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A Registered Dietitian’s Guide to Supplements

This blog post has been kindly written by Maleeha Ali (Student at the University of Leeds) and edited by Debra Williams (Registered Dietitian).

Introduction

The nutritional supplement industry was estimated to be worth an astonishing £102.33 billion in 2020 and this industry is continuing to grow at a rapid rate. Nutritional supplements take many different forms each serving a different purpose. It is important to take a food first approach so that nutrients from food are encouraged first before adding in a supplement. Supplements have distinctive functions thus aren’t suitable for all individuals and may even cause harm if consumed incorrectly. This blog post is for information only and aims to clarify any confusion regarding nutritional supplements. If you have questions about your supplement needs, speak with a qualified health professional that can assess your diet considering your medical history and any relevant blood test results.

So, what are the different types of supplements?

Before we get started, it is first necessary to define exactly what a nutritional supplement is. According to the Food Standards Agency, nutritional supplements are described as ‘a concentrated source of a vitamin, mineral, or other substance with a nutritional or physiological effect, alone or in combination and is sold in dose form.’ They can be found in many forms including powder, tablets, capsules, liquid, and even gummies.

Vitamins and minerals are micronutrients required by our body for various functions. Supplements can be used to treat a deficiency or to help an individual meet a specific nutrient need.  Other popular supplement categories include herbal supplements, weight loss supplements, protein powders, and sports nutrition supplements such as BCAAs, creatine, and pre-workout powders. Some common supplements taken in the UK include Vitamin D, B12 and folic acid as well as other products such as protein powders and probiotics.

Who needs supplements?

There is no specific criteria on who requires nutritional supplements; this will vary greatly depending on individual factors such as lifestyle, diet, genetics etc. The list below describes some common supplements and explains who may require them.

Vitamin D: In the UK, the limited sunlight means vitamin D intake is sometimes insufficient and thus children and adults are recommended to take vitamin D supplements to prevent any deficiency forming.

Protein Powders: Individuals who are building muscle need to increase their protein intake and may achieve this via protein powders and shakes. The increased intake will help with muscle growth and repair.

Folic Acid: folic acid supplements are standard for pregnant women and women who plan to become pregnant to reduce the risk of spina bifida.

Vitamin B12: many individuals can meet their nutrient needs through a balanced diet, however there are certain scenarios where deficiencies may occur. For example, supplementation of vitamin B12 is often helpful for those following a vegetarian or vegan diet.

What are meal replacements?

These are usually low-calorie items that are fortified with essential macronutrients and micronutrients that aim to promote weight management and/or accommodate weight loss. They usually come in the form of drinks, bars, or soups.

Studies have found that meal replacement products are often preferred by individuals trying to lose weight as there is a ‘reduced need to think about food’ as well as no need for ‘portion control and calorie counting’. Astbury et al 2019, found that ‘programmes incorporating meal replacements led to greater weight loss’ and thus deemed them a ‘valid option’ in controlling obesity. Type 2 diabetics may also find meal replacement products beneficial when managing their symptoms (Dasgupta et al 2022). However, it is important to seek advice from a registered dietitian on how long these products can be used for.

What are the risks of supplements?

Many people will decide to take a supplement simply because they saw a targeted ad, or a friend recommended it. This comes with risk! and can often be unnecessary money out of your pocket.

Other risks include:

Drug interactions – some supplements may interfere with pharmaceuticals. For example, Vitamin K can reduce the effectiveness of blood thinners like Coumadin.

Overdosing – more is not always better! Some micronutrients, namely fat-soluble vitamins (vitamins A, D, E, and K), can build up in the body. There are also many supplements that provide very large doses of particular nutrients, which may be dangerous in some cases.

Misleading labels and marketing – Dietary supplements are not well-regulated and manufacturers will often use misleading information to drive sales.

Should you be taking a supplement?

In typical dietitian talk, the answer is that it depends! While there may be benefits for some, there may also be potential risks. If you feel that you may have a nutrient of concern, ask a registered dietitian https://eatwellnow.co.uk/ if you can increase your intake of that nutrient with food first before turning to a supplement.

Further information

For more information on nutritional supplements please read this fantastic BDA food fact sheet https://www.bda.uk.com/resourceDetail/printPdf/?resource=supplements

References

Astbury, NM, Piernas, C, Hartmann-Boyce, J, Lapworth, S, Aveyard, P, Jebb, SA. A    systematic review and meta-analysis of the effectiveness of meal replacements for weight loss. Obesity Reviews. 2019; 20: 569–587.

Dasgupta K, Boulé N, Henson J, et al. Remission of type 2 diabetes and improved diastolic function by combining structured exercise with meal replacement and food reintroduction among young adults: the RESET for REMISSION randomised controlled trial protocol. BMJ Open. 2022;12: e063888. 


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Fantastic video all about diabetes

I would love to share with you this video giving you some interesting facts about diabetes and how this can be improved with diet and lifestyle. This has been kindly prepared by 1st year student, Maleeha Ali at the University of Leeds. Thank you Maleeha!

Check out our knowledge hub section where you can learn more interesting facts about diabetes https://eatwellnow.co.uk/facts-about-diabetes/

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Promotion 15% discount- Spring clean your diet

Are you struggling with your diet? Having issues controlling your cholesterol levels or blood sugars? Feeling tired and lethargic? Suffering with abnormal gut issues? Having menopausal symptoms? Trapped in a yo yo dieting cycle? Spring is a time of new beginnings.

At Eat Well Now we are offering a 15% discount off all packages booked before the end of March 2023. Debra is available for online 1 to 1 consultations and there are various packages to choose from. Why wait, contact Eat Well Now today via email enquiries@eatwellnow.co.uk or phone 07780998732.

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Online remote consultations

At Eat Well Now we are still continuing to offer nutrition consultations and work with businesses during the period of lockdown. If you are an individual or business needing dietary advice we can do zoom consultations which offer flexibility and convenience to suit your requirements.

We understand this is a period of anxiety and uncertainty for many people and especially with concerns over health and wellbeing.

I hope you are all keeping safe and well.

Debra

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Dietitian SOS during the coronavirus pandemic

No matter who we are, the Coronavirus pandemic has caused trouble for us all. Unemployment has risen, many of us are missing friends/family, and there can be difficulties in obtaining staple food items such as pasta and flour at the local supermarket. However, there are several steps we can take to ensure that we stay positive and resilient to get through these challenging times.

How to eat well during a pandemic 

A pandemic may cause some difficulty in obtaining all your normal food essentials; however, it does not have to result in unhealthy eating. It is important to try to stay strong and keep to a routine during such a confusing and distressing time. This period in your life may give you the prime opportunity to learn the value of nutrition and get innovative in the kitchen! Always aim to use up your fresh, but perishable ingredients first, to ensure food does not to go to waste. In order to do this, you need to know what fresh food has a longer shelf life. Root vegetables such as potatoes, carrots, or onions usually last well after their use by date. As always, try to consume the recommended 5-a-day, and be aware that frozen/canned varieties of fruit and vegetables can be equally as nutritious as fresh. 

Ensure that you keep some easy to cook and prepare meals on standby in case of sickness. Soups and frozen ready meals are some examples.

Can diet boost immunity?

Diet cannot directly boost immunity and no specific food or supplement will prevent you catching Covid-19. However, good nutrition and hydration aids the normal function of the immune system and people who are nutritionally well cope better if they do catch Covid-19. It is important to follow a healthy balanced diet with foods from all food groups as shown in the Eat Well Guide. Micronutrients that will support immunity include copper, folate, iron, selenium, zinc, and vitamins A, B6, B12, C and D.

If you are self-isolating, especially if you have symptoms, good nutrition is essential and you need to ensure you are eating regularly even if you have a low appetite. If you feel that you are not consuming a healthy balanced diet you may want to consider a multivitamin/mineral supplement but ensure you seek advice from a dietitian or other healthcare professional on which would be most suitable for your circumstances.

Lack of time outdoors

Vitamin D works with calcium and phosphorus for healthy bones, muscles, and teeth. Most of our vitamin D comes from sunlight hence why it is often called the ‘sunshine vitamin’. Getting in some daily sunshine, as little as 15 minutes in the garden or during a short walk, or by consuming a daily supplement, will assist in boosting serum vitamin D levels. If you are self-isolating and unable to go outside, it would be highly recommended that you take a vitamin D supplement of 10mcg daily. It is difficult to obtain enough vitamin D from food sources however it can be found in eggs, oily fish, meat, offal and milk. Many breakfast cereals are also fortified with vitamin D. 

Food shopping

Try and keep shopping trips to a minimum to avoid risk of too much exposure to others and ensure you follow the social distancing rules. If you are sick and/or self-isolating you can ask friends or family members for help with getting your supplies. You can also try doing online food shopping so that your supplies are delivered. Panic buying is not necessary, even for toilet roll, as the government will not close supermarkets. Currently, any product shortages are mostly due to panic buying. Kidney beans for example, are often a regularly consumed food for vegan individuals, therefore if you do not normally buy kidney beans, please do not ‘stock up’.

What can you do when essentials cannot be found?

If some essentials cannot be bought at the time you go shopping, do not worry. There are alternatives to foods such as eggs and pasta – you just have to be imaginative. For example, if you have promised the kids that you are going to bake some cookies, yet eggs cannot be obtained then look for other recipes that use different ingredients. Furthermore, pasta can be substituted for spiralised courgette. You may not currently own a spiraliser, but they are a useful kitchen utensil which can be easily ordered online, enabling meal creativity. Alternatively, you could use other starchy carbohydrate sources such as potatoes, noodles, rice or cous cous.

Time to get cooking

Staying at home will free up time to enable you to do more home cooking which is a great time to learn some new skills and try out different recipes. It will also be an opportunity to do a stock take of your kitchen cupboards and fridge and have a decluttering session and throw away any goods that have gone past their best before date. There are many websites you can go to for healthy recipes suitable for all dietary preferences including BBC good food, let’s get cooking https://letsgetcooking.org.uk/  and love food, hate waste https://www.lovefoodhatewaste.com/. You could do some batch cooking so that you can freeze some meals ready in case of sickness. It is important to follow general food safety advice such as washing your hands with antibacterial soap (which you should be doing regularly anyway) and cleaning down food preparation surfaces. 

Keep to a routine

Keeping to a routine at this time regarding meals is important as it will aid in life feeling a little bit more normal. Restricting food or overindulging due to boredom could cause constipation or weight fluctuations. Mealtimes are likely something you look forward to and give you an opportunity to be creative (something your working hours may usually prevent). If you can exercise, make sure that you are keeping active daily as this will help to ensure you keep a positive frame of mind. To prevent yourself from feeling lonely and isolated ensure you keep connected with others either online/by telephone. 

Further information and support

If you have any specific dietary queries, then ensure you contact a registered dietitian or other healthcare professional for further help.

Article written by Erin Wilson-Taylor and edited by Debra Williams (Registered Dietitians)

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Thinking of becoming a harmonious herbivore?

What is plant based eating?

Plant based diets are those that focus primarily on foods derived from plant sources, including fruit, vegetables, grains, nuts and meat substitutes, such as tofu, to name a few. People choose plant based diets for many different reasons including concern about the treatment of animals, health reasons, environmental concerns, personal tastes and also social pressure. These types of diets are becoming very popular but they do need some careful planning to ensure that you receive all the nutrients you require for good health.

There are various types of plant based diets, so you should make sure to choose the version that best suits you. These include being semi-vegetarian/flexitarian, pescatarian, vegetarian and finally, vegan.

Those whom follow plant-based diets tend to consume a wider variety of fruits, vegetables and pulses, so are more likely to reach their ‘five-a-day’ target, as well as consuming a higher intake of fibre, vitamins and minerals. Currently, only 1 in 4 adults and 1 in 5 children manage to achieve their five-a-day in the UK – the ‘five-a-day’ goal was set by the World Health organisation in order to help reduce the risk of certain cancers and cardiovascular diseases, so is essential to follow in order to remain healthy.

Why is it important to follow a healthy, balanced diet?

Unfortunately, ‘plant-based’ does not automatically mean ‘more-healthy’, particularly when it comes down to processed and packaged foods. For example, refined sugar, white flour and certain vegetable fat products labelled ‘plant-based’ should not make up the bulk of your diet. It is still important to ensure that the diet you are predominantly following has as many nutritional benefits as possible. Following a consistently well-balanced plant-based diet rich in wholegrains, fruit, vegetables, nuts and seeds can provide benefits, due to helping lower the body mass index, cholesterol levels and reducing the risk of developing diseases such as type 2 diabetes and heart disease, as well as protecting against some cancers.

There is a high risk of certain deficiencies and nutrients associated with plant based diets and veganism, therefore, key nutrients that should be focused on include protein, iron, vitamin B12, calcium and vitamin D as well as omega-3 fatty acids.

What types of food should vegans/those following plant based diets eat, in order to receive all nutrients? e.g. alternatives to animal and dairy products.

In  the UK, adults are advised to eat 0.75g protein for each kilogram they weigh, daily. However, a more active individual requires more protein than those living a more sedentary lifestyle. A rough guideline suggests that men should aim to eat 55g protein and women should eat 45g of protein daily. Animal and dairy products provide ‘complete’ protein sources, however, in terms of plant-based eating, soy is the only complete protein source. However, beans, pulses, nuts & seeds are all also protein sources, but due to not containing all the essential amino acids, variation is key  throughout the day and week so a mixture of both pulses and cereals are recommended. Nuts and seeds are great sources of proteins and essential fats – those which are particularly rich in protein include almonds, cashews, chia seeds and flaxseeds. For example, a 30g portion of almonds provides 6g of protein.

Calcium is important to maintain bone density and prevent osteoporosis – for vegans, sources include nut milks such as almond milk and soya milk as well as some vegetables such as broccoli and dried fruit. Calcium-set tofu and calcium-fortified bread are also options.

Iron is also an essential nutrient required and is especially important for menstruating and pregnant women. Iron can be sourced via many foods including lentils, chickpeas, beans, dried fruits, nuts, wholegrains and tofu as well as seeds including chia seeds, hemp seeds and pumpkin seeds. Iron from plant based foods is absorbed much less efficiently than iron in animal sources. Eating plenty of fruit and vegetables rich in vitamin C aid in the absorption of iron.

In order for vegans to obtain adequate vitamin B12, they will need to take a daily supplementation or eat foods that are fortified with vitamin B12 at least twice a day.  Examples of foods that are fortified with vitamin B12 include some breakfast cereals and yeast extracts.

What is the importance of seeing a Registered dietitian for tailored advice?

It is important that people choosing to follow a vegan/plant-based diet receive correct advice from a reliable sources due to the lack of nutrients available within these specific diets – visiting a Registered dietitian will allow them to access advice tailored to their individual nutritional needs.

“Dietitians use the most up-to-date public health and scientific research on food, health and disease, which they translate into practical guidance to enable people to make appropriate lifestyle and food choices.” – BDA

This article was kindly written by Ella Goddard (Student) and edited by myself Debra Williams.

 

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18/12/18 – Eat, drink and be merry


It’s almost that time of year again when we look forward to all the festivities that Christmas brings with lots of parties, socialising and enjoying festive dining. However, for those that are struggling to battle the bulge being surrounded by all the temptations of high calorie food and drink it can be a time of despair.

It is just a case of being sensible. You can still enjoy all the celebrations of Christmas at this magical time of year. You can easily make healthy choices by following the top ten tips below:

1.       Start the day with a healthy breakfast e.g. fruit/low fat yoghurt, porridge with dried fruit, wholegrain toast/muffins with low fat spread.

2.       Starters – you could chose something with smoked salmon on crackers, melon or homemade vegetable soup.

3.       Main course – turkey is very low fat, high protein (ensure you take off the skin), for vegetarians try a Quorn roast or a nut & vegetable bake.

4.       Roast potatoes – try and use an oil spray such as rapeseed/sunflower oil and not have too many of these.

5.       Vegetables – aim to cover a 1/3 of your plate with vegetables which are a great source of fibre, vitamins and minerals and very filling.  Don’t cook for too long.  Either steam or microwave to keep all the nutrients in.  If you are cooking in water only use a small amount to reduce the amount of nutrients lost in the water.

6.       Desserts – have fresh fruit salad (with crème freshe) as an alternative.  Also, Christmas pudding does contain lots of fruit so have a small portion and serve with crème freshe/low fat custard.

7.       Cheese boards – watch your portion sizes as cheese can be highly calorific.  Try and choose lower fat versions such as Edam, goats cheese, camembert.  Have with high fibre crackers such as oatcakes.

8.       Watch out for those snacks – it is often the biscuits, cakes, sweets that tend to pile on the pounds.  Make sure that there are healthy alternatives around as well – for example popcorn, pretzels, satsumas, dried fruit, raw vegetables and low fat dips.

9.       Alcohol – provides lots of empty calories.  Try and make healthier choices so choose low calorie diet mixers with spirits.  Alternate alcoholic drinks with a glass of water.

10.   Be active – ensure that you keep active and get some fresh air by perhaps going for a daily walk over the festive season.  This is a great opportunity to spend time with family and friends.

I wish you all the best for a fabulous Christmas and a very Happy New Year to all.

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26/06/18 – Are you wilting as summer temperatures soar?

Now the summer is well and truly in full swing and we are spending more time outdoors, being more active and feeling the heat it is important to stay hydrated.

Signs of dehydration include Headaches, lack of concentration, irritability, high pulse rate, and extreme thirst.

So it is important that we drink enough fluids throughout the day to ensure that we are not getting thirsty.  One should never be thirsty or else we are already in a state of dehydration.

Here are my top ten tips to staying hydrated.

1.       Hydrate in advance – start your day with a big glass of water and ensure that you drink water before you go out in the sun or exercise.  Obviously, you need to drink regularly throughout the day but think ahead.

2.       Avoid too much caffeine – drinks containing caffeine act as a diuretic (make you pee more) and therefore cause you to lose more fluids so make sure that you avoid caffeinated drinks.

3.       Avoid too much alcohol as this can also also act as a diuretic and make you dehydrated.  You could try drinking water between alcoholic drinks.

4.       Keep an eye on the colour of your urine – if it is too dark you are dehydrated.

5.       Eat more fruit as this contains water.

6.       Flavour water naturally with fruit if you don’t like plain water.

7.       Milk and sugar free drinks including teas and herbal teas, coffee and fruit juice contribute to your fluid intake too. However, limit yourself to one glass  150mls of unsweetened fruit juice per day,

8.       Keep a refillable water bottle with you at all times.

9.       Have a liquid breakfast such as a smoothie.

10.   The amount of fluid we need depends on many factors including humidity, temperature of the environment and the amount of exercise we do.  The amount we need can vary from person to person.

How much should I be drinking?

As a guide women should be drinking a minimum of 1600mls a day and men at least 2000mls a day.

Please click on the link to find more detailed information on recommended intake for specific groups including the children and pregnant/lactating women – https://www.bda.uk.com/foodfacts/fluid_water_drinks

If you need further advice and help on any nutrition and hydration issues please contact us at enquiries@eatwellnow.co.uk.

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16/04/18 – Spring clean the health and wellbeing of your workforce

16/04/18 Spring clean the health and wellbeing of your workforce

Are you an employer looking to create a healthier work environment in your workplace?  Perhaps you are an HR manager who is responsible for organising employee perks and benefits?  At Eat Well Now we run workplace nutrition workshops that cover topics such as food and mood, heart health, weight management, how to manage stress/IBS and much more.

Improving the wellbeing of your staff can reduce absence; lead to a more productive workforce; and improve staff morale.  Having fun, interactive events and workshops in your workplace can help foster a positive thinking culture amongst your employees and help with team building.

Debra has recently become accredited to deliver the BDA Work Ready programme so be rest assured that you will be receiving advice which is evidence based by a Registered Dietitian. The BDA work ready programme offers a bespoke nutritional wellness programme tailored to your employees’ needs.

To find out more about the BDA Work Ready programme  and the benefits of improving your employees’ health and wellbeing and please follow this link https://eatwellnow.co.uk/workplace-nutrition-workshop/

You can contact us at enquiries@eatwellnow.co.uk to book an initial meeting or arrange an nutritional needs assessment of your organisation.

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5/06/2017 Very Low Calorie Diets (VLCD) for Type 2 Diabetes

 5/06/2017 Very Low Calorie Diets (VLCD) for Type 2 Diabetes

Research on very low calorie diets

The use of very low calorie diets for Type 2 Diabetes hit headlines when researchers at Newcastle University found that a VLCD was effective in reversing Type 2 Diabetes.  Since this initial research another high profile research study has started.  Diabetes UK are working with Professor Roy Taylor at Newcastle University and Professor Mike Lean at the University of Glasgow.  Their research team are looking at the long term effects of an intensive weight management plan that can help put Type 2 Diabetes into remission.

The study by Diabetes UK is called the DIRECT study. For further information on this please click on the link 

What is a very low calorie diet?

A very low calorie diet is defined as a diet with a calorie intake of 1000kcals/day or less. A very low calorie diet will typically involved replacing conventional foods with diet milkshakes, soups or bars.  It is not recommended that you maintain a very low calorie diet for longer than 12 weeks as extreme calorie reduction can lead to nutrition deficiencies and could even lead to heart problems.

Is the diet safe to follow?

Very low calorie diets are regarded as extreme diets and anyone interested in trying the diet should consult their doctor or specialist who can assess its suitability for you.

One issue with very low calorie diets is ensuring you get enough essential vitamins. A dietitian can help you to ensure your nutritional needs are best met whilst following the diet.

What diet is being used in the DIRECT study?

The diet used in DiRECT will last for between 8 and 20 weeks and provide around 800 calories a day. It will consist of four diet soups or shakes per day, providing all essential vitamins and minerals and lots of fluids.

How can I follow a similar diet?

If you are interested in following a similar diet then it is essential that you do so under medical supervision to ensure that it is appropriate for you to follow a VLCD.  It is also essential that you do so under the guidance of a Registered Dietitian.  At Eat Well Now we specialise in weight management issues and diabetes and can provide advice that is tailored to your individual needs.  We can advise on a range of low calorie diets including meal replacement programmes.