5 OF THE BEST ICE CREAMS

There’s nothing quite like ice cream on a hot day — but, sadly, most of our favourites are packed with saturated fat, sugar and calories. so what’s the best choice? here, harley streetbased dietitian Noor Al refae identifies five healthier options:

Cornetto Mix Mini Classic 6 Pack (£2, most supermarkets) Per 28ml Cornetto: calories, 84; saturated fat, 4.4g; sugar, 5.9g These mini versions — which are around a third of the size of the original Cornetto — are a great way of enjoying your favourite calorie, fat and sugar-laden treat in a healthier amount. They provide less than 90 calories (but around 1½tsp sugar). Ideal size as a treat, or a child’s dessert.

Perfect World Banana Walnut Chip Ice Cream, (£3.59 for 500ml, Tesco and Holland & Barrett) Per 100ml serving (two scoops): calories, 136; saturated fat, 3g; sugar, 3.6g DaIry-free and with just under 1 tsp of sugar per serving (most of which comes from the 14 per cent banana puree), this is good for anyone watching their sugar intake or who needs to control their blood sugar levels, such as those with diabetes. It also offers a healthy amount of antioxidants and antiinflammatory vitamin e, which comes from the nuts.

Real Nice Organic Fruit Smoothie Lollies (£2.99 for four, Whole Foods and Ocado.com) Per lolly: calories, 34; saturated fat, 0g; sugar, 7g These are simply pureed organic fruit on a stick, with no additional ingredients. They’re low in calories and with almost half the sugar of some other kids’ lollies, they make a relatively healthy sweet treat for children or for anyone on a calorie-restricted diet. The 7g sugar (just shy of 2 tsp) may seem a lot, but approximately half of this is natural sugar from the fruit and comes with other benefits, such as vitamins. Best eaten at mealtimes to minimise the corrosive impact on teeth.

Swedish Glace Vanilla Non Dairy Dessert (£2.20 for 750ml, most supermarkets)

Per 100ml serving (two scoops): calories, 110; saturated fat, 3.1g; sugar, 13g MaDe with soya bean powder, rather than milk and cream, this gluten and egg-free product is good for those with allergies or who follow a vegan diet. But it’s high in sugar — with just over 3 tsp of added sugar in two scoops — so best as an occasional treat.

Only By Nature Frozen Mango Yoghurt (£3 for 450ml, from Tesco and Waitrose) Per 100ml (2 scoops): calories, 56; saturated fat, 1g; sugar, 5g ThIs simple ice cream alternative is low in fat and calories and has just 5g (around 1tsp) of sugar per serving — all of which come from the 14 per cent fruit content and dairy ingredients. It is gluten-free, which makes it suitable for people with coeliac disease, and contains stevia, a natural, caloriefree sweetener, which has little or no effect on blood sugar levels.

know intimately what we are giving our patients.

WHY DIDN’T YOU BOOK TO SEE ME SOONER?

ONE of the endless fascinations of general practice is why some patients seem to come in with trivial complaints, while others stoically sit at home with chest pains, determined not to bother the Gp.

This first struck me when, as a hospital doctor, I was caring for two patients in adjacent cubicles.

One, a young woman, was whining loudly about a barely visible rash. The other, a factory worker, thought I was overreacting when I suggested we should try to sew back his fingers, which had been severed by a machine.

More than 20 years later, I am constantly amazed by how some people are completely unsuspecting about the most alarming signs. For example, a paralysis of one side of the body that one patient put down to a minor arm injury, rather than a stroke. Or severe long-standing cardiac chest pain attributed to indigestion.

I’ve also heard widespread, even ulcerating, cancers described as ‘sores’.

What makes reluctant patients eventually decide to see a doctor?

In 1973, research identified five triggers: an interpersonal crisis (such as a death in the family); interference with relationships (‘I can’t look after the kids’); interference with activity (‘I can’t do my normal exercise’); setting a deadline (‘If it’s not better by Monday, I’ll see the doctor’) and, last but not least, pressure from others (‘The wife told me to come’).

HOW WE GET YOU OUT THE DOOR

WE SpENd hours at medical school and in Gp postgraduate training learning the key skills of building rapport.

Eye contact, echoing speech, mirroring body language, listening carefully, using silence, empathising and so on. But sometimes, when patients seem to be settling in for the day, the skill we need more than anything is how to break that rapport.

The specific tricks we learn include breaking eye contact (that’s easy, just look at the computer) and altering our body position away from the patient.

Alternatively, we can try speaking faster and louder than the patient, sitting up straighter, handing over a prescription or patient information leaflet or picking up the patient’s bag or walking stick for them.

Finally, there is the nuclear option: stand up and go and open the door. I’ve been known to use that.

AdAPTEd from The Appointment: What Your doctor Really Thinks during Your Ten-Minute consultation by Graham Easton (Robinson, £13.99). Offer price £11.19 (20 per cent discount) until August 30, 2016. Order at www. mailbookshop.co.uk or call 0844 571 0640. P&P free on orders over £15.