Sort your salt out: a summary and suggestions

At a time when nutrition headlines are saturated with information about fat and sugar, CASH (Consensus Action on Salt and Health) has done a great job at getting us talking about salt, again. This is important because although we need a little bit of salt in our diets, too much puts us at an increased risk of high blood pressure, which is a major cause of strokes and heart attacks.

Their National Salt Awareness Week had hospitals, schools, community groups and health professionals engaging in activities, displaying key information and talking and tweeting about salt. View some of the conversations on Twitter by following @cashsalt and using #nationalsaltawarenessweek.

I attended their Parlimentary reception at The House of Commons to hear the latest on salt from other health professionals, academics, members of food industry and chefs. Here are some of the key updates:

• We reduced average daily salt intakes by 15% (from 9.5g – 8.1g) between 2000/2001 and 2011. This is mainly due to food industry reformulating their products to reduce the amount of salt in them.
• Reducing salt intake by 1g prevents 4147 deaths and saves the NHS £288million each year.
•  Adults should aim to work towards no more than 6g salt/day (full recommendations below).
• Businesses have pledged to further reduce salt in many commonly eaten everyday foods by 2017.
• A recent survey carried out by CASH showed that almost a quarter of children’s meals in family-friendly eateries contain ‘more than 2g of salt per meal – that’s the entire maximum recommendation for a whole day for a 1-3 year old – and more salt than 4 packets of crisps!’. Read the full survey summary, here. The main offenders were: Burger King, Hungry Horse, Loch Fyne Seafood and Grill, Beefeater and Bella Italia.
• A recent study showed that educating primary school children in China about the dangers of salt resulted in their whole family reducing salt intake. Read more, here. It would be really interesting to see if a similar outcome could be replicated in other studies and with other nutrients.

Want to learn more? How much is too much?

6g of salt is approximately a teaspoon.

Ready to sort out your salt intake? Here’s how:

Keep the table salt away from the table:

Most of the salt we consume is already in the foods we eat. So avoid adding additional salt to your food, including whilst cooking. If you’re worried about the food not tasting the same, gradually reduce the amount you add and your taste buds will adapt. They are not set for life!

Limit foods that are high in salt, like:

• Bacon
• Cheese
• Ham
• Olives
• Pickles
• Prawns
• Smoked meat and fish
• Salted nuts

Read the label to see how much salt is added to packaged and processed foods, like these:

• Bread products
• Sauces (e.g. pasta sauce, Ketchup, mayonnaise)
• Pizza
• Ready meals
• Soups
• Sandwiches

Get technical about your takeaway and be restaurant ready:

We are eating foods cooked outside of the home more and more. When eating out, try to choose somewhere that gives you the nutrition information of the food they serve to help you make educated choices. Only choose foods that you know are high in salt (see list above) occasionally, or ask for a smaller portion. And don’t forget to request that less salt is added during cooking. Check out CASH’s ‘Less salt, please’ campaign and some more ideas, here.

Good luck! Share what changes you’ve made by leaving a comment below or tweeting me @HelloHealthyYou

References and further reading:

Consensus Action on Salt and Health http://www.actiononsalt.org.uk/index.html

Department of Health: Public health responsibility deal https://responsibilitydeal.dh.gov.uk/salt-reduction-onwards-and-downwards/

NHS Choices, Salt: the facts

http://www.nhs.uk/Livewell/Goodfood/Pages/salt.aspx

Beat the breakfast battle

 ‘Rumbling hour‘

Teachers are describing 10.30am as ‘Rumbling Hour’. According to research by Quaker*, teachers said that the hungry kids who skip breakfast:

• Struggle to concentrate (76%)
• Are sleepy and lethargic (54%)
• Disrupt other children in the classroom (44%)
• Demonstrate lower levels of creativity and focus throughout the day (44%)
• Try and find something to eat (10%)

Visit the Magic Breakfast website to learn more*

Fuel before school

We hear it all the time; ‘breakfast is the most important meal of the day’. But why? Here are the facts:

• Fuelling the body and brain at the start of the day provides the energy and aids concentration.
• Breakfast foods are full of goodness. Typical breakfast foods like cereal, milk, bread, eggs and fruit provide a range of nutrients such as fibre, dairy, protein, vitamins and minerals.
• Eating breakfast is important for maintaining a healthy weight. Skipping breakfast means hunger sets in before lunchtime. We’re likely to opt for more fatty and sugary foods throughout the day and consumer larger portion sizes.

Beat the breakfast battle

Achieving a successful breakfast time can be a struggle. Children might prefer extra sleep time, they might not yet feel hungry or perhaps they’re just not a big fan of breakfast foods. Here are some top tips to help fuel your family off to a great start each morning:

• Who’s the chef?

Make breakfast a fun occasion. Involving children in preparing and cooking food will increase their chances of eating it! If it’s a food they don’t like yet don’t force them to eat it, but still get them to help. They’re more likely to try the food once it has become more familiar to them.

There’s a role for everyone at your homemade restaurant; from waiter and waitress, to menu planner and chef. Offering the children limited choices can help them feel like they’ve had an input and make them more likely to try the food. For example, you could ask them to choose whether they want cereal or toast, or a banana or apple, to go with their breakfast.

• Bond at breakfast 

Start the day off positively by making it a family occasion. Get as many family members around the table as possible; children learn by copying and if you’re enjoying breakfast, they’re more likely to enjoy it too.

Try to keep it as stress-free as possible so everyone looks forward to breakfast. Engage the kids by giving them the task of setting the table (do it the night before if time is an issue). They can personalise everyone’s spot at the table by making name places and plate mats.

• The breakfast pact

Organise a family meeting to discuss how you will work towards a successful breakfast time as a family. Agree on a set of rules that everyone should stick to and make a breakfast pact. For example, if a lack of appetite in the morning is a breakfast barrier, agree that everyone must have something for breakfast, however small.

For the best chance of breakfast success, be consistent. Stick to your breakfast pact and agree on a family reward. Creating fun sticker charts and monitoring sheets as a way to keep track of everyone’s progress is a great way to see what helps and what gets in the way.

Recipes

Visit these great websites for family-friendly breakfast recipes:

• Shake up your wake up

There are loads of ideas on this site, that suit both a busy school morning and a lazy weekend brunch. You can use the search tab to quickly discover creative breakfasts containing the ingredients you have to hand.

http://www.shakeupyourwakeup.com

• Change4Life: what’s for breakfast?

Use the recipe finder on this site to find healthy and tasty breakfast ideas. Involve the kids and get inspired by using the ‘What’s for breakfast’ function. Change4Life also has a handy recipe app, so you can plan your meals on the move and always be prepared.

• ‘Healthy and easy breakfasts your kids will love‘

Read this Buzzfeed article if you have extra time at the weekend and want to get creative with your kids. They’re not all entirely healthy, but there’s lots to choose from. This yoghurt and fruit breakfast popsicle looks great!

http://www.caramelpotatoes.com

 

Enjoy! Tweet me your breakfast questions and recipes @HelloHealthyYou #hellohealthybreakfast

Owning obesity: banishing blame and acting accountable

Here is an article I wrote recently for the British Obesity Society. Hopefully it provides some food for thought…

The topic of obesity is heavily present in the news, now more than ever. In 2013, obesity was classified as a disease by the American Medical Association. Advocates of this decision surmised that it would reduce the stigma of obesity, derived from the belief that it is merely the consequence of excessive eating and inadequate exercise. Additionally, support from health professionals, which had previously been reserved for obesity-related consequences, such as diabetes, would become more accessible. However, those against the classification are concerned that it may encourage an over reliance on drugs and surgery as treatment, rather than lifestyle change.

A recent article in the New York Times, which explored the decision to classify obesity as a disease in the US, presented the following conundrum:

‘If obesity is not classified as a disease, people are too embarrassed to accept their state. Taking responsibility is seen as failure. Whereas if obesity is classified as a disease, people assume they are exempt of responsibility.’

So does the classification exempt individuals from accountability and the belief that they can achieve a healthier weight? Are some people destined to be overweight, or are we shifting blame? To understand this, it’s important to consider the causes of obesity. Broadly speaking, is it genetics, the environment or both?

It’s genuinely genetics

Some people are convinced that they will never reach a healthy weight as it’s in their genes, whereas others interpret genetics as an ‘excuse’ for behaviours. Evidence shows that obesity does run in families. Genetics are responsible for pre-disposing us to certain traits that will lead to behaviours which aren’t conducive to maintaining a healthy weight. But we also know that behaviours, healthy or unhealthy, are learned.

It’s inevitably environmental

It is difficult to maintain a healthy weight in, what has been coined, an ‘obesogenic environment’. Access to fast food is high and motorised transport and computer games are often favoured over an active lifestyle. But it is not impossible to take a step in the right direction. Becoming healthier does not have to mean reaching a healthy weight. Just reaching a healthier weight has benefits.

Empathy and empowerment

Whatever the cause of obesity individuals need to be accountable, not specifically for their weight but for being aware of their weight status and by choosing to take action. However, there are many barriers which make this challenging. For example, feelings of embarrassment and self-blame can be debilitating and effect our ability to problem solve and make changes. Those with a weight classification of obese need to feel empathy that maintaining a healthy weight is difficult and extremely complex. But they also need to feel empowered that they can take a step in the right direction, with realistic goals and access to the right support. Ultimately, any engagement in working towards a healthier lifestyle is a positive thing that people should be proud of. And in doing so, it should be recognised that any feelings of embarrassment or failure is a societal flaw, not a fault of the individual trying to lead a healthier lifestyle.

So what is the impact of labelling obesity as a disease? It’s too soon to tell. But we do know that weight stigma can be disabling. It’s therefore important to monitor, by looking at how obesity is being dealt with at an individual, community and national level. The proof, as they say, is in the pudding.

Hello healthy pancake day

Whether you celebrate Shrove Tuesday for religious reasons, societal camaraderie or as part of a family tradition, there’s always one common feature: pancakes.

Pancakes (with their classic caster sugar topping!) are not the healthiest of food choices. But there are many ways in which we can enjoy a healthier Shrove Tuesday. Here are some simple dos and don’ts to get you started:

Do modify the menu

Find a pancake recipe and make some healthy modifications. Can you swap white flour for wholemeal, cook in less fat or reduce the amount of sugar?

Offer a selection of healthy toppings and let the kids choose theirs. Fresh, dried or tinned (in natural juices or water) fruit is a great choice, as is a small handful of chopped nuts. You can get adventurous by adding a spoon of creme fraiche, natural yoghurt or peanut butter, or stick to tradition with some squeezed lemon juice.

And don’t forget, savoury toppings are an excellent choice too; from eggs and lean bacon to avocado, goats cheese and beetroot. Whatever takes your fancy!

Do let your children play the chef

Allow the children wear the chef’s hat; they can pour, stir and shake! Involving children in cooking enables them to become more familiar with the food and subsequently increases the likelihood that they’ll try it. Not only that, cooking skills are a crucial part of living a healthy lifestyle and ones that your children will value throughout life.

Get creative – make pancake people and funny faces with your selection of healthy toppings.

Pancake people (image: food-4tots.com)

Do play with your food

Would you usually encourage your family to run around the house throwing food in the air? No. But this is a Shrove Tuesday tradition that should be embraced! Make a couple of spare pancakes and create a race track. Add some tricks (flip the pancake, wear a blind fold, run backwards etc), agree on the rules and keep track of the scores. Good luck!

Don’t skip dinner

As much as Shrove Tuesday is about pancakes, it’s important to include a variety of food in our everyday diets.  So make smaller portions, but don’t ditch dinner completely. Dinner will keep your hunger at bay and will stop you wanting to overload on pancakes.

Don’t stack them

Enjoy your pancakes, but in moderation. Despite the presentation of pancakes we are often served at restaurants,  see in images or associate with an American diner, we don’t need to eat a stack!

Healthy pancake recipe

Try this fun and fruity recipe with your family for nutritious pancakes full of fibre and low in added sugar.

Feeds: 6
Prep time: 5 mins
Cooking time: 6 mins per pancake

What you need:

• 100g wholemeal self-raising flour (or 100g wholemeal plain flour and 1½ teaspoons baking powder)
• 2 tablespoons granulated sweetener
• 1 egg, lightly beaten
• 150ml skimmed milk
• a little spray oil
• Any fruit you fancy: fresh berries, bananas, kiwi, mango, raisins etc

Step 1: Mix the flour and sweetener in a bowl, then add the egg to make the consistency of thick cream (don’t over-mix!)

Step 2: Lightly spray oil into the frying pan and heat it up

Step 3: When the pan’s hot, drop spoonfuls of the batter into the pan

Step 4: Wait 2 or 3 minutes for bubbles to come to the surface, then flip it over and cook for 2 or 3 more minutes

Step 5: Serve with natural yoghurt or a spoon of peanut butter and your favourite fruits

Enjoy! Tweet me your pancake pictures  @HelloHealthyYou #pancakepicture #pancakepeople

Mealtime mayhem: the fussy phase

What happened? Up until now, your child put anything in their mouth; peas, carrots, their favourite toy, a lump of mud… Now all of a sudden, they’re refusing foods and achieving a stress-free mealtime seems like the ultimate challenge. Sound familiar? You’re not alone!

Children commonly experience a phase of ‘neophobia’ (a fear of eating new or unfamiliar food) for many reasons. New foods with different textures, colours and smells can make a child apprehensive and more likely to refuse it. The mealtime environment, distractions at the table, other family members and irregular eating patterns can all have an impact. As children develop they like to assert independence in a world where they have little control, and this can manifest in their eating habits. And sometimes, we’re panicking over nothing; they may have just refused their meal because they’re not hungry. The issue is that panicking about the ‘problem’ can escalate the problem.

Here’s the good news: identifying what might be fuelling this fussy-phase and introducing new foods with a calm and consistent approach, should help to reduce the length and intensity. Often, changing your mealtime approaches and implementing some strategies will help this fussy phase pass as smoothly and quickly as possible.

Follow the FOUR-Ws checklist below to get started:

WHEN are the eating?

Sometimes, a child might not want to eat their meal simply because they’re not hungry. Feeling tired or ill can affect appetite, or they might be full-up from other foods and drinks. Plan snacks and mealtimes across the day to establish regular eating patterns. If a child has had a snack or glass of milk whilst you’re cooking dinner, the chances are they won’t want their meal.

At dinner time, if your child still hasn’t touched a certain food after approximately 20 minutes, remove the meal calmly and explain that you’ll keep it in the fridge incase they feel hungry later. Don’t offer an alternative as they’ll learn to expect one every time.

WHAT are they eating?

We don’t all love every food we eat. However, this doesn’t mean our taste buds are set for life. It can take approximately 10-15 tries to become familiar with a new food. We acquire a liking over time. Not convinced? What foods did you used to hate as a child that you like now?

Continue to re-introduce new foods to your child. It’s helpful to introduce one new food at a time, rather than a whole new meal. Don’t make a fuss or try to force-feed them if they don’t eat it. Let your child explore the food; seeing it, touching it and smelling it all count as exposure. Over-time, when they have become more familiar with the food, they’re more likely to try it.

Create a sticker chart with your child to keep track of how many times they’ve tried a new food. Let it become a positive part of meals rather than a burden.

WHERE are they eating?

If your child is eating in front of the TV or is being distracted by their favourite toy at the table, the chances are they’ll lose interest in the food. Eating in a familiar, consistent environment will help them to feel more relaxed.

It can be helpful to give your child a five minute warning that the meal will be ready, rather than just tearing them away from their favourite program or game to sit at the dinner table. Or, better still, involve them in the process and get them to help you prepare the food or dinner table. Even the little ones can help with something!

WHO are they eating with?

We learn by copying and this is particularly prominent when it comes to what we eat. So if they’re eating separately from others, or other family members aren’t practising helpful eating behaviours at the table, they’re less likely to as well. As children get older, their range of role models become broader, and potentially less healthy, so it’s important that they develop healthy eating habits from a young age. Family mealtimes are a great opportunity to encourage children to try new foods and make eating a sociable and enjoyable experience.

On a practical note, an appropriate mealtime for children and adults may be different. But ensure that at least someone in the family is eating with the child (even if something small) and aim to create a routine around eating at least one meal together as a family per day (or a variation of this that works for your family).

The key to overcoming a fussy eating phase is consistency and persistence. It’s not always easy, but overtime your child will hopefully become more willing to try new foods. In the mean time, hopefully one or two of the tips above will get you going. Remember, try to stay as calm and relaxed as possible to make mealtimes and eating a positive experience.

If this fussy eating phase is particularly prolonged and you’re concerned about your child’s lack of nutrient intake, contact your GP. They should refer you onto a professional (Dietitian or Registered Nutritionist) who can work with you and your child for more tailored support.

Healthy growth in children

Public Health England’s National Child Measurement Programme shows that the number of overweight and very overweight children in year 6 is double that of Reception children*. This means that many children are gaining weight as they progress through Primary School.

Over one third of children in the UK are above a healthy weight. Here are some of the facts on child growth and living a healthy lifestyle:

How do I know if my child is a healthy weight? It can be difficult to recognise if a child is carrying extra weight. They are still growing, so their body size and shape is constantly changing. As the percentage of children above a healthy weight increases, it’s becoming more normalised. It’s important that children are weighed and measured a few times a year (ie every three to six months) to determine their Body Mass Index, which indicates whether they fall within the healthy weight range for their height, age and gender. We can’t assess a child’s weight based on appearance. You can enter accurate height and weight measurements into an online BMI calculator to learn more about your child’s weight status.

Carrying extra weight can put a child’s health at risk. Many overweight and very overweight children are happy, confident and have fulfilling lives. But it’s important to be aware of the potential health-related consequences. Some of these are:

• Type 2 diabetes
• Asthma
•  Cardiovascular disease risk factors
• Lower self-esteem and poor body image (which can make them more susceptible to eating disorders later in life)
• Joint pain and injuries

Children rarely grow out of ‘puppy fat’. Between 40 – 70% of very overweight children go on to become very overweight adults. The good news is that children’s habits can be easier to change compared to adults, as they’re not as engrained. Health behaviour change in children must be led by the parent/carer and is more effective when consistent across the whole family. Children learn by copying.

Making healthy choices can be difficult. Factors in our environment, along with genetics that may predispose us to wanting certain foods, can make healthy eating and leading active lifestyles hard. Being able to identify some of the key barriers to living a healthy lifestyle is key to making health behaviour changes.

Healthy eating is confusing. Food is relevant to everyone and so everyone has an opinion. This means that there is a lot of misleading and conflicting information out there and we many not realise that we’re making unhealthy choices. It’s important that we get nutrition information from professionals – Doctors, Registered Nutritionists and Registered Dietians or from reliable, government healthy eating websites and resources such as NHS choices and Change4Life.

Enjoying exercise and developing fitness skills promotes an active lifestyle throughout childhood. Being active is extremely important for weight maintenance and overall mental and physical well-being. The most effective approach to weight management is one that includes both exercise and healthy eating.

You can learn more about healthy eating, activity and how to effectively make healthy family lifestyle changes in upcoming blog posts. If you are concerned about your child’s weight, contact your GP for further support.

*National Obesity Observatory

Hello healthy Halloween

More tricks, less treats.

Most children (and adults) love Halloween. It’s an opportunity to wear something silly and accept sweets from strangers. In other words, we get to break all the rules. Whilst Halloween is fun, it is often centred around collecting sweets, filling up on unhealthy party food and drinks and using the only Halloween-related fruit to carve, not eat.

Frightful facts

Typical Halloween treat foods are full of unhealthy fats and/ or added sugars. Over time, too much of these can lead to weight gain and tooth decay. Children are already consuming more than the maximum daily recommendation of added sugar. And almost 30% comes from foods such as chocolate and sweets*.

In addition to food, if fizzy drinks are the party pop of choice, it’s worth considering that many of the 500ml bottles contain almost 11 tsp of sugar. If this doesn’t alarm you, ask the next person you see for 11 tsp of sugar in your coffee and judge their reaction. Just because the sugar in fizzy drinks is hidden, it shouldn’t be ignored.

It’s true that we should all enjoy treat foods (chocolate, sweets, cakes, biscuits, sugary drinks) occasionally and as part of special occasions. But when many children are already consuming above and beyond on a daily basis, it’s worth planning other ways to enjoy Halloween that don’t focus on filling up a bucket with sweets. For a healthier Halloween, focus more on the tricks below and less on the treats. 

Welcome treats, Texas.

Top tricks for a happy, healthy Halloween

Trick one

Don’t substitute dinner for treats. Feed the family three meals throughout the day as usual. We’re more likely to over-consume the sweet stuff when we’re hungry. Ask the kids to help you choose some Halloween-coloured fruit and vegetables to include in your meals – there are plenty to choose from.

Fresh fruit and veg at Garsons Farm in Esher, Surrey.

Trick two

Celebrate with crafts and cobwebs, not candy. Make Halloween decorations and let the kids turn your home into a haunted haven.

Creative street decor in Chicago, USA.

Trick three

Create creepy costumes. Enjoy designing scary Halloween outfits or check out these fun face paint ideas.

Dress up and pumpkin fun!

Trick four

Choose, carve and cook pumpkins as a family. Create spooky Jack-o’-lanterns but don’t throw the flesh. Try this Pumpkin lentil soup for a healthy, Halloween themed dinner.

Pumpkin picking at Garsons Farm in Esher, Surrey.

Trick five

Cook and create! The best way to get children to try new foods, is to make them the chef. Halloween is the perfect opportunity to get creative and experiment with healthy foods. Visit the Great Grub Club website for some great ideas – from ghost toast and frightening fangs to slime soup and spaghetti worms.

Trick six

A treat doesn’t always have to be something to eat. Give the trick-or-treaters fun Halloween themed stickers, small toys or stationary. Or even a toothbrush (too far?)!

Trick seven

Bring back apple bobbing! This classic Halloween activity will keep everyone busy and hopefully promote healthy eating. If you’re throwing a party, try these frightening, fun foods by Registered Nutritionist, Catherine Lippe, to get everyone in the spooky spirit of Halloween.

Healthy Halloween treats by Catherine Lippe (RNutr)
http://catherinelippenutrition.co.uk/healthy_halloween.html

Trick eight

Create your own family Halloween Olympics. Challenge the children to come up with activity ideas to keep the whole family happy and active. Pumpkin trophy for the winner?!

Happy Halloween! Tweet me your healthy Halloween pics @hellohealthyyou #hellohealthyhalloween

[Reference: *National Diet and Nutrition Survey]

Back to basics

Central Park, New York.

Welcome to my blog – and my very first post!

I’m a bit of a latecomer to the blogging scene, especially as there are already lots of Registered Nutritionists and Dietitians blogging about lots of great things. My aim is to go back to basics. There’s so much nutrition and health information out there, how do you know where to start? And it’s not with coconut water*.

I’m hoping that I can use my wealth of experience, having developed and delivered healthy lifestyle and child weight management programmes internationally, to help you identify what healthy behaviours are important for you and your family, and how to realistically and effectively make them happen.

Setting up the blog from Millennium Park, Chicago.

My main area of focus is child nutrition, but I may digress from time to time. Please get in touch if there are particular topics that you would like to hear more about.

Jenny

*I’m not saying that blog 195 won’t be about coconut water – but let’s get our head around the importance of regular eating patterns and the five food groups first!