Ask the Expert: All the Answers

 

Today we inaugurate a new resource: Ask the Expert

A big thank you to our Facebook followers for a fantastic response; although identities have remained confidential for the purpose of the article, all questions have been addressed and you can view the public questions on our Facebook pages. And with such an excellent selection, we have provided our ever-popular Ian Thomas BSc RD, the honour and challenge of providing all the answers!

I’m certain many of the issues raised will resonate with our wider readership. Do please feel free to contact us for further dialogue.

Peter Allen

CEO

peter@notjustr.com

 

Ask the Expert Q&A

 

Q1.

I find nutrition advice quite confusing. The Body Coach says you can eat what you want as long as you workout. But I run and attend Bootcamp where I’ve been put on 1250 cals. I’m female, weigh 9 stone 6 and I’m 5ft 6.5ins. I also have to have at least 80g of protein per day, as I want to be lean.

My question is not just for weight it’s for health.

Should we be avoiding things like ham?

Should we avoid white bread and white pasta or are these foods okay in moderation?

Can we treat ourselves without feeling guilty?

This nutrition stuff is hard to get your head around and I don’t want to become obsessed. Thank you.

This is a great question. You are absolutely right; the nutrition world is confusing! There are many competing opinions and methods of achieving the same outcomes, so you must find a way that works for you.

On the surface, much of the advice we hear seems contradictory, however, from a weight and health perspective there are definitely some recurring themes:

  • Eat lots of vegetables and moderate amounts of fruit, trying to get plenty of variety.
  • Make sure you are getting plenty of fibre from whole grains, pulses and vegetables.
  • For weight management and to prevent muscle loss eat 1-1.5g protein/kg body weight.
  • Limit the amount of processed food you eat and choose natural options if available.
  • Don’t eat to the point of ‘fullness’ eat until you are no longer hungry.

Most dietary approaches will encompass most if not all of the above points, but you don’t need to be 100% rigid. Follow these ideas 80% of the time and the other 20% you can afford to be more relaxed. In my opinion, your choice of food should never leave you feeling guilty and it’s absolutely fine to eat food for the pleasure of it, just try and make it part of an overall balanced diet. This is where the Just Routine App would be perfect for helping you focus on overall diet quality and balance, not just fixating on the numbers.

Weight loss & health improvement are not sprints, they are long term pursuits, so if you don’t see an approach as being sustainable it’s probably not the right one for you.

Q2.

Is this still true that breakfast is the most important meal of the day?

I have heard someone arguing that this is a myth made by food producers and it is actually good for you to skip it, as fasting is good for you.

Despite this being repeated for years the research has never supported a claim that breakfast is the most important meal of the day for everybody.

There are certain groups of people i.e. young children, those looking to gain weight and people who have difficulty regulating their blood sugars, that will probably benefit from having breakfast, but for everyone else it is a matter of personal preference.

Ask yourself these questions:

Is my breakfast choice high fibre and a good source of protein to keep me satisfied?

If I eat breakfast am I less likely to eat something processed and sugary during the morning?

Am I safer and more pleasant to be around if I eat breakfast?

Do I feel more focused in the morning if I eat breakfast?

If you answered yes to most of these questions then breakfast is probably a good idea, if not, then experiment with not eating breakfast and see if extending your morning fast works better for you.

Check out this article at examine.com for a good breakdown of the research.

Q3.

Hi Ian, why do some nurses think bananas are not a great option for breakfast for an insulin dependent diabetic?

Bananas are mostly sugar, which if eaten by themselves can increase the demand for insulin and will probably result in an energy low shortly after you have eaten one.

Overcome this by eating a banana with something protein rich, Greek yogurt for example, or high fibre such as seeds or nuts. Both protein and fibre slow down how quickly we process carbohydrates resulting in much more stable energy levels and lower demand for insulin.

Q4.

I’ve heard about intermediate fasting, but am nervous about feeling hungry; does it really work for weight loss?

Intermittent fasting does work for some people and it’s hard to say whether this is because:

  • people end up eating less over all
  • people are more compliant, as it fits their lifestyle better
  • or there is something beneficial about fasting itself

Bottom line, it works well for some people, but not necessarily for everybody!

You raise a really interesting point about being nervous about feeling hungry. I think a lot of people can relate to this. Hunger is an uncomfortable sensation, especially if there are emotional ties to it.

If you want to see whether fasting might work for you, why not approach it with a curious mind set and set yourself small initial goals – for example delaying your normal eating by 5 minutes. Then focus on how this makes you feel. It may be that it doesn’t feel as bad as you were expecting and over time you can extend this fast if you wish.

Q5.

I wonder if Ian could shed some light on the difference between a Paleo diet and a Keto diet.

Are they the same? Which is better, if at all?

Both diets are open to interpretation, but the following broad definitions can be applied:

Paleo diet: Eating in a way which mimics our Palaeolithic ancestors.

Keto diet: A way of eating designed to encourage the body to produce ketones as a fuel source.

A Paleo diet excludes dairy, grains, refined sugar and pulses based on the idea our ancestors would not have had easy access to them. The problem with the paleo diet is that no one is certain what our ancestors would have eaten, but we do know that different populations around the globe adapted to survive on very different diets, so there is no single way they would have eaten.

On a Keto diet, carbohydrate and to an extent protein intake, is kept low to encourage the body to break down fat into ketones which can be burnt for energy.

From a weight loss perspective neither ways of eating have been shown to be significantly better than a calorie-controlled diet over the long term, however the ketogenic diet may attenuate symptoms in those who struggle with epilepsy.

Proponents of both diets will say that their way of eating can help improve energy and focus, reduce gastrointestinal symptoms and decrease the risk of developing long term conditions. However, the research in these fields is still rather new and it is not possible to say, beyond small studies and anecdotal evidence, whether these points are valid.

What these diets have in common though is:

  1. the removal of highly processed foods, which people otherwise are likely to over consume
  2. the promotion of a greater variety of plant-based foods, which has been shown time and again to improve health markers

There is no proven long-term benefit to either form of eating and although eating paleo can often lead to adopting keto and vice versa, they are different and separate diets.

Q6.

I have now finished breast feeding with my second child. I move a lot having 2 kids under 3 but can’t shed the baby fat.

What would you advise is the best way to help me shed some weight?

I still need my energy to chase the little ones.

Whilst there may be some hormonal changes in the body after you have given birth, weight loss still comes down to consuming fewer calories than you are burning. Now chasing after 2 youngsters is going to keep you on your feet, but it can also leave you with little time for yourself.

So, the first thing I would recommend is starting a log of what you are eating, including all the ‘little extras’. The Just Routine app would be perfect for this. This may bring light what you are eating, whether you are eating more than you think, or that you are too busy chasing after the little ones to sit down and actually eat and enjoy a meal.

Once you have identified what you are eating there are two habits I would work on:

  1. Eating slowly and with focus
  2. Eating to only 80% full.

This article will provide more detail – Master habits for sustained weight loss

Q7.

I have lost a few kilos, but now my weight seems to be stuck. How can I budge some more?

Whilst it is tempting to try and keep cutting back on calories there is only so far you can take this before your body will fight back. Unfortunately, we are designed to hold on to energy more efficiently than we are to lose it!

Rather than just losing weight it’s a better strategy to try and increase your lean tissue, or muscle mass, whilst decreasing your body fat. This can be achieved by taking part in regular resistance training and eating a varied diet of whole foods. By exercising rather than cutting calories further you can keep your body working efficiently and be better able to process the energy coming in.

After only a couple of weeks you will notice that your body shape starts to change. This isn’t always reflected on the scales, so start using other ways of tracking progress such as recording waist circumference and measuring strength improvements.

Q8.

How do I keep off weight I have lost?

Losing weight is hard so congratulations, but arguably keeping weight off is the bigger challenge.

Remember that even when you lose weight your body will still be craving the same number of calories it had before; developing new eating habits and behaviours will make sticking to your new weight easier. Basing your meals around protein and fibre rich foods will help satisfy you providing more food bulk without being calorie dense.

Rather than just cutting back calories increasing exercise and activity can be a more sustainable approach to maintenance. If you add in half an hour of activity each day, even in the form of walking, this can help balance the energy equation.

Another skill to master is that of intuitive eating and only eating to 80% full. I have already mentioned this in answer to Q6, but so many of us allow external cues to dictate what we eat i.e. the size of our plate, not wanting to waste food etc. If you are eating to the point of fullness, then chances are you will regain weight.

Try and identify the difference between being hungry, feeling satisfied and fullness.

Q9.

How can I avoid snacking in the office when people keep bringing in sweet treats?

Office culture can be a real challenge for people trying to change their eating behaviours. It took some trial and error, but the way I managed to overcome this when I worked in an office was to follow these steps:

  1. Understand and recognise that people are going to keep bringing in sweet treats; this will never change!
  2. Give yourself full permission to eat whatever you want…but only if you think it will really satisfy you. This helps overcome ‘fear of missing out’ and the ‘scarcity’ mentality which dieting often brings.
  3. If you decide you want a sweet treat, then it’s absolutely fine to go for it, but try and find a space and time when you can eat is slowly and really enjoy it. You may discover it proves not to be as tasty or as satisfying as you thought it would be.
  4. Realise that it’s not rude to say no!

These rules aren’t bullet proof, but over time you will be able to sit in an office full of cake and biscuits feeling at ease and in control, knowing that ultimately you can decide what is best for you.

Q10.

How do I break my “food as a reward” cycle?

Congratulations – recognising you use food as a reward in the first place is a great first step.

Using food as a reward is a habit loop which may have been engrained for a long period of time. All habits follow the same pattern – Trigger – Behaviour – Reward

In the case of the reward being food, it is likely that you are responding to an uncomfortable emotion and proceed to eat food which soothes this emotion.

Your trigger is the emotion, the behaviour is to eat, the reward is to feel better.

To break the cycle, first try and identify your trigger. This may be stress, anxiety, loneliness or even a positive emotion such as relief or joy. Once you know the trigger you can take steps such as mindfulness, body scans* and/or exercise to reduce its intensity.

Secondly, you can adapt your behaviour in response to the trigger. The key here is to choose a new behaviour which will provide a similar reward, but different enough that it doesn’t feel like the same old habit.

This could be:

  • Going for a coffee with a friend rather than reaching for food.
  • Choosing a treat less ‘moreish’ than the one you currently choose.
  • Eating in a different environment i.e. if you would normally eat in your bedroom, then sit at the kitchen table instead.

James Clear does some great articles on understanding habits and how to change them.

*For anyone unfamiliar with body scans, this is a mindfulness/meditation technique where you bring awareness to different parts of the body, progressing usually from the toes up or vice versa. It can help people identify any sources of discomfort or anxiety.

Q11.

Hi, what is the recommended food for people with fever?

Research regarding the most effective food to fight a fever is quite sparse, but subject to the medical particulars and individual requirements, nutritionally, homemade chicken soup, garlic, green tea and honey can all help speed recovery from sickness.

If you have a fever, consult a doctor.

Q12.

I’m intolerant to egg, but I think I have a problem with bread as well. Every time I eat bread I feel really tired. I’ve just been diagnosed with sleep apnea and feel exhausted all the time. I have started walking and trying to do my 10,000 steps a day. Any advice?

Trying to operate whilst constantly tired is a challenging and frustrating thing.

If you feel that bread really is an issue for you the best thing is a short term (4 week) elimination diet to see if this improves your symptoms. If it does, then you can follow this up with a re-introduction phase to see if the symptoms return. If they do, then you can be reasonably certain the bread is the cause of the issues.

Weight loss and lifestyle changes are shown to improve obstructive sleep apnea (OSA) however there is no diet which has been shown to be more beneficial than any other: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5559698/

It’s great that you are working on your 10,000 steps a day and this will really help with improving any weight loss efforts and also help improve respiratory function.

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