What does a consensus statement from expert nutritionists tell us to eat?

Life has been busy with lots of clinics, fun, sleep (my children are finally sleeping through the night!) and trying (been saying this for years but nearly there) to finish my new website. Hope you’re all well too 🙂

In the meantime, I read a very interesting article about a non profit organisation called Oldways, which convened a two day conference bringing together 21 top nutrition scientists with the aim  of defining what exactly is healthy eating.

Apparently (and obviously) there were some heated debates and exchanges; Paleo versus Mediterranean versus low fat and so on. And lots of science to back each school of thought up. However, the whole aim was to show the world that a consensus of nutrition advice can be reached – and that’s exciting in itself.

An 11 point consensus statement was released (link below). Guidelines reached were not surprising, but nevertheless very welcome.

Everyone agreed that a healthy diet should be high in vegetables, fruits, wholegrains, low or non fat dairy, seafood, legumes and nuts. Add moderate alcohol consumption and decrease red and processed meats with sugary and refined grain foods being minimised.

The authors also touched upon the role of media in causing much dietary confusion to the public – and how this needs to stop. One study does not a guideline make.

What I find really beautiful about the consensus is how the vital interaction between human health and planetary health was emphasised: focusing on sustainability and the carbon footprint of your diet is fundamental. Here’s a website which can tell you more about your choices: http://www.eatlowcarbon.org/diet-tips/

Link  to consensus: here: http://oldwayspt.org/sites/default/files/files/OW_CommonGround_Nov19.pdf

And yes, the bottom line again – eat real food, not processed and mostly plant based.

 

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Processed meat, cancer and….so what? This is not news!

The media has been overflowing with the news that the International Agency for Research on Cancer has declared processed meat as carcinogenic. Many conscientious people are mourning their bacon while others are making rebellious statements about how they will continue to eat it because their 96 year old grandma who smokes 20 a day still does. Go on then – yawn.

This really isn’t news, though I am glad if the declaration does bring some more purity back to the diet of many people: that would be a wonderful outcome for everyone (including the poor farmed animals, and our suffering planet). It is indeed important to be mindful of the amount of processed meat in your diet – aim for none if you can. Anything close to none would be great if coupled with an outstandingly healthy diet to wash it through (high natural fibre – thick oats, legumes, leafy veg and berries, to name a few).

By the way, examples of processed meat include salami, hot dogs, bacon, sausages, luncheon meats/cold cuts and so on….

The bottom line remains the same: we have had overwhelming research for a very long time which shows that diets which are predominantly plant based are associated with lower rates of chronic disease, including cancer. In addition to the research, we have real world observational studies which show the same thing. We know how to improve our diets to an excellent settling point – avoiding processed anything! Don’t go swapping that processed meat for fake, processed, tofu bacon – yucky and likely unhelpful. Don’t start eating cereal (more refined carbs) instead of cold cut processed chicken – not helpful.

DO:

  • Roast a whole organic chicken or piece of organic beef and use it for meals and cold slices for sandwiches (this can work out as more economical too).
  • Use cold, precooked oily fish in sandwiches or salads instead (mackerel or salmon are delicious).
  • Legume based dips make a fantastic, protein rich sandwich filler – hummus is now available everywhere, and making your own dips from mashed beans and/or lentils is so easy and yummy.
  • Don’t forget about nut butters – so yummy and versatile. Try peanut butter and banana together.
  • And don’t neglect eggs – so reliable, versatile and cheap – remember to get organic ones if possible.

Every meal should be accompanied by a lovely mountain of vegetables – rotate through different types ensuring a large pile of dark, leafy greens at least once a day.

You really won’t look back once you start trying the fillings I’ve listed above: yummy, so healthy and colourful too – the way food is supposed to look.

The announcement about processed meat is just another nail in the coffin of processed food in general: eat real food, mostly plant based – see how different you feel. If you don’t know how to go about it, come and see me!

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Patient testimonial: irritable bowel syndrome and fatigue

Thank you to my wonderful patient for this testimonial – it only took three sessions to get here. This patient was nervous to leave the house because of such unpredictable, unpleasant bowel symptoms, nervous to eat and had debilitating fatigue. Seeing the renewed energy, zest for life and joy is the most rewarding thing for me 🙂 Keep eating well!

‘I can honestly say that going to see Dalia has changed my health for the better – It has given me my life back.
From not being able to get through the morning without having to have a sleep, I now have energy levels that enable me to stay awake all day and live the life I had been missing out on for years’
You don’t need to suffer. Even if the doctor says you are fine, if YOU don’t feel right, let’s fix it 🙂
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Calcium intake and bone density: not really connected

You just have to sit in clinic with me (especially NHS ones) to see, on an anecdotal level, that dietary calcium intake (particularly of dairy foods) does not lead to super strong bones at all. Just this week I saw a number of women in their fifties and sixties with shocking osteoporosis and arthritis, all of whom consumed at least two pints of milk per day for decades. A major study just released backs this up: the connection between calcium intake and bone density ( or risk of fracture) is tiny, if existent at all.

For anyone who ever bothered to do independent research, it was always clear that the connection between calcium and bone density was way more complex then simply meeting your recommended daily allowance of calcium. I wrote about it on this post a while back: http://dalianutrition.com/2014/09/14/dumbing-down-the-building-of-strong-bones/.

I do hope this study will settle the minds of people who are scared to lower their dairy intake for fear of becoming predisposed to osteoporosis: your bones are a symphony of living tissues; my post linked above will help to guide you in what you need to do to take care of your bones – drinking gallons of milk is not one of them, nor is being obsessed about calcium intake.

This study is a happy day for practitioners like me; dietitians who have stepped away from the classic ‘three portions of dairy a day’ healthy eating advice spoonfed to us under the likely influence of industry: Being evidence based is important to me, as well as common sense based – humans were not put on earth, only capable of living a healthy life, if they consume the milk of another mammal.

Eat yer greens! Here’s an article about the paper: http://well.blogs.nytimes.com/2015/10/05/study-reviews-find-calcium-doesnt-improve-bone-density/

Whoopeee!!!

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Testimonial about Dalia

I’ve been collecting testimonials (have failed to do it for too many years!) from my clients for my new website (which should hopefully be completed in the next few months…too busy with life to get to it!) and thought it would be lovely to share some testimonials here from time to time. It is a privilege to help people step onto a better path for their health. I say it again and again; the thrill and joy never fades for me. Thank you so much to precious L.C. for this testimonial which made me cry.

‘Dalia’s ongoing, unfailing support, guidance, knowledge and compassion is extraordinary and invaluable. I count on her in difficult times, and she is always there. Her advice extends widely around and beyond the plural topics concerning food and nutrition, towards every perspective that reaches around life itself. This is not an exaggeration: Dalia has helped me in my (ongoing) recovery from an eating disorder (and other disorders. Let’s say ‘disorder’ as a very complex problematic), by planning goals to improve my health and wellbeing, and helping me encounter and achieve each (mammoth or tiny, equally challenging) step of the way. Every fortunate person who meets Dalia will feel enhanced and enriched by the help that she will always provide.’

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It-must-be-a-bit-healthy, flourless, chocolate banana cake

I made a rather good cake which I believe should be quite nutrient dense: a good step up on a conventional cake in any case. Almost suitable for Paleos, completely suitable for gluten free people and a good choice for diabetics. Here you go 🙂

Flourless Chocolate Banana Cake a la Dalia

Ingredients:

4 very ripe mashed bananas

4 eggs

1/2 cup of nut butter (I used natural peanut butter)

4 tablespoons of extra virgin olive oil

1/2 cup of ground almonds

1 teaspoon of baking soda

1 teaspoon of baking powder

1 teaspoon of natural vanilla extract

2 tablespoons of dark chocolate chips

2 tablespoons of cocoa

1/4 cup of natural maple syrup

Method:

  • Preheat oven to 170 C.
  • Mix the wet ingredients together (bananas, nut butter, oil, maple syrup, vanilla extract and eggs). Mix till smooth.
  • Mix dry ingredients together (ground almonds, cocoa, baking soda and powder). Mix well.
  • Add dry ingredients to wet ingredients. Mix well.
  • Stir in chocolate chips.
  • Add mixture to already oiled pan.
  • Bake till a thingy stuck in the middle comes out clean.

Did I say mix well? 🙂

Enjoy! Happy week ahead everyone!

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If you’re thirsty, you need water: End collaborations between dietetics and Big ‘Food’. Please!

Growl…today I read that the Academy of Nutrition and Dietetics (the American version of the British Dietetic Association – I am registered with both) has received $1.7 million in Coca Cola funding since 2010 (the partnership is supposed to end soon; word on the street is that it was Coca Cola which pulled out. Makes it almost worse. The bottom line is also that even if it is not Coke, Pepsico and other such companies will step in – same problem).

Full article here: http://well.blogs.nytimes.com/2015/09/28/coke-spends-lavishly-on-pediatricians-and-dietitians/?_r=0

And here’sssss Rhona from Coke:

‘We are proud to support the Academy of Nutrition and Dietetics, one of the country’s leading authorities in health and nutrition education. Our support of the Academy is central to our efforts to continually provide consumers with innovative options that meet their hydration needs and ever-changing tastes and information that allows them to make informed decisions about their personal well-being. Like the Academy, The Coca-Cola Company Beverage Institute for Health & Wellness understands that a healthy lifestyle involves balancing many different elements — staying physically active, consuming a balanced diet, getting enough rest — and even keeping a positive attitude.” — Rhona Applebaum, PhD, Vice President, Chief Scientific & Regulatory Officer, The Coca-Cola Company

Ahem.

Innovative options to meet hydration needs‘ – Well…we’re mammals, so water and herbal teas will do just fine thank you.

Ever changing tastes’ – Nope. Mammals are still drinking water. Planet Earth has still not caught up with these ‘ever changing tastes’ by providing rivers of fast flowing acidic soft drinks. Stupid nature. Thank God for Coke!

Informed decisions about their personal well-being‘ – An informed decision about personal well-being would be to avoid your products like the plague Rhona darling.

‘Even keeping a positive attitude‘ – Impossible to keep a positive attitude with a blood sugar spike and crash induced by one of your ‘beverages’. Or after suffering that nondescript, immeasurable-by-science-but-definitely-there blah feeling we get after putting something unnatural into our body. Thanks for telling me the bit about a balanced diet though Rhona, none of us knew that – thank God Coke is there to enlighten us!

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In case you weren’t aware, Coca Cola actually has a Beverage Institute for Health and Wellness. Global in scope, they say. Gosh, they are so ON it, so forward thinking! Here’s a link: http://www.beverageinstitute.org/

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I’ll stop with the sarcasm. This sickens me to the core. If you haven’t seen Jamie Oliver’s brilliant Sugar Rush documentary, please do. Here’s a link to his wonderful initiative: http://www.jamieoliver.com/sugar-rush/#0qLLREpHII4EgvG2.97

I don’t care how much manipulated science Coca Cola and it’s highly paid, misguided (I’m being kind using that word) dietitians and scientists present – it goes against basic human decency and common sense for Coca Cola to place one foot in the the world of healthcare. Stay in the free market if you wish, but leave us to do our jobs and pass the right message on, which is to avoid Coca Cola’s products if you want a healthy, vital life.

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The British Dietetic Association is not without its own version of this. Over on this lovely green island we have Coke’s Thirst for Knowledge (are you laughing yet at the way they name themselves?? Repeat after me; If you’re thirsty, you need water. If you don’t like water, your palate is out of whack – probably too much processed food – see me for some tips to get it back into balance). It was apparently set up to support the needs of healthcare professionals and our patients (howling with appalled laughter here!). If they’re so supportive, why have I never seen them attend our clinics (to get some real insight into what children and adults are facing with these drinks as a major part of their diet)? Why have they not removed their marketing ploys which interfere with tired parents trying to provide their children with a basic healthy diet? And WHY does the organisation which prides itself on saying ‘trust a dietitian’ have ANY connection with them?

There have been a fair few dietitians on Twitter moaning about Jamie Oliver and celebs getting on the anti sugar bandwagon, and asking (whining) why dietitians have not been approached by the media. Well, why do you think? Stop being so defensive and have a ponder. I don’t hear enough dietitians making appalled noises about these kind of partnerships, apart from the brilliant http://integritydietitians.org/.  You moaning group of RD’s spend more time mocking (ever so annoying) Paleo, quinoa, ‘clean eating’, low carb, high healthy fat and so on (ALL of which are healthier then a diet which contains these beverages!). So of course people are going to go to others with a visible, palpable, passionate interest in food and nutrition, like chefs and holistic health counselors. Why the caution in loudly rejecting Coca Cola fellow RD’s? There is not a chance in hell that Coca Cola and it’s sister products are health giving; why the caution? What I hear from a lot of co dietitians is ‘everything in moderation’. It’s a boring, nondescript thing to say. Stop saying it. That’s what GP’s say before they need to refer to us. And deeply unhelpful in this environment where everyone has an opinion, and some of those opinions downright dangerous, about nutrition. ‘Everything in moderation’ needs to be defined. I suggest something like the following:

That most real food types, unprocessed, can keep us healthy when eaten in moderate amounts; they have a place in the human diet and we are thankfully, highly adaptable beings. In other words, try to eliminate processed food from your diet as much as possible, concentrate on eating from the earth (recognisable foods), mostly plant based food with some high quality unprocessed protein and drink water. If a drink comes in a can and fizzes, it is not part of that moderate diet. Therefore, we strongly recommend that soft drinks are avoided as much as possible. Because we, the RD’s, claim our place at the top of the chain of food advisers and will start actively saying that we want absolutely NO connection with these companies, no matter how helpful they pretend to want to be. And that eating in moderation means eating real food in moderation, not anything which is marketed as food, but is actually a food-like-product which destroys your health with every bite.

Rant over.

Have a wonderful week everybody.

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Adding life to years!

I’ve been having a busy old time. Just under a month ago I left my job in paediatric diabetes and joined the overweight and obesity lifestyle services for Cambridgeshire: it’s very exciting, inspiring and also, sobering. Working in mainstream healthcare, while knowing there is a different way to grow older for most of us (good nutrition, movement etc), is a daily reminder of how good health really is the ultimate gift: cherish your body and its daily miracles.

I see a lot of morbidly obese patients – knees, joints and organs buckling under the pressure of excessive weight, in indescribable pain and on multiple medications. One patient, on a decades long diet of only soft drinks and confectionery (literally), was told by a doctor that her conditions were degenerative and that they would only get worse. She then tried to kill herself in utter agony as to why and how she befell such a fate.

How can such a statement be made to somebody who is not nourishing their body in any way? No vitamins, no minerals, no antioxidants, no protein, no fibre, no high quality carbohydrates, no healthy fats? Of course the body will continue to degenerate with no nutrition. But what of the healing that can occur when the right nutrients and movement is provided? I don’t believe in degenerative disease unless everything has been done to try to utilise the body’s inherent wisdom of its natural healing pathways: proper nutrition, fresh air, sleep. sunshine, laughter, stress management and lots of love. We all will die – but hopefully in peace that our life has been long, productive, mobile and delicious. To coin a phrase I first heard from Dr. David Katz: We want to add life to years, and years to life. 

I watch this healing in my clinics: This week’s happy clinic moments have included a child of six off reflux medication for the first time since he was a month old, a lovely woman in remission from ulcerative colitis and a chronic fatigue patient back to exercise, work and good, vital energy. Do not underestimate the power of good nutrition. I tell my friends that each and every healing experience moves and excites me to my core.

Dr. Terry Wahls is a lady who awes me in how she recovered from severe MS using strong nutritional and lifestyle medicine. Please get a cup of tea and watch this video.

http://www.mindbodygreen.com/0-14451/how-i-went-from-wheelchair-to-walking-by-changing-my-diet-dr-terry-wahls.html

And eat your greens! Happy weekend all 🙂

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Alcohol and health: the honeymoon is over.

The Lancet released a study last week (covering approx. 115,000 people in 12 different countries) which has convincingly shown that drinking alcohol does not result in net health benefits. In fact, alcohol consumption increases the risk of alcohol related cancers by 51%: quite a punch (ouch). I suppose it’s celebratory news for us lightweights, and not so good for those who have a close relationship with their favourite, regular drink (sorry).

It is true that there appear to be some health benefits associated with alcohol consumption: this is especially true for wine drinkers – a wine drinkers risk of cardiovascular (heart) disease is lower than that of a non drinker. But that cannot be said for the cancer risks (38% higher in wine drinkers than non drinkers). Gulp.

The 51% increased risk for alcohol related cancers include mouth, esophageal, stomach, colorectal, liver, breast, ovary and head and neck cancer. Nasty.

In addition to the study above…if we dig a bit deeper and enter the individualised clinical setting, I think many of you will agree that over consumption of alcohol has not led to great success in desired lifestyle changes. The behavioural slippery slope that ensues when a person has had one-too-many includes: eating those foods you didn’t really want to (greasy kebab to further aggravate that grumbling gallbladder?), taking drugs you were trying to stop leading to the munchies (a whole box of muffins gone…), saying mean things to somebody you love and so on.

For those of you who are reading this and thinking, my Lord she is such a wet lettuce – here are some further tips for prevention of lifestyle related cancers for those of you who wish to continue a lot of drinking. Perhaps you can make a difference with masses of vegetables, and continue that bottle of wine 🙂

  1. Do not smoke (even if the wine tells you to!)
  2. Be as lean as possible without being underweight. Do not go by the number on the weighing scale – keep your waist trim and if possible be assessed for body fat percentage and keep that in the lower end of the recommended value for your gender. Women, don’t go below that or you will likely experience menstrual/fertility challenges which bring a whole host of other health risks.
  3. Eat a diet super rich in a variety of colourful vegetables and plant based foods (legumes, natural nuts, seeds, all the colours of the rainbow in vegetable form).
  4. Eat low amounts of animal fats – fill up on unadulterated plant fats e.g. olives, avocados, raw nut butters.
  5. Keep active with at least 30 minutes of physical activity daily (sweat out that hangover :-))
  6. Avoid high glycaemic foods (refined carbohydrates, added ‘free sugars’)
  7. Do not eat processed meats.
  8. Concentrate on a low salt diet – easily done when you’re eating mountains of veg.

Instead of your glass of wine tonight, how about you try some chamomile tea…

JOKE! But seriously, take a look at your lifestyle and see where reducing alcohol may make a massive difference to some of your poorer choices.

Have a lovely week 🙂

For more info on the article: http://www.medscape.com/viewarticle/851459

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Is the tide turning? A nutrition article to cry for…

An outstanding editorial by Dr. Aseem Malhotra, cardiologist, has happily blown me away. It really is worth a read of the full text (linked below), but I thought I’d break down the best parts for you to get an idea of his viewpoint and recommendations. I have a deep respect for the expertise and work ethic of medical doctors – and it is even more wonderful when they are strong promoters of the power of nutrition.

As many of you are aware, I largely refrain from weighing and calorie counting in my clinic. In fact, I may be developing an allergic reaction to the latter. If I have to see one more patient tormenting themselves over the calories in a healthy food I may have to take some nutrition labels and burn them in an act of defiance. Grrrr.

Meanwhile, as the bonfire rages, Dr. Malhotra’s article offers me much comfort.

Some key points:

  • Simple dietary changes can significantly reverse cardiovascular disease and mortality within months. Even if a person has had a poor, disease promoting diet for all of their life. It really is never too late to change. Examples include the introduction of fatty fish, extra virgin olive oil, omega 3 fatty acids, flaxseed and raw nuts to the diet. Our bodies are so very forgiving of us.
  • These positive impacts on the disease process of these major killers are much more significant than the modest help offered by aspirin, statins, coronary stents or the American Heart Association’s low fat diet recommendations.
  • These positive life preserving (not to mention yummy) interventions improve health outcomes irrespective of whether weight was lost or not. This emphasises the importance of not making weight loss the primary goal – weight loss will happen organically if optimal health is the focus of an intervention. A properly nourished person will not become overweight.
  • The weight loss industry has made billions through its messages of calorie restriction over good nutrition. Emphasis must be placed on counting nutrients, not calories. Just do this and watch the magic happen. Think what could be done with the money saved and the happiness and vitality created.
  • The emphasis placed on prescribing pharmaceuticals for heart disease is likely distracting health professionals, and patients, from implementing these important changes which have a far more effective impact. Heart disease and type 2 diabetes do not occur because humans have suddenly developed a deficiency in metformin, statins, insulin or blood pressure medication! It is time for doctors, and dietitians, to read the actual research and wake up and smell the oily fish.

Here’s a link to this wonderful article. I may hug it for quite a while.

It is time to stop counting calories, and time instead to promote dietary changes that substantially and rapidly reduce cardiovascular morbidity and mortality

http://openheart.bmj.com/content/2/1/e000273.full

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