We humans have become really bad at knowing exactly what to eat to maintain a healthy diet. When once we roamed in search of a healthy balance of fruit, veg and meat, today we scoff a variety of nutritionally questionable but tasty and moreish snacks. Almost certainly, we didn't evolve to eat biscuits and down fizzy drinks all day. But we do it anyway, succumbing to temptation.
Most of us, of course, still know what constitutes an ideal diet. The Mediterranean diet gets plenty of praise, with its focus on an abundance of fruit and veg, olive oil, lots of a fish and less meat. Or the varied pre-industrial peasant diet, with healthy grains, veg, potatoes, meat and milk featuring heavily.
It's not rocket science, really. A balanced diet of real food is essential to staying healthy. Yet 50 per cent of food bought by British households is now thought to be 'ultra-processed', increasing risk of cancer as vital nutrients are replaced by harmful additives. Not by coincidence, obesity and diabetes rates continue to rise.
Rather than trying to consume a healthy range of foods, we look for quick fixes - a juice cleanse, perhaps, or intermittent fasting. Evidently, we need help. So we asked registered dietitian Melissa Wilson, who also works for leading dietary food specialists Schär, what the most common questions people came to her with. Here are her answers to those questions.
1. How can I tell if I have a food allergy or intolerance?
Reactions to food can involve either the immune system (indicating a food allergy) or no immune involvement (indicting a food intolerance). Symptoms for both vary in type and severity, from immediate to delayed symptoms several hours or even days later. Sometimes allergic food reactions can be severe or life threatening, but in contrast food intolerance symptoms are generally less serious.
If you suspect you might have a food allergy or intolerance it is important to speak to your GP, who will likely refer you to a specialist. Diagnostic tests for food allergies include specific blood and skin prick tests in conjunction with a detailed history taken by a healthcare professional. Whereas diagnosis of food intolerance is by a detailed history taken by an experienced HCP.
2. What are the best foods to improve my energy levels?
Having a healthy, well-balanced diet is important to help maintain energy levels as well as eating regular meals supplemented with small between-meal snacks if needed. Starchy foods such as bread, pasta, cereals, rice and potatoes are good sources of energy in the diet, but you should keep the intake of sugary foods to a minimum to help maintain stable energy levels.
The key is to ensure you eat enough for your level of activity (but do not overestimate how active you are). As a rule, for carbohydrates, a portion about the size of your fist is an appropriate mealtime portion and this can be adjusted according to individual activity levels. Around half of our energy intake should come from carbohydrates.
3. I am considering going vegan, how can I make sure I am still getting enough of the right nutrients?
A well-planned vegan diet can be healthy and nutritious, but it is important to plan it well to ensure all the required nutrients are included in your diet. Enjoy plenty of green leafy vegetables (e.g kale and pak choi), as well as pulses, nuts and seeds and different proteins (beans, lentils and chickpeas), to make sure you are getting the right nutrients.
Fortified, plant-based dairy alternatives and wholegrains foods such as oats, rice and cereal-based foods are also important sources of key nutrients in the diet.
4. I've heard that fibre is important. What should I eat to boost my fibre intake?
Fibre is an essential nutrient for the normal functioning of the gut and is related to a reduced risk of certain chronic diseases, such as diabetes and cardiovascular disease. Fibre-rich food sources include porridge, high-fibre breakfast cereals, potatoes, wholemeal or wholegrain bread and pasta. A food product is ‘high in fibre’ if it contains at least 6g of fibre for every 100g of its weight, and is classified as a ‘source of fibre’ if it contains 3g fibre per 100g.
You can try the following things to increase your fibre intake:
- Having a high-fibre breakfast cereal
- Adding fruit to cereal
- Mixing linseeds with yoghurt
- Choosing wholemeal or wholegrain varieties
- Adding extra vegetables or pulses/lentils to dishes
5. What's the difference between a dietitian, nutritionist and nutritional therapist?
There are some subtle differences between a dietitian, nutritionist and nutritional therapist:
- Dietitians are the only nutrition professionals that are regulated by law and governed by an ethical code. Dietitians are qualified to a degree-level and use evidence-based research on food, health and disease, which they translate into practical guidance.
- Nutritionists are qualified to a degree level and provide information about food and healthy eating in a variety of non-clinical roles including public health, health policy, government and NGOs. Only those meeting specific criteria can join the UK Voluntary Register of Nutritionists (UKVRN) and can then call themselves a Registered Nutritionist.
- Nutritional therapists don't have a degree in nutrition but have an accredited qualification. Nutritional therapists encompass the use of recommendations for diet and lifestyle in order to alleviate or prevent ailments, and the advice they provide may not be recognised as valid treatments by medical and allied health professionals.
6. What are probiotics and prebiotics and do I need to eat them?
Natural bacteria in our gut helps us stay healthy, but sometimes the balance of these bacteria is disrupted. Eating probiotics and prebiotics can help maintain this natural balance:
- Probiotics: ‘Good’ bacteria can help improve the balance of gut bacteria and can be found in some products such as yoghurts or supplements. Probiotics are generally considered safe for healthy people to consume; however, those whose immune system does not function properly should seek specific advice from a dietitian or doctor before taking these.
- Prebiotics: Types of carbohydrates that our gut bacteria ‘feeds upon’. By eating these, it can help more ‘good’ gut bacteria to grow in the gut. Natural sources of prebiotics include onions, garlics, asparagus, artichoke and banana.
7. I've heard many people are 'going gluten free'. Would I benefit from a gluten-free diet?
Research has shown that although there is no health benefit in going gluten free for healthy individuals, for those with conditions like coeliac disease, a gluten-free diet is the only treatment for the condition.
Some individuals also experience symptoms when eating foods containing gluten, even if they do not have coeliac disease; this is called non-coeliac gluten sensitivity. Symptoms are similar to coeliac disease but it is still not understood how the immune system might be involved and there does not appear to be damage to the lining of the gut as in untreated coeliac disease.
There is a growing body of evidence that a gluten-free diet may help improve symptoms in some people with IBS. Individuals should seek advice from a healthcare professional before making any changes to their diet.
8. I do a lot of high-intensity exercise. How can improve my performance with food?
No matter what sport you enjoy, carbohydrates are the main fuel used by our muscles during high-intensity exercise. Carbohydrate is stored in the muscles as glycogen. Glycogen stores are limited and need topping up each day, particularly if exercising daily or at a high intensity. The higher the intensity of exercise, the faster your glycogen stores will used up.
You will not benefit greatly from eating carbohydrate during high-intensity exercise lasting less than 60 minutes. However, you can improve your performance by ensuring there is enough fuel in the tank before you begin. The best way to do this is to have a regular meal or snack that is high in carbohydrate two to three hours prior to exercise, such as porridge with milk and fresh fruit or wholegrain toast with poached eggs.
Following exercise, glycogen stores should be replenished with a high-carbohydrate, low-fat snack or meal - you could try Greek yoghurt with berries or a fresh banana smoothie. Refueling is most effective when it takes place within 30 minutes after exercise.
Protein also plays an important role in how the body responds to exercise and is required for building and repairing muscles. The addition of 20-40g protein SUCH AS to a post-workout meal or snack promotes muscle repair as well as boosting glycogen storage.
Maintaining fluid intake is also critical as dehydration can affect your concentration, strength and power. By consuming adequate food and fluid before, during and after exercise, you can maximise your performance and enhance recovery.
9. I suffer from irritable bowel syndrome. What foods should I avoid to help reduce my symptoms?
Irritable Bowel Syndrome (IBS) is a condition that results in range of gut symptoms including diarrohea, bloating, abdominal pain and constipation. IBS affects 10-20pc of the population and up to 90pc of patients with IBS report various foods as symptoms triggers.
In the first instance, simple changes to diet such as having regular meals, eating slowly, and limiting alcoholic, fizzy and caffeine-containing drinks (like tea and coffee) as well as drinking plenty of water, can help lessen the symptoms of IBS.
If the initial advice is not working, a low FODMAP diet may be recommended to help manage IBS symptoms. FODMAPs are a collection of carbohydrates that are poorly digested and absorbed in the gut and can trigger IBS symptoms such as intestinal bloating and pain in some people.
A low-FODMAP diet is a complex three-stage diet and should be followed under the guidance of a FODMAP-trained dietitian. It has been shown to improve symptoms in 70-75 per cent of IBS patients. Schär are the first brand to offer low-FODMAP certified products in the UK.
10. What is the best diet to help me lose weight and keep it off?
Eating a healthy, well-balanced diet is the best way to lose weight and / or maintain a healthy weight, but there is no quick fix. The following tips and lifestyle changes can help:
- Start the day with a healthy breakfast
- Aim to eat three balanced meals per day
- Aim to eat more fruit and vegetables (five portions a day)
- Half fill your plate with vegetables / salad and divide the other half between protein foods (eggs, fish, chicken) and starchy foods (potatoes, rice, pasta, bread)
- Choose low-fat and low-sugar drinks and foods
- Maintain a moderate alcohol intake
- Watch portion sizes
- Avoid eating the same time as doing something else, e.g watching the TV
- Eat slowly and enjoy your foods
- Aim to drink at least 2 litres/ day of fluid (water, non-caffeinated / non-fizzy drinks)
- Include regular physical activity to help achieve weight loss and boost mood
- Set realistic and achievable goals
11. How can I eat a more ‘sustainable’ diet that is healthy for both the environment and me?
Eating a plant-based or vegan diet has been shown to be beneficial for the environment. It is estimated that a well-planned, plant-based, or vegan diet needs about a third of the fertile land, water and energy of a typical meat and dairy diet.
If you are planning to avoid or reduce your intake of animal-based foods, it is important to ensure you maintain sufficient intake of certain nutrients including calcium, omega-3, vitamin D, iodine, vitamin B12, iron, zinc, selenium and protein.
Eating a variety of plant-based foods including beans, nuts, seeds, fruit, vegetables, wholegrains and cereal-based foods will provide all the nutrients required for good health, including essential fats, protein, fibre, vitamins and minerals.
12. Can diabetes be treated with diet alone?
Diabetes is a serious, lifelong condition where the blood sugar level is too high. There are two main types of diabetes: Type 1 and Type 2. They are different conditions but are both serious, and can lead to long-term complications if not managed properly.
Type 1 diabetes is an autoimmune disease, and needs to be treated with insulin, but those with Type 2 diabetes may be able to manage the condition with a good diet and exercise alone. However, Type 2 diabetes is progressive and may require medication over time to help manage it.
Nevertheless, a healthy, balanced diet is recommended for all diabetics and individuals should try to avoid sugary drinks to help keep blood sugar levels down. Foods labelled as ‘diabetic’ or ‘suitable for diabetics’ are also worth avoiding as they may have a laxative effect and can still have the ability to affect blood sugar levels.
13. I have high blood pressure. Can diet help me improve this?
If left untreated, high blood pressure can increase the risk of heart attacks, strokes and cause kidney and eye damage. Making simple changes to your diet can help lower blood pressure, such as cutting down on salt, keeping to the recommended amount of alcohol and eating a diet rich in essential minerals. Reducing your intake of caffeinated drinks may also be beneficial.
It's known that there is a strong link between being overweight and having high blood pressure, especially if the weight is carried around the waist, so losing weight could help.
14. How do I need to adapt my diet to make sure I have a healthy pregnancy?
The most important thing is to make sure you are following a healthy, well-balanced diet. However, specific dietary advice for pregnancy includes avoiding alcohol, raw shellfish, raw or undercooked meats, raw or partially cooked eggs, unpasteurised dairy products, supplements containing Vitamin A and any dish containing these products.
It is also recommended that pregnant women take two vitamin supplements during pregnancy: folic acid and Vitamin D. Folic acid can help prevent the baby developing neural tube defects, so you should try and take a 400mcg folic acid supplement every day before pregnancy (start taking as soon as contraception stops) and continue until week 12 of pregnancy. You can also increase the amount of folate rich sources in the diet e.g. fortified cereals and green, leafy vegetables.
Vitamin D is also helpful in helping ensure the baby’s teeth and bones grow properly and keeps the mother’s teeth and bones healthy during pregnancy as well. You should aim to take one 10mcg Vitamin D supplement per day all through pregnancy.
15. My child is a fussy eater, how can I be sure that she’s getting all the nutrients that she needs?
A good diet is important for children as they are growing and developing quickly. However, if your child is refusing food this can be quite challenging! It is important to try to achieve as balanced and varied a diet as possible to ensure an adequate intake of nutrients whilst making mealtimes enjoyable:
Simple tips include:
- Having regular meals or snacks to avoid your child becoming too hungry
- Avoiding distractions at mealtimes and eating together
- Offering small portions on plate as too much can be off-putting
- Allowing about 30 mins max for mealtimes to prevent children becoming fed up
- Giving lots of praise if the child eats well
- Making meals colourful
- Offering your child finger foods
- Introducing new foods ones at a time