Anyone for a short black?

Coffee. Mmmm. Even those people who don’t drink coffee can enjoy the pleasurable sensory satisfaction of freshly ground coffee beans. Coffee drinkers that don’t have their morning / post lunch / pre-bed espresso can feel just a little bit less than human. Actually for some, that’s being polite. Like someone falling off the edge of a glucose cliff, they can turn into the worst version of themselves if they haven’t slammed their triple shot short black, hold the glass. There is a reason why we turn our nose up at Starbucks or McCafe when there is a small local espresso stand just down the road. As a rule, New Zealand has GREAT coffee and even the less seasoned drinkers can wax lyrical about coffee machines, a well roasted coffee bean, or a good crema on top of our espresso. We trump Australia in the coffee stakes and are as proud of that as we are of the All Blacks.

And what’s not to love? Now that it is pretty much undisputed that, for regular consumers, coffee isn’t going to dehydrate you, it can also boast about being protective against risk of type 2 diabetes and cardiovascular disease. It is known for its performance enhancing effects for athletes due to the effect of caffeine on the central nervous system. But really, these are almost positive byproducts of consumption  for most people. Coffee, with it’s stimulant effect, helps us get out of bed in the morning, gets us through the two hour meeting (which, like most meetings, could be over and done with in half an hour), gives us something to do at 3pm when we feel like we are going to crash, and helps us unwind at the end of a busy day. While some of these are more psychological (particularly the last one), the others are to do with the effect that caffeine has in the brain. Caffeine has the ability to take the place of adenosine in our brain, an inhibitory neurotransmitter released by neurons to help promote sleep by binding to adenosine receptors and causing the release of dopamine. Caffeine is perfectly shaped to take place of the adenosine in certain adenosine receptors and take up residence instead. This allows the brain to function as normal instead of it preparing for rest, increasing alertness and offsetting any drowsiness we might be experiencing particularly when we are lacking in sleep. For some, operating in this sleep deprivation/fatigued state is pretty much how life rolls at certain times of the week or year.  While some notice the effects of caffeine more than others, most will build up a tolerance over time so its stimulant effect will be harder and harder to come by without upping our dose of caffeine. It has a half-life of around 6 hours (i.e. it takes this long to eliminate half the caffeine dose from our system) which means that your body can still be in a state of alert well into the night if you typically enjoy a long black after dinner (or, to a lesser extent, an afternoon coffee). Despite assertions from people that the post-dinner caffeine hit doesn’t affect their sleep, research shows it can affect the time it takes to get to sleep, the amount of time we sleep in total and the amount of quality restorative sleep we are able to get. This could be the start of a vicious cycle where the pleasurable cup (or three) of coffee in the morning starts becoming a necessity to keep you feeling awake or alert. The ‘tired but wired’ feeling typically experienced comes from the effect that caffeine has on the pituitary gland, causing the release of adrenaline. I’ve talked before about the short (and long) term effects of this stress hormone response, and imagine many out there can relate to the exhaustion that comes from the sleep deprivation and blood sugar disregulation that can come from too much coffee.

When I chat to clients about their coffee intake they are often anxious that I will suggest they need to drop all coffee immediately. But that’s not my default position. If you aren’t experiencing any digestive issues, symptoms of liver toxin overload, sleep deprivation or any problems with anxiety, then there may be no reason to do cut back. However, if you recognise that your coffee intake is higher than it should be, and you’re using it as a crux to get you through the day, then cutting back on coffee is one strategy among other dietary and lifestyle modifications that help bring you back into balance. Some people can quit drinking coffee and experience no physical symptoms. Here are a few things that I’ve recommended to clients to help them reduce their intake and potentially limit those withdrawal symptoms:

• Warm water with lemon in the morning: this can help support liver function and reduce symptoms of sluggishness related to metabolising nutrients and toxins in the body.
• Higher protein content at breakfast:  this helps support a normal cortisol level (another stress hormone which helps maintain energy and concentration and should be higher in the morning and decreases over the course of the day. This isn’t possible with increased adrenaline). A higher protein breakfast will also help keep you fuller for longer. This is important if you notice that the 10am coffee is in lieu of a snack because you’ve had a cereal-based breakfast that has barely touched the sides.
• Ensure you are drinking enough water during the day. This will help you remain hydrated and reduce any dehydration-related fatigue.
• Quit the coffee after lunch. Find a substitute. This will help restore restorative sleep patterns which will obviously reduce fatigue throughout the day. Combined with a better breakfast, your concentration and energy levels will be a lot higher, negating that 3pm coffee.
• Which of your four morning coffees are a necessity for you and which are merely a distraction from what you should be doing? Gradually reducing your intake and setting a timeline around this can be helpful. You will feel good about achieving your short-term goals, and it will may make it easier to cut back further if need be. By substituting one of these for a brisk walk up and down the stairs you will increase your blood flow and level of alertness without the caffeine hit.
• Find another beverage. If you’re not a fan of herbal teas then I can relate. I don’t like a herbal tea bag as they promise SO much more than they deliver. However a visit to a specialised tea shop uncovered some great options in the form of leaf tea which, surprisingly (to me) provided just as much pleasure as an afternoon long macchiato. Once I got my head around it.
• Jumping in a cold shower for a few minutes can also increase your alertness, as the shock factor from the cold water will increase your deep breathing and deliver oxygen (i.e. energy) to your muscles. Your heart rate will also increase and blood will pump through your body faster. Of course, this is pretty impractical for all but a few of us, so try splashing your face with cold water throughout the day for the same effect.
• Drink green tea: while this contains some caffeine, it is a lot less than your standard cup of coffee (25 mg versus 150 mg, though obviously this will vary). There is a compound in green tea called l-theanine that works to increase alertness, particularly in the presence of the small amount of caffeine in it.
• Put your feet up… literally. Putting your legs up against the wall for a few mintues will increase the blood flow to your head and can eliminate brain fog. Try it.
• When you feel a craving come on, actively busy yourself with another task – i.e. Take your mind off it. Research shows that this can help suppress your craving for coffee.

Do you need to reduce your intake? You might not need a nutritionist to answer that. Be honest with yourself about how much you are consuming and hopefully some of these strategies listed above will help you if you do. It’s likely that, after a period of time, you’ll rediscover the real feeling of pleasure that is derived from a perfect cup of coffee, which may be somewhat diluted if you’re overloading your system.

Biggest loser: best for weight loss?

The Biggest Loser has been getting some flack in the media about the tactics participants use (and the humiliation they endure) in order to gain the biggest advantage when it comes to the weekly weigh in. This is no surprise – I doubt anyone is under any illusions as to the type of regime these people undertake to make those types of losses. I remember watching Downsize Me, a reality diet show where well known New Zealander’s take on the challenge to overhaul their diet and their exercise in an effort to lose weight. Notable people who exercised up to two hours a day in the weeks leading up to their final weigh in are now a much larger version of their svelte self. This should make anyone question why you would put yourself through the torment of such a deprivation diet and exercise regime only to regain the weight in a few months time. On top of that, they must have put themselves in such a vulnerable position to have it played out in the public domain to then be unable to maintain such a diet. Most people would agree that this pretty much captures the essence of the Biggest Loser.

What was perplexing, then, was the recent US News and Health report that evaluated 32 popular diets and determined the Biggest Loser diet to come out on top in the categories for ‘biggest weight loss’ and ‘best for reducing diabetes-related symptoms.’ These were ranked by nutrition experts for highest ratings in seven categories:

Short term weight loss: Likelihood of losing significant weight during the first 12 months, based on available evidence (5=extremely effective, 4=very effective, 3=moderately effective, 2=minimally effective, 1=ineffective).

Long term weight loss: Likelihood of maintaining significant weight loss for two years or more, based on available evidence (5=extremely effective, 4=very effective, 3=moderately effective, 2=minimally effective, 1=ineffective).

Diabetes: Effectiveness for preventing diabetes or as a maintenance diet for diabetics (5=extremely effective, 4=very effective, 3=moderately effective, 2=minimally effective, 1=ineffective).

Heart: Effectiveness for cardiovascular disease prevention and as risk-reducing regimen for heart patients (5=extremely effective, 4=very effective, 3=moderately effective, 2=minimally effective, 1=ineffective).

Ease of compliance: Based on initial adjustment, satiety (a feeling of fullness so that you’ll stop eating), taste appeal, special requirements (5=extremely easy, 4=very easy, 3=moderately easy, 2=somewhat difficult, 1=extremely difficult).

Nutritional completeness: Based on conformance with the federal government’s Dietary Guidelines for Americans 2010, a widely accepted nutritional benchmark (5=extremely complete, 4=very complete, 3=moderately complete, 2=somewhat complete, 1=extremely incomplete).

Health risks: Including malnourishment, specific nutrient concerns, overly rapid weight loss, contraindications for certain populations or existing conditions, etc. (5=extremely safe, 4=very safe, 3=moderately safe, 2=somewhat safe, 1=extremely unsafe).

I wondered whether the nutrition experts knew something that we didn’t. If you watch the show (I did, perhaps 10 years ago) you might have an idea of what the contestants undertake on a day-to-day basis regarding diet and exercise. But for those who don’t know, here is some information on the Biggest Loser plan that is deemed to be so successful. It comes from Cheryl Foberg, the dietitian who consults to the show, and who also runs a clinical practice counseling clients along the same Biggest Loser lines.  By all accounts, it sounds pretty intensive. Unsurprisingly the food choices were around a low carbohydrate, low fat, high protein diet plan. The clients spend around a year in her counsel, with weekly to fortnightly visits reviewing food journals and exercise plans. The amount of activity recommended is up to seven hours a week – which may not rival that of a moderately competitive long distance triathlete, but is certainly up there in terms of hours spent working out.

An actual diet plan was a little harder to come across. However Foberg kindly put together a diet plan for an magazine article that emulated a weekly food plan of a biggest loser contestant. I might be wrong, but this appears to be a watered down version of the diet plan that is used on the television show. It seems to be more in line with the traditional three meals, two snacks, dietary guidelines approach to diet that would be challenging to maintain over the long term, but certainly one could follow it in the short term to lose weight. Do note, however, the recommendation by a trainer on the US Biggest Loser show, Bob Harper, to do 60-90 minutes of exercise at least four times a week to ensure success with the plan. This news piece by an Australian journalist perhaps more accurately illustrated the diet of the participants who were involved in the show, as this was given to him by the producers:

• Breakfast: egg white omelette with spinach
• Snack: apple
• Lunch: chickpea and vegetable salad
• Snack: yoghurt and 10 almonds
• Dinner: chicken stirfry

Noone would argue that this is quite a bit more stringent than that of the seven day diet plan touted above as the way to become the Biggest Loser. Low fat, low carbohydrate, low protein and actually just low food. Undoubtedly difficult to maintain day in, day out, particularly with the demands of an exercise regime.

Speaking of exercise, while the guidelines already mentioned are recommended for those wanting to lose weight already seem at the higher end of the time and effort range. However, there is nothing like a past contestant to spell out exactly what was expected of those on a day to day basis in the show. According to this contestant who was involved in the show for three weeks, the majority of time spent on the ranch was, in fact, exercising:

• 5 a.m.- 8 a.m: Small breakfast. Do a five mile walk or hike.
• Mid-morning: Small snack. Work out for five hours with trainers.
• Late afternoon/early evening: Eat late lunch or early dinner.
• 10:30 p.m: Lights out.

Hard core, and about five times more than that recommended in the Biggest Loser weight loss plan. Take away the support structure, the environment, the hours of exercise, and it’s difficult to see how anyone could maintain the weight they lost during their time on the show.  But it appears that it’s not impossible. While there are clearly people who struggled to maintain their incredible weight loss, those who were part of this article seemed to do really well, committing a lot of energy to continuing the diet and exercise habits created on their Biggest Loser journey. Of course this doesn’t speak to the numerous people who also lost a lot of weight but didn’t win the show – there is likely less of a commitment to their weight loss journey given that, outside of those in their community, there is no public accountability for their weight loss. It seems the most successful winners capitalised on their weight loss and turned it into a career opportunity, and as such they have a vested interest in keeping fit and lean.

The one thing I’ve failed to mention (importantly) is that the US News also rated the ‘Paleo’ diet alongside others such as the aforementioned Biggest Loser, Medifast, Slimfast and other plans people turn to when wanting to lose a couple of kilos. While these diets certainly help shed the weight, sustainable they are not. Most health professionals would never recommend people follow these diets long term. There was no need to delve into the reasons why Paleo, yet again, has been slammed; people like Robb Wolf have already critiqued this far more eloquently than I ever could. Which begs the question as to why Paleo was part of this list in the first instance, if the goal wasn’t to follow an eating style that is sustainable and achievable.

My awesome Dad.

My dad is awesome*. Out of all of my family members he’s the one that I’m most similar to. In fact, if it wasn’t for the striking physical likeness (draw a beard on a picture of me and I’m a dead ringer for him circa 20 years ago), I’m so different from everyone else that I would have sworn there was a mix up in the hospital when I was born and my parents brought home the wrong baby. Dad and I share similar tastes in music (Captain Beefheart aside), enjoy whiling away time in secondhand bookstores and a love of big portions at dinner. Our regular Saturday evening meal was splitting 500g packet of spaghetti to have with a tomato based sauce and a supermarket French stick made into garlic bread. Between two people! However he has (for the most part) always been very slim and quite fit. I got my running genes from him too. He won the Lifeboys cross country event when he was 11 years old and jogged a bit when we were growing up as necessary stress relief. Despite being the least out of everyone in my family in need of health advice, he’s the one that has always been most interested in learning about health and nutrition from me. The only one to say ‘tell me more’ and mean it when I start banging on about something new I’ve learned, or a frustration I have with how something has been portrayed in the media.

While Dad has always been in pretty good health, there have been two notable changes he’s made in the last 25 years that I think really ensured that he remained that way. The first is related to stress. Nowadays Dad is very patient and laid back – in fact, in our family we joke that if he was any more laid back he’d probably be dead. That wasn’t always the case though, and we remember Dad being someone best avoided a lot of the time due to the effect his job as a bank manager at Trustbank had on him. The demands and stress of the job affected not only his work life, but permeated into the home as well. It can’t have helped that he had five children to contend with after a long day working in a job that he despised, and it’s no wonder this grumpy disposition was his default personality. No amount of jogging or deep breathing (which he also regularly did) would have offset this. However it reached a point where enough was enough and, as he’d been in his job since he was 19 years old, he was eligible for retirement at 37 years old and took it. What a change. Even though money got a whole lot tighter, there was a monumental shift in his personality and state of being that is almost indescribable. There is no doubt in his mind (and mine) that continuing on in the role would have taken a massive toll on his health over time, particularly given what we now know about the relationship between stress and health. It was such a brave thing to do given that he didn’t have a job to go to, and certainly not one that offered a similar salary. But we finally got an opportunity to have the type of father all children would want, which wasn’t possible while he was in that career.

The second major change he made was around eight years ago. Despite his active job as a cleaner and a relatively healthy diet, he had steadily gained weight over the years. No one would have called him overweight by any stretch of the imagination, but the 67kg he weighed was about 6kg more than he should have been carrying. Most would have called this weight gain an inevitable increase due to age. The visit to his doctor revealed his cholesterol was a bit high – his total cholesterol was around 6.2 mmol/L and his HDL cholesterol (the lipoprotein carrying cholesterol that is responsible for breaking down the plaque in your arteries) was below 1 mmol/L. His cholesterol wasn’t high enough to warrant medication, but the doctor thought it prudent to keep an eye on it. His job as a cleaner split his day into two shifts of 8am-12pm and 5pm-10pm, which dictated the timing of his meals. He would start the day with muesli, fruit and yoghurt, and come home to have toast with cheese, onion and tomato, with some handfuls of honey roasted peanuts or roasted salted peanuts. His main meal would be eaten before heading back out to work at 5pm and while this always included vegetables, it was predominantly based around pasta or rice. When he got home from work at around 10.30pm he would have four slices of toast with cheese, onion, tomato and a smoothie with fruit yoghurt, banana and milk. He wouldn’t be that hungry when he woke up the next morning due to the large amount of food he ate just before bedtime. Dietary intervention was required.

Major changes we made at this time was to reduce the evening snack to just the smoothie, replace a lot of the cheese with tuna or salmon, and substitute a large portion of the get rid of the potatoes, pasta and rice that was included in the evening meal with more green vegetables. He also swapped the full fat milk for trim, and started using a margarine spread that contained plant sterols to help reduce cholesterol absorption. This reduced quantity of food resulted in a weight loss of around 6kg. However, despite his weight loss, his improved diet along with an increase in exercise (we had re-introduced a half hour walk) and overall better lifestyle, his total cholesterol did not shift. More inquiry revealed lower levels of LDL cholesterol and triglycerides (a fatty acid that is influenced by the amount of carbohydrate in the diet), with a significant increase in HDL cholesterol. I would say this was the first illustration of someone close to me being in near perfect health, yet this wasn’t reflected in their cholesterol level, and it made me question the concept of using total cholesterol as an indicator of heart disease risk. He has maintained this lower weight for the last eight years relatively effortlessly.

Unsurprisingly, Dad’s diet has also shifted in the last year based on my increased understanding of nutrition. He hasn’t gone paleo, but has taken on board the whole food message and has started looking more at ingredient lists on products and less at fat content on a nutrition information panel. I noted definite glee when I told him full fat milk was fine in the context of a minimally processed diet and to switch out that Flora Proactive for butter. He removed a lot of low fat, processed dips like hummus, sugary condiments and low fat fruit yoghurts and has replaced them have been replaced with homemade versions such as the salsa found on my recipe page and Greek yoghurt. He is a willing recipient of my recipe ideas (such as the flourless muffin in a cup, also new on the recipe page). Cheese is now enjoyed as part of a vegetable snack instead of on crackers and his intake of bread has reduced. He got a slow cooker earlier this year and has started enjoying eating more of the animal that I would normally have encouraged him to remove. Despite this increase in fat and saturated fat, his weight hasn’t changed at all and neither has his cholesterol profile.

While Dad has never experienced major health issues, I believe that at critical times in his adult life he made lifestyle decisions that helped prevent the progression of health issues related to stress, diet and exercise. Of course, this might not have been the case at all, as the only ‘evidence’ is the absence of chronic conditions that are prolific among our population, which he may never have experienced anyway. At least we won’t look back and wonder. The most recent changes haven’t altered his immediate health at all but I firmly believe that less processed food and sugar will ultimately keep him in the good health he’s enjoyed over the last eight years. And because his interest in what I bang on about means he has learned a lot over the last year also, he thinks so too.

Dad and I both being awesome (obviously).

*You are also awesome Mum. I’ll be writing about you soon x

Back to work breakfasts: make them protein packed

Hands up who’s back at work tomorrow? Me too. I was pleasantly surprised the feeling of dread had switched to anticipation of starting to tackle some tasks and feeling mildly productive. I do predict, however, some element of post-holiday blues that always accompanies the return to 9-5 (lol. As if anyone works 9-5 anymore). On the food front, you might also be coming back to work from an alcohol and sugar fuelled holiday and wanting to lose that kilogram gained over the Christmas period. Therefore, not only do you have the perceived mundane-ness of getting back to real life to grapple with, it is a double whammy to also get back into real life food habits. It’s always best to acknowledge early in the piece that the increased regularity of chocolate and wine can turn a treat into an unwanted habit that’s increasingly hard to break if not knocked on the head. I hate to sound like a spoil-sport but I have sat down with many clients who lament post-holiday weight gain due to this come March. How can we tackle both holiday blues and getting back into good food habits at the same time without the risk of dying of boredom before Monday afternoon courier drop off? Yes, the latte bowl and muffin from the coffee cart downstairs might seem appealing, and moreso when motivation levels are somewhat lacking. However, we need to change our perception (of the entire situation) and use food to our advantage by making meals with ingredients that will help your energy and motivation, not drain you of both.

The obvious place to start is breakfast. You may have your tried and true options that you know keep your energy levels stable, fill you up and keep you satisfied until lunch. You might even be looking forward to getting back to these as a way to get back to routine after the holiday. Great. However if you know you need to change it up and are looking for a bit of inspiration, then I have included a few options below, and have deliberately made them protein packed. These aren’t all new ideas, rather it’s a gentle reminder that this strategy is best for maintaining blood sugar levels and keeping you fuller for longer due to protein’s increased satiety factor.  While the bowl of Special K and trim milk may seem like the sensible 250 Calorie breakfast option for those who have been overindulging of late, this lower calorie, low fibre and high gluten breakfast will likely just lead to a cereal-fuelled blood sugar crash come mid-morning. Basing your breakfast around protein and fat, and including a good source of carbohydrate (i.e. not cereal or toast) will provide nutrients, keep energy levels even and (for the athletes among us) help refuel any early morning training session. A few options for you could be:

1. Eggs. Always a favourite of mine and, at 7g of protein per egg, 2 or 3 of these can really help fill you up, depending on your appetite. Scramble these in the microwave or on the stovetop and and serve with a vegetable or three, including avocado is delicious.
2. Scoop the flesh out of a left-over potato or kumara and mix in hardboiled eggs, avocado, some paprika, salt and pepper for a breakfast that includes nutritious carbohydrate, protein, fat and flavour.
3. Grain-free cereal (either home made  (such as this but without the coconut sugar) or purchased) with unsweetened yoghurt plus/minus a piece of fruit is a handy substitute to your standard cereal breakfast. Do note, however, grains are replaced by nuts and seeds – a nutritious source of good fats. This will make it more energy dense and when consumed in the same volume as, say, Special K, can end up being a bit of a brick in your stomach. Lighten it up with some grated fruit (such as apple or pear) or berries – both low fructose options – to prevent this.
4. Leftovers – yum! We are definitely in a ‘cereal or toast as a breakfast’ culture so instead think of having left-over steak or fish as part of your breakfast. It can take a little while to get your head around but you really notice the difference in your energy levels later on in the day.
5. Make a breakfast burrito to rival that of your local café, by preparing a wrap from a very thin omelette, and including salmon, thinly sliced meat, avocado, bacon, some greens as an almost ‘breakfast on the go’.
6. Smoothie: A great option if you want something quick – but mix it up a bit. Change your standard milk based smoothie to coconut milk – the additional fat will certainly offset hunger for your later meals. Throwing berries in there (and some spinach) with ice would make a nice change. Unsweetened almond milk with some espresso coffee, perhaps a date or two for sweetening and nut butter is another nice alternative. The addition of protein powder for those that have some on hand would make it a substantial after-training option.
7. Cottage cheese blended with cooked pumpkin, cinnamon and vanilla extract, and topped with sliced banana and chopped walnuts.
8. Egg-based muffins: Whizz 8-10 eggs as a base and change up the fillings to put into a texas-sized muffin tin or mini-loaf tin. Get creative with your fillings to increase variety if you get bored easily to have a different flavour every day of the working week. Some of the fillings can be put directly into the muffin tin with the egg poured on top, some would be best whizzed separately and then popped into the muffin tin (i.e. the apple and the banana option). Bake them in oven for 25-30 minutes on around 180 degrees and you are good to go. You could slice one or two of these up to have with some salad greens and avocado (the savoury options) or perhaps with a dollop or two of unsweetened yoghurt/coconut cream (the sweet options) and nut butter to have an easily prepared breakfast. Some different fillings might include:

– Chopped bacon, avocado, frozen spinach
– Grated carrot, cheese and courgette
– Chopped smoked salmon, dollop of cream cheese and capers
– Blueberries and coconut threads
– Grated apple and coconut threads with cinammon
– Banana, cottage cheese and nut butter
– Feta cheese, sundried tomatoes and olives topped with pumpkin seeds

Much of the return-to-work blues really is just a mindset, and the sooner you get back into the reality of work, the easier it is to have a happier disposition. A protein-packed breakfast that is satisfying and a little different will help :-).

Awesome breakfast muffin