge of the child rather than the other way round, it basically helps to control calorie intake and increase activity to help prevent excessive weight gain.

 

You only have to spend a little time in a shopping centre or local kids entertainment centre to see fat kids. In Australia at least 1 in 4 kids has a significant weight issue and no parent or grandparent really wants this.

 

School Holiday Healthy Family Tips

1) Limit treats to at most 1 extra food item such as a small ice cream once a day.

2) Limit screen time to 2 hours a day, this includes ipads and DVDs.

3) Arrange play dates with other children.

4) Avoid all sweet drinks and choose only water.

5) Pack lunches where possible.

6) Allow children to choose their treat each day; for example, do you want an ice cream now or a sushi later?

7) Avoid shopping centres where overconsumption is encouraged.

8) Never take a child out of the house hungry.

9) Choose kids sized portions of everything including milkshakes, cakes and drinks.

10) Avoid ‘all you can places’ such as sushi trains and smorgasbords.

 

Susie Burrell is a paediatric dietitian who has worked in the area of childhood obesity for more than 10 years – www.susieburrell.com.au.

To wrap or not to wrap?

Have you ditched the bread in favour of a healthier ‘wrap’ or ‘bagel? Would you rarely eat a sandwich but happily order a wrap when grabbing lunch on the run? Does Lebanese or Mountain bread frequent your shopping basket to be used as a pizza base or low carb bread-like option? Unfortunately, despite the growing popularity of bread alternatives, it seems that we may be being misled when it comes to thinking that these are a better option nutritionally. In fact, with some wrap style bread options and bagels containing more carbohydrate than four regular slices of bread, a simple sandwich made using small, grain based slices of bread may not be such a bad option after all.

For some time, the humble loaf of bread has been the diet taboo for many, with claims and beliefs that bread is the enemy when it comes to digestive comfort, weight control and cravings for sweet foods. And, to defend this, there are a growing number of people being diagnosed with gluten intolerance, wheat intolerance, other food allergies and coeliac disease, for which wheat based foods are best avoided. In addition, there are also a growing number of people who simply prefer not to eat bread for a range of reasons including the effect these carbohydrate rich foods appear to have on their weight and digestive health in general.

Enter the bread revolution – Mountain Bread, Lebanese bread, a huge range of oat, barley, chia and rice wraps you may have noticed taking up more and more space in bread aisle of the supermarket. Alas though, when we take a closer look at the numbers, what may appear to be a ‘healthier’ choice, may simply be a concentrated volume of various types of flour compressed into a ‘healthier’ looking wrap style sandwich. Sure there are some lighter options in which a single wrap is equivalent to less than a slice of regular bread in terms of both carbohydrate content and calorie load, but these options are rarer; they are much more likely to fall apart when you make a decent sandwich out of them and they cannot be guaranteed to taste as good as a hearty sandwich would.

The other nutritional issue is that many of the commonly purchased wraps have a high GI – the nature of processing means that the flour used to make wraps is heavily refined, leaving a bread product that is digested quickly and results in a subsequent quick rise in blood glucose levels and long term this is a big issue for insulin levels and weight control.

So, this is not to say that there are not some great wrap choices out there simply check those labels as just because it is a wrap, does not make it a better choice.

Bread                                       Cal           Carbs         Sug        Fib

2 slices Burgen Soy Lin           198          21.2          2        4.6

White Lebanese                         275           53            3        3
Wholemeal Lebanese                  240          45            3        4.5
Mission White                            216          33.6         4.3     1.8
Freedom Gluten Free                  143          28.2        1.4     0.6
Pita Pocket                                 165         31.8        2.1     1.8
Bagel                                        223         43.1         5.3     2.6       
Mountain Bread                       72           3               1        1.1

BarleyMax                               100          10.6         0       10.4

Soji Wholemeal                        87          16.1         0.6     1.8
Wattle Valley Grain                 129        19.7          1.8      3.6

Why what you eat is important when you are trying to get pregnant

Each week, on average I would see at least two women at my private clinic who have been referred by a leading endocrinologist for help with their diet while they try and maximize their chances of getting pregnant. Some of these women are overweight or obese; others have PCOS or insulin resistance and a high proportion of them of spending significant amounts of money on various fertility treatments to improve their chances of getting pregnant. One of the things I tell these women very early on in our interaction is that in my experience, weight loss, even a relatively small loss, seems to increase fertility significantly. Now admittedly, this is based on my clinical experience only, but over the past 12 years I could tell you of numerous women who have lost a few kg using a classic reduced carbohydrate dietary regime, who then find themselves pregnant within a few months.

 And now, we have some research available that supports this observation. Research released just this week at the American College of Obstetricians and Gynecologists Annual Clinical Meeting reported that patients undergoing IVF treatments who consumed a moderate carbohydrate, increased protein meal plan had higher pregnancy rates than those with a lower protein intake.

There are numerous explanations for this observation – a higher protein diet is likely to support egg quality, while a reduced carbohydrate intake may help to reduce levels of the growth hormone insulin, high levels of which can promote inflammation the body. A higher protein diet or any diet that is being carefully controlled with a focus on fresh foods is also likely to boost total nutrient intake and in turn improve health and fertility in general.

Now while these results are preliminary in nature and more in depth studies do need to be completed to support this dietary approach universally, for me it makes sense that much more attention should be paid to pre, post and total pregnancy nutrition in general. We know that mothers who do not gain excessive amounts of weight are much more likely to have an easier birth, find it much easier to return to their pre pregnancy weight and also have a healthier baby. For this reason, it makes sense that good nutrition and weight control be the focus right from the beginning, to not only enhance our chances of getting pregnant but for doing it in the most health way possible.

So if you, or someone close to you is going through the intense process of IVF, let them know that their diet may be one important variable also worth considering. Indeed, for a number of issues relating to infertility, changing your diet is certainly a much cheaper option.

 

Enjoy Easter without weight gain

Avoiding the Easter weight trap

 

The Easter buns and chocolate eggs have been visible since January and with Easter just a week away, the lure of sweet treats may be becoming just too hard to bear. If though, you are hoping to survive the long holiday weekend without gaining a couple of kg to match, you do need to take control immediately.

 

First of all, try, try, try to not indulge until it is actually Easter which means that that bag of tiny eggs you have in your desk drawer needs to go into the rubbish, right now! Considering that a that a single, small milk chocolate bunny has the equivalent number of calories that it would take an hour of treadmill running to burn off, the little bunny may suddenly seem far less attractive.

 

Unfortunately those little eggs are not much better either with just three mini Easter eggs containing more than 500kJ and let’s be honest, who can stop at three? Generally speaking, once we open a packet, we eat the packet. The same can be said for Easter buns – a traditional small Easter bun contains just 600kJ compared to the mega chocolate chip varieties that now inundate our stores which contain more than 1000kJ, and that is without the butter. More importantly, trying to hold off these tempting treats until Good Friday is an even better idea.

 

Where possible, look for portion controlled treats – small individual eggs rather than an entire bag of minis and a packet of buns to share rather than just to keep at home. Remember when it comes to food, especially sweet foods, if they are there you will want to eat them so the fewer Easter treats you keep at home, the better. Finally but perhaps more importantly, go for quality over quantity. Enjoy a social Easter feast with plenty of good food and a small amount of good quality chocolate, and use the extra holiday days to embrace your training program to make sure that you survive Easter without a couple of extra kg to boot.

 

Still looking for chocolate? Once you translate your Easter calories into workout unit the treats may no longer seem so appealing.

 

Eggs Selection                                     kJ                                           Fat                          Exercise units

200g Easter Bunny                             3740kJ                                   50g fat                   2 hrs of running

2 Caramello Eggs                                500kJ                                     6 g fat                    15 min rowing

1  Crème Egg                                        718kJ                                     6g fat                     45 min fast walking

100g Deluex  Bunny                           2270J                                     33g fat                   2 cycle classes

3 mini eggs                                            560kJ                                     7.5g fat                  15 min skipping

Small hot cross bun (no butter)         600kJ                                     2 g fat                    30min swimming

Large hot cross bun with butter        1200kJ                                   10g fat                   30 minutes jogging

Choc chip hot cross bun                     1100kJ                                   9g fat                     1 Zumba class

Getting the school lunchbox right nutritionally

The start of another school year signals a reminder to mums of the need to get back into grind of preparing a tasty, appealing and nutritious school lunch, five days a week for hungry, growing children. Unfortunately, despite the very best intentions, all too often sandwiches and fresh fruit are returned squashed in the bottom of school bags leaving parents in despair and children potentially not getting all of the nutrition they require.

Primary school aged children eat up to a 1/3 of their daily kilo joule requirements while they are at school, so it is worth making sure that you get the balance right. Unfortunately research available suggests that we still have a little way to go when it comes to getting the lunchbox food balance right. Data collected on the lunchbox contents of over fifteen hundred primary school aged children in Victoria found that on average children had three packaged snack foods such as potato chips and muesli bars in their lunchbox each day. Furthermore, researchers recently found that after looking into the lunchboxes of 170 lunchboxes of first grade children that 72 per cent of students had no vegetables or salad in their lunch box, 24 per cent had less than one serve of fruit and only 34 per cent had one or more pieces of fruit packed in their schoolbag.This research also found that up to 77 per cent of students had one or more snack foods such as chocolate, chips or cake. And 48 per cent had their total recommended daily amount of junk food - one to two small serves a day - just in their lunch box.

Packaged snacks such as cheese and dip snack packs, muesli bars, fruit twists and straps, potato chips and biscuit dippers are often full of fat and highly processed carbohydrates but tend to offer little in the way of nutrition. Too many of these snacks can mean that children are receiving many empty kilojoules without the amounts of calcium, fibre, iron and protein that they need for optimal growth and development.

What is good lunchbox nutrition?

A nutritionally balanced lunchbox can be divided into four core sections: low glycaemic index carbohydrates for energy, proteins for nutrition and fullness, fruit for fibre and vitamins and a snack food that has some nutritional benefit. Most importantly, busy children need plenty of water for optimal hydration, particularly in the warmer months when small children are at high risk of dehydration.

Wholegrain carbohydrates for energy:

Forget the idea of plain soggy bread - the vast variety of wrap and flat breads, grain bread rolls, thick crusty bread, crackers and high fibre loaves available means that a traditional sandwich can remain fresh and tasty until lunchtime. Always aim for either wholegrain varieties of bread or if you have a white bread fan, try the wrap or Mountain style breads that kids love. Something to keep in mind if you have children who constantly reject grain varieties of bread is that recent research has shown that if a range of breads with high grain contents are gradually introduce into lunchboxes, the kids do not even notice – so the secret is to not tell them or ask them what they want! Protein rich sandwich fillings include tuna, lean ham, chicken or turkey or hard boiled eggs are ideal as they provide a range of vital nutrients including iron. Protein based fillings also help to slow the rate in which sandwiches are digested, supporting optimal concentration and energy for the entire school day.

TIP: Remember, children often prefer simple sandwich filling to more elaborate concoctions so try not to be offended if they reject your mix of lamb, hummus and roasted vegetables instead asking for plain ham or a simple spread OR

Try mixing bread types for sandwiches with one slice of high fibre white and one slice of grain

In sandwich negotiations with children, try offering their choice once each week and maintaining a mix of salad and protein on the other school days

Fruit:

Fresh fruit is always preferable to dried, fruit sticks or juice as it contains fewer kilojoules, more fibre and teaches children the importance of eating fresh food.

TIP

If you are worried about it getting bruised, stick to hard fruits such as apples or nectarines or pack a small container filled with berries, grapes or melon pieces. If you find that no matter what the fruit always comes home, try cutting it up and serving with low fat ice-cream or yogurt after school.

Protein food

Protein is the nutrient that tends to be missed in school lunchboxes and is often replaced with extra fruit, juice or more snacks.  Protein rich foods including low fat dairy provides calcium and a number of other key nutrients including magnesium and phosphorous which all growing children need daily. Recent research commission by dairy Australia found that up to 84% of school aged children were not consuming the recommended number of dairy serves each day  and hence school lunchboxes offer a perfect opportunity to boost up these nutrients in their kids diets.  Great protein rich lunchbox fillers include cheese sticks, yogurt tubes; milk protein based snacks bars and flavoured milk poppers are popular with children and are also low GI, which helps to keep kids fuller for longer after eating them.

TIP: If you are worried about food safety and using meats on sandwiches, try freezing the sandwich the night before or keep a small popper of frozen water in the lunchbox to keep the food cool. Alternatively check out the cooler style lunchboxes, which are popular during the summer months.

Nutritious Snack

Busy, growing bodies do need energy but they need good quality energy and many processed snack and muesli bars available do not contain a lot of nutrition for many kilojoules. While children do not necessarily need packaged snack foods, not providing them may see them start to swap their lunchbox contents for other, more appealing options and hence providing a limited amount of snack food may prevent the swapping issue so, aim to provide just one packaged muesli or snack bar in your child’s lunchbox each day and try and choose options that have < 100 calories. Wholegrain and dairy based snack bars are more nutritious options.

TIP: Snack Food Checklist

<100 cal="" nbsp="" o:p="" per="" serve="">

Protein – 3-5g per bar

Total carbohydrate - <20g bar="" o:p="" per="">

Contain wholegrains, are low GI or have calcium

Fluid

Water should always be the drink of choice for children. Fruit juice, soft drinks, sports drinks and cordials are high in sugar and are not appropriate everyday drinks for children. In fact, a recent review has suggested that children drink no more than two sweetened drinks each week, which includes fruit juice, to help prevent childhood obesity.

TIP: Freeze water bottles to help keep the rest of the lunchbox cool during the warmer months. Children will also be more likely to drink water when it is cold.

My son loves going to the canteen, how often should I let him have canteen options for his lunch?

Many schoolchildren love the canteen as the food is fresh and it offer an interesting change from their day to day lunchboxes. If you pack a healthy lunchbox most days, once each week or fortnight is a reasonable number of canteen visits and try and encourage your child to make good choices like what? and avoid fatty pies, chips and cheesy pastas and pizza pockets.

What about treats?

If you pack too boring a lunchbox you run the risk of your child swapping their food with other children, and if you pack too many treats, it means there is less chance your child will eat the good stuff. There is nothing wrong with including a small treat such as a small packet of chips or fun size chocolate in the lunchbox occasionally, but limit it to just once each week and keep portions small.

 

Sandwich	Fruit/Vegetable	Protein	Snack
Ham and Cheese wrap	Frozen grapes	Aktavite Milk	Packet of Vita Weat Grain Snacks
Baker’s Delight Low GI Turkey and Light Cheese cheese sandwich	Banana	100g tub Ski D’Lite yoghurt – frozen OR Streets Paddle Pop MOO	Uncle Toby’s Low GI Muesli Bar
6 Vita Weats + Vegemite	2 small peaches	Bega Cheese Stringa	Tasti Rice Bubble Bar
Egg, lettuce and mayo wrap	Apple	Munchables Light Cheese and Cracker Snack Pack	Hip Hop Bar
Small whole meal roll with cheese and vegemite	Packet of Mini sultanas	Big M popper	Packet of popcorn
John West Tuna To Go	Cut up melon	Tub of Vaalia Yoghurt	Packet of Vege chips
Chicken sandwich on grain	Tub of Goulburn Valley Fruit	KRAFT Dairybites Cheesy Pops	2 homemade mini muffins
4 corn thins + spread	Cut up carrots/celery	Mini Babybel Light	Pitos Premium Pita Chips
Pita Pocket	10 dried apricots	Munch Bunch Yoghurt Tub	Tasti Milkies Bar

 

Please do not overcarb your kids lunches this year

With just a week or two until school returns, many mums are counting down the hours until life becomes relatively sane again, well, at least between the hours of 9-3pm anyway. With the start of a new school year also come the annual school lunchbox recommendations, in which committed, organised mums are thought to spend hours preparing marinated chicken drumsticks, mini frittatas and muffins for their brood in the hope that their lunchbox ticks all nutritional standards.

As a nutritionist who has spent more than 10 years working with overweight children and teens I have one request for all the mums out their this school year, please do not overcarb your kids school lunchbox!

The average lunchbox which contains fruit, muesli bars, plain white bread sandwiches and fruit juice is more than 60% carbohydrate. Now while growing, active kids do need plenty of energy, energy in the form of processed, high sugar carbs such as fruit snacks, juices, snack bars and biscuits are digested quickly, result in a high release of the hormone insulin and leave kids prone to overeating and weight gain long term. A study completed several years back with Melbourne school children found that on average the kids lunchboxes contained 3 packaged snacks – bars, bites, twists and dips which offer little nutritionally except empty calories. Based on this alone it is not surprising that so many of our children have significant weight issues.

It is this very reason that children return home at 3-4pm each day absolutely ravenous, simply as their digestive hormones are far less likely to be keeping them full and satisfied if their food intake has been largely carbohydrate in nature for the entire day. Overeating after school then leaves young children less likely to eat their dinner, a dinner of meat and vegetables that they need to get all of their essential nutrients and leaves their overall nutritional intake less than ideal.

To shift this dietary pattern, all you need to do is focus on adding protein rich choices to your child’s lunchbox mix. Always choose wholegrain bread or wraps (remember, if you keep buying white bread, they will keep wanting it), and fill with protein rich choices such as lean meat, tuna, cheese or egg. If you are worried about the temperature of the lunchbox, simply freeze a popper or water bottle and sit next to the sandwich to keep it cool. Add just 1 piece of fruit and always one vegetable, one dairy based snack such as flavoured milk, cheese and crackers, a frozen yoghurt tube or tub or some roasted chic nuts or broad beans. If you do choose to then also add a snack food – a mini muffin, small wholegrain bar or potato chips, at least the rest of the lunchbox is nutritionally balanced.