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Nutrition and Dietetics

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Frequently Asked Questions

Cancer

Children

Cholestrol

Coeliac disease and gluten free diets

Diabetes

Irritable Bowel Syndrome

Malnutrition

Specific food and drink

Weight gain and being overweight

Weight loss

 

What is the difference between a dietitian and a nutritionist?
‘Dietitian’ is a professional title protected by law. Registered dietitians (RDs) are the only nutrition professionals regulated by the Health & Care Professions Council (HCPC). It is a criminal offence to use this protected title without being registered to the HCPC. The title ‘Nutritionist’ is not protected by law in the UK. Nutritionists are not statutorily regulated, meaning anyone is able to assume this title even without adequate training and experience.For more information on what a dietitian’s role is, please click here.

Should I include extra 'superfoods' in my diet like blueberries, broccoli, garlic and raspberries to guarantee reducing my risk of getting cancer?
There is not enough evidence to support eating any one “superfood” to reduce the risk of cancer. Aim to eat a variety of fruit and vegetables in your diet on a daily basis.

Do I need to take a vitamin and mineral supplement during and after my cancer treatment?
During treatment if you are unable to eat as much as you previously did and are not eating fruit and vegetables on a daily basis a general multivitamin may be beneficial. If you need further advice discuss this with your health professional. After treatment a multivitamin is only required if you have not returned to a normal balanced diet.

Do I need to follow a different or alternative diet to cure my cancer?
There is not enough evidence that any type of diet in particular will help to cure your cancer and you should try to eat a healthy balanced diet. If you would like to follow a particular diet it is best to discuss this with a Dietitian to ensure you are not missing out on any nutrient.

My child won't eat, what should I do?
It is important that you do not give up offering the foods you want him/her to eat. Do not offer alternative meals or foods otherwise your child will take advantage of this. Respond to bad behaviour with no comments and good behaviour with praise. Set routine mealtimes and snack times and make them fun, calm and social. Try to keep meals balanced (refer to the Food Standards Agency's Eatwell plate) and for children under 5 a Vitamin D supplement is a government recommendation.

What is the best age to start weaning my child?
The introduction of solid food should commence ‘at around six months of age’ in line with Department of Health (DoH) guidance. The DoH guidelines acknowledge that babies’ individual development varies widely and that some babies may be ready for solid food before, or after, this time. With this in mind the introduction of solid food should commence no later than six months (26 weeks) of age, but not before four months (17 weeks).

My doctor has told me I have high cholesterol. What changes can I make to my diet to help lower my cholesterol?
There are various changes you can make to your dietary intake that may have a beneficial impact on your cholesterol levels:

  • Reduce the amount of saturated fat and trans fats in your diet. These types of fats are found in foods such as butter, cream, full fat dairy products (cheese, custard, yoghurt, milk) as well the fat found in meats and processed foods such as cakes, biscuits, pies and sausages.  Use lean meats (with fat trimmed off) and low fat dairy products.

  • Include a variety of unsaturated fats in your diet. These are found in oily fish (tuna, mackerel, sardines), nuts, seeds, and various plant and seed oils such as olive oil, sunflower oil, canola oil and rapeseed oil.

  • Increase the amount of fibre in your diet.  High fibre foods include oats, wholegrain cereals and bread, fruit, vegetables and lentils/legumes.

  • Reduce your alcohol intake to within sensible, recommended limits.

Although having a healthy diet is a central part of reducing cholesterol levels, it is only one aspect of living a healthy lifestyle. Changing diet, losing weight, being more active and stopping smoking should all contribute to lowering your cholesterol levels. For more information, see the British Heart Foundation website.

Does eating eggs raise your cholesterol?
Eggs are naturally rich in cholesterol, as are liver, kidneys and shellfish. However, the cholesterol found in foods does not make a significant contribution to raising the cholesterol levels in your blood. It is much more important to reduce the saturated fat in your diet, as these foods play a bigger part in raising blood cholesterol.  Foods high in saturated fat include butter, cream, lard, ghee, full fat dairy products, fatty meats, meat products, cakes, biscuits, takeaway foods and fried foods.

I need to gain weight but I have high cholesterol. What can I eat?

  • Have a high calorie, high protein snack mid morning and afternoon. For example: hard boiled egg, small slice of quiche, ½ an avocado, pate on a crumpet or wholegrain toast, breadsticks and hummus dip, yoghurt, rice pudding, bowl of cereal, fruit loaf/hot cross bun or scone with jam or honey.

  • Have high protein foods at each meal. For example: lean cuts of meat (beef, lamb, pork, poultry), fish (particularly salmon, mackerel, tinned sardines, pilchards), eggs, yoghurts, lentils, pulses, beans, peas, nuts.

  • Have a nourishing drink between meals (but allow one hour before having a meal to avoid filling up). For example: milk, milkshake, milky coffee, hot chocolate, Ovaltine, Horlicks, fruit juice or fruit smoothie (with yoghurt).

  • Add the following high calorie foods to food and drink - olive oil, rapeseed oil, yoghurt, half fat crème fraiche, quark, skimmed milk powder, golden syrup and honey.

  • Have a main course and a pudding at both lunchtime and evening meal.  Good pudding ideas include milk puddings (rice pudding, sago, tapioca), fromage frais, yoghurts, crème caramel, stewed fruit and custard, jellies and ice-cream. 

  • Use 1 pint of milk per day – on cereals, in drinks, in sauces, in puddings etc.

  • Drink at least 6-8 mugs of fluid daily. Try milky drinks, fruit juice, soup, smoothies and try to have them after meals rather than before, so that you don’t fill up on fluid.

Do I need to follow two different diets for diabetes and to lower cholesterol?
No.  For both the focus is making healthy food choices – that is fruit and vegetables, starchy foods, lean meat, fish and pulses, and low in fat, sugar, salt and alcohol.  Being more active will also help manage both these conditions.

Should I be seeing a dietitian if I have Coeliac Disease?
Coeliac Disease is a condition which requires people to follow a strict lifelong gluten free diet. There are many hidden sources of gluten in the diet and dietitians are specially trained to be able to provide information to help those with Coeliac Disease to avoid these. A dietitian is also able to provide information about a balanced diet to meet all vitamin and mineral requirements which can be different for those with Coeliac Disease. If you have been diagnosed with Coeliac Disease and have not been seen by a dietitian, please speak to your GP or Consultant about being referred.

Is it healthier to follow a gluten free diet?
A gluten free diet is a diet which excludes all foods which contain a protein called gluten. Gluten is found in cereals such as wheat, barley, rye and some people are sensitive to oats. There are also lots of hidden sources of gluten in the diet; such as when derivatives from these cereals are used as ingredients. A gluten free diet is only required by those who have Coeliac Disease or another form of intolerance to gluten. For the majority of the population who do not have an intolerance to gluten, a gluten-free diet is not healthier than one that contains gluten and is not recommended. Many processed gluten-free products actually contain more sugars and fats than their gluten-containing counterparts. More information on following a healthy diet can be found on the NHS Choices Website.

How much sugar can I eat if I have diabetes?
The recommendation for people with diabetes is to cut back on sugar; this doesn’t mean you need to eat a sugar-free diet. You can include some sugar in foods and baking in a healthy, balanced diet, provided you don’t overdo it; just aim to have less of it. You can also use sweeteners as an alternative to sugar. Some easy ways to cut back on your sugar intake are: choosing sugar-free, no-added sugar or diet/light drinks; buying canned fruit in juice rather than syrup; reducing or cutting out sugar in tea and coffee.  We’d suggest you aim to have foods with less than 5g per 100g sugar, or no more than 10g per 100g sugar.  Foods with greater than 15g per 100g sugar are high in sugar and should be had in small portions infrequently or avoided altogether.
 
Can I eat grapes and bananas if I have diabetes?
There is no fruit that we would recommend to avoid if you have diabetes.  We would however suggest you have one portion at a time spreading any further portions out throughout the day.  A portion = one medium apple, two small fruits i.e. satsumas, plums, a small banana, a small handful of grapes. Fruits and vegetables are naturally low in fat and calories, while being packed with vitamins, minerals and fibre. They can help protect against stroke, heart disease, high blood pressure and certain cancers.

Is it okay to drink fruit juice with diabetes?
Yes, but it’s best to keep this to a small glass i.e. 150ml.  Fruit juice can only count as one of you 5-a-day (fruit and vegetables) no matter how much you drink due to the reduction in its fibre content.  Other suitable drinks to have throughout the day would be water, ‘no added sugar’ squashes, herbal and fruit teas, tea and coffee.  Do not add sugar to your drinks and if you need them sweeter, consider a sweetener.
 
Can I sometimes eat foods high in fat and sugar?
Technically, your body doesn’t need any foods in this group, but eating them in moderation can be part of a healthy, balanced diet. Sugary foods and drinks will raise your blood glucose so opt for diet/light or low-calorie alternatives. It’s also worth remembering that fat is high in calories, so try to reduce the amount of oil you use in your cooking and choose lower-fat alternatives wherever possible.

Should I be seeing a dietitian if I have Irritable Bowel Syndrome?
Irritable Bowel Syndrome (or IBS) is a condition which describes a range of gut symptoms such as abdominal pain, diarrhoea, constipation, bloating and wind amongst others. It is important that people with these symptoms are seen by their GP to have other potential causes ruled out. The symptoms of IBS can be affected by diet and the British Dietetic Association has published a Food Facts Sheet on Irritable Bowel Syndrome and Diet which provides information on dietary changes to improve IBS.  For people with IBS who do not see any improvement from these changes, seeing a dietitian is an important step. Please speak to your GP or consultant if you feel you need to be referred to a dietitian.

What is malnutrition?
Malnutrition is a serious condition that occurs when a person’s diet does not contain the right amount of nutrients. It can be identified by measuring unintentional weight loss. Undernutrition is when you don't get enough nutrients, especially energy and protein.

Who might be affected by malnutrition?
Malnutrition is a common health problem. It is estimated there are about three million people who are malnourished in the UK at any time and many more at risk of becoming malnourished. Around one in three people admitted to hospital or care homes in the UK are found to be malnourished or at risk of malnourishment. This can be identified by unintentional weight loss, low BMI and higher nutritional needs

How is malnutrition treated and what does nutrition support mean?
The main treatment for people diagnosed with malnutrition is nutrition support. This may involve increasing the nutritional content of your food through fortified diet, with or without taking nutritional supplements and eating little and often. By fortified diet we mean adding extra calories and protein to everyday food and drinks, as and when appropriate for example cream, butter, vegetable oils, cheese, honey, jam, skimmed milk powder. If you are unable to eat enough to meet your nutritional needs, nutrition support may also include tube feeding to provide nutrients directly into the digestive system.

Are red wine and dark chocolate good for you?
Both red wine and dark chocolate are often touted in the media as being “good for you”. The main reason for this is because they contain antioxidants. Antioxidants reduce oxidative stress in the body caused by free radicals, and this has been proven to have various long term health benefits. However, the benefits from the antioxidants in red wine and dark chocolate are only present when you consume them in moderation, for example 1-2 standard 125ml glasses of red wine per day, a couple of small squares of dark chocolate per day.  Red wine is high in calories and contains alcohol, and dark chocolate is high in calories and saturated fat.  Consuming too much red wine and dark chocolate could lead to weight gain and/or raised cholesterol – both of which are risk factors in heart disease. A better way to obtain more antioxidants in your diet is by eating plenty of fruit and vegetables (at least five portions a day and a wide variety) as these will not contribute to weight gain, can help lower cholesterol and therefore, can lower the risk of having a stroke and coronary heart disease.

How much alcohol is classified as a safe intake?
Men should not regularly drink more than 3-4 units of alcohol each day, and women should not regularly drink more than 2-3 units of alcohol each day. It is also recommended that both men and women have at least two alcohol free days per week.  See the Drink Aware website for more information about what is a standard unit of alcohol.

How much salt is too much?
A diet high in salt has been linked to raising blood pressure, which is a risk factor for heart attack and stroke. It is recommended that we consume no more than 6g (one teaspoon) of salt a day for adults (less for children).  About 75% of the salt we consume is already added to the ready made, everyday foods that we buy such as processed meat products, snacks such as crisps and biscuits, ready meals, soup, pasta sauces, bread and some breakfast cereals.

Is it true that carbohydrates are fattening and make you gain weight?
Carbohydrates are usually low in fat. As long as you don’t overdo it on the portion sizes or add lots of high fat ingredients (butter, cheese, etc.), carbohydrates will not make you put on weight. People who lose weight on diets such as the Atkins diet (high protein/low carbohydrate) may be losing weight due to an overall reduction in calorie intake rather than the specific reduction of carbohydrates.

Is reducing fatty foods always a healthier choice?
A reduced-fat snack should contain less fat than the full-fat version, but that doesn't automatically make it a healthy choice: it could still contain a lot more fat than say a portion of fruit. While an item labelled ‘low-fat’ has to meet recommended criteria of 3g of fat or less per 100g, it may be higher in sugar.
 
Is it true that being overweight is inherited and that if you have the ‘fat gene’ weight gain is unavoidable?
There may be a genetic link; however the ‘fat gene’ is only found in a small proportion of people and even with this you can prevent excess weight gain by living a healthy lifestyle – eating a balanced diet and exercising. It is more likely the bad habits we inherit from our parents or those around us are the major contributor towards the recent rise in obesity and may prove harder to tackle.

What do I do if I have unintentionally lost weight and am worried about it?
Discuss this with your GP who will assess you and get you refered to a Nutrition Support Dietitian.

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