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How can your diet help you to sleep well during the winter months?

How can your diet help you to sleep well during the winter months?

Sleep patterns may easily be thrown off course during the winter as the increased darkness impacts on our circadian rhythms.  The result is that it may make it more difficult to wake up and leave us feeling sluggish or lacking in energy.  These effects may also impact on the food choices we make and vice versa our diet may impact on sleep.

How can the winter months impact on sleep?

Darker evenings and mornings can impact on sleep in several ways.  Some of these may be associated with the fact that our basic diet and lifestyle behaviours could become challenged during the winter.

How can mood impact on sleep?

How we feel can affect our food choices and pattern of eating.  In some cases, skipping meals may affect overall nutrient intake, some of which are linked to poor sleep such as magnesium.  Erratic eating patterns can also encourage snacking on foods high in sugar that may also affect sleep.

Low mood can also lead to overeating and weight gain, which may impact on mental health. Any form of anxiety linked to our lifestyle can play on the mind and affect our ability to sleep well.

How does diet play a role?

Comfort eating and alcohol consumption may increase during the winter as we get cosy indoors.  This is even more so during the festive season which can also play havoc with our sleep patterns.  The tendency to choose richer foods may also trigger indigestion in some people which will negatively impact on sleep quality.

So, what can you do to help achieve a good night’s sleep in the Winter months?

Stick to your regular sleep/wake pattern

Establishing a set routine is bedrock to sleeping well. Going to bed at the same time every night and waking up at the same time every morning is key to keep your circadian rhythms in sync.

It’s often tempting to hit the hay earlier than normal and stay in bed longer, but this is not going to help with how energised you feel during the day.

Avoid the stodge

It’s tempting to seek out stodgy foods during the winter months but this may impact on your sleep quality.  Overly rich foods can cause indigestion, especially if you’re not used to eating them.

Heartburn is a symptom of indigestion and something many people experience during the festive season, especially when partnered with more alcohol than usual.

If you’re going to eat more stodgy food then try to eat smaller portions and team them with plenty of veggies on the plate to try and balance out your meal.

Invest in a vitamin D3 supplement

We all rely on sunlight to provide us with adequate amounts of vitamin D but during the winter months it has been shown that many of us are lacking in this nutrient (1).  This essential vitamin helps to maintain healthy bones and supports immunity but inadequate levels are associated with fatigue, muscle weakness and low mood.

Research published in the journal Nutrients has suggested that vitamin D deficiency is associated with a higher risk of sleep disorders (2).

Food sources of vitamin D are limited to fortified foods, oily fish, liver, mushrooms and eggs but will not provide you with everything your body needs.

During the Winter months you should take a supplement containing 10mcg of vitamin D3.

Try and stick to making healthy food choices

The colder months can have an impact on our eating habits and food choices.

The longer evenings can also lead to snacking late at night which will do little for your ability to sleep as eating and digestion can prevent the body from shifting into sleep mode.

Foods rich in carbohydrates are craved more in the winter which may be linked to their connection with serotonin (the feel good hormone) and could be the body’s way of attempting to improve mood.  Always choose wholegrain varieties of carbohydrates as these have less impact on blood sugar levels.

Simple carbohydrates such as sugar are digested much more quickly and may impact on sleep quality (3) as well as doing little for your waistline if eaten in excess.  Obesity has been linked to poor sleep by way of its impact on hormones associated with satiety (4).

Eat a nourishing diet that will provide your body with the essential nutrients required for good health, some of which may be connected to sleep such as magnesium.  It is widely understood that magnesium deficiency can cause insomnia.  Research published in the journal Public Health Nutrition has also shown how adequate levels of magnesium are positively associated with sleep duration (5).

Don’t eat too close to bedtime and keep evening meals light including lean proteins (poultry, fish, tofu) and wholegrain carbohydrates (brown rice, wholemeal pasta, quinoa) as this combination can help with the uptake of tryptophan into the brain which assists with the production of melatonin (the hormone that regulates the sleep cycle).

Try and avoid the classic ‘pick-me-ups’

If you’re feeling sluggish during the day then it can be tempting to reach for a food or drink containing caffeine or sugar to help boost your energy levels. Both caffeine and sugar have been shown to disrupt sleep.  The effect is usually short-lived and often followed by a craving for more of the same creating a vicious cycle of highs and lows.

The first morning coffee is like nectar and a perfect way to get you ready for the day ahead.  After this it may be worth avoiding, especially if you have trouble sleeping. Try alternatives such as herbal teas including ingredients such as ginger and lemon which have an invigorating and refreshing effect without the caffeine hit.

It’s worth remembering that tea, chocolate, energy drinks and even decaf coffee all contain a source of caffeine.

Pay attention to the health of your gut

Early research has suggested that the microbes in our gut (microbiome) may be linked to sleep.  It is thought that while a lack of sleep may negatively impact on our microbiome the diversity of microbes in our gut may also lead to disrupted sleep (6).

The connection is not fully understood but it may be worth taking a probiotic supplement to promote a good diversity of bacteria in your gut.

Try to also include plenty of prebiotic foods in your diet which help gut bacteria to flourish.  Prebiotic foods include onions, garlic, beans, pulses and lentils as well as cooked and cooled potatoes, pasta and rice.

The winter months can pose challenges to many areas of your health.  If you are struggling with your sleep then consider the approaches above while also paying attention to the basic sleep hygiene practices addressed in my new book which focus on behaviour, environment and diet (BED).

References

  1. https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213953/
  3. https://www.ncbi.nlm.nih.gov/pubmed/26156950
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC535424/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675071/
  6. https://www.ncbi.nlm.nih.gov/pubmed/31589627
Nathan Khider Sleep Podcast 2019

Nathan Khider Sleep Podcast 2019

This is a new podcast hosted by my lovey mate Nathan Khider.

Nathan’s YouTube channel is fantastic and involves him interviewing guests that have many interesting stories to tell to hope to inspire and educate his listeners.

My new book, ‘The Art of Sleeping’ is due out today (14th Nov 2019). I talk with Nathan about the reasons why I chose to write this book which revolve around my own persona interest in sleep and my experiences of sleep deprivation and insomnia.

While some of you may sleep well, the reality is that we are a nation of non-sleepers.  Some people believe they can survive on hardly any sleep, but I disagree.  From personal experience of insomnia, I know first-hand how the effects can negatively impact on every aspect of your life.  I’m also guilty of telling people how tired I am rather than taking the action required to tackle the issue head on.

We all need to take sleep seriously as the long-term consequences of not sleeping well are scarier than you think.  For these reasons I decided to write my new book ‘The Art of Sleeping’.  I share my experiences with Nathan and discuss the positive steps we can all take to improve our sleep which in turn will help us to achieve optimal health and wellbeing.

 

Whats the deal with free radicals and antioxidants?

Whats the deal with free radicals and antioxidants?

The world of nutrition has evolved hugely over the last few decades as interest in the topic has grown.  Basic dietary advice is no longer enough for many people as they seek out other ways to optimise their health, combat ageing, lose weight and maximise exercise performance.

The desire to learn more has helped drive this evolution but has also exposed us to information that may be lacking in reliable science.

One topic that has always been popular is that of free radicals and antioxidants.  These terms are frequently chucked around and often oversimplified as being either good or bad for us but is it really that simple?

A little too much knowledge can be dangerous

One of my old bosses many years ago once said to me that a little bit of knowledge can be a dangerous thing and this is something that always rings true when I listen to people talk about nutrition.

How has dietary advice evolved over the last couple of decades?

Not long after I started out as a nutritionist the Department of Health had just launched the five-a-day campaign (2003) to promote the health benefits of eating more fruits and vegetables in the diet.  This campaign was driven by the science which proved fruits and vegetables had a key role to play in the prevention of cardiovascular diseases, cancers and diabetes.

The conversation around diet and nutrition at this time was heavily focused on key public health messaging to help tackle obesity and heart disease.

In 2007 the Food Standards Agency launched the ‘Eatwell Plate’ to help people to understand how the five key food groups form the basis of a balanced diet. This has since been replaced with the updated ‘Eatwell Guide’ (1).

When did the conversation start to change?

After this is when the conversation began to change as more people took an interest in the topic of nutrition.

Reporting in the media began to focus more on research findings linking diet to disease (many of which were contradictory), food companies started to coin phrases such as ‘superfoods’ and many books and TV shows on the topic became hugely popular.

During this time the quality of advice given out was questioned by qualified health professionals and authors such as Ben Goldachre putting much of it down to bad science.  This also saw the demise of well-known ‘health experts’ who dominated our screens at this time.

Around this time was also when the food industry became more regulated as they had to provide evidence to support any health claims made on their products (2008).

In 2007 the UK regulator Ofcom introduced regulations banning the advertising of foods high in fat, salt and sugar on children’s TV channels.  Bans were also introduced on the advertising of these foods on non-children’s channels during, before and after programmes aimed at those aged between four and fifteen.

The UK was the first country to introduce statutory scheduling restrictions of food advertisements to children.

The birth of social media

Around the same time came the social media explosion with the birth of Twitter in 2006 and Instagram in 2010.

These social media platforms are now home to many health and wellness ambassadors who churn out advice and represent food and wellness brands in the media.  This has raised many issues as to the quality of nutrition and diet advice as people turn to unqualified influencers for information over experts (although there are now many trusted voices on these platforms).

The topic of free radicals and antioxidants

As our interest in the nitty gritty of nutrition has grown one of the topics that has continued to come up is that of free radicals and antioxidants.  The terms are chucked around willy nilly and while most people may be familiar with them, very few actually know what they are.

The problem of oversimplification

The science behind free radicals and antioxidants is actually quite complex.  One problem with delivering these concepts to people has been an oversimplification of the science which has led them to be classed as either being good or bad for you.

The idea that free radicals are bad and antioxidants are good is one that is used to sell myriad of products in the wellness market, but the science is not that straight forward.  Antioxidants are normally depicted as the superhero defending our body against ageing and chronic disease risk caused by free radical damage.

There is of course truth in this depiction but unfortunately biology is never that simple.

What are free radicals?

Free radicals are very reactive chemicals, which are created when an atom or molecule (chemical that has two or more atoms) either gains or loses an electron.  The most common type of free radicals produced in living tissue are called reactive oxygen species or ROS for short and these contain oxygen.

We produce free radicals naturally through chemical processes that occur in the body such as the breakdown of food and its transformation into energy used by cells.

We are perfectly equipped to deal with free radicals but they may become an issue when they build up in high concentrations.  This can put the body in a state of oxidative stress (when free radicals outweigh antioxidants), which has the potential to damage every major component of cells when it occurs over a prolonged period of time. The most significant damage is that caused to DNA, which is thought to play a role in the development of many health conditions including heart disease and cancer (2).

The most likely cause of excess free radicals in the body are due to a combination of environmental, lifestyle and dietary factors which include pollution, stress, smoking, alcohol, sun exposure, infection and overconsumption of foods high in bad fats and sugar.

What are antioxidants?

Antioxidants are essential for the survival of all living things.  These chemicals are able to interact with free radicals and neutralising them without getting damaged or becoming a free radical themselves. Whilst the body relies on external source of antioxidants, which are gleaned from the diet, it’s also able to make some such as the cellular antioxidant glutathione.

Dietary antioxidants are found in fruits, vegetables and grains, which are all a rich source.  Examples of dietary antioxidants include lycopene and beta carotene found in red, orange and green vegetables as well as vitamins A, C, E and minerals such as selenium.  Plants also contain compounds such as polyphenols, which act as antioxidants and are found in foods such as berries and raw cacao.

Are free radicals always bad for us?

Most people equate free radicals to poor health but there is more to the story as they also play an important role in many normal cellular responses.

The immune system uses free radicals to help kill foreign invaders (phagocytes) in the body, which are just one of many ingredients in a cocktail of chemicals released in this defence mechanism, which is known as an oxidative burst.

Another interesting example of where free radicals may be beneficial is linked to exercise, particularly amongst athletes. Free radicals may play a key role in the benefits gained from exercise, which goes against much of the information provided on this topic.

One of the benefits of exercise is that it helps to improve insulin sensitivity, which is a good thing as the body becomes more attuned to maintaining blood sugar levels. Insulin resistance has the opposite effect resulting in higher insulin and blood sugar levels, which form part of the aetiology of diseases such as diabetes.

Research has shown that the oxidative stress (excess free radicals vs antioxidants) induced by exercise actually promotes insulin sensitivity and triggers an internal mechanism to protect the body against the potential damage from free radicals (3).  Interestingly, the same research has also shown that flooding the body with antioxidants (mostly in the form of supplements) may inhibit this health benefit from occurring.

These and similar findings have prompted experts in the field of sports nutrition to question the use of antioxidant supplements as part of their prescribed diet regime.

Are antioxidants always good?

The reputation of antioxidants has evolved over the decades into something of a panacea for good health.  Early research many decades ago identified their role in the ageing process and their association with health has stuck.

There is no doubt that antioxidants have a key role to play in the aetiology of disease and cell ageing, but this doesn’t mean that overdosing on them will help you to live longer, stop you getting sick or prevent wrinkles.

Antioxidant supplements

Supplements containing antioxidants have always been popular but the evidence to support their use in the reduction of disease risk is often lacking and often contradictory.

Supplements have their place and as the name suggests this is to supplement the diet to make up for any shortfalls that may exist when your diet may be compromised for whatever reason.  Public Health England currently recommend we supplement our diet with vitamin D during the winter months in the absence of sunlight and it has long been advised that women take folic acid during the early stages of pregnancy.

Supplements are also useful for young children, older adults and those following strict diets such as veganism.  In such cases there may be a greater risk of deficiency.

In some cases, supplements could do more harm than good and especially high doses of antioxidants.

One example is the link between beta carotene supplements and lung cancer as shown in the World Cancer Research Fund/American Institute for Cancer Research Third Expert Report Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. This report found that there was strong evidence to show that taking high-dose beta carotene supplements increased the risk of lung cancer in both current and former smokers (4).

It’s all about balance  

Adopting a healthy diet which includes plenty of plant-based foods, especially brightly coloured fruits and vegetables, will ensure a good intake of antioxidants. Leading a healthy lifestyle which involves being active, maintaining a healthy body weight, not smoking and addressing stress and sleep issues can help to reduce excess free radicals.

I get that this may be easier said than done and behaviour change is a tricky thing that often challenges our ability maintain a healthy way of living.  However, focusing on the information and advice which is supported by science is always going to be a better long-term option than seeking out quick-fix fads.  A faddy approach to your health is  not only likely to be short-lived but may in fact be more detrimental to your health.

References  

  1. https://www.gov.uk/government/publications/the-eatwell-guide
  2. https://www.sciencedirect.com/science/article/pii/S2231253611110048
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680430/
  4. https://www.wcrf.org/dietandcancer
Food For Thought podcast with Rhiannon Lambert

Food For Thought podcast with Rhiannon Lambert

How foods and sleep can change your life

My chat with Nutritionist Rhiannon Lambert on her podcast Food For Thought is now available.

It was great chatting with Rhiannon who I have known for quite a while now.  We talk about the importance of sleep and in particular the role of diet.

Here is just one of the questions I was asked…

With two-thirds of adults in the UK failing to get the recommended quality and quantity of sleep, could our nutrition be more as effective than getting an early night?

Interesting question….  The first point to make here is that there are many factors that impact on our ability to sleep well both in terms of the number of hours we get and equally as important, the quality of sleep.  As we both say when it comes to many areas of health, there is no one size fits all and this mantra can be applied to sleep.

Modern lifestyle

Our modern lifestyle is fast paced, and this is not just work related as everyone is affected by the pressure, we put ourselves under to be and be seen as achieving and this looks different for every individual whether it involves work goals or doing the best for your family.

Anxiety

The reasons for not sleeping are common amongst all groups and include things like anxiety which could be linked to lifestyle or other behavioural habits associated with overuse of modern technology.

Addressing diet

I would say that addressing your diet can help you to sleep but you also need to address behaviours and the environment you sleep in.  In my new book, I use these three pillars (BED) as a way of helping people to really think about how they can tackle their sleep issues and form their own personal sleep ritual.

Foods that harm and foods that heal sleep

When it comes to diet, it’s about looking at the foods and drinks that both help and hinder sleep as well as also looking at your eating behaviour and pattern of eating which also play a role.  This may link to micronutrient deficiencies, food and drinks that stimulate our bodies or the effect of food on digestion which can all keep us awake in some way.

Diet plays a role but is just a contributory factor that should be considered alongside other things as part of addressing and understanding the bigger picture as to why you’re unable to sleep.

There is also another angle here in that sleep deprivation can cause depression, anxiety and fatigue which can lead to erratic eating patterns and impact on the food choices we make which may exacerbate the issue of sleep deprivation.

You can listen to the podcast here.

How to tackle the issue of migraine

How to tackle the issue of migraine

What is migraine?

This is a complex neurological condition which affects the whole body and can be both debilitating and disruptive to the day-to-day life of sufferers.  The cause is not fully understood and as of yet there is no diagnostic test of cure for the condition.

What do we know about the cause of migraine?

What we do know is that migraine starts deep in the brain and that a glitch in the release of neurotransmitters (chemical substances released at the end of a nerve fibre) set in place a chain reaction which causes a number of symptoms.  These symptoms can differ between individuals and include visual disturbances (flashing lights, blind spots in the vision, zig zag patterns and many more), nausea, vomiting, debilitating head pain, pins and needles, numbness in the limbs and even paralysis.

Key facts about migraine

  • 1 in 7 people in the UK suffer from migraine.
  • Migraine costs the UK around £2.25 billion every year.
  • The World Health Organisation has classified headache as a major health disorder and found it to be the sixth highest cause worldwide of years lost due to disability.
  • Migraine affects twice as many women as men.
  • Migraine affects people from all age groups (even young children).
  • A migraine attack can last for between 4 and 72 hours.
  • Sufferers experience an average of 13 attacks each year.

What triggers migraine?

Migraine can be triggered by many different factors and these are specific to the individual.  The onset of a migraine is normally the result of several factors which individually can be tolerated but when occur together or accumulate can pass a threshold at which an attack is triggered.

Common triggers are related to lifestyle, environment and diet.  Whilst some of these triggers are easily recognised you may be unaware of other that could be making your migraines worse.

There is no definitive list of triggers but some of the more common ones are listed below.

Emotional stress Anger Tension Worry Shock Depression
  Excitement
Physical stress Over-exertion Tiredness and fatigue Late night Irregular sleep pattern Tension
  Travel
Foods Caffeine MSG Citrus fruits Marmite Cheese
  Red wine Onions Chocolate Pork Seafood
  Wheat Aspartame
Environment Flickering lights Bright lights Loud noise Change in climate Intense smells
  Smoking Stuffy atmosphere
Hormones Menstruation Puberty Pregnancy Contraceptive pill HRT
Others Eye strain Medication Congestion Toothache

Keep a diary

Keeping a dairy can help you to identify any triggers that are causing symptoms. Once these have been identified you can start to remove them one at a time to see if there is any improvement in the intensity and frequency of your migraine.  Whilst this may seem simple, don’t be disheartened if you cannot identify any specific triggers as they are often difficult to pinpoint.

You can download a migraine diary from Migraine Action.

How does diet affect migraine?

Dietary triggers only occur in a small percentage of migraine sufferers and it’s advisable to start cutting out large swathes of food groups from your diet unnecessarily. Interestingly, sweet cravings can occur in people before the onset of migraine so don’t automatically assume that foods such as chocolate are a trigger.

What affect does blood sugar have on migraine?

It may not be what you eat but the time between meals that could be triggering your migraine as fasting (more than five hours between meals during the day or 13 hours overnight) has been identified as a major factor for sufferers.

The body uses glucose to supply energy to all the major organs including the brain whose function is impacted on when blood sugar levels are low.  One response to low blood sugar is an increase in the flow of blood to the brain, which is thought to contribute to the pain of headaches and migraine as nerve tissues become more sensitive to the dilated blood vessels.

Try to eat every 4 hours during the day and no more than 12 hours overnight.  If you have a very active lifestyle that also includes vigorous exercise, then you may want to introduce small healthy snacks between meals to account for the energy used and to help keep blood sugar levels balanced.

What should you eat to keep blood sugar levels balanced?

Plan your meals around foods rich in protein (lean meat, poultry, Quorn, tofu, beans and pulses) alongside wholegrains (brown rice, wholemeal pasta, oats, wholemeal bread), healthy fats (oily fish, olive oil, nuts, seeds and avocado) and plenty of vegetables.  This combination of protein, healthy fats and foods rich in fibre can help to maintain steady blood sugar levels and keep you feeling full between meals.  Try to avoid sugary snacks and drinks as these can cause rapid spikes and dips in blood sugar levels.

Are there any alternative remedies?

Herbal remedies such as Feverfew have traditionally been used to help tackle migraine as have supplements such as vitamin B2 and magnesium (low levels of which have been associated with migraine).  These offer a natural alternative that may work for some and if you want to explore these options then take for a few months to establish whether they have any effect.

Migraine can seriously impact on the day-to-day life of sufferers and whilst there is no definitive cure, there may be areas of your lifestyle that can be addressed to help tackle the condition.  There is no ‘one-size-fits-all’ approach to treating migraines as the factors that encourage the onset of an attack can differ between individuals.  Understanding what the common triggers are and taking the time to monitor your lifestyle may be a useful approach to proactively dealing with the condition.

My essential curry formula

My essential curry formula

I have been interested in food and cooking since my early teens and Indian cuisine has always been a favourite.  Early recipes involved a simple cook-in-sauce with the addition of meat and veggies.  This evolved into an exploration of ready prepared pastes and powders.  Since then I have perfected my own personal formula to make ‘curry-in-a-hurry’, whether made with meat, fish or an alternative protein such as beans, pulses, tofu, Quorn or paneer.

Health benefits of curry

Whilst some people may view curry as somewhat of an unhealthy food synonymous with boozy nights out or take-away nights in, I actually think they can be hugely healthy if prepared in the right way.  Dried spices have been shown to be beneficial to heath in many ways including their ability to help reduce inflammation.  Spices are also a rich source of minerals such as iron.  Using spices in foods such as curries also helps with the bioavailability of certain compounds found in spices – fat helps the body to absorb the active compound in turmeric called curcumin. 

(You can find out more on the health benefits of curry here

My curry preference

This is my take on what makes a good curry and once you get to grips with the formula you can whip up a curry in no time at all.  Everyone’s tastes differ but for me this basic formula works every time and delivers on what I want to get out of a curry.

My preference is a recipe that delivers on freshness and has a rich umami taste that satisfies the savoury flavour I desire from a curry.  You can enhance this richness of flavour by cooking the curry down for longer time before adding the yoghurt.

The basic elements

The basics are onion, garlic, chilli and ginger.  My favoured blend of spices is a good curry powder, ground cardamom and turmeric.  I like to add blitzed cherry tomatoes (these add to the umami flavour).  After that it’s up to you.  Chuck in a protein which may be meat, fish, beans, pulses, Quorn, tofu or paneer.  Add plenty of vegetables – those that work best for me are peppers, okra, cauliflower, potato and squash.  I like to thicken the curry with spinach and add a subtle creamy texture with Greek yoghurt.  Coriander is my herb of choice for any curry.

My fancy ingredient!

My fancy ingredient is always fresh curry leaves, which are available in larger supermarkets or health food stores.  To get the best out of curry leaves I like to fry them in oil at the very beginning of the recipe before adding the onions, garlic, chilli and ginger.  You only need to add a handful of curry leaves to a recipe and any left over can be placed in a container and frozen.

My basic curry formula

Serves 4

Ingredients

2 onions (peeled)

2 large garlic cloves (peeled)

250g cherry tomatoes

1 tbsp oil (light olive, coconut or groundnut)

1 inch piece of ginger, peeled and cut into thin strips

1 fresh chilli (chopped)

1 tbsp curry powder

1 tsp ground cardamom

½ tsp turmeric

400g protein (meat, fish or veggie alternative)

500g chopped vegetables such as peppers, cauliflower, squash, sweet potato or green beans

500ml stock (meat or veggie)

100g spinach leaves

1 heaped tbsp Greek yoghurt

1 handful fresh coriander, chopped

Sea salt

Method

  1. Blitz the onions and garlic in a food processor. Transfer the mixture to a bowl.
  2. Blitz the cherry tomatoes in the same food processor.
  3. Heat the oil in a large, deep-sided frying pan set over a medium heat.
  4. Add the onion and garlic then fry gently for 5 minutes until soft and translucent.
  5. Add the ginger and chilli then fry for a further 2 minutes.
  6. Add the processed cherry tomatoes and fry for another 3 minutes.
  7. Add the spices and cook for 2 minutes as they become fragrant.
  8. Now add your protein of choice and cook for 3 minutes, stirring regularly.
  9. Add the chopped vegetables and then pour in the stock. Cover and cook over a medium heat for 15 minutes.
  10. Remove the lid from the pan, add the spinach leaves and turn up the heat then cook for another 5 minutes to reduce down (you can decide how ‘wet’ or ‘dry’ you prefer your curry).
  11. Take the pan off the heat and stir through the yoghurt and coriander.
  12. Check for seasoning and add salt if needed.
  13. Serve with wholegrain rice, quinoa or wholemeal pitta bread.

The benefits of gut health go beyond digestion

The benefits of gut health go beyond digestion

The important role of the gut

Diet, exercise and sleep are key to good health and the prevention of disease.  The health of your gut is inextricably linked to the quality of your diet, which impacts on digestion. Besides this, research is beginning to identify how your gut may also be linked to immunity, sleep, mental health (stress, depression) and obesity, all of which can affect your health in a multitude of ways (1).

The initiative, ‘Love Your Gut Week’, starts on the 17thSeptember (2018) and highlights the importance of our digestive system to good health.

What is the microbiome?

The term ‘microbiome’ refers to the collection of around 100 trillion microbes that live in and on our body, most of which are found in the gut.  An army of microbes (including bacteria) colonise the body even before we’re born to form a protective barrier that defends against foreign invaders harmful to our health.

Your microbiome is unique like a fingerprint

Your microbiome is unique like a fingerprint reacting to the world both around and within you.  The microbes you cultivate make up the unique diversity of your microbiome. The bacteria in your gut help maintain the efficiency of your digestive system.  These bacteria also help to synthesise vitamin D, K, B12, folic acid and thiamine as well as assisting in the digestion of polyphenol compounds shown to protect the body against disease.  Gut bacteria also produce short chain fatty acids that supply energy to the cells of your colon and have been shown to play a key role in the maintenance of health and prevention of disease (2).

What can impact on the ‘health’ of your microbiome?

 Diet and lifestyle choices can impact on the diversity of bacteria found in your gut.  The ‘typical’ Western diet is characterised by an overconsumption of foods high in ‘added sugars’ and ‘bad’ fats. The impact of overeating and a lack of exercise has led to an overweight nation although the complexities of weight management are not as simple as calories in and calories out.

Being overweight is a risk factor for many diseases and the physiological effects it triggers such as inflammation are now widely recognised as being a contributory factor.  It’s often suggested that a diet overloaded with sugar and ‘bad’ fats encourages the growth of bad bacteria, but these effects don’t seem to be that clear cut. Another more straightforward explanation is that people who eat an unhealthy diet are less likely to eat the foods that support an environment that allows good bacteria to thrive such as vegetables, wholegrains and other high-fibre foods.

Five strategies to support the health of your microbiome

Whilst the overall quality of your diet can impact on the health of your gut, certain foods have been shown to be particularly beneficial in supporting the diversity of bacteria that live there.  Lifestyle factors and the use of medication have also been shown to impact on your microbiome.

1. Don’t underestimate the effects of stress

Stress is fast becoming a common side-effect of our modern lifestyle.  We all experience stress, sometimes on a daily basis, but the effects are usually short lived.  Problems can arise when stress becomes chronic, not only impacting on mental health but triggering inflammation within the body (3).  Stress can also increase the demand for certain nutrients such as the B vitamins and magnesium as well as influencing food choices that can result in a failure of the diet to provide everything the body needs.

Feeling ‘butterflies’ in your stomach or nausea are common symptoms of stress and illustrate how the brain is closely linked to the gut.  Sadness, happiness and anger are a few examples of the emotions that can affect the gastrointestinal (GI) tract, which is sensitive to such emotions.  In some cases, psychology combines with physical factors to cause pain and bowel symptoms that characterise conditions such as irritable bowel syndrome (4).  Psychosocial factors such as stress can influence the actual physiology of the gut, affecting movement and contractions of the GI tract, increasing inflammation and even making you more perceptible to infection (5).

The link between the gut and brain is referred to as the gut-brain axis and the association with gut bacteria is a new area of research.  Studies are beginning to unveil the potential impact this relationship between the gut and brain has on the microbiome.  Mental health is just one area of research and stress has been shown to alter the diversity of gut bacteria (6). These changes also appear to be amplified when stress is more severe or prolonged. In this regard, the concept of psychobiotics is being developed and refined to find ways of targeting the microbiota to help with mental health outcomes

Don’t dismiss the impact stress has on the body.  Addressing your mental health is just as important as the food you eat, exercise you take and sleep you get, all of which are intertwined.  Try exploring techniques such as meditation that has been proven to help with stress. There are many apps available that can help to teach you this practice.

2. Eat prebiotic foods in your diet

Certain fibres in foods are indigestible and commonly referred to as prebiotics.  Gut bacteria feed of these fibres, helping them to flourish and process by which they break them down (fermentation), produces short chain fatty acids.

The different types are prebiotic foods include:

  • Onions, garlic, leeks, asparagus and bananas contain inulin and fructooligosaccharides that act as prebiotics.
  • Oats and barley contain beta-glucans that act as prebiotics.
  • Starchy foods such as pasta, rice and potatoes form resistant starches (resistant to digestive enzymes) once they’ve been cooked and then cooled. Resistant starches act as prebiotics.

3. Watch your medication

Many people rely on the long-term use of medication to help manage the symptoms of their health condition. Aspirin and ibuprofen are types of Nonsteroidal Anti-inflammatory Drugs (NSAIDS) commonly used to treat inflammatory conditions such as rheumatoid arthritis, but these drugs have been shown to reduce levels of good bacteria in the gut (7).

Other medications such as antibiotics are prescribed as a short course to support the body’s ability to fight infection.  These drugs are not a friend of gut bacteria as they can wipe out swathes of both good and bad.  In certain cases, such as severe bacterial infections, they’re required to help the body recover but are of no use in fighting viral infections such as colds or flu.

Using probiotics alongside certain medications such as NSAIDS or after a course of antibiotics can help to re-balance your microbiome.

Another interesting issue surrounding antibiotics is their extensive use in the farming of food animals.  The issue is a topic of debate but eating less meat and choosing better quality meat may not only be better for your health but reduce the transmission of antibiotics through the food chain.

4. Include probiotic foods in your diet

Strains of bacteria that have been shown to have a positive health benefit are referred to as probiotics.  Bacteria from the Lactobacillus and Bifidobacterium family are some of the most widely researched strains.  One of the most common probiotic foods is live yoghurt, which contains strains such as Lactobacillus Acidophilus and Lactobacillus Casei.  These strains are also found in yoghurt ‘shot’ drinks that have become very popular. When you’re choosing live yoghurt or yoghurt products try opting for those that are low in sugar.

Fermented foods such as kimchi, kefir and miso also contain strains of bacteria that can support good gut health. These foods are now widely available in most supermarkets.

5. Take a probiotic supplement

Probiotic supplements offer a way of delivering large doses of specific bacteria to the gut.  Stick to preparations that contain well researched strains such as Lactobacillus and Bifidobacterium in a dose of at least 10 billion bacteria per serving.  To help with their transit to the gut, avoid taking with hot food and drinks or alcohol that can destroy them.

As the research linking gut bacteria to health and disease outcomes evolves, so does the potential role of probiotics supplements.  Their use and efficacy have recently come under scrutiny, but there’s still plenty of good quality research that points towards their beneficial role in health.

Prevention and treatment of diarrhoea

Bacterial strains such as Lactobacillus Rhamnosus and Lactobacillus Casei have been widely researched for their ability to prevent and reduce the severity of diarrhoea.  Research published in the Journal of the American Medical Association showed that taking probiotics helped reduce the risk of diarrhoea associated with antibiotic use by 42% (8).  Further research published in the Lancet showed that probiotics helped to reduce the risk of travellers’ diarrhoea by 8% and from all other causes in adults by 26% (9).

Immunity

The cells found in the gut are thought to make up almost 70% of the entire immune system, so it makes sense that it’s inextricably linked to immunity.  Research has shown how probiotic supplements containing certain strains can promote the production of antibodies. The same strains have also been shown to stimulate the activity of immune cells such as natural killer cells and T-lymphocytes that help to regulate immune responses.

Research has shown how probiotic supplements may prove beneficial for upper respiratory tract infections such as colds, coughs and flu. Research published in the British Medical Journal found that children who regularly took probiotics (Lactobacillus GG) had 19% fewer infectious diseases over three months compared with those that didn’t (10).

Obesity

This is new area of research and the question of whether obesity is linked to gut bacteria is not yet answered.  Data suggests that the composition of bacteria in the gut differs between people who are obese and those that are lean (11).  It’s also been shown that the typical Western-style diet rich in fat and refined carbohydrates may even increase the strains of bacteria linked to obesity (12).  Research has provided several potential reasons why the diversity of bacteria in the gut may be linked to obesity.  Certain bacteria are involved in the digestion of carbohydrates and fats (13), whilst others have the potential to increase inflammation in the body (14). Other may impact on the production of hormones that influence appetite (15).

Whilst in its early stage, this research highlights the future potential for probiotic supplements as part of personalised nutrition guidance to help in the fight against obesity.

Essential steps to good gut health

The bacteria in your gut play a role in health that’s essential to life.  New research not only helps to confirm this but is exploring the many benefits that go beyond digestion. Diet and lifestyle can both influence the diversity of bacteria in your gut and this can have a negative impact on your health.  Following a healthy balanced diet will help to maintain the health of your gut and the bacteria that reside in it as will addressing lifestyle factors such as stress. Research into the use of probiotic supplements is ever evolving but they can provide a useful way to help maintain the balance of bacteria in your gut.

Healthy gut plan

  1. Maintain a balanced diet and try to avoid foods high in sugar and ‘bad’ fats.
  2. Eat wide variety of plant-foods such as vegetables, nuts, seeds and wholegrains that are high in fibre and support efficient digestion.
  3. Include prebiotic foods in your diet – onions, garlic, bananas, oats, barley.
  4. Include probiotic foods in your diet – live yoghurt, kimchi, kefir and miso.
  5. Use relaxation techniques to address the issue of stress.
  6. Factor the use of medication into your diet and the effect on gut bacteria.
  7. Take a probiotic supplement that includes strains such as Lactobacillus and Bifidobacterium in a dose of at least 10 billion bacteria.

 

References

  1. https://www.bmj.com/content/361/bmj.k2179
  2. https://www.ncbi.nlm.nih.gov/pubmed/24388214
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341031/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202343/
  5. https://www.ncbi.nlm.nih.gov/pubmed/15740474
  6. https://www.sciencedirect.com/science/article/pii/S2352289515300370
  7. https://www.ncbi.nlm.nih.gov/pubmed/26482265
  8. https://www.ncbi.nlm.nih.gov/pubmed/22570464
  9. https://www.ncbi.nlm.nih.gov/pubmed/16728323
  10. https://www.ncbi.nlm.nih.gov/pubmed/11387176
  11. https://www.ncbi.nlm.nih.gov/pubmed/27648960
  12. https://www.ncbi.nlm.nih.gov/pubmed/28199845
  13. https://www.ncbi.nlm.nih.gov/pubmed/15505215
  14. https://www.ncbi.nlm.nih.gov/pubmed/23985870
  15. https://www.ncbi.nlm.nih.gov/pubmed/27616451/

 

 

 

Colour code your health by eating the rainbow!

Colour code your health by eating the rainbow!

Colour code your health by eating a rainbow of foods (download as PDF Colour code your health with rainbow foods)

It feels as though we are continually being told to eat more fruits and vegetables to maintain good health and keep diseases at bay, with current research suggesting that eating five-a-day is not enough to reap the health benefits they have to offer.  So, what exactly is it about these nutritious colourful allies that makes them so great? 

The protective effect of antioxidant micronutrients such as the ACE vitamins and selenium have been understood for some time now.  These antioxidants are essential to help reduce free radicals in the body (unstable molecules produced from digestion and exposure to pollution, sunlight and cigarette smoke) and they have have been attributed to lowering the risk of many diseases including cardiovascular disease, cancer and dementia.  However, research has now moved forward to discover the beneficial effects of compounds known as phytonutrients that are responsible for colouring fruits and vegetables, and how they too can have a powerful effect on our health and reduce the risk of disease.

 


“The protective effect of antioxidant micronutrients such as the ACE vitamins and selenium have been understood for some time now”


 

Phytochemicals originally evolved to help plants protect themselves from diseases and insects and research is beginning to demonstrate that in the same way they can also help to protect us from disease.  There are thousands of phytochemicals found in fruits and vegetables and as the research is new we’re only just starting to unveil their identity and extremely complex action within the body.

Although the science is complex, the message is simple; eat a wide variety of different coloured foods.  As nutrients in foods work in synergy and different phytonutrients can be more freely absorbed depending on their make up within the structure of the food, it’s also a good idea to not only mix colours and types of fruits and vegetables but also cooking methods combining raw with cooked (such as adding roasted sweet potato or tomatoes to salad).

 


“Although the science is complex, the message is simple; eat a wide variety of different coloured foods”


 

By dividing different fruits and vegetables by their hue you can see how mother nature has allowed us to colour code our health by eating a rainbow of foods.

 

Red and pink 

 

 

Foods:  watermelon, pomegranate, red peppers, tomatoes, strawberries, pink grapefruit, cranberries, red grapes, raspberries, rhubarb, red chillies

Benefit: Most red fruits and vegetables contain lycopene, which is a member of the carotenoid family which are converted into vitamin A within the body.  This vitamin along with vitamins C and E help to protect the body from free radical damage.  Studies show that Lycopene* may reduce the risk of prostate cancer as well as helping to promote good colon health.  Red berries contain ellagic acid (helps to support the immune system) and anthocyanins, which research suggests reduces inflammation and help preserve memory whilst helping to slow down the degenerative processes of ageing.  These are also considered to be protective against certain cancers and cardiovascular disease as well as showing antiviral and antibacterial properties.

*Lycopene is more freely available in processed or cooked tomatoes.  Try roasting cherry tomatoes with balsamic and a little olive oil, which helps with the absorption of lycopene.

 

Yellow and orange

 

 

Foods: Yellow peppers, orange peppers, cantaloupe melon, carrots, sweetcorn, butternut squash, mangoes, grapefruit, peaches, pineapples, oranges

Benefit: The key antioxidant found in orange and yellow fruits and vegetables are carotenoids (also found in green leafy vegetables). These are converted to vitamin A in the body, which is essential for healthy skin and eyes.  Beta-carotene has been linked to a reduced risk of heart disease and certain cancers as well as playing a role in the immune system, reducing cognitive decline and possibly dementia risk.  You will also find a group of compounds in this hue known as bioflavonoids which studies suggest reduce inflammation in the body and may also work to slow down the development of cancer, heart disease and neurodegenerative diseases such as Alzheimer’s and Parkinson’s. Combining your orange foods with healthy fats found in avocados or oils will help with the absorption of carotenoids.  Try drizzling olive oil over roasted butternut squash.

 

Green

 

Foods: Peas, kale, broccoli, kiwi fruit, avocado, mint, gooseberries, grapes, asparagus, artichokes, pak choi, honeydew melon, green peppers, Brussles sprouts, cabbage, green beans

Benefit: Lutein (found also in yellow fruits and vegetables) and zeaxanthin found in green vegetables are major pigments in the eyes and important for the maintenance of healthy vision.  Studies have shown that people who eat higher amounts of these compounds in their diet have a lower risk of developing age-related macular degeneration (AMD) which is a major cause of blindness as we age. Zeaxanthin may also help to reduce the risk of breast and lung cancers, and play a role in the prevention of heart disease and stroke. Leutiolin is another antioxidant found in green peppers and celery which has been found to lower inflammation in the brain and central nervous system. Green foods also contain quercetin which also has an anti-inflammatory effect within the body.

 

Purple and blue

 

Foods: black grapes, beetroot, cherries, blackberries, blueberries, red onions, aubergines, purple potatoes, purple cabbage, plums

Benefit: Anthocyanins are present in this colourful group of fruits and vegetables.  These compounds are thought to reduce inflammation, which may help with preservation of memory and reduced risk of certain cancers. Blueberries have been the focus of research into the effects of anthocyanins and reduced mental decline (including Alzheimer’s).  Purple grapes are especially high in a type of polyphenol known as resveratrol, which has been shown to protect against heart disease and promote a healthy circulatory system by reducing the levels of bad blood fats and blocking the formation of blood clots (which can cause heart attack and stroke).  Blackberries contain ellagic acid and catechins, which may help to protect against cancer.

 

White

 

Foods: Mushrooms, garlic, onions, cauliflower, endive, parsnips, turnip, taro, celeriac

Benefit: Although not strictly a colour of the rainbow, white vegetables also contain a variety of phytonutrients that can have a protective effect on your health.  Onions and garlic contain quercetin and allicin, which are known to kill harmful bacteria and protect capillaries (smallest of the body’s blood vessels).  You will find powerful polyphenols in mushrooms which can help to reduce the risk of heart disease.  Glucosinolates and thiocyanates found in cauliflower may also help reduce the risk of heart disease and cancer as well as help with digestive disorders.

 

Just adding a few more colours to your meals each day can make a big difference to the nutritional quality of your diet.  Here are my top five tips to adding a little extra colour to your diet:

  • Try to include at least two different colour vegetables with each meal, this could be a salad with tomatoes and cucumber, roasted squash and beetroot or peas with baby onions
  • Smoothies and juices are a great way to combine lots of different coloured fruits and vegetables such as beetroot, carrot and apple
  • Homemade soups are an easy way to combine colours as are stews and casseroles
  • Snack on a variety of chopped veggies (perhaps with a dip such as hummus) such as courgette, red peppers and carrot
  • Throw a handful of mixed berries over porridge, breakfast cereal or yoghurt;  you could even combine them with sweet apples to make a antioxidant-rich fruit compote

 (download as PDF Colour code your health with rainbow foods)

Dementia – tips to help care for loved ones at home

Dementia – tips to help care for loved ones at home

 

Guide to help loved ones with dementia to eat well  (download PDF here  Guide to help loved ones with dementia to eat well  Guide to help loved ones with dementia to eat well )

Having trained in public health I take a particular interest in dementia care and have worked closely with the NHS and care home groups delivering expert advice on how to help older people with dementia to eat well.   I hope to share a little insight and a few tips to keep your loved ones with dementia properly nourished

 

What is dementia?

Dementia is a word used to describe a group of symptoms that occur when brain cells stop working properly.  This happens to specific areas of the brain, which affect how you think, remember and communicate.

The condition has a huge impact on the lives of someone with the condition and those around them.  Dementia is now the biggest killer of women and third biggest killer of men in the UK.

 


“Dementia is a word used to describe a group of symptoms that occur when brain cells stop working properly”


 

Dementia statistics  

  • 850K people living with dementia in the UK and is expected to increase to over 1 million by 2025
  • 24% of males and 35% of females born in 2015 will develop dementia in their lifetime
  • A person’s risk of developing dementia increases from one in 14 over the age of 65 and to one in six over the age of 80
  • Over 42K people under 65 years old have dementia in the UK

 

Why do older people with dementia need to eat well?

The purpose of a good diet is that someone receives the right amount of energy and nutrients they need to maintain bodily processes and protect against ill health.  There is plenty of evidence to support the fact that a poor diet will increase the chances of illness and many other health conditions as well as lowering someone’s quality of life.  Eating a wide variety of foods regularly will ensure someone’s dietary needs are met although in the case if dementia there are often many challenges that must be overcome to achieve this.

 


“The purpose of a good diet is that someone receives the right amount of energy and nutrients they need to maintain bodily processes and protect against ill health”


 

How the ageing body changes

Ageing can render the immune system less efficient, which makes older people with dementia more vulnerable to illness and infection.  A slower digestive system make constipation more common and a loss of muscle and bone strength increases the risk of falls and fractures.  Understanding thirst can also occur as less efficient kidneys make urine less concentrated and this can make dehydration more common.

 

Why are older people more likely to become malnourished?

A good diet is important for everyone but even more so for people with dementia who are at greater risk of becoming malnourished.   Not eating an adequate diet can lead to someone becoming under-nourished and this will impact on the greater chance of getting ill, skin problems, muscle weakness, tiredness, confusion and irritability.  There are many reasons why this this may be more common in older people with dementia: 

  • Smaller appetites and eating too little food
  • Chronic disease
  • Increased need for energy and nutrients due to illness or wound healing
  • Chewing and swallowing problems impact no food choices
  • Medicines may contribute to change in appetite, abnormal eating or eating disorders
  • Changes to the senses of sight, hearing, taste and smell make meals less enjoyable
  • Reduced communication skills make it difficult to explain your food preferences or that the temperature of your food is too hot or cold or that you may still be hungry

 


“A good diet is important for everyone but even more so for people with dementia who are at greater risk of becoming malnourished”


 

Informal dementia carers in the UK

There are currently 700K informal carers for the 850K people living with dementia in the UK.  Looking after someone with dementia is challenging and often impacts on family relationships and physical and psychological health but at the same time it can be rewarding and strengthen family bonds through the intimate relationship.  Caring for someone at home can allow loved ones to catch glimpses of past personality such as the occasional smile, laugh or a few words that allow an emotional connection to stay alive and that may be missed in residential care.

 


“There are currently 700K informal carers for the 850K people living with dementia in the UK”


 

Whether you’re a sibling, child or family friend, the effects of possible sleep deprivation and carrying out all the household chores, extra cleaning and laundry as well as moving and lifting their loved one can be exhausting and this is even more relevant as 44% of carers have a long-standing illness or disability according to research carried out by NHS digital.

Providing adequate food can be a challenge for home carers.  Budget constraints, lack of food knowledge or cooking skills, managing difficult eating behaviours anda exhaustion means that cooking home-prepared meals from scratch three times a day is often not a reality.  Understanding how to make mealtimes more manageable and quick healthy food fixes can lessen the burden whilst keeping your loved ones with dementia healthy.

 

A few tips to help people with dementia to eat well

Dementia is a fluid condition and every case is different but I hope these tips can offer a little insight and advice to help manage mealtimes.

 

Stimulate the appetite!

If you’re struggling to get someone to eat then try whetting their appetite.  Any increase in activity can help instigate hunger so a short walk or chair-based activity may help (this also helps relieve constipation).  Don’t fill stomachs with excess fluids before mealtimes as this will blunt the appetite. Prepare very flavoursome meals by adding spices or strong flavoured foods such as mature cheese, mustard or tomato puree.  Food should also look appealing and eye-catching with bright colours as we often, ‘eat with our eyes’. 

Try and use simple food cues to help older people with dementia orientate themselves with mealtimes.  The smell of toast or coffee in the morning, the clanking of pans or sight of someone cooking may all help someone with dementia to understand that it’s time to eat.

Mealtimes can be flexible and it may be easier to focus on the times of the day when someone usually has a bigger appetite, whether this is at breakfast, lunch or evening meal.  You should also offer small portions of food if someone has a small appetite as too much can be off-putting.

 


Create a calm eating environment

  • Avoid noise from the television or radio at mealtimes
  • Make sure plates are clearly visible on the table opting for red or blue colours or ones with a coloured ring around the edge (you could also try a white plate with coloured placemat)
  • Don’t clutter the table as this can be very distracting
  • Allow plenty of time to eat
  • Eat together

 

Take account of food preferences

Understanding someone’s food likes and dislikes can make a difference at mealtimes.  Be adventurous with new flavours but not to the point that someone refuses food.  Think about food occasions that the person your caring for may have been familiar with as it may even trigger a memory and connection with that particular food.  A Sunday roast, Christmas dinner, Strawberries during Wimbledon, seasonal foods, Birthday cake or hot cross buns at Easter are all good examples.

Taste and smell diminishes with age and more so with dementia so food preferences may change day-by-day.  It’s not uncommon for people with dementia to prefer sweet foods so try adding a little honey to savoury quiches, pies and omelettes or serve main meals with apple or cranberry sauce.  Fruit chutneys are also great to serve with cheese or cold meats, which also work as finger foods.  You can also add honey to roast vegetables and apples or dried fruit work well in stews, casseroles, curries and other one-pot dishes that can be cooked in batches and frozen.

 


“Understanding someone’s food likes and dislikes can make a difference at mealtimes”


 

Be aware that someone may not remember when they last ate and this may cause reluctance to meals.  Listen to what they are saying or trying to communicate and try and work around this with the food you offer. For example, if the person you’re caring for keeps asking about breakfast then you could consider several breakfasts across that day to encourage them to eat.

 

Maintain independence

It’s important that someone with dementia is given the opportunity to feed themselves as this helps retain a sense of independence and dignity.  Don’t worry about neatness as it’s more important that someone is eating independently. This may mean being patient and mealtimes could be lengthy and often require gentle encouragement along the way as well as appropriate supervision to reduce any risks of choking.

As dementia progresses someone may become less dexterous and lose the ability to use cutlery.  You can find specially adapted cutlery, cups with handles and non-slip placemats to make things easier.  If cutlery becomes difficult to use then provide finger foods.  A finger food diet can be just as nutritious and served hot or cold.  Pizza slices, chopped vegetables, fruit, meat pies, boiled eggs, potato wedges, sandwiches, fruit loaf are all good examples.

 


Recognising weight loss

There are many reasons why someone with dementia may lose their appetite such as suffering with constipation, swallowing issues, depression, mouth ulcers or painful teeth.  It’s important to be aware of weight loss in people with dementia and act immediately to help regain a healthy appetite and reduce the risk of malnutrition.

  • Bones visible under the skin
  • Loose clothing
  • Loose rings
  • Loose fitting dentures
  • Leaving food on the plate

 

Fortify foods 

If someone is losing weight then you may need to consider fortifying foods as it’s important to get as much nutrition as possible into a small serving of food, especially calories and protein.  Full fat milk, cream, cheese, oils, butter, mayonnaise, crème fraiche, milk powder, coconut milk, avocado, nut butters and pureed tofu are a few ideas of foods you can use. 

Nourishing smoothies can also help to top up someone’s calorie and protein intake.  There’s no end to the different combinations you can use and the best base is full fat milk.  

 


Planning meals

When you’re trying to think about what food to prepare each day it’s worth paying thought to a few factors that may make mealtimes more enjoyable for people with dementia.

  • Combine colours on the plate to help meals become more visible. Choosing three or four is a good target such as steamed fish with carrots and peas
  • Combine textures to make food more appealing. Mix up crisp, crunchy, chewy, soft and smooth foods (unless someone is having difficulty swallowing)
  • Vary taste but don’t add too many favours to any one meal
  • Have a buffet day with finger foods such as quiche, scotch eggs, vegetable sticks, cocktail sausages and yoghurts

 

Quick fixes 

If you don’t have the time to prepare something from scratch or are just too exhausted then there is nothing wrong with turning to good quality ready meals as a quick option.  Dishes such as lasagna, cottage pie, fish pie, macaroni cheese and risotto all provide a good soft food option.  Canned foods can also save time and offer a quick nourishing meal.  Canned fruit, fish (watch out for bones that pose a choking risk) or even baked beans are good examples and can be partnered with other ingredients.  Eggs are also a quick food option and can be scrambled with soft vegetables such as tomatoes and mushrooms or made into a simple omelette.

Pre-prepared foods can be used to make an interesting buffet meal that is also suitable for people that require a finger food diet.  You can also cook foods in batches and keep individual portions in the freezer to help save time. 

 


Food textures

Some older people with dementia may need the texture of their food altered.

  • Difficulty using cutlery or with a tremor may need finger foods
  • Difficulty chewing and poor teeth may need softer foods (mash, tender meats and fish, soft vegetables)
  • Difficulty swallowing may require a pureed diet (you must seek professional advice to assess someone’s potential swallowing problem before pureeing their diet) 

 

Hydration

Dehydration is common among older people with dementia as they may not recognise they are thirsty, may forget to drink, may be unable to communicate that they are thirsty, or may refuse to drink because they are worried about incontinence.

Dehydration can cause headaches, confusion, irritability and constipation which can contribute to urinary tract infections.  Older people who are incontinent need to drink more, not less, to encourage the bladder to empty regularly to prevent infection and to exercise the bladder muscles.

 


“Dehydration can cause headaches, confusion, irritability and constipation which can contribute to urinary tract infections”


 

We get some of our fluids from food, particularly foods such as soup, stews, fruits and vegetables, jelly, sauces, ice Lolli’s and yoghurt.  All drinks help us to remain hydrated, including tea, coffee, water, milk, fruit teas and fruit juices.

Caring for someone with dementia is a full time job and mealtimes present a whole new set of challenges however, maintaining a well-nourished body will help someone with dementia achieve a better quality of life and help to deter the onset of other illnesses that may make caring for them even more challenging.

 

More information

Dementia UK

Caroline Walker trust

Alzheimer’s research UK 

Age UK

 

Download PDF here Guide to help loved ones with dementia to eat well 

 

When is the best time to eat?

When is the best time to eat?

Mindful eating

I was recently asked by the Daily Mail Online about my favourite go-to breakfast?

This had me thinking a little bit about how my view of breakfast and eating in general has changed over the years.  There was a time when I conformed to the view that breakfast was the most important meal of the day and that you should eat as soon as you get up.  However, as i’ve gotten a little older (heaven forbid I am nearly 40!! – cringe) my food taste and lifestyle has changed.  I’m no longer dashing to the gym at the crack of dawn as stressful deadlines and lack of organization skills have me up early, frantically typing to meet overdue deadlines and for some reason the last thing I feel like doing when I’m stressed or distracted is eating.  Coffee is the only thing that’s going to hit the spot at 6am.

Forget the old adage of eating breakfast like a king, lunch like a prince and supper like a pauper.  Who even came up with this anyway! I now firmly believe that eating should be more intuitive.  Not that you should throw regular meal times out of the window but I do think that we need to learn to listen to our body and eat when we genuinely feel hungry.

Understanding your own hunger and fullness is probably the best thing you can do to help maintain a healthy weight and work in sync with your body.  This doesn’t mean starving yourself because you’re too rushed in the morning to make breakfast or cant be bothered to cook, but satisfying the need for food when your body asks for it.

There’s a whole raft of information out there dictating when, how and what we should be eating, but understanding and listening to your own body is always going to be the best option.  There was a time when we had to hunt for our food and mealtimes were dictated by what you managed to forage or catch.  Although you cant draw comparisons as we have come a long way since then, eating for the sake of eating or at a set times during the day just doesn’t seem to make sense.

It’s really flippant to think this is an easy way to eat as there are wider issues around food that influence how and what people eat but learning to adopt basic mindfulness and intuitive eating skills can help.  Don’t be put off by the sound of these concepts as they really are just common sense.

Whilst a healthy balanced diet is key to good health, the idea of what this is has become very blurred as we have so much access to nutrition advice and media attention on the latest superfood or wonder diet.  Just getting back to basics about healthy eating and focusing your attention more on how you eat and not what you eat will help you to tune into your basic cycle of hunger and satiety.

Tips for mindful eating

Eat slowly

Eating is not a race.  Taking your time to eat and enjoy your food will help you to recognize when you’re full.  Chew your food slowly as this will help with digestion and give your body time to recognize that you are full.  Eating too quickly also leads to indigestion and bloating.  Many fast eaters have adopted these habits from childhood and they often come from large families so trying to educate your children on the idea of eating slowly may go some way in helping to prevent this habit from being passed on.

Switch off! 

Try and make food and eating the main attraction at the dinner table.  Turn the TV off and make dinner time an electronic-free zone.  This doesn’t mean forgoing the Saturday night take-away and movie but just making all other evening meal times about the food without distraction.

Savour the flavour

Eating slowly and savoring every mouthful of food allows you to appreciate the flavours and textures of food, which adds to the enjoyment of eating.  If you wolf down you meal in five minutes then it’s likely you won’t even notice what you’re eating and this can lead to a lack of appreciation making food and eating a mechanical process of eating to live rather than living to eat.

So after all that, what was my favorite breakfast?  Well it was chopped egg and avocado on toast that I actually ate at 11am when I finally felt hungry after a morning of deadlines and coffee.

 

Chopped egg and avocado on toast 

Serves 1

300 calories per serving 

 

Ingredients 

1 egg

1 small avocado

1/2 yellow pepper, deseeded and finely diced

1 spring onions, finely sliced

2 chives, finely chopped

1 small handful of coriander, finely chopped

1/2 lemon, juiced

Sea salt

Black pepper

1 tbsp Extra virgin olive oil

1 slice of granary bread, toasted

 

Method

  1. Place the egg in a small pan of water set over a high heat and bring to the boil.  Simmer for 8 minutes then take the pan off the heat and place under cold tuning water to cool.
  2. Once cooled (about 2 minutes), peel the shell from the egg.  Quarter the egg.
  3. Add the remaining ingredients (except the granary toast) to a medium-sized bowl and combine well.
  4. Serve the egg on a plate with the avocado mixture and granary toast.

 

Download recipe here Chopped egg and avocado on toast