Essential Nutrition for Recovery after Surgery (Part 1)
In the first of a two-part series, Director and Principal Dietitian Gillian Killiner, discusses the relationship between good nutrition and surgery and how this can help your recovery process. Are you waiting for an operation? More and more people are spending months on waiting lists for minor and major surgery. Waiting when you are in pain or unable to function can have a devastating effect on your day to day abilities. If severe, your ailment can affect your job and income. These and many other issues related to surgery can negatively impact on your mood, your ability to eat, sleep, movement, your mental health and general well-being. Surgery is a deliberate, skillful injury to your body which following, may take you several weeks or months to heal. Infections and blood loss are two possible complications that you will want to avoid. While you are waiting for your procedure you can do your part to make sure you heal well without problems. You can do this by choosing the most nutritious diet well in advance of your hospital admission. Surgery is a big event. It makes sense to give yourself extra nutrition, so you can replace any blood loss and protect your immune system against infection. These same nutritional elements will repair your skin, nerves, blood vessels, muscle and bone and get you back on your feet again. What do vitamins and minerals do for you? The following are a snapshot of the major ones to assist your recovery: Vitamin B12 Vitamin B12 is the largest and most complex of all the vitamins. You need vitamin B12 so your body can create energy from your dietary fats and proteins. B12 is needed for you to make haemoglobin. It even helps your memory, mood and brain function. Vitamin B12 deficiency affects about 15 percent of people over the age of 60. There are several reasons people are low in B12: age, alcohol, bacteria infection and certain drugs. B12 rich foods include: beef, shellfish, cottage cheese, chicken, egg and nutritional yeast. Folate Folate plays a vital role in the work and growth of all your body cells. Not having enough folate causes problems in the cells. Some of your immune system white blood cells will be affected. If you do not take in enough folate you will experience fatigue, weakness, and shortness of breath. Never take a folate supplement without making sure you have enough Vitamin B12. Folate rich foods include: spinach, kale, Brussels sprouts, cabbage, broccoli, beans and legumes (e.g. peas, blackeye beans), yeast and beef extracts, oranges and orange juice, whole grain foods, poultry, pork, shellfish and liver. Vitamin B6 Vitamin B6 is needed for the proper function of about 100 essential chemical reactions in the human body. People who are low in vitamin B6 have impaired immune function. This is especially true for the elderly. Sleep, pain, mood, memory, and clear thinking are also affected by a shortage of Vitamin B6. The stress of hospitalisation for surgery causes many people to lose sleep. Increased pain and mood changes are also common. You may find your appetite is changed when you are in the hospital. Vitamin B6 is important at this time. B6 rich foods include: turkey, beef, pistachios, tuna, avocado, chicken, sunflower seeds, sesame seeds. Vitamin B1 (thiamine or thiamin) Vitamin B1 plays a critical role in making energy from food. It is needed for your heart, digestive system, and nervous system. Your muscles especially need vitamin B1 to work properly. Alcoholism is linked with a low intake of thiamine and other nutrients. If you drink large amounts of tea and coffee (even decaf), you may end up with not enough thiamine. This is because of the action of certain enzymes in these drinks. Vitamin B1 foods include: nutritional yeast, seaweed, sunflower seeds, blackbeans, lentils, white beans, asparagus, sprouts. Vitamin B2 (riboflavin) Riboflavin or Vitamin B2 is essential for changing the carbohydrates, fats, and proteins in your food into energy in your cells. It also helps manage drugs and toxins in your liver. If you do not have enough riboflavin you may not be able to absorb the iron, you need to make haemoglobin in your red blood cells. Riboflavin improves your ability to prevent or recover from iron-deficiency anaemia. Food rich in B2 include: liver, seaweed, feta, almonds, tempeh, mackerel, eggs, tahini. Vitamin B5 Pantothenic acid is essential to all forms of life. It is another of the vitamins you need in order to create energy from your food. Vitamin B5 will speed up wound healing. It can also increase the strength of scar tissue. Vitamin B5 rich foods include: beef liver, avocado, sunflower seeds, duck, portobella mushrooms, eggs, salmon, lentils, plain yoghurt, broccoli. Vitamin B3 (niacin) Vitamin B3 is also called nicotinamide or nicotinic acid. It is required for the proper function of more than 50 enzymes. Without it, your body would not be able to release energy or make fats from carbohydrates. It’s important for insulin-dependent diabetes. Vitamin B3 rich foods include: beef liver, chicken, tuna, lamb, salmon, sardines, turkey, white mushrooms. Biotin Biotin is one of the B-complex vitamins. It is needed for four important enzyme reactions in your body allowing cell growth and immune system protection against bacterial and fungal infections. If you do not have enough biotin it can lead to depression, a sense of tiredness, and weakness. You may also notice a rash on your face and numbness and tingling of your hands or feet. If you have brittle fingernails or notice increased hair loss, you may be low in biotin. Biotin rich foods include: liver, eggs, yeast, salmon, cheese, avocado, raspberries, cauliflower. Vitamin C Vitamin C is a water-soluble vitamin. Unlike most mammals, humans do not have the ability to make their own vitamin C. You have to get the vitamin C you need through what you eat and in supplements. (These are not all the same and can do more harm than good.) Vitamin C is a powerful antioxidant required to
The real truth about fats in your diet
The research on fats has been turned on its head and the advice now is to embrace fats, rather than fear them. Here, we get clear on the role of fats and introduce you to the ‘best’ fats to incorporate into your diet. “NEW RESEARCH FINDS CURE”… “EXCITING WEIGHT LOSS PILL”… Who else is tired of reading sensational tabloid headline like these? I know we at 121 Dietitian love to read the latest news but are often left confused, annoyed or fed up after reading a rehash of facts that are no longer scientifically balanced. In this article I hope to provide you with some interesting observations of past and recent research that will actually be of relevance to your future health. One to begin is regarding fats within the body and not just the fats you eat, but both important none the less. The role of brown fat A study released in Diabetes Journal July 2014 suggested people with higher levels of brown fat have a reduced risk for obesity and diabetes. Unlike white fat, which lowers insulin sensitivity, researchers found that brown fat actually improves insulin sensitivity, blood sugar control and fat-burning metabolism. This was good news for overweight and obese people and those with insulin resistance and diabetes, and suggested that brown fat may prove to be an important anti-diabetic tissue. What did they find? The study found when the body was exposed to slightly cold temperatures, brown fat can boost energy expenditure and burn calories. But what is brown fat? It is fat we are born with and is stored around our neck and upper abdomen to keep us warm in infancy. It was thought only until a few years ago that this disappeared into adulthood but now it has been found that thin people have more of this than those who are overweight. So how was this put into practice? Unfortunately this study did not provide answers to this, however in other papers it was suggested shivering for 10-15 minutes at 14-16 degree celcius could be beneficial. The hype for this was big and so I thought I would reinvestigate this four years on to see the outcome. Sadly, the benefits for you; ie shivering at low temperatures to get brown fat activated was not as successful as suggested. Brown fat is there to keep you alive, not thin and so shivering all day may possibly see some brown fat activity but did nothing to warrant any weight loss or health benefits. It seems as usual, further investigation is required. Getting clear on fats Moving on, let’s look at the national guideline on the subject of fats and health. I am sure for the past 30 years, you have been dutifully following the national dietary guidelines to cut out fats and eat high carbohydrate, low fat food choices. Yep, we know all about how fat has been demonised for decades, and that every product under the sun was turned into being fat free. We were not so sure this was a good thing and we rethought our practice here at 121 Dietitian as we realised the health of our patients was not improving but worsening due to “low fat everything”. The key here? Don’t be fooled into believing that foods labelled as ‘low fat’ are actually better for your health. Embrace fat, rather than fear it So we are proud to say that for over 12 years, we at 121 Dietitian have been seeing amazing results by ensuring: good healthy fats, sufficient lean proteins, specified volumes of fruit and vegetables and lower levels of specific carbohydrates. We embrace fat not fear it and it is clear we are not the only ones! For the past 2 to 3 years, voices are being heard and with the assistance of the media there has been a turning of the tide on fat shaming and putting the correct spotlight on sugars. Eating the ‘best’ fats Fats are no longer the demon but you do have to be aware that convenience foods, processed foods and take-away meals are meals that you should hold back on as they are fats created from hydrogenation and artificial saturation, interestification and are pro-inflammatory to the body. The fats you can seek to eat in a balanced programme are what you great grandparents ate and are as tasty as: avocados, lean meat, poultry, eggs, fish, cheese, butter, semi-skimmed milk, nuts and seeds. The role of 121 Dietitian As Dietitians, we see hundreds of male and female patients for a plethora of medical related nutritional concerns. If not in clinic, we are working with sports people for endurance and performance enhancing bespoke nutrition, or we are out on the road regularly visiting businesses to optimise staff health and work performance. You may also see us in the media answering national queries. Nutrition is a vital piece of the jigsaw to feel alive, focused and ready for the day ahead. If you are not feeling this then you should question your overall health and lifestyle choices and really try to make some changes. Gillian Killiner – Lead Dietitian and Director at 121 Dietitian. 121 Dietitian is an award winning nutritional consultancy company based in Belfast. Clinics are available in Belfast and worldwide via Zoom, Google, Skype… If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2018
Could fitness technology be causing you to gain weight?
Are you one of the many thousands of people who has invested in a piece of fitness technology or fitness tracker app in recent years? If so, you might want to read on… I have been a Dietitian for over 20 years and have observed the many nutritional changes and fads (fitness technology) that come and go. However, over the past two years, I have noticed an increasing but new reason as to why my clients are requesting advice for weight loss and healthy eating. They are coming to me totally confused and despondent. After originally embarking on a positive health change themselves, making a conscious effort to track their food and exercise, they have found instead of weight loss and health; additional weight gain and sluggishness from the commencement of using the gadget or app they purchased one to two years previous. Doing a little investigation, I am not alone in these findings and a research paper from JAMA September 20, 2016, entitled: ‘Effect of Wearable Technology Combined With a Lifestyle Intervention on Long-term Weight Loss: The IDEA Randomized Clinical Trial‘, found that the group selected to wear technology did not lose as much weight as the group who followed regular advice and exercise. Interesting indeed. As always, there are various factors involved behind research findings and as expected, limitations. However, what I took from this study in particular was the time factor: it was monitored for a full 24 months. Other studies have shown different results with 9 months or 6 months but when looking at a full two years, the study highlights that using technology doesn’t provide all the answers and the results are disappointing. So what now with fitness technology? Well, it is not time to throw out the technology just yet! What is however important to focus on – and what I feel is the most important element – is support. I know with my own personal health and well-being, if I did not belong to a running group I would not run the length of myself!! I do believe that support is still the foundation to success and people benefit from either individual or group support when needing advice and change. I’m sure like me you have all tried to do something new or different; from watching cooking shows, to learning an instrument. If teaching yourself, it is a really big challenge and commitment. Our self-doubt and often our over ambitious desires can derail our smallest but valid attempts and efforts. Putting this into something useful for you going forward…. Support is important, and one size does not fit all. Technology can only contribute to a portion of the puzzle when it comes to health. The watch may say ‘500 kcals burned’ but has your body the capability to metabolise at the rate the watch is set at? If you are not getting results you need to seek a personalised assessment and plan. For me the bottom line is this… whatever group or individual you choose, you need to know they have evidence to back up what they are providing. The support needs to be realistic, enjoyable and you need to be comfortable to see this advice through for the rest of your life. Knowing you are not alone and that you have expert support as required is golden. If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2018 and Jan 2021.
Is coffee good or bad for you? All you need to know
Coffee has been researched over and over and over, and why not! A universally consumed drink, it is complex, with over a thousand different substances present. So is it actually good for you, or should we avoid it completely? Here, we separate the facts from the fiction so that you can make an informed decision on its consumption. For years, researchers have warned us to avoid coffee because it might increase the risk of heart disease and affect growth. They worried that people could become addicted to the energy that high amounts of caffeine provided, leading them to crave more and more coffee as they became tolerant to higher amounts of caffeine. Experts also worried that coffee had damaging effects on the digestive tract, which could lead to stomach ulcers, heartburn and other ills. All of this concern stems from studies carried out decades ago that compared coffee drinkers to non-drinkers on a number of health measures, including heart problems and mortality. Coffee drinkers, it seemed, were always worse off. But it turns out that coffee drinkers were not compared fairly. Those studies didn’t always check for other factors that could account for poor health, such as smoking, drinking and a lack of physical activity. If people who drank a lot of coffee also happened to have some other unhealthy habits, then it’s not clear that coffee is responsible for their heart problems or higher mortality. That understanding has led to a rehabilitated reputation for the drink. Recent research reveals that once the proper adjustments are made for confounding factors, coffee drinkers don’t seem to have a higher risk for heart problems or cancer than people who don’t drink coffee. Recent studies also found no significant link between the caffeine in coffee and heart-related issues such as high cholesterol, irregular heartbeats, stroke or heart attack. Is coffee actually good for you? Studies show that people who drink coffee regularly may have an 11% lower risk of developing type 2 diabetes than non-drinkers, thanks to ingredients in coffee that can affect levels of hormones involved in metabolism. In a large study involving tens of thousands of people, researchers found that people who drank several cups a day—anywhere from two to four cups—actually had a lower risk of stroke. Heart experts say the benefits may come from coffee’s effect on the blood vessels; by keeping vessels flexible and healthy, it may reduce the risk of atherosclerosis, which can cause heart attacks. Some studies now suggest that decaf and caffeinated coffee may have the same health effects and suggest that it’s not just the caffeine that is responsible for coffee’s health benefits. Coffee is high in antioxidants, which are known to fight the oxidative damage that can cause cancer. That may explain why some studies have found a lower risk of liver cancer among coffee drinkers. Coffee has also been suggested to help you live longer. A recent study involving more than 208,000 men and women found that people who drank coffee regularly were less likely to die prematurely than those who didn’t drink coffee. Researchers believe that some of the chemicals in coffee may help reduce inflammation, which has been found to play a role in a number of ageing-related health problems, including dementia and Alzheimer’s. Some evidence also suggests that coffee may slow down some of the metabolic processes that drive ageing. One negative is that people may become dependent on caffeine and if stopped will cause withdrawal symptoms. The symptoms—headaches, irritability and fatigue—can mimic those of people coming off addictive drugs. Yet fortunately the dependence is nothing close to or as worrisome as addictions to habit-forming drugs like opiates. While unpleasant, caffeine “withdrawal” symptoms are tolerable and tend to go away after a day or so. How much coffee is safe? Like so many foods and nutrients, too much coffee can cause problems, especially in the digestive tract. But studies have shown that drinking up to four cups of coffee per day is safe. Moderation is key. For now, sipping coffee in reasonable amounts just might be one of the healthiest things you can do. If you have side effects however do reduce your intake to a level that is comfortable for you. If you have any concerns about how to get healthier please get in touch. We are experts in nutrition and able to assist you with all health issues. If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2018.
What to eat for a good night’s sleep
Do you struggle to nod off at night? Did you know that diet actually plays a key role in contributing to a good night’s sleep? Here, we discuss how what you eat affects your sleep, the foods to avoid and those which will help you welcome those zzzs. Incorporating certain foods into your food plan that are known for aiding relaxation and calming frayed nerves may help aid you for a good night’s sleep. What you eat affects how you sleep. How many times have you gone to bed after a late dinner or a midnight snack, tossed and turned and had the most ferocious dreams all because of that late feast? Become a tryptophan fan Some foods actively contribute to a good night’s sleep because they contain tryptophan, an amino acid that the body uses to make serotonin. Simply put, serotonin is a neurotransmitter that slows down nerve traffic so your brain isn’t revved up and raring to go. By adding more foods containing tryptophan, a natural sedative, you are giving yourself a better chance of undisturbed rest. Carbohydrates are particularly rich in this calming ingredient and many meal options can be planned that not only fit into your food plan but can also ensure you enjoy a safe passage to the land of nod. Foods such as potatoes, gluten free pasta and bread, rice, eggs, seafood, chicken, turkey, gluten free cereals, buckwheat, seeds and nuts are high in tryptophan and are perfect snooze boosters, and can be, if over eaten, the reason why you have a 3pm office slump! Try to have little snacks of these during the day or incorporate them into your evening meal to ensure you benefit from their in-built snooze facilities. Of course going to bed hungry is a sure-fire way to ensure you’ll be counting sheep all night. So make sure your evening meal is satisfying and not too heavy in proteins, which will lay heavy on the stomach and could keep you awake. If you do find you are hungry at bedtime, then great bedtime snacks could include: Houmous (homemade with garlic oil) with wholemeal gluten free pitta bread Wholegrain gluten free cereal with a little skimmed milk Porridge made with skimmed milk and raisins Peanut butter spread on crisp breads Foods to avoid to get a good night’s sleep If you don’t want to be tossing and turning all night, avoid the following: Caffeine-rich drinks such as tea, coffee and colas at bedtime Late night curries Alcohol High protein foods late, such as large portions of red meat or full fat cheese Sugary drinks Cakes, chocolate and biscuits – these can play havoc with your blood sugar levels Some people sensitive to garlic may find that too much of this ingredient in their meals can upset their sleep pattern Perfect snooze foods And lastly before you drift off, meals that are high in carbohydrates and low to medium in protein will help you relax in the evening and could ensure you have the best chance of a good night’s sleep. Try the following dinners for new ideas in the best in snooze food: Wholemeal GF pasta served with chicken, white sauce made from cornflour and milk, sprinkled with parmesan cheese Scrambled eggs with parsley Tofu/vegetable stir fry Houmous, (homemade) raw vegetables with wholemeal pitta Seafood/ pasta and salad Tuna salad / chicken sandwich Chilli with beans (not too spicy) Herbal teas such as camomile or valerian have been found to be useful as night-time relaxants and many supermarkets and health food stores now stock a delicious range of bedtime teas that are worth exploring. Remember… Eat regular meals and snacks of a wide variety of colours and flavours to achieve a range of essential nutrients. If you have any concerns about how to get healthier please get in touch. We are experts in nutrition and able to assist you with all health issues. If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2018.
Confused by food labels? Let’s get clear!
Food labels which can leave you confused. Here, we share our top tips on understanding what they really mean. Food labels – You’re ready to make some health changes and like many others, your new year resolution may have you rethinking your shopping trolley contents. The internet bombards us with recipes and healthy eating advice multiple times a day. So surely it must be easy to eat healthily? Wrong! With more advice and food labels it has become more confusing to eat healthy. We see this in clinic every day, and it affects a wide range of people. Whether it’s acute or chronic health issues, sports nutritional needs, weight loss, weight gain or allergies, everyone struggles to not only find the right foods for their needs, but how to integrate them into their day, suit their budget and time constraints for shopping and cooking. As Dietitians, we work with individuals to ensure they select the correct foods and nutrients optimal for their particular health issue or request. We also work with families to ensure they get value for money when they shop and that their kids will enjoy eating the same meals. A win-win in reducing the shopping bill and stopping the need to cook separate meals. How can you be sure you are picking foods that are correct for you? We know from The Institute of Grocery Distribution’s research since 2015 that many people are confused about how to use the information displayed on nutritional labels correctly. The main areas of confusion, in particular, are portion size information, reference intakes and colour coding. As a general guide the front of label’s nutritional information can be helpful. Taking a particular food – like bread as an example – there can be numerous options to choose from. Some are low fat, some high fibre… What therefore do you need to consider when looking at labels of foods in general? Using front of label information 1. Start with the colour background All green and it should be a good choice in relation to the nutritional guidelines – HOWEVER… My advice in addition to this is to always turn to the ingredients to check it is not loaded with artificial sweeteners and fat substitutes as this is a great way manufacturers can achieve all green. Some foods that fall into this amazing green light category can actually be chemical junk. The goal: Choose foods that are unprocessed. 2. Know your portions This detail can be very telling and misleading. A small cake may have the nutritional information available for a portion and doesn’t look too bad! Think: supermarket coffee and walnut cake (400g). The portion info is for 1/6 of the cake or 68g. If you manage to keep to 1/6 of a slice then that’s fine but most people cut bigger portions and so the nutritional information then becomes meaningless. Don’t just rely on portion measurements but take a look also at 100g measures. If your sugar value is below 5g per 100g then you are on the right track (unless your portion is over 500g!). For fibre push for 20g per 100g. 3. Checking the carbohydrates content is useful It’s worth remembering that too high carbohydrates intake is converted to fat if over-eaten. My advice is to check the total sugar and fibre content which makes this carbohydrate figure more meaningful. High fibre 20g/per 100g, low sugar 5g/100g is what you want to see. 4. Fat is very much in vogue The media are all about fats at the minute. After being banished for three decades, fat is now back on the menu. Fat is found in various healthy and not so healthy forms. Watch out for the saturated fat content in processed foods and keep to below 5g per 100g or 5%. Palm oil, refined oils and processed vegetable oils are linked to inflammation, due to the chemicals used for extraction and production. Many more factors are involved in selecting foods and using front of packet labels are helpful and a good starting point. Using common sense and checking the ingredients are also top priority. Remember the first ingredient on the list has the largest amount in the product and so on with the smallest amount of the ingredient last. If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2018.
