​Life is an up and down journey for all of us  

And it can be quite a roller coaster ride at times.  And during those low moments it may not be easy to believe that there is light along the way – there is, it’s just that we can’t see it yet, sometimes because we don’t know which way to turn or in which direction to look. 
 
The ‘moments’ when we don’t feel at our best might be stretched out over weeks or many months … or they could be, for want of a better term, ‘mini moments’.  You know, a day when up to that point things might generally have actually been rather good, but for whatever reason, something is said, something is done or something is thought or felt, and we no longer feel alright … and we … eat!  
 
We’re not necessarily hungry, but ...

Eating is an easy and enjoyable way of coping with the emotions of that moment … “hmmm, now, where did I hide that chocolate from myself?” No worries there, it will be in the same place it was hidden the last time!  The flaw with the “I’ll eat my way out of this” approach is that it can leave you feeling, at best, no better than before you indulged, or you may be consumed with self-loathing, having done what you quietly promised yourself not to do again this week.
 
A moment on the lips, a lifetime on the hips?  

Actually no, and for a number of reasons. What I think is an important takeaway here is the fact that we can’t gain more weight than the actual weight of the calories in whatever it is we’ve eaten.  That 75g pot of Cadbury Flake Chocolate Dessert has a ‘calorie weight’ of around 37g, which is the combined weight of the fat, carbohydrate and protein it contains - the other half is water.  
 
To gain one pound of weight from eating this particular dessert, you’d need to eat around 17 of those pots – if there are 17 of these in the fridge, then there’s an entirely different discussion to be had around ‘planning to overeat’.  Okay, so, this puts ‘unplanned’ eating, into some perspective.
​
The next time it happens to you, put your go-to pick-me-up (if there’s any left!) on the bathroom scales and see if the number goes up – btw, how helpful is it to weigh ourselves and how often on our journey – a blog for another day, perhaps?
 
That was a bit about the science around weight change after eating we hadn't planned, but emotional eating is about much more than waist size or numbers on the scales.  

It’s not just about chocolate, is it? 

We use all types of foods, and some may drink alcohol or do some other activity, such as go online to buy something, or obsessively clean the house to make us feel better.
 
Triggers of emotional eating include stress, boredom, anxiety, anger, sadness, loneliness, exhaustion and many other things we’d rather not be feeling in that moment.  Some of the reasons for choosing a particular food to make us feel better may be rooted in cherished childhood memories – and how comforting that can be, enjoying that ice cream the way we did when our parents used to give it to us out of love.
 
What's the story around your emotional eating?

Keeping a diary (there’s one on the Resources page) can be very helpful for building a story around the emotional eating pattern.  When we know the circumstances leading up to that first mouthful of whatever we choose to soothe ourselves with and know what we are thinking and feeling before and after we take that last mouthful, we can develop a better understanding of why we do it.  

​Is it when we’re with a particular person, time of the month, having to deal with finances? There are numerous possibilities, learn what your triggers are …
 
The solution is to change how you decide to cope with the emotion itself
 
Doing something physical is a distraction from the trigger emotion and has you burning addtional calories rather than eating them. That's a win-win.

​If anxiety is a trigger, get physical rather than 'feed' the emotion. Try playing some music and dancing (do it like the world isn’t watching!), squeezing a stress ball or going for a brisk walk - doing it in green space is particularly soothing. 
 
Or is being emotionally exhausted the trigger?  Immerse yourself in some recovery ‘therapy’, by burning scented candles, relaxing in a warm bubbly bath whilst listening to music or podcast that is undemanding on the ear and soothing. 

Tackling the trigger head on ...
 
A more challenging approach to the management of emotional eating is to change our mindset around the event that triggers the emotion that triggers the eating.

​Cognitive behaviour therapy (CBT) can help with this and there is a lot of information about it out there – this might be a useful starting point. 

Getting a handle on emotional eating takes effort, as does any aspect of looking after our health and wellbeing. Knowing how to do it is that first step. HelpGuide has lots of information on the management of emotional eating – it’s a longer read than this short blog, but may prove useful to you.

Tony Hirving
Dietitian

A craving for food comes in all shapes, sizes and tastes   

At the extreme end, a pregnant woman can have an intense desire for a specific food (and non-food!) that makes you wonder of all the choices readily available, why crave that?  Yes, I know it’s subjective.  One person’s beef is another person’s meat and all that, but few of us are surprised to hear that cravings for sweet food is indeed common, and that the menstrual cycle is one of the factors linked to this.
 
A couple of years ago, a small study in Poland found that women wanted to eat more and had stronger cravings for the sweet stuff during the luteal phase of their cycle – this is the two weeks between ovulation and the next period.  And way back in 1994 a really small study of 25 women, most of whom were healthy weight, found that food cravings for different types of foods increased in pre-menstrual days and 49% of their cravings were for chocolate and chocolate-containing foods.

... There’s that something about the feel and taste of chocolate that makes it irrisistible, isn’t there?!

Is it just about your hormones?

Men also crave foods, including the sweet stuff, so an intense desire for a food is not just about hormones.  Importantly, for those who are cutting back on what they eat to lose weight, food cravings do not seem to be linked to dietary restraint – not having your cake doesn’t make it more likely that you want to eat it!
 
Can I do anything to stop sweet cravings?
 
When it’s related to the menstrual cycle, it might help to add starchy carbohydrate snacks into the eating plan, if not being done already.  The aim is to keep your blood sugar levels fairly stable through the time when metabolism may slightly increase during the cycle and the body subsequently uses up calories slightly more quickly.  
 
A small starchy carb snack (80-1oo calories), such as a Ryvita slice with an ounce (~30g) of light cheese spread, provides the glucose to keep blood glucose steady between meals and possibly reduce the craving for something sweet that you then overeat at a cost of lot more calories?  A slice of ham or vegan ham-style topping on a slice of Ryvita is another option for that 80-100 calorie snack.
 
But my sweet craving surfaces at any time of the month
 
Again, keeping blood sugar stable between meals is the aim.  And you can do this by including starchy carbohydrate with each meal and keeping the glycaemic load (GL) of the meal low, which means a slower rise and fall in blood glucose between meals.  A stable blood sugar may be less likely to trigger a craving for something sweet. When people start a plan for weight loss they may cut-back on carbs a tad too far. Btw, carbs don't make you put on weight - see the blog Do carbs make you gain weight?

Choose starchy carbs that themselves have a low GL, such as oats, branflakes, wholemeal bread, wholemeal pitta and brown rice.  Adding a protein food, such as egg, chicken, fish, pulses, Quorn, soya protein, meat, to the meal further slows down the rise and fall of blood glucose low GL carbs, thereby helping keeping blood sugar stable betwen meals
 
Give it a try and let us know if it does or doesn’t work for you …
​
Tony Hirving
Dietitian

It's not "all in your head" ... it IS in your gut​

​Apart from troublesome bowel habit, such as going too much, experiencing urgency, or going too little and a feeling of incomplete evacuation, another issue can be bloating and excessive gas.  Fermentation of fibre and other types of carbohydrate by ‘friendly’ bacteria in the large intestine (colon) can produce lots of malodorous gas, which may make for very uncomfortable work and social situations.  And then there is the burping and stomach gurgling that can add to this misery of a gut that ‘talks’ too much.
​

Gut transit time affects poo consistency
 
The speed at which food and poop moves along our gut varies, depending on a range of factors, including the particular foods and fluids we’ve eaten and drunk in the past day or two.  At the extremes, this journey may be too fast, leading to the passing of loose or liquid stool several times a day, or the transit time may be too slow … resulting in hard stool … that takes … forever …to pass and is done so irregularly.

Can it be normal to go three times a day?

A US study a few years ago found that 96% of people have a bowel movement somewhere between three times a day and three times a week.  And there seems to be some variation between the sexes when it comes to stool consistency, with most men passing poo somewhere between stool type 3 (‘cracked sausage’) and type 5 (‘soft blobs’), whilst women tend to pass stool between types 2 (‘lumpy sausage’) and 6 (‘mush’).  There’s even a poop scale, known as the Bristol Stool Form Scale.
 
Whichever extreme of bowel habit you might be at, asking your doctor to refer you to the in-house dietitian at your practice would be a good move, especially if you have lots of gas and bloating.  The dietitian will guide through a process that may otherwise have you chasing your tail if there are a number of factors contributing to the problem.

 Try a simple approach to management of gut symptoms ...

At its simplest, the approach to resolving a tendency to produce hard stools that are difficult to pass and perhaps only a couple of times a week is to consume enough fibre and drink enough fluid.  And to do this consistently every day.  Getting your 5-a-day every day would be a sensible start, and also switching to a wholemeal bread and high-fibre breakfast cereal every day. Drinking enough fluid to pass pale yellow pee 5-6 times a day is quite a good indication of drinking enough fluid.  Try this for a week and see what happens …
​
Garlic and onion are often the culprits!

Resolving loose frequent stools, especially when excessive gas is a major issue, is trickier, but avoidance of onion, garlic and pulses is all that some of my patients need do to greatly reduce flatulence – easier said than done, because garlic and onion seem to be in every savoury processed food on the planet (as powder, puree, dried - have a read of ingredient lists).  
 
Too much coffee, too much fat, too much spicy food, too much alcohol and other dietary and non-dietary factors can contribute to frequent loose stools, so it can be a challenge knowing how to identify the culprit. Getting a handle on this extreme of bowel habit is much easier with the guidance of your GP practice’s dietitian.

And the good news is that most people can get satisfactory improvement in the pattern of their bowel habit, by trying a range of things to slow down intestinal transit time or speed it up, depending on whether its currently too fast (loose, frequent stool) or too slow (hard. infrequent stool).

Tony Hirving
Dietitian 

Why do carbs get a bad rap?

Some are convinced that eating carbs piles on the pounds. They may have followed a no-carb diet rigidly for a week or two, shed 4 or 5lbs and then given in to the pleasure of a slice of toast with their boiled egg at breakfast, had some pasta with a tuna salad lunch and added a few potatoes to the evening meal of chicken and veg.  

​... And when they step up onto the scales the following day ... horror of horrors, as they see a gain of a couple of pounds in just 24 hours, and wonder, “How can this be?” The blame may fall on the bread, pasta and potato, and they wrongly conclude that carbs make you gain weight.

The different types of carbs

There are two main types of carb, one is the starchy carbohydrate found in potato, rice, yam, green banana, bread, pasta couscous and the like.  And the other type of carbohydrate are the sugars found in fruit, honey and the huge amount of processed foods that have sugar added to them – this makes a product taste good, look good and feel good as we chomp our way through whatever it is.
 
Fermentable carbs feed gut-friendly bacteria

And then there are types of carbohydrate that we don’t have the ‘tools’ to breakdown and these are fibre and short-chain carbohydrate, such as in onion, garlic, pulses, wheat, cabbage and many other plant foods.  Our gut-friendly bacteria do have the ‘tools’ to breakdown those types of carbohydrate, and most of that fermentation takes place in the colon.  
 
This is a good thing, despite it being a cause of excessive gas in some people ...

The diversity of our microbial friends may play a part in weight management – research shows that weight gain is lower when we have lots of the different types of bacteria in our colon. And there are fewer different types of bacteria in our gut when our fibre intake is low.

Glucose carb is our primary source of energy 

Back to the question, when people talk about carbs causing weight gain, they are usually referring to starch and sugar carbs. Both types are a source of the glucose sugar used for energy by muscle, brain and every other organ in our body.  

Glucose fuel is kept in storage (as glycogen) in our muscle and liver.  Eat or drink more carbohydrate than can be stored in that ‘tank’ and the excess will be converted to fat and stored in the places where you’d rather it wasn’t!
 
A low-carb diet produces ketones

At the other end of excess carb consumption there is low-carb eating and drinking.  A very low intake of carbohydrate causes the body to produce ketones (derived from fat), and you may have heard the term ‘ketogenic diet’. This very restricted diet is actually proven to help in the management of epilepsy, but we’re talking about weight management here, rather treatment of epilepsy, so let’s stay with this with regard to a ketogenic diet.
 
A low-carb diet or keto diet will, of course, bring about weight loss when calories consumed are less than calories used by the body’s organs and muscle that move us around.  But carbs themselves don’t make us gain weight, any more so than does fat or protein, unless we eat any of those nutrients to excess.  

It simply comes down to energy balance: our weight is stable when we consume the same number of calories as we expend. Spend a few days eating more calories (doesn’t matter whether from carbs, fat or protein) than spent and the scales will soon tell you what you’d rather not know.

Yes, you can lose 7lb in 7 days on a keto diet, but ...
 
People will say, “I lost 7lb in a week on a low-carb diet”.  Sure, that’s possible, because at least 4lb of that weight loss will be water (not fat) – water is lost following depletion of muscle and liver glycogen stores.  On average, we store around 1lb of glycogen, which is stored with 3lb of water – lose that 1lb of glycogen and you lose that 3lb of water.  Those same people won’t lose another 7lb over the next seven days, because the glycogen stores ran dry the previous week.  
 
But, despite big weight loss in that first week, will they stick to the low-carb diet?

How many of us could refrain from eating bread, pasta, potato, cake, biscuit, chips and other sources of delicious carbs ever again? It wouldn't be easy that's for sure - it's much better to start off as we mean to go on  ...
 
Moderation is the key to sticking to a diet. Extreme restriction is no fun, but there’s a happy middle ground between denying yourself carbs and consuming to excess.  The take-home message: eat carbs, not too much, control your weight.
 
Have you ever tried a low-carb or keto diet? Did it work for you? How long did you do it for?

Tony Hirving
Dietitian

               
​Breakfast kick-starts metabolism ... Really?

If you put “benefits of eating breakfast” into a search engine, one of the claims you'll read in the posts of bloggers is that breakfast will “kick-start your metabolism”. 

What do they mean by this?   

Our metabolism is the sum of hundreds of essential cellular processes that our body does 24/7, such as our heart beating, lungs inflating and deflating, liver detoxifying our blood – and the metabolic rate is the speed at which our metabolism burns calories, multi-tasking in a way that we (well, at least us  men!) can only dream of. 

So, the idea that breakfast “kick-starts your metabolism” doesn't make any sense – and this is supported by research.  Metabolism never stops, so it doesn’t need a helping hand to get started each morning.  It's still busy doing what it was already doing when your head hit the pillow last night!

... Or to coin a phrase that gives New York its famous nickname: metabolism is the activity that never sleeps.  And if it did ... well, we’d be more than asleep.

Does skipping breakfast make us overeat later on?

You may also have read that skipping breakfast makes us eat more later in the day. This is not supported by research, which found that eating breakfast within 2 hours of waking (and before 11am) or fasting until mid-day did not make any difference to how much people ate across the day. 

Over the years, some patients have told me that eating breakfast increases their appetite and makes them want to eat again before lunchtime arrives. Understandably, they are always reluctant to start a breakfast habit if they think their weight will go up instead of down!  The type of breakfast seems to be a factor here – a US study found that a high protein breakfast helped reduce hunger across the day.

Breakfast kick-starts our day's nutrient intake 

If you tend to skip breakfast, you may be reading this and wondering why do something that doesn't in fact kick-start metabolism. Let’s look at why making breakfast a daily habit is worth you considering ... 

Weight management is just one component of our health and wellbeing. Eating breakfast is an opportunity to start taking on board some of the nutrients needed for meeting our daily requirements. Think iron-fortified wholegrain cereal with a small glass of orange or grapefruit juice (the vitamin C aids iron absorption), which can deliver 25% of the target amount of iron.  

Are you getting enough fibre?

​The average fibre intake in adults is around 60% of what is recommended (30g a day), so fitting wholegrain cereal or toast into the day helps to bridge that gap.  A couple of poached (or scrambled) eggs delivers about 25% of our protein requirement and they are a good combo with wholegrain toast (for fibre and other nutrients) and grilled tomato, a great source of vitamins A and K1 – this vitamin can be in short supply in some diets.
 
Eating breakfast is a healthy habit to adopt as you step out on your journey to good health, wellbeing and management of your weight.  Are you among those who "don't have time for breakfast"?  Re-set your alarm to give yourself the extra 10 minutes you may need to kick-start your intake of nutrients for the day!

Perhaps you're someone who absolutely can't stomach the thought of eating anything until you've been up and about for a couple of hours? Or are you like me and thoroughly enjoy eating breakfast. Have any of you have noticed that eating breakfast makes you want to eat again before lunch time? 

Feel free to comment below ...

Tony Hirving
Dietitian