The benefits of a personal nutrition consultation and what to expect.

Posted on November 6, 2009 by Ian Marber

Every year my colleagues and I see hundreds of clients here at the clinic in London. Whilst there are several reasons why someone might seek advice about their diet, the most common being weight loss, digestive issues, skin, energy, stress and making healthy babies.

We also see many clients who don’t have any specific health problems but want guidance on their diet to ensure that they are eating the right things and taking the right supplements.

I have put together some answers to the most frequently asked questions. If you are considering seeing a nutrition therapist and require any more information or have any questions that aren’t answered here then please contact us by telephone on 020 7792 6700 or via www.thefooddoctor.com.


What is nutritional therapy?

It’s a process by which food and nutrients are used to enhance and optimize overall health. There is so much conflicting information on food and what to eat these days, mostly fuelled by a desire to lose weight, that we have lost sight of what food can really do for us. For many people, dietary changes are prompted by ill health, but eating well and appropriately for your state of health and stage of life can go a long way to help prevent conditions from occurring in the first place.

How does it work?

By enhancing bodily functions through nutrient intervention, supplying the body with the optimum level of nutrients, encouraging normal day to day functions to work at their very best. This may involve working to optimize the way energy is produced by every cell, or improving digestion so that nutrients are derived more readily from the food you eat.

What does a session involve?

The therapist will take a full history and identify health goals. A good therapist will be able to show the client what is achievable now and what can be worked on at a later stage.

The therapist would work with the client to find out how nutrition has contributed to their condition, and how they can use nutrition to their advantage. Consultations are usually around an hour, although I find that 30 – 45 minutes is sufficient time. Food groups, ratios and amounts would be discussed, culminating in creating a menu with a typical days food intake, complete with choices taking into account the clients lifestyle and time restraints, together with what the client likes to eat.

I like to take the time to explain exactly why I am making recommendations, using drawings and diagrams where appropriate, so that the client has a good understanding of why changes need to be made.

What kinds of health conditions can it help?

I know that many therapists feel that their chosen therapy can do everything except raise the dead, but I am confident that the correct nutrition can help in cases as wide ranging as IBS, migraines, skin problems, lack of energy, bloating, food sensitivities etc. I have seen such great results in countless clients, who have achieved a level of good health through dietary changes.

Will I have to have any tests while I’m there?

It may be necessary to carry out some simple tests to ensure that the course you embark upon is right for you. These include taking a snippet of hair for analysis, or a pinprick of blood to test cholesterol levels. These are done in house, but its possible that your therapist might suggest a blood or saliva test to measure thyroid activity or hormones levels. In some cases, a stool analysis may be suggested, to discover digestive capability and find out if there any bacterial imbalances or parasites that are having a negative effect on the gut.


Will I get homework to do before or after?

In advance of the consultation, you will be asked to complete a questionnaire which takes twenty minutes or so to fill in, as well as a three day food diary before the consultation, recording everything you eat and drink. After the initial consultation, you will be given information on why the various recommendations have been made, and asked to keep a new food diary. This will help the therapist to find out if the changes that have been recommended have been kept to. I ask clients to stay in touch via email until we meet again, which is usually three or four weeks after the initial consultation.

Will I have to change my diet radically?

If your current diet is really bad, then perhaps yes, you may be asked to make significant changes. But don’t worry as a good consultant will be able to guide you through exactly what to eat, explaining exactly why such changes are in your interests. Changes can be made slowly in your own time, so don’t worry if you feel anxious about new unfamiliar foods.

I find that by explaining as much as possible, the client is far more likely to comply, and thus achieve their goals. It may be that more subtle changes are required, or a few simple changes one at a time over a period of weeks. Either way, it won’t be as hard as you might imagine, as you will be given all the help, and support you need.

Can you tell if I’m allergic to foods?

This is a hard one, as food intolerances and allergies are more often than not a symptom and not always the sole cause of ill health. I find that it’s much more successful in the long run to improve the internal environment and enhance digestion. This way you will be able to eat more or less anything, within reason, rather than embark on a restrictive diet. I believe that its best to widen the choices, rather than limit them, as this makes life much easier.

What benefits can I expect to see and how long will they take?

Benefits include increased energy, less bloating and digestive symptoms, enhanced appearance of the skin and hair etc. As nutrition is so relevant, the improvements can in fact be experienced in many areas.

Will I have to spend lots of money on supplements?

Whilst it is quite possible that supplements might be part of the course, personally I try to stick to dietary changes. After all, you are going to eat every day but do you really want to take pills every day and have your health rely on them? Having said that, people want results, and supplements can help speed things along, so that the benefits can be felt sooner rather than later. A good therapist will make sure that supplements will be kept to a minimum.

If you have any questions that aren’t answered here please feel free to post them.

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What to do with a pumpkin after Halloween.

Posted on November 2, 2009 by Ian Marber

I was inundated with pumpkins this weekend and having gouged out the scary faces I was left with a mound of bright orange pumpkin flesh. An obvious was to use it was to make soup, and as it was delicious, here is the recipe. One tip – by adding legumes to the soup you instantly add in some protein and by doing so, you can bring down the overall glycemic load of the meal. Rather than concern yourself with the individual score on the glycemic index of any one food, the addition of protein sorts that out for you.

You can have this as a starter or as a meal in itself.

Ingredients;

2 medium white onions
5 tablespoons of extra virgin olive oil
350g of pumpkin flesh ( or butternut squash ), cubed
350g of sweet potato, peeled and cubed
1 stock cube ( vegetable or chicken )
1 400g can of butter beans ( in water, not with salt or sugar )
40g of Parmesan cheese

Making soup is happily very simple and it’s an excellent way to enjoy fresh produce.

Peel the onions and dice the flesh. Warm 2 tablespoons of olive oil over a low to medium flame and stir in the onions. Allow to cook until translucent but do not let them burn.

Place the sweet potato and pumpkin in a large baking dish and drizzle with the remaining 3 tablespoons of olive oil. Stir well. Bake for 35 minutes in at oven at 200C/350Fd ( gas mark 3 ) mixing them well with a spoon after 15 minutes.

When the vegetables are cooked through add them to the onion mix together with 1 litre of water. Add in one stock cube, cover the pan and simmer for 30 minutes.

Allow the soup to cool and puree roughly in a blender.

Meanwhile, rinse the butter beans. Transfer two portions of soup into a smaller pan and warm the beans in the soup.

Serve topped with shaved Parmesan cheese. Add fresh black pepper to taste.

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Folic acid, the FSA and mass fortification.

Posted on October 20, 2009 by Ian Marber

Folic acid should be added to bread on a mandatory basis, the Food Standards Agency has advised government and so I was on LBC with Nick Ferrari this morning discussing the benefits of the fortification of bread with folic acid. This is the first time that the UK has undertaken mass changes of this nature since the addition of fluoride to water in the 1950’s so it is a significant move. A spokesman for the Department of Health said: “We will now consider their recommendation for the introduction of mandatory fortification of flour with folic acid alongside controls on voluntary fortification.”

There is now overwhelming medical evidence that correct levels of folic acid in women conceiving lessens the incidence of neural birth defects. This has been witnessed in countries ( mainly the US ) where adding folic acid fortification to bread has been mandatory for several years and a correlation has been identified against reduced incidence of such defects.

In the UK, after many years of debate and on considering the medical evidence, the Food Standards Agency finally recommended to Government that a similar programme should be adopted. However, concerns expressed by various groups have held up the implementation of such a policy and whilst the evidence has not changed in terms of the target group, there are growing concerns that mandatory fortification could cause as many problems as it solves in the population at large.

A intake of 400mcg folic acid per day is recommended by the FSA for pregnant women or for women who are planning pregnancy. Folic acid is particularly important during pre-pregnancy and in the very early stages of pregnancy, as the neural tube growth in embryos is particularly intense in these first few weeks. There are also many unplanned pregnancies where the woman only realises she is pregnant after the stages where folic acid is most needed, and since the human body cannot store folic acid it is essential that this vitamin be integrated into the food chain.

Foods that are naturally rich in folic acid include liver, yeast extract and green leafy vegetables such as broccoli, beans and peas. A diet rich in other B vitamins and in vitamin C usually contains a high amount of folic acid. However, a large percentage of the UK has a poor diet high in saturated fats, sugars and a modest consumption of fruits and vegetables, which do not provide them with enough of these essential nutrients. Bread has always been a very popular food and traditionally was a good source of such nutrients, however in the modern production process, 50% of the folic acid is lost when the whole wheat is roller milled and bleached. This indicates that it is important to replace the vitamins and minerals that have been removed, so that the British population receive a wider variety of nutrients in their diet.

Several countries in the world are now fortifying flour with folic acid along with other vitamins and minerals to reduce the risk of neural defects. In Canada, United States and Chile, the addition of folic acid in food is thought to have reduced neural tube birth defects by up to 50%. Other countries such as New Zealand and Australia are also marketing fortified bread and have witnessed about a 45% fall in births with neural defects.

Folic acid in excess can encourage the incidence of colon cancer but this can be managed through moves such as ensuring fibre intake is adequate, cutting back on alcohol and saturated fats ( found in red meat ) as well as processed meats such as ham. For more information on bowel cancer please see www.bowelcancer.tv.

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Tweetwhatyoueat and why it irritates me.

Posted on October 15, 2009 by Ian Marber

I have a new pet-hate – tweetwhatyoueat. For those people who don’t know what it is, and until a day or two ago, I didn’t, it is a twitter-like website on which you enter what you have eaten ( or ‘tweaten’, a word that now joins ‘veg’ and ‘carb’ on my list of annoying words ).

I have no issue with listing what you eat ( although one has to ask if it is really that interesting to anyone else ) but the page suggests you list the calorie content too as if calories were the only thing worth listing. I have read that the site has helped people lose weight as they can see how many calories they are consuming, but reducing calories isn’t the only factor when it comes to weight loss, far from it. Highlighting the calorie content of food misses the point completely, and simply perpetuates the notion that food is something that has to be conquered, a battle that is waged, which some days you win, other days you don’t.

I see that they also offer a service whereby one can “track and manage your taboo food list” simply by making a note of it. Oh dear.

If you see an avocado and simply see it as having 340 calories, then you are completely missing the point. What about the mono-unsaturated fats, vitamin K, folic acid, vitamin B6, potassium and lutein? To my mind they are more important than calories.

As long as you see food as something that either makes you fat or thin, and whilst sites like this may have some benefits, they do perpetuate this notion, then you are more likely to battle with your weight.

Understand food instead, educate yourself about what to eat and how the food groups work and you will never have to count another calorie again. Nor will you have to log on and write it down.

Filed under: How Not To Get Fat, Weight, Weightloss, weight gain, weight loss, weight maintenance | Tagged: , , , | Leave a Comment »

Be Beautiful – skin care and a clever book for teens on hair, skin and make-up.

Posted on October 13, 2009 by Ian Marber

Given that we hear a lot about teenagers and children and their health these days, and not much of it is positive. News reports about overweight children and obese teens are not uncommon, so its rather nice to hear about a 14 year old girl who has written a book for other teenagers. Together with her mother, Alice Hart-Davis, Molly Hindhaugh has written ‘Be Beautiful – Every Girls Guide to Hair, Skin and Make-up’ ( Walker Books, £9.99 although its £6.99 on Amazon – http://www.amazon.co.uk/Be-Beautiful-Every-Girls-Make-up/dp/1406318310/ref=sr_1_1?ie=UTF8&s=books&qid=1255429563&sr=8-1 ).

Whilst there are several reasons why someone might seek the advice of a nutrition consultant, solving skin problems is one of the most common. Whilst skin care is important, even the most rigorous regime isn’t going to make second rate skin look as good as it could do. Skin problems such as eczema and psoriasis have specific nutritional protocols, but day to day skin, the sort that might be termed ‘good skin’ is closely linked to good nutrition.

As skin is manufactured deeper in the dermis, it is the makeup of the new skin cells that largely determines the quality of the skin once it surfaces. For the healthiest looking skin there ideally has to be an optimum intake of several nutrients, amongst them the essential fats, found in nuts, seeds, oils and avocado, yet such foods are off many peoples shopping lists due to the high fat content. Despite the potential downside, these foods should be included in the diet, preferably in small amounts eaten frequently.

Skin shows its ages for many reasons, and one look at the skin on your face compared to that on the underside of your arm will show how being exposed to the elements can encourage skin ageing. This is partially due to the breakdown of the structure of the collagen content of skin, which is vulnerable to the action of free radicals ( not a political body, but in fact the natural by-product of metabolism, yet also increased by ultraviolet light ). The collagen in young skin should be fully intact allowing the structure of the skin to have flexibility, yet this fluidity of collagen can be affected by free radical damage.

There are a number of factors that can to some extent speed up the visible process of ageing, such ultraviolet light, pollution and cigarette smoke, yet older skin can lack the ability to repair itself to the same extent that young skin can. For those of us who are older than Molly all is not lost, and help can be found in the form of antioxidants, which are nutrients found mostly in fresh produce that work to counteract the action of the free radicals. No one fruit or vegetable is better than another, so ensure that you have a wide variety of them all when possible to allow full benefit from

It may not be cutting edge nutrition to suggest that we all eat more fruit and vegetables, but now you can eat your five or more portions a day, safe in the knowledge that your skin will probably thank you quite soon.

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Obesity, kids and How Not To Get Fat.

Posted on October 12, 2009 by Ian Marber

I was interested to read about obese children rejecting weight loss surgery ( “More than half of 100 children, who are on the government backed Carnegie Weight Management Programme, say they view gastric bands as “cheating”".).

Added to this, some 60% of the children in the group “felt they do not get any support in overcoming their weight issues at school”. What stands out for me is that this story is about weight loss, and not weight gain. How did these children become obese in the first place? Yes, they ate too much of the wrong things and weren’t active enough, but how did the adults around them, parents, family and school, allow things to get this far?

You can see the full story here http://news.bbc.co.uk/1/hi/health/8299555.stm.

Surely prevention is better than cure as understanding how not to get fat in the first place is preferable to even having to consider weight loss surgery?

Think of the misery that obesity is causing for these kids. Some 42% of the group that were surveyed said that they had been bullied because of their size. When I work with overweight clients they often tell me that despite being adults, in employment, qualified and experienced in life, they would suffer jibes and sneers from strangers about their size.

I have a new book out in January, How Not To Get Fat ( Quadrille, £9.99 ) which looks at how to eat so that we don’t gain weight rather than how to lose it after we have. No-one else has taken this approach before, as I maintain that we know how to diet, but we don’t know how to eat.

Details can be found here, http://www.amazon.co.uk/How-Not-Get-Fat-Marber/dp/1844007901/ref=sr_1_10?ie=UTF8&s=books&qid=1255338204&sr=1-10.

The press release reads “If all diets work, why is it such a problem for us to maintain a healthy weight while still enjoying life? And why do we fall into the trap of sending ourselves on an endless rollercoaster of boom and bust, dieting and overeating, which makes us feel bad or ashamed about ourselves? In Ian Marber s long-standing experience as a nutritional therapist, most people want to eat in a way that satisfies their hunger, enables them to enjoy good food, minimises cravings, and works with even the busiest work, or social, schedule all without gaining weight. We do not always understand how our bodies work and therefore how and what to eat. Ian explains how to ensure that the food we eat is enjoyable and converts to energy rather than fat. And we do not always think about ourselves, and food, in a positive way. We often see food as the enemy, and engage in a battle that we feel we will always lose. Or attitudes from family, friends, colleagues, and the media about our weight, or how we should look, lead many of us to try extreme diets, buy low calorie foods, or over-exercise. We learn how to diet, not how to eat, and when we treat ourselves the weight creeps back on and another cycle of emotional guilt and self-denial begins. In this revolutionary but commonsense book, Ian tells the reader how to eat so that they will never get fat. This is not a one-off diet book, it is a way of life…that works! Radical yet realistic, packed with quotes and scenarios that the reader will recognise, informative yet humorous, Ian Marber delivers us from dieting”.

Filed under: How Not To Get Fat, Weightloss, obesity | Tagged: , | 1 Comment »

Coeliac disease and osteporosis – an exciting discovery.

Posted on October 8, 2009 by Ian Marber

Coeliac disease is a chronic and permanent auto-immune disease caused by gluten intolerance and is becoming more recognised in Britain than ever before. Coeliac UK, the organisation for sufferers, confirm that whilst the condition is diagnosed in 1 in 1000 people, the figure is more likely to be 1 in 80 ( the remainder probably being undiagnosed ), rising to 1 in 10 prevalence in families with coeliac disease. When a person with coeliac disease eats gluten ( found in wheat, barley ,oats and rye ) even in minute quantities, it causes damage in a specific part of the gut, the duodenum and jejunum. This prevents normal digestion and absorption of food as it leads to inflammation, and then degeneration of the villi, the protrusions that are responsible for the absorption of nutrients. Sufferers can experience anything from nutrient deficiency to mild malnutrition if they continue to eat gluten. Symptoms can range from diarrhoea, fatigue, being underweight, depression, anaemia and abdominal pain and distension. In theory however, symptoms can be very wide ranging as the sufferer is not absorbing nutrients and deficiencies of vitamins are common, which can make the condition easy to miss. On avoiding gluten however, the villi are mostly restored along with a return to health.

There are various degrees of the condition, and some are termed ‘exquisitely sensitive’ whilst others may suffer no symptoms at all. Those that are very sensitive have to be very vigilant, as even a pinch of flour or the wrong type of binder in a meal, or even soy sauce, can lead to pain and diarrhoea. It’s almost as bad for those that have no symptoms ( termed silent’ coeliac disease ) as its hard to follow a gluten free diet without the threat of a reaction but such sufferers are at increased risk of deficiencies and conditions in the future, such as osteoporosis.

The link between ceoliac disease and osteoporosis may have been identified as a study published in the New England Journal of Medicine suggests “coeliac patients produce antibodies which attack a key protein that maintains bone health.” The study, carried out by the University of Edinburgh indicates that it may be a protein called osteoprotegerin which holds the key to the link as in some 20% of the coeliac patients tested, antibodies were produced which stopped this protein – crucial for maintaining bone strength – from working effectively.

This is a significant discovery as if further research proves the link then sufferers can potentially avoid osteoporosis in the future with the use of appropriate medication.

Filed under: Bone loss, Coeliac disease, Gluten, Osteoporosis, study | Tagged: , , | Leave a Comment »

Food safety and hygiene at home.

Posted on October 5, 2009 by Ian Marber

There are several reasons why people might come to the clinic to consult with me or one of my fine colleagues. One of the most common is to address digestive symptoms such as bloating and discomfort, and aside from dietary advice, we often suggest that the client undertake a stool analysis. This isn’t the most pleasant of tests but it is often revealing and a good investment as it identifies the concentration of beneficial bacteria, unwanted bacteria, yeasts and parasites. The balance between these various elements can create many different situations including symptoms more commonly associated with IBS such as irregular bowel movements, bloating, gas/flatulence and sensitivities to food.

One aspect of eating that does often get overlooked is food safety. Whilst restaurants and food outlets are subject to rigorous checks, our own kitchens are obviously not. Unwanted bacteria can spread easily and, when ingested, they can lead to low-level digestive problems as well as the more explosive symptoms such as vomiting and diarrhoea.

Food safety at home is perhaps easier than we might think, here are some simple pointers that should help keep you safe from unwanted bacteria;

 Storage

  • Store raw foods away from cooked foods.
  •  Foods that could drip should be stored at the bottom of the fridge and must be well covered, or kept in food storage boxes.
  • Eggs are best kept in the fridge, preferably in their boxes.
  • Avoid storing tinned food after it is open, instead decant contents into a bowl and cover it securely and use within a couple of days.
  • Allow frozen food plenty of time to defrost and keep the liquid that collects during defrosting away from all other foods.
  • Do not allow food to partially defrost and then re-freeze it.
  • If using a microwave to defrost food, cook it immediately after defrosting.

Cooking

  • Ensure that what you cook is cooked all the way through.
  • Preheat your oven to guarantee the correct cooking temperatures.
  • Microwaved food should be stirred and then left to stand for a few minutes before eating.
  • If you do eat ready meals, then follow the instructions on the label, don’t undercook and ensure that the meal is cooked at the correct temperature.
  • Serve foods as soon as they are ready, don’t allow them to stand around.
  •  Try to avoid using your bare hands, especially when handling cooked and raw foods as you prepare your meal. Its best to use clean kitchen tongs and wash them after each use.
  • Have two chopping boards, one for cooked food, one for raw food and wash them thoroughly before placing a different food on them

 

 

Filed under: Bloating, Food safety, Hygiene, IBS, Irritable Bowel Syndrome, food wastage | Leave a Comment »

Gluten free, dairy free and salt – a report from CASH.

Posted on September 24, 2009 by Ian Marber

“People choosing wheat or dairy-free products could be risking their heart health because many are loaded with salt, a study reveals. Consensus Action on Salt and Health ( CASH ) surveyed 71 own-label “free from” products from five leading supermarkets in the UK “says the BBC this morning.

‘Free from’ foods are those that are aimed at customers with specific dietary requirements. The most common are gluten free foods that are formulated for people following a gluten free diet ( ie those living with coeliac disease ). As I have ceoliac disease I am a typical customer and over the years have looked at the foods in the ‘free from’ aisle. But I have never bought any, simply because whilst the foods might suit my gluten free diet, they still contain sugar and salt and therefore don’t appeal to me.

Most people with specific dietary requirements would be likely to eat these products simply because they fit certain criteria – i.e. gluten free. I am pleased that this story has broken today as it highlights the real issue here, which is that just because you have ceoliac disease doesn’t mean that you can eat anything you like as long as its gluten free. You still have to check sugar, salt and saturated fat, why wouldn’t you? Having ceoliac disease does not preclude one from risks associated with high salt intake such as raised blood pressure. Not does having being overweight and choosing low fat products preclude such issues. Or needing to avoid dairy.

There are several gluten free biscuits on the market that look and taste like the regular alternative which always a delight for anyone on a gluten free diet. Many years ago gluten free food was akin to cardboard so the improvements in recipes over the last two decades have been very welcome. But a look at the label might tell you that the texture and taste have been achieved not only by improved baking techniques and ingredients, but perhaps by increased levels of sugar and salt?

In other words, if your main reason for buying a food is what dictates your decision, please be aware of what else the food contains as the CASH investigation has revealed.

Filed under: Coeliac disease, Dairy free, salt, wheat allergy | Tagged: , | Leave a Comment »

Personal choice – light bulbs, smoking and vitamins.

Posted on September 21, 2009 by Ian Marber

No-one needs reminding that smoking cigarettes is serious risk to health. Countless people have died whilst countless more live with disease both as a direct result of cigarette smoke. Untold billions are spent on treating disease caused by smoking, whilst resources that could be directed elsewhere are spent treating those that have or still smoke. Should we have started and want to stop, there is state-funded support to help us do so.

If one asked the powers that be why cigarettes are still available I am quite sure that the answer would be ‘choice’. It’s a personal choice to smoke, and whilst we are warned in no small way about what the risks are people do choose to smoke. That’s their choice and in a democratic society we live side by side with other peoples choices however much we might not like it. I am sure that some of my life choices aren’t popular with everyone but that’s the benefit of a democracy, we all get choices.

Over the weekend I had to change a couple of lightbulbs, and whilst I thought I had a pretty good stock of 100w crown silvered bulbs that go into my bedside lamps, I saw that I was down to just a few. Needless to say my usual supplier isn’t allowed to sell 100w light bulbs now let alone frosted or pearled ones. I know all the reasons why incandescent bulbs are being phased out now.

But seeing as we are ‘allowed’ to smoke, all in the name of personal choice, why do the same authorities feel that we shouldn’t be allowed to buy 100w light bulbs even if we want to? Are we all so misguided and selfish that we would buy them and leave them on all day even if we are out, sod the planet?

Why do the same authorities talk about legislation governing the sale of vitamin supplements? There is still talk of legislation about the level of nutrients allowed in vitamin supplements being capped, and also control of who might be able to sell or advise the public on such matters. Are they seriously suggesting that you and I shouldn’t be allowed to buy higher dose supplements in a health food store or a 100w light bulb to read by yet still buy a pack of cigarettes?

I am a responsible adult and I choose not to smoke. I also choose to take supplements and do so with the information about the possible side effects very much in mind. I would also like to keep using 100w light bulbs, but that’s not going to happen.

So much for personal choice.

Filed under: supplements, vitamins | Tagged: , , | Leave a Comment »

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