Should public health services help?

I read a lot... and I mean a lot.  I go running or cycling everyday and instead of listening to music, I listen to audio books about how we can improve our health through nutrition and healthy lifestyles.  I listen to books about clinical studies on nutrition - anything that will help me help my clients.

I also read lots of stories in the press about people who have been morbidly obese and have managed to turn their lives around and lose huge amounts of weight.  I find these stories inspiring and these people have my total and unconditional respect.  When ever I run past an overweight jogger, trying their upmost to haul themselves around the local park, I want to shout out,

"You're doing great!  Keep going!"

at the same time I fear for their knees and hip joints suffering from carrying the extra weight, but these people are trying their hardest to do something about their health, and that is amazing!

But is the system helping of failing these "fat warriors"?

We know... it's a fact that there is a severe obesity epidemic which is stressing our public health services to the limit.  Being over weight or obese is not just an "unsightly" problem in a world where stick thin models are shoved under our noses every single day.  A world where to be an actress you have to be a size 0.  A world where young girls aspiring to be models are told that they have to lose weight from their already size 0 frames.  Where eating disorders start as young as primary school.  A world where HEALTH is not considered.

Being overweight or obese drastically raises your risk of pre-diabetes, type 2 diabetes, metabolic syndrome, heart disease, and some cancers, and young obese people are facing the prospect of dying young.  So it is not something to be taken lightly.  

As I said at the beginning, there are people who turn their lives around.  They diet, and exercise and lose vast amounts of weight.  Here I am not going to get into HOW they lose the weight.  As long as you lose it to improve your HEALTH, then that is all that is important.  However, lots of people (mostly those who don't have a weight problem) often criticize those who have gastric by-pass surgery, gastric balloons fitted, or stomach reductions done by the public health services.  There are also lots of people who don't, like the woman who installed a treadmill in her garage as she was too embarrassed to go out in public because of her weight, and once she lost some, she started going out at night so no one would see her.

The thing is that treating a person who has serious illnesses such as type 2 diabetes, heart disease or cancer, COSTS A LOT OF MONEY and it isn't just a one off.  Treatment of type 2 diabetes can go on for decades - the same for heart disease and cancer.  

The cost of gastric band surgery on the NHS in England is roughly 6,000 GBP per surgery.

Cost of diabetes treatment in the UK in 2012

Area of expenditure	Type 1 diabetes	Type 2  diabetes	Total cost	Percentage of costs
Source: Kanavos, van den Aardweg and Schurer: Diabetes expenditure, burden of disease and management in 5 EU countries, LSE (Jan 2012)
Diabetes drugs	£0.344 billion	£0.712 billion	£1.056 billion	7.8%
Non-diabetes drugs	£0.281 billion	£1.810 billion	£2.091 billion	15.2%
Inpatient	£1.007 billion	£8.038 billion	£9.045 billion	65.8%
Outpatient (excluding drugs)	£0.170 billion	£1.158 billion	£1,328 billion	9.7%
Other (including social service)	-	-	£0.230 billion	1.7%
Total	£1.802 billion	£11.718 billion	£13.750 billion	100%

So, to me, it is obvious that if you can reverse obesity at 6,000 GBP a pop then you will actually be saving money in the long run...

However, the problem doesn't stop there.  There is a HUGE psychological problem involved in obesity and weight loss.  Lots of obese and overweight people say that they have had social problems because of their weight, or have been passed over for a promotion or are unable to get work because of their weight.  They are considered lazy and greedy by others who think that they should just stop eating so much and move more.

One thing that happens repeatedly is that when an overweight or obese person does finally turn
his/her life around, in too many cases he/she is left with the most horrendous excess skin that sags and hangs from his/her leaner frames.  

Put yourself in that position.  For whatever reason you are obese... maybe it is because you have eaten too much for too long, or depression has caused you to comfort eat, or you have an illness or medication that causes weight gain... and you finally decide to improve your life and lose weight.  You have spent at least a year if not more changing your diet, resisting temptation, forcing yourself to exercise and stay motivated watching that needle on the scale slowly going down.

But in the end you are left with literally kilos of sagging excess skin.  Every time you look in the mirror you see this, it makes you feel unattractive, depressed and makes you wonder why you even bothered.

Many people in this situation have commented that they were happier BEFORE the weight loss.  That now their lives are blighted by this unsightly excess skin that they have to try and hide.

Skin removal surgery done privately can cost anywhere between 1,500 to 6,000 GBP.  Lots of stories I read say how people have been denied excess skin removal surgery because of the cost.  So a person does their best to lose weight and improve their health and not cost the public health services vast amounts of money in treatments for serious illnesses, only to be abandoned by the public health services - excess skin obviously isn't important enough.  One woman was even told she couldn't have her excess skin removed because she HADN'T had a gastric band operation!

A person in this predicament has SAVED the public health services large amounts of money, and in my opinion should be helped to go that final step to making their turn around complete and having a happy and healthy person integrated into society.

How would you feel, if this was your story?

I can help you improve your health.  If you would like to make an appointment with me either in person or via Skype, just send me an email to lucycarr@socialnutrition.com

It's the party season!

Ok, so Christmas is just around the corner, that means parties to go to, and lots and lots of food.  So how does Christmas affect our waistlines?

New research has been published from an unlikely source - Tilda Basmati Rice, that surveyed 1,000 adults in the UK about their Christmas eating habits.

The survey found that the first Friday of December is when Britons tuck into their first festive food of the season - and as early as 9.58 am on the first Friday.  This starts off the beginning of what will end up being an extra 30.000 calories consumed between now and Christmas.

Let's face it, it's very easy to overeat at this time of year with all the delicious treats on offer every time you go anywhere near a food department.

According to the survey, the biggest over eaters are young adults between 16-24 years of age.  Probably due to the number of parties they'll be attending, or students back from university.  But all age groups will be joining in the overeating and less healthy foods; men are less likely to treat themselves than women, just 28% of men stated they never indulge in festive treats versus 23% of women who claimed the same.

Lots admitted to comfort eating (28%) and others that the cold weather led them to stay at home and indulge (24%) and others said that the Christmas over indulgence was a "reward" for all the hard work during the year (21%).

However, there is a way to have your cake and eat it too!

My advice is to plan ahead.  If you know you have a party to go to on a Saturday, then be really strict with yourself all week prior to the party.  Don't mix your carbs and your proteins and stay as active as possible.  Reduce your carb intake to just twice a week.  If the party you are going to is a cocktail type with only "finger foods" available, I suggest you eat something healthy before going.  Nibbles are usually all carb based with lots of mayonnaise and protein mixed in.  A sure way of piling on the pounds!  If you eat beforehand you won't be so hungry and it will be easy to avoid the fattening foods.

If you have a dinner or a lunch to go to then do the same, be strict with yourself during the days leading up to the event and then enjoy.

In both cases, be strict again from the next day onwards, to counteract the "damage" that may have been done.

Drink lots of water before and after drinking heavily.  Think before you eat, ask yourself if you are really hungry first or if you are going to regret eating that afterwards.  If you do decided to indulge then ENJOY it!  Don't feel guilty about doing it.

After all, Christmas is for having fun too!

I can help you improve your health.  If you would like to make an appointment with me either in person or via Skype, just send me an email to lucycarr@socialnutrition.com

It's all in the mind...

A huge problem in today's society is weight gain.  More people are obese than ever before and that includes children.

Obesity is bankrupting our health services due to obesity related illnesses such as type 2 diabetes, heart disease and cancer.  There is a huge weight loss industry generating millions of dollars which tells you to stop eating fat, stop eating carbs, stop eating.... exercise more...

But just as many criticize the medical profession for becoming too specialized; you see a cardiologist for heart disease, an oncologist for cancer, and endocrinologist for diabetes, and not treating people as a whole, the same can be said for the weight loss industry.

People aren't fat just because they eat too much.  There are many reasons why a person puts on weight... eating too much is just one of them.  There are medical reasons and also psychological reasons.  Stress, anxiety, and even emotional attachment to food all play a part in weight and if these are not taken into consideration and treated along with a weight loss program then in most cases, weight loss will not be sustained.

Orlando Health researchers have revealed that only 1 in 10 Americans recognize the importance of psychological well-being in weight loss.  People tend to attribute more importance to other components such as exercise when it comes to losing weight.

31% of Americans think exercise is the biggest barrier to sustaining weight loss, while 26% think that eating less is important and 17% blame the cost of a healthy lifestyle as the biggest problem to losing weight and keeping it off.  12% cited a lack of time to dedicate to changing their lifestyle to be healthier.

Dr. Diane Robinson, a neuropsychologist and the program director of integrative medicine at Orlando Health said:

"Most people focus almost entirely on the physical aspects of weight loss, like diet and exercise.  But there is an emotional component to food that the vast majority of people simply overlook and it can quickly sabotage their efforts."

Food has become the center of the social aspect of our lives.  When you meet up with friends it is
usually over lunch or dinner or drinks, special occasions are celebrated with food like cakes, or Thanksgiving or Christmas are centered around huge spreads of food, Valentine's Day chocolates, Halloween candy and we even reward or pacify our children with sweets.  

Many people turn to food in moments of emotional stress and anxiety, comfort food doesn't tend to be a salad with grilled fish.  Comfort food is high fat, high carb indulgence that leads to extra weight that we then can't shift.  Even when on a diet people tend to reward themselves with "treats" when they have reached a certain goal.  A too restrictive diet and cause feelings of deprivation and then a treat of a piece of chocolate means you end up eating the whole bar.

Finding out WHY you eat the way you do is of vital importance when losing weight.  You can't just treat the fat around your middle, you have to treat the psychological aspect of why you are eating in a way that has lead you to put on weight to start with.

Becoming aware of your habits is very important and isn't as difficult as it may seem.  Ask yourself simple questions when you are considering reaching for the cookie jar;

Am I hungry?  Or am I just bored or upset?  Keep a diary and write down what you have eaten and how you felt prior to eating and afterwards as well.  If you ask yourself the right questions you may discover that boredom is a large part of why you eat between meals.  So, what can you do instead?  If you are bored go out for a walk, or read a book.  I find doing housework keeps me occupied and makes me feel more positive because there is a positive end result.  Find what works for you to keep boredom at bay.

If you eat when you are upset, what is upsetting you?  What can you do about it?

If you eat when you are stressed, then you may need to find something that helps with stress relief.  Depending on what you like, stress relief could be a physical activity such as running or cycling.  For other people meditation works wonders - although here I believe that meditation works wonders for everyone.

We humans have a strong emotional attachment to food which is learned from a very young age.  So if your go-to reward is food, think about other rewards you'd enjoy which aren't food based.  Treat your self to a pampering session or a movie, a new item of clothing, indulge yourself in a non food based way.  Think about how you can reward your children without giving them food, maybe a small toy or movie night at home, a play date with a best friend.  There is so much we can do to reward ourselves without reaching for food.

The minute you identify your psychological triggers you will automatically begin to change your habits and the weight will drop off and stay off and you will be all the more happier for it.  You will also feel more in control of your life and more able to cope.

I can help you improve your health.  If you would like to make an appointment with me either in person or via Skype, just send me an email to lucycarr@socialnutrition.com

How big is a portion?

Portion size has changed over the past 20 years - according to a report from the British Heart Foundation.  For example; ready-meal portions (think lasagne) have increased by 50%.  And it isn't just these dishes that have grown, the humble digestive biscuit has gone up by 17% - so what?  I hear you cry... Well, the skinny on that one is that if you eat just ONE digestive biscuit a day it would add 3,330 calories a year to your diet - compared to the biscuits back in 1993.

You see, we eat too much.  We really don't need the amount of food we tend to eat.  We don't need a super sized meal from McDonald's or any where else for that matter.

CONFUSION:

Trying to eat properly is just plain confusing.  We are given guideline such as: 5-8 portions of fruit and vegetables every day, 2 portions of oily fish per week, and then there is the food plate where half should be vegetables (great) a quarter animal protein and the other quarter carbs (not so great), they don't specify the plate SIZE either, or the infernal food pyramids that just don't make any sense at all.

Fruit and vegetable portions are detailed at 80g per portion - but, do you know what 80g of cauliflower or broccoli look like?  And what about leafy vegetables such as spinach that when cooked reduce in size drastically but weigh more from acquired water?  You'd have to spend a lot of your meal planning time weighing your food and, let's face it, who has the time for that?


THE SOLUTION:

So, here's a "handy" solution to your portion size woes.  Use your hands as a guide.  They go with
you every where you go, so a much more practical solution to lugging the kitchen scales around with you.  Also, hand size is in proportion to body size; so a petite person's hands indicate the correct amount of food for that person, as do the larger hands of larger people who will need more food.  This even works for children.

So, here we go:

BROCCOLI, CAULIFLOWER, etc.: the size of your clenched fist, but these really shouldn't be limited, getting 5-8 a day isn't easy so you could have 2 or more at one meal.  Aim for HALF of your plate filled with vegetables.

LEAFY GREENS such as spinach: 2 double handfuls - raw, this is almost a whole bag.

SMALL FRUITS such as raspberries, blueberries, etc.: two cupped palms.  Larger fruits such as apples and oranges should fit snuggly into your hand.

MEAT - beef, chicken, lamb, pork, etc.. should be the size of your PALM - so, your hand minus the fingers, and as thick as your palm too.

OILY FISH such as salmon.: like meat, the palm of your hand.  Heart-healthy fish packed full of Omega 3 fatty acids are essential at least once a week if not twice.

WHITE FISH such as cod, haddock, hake, etc.: your whole hand, including the fingers.

PASTA - uncooked: the size of your clenched fist.  It may not seem like much but it doubles in weight once cooked and refined white flour foods aren't really that nutritious anyway.  The best way to eat pasta is with lots of fresh vegetables.

POTATO, CARROTS, PARSNIPS, etc.: starchy vegetables, just the size of your clenched fist.  These are better for you than refined carbs but they are still high in sugar and should be considered as carbohydrates and as such should be limited if you are trying to lose weight.

NUTS:  one palm full.  You don't need more than this to reap their healthful goodness.  Did you know that just THREE brazil nuts give the same anti depressant brain boost as 1 dose of Prozac?

FATS such as butter, peanut butter, oil, etc.:  Thumb tip (from the first knuckle to the finger tip) or a
teaspoon, 2-3 times a day.

CHOCOLATE: the length and width of your index finger.

CHEESE: Length and depth of two thumbs.

All these should be calculated raw as in before cooking.  I hope this helps keep your portion control in check.  Remember, if you want to lose weight, try using a smaller plate.

I can help you improve your health.  If you would like to make an appointment with me either in person or via Skype, just send me an email to lucycarr@socialnutrition.com

How many diets have you been on?

New statistics have come to light about our dieting habits and, as a nutritionist, I find it quite depressing.

In general, women will have dieted for THREE YEARS by the time they are 30, with the average woman dieting twice a year and losing roughly 2kg each time.

The survey by Forza Supplements of 1000 British women, claims that the average female dieter will have spent 168 weeks trying to lose the extra weight between the ages of 18 and 30.  But it doesn't stop there, by the time the "average woman" reaches 40, the number reaches just under 6 years or 308 weeks of dieting.  This means that in total she will have lost an unbelievable 89kg by the time she's 30, that's 19kg more than the average weight of a British woman (69kg).

Now that is a heck of a lot of weight to lose between 18 and 30 and by the time she's 40 she'll have lost 158kg.... which demonstrates the yoyo effect of dieting instead of eating healthily all the time and maintaining a healthy weight.

You diet... you lose weight... you stop the diet... you go back to eating the way you did before - which made you gain weight to begin with... you put the weight back on, and then some... you diet again... and you keep going round and round in a vicious circle.

Oprah Winfrey has lost and regained weight many times.

According to the survey, the peak age for dieting is 33 due to the effects of motherhood and the fear of putting on weight in middle-age, however, women over 40 are apparently the most comfortable with their figures (really?  I'm over 40 and most of the women I know are die-hard dieters and desperately trying to reverse or slow the aging process!).

Forza Supplements also asked what were the main motivations for dieting, they turned out to be - in order of importance:

• Putting on more weight than a close friend or sister.
• How a woman sees herself in a shop fitting-room mirror.
• The end of a relationship - 57% of women said this would inspire them to do something about their weight to look more attractive.
• Embarrassing holiday photos.

If you have a weight problem, by all means, examine your lifestyle and make the necessary adjustments to lose the weight and then keep it off by not going back to your old ways.  It really isn't that difficult once you make the change, although I do realize that making the change can be daunting!

However, just as hundreds of thousands of people before you have managed it, I know that YOU can
too.

Analyze your diet, what changes can you make?  Make sure you eat lots of vegetables and some fruit.  By all means eat meat, chicken, fish and eggs - you just don't NEED to eat the whole cow at one meal!  Keep carbs to a minimum and make them as wholegrain as possible.  EXERCISE... move as much as possible, help the environment and take public transport or a bike when ever possible - you'll be helping yourself too. 

Come on people!  This isn't rocket science!

I can help you improve your health.  If you would like to make an appointment with me either in person or via Skype, just send me an email to lucycarr@socialnutrition.com

Holding back the years

When I was a child it felt like Christmas took forever to come, when I was in my early 20s I smoked, ate all the wrong things and danced all night and being "an adult" seemed like a long way off.  To be honest, even now I still don't feel like an adult.

But life goes on and things happen that change your way of thinking and living.  I wish I could say that my mother's death changed me for the better, and maybe it did - later... But at the time it pushed me even further off the deep end.

However, what really changed me was becoming a mother.  I know it sounds like the typical thing that every mother says, and it probably is, because all of a sudden there is the deepest most profound love and longing to see what this baby will grow up into.  I have this strong desire to live as long and as healthily as possible to see what my children do with their lives.

Today's society is very orientated towards modern medicine and taking medication for any "age-related ailment" that might befall us; high cholesterol, osteoporosis, arthritis, etc..  But what if you could ward off those ailments?

I strongly believe that the more we look after ourselves when we are young then the better we will age.  The lifestyles we lead are so very important, and no, I'm not talking about how much money you have, or the make of car you drive, or how many holidays you have every year.

I'm talking about healthy living.  Forming and maintaining healthy habits as early as possible in life in order to prevent disease and live a longer and healthier life.

It is so easy to base your daily life on a healthy one which will enable you to be healthy and therefore to enjoy your life, love and family much more fully and it doesn't take much at all.

Here are 5 healthy habits you can develop at any age - but the sooner the better:

1.  Meditation.  Learning to meditate is not at all easy, it takes time and dedication, but the benefits are limitless.  Quietening the mind everyday for a while brings stress relief, better sleep, better relationships with those around you and even more thought clarity.  People who meditate every day are found to be much happier.

2.  Watch what you eat.  Well, I am a nutritionist!  Fresh produce cooked at home is the best way to eat.  That way you know exactly what's in it.  If you make this your base for food, then the odd "junk" meal will do no harm at all - when it really is once in a very long while!

3.  Keep sugar and refined carbohydrates to a minimum - or get rid of them completely!  Sugar is a drug and refined carbs have no nutritional value and just make us fat.  Now, I do understand that giving up sugar and carbs may seem impossible to you, so start off by limiting them to twice a week - not two whole days a week, just two meals a week.  Fruit contains sugar, but I do not advise giving up fruit - just eat the whole fruit and DON'T JUICE.

4.  Keep active.  I run, I cycle and I do yoga - that's me.  I'm lucky, I make my own schedule and am not stuck to a 9-5 office job.  The thought of sitting still drives me insane.  But if you hate running that's ok!  Find a sport that you like, and if you can do it with friends then even better.  But don't stop there.  We can be far more active than we realize.  Stand up as much as possible, even when you are at the office.  You need to stand up at least every 30 minutes, even if it's just for 1 minute.  Go and fill up your water bottle, take a brief walk or take the stairs instead of the elevator.  If you use public transport, get off 1 or 2 stops earlier and walk the rest of the way.  If you use a car, don't always park as close as possible to where you are going.  Just small adjustments like these are extremely beneficial.

5.  Have a yearly check-up with your doctor to control your glucose levels and blood pressure.  Blood pressure is a good indicator of overall health, and controlling your glucose levels is extremely important.  Developing type 2 diabetes can lead to a whole host of other health problems.

Just think, if you look after yourself and remain active, then once you hit retirement age you'll actually be healthy enough to enjoy yourself!  Remember, old age is also an attitude!

I can help you improve your health.  If you would like to make an appointment with me either in person or via Skype, just send me an email to lucycarr@socialnutrition.com

What bingeing really does to you

Who hasn't blown the diet on a weekend?  After controlling what you eat and drink all week it's really easy to go off the rails at the weekend.  Socializing at weekends makes it all the more difficult to avoid temptation and also the just plain boredom of a restrictive diet makes it easier to give in.

Lots of people think that no harm can come from indulging at the weekends when you've been good all week, and whereas indulging occasionally doesn't hurt, when it becomes a weekly habit there are consequences.

Binge eating can also be an eating disorder sometimes due to a mental or traumatic issue.  When recognized, the problem can be solved helped a number of treatments such as self help or support groups, therapy and even medication.  If you suspect you have an eating disorder then you should seek help from you GP.

However there are physiological consequences to over-indulging:

Bloating.

This is a pretty obvious consequence.  Eating a large amount of food, often in a very short period of time, leads to bloating and abdominal discomfort.  This bloating can also cause a feeling of being breathless as the swollen stomach pushes upwards reducing the lung space available.

Let's face it, you aren't going to binge on salad and grilled fish.  Most binge food is unhealthy junk food which is seriously lacking in fibre.  As fibre is what helps move food through the digestive tract, eating low fibre foods just makes all that junk food hang around for a lot longer and can lead to constipation.  So your binge will take longer to leave you!

Heartburn.

An overfull stomach can lead to pressure on the sphincter or the "door" on the bottom of the gullet, causing it to open.

This "door" is there to stop food and digestive juices from coming back up into the gullet.  But pressure from beneath can cause it to open and release some food or juices causing a burning sensation from your stomach up to your throat.  This can also cause vomiting.  The juices that are involved are highly acidic and can cause longterm damage to the tissues in the gullet, and if not addressed it can also affect gums and teeth where regular vomiting is experienced.

Hormonal Disruption.

Binge eating has been linked to the several hormones; oestrogen and progesterone - made in the ovaries, ghrelin and leptin - otherwise known as the hunger hormones, cortisol - the stress hormone and of course, insulin which helps our bodies to process sugar from food.

When you binge, you often do so on foods high in sugar, causing a spike in blood sugar which triggers the release of insulin from the pancreas so that the blood sugar is normalized by storing the excess sugar as fat.

This process is why we gain weight.  But the stress caused by the overproduction of hormones can cause other problems such as lack of energy, fatigue, and tiredness that produce a signal to the brain to eat more.  If this is sustained, it can cause obesity and other weight associated illnesses such as type 2 diabetes.

Undernourishment.

Yes, you can eat a lot and still be undernourished,  Bingeing on high calorie foods with little nutritional value will not give you the nutrients you need.

A stable balanced diet is needed to carry out our daily routines, and exercise is an important part of a healthy lifestyle, so if you are not eating enough and going to the gym - or whatever exercise you choose - in order to slim down quicker, you will not be doing yourself any favors.  Undernourishment whether caused by bingeing on inappropriate foods or under-eating can cause longterm effects on the skin, heart and bones.

Women especially should have regular bone-density scans once they reach menopause.

Anxiety and Low Mood.

Someone trying to lose weight who binges can often feel ashamed, guilty, anxious and worried.  It can turn into a vicious cycle... you control your diet during the week, you feel you are justified to have a treat at the weekend and when you do you feel guilty afterwards... This can go on and on and become very difficult to break.

I know it isn't easy, but try not to binge on the weekend.  If you need a treat, set a date in the future and plan what you are going to have, like a piece of your favorite chocolate cake.  Then when the day comes, enjoy it... just the one piece mind, not the whole cake!  Make sure it is WORTH IT!

Weight Gain.

Of course, all of this does lead to you putting on weight.  The cycle of control and weight loss during the week and then bingeing and weight gain at the weekend is due mostly to WHAT you are bingeing on.  As I said before, it isn't that easy to binge on salad and grilled fish!

Be mindful of what you are eating and how that food nourishes your body, how it keeps you healthy.  If you do binge, don't ignore how it makes you feel... sluggish?  Exhausted?  Sick?  Remember those feelings the next time you are faced with temptation.  Ask yourself if what your are tempted by is worth the consequences?  How are you going to feel after you have eaten it?  Will you feel guilty and wish you hadn't eaten it?  Will it give you heartburn or gas?

Think before you eat....

I can help you improve your health.  If you would like to make an appointment with me either in person or via Skype, just send me an email to lucycarr@socialnutrition.com