I am constantly reminded in my job how much stress affects our health. This year alone I have seen numerous clients with serious stress situations in their life. Although I’m a nutritionist, and not a councillor, its important for me to listen to the problems my clients are having as this helps me support them with diet.
It is vital in times of severe stress to try and eat well. With high levels of adrenaline and cortisol charging round the body, we crave foods that will either wake us up or calm us down. These will include caffeine, sugar, and other stimulants, as well as cravings for carbohydrates, chocolate and cheese. Often these foods will have a direct affect on our brain chemistry helping to raise serotonin and give us energy. This may sound good but the effects are short lived and long term can lead to more anxiety and stress.
So whats happening in the brain?
Your feelings are generated by tiny brain chemicals called neurotransmitters. These include dopamine, serotonin and adrenaline. Neurotransmitters are responsible for dictating your mood and are greatly affected by what you eat. Serotonin is associated with a reduction in stress and tension and feelings of happiness, whereas dopamine and adrenaline have different mood effects by boosting concentration and alertness. The influence of food is extremely relevant when neurotransmitter production is considered. Amino acids found in proteins provide the raw materials needed to make neurotransmitters and a low protein diet is often at the route of neurotransmitter imbalance.
Some foods directly stimulate a neurotransmitter response for instance carbohydrates influence serotonin production and caffeine stimulates adrenaline synthesis. There are many other specific vitamins and minerals that have a powerful effect on your mood. Without proper neurotransmitter balance brain function and mood can be seriously affected. Feelings of anxiety and stress are commonplace in today’s society. The body’s stress response has not yet evolved to deal efficiently with modern life, meaning the slightest emotional stress still causes a powerful release of chemicals. Two minerals, calcium and magnesium play an important role in regulating your nervous system. By making sure you have adequate dietary intake of these two nutrients you can help yourself combat feelings associated with stress and induce calmness and relaxation. GABA restores calm after a stressful event, helping you to relax. Another called dopamine enables your body to deal with stress more efficiently, helping to reduce feelings of anxiety.
If you are going through a particularly stressful time at the moment, try my top 10 tips to combat stress.
1. Do eat little and often – this is vitally important to keep your blood sugar level stable throughout the day – a decent protein breakfast like scrambled eggs on toast, a mid morning snack like an apple and a handful of nuts, lunch, of protein and carbohydrate like rice salad with chicken, mid afternoon snack, a yoghurt and some fruit or oatcakes and hummous, and dinner, grilled salmon, saute potatoes and steamed vegetables.
2. Remember to stay well hydrated on 1.5 litres of water daily, this can include green tea, or redbush and fruit juice. Try and avoid caffeine and colas as this may only make you more anxious and nervy. Cammomile tea is good for anxiety, and peppermint and fennel tea are good for indigestion and nausea.
3. Avoid all refined foods, particularly white sugar, and white bread etc. Choose wholegrains, brown rice and brown pasta. Eat plenty of dark green leafy vegetables as these are high in magnesium, as are nuts, brown rice, and baked beans.
4. Choose foods high in vitamin B which is the anti stress vitamin (particularly vitamin B5): these include brown rice, lentils, nuts, and whole grain foods and avocadoes. If you are not eating enough of these you can take a Vitamin B-50 complex daily for a month then every day until you feel better.
5. Its important to concentrate on your protein levels and make sure you have some protein at every meal. Protein contains the raw materials needed for neurotransmitters. Protein sources include: chicken, fish, tofu, nuts, pulses, eggs, cheese and meat.
6. Inflammatory conditions like asthma, eczema or skin disorders can flare up. Its important to keep your levels of omega 3 up – either by eating salmon, mackeral, herring or sardines three times a week or take flaxseed oil if you are vegetarian.
7. A glass of red wine every night is not going to do you any harm but try not to depend on alcohol to relax you and find another way like yoga or meditation.
8. If you are craving chocolate, avoid all refined products and go for organic or 70% dark chocolate and have a few squares after a meal instead of a pudding.
9. Foods that will calm you down include: dark leafy vegetables like watercress, kale, broccoli, spinach along with brown rice, almonds and walnuts, wheatgerm and sardines to top up on calcium and magnesium. To boost GABA formation include cheddar cheese, cow’s milk, chicken, turkey and eggs in your diet. For dopamine add in a few soya products like tofu, miso and soya yoghurt with peanuts, almonds and tuna.
10. Eat every three hours throughout the day. So if you have breakfast at 7am, snack at 10am, lunch at 1pm, snack at 4pm, supper at 7pm and if needed another snack at 10pm. Foods high in trytophan might help you fall asleep – these include turkey and lettuce, oats, bananas, milk, yoghurt and cottage cheese.
I think quite a few of you caught BBC2’s The Men That Made Us Fat and Channel 4’s Dispatches – The Myths about your 5 a Day. Both programmes highlighted exactly what is wrong with the food industry, who has the power and how we as consumers are manipulated by advertising and marketing. This month I’d like to discuss this in a little more detail and also what we can do about it. Sadly being in a double dip recession doesn’t help our food choices, and many families are going back to cheap processed food. I know its my job to advise you, but your health is paramount and good food needs to come as top priority in the budgeting! Many of you who read this newsletter are very well informed with what’s good and whats not, but you are a small minority of the population! Unless you take the time to read every ingredient on the label you cannot assume anything! So if you have any friends who you think could do we learning a thing or too, perhaps subtly forward on this newsletter!
Advertising for kids
Cereals manufactured for children have allegedly become more nutritious in the last few years, however it is often the least nutritious cereal that runs the most advertising. If we take the US as an example (the numbers are far greater and more alarming over there) – according to a study by Yale Rudd Centre for Food Policy and Obesity, cereal companies spend $264 million on advertising for children annually – that’s a 34% increase from 2008 and the advertising is for, guess what.. the least nutritious cereal. If we look at the brand leaders over here they are full of sugar or the cheaper sweetener – corn syrup. Its rare to see plain porridge oats marketed but very common to see Cheerios and Coco Pops. When was it ok for kids to go to school on sugar, but is it any wonder that they do particularly with pester power and the convenience of packaged food?
Walt Disney have acknowledged at last the powerful role that television can play in influencing children’s behaviour and announced that they have instituted a junk-food advertising ban on programmes for kids. The Campaign for a Commercial-Free Childhood, a US non-profit advocacy group, applauded Disney’s announcement but questioned the three-year delay until the stricter rules take full effect. In my mind, it’s just too little too late, the horse has already bolted. Today’s children consume multiple types of media (often simultaneously) and spend more time (44.5 hours per week) in front of computer, television, and game screens than any other activity in their lives except sleeping. Research has found strong associations between increases in advertising for non-nutritious foods and rates of childhood obesity.
Most children under 6 yrs old cannot distinguish between programming and advertising and children under 8 yrs do not understand the persuasive intent of advertising. Advertising directed at children this young is by its very nature exploitative. Children have a remarkable ability to recall content from the ads to which they have been exposed. Product preference has been shown to occur with as little as a single commercial exposure and to strengthen with repeated exposures. Product preferences affect children’s product purchase requests and these requests influence parents’ purchasing decisions – there’s that pester power again! To try and limit exposure is difficult and I’m not here to tell you how to bring up your children, but certainly less hours in front of the television and starting early on healthy food can help. Getting children involved in cooking and often growing food as well can educate them for the future. The power of the cereal packet is immense and market leaders with exciting toys inside the packet stand like a Collossus over the humble porridge oat – its a David vrs.Goliath task to rise above this but you can do it with a little creative input and discipline! So what about adults?
Do you buy what’s there?
When I take people shopping, three main issues come up within several of the supermarkets: the lack of stock or variety of decent bread, cereal and non alcoholic drinks. The other week I was shopping with a client in one of the major supermarkets and the soft drinks aisle was about 98% full of sugar free/high energy drinks full of corn syrup and artificial sweeteners with about 2% dedicated to cordials/organics etc. This same supermarket had the whole bread aisle full of the two main brand leaders which to my mind does not even pass as a real loaf of bread. The cereal aisle was much the same – anything organic and not full of sugar was certainly less obvious or on the bottom shelf. What happens if this is your only nearby supermarket – are you then forced into buying produce you don’t want unless you drive out of town? Do you have the time to do this? Does it matter that much to you?
Food advertising is big business and its getting more clever. The countless food advertising tricks that are used to persuade us to buy their products is disturbing. Food manufacturers are pushing the limits of what is truth and what is a simple technicality. So many packaged foods are little more than white flour, fat, sugar, salt and additives in various combinations, yet they are marketed as modern-day medical miracles, offering vague benefits for virtually every part of the body.
Marketing claims and tricks
Reduced sugar is still a hook for many people purchasing foods that they think will be more healthy for them. However reduced sugar is replaced by a range of artificial sweeteners. Whole grain is another minefield – particularly if there is more whole grain than any other ingredient – it still may contain corn syrup, artificial sweeteners etc. You are being marketed a healthy product when in fact its anything but that. I recently saw a fizzy drink can with includes Antioxidants as if that made the drink healthy – trust me any antioxidants that might be present would be negated by the rest of the ingredients. I’ve seen cereal brands saying heart healthy (what does that even mean?!) or good for weight control but the ingredients tell me something different – is it any wonder why people fail to lose weight? The other huge bugbear I have is the under 100 calorie snack bar – you eat it because you think it will not make you fat because you have bought into the calorie myth but again the truth lies at the back of the packet where the hydrogenated fat or the artificial additives lie. Much of this is common sense and yet I see even the most switched on mums and dads get caught out.
If I asked all of you now how much protein, salt, fat and carbohydrate you need daily – do you know? I suspect most of you don’t carry those figures in your head and that is why looking at the ingredients is the best bet you have when you shop. You are consumers not dieticians and nutritionists – its not your job to carry those figures around!
Quick tips for buying bread, cereal, and soft drinks
If it has a non see through plastic wrapper on it and you cant see the bread, don’t buy it. If its heavily marketed on TV don’t buy it. Go for own brand wholemeal bread that you have an ingredient list to read. Organic breads, artisan breads, soda breads, rye breads, pita breads etc might not be so easily found in some of the major supermarkets, but they are getting better. Don’t assume that baked on the premises bread is any better – again – where’s the ingredient list?
To be honest, no cereal is all its cracked up to be except plain 100% oats or a puffed rice brand with no sugar. Unless its got one ingredient its more than likely got sugar as the first ingredient or the delightful addition of glucose syrup or corn syrup. So yes that’s 95% of the supermarket aisle gone before you’ve started! The odd packet of Dorset organic cereal/granola etc is fine but don’t forget its still sugary with dried fruits and honey! Better to stir a spoonful into yoghurt or try and add more nuts!
Go for cordials – try Rocks, Belvoir, Firefly, or 100% non concentrated juice. Avoid all sugar free/reduced sugar drinks. You may notice that the soft drinks aisle is full to bursting with all the drinks I haven’t listed and there will be a small portion of the aisle with a few bottle of the above. If you want more choice, quite frankly I’d go to Waitrose and check out their great range of non alcoholic drinks! And remember fructose is sugar – and fruit juice is concentrated sugar – keep it to a minimum!
How important is your 5 a day?
Did you think five a day was a global campaign – that all countries needed to eat five portions of fruit and vegetables a day? Well if you did, you’d be wrong! In actual fact it’s a different number for every country campaign. The USA is 9 portions, two and half cups of fruit and vegetables per day. Australia is 5 but the portion is 75g. Denmark, 6, Ireland is 4, Switzerland, 5, as is Belgium and Austria. Italy… well they are very laid back with their advice to eat more fruit and vegetables – no exact number! Ah now wonderful Greece – they recommend 3 portions of fruit and 6 of vegetable – so sensible. Germany looks pretty cool with 3 portions and their food pyramid has more emphasis on vegetables than fruit. This 5 a day programme started in 1991 as The National Five a Day For Better Health Programme. It was a public-private partnership between the Produce for Better Health Foundation and the National Cancer Institute and it started in sunny California. It has since become the worlds largest education initiative. So far so good. However there is a conflict of interest as The Producers For Better Health Foundation whose purpose is to get us to eat more fruit and vegetables are sponsored by these folk!:
Logistics firms: C.H. Robinson Worldwide, Inc.; Caito Foods, Inc.; Capital City Fruit; Coast Produce Company and J&J Distributing.
Specialist producers: Driscoll’s (berries); U.S. Highbush Blueberry Council (blueberries); Ocean Mist (artichokes and fresh vegetables); Giorgio (mushrooms); Columbine Vineyards (grapes); Nature sweet tomatoes; Potandon Produce (potatoes) and Paramount Farms (nuts and flavoured nut snacks).
General fresh produce firms: W. Newell & Companies; Eurofresh Farms; Giumarra Companies; General Mills (Green Giant brand); Sun-Maid raisins and dried fruit; Kagome juices and Duda Farm Fresh Foods;
Other: such as BASF (the world’s leading chemical company, and a provider of fungicides, insecticides and herbicides); Glad Products Company (containers, bags and ovenware); Nunhems USA (commercial vegetable seeds);
Excuse the cynicism but one could say that these companies stand to benefit if the government dictated the five a day campaign. While there is nothing wrong with tomatoes being sponsored, there is still a conflict of interest with the above companies.
So why 5 a day? Well it certainly did not come from evidence based scientific investigation! In essence its easy to remember and it is a marketing campaign and the most successful the world has ever seen. With little or no evidence at this time of any benefit from eating exactly 5 portions of fruit and vegetables a day, it is astonishing to look at how far this marketing campaign has gone. Questions that need to be asked are what has it achieved? Has it worked? What was its aim in the first place? The campaign has since been reviewed. Between 1991 and 1998 the figure of Americans who knew to eat 5 portions of fruit and vegetables a day rose from 8% to 39% – so that’s a good thing right? Well, at the same time the obesity figures rose from 12% to 17.9%. It’s all a bit nonsensical and then of course for those of you who saw the Dispatches programme – The Myths about your 5 a day – a made up magical number was then taken by marketing and advertising companies and twisted even more into the fabric of what we eat. It’s exhausting isn’t it!
Added to the already mind boggling food labelling – shopping, food advertising and food marketing is big business. We need to simplify the whole thing and fast. The only part of dietetics I don’t like is the fixation of looking at the front of the packets of food with the wheels and fat/protein breakdown. We need to look at the ingredients list, we need to know what manufacturers are putting into food not just the fat content. So always look at the ingredients on the back of the packet – you will find out very quickly whether this product is worth buying. As I’ve said before fast food outlets don’t let you easily see the full list of ingredients in their products – perhaps because you wouldn’t buy them if you really knew. I’m more concerned at the hideous ingredients like anti foaming agents that go into chips than I am at how much saturated fat it contains.
So when you are next food shopping which most probably will be in the next week – if you haven’t done already, open your eyes!! There are aisles which just need to be avoided full stop. Look at the back of all the ingredients – for example Ragu tomato and basil sauce for spaghetti last time I looked – great ingredient list – Dolmio, hideous! Keep looking, keep reading as the products can change. Of course if you buy one ingredient at a time you don’t have this problem!
Take for example two popular packets of crisps.
One brand contains: Potatoes, sunflower oil, salt.
If you look at the above it’s quite obvious which bag of crisps is healthier and less allergenic. If the ingredients are kept simple then the product will be healthier! Have a great month – see you in August.
I’ve started an omega 3 challenge. Yesterday I ate three portions of oily fish in one day – which I will do for four days. I did this a couple of years ago and noticed a real improvement in my skin ie less wrinkles – will let you know how I get on although I wont be posting before and after shots!
Ok so I did three days and it was great – however the smell of pan fried mackeral would make me cringe at the moment so will give it a break for a while. I noticed I was very very full after every meal and yes the skin was a little plumper!
The thyroid gland lies in front of the neck between the voice box and the skin. The entire gland weighs less than an ounce. Despite its small size its an extremely important organ which controls our metabolism and is responsible for the normal working of every cell in the body. It achieves this by making the hormones thyroxine (T4), and triiodothyronine (T3) and secreting them into the bloodstream. In healthy people the amounts of T3 and T4 in the blood are maintained within narrow limits by TSH which is secreted by the anterior pituitary gland. If your GP suspects that you may have an under active thyroid they will send you for a blood test. High levels of TSH mean you have an under active thyroid. You will then need to take thyroxine, and your blood will need to be monitored as its not easy getting the right amount – it’s certainly not a one size fits all situation.
The typical (but not necessarily accurate) type of person to get this condition is female, overweight and over forty. However that is too specific. I’ve seen many underweight people who have under active thyroids in their late 20’s and 30’s. If you are having trouble losing weight, feel the cold a lot and feel tired, its worth asking your GP for a test. I have listed most of the symptoms below, but the list is far longer and the symptoms can be strange and vague e.g. the fatigue has been described as “feeling drugged”. Unfortunately the thyroid blood test is notoriously unreliable as the thyroid secretions change, so you might need several tests to get a positive result. If your blood tests come out positive your GP will usually leave it a month or two and do another one just to make sure. You are measuring your TSH level and often you can be borderline and then normal several months later. There is a strong hereditary link to this condition – all my family have hypothyroidism and at the moment my results are borderline.
What are the symptoms of an under active thyroid?
* Cold hands and feet * Tendency to feel the cold * Fatigue, especially in the morning
* Depression * Dry Skin * Headaches * Constipation * Loss of hair * Aching in the joints
* Muscle cramps in the feet at night * Swollen eyelids (especially in the morning) * Swelling of hands and feet * Heavy periods * Loss of libido * Brittle nails * Difficulty swallowing * Elevated cholesterol * Hoarseness *Low blood pressure * Inability to concentrate * Poor memory
* Slow heartbeat (bradycardia) * Weight gain.
How is it diagnosed?
The conventional approach to diagnosing hypothyroidism revolves around the measurement of thyroid blood tests, primarily the TSH test. If the TSH is elevated, the pituitary gland is sensing a low thyroid hormone level in the body and TSH is being secreted in order to stimulate the thyroid gland to produce more thyroid hormone. If the TSH is normal many doctors believe that automatically rules out a hypothyroid state. The reference ranges are:
TSH normal range 0.4 – 4.5 mIU/L
TSH Hypothyroid > 4.5mIU/L
So what’s the problem with the TSH test?
There are several schools of thought regarding the validity of the TSH – this is just one of those. The TSH blood test has been the gold standard in conventional medicine for over 30 years. When TSH values fall above this range i.e. >4.5 mIU/L a diagnosis of hypothyroidism is given. When this reference range was established it included approximately 95% of the population. Therefore 5% of the population fell outside this range and therefore could be classified as having a thyroid disorder. In the Colorado Thyroid Study researchers believed that the true incidence of hypothyroidism was higher than 5%. Dr AP Weetman, professor of medicine wrote in the BMJ:
“Even within the reference range of 0.5 – 4.5 mIU/L a high thyroid stimulating hormone concentration ie > 2 mIU/L was associated with an increase risk of future hypothyroidism. The simplest explanation is that thyroid disease is so common that many people predisposed to thyroid disease are included in laboratory references which raises the question whether thyroid replacement is adequate in patients with thyroid stimulating hormone levels > 2 mIU/L. The high frequency of overt and subclinical hypothyroidism observed raises another contentious issue – namely whether screening for hypothyroidism is worthwhile”.
Before you all get too excited, I did say this was one school of thought, but I do know quite a few GP’s who feel the same and feel restricted in what they can do when the test is borderline or the patients symptoms are severe. Over 30 years ago Dr Barnes wrote about the inadequacies of solely relying upon blood tests in: Hypothyroidism The Unsuspected Illness. Dr Barnes agreed that lab testing could not be the sole judge of whether there is hypothyroidism present or not. He wrote “all commonly used lab tests for thyroid function leave much to be desired. They are useful in some but not all cases, and they are no substitute for a good physicians knowledge of what thyroid deficiency can bring about and his expert clinical impression of what it may be doing in the case of an individual patient”.
There is great controversy in conventional medicine about what the normal TSH range should be set. There are many doctors and organizations who believe the upper limit of the TSH range should be lowered from 4.5 – 3.0 mIU/L. This small change may result in a doubling of the numbers of individuals diagnosed as hypothyroid. Some people may do better at a TSH of 1.0 while another may do better on 3.0. It is also important to check more than just the TSH test. T3 and T4 levels are also important. Its common to see patients who have normal T4 and TSH levels and low T3 and may therefore have the symptoms of hypothyroidism. Many people do not convert T4 to T3 and might well be hypothyroid even though the TSH falls within the normal range.
Don’t get me wrong, blood tests are important but for some conditions, we could wonder how relevant they are. So many people have clear blood tests but are still symptomatic (and this goes beyond hypothyroidism) and if its not “in their heads”, which it often isn’t then there is something else going on.
Factors that may cause inability to convert T4 to T3
If you have the above symptoms and/or have a family history of hypothyroidism, go and get your TSH tested. If there is a family history, ask for T3, T4 and thyroid antibodies as well. If the test comes back borderline, discuss this with your GP in more detail and ask for another test in a few months time. In the meantime concentrate on your diet (see below) and get as much exercise as you can. Make sure you are not deficient in any of the above vitamins and minerals and get expert personalised help if you are still having problem – this can be with a nutritionist.
Diet tips for hypothyroidism
If you thought diet had nothing to do with an underactive thyroid think again: The key is adopting a diet that is rich in whole foods, including plenty of vegetables, fruits, lean meats and whole grains like brown rice, quinoa or barley instead of wheat based products. These foods typically nourish the body and provide plenty of natural vitamins and minerals.
Avoid excess sugar and refined foods. Too much sugar can cause weight gain, but especially in someone with hypothyroidism. Typically, eating too much sugar results in the body creating too much insulin. This means your body is not able to use its own fat for energy, so any carbohydrates and other molecules you eat are stored as fat, so you find it hard to shift excess weight.
Someone with hypothyroidism is much more likely to end up exhausted, fatigued and hungry for longer-periods of time when they are not eating correctly. So eat several small meals during the day instead of three larger ones. This helps maintain a steady level of energy and provides the body with a steady source of constant fuel and also helps to improve metabolism.
If you are not doing so already, begin a moderate exercise regime to boost your metabolism.
An under active thyroid may increase your risk of a heart attack, so take nutritional steps to make sure your heart is healthy. Keep an eye on your cholesterol – raised cholesterol levels can be a sign of hypothyroidism rather than an unhealthy diet and lifestyle.
Foods that support thyroid health
1. Seafood, like sushi and seaweed, which contain iodine to support the thyroid gland. But also fish for its essential fatty acids content (Omega 3’s) that assist with weight loss, reducing inflammation, and the production of hormones.
2. Green tea, which can help support the metabolism.
4. Lean meats and fish which contain tyrosine, thought to help boost thyroid hormone production.
5. Foods rich in selenium, a mineral that supports the thyroid and immune system for those suffering Hashimoto’s disease (an auto-immune based thyroid condition). These include brazil nuts and salmon.
6. Eat in moderation (as they can suppress the thyroid function): Broccoli, Brussels sprouts, cabbage, kale, mustard, greens, peaches, pears, radishes, spinach and turnips.
7. Eat zinc rich foods such as almonds, tofu, chicken, turkey and pumpkin seeds.
If you are putting on the pounds due to an underactive thyroid, it can be a tough call to lose the weight – if you would like some personalised help with this then do contact me on 01323 737814.
Hello Blog readers – am still blogging – I’ve just been sidetracked with piles of work. If you’d like to be kept more up to date try my Facebook page as well at Kate Arnold Nutrition. Newsletter coming up in two weeks on Food advertising and marketing. After the BBC2 documentary The Men That Made Us Fat more of you are now understanding the issues behind the obesity/fat/sugar debate. It’s not pleasant and difficult to hold one person accountable but these problems are here and real and not going away. The only way you can change this is to take control of your weekly shopping baskets, read all the ingredients on the back of all produce and make informed decisions for you and your family!
I’m still offering 25% off all consultations until end of July. If you’d like to take this up but not sure I can help – please do call me on 01323 737814 for a free five minute chat. I look forward to hearing from you! x