Alcohol

Alcohol can be one reason why people fail to achieve their goals so here’s hoping this piece will help you….

Alcohol could be seen to be one of the hardest areas in lifestyle change. but is it?

What does it mean to you? Do you love your drink after work, or when cooking your evening meal? 80% of adults in the UK drink alcohol, so if you do, do you think you should cut it down or out? It is completely up to you and may not be as hard as you think.

I usually tackle all the food issues first and put alcohol safely to one side until it comes up (try to keep to one drink a day, cut it out if your weight loss stalls, look at the lower carbohydrate versions on www.dietdoctor.com)

Recently, a woman told me she was very annoyed she could not stick to 2 drinks a night, despite fully intending to at the beginning of many evenings. I recommended www.soberistas.com which is a super support system for people wanting to give up. It is much more life affirming and less stark than AA, though AA has helped many people and has its’ fans. The trouble with AA is that people perceive it is for alcoholics, whereas this online support group is for people who would like to cut alcohol down or out, and no label is needed for joining or reading.

She came back to me a week later and said she had not only given up, but also felt full of joy at the idea of never drinking again! She had done this following reading Jason Vales book- ‘How to give up drink easily’, as well as talking to people on the Soberistas site.

Have a look and try them both out if you are interested, and let me know your story of success.

Have a great week!

Dr Jo

Fat Friends & Foes

Last week was a very interesting week one with my low carb behavioural change groups. I would encourage any low carb GP or nurse to start one- if you are a GP or nurse reading this, ask to observe one if you want. If you are a patient, tell your GP or nurse about this blog. I have an 8 week plan we work through and you can see it here. You and they will benefit from the economy of scale ( maybe 20 people in an hour rather than 4-6) and we all learn from each other. People come weekly or monthly and can follow the other weeks on the blog as they go.

2 more members who started in May have now reversed their diabetes and are off medication- fabulous!! It is less than 3 months from starting and I will ask them to keep checking their blood glucose from time to time and HbA1c annually to make sure they are on track but they have achieved their goals and are delighted 😃

On a different note I overheard one member tell someone that what I advise was ‘just a high fat diet'(that is an oversimplification and not how it sounds- I will explain why), and another told me he was confused because his cardiology team had told him 3 years ago to follow a low fat diet. This had been after heart surgery, so was clearly very important to address this issue with him. I feel confident about what I mean by healthy fats are so let me explain. I have the back up of secondary care colleagues on this.

One colleague, a cardiologist, tells his patients that a healthy diet is one that consists of

“Oily fish, quality animal and plant proteins, extra virgin olive oil, berries and leafy green veg – YES

Bread, Rice, Potatoes, Added sugars, Biscuits, Cakes, confectionery – No”

This blog is an attempt to help you form a view on which fat foods should be part of a healthy diet.

Food rarely comes as just fat.

There are fat and sugar/starch combinations- like in donuts , cakes, biscuits, chips and crisps- always bad in everyone’s books. We all agree!

There is the fat in meat, chicken and eggs, and some doctors believe this raises your cholesterol. What I say is that rarely happens and you can prove whether it does or not by having a lipid test. If your lipids are normal, you can relax about your intake of natural fats. Cholesterol is a very complicated business and you can read in more detail here.

There are seed oils like sunflower and rapeseed, which are now known to change to trans fats at high temperature, and this is bad. We all agree about trans fats but some doctors do not know that seed oils change to trans fats at high temperatures.

Trans fats are in margarine too and trans fats are bad. Look up trans fats and you will see. We all agree on this too.

Olive oil is not stable at high temperatures, so enjoy it on salads and vegetables. We all agree!

Coconut oil is stable at high temperature so use it in cooking or frying. Some doctors may believe it raises the cholesterol but you can prove that it doesn’t with a simple lipid blood test.

Palm oil- I’m not sure about this so don’t advise it, and it is more of an ingredient in processed foods, than something you buy to cook with.

Nut oils – use these in dressings but not in cooking, as they are not stable at high temperatures.

Salmon, avocados, olives and nuts – we all agree that the natural fats in these foods are part of a healthy diet. Just don’t overdo nuts as it is easy to do so, and they can contain a lot of carbs too. Avoid peanuts and cashews.

Now the other question- is the way of eating I advocate a high fat diet?

It depends on if you are overweight or not..

Some people in my groups are not overweight, and for them the natural fats in foods are a source of energy, fat soluble vitamins and essential fatty acids which are needed for bodily and mental health.

Most people start my groups overweight and for them I say…

Your stored body fat is a source of energy, and if you plan to use it all that is where most of your fat will come from, so in that sense it is a high fat diet, but you don’t need to eat a lot because you already have it in you. 3500 calories per pound, it is said. This stored energy is what you use up when you want to lose weight. You are using this stored body fat as energy, so your diet is always high in fat- from YOU, before you even consider what you eat.

In fatismyfriend, I encourage overweight people to eat real, unprocessed foods and not worry about the fat content of food, as long as they are losing weight each or most weeks. The mainstay of this way of eating is not DIETARY fat if it is coming from your body fat. Once you have lost your excess weight then you will need fat from food, in the natural way it comes from nature. This is to ensure that you get enough energy, essential fats, and fat soluble vitamins. I would argue that this a “healthy fat , normal fat” way of eating, and if your cardiologist is happy with your lipid profile, then you will have no cause for concern.

Final word..

Zoe Harcombe PhD has some sensible things to say about fat so take a quick look.

Nutritional Needs in Pregnancy

When you are planning a pregnancy or find yourself pregnant what sorts of thoughts do you have about your nutrition? You want your baby to thrive, so is it enough to eat a balanced diet as per the Eatwell Guide and let nature do the rest? It’s hard to know where to seek trustworthy information so I was very excited to read this guide about the vegetarian diet, that actually helps everyone find out the essential components of a healthy diet in pregnancy focusing on the babies needs for growth and development. I’m mindful that busy people don’t always prioritise their nutrition, so take a break, sit down and read on. This would have been as useful for my patient who only ate biscuits( and was newly pregnant) , as for those of my pregnant patients who thoughtfully followed a vegetarian or “Eatwell Guide” diet. http://pilatesnutritionist.com/vegetarian-diet-in-pregnancy/

Carb cycling- what is it and should you do it?

Carb cycling refers to the practice of eating higher carb amounts on days you do strenuous exercise. As most of my patients are carb intolerant and gain weight easily I don’t advise it. However, you may notice that you can tolerate higher amounts of carbs on an exercise day. For instance, my expert patient Keith notices that he can eat porridge and maintain a normal blood glucose if he goes for a run afterwards. However, I would recommend porridge with nuts such as almonds or walnuts, rather than adding fruit which might push you over the 4-7 limit, 1-2 hours after the meal. Try making it with water one day, and almond milk the next. See if you can stay in the 4-7 range if you are doing strenuous exercise after. If you can’t stick to lower carb breakfasts instead.

Introduction to the 8 week course

This is an 8 week course that helps you change your eating and drinking habits permanently. I get emails from people many months and years down the line telling me they are still doing it and that could be you! It’s not just about food and drink, but also about sleep, movement and exercise, relaxation and stress management and getting over processed food addiction. Addressing these things will help you achieve your goals and so become much healthier.

First up, what does healthier” mean to you….would you think of YOUR hopes, dreams and goals and write them down- how would you like to feel a year from now, what would better look like? Build up a detailed picture in your mind of the things you would like to be doing, who you will be with, and how you will look & feel as this new healthier you.

Ask yourself what you eat and drink now meal by meal, drink by drink, snack by snack? If you eat bread, rice, pasta, potatoes, cakes, biscuits or sweets and are ready for change there is a brilliant chance of success. If you secretly eat a lot of junk, you are not alone, and can change with the right approaches.Look here.

What is low carb/ low GI food and drink? What do you know about it? This link will show you. Look at the plate and click through the dots.. 🍽

Clearing your cupboard of processed food is an important first step, so do it with your partner, friend or family and maybe one of them will join you on the 8 week plan. All that sugary and starchy stuff has to go- so pile it up and give it away.

1 recipe- breakfast– and food samples to taste

Breakfast ideas

Set YOUR quit day

and if you try and don’t succeed , try again. It is much easier if you have none of that rubbish food in the house, and you avoid places where you are tempted.

Can you involve the rest of your family- like who does shopping and cooking? Get them on board if you can, and bring them to the group, but if they are not ready, just get on with it yourself.

If you are diabetic, get a blood glucose meter from your practice nurse or online, and check your blood glucose 1-2h after meals and learn what happens. We are aiming for 4-7 and 4 is the floor! Write down your results so you can avoid foods that raise your blood glucose too high- it will vary day to day so try things with & without exercise and learn how your body responds. See your GP with one of my medication letters if you are on medication for diabetes before you start.

Move more- do what do you enjoy, think of what would you like to do that is fun. If you have a lot of weight to lose, start with chair or floor based exercise or walking and build it up gradually. Would you consider giving yoga a go?

Mindful eating– what does it mean to you? To me, it means taking my time, enjoying the tastes and textures, and turning off the TV.

Habit releaser of the week: For one week sit in a different chair when you watch TV or eat a meal. A little habit change like this enables bigger habit changes!

Sleep– try to go to bed and get up at the same time each day from now on as this reduces your stress hormones and improves your health.

Blood requests and record charts- would you like to get your blood tests and measurements done before you start? These include…. weight, height, waist, HBA1C, lipids, liver function and kidney function. Do you want to do BEFORE photos, to compare with your AFTER ones?

Website list, books, social media links Look to the bottom of the page.

Reversing your diabetes

It is a long time since I wrote a blog, because I have had to cope with the illness of someone who is very close to me. I am hoping to get back to regular blogs soon, but I wanted to share something now.
Yesterday, I helped someone I had never even met or spoken to or emailed, and I found out by phone via the friend of a friend. This man has reversed his diabetes via my site. Isn’t that fantastic? I have met and spoken to many people who have reversed their diabetes now, but I want to point something out. The reversal only lasts for as long as you follow the low carbohydrate way of eating. For instance, another person, Keith, an X-pert patient, has continuous blood glucose monitoring and his blood glucose stays firmly in the 4-7(normal) range for as long as he eats low carb food. If he eats cornflakes with skimmed milk and orange juice it goes up to 15. Here is what happened when he ate sandwiches and fruit for lunch.
On the other hand, my uncle thinks his diabetes went away when he cut out sugar. Maybe it went away temporarily, but it has now come back, as confirmed by his blood glucose levels. To get rid of it he needs to cut out sugary and starchy foods all over again.
If you are reading this and are not my patient, ask your doctor to refer you to a dietitian specifically for a low carbohydrate plan, or look at DietDoctor or Diabetes.co.uk.

New group starting in Stockton Heath

Change your Eating in 8 weeks

A behavioural change & low carb approach.

Tuesday 7th August 12-1pm @ St Thomas’ Church Stockton Heath

Just turn up +/- bring a friend or your partner.

Run by Dr JOANNE MCCORMACK of www.fatismyfriend.co.uk & the charity www.PHCuk.org
7th August, 14th August, 21st August, 28th August

These & future dates to be posted in St Thomas’ church and Stockton Heath Medical centre
Free to all to attend – you do not need to be a member of the church

Children and Sugar

I work in an area where people are generally healthy and people in my practice think hard about bringing their children up in the best possible way. They mostly cook from scratch and never give their children sugar or so they think….

They forget that breakfast cereals, toast and toppings, orange juice, brown bread, wholewheat pasta and rice all break down to sugar in the body. Not forgetting the “occasional” sugary treats.

To cut out sugar for your child, look at the recipes on www.ditchthecarbs.com and www.dietdoctor.com

People who have changed over to a low sugar lifestyle for their children experience better behaviour, better concentration, and even better sleep. A head teacher I spoke to told me that the behaviour at his school even improved when they removed the vending machines.

Can’t lose weight on #lowcarb?

Can’t lose weight on LCHF?
When I started a 30g carbs a day way of life, I never imagined the changes it would bring. The weight loss was an unexpected side effect and not my primary concern.
However, not everyone does lose weight with the first version of LCHF they try

If this applies to you have a think:

Do you eat a lot of fat e.g. fat on your chicken, and in your coffee, and cream on your fruit? If you have fat on your body, you don’t need to eat that much fat in your food.
Fat is your friend and protects your body from too much glucose, and it is also a source of fat calories when you want to lose weight.

Are you counting your carbs- e.g. through “Carbs and Cals”( remember you do not ned to count the Cals) How many grams of carbs are you having in a day? 20-30g per day should be enough. Be honest with yourself( photograph everything you eat and drink with your phone and count it up) and cut it back below 30 g a day if need be.

Are you stressed? The high levels of cortisol, adrenaline and noradrenaline can stop you from losing weight, so how about some relaxation in the form of yoga or mindfulness? When you are stressed you will sleep less well, and have more difficulty sticking to a sensible way of eating.

Are you eating too much protein? You don’t need more than 1g/kg, or 2g/kg if weight building or growing. Some restaurants serve 14oz, which is about 400g- beef steaks- that is not necessary. As a rough guide a piece of meat or fish the size of the palm of your hand will do.