Health & Wellness

The truth about celebrity online nutrition programs - why Chris Hemsworth’s 'Centr' is one of the best

Image courtesy of Centr

Image courtesy of Centr

You would not be alone if on first impressions you thought Chris Hemsworth’s new Centr health and fitness program was just another celebrity program with plenty of hype but not necessarily substance.  Celebrity programs have received much criticism for their lack of evidence-based content, however not all online health and well-being programs are the same…..some take their nutrition seriously - and they do it well.

Centr for example uses a range of ‘experts’ to provide varied nutrition content, including recipes, articles, cooking tips and meal plans.   I know first hand that all of their nutrition content is carefully planned, created and reviewed by the experts and the team at Loup (a complete digital business that produces online health and fitness programs) which includes an Advanced Sports Dietitian.   Loup are super passionate about health, nutrition, food (and food enjoyment), and provide ongoing support and expertise to the Centr program (in addition to other programs such as Tiffany Hall’s TiffXO). Great care is taken to provide nutrition content that is based on science, and approved by a dietitian for accuracy and consistency.    

Centr DOES provide meal plans, but with significant flexibility built in, and a focus on food enjoyment and listening to your body rather than counting calories and macros. Recipes incorporate seasonal, nutrient-dense wholefoods, to help nourish our bodies and brain rather than promoting a  ‘diet’ approach.  Yes, there are some issues with prescriptive meal plans in general, but Centr provides meal plans as a starting guide - in fact many, if not most, members do not follow the meal plans to the letter, but use them for recipe ideas to suit their food preferences and lifestyle.  The overall nutrition program aims to educate and empower individuals to actively change habits for a positive impact on both physical and mental health and well-being.    Clear recommendations are provided to seek individualized advice from an Accredited Dietitian for those with specific needs.

Online programs and meal plans are often criticized, and I admit a few years back I was one of those criticizing, but the feedback from Centr speaks for itself – individuals making better lifestyle choices and creating new habits leading to improvements in health, well-being, body composition, energy levels, confidence and happiness.  Thousands of individuals, from vegans (Centr has the most amazing vegan recipes!), to pescatarians to those who enjoy all foods.  The potential benefits for participants seem to far outweigh any perceived negatives.

Of course online programs are not for everybody – there will always be an important role for individualized advice and private consultation with dietitians like myself.  But if an online program can have a positive impact on individuals by providing credible and accurate nutrition information, delicious recipes, and practical meal ideas, this can only be a positive.

Best foods for reducing stress and improving work performance


Long and demanding work hours can really take a toll, with health and fitness commonly becoming a lower priority when work demands are high. Regular exercise can become difficult, and planning and preparing nutritious foods drops down the to-do list. Ironic really, when eating well and exercise are even more important when you are busy and need to be energised and functioning at your best.  

Many people find they might get through the morning ok, but by mid-afternoon can really start to slide. Lack of energy and focus can quickly lead to a hand in the biscuit barrel or a quick break to grab a different kind of sugar hit. The problem with this reactive approach is that after the initial energy rush, your blood glucose levels can drop which leads to a crash in energy levels and work performance. 

Here are 5 of the best foods and fluids to help your brain and body get you through to the end of your working day in top shape (from Eat Right For Your Life):

5 Best Foods and Fluids


Omega-3 fatty acids are a prominent component of neuronal membranes – essential for normal brain function. Many of us don't consume anywhere near enough omega-3 in our diets, and the best way to increase your intake is to eat more fish and seafood, particularly oily varieties such as salmon, sardines and mackerel.

Tea (black or green)

If you love your hot drinks at work, tea is the perfect option. Tea contains theanine, a compound which can have a direct impact on the brain to keep you alert but relaxed at the same time.  There is evidence suggesting that a good cup of tea is a great way to reduce stress. Tea also contains high levels of flavonoids, a type of antioxidant that has a positive effect on overall health. 


Instead of reaching for the biscuits, keep your own fruit basket at work. Stock it up at the start of each week for a constant supply of nutritious snacks to boost energy levels and concentration for a busy working day. Any fruit is great, and variety is important, aim for at least six different fruits over a week. Bananas may be particularly beneficial for stress, they contain potassium, which can be good for blood pressure, and are low GI, which keeps your blood sugar and mood stable. 

Substantial Salads

A big salad with lean protein is the perfect lunch for a busy work day, and it doesn’t have to be rabbit food. A light and fresh salad can fill you up without leaving you feeling sluggish. For a different high-fibre spin, try your salad with chickpeas or 3-bean mix, or stick to the traditional protein sources of chicken, tuna, salmon or leftover lean roast meat. You can also try adding some nutrient-dense carbohydrate with sweet potato, sweet corn or quinoa.


If you are looking for a nutritious lunchtime salad when you are away from the office, search for calamari on the menu.  But not the golden crumbed deep-fried rings - if you choose the marinated grilled or seared variety in an Asian style salad then you are on to a winner.  Seafood provides protein that is easily digested compared to a heavy steak and will help you to feel energised for the afternoon. Plus additional omega-3 fats for a healthy brain and body.


You will find the other 5 of my top 10 foods for corporate and high stress workers, and the best 10 foods for other stages of life, in my book Eat Right For Your Life.

My new book Super Food For Performance, in Work Sport and Life is due for release late October 2017, check it out for more info on high performance eating and practical snack and meal ideas and recipes.

How 'food porn' marketing of health foods misleads us towards temptation

We see them on social media every day - gorgeous food photos, stacked and styled to perfection with delicious looking fresh ingredients. But are these artistic creations of fritters, stacks, smoothies and bowls really good for us? If we are using these beautiful bowls of goodness as inspiration for our daily meals are we doing ourselves a favour or doing more harm than good? 

I am relatively new to Instagram, but I feel more and more concerned about the way nutritious foods are portrayed and promoted. Others share my concerns!  Nina Mills from What's for Eats (an experienced Instagrammer!) has written Why I post food photos on Instagram that is well worth a read and I certainly share many of her sentiments. 

Below are some things to think about as you scroll through your favourite food photos.....

Is that really healthy?

The two health food photos that frustrate me the most are breakfast related – pancakes and smoothie bowls. Although those high protein maple and berry pancakes look amazing and sound super-healthy, if you replicated this at home you may be shocked at the sugar content. Same for smoothie bowls – some of the ingredients may be nutritious, but there is also often a lot of hidden sugars. Nut butters, seeds, dried fruit, coconut, avocado…..all nutritious ingredients but the energy can quickly add up. Natural sugar is still sugar (think maple syrup, rice malt syrup, agave, etc.) and not a more nutritious substitute for table sugar. Your protein bliss balls washed down with a cacao salted caramel smoothie could very well be equivalent to breakfast and lunch put together!  *You can read more about natural sugars in my blog post 'The Great Sugar Con....'

Size matters

Let’s face it, most Instagram serves are not small. Unless you are a 120kg+ rugby player, that plate may not be the best amount for you.  Fine dining portions don't always look as enticing as a platter-sized meal.  Large portions that look tasty can make healthy food more appealing, but the serves depicted are not going to suit everyone. 

Eating well can be boring

I don’t tend to share photos of my daily breakfast. A standard bowl of porridge with yoghurt and fruit/nuts is probably not going to create too much excitement on Instagram. We want to see fun and interesting food that excites our tastebuds!  But as Nina mentions in her post, seeing images of everyday foods can be useful to help us to feel ok when we aren't whipping up exotic dishes three times per day.

To eat well day-to-day, you don’t need to be making corn fritters with avocado salsa every morning. Social media images can create pressure on people to spend hours in the kitchen using expensive ingredients. As much as I hate to say it, healthy eating in most households is not particularly flamboyant, especially as part of a busy lifestyle. Many of us could put in the effort to make our meals a bit more exciting, but we don’t need the extravagance of healthy eating portrayals on social media. 

Social media can provide some great food inspiration, but don’t be blinded by the dazzle and hype. Think about what is in your food, your individual needs and food that makes you feel good - and enjoy an over-the-top over-styled Instagrammable feast now and then! 

Interested in nutrition?  I would love to send you free updates and recipes, just leave your details here.  You can also follow my pages on Facebook, Instagram and Twitter, or check out my Thoughts page for more articles like this.

Brain food for work and study - how to prevent the mid-afternoon brain fade

Do you sometimes find yourself sitting in front of your computer in the middle of the afternoon, staring into space and unable to focus on the task at hand? This happens in workplaces and schools all around the world every day at around 3pm. Think about what you eat for lunch. Does it include foods that will boost your brainpower or more likely to leave you feeling drained? The foods you eat at work or school can make a big difference to concentration, focus, productivity and learning later in the day. Not to mention the positive effect on mood and stress levels. Here are some nutrition tips to help keep you thinking clearly and on top of your game all day. 

Eat foods high in Omega-3 fatty acids

You may have heard before that eating fish is good for your brain. Omega-3 fatty acids are a prominent component of neuronal membranes – and fish are our best dietary source of these fats. The best way to increase your omega-3 intake is to eat more fish and seafood. Research has also shown that EPA predominant fish oil supplements may have benefits for individuals with diagnosed depression (however please see your qualified health professional to discuss your individual needs when it comes to nutrition supplements).

 Choose Low Glycemic Index

Stable blood glucose levels help to the brain continuously fuelled. High glycemic index foods which are quickly absorbed into the blood stream may cause erratic blood sugar levels which can effect energy levels and mood. If you choose wholegrain over high-sugar you can help to keep blood glucose stable and this means consistent brain fuel. Protein and healthy fats can also reduce the glycemic impact of a meal or snack.

Don’t go hungry

‘Hungry grumpy’ really is a thing! If you haven’t eaten enough you feel hungry and blood glucose levels can get quite low, leaving it hard to concentrate and having an impact on brain function. Keep your brain well-fuelled to improve your mood.

Drink enough fluid

Numerous studies have shown the benefits to athletic performance from being well-hydrated, from concentration to co-ordination to judgement. These same performance principles can apply to work and school scenarios, so keep up fluid intake in the morning and as the day progresses.

Drink tea

Sometimes we use caffeine as a pick-me-up, but this doesn’t address the real reason why you need that extra boost. By eating more wholefoods and less processed, you may not need the coffee. Nothing wrong with a daily coffee, but tea is a great option for your brain. Tea contains theanine, a compound which can have a direct impact on the brain to keep you alert but relaxed at the same time.

Mix up your fruits and vegetables

Several studies have shown a link between fruit and vegetable intake and improved mood and feelings of depression. It is difficult to determine which particular nutrients or antioxidants are of most benefit, but just another reason to include a wide variety of different fruit and vegetables every day.

Add probiotics

More and more research is showing links between the health of the gut and other body organs. A healthy gut may reduce inflammation throughout the body, and can impact on your brain and mood. More research is required, but by including probiotics from yoghurt, fermented foods and drinks we can help to keep our mind and body healthy.

If you are interested in more updates about the links between the food we eat and performance at work and sport, I would love to send you my free newsletter, just leave your details here. You can also follow me on Facebook, Instagram and Twitter for more regular nutrition updates, recipes and food ideas.

Best fluids to hydrate at work (including coffee!) and why you don't need 2 litres of water per day

 Are you someone who carries a water bottle with you everywhere you go?  Or do you struggle to gulp down a few mouthfuls of water in between coffees? If you are not hydrating well it can impact on your concentration at work, energy levels, motivation, general well-being and the results you achieve through training. It’s not just all about water though!

How much do I need to drink?

You have probably heard that you need 2 litres of water per day to stay hydrated. This may be a reasonable estimate for some people, however individual fluid needs vary quite a bit. A petite female is unlikely to need as much water as a 100kg+ active rugby player.   If you are not drinking a 2 litre jug of water every day don’t despair, you may not need that much (or you may actually need much more).

Is water the best drink for hydration?

Although water should make up a fair volume of your daily fluid intake, it’s not the only drink that will hydrate well. Other nutritious fluids such as milk, tea, coffee, blended fruit smoothies and soup all help (for more about the hydrating qualities of soup and smoothies check out my posts Best Fluids For Hydration - Look No Further Than Soup and Why Juice is Not as Bad as You Might Think - Tips For Making a Top Choice). 

Tea vs coffee

Yes, even coffee can help with hydration!  If you work in an office, it’s pretty common to be drinking several cups of tea or coffee per day. Coffee CAN have a diuretic effect, so it’s not as effective in helping your body to hold onto your daily cup full as some other fluids, but it doesn’t make it all go straight through either!  It all comes down to how much you drink. Black tea has far less caffeine (<20mg per cup) vs coffee (>80mg per cup, depending how it is made), so if you like both, tea may be better for helping hydration. 

‘I don’t like water’

If you don’t love plain water, try adding ice, sliced lemon and lime, frozen berries, fresh chopped fruit or herbs and spices to give water a fresh flavour, or choose bubbly plain mineral water for a taste and texture change. 

How do you know if you are drinking enough?

Try the pee test. Pale yellow to clear is what you are looking for. No need for it to be crystal clear but you don’t want it to look like the colour of beer either. (the urine colour test doesn’t work if you take vitamin/mineral supplements because these often cause urine to be darker in colour).


So drink up, and remember that the average body is made up of over 60% water and your body doesn’t function at its best without it.


If you are active, you might also be interested in the best fluids for training in my recent post Hydration is Important, But What is the Role of Sports Drinks and Electrolytes and Who Needs Them.

If you would like me to send you nutrition updates and recipes direct to your inbox (I won't bombard you, only once a month or so!), please leave your details on my Thoughts page and check out some of my other blog posts while you are there.  You can also follow me on Facebook and Instagram.

Why juice is not as bad as you might think - tips for making a top choice

I am the first to admit that I am one of those dietitians who was never a big fan of juice.  My standard line was always to ditch the juice and eat a piece of fruit with a glass of water instead.  You have probably heard that one before!  Over time my views on juice have changed.  This is because juice has changed.  No longer is juice just the bottled reconstituted supermarket variety, or the sugary juice box that would be a school lunch order ‘treat’.  Today more and more juice is fresh.  Juice bars provide a range of juiced and blended options, which contain a whole lot more than just the liquid extracted from fruit.   With the variety of juice options out there, it’s possible to make fresh, smart choices that can help you meet your nutritional needs.  

Many dietitians are likely to recommend you keep juice intake to a minimum.  The Australian Dietary Guidelines suggest a maximum of 125ml of 100% juice as an occasional substitute for a piece of fruit.  This is based on the fact that many juices (sugar-added or not) contain over 10% sugar, just like soft drink.  It’s easy to drink that sugar and just a 300ml glass can give you over 6 teaspoons.  With obesity being a national health concern, public health messages to reduce sugar intake are warranted.  Many people consume too much from drinks that are loaded with sugar but low in important nutrients - these don't fill you up at all, making it easy to drink and drink and drink.

But with the age of the whizz-bang super blenders and superfood smoothies, a new variety of fruit and vegetable-based drinks has emerged.  Unlike old-school bottled juice, the new-age juices are more than simply sugar, water and a sprinkle of vitamin C.

Blended fruit drinks, with the inclusion of whole fruits and vegetables, herbs, spices, milks, nuts and seeds have seen traditional juice turned on it’s head.  Coconut water is now apopular base for fruit and veg drinks, along with dairy, soy, rice and almond milks.  Juice is often not ‘juice’ at all.

Nutrients such as protein, healthy fats and fibre are becoming more prominent in blended juice drinks as a result, providing health benefits and fullness.  A blended fruit drink can really become more of a meal or snack rather than just something to drink.

One criticism of regular juice is that the fibre and pulp are removed during the juicing process.  Many of the nutrients in fruit are found near the skin.  When whole fruit is blended, the skin is included, boosting fibre and nutrients.  Blending is best! 

Yes, there is still sugar in blended fruit drinks or smoothies.  But when the sugar comes from fresh fruit or milks, it brings with it other beneficial nutrients, an important point of difference compared to soft drink and other high sugar, empty-calorie beverages.  The presence of a wider range of nutrients replaces some of the sugar, which ends up reducing the overall sugar content of the drink (especially if vegetables are incorporated).  If you know your vegetable intake needs a boost, a blended fruit and vegetable smoothie is a great way to sneak a in a few extra serves to help you reach your 5 per day.

A recent study by the University of New South Wales* compared a range of on-the-go drinks for their overall nutrition quality and found the drinks that contained blended whole vegetables or fruits to be the most beneficial for nutrients overall.  It's important to consider the overall nutrition value of a drink rather than just focusing on one nutrient or the kilojoules.  By keeping informed about the nutrient balance of on-the-go drinks, you can make an appropriate choice of drink, serving size, frequency and timing of intake to meet your individual needs and preferences.

For example, someone looking for a lower-kiojoule but nutrient-dense refreshing drink may choose a green smoothie with plenty of blended vegetables and a coconut water base.  Someone who is super-active and trying to gain some muscle mass may benefit from a dairy based smoothie higher in protein with some fruit, nuts and seeds providingextra nutrition and energy.  Everybody's needs are different.

One concern about juice is that it can be acidic, creating an environment for potential damage to teeth. A number of factors contribute to your likelihood of dental issues, including the acidity, sugar content, 'stickiness' and frequency that foods and drinks are consumed.  You can reduce your risk by drinking fruit/vegetable based drinks through a straw to reduce contact with teeth, and make sure to always rinse and swish with water after drinking higher acidity drinks.  Incorporating dairy with whole fruit to make a smoothie can be protective for teeth compared to drinking juice on its own.  

Water is important for daily fluid needs (tea is right up there for hydration too), but if you are looking for a nutritious and tasty choice, a blended fruit and vegetable drink can provide a range of important nutrients, keep you full and put a smile on your face!

For more nutrition info, recipes and tips, sign up to my free newsletter below or check out my other blog posts on my Thoughts page.

* Reynolds, R & Lin, S. (2016) Nutritional analysis of a selection of on-the-go drinks, Full Analytical Report, UNSW Australia.


Marketing 101 for nutrition and exercise professionals - bikini shots guarantee 'likes' and sales

I searched and searched for a picture to go with this post, and I came across this one that I think sums up the topic perfectly.  A fictitious character with a physique unattainable for most, tanned and toned, bouncy hair and made-up face, wearing clothing which couldn't possibly be comfortable for whatever activity she is attempting.  The rise of the celebrity/model/attractive person becoming the next nutrition and fitness guru is getting under the skin of many, who are vocal with their concerns. 

I am certainly not the first person to write about this topic.  Not that I am particularly bothered by the endless pictures of young gorgeous creatures parading around in the tiniest of bikinis and active wear, promoting all manner of things health, nutrition and fitness.  It doesn’t seem to bother their millions of followers either. Funnily enough, there is a huge market for this form of health-promotion/self-promotion and these entrepreneurs are tapping in.  Is it just harmless (and clever) entertainment or is there a more serious side to the creation of these glossy images that so many people seek for fitspiration?.

No question, some people in this world, whether natural or cosmetically enhanced, are absolutely beautiful to look at.  The problem is that just because something is attractive to the eye, it doesn’t automatically equate to knowledge and expertise in all things beauty, health, fitness and wellness.  Of course, you can have perfect bone structure and be intelligent at the same time, but there are plenty of people out there using their appearance to their advantage (and to be honest why wouldn't you?).  But using an attribute to your advantage in a genuine way is very different to misleading people to believe that you are something that you are not. 

A beautiful AND intelligent colleague, Sarah Nehme, a first class strength and conditioning coach and personal trainer recently posted on Facebook ‘So over these fake-boobed, naked girls on Instagram calling themselves "fitness professionals" or "master trainers". If you need to get naked to sell it then you don't know much about it.’

Sarah’s post got a great response and created a lot of interesting discussion.  My immediate response was to agree with Sarah, although it has also got me thinking about the concept from different perspectives.

From a sports nutrition angle, you don’t see too many Accredited Sports Dietitians (personally I coundn’t name one) who work with professional sporting teams parading themselves on social media in their short shorts and crop tops.  Not that there is anything wrong with that- we can all wear whatever we like, but in the world of professional sports medicine and high performance sport, flaunting your body is not really the done thing (for the staff anyway!).  In fact I would say most sports dietitians almost go the opposite way and cover up a bit more at work compared to what they may do in other environments.  But is this necessary?  Do females working in predominantly male environments, which many professional sporting teams present, need a more conservative dress code?  This is perhaps another point of debate in itself, professional conduct and what is appropriate or not…..

When we move from the workplace to the social media domain we are looking at a totally different scenario.  Competition is fierce, direct and consistent.  Amongst the millions of nutritionist and personal trainers some individuals feel they need to show off their assets to stand out in the crowd.  I must have missed the marketing classes in my nutrition and personal training studies that recommended you should prove that you have knowledge and applied skills by stripping down to your smalls to show your worth.  But as a marketing strategy it works a treat.  Many self-described ‘nutrition gurus’ are very savvy business people who know what creates attention and do a great job promoting their wares.  You know what, good on them I say.  If they really do have a useful product or service that is sound then well done on your marketing skills and success. 

If you work hard to train and eat well then why not show off your result?.  Just don't promise to those who lack your amazing genetic make-up that they can look like you by doing what you do.  Don’t claim to be something that you are not, while giving out incorrect and potentially dangerous information that in the long-run can have a negative impact on a person’s health and psychological well-being (long after they have generously donated to your bank account).  It might be worth considering your own longer-term health too, both physical and psychological.  Receiving positive feedback from strangers about your appearance must feel great at the time, but how long will it last.  What about negative feedback?  If your messages are not authentic or accurate then negativity will eventually come your way.

In the end, these bikini-clad babes are holding the dreams of many of us in the palms of their fake-tan stained hands.  Most of us want to try to look and be our best.  Perhaps these online role-models are providing us with hope – who am I to ruin the dreams of thousands and bring reality crashing down to earth with my claims that the majority of these starlets don’t know what they are talking about.  'Surely if I eat like Miss M I will start to look like her?'  You know, I think most people aren’t naiive enough to think that. Maybe it’s the fantasy of it all that is compelling.   Perhaps that’s what it’s all about, the unattainable reality but with the glimmer of belief that we could look or be a little bit more like these new-age role-models of health and fitness?   Who am I to destroy anyone’s dreams and motivations.  Or should more of us be standing up and speaking up against those who take advantage of people’s vulnerability as they yell ‘so long suckers’ and ride into the valley on a white horse with their blond hair flowing and bags of cash in tow??

Or maybe the bikini babes have it spot on.  Perhaps exactly what I need is a good boob job, a fake tan, exceptional lighting and angles, filters and strategic photoshopping.  This seems to be what people are interested in these days.  Forget the science and evidence-based strategies, let’s just go for the latest active wear and and inspiring pose to get people out of their chairs and making salads.  One thing’s for sure, I would definitely have a lot more followers and be a lot richer!  Or I may just stick to my everyday clothes and continue my current day job……I'll keep you posted!

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The Great Sugar Con - why 'refined sugar-free' is a waste of time

It has raspberries, so it must be healthy.....

It has raspberries, so it must be healthy.....

‘Refined Sugar-Free, Gluten-Free Choc Caramel Cupcake’.  This was the latest ‘free-from’ delicacy that popped up on my screen, one of many that I see daily.  I can’t help but cringe, and rather than making me salivate these images just make me more and more agitated.  Refined sugar-free treats are everywhere, from raw slices, to bliss balls, to smoothies to cakes.   These creations look absolutely delicious and of course they are touted as guilt-free as well as sugar-free - but are they either?  They are often promoted by a celebrity or nutritionist or the latest sugar-free café or recipe book, to convince us of their goodness.  So how do the creators manage to formulate alternative options that are made from healthy ingredients and match the textures and taste of the real deal??  How is it possible to cut out all the wheat, animal products and sugar while achieving such remarkable taste, texture and visual results. 

Well, I’m sorry to be the bearer of bad news but we are all being conned - big time.  The reason these ‘free-from’ treats look and taste so superb is because in fact they do contain sugar, and often lots of it.  But how can that be so, when they are labelled sugar-free.  Look a little more closely – ‘refined sugar-free' does not equal free from sugar.  It simply means the sugar is not in the white powder form, everyday table sugar that is labelled as everything from dangerous to toxic.  But there is no limitation on the huge number of sugars that are considered ‘natural’, or not refined, and these are often used amply.    I’m sorry, but it is impossible to make a cupcake taste evenly remotely like a cupcake without adding sugar. 

Pick up many of the trendy low-sugar recipe books and you will find the widespread use of products like rice malt syrup, agave, coconut sugar, etc.  If you asked the cafes and bakers the ingredients of their ‘’free-from’’ caramel cupcakes you would most likely find the same thing.  I honestly don’t know how the promoters of these products feel comfortable, knowing that their products contain just as much sugar, if not more, than the traditional product counterparts.  Maybe because 'no sugar' sells.  Even if it is a misrepresentation, or in fact a blatant lie.

For example, just flicking through some online recipes from a well known nutritionist and quickly came across a Choc Coconut Cupcake recipe.  Sounds innocent enough, except that the recipe makes 15 and contains a whopping 3 cups of coconut sugar in the icing - nearly ¼ cup coconut sugar PER cupcake!  But it is still technically refined sugar-free.  Or another website about quitting sugar that simply uses rice malt syrup instead of white sugar to make it sugar-free. (For more details about what coconut sugar and rice malt syrup really are, have a read of my previous post The facts about sugar - are natural sugars really healthier than white?)  Education on Sugar 101 is seriously lacking.  The other downside is that many of these recipes can be complicated to make and you may be wasting your time and effort thinking you are making the healthier option.

Of course overconsumption of refined sugar is a serious problem.  I just read in the paper today some data from the Australian Bureau of Statistics, that boys aged 14-18 years are consuming on average 92 grams per day (nearly 20 teaspoons) of free sugar (and 38 teaspoons/day in total), with much of this coming from soft drinks alone.  This is quite alarming considering that WHO recommends we aim for less than 12 teaspoons of free sugar, or less than 6 for dental health.  Products that contain pretty much just sugar with no other nutritional value, like soft drinks, are a major contributor to free sugar intake.  But if you think you are doing your best to reduce sugar by choosing the organic low-refined options you may not be doing yourself any favours.   Natural syrups and unrefined sugars are still considered free sugars, and although claimed to provide nutrients, the trace amounts are pretty much negligible (other than honey, but you still don’t’want to overdo it).  Perfect example, a small drizzle of honey on some porridge is not going to over-do your sugar intake for the day and can add to the enjoyment of an otherwise nutrient-dense meal.  However using honey in a refined sugar free choc honeycomb cupcake that is also loaded with other ‘natural’ sugars is probably not a great representation of a healthy option. 

Bottom line – many of us should reduce our total sugar intake, not just white sugar.  Think back 50 years where something sweet was enjoyed wholeheartedly on a special occasion, but not everyday.  When you do indulge, choose something you really like that is going to satisfy you.  If  the refined sugar-free raw raspberry slice from the vegan café does it for you then go for it, or you may be happier with a good old-fashioned piece of home-made cake now and again.  Choosing refined-sugar free does not guarantee lower sugar and higher nutrient content.  Don’t be fooled - most of the ‘refined sugar-free' treats should be treated the same as a piece of regular chocolate mud cake or a chocolate brownie.

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Image by Whitney - originally posted to Flickr as Chocolate Cupcakes w/ Raspberry Buttercream, CC BY 2.0, (may or may not be refined sugar-free?)

Kids' party food - go healthy or sugar-laden free-for-all?


This post has absolutely nothing to do with sports nutrition, as my nutrition focus has switched to kids party fare with my son's recent birthday.  If you have ever known a 5 year old, then you probably understand that when you are 5, birthdays are a big deal.  We had two small parties and co-ordination of catering was required for both.  My biggest dilemma when it came to planning was whether to go super healthy or stick with traditional.  As a dietitian I feel a responsibility to a degree to provide some nourishment, but then I don't want my kids to feel like their parties aren't quite as exciting and just full of everyday foods either. 

One party option was the local pub, a child-friendly venue with a fantastic playground and low-maintenance for the host parents, BUT as you would imagine, there were no date & chia balls or frozen fruit pops on the pub catering menu!  So my dilemma was this - have a party at home with the risk of inclement weather and 12 kinder kids and toddler siblings squashed into a space designed to really only cater well for 5 or 6......or head to the pub.  Home party means healthier menu, pub means typical party fare from packets and either fried or mostly pastry.

I was torn...the pub menu wasn't really negotiable, other than the additional fruit platter I could order.  I love a  party at home, but last year's proved to be challenging when it poured rain all day and we were stuck indoors.  However a home party allowed total control of the menu, and the preparation of at least a few healthy options.  I swung to and fro and deliberated on my decision, but in the end the low maintenance pub won out.

I know there may be some of you reading this who are horrified to think I would expose my children to such toxic food.  I also know there are many parents, and party venues, who go the whole distance when it comes to healthy parties - organic, raw, no sugar, no nuts*, no dairy.   That's great if you can make it exciting.  I am not sure that kids get quite as excited about high-fibre bran muffins as they would blue cupcakes with sprinkles!  Or maybe I'm not being creative enough??  I know for myself that many of the special memories of parties were related to the food.  If the food at a party is the same as what a child gets in their lunch box every day then it wouldn't be a party would it?   I believe in the fun of parties and enjoying special foods, especially when it comes to birthdays. 

*When catering for children you do need to be careful when it comes to nuts and other allergies.  There were two children out of 15 with nut allergies on the day, and avoiding nuts in party foods is pretty standard these days. 

So, the pub party food it was, although I couldn't help myself and ordered a fruit platter to go with it!  I didn't think the kids would touch the fruit, but to my surprise they actually had a good go at it.  And do you know what?  Even with all the high fat, processed foods available, most kids didn't actually eat that much of it.  Children seem to be so much better than adults at regulating intake, and have a great sense of hunger and appetite.  At a birthday party there are usually lots more exciting things to do than sit around eating all day.  So maybe that's the big tip for kids parties, make sure there are some activities on the go and they may not eat that much sugar anyway.  Oh, and you probably don't need to serve soft drink or juice.  Water is perfect, there is probably going to be enough sugar in everything else.  No soft drink also means no artificial colours too.

When it comes to parties, I do have a concern about the amount of artificial additives consumed by kids, so my effort to make the party fare healthier was to use natural food colourings and use lollies in the lolly bags without added flavours/colourings.  The lollies were easy, but the natural food colourings were a new experience, especially with my history of regular cake making and use of super-concentrated food colourings.  My Octonauts Amazon Adventure cake, as requested by my son about 6 months prior to his party, required both blue and green food colouring.  One word to describe natural food colourings - pale.  Unless you use almost the whole bottle at $10 a pop.  In the end, I kept on adding and managed to get a reasonable colour, see below (minus the Octonauts who were yet to be added).

Now for the second party, the family gathering, which was straight after the pub.  I love home parties and planning the menus, and my philosophy for home is to incorporate traditional party foods, with a few healthier options on offer (a sushi/rice paper roll platter and fruit salad).  I don't try to mess with delicious traditions in an attempt to make them healthier, by substituting with spelt flour or coconut oil, I let everyone enjoy party foods as they are meant to be (other than the colours).  At least if you some of the options are home-made it will help with reducing the level of processing and intake of additives.  As a dietitian I sometimes feel a bit of pressure, or feel like I am being judged by what I provide at children's parties, or in their lunchboxes for that matter......but in the end it comes down to enjoying a range of food and avoiding 'good' or 'bad' food labels with youngsters who are developing their relationship with food. 

So in summary I think parties are great!   Traditional party foods are fun, watch the artificial stuff though and maybe throw in a few healthier options as the kids may actually enjoy them.  Or they may be so busy they don't eat much at all.  Occasional party foods are totally fine, HOWEVER, the big issue is that young children can end up going to A LOT of parties.  If you are going to a party nearly every weekend, all those party food add up, and that's where I can see the value in providing healthier party foods.  But how do you know how many parties your guests are going to that weekend?  My strategy this year to help the parents out was to only put a small number of lollies in the lolly bags so that what is eaten at the party is done at the party, and the sugar intake doesn't continue on for weeks after via lolly bags bursting at the seams.  My boys have about 4 lolly bags in the cupboard that they are gradually trying eat their way through, one lolly at a time! 

The important thing is for everyone to enjoy the party, from planning, to preparation, to playing!  Your decision to provide more or less healthy options will depend on a range of factors individual to you and your guests.  Make choices that create the least amount of stress and maximum amount of fun!


This celebrity chef has always been a true ambassador for fresh, seasonal eating.....

I was flicking through the Coles catalogue today and all of a sudden it dawned on me.  We are surrounded by chefs and celebrities, local and abroad, who claim to be  experts on all things nutrition.  Many of these 'sudden experts' quickly capitalise on their popularity to sell their newfound knowledge via commercial avenues.  There seems to be a lot of negativity, and downright nasty attacks, towards some of these individuals selling their nutrition message, but the thing that dawned on me was the fact that there is one famous chef who has been promoting the virtues of seasonal and fresh food for years.  All this time we could have just been reading the Coles catalogue weekly to help us learn about how to eat and cook.  Or watching repeats of Surfing the Menu.

Yes, most of us have heard of Jamie Oliver and his passion for healthy fresh food.  I think he does a wonderful job spreading his messages - not necessarily telling people what to do, but promoting fresh, wholesome eating and inspiring young people to learn about food and where it comes from.  But I think we sometimes forget that we have our own ambassador in Australia for local, seasonal, sustainable eating.  He doesn't promote himself as a nutrition or health guru, but his subtle messages and actions are just as powerful as those of others around him who sell themselves as health ambassadors.

Image courtesy of  Ray Kachatorian

Image courtesy of Ray Kachatorian

Curtis Stone has been promoting the virtues of local, seasonal produce and an active lifestyle for well over ten years.  Back in 2003 he and fellow world-class chef Ben O'Donoghue filmed the food and travel series Surfing the Menu for ABC in Australia.  Most of the food preparation and cooking was done outdoors, relying on locally grown or available produce, with a surf always included at some part of the show.  The program was not advertised as a 'health' program as such, more a showcase of Australia and the wonderful food experiences and lifestyle on offer.

Curtis Stone's values when it comes to food and nutrition are solid and have not changed over time.  The title of his latest book, Good Food, Good Life sums up his simple and sensible approach.  Have a read of the 'About Curtis' page on his website, and particularly the section on 'My Cooking Philosophy'. In Curtis' words: 'When Mother Nature worked out what we should be eating at different times of the year, she did a pretty good job, so listen to her. Food that is in season just tastes better and you really don’t have to do a whole lot to it to make it taste great! It is always less expensive, and chances are it hasn’t been artificially treated or travelled halfway across the world to reach your kitchen'.  Pretty simple really.

Eating well does not have to be complicated and often the most nutritious way to eat is to keep things simple, but not boring!  Curtis Stone's three words to live by - Cook, Create, Celebrate.  This is also the the title of his blog and is a wonderful way to think about nutrition and eating and the enjoyment of food.

Looking at Curtis' website you won't find any mention of sugar-free, low-fat or Paleo.  You will find gluten-free, but many people have to avoid gluten for medical reasons.  Otherwise there is nothing else that alludes to the restriction of any other foods or food groups.  Foods are not categorized, ranked or banished in terms of nutrition, rather all foods and ingredients are embraced and respected for the flavours, textures and experiences they can provide.  Have a look at the recipes on the Curtis Stone website.  Some are in fact sugar-free, low-fat or Paleo but are not labelled as such, and there is not a nutrition table to be found.  I have a book coming out soon that contains about 40 recipes and I too have avoided including nutrition tables.  Some people might not be happy with the lack of nutritional info, but I think it is important to not always base food choices on the numbers.

Curtis Stone believes in seasonal, local, sustainable eating and is obviously aware of nutrition but should be respected for not trying to push, preach or be something or someone that he is not.  He sticks to his beliefs and admits on his website to enjoying the good life as well.  Not all of his recipes would be considered 'healthy', although many are, and this reflects reality and the importance of variety and enjoyment.  If you eat fresh, seasonal, nutritious food a lot of the time, there is room for desserts and sweet foods here and there.  I really don't like the word 'balanced', it makes food and nutrition sound so dull, but having a mix of mostly nutritious foods and 'balancing' it out in combination with richer foods that we love now and then helps to make life fun.  The effects on your body from feeling stressed about your kilojoules or grams of carbohydrate are potentially far more negative than relaxing a little about intake and enjoying foods and flavours without deprivation.

Anyway, my message is, if you are looking for a celebrity chef role-model among the vast array of self proclaimed nutrition experts, look no further than Curtis Stone.  His philosophies are great, he won't suggest you avoid any particular food if you don't have to, and his website has an unexpectedly large number of his recipes available to the public, as well as a range of recipes that he has developed for Coles.  Sure, if you only  eat his desserts then you may be needing an appointment with me in the near future, but if you scan through his recipes you will find most are based on fresh ingredients and are not overly complicated.  Or you may just find a Curtis Stone recipe in a Coles catalogue or store near you.

* After I wrote this post, media coverage was released about comments that Curtis Stone made about the food his children eat, and his thoughts on kids nutrition in general, .  There was much criticism of his comments about restriction of 'junk' foods and how to manage fussy eaters.  The problem was that many people did not read the full article, and just read bits and pieces printed in other articles or social media posts that were taken out of context.  If you read the whole article, it is clear that his approach is to offer your children nutritious options most of the time, but that it's ok to eat 'occasional' foods too eg. parties.  His comments about kids eating healthy food if it is put in front of them regularly were a little misplaced, as it is not that easy and I can guarantee that as a dietitian and mother of two young boys myself.  But I don't think Curtis Stone's overall messages were misplaced at all, keep offering healthy options at home and don't just give them a hot dog instead!  Yes, this involves restriction to a degree but not complete avoidance -  children need adults to provide some guidance and boundaries in all areas of life, and as many dietitians say 'the parents decide what to offer, the child can decide what and how much they eat'.

Disclaimer - I do not have any association with Curtis Stone or Coles supermarkets. However my son's name is Curtis and that may make me unknowingly biased!  Before you ask, no, my son was not named after Curtis Stone!


Why 'everything in moderation' is not always the best way to go

Over recent weeks I have seen something that I never imagined I would ever see. Dietitians publicly promoting images of themselves chowing down on donuts, biscuits and all manner of sugary morsels.  Dietitians, and other health professionals of a similarly  conservative background - all promoters of nutritious foods, who help people to reduce their intake of high sugar, high fat foods.  But shouldn't a dietitian be seen crunching on an apple or a carrot stick?  These sugar-sweet images certainly don't seem to convey the message of good nutrition and health at first glance.  However, there is a valid reason why many dietitians are going against the grain.  It has everything to do with moderation.  But what is moderation, and is moderation the best approach for everyone?  My suggestion would be, not necessarily.

There appears to be a show of unity amongst a growing number of dietitians in promoting the messages of balance, moderation and non-restrictive eating (exactly what most of us should aim for ultimately).  This reaction is in direct response to the current glut of dietary approaches that involve extreme restriction of foods and food groups.  Many nutritionists and dietitians do not support these popular diets and are taking a stance to illustrate that all foods can be enjoyed in moderation, for both health and enjoyment, and that no food or food group is completely off-limits.  

One thing I do love about the ambassadors of the back-to-nature style food trends is their passion.  They practice what they preach (mostly, unless they are getting paid the big bucks on cooking competition shows, then 'toxic' sugar is all of a sudden neutralised).  They live and breathe nutrition and health, almost to (and sometimes beyond) the point of obsession.   When 'clean' eating goes too far it is no longer a healthy way to live.  Unfortunately this all or nothing approach can often lead to disaster, or at least a major fall of some sort, in the long-term. 

Personally, I don't recommend that people eat donuts, cakes, biscuits, etc.  I don't label them as 'never' foods either.  Many people come to see me to improve their nutrition either for exercise performance, to achieve body composition goals or to manage digestive issues.  For athletes to improve their chances of success, there are benefits to relatively specific structure when it comes to training, nutrition and other factors that contribute to performance.   If someone is trying to lose body fat or gain muscle mass in a timely fashion then the same applies.  For those with digestive issues, restriction is often required, no question.  I would suggest that all people who book in to see a dietitian are working towards particular goals and looking for strategies to achieve these.  In my experience structure beats moderation hands down, in the short-term at least. 

Moderation is a term that is interpreted differently by different people.  For some people, it may mean eating well most of the time, then relaxing a bit once per week or fortnight when they go out for dinner.  For others, moderation may mean having a small piece of dark chocolate every night within a relatively healthy eating style.  Others may have half a chocolate block and find moderation there.  For others it might mean having 4 beers per night instead of 8.  Moderation varies widely in its application, and can mean very different things for health and associated outcomes.   The term moderation is in some ways irrelevant without some level of boundary with regard to the types and volumes of food.  For some people these boundaries can be more flexible than others. 

Back to my example of athletes.  For particular times of the year their boundaries may be quite tight if there are specific goals for a given time-frame, then more flexible at different times of the year.  Someone trying to lose weight may also need more structure to start with, but we all have different motivators, so some people might like generalised guidelines in preference to the 7-day plan that could work well for others.  For someone with intolerances and allergies,  moderation is not an option.  For someone who cannot eat certain foods, it may be quite frustrating to hear 'everything in moderation' as the best strategy for healthy eating, as this is an option they may yearn for but will never experience as a reality.

For someone already at a healthy weight and of good health, moderation is the way to go.  The idea of being able to maintain good health while still enjoying the foods and drinks that you love is very appealing.  Maintenance with moderation is achievable, although for people with a history of weight fluctuation, mindful moderation will still be important to ensure long term good health.  This brings up another point - moderation is very hard for a lot of people.  Not everyone can just stop at  one chocolate out of a fresh box, or one donut, or a handful of chips.  Actually I would say that most people find moderation hard.  Moderation is great in theory, but putting moderation into practice doesn't just takes some time, effort and prioritizing, and it often requires some professional help. 

Of course there are individuals who find moderation easy, or don't have the same food temptations experienced by many.  There are also those who have the genetic make-up where they seem to be able to eat almost anything and as much as they like with  absolutely no difference to their weight and health (although not everyone within their healthy weight range is fit and well). 

For those experiencing disordered eating, moderation can be a real challenge.  More and more young (and older) people are being effected by disordered eating, which is often characterized by restrictive patterns.  A strong message of 'moderation' is particularly relevant with regard to disordered eating.  As the above examples indicate, the specifics of the moderation message need to be tailored according to an individual's relationship with food.   

So perhaps the image portrayed by some dietitians of late has more to do with the particular client groups that they work with and how the moderation concept applies. I can think of a personal example myself, where I was acutely aware and concerned of my image as a dietitian.  When I was pregnant I suffered from reasonably bad morning sickness, and the one thing that I craved and could stomach was eggs.  Eggs and bacon and extra salt to be exact, and the drive-through muffin varieties were particularly appealing and convenient.  If the timing was right I would have prepared my own eggs and bacon, but as I was finding it very difficult to cook due to illness, the take-away was the best option at the time.  My heart would race every time I drove through, in fear of being spotted by one of the staff or players from the sporting club where I worked.  The thought of one of them seeing me eating foods that were perceived to be unhealthy made me nervous.  It may sound ridiculous, but for the type of clients I work with, visuals of myself eating perceived 'junk' foods would not, I feel, be the best example of my philosophies when it came to nutrition.  Not that I don't ever eat those foods, but I think it would be quite hypocritical in a way, and almost offensive, to be seen devouring foods that I have recommended that my clients reduce their intake of.   The reality is, that for many athletes there are times where they do need to reduce their intake of particular foods to reach their goals.  Not all the time, just certain defined time periods.  I am not embarassed about any of my food choices, and I do believe in the moderation concept, but the application of moderation is highly variable for individuals, and their specific needs, whether that be within a training cycle, a calendar year or over a lifetime.  

There is an important place for moderation in nutrition, when applied appropriately and interpreted and communicated effectively.  Finding the right approach for your individual needs is the key, to be able to reach your goals, enjoy good health and appreciate and enjoy delicious foods and flavours.  No foods or food groups need to be avoided completely, other than for medical reasons, but don't expect all dietitians to be putting donuts on your menu either.

The facts about sugar - are natural sugars better for you than white?


If there is one thing that everyone seems to agree on, it's that too much sugar is not great for our health.  But are natural sweeteners like honey and maple syrup any better for you than everyday white table sugar?  There is plenty of information out there that would convince you to choose a natural sugar source over refined.  But if you look at the less processed options more carefully, it is quite obvious that they may not be quite as sweet for your health and weight as they are for your palate.


Over the past few weeks I have been fascinated by the plethora of back-to-school lunchbox ideas on Facebook.  Some are just suggestions, others are quick an easy recipes and many are photos of entire lunchboxes.  Of the lunchboxes I saw, many were of the bento box-style variety, packed by families who follow Paleo, low-carb, LCHF*, GAPS*, JERF* or any other popular way of eating that is described by an acronym these days (*see end of the article for definitions).  The common denominator of many of these dietary approaches are that they are as natural and unprocessed as possible and often ban carbohydrate from grains, but not carbohydrates completely.

I love the bento box style lunchbox, and can't wait to get them for my boys, but the thing that interested me most about the lunchboxes I viewed was that although there were no grains included, a quick visual assesment indicated that carbohydrate, as sugar, was well and truly present.  This got me thinking about how going grain-free can subsequently lead to increased sugar intake. 

The small individual compartments of the bento boxes were impressively jam packed with vegetable sticks, cherry tomatoes, chopped fruit, maybe some cheese or yoghurt and some leftover cold meat or chicken (no nuts due to the imporant nut-free school policies).  Terrific and great examples of nutritious foods for a child throughout a school day, or for an adult!  But what also seemed to feature highly in these boxes where substantial quantities of grain-free delights, think seed/fruit slices and balls (every nutrition website seems to have a recipe for a ball of some sort), 'healthy' slices and cookies, even chocolate mousse!  Not just a small serve, but enough to make up a fair portion of the healthy lunchbox.  Many of these 'healthy' type of sweet concoctions use natural sugars to help bind the ingredients together.  Syrup-form is common, but dates are also often used as the main ingredient.  Nothing against dates, they do contain a range of nutrients, but they are also up towards 70% sugar.  Actually most dried fruit has greater than 50% sugar (compared to fresh fruit which is usually <10%, even bananas, with the highest carbohydrate concentration of all the fruits, is around 18%).   So is using dates, or other natural type sugar sources, as the sweet component really any better than using other types of sweetener? 


White sugar, like the type you put in your cup of tea, is often labelled as a toxic poison, while the natural options like honey, agave, coconut sugar, rice syrups and maple syrup are increasingly being added in many homes as staple kitchen cupboard ingredients.   The theory behind the use of these natural sweeteners seems to be that less processing will retain some of the trace vitamins and minerals and may also have a reduced impact on blood sugar levels.......true or false?  Mostly false.  If you are relying on honey or maple syrup for your vitamin and mineral needs then you are in trouble.  Adding any of the less processed sweeteners does not improve the nutrition value of a food either.  The 'trace' amounts of nutrients in these sweeteners are exactly that, trace amounts, so small that they will not contribute significantly to overall nutrient intake.  But they will contribute significantly to overall sugar and kilojoule intake, and perhaps even have implications for dental health.  The chewy, sticky type balls and slices with natural-based sugars and dried fruit that can stick to the teeth for longer are far more likely to contribute to dental issues compared to a piece of wholegrain bread or small serve of rice.


Can we throw all sweeteners into the one basket as 'just sugar and kilojoules'?  Not quite, but just about. 

HONEY has always been a standout in the sweetener stakes, with research in humans showing potential health benefits with regard to anti-inflammatory and anti-biotic effects (note - it won't cure cancer).  The only thing is, most of the studies on honey involve consumption of a lot of honey, 3-5tbsp per day.  That is up towards 100g of honey per day, which is 20 teaspoons or over one third of a cup - a lot of honey.  Many of the health claims related to honey require further research to support them, and to determine a useful dose.  In terms of the type of sugar in honey, it contains glucose and fructose in a 1:1 ratio, same as table sugar.  So depending on your overall nutrition requirements, the potential benefits of honey may be outweighed by the additional sugar and kilojoule effects. 

AGAVE, agave nectar, or agave syrup is heavily promoted as a natural and low GI sweetener, but they forget to tell you that the reason it has a low GI is because this syrup is loaded with fructose, potentially around 85% fructose.  Great, it's low GI, but overloading on fructose is probably not a great health choice.  Yes, many fruits contain fructose, but in very, very low concentrations compared to a sugar syrup like agave, and fruit is tied up in a pretty little package with lots of fibre, water and nutrients. A lot of the agave available for sale is highly processed too, not as natural as it may claim.

MAPLE SYRUP is the best thing ever on pancakes (in my opinion!), nothing else tastes quite like it.  But amongst all that deliciousness is lots of sugar, most of the sugar in maple syrup is sucrose.  Sucrose is table sugar, maple syrup is over 2/3 table sugar, with some water and trace vitamins and minerals.

BROWN RICE SYRUP, or rice malt syrup, sounds so healthy.  The word 'brown' is quite deceiving, most 'brown' or wholegrain foods are low GI.  Brown rice syrup is the complete opposite, being high GI and bad news for blood glucose levels.

COCONUT SUGAR must be good for you, because coconut products are meant to treat everything from the common cold to cardiovascular disease, right??  Coconut sugar is 70-80% sucrose, basically just table sugar.  It may have a slightly lower GI, but who cares, it's predominantly table sugar with a not-worth-mentioning tinge of nutrients.

There are plenty of other natural sweeteners out there, these are just some of the popular ones often used as a healthier substitute to sugar.  Unfortunately there is not a lot of good news if you are trying to improve your nutrition by using white sugar alternatives.


Don't get me wrong, I have absolutely nothing against a little bit of sugar on a regular basis.  I love the idea of making sweet snack options healthier (I made some cookies with oats, cranberries, brown sugar, honey, butter, eggs, a little bit of flour and some mini-choc chips on the weekend, but I don't make them every week).  But don't be fooled into thinking that by using a 'natural' sugar it is necessarily better for you, in terms of health or energy levels.  Using regular white or brown sugar, in small amounts as part of nutritious foods is absolutely fine!  

If you are an athlete or someone who trains a lot, then your choice of carbohydrates may need a bit of planning and the type and timing of sugars can be critical to performance.  But if you know me, you will know my thoughts on jelly lollies at half time....just because you are running around for an hour or two doesn't mean you need stacks of processed sugar products.  One of my upcoming posts will address the more specific needs of active people when it comes to carbohydrates and sugars.


Choose your sweetener based on the taste and texture, not on health.  Get nutrients from vegetables, fruits, lean proteins, nuts/seeds, dairy or alternatives and wholegrains (wheat-free if required), and enjoy sweet foods as part of eating beautiful, delicious food, being mindful with regard to your individual overall health.

Diet definitions: 

JERF = Just Eat Real Food                                                                                                    GAPS = Gut And Psychology Syndrome                                                                              LCHF = Low Carb High Fat

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5 secrets of the French - how to eat the foods you like and not gain fat

Believe it or not, it is possible to eat whatever food you like and not put on weight.  Lots of people do it.  French people have perfected it. Although there are a few conditions.

My title is a little misleading, the French aren't really keeping anything secret, they showcase their remarkable way of life to every visitor who crosses their borders.  They eat beautiful, fresh, amazing food.  Some nutrient-rich, some not.  First impressions of French food don't usually remind you of 'clean eating' (for want of a better term), but somewhat surprisingly their everyday way of life is conducive to good health and managing weight well.  The graph below compares the trends in obesity in different countries.  Many countries are on the increase, including France, but they are starting at a lower waist measurement, and are a long way from catching the US or Australia.  Remarkable really when you think of all those croissants, pastries and creamy sauces.  If the French can maintain their traditional food culture and customs this will help to keep them at the bottom of this graph, but as fast food culture infiltrates this may see their country sloping further and further towards the top. 

Obesity trends in selected OECD countries, source:

Obesity trends in selected OECD countries, source:

So what are the secrets of the French that has been keeping their obesity rate around half that of Australia?

1) Small portions

Number one habit of the French that works every time - small portions.  I truly believe that how much we eat is more important than what we eat when it comes to weight management.  Not as important for health perhaps, as 1500 calories worth of chocolate and sweets per day is not going to be all that sustaining or nutritious.  The foods that make up your portions are important for keeping you full and also to give your body nutrients, but getting the volumes right is key.  In France they enjoy their pastries, breads (white!), cream, cheeses, wine and rich, rich sauces but they also eat salads and vegetables.  Most of their food is served petite. 


Image courtesy of

I am not claiming that there is not one person in France who is overweight or overeats.  With an obesity rate in 2012 at 15% and overweight 32%, the French are still considered the thinnest people in Europe and doing better than most developed countries.  

Eating less is not all the French do well...... 


2) Enjoy and savour food - eat slowly and sit

Everyone is busy and it seems very few family meals are enjoyed at the traditional dining table, sharing news of the day and a delicious home-cooked meal.  The French have refined the art of sitting down (often at a café facing the footpath) to enjoy a coffee or something to eat.  French children are more likely to sit down to a hot lunch rather than a sandwich, with a small dessert to follow, which may in fact be fruit of some description.  When we eat on the run we usually eat quickly and don't have time to think about the flavours and textures, or how much we are consuming.  Eating out of a bag or a packet is common, while eating from a plate has greater benefits.  If you put your food on a plate you can see exactly how much there is, and using utensils also helps to slow down the rate of consumption.  You may yourself have been shocked by tipping a take-away carton of noodles or curry onto a plate and realising the sheer volume that was about to go into your stomach.  Eating from a plate will help to reduce your portions.  If we are eating while doing something else, like working on the computer or sitting on the couch in front of the tv, then we are also eating mindlessly and this increases the speed we eat and the likelihood of over-eating.  Sitting down to eat a meal and focusing solely on the food and our dinner companions is worth the time and effort.    

3) Meticulous preparation

French people take the time to eat, and perhaps this is because they are admiring what they are about to enjoy.  Just think of a French pattiserie and the sparkling clear glass cabinets full of intricately designed and crafted pastries and cakes.  The structure and artistic appeal is of equal importance to flavour.  Petit fours is a French term meaning 'small oven', as these miniature sweet morsels were traditionally made in a small oven next to the main larger oven.  Most enjoyment of food is in the first couple of bites, and in France they recognize this.  What is the point of having a huge piece of chocolate cake, all the one flavor, when you can have a range of different flavours and food experiences.  Nothing is just slapped onto the plate in France, pride is taken in food preparation and presentation.  Not everyone's lifestyle can accomodate hours in the kitchen, but allocating a small amount of time to improving your food skills and making food look nice can make eating so much more fun, and help your health and weight at the same time.

4) Mealtimes are for eating

It seems that the French eat their food at mealtimes and don't rely on too much snacking for their daily nutrients.   I don't really know why there is less snacking, but eating a 'proper' meal at lunch may mean that hunger in the afternoon is less of an issue?  Three square meals per day won't suit everybody, but it may be a useful strategy for reducing overall calorie intake, as the types of foods we eat between meals are often higher-calorie and lower-nutrient density than the type of foods we eat for main meals.

5) Good habits start early

Most of the food habits described above begin during childhood in France.  The child obesity rate in France has historically been one of the lowest in the world, while in other developed countries children are becoming more and more overweight.  If you want to learn more, check out this post by Karen Billon  'French Kids Don't Get Fat' which is a terrific insight into the eating patterns of French children.


Although we can't all move to France to live, we can make the effort to understand some of their everyday habits and apply them to our own lifestyles and eating patterns.  With Christmas and associated food-related celebrations ahead, there is no better time to start thinking about your own choices.  Portions really are the key, whilst enjoying a range of nutritious foods eaten for pleasure. Bon apetit!! 







Effect of LCHF on blood test results PLUS ketogenic diets PLUS coconut oil


I have been thinking about this whole LCHF movement and some of the passionate advocates of this style of eating, and I continue to be bewildered as to why they are SO passionate about spreading the LCHF word?  Perhaps their own personal experience has been so overwhelmingly powerful that they feel no option but to help others to experience the same?  Or is it to challenge the exisiting dietary guidelines and advocate for change (not that too many people actually follow the current dietary guidelines anyway)?  Or is it to promote the next diet book they have at the publishers, just about ready to hit the shelves.  You know what, I am really not sure, and there are probably different incentives depending on the individual.  The wide range of characters promoting LCHF makes things even more confusing – some scientists, doctors and dietitians are gunning for it, and so too celebrities, chefs, and everyday Australians.  Interestingly, Australia is the number one country at present where the LCHF message seems to be getting air time.  Apparently in the US and other countries, there is no such interest, and LCHF may just be viewed as another fad diet.  Jimmy Moore, a speaker at LC Downunder seminars is from the US and he was congratulating Australia on their interest and uptake of LCHF (and for supporting his livelihood via purchasing his books and other resources).  So are we just all being sucked in, when other countries don’t seem to give two hoots about LCHF, or are followers on the crest of the next wave of nutrition truth……..

My curiosity about why LCHF supporters are so passionate extends to Associate Professor Ken Sikaris. His name may sound familiar to you if you live in Victoria and received a blood test report in the last ten years or so - his name may have been printed at the top of each page.  Ken Sikaris is a pathologist, specialty biochemistry, with a particular interest in cholesterol.  A/Prof Sikaris has an impressive resume in the world of pathology.  I hope I am not being naïve, but his apparent neutrality in the commercial world (unless he has plans to release his own brand of coconut oil/fat/paste/milk/cream*see end of post), along with his vast professional experience in pathology, makes it difficult to predict any reason why he would want to be talking about LCHF at the Low Carb Downunder seminar, other than because the research is indicating something.  A/Prof Sikaris has also tried LCHF himself and he credits this for his personal weight loss and improvements in blood lipid profile, which he presented as one of a number of case studies.  He also showed some real research, a pleasant change from the heavily weighted anecdotal and case study format of most of the seminar sessions.  Admittedly, I have not critiqued every study that was presented, but the trends that were observed in the large number of studies he discussed shone quite a positive light on LCHF for cholesterol, triglyceride and blood glucose levels.

I don’t want to simplify the complexities of blood testing and interpretation, but to summarise the content and research within the presentation, the trends observed in blood parameter changes with LCHF from the studies presented are something along the lines of this:

- Increase in Total Cholesterol

- Increase in LDL cholesterol (‘bad’ cholesterol)

- Increase in HDL cholesterol (‘good’ cholesterol)

- Decrease in small dense LDL (‘bad’ cholesterol)

- Decrease in triglycerides

- Decrease in HbA1C

  • Please note, these are observed trends that were presented based on studies during one session of the Low Carb Downunder conference and are not indicative of expected changes in ALL individuals.  For some people, a LCHF diet may produce unfavourable results which may be of significant risk to health.

Reading through the list above, the first impression is that eating more fat through LCHF will increase total and LDL cholesterol. Higher fat intake is likely to increase total, LDL and HDL cholesterol, but reducing carbohydrate helps to reduce triglycerides, which A/Prof indicated may be the key element in reducing cardiovascular risk.  He indicated that as triglyceride levels increase >1.5mmol/L, more LDL will be in small dense (modified) form, that hangs around in the blood, rejected by the liver and may end up in blood vessels.  On the other hand, if triglycerides are <1.5mmol/L, LDL are likely to be in the larger form that may be taken up by the liver.  It may be that small dense LDL could potentially be the new marker of CVD risk, and that even if total and LDL cholesterol are higher, CVD risk could be reduced if small dense LDL% is lower.  And this could all link back to carbohydrate and their impact on TG's.  On a low-fat, higher carbohydrate intake, it was observed that more small dense LDL is formed. It was suggested that a short period time of only 3 weeks could potentially show blood changes of decreased triglycerides and small dense LDL.

With regard to HDL, observed increases have been quite large in magnitude, and it was suggested that there is no drug that can increase HDL to that extent. 

HOWEVER, it was acknowledged that not ALL individuals experience positive changes to blood cholesterol profile with LCHF.  For some people, LCHF increases total cholesterol excessively, and this is likely related to genetics.  This is often due to an increase in Lp(a), a modified LDL particle that the liver does not particularly like and so, like the small dense LDL, it can end up in the blood vessels, which can be dangerous for cardiovascular health.

So to summarise the presentation by Ken Sikaris, LCHF can have a positive effect on blood lipid profile, but can have a negative effect in some people.  The dilemma for me is how do you know who will have the favourable outcome and which individuals should be wary. 

During the Q&A panel session, the question was asked if LCHF would be suitable for someone after a stroke or heart attack.  The overwhelming response from the panel was yes, it would be a better dietary strategy for future health, but how do they know how that person will respond to LCHF.  Can a favourable outcome be guaranteed??

The other question is whether the change in blood results is due more to the actual change in macronutrient intake, or related to the associated loss of weight?

During the panel discussion it was also suggested that individuals may be better to go very low carbohydrate to start with, rather than easing into it, to achiever results sooner and allow the body to fat adapt.  Many of the blood parameter changes in the studies presented were based on very low carbohydrate intakes of <40g/day, or what would be considered a ketogenic diet.  The word 'ketogenic' sounds very clinical and a little bit daunting, but is basically the lowest carbohydrate form of LCHF, where ketones and fat replace carbohydrate as fuel.

Jimmy Moore calls ketones 'super fuel', but indicates that you need to keto adapt to become a ketone burner.  I am sure there are a variety of approaches, but his recommendation is to start eating unlimited fat to become fat adapted, then decrease intake over time so it allows stored fat to be broken down for energy.  So it is not a matter of eating as much fat as you like, effectively there calorie control.  With regard to carbohydrate, 30-80g seems to be deemed acceptable for 'keto', and protein is recommended not to be overdone, in case it is converted to glucose (there was lots of talk about gluconeogenesis), which may impair ketogenesis.  Of course, you need to buy a ketone monitor to carefully track ketone levels.  After about 1-4 months you become keto-adapted, and on your way to health and happiness by all accounts.

Many dietitians have scoffed at LCHF as just another fad.  But how many dietitians recommended VLCD programs like Optifast?  I know I do, not routinely but for individuals where it is deemed appropriate.  These programs create ketosis, and can be very successful for weight loss, but they are not for everyone and are not representative of longer term healthy eating patterns.  Is there a difference between VLCD programs and LCHF diet??  There are many, the most obvious being that Optifast for example is designed for a short period of time, not forever.  There are a lot of things to consider when making decisions about the best approach to food and nutrition for any one individual.

It seems that nutrition is becoming more and more complex when really in a practical sense when it comes to food choices we should be getting back to the basics of simple, fresh, delicious food.  The foods you choose are up to you, and based on a range of factors that are unique to you.  If you are finding your nutrition a challenge, speak with a dietitian who can help you work through it.  (although some dietitians may not recommend eating coconut oil by the spoonful as an afternoon snack, see below....)

* Just as a side note from earlier in this post, I really don’t get the coconut oil thing, nor do I understand the current interest and obsession with all things coconut.  Why is coconut oil considered so much better than any other fat?  It’s basically just saturated fat, although it does contain significant amounts of medium chain triglycerides (MCT's) with about 50% of the MCT's being lauric acid, which has been reported to have health benefits.  Coconut oil is great to cook with and adds flavour to foods, but the evidence that it does a lot more is currently lacking.  I heard Professor Andrew Sinclair, Chair in Nutrition Science from the School of Medicine at Deakin University, speak at a recent nutrition seminar in Melbourne, the topic being his area of expertise – fats.  He didn’t have anything particularly groundbreaking to say about coconut fat, but did mention that researchers at Deakin are looking into reviewing the literature on coconut oil and health…..perhaps they will find something exciting, until then.....

This Thoughts post provides informational content only, and is not for individual nutrition prescription purposes.  For more specific nutrition guidance and recommendations tailored to your individual needs you should speak to an Accredited Practising Dietitian.



Saturated fat is back and ketones are the new carbs…if you follow LCHF

Yes, a LCHF meal can look like this.....&nbsp;

Yes, a LCHF meal can look like this..... 

I felt as though the Low Carb High Fat (LCHF) movement was taking over my life last week.  Along with everyone else in the country who has an interest in nutrition, I watched ABC’s Catalyst last Thursday night.  I then backed this up with the Low-Carb Downunder seminar in Melbourne on Saturday, so I was up-to-my ears in ketones and carbohydrate talk. My brain actually feels a bit overloaded and is experiencing a slight tug-of-war between my entrenched knowledge that has been accumulating over many years and this ‘new’ input that is being promoted by everyone from doctors, to scientists, to athletes and celebrity chefs. 

I am writing this post to provide an insight to some of the information presented at the Low Carb Downunder seminar for those who did not attend and may be interested.  There will also be the unavoidable mentions of Catalyst and associates, as well as a few interpretations of my own relating to all things LCHF.  Apolgies in advance about the length of this post, and there will be Part 2 to come, just so much to think about!

I arrived at the seminar and was greeted at St Kilda Town Hall by an unusual crowd, some sporty types, some middle-aged overweight men and women, mostly older vs younger people and I think more potential ‘users’ than health professionals.  There were also not as many people as I expected, from reports of the last Low Carb Downunder seminar that sounded like standing room only.  I was the only dietitian there (I will get to my concerns about that later….)

So I managed to find a comfortable seat amongst the believers, without being blown away by any ketone-related bad breath.  First line of the introduction by Dr Rod Tayler, anaethetist, was ‘How good was Catalyst?’ to which there was an almighty cheer.  Oh no, I was starting to think that maybe I really shouldn’t be there, but once the cheering had subsided I got out from under my chair and composed myself because I really wanted to hear what all the fuss over LCHF is about.  Well, the introduction was like nothing I had seen before – slide after slide of recommended reading. Actually not recommended reading, recommended purchasing!  It was a book sale….right up front, no warming us into it.  Not just books – there were DVD’s (including Cereal Killers of course), sponsors products, even ketone measurers!  All very strange for a so-called professional conference.  But I stuck it out, and I am glad I did, because things did get more interesting.

First presenter was Jimmy Moore, who also started off with visuals of his programs and books for sale, but then did get into more substantial content.  Throughout the entire day I found myself intrigued and amazed one minute, then finding it very hard to take things seriously the next.  The thing that seemed to get me off-side was that most of the information presented was based on anecdotes, case studies or articles written by journalists who had interviewed someone who has tried LCHF.  There was not a lot of original research or content (except for A/Prof Ken Sikaris, whose great presentation I will discuss in a future post).

One thing that quite surprised me, that was also very obvious during the Catalyst program, was the non-extreme approach.  Of course there was thorough discussion of the ketogenic diet, where carbohydrate intakes approaching less than 20g/day are all the rage, but there was also recognition that carbohydrates (albeit vegetable-based) can still make a valuable contribution as part of a LCHF approach.  From my perspective, it seems that the LCHF approach is not as anti-carbohydrate as Paleo, and there could be the potential to sneak in some fruit or grains here or there without feeling like you have betrayed the low-car fellowship.  There were no ‘carbs are poison’ or ‘sugar is toxic’ signs anywhere, and carbohydrates were in fact spoken of, at times, in a favourable light, particularly for active people.  I repeatedly heard the phrases ‘there is no one-size fits all’ and ‘what works for you’.  There was also an emphasis on the types of people that LCHF could work for and there was not necessarily a directive that everyone should be eating this way.  For example, it was highlighted both on Catalyst and at the conference that LCHF works best for individuals whose bodies have trouble 'managing or tolerating' carbohydrate and a major focus was people who are overweight and/or have diabetes.

In fact, when Dr Zeeshan Arain, a Melbourne based doctor who works in both general practice and sports, spoke about his experiences with LCHF and athletes, he openly discussed the potential detriment of inadequate carbohydrate for an athlete who is highly metabolically active. Young male athletes with a decent amount of muscle mass perhaps?  There is currently a lot of focus on athletes and LCHF, but again much of the ‘evidence’ is anecdotal.  Dr Trent Stellingwerf, regarded sports nutrition researcher from Canada has recently been active on Twitter summarizing the published data on fat adaptation and ketogenic diets and performance and showed the majority of studies indicate no change or reduced performance with LCHF (see my Facebook page Lisa Middleton – Advanced Sports Dieititian for the shared post, thanks to Thinking Nutrition for sharing this also).  John Hawley and his team at RMIT, along with Louise Burke and other researchers have led the way in this area of sports nutrition, and it would have been great to get their perspective on Catalyst.  It was a shame that line-up of interviewees on Catalyst was basically the presenter list from the Low-Carb Downunder seminar earlier this year, no bias there at all.  How about a novel idea, get the world's best researchers together in the same room to present the evidence and sort it out and come to some type of consensus so we can all move on with our lives?

One thing that has frustrated me are the headlines about athletes who are using LCHF, without any description about when and how they are using it.  I think if we asked for more detail, it may become obvious that LCHF is often being used as a weight loss strategy in the off-season, when peak performance is not required.  In-season carbohydrate intake may be a different story.  I think the potential role of LCHF for weight loss is quite obvious…..if you cut out most of the carbohydrates and sugar from your weekly intake, you automatically reduce your total calorie intake, and how much fat can you really physically eat?  You eat less so you lose weight.  No problem with doing this in the short-term, with appropriate guidance from a dietitian to ensure you are doing it properly.  Another key message from the conference is that LCHF is not high protein, with the recommendation that protein intakes should be kept relatively low.

It was great to hear real athlete perspectives at the Low Carb Downunder seminar.  Tom McDonald, a player from Melbourne Football Club, spoke of his experience with LCHF, and one of his incentives to initially reduce carbohydrates was for his digestive system. He was not trying to lose weight, in fact he reported that he has always been underweight.  So he reduced his gluten and grain intake, but still maintains an estimated 100-200g carbohydrate per day, with much of this coming from sweet potato and bananas. Tom indicated his normal breakfast on training days would be bacon/sausage/eggs, occasionally with sweet potato and the night before games he would go for something like bolognaise sauce with cheese, vegetables and sweet potato.  So effectively he has reduced his wheat/gluten/processed carbohydrates but does not follow extremely low carbohydrate patterns.

Other anecdotal examples followed. Brian Rabinowitz, an experienced and successful triathlete and coach, who has been doing LCHF of late and says he has never trained better and can vouch for a number of the athletes he trains who are also flying with their training and performance, having changed from a gel-fuelled race to virtually water and oil.  Vicky Kuriel is a ‘LCHF dietitian’ who presented on the day (so there were in fact 2 dietitians at the conference!) and reported that her husband competes in ironman events with nothing more than water and nut butter, a significant change from his previous high-carb fuelling.  Apparently he is feeling and performing better than ever (he does eat carbs usually, ~150g/day although it varies day-to-day).

I know these personal accounts are not evidence-based science, but I find them quite powerful, especially when they come from credible sources.  That is another point, some of the outspoken experts on LCHF are very smart people….they are not just salespeople trying to boost their commission (although they may have a book or product on the side?).  I have spoken with many professional people who I know and trust who have great faith in the LCHF approach.

Saying that, I am certainly not sold on the concept of athletes becoming fat adapted by eating more fat, allowing fat to be more readily available as the main fuel to power elite performance.  Examples were presented of ultra-endurance athletes who train their bodies to burn fat as fuel and use ketones instead of carbs, but the thing with ultra-endurance is that it can be done at a steady-state pace.  If you need to put on a burst of speed to pass a competitor or at the finish line, carbohydrate will provide the rapid fuel to do this.  The question remains, that even though the bulk of science does not support the role of LCHF for performance, are there specific types of athletes, or individuals with a specific genetic make-up, who may benefit from the LCHF approach?

A great quote that I came across on Twitter from Professor Stuart Phillips, well-regarded sports nutrition researcher from Canada:

‘When it comes to LCHF and sport performance, I think it's important to remember that "Science is “the process of understanding the world through experimentation and observation,” whereas beliefs are “feelings that something is true.” Thus, the former represents an ideal of discovering truth that exists separate from the knower, whereas beliefs are internally held understandings filtered through one’s world view. By “unscientific belief,” something is held as generalizable fact without substantial scientific supporting evidence…" Brown et al. Adv. Nutr. 5: 563–565, 2014. So evidence trumps anecdotal experience and cognitive dissonance!’

Stuart Phillips PhD Twitter - @mackinprof

I can certainly understand why scientists and health professionals, including dietitians, are having a hard time accepting this LCHF theory, and perhaps why I was the only dietitian at the seminar.  If your entire academic and working life has revolved around evidence-based practice, LCHF doesn’t quite fit as the bulk of evidence just is not there.  Health professionals are trained not to base their practice on case studies or something that worked for your neighbor down the road.  But I don’t think you can ignore emerging trends or turn a blind eye to what people are out there doing, even if it doesn’t fit the evidence-based practice model.    

Vicky Kuriel is a dietitian who was disillusioned about dietetics, and stopped working in nutrition for a period of time due to her frustration about the lack of results for her clients with traditional methods.  She is proud to be a LCHF dietitian and provided compelling reports of client success in the areas of weight loss and reduction of gastrointestinal symptoms.  Vicky also emphasized that the key is to find the right mix of nutrition for your individual needs and to listen to your body, so again it is not all about the lowest carbohydrate intake possible for everybody.  Vicky’s final slide said this, ‘The truth is transient in nutrition’ and her message was that we need to be open to new ideas and science.

Of course during the seminar there were a number of digs at ‘those nosy’ dietitians, although the speaker, knowing that I was the only dietitian in attendance, did kindly indicate that I was not one of those he was speaking negatively about!

I had been prepared for dietitians to be criticised at this conference, and to be honest, some of the comments were spot on.  As a young dietitian working at my first professional sporting club I was known as the carbohydrate queen.  My studies had taught me that carbohydrate and athletic performance, in the majority of sports, go hand-in-hand and that was my message for athletes…..carbs, carbs and more carbs.  Of course I still recommend carbohydrate to athletes, but my approach these days is somewhat more balanced with greater emphasis on overall nutrient balance and individualized nutrition strategies.  Another example where dietitians have a lot of work to do is in the hospital food service.  Admittedly I have never worked in a hospital, other than my placement at uni nearly 20 years ago, and I don’t have full comprehension of budgetary and other contstraints that may exist, but surely something can be done to improve on the rubbish food that is currently provided in many hospital settings.  During a short stay at hospital with my young son a couple of weeks ago, I was absolutely appalled at the breakfast tray that he was presented with.  A sachet of puffed rice cereal, a piece of white bread with margarine and jam and a tub of apple juice.  Absolutely terrible, and this is what hospitals are dishing up to our sickest members of the community whose bodies are crying out for nutrients (I am happy to be challenged on this one, as I am sure dietitians have made efforts to improve food service, with likely limitations.....please say this is the case?????). 

There has been outcry from dietitians around the world about the potential risks of LCHF.  Not enough fibre, not enough calcium, too much fat, not enough wholegrains….the list goes on.  With plenty of vegetables, fruit, nuts and seeds, a well balanced LCHF diet provides great potential to eat lots of fibre.  Especially for those following LCHF who are not following a super-low carbohydrate ketogenic plan, there is scope to eat many high fibre foods.

I can see the potential issues with calcium and this would need to be addressed for any person choosing a LCHF way of eating.  For someone who does choose to eat in a LCHF style, it is important to know what you are doing and it would be advisable to seek professional advice from a dietitian who can help to ensure you are getting all of the nutrients you need. 

In terms of fat intake, concerns about too much or the wrong type have mostly been driven by the impact on health and cholesterol levels, but the evidence is mounting that LCHF eating does not have a negative impact on blood cholesterol profile for everybody, and I will go into more detail about this in my next Thoughts post.

Most dietitians are anti-diet of any type, and there are warranted concerns about LCHF's restrictive nature and the potential impact on psychological well-being and a person's relationship with food.  I was very pleased to hear Dr Arain mention this issue in his presentation and address body image and societal pressures to be a certain shape/size.  He also mentioned body dysmorphia and disordered eating, and this highlights the fact that many people who recommend LCHF are also aware of the sensitivities associated with food, and the potential psychological impact of restriction and 'diets'. Although some LCHF advocates are not as aware....

Dr Arain also mentioned another potential negative associated with LCHF eating - the development of commercial 'low-carb' products.  Similar to the proliferation of highly processed 'low-fat' products, these 'low-carb' products would not fit the 'real food' approach of LCHF but many people may use these frequently for convenience.

This leads on to probably the biggest problem that I see as a result of generalised LCHF guidelines - people don't do it properly.  The message that 'high-fat' is good could be interpreted as 'well, make that double bacon with my triple-decker cheeseburger then thanks'.  I can visualize this at take-away stores around the country, with this new message that saturated fat is a good guy.  Not that I think this is or was the intention of the low-carb, high-fat supporters, but this is the message that is coming across to the general public loud and clear.  And it creates the problem that people skip the low carb bit and just add in the fat, because fat is ‘good’.

The danger is that people choose selectively to include or omit the foods they wish.  A friend of mine who is a great GP put it perfectly ‘people just take the bits and pieces from different diets that they like’, which from my perspective creates a potential risk of even greater negative effects on their health.  Bacon is good, so must be good with everything, right??  Maybe on an extra piece of white toast, but is butter or margarine better with that?? 

Nutrition right now is confusing, but one thing that everyone does seem to agree on is that you need to find the best way of eating that works for you, based on real foods, that allows you to live and perform at your best.

In the next post I will give a summary of Associate Professor Ken Sikaris' presentation on the effect of LCHF on blood cholesterol profile, plus Ketogenic diets and Banting…. To make sure you keep up to date as new articles go up, 'Like' my Facebook page Lisa Middleton - Advanced Sports Dietitian and subscribe to my newsletter via the website home page.


This Thoughts post provides informational content only, and should not be substituted for individual nutrition prescription from a health professional.  For more specific nutrition guidance and recommendations tailored to your individual needs you should speak to an Accredited Practising Dietitian. 




Low-fat does not always mean high-sugar, but do we need low-fat anyway?

When we see 'low-fat' plastered over a food label, we often automatically assume that the fat has been replaced with sugar, salt, additives or something else that is worse for us than the actual fat that has been removed.  As a result, many people avoid low-fat products, but if you take a closer look you will find that not all foods with fat taken out have nasties added back in (although many do).  Some low-fat products are in fact higher in nutrients and lower in kilojoules than their full-fat relatives, but you need to read the labels carefully.  More importantly, do we even need to choose low-fat anyway or just stick to the full-fat versions?  I am asked this question all the time, and the answer is far from clear cut, so I thought I would write about it and try to clarify the best options for different individuals and circumstances . 

'Low-fat' can be a very deceiving label on a food.  Some foods are labelled low-fat when they are naturally low in fat to start with, so the food has not been altered in any way from it's natural state (eg. rice-based crackers).  Some foods can have the fat reduced, but nothing else is added to replace it (eg lean meats from which the fat has been trimmed).  Other foods named low-fat or "xx% fat free' have had fat removed, or are formulated to have a lower fat content, but to make the food palatable have a myriad of sugars added.  Sugar can be can be disguised within an ingredients list within a range of forms such as glucose, dextrose, fructose, corn syrup, fruit concentrate, brown rice syrup, honey, honey powder (!), maltodextrin, invert sugar, maltose, malt syrup and agave (which for some reason is often promoted as a healthy sweetener but is still high in sugar and super-high in fructose, reducing the glycemic index but big deal, it's still sugar).  Additives are also often plentiful in processed foods to maintain texture and shelf life.  An example of the types of foods that may be low in fat but higher in sugar and other additives include processed sweet and dry biscuits, fruit/muesli bars, breakfast cereals, flavoured milks and smoothies, sauces and dressings, ice-cream and flavoured yoghurts. 

Speaking of yoghurt, the dairy cabinet is one area of the supermarket that can be overwhelming when it comes to choice, and yoghurt is probably the main culprit when it comes to reducing fat content but adding sugar.  I don't read labels in the yoghurt aisle. I just try to keep it simple and stick to natural or Greek varieties, and most of the time avoid fruit flavoured yoghurts.  Whether sweetened with sugar or artificial sweetener (I am a little unsure to be honest which one is least preferable),  there is usually minimal fruit content and most of them don't even taste like real yoghurt.  Add your own fruit/nuts/seeds at home.

The next dairy option to consider is milk.  LOW-FAT MILK IS NOT HIGHER IN SUGAR THAN FULL-CREAM!  Back to my fridge for some nutrition comparisons, per 100ml:

                                       Full-cream milk                Reduced fat milk

Energy                          64 calories                       46 calories   

Protein                          3.4g                                  3.5g

Fat                                 3.4g                                  1.4g

Saturated fat                 2.3g                                  0.9g

Carbohydrate                4.8g                                  4.9g

Sugars                            4.8g                                  4.9g

Sodium                           44mg                                44mg

Calcium                          128mg                               132mg

Similarly with yoghurt, low-fat natural or Greek varieties DO NOT have more sugar than full fat. 

Milk and natural yoghurts do not contain extra sugar when the fat is removed, but do we really need to choose the low-fat versions anyway?  I am asked almost daily whether low-fat or full-fat milk is better and my answer always varies depending on who I am talking to.  I have both reduced fat (not skim) and full cream milk in my fridge. I give my two young growing boys full-cream milk.  You can offer low-fat milk once little ones reach 2 years of age, but my boys are bundles of energy and the additional calories are useful for them.  We also have low-fat milk, mostly for my husband who is a large consumer of milk as part of milkshakes and protein drinks.  The benefit of low-fat is the reduction in calorie intake with larger volumes.  Myself I vary it, going for full cream milk usually, but sometimes low-fat if I seem to be having a bigger dairy day.  My preferred dairy option is yoghurt, and again, sometimes I choose full-fat, but probably more often low-fat as I eat a fair bit of it.   So it comes down to the amount of dairy food you eat, as to whether or not you need low-fat dairy options, with consideration also of health and body composition goals.  Many people are concerned about saturated fat intake with regard to specific medical conditions and this is also an area for discussion based on individual circumstances.  A great article for an update on the debate over saturated vs. unsaturated fats from Harvard School of Public Health, 'Is butter really back?'.  It is long, but well worth a read and outlines the positive aspects of unsaturated fats for good health rather than trying to solely reduce total or saturated fat.

It is interesting to also compare the carbohydrate and sugar contents of non-dairy milk options also.  Looking at the full fat varieties, soy milk generally has a slightly higher carbohydrate content than dairy milk (5-6g/100ml vs. 4.8g/100ml). Oat milk (>8g/100ml) and almond milk (4.8-9g/100ml) are generally higher in carbohydrate than dairy milk, and rice milk usually twice as high (10-13+g/100ml), depending on the brand....rice milk is a terrific base for protein powders for athletes!  Regular coconut milk is not that much lower in carbohydrate (4g/100ml) than dairy milk but significantly higher in fat (the brand I looked at was ~24% fat, so 6x the fat of regular milk) and almost 4x as many calories. *Note, these values were taken from a range of supermarket products, some milk varieties may be higher, or lower in carbohydrate (particularly unsweetened varieties).

Above all, it is important to remember that most foods with a low-fat claim are highly processed.  If you are eating mostly fresh foods in as close to their natural state as possible then you don't have to worry too much about labelling, or ingredients, or the numbers in the nutrition information panel.  By eating less-processed and including fresh vegetables, lean proteins, fish, dairy, nuts, seeds, fruits and wholegrains you are likely to automatically reduce your intake of fat and sugar.  Fat is not the bad guy.  Healthy fats are good for you and should be eaten daily.  Whether you choose low-fat varieties of foods may relate more to your overall energy and calorie needs than anything.  But the other thing to remember is that even though reducing fat intake may reduce calories, you may end up hungry and disappointed.  The full-fat alternative may leave you feeling fuller so you may in fact eat less overall, and feel more satisfied if you prefer the taste.  Also remember that full-fat yoghurt is still only ~4% fat, or 96% fat-free, it's not like you are eating half a cheesecake for breakfast! 

If you are an athlete you may not want to reduce your calories necessarily, but instead focus on optimal carbohydrate and protein intakes for training and performance, so low-fat varieties of certain products may be useful to manipulate macronutrient intake for fuelling, recovery or body composition goals. 

I feel like I am making things more complicated than they really are, but the best choices in nutrition are very individual based on a range of personal factors - lucky there are so many options out there to choose from, the challenge is choosing from these the best one for you. 


Why dietitians are great dinner companions

'I don't want to eat in front of you!' she says, as our meals come to the table.  Eating out for dinner with friends can be an interesting experience when your job involves nutrition.  'I can't eat this while you are here, I'll feel guilty' is another common response that I've heard many times over the years.   Some people have a real fear that I am going to be analyzing their every bite and they will be overwhelmed with guilt and anguish about their choices.  Some people couldn't give two hoots and tuck into their parma and chips with not a care in the word about who is watching, but apparently a percentage of the population cannot stand to eat in the presence of a dietitian, their dining experience ruined.

If you have eaten with a dietitian before you will most likely have found that he or she is more interested in perusing the menu , making their own selections and enjoying their own meal than having any concern about what you are eating.  Wow, that sounds particularly selfish doesn't it?  I love working as a dietitian because I love food and eating, and I am of course intrigued by what people eat and why.  But if you are out for a dinner with me, you can choose whatever you like, I am certainly not going to judge you or embarrass you for the choices you make, and I most likely won't even think twice about your meal.  Besides, even if you happened to choose the most fatty and sugary food on the menu, it is only one meal....which means absolutely nothing in the scheme of things.   If I ate out for dinner with you three times per week and you were choosing a 3-course meal of fried entrees, creamy pastas and rich desserts every time then I may take a small mental note, but as a one off meal I am not really all that concerned. 

I love eating out with my dietitian friends.  I know what you are thinking, I love it because we can order quinoa with kale and a side of lettuce, but this couldn't be further from the truth.  I love eating out with dietitians because we can eat out without being judged.  It works both ways.  People may worry about what dietitians think about their choices, but dietitians often experience far from positive feedback on their choices along the lines of 'You shouldn't be eating that, should you?' or 'I didn't think you would eat that?' or the worst one 'Of course you would order the salad!!".  Eating with other dietitians means you can choose the healthier option if you want to, or not, with no comments, disappointments or stereotyping.  Dietitians love to share different dishes to try new things, so eating with them is fun.  FYI contrary to popular belief, dietitians love buffets, so many amazing foods to try!  Although I must admit that the behaviour of a dietitian at a buffet may be slightly different to the image of an overweight person at a budget US All-You-Can-Eat style establishment. 

So, do dietitians eat dessert?  Personally, I am someone who reads the dessert menu first and then I choose my main meal accordingly.  If I like the look of something for dessert, I don't want be too full from my main and not be able to choose dessert IF I FEEL LIKE IT.   The 'if' is the key word there, and important to consider when you are eating any meal and thinking about whether you need seconds or another course.  Remember, if you see a dietitian choosing a lighter style meal like a chicken salad for main, don't be fooled, it may mean they are saving room for dessert.  Although to be honest, with the serving sizes of meals in many restaurants these days it is not unusual to feel too full from the main to want a dessert.  This is where I could launch into a discussion about mindful eating, but Dr Rick Kausman already does a pretty good job of that.  Hunger awareness and consideration of whether or not you really want or need that extra serve is something worth working on.

Sometimes I feel like dessert, sometimes I don't (and sometimes I just don't feel like paying $14 for a slice of cake).  If I decline dessert, I admit that I do have that annoying female habit of asking for 'just one bite' of someone else's dessert, and this often surfaces during the food envy stage when other desserts come out.  My favourite desserts when eating out don't quite fit the image at the start of this post, ie. fruit salad.  It is also important to declare that I am not eating out overly frequently, which impacts on my likely intake and choices, but when it is an option I love a fresh lemon tart (that is quite 'tart'), a basic cheesecake (no fruit purees or salted caramel please) or sticky date pudding with ice-cream, not cream, (or if available just a small piece of caramel slice).  I often go halves.  A fair percentage of the enjoyment of food is in those first few bites, and I think that's why my dietitian friends love to share different can get a whole range of food experiences and enjoyment without necessarily over-doing the portions.   On a side note, it's so interesting that the more you pay for a meal the less you get.....probably better for your health to fine dine infrequently than go for a cheaper pub meal every week.

So relax and enjoy eating out with a dietitian, and if you feel like sharing a dessert with someone, ask the dietitian, they just could be the one at the table most likely to help you out.  Or if you order a whole one, move away from the dietitian as they are probably the most likely to try and steal a spoonful.

* Note - these views are based on my personal experiences, I cannot speak for the views of all dietitians, but I can comment about what I know about my dietitian friends.  I welcome comments if other dietitians feel differently.

Boost your gut bugs for short- and long-term health benefits

How do you get your daily prebiotics and probiotics? Maybe from yoghurt, or a daily Yakult?  Or you might take one of the many supplements on the market containing a range of bacteria with really long names.  Or maybe you have never heard of prebiotics or probiotics and have no idea what I am talking about!  The understanding of probiotics, adding good bacteria to our guts, has increased over recent years, with much research effort placed on determing the health benefits of various types of bacteria.  Good bacteria are our body's friends and can help our immune systems to work at their best and potentially reduce the risk and symptoms of a range of health ailments.

You may have seen the recent two part special edition on ABC's Catalyst program,  Gut Reaction, which presented some of the current research looking at the relationship between food, our gut bacteria and our health.  The messages were very clear, that if we feed our gut bacteria well, they will thank us by producing compounds that can benefit our health. So it's not just adding probiotics to our existing gut ecosystem, but feeding our gut bugs the fuel they need to improve the gut environment.

A healthy gut bacteria ecosystem = a healthy body. 

This is where prebiotics come in.  You might have heard of probiotics, but perhaps not prebiotics.  Prebiotics provide non-digestible fibre that is the perfect food for gut bugs.  Examples include bananas, asparagus, artichokes, chicory, leeks, onions, legumes, wheat bran, barley and oats.  (Unfortunately the positive prebiotic effect provided by the oligosaccharides in these foods can also cause gastrointestinal symptoms in some people, such as those with IBS who may choose to avoid these foods as part of a low-FODMAP diet.)

Our overly processed world means that we often don't consume adequate prebiotics from food, which can lead to an increase in bad bacteria, and potentially increase inflammation in the body (inflammation is now being linked to range of chronic health conditions).

The Catalyst programs also identified good old vinegar as one of our best medicine's for the immune system, indicating that the acetate (our good bacteria can also make acetate), can help stop immune system from over-reacting, providing potential benefits for inflammatory conditions, such as asthma.  A study on mice was discussed that gave fibre or acetate to mice and found that both helped to reduce asthma symptoms.  Watch the shows, they are really interesting, you will even learn about faecal transplants which sound strange but seem to be producing amazing results for individuals.  They involve putting live bacteria from a healthy person into a sick-person, placed 1 metre into the intestine via the backside, a bit like a colonscopy procedure, and there is hope that this could be a treatment for many conditions.

What about athletes?  Many athletes who train hard will find they are prone to the common cold, often just before an important competition or game.  A study by Gleeson et al in 2011 has always stood out to me, where they found up to 50% reduction in frequency of upper respiratory tract infections in athletes when Yakult (containing Lactobacillus casei Shirota strain, which you may have heard of before from the Yakult ads!) was consumed daily.  For athletes who are training hard, competing or travelling, the last thing you need is to get sick, and daily probiotics seem to be quite an easy way to help.

So, eat more prebiotic fibre.  Use more vinegar.  Consume probiotic foods and fluids.  Do we need probiotic supplements as well?  The amount of live bacteria in foods such as yoghurt and fermented foods and drinks may not be enough for a clinical effect, but could it be enough for general good health?  There are no clear guidelines about the specific bacteria dose to take for different purposes and health conditions, although general recommendations can be made.  Side-effects of supplements are common, including increased gas production, bloating and stool changes initially, so if you start taking a probiotic it is best to introduce gradually over a number of weeks.

When would I consider recommending probiotics in a supplement form?

- During and after a course of antibiotics, which kill both good and bad bacteria

- After food poisoning or a bout of gastro

- For individuals who are prone to recurrent colds/infections

- Athletes doing high levels of training

- Irritable Bowel Syndrome

- Women suffering from candidiasis (thrush)

The amount, type and form of probiotic will vary for individuals, as will the duration of intake. But remember, a probiotic supplement should be used in conjunction with other dietary strategies for optimal results. Our body will respond very quickly to changes in diet, within days, even if you don't particularly notice.

Research is showing that different strains of bacteria can have very specific effects.  In the future it is very likely that different strains will be recommended for different purposes and we may be prescribed specific bugs to boost our individual health.



What I love about eating like a cavemen


Perhaps like you, I have been quite fascinated at the to-and-fro in the media between various individuals about the merits, or otherwise, of following a Paleo style of eating.  I love a bit of healthy debate, and I think everyone has a right to their opinion, but the thing that disappoints me most is the tone of recent discussions and the use of blatant or insinuated negativity directed towards individuals and their opinions.  Present your arguments, based on science and fact, but please don't ridicule others to promote your own opinions.  Credibility is built on honesty, transparency and results, not by personal attacks to try and make your opinions appear superior.  At least the fiery debate has put nutrition into the spotlight and inspired many of us to think about, and discuss, how, what and why we eat.

So what is 'Paleo' anyway?  I think there is plenty of confusion about Paleo, low-carb, gluten-free, clean eating, etc.  The Paleo approach promotes gluten-free, but is not completely carbohydrate free, and is based on the eating patterns of our caveman ancestors from Paleolithic times.

The brief in a nutshell:

Include - fresh meat, poultry, fish/seafood, eggs, nuts, seeds, vegetables, herbs, occasional fruit

Avoid - everything else, including dairy, grains (especially wheat apparently), legumes and all processed foods.

Things I love about Paleo:

- food in as close to natural state as possible

- high quality protein from meats, poultry, fish/seafood, eggs, nuts and seeds

- plenty of fresh seasonal vegetables 

- use of herbs and spices

- not much sugar

- no additives

- sustainability

Things I don't love about Paleo:

- avoiding dairy and grains completely, even minimally processed varieties

- not  much fruit 

- unlimited type and amount of fat

- potential expense

- preparation time

- not family friendly, inappropriate for children with regard to nutrient inadequacy and restrictive nature 

I seem to have  more positives on my list than negatives BUT the negatives are deal-breakers.  A positive relationship with food involves flexibility with choices, and the option to incorporate any type of food (obviously some more regularly than others).  It also is important to enjoy food without guilt, and I think this could be challenging with any style of eating that prescribes long-term rules and restrictions.  

How about 'partial-Paleo' or even 'lacto-graino-Paleo' as an alternative to full-on Paleo?  Just like there are various options for vegetarians (eg. lacto-ovo-vegetarian follow a vegetarian style of eating, and don't eat meat but include dairy and eggs), there could be different options for Paleo, which allow for our modern lifestyles, preferences, cooking options and nutrition needs?  Lacto-graino-Paleo could include some nutritious options within the dairy, grain and legume families.  Perhaps some A2 milk, some natural/Greek style yoghurt, a delicious tasty cheese, and some nutrient-packed oats or rye products.  Or even sometimes, shockingly, enjoying delicious fresh-baked white bread or a crunchy and gooey chocolate brownie! 

I am certainly not endorsing a Paleo style of eating, or any other specific style of eating,  across the board, because everyone is different and different things work for different people.  I do believe that it is everyone's individual choice as to what, how and why you eat and how you live your life in general.  Food serves a purpose in keeping your body energised and healthy, but is also a big part of our lives to be shared, appreciated and enjoyed.  Many of our most wonderful food memories involve foods that would not be considered to be 'healthy'.  I can still smell the home-made sausage rolls, an infrequent but much loved and anticipated lunch order from the local general store next to my old primary school.  Or Mum giving my brothers and I a few coins (no doubt silver ones, that we often pooled together for maximum value) to spend at the supermarket on snacks to take into the movies.  We weren't in the fresh produce section that is for sure.  Who would want to deny children these experiences and memories?  Being a dietitian I am obviously interested in health and eating well, but I also love to enjoy special food occasions.

If you like the idea of Paleo, or any other particular style of eating, make sure it is right for YOU.  Think about how it fits your lifestyle, the demands, pressures and costs involved, whether there is good nutrient balance for your particular health needs, potential for nutrient inadequacies and if it really makes you feel may have to make some modifications to come up with something that suits your unique needs.  Above all, work towards eating choices that you can live with long-term and that allow you to eat well, widely and without ongoing deprivation or guilt.