Green leaf goodness: kale vs spinach vs rocket, and the winner is.....

Do you love kale.  Or do you just eat it because it is supposed to be good for you?  I like kale, but I do question the hype.  So I decided to look a little closer and do some nutrient comparisons.  Specifically, I was keen to look at the differences between kale and other common green leafy vegetables that are used in similar ways to kale - spinach and rocket (arugula) and your everyday iceberg lettuce.   

Kale is not a new vegetable.  Kale has been around for centuries, with its popularity as a 'superfood' having only skyrocketed in recent times.  Does kale deserve this reputation as the king of all things green?  Kale is from the cabbage family and related to the highly nutritious cruciferous group of vegetables, which includes broccoli, cauliflower and brussel sprouts.  There are many different types of kale, with either curly or flat leaves, which can be eaten in a variety of ways, from salads to soups and smoothies.

To start with, let's just clarify that ALL dark green vegetables are packed with nutrients. Any small differences in nutrient content can be balanced out by eating a variety of greens for a range of different nutrients and health benefits.  This is easy if you like vegetables!  But if your palate hasn't quite extended to enjoy green vegies and you know you probably don't eat enough, then small differences could have more of an impact, and it may be well worth focusing on those vegetables with a higher nutrient density.

So here are the statistics for kale vs. spinach vs. rocket vs. iceberg lettuce.  Of course there are many other green vegetables, but these represent some that are often used interchangeably with kale.  These figures are from the US and represent a tested sample of each vegetable.  Therefore they are approximate values only, as nutrient content can vary from place to place, often due to growing conditions.  Although approximates, these figures still provide a useful comparison for measurable nutrients.  

What do you think?  First of all, I know some people may have looked straight at thecarbohydrate values and panicked when they saw that kale has over twice the amount of carbs compared to the other greens.  Before you throw your kale out, remember that 8.8g is a tiny amount of carbohydrate and these values are per 100g, which is a lot more than a standard serve.  Leafy greens are pretty light, so a serve of kale with other mixed vegetables is more likely to be around 20g, providing less than 2g of carbohydrate, which is practically nothing.   

My interest is not so much in the kilojoules or carbs, but the vitamin and mineral content and nutrient density.  Looking per 100g (which indicates the % of the nutrient in a food), the nutrient contents for kale look pretty impressive and you can see where the claims arise for 'high calcium' and 'rich in Vitamin C'.  But again, because leaves are so light, you need to divide the nutrient by 4 or 5 to get a better idea of actual nutrient content per serve.  

The firs thing that really stands out to me when I look at this table is the vast difference in nutrient content between the darker green leafy vegetables and iceberg lettuce.  Iceberg just doesn't compare really, right across the board.  This provides a very clear message that for nutrition, stack your salads with darker leaves.  Of course iceberg lettuce provides wonderful texture and can be a great base for other flavours within a salad, but for nutrition it really lags behind.

If we then look back to compare kale with spinach and rocket lettuce, for most nutrients there are only small differences.  When you compare the differences to the huge gap to the iceberg lettuce, then you realize that kale, spinach and rocket are jostling for first line position, with iceberg a distant last, rather than being spaced out well across the field.   Kale and rocket have more calcium than spinach but spinach has more iron (although not terribly well absorbed).  Most differences are minimal and although I could analyse every nutrient, when we consider the overall impact on health there is really no point.  There are, however, a handful of nutrients for which kale is a standout.

Kale is a far greater source of Vitamin C and Vitamin K compared to spinach and rocket.  Kale contains 120mg/100g Vitamin C, so per serve may contain around 25-30mg Vitamin C, making it a useful source when eaten raw.  Vitamin C can be damaged with heat/cooking so cooked kale may not provide the same benefits as raw. 

Kale is high in Vitamin K, which is particularly important for blood clotting, but not a nutrient that is at a high risk of being low or deficient for most people.  So strong is the blood clotting effect, that people need to monitor their intake of Vitamin K if they are taking blood-thinning medication such as warfarin.

Kale and spinach are both able to supply plenty of Vitamin A, an important nutrient for the health of our skin and eyes. The beta-carotene in kale and spinach can also act as an antioxidant.

All other differences in nutrients are either minor, or insignificant or not all that important for overall health.  One thing that is missing from the table above is baby spinach leaves.  I have found it difficult to find nutrient breakdown info for baby spinach to compare to regular spinach, but have read that the baby leaves may be higher in some nutrients and lower in others.  Current data on baby spinach would be welcomed. I have a sneaking suspicion that the baby spinach, such a popular option in salads, may in fact not be quite as nutrient dense as regular spinach, but I would love to compare the figures to be sure.

It is important to remember that the nutrients presented in the table above are those that we can measure readily in food, but this analyss neglects those other phytonutrients which are not routinely tested for.

Nitrate is the other one that is not listed above, but is present in dark green leafy vegetables.  Nitrate may have an important role for athletes by reducing the energy cost of exercise - nitrate is taken in concentrated form via beetroot juice for performance effects, but there is potential for green vegetables to contribute to nitrate intake also.  For more on nitrate visit my article Green Vegetables Can Make You Go Faster and For Longer - Really! and this one by Alan McCubbin Beetroot Juice: Good Science or Great Marketing Hype.  

Kale is reported to contain important antioxidants, including flavonoids and polyphenols.  Kale contains the flavonoids quercetin and kaempferol.  Quercetin has received some attention for a potential influence on endurance exercise capacity, however published research findings have been mixed (http://www.ncbi.nlm.nih.gov/pubmed/21606866).  Antioxidants provide a range of health-related benefits and dark green vegetables, including kale, contain plenty.

So it seems that kale really is good for us, but is the nutrition value worth making the effort for?  I recall the first time I tried kale and it was definitely a case of take it or leave it!  I continued to revert back to the trusty spinach leaves as my tried and true salad base.  But lately I have been experimenting a bit, and recently ordered a kale salad with prawns and haloumi at a local restaurant.  When it came out I was actually very concerned about how I was going to manage to eat the amazingly large bowl full of green curly raw leaves, that to be honest looked terribly unappetizing.  But here is the thing with kale, and in fact most green vegetables.  How you prepare it and what you add to it can make or break your eating experience.  On this occasion, the chilli and lemon on the prawns, with the salty haloumi, pinenuts and a yoghurt based spicy dressing made the seemingly throat scratching unchewable bowl full of kale totally edible. In fact it was delicious.

The benefit of adding some healthy fats, like olive oil, avocado and nuts, is that the fat helps with the absorption of fat-soluble vitamins, such as Vitamin A, from the leaves.  So dressing your kale with some oils for flavour has the added benefit of boosting the nutrient availability.

The other great thing about kale is that, unlike many other so-called superfoods, kale is not ridiculously expensive when you consider other similar alternatives.

So what's the verdict, does kale win out over all other green vegetables as the senior member of the superfood brigade?  Kale is just one of the wonderful foods that is no doubt super, but certainly not that much more super than spinach, and for some nutrients less super.  But well worth including as one of your green vegetable options within different coloured vegetables every week. 

If you enjoyed this article please share, and don't forget to subscribe for free to my newsletter, sent out every month or so for more nutrition info, links and recipes, just fill in your details here.  You can also follow me on Facebook and Instagram for more regular updates!

Carbohydrates and sugars for athletes during exercise - type, total amount and teeth

Are home-made carbohydrate snacks better than gels?

Let's face it, most people eat too much sugar.  Far more sugar than our bodies need for energy levels and health.  But if you are an endurance athlete, your body needs carbohydrate, which ultimately breaks down to sugar.  Your body needs sugar during  long duration exercise to perform at its best.  If you are a strength athlete you need some carbohydrate too.  When it comes to performance, the key is to consume the right type of carbohydrate, at the right times and in the right amounts.  Not all carbohydrates and sugars are equal, but neither are individual needs, and athletes often need a mix of sugars that will be different to someone who doesn't train.   We talk about carbohydrates and sugars, but, this doesn’t mean eating a bag of lollies every day, weighed to the gram.  Far from it.  Not all sugars are equal and there is even more to the story if you train a lot.

WHAT IS SUGAR?

The word sugar automatically creates visions of sugar coated sweets, lolly pops and coloured sprinkles.  The other images that may come to an athlete’s mind with regard to sugar are carbohydrate gels, chews and sports drinks.  Sugar is everywhere, and for those of us following a largely sedentary lifestyle it is easy to eat too much.  In a country where around 2/3 of the population are overweight, sugar is rarely seen in a positive light, but for athletes there are benefits. 

All carbohydrate foods and drinks we consume are converted to sugars in the body.  However, this does not make all carbohydrate-based foods unhealthy. 

Carbohydrates are made up of chains of various sugar molecules.  These chains are broken down in the body to release individual sugars, which can be used as an effective fuel by the muscles and brain.  Sugar is not always nasty, and can be a valuable energy source for optimal human performance.  Different types of individual sugars can be used by the body, and the right balance can be beneficial for providing the best fuel to sustain endurance efforts.  Although it sounds like I am talking up the benefits of sugar, there is a time and a place for different types.  Some athletes may need to tailor their carbohydrate intake around training and competition in light of other nutrition goals, while others with elevated fuel needs and revved up metabolisms may need regular carbohydrate throughout the day.

HOW MUCH SUGAR FOR ATHLETES?

If you are an athlete that burns a lot of carbohydrate, then sugar will help to fuel performance.  But just because you train a lot, doesn't mean you necessarily need to carbohydrate load for every training session.  Every athlete has different requirements for carbohydrate and sugars based on a range of factors including gender, body weight, body composition, training program, training phase, health status, altitude and genetics.  Two people doing exactly the same training could in fact have quite different carbohydrate requirements.  An athlete’s daily carbohydrate needs can be estimated based on body weight and current training, and this can be adjusted over time to accommodate other individual factors as just listed.  

For exercise less than one hour duration, carbohydrate fuel requirements may be low, but there is evidence for performance benefits of a small amounts of carbohydrate during exercise due to potential central nervous system effects.  As the duration of exercise increases, so too does the requirement for carbohydrate, with 60-90g/hour recommended for athletes during endurance activity (or even higher for some ultra-endurance athletes working at a high intensity, up toward 110g/hour). 

I recently attended a nutrition for ultra-endurance sports symposium run by Monash University and there seems to be a wide range of carbohydrate intakes during competition and different types of training sessions.  As you may expect, many individuals find it physically difficult to consume 90g/hour during exercise, and may struggle at even half of this (45g/hour).  This is often due to gastrointestinal symptoms, which can be related to individual factors and the type of activity.  It is easier to eat and drink riding a bike at a moderate pace compared to running at elite marathon pace for example.  Some people also may simply use carbohydrate more effectively than others.  For serious athletes, it may be worth seeking a laboratory that can test your individual ability to oxidise carbohydrate and to help you work out the best type and amount of carbohydrate for during exercise. 

TYPES OF SUGAR

The recommendation in recent years has been for endurance athletes in events >2 hours duration with high carbohydrate needs (>60g/hour) should consume multiple transportable carbohydrate during exercise in a 2:1 glucose:fructose ratio.  Fructose has a different transport system for absorption from the intestine, so adding some fructose to the glucose consumed allows a greater amount of carbohydrate to be absorbed by the body.   An increasing number of people are being identified as fructose malabsorbers, and trying to increase fructose as a fuel option for exercise may be problematic in terms of gut comfort.  Fructose malabsorption may be exacerbated with exercise due to increased irritation of the gut, even though there may not be any gastrointestinal symptoms day-to-day. So it comes down to looking at maximizing carbohydrate intake within individual tolerance levels and exercise needs.

NATURAL SUGARS VS REFINED

Some endurance athletes have taken an interest in ‘natural’ forms of carbohydrate and sugars as an alternative to formulated sports products eg. gels.   This involves preparing home-made snacks rather than relying on commercial sports nutrition products.  As per my recent blog, natural sugars are not always as innocent as they may seem, and are not necessarily healthier than refined sugar.  I am all for reducing intake of processed food and additives across the board, but when it comes to athletic performance we really need to think about the type of individual sugars from a more scientific perspective.  Home-made cookies, balls and cakes are terrific, and there are a range of sweet and savoury options that work well.  The only problem is that many natural sugars are often high in fructose, which can cause major gut issues for long-duration exercise. Natural options are often low glycemic index, which means they may be more slowly digested….great if you are trying to lose weight and need help staying full for longer but not so great if you want food to empty rapidly from the stomach while exercising.  Finding the right balance of carbohydrates takes planning, and also some trial and error.  If you are set on going all natural then go for it, but if your gut is telling you ‘no’ then you may need to mix it up a bit.  Pre- and post-exercise is where unrefined carbohydrates come into their own, but during exercise the focus should be on glucose vs fructose rather than natural vs processed.

DO ATHLETES REALLY NEED ALL THAT CARBOHYDRATE?

There is so much discussion about carbohydrate as a fuel, but athletes don’t need to be carbohydrate loading for every session.  There are potential benefits of training with low fuel stores for selected training sessions to encourage physiological adaptations that optimize fuel systems.  In reality, a competitive situation may lead to low carbohydrate stores with limited carbohydrate availability, so an improved ability to rely on fat oxidation for fuelling may be of benefit. Some athletes are following the low carb trends and there is a movement by some ultra-endurance athletes to train their bodies to use predominantly fat as a fuel, replacing gels and bars with tubes of nut butter to fuel exercise.  Fat is a slow-burning fuel, so although this approach may work well for some individuals, to truly maximize endurance performance, sugar throughout will help.  Numerous studies show that faster finish times for endurance athletes correlate with higher carbohydrate intake during an event– if you can use more carbohydrate you can move faster.  However if your exercise is of shorter duration, you won’t need to be so aggressive with carbohydrate intake.  If you are not sure how much carbohydrate you need, speak with an Accredited Sports Dietitian to tailor your intake.   

WHAT ABOUT STRENGTH ATHLETES?

Strength athletes may benefit from carbohydrate prior to sessions for improved energy levels, work capacity and muscle mass gains.  So it’s not just all about protein -  carbohydrates and overall kilojoules are just as important.  Strength-based activities don’t use the same volume of carbohydrates as endurance pursuits, therefore carbohydrate needs may be more likely to be met through meals, without the need to consume large amounts during exercise.  However some athletes with very high energy requirements may benefit from taking in kilojoules, including carbohydrates, during strength sessions.

WEIGHT LOSS

Athletes trying to lose weight often reduce carbohydrates.  This can be an effective strategy, but it is important to be selective about where in the day carbohydrates are reduced and by how much, with the priority to time carbohydrate for training needs to produce the best training outcomes and adaptations.  There has been recent interest in ‘train-low’ and ‘sleep-low’ concepts of carbohydrate timing, which may improve fuel utilization but may also be appropriate to support body fat goals.

TEETH

Dental health is often compromised in athletes.  With reduced saliva production during exercise, coupled with high sugar intake and the acidity of most sports drinks, the teeth of an athlete are constantly at risk.  Dental problems are the result, so it is wise to try to reduce the contact of sugars with your teeth and try to get plenty of water rinses to reduce the risk of tooth damage.

SUMMARY

Sure, carbohydrates are beneficial for athletic performance, but this doesn’t mean you have to be on a constant carbohydrate load.  The type, timing and amount will vary according to specific exercise requirements, gastrointestinal tolerance and personal preference.  Choosing natural sugars is not necessarily better for during endurance activity.  Work on finding the right mix for your individual needs. 

Please feel welcome to subscribe to my regular newsletter, you can do so at the bottom of this page, and I am more than happy for you to share this article with others who may be interested in performance nutrition.

Further reading:

Jeukendrup, A (2011) 'Nutrition for endurance sports: marathon, triathlon, and road cycling' JSpSci 

Stellingwerff, T & Cox, G (2014) 'Systematic review: carbohydrate supplementation on exercise performance or capacity of varying durations' ApplPhysNutrMetab

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 happen....it 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.

NATURAL INSTINCTS

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? 

NUTRITIOUS NATURAL SUGARS?

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.

ARE ALL SUGARS THE SAME?

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.

ENJOY SWEETENED FOODS

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 SWEETENERS WISELY

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

If you enjoyed this article, sign up to my newsletter via 'Connect' at the bottom of the page for more nutrition updates, articles and recipes.

The 10 best wheat and gluten-free carbohydrate foods if you train a lot

Grilled vegetable and quinoa salad, gluten-free

If you don't eat gluten or wheat then you are part of a very large club.  It seems that more and more people seem to be going grain and gluten free, and for a variety of reasons. For some people it is critical to their health for no gluten not to pass their lips, while others may be avoiding wheat unnecessarily, without really knowing if their body is better off or not.

The original wheat avoiders are those with coeliac disease who simply cannot tolerate a crumb of any gluten-containing food.  Gluten is a protein found in wheat and related grains such as rye, barely, triticale and oats.  Gluten truly is toxic to people with coeliac disease as it damages the lining of the small intestine and must be avoided at all costs for short-term digestive comfort and long-term health. 

Wheat can also cause digestive symptoms if you don't have coeliac disease.  If you are following a new eating style then you also may be avoiding wheat, and this may or may not be necessary.  I was speaking with the owner of a cake business recently and he mentioned the increasing sales of his flourless cake range.  Upon asking his customers why they are choosing the flourless, the frequent answer is 'because it is healthier'.  But is it really healthier for everybody?  Many people do need to avoid wheat products but how do YOU know if you should avoid wheat and gluten?  Here are the three main conditions that lead to avoidance of gluten and wheat:

- Coeliac disease

  Nil gluten allowed, full stop.

- Fructose malabsorption

More and more people are being diagnosed with fructose malabsorption.  The hydrogen breath test companies must be raking it in, with fructose and lactose malaborption testing readily available and although lengthy, can provide an indication of existing intolerances.  If your gut does not absorb fructose well, it is likely you may have trouble with fructans, which are found in wheat-based foods (individual tolerance varies significantly, so it is worth seeing an Accredited Practising Dietitian for more advice so that you are not avoiding foods that you could be enjoying).

- Gluten sensitivity/intolerance or Irritable Bowel Syndrome

Many people describe a range of gastrointestinal symptoms that improve when they stop eating gluten, so the natural inclination is to think this is a 'gluten sensitivity’.  There are a wide range of factors that can cause gut symptoms, including stress which is sometimes overlooked.  

Research has shown that gluten may not be the main culprit when it comes to Irritable Bowel type symptoms, but it could be the malabsorption of fermentable sugars (FODMAPs), some of which are present in wheat-based foods.  It is worth investigating a little further if you have gastrointestinal symptoms, see your doctor and specialist/s if required to ensure you are making dietary choices that are appropriate for your individual circumstances. 

If you need more advice checkout my book ‘Super Food for Performance’ and use my special discount code of LISA10 to get 10% off. Limited stock available.

The other popular reason that people avoid wheat is because the latest diet they are following tells them to!  Whether it be Paleo, LCHF, Atkins.....many fad diets recommend a reduction in carbohydrate, which is often very successful for weight loss, but unfortunately some diets also imply that 'wheat is toxic'.  Yes, toxic to someone with coeliac disease, but not for most people.  Personally, I am all for reducing carbohydrate as I think most people eat too much, but if you have a healthy digestive system then you should have absolutely no trouble digesting wheat. 

Some people DO just feel better avoiding wheat.  If you cut out wheat you are not just avoiding nutritious carbohydrate foods like wholegrains - you will also omit cakes, biscuits, savoury snacks, pastries and many other processed, high sugar and low-nutrient foods.  So it makes sense you would feel better and probably lose weight eating less of the latter.

Poor old bread seems to get terribly bullied when it comes to grain bashing, it is always the first food to be discarded when there is a change to wheat-free.  But it may not be the rye/spelt/wholegrain slice that is contributing to digestive symptoms.  It may just be the amount....think big thick sandwiches (the ones you buy at sandwich shops are often equivalent to about 4 pieces of standard bread) and overflowing bowls of pasta........eat a bit less at each sitting, and slowly, and your digestive symptoms could likely improve.

Be aware that sometimes a change to wheat and gluten-free can lead to weight gain rather than weight loss, not to mention constipation if fibre intake is reduced.  Some of the gluten-free substitutes are low in fibre and can be higher in fat/kilojoules, and often not as filling as wholegrain wheat options.  This is important to consider if you are eating gluten-free and trying to lose weight. 

If you DO need to avoid wheat, and you train really hard, it can be a real challenge to make sure you are eating carbohdyrate foods that are nutrient-dense (rather than living on processed gluten-free bread, rice crackers and jelly lollies for carbohydrates).  Here are some super nutritious wheat and gluten-free foods that will give you carbs to power your training and have you recovering like a champ, without the gastrointestinal issues.  

POTATO (SWEET OR WHITE) - For some reason potatoes have gone out of favour in recent years, but as far as a natural source of carbohydrate, you can't go past nutritious potatoes.  Often sweet potato is recommended over white, usually because of its lower glycemic index and vitamin content, but white potato with a higher glycemic index is terrific for post-exercise meals, and is fine when combined with other vegetables anyway.  Remember, although potato is higher carbohydrate than other vegetables, it is still a lot lower in carbohydrate than rice, pasta, and many other grains ( for example, the carbohydrate content of white potato is ~12.5g/100g cooked, sweet potato ~19g/100g cooked, brown rice ~30g/100g cooked).

SWEET CORN - Sweetcorn is another sneaky source of carbohydrate, also packed with nutrients and fibre, and a similar carbohydrate content to white potato at ~13g/100g cooked.  Great in salads, soups, main meals or a cob of corn as a snack.

QUINOA - Probably the most over-promoted and over-estimated food in the world, if you can afford quinoa it is still a great gluten-free 'seed' (see my comparison of oats an quinoa for more detail Oats vs quinoa for health, energy and performance.

RICE - Super-rich in carbohydrate, try the different colours and varieties of rice, or one of the many rice mixes available these days (such as rice with lentils or quinoa) to boost the fibre and nutrient content.  There is nothing wrong with white rice too, especially if you get lots of fibre and nutrition from other foods.  If you are looking for optimal nutrition value though,  go for the less processed varieties (but not everything you eat has to be wholegrain or brown all the time!).  If you are active, sometimes too much fibre can be a problem with stomach symptoms, particularly around competition.

OATS* - Oats are still controversial for people with coeliac disease and in Australia oats are not permitted to be considered gluten-free, although in many European countries uncontaminated oats are considered safe.  The issue is complex and relates to contamination risks during processing and also a component in oats called avenins that some people can react to.  For those avoiding wheat for reasons other than coeliac disease, enjoy oats regularly.  For more info on oats see my previous blog mentioned above Oats vs quinoa for health, energy and performance.

RYE/SPELT BREAD (not suitable for coeliac) - If you have coeliac disease you need to avoid rye flour and all bread needs to be of the gluten-free variety.  But if you are trying to reduce gluten for other reasons then choosing a bread with a high proportion of rye vs wheat, or a spelt slice, can be a tasty source of carbohydrates.

GLUTEN-FREE PASTA - Pasta is a quick and easy carbohydrate option for active people. Gluten-free pasta has improved over the years, and you can now find a wide range of varieties in most supermarkets.  If it's a while since you have tried gluten-free pasta, give some a try, combine with lean protein and vegetables or salad for a balanced meal.

MILLET - I have a confession to make.  Only once have I knowingly eaten millet.  Well, millet flour, when I was trialling some gluten-free muffin recipes.  This sounds very hypocritical, to incude millet on this list but not really eat it myself!  I am one of the many fortunate people who does not have a problem digesting wheat and wheat products, although to be honest I don't actually eat a lot of wheat on a day-to-day basis.  I am not on the lookout for wheat subtitutes for personal use, but I acknowledge the nutrient value of millet (it is a wholegrain, contains fibre and rich in magnesium). Try millet as a side dish with savoury dishes in the place of rice, or mixed together with quinoa or rice or made into porridge for breakfast.

AMARANTH - Again, not a regular staple in my cupboard, but amaranth is a nutritious pseudo-cereal (not officially a grain, but is used in similar ways and has a similar nutrition profile to other grains).  Amaranth contains a range of minerals (such as calcium and iron), and has one of the best amino acid profiles of plant-based proteins.  In Australia amaranth is commonly seen in dry cereals, but can also be cooked and used in dishes such as porridge and soup.  In many countries it is popped and eaten like popcorn.

POPCORN - Speaking of popcorn....it won't quite do the job for recovery needs, due to its carbohydrate content being so low, you would need to eat buckets worth.  But its low carbohydrate and energy density (1 small packet of popcorn only weighs 13g, with only 6g carbohydrate and ~55 calories) makes this a terrific wholegrain snack for active people who may be trying lose weight.  A great alternative to potato crisps or other savoury snacks, which are often a popular choice when eating gluten-free.  Make sure you go for the plain varieties, not the sugar/caramel coated options.

These are just a few nutritious and convenient options to help fuel your training and recovery.  For more ideas, see Better Health Channel - Gluten-free Diet for an easy to read listing of gluten-containing and gluten-free foods.

For more information on coeliac disease and gluten go to Coeliac Australia and to learn more about fructose malabsorption and FOMAPS go to Monash University - Low FODMAP Diet for Irritable Bowel Syndrome. 

If you are a bit confused about whether or not you should be avoiding gluten and/or wheat or if you already eat gluten-free and not sure if you are quite getting the balance right, then it might be worth sitting down with an Accredited Sports Dietitian, look for someone local to you via SDA Find a Sports Dietitian. 

Don't forget to sign up to my newsletter by leaving your details via 'Connect' below for regular nutrition news just like this, plus practical nutrition updates and recipes.  The picture at the top of this post 'Grilled Vegetable and Quinoa Salad' is featured in this month's newsletter, so sign up now if you want the recipe!

Lisa

P.S Click here to get a copy of my latest book, LISA10 % off.

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: www.oecd.org/

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 www.ribbonsandbowscakes.com.au

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

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 https://twitter.com/TStellingwerff 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. 

Back to basics protein - foods that contain the most and best protein for recovery and training

Following on from my recent post about recovery meals, I have been asked by a few people if I could provide some more information about protein, what it is and specifically how much is found in different foods.  Protein is one of those nutrients that receives a lot of attention for a range of reasons.  People who are training want to know about protein for recovery and muscle mass.  People trying to lose weight want to know about protein for its effect on satiety and reducing hunger.  People who are low in iron want to know about protein foods for iron.  Some people just love meat and don't want to know anything about protein, they just want to get the BBQ started and eat a juicy steak! 

Following is a brief run-down as to what protein is, which foods provide protein and how much and the best options and timing of protein for training.

Proteins of varying composition are found in a wide range of plant and animal foods.  You may have heard the term 'high quality' or 'high biological value' protein, and this relates to the composition of amino acids within a protein.  A variety of amino acids makes up a protein, and it is the amino acids which are the important building blocks for muscle and other body structures.  Some proteins contain all of the essential amino acids and are considered to be higher quality than those with some lacking.

Active people need protein to build and repair muscle. To achieve muscle mass gain you need to eat enough protein and overall kilojoules, but you also need a carefully planned training program to stimulate the muscles to develop and grow.  Unfortunately there are not too many shortcuts when it comes to getting your best results - training and eating should be  specific to  your needs and goals.

Resistance training seems to be synonymous with protein supplements, and the bigger and more expensive the bucket of powder, the greater the perceived effectiveness for building muscle.  Having protein powder after gym is far less important for recovery and overall muscle mass gain compared to eating enough total kilojoules, protein and overall nutrients from foods in the hours and days post-training.  It's great to get the immediate post-exercise recovery nutrition right, but if you don't back it up for the rest of the day then you won't be maximizing your results.

So do you need to take a protein supplement?  Supplements are extremely popular as a convenient way to get the right type and amount of protein for the initial recovery phase.  Whey protein is a complete protein, rich in essential amino acids, including leucine, that will promote muscle synthesis.  There is certainly a time and a place for appropriate protein supplements in certain training circumstances, however don't forget that many everyday foods are high quality protein sources too.  If you are training hard and want results, you need to have a plan in place with regard to food first and supplements if necessary. Current recommendations for children and adolescents are to avoid protein powders - many young athletes are looking for ways to build muscle quickly, however food and fluids should be the priority, and supplements generally avoided until after growth is complete.

Be careful how much you spend on the latest whizz-bang powders too.  Those with lots of added extras, that you pay for, are often filled with unnecessary ingredients which your body may not need.  Sometimes it is best to keep it simple, and stick to a pure whey protein product, or a food option.  

Complete proteins, such as whey protein, contain the full range of essential amino acids.   Plant sources of protein, other than soy protein, tend to be lacking one or more essential amino acids and are considered incomplete proteins. This can be a challenge for vegetarians, but all it really takes is some additional planning to achieve the key amino acid balance from non-animal sources.  I have listed below a range of foods and that are often considered as good protein sources, with the amount of protein listed per average serve and per 100g.  Note that values are approximates only, and will vary according to the specific variety of the food.   These are in no particular order:

                                                                                Per serve                        Per 100g

Medium chicken breast, 160g cooked                    44g                                 28g

Medium beef steak, 150g                                         47g                                  31g

Lamb fillet, 150g cooked                                          48g                                  32g

Medium fish fillet, 120g cooked                               38g                                  32g

Small tin of tuna                                                        20g                                  28g

Eggs, 2 medium                                                         10g                                   10g

Cow's milk, 300ml                                                     10g                                   3.5g

Greek yoghurt, 200g                                                10g                                     5g

Cheese,20g                                                                 6g                                   30g                          

Almonds, 30g                                                              6g                                   20g

Cottage cheese, 2tbsp                                               4g                                    10g

Tofu, firm, 100g                                                           13g                                   13g    

Dried beans, 100g cooked                                         7g                                      7g

Soy milk, 300ml                                                          10g                                    3.2g

Whey protein powder                                            ~22-30g                           75-90g+

(the content of supplements varies greatly depending on whether whey protein concentrate or isolate is used and any other ingredients, check labels)

As you can see from this list, the animal-based proteins are particularly rich in protein.  Meat, chicken and fish are all around 30% protein, so if you think about achieving regular protein intake spread over the day, only small portions of these foods are required to achieve adequate intake.  Dairy and eggs provide great quality protein, but you need to eat more of these to get the same amount of protein.  I have not included grain foods in this list as most of them contain quite small amounts of protein, although it all adds up over a day.

You may look at the chicken, meat and fish and automatically think that because they contain more protein they must be better choices.  But just because tuna contains a lot more protein per serve than eggs, this doesn't mean it is the preferred option.  Massive serves of protein aren't required to get results....regular intake at the right times will make the difference.

It is also clear that vegetarian foods are relatively low in protein, and if you combine that with the lower quality of non-animal proteins you can run into trouble.  But if you plan carefully you can ensure amino acid intake to support your recovery, training and performance needs.  Leucine is a particular amino acid that has been identified as important for stimulating muscle protein synthesis and can be a little bit hard to find for vegetarians, especially those who don't eat soy products.  This is where vegan-friendly supplements can be of great use, but always be careful with supplement use in terms of their safety, actual benefits and cost.   

Active people should try to include high quality protein in all of their meals, and potentially snacks also, and should plan the type and timing of protein around specific training sessions.  It is a good strategy to spread protein intake over the day, ~20-25g is all you need to stimulate muscle protein synthesis.  Taking in more than this will not provide any further benefit.  Saying this, many people eat a lot more protein than they need....especially the animal sources.  You don't need 1/2 a chicken or 2 steaks at each meal, and research is showing that you are potentially better to stick to smaller protein serves more frequently over the day.  Over-consumption of protein can lead to excess kilojoules, which is ok if you are trying gain weight, but if you want to condition your muscles and stay reasonably lean then you may need to consider your protein portions.  More protein does not = more muscle. 

If you are trying to lose body fat, protein can help keep you full for longer and help keep blood glucose levels stable, reducing hunger and cravings.  You will need to consider your overall portions and nutrient intake related to your overall goals.  Sometimes protein supplements are useful for people trying to lose weight, as they give a good dose of protein with minimal calories.  It might be worth seeing an Accredited Sports Dietitian (www.sportsdietitians.com.au) if you need more specific advice and assistance with reaching your body composition, training and performance goals.

There is still much to learn about protein and its importance for recovery and muscle mass.   Researchers are still interested in the ideal amount of protein around training and timing of intake, the importance of leucine or other amino acids and specific recommended intake, and the variety of protein requirements for different individuals, based on specific characteristics such as gender, body size and shape, genetics and activity levels.

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 http://www.hsph.harvard.edu/magazine-features/is-butter-really-back/ 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. 

AFL Grand Final nutrition - what and when the players will be eating and drinking

Game day nutrition plans are usually well practiced and refined by the time grand final day arrives, but on the big day these strategies are often challenged by a number of September factors.  I cannot claim to know the exact nutrition plans for the Hawthorn and Sydney FC players this week, but I can write from my previous experiences with finals football.  I have been fortunate enough to work with AFL teams in five grand finals, including the week leading up to the game, and at the ground as the players arrive for their last warm up for the year.  I have seen nutrition strategies work well but have also seen some on shaky ground due to factors which are largely difficult to control but need to be considered and planned for.

Grand final week is a week like no other for an AFL player.  In fact, it may be the only time they experience grand final week from a player perspective in their entire life.  During the season, nutrition plans are created and trialed to ensure optimal fuelling, recovery, health and body composition and most players have a fine-tuned pre-game nutrition routine that is flexible depending on game times and location but reasonably consistent week-to-week.  Players work with an accredited sports dietitian at most clubs to determine what works best for them the day before a game and then on game day.  Players will have different requirements in terms of the type of foods, nutrients and timing depending on a number of factors including playing position, body weight, individual hydration considerations, climate and travel.  By the end of the season it should all be pretty well rehearsed.  Often things do run pretty smoothly up to preliminary finals, but those 7-8 days prior to the grand final bring various challenges.  Of course the club tries to keep things as normal as possible and treat it as just another week and another game, but it obviously isn't.   In terms of nutrition, a grand final brings significant challenges that are not always controllable.  There are additional activities that are compulsory for the players and quite unlike a normal week, in particular  the Grand Final parade which is scheduled just over 24 hours pre-game.  Who came up with this concept I am not sure....it is great for building the excitement in the city, and for the wider community and supporters who can't get to the game because of all the corporates, plus a great activity for kids on school holidays, but in terms of preparation it is probably less than ideal for the players!  Players have to travel into the city, wait around for the parade to start, then sit in the trays of utes (often out in the blazing sun), all when they could be relaxing and preparing.  Considering that usually on the day before a game players have their own individual routine that might be quiet and low-key, with no restrictions on timing of meals and fluids, players need to be organized to ensure adequate nutrition and fluids during this time.   

Speaking of fluids, September in Melbourne is ridiculous when it comes to weather.  I recall one grand final I was involved with was hot and windy, another winter-like conditions and rain.  If it is hot, it can often be the hottest day for 6 months and players are not accustomed to playing, and drinking, in that type of heat.  At least players from both teams are subjected to the same conditions but how it is managed in terms of cooling and hydration strategies could become important.  So, the weather can impact on hydration but there is a bigger factor that can play havoc with the best laid nutrition plans, and this is not specific just to AFL football but any major sporting events - nerves (for want of a more technical description).

In many ways a grand final is just another game, but in other ways it is not.  If you play in a grand final and your team wins, you are a premiership player for life.  If your team loses, you are not, simple really. The winners will be recognized for life and earn a coveted medal that all AFL players crave.  I am certainly not a psychologist, but it is clear that there is both internal and external pressure created, and some players manage this better than others.  I have frequently heard athletes say that if they don't feel nervous they won't perform well, so butterflies in the stomach can be helpful, perhaps because if you feel anxious it means whatever you are nervous about means a lot to you and you really want to do well.  Some players thrive on the 'big-game' pressure and it brings out their best, others may be terribly nervous but can turn this around into a positive, and others can have a terrible time that interferes with them performing at their best.   These nervous feelings can have a psychological impact, but also a physical impact that can impact on nutrition and hydration strategies. 

A common side-effect is stomach upset, which can impact on appetite and make it difficult to consume regular pre-game intake both the night before and on game day itself.  This effect is not exclusive to AFL.  I see a lot of elite and recreational athletes who train for events such as a marathon or ironman triathlon, events difficult to simulate in training and that require extensive preparation for that one day, whose nutrition plans are severely impacted by nervousness on the day.  The type of foods that are usually consumed may need to be altered, for example a change from a dense oat-based cereal breakfast to a lighter toast option, lower-fibre options and avoidance of dairy for improved gastrointestinal comfort.  

Often nutrients are more easily tolerated via fluids rather than solid foods, so these can be a good option for athletes who struggle to eat pre-event.  But over-drinking can be another concern.  Fluid intake can easily be over-done pre-game when nerves are involved, with players taking sip after sip as they count down the minutes to game-time, so fluid intake should be monitored so players don't feel bloated and racing to the toilet all the time.   If gastrointestinal symptoms are severe, players may struggle to eat much at all.  I will always remember one grand final where we were providing regular small doses of lemonade, rice crackers and electrolytes throughout a game to one player who was really struggling and it was all he could manage.  Not quite the usual theoretical sports nutrition recommendations, but it worked for that player on that day, sometimes you have to compromise and be creative. 

Of course not all players experience disruptive physical symptoms, but they still have the challenge of timing their nutrition on the day.  Ideally it would be good to wake at the usual time and stick to the usual breakfast then snack and/or light lunch before heading to an afternoon game. But players always like to make sure they get to the ground in plenty of time on Grand Final day, so with a 2.30pm start it means that players are likely to be in transit in that 2-3 hours prior to the game, when theory indicates is an ideal time for pre-event nutrition.  With lots of things on a player's mind on the day, prior organization is paramount to ensure optimal fuelling in those critical hours.

As important as nutrition is, it is one of a number of factors that contribute to performance.  Never is this more evident than on grand final day.  Just think of those players who are injured and play out the game with a broken hand or finger, those who have ran and ran all day but still find that extra few metres of speed, and those who I have observed that you know would literally have no fuel left in the tank but still, somehow, manage to reach the contest and punch the ball away.  It's why we love sport and why we love Australian Football.  The psychological drive seems to be able to over-ride a lot of the physical aspects that would normally limit us (happy for any experts who may have research papers on this to chip in here!).  That quest for a premiership....an individual medal, but more importantly a win with your team who have worked so hard all year, and for your club, to be remembered in history for years to come.   A premiership win is the ultimate for AFL players, and although it may seem like I am over-dramatizing a little, for AFL players on grand final day, and many other athletes at their pinnacle events, they are playing for their lives.  Not playing to stay alive (well perhaps to keep their career alive), but playing to achieve something that to date they have dedicated their whole life to. 

Even if the parade and grand final day means nutrition is not always perfect in terms of sports nutrition strategies, any potential benefit that nutrition can still bring makes me feel happy!  We know that pre-game and during the game nutrition can often be slightly different for a grand final, but what about recovery on grand final day?  There are no specific recovery strategies on grand final day because there is nothing immediate to recover for.  But one thing is certain, after the siren sounds, half the players on the ground will be swallowing tears of utter joy and jubilation, and the other half will be stuck with tears of absolute disappointment and despair.  Let's hope all the players in this years Grand Final can manage their nerves and nutrition as best they can and play their best game for the year.

*Photo courtesy of www.sherrin.com.au

Oats vs quinoa for health, energy and performance

I am officially over superfoods.  They are over-promoted, over-priced and over-done.  Take quinoa for example.  Sure, it's a nutritious grain.  Actually it is not really a grain, the part we eat is the edible seed of the quinoa grain crop, although the nutritional composition is similar to that of other grains so it tends to get lumped into the grain family. Quinoa is a great gluten-free option for those who have a true allergy or intolerance to wheat protein, which many people do (but don't get me started on the fad that 'gluten-free' has become).  Quinoa is nutritious, as many of the labelled superfoods are.  But there are hundreds of other foods NOT awarded the title of superfood that are equally, if not more nutritious.  

I like quinoa, but it is not always a staple in my kitchen cupboard.  I have some at the moment as I am trialling some quinoa recipes for my book.  Part of this inclusion relates to my fear that as a dietitian my integrity will be questioned if I don't include quinoa or some sort of other ancient grain somewhere in the book.  Saying this, my quinoa recipes are awesome (thanks to Justin Moran from Just In Time PT for his quinoa soup contribution, delicious)!  Don't worry, I have totally succumbed to peer pressure and included kale in a couple of recipes too.   

So, I was thinking about the whole superfood super-saturation and I got the quinoa packet out of the cupboard for a direct comparison to the homebrand oats (of which my family eat over 1kg per week).  You may be surprised by the results, based on 100g:

                                 Quinoa    Oats

Kilojoules                1590kJ    1590kJ

Protein                     12.9g       12.8g

Fat                             5.7g          9.3g

Carbohydrate          67.2g      54.8g

Fibre                          2.7g        12.1g

I was actually hoping that quinoa might prove me wrong and live up to the hype, but sadly no.  Quinoa and oats contain similar kilojoule and protein content per 100g, less fat in quinoa, less carbohydrate in oats and just over four times more fibre in oats.  Sometimes people are concerned about the fat content of oats, however they are  still relatively low in fat, based on serving size, so don't be mistaken that oats are fattening (we need some good fat).

I must give credit where it is due, and hail quinoa for it's vitamin and mineral content (which is similar to oats in terms of iron, calcium and magnesium content), amino acid profile and taste, I do love the taste.  Quinoa has great value for vegetarians and athletes due to the higher protein and nutrient content compared to standard rice, pasta and noodles - you don't see stir-fry and oats served too often.  Quinoa has a wide range of amino acids, and although often promoted as a complete protein, the total amount of protein in an average serve is quite small, around 6g per serve (50g dry).  Particularly when we consider athletes, who need adequate essential amino acids from ~20-25g protein for the immediate post-exercise recovery period.   Quinoa doesn't quite cut it for recovery protein on it's own, but combined with a high biological value protein source such as meat, fish, eggs or dairy it is a highly nutritious choice, and a great option as part of meals over a training day.

Oats are not considered a complete protein, but the amino acid profile comes pretty close.  It lacks lysine, an amino acid which is low in many grains, but which quinoa does contain in small amounts.  As per quinoa, oats should be served with an additional high quality protein source if consumed as a recovery option. 

An additional tick for oats relates to the beta-glucan they contain, which may be beneficial for those trying to reduce blood cholesterol levels.  Porridge or muesli for breakfast looks all that more attractive.

If you are trying to lose weight, both oats and quinoa are low-glycemic index, great for sustained energy levels and improved satiety - a small amount goes a long way.  Have you tried quinoa porrdige, not too bad!

Quinoa is gluten-free and a great option for those who have a gluten allergy, oats are not quite gluten-free but come pretty close, and are tolerated well by most people with an intolerance to wheat and wheat products.

So without labelling, both quinoa and oats can be considered 'super' 'foods' (note the differentiation from 'superfoods').

If I had to choose one over the other......I think the real clincher would be the price.......homebrand oats work out at around $1.60/kg, compared to over $20/kg for quinoa.  You pay 12 times as much for quinoa.....is it 12 times as nutritious??   Think about your overall dietary patterns, what YOU need and how you can enjoy both/either oats and quinoa to bring you health, energy, and performance benefits.

If you enjoyed this article you will find more on my Thoughts page and please subscribe to my free newsletter, just leave your details below.

My book Eat Right for Your Life is out now too, available at bookshops, newsagents and online retailers, including recipes with both oats and quinoa respectively!

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 dishes.....you 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 http://www.abc.net.au/catalyst/., 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.

Paleo, prawns and potato for athletes

Here is a photo of last night's prawn and tomato dish, a recipe I am trialling for my new book, and guess what, it is Paleo!  Well almost....it would be if I hadn't melted the feta cheese through it, or served it on top of rice!!  But it could be a tasty Paelo dish. If only it were a child-friendly dish in my house too, (my boys are two of the fussiest eaters I know, but I will leave that discussion for another day).  Or budget-friendly, I can't imagine it would become a weekly regular in most houselholds, but it was delicious!  Would it be a meal I would recommend for an athlete?  Yes and no.

Consdering I am a sports dietitian, I thought I should follow up on my previous post about caveman style eating and consider whether Paleo is suitable for acitve people.  My initial response would be 'no', but there is probably more to it.  There are a number of high profile athletes who follow a Paleo style of eating and seem to do ok.  Gary Ablett Jnr for example.  I have heard and read in the media that he follows a Paleo style of eating, although I don't know what exactly that entails for him.  I would love to know a little bit more about what he eats on training days and pre-game to give him the energy to run all day.   Sweet potato three different ways for breakfast, lunch and dinner?  It seems that he must be doing something right with his preparation, I am hearing Andrew Demetriou in my head right now at the Brownlow medal count, 'G. Ablett.....3 votes', 'G. Ablett.....2 votes', 'G. Ablett.....3 votes', etc.

The main concern about Paleo for active people is meeting carbohydrate fuel needs.  Although I am still a little confused about 'true' Paleo and exactly which vegetables and fruits are ok, as sources vary.  Carbohydrate requirements depend on the type of training and competition week-to-week, as well as individual body size and physiology.  You always hear about carbohydrate being important for athletes, which it is, but the amount required can vary significantly between athletes and for individual athletes at various stages of the week and season. 

In practice, I see a lot of athletes who are eating more carbohydrate than they need, as are much of the general population.  Perhaps not intentionally, but sometimes people can underestimate the amount of carbohydrate in foods and fluids or forget to consider fluids entirely. 

There are also athletes who do not eat enough carbohydrate for their specific needs and often there are obvious symptoms such as fatigue, but sometimes there are not and although the athlete may feel they are performing ok, they could be performing a lot better with well timed carbohydrate intake.  Athletes are equally exposed to the media promotion of low-carb diets, but for many active people low-carb is not appropriate. Low-carbohydrate may be a useful strategy at particular times of the year in conjunction with specific body composition goals, but the definition ad degree of 'low-carbohydrate' is different for everyone.  Cut down carbohydrate too much when you are training hard and you are likely to experience fatigue, impaired recovery and increased risk of muscle soreness, accident and injury.  You may also end up losing muscle if kilojoules are particularly low, which will effect performance and potentially metabolism, which can lead to faster weight gain once carbohydrate intake increases.

So, is Paleo suitable for athletes??  I would still say 'no' to a super rigid Paleo style plan.  It's not just all about the carbohydrate but the potential for inadequate intake of other nutrients, for example calcium which is an important mineral for athletes. In particular female endurance-type athletes who are lean, have low energy intakes and often menstrual dysfunction, as their bone density can be compromised and may have increased risk of stress fractures.

There are, however, particular athletes who definitely benefit from a reduced carbohydrate intake, specific to their individual needs and performance goals.  As per my previous post, I love many of the concepts associated with Paleo, but others I am not so excited about .  Athletes should be extra cautious of any type of 'popular' generic dietary plan or rules and would be better off addressing their own individual health and performance (and other) needs and planning and choosing foods accordingly.  Each athlete will be different.

Would I recommend the prawn dish to athletes?  Yes!  But probably not the Paleo version, it tastesmuch better with feta!  If an athlete had particular goals that required a reduction in carbohydrate then I may recommend serving it with salad, or a very small serve of rice.  For an athlete with a heavy training session the next morning I would still suggest some salad but with a larger serve of rice.

G. Ablett, if you are reading this, I would love to hear exactly how you do Paleo seemingly so well? I would love to learn more.....

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 good.....you 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.

Lisa Middleton's nutrition, exercise and health 'blog'

Welcome to my 'Thoughts' page.  Well, really it is a blog page, but I used the title 'Thoughts' as I find the word 'Blog' very strange!  Right here is where I plan to include a whole range of different nutrition, exercise and health updates, although to be honest it will be mostly nutrition.  Usually short and sharp, nothing that you have to scroll too far down the page for.  I love discussing all things nutrition,  such as practical food ideas, current nutrition topics in the media, a bit of the more serious research and science stuff, a few recipes (maybe a few sneak peaks at recipes from my book that I am working on),  dining out (and in), shopping, cooking and eating!  My real passion lies in the world of sports and exercise nutrition, so there may be some heavier weighting there too.  My first post won't be too far away.....