caffeine, mercury & food safety whilst pregnant

Congratulations, you’re pregnant! Here is some food advice to get you started. Caffeine crosses the placenta during pregnancy. Is it safe? Too much can increase the risk of miscarriage or a low birth weight baby. It is safe to drink coffee, it’s all about the quantity:
– Limit to <200mg/day = 1-2 small cups of coffee per day (espresso, percolated) and a cup of tea (green or weak strength), or 3-4 instant coffees per day
Other sources of caffeine include: tea, cola, energy drinks, chocolate, guarana and caffeine supplements.

Mercury:
Found in fish and seafood. Excessive amounts associated with brain injury and toxicity. Deep sea fish contain the highest levels. Fish is a really important source of omega-3 fats, which assist baby’s brain development, so include it in the below quantities:

Current recommendations (FSANZ):

– Limit fish such as swordfish and flake to once per fortnight and avoid other fish for the fortnight.

– Limit fish such as orange roughy, catfish to (150g) per week.

– Limit all other fish (such as salmon, tuna, whiting) to 2-3 serves per week.
There are many dietary consideration during pregnancy. If you’d like individualised advice, come along for an antenatal nutrition consult at NEST Family Clinic.
(Image courtesy of www.pexels.com) to edit.

April 23, 2023

THE BLOOD GROUP DIET: PSEUDOSCIENCE?

April 23, 2023

Developed by a naturopathic physician, Peter D’Adamo, proponents of this diet believe following a diet and exercise program based on blood group (Types A, AB or O) improves fitness, digestive health, weight loss and wellbeing. Much of the discussion appears scientific, however it doesn’t hold pH neutral water. The Type A diet suggests more fruit, vegetables and less meat products, Type AB recommends less meat, more plant protein, some low-fat dairy and the Type O is similar to paleo; more animal products and low carbohydrates.
What does the science say?
A 2015 study of 1450 healthy adults debunked the blood group diet theory. On the Type A diet, an improvement was seen in body mass index, triglycerides (fats in the bloodstream), blood pressure and waist circumference, which are risk factors for heart disease, however this was independent of the individual’s blood type. Given the Type A diet is similar to recommendations of leading health bodies – more fruit, vegetables and less meat products, it is not surprising that a reduction in risk factors was seen in this group. The claims made about metabolism ad enzyme activity based on blood type are not scientifically true. Weight loss will occur whilst following these diets, given a reduction in processed foods, a greater intake of fresh foods and the reduced variety of foods you are ‘allowed’ to eat.

The bottom line?
This is another fad. Our blood group does not dictate an individual’s dietary requirements, it’s both far more simple and complex than that. Ultimately, follow a Mediterranean or flexitarian diet, with plenty of fresh fruit, vegetables, legumes, whole grains, low-fat dairy, some lean meat, fish and good fats for a sustainable approach, with rigorously scientifically proven health benefits whatever your blood type.

Wang J, García-Bailo B, Nielsen DE, El-Sohemy A. ABO genotype, ‘blood-type’ diet and cardiometabolic risk factors. PLoS One. 2014;9(1):84749.

April 23, 2023

THE BLOOD GROUP DIET: PSEUDOSCIENCE?

Wang J, García-Bailo B, Nielsen DE, El-Sohemy A. ABO genotype, ‘blood-type’ diet and cardiometabolic risk factors. PLoS One. 2014;9(1):84749.

April 23, 2023

THE KETOGENIC DIET: A REVIEW

April 23, 2023

THE KETOGENIC DIET: A REVIEW

Many of you have asked for my opinion on the ketogenic diet, here is my summary, based on current evidence.
What it is:
A very high fat, low carbohydrate diet, initially devised in the 1920’s to treat severe seizures in epilepsy.
Gained popularity for weight loss in recent years.

Breakdown: 70% fat, 10-20% protein, 5-10% carbohydrate. Looks like this:
Breakfast: 2 eggs, 1/3 avocado Lunch: salad with low carb veg, 100g meat, 1 boiled egg, 30g cheese, Dinner: 150g meat + low carb vegies, snacks: low carb protein bar, nuts, cheese, chopped veg, berries.
Studies show short-term improvements health markers
Benefits: fuller for longer due to fat content, ketones suppress appetite, fat loss instead of muscle
Disadvantages: sustainability, social occasions, restriction severe, satisfaction, expensive

What is ketosis?
Glucose is the main source of energy for the body, from carbohydrates. Brain uses 120g glucose per day
When the body is deprived, alternative fuel is produced =‘ketones’
During fasting – body removes glucose from the liver and breaks down muscle (glycogen) to release glucose
Once this depletes glucose stores, (3-4 days), insulin decreases and body uses fat as primary fuel.
Liver produces ketone bodies from fat.
Ketones accumulate in the blood = ketosis

Symptoms of ketosis: hunger, fatigue, low mood, irritability, constipation, headache, ‘brain fog’, nausea, vomiting, reduced exercise tolerance
Safety:
Unclear long-term risks, risk to heart health with high saturated fat diet (risk of high cholesterol)
Kidney stones, osteoporosis, uric acid (gout), nutrient deficiencies, gut health
Unsafe in certain medical conditions and times of growth: pregnancy, breastfeeding, children, adolescents

So what is the bottom line?

Option if difficulty losing weight other methods
If individual can stick to it and meet nutritional requirements
Consult GP and Dietitian before commencing
Dietitian can guide reintroduction of carbohydrates to enable long-term weight maintenance
Good option is a modified carbohydrate diet – easier to stick with in the long-term

– Weight regain a risk after following a restrictive diet

April 23, 2023

intermittent fasting

April 23, 2023

intermittent fasting

Intermittent Fasting: a summary of the evidence
April 4, 2019

What is Intermittent Fasting (IF)?

Cycles between brief fasting periods and unrestricted eating
Loss of fat, clinically significant improvement in blood pressure, cholesterol, blood glucose, possibly insulin sensitivity
Thought to reduce risks of CVD and Diabetes, however longest follow-up remains 12 months
Stops body from adapting to prolonged caloric restriction, preventing further weight loss

Different types of IF:

1.Alternate day fasting: (the most well-studied)

Is it easier to eat 500kcal 2 days a week, than 1200kcals every day on a traditional calorie-restricted diet?
What does 500kcals look like?

Breakfast: black coffee, small boiled egg, 3 asparagus
Lunch: bread, slice ham, lettuce
Snack: herbal tea/low kJ hot chocolate
Dinner: Small piece fish, 100g boiled potato, 100g boiled peas

25% energy intake more for heavier person or with higher activity levels

1.Time restricted feeding (16:8)

E.g. Meals 8am-3pm, fasting remainder of day

2.Whole-day fasting

1-2 days per week 0-25% calorie needs, no restriction other times

What does the literature say?
When IF and normal calorie restriction compared reduction in health parameters, studies show there is NO SIGNIFICANT DIFFERENCE BETWEEN:

Weight loss or body composition
Weight regain
Blood pressure, HR, glucose, insulin, cholesterol at 12 months’ follow-up
Studies have shown that followers generally do not overeat on non-fasting days when compared to other weight loss methods.
In women, there are anecdotal reports of changes to the menstrual cycle, therefore a modified approach may be required

There are benefits:

Weight loss and resultant improvement in health parameters
It’s simple to implement, no difficult rules or expensive products
More food may be eaten over a shorter time frame

There are disadvantages:

Difficult to sustain in the long term (consider social events, which many people struggle with moderating)
Lowered energy levels and productivity (reduced capacity to exercise, concentrate)
Risk of binge, constant thinking about food – not recommended for individuals who follow a binge-restrict pattern of eating.
No focus on QUALITY of diet only QUANTITY
Risk of nutrient inadequacy if not well considered
Risk of weight regain

There are disadvantages:

Difficult to sustain in the long term (consider social events, which many people struggle with moderating)
Lowered energy levels and productivity (reduced capacity to exercise, concentrate)
Risk of binge, constant thinking about food – not recommended for individuals who follow a binge-restrict pattern of eating.
No focus on QUALITY of diet only QUANTITY
Risk of nutrient inadequacy if not well considered
Risk of weight regain

It is unsafe in the following categories:

Eating disorders
Adolescents (active growth)
Pregnancy and breastfeeding
Specific medical conditions requiring medications (e.g. diabetes) – can be utilised in diabetes with medical management, including medication adjustment.
Food/dieting can cause adverse reactions, malnutrition
Refer to your resident NEST dietitian to assist with nutritional adequacy and safety

So the bottom line is:
Confirms evidence for caloric restriction
May be helpful in the short-term due to reduction in hunger hormone, grehlin

There is evidence that it can be a good alternative to usual caloric restriction for some individuals
It is unclear if it is superior to other methods weight loss: more high quality studies are needed with longer-term follow-up
Certain people who eat 1-2 meals per day may do better on this
More high quality studies, including RCT’s are needed, with follow-up greater than 12 months
Therefore cannot make strong recommendations
Difficult for person who eats every few hours
Risk overeating
Binge-restrict cycle
Fixation food
Impact on children who see parents skipping meals?
How long should diet be followed for benefit?

References

Trepanowski JF, Kroeger CM, Barnosky A, Klempel MC, Bhutani S, Hoddy KK, Gabel K, Freels S, Rigdon J, Rood J, Ravussin E, Varady KA. Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial. JAMA Intern Med. 2017; 177(7):930-938.
Schübel R, Nattenmüller J, Sookthai D, Nonnenmacher T, Graf ME, Riedl L, Schlett CL, von Stackelberg O, Theron J, Nabers D. Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial. American J. Clin. Nutr. 2018; 108(5):933–945,
Seimon RV, Roekenes JA, Zibellini J, Zhu B, Gibson AA, Hills AP, Wood RE, King NA, Byrne NM, Sainsbury A. Do intermittend diets provide physiological benefits over continuous diets for weight loss? A systematic review of clinical trials. Mol Cell Endocrinol. 2015; 418:153-72

April 23, 2023

Rock silly season nutrition with these 5 tips

April 23, 2023

Rock silly season nutrition with these 5 tips

1. Balance
When life gets a little crazy busy, aim to be prepared for the weeks with meal prepping. Try double batch cooking and freezing. Keep canned or frozen foods handy, such as vegetables, eggs, baked beans & wholegrain bread for quick and healthy meals. If you can, take some time for yourself to do something you love.

2. Don’t restrict yourself
Though there may be more treats around than usual, it’s important not to restrict yourself before or after social occasions, by skipping meals. Stick to fresh whole foods where possible, with loads of fruits and vegetables, and remember this season is a small part of the year, so enjoy it and listen to your body.

3. Find time to move
Movement is so important for both your physical and mental health. Small steps count, so even 10-15 minutes of activity is a great start, try gradually building up to 30 minutes a day. Switch off by playing a podcast or your favourite music.

4. Listen to your hunger cues
It’s easy to overeat when food is plentiful. Tune into your hunger & fullness signals by taking your time. Remember it takes 20-30 minutes after eating for these signals to occur. Eat with awareness; choose foods you really feel like, to avoid mindless grazing.

5. Perspective
Don’t let a day, a week, or even a month derail your overall health and wellbeing. It’s a small part of the year and whilst it’s important to make healthful choices and keep moving, it is also ok to indulge sometimes. If you can give yourself permission to enjoy, and tune into your body’s messages, it can help to avoid unhelpful guilt. Aim to keep routine and structure where possible.

By Emma McShane, Dietitian & Nicole Bando, APD, IBCLC

April 23, 2023

5 steps to sustainable food choices

April 23, 2023

5 steps to sustainable food choices

Follow these 4 small steps to make sustainable food choices, to save money and make a positive change to our environment:

Reduce food waste

– Be prepared. Meal plan your week to ensure you are only buying the ingredients you will need and use.

– Be savvy with your storage; freeze leftovers, store spices and pantry items in airtight containers and jars, freeze fruit and vegetables to use at a later date for smoothies or soups.

– Leftovers become handy lunches, so use containers and take any food to work the next day.

– Use sustainable food wrapping e.g. beeswax to cover food rather than plastic.

– Be savvy with your food, use all aspects of fruits and vegetables, or start your own composting or feed to the animals.

2.Frozen vs Fresh

Fresh doesn’t always mean better. Frozen fruit and vegetables are just as nutritious and make food preparation easier. Frozen food lasts longer leading to reduced food wastage. Frozen fruit and vegetables are cheaper, and means that non-seasonal vegetables can be consumed all year long if needed.

3.Meal planning

As briefly touched on before, meal planning can help to reduce wastage and help to reduce excess landfill entering our environment.

– Plan your week of meals, and write a list before going shopping[NB2] .

– Only buy the amount you need and will use, this can be done by using recipes with specific measurements.

– Use frozen items from your freezer in your cooking, to prevent food build-up in your freezer.

– Check your pantry, freezer and fridge before shopping so you don’t double up.

4.Avoid excess plastic packaging

– Use material reusable shopping bags, and leave some in your car as this can help with those last minute ingredient pick-up at the supermarket!

– Small mesh bags can be used instead of plastic bags when buying fruit and vegetables.

– Try choosing fruit and vegetables that are free from plastic in the supermarket i.e. not already packaged.
Make sure you check out upcoming article for more alternative plastic packaging ideas.

5.Limit takeaway meals

Take-away can be a quick, easy meal every now and then, but they provide limited nutrition. They also provide excessive amounts of packaging, we may over order, further contributing to food waste. If you are choosing takeaway meals, choose only the amount you will consume and take your own packaging e.g. a container to collect your food!

Additional resource.

Meal prep for beginners

By Emma McShane, Dietitian, September 2022

April 23, 2023

Meat and the environment: small steps matter

April 23, 2023

Meat and the environment: small steps matter

The planet’s population is increasing, therefore meat intake continues to rise. Livestock production has negative effects on our environment as meat produces more energy emission per unit than plant-based foods, and livestock production produces methane, affecting the earth’s temperature and climate.

There is no need to cut out meat entirely, however reducing the amount of meat your family consumes is beneficial for the environment and overall health.

Try slowly reducing the amount of meat you eat by implementing one meat-free night per week and then slowly building this up, aiming for 3-4 meat free days per week. You may be asking, what can I eat instead?

Meat substitutes include:
– Legumes; lentils, chickpeas, butter beans
– Tofu & tempeh
– Vegetables e.g. mushrooms, eggplant
– Cheese e.g. paneer, ricotta
– Egg

Try this easy roast vegetable recipe, simply add a drained can of chickpeas for a balanced meal.

If reducing your meat consumption is not for you and/or your family at the moment, there are some meats that are considered more sustainable than others. Kangaroo is a high protein, lean meat that requires less feed and water during production than other meats, sustainably caught fish is also another good option. If choosing chicken, try buying free-range. Grass fed beef isn’t necessarily better for the environment overall, given the demand for this has increased over the last few years. Or try adding a can of lentils to your bolognaise to boost plant intake and make the meal go further.

By Emma McShane, Dietitian (edited by Nicole Bando, APD, IBCLC), September 2022

April 23, 2023

A HEALTHY LUNCHBOX

April 23, 2023

A HEALTHY LUNCHBOX

A balanced, nutritious lunchbox is important to support the growth and development of children. Food is fuel, that children need to learn, concentrate, thrive, play, and grow. A balanced lunchbox can help promote performance (academic, physical, emotional), as well as body image, mood and environmental sustainability. It also helps your child to learn to manage their hunger & fullness cues, a wonderful habit to take through life.

When providing food to children, it is up to the parent to provide:

The right types of food
Regular meals and snacks.

However, it is up to the child to decide:

What to eat
How much to eat

It can take up to 1-15 times for a child to accept new food, which may seem like a lot, however the lunchbox provides the perfect opportunity to introduce new foods. Role modelling and positive food environments play a key role in children trying and accepting new foods, so the school environment can have a positive effect on your child’s eating. To save time, pack lunches the night before, you can even use dinner leftovers packed into a thermos.

Choose an option from boxes 1-4 to create a balanced lunch box.

See below for 3 days of lunchboxes:
Also see our great resources on simple snack swaps and soy/dairy-free alternatives.

By Emma McShane, Dietitian & Nicole Bando, Dietitian, May 2022

April 23, 2023

10 tips to buildING a healthy lunch box

April 23, 2023

10 tips to buildING a healthy lunch box

I have lots of conversations about lunch boxes: here is a great infographic from Nutrition Australia that summarises what should go in to the lunch box each day.

Basic guide:

Lunch provides a third of daily requirements, so it’s important.
Cover the 5 food groups to ensure that your child is receiving all the nutrients they need to play, grow and learn
This will ensure they do not come home starving and over consume in the afternoon/evening.
Do not spend your time cutting sandwiches into interesting shapes, it’s soul destroying and will not make a fussy eater less fussy.
Present the same foods in different ways: e.g. cucumber slices or sticks or whole baby cucumbers
Treat foods are just that and should appear sometimes, once every week or two. Consider where your child may be receiving other treats, do they need them in their lunches too?
Involve the children in lunch prep – ask what they would like within reason e.g. carrot or cucumber
Continue to send new foods, even if they come home at first. If they are not offered, your child will never try them
If parts of lunch are uneaten, offer as an after-school snack before offering other foods
This can be a tricky area to navigate for families, please come and see me for advice to help your kids achieve their best growth and learning potential through nutrition.

https://heas.health.vic.gov.au/schools/healthy-lunchboxes

April 23, 2023

WHAT YOU NEED TO KNOW ABOUT SUGAR

April 23, 2023

WHAT YOU NEED TO KNOW ABOUT SUGAR

MYTH BUSTER #1: Shades of sugar

There is so much information about sugars, it is often confusing and misleading. Let’s clarify the information to help you make healthy decisions.
Sugar refers to simple chemical structures: glucose, fructose and galactose, all carbohydrates contain these building blocks in various forms. E.g. Sucrose (table sugar) = glucose + fructose, honey= fructose. There are more than 50+ alternatives for sugar, e.g. molasses, date syrup, coconut sugar, dextrose, honey, golden syrup, coconut sugar, barley malt, rice syrup, brown sugar, etc., and they are all nutritionally similar. The differences between the types is the source (e.g. plant, fruit or bees), and the type of processing to derive syrup or granules.

Manufacturers use alternative sugars for their health halo (e.g. coconut sugar), to trick consumers into thinking that they are making a healthy choice. A product with 4 different types of added sugar may falsely appear lower in sugar than it actually is. Check the label for all the different types; if any type of sugar appears within the first 3 ingredients, as well as further down the list, it’s a good indication that the product isn’t the best choice.

Honey is touted for its germ-fighting (antimicrobial) properties, but it is still uncertain how we would attain such benefits. Other sugars, e.g. date molasses contain antioxidants, though we would need to consume 500g for this benefit, which is obviously not recommended. Alternatively, a single cup of berries would provide the antioxidants along with myriad nutrients.

Fructose is another point of confusion. It is naturally found in fruit, and when we eat the whole fruit, we obtain the benefits from the fibre and multiple other nutrients in that food. Include two pieces of fruit per day as part of a healthy diet. This differs to free sugars, such as fructose syrup, added to foods in food processing.

The bottom line? When it comes to added sugar, no variety is a healthier choice than the other, our bodies absorb them in the same way. Overall keep any type of added sugars to a minimum by eating a range of fruit, veg, lean meats, legumes, fish, low fat dairy, whole grains and good fats.

Cake is cake, if made with raw vegan ingredients such as dates and coconut sugar, or old school white sugar, flour and eggs. My philosophy? Occasionally choose a small piece of the best quality cake you can afford and really want to eat…and savour it.

April 23, 2023

WHAT YOU NEED TO KNOW ABOUT SUGAR

MYTH BUSTER #1: Shades of sugar

Email: info@nicolebando.com

Call 8840 1652

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caffeine, mercury & food safety whilst pregnant

THE BLOOD GROUP DIET: PSEUDOSCIENCE?

THE KETOGENIC DIET: A REVIEW

intermittent fasting

Rock silly season nutrition with these 5 tips

5 steps to sustainable food choices

Meat and the environment: small steps matter

A HEALTHY LUNCHBOX

10 tips to buildING a healthy lunch box

WHAT YOU NEED TO KNOW ABOUT SUGAR

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