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Studies support 3 glasses of milk daily

Individuals who drink three glasses of milk a day decrease their risk of cardiovascular disease by 18 percent, according to new research published in the American Journal of Clinical Nutrition.Researchers at Wageningen University and Harvard University examined 17 studies from the United States, Europe and Japan and found no link between the consumption of regular or low fat dairy and any increased risk of heart disease, stroke or total mortality. “Milk and dairy are the most nutritious and healthy foods available and loaded with naturally occurring nutrients, such as calcium, potassium and protein, to name a few,” said Cindy Schweitzer, technical director of the Global Dairy Platform. “It's about going back to the basics; maintaining a healthy lifestyle doesn't have to be a scientific equation.”

Schweitzer said during the past three decades as research sought to understand influencers of cardiovascular disease, simplified dietary advice including consuming only low fat dairy products emerged. However, in 2010 alone, a significant amount of new research was published from all over the world, supporting the health benefits of dairy. From dispelling the myth that dairy causes heart disease, to revealing dairy's weight loss-benefits, the following is a roundup of select dairy research conducted in 2010:

  • U.S. researchers examined 21 studies that included data from nearly 350,000 and concluded that dietary intakes of saturated fats are not associated with increases in the risk of either coronary heart disease or cardiovascular disease. The study was published in the American Journal of Clinical Nutrition.
  • A study published in the American Journal of Epidemiology examined 23,366 Swedish men and revealed that intakes of calcium above the recommended daily levels may reduce the risk of mortality from heart disease and cancer by 25 percent.
  • An Australian study published in the European Journal of Clinical Nutrition concluded that overall intake of dairy products was not associated with mortality. The 16-year prospective study of 1,529 Australian adults found that people who ate the most full-fat dairy had a 69-percent lower risk of cardiovascular death than those who ate the least.
  • A Danish study published in Physiology & Behavior concluded that an inadequate calcium intake during an energy restricted weight-loss program may trigger hunger and impair compliance to the diet.
  • An Israeli study published in the American Journal of Clinical Nutrition showed that a higher dairy calcium intake is related to greater diet-induced weight loss. The study sampled more than 300 overweight men and women during two years and found those with the highest dairy calcium intake lost 38-percent more weight than those with the lowest dairy calcium intake.

The amount of dairy recommended per day varies by country and is generally based on nutrition needs and food availability. “In the US and some European countries, three servings of dairy foods are recommended daily, said Dr. Schweitzer.”


Health warning for Dukan Diet

FRANCE'S most popular weight-loss regimes, including the number one Dukan diet, are ineffective and potentially dangerous to people's health, doctors have warned. The Agence Nationale de Sécurité Sanitaire has issued a warning over 14 of the most fashionable diet regimes in France. Researchers at the Institut Pasteur in Lille assessed each regime, including Atkins and Montignac, for its nutritional value and potential side-effects. Head of nutritional research Jean-Michel Lecerf, who led the study, said the diets disrupted the body's natural metabolism and led to serious nutritional imbalances.

In nearly all the diets, the protein content was typically much higher than the recommended daily intake, especially the Dukan diet, which is France's top-seller. Some of the diets contained 10 times less fibre than the recommended level and up to twice as much salt. They also lacked vital vitamins and minerals. The study also pointed to an increased risk of fractures and other bone problems, muscle wastage and cardiovascular problems in some of the regimes.

Dr Lecerf said that in 95 per cent of cases, people who follow a dietary regime regain weight as soon as they finish. In some instances, the weight they regain is greater than the amount lost. He said: “Each regime is less effective than the one before, and the weight gain afterwards is greater each time.” According to the study, about 70 per cent of people in France have followed some sort of weight-loss programme, many without consulting a doctor beforehand.

The Régime Dukan is the most popular diet in France at the moment. Like Atkins, it is high in protein in the initial “attack” phase, but low in fat. Next comes the “cruise” phase, with protein-only days and protein-and-veg days. Potatoes are banned, as are high-calorie vegetables such as peas, carrots and sweetcorn.

More than two million copies of the Dukan book Je ne sais pas maigrir have been sold in France.


Food Advertising Promotes Imbalanced Diets

Researchers analyzed 84 hours of primetime and 12 hours of Saturday morning broadcast television over a 28-day period in 2004. ABC, CBS, Fox and NBC were sampled on a rotating basis to develop a complete profile of each network. The Saturday-morning cartoon segment (from 8:00 am to 11:00 am) was included to capture food advertisements marketed primarily to children.

All 96 hours of observations were videotaped and reviewed later to identify food advertisements and specific food items being promoted. Only food items that were clearly promoted for sale during an advertisement were recorded. Each food item was then analyzed for nutritional content. Observed portion sizes were converted to the number of servings.

The article indicates that the observed food items fail to comply with Food Guide Pyramid recommendations in every food group except grains. The average observed food item contained excessive servings of sugars, fat, and meat and inadequate servings of dairy, fruit and vegetables. The situation was similar for essential nutrients, with the observed foods oversupplying eight nutrients: protein, selenium, sodium, niacin, total fat, saturated fat, thiamin and cholesterol. These same foods undersupplied 12 nutrients: iron, phosphorus, vitamin A, carbohydrates, calcium, vitamin E, magnesium, copper, potassium, pantothenic acid, fiber, and vitamin D.

The authors advocate nutritional warnings for imbalanced foods similar to those mandated on direct-to-consumer drug advertisements. They recommend investigating health promotion strategies that target consumers, the food industry, public media, and regulation focusing on a three-pronged approach.

“First, the public should be informed about the nature and extent of the bias in televised food advertisements. Educational efforts should identify the specific nutrients that tend to be oversupplied and undersupplied in advertised foods and should specify the single food items that surpass an entire day's worth of sugar and fat servings. Second, educational efforts should also provide consumers with skills for distinguishing balanced food selections from imbalanced food selections. For example, interactive websites could be developed that test a participant's ability to identify imbalanced food selections from a list of options. This type of game-based approach would likely appeal to youth and adults. Third, the public should be directed to established nutritional guidelines and other credible resources for making healthful food choices.”


Vitamin D – What you need to know

Some people may be at risk of not getting enough vitamin D because they don’t get enough in their diet or because they have more limited sun exposure which reduces the amount of vitamin D their bodies make. Those at risk include:

  • Breastfed infants require 400 IU vitamin D per day from birth. Because breast milk is naturally low in vitamin D and infants are not usually exposed to the sun, a vitamin D supplement of 400 IU is recommended. Healthy term infants fed infant formula do not require a vitamin D supplement as it is already added to the formula.
  • Pregnant women should consume vitamin D from food (for example, from a least 3 glasses of milk der day) or supplements (usually 200-400 IU is provided in a supplement) to ensure the baby is born with optimal vitamin D in their body. If a supplement is taken, be sure not to exceed 2000 IU vitamin D per day.
  • Adults over 50 years may not prodce vitamin D in skin as well as when they were younger. It is recommended that adults (men and women) over 50 years take a supplement of 400 IU / day.
  • People with skin darkly pigmented with melanin are less able to make vitamin D from exposure to sunlight. Since many people with darker skin colour also avoid vitamin D fortified milk due to lactose intolerance, their dietary intake of the vitamin may be low, so extra vitamin D, such as the amount typically found in a general multivitamin-mineral supplement (200-400 IU) would be a good idea.
  • People with limited sun exposure sun exposure is limited due to mostly living or working indoors, wearing clothing such as long robes and head coverings, then it is wise to carefully choose vitamin D rich foods (see above) or to take a vitamin D supplement, such as the amount typically found in a general multivitamin-mineral supplement (200-400 IU).
  • Some medical conditions such as Crohn's disease, cystic fibrosis, celiac disease, surgical removal of part of the stomach or intestines, and some forms of liver disease, interfere with absorption of vitamin D. Being overweight and obese causes fat to stay stored in fat tissues and not be released into the blood, preventing vitamin D from being available to the body. If you have one of these conditions, check with your doctor to ask if a vitamin D supplement is needed.
  • Can I take too much vitamin D?

    Yes. Too much vitamin D can be harmful. The total daily intake from food and supplements combined should not exceed 1000 IU for infants and young children and 2000 IU for adults.

    The Bottom Line

    Most people, except those in the risk groups noted above, can get enough vitamin D if they eat enough vitamin D rich foods (for example, milk, vitamin D fortified foods and some fatty fish) and if they engage in safe sun practices. If you are concerned about your vitamin D status, discuss the issue with Nastaran.

    Source: Dietitians of Canada. Reproduced with Permission. Note: The Australian adequate intake is 200 IU however Nastaran recommends 400 IU as per the Canadian recommended intake.



Eating Guidelines for Multiple Sclerosis


  • Maintain a healthy weight. If unwanted weight loss or weight gain occurs, contact your doctor or dietitian

Reduced mobility can result in overweight or obesity, because you are using fewer calories. Some medications, like steroids and antidepressants can also cause weight gain.

Being underweight and having poor nutrition can be caused by

– reduced mobility and feeling tired, which can make shopping, cooking and eating difficult

– difficulty getting food or drinks to the mouth

– poor appetite, and

– difficulty swallowing.

If you are having any of these symptoms and they are keeping you from eating, discuss your symptoms with your doctor.

  • When you have MS, it is especially important to get the recommended amounts (the Dietary Reference Intakes, or DRIs) of the following vitamins and minerals. If your doctor has diagnosed that you are deficient in any of these, you may be advised to take more. Do not take amounts higher than what is recommended because this can be harmful.

– Calcium and vitamin D. People with MS have a higher risk of low bone mineral density and breaking bones. This may be due to low vitamin D and calcium in the diet, or other factors such reduced physical activity, such as walking. Good food sources of calcium include dairy products (milk, yogurt and cheese), fortified soy and rice beverages, fortified juices, tofu with added calcium and canned fish with the bones. Good food sources of vitamin D include milk, fortified soy and rice beverages, fortified juices, fatty fish, such as salmon, and eggs. If you do not eat these foods daily, you should discuss adding a daily supplement with your doctor or dietitian. 

– Vitamin B12. Vitamin B12 deficiency is common in people with MS. Low levels of vitamin B12 can cause a type of anemia that can make you feel tired. Good food sources of vitamin B12 are dairy products (milk, yogurt and cheese), eggs, meat, fish, poultry, and fortified soy and rice beverages. It is recommended that people over 50 take a vitamin B12 supplement, because as you get older, you don't absorb the vitamin B12 from food very well. The amount of vitamin B12 in a multivitamin is usually enough.

– Zinc and selenium. Zinc and selenium deficiencies are common in people with MS. Zinc is needed for the growth and repair of body cells. Selenium works as an antioxidant to protect body cells from damage. Good food sources of zinc are meat, seafood, dried beans, peas, and lentils, and whole grains. Good food sources of selenium are Brazil nuts, seafood, fish and shellfish, liver and kidney. If these are foods that you don't eat regularly, you may need a supplement. The amounts in a multivitamin mineral supplement are usually enough.

  • Many people with MS try different herbal or nutritional supplements hoping these will improve their symptoms or prevent MS from getting worse. Ginkgo biloba has been studied in people with MS, and while early studies show some benefit, larger studies need to be done before it can be recommended. Gingko biloba has many side effects and shouldn't be taken by people who have bleeding disorders, who are taking blood thinning medication, or who are planning surgery.

Other supplements, including St. John's wort, ginseng, echinacea and valerian, have not been studied in people with MS, so it is not known if they are effective or safe. Because echinacea can stimulate the immune system, it might make MS symptoms worse.


Source: Dietitians of Canada. Reproduced with Permission.


Diet Advice for Doctors

 Q: What evidence is there that diet can make a difference?

A:  As an Accredited Practising Dietitian the advice I give has to be scientifically based. Recommended dietary allowances are set for a population group and includes sub-sectors like infants, children and the elderly.

Dietary advice is often based on epidemiological research that is carried out by public health scientists. It is this kind of research, for example that has suggested the value of the Mediterranean diet in reducing the risk of heart disease and cancer. Another example is selenium. Research suggests that this is a mineral influential in improving our immune systems but also indicates that, given its toxicity level, taking a selenium supplement can’t normally be recommended.

People who consume a varied diet tend to have a wider nutritional profile, and therefore are more likely to achieve recommended nutrient intakes. It is important that no foods are portrayed as good or bad, all foods can be consumed in moderation and food choices should be put in context with an individual’s lifestyle.

Whatever condition you’re treating a patient for, once their basic nutritional needs have been met, research suggests that the biggest difference diet can make will be in relation to weight control. It’s down to mathematics. However, what we need can differ. If you’re in your 20s you may have a different level of physical activity from when you’re in your fifties and therefore your requirements will be different. Normal body weight with a slight increase with age appears to be the most beneficial to health and longevity.

Q: Is there any new evidence emerging, which doctors should be aware of?

A: Because diet is part of the treatment programme for diabetes it is sometimes assumed that diet (sugar intake) causes diabetes. However the idea that sugar causes diabetes/heart disease was dismissed as long ago as 1989. A number of more recent, international expert committees have come to the same conclusion. A very recent report shows no association of sugars or total carbohydrate intake on the risk of cardiovascular disease. Obesity and lack of exercise appear to be the main risk factors.

Modest intakes of alcohol have been shown to increase protective HDL cholesterol levels. Those with an increased risk of CHD are recommended to consume alcohol regularly in small quantities, 1-2 units a day for men and women. However, binge drinking is certainly not recommended. Only modest amounts of alcohol should be included in the diets of patients with hypertriglyceridaemia and sometimes-total alcohol avoidance is advised.

Epidemiological evidence is quite clear that communities with a higher intake of fruit and vegetables have a lower incidence of heart disease and cancer.

Pregnant women need a supplement of folic acid before and throughout pregnancy to reduce the risk of neural tube defects.

Prospective cohort studies have shown that a high consumption of plant-based foods is associated with significantly lower risk of coronary artery disease and stroke. The protective effects are thought to be due to beneficial nutrients within the foods, for example, n-3 fatty acids.  A healthy plant-based diet should include unsaturated fat as the predominant form of dietary fat.  Animal products may be included, such as fish, poultry and low-fat dairy.

Q: Doctors are busy professionals, usually with a range of commitments. What are the things they are most likely to miss out on, as far as diet is concerned?

A: Lack of regular meals is probably the most important factor here. If you eat three meals a day you’ll normally eat a wider variety of foods and will be less likely to graze on fatty foods.

One meal you commonly miss out on if you’re busy is breakfast. Research here is absolutely clear – people who have breakfast cereal tend to be thinner and have a higher nutritional intake.

If you’re very busy you may also end up eating late at night, so have less control over what you eat because you’re hungry. You’ll eat pretty much anything.

If there’s a canteen at work you could end up eating two dinners a day and over consuming.

You may eat more convenience foods and miss out on fruit and vegetables and women doctors may not eat enough calcium and iron rich foods.

Q: What would you suggest to counteract this?

A: Breakfast is the most important meal of the day. Healthy breakfast options include wholemeal bread/toast, breakfast cereal with low fat milk, fresh fruit, fruit juice, tea or coffee.

Research suggests a higher intake of cereals and grains, such as whole wheat and rye, are associated with a lower incidence of cardiovascular disease. People who eat breakfast are also less likely to be overweight.

Fortified cereals can be a significant source of minerals and vitamins – for instance calcium which is essential for bone development. Folic acid is highly recommended to pregnant women or women planning a pregnancy, as it is proven to prevent neural tube defects. And iron which is particularly important for women of menstruation age.

No matter how busy you are, aim to eat three meals a day and have fruit or juice with each meal. Avoid high density energy  snacks.

Contrary to popular belief, carbohydrates are not fattening and in general are either fat free or very low in fat. Recent research has shown that a higher cereal fibre intake in adults aged 65 years and over is associated with lower risk of CVD with the lowest risk appearing to be related to intake of dark breads, such as whole wheat, rye and pumpernickel. Meals should therefore be based around carbohydrate foods. This would include the use of high fibre breakfast cereals especially porridge, brown breads, potatoes, pasta, rice, noodles and pitta bread.

If you eat at the canteen then have a wrap or sandwich at lunch and dinner in the evening, or vice versa.

If you live on your own, plan ahead. Online supermarket shopping can be very helpful here. You can plan a balanced diet for the week ahead, order it online and get it all delivered at one go. Also consider bulk cooking and freezing individual portions to ensure healthy options are readily available especially on those particularly busy, stressful days.

Q: So what is a balanced diet?

A: A well balanced diet is one that provides the body with enough energy, and all the nutrients required in their correct amounts to prevent illness and disease. However, how you translate this into food terms is quite difficult.

The biggest difference diet makes to health is through weight control. If you are maintaining your weight over a period of time then your energy intake is matching your energy output. However, if your weight is increasing slowly over a period of a year then you are eating more than your body actually needs. In reverse, if you are underweight then you are not eating enough food to meet your body’s needs. Most diet related problems are associated with weight, either the risk factors associated with obesity, or the health factors associated with anorexia.

People who consume a varied diet tend to have a wider nutritional profile, and therefore are more likely to achieve recommended nutrient intakes.

A diet high in saturated fat will raise blood cholesterol levels in individuals who have a genetic predisposition for raised cholesterol and most people won’t know whether or not they are genetically predisposed. In some individuals, a low saturated diet is sufficient to control blood cholesterol levels. In others, medication is required.

A low fibre diet is associated with cancer of the bowel, constipation and other bowel disorders

Low intake of fruit and veg is associated with higher incidence of cancer and heart disease.

It is important that no foods are portrayed as good or bad, all foods can be consumed in moderation and food choices should be put in context with an individual’s lifestyle.

The main keys to good health are:

  • Be a good weight. Obesity is a major risk factor for type 2 diabetes and can also induce raised blood pressure. Combined with type 2 diabetes this would become a major risk factor for heart disease.
  • Exercise regularly. Epidemiological evidence shows that people who are physically fit have fewer medical problems and a longer life span that people who dont do any exercise at all. Daily activity, like walking or cycling to work is potentially beneficial to health, especially in terms of type 2 diabetes prevention.
  • Don’t smoke.
  • Drink alcohol but in moderation.

Q: From a dietary perspective what are the three most useful things doctors can do themselves and advise their patients to do, to reduce the risk of a heart attack?

A key dietary message is the value of fish in preventing heart disease. Omega-3 fatty acids found in oily fish are beneficial for blood clotting and platelet aggregation, having an anti-thrombotic and anti-inflammatory effect. Omega-3 fatty acids also reduce plasma triglyceride levels, but have minimal effects on LDL and HDL cholesterol levels.

Oil rich fish include herrings, kippers, salmon, sardines, mackerel, trout, tuna and swordfish. These contain much higher levels of Omega-3 than white fish.

Try to include three or more portions of oily fish a week. Those unwilling to do this should use a fish oil supplement (fish body oil not fish liver oil) that contains 0.5-1.0g of omega-3 fatty acids (DHA and EPA).

Epidemiological evidence has shown that diets rich in fruit and vegetables are protective against CVD, including CHD and stroke. These foods contain many important nutrients. Potassium can help reduce blood pressure, folic acid limits homocysteine formation and soluble fibre helps reduce LDL cholesterol and improves HDL cholesterol. In addition, fruit and vegetables contain anti-oxidants as well as bioactive compounds with anti-oxidant activity such as carotenoids and flavonoids. However, anti-oxidant supplements in whatever form are not recommended to replace fruit and vegetable.

Avoid high intakes of total fat, saturated fat and trans fatty acids, as these are linked to raised blood cholesterol levels especially LDL cholesterol. This means limiting how much cream, butter, mayonnaise, cheese, chocolate and biscuits you eat. Products like biscuits are often produced using cheap vegetable oils, which change their chemical composition when cooked, creating trans fatty acids, which are more damaging than even cholesterol.

A high fat intake is also linked with excess weight and obesity. Women should limit fat intake to 60-70g per day with a maximum of 20g coming from saturated fat. Men should limit fat to 80-90g per day with a limit of 25g saturated fat. If the patient needs to lose weight then fat levels should be cut by half.

Potassium will help reduce blood pressure. Good dietary sources are bananas, orange juice and potatoes.

Cholesterol lowering spreads containing plant sterols or stanols have been shown to lower LDL cholesterol by up to 15%

Consuming alcohol three or more times a week even in small to moderate amounts was associated with reduced risk of coronary heart disease and myocardial infarction.

So, in summary, eat:

  • Three or more portions of oily fish a week
  • Less fat, especially saturated fat
  • More fruit and vegetables

Q: One in three people is diagnosed with cancer at some stage in their lifetime. What changes should doctors be thinking of, in their own diet and that of their patients, to try to reduce the risk of cancer?

The association between diet and cancer is still only in its infancy. Most studies are epidemiological in origin and research trials are sometimes hard to replicate.

The evidence is currently suggesting that isoflavones, which are phytoestrogens present in high quantities in soy products, may play a preventative role in breast cancer.

An abundance of data suggests that consuming diets high in fruit and vegetables and thus anti-oxidants, results in a decreased risk for many cancers including colorectal and lung.

Vitamin C has been associated with a decreased risk of many types of cancers especially stomach cancer.

Selenium supplementation has been associated with a decreased risk of prostate cancer (but given its toxicity levels need to be regulated by the GP).

Resveratrol , a polyphenolic phytoalexin found in grapes is an anti-oxidant that has been shown to exhibit strong anti-inflammatory, cell growth-modulatory and anti carcinogenic effects so can be helpful if there is genetic predisposition.

Some evidence has shown a protective effect of tea on the incidence of stomach and rectal cancers. There is little to associate coffee drinking with cancer. Decaffeinated coffee may be worse for you than ordinary coffee, as a result of the decaffeinating process.

Diets rich in cruciferous vegetables like broccoli,  cabbage, cauliflower, horseradish and mustard seed appear to reduce the risk of cancer of the colon and rectum.

Allium vegetables like garlic and onions appear to be preventative against stomach cancer.

High alcohol intakes are associated with cancers of the mouth, pharynx, larynx, oesophagus and liver.

Based on the most recent evidence, the recommendations to prevent cancer are, that the diet should contain foods of plant origin, they should be varied and nutritionally adequate, 7% of energy should come from fruits and veg and 45-60% from starch and protein foods of plant origin. In addition, the diet should maintain a normal BMI (body mass index) and active lifestyle.

Excess intakes of salt, alcohol, heavily cooked meats and hydrogenated fats should be avoided. To achieve this cut down on barbequed food and cheaper manufactured foods, for instance.

Q: Is there anything diet can do to help boost our immune system?

A: Unknown to many people is the role that vitamin A plays in our immune system. Mild vitamin A deficiency leads to an increased susceptibility to a variety of infectious diseases. However, because it is a fat-soluble vitamin that can be stored in the body, supplements should be used with caution. It is far better to improve the sources in the diet, such as fortified milk with vitamins A and D added to it.

Liver is such a rich source of vitamin A that pregnant women should actually avoid it. Many margarines have vitamin A added to them. Carotenes, which are precursors of vitamin A are found in green, yellow and red fruits and vegetables, and these are also a great source of antioxidants.

Selenium (a mineral) and also an antioxidant plays a major role in immunity. Selenium deficiency is accompanied by loss of immunocompetence. Covert suboptimal selenium status may be widespread in human populations. However, there is a narrow margin between beneficial and harmful intakes of selenium so be careful of supplements. Brazil nuts are a rich source of selenium. Fish, shellfish, liver and kidney as well as milk and eggs are also good sources of selenium.

Zinc deficiency causes increased susceptibility to infections. Meat, (beef and lamb being higher than pork and chicken) seafood (especially oysters and crab) and liver are the main sources of bioavailable zinc.

Q: For doctors working long hours, do you have any diet tips to help maintain energy?

A: A high carbohydrate diet is the only way to maintain energy levels. It depends where you are.

For immediate energy, that is fat free, go for something that is sugar-based like tea or coffee with two spoons of sugar added or a soft drink or sweets like pastilles or wine gums. This is so much better than eating biscuits, chocolate or crisps, which are all high in fat.

If you have time and you can get it, white bread is absorbed the quickest so a bread roll will give you instant energy and is also fat-free. Nutritious energy snacks would include fruit juices, a smoothie, a fruit or wholemeal scone, a wholemeal cereal bar, a piece of fruit or even just a couple of slices of toast.

Q: Do dietary supplements have any value or is the main benefit from what we eat and drink?

A: The aim should be to get all the nutrients that your body needs from your diet. However, this is not always practical. There is a role for supplements but in special situations, not for the general population.

Women who do not eat dairy products should take a calcium supplement. Vegetarians should take an Iron and vitamin B12 supplement. Vitamin D requirements increase in the elderly so a vitamin D supplement could be necessary here. If someone has been ill then a short course of a vitamin supplement would be useful.

Most important of course is folic acid for women who are planning a pregnancy.

But for the rest of us, they really are not necessary.

One other point to bear in mind is the value of the sun, within reason, as a source of vitamin D. We are now hearing of an increase in rickets in children, as a result of very high levels of sunscreen use.

Q:  The word diet sometimes conjures up the idea of weight loss and every year seems to bring the latest celebrity diet. What would your advice be for someone looking to lose weight? 

A: There’s no mystery to dieting. It is simply a question of mathematics. Bigger portions contain more calories, which can contribute to weight gain. So to lose weight, or maintain body weight, reduce portion sizes.

Don’t skip breakfast. Have three regular meals a day – just keep the portion sizes down. If you’re eating in, a smaller plate is an easy way of achieving this.

Q: For doctors studying for examinations is there anything they should include in their diet or avoid to help their concentration?

A: The brain is one of the smallest organs in the body yet it uses up 20% of our daily energy. Keeping a constant supply of glucose to the brain will ensure concentration so, again, don’t skip breakfast. Lack of glucose will reduce your ability to recall and concentrate.

High fire carbohydrate foods will ensure a slow but sustained release of glucose. Foods like high fibre breakfast cereal, brown bread, fruit and vegetables are all recommended.

Q: Would you give different advice to doctors at different stages in their lives and careers? For instance, how might your advice differ, talking to a recently qualified doctor compared with a doctor approaching retirement?

A: The basic nutritional requirements will be pretty much the same throughout your life and career. What is more likely to change is your requirement for energy.

There was probably a time when the pace of life earlier in your career was more frantic but changes in Medicare mean you may now be experiencing a hectic pace throughout most of your career. In the past too, many male medical careers were partly built on having a wife at home looking after the home and children and doing the cooking. With both men and women now having careers, pressures outside work may be growing, hence increasing concerns about achieving a work/life balance.

However, physical activity may still be more likely when you are younger, for instance if looking after young children compared with after they have left home.

Other factors will also be age related. As we grow older our appetite may be reducing, there may be a slight loss of taste and smell, we may be getting a bit bored with and losing interest in the food we have traditionally eaten. All this suggests the value of planning our diet to ensure we continue to eat regularly and enjoy a varied diet as we grow older. I’ve already explained the value of higher cereal fibre intake in adults aged 65 years and over.

Also, as you grow older, if your weight goes up your blood pressure tends to rise, so the diet and exercise advice I mentioned earlier becomes increasingly important.

Q: Food allergies seem to be an increasing problem. Is there anything we can do, through choice of diet, to reduce the risk of developing food allergies?

A: Food allergy is a reaction by the body to a dietary protein like milk, egg or nut. This allergic response produces a lot of IgE antibodies and will make you ill immediately after eating the food. 1 – 2% of the population is believed to have a food allergy.

Food intolerance causes symptoms hours/days after eating the offending food. This response may or may not involve the immune system. Foods like soya, milk, eggs, and wheat; chocolate, caffeine and wine can all be listed as offenders. There is no scientific test to prove food intolerance. Advice is usually to avoid the offending food. If you think you have a food intolerance seek advice from an Accredited Practising Dietitian like myself.