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Can sleep influence your body weight?

Can sleep influence your body weight?

Does a lack of sleep encourage weight gain?

Sleep has become a hot topic in the world of health, and research highlights the broader issues of sleep deprivation extending way beyond simply feeling tired. One particular area of interest is the impact of chronic sleep deprivation on body weight and studies suggest that sleep deprivation is independently associated with a higher risk of obesity.

A study published in the American Journal of Epidemiology found people who sleep less than 5 hours a night eat more during the day (1).  A further study found people who slept 5 hours or less a night had the highest BMI and greatest weight gain when compared to those who slept for 7 hours (2).

But does this mean that if you don’t sleep well, you will get fat?

What is the role of sleep?

Sleep is defined as “A condition of body and mind which typically recurs for several hours every night, in which the nervous system is inactive, the eyes closed, the postural muscles relaxed, and consciousness practically suspended.”

A lot is going on once you fall asleep. The body needs a surprising amount of energy to fuel these functions, including memory processing, muscle and joint recovery, and growth. Poor sleep impacts mood, concentration, and alertness, and the effects of long-term sleep deprivation have been linked to several severe health conditions, including heart disease, diabetes, and stroke (3).

How well are we sleeping?

Optimally, we should all be aiming to get around 8 hours of sleep a night. However, according to research carried out by the Royal Society for Public Health, it appears most of us only manage to get less than seven.

Over a week, this deficit equates to a whole night’s sleep, and research by The Sleep Council has shown that 33 percent of people only manage 5–6 hours, while 7 percent get less than 5 hours.

Researchers at Loughborough University found that those who habitually slept for less than six hours each night tended to have a higher BMI than those who managed to get the recommended eight nightly hours.

Does sleep deprivation affect our appetite hormones?

Research has suggested that a lack of sleep may impact the hormones leptin and ghrelin, which control appetite. Leptin sends signals to the brain to help inhibit hunger, while ghrelin is released by the stomach to stimulate appetite. The research suggests that a lack of sleep may reduce leptin and increases ghrelin which may be a factor for weight gain in non-sleepers.

In one study, men who got four hours or less of sleep had increased ghrelin and decreased leptin compared to those who got 10 hours. This dysregulation of such hormones could lead to increased appetite and a reduced feeling of fullness in sleep-deprived people (4).

This hormonal effect may explain the correlation between obesity and sleep deprivation highlighted by specific studies, but more research is needed.

In addition, several studies have also indicated that sleep deprivation affects food preferences. Sleep-deprived individuals tend to choose foods that are high in calories and carbohydrates (5).

Insulin and sleep

Insulin, the hormone that regulates blood sugar, may also be affected by sleep. This hormone also promotes the storage of fat, and as such, it has been suggested that higher levels may impact weight gain. One published study found that sleep deprivation may increase the release of insulin and another hormone called cortisol which has also been associated with fat storage in the body (6).

How does being overweight affect our ability to sleep?

Being overweight can affect our ability to sleep in a couple of ways. Sleep apnoea is a condition that affects breathing during the night which can disrupt sleep. If this is an issue, make sure you sleep on your side to help open up the airways.

Indigestion is another problem that interrupts sleep and is more common in overweight people. Heartburn is a common symptom of indigestion as stomach acid rises into the oesophagus and throat.

Does this all mean that poor sleep makes you overweight?

Definitely not as the research is far from definitive. There may also be a much simpler connection….

Sleep deprivation causes fatigue and tiredness, impacting our motivation to eat well and keep active. Chronic sleep deprivation could also affect mental health contributing to low mood, depression, and anxiety. Such mental health conditions may lead to erratic eating behaviours such as skipping meals, comfort eating, or binging on unhealthy foods, contributing to weight gain.

The possible link between sleep and body weight is just one of many areas of research on this topic. Maintaining a healthy body involves diet and exercise but sleep should be a consideration.

References 

  1. Xiao, Q., Arem, H., Moore, S. C., Hollenbeck, A. R., & Matthews, C. E. (2013). A large prospective investigation of sleep duration, weight change, and obesity in the NIH-AARP Diet and Health Study cohort. American journal of epidemiology, 178(11), 1600–1610.
  2. Patel, S. R., Malhotra, A., White, D. P., Gottlieb, D. J., & Hu, F. B. (2006). Association between reduced sleep and weight gain in women. American journal of epidemiology, 164(10), 947–954. 
  3. Cappuccio, F. P., Cooper, D., D’Elia, L., Strazzullo, P., & Miller, M. A. (2011). Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. European heart journal, 32(12), 1484–1492.
  4. Motivala, S. J., Tomiyama, A. J., Ziegler, M., Khandrika, S., & Irwin, M. R. (2009). Nocturnal levels of ghrelin and leptin and sleep in chronic insomnia. Psychoneuroendocrinology, 34(4), 540–545. 
  5. Zuraikat, F. M., Makarem, N., Liao, M., St-Onge, M. P., & Aggarwal, B. (2020). Measures of Poor Sleep Quality Are Associated With Higher Energy Intake and Poor Diet Quality in a Diverse Sample of Women From the Go Red for Women Strategically Focused Research Network. Journal of the American Heart Association, 9(4), e014587.
  6. Hackett, R. A., Dal, Z., & Steptoe, A. (2020). The relationship between sleep problems and cortisol in people with type 2 diabetes. Psychoneuroendocrinology, 117, 104688.
What I have learned as a freelance nutritionist

What I have learned as a freelance nutritionist

What have I learned as a freelance nutritionist?

These are my learnings as a freelance nutritionist. I started studying nutrition in 2003 at the ripe old age of 25 after years of trying to figure out what I wanted to do with my life. So, my first bit of advice is that it takes some people a little longer to figure out what to do. Once you find your passion, you will find your drive to succeed in whatever you put your mind to.

After completing my degree, I fancied learning more about public health, which interested me most in my course. Despite the financial challenges, I decided to do a master’s degree on the topic as I knew I would never do it if I didn’t strike while the iron was hot. I worked my socks off and took out a bank loan to cover the substantial fees, then worked five nights a week in a restaurant to support myself. Hilariously, I remember the tutors on the induction week saying it wasn’t possible to work and study this course at the same time – a few hours after that lecture I put on my apron ready for work! I have always been a believer in doing whatever you have to do to achieve your goals – some of us just ain’t that privileged! After this, I continued to work in hospitality and volunteered at various charities and NGOs focused on nutrition.

I got a lucky break and found a job with a small tech company that developed software that helped schools, care homes and hospitals analyse their menu plans. Being part of a small company, I had to develop software and pitch the software to local authorities throughout the UK as well as talking at events and delivering training sessions. After several years doing this, I was given voluntary redundancy, which allowed me to set up on my own as a freelance nutritionist.

After paying for a website to be built and buying myself a new laptop and various bits of software, I got myself up and running. I contacted everyone I had worked with in my previous company and got work. At the same time, I also set up a small consultancy on the side called HOPE which was Helping Older People to Eat Well. I worked with many care home groups delivering training focused on older people and dementia through this consultancy. I also started to contact personal trainers and nutrition and wellness companies to offer my services while also building my social media profile on Twitter and Instagram. I also bagged a part-time position as head of nutrition with a leading supplement brand called Healthspan.

My position at Healthspan is very media-focused, working with the press office, which has helped me build my profile further in the media. At this time, I was also introduced to Lily Simpson by a contact and worked with her to help develop her business called The Detox Kitchen working on the food and menu planning side of things. Together we wrote a book called The Detox Kitchen Bible, published by Bloomsbury which has since been a very successful book sold in many languages around the world.

This gave me the platform I needed to get more work in this industry. I have since worked around the globe with many wellness brands, retreats, celebrities, and other high-end clients. Further to this, I also followed another interest of mine which is sleep. I wrote another book called The Art of Sleeping which has also been successful and sold worldwide in many different languages. What I love most about being a freelance nutritionist is that I am always learning as I have to cover so many different areas of nutrition in my work.

It all sounds very glamorous on paper, but I still have to work incredibly hard to make ends meet as a freelancer. I still worry all the time about where the next bit of work is going to come from and to be honest even the best of us are always trying to figure things out.

So, what have I learned, and what are my top tips for being a successful freelance nutritionist?

Here goes (in no particular order) and apologies as this blog appears to have become quite epic so you might want to make yourself a nice cup of tea at this point as you could be here for a while!

Set up

This is where the initial costs are involved. You need a website and it doesn’t need to be fancy to begin with. I did my first website myself then got someone else to do one for me when I had a little more money coming in. Think carefully about what you want to include on your site from the start.

The bare necessities will include a home page and then various pages explaining your services and obviously a contact page with a link to your email. I have a blog which to be honest is more for my own benefit than anything else as I can make them downloadable and use them as factsheets or direct people to them on social media. A place to store recipes is nice if that’s your thing and you may want to include a page to showcase any writing or other media work you have done. Make sure there are links on your site to all your social media.

Make sure you have control of the back end so that you can add stuff to your site easily – my website is built in Word Press. I have someone that hosts the server and also helps with the housekeeping which includes updates to the various bits and bobs (as you can see I have no clue what actually goes on in this department!).

Also, get some business cards made up and remember to keep them on you at all times as you never know who you are going to bump into. I have found the most cost effective place is Moo.com.

Join the AFN

As nutritionists you should join the Association for Nutrition. It’s a faff getting your portfolio together but you need to support this charity as they have your back. You have worked so hard to train in your qualification and this charity helps raise awareness of properly trained nutritionists. Without this type of backing and support anyone can call themselves a nutritionist even those that have done a weekend course on the topic so get with the program and be sure to mention them when you can so people understand who they can use as a trusted source in our industry.

Find your vibe 

This is a really tricky one especially as you start out and look for work in many different areas. I have ended up working in many different areas labelling myself as a consultant and a lot of my work is media based (I also cover the topic of sleep) and my work has always included a huge food/recipe element.

However, I know many very successful nutritionists who have focused in on one particular area which could be weight management or gut health for example. While this may make it more difficult at first as you try to get experience it can make it easier in the long run as you build your profile as an expert in your chosen field. Becoming a trusted voice in one area can also make it easier to focus on things like your social media or give you a platform to pitch book ideas to publishers or collaborate with health and wellness brands as well as getting involved in expert working groups centred around your chosen specialism.

Get to grips with some of the basics 

There are a few good skills you should try and get a grip on when starting out and many of these I still use on a day to day basis. Invest in a recipe analysis program as I always get asked to analyse recipes or menu plans and while this work is a little dull the information is useful to include when writing about nutrition and dealing with private clients. I use Nutritics mostly because its web-based.

Keep a note of foods that are high in one or other nutrients. I know this sounds a little rudimentary but I can’t tell you how many times I have to write about something and refer to foods rich in one or other nutrient. On this point it’s also useful to understand the health benefits of foods, nutrients and key conditions where food has been shown to play a role (e.g. fibre reducing cholesterol). I actually have spreadsheets now with all this stuff on as a quick reference and I organise them in my computer files by topic – it saves me loads of time.

It is also useful to develop your writing skills and learn how to translate the science into something everyone will understand. You should also try to include practical advice where possible as this is most useful thing to most people such as what to cook and how to cook it or include more of it in your diet. I have written tons of stuff in the media as well as copy for websites or PR campaigns. You need to understand your audience but at whatever level try to include references to anything science-related you refer to as this is the easiest way to cover your back should anyone question your opinions. Writing on your blog is a good way to get practice.

Develop a good understanding of public health nutrition. I know it’s not particularly glamorous but it is the grass roots of what is going on in the world to help keep the nation healthy and it provides perspective that can keep you grounded. Honestly, this to me is the most fascinating aspect of nutrition!

I know I work with companies that provide supplements and other such products but I try to get them to stick to the science and always give them the perspective of the population as a whole rather than just the worried well. It does leave me little patience with some clients but at the same time you can’t bite the hand that feeds you so you have to find a balance which is why you have to turn some work down from time to time.

Keep up to date with key nutrition papers and nutrition guidelines so you always have your finger on the pulse. The NDNS survey is a good one to keep track of as this has tons of information as to what the nations diet looks like. The EFSA nutrition and health claims are also good to familiarise yourself with if you are working with food companies. I also keep reports to hand from charities like the British Heart Foundation and I also find factsheets from resources such as the British Dietetic Foundation useful to keep as a reference. Also good to keep abreast of what is trending in the world of health and wellness. On this point…. Don’t get sucked into what the media says… You are scientifically trained in nutrition so use this skill to try and see the wood for the trees!

I also have loads of templates to hand that I have created in powerpoint and other programs to give me a quick way to create new presentations, lectures and reports. I also think it’s a really useful skill to learn how to put together an interesting presentation that isn’t “death by powerpoint”. I know you learn this stuff at uni but it took me ages to understand that I could use a picture or other interesting visual in place of endless bullet points. Honestly, there is nothing worse than presenting something to a sea of bored faces! Don’t be shy to let your personality shine through – I use all sorts of funny gifs and video links as I don’t like to take myself too seriously but of course you still need to remain professional and what you choose to use must be sensitive to the topic in hand.

Get familiar with programs like Canva as it is a really easy way to create things like infographics which you can use in your writing or with clients – you can also create some really nice content for your social media with this program.

Last one….I am really annoying in that I love to pick up the phone and talk to people. This gets things done in half the time and talking to someone is a better way to build working relationships than always corresponding via email.

Social media

Mmmmm, I hate it, but it is something you just have to do. Social media has evolved so much since I started out, and to be honest, I tend to focus mainly on Instagram. I dip in and out of instagram posting pictures and writing content in the feed and do some videos. These days the video content gets much more attention than just pictures and text. Posting on stories is also an easier option and always seems to get more views.

You will ask yourself questions such as “what do I post”, “how do I get more followers”, bla bla bla. Don’t stress yourself out and don’t make this the main focus of how you think you will get work. It’s a nice platform but I have come to realise that I can’t compete with those in the wellness industry with 10’s if not 100’s of thousands of followers. I have a moderately OK number of followers, enough to allow me to do what I want to do.

I hate that the number of followers you have somehow defines your worth to some people as a nutritionist especially for me given my qualification and years of experience, but this is the way of the world! Remember that this is just one way to promote yourself for work but it’s not the only one and to be brutally honest you can spend hours every day on Instagram but it is unlikely to significantly improve your chances of getting work.

Put plenty of more valuable time into using your imagination and follow your passion. Get out there and meet people face to face even if this means doing stuff for free to start with and contact people you have a genuine interest in working with

As a 43-year old, I refuse to film gimmicky videos of myself trying to be funny – there is a limit to what I am prepared to do to get work! I would rather use these platforms to highlight stuff about nutrition I am genuinely interested in.

Structure your day

It’s lovely working at home but it’s easy for things to go awry if you have no structure to your day. I don’t work 9-5 as I am an early riser to prefer to start when I get up at around 6am. I hit the gym or go to yoga early to get out of the house then I work through to about 3pm on a usual day at home. I start by answering emails then spend some time going through the news and various websites to see whats going on and if there is anything new and interesting in the world if nutrition (good stuff to post on social media especially Linkedin). After that its about dividing my time between various bits of work I need to get done for clients and prioritising to (try) and meet deadlines.

I always set time aside to think about how I can get more work. This bit is always a bit painful so I tend to set about half a day week to focus on it. I also set a little time aside every day to do some social stuff although I have to admit my interest in this goes in waves!

If its quiet and you have done everything you need to get done then don’t feel guilty about enjoying your free time. I waste a lot of time when its quiet freaking out about work instead of using these periods to do other interesting stuff –  something I regret when it gets busy again. You can also use this time to focus on any reading or watching podcasts/instagram lives/webinars on things that interest you in your field. Also spend some time looking for events you can attend as these are good places to meet people. Try a mix of events – some are nutrition focused and some of these offer CPD points but look at wellness and fitness events as these are good places to meet people. Eventbrite has lots of things going on (and don’t forget your business cards!)

Linkedin

This is my most valuable source of work. I hate talking about myself or blowing my own trumpet, but you just have to do it here and post everything you are doing or have done. This is where people look for professionals, and they need to see what you’re up to, so don’t be shy. Voice your opinions on anything you have come across as potential employers love to see this and it shows you are passionate about what you do. Also, share anything you have done in the media or achievements at work.

Know when to refuse work

I have really struggled with this over the years, but if you feel you are jeopardising your professional profile and if it just doesn’t feel quite right, then just say no. It’s so tempting some times when a company is offering you lots of money but honestly in the long run it’s just not worth it.

Take control

Again, I have struggled with this. Be mindful of where your work is placed, and always get a copy of anything you have written sent to you to be approved. You can charge for quotes and copy but make sure there is a timescale on this. The information you provide for a campaign should not really be rehashed and used by companies in perpetuity. It just dilutes your worth to future clients. It is often quite helpful to have a freelance contract you can give to the client to agree to your terms and conditions.

Rates

This is the biggest challenge as a freelancer. The problem is that there is no recognised fee structure for a nutritionist. I have a set day rate and costs for other things such as quotes or radio days, but these all end up being negotiable. I weigh up the cost of future work with a brand or company, and I reduce my costs if they offer a retainer. I am happy to do lots of stuff for free if it provides a reasonable quid pro quo which may mean a feature in a leading magazine or quote to help maintain my profile and build relationships with health journalists and PR agencies.

Socialising

There is no point in going freelance if you’re unwilling to get yourself out there and meet people, as this is how you get yourself known. As your career progresses, you may have to do less of this as people start to contact you based on referrals, but you have to put the hard work in at the start.

Create a media pack

Suppose you want to work in the media. In that case, you need a media pack that includes a biography and examples of what you have done alongside a structure of fees. A showreel is also helpful to show what you have done on screen.

Control the narrative

This is one of the most important things to help maintain your integrity as a nutritionist. You’re the expert, and you are employed to provide your expert opinion, so if you disagree with what a client wants you to do, then walk away. On the whole, you can generally find a compromise to help companies deliver the messages they need to promote their products or services. Always stick to your guns when it comes to science and things such as health claims – I have learned the hard way with some clients and been pulled up on some bits of work or something I have said in the media.

Deadlines 

I have to admit that I am totally hopeless when it comes to deadlines, but you need to keep clients in the loop if you cannot deliver on time. This is quite important if you want them to come back to you with more work.

Housekeeping

It’s important to keep on top of invoicing and bookkeeping and things such as tax and VAT. If you can’t do it yourself, then employ someone to do it for you.

Public speaking

It took me ages to build up the confidence to do this, but years of training, delivering talks, and cooking demos at events have made me much more confident. This stuff also gives you the confidence to record videos on social media showcasing what you do. If you are going to work as a freelance nutritionist, you need to get to grips with this  skill. I don’t have many tips to offer here but one thing that has always helped me is to socialise with people during the coffees beforehand as you get to meet people in the audience and this can offer a little familiarity and make you more comfortable. My default when I feel nervous or uncomfortable is humour so I always try to add a little humility to my presentations and always relate them where I can to real life experiences or something the audience can relate to.

Diversity

You need to diversify all the time as a freelance nutritionist in order to increase your worth and open up new opportunities. I am just finishing off a post-grad diploma in sports nutrition as this is an area I fancy doing more work in.

Imposter syndrome

All freelance nutritionists succumbs to this at some point when you feel you are crap at your job and that everyone is doing better than you. Stay confident in everything you are doing and continually refer to the scientific literature to support your opinions and work.

Focus on your own thing and try not to compare yourself to what other people are doing. Instagram is a real bugger for this but always remember that people tend to only post the good stuff. My feed is full of lovely experiences showing fancy press trips or videos with clients, but this is just a snapshot of what is going on at that point in time. I’m not going to post a video of me fretting about where the next bit of work will come from or that I am worried about how my age may prevent me from getting a job in the future!

Explore all avenues of work

I always try to think outside the box as a freelance nutritionist and get involved with new start-up companies I believe may have a chance of doing well. Sometimes they feel like they have little to do with nutrition, but I will always give things a go and offer ways I think I can help.

Private clients

I dip in and out of this as a freelance nutritionist, and one of the reasons I have been doing my course in sports nutrition is because this is an area I feel I would be happy to help people with. I’ll be frank in saying I have very little interest in weight loss and don’t feel qualified to help people with specific health conditions. I like sports nutrition because it’s about performance. Those you deal with are fully committed to acting on your advice. My other bit of advice here is that you have to work out of a practice or somewhere you can rent a room for this to work financially. Traveling here, there, and everywhere to see clients in their homes is not economically viable in most cases.

Offer your services for the greater good.

I go through periods of getting a little bored with what I am doing, so I offer help to charities or other groups. I have delivered talks and cooking sessions to charity organisations and care homes, which I find exciting and inspiring. I have also been working with a para-athlete through my course, which has also been helping me to build my confidence in working with athletes on a one-to-one basis. It’s an excellent way to fill the time when you are quiet and learn new skills and, of course, forging new working relationships.

Create a network

As a freelance nutritionist it’s important to make contact with other people in your field. Freelancing can be lonely, and it’s great to have people to talk to in your field for advice on all work areas. I always have time for anyone who wants to get in touch to talk about anything they are working on. There is plenty of work to go around and ditch the idea that we are in some way all in competition with one another. I hate to say that sometimes I get emails from new nutritionists looking for advice but it can slip my mind to get back and respond. Don’t ever be shy to get in touch with people for help or advice.

Chipotle prawn fajitas – Eats and Cheats

Chipotle prawn fajitas – Eats and Cheats

So this is a quick flash back of the cookery videos I recorded with Jackie Wicks.  I had the privilege of working with Jackie on the UK edition of the book.

This is one of the recipes taken from the Eats and Cheats cookbook.

Chipotle prawn fajitas 

Serves 4 

Ingredients

 1 tbsp extra virgin olive oil

450g raw king prawns

Chipotle sauce to taste

Chilli flakes to taste

2 red onions, finely sliced

1 green pepper, deseeded and finely sliced

1 red pepper, deseeded and finely sliced

80g button mushrooms, sliced

1/2 green chilli, finely chopped

Round lettuce

Salsa (optional)

Avocado, diced (optional)

Black beans (optional)

Method 

  1. Heat a frying pan over a medium heat.
  2. Add the olive oil.
  3. Coat the prawns in the chipotle seasoning then place in the pan and cook for 2 mins.
  4. Now add the chilli flakes, onions, peppers, mushrooms and green chilli.
  5. Take the prawns off the heat.
  6. Create your wraps by loading with the prawns, lettuce and optional items including salsa, avocado and beans.

Find more videos like this on my YouTube page.

What’s the best way to lose weight?

What’s the best way to lose weight?

What’s the best way to diet and lose weight?

During my many years working as a nutritionist I’ve always shied away from the topic of weight loss mostly because I think it’s a hugely complex topic, which requires input from many disciplines and a unique skill set held by dietitians and nutritionists who specialise in this area.

I can tell someone what and how much to eat and devise menu plans and shopping lists to fit in with their lifestyle and food budget, which in some cases has been successful. However, on the whole my experience of helping people to lose weight has been frustrating and enlightened me to the realisation that, ‘you can lead a horse to water, but you can’t make it drink’.  I know that if a client has me at their disposal to follow them around each day and cook every meal then i’ll get great results, but the reality is that when they leave, the onus is on them to make healthy food choices.

Motivation 

Losing weight takes a huge amount of motivation and commitment and the factors influencing food choice are hugely complex.  It drives me absolutely bloody bonkers when I hear people say that losing weight is simple and just a case of eating less and moving more.  This ignorance comes from a complete lack of understanding amongst those that have never had an issue with their weight.  The problem is that being overweight is very visible and conjures up an unfair image of indulgence or greed as well as being associated with many other social stigmas and unfortunately society often has very little appreciation for the wider issues involved.

Mindset

Mindset is a major component of losing weight and the psychological issues involved are becoming more apparent as being a key factor in compliance and long-term weight maintenance.  One very relevant factor in the aetiology of weight loss is the link between food and mood, which often manifests as an emotional crutch, hampering efforts to lose weight.  Some people put all their faith and commitment into diet plans to the point at which falling off the wagon represents a huge failure impacting on their ability to stick to the programme and sometimes results in binge eating and reverting back to old ways of eating.  Tackling the psychological effects of food is something that needs to be addressed if this is getting in your way of losing weight.

Decision to lose weight 

When it comes to losing weight, there are those that just want to shift a few pounds and others with a much greater amount of weight to lose to improve their health.  In my experience it can be more challenging to shift the last few pounds and those with less weight to lose tend to get drawn to the abundance of diet fads. Unfortunately, for many people, the decision to lose weight is often made as a result of a health diagnosis that puts things into perspective but the positive here is that it’s never too late to reap the benefits. Many of the risks associated with being overweight can have a major impact on someone’s lifespan but just as damaging is the effect on long-term wellness and the number of years living with poor health.  Being overweight or obese can mean living with joint pain, difficulty sleeping, tiredness, breathlessness and psychosocial issues such as depression, low self-esteem and feeling isolated, all of which make it more difficult to drum up the motivation to lose weight.  On top of this, many of the conditions that often accompany being overweight or obese involve medication, which can have unwanted side-effects and become a day-to-day burden.

No hard and fast rule 

There’s no hard and fast rule to losing weight and one size certainly doesn’t fit all.  The key to long-term success has little to do with the speed at which you lose weight, but the habit changes made along the way, which often dictate the chances of keeping the weight off.

Weight loss is a minefield and there are some brilliant nutritionists and dietitians out there that can offer support and guidance.  The support provided by weight loss groups such as Weight Watchers has also been shown to be a key factor in success, but if this isn’t your thing then approaching weight loss with a friend or work colleagues can have a similar impact.  You can of course embark on a weight loss regime on your own but it’s important to do this in the right way and not get sucked into the hype around new diet fads.

Media confusion 

Ignore what you read in the media as this can often cause confusion.  Advice such as that telling you to cut out carbs, shun counting calories, eat loads of protein or avoid eating at certain times is fine in the context of certain methods of weight loss but these messages are good examples of our current obsession of defining diet and health by individual foods and nutrients.  The negative impact of such messaging is that it has the potential to cause false ideas around healthy eating and labelling foods as somehow being ‘good’ or ‘bad’ can detract away from the basic principles of eating well. Focusing on certain nutrients and positioning them as a key driver for weight gain also causes confusion, blurring the basics of healthy eating and making it seem more complicated.

Carbohydrates 

Carbohydrates are one of the best examples of how we have become overly focused on individual nutrients and foods groups.  The messaging around carbohydrates and health has become very negative and for some are viewed as being at the root of weight gain and disease.  A diet high in carbohydrates can cause weight gain, diabetes and inflammation but it needs to be put into context to be fully understood.  Whilst people attribute a diet high in carbohydrates to poor health, few actually define what this looks like, which has led to people taking the issue out of context.

If your daily diet includes over-sized portions of sugary cereals and muffins for breakfast, huge white baguette filled with something high in sat fat for lunch and an extra-large pizza for dinner, all of which are accompanied by sugary snacks, soft drinks and hot beverages doused with sugar, then this is clearly not a healthy way to eat and goes against the basic principles of healthy eating.  If you eat like this, then there’s also a very good chance that you’re unhealthy in many other ways such as lacking in exercise. However, this cannot be compared to a diet that includes a sensible portion of porridge oats for breakfast, quinoa and chicken salad for lunch and then a tofu stir-fry with brown rice for dinner, whilst also avoiding snacks and sugary drinks.  These two diet examples both include carbohydrates and one is clearly healthier that the other but without putting this nutrient in the right context, people develop false ideas and the confusion around what foods they should be eating continues to grow.

Small changes 

Taking a small changes approach is a good way to start.  Rather than becoming overwhelmed and trying to make dramatic changes to the way you eat, start by looking at your current diet and thinking about how you can adapt this to make it healthier.  The basics of healthy eating still apply to weight loss in that you need to cut down on the number of calories you eat and insure that these calories come from nutritious foods that will help to keep you feeling full and reduce your risk of disease (lean proteins, healthy fats, vegetables and fibre-rich wholegrains).

These are just a few ideas of some of the changes you might think about making:

  • Switch to low fat milk and dairy products
  • Choose lower fat meats
  • Avoid snacking or choose healthy snacks
  • Use a smaller plate to control your portion size
  • Make take-away food a treat and reserve to one night of the week (try making healthy choices)
  • Reduce your alcohol intake and avoid binge drinking
  • Gradually reduce your sugar intake in hot beverages and switch to low sugar food products and diet soda
  • Limit fruit juice and smoothies to one-a-day
  • Increase your intake of vegetables
  • Switch to ‘brown carbs’ such as wholemeal pasta and bread, and wholegrain rice
  • Work out your meal combinations in handfuls i.e. one handful of protein, one handful of ‘brown’ carb and unlimited veggies
  • Check food labels; the reality is that many people don’t cook from scratch so choose foods that are labelled as green or amber on the front-of-pack

The accumulation of many small changes can have a big impact on your food intake and weight loss. Every small change also represents a change in eating behaviour that can have a greater impact in the long-term.

Diets

Diets are another approach and can provide a kick-start that some people need to achieve their weight loss goals.  Diets are appealing because they offer a starting point and end goal as well as providing a set of rules to follow. The fact that you are told what, how much and when to eat also adds to their charm. Embarking on a diet can provide motivation, which is amplified by the availability of apps that can help to monitor and track your progress.

Putting very extreme diets aside, there is no single diet that can be said to be superior over another no matter what their marketing says.  The most successful diet is only going to be the one that you stick with and this is influenced by the way you live your life.  There are a multitude of diets out there, which will all tell you they are the best but just because your best friend or a certain celebrity lost lots of weight doesn’t mean you will.  Do your research and figure out what diet will work best for you.  If you know you can’t live without carbs then don’t try following a ketogenic diet (low carb).  If you struggle with energy levels across the day because of a very busy work schedule, then fasting two days of the week may not be realistic.  If your job involves long working hours and late nights entertaining clients then fasting for 16 hours could mean eating your first meal at 3pm, which is clearly not going to work.  If the diet becomes a chore then your chances of sticking to it are less likely.

Weight maintenance 

Whatever the outcome of your diet, you need to consider how you are going to take things forward once you have managed to lose weight.  It’s not uncommon for the end of a diet to signify an opportunity to revert back to old eating habits but what’s the point in dieting if this is the case. This all goes back to the benefits of developing new eating habits that will help you to maintain a healthy weight. A diet worth its weight in gold is the one that teaches you ways to eat that encourage healthy eating habits.

Many diets talk about other health benefits such as increased energy levels, reduction in certain diseases or glowing skin, but you should keep your eye on the prize and these are all potential benefits of losing weight and not specific to that diet per se.

I have no answer to the question of what the best way is to lose weight as it is dependent on the individual.  Losing weight is not simple and there are many factors that can impact on someone’s ability to do so and keep the weight off.  What I can tell you is that finding a method that fits in with your lifestyle and encourages you to develop new habits around food choice is more likely to result in long-term success and that tackling the wider issues such as the psychologically around food may be hugely beneficial in some cases.

The big fat debate about carbohydrates

The big fat debate about carbohydrates

The big fat debate about carbohydrates

I recently wrote a piece about food myths, which was unfortunately given the headline “carbs don’t make you fat”, and whilst slightly misguided, not completely wrong.  Interestingly, of all the myths mentioned, the focus of readers was “not all carbohydrates make you fat”.  Amongst other things, the main lesson learnt was not to read people’s comments in the Daily Mail!

After reading more around the topic, it’s become clear that the debate over fat versus carbohydrates is still controversial and not something I intended to be part of.  Seeing how the content of my article was spun by readers (many of whom simply commented on the headline without reading the article) only proved my thinking behind the myth as many related the information to their own personal experiences, which can’t be applied to the general population.  People have different lifestyles and energy needs so it’s difficult to generalise about fats and carbohydrates.

I still stand by my view that not all carbohydrates make you fat but accept that the topic requires more explanation to comment on both sides of the debate and cannot be summed up in two paragraphs of a health article!

 

My clients and training

I also received many negative comments about my training and clients I choose to work with and feel I need to fight my corner!  I’m happy to be completely transparent about my work.

Firstly, I’m not a vegan (not sure where that one came from!).  Even if I were, then this would still not impact on my views about carbohydrates.  I’m a registered nutritionist with the UK Association for Nutrition and have a BSc in nutrition (not nutritional Therapy) and a MSc in public health nutrition.  I currently work with food companies, mostly restaurants to improve the quality of their food and help them to meet legislation that provides transparency to customers about the food on their menus. I also work with care homes to improve the food offered to residents with dementia as well as schools and nurseries to ensure the nutritional needs of our vulnerable population groups are met.

I currently work with one of the UK’s largest supplement companies as their head of nutrition in a role that requires me to objectively ensure the right information is given to customers within the strict legislation around health claims.  I don’t promote unnecessary use of supplements and stick with a message and belief of food first.  Most importantly, I’m independent and simply use the scientific facts as a basis for my writing and not those of commercial companies.

I have written a recipe book with my good friend Lily called ‘The Detox Kitchen Bible’ and we exclude wheat, dairy and refined sugar from our food (which was initially based on the needs of the clients we deliver food to who include vegans and those with diagnosed food intolerances).  I hold my hands up that the word ‘detox’ has bad connotations,  but our ethos is to cook from fresh and focus on including lots of nourishing foods that ensure nutrient balance (including carbohydrates) rather than those excluded.

 

Nutrition is a science

At its core, nutrition is simple; eat healthy foods in the right portion size for your energy needs, don’t fear food or categorise as good and bad and understand there is room for all foods as part of a balanced diet. Putting this into practice is more difficult and is influenced by other factors such as behaviour change, food access, income, cooking skills and the information made available. We all know when we’re eating the wrong foods and don’t need to be patronised by health professionals like me, however, those interested in health often like to learn more about the subject.

Nutrition is also a science and research will continue to emerge that questions traditional thinking. Understanding how to read scientific papers requires training and reporting about health in the media often focuses on the initial findings of studies and those that can’t be translated to everyday life such as animal studies or those carried out on small study groups. Reporting these findings undoubtedly causes some confusion and frustration as often the messages contradict themselves between articles.

I try to avoid focusing on a single aspect of any diet and prefer to keep the bigger picture in mind as there are many challenges facing public health nutrition, but here are my views about carbohydrates and in particular their impact on weight.

 

Carbohydrates

Carbohydrates are one of the three macronutrients that provide energy, along with proteins and fats and an excess of any one will cause weight gain.  Most foods contain a combination of these nutrients so blaming a single food or nutrient for weight gain makes little sense. There are also other factors that influence weight as mentioned above but these are not relevant to the question at hand.

Yes, carbohydrates raise insulin levels that can trigger the uptake of fat, but not before the body has taken what it needs for energy.  The role of insulin is to regulate the usage and storage of both glucose and fat.  This hormone controls blood glucose levels by messaging muscle, liver and fat cells to take up glucose from the blood, which is used for energy.  When the body has enough to meet its energy needs, glucose is taken up by the liver and muscles to be stored as glycogen.  Once the liver has stored all the glycogen it can, fat cells take up glucose and store it as triglycerides.  Insulin also inhibits the breakdown of fat, glycogen stores and proteins as well as the pathway that produces ketones (more on that later).

It’s also worth noting that energy metabolism is not an all or nothing process and the body will use fat and glycogen stores simultaneously in response to its needs.

However, just because you eat carbohydrates doesn’t necessarily mean a sudden rise in fat storage! People have different energy requirements relating to their lifestyle (particularly exercise) and not everyone needs to lose weight.

 

You can’t lump all carbs together

Brown rice and quinoa are not the same as calorie-laden pizza and chips that also contain high amounts of fat and other nutrients such as sodium, which can negatively impact on your health.  Wholegrain carbohydrates contain fibre, which is lacking in the UK diet, as well as other essential nutrients such as magnesium and B vitamins.  Foods made with flour, mostly white (fortified in the UK with calcium, iron, thiamin and nicotinic acid),  also provide valuable nutrients, which are especially beneficial for those on a low food budget.

A far as low fat diets versus low carbohydrate is concerned then the science behind them does differ and as explained above, an excess of glucose will be stored as fat and effect how the body utilises these nutrients for energy.

 

The traditional low fat diet

The traditional dietary advice for losing weight is to follow a low fat diet and is favoured by the Department of Health. The principles are that you cut down on your overall intake of fat, which helps to reduce your overall calorie intake and so lead to a steady reduction in body weight over time, an approach that many consider easier to maintain in the long-term as opposed to short-term fashionable diets.

The low fat diet also requires sticking to a reduced number of calories and endorses following other key healthy eating messages such as reducing your intake of saturated fat and sugar, eating oily fish and plenty of high-fibre foods such as wholegrains, pulses, fruits and vegetables, which will benefit long-term health.  There is no recommendation in this diet to reduce your carbohydrate intake but guidance suggests that half your daily calories should come from foods rich in this nutrient and that you should opt for those that are unprocessed. High fibre carbohydrates have also been shown to help with weight loss as they have a filling effect, especially when eaten with protein and healthy fats that slow down the release of sugar.

Health bodies including the Department of Health worry that low carbohydrate diets encourage the intake of saturated fat that may impact on your risk of heart disease, however research shows that a moderately low carbohydrate diet may benefit the heart as long as proteins and fats come from healthy sources (1).

Some researchers believe that saturated fat may not be such a major factor in the development of heart disease compared to other dietary habits such as an excessively high intake of carbohydrate foods including sugar.  Whilst this is a whole other issue it adds another dimension to the low fat versus low carbohydrate debate.

 

The low carbohydrate diet

Diets such as Atkins remove virtually all carbohydrates from the diet during their initial phases (prescribes just 40g of carbohydrate daily, which is the equivalent to about two slices of bread).  In the absence of glucose from carbohydrates, the body is forced to use some protein and also fat stores for energy.  Fats are converted to ketones that the body uses to supply energy to cells of organs such as the brain that usually favour glucose.  In essence, your body is burning fat, which is the basis for the weight loss and loss of fat tissue, the latter of which is generally better for your health.

Low carbohydrate diets are effective, which is backed up by plenty of studies that report quicker weight losses and reductions in body fat compared to a traditional low fat diet (2, 3, 4).  Researchers have even suggested that this may be a better approach for treating obesity.  However, low fat diets can also help you to lose weight and studies have shown that both low fat and low carbohydrate diets can lead to significant weight losses (5).  It’s also not fully clear how significant the weight losses are in the long term between the two approaches,  although it’s been suggested that both are similar over time. Diets high in protein are also very satiating, which can lower overall calorie intake.

Its also worth noting that glycogen can make muscle tissues hold on to extra water,  which may reflect the numbers on your scales.  This is one reason why drastically cutting back on carbohydrates can initially result in a quick loss of weight as you use up glycogen stores and with that, lose water.

A recent study looked promising to finally end the debate about low carbohydrate diets versus low fat diets but as is the case with nutrition, it only provided another take on the debate and little to sway the argument either way (summed up nicely by NHS choices).

 

Diets are temporary

Diets are considered by most to be temporary, meaning they have an end goal.  However you decide to lose weight, bear in mind, its important to think about how you’re going to keep the weight off that you have worked so hard to lose.  My advice is to focus on adopting small realistic changes that can be followed through to the way you eat after you have lost the weight, whether that’s to eat less processed carbs, serve smaller portion sizes or choose low fat varieties of dairy foods.

 

You can’t generalise about food intake

Interestingly, my concerns from the article were only proven by readers comments, many of which favoured the low carbohydrate approach.  Everyone has his or her own personal experiences, some react badly to gluten and wheat so cutting out certain carbohydrate foods is necessary and others have had more success losing weight following a low carbohydrate diet rather than a low fat approach. However, when advising public health, the message has to meet the needs of everyone in a way that is easily understood and able to be applied.

Whilst the low carbohydrate approach is convincing, these diets are not that straight forward, especially those that include different phases of carbohydrate intake and require the body to enter ketosis in order to achieve the fat burning state. It’s hard to see how this could be relayed to the general public and the last thing you want is for ketosis to be considered a healthy body state, especially for those with underlying health conditions.  Saying that there may be some benefit to cutting down on your carbohydrate intake.

Yes, a diet high in sugar, pizza, pasta with creamy sauces or toast laden with butter and jam will encourage weight gain, especially when partnered with a sedentary lifestyle and excess calories but including carbohydrate foods, especially unprocessed, in the right portion size, will not.

When you talk about carbohydrate foods, many people automatically refer to cases of high calorie diets laden with large amounts of sugar and foods mentioned above, which are linked with obesity and other diet related diseases such as heart disease.  For those with a healthy weight and active lifestyle, there is no reason to completely remove them from the diet.

There are many books citing the perils of carbohydrates (namely processed) and especially sugar. Whilst these are very valid arguments backed up by credible research, our body’s are more than capable of dealing with this food group in the diet, dare I say, even a little sugar.  Ill health occurs in those who are over consuming large quantities of all foods including an excess of sugary processed carbohydrates; a diet that is typical in those with other unhealthy dietary habits and lifestyles.

 

My concerns about vilifying carbohydrates

My main concerns include:

  1. People self-diagnosing food intolerances and allergies resulting in unnecessarily removing food groups, potentially putting them at risk of nutrient imbalances.
  2. These food views getting filtered down to feeding young children and other vulnerable groups.
  3. Labelling foods as bad, which encourages an unhealthy relationship with food.
  4. The idea that all carbohydrates are the same.  Eating a portion of foods rich in complex carbohydrates such as wholegrains, starchy vegetables and pulses is not necessarily the same as eating the same serving size of sugar.

 

The most effective diet is one you can stick with

In my opinion, if you’re trying to lose weight, which seems to be the main association with carbohydrates in the diet, then the decision of what diet to choose is really up to you and there is no right or wrong approach as sticking to either low fat or low carbohydrate will result in weight loss.

Unfortunately, the media exposure of research and debating on the topic has detracted away from the fact that the most effective diet is going to be the one that you stick with.  Dr Susan Jebb at the MRC Cambridge summed the situation up perfectly with the comment, “there is too much significance placed on the nutritional composition of diets when the biggest challenge is finding strategies that help people to adhere to them”.

My point still stands, carbohydrates are a beneficial nutrient and choosing the right foods (preferably opting for unprocessed grains), in the right portion size as part of a balanced diet tailored to meet your energy needs poses no serious threat to health.

 

References

  1. Halton TL, Willett WC, Liu S, et al (2006). Low-carbohydrate-diet score and the risk of coronary heart disease in women. N Engl J Med. 355:1991-2002.
  2. Hu T1, Mills KT, Yao L, Demanelis K, Eloustaz M, Yancy WS Jr, Kelly TN, He J, Bazzano LA (2012). Effects of low-carbohydrate diets versus low-fat diets on metabolic risk factors: a meta-analysis of randomized controlled clinical trials. Am J Epidemiol. Oct 1;176 Suppl 7:S44-54.
  3. Foster GD, Wyatt HR, Hill JO, et al (2003). A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med. 2003;348:2082-90.
  4. Samaha FF, Iqbal N, Seshadri P, et al (2003). A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med. 348:2074-81.
  5. Una Bradley, Michelle Spence, C. Hamish Courtney, Michelle C, McKinley, Cieran N. Ennis, David R. McCance, Jane McEneny, Patrick M. Bell, Ian S. Young and Steven J. Hunter (2009). Low-Fat Versus Low-Carbohydrate Weight Reduction Diets Effects on Weight Loss, Insulin Resistance, and Cardiovascular Risk: A Randomized Control Trial. Diabetes. Dec; 58(12): 2741–2748