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Are sleep trackers useful?

By Rob Hobson

What’s the deal with sleep trackers?

Health tech is ever evolving, and trackers such as FitBit and smartwatches are something that has been adopted by anyone serious about looking after their health. These trackers and associated apps can monitor everything from heart rate to dietary intake.

Many people also use these devices to monitor their sleep, even more so as research begins to unveil the true impact of not sleeping well. However, the accuracy of these trackers to monitor sleep accurately has come into question. In some cases, an overreliance and obsession over the data they provide have led to further sleep issues.

 

How much sleep do you need?

Current advice around sleep is that the average healthy adult needs 6-9 hours a night1. Like everything related to health, there is no ‘one-size-fits-all’ for sleep and indeed no magic number. The variability in sleep times between individuals may be down to genetics and numerous other lifestyle factors. In fact, a decade ago, researchers discovered a genetic mutation in some people linked to short sleep, meaning they got the same benefit on six hours of sleep as those without the mutation who got eight2. Since then, several other similar genes have been discovered, contributing to the evidence that functioning well on less sleep is a genetic trait.

Research is ever evolving around sleep. There is plenty to suggest that a lack of it is linked to an increased risk of heart disease, high blood pressure, stroke, obesity, type 2 diabetes, depression, and anxiety3. However, the definition of ‘lack of sleep’ varies between individuals, so it’s wrong to assume that there will be health consequences if you get less than eight hours a night. It is also not just about total sleep time but sleep quality.

What are the stages of sleep?

Four sleep stages make up a single cycle that lasts around 90 minutes and the number of cycles that occur is dependent on how long you are asleep.

Stage one is short only lasting 5-10 minutes. Sleep is shallow during this stage, and while your brain is dipped into sleep, you may not feel as though you are asleep. This is the stage at which you can be easily woken.

Stage two is often referred to as light sleep. It’s an important stage that takes up much of the night and is characterised by a slowing down of breathing and heart rate. During the first sleep cycle, this stage lasts around 10-25 mins but increases during subsequent cycles to make up half of the time you spend asleep.

Stage three is deep sleep, and it is difficult to wake people up from this stage in the cycle. The body totally relaxes during this stage, and your pulse and breathing rate drops even further. This stage is restorative and essential for recovery and growth and bolstering the immune system. The body is vulnerable during this stage, so after the first couple of sleep cycles, the time spent in this stage reduces as you spend more time in REM sleep.

The final stage of sleep is REM. During this stage, the body is inactive, but your eyes move rapidly hence the name. Heart rate increases and breathing becomes more irregular during this stage. Bodily functions such as protein synthesis peek at this stage, which is also when you are most likely to dream. This stage is also essential for cognition, learning, and creativity.

So, back to sleep trackers.

 

How do sleep trackers monitor sleep?

Sleep trackers monitor sleep by movement and heart rate, but their accuracy is certainly not 100%. Just because you’re not moving doesn’t necessarily mean you are asleep, which is a flaw in the tech. Wearables that monitor heart rate are likely to be a little more accurate at defining between the sleep stages as it fluctuates between them.

Only a few studies compare the accuracy of sleep monitoring devices set against the recognised lab testing called polysomnography, which looks at brain waves, blood oxygen levels, heart rate, breathing, and eye and leg movements. One such study published in the journal Sleep Medical Reviews found that sleep trackers were only accurate 78% of the time when identifying sleep versus wakefulness. This accuracy dropped to just 38% when estimating how long it took participants to fall asleep4.

 

What information do sleep trackers provide?

Most sleep trackers will tell you how long you were asleep and awake during the night. The data is also broken down into the different stages of sleep, and how well you slept is given as a percentage score. This data is helpful to help identify your sleep pattern and provides a way of monitoring your sleep over time.

How people interpret, this data is an issue with these trackers. Most people do not understand how sleep cycles work and how the timing of each stage varies during the night. A common misconception is that you should be getting lots of deep sleep when this is the stage you spend the least time in during the night.

Sleep trackers also have no way of assessing exactly how much sleep you need. Most trackers give you a higher score for getting closer to eight hours a night, but this is misleading if you only need six hours to function optimally.

 

Can sleep trackers do more harm than good?

While the information provided by sleep trackers can be helpful, it can’t be relied upon to give you an accurate analysis. In some instances, people have become too focused on this data in their quest to achieve the perfect sleep score. This obsessive focus can cause anxiety and unhealthy sleep behaviours, ironically disrupting sleep.

Researchers have coined the term ‘orthosomnia’ to describe the potential risks associated with people who develop an unhealthy preoccupation with improving the data from their sleep tracker5. Studies on the topic have shown how people self-diagnose and convince themselves they have a sleep disorder based on their sleep data even though they may not5. The knock-on effect is increased stress and time and money wasted investigating the issue.

Some people may also spend excessive time in bed to improve their sleep scores. The problem with this behaviour is that it reinforces poor sleeping habits and can condition the body for sleeplessness, leading to future issues with insomnia further down the line.

 

How useful are sleep trackers?

Sleep trackers provide some helpful insight into your sleep patterns, and they offer a way to monitor this over time. They won’t help you get a better night’s sleep, as this is down to good sleep hygiene habits.

The problem with many health techs is that it needs to be programmed around a set of algorithms based on generic data or information imputed by the user. As far as sleep is concerned, wearables do not have the functionality to establish precisely how much sleep you need to function at your best. Research has shown how people become more reliant on their tracker to tell them whether they got a restful sleep. The only way to figure this out is by listening to your own body. Rather than focusing too much on numbers, it is better to assume you are getting enough sleep if you wake up fully rested and perform well during the day.

References

  1. Hirshkowitz, M., Whiton, K., Albert, S. M., Alessi, C., Bruni, O., DonCarlos, L., Hazen, N., Herman, J., Katz, E. S., Kheirandish-Gozal, L., Neubauer, D. N., O’Donnell, A. E., Ohayon, M., Peever, J., Rawding, R., Sachdeva, R. C., Setters, B., Vitiello, M. V., Ware, J. C., & Adams Hillard, P. J. (2015). National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep health, 1(1), 40–43.
  2. Shi, G., Xing, L., Wu, D., Bhattacharyya, B. J., Jones, C. R., McMahon, T., Chong, S., Chen, J. A., Coppola, G., Geschwind, D., Krystal, A., Ptáček, L. J., & Fu, Y. H. (2019). A Rare Mutation of β1-Adrenergic Receptor Affects Sleep/Wake Behaviors. Neuron, 103(6), 1044–1055.e7.
  3. Nagai, M., Hoshide, S., & Kario, K. (2010). Sleep duration as a risk factor for cardiovascular disease- a review of the recent literature. Current cardiology reviews, 6(1), 54–61.
  4. Conley, S., Knies, A., Batten, J., Ash, G., Miner, B., Hwang, Y., Jeon, S., & Redeker, N. S. (2019). Agreement between actigraphic and polysomnographic measures of sleep in adults with and without chronic conditions: A systematic review and meta-analysis. Sleep medicine reviews, 46, 151–160. https://doi.org/10.1016/j.smrv.2019.05.001
  5. Baron, K. G., Abbott, S., Jao, N., Manalo, N., & Mullen, R. (2017). Orthosomnia: Are Some Patients Taking the Quantified Self Too Far?. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 13(2), 351–354.

Can sleep influence your body weight?

By Rob Hobson

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.

Key nutrients every man should include in their diet

By Rob Hobson

Diet and men

Regardless of what sex you are it’s been shown time and again that diet and lifestyle choices have a significant impact on your health and reduce the risk of disease.  Men and women share similar risk factors for ill health and weight is a concern for everyone, but some conditions are more sex-specific and for men this includes certain cancers and prostate health.

Men can improve their health by eating a balanced diet overall but some nutrients may be worth focusing on to improve certain aspects of men’s health.

 

Fibre

Dietary fibre is a term that is used for plant-based carbohydrates but unlike other carbohydrates (such as sugars and starch) they are not easily digested in the small intestine and end up reaching the large intestine or colon. Fibre helps to aid digestion and has also been shown to help reduce the risk of heart disease and colorectal cancer (1).

Why is it important for men?

  • This nutrient is often overlooked in the diet, but it actually has a huge number of proven health benefits.
  • According to the UK National Diet and Nutrition Survey (NDNS) only 13% of men meet the recommended 30g of fibre per day (2).
  • A high fibre diet has been shown to help protect against heart disease – fibre can help to reduce LDL cholesterol which is a risk factor for the condition (3).
  • Findings from the World Cancer Research Fund (WCRF) have shown that there is strong evidence that consuming foods containing dietary fibre (wholegrains in particular) decreases the risk of colorectal cancer which is a leading cause of premature death in men over 50 (1).
  • Fibre adds bulk to the diet and can help to retain fullness between meals which may help with weight loss.
  • Fibre helps to aid digestion and maintain a healthy microbiota (certain fibres in foods such as bananas, artichokes, asparagus, onions and garlic act as prebiotics which help gut bacteria to flourish).

What foods are rich in this nutrient?

  • The richest sources of dietary fibre are found in beans, pulses and lentils – a serving of these foods can offer as much as 1/3 of your recommended daily intake.
  • Wholegrains such a oats, brown rice and bran cereals are also a great source of fibre as are fruits (fresh and dried), vegetables, nuts and seeds.
  • Some foods contain certain fibres that can help to lower cholesterol such as oats (beta glucan) and fruits such as apples, grapes and berries (pectin).

How can you include more of this nutrient in your diet?

  • Start by eating more fruits (fresh and dried) and vegetables. This includes snacking so try keeping chopped fruit and vegetables in the fridge which can be eaten alone or with a dip.
  • Leave the skin on fruits and vegetables.
  • Add beans, pulses and lentils to dishes such as one-pot meals (stews, soups, curries and casseroles) and salads – these foods can also be used to make high-fibre dips such as hummus.
  • Switch from white starchy foods to brown – this includes bread, pasta, rice and breakfast cereals.
  • Keep nuts and seeds to hand as they can be eaten as a high-fibre snack or used to top an endless number of dishes including yoghurt, salads and stir-fries. Keep them in small jars on your worktop so you remember to use them.

 

Omega 3

These essential fats have to be obtained from the diet as the body cannot make them.  Omega 3 fats include EPA and DHA from oily fish and ALA found in plants. These fats are integral to cell membranes and provide a starting point for hormones that regulate blood clotting, contraction and relaxation of artery walls as well as reducing inflammation in the body.

Why is it important for men?

  • Very few adults including men eat oily fish on a regular basis (current advice is one serving per week).
  • There has been a lot of research surrounding the consumption of oily fish (rich in omega 3 fatty acids) and heart disease which is the leading cause of premature death in men. It has been shown that omega 3 fatty acids may help to improve risk factors for heart disease in several ways which includes:
    • Reducing triglycerides in the blood (4)
    • Reducing blood pressure levels in people with high blood pressure (4)
    • Increasing HDL (good) cholesterol (5)
    • Preventing harmful blood clots (omega 3 keeps blood platelets from clumping together) (6)
    • Reducing inflammation in the body (7)
  • Mental health is a major health concern for men and suicide has been shown to be a leading cause of death in men under 35 – depression is a common mental health disorder (8). Research has suggested that people who consume more omega 3 regularly are less likely to be depressed.  It has also been shown that when people with depression start taking omega 3 supplements their symptoms improve although this doesn’t mean it will cure the condition in all cases (9).
  • Research published in the journal JAMA Open Network has suggested that omega 3 supplements may be associated with higher semen volume and total sperm count which may be relevant to men trying to conceive (although these findings need to be confirmed with more thorough clinical trials) (10).

What foods are rich in this nutrient?

  • The richest source of omega 3 fatty acids are found in oily fish. This includes fresh salmon, trout, herring, pilchards, sardines, sprats and mackerel. Some canned fish are also rich in omega 3 and this includes salmon, pilchards and sardines.
  • Plant sources of omega 3 include nuts (especially walnuts), seeds, seed oils (especially chia and flax), tofu, edamame (soya) beans, avocado and whole wheat bread. These are not the best source of omega 3 the type of fatty acid (ALA) found in them is converted poorly in the body to the more usable EPA and DHA.

How can you include more of this nutrient in your diet?

  • Try grilling salmon, trout or mackerel and serving with a wholegrain and vegetables. Look out for interesting ways to flavour fish such as spices, marinades and salsa.  These fish work really well with fruity salsa’s made from ingredients such as papaya, mango, lime, avocado, coriander and chilli.
  • Try smoked salmon and scrambled egg for breakfast or as a light meal.
  • Pates are. Good way to get ore omega 3 and you can make these from smoked mackerel or canned fish such as salmon.
  • Keep seeds and nuts to hand to sprinkle over foods.
  • A good fish pie or pasta sauce is a great way to add more oily fish to your diet. Kedgeree is good too and a nice way to use smoked mackerel.  Fish curries also work well, and the strong flavours are good with oily fish such as salmon and trout.
  • Consider a supplement – vegan supplements are also available.

 

Zinc

Zinc has many roles in the body which include making new cells and enzymes, processing carbohydrates/fats/proteins in food and also helping wounds to heal.

Why is it important for men?

  • Zinc helps to support normal testosterone levels in men. Low levels of testosterone can result in low libido, fatigue, loss of muscle mass and in some cases erectile dysfunction.
  • Zinc is important for all male reproductive health and this includes the health of their prostate. Problems with prostate health may occur in men beyond the age of 50 and prostate enlargement (BPH)can causes symptoms such as frequent urination, weak urine stream and difficulty urinating – this can also have an impact on your pattern of sleep. Zinc may help to reduce the risk of developing enlarged prostate and reduce its size in those who have enlarged prostate (11).
  • Zinc is vital for male fertility as it is involved in making male sex hormones and sperm is thought to contain high levels of this mineral.
  • Zinc is important for the synthesis of protein and is also required to make the protein found in har called keratin. A healthy hairline is a concern for any men and while zinc may not slow down baldness it will ensure what you have is strong and healthy.

What foods are rich in this nutrient?

  • Food rich in zinc include beef, chicken (dark meat), tofu, nuts, seeds, lentils, low-fat yoghurt, oats, mushrooms, seafood, eggs, cheese, wholegrains and pulses.

How can you include more of this nutrient in your diet?

  • Keep nuts and seeds to hand so you remember to sprinkle them over dishes such as salads, porridge and yoghurt – well anything really!
  • Go plant-based a couple of times each week – Many plant-based foods are high in zinc and especially the ones that form the base for dishes such as lentils, beans, pulses and wholegrains.
  • Include a couple of servings of seafood in your diet each week as these foods are a good source of zinc – while oysters are the richest source, they are not high on everyone’s shopping list so try prawns, cram, clams and lobster.
  • Ditch breakfast cereal in favour of foods such as porridge, yoghurt, eggs and wholegrain toast which are all loaded with zinc.
  • Consider either a multivitamin and mineral supplement or zinc supplement.

 

Lycopene

Lycopene is a powerful antioxidant found in red or pink fruits and vegetables.  As an antioxidant it helps to reduce inflammation in the body and reduce the damage caused by excess free radicals.  Research has suggested that lycopene may play a role in protecting the body against heart disease, certain types of cancer and may even help protect against sun damage according to some studies.

Why is it important for men?

  • The World Cancer Research Fund has previously shown that lycopene probably helps to reduce the risk of prostate cancer in men. The latest report is not as convincing as no evidence could be drawn to show either way. Despite this, it is probably a good idea for men to still include lycopene rich foods as part of a healthy balanced diet (12).
  • Lycopene may also help to slow down the progression of enlarged prostate (BPH) in men (13).

What foods are rich in this nutrient?

  • The richest source of lycopene can be found in tomatoes and the more processed they are the greater the content of lycopene – tomato sauces, sundried tomatoes, tomato puree, canned chopped tomatoes.
  • You can also find lycopene in foods such as watermelon, guava, papaya, pink grapefruit and red peppers (cooked is best).

How can you include more of this nutrient in your diet?

  • Try to add a daily serving of tomatoes to your diet. Roasted tomatoes work well with scrambled egg, tropical fruits are great for breakfast and you can add chopped tomatoes to many dishes including sauces, curries and stews.
  • Sundried tomatoes make for a delicious snack or can be chopped into salads – great in the summer with mozzarella, sliced tomatoes and basil.
  • Consider taking a lycopene supplement.

 

Potassium

Potassium is a mineral that helps control the balance of fluids in the body, and also helps the heart muscle work properly.

Why is it important for men?

  • Potassium is required for fluid balance in the body which is associated with blood pressure. Blood pressure is a serious health problem which increases the risk of stroke – leading cause of premature death in men. 
  • Findings from the UK National Diet and Nutrition Survey (NDNS) have shown that average intakes of potassium in men are below the RNI – mean as a percentage of RNI is just 82% (2)
  • Further findings from the NDNS show that 11% of men have intakes below the lower reference nutrient intake which means they are simply not getting enough (2).

What foods are rich in this nutrient?

  • Foods highest in potassium include bananas, spinach, kale, beetroot, salmon, beans, pulses, lentils, avocado, potatoes, melon (all varieties), squash, courgette, low fat yoghurt, mushrooms, kiwi fruit, tomatoes.

How can you include more of this nutrient in your diet? 

  • Start by simply eating more vegetables on a daily basis. Vegetables are the richest source of potassium and one of the reasons intakes are low is because less than a third of men manage to eat 5-a-day.
  • Focus on including foods which are particularly rich in potassium. Try chopped banana on low fat yoghurt for breakfast or roast salmon with steamed green vegetables and boiled new potatoes for dinner.
  • Go plant based a few times each week. This will ensure you are eating more plant-foods rich in potassium.
  • Consider taking a multivitamin and mineral supplement.

References

  1. Diet, Nutrition, physical activity and colorectal cancer. World Cancer Research Fund (2018).
  2. National Diet and Nutrition Survey (2018)
  3. Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr. 1999;69(1):30-42.
  4. Cazzola R, Russo-Volpe S, Miles EA, et al. Age- and dose-dependent effects of an eicosapentaenoic acid-rich oil on cardiovascular risk factors in healthy male subjects. Atherosclerosis. 2007;193(1):159-167.
  5. Eslick GD, Howe PR, Smith C, Priest R, Bensoussan A. Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis. Int J Cardiol. 2009;136(1):4-16.
  6. Marchioli R, Barzi F, Bomba E, et al. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI)-Prevenzione. Circulation. 2002;105(16):1897-1903.
  7. Kiecolt-Glaser JK, Belury MA, Andridge R, Malarkey WB, Glaser R. Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial. Brain Behav Immun. 2011;25(8):1725-1734.
  8. Suicides in Great Britian. Office for National Statistics (2016). https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2016registration
  9. Burhani MD, Rasenick MM. Fish oil and depression: The skinny on fats. J Integr Neurosci. 2017;16(s1):S115-S124. doi:10.3233/JIN-170072
  10. Salas-Huetos A. More Evidence of the Association of Diet With Human Testicular Function—Fish Oil Supplements. JAMA Netw Open.2020;3(1):e1919569
  11. Christudoss P, Selvakumar R, Fleming JJ, Gopalakrishnan G. Zinc status of patients with benign prostatic hyperplasia and prostate carcinoma. Indian J Urol. 2011;27(1):14-18.
  12. Diet, Nutrition, physical activity and prostate cancer. World Cancer Research Fund (2018).
  13. Schwarz S, Obermüller-Jevic UC, Hellmis E, Koch W, Jacobi G, Biesalski HK. Lycopene inhibits disease progression in patients with benign prostate hyperplasia.J Nutr. 2008;138(1):49-53.

What are the health benefits of herbs and spices?

By Rob Hobson

What is a herb and spice?

The definition of a spice is an aromatic part of a tropical plant, whether that is a root, bark, flower or seed and except for vanilla, chilli and allspice, nearly all of them are of Asian origin. Dried herbs are fresh herbs that have been dried to preserve them for storage and to concentrate their flavour.

Dried herbs and spices are used to flavour dishes but they also possess some interesting health benefits including anti-inflammatory, anti-bacterial and antioxidant properties.

 

Ginger

This pungent root is native to Southeastern Asian countries including China, India and Nepal and has citrus notes and a peppery flavour.

 Ginger has been shown to help quell nausea associated with morning sickness, chemotherapy and sea sickness. Ginger has also been shown to help reduce inflammation in the body with one study suggesting commonalities with aspirin or ibuprofen for pain treatment in those with osteoarthritis.

 

Turmeric 

Turmeric is native to Southern India and Indonesia and it features frequently in their local cuisine. This spice contains a compound called curcumin which acts as a powerful anti-inflammatory in the body and research has drawn similarities to the effects of ibuprofen for pain relief in those with joint conditions. Reducing inflammation is important as it is considered to contribute to the development of almost every chronic Western disease.

 

Cinnamon

The spice is sometimes called Ceylon cinnamon as this is the bushy evergreen tree it originates from which is native to Sri Lanka, India and Burma.

The active compound in cinnamon is called cinnamaldehyde which may help to fight bacterial infections in the body. Cinnamon has been shown to help reduce blood sugar levels by slowing the breakdown of carbohydrates in the digestive tract and improving insulin sensitivity.

 

Sage

This herb is a member of the mint family and is commonly used to flavour savoury dishes albeit in small amounts given its pungent aroma.

Sage is a rich source of vitamin K which is used by the body to help with blood clotting. This herb is also rich in over one hundred polyphenol compounds that act as antioxidants in the body. Sage is recommended to help treat symptoms of the menopause as it contains phytoestrogens which act in a similar way as human oestrogen but with less effect.

Basil

This aromatic herb originated in India and other tropical regions spanning Africa to Southeast Asia. Today the largest producers of basil are centred around the Mediterranean especially Italy.

Basil contains the antioxidants beta carotene and anthocyanins which can help to protect cells in the body from oxidative stress considered to increase the risk of many diseases. Other research is thin on the ground but has suggested other health benefits including the reduction of high blood pressure.

Thyme

This herb originates from Southern Europe and the western Mediterranean and has a floral scent and peppery taste. The Egyptians used thyme as part of the embalming process while the Greeks used it as incense in their temples.

Thyme is believed to have antimicrobial properties which are due to a class of compounds called biocides including thymol. Studies have suggested that this compound may help to reduce bacterial resistance to drugs such as penicillin. Thyme tinctures has also been researched as an effective way to help treat the skin condition acne.

 

Rosemary

This herb is native to the Mediterranean and is a member of the mint family. The pungent and slightly bitter taste of rosemary has made it a common addition to savoury mint dishes especially those involving lamb.

In its dried form Rosemary is a source of iron which can make it a useful addition to the diet of those at risk of anaemia which is more common in women than men. Rosemary is often used in alternative medicine as a way of treating indigestion and its essential oil may help to improve concentration and mood according to research.

 

Mint

This herb is native to North America, South Africa and Australia and some of the most common varieties include peppermint.

Research has suggested that mint (peppermint oil) may help with the management of IBS by relaxing the muscles of the small colon relieving pain during bowel movements. Mint also helps to relieve bloating by relaxing muscles that link to the stomach to the oesophagus allowing trapped air to be expelled.

Adding plenty of herbs and spices to your cooking is not only a delicious way to add flavour to the dishes you prepare but may hold a vital key to helping promote your long-term health.

Men and disordered eating

By Rob Hobson

I am not the kind of person who divulges or dwells too much on the past, but my sister posted this picture on my birthday. It drummed up a few memories about my eating habits at the time.

As you can tell by the picture, I clearly wasn’t eating well, but it was never addressed even though I looked terribly thin. I wouldn’t use the word anorexic as it was a phase that lasted just a couple of years, but when I think back, I had all the traits of an eating disorder.

I remember being obsessed with what I was eating while exercising a lot. I became infatuated with counting calories which I jotted down every day on scraps of paper, intending to consume no more than 800 calories a day. I knew the calories of many foods off by heart and could adjust them in my head for the serving size. Embarrassingly, I followed the diet plans found on the back pages of one of the Sunday paper magazines aimed at helping women to lose weight.

My meals consisted of banana sandwiches, cuppa soups, canned tuna, and tiny portions of pasta. I visited my local gym many times a week to do circuit training and aerobics (yes, can you imagine that one!). I also had weights in the shed that I used daily.

As I said earlier, no one really said a thing even though I looked the way I did and it was probably put down to being a skinny teen. I was 15, which would have been in the early ’90s and there was a lot of stuff going on for me at that age as my mum was very ill with cancer, but I was never told what was going on. I was also really struggling at school as I was gay, and it was clearly apparent, which resulted in a long period of bullying. Family life was also chaotic with lots of arguing and a brother who nowadays would have been diagnosed with ADHD.

Psychology is very twisted when you are in this state of mind. I didn’t want to be thin, but I thought I was being healthy. I also wanted to get ‘muscly’ as I was naturally thin but clearly had no idea what I was doing! I think the problem is that it is so easy to take things to the extreme especially when there is a lot of stuff going on around you and you don’t feel confident in your own skin.

I got a buzz from controlling my diet and exercising like a madman. Still, I needed to get grounded somehow and in control and given everything that was going on around me focusing on food and exercise was a way of doing this.

So, what is the point of this blog?

I have been doing lots of stuff around men’s health lately, and I think current society is tricky for young boys to navigate. In the same way women have always had to battle with how the ‘perfect’ body has been portrayed; I think young men are now becoming more exposed to the same type of thing in the media. This isn’t the reason for disordered eating but it can contribute to the issue.

As young girls grew up with barbie dolls and impossibly thin wasted female cartoon characters, boys grew up with muscley characters and action figures. The skinny characters are always seen as weaker and somewhat nerdy. Social media is also riddled with incredible-looking men with a body that is impossible to achieve for most boys. Alongside this, they all seem to lead an extraordinary life on Instagram and if you are feeling insecure about how you look you will attribute this all to how they look.

While many campaigns have helped women to accept, embrace and celebrate their size and shape I am not sure the same thing would be as affective for very slim men. There is quite a lot of stigma around very slim men which is bred from both men and women viewing them as less masculine, weak or less attractive than the macho man. I guess the same could also be said for larger men who I think may not be seen as sexy as the fuller figured woman – although this is just conjecture on my part so please don’t start laying in to me on that one.

One of the most common questions I get asked by men is “how can I bulk up” as they see this as more desirable, and let’s face it, other men and women find a sporty muscle bound body shape to be more attractive.

I got skinny, but many men fall into an unhealthy trap of bigorexia as they become obsessed with getting bulky, spending hours in the gym, and panicking when they can’t seek food or a protein shake every couple of hours.

I have seen and heard from young athletes (mostly endurance sports) who become obsessed with their weight, which can be to the detriment of their performance as they lack the energy and food required to help them train, recover and support a healthy immune system. This can also affect their mental health which is closely linked to performance. Interestingly, they too have become obsessed with food and training to become fitter and perform better rather than being thin but one thing leads to another and it starts to become an issue.

This period for me lasted a year or so and then I started to improve my eating habits and focusing less on food which may have been due to a change in environment and situation. I am still conscious about what I eat and thrive on being fit but it is no longer all consuming and certainly not an issue for me anymore as a 15 stone fitness junkie.

My training as a nutritionist and now sports nutritionist alongside all my experience in this field has given me the knowledge I wish I had when trying to be healthy as a youngster. I love delivering the right science-based advice to clients to help them improve their health in a sensible and sustainable way while also helping them to cut through the ‘noise’ that dominates the health media such as faddy diets and so on. I also hope that my experience of this puts me in a position to speak out and help guys struggling with disordered eating to seek help.

I’m not an expert in this field which relies on the expertise of psychologists and dietitians trained in the topic. I think disordered eating is still a topic considered to be a female issue and something many males may be embarrassed to seek help for as they feel it makes them look weak or less macho.

Unfortunately, I think there are many young boys and men who fall into the trap of disordered eating. There are obviously many reasons why this might happen but the one I am most familiar with in males is trying to improve the way they look or get fitter which alongside low self-esteem and other mental health issues gets taken to the extreme and becomes a problem.

Considering this, I think it’s an issue that should get a little more airtime. Hence, boys feel more comfortable speaking up when they think they are losing control. Even though the stereotype of disordered eating suggests it only occurs in women, one in three people struggling with an eating disorder is male. Subclinical disordered eating behaviours such as binging, purging, fasting for weight loss, and laxative abuse are almost as common in men as in women.

The roots of disordered eating usually lie in deeper embedded problems that can impact men’s mental health and wellbeing. The boys and men I have worked with over the years who are desperate to ‘bulk up’ are often really affected by how they view themselves physically, which affects their self-esteem and confidence.

I guess I just wanted to vent a little bit on the topic. I know it might seem weird as a nutritionist sharing this post but it is a topic I experienced and have often asked myself ‘why did no one recognise that it was a bit of a problem at the time?”. I think there are many issues for men that are still difficult to approach and ‘manning up’ is definitely not the answer.

If you need information or support on eating disorders then go to the Beat website.

What I have learned as a freelance nutritionist

What I have learned as a freelance nutritionist

By Rob Hobson

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.

Training and competing during Ramadan

By Rob Hobson

Ramadan

I have recently been working with an Para athlete with a spinal cord injury to help with training and competition.

There are lots of consideration to be made in such athletes but one I never fully considered was training and competing during ramadan.

This fact sheet should provide a little insight into how athletes can maintain their training and competition performance while fasting.

 

Why did healthy eating get so complicated?

Why did healthy eating get so complicated?

By Rob Hobson

Why has eating well become such as minefield?

Healthy eating has become a tricky little fellow over the years, but the basic messaging has not changed over the last few decades.  Eat more fruit and vegetables, choose wholegrain foods, choose low fat dairy foods, eat oily fish and opt for lean proteins are a few of the key messages.

Alongside this we are advised to eat less sugar and processed foods while also paying attention to the portion size of foods we choose to eat.  If you stick by these basic concepts, then you are likely to be eating in a way that will benefit your health and reduce the risk of disease.

“Only 30% of adults in the UK eat 5-a-day and only 4% of women and 9% of men achieve the recommended 30g of fibre daily according the NDNS survey”

Despite this simple messaging the majority of the population still don’t manage to eat a healthy balanced diet and are confused about what to eat.  There are also many other factors which influence food choice such as those relating to society, lifestyle, psychology, environment, food access and finances.

How has the food industry and modern culture impacted on food choice?

These basic healthy eating messages have been around long enough for most people to understand what a healthy plate of food looks like while also recognising that a piece of fruit or yoghurt is a better option than a mars bar if you fancy a snack. However, the way food is marketed and how health is interpreted in the media have likely caused some confusion.

The obesogenic environment

The obesogenic environment does not make it easy for people to make healthy food choices.  This concept was fist coined in the 1990’s as a hypothesis to help explain the obesity pandemic.

“The obesogenic environment is defined by the influence that the surroundings, opportunities or conditions have on promoting obesity on individuals or populations”

In 2007 the Government’s Foresight report was published and one of the highlights was the monumentally complex obesity system map. This map illustrates the many factors that contribute to energy balance including psychology, food production, food consumption, physiology, physical activity and physical activity environments (1).

Fast food

Yes, the crux of weight gain is eating less and moving more but you only have to take a look at this diagram to appreciate the many complexities involved in order for people to achieve this ideal (see below).

Foresight report

The complexities of this diagram highlight the fact that we all need to work together to help improve the health of the nation.  While the food industry has become much more transparent in their marketing of foods which is driven by legislation around health claims and food labelling,  supermarkets and other high street outlets are still offering promotions on unhealthy foods more than they are healthy food options.

How have our eating patterns and habits changed?

Modern eating habits have changed and one the most significant is our penchant for snacking.  In part this has been driven by the food industry and an ever-growing number of snacks made available to us.  Many of these snacks are marketed as being healthy or having a health benefit which implies, they should be a part of our daily diet.

“More than two thirds of people snack at least once a day according to Mintel who also predict that snacking will become more pertinent post COVID-19″

However, the reality is that snacking is only beneficial when we need more energy throughout the day to match our requirements.  Outside of this they are simply an opportunity to eat more than we need.

Snacking has also been driven by working hours and lifestyle. Both these factors can influence our ability to eat at set hours across the day and can also result in longer periods of time between meals.  In such instances, healthy snacking may prove useful to maintaining energy levels and overall nutritional intake.

How has the media influenced eating habits and perceptions of nutrition?

The growing interest in nutrition over the last couple of decades has led to an increase in scientific reporting in the media.  Over this time period we have also seen countless books on the topic which include those offering many different ways to lose weight as well as those questioning traditional thinking around nutrition.

In combination these two factors have contributed to skewing basic health messaging and a good example is the way in which dairy and gluten-free eating is now considered by many to be a healthier way to eat when in fact they should still be considered special diets reserved for those with food intolerances or conditions such as coeliac disease.

“Only 5% of the UK population are thought to suffer any degree of lactose maldigestion and 1% are thought to suffer with coeliac disease.  It has been estimated that 1-2% have a diagnosed food allergy”

This is not really a major problem as there is no real harm in omitting these foods as long as you understand how to adjust your diet to make up for any nutritional shortfalls.

The bigger issue is that in light of this foods have started to become labelled as ‘bad’ for us when in fact they are still healthy components of a balanced diet.

Media reporting of new research is often misleading as there is usually a bias towards positive findings.  However, on closer inspection the results are often confounded by various limitations of the research which might include sample size or the type of study and its strength (clinical trials are more reliable that rat studies).

Then there is the fact that the journalist has simply not understood or inaccurately reported the findings (although to be fair many experienced health journalists will take their lead from experts in the field).  I love to read the ‘Behind the Headlines’ section of NHS website (2) which brilliantly discusses some of the more popular scientific findings reported in the press.

What about social media?

Unlike other areas of health, people are surprisingly willing to take dietary advice from unqualified influencers or personal trainers with a hot bod and large social media following.

A survey carried out in 2017 on behalf of the British Dietetic Society showed that 58% of people would trust diet and nutrition advice given to them by their personal trainer or fitness instructor. Amongst young people, 41% said they would trust the advice given out by a healthy eating blogger which highlights the importance for more qualified professionals to have a greater voice on social media platforms (3).

“The UK public do not know who to trust for dietary advice according to research carried out by the British Dietetic Association“

Celebrities are also highly influential when it comes to food choice and as such, they are frequently used to support the sale of supplements and diet regimes.

Supplement celeb

These people may know a little about nutrition but where the expert excels is in taking a science-based approach to their practice which means they don’t offer advice based on personal experience or opinions. Why would you take advice from someone not qualified to do so? Would you let your PT take a tooth out?  Probably not.

Got a dodgy gut?  Bloated? Constipated? Someone unqualified told you to eat lots of fibre?  Let’s see how that pans out if what you actually have is IBS or even worse coeliac disease. Trying to lose weight?  Someone told you to cut out carbs and eat a shed load of fat in your diet?  Did they ask you if you had a family history of heart disease or whether you were aware of your cholesterol levels? You get my drift.

What about the trailblazers?

These are the guys who set out to challenge traditional thinking around nutrition.  Books and articles that attempt to question traditional thinking around nutrition can often cause a lot of confusion. I personally find this literature massively interesting, but I am qualified enough to read with a degree of objectivity and an understanding of the science.

Often these books are biased in favour of their topic and without this training and experience in nutrition and research it’s really easy to believe everything you read without question.  Also, if you read too many of these books, they can start to become a little contradictory making it tricky to see the woods for the trees.

Scales

A good example here is the debate around saturated fat in the diet which was sparked by findings of a landmark study in 2014 which found no significant evidence that saturated fat increased the risk of heart disease (4).

The study caused a lot of controversy amongst leading researchers in the field of nutrition who questioned the data analysis. Subsequently a report in 2019 by the Scientific Advisory Committee on Nutrition (SACN) found no reason to change the current advice around saturated fat intake (5).

In the meantime, messaging around saturated fat and fat in general became confused which potentially left many people thinking it was OK to eat lots of saturated fat in their diet. The problem with this type of reporting in the media is that the findings are open to interpretation by the public which can prove detrimental to their health. The other issue with this type of reporting is that people take the initial findings on board pretty quickly which makes it more difficult to reset the message.

As far as this research was concerned. Wholefoods high in saturated fat include full fat dairy and fatty cuts of meat which can form part of a healthy balanced diet but should still be eaten in moderation given their high energy content which can contribute to weight gain (a risk factor for heart disease).

However, other sources of saturated fat include convenience foods often loaded with salt and sugar which in themselves can increase the risk of heart disease. Also, eating lots of red meat and processed meat (often high in saturated fat) is not a healthy option given their association with the increased risk of colorectal cancer.

What about superfoods?

The term ‘superfoods’ was thought up in the nineties.  A handful of people are said to have coined the term including the alternative medical practitioner Michael Van Straten who wrote a book called superfoods.  The idea behind the term is that certain foods have a higher nutritional value deeming them more beneficial for health and well-being.  However, the term has little significance when talking about overall diet.

“There is no official definition of a superfood and the EU has banned the use of the word on product packaging unless the claim is backed up by convincing research”

This term also highlights the attention placed on individual foods in the media based on their supposed ability to prevent disease.  Research into the effects of individual foods on health are very tricky to carry out.  Our diets are hugely complex and it’s difficult to entangle the effect of one particular food or compound from all the others we consume.

Superfoods

Much of this research is carried out in a lab or on animals which can’t be translated to humans.  Often this type of research also involves a very concentrated amount of a compound or large amount of food in a form which is not viably consumed as a whole food in reality.  A good example is the research surrounding beetroot and blood pressure which has used both supplements and juices which represent a huge amount more than an 80g serving of the whole vegetable (6).

Blueberries

While this research is interesting it has to be taken with a pinch of salt.  While blueberries may have been shown to reduce the risk of cancer it doesn’t mean eating a bowl everyday will prevent you from getting cancer.  Besides the fact that the research is not strong enough to prove cause and effect there are many other dietary and lifestyle factors that contribute to an increased risk of the disease.

Can food really heal? 

The food you eat provides you with macronutrients which are used for energy (carbohydrates and fats) and the growth and repair of tissues in the body (protein).  We also glean micronutrients (vitamins and minerals) from foods which are needed for all bodily processes.

If we don’t get enough of any of these nutrients in our diet, then there may be health consequences such as a lack of iron which can cause anaemia.  In terms of healing then these deficiencies and the symptoms that come with them can be corrected by eating more of the foods which contain one or another nutrient in question.

In some cases, certain foods have been shown to be beneficial for specific health conditions.  A good example is high cholesterol which can benefit from increasing the amount of fibre in the diet as well as other specific foods such as oats (7).

So, what’s the take home message?

The thing to remember here is that nutritional science is relatively new and as such ever evolving so what you read at one point in time could be completely different at another.

People love the idea of a quick fix or miracle cure, but the reality is that there is no such thing when it comes to health. Diet has a hugely significant role to play in the prevention of disease and overall health but it’s the balance, moderation and consistency of our diet overall that has the greatest impact.

Getting back to the basics of healthy eating is your best bet and it also helps you to find a baseline which is a useful starting point for nutritionists and dietitians how may adapt you diet to help with a diet-related condition.

References

  1. https://www.gov.uk/government/publications/reducing-obesity-future-choices
  2. https://www.nhs.uk/news/
  3. https://www.bda.uk.com/resource/survey-finds-that-almost-60-of-people-trust-nutrition-
  4. https://www.acpjournals.org/doi/10.7326/M13-1788
  5. https://www.gov.uk/government/publications/saturated-fats-and-health-sacn-report
  6. https://www.ahajournals.org/journal/hyp
  7. https://www.frontiersin.org/articles/10.3389/fnut.2019.00171/full
The basics of plant-based eating to get you through Veganuary

The basics of plant-based eating to get you through Veganuary

By Rob Hobson

Veganuary is a charity campaign encouraging people to try being vegan for January and, if possible, throughout the rest of the year.  Last year (2019) saw the greatest number of people involved in the Veganuary campaign as over 250K from 190 countries embarked on the month-long pledge.

What were the key findings from last year’s Veganuary campaign?

  • For the first time since the campaign began, health became the main driver (46%).
  • 34% of participants stated animal welfare and 12% environmental concerns as drivers for involvement in the campaign.
  • Most participants were women (87%).
  • The majority of participants were aged between 25 and 34 years old (28%).
  • 47% said they plan to remain vegan after Veganuary.
  • 77% said that while not planning to remain vegan after the campaign, they will try vegan again in the future.

How can you make a smooth transition to veganism?

Findings from last years Veganuary campaign showed that 60% found the challenge easier than anticipated.  The rise of vegan food on the high street (including both take-out and restaurant options) as well as the wide range of meat-free alternatives and snacks now available is likely to have helped many people switch to eating plant-based.

Cooking from scratch is always going to be a healthier option and while this may seem daunting it’s not difficult to ‘veganise’ many of your favourite home-cooked meals using these alternatives.

Seek out your preferred dairy alternative

Oat and soya milk have a richness which is similar to cow’s milk while those made from nuts, seeds and rice tend to be waterier.  Each alternative has its own unique flavour and out of all of them, soya has the highest amount of protein which may be an important factor for some people.

What you choose is a matter of personal preference so try all of them to see which one you prefer but always look for fortified varieties to help maintain good intakes of calcium and vitamin B12.

Soya is a good alternative to dairy yoghurt.  Other options include coconut milk and nut varieties including cashew, but they do come with a higher price tag.

Meat alternatives

There are a number of meat alternatives to choose from which include tofu and tempeh (made from soya), seitan (made from wheat gluten) and Quorn.  These foods are all high in protein and also contain a variety of other nutrients including magnesium, iron, zinc and calcium.

These options are available in many forms including mince, pieces and shredded which can be used to replace minced beef, chicken, pork and duck in many common home-cooked dishes.

You can find marinated varieties of tofu which are easier to use for beginners.  Tofu can also be scrambled as a good alternative to egg for breakfast.

Other interesting alternatives include jackfruit, palm hearts and banana blossom which have been used to emulate the look and texture of dishes such as pulled pork, scallops and breaded or battered fish.  While these options make a convincing alternative, they do lack the same protein content.

Fruits and vegetables

It sounds counter-intuitive to talk about fruit and vegetable consumption given the nature of a vegan diet but given only 30% of the population eat five-a-day (1), it’s worth flagging up for those going vegan for January.

This groups of foods are a key source of vitamins, minerals and phytonutrients that help to protect the body from disease.  Including above and beyond five daily servings is important on a vegan diet to glean as many of these nutrients as possible.

Given the availability of vegan processed and ready-made meal options as well as the rise in vegan ‘junk’ food it is easy to exist on this type of diet without eating enough vegetables.

Keep it in mind to always add more vegetables to the dishes you cook.  You can boost your intake with smoothies and dishes such as soups, casseroles, stews and stir-fry’s which can be bulked out with plenty of vegetables.   Varieties such as spinach and peas are really easy to throw into many dishes.

Explore different flavours

The absolute key to great tasting vegan dishes lies in the spices and marinades used to make them. Meat alternatives, beans, pulses and grains can be a little bland so make use of dried spices and spice blends, sauces (e.g. cook-in sauces, soy sauce, sriracha, harissa), fresh herbs, flavoured oils and dried fruit to add flavour.

You can create a strong savoury flavour (umami) by incorporating ingredients such as nutritional yeast, mushrooms (especially dried made into a stock), seaweed, miso paste, tomato puree, sundried tomatoes, soy sauce and nuts into dishes.   Vegetables such as onions, garlic, beetroot, asparagus and tomatoes also help to create umami which is often enhanced when they’re cooked.

Shop-bought dressings are great, but you should explore recipes from cookbooks and on the web for homemade options which are bursting with flavour and include additional ingredients such as tahini, miso, citrus juices, pomegranate molasses and umeboshi paste.

Don’t be put-off by unusual ingredients that seem a bit ‘fancy’ as they are all now widely available  in supermarkets and not too expensive.  Many of these ingredients keep for a while and dressings can be made in bulk and kept in the fridge.

Beans, pulses and lentils

No vegan diet is complete without these highly nutritious ingredients which supply protein, fibre, magnesium, iron, zinc and calcium.

This group of foods are available canned or in ambient packs which is more convenient than soaking overnight and then boiling to cook. They’re really versatile and can be used to make vegan dishes such chilli, curries, soups, stews and salads to bulk them out and increase their nutrient content.  Chickpeas and soya beans make a good snack when roasted with spices.

Grains

All grains are vegan and can be used as a base for many dishes.  These foods are a useful source of protein as well as zinc, magnesium and B vits.  Grains such as rice, barley and spelt as well as pseudo-grains such as quinoa can be used to make salads to which you can add anything to and make in bulk to use across the week. You can also add cooked grains to soups or sprinkle over vegetable salads.

Snacks

Some people may find they need to supplement their diet with snacks across the day if they need to eat more food to meet the demands of their lifestyle.

Easy vegan snacks include dips with pitta or chopped veggies,  dried fruit and nut bars, dairy-free yoghurt (topped with nuts, seeds or dried fruits), rice cakes (topped with nut butter, guacamole or mashed banana), edamame beans, nuts, seeds or roasted chickpeas.  Smoothies and shakes are also good and can be made to be high in protein.

Fortified foods and supplements

There’s no reason why you can’t get everything you need on a vegan diet, but it can be tricky to start with for some people.  Seek out fortified varieties of foods, especially those containing vitamin B12 which is difficult to obtain on a vegan diet.Food should always come first but if you’re worried that your diet may not very well balanced then a basic vegan multivitamin and mineral supplement is a cost-effective way to bridge any gaps.  Young children, particularly fussy eaters and also teenage girls are groups that will probably benefit from a supplement especially when going vegan.

It’s not that difficult to switch to a vegan diet once you know what’s available and how to modify your favourite everyday meals.  Don’t rely solely on ready-prepared vegan dishes and stick to the basic principles of healthy eating (it’s just as easy to eat an unhealthy diet when going vegan).

Try and use Veganuary as an opportunity to explore recipes that use ingredients which may be new to you.  This campaign is also a great opportunity for you to commit to new eating habits that can extend beyond January and help you to improve your overall long-term health.

 

Try this simple one week vegan menu plan to kick start your Veganuary.

 

References

  1. https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined

How to cater for vegan guests at Christmas

How to cater for vegan guests at Christmas

By Rob Hobson

Planning Christmas lunch can be a huge operation and even more so if it’s your first time at the helm.  So, what do you do when one of your guests tells you they’re vegan?

If you break down the Christmas lunch table then most dishes are actually plant-based and those that are not can easily be adapted without too much effort.

What do you serve in place of roast turkey?

There are many options that can be cooked alongside the turkey for your vegan guests.  

Vegan roasts made from ingredients such as nuts, seeds, beans, pulses and lentils are a good option and you can find many recipes online.  Look for recipes full of flavour which make the most of dried spices and dried fruits. Stuffed butternut squash is also a really nice option and you can make festive fillings using grains and dried cranberries.

Cooking a vegan roast is always going to be full of the key elements of taste including both flavour and texture.  Another option is a meat-free alternative which are normally made using tofu.  

What about the roast potatoes?

The only consideration here is the type of fat that you choose to cook them in.  Animal fats are often used to roast potatoes at Christmas so be sure to switch to olive or rapeseed oil.  Coconut oil can be used and offers an interesting flavour.  You can also roast with garlic and rosemary for something delicious. 

The key to nice and crispy roast spuds is picking a floury variety and giving them a good shake before you put them in the oven.

What about the vegetables?

All veggies are plant-based so there’s no issue here.  Some vegetable options do contain dairy such as parmesan roasted parsnips or cauliflower cheese.  You can adapt these dishes by using nutritional yeast and fortified plant-based drinks made from soy, nuts and seeds.

What about the gravy, savoury and sweet sauces?

No Christmas lunch is complete without a good gravy.  You can make a good vegan alternative using dried porcini mushrooms which give it a strong ‘umami’ flavour.  

Savoury and sweet sauces that use butter, milk or cream can be made using alternatives made from plant oils, fortified plant drinks, soy, nuts and coconut.

What about the Christmas pudding?

Christmas pudding is not vegan as it contains ingredients such as suet, eggs and honey.  You could make your own vegan alternative but buying one in is much easier.

What about the booze?

This is one thing that non-vegans may not even have ever thought about but not all booze is vegan friendly.  

Some drinks may use isinglass (substance obtained from fish bladders), gelatine, eggs white, seashells and other animal products during the filtering process prior to bottling.  Honey may also be used to sweeten certain drinks so worth keeping an eye out for.

You can check out which brand of alcoholic drink is vegan by using the website Barnivore.

Adapting your Christmas lunch to accommodate vegan guests is really not that difficult once you know where to make the changes.  Many of these changes can be used to feed everyone and will likely go unnoticed by your other guests.  

Of course the other option is start veganuary early and go completely plant-based this Christmas!