GET ENERGISED: a healthier you in 2020

For long-term health, don’t start the year with a punishing detox, but with the best food advice you’ll ever find. By Prof Kerryn Phelps and nutritionist and dietitian Jaime Rose Chambers.

It seems with every passing year that there is new advice about what is healthy to eat, and what is not. Some of this advice comes from well-intentioned but unqualified people promoting the latest ‘fad diet’. These fad diets are usually based on the results of a single research study or a random thought bubble. They might provide some short-term gains but are at best unsustainable, and at worst dangerous to your long-term wellbeing because of restrictions or even elimination of essential food groups.

When I think back over the years since I have been writing about health, I can recall literally dozens of these fad diets. Remember these? Atkins, Ketogenic, Israeli Army, Blood Type, Paleo, Raw Food, Cabbage Soup, Alkaline, Zone and South Beach to name a few. The reason these fad diets have come and gone is they promise miracles but deliver disappointment.

As a GP, I know the value of nutrition in preventing and managing disease. I know it seems as though the research flip-flops all the time, and just when you think you know exactly what to eat, you read yet another

report that changes the guidelines again. So what do GPs want you to eat? Or not eat?

We are guided by two crucial factors: the evidence available at the time, and an assessment of the patient’s individual needs. I have been searching the evidence on the links between nutrition and health for decades. The evidence base grows all the time, and the medical colleges and dieticians are always reviewing new evidence and comparing it with the existing evidence base. As new studies are published, the consensus on what is a healthy diet will shift to incorporate that new information.

Yes, new studies sometimes conflict with existing knowledge, and that always sparks a reassessment of previous advice.

It can also be difficult to condense a lot of complicated information into simple rules for living. ‘Diet’ is not a one-size-fits-all. There are some guiding principles that suit most people, but in my experience, there are many people who need to have individualised nutrition plans.

There are people with known or suspected food allergies who have to be extremely cautious to avoid ingredients that might cause an allergic reaction. People with coeliac disease have to avoid all gluten and if you have lactose intolerance, you need to avoid foods containing lactose. People who choose to be vegetarian have to make a special effort to avoid micronutrient deficiencies, and often need to supplement nutrients such as iron, zinc, magnesium and protein. People with hypertension need to be more careful about avoiding salt than those with lower blood pressure.

Of course, personal taste comes into it too. For example, I may recommend fish several times a week, but if you hate eating fish that is just not going

to happen. You have to find your protein and omega-3 essential fatty acids from other food sources.

Will there ever be a definitive ‘healthy diet’? The answer is probably not. Your GP is guided by your individual needs and the best available evidence at the time. As new information emerges, our notion of the healthiest diet will be modified and updated so that you can make informed decisions.

To eat, or not to eat?

Eggs

The controversy:

Eggs are high in cholesterol. High cholesterol levels in our blood are a risk factor for heart disease and are often associated with type 2 diabetes.

The reality: The cholesterol in eggs has almost no impact on our blood cholesterol levels. The more powerful contributor to high cholesterol is saturated and trans fats from fatty meat, coconut and palm oil, and processed foods like cakes, biscuits and chips. The reward: Eggs are nutritious, inexpensive, versatile, low GI and low in energy. Eating eggs in moderation, even with high cholesterol, is safe. A good guide is The Heart Foundation recommendation of no more than seven whole eggs per week, in combination with a diet high in plant foods.

Meat

The controversy:

Research shows bowel cancer is more common in those who eat the most red meat.

The reality: Chemicals found in red meat can damage the

cells that line our bowel. Processed meats like frankfurters, salami, bacon and ham are concerning as they are linked to a higher risk of heart disease and other conditions like bowel cancer. However, white meats like chicken have shown no association with other health concerns and fish has been shown to reduce the risk of some diseases.

The reward: There’s no need to completely eliminate red meat. It’s an excellent source or protein, iron, vitamin B12 and zinc. Choose lean cuts and no more than 350g in total per week.

Dairy The controversy:

A dairy allergy is an immune reaction to the protein in dairy foods so all dairy needs to be avoided. A lactose intolerance is where the gut doesn’t produce enough enzymes to break down milk sugar (lactose) and usually causes diarrhoea.

The reality: Only people with a dairy allergy or lactose intolerance need to avoid dairy products. Not all dairy needs to be avoided though – mature cheese contains almost no lactose and there are excellent lactose-free products available. Full fat milk, yoghurt and cheese contain saturated fats, they are fine for healthy people to consume but if you have high cholesterol, choose low fat varieties. Ice-cream and dairy-based desserts contain added sugars and should be limited.

The reward: Plain or natural dairy foods have no added sugar, the sugar on the nutrition panel is the naturally containing lactose. They’re also rich in calcium for healthy bones and protein, which is good for weight management.

Vegan meats The controversy:

Faux meats are highly processed and made to look like, and be used in place of, meat such as mince and sausages.

The reality: These products usually contain high amounts of sodium or salt and are made from processed soy products. To be sure you’re choosing a healthy option, look at the ingredient list of these products to see what you’re getting and choose wholefood options wherever you can.

The reward: There are other vegan meat substitutes such as burger patties made from wholefood ingredients like legumes, brown rice and vegetables, which are a good convenience food option for vegans.

“Never, ever should fruit and vegetables be questioned when it comes to health.”

Vegetables/fruit The controversy:

Vegetables are high in carbohydrates and fruit is full of sugar, causing blood sugar spikes and weight gain.

The reality: Natural sugars found in starchy vegetables like sweet potato and fruits are a great source of energy, the fruit sugar fructose is in small doses and because of the fibre in fruit and veg, the sugars enter our blood stream slowly and don’t cause havoc with blood glucose levels.

The reward: Never, ever should fruit and vegetables be questioned when it comes to health! Every fruit and vegetable has a different profile of nutrients including fibre, vitamins, minerals and antioxidants, which are essential for our health. In fact, you could link them with preventing or reducing the risk of most diseases and conditions.

Fats The controversy:

We have long preferred polyunsaturated fat for a healthy heart; however some now say saturated fat is actually good for us.

The reality: Some fats are not good for our health and should be limited in our diet, such as trans and saturated fats found in processed foods (margarines, packaged biscuits and cakes), fatty meats and full-fat dairy (butter and milk) as well as coconut, palm and vegetable oils. These foods drive up ‘bad’ LDL cholesterol, which is a risk factor for heart and other chronic diseases.

The reward: We need fat in our diet, some are essential and have many jobs such as transporting fat soluble vitamins into our body. Plant-based fats such as olive oil, avocado, nuts, seeds and fatty fish containing poly and mono-unsaturated fats are protective of our health.

Grains The controversy:

Slimming, fattening, nutritious, anti-nutritious … Never has a food group been associated with so much conflicting and confusing information!

The reality: There are many sides to grains and you need to choose what’s best for you. Grains are a rich source of carbohydrate and everyone processes carbohydrates differently, but they’re only ‘fattening’ when eaten in too great a quantity in combination with a high-energy diet. Grains also contain lectins or ‘anti-nutrients’ which interfere with the absorption of nutrients, but they’re most potent when raw so sprouting, soaking and cooking will deactivate them. Anyone with a gluten, wheat or fructan allergy or intolerance needs to avoid gluten/ wheat/ fructan-containing grains.

The reward: Wholegrains include wheat, barley, rye, rice, spelt and quinoa which contain all parts of the whole grain and are highly nutritious, help regulate blood glucose levels and, because of the fibre and prebiotics, are excellent for bowel health.