Published on the 31st Jan, 2018 by Azmina
In my practice, I find that young people, especially girls, begin to explore vegan eating after watching a documentary that may be sensational, or even alarming, in parts. And although this is worrying in terms of making sure that people get a balance of nutrients, my view is that veganism isn’t just a passing trend. It’s here to stay, and so it needs to be considered within the context of a varied eating pattern.
Why is it a movement?
You just need to look around you to see how this is becoming big business. Anyone who’s been to coffee shops like Pret in the last 6 months could be tempted to try a vegan or veggie diet – they have an entire section of each of their shops dedicated to it. Anyone who shops in Tesco could be influenced to try the vegan diet as they scour shelves with a massive new range of plant based ready meals and sandwiches. Anyone who reads Time Out could be influenced to try the vegan diet due to the myriad of new vegan cafes and restaurants popping up all over London, pretty much every week. Anyone who sat on London Underground this month could be influenced to try the vegan diet as they read the “Veganuary” tube adverts. More on Veganuary.
Dietary change needs to be carefully considered
There are limited studies specifically on vegan diets, so it’s difficult to draw firm conclusions about the long-term health benefits. Vegan eating tends to be lower in calories and saturated fats than non-vegetarian diets, and typically, vegans have been shown to be slimmer, and have lower cholesterol levels. Having a lower BMI may also help to protect against certain cancers. But as yet, there simply isn’t enough research to suggest that we should all turn to vegan eating, and indeed, certain groups who may be tempted to go vegan need to be mindful of meeting their nutritional needs.
What young people need to watch
- Calories. It may be tempting to opt for a vegan diet to lose weight. Chances are, you will lose weight, and that’s helpful if you’re overweight and need to address that. But many of the girls I see do not have a weight issue. Plant-based foods tend to be lower in calories, so they need to be advised on making sure they eat regular meals and snacks to allow them to take enough food over the day.
- Calcium. Dairy foods are the richest sources of calcium. Teenage life is a time of rapid growth and about half the strength of the adult skeleton is laid down in adolescence. Many dairy-free milk and yogurt alternatives aren’t fortified with calcium, and those that are may not have the same amount of calcium as dairy products. Check labels and compare the “calcium per 100g” figure with milk or yogurt. A teenage girl needs 800mg calcium per day.
- Iron. You need more iron during adolescence to help with growth and muscle development. Red meat is a rich source of iron, but you can also get iron from plant foods: choose dark-green vegetables, such as kale and broccoli, lentils and beans (especially dark coloured ones like green mung beans), nuts, and breakfast cereals that are fortified with iron. Teenage girls need 14.8 mg of iron each day.
- B12. You need this vitamin for healthy blood and a healthy nervous system, but you only find it in animal foods. Make sure you have foods that are fortified with vitamin B12, such as breakfast cereals, soya drinks, and yeast extract (such as Marmite). You may need a supplement of B12.
- Omega-3 fatty acids. Since these are found mainly in fish, you need to get yours elsewhere. Vegan sources include walnuts, linseed oil, rapeseed oil, soya oil and soya-based foods, such as tofu. Note they may not have the same cardio-protective effects as the type of omega 3 fats you find in oily fish.
Switching to eating more plant based foods is a good thing. But a strict vegan diet is very hard to get right, and you need to make sure you’re thinking about where you’ll get your nutrients from. Ideally, seek professional advice from a registered dietitian.
Fraser GE. Vegetarian diets: What do we know of their effects on common chronic diseases? Am J Clin Nutr. 2009;89(5):1607S-1612S.
Craig WJ. Health effects of vegan diets. Am J Clin Nutr. 2009;89(5):1627S-1633S.
Spencer EA, Appleby PN, Davey GK, Key TJ. Diet and body mass index in 38,000 EPIC-Oxford meat-eaters, fish-eaters, vegetarians and vegans. Int J Obes Relat Metab Disord. 2003;27(6):728-734.
Published on the 31st Mar, 2017 by Azmina
I have a personal interest in the value of yogurt in health promotion, so I was delighted to be asked by the Yogurt in Nutrition Initiative for a Balanced Diet (YINI) to attend the 4th International conference on Nutrition and Growth in Amsterdam. Here are my insights from the symposium entitled How Yogurt could improve Health in Children (plus some pretty pictures from Amsterdam!).
The array of eminent speakers shared their research on topics including how yogurt may facilitate better eating habits in children, how tastes for sweet and sour can be learned, how yogurt maybe associated with reduced cardio-metabolic risk factors in children, including susceptibility to obesity. My fingers could hardly tweet fast enough!
My 3 key learnings (more…)
Published on the 21st Feb, 2017 by Azmina
On 15 February, I presented to nutritionists and students at the University of Westminster on the potentially damaging effects of nutrition misinformation, on behalf of the Dairy Council. Why? Because since 2009 I’ve been concerned about fake news on nutrition being dished out by non-experts and being taken as fact by people who just want to eat a little better.
What’s the fuss about Fake News in nutrition? (more…)
Published on the 3rd Oct, 2016 by Azmina
As experts in nutrition, dietitians pride themselves in keeping up to date with the latest developments in public health policy, research and nutrition trends. The publication of Public Health England’s Childhood Obesity Report in August 2016 received mixed reviews, and the Childhood Obesity Summit offers us a chance to come together and debate the best way forward.
When and where?
The Royal Society, London on Thursday 3rd November. Full programme.
Why go? (more…)
Published on the 18th Aug, 2016 by Azmina
Today, the British Dietetic Association has expressed its disappointment at the “much diminished” Childhood Obesity Strategy published today by the government:
Key policies which could drive down obesity rates amongst children and young people have been dropped, including proposals to ban junk food advertising before the 9pm watershed and regulation of price promotions on unhealthy food. This is despite support from numerous sources, including the Commons Health Select Committee[i] and the Obesity Health Alliance[ii], which have brought together a huge range of expertise and evidence.
Published on the 5th Aug, 2016 by Azmina
When & Where: Thursday 22nd September at The Royal Society in London
This conference looks pretty exciting – have you seen the line-up of speakers? I’m looking forward to hearing about expert views on voluntary reformulation and the potential impact of a sugar tax. I’ve been fairly vocal about my views on how realistic the SACN “5% energy from free sugars” recommendation is in practice, so it’ll be particularly interesting for me to hear my friend and colleague, Prof Jack Winkler, talk about how differently we’d need to be eating in order to achieve that.
And I’ve also voiced my opinion at conferences and in publications about the necessity to look at the whole food, rather than focusing on one single macronutrient. Indeed, demonising sugar could compromise fibre intakes (think whole grain breakfast cereal), although the SACN Report advises us to increase our intake to 30g fibre daily. It could also potentially affect our intake of micronutrients like vitamin C or potassium (think juices and smoothies, in appropriate amounts of course). Check out the BNF Paper on Micronutrient status and intake in the UK – where might we be in 10 years’ time? It’s really worth a read.
The lovely Tanya Haffner will no doubt be a hit for me and other dietitians as she presents on “Is a continued focus on sugar actually counter-productive?”. I’m guessing she’ll be balanced – we all know we are eating too much sugar, especially as sugar sweetened beverages; that’s not in question, in my mind. It’s the practicality of cutting to such drastic levels, and the unintended consequences on our overall nutrient intakes.
There’s so much more on the programme about the big question: will all this sugar frenzy lead to an impact on childhood obesity, or not? And there are also insights on sweeteners, sugar tax and much more.
- Sugar Reduction: 3 years on, what’s changed – and what’s next
- How has consumer purchasing of sugar changed in the last 12 months and what impact did the sugar tax announcement have on purchasing
- Can we achieve the 5% target or is it unrealistic?
- What would need to change to get us closer to 5% of calories from added sugars?
- What changes would have the most dramatic impact in reducing sugar consumption?
- Should and can we follow the USA, in separating added and total sugars on labelling?
- Is the focus on sugar counter-productive and muddling for consumers?
- Should sugary drinks contain health warnings?
- Will the sugary drinks tax be passed on to consumers, lost in promotions or absorbed by manufacturers – and will it have any impact on purchasing?
- The evidence: are sweeteners an effective way to reduce total calorie intake?
- How do sweeteners impact on behaviour?
- Artificial versus natural sweeteners – what’s the difference?
- Sweetness economics – what impact will changing prices of sugar and sweeteners have on manufacturing
- Could sweeteners be extended to more categories?
- What are the opportunities for new sweeteners?
- Is the sugar tax legally viable?
- How will the design of the sugar tax impact its effectiveness?
- Is positioning the sugar tax as a positive for school sports actually counter-productive?
- Which categories might be next in line for a sugar tax?
- Industry is “on notice” to produce meaningful change – how will that happen without legislation?
- What motivates voluntary action in the food industry, how do we get it right?
There are a limited number of discounted tickets to freelance nutritionists and dietitians or those working for the NHS or in community healthcare roles, please contact firstname.lastname@example.org for more details.
Published on the 25th May, 2016 by Azmina
The foodie news this week has been dominated by the announcement from the National Obesity Forum (NOF), which the headlines summarise as advice to eat more fat, fewer carbs, and to stop buying low fat foods and counting calories. This may sound like the best news ever, but it was criticised by Public Health England as being “irresponsible”.
Here are my top ten thoughts:
- Nutrition is an evolving science and it is essential to review dietary guidelines as and when new research emerges. Controversy and debate over the science helps us to re-examine our advice.
- Dietary guidelines should always be based on robust scientific evidence. The British Heart Foundation and others have suggested that the NOF Opinion Paper has been selective in its review and that it has not been compiled after a comprehensive review of the evidence.
- The recommendations made in the NOF Opinion Paper go against current dietary guidelines from Public Health England and leading bodies such as the British Dietetic Association (and other Dietetic Assoc. around the world), British Heart Foundation and Diabetes UK. These organisations are globally respected bodies; they are robust in their policies.
- Lower fat products can help people enjoy everyday foods at a lower calorie cost. Foods like lower fat milk, yogurt, and cheese are great examples. Having said that, in my experience many clients think they can get away with twice as much of foods like reduced fat sausages and mayonnaise, so this could potentially be counter-productive.
- Low carb, high fat diets can compromise our intake of fibre.The latest SACN Carbohydrates and Health Report recommends we eat 30g of fibre a day. It’s hard enough to do this with a moderate carb diet. We also need whole grains from carbs for good health and cardio-protection.
- Taking in more calories than your body needs will make you gain weight, regardless of where those calories come from.
- It does make sense to eat high fat foods that are part of the traditional Mediterranean diet – avocado, nuts, oily fish, and olive oil. This diet, which is also rich in fruit and vegetables, has been linked to longevity and a lower risk of cardio-vascular disease. (And I also think eggs, which are often quoted as being high in fat, are a great food!).
- Choosing fewer processed foods and more home-cooked meals is a good thing. But some processed foods enable us to eat better – milk, whole grain bread, canned tuna, frozen peas, stir-fry veg packs… These are all processed, yet also healthy. Best to limit processed foods like cured meats, pies, pastries, cakes and biscuits. (Note these foods are typically high in fat).
- Media frenzy over such sensational headlines leads to confusion and a lack of confidence in the experts. We all need to work together to compile realistic and evidence-based dietary advice that speaks in an engaging tone of voice.
- I will not be changing my advice as a result of the NOF publication. Eat more vegetables, more fruit, more whole grains, and healthy fats. Eat a variety of foods. Eat slowly and mindfully and watch your portion size.
In conclusion, I welcome debate, but it must always be entrenched in a robust body of scientific evidence for it to be taken seriously by the experts in nutrition – registered dietitians (BDA) and degree-qualified nutritionists (AfN).
Read Azmina’s views on the Sugar Debate.
Published on the 15th Dec, 2015 by Azmina
Sugar is still high on the government health agenda and The Royal Society of Medicine was this year’s venue for the Sugar Reduction Summit. I love going to conferences for the networking, tweeting (#sugarsummit was trending in the UK!), as well as the learning.
Here are 10 summary tips from some of the lectures: (more…)
Published on the 25th Jul, 2015 by Azmina
I’m always keen to get consensus of opinion from my colleagues on hot topics, so here are screenshots of the tweets that were posted after I published my blog on the 17 July 2015 SACN Report on Sugar and Carbs. Scroll down, enlarge if needed, and have a peek!
Published on the 29th May, 2015 by Azmina
Today, on the BBC, Action on Sugar highlighted the sugar coating on dried fruit snacks. I agree that the coating is an unnecessary addition of sugar and calories, but I am concerned that too much focus on sugar in healthy foods like dried fruit and fruit juice (in the right portion size, of course) could mean we eat less fruit as a nation.
We are already not meeting the government target of 5-a-day, and scaremongering can sometimes cause so much public mistrust, that they end up not listening to good practical and realistic advice from experts like registered dietitians.
Fact 1: Sugar is empty calories
Sugar gives you energy and carbohydrate, but no vitamins or minerals, so it isn’t good for you. It provides 4 kcal/gram, which is the same as a gram of pure starch (like flour), or a gram of pure protein (like egg white). Note that it has less than half the calories of fat (such as oil), which provides 9kcal/g.
Fact 2: Sugar is not the new tobacco
There is no conclusive link between sugar intake and diseases like diabetes, obesity or heart disease (1). The only proven link is sugar can cause dental caries.
I believe that small amounts of sugar as part of a varied diet helps us to enjoy food. A little sweetness in healthy foods can encourage consumption – think of a fortified breakfast cereal which can help children to eat a nutritious breakfast containing whole grains, vitamins and minerals, as well as milk. Or a slice of wholegrain bread with honey.
Similarly, people who don’t like plain yogurt, a healthy source of calcium and quality protein, might enjoy sweetened fruit yogurt.
Fact 3: Fruit juice is not junk food
Fruit juice does contain natural sugars in liquid form, but it comes with nutrients like vitamin C and potassium. This could be important particularly for people on low incomes, as it’s a cheap source of these nutrients.
Fruit juice can’t be put into the same camp as soft drinks that have the same amount of sugar, but don’t provide the added nutritional benefits. Smoothies, which are typically made up of pulped fruit and fruit juice, will also contribute fibre (2). People who drink fruit juice tend to also eat more fruit & veg (3).
It’s easy to over-consume sugar in liquid form, so keeping to 150ml of fruit juice a day (which counts as one of your five a day fruit and veg recommendation), is a sensible portion size. And best to have it with a meal so you reduce the damage to teeth.
The Bottom Line
Stop demonising sugar or fat and let’s talk about food! We eat food not nutrients, so we need to put all this into context. After all, healthy eating is about balance, variety, and enjoyment.
- European Food Safety Authority (2010) Scientific Opinion on Dietary Reference Values for carbohydrates and dietary fibre. EFSA Journal 8(3): 1462 [77 pp.]
- Ruxton CHS (2008). Smoothies: one portion or two? Nutrition Bulletin 33, 129-132.
- Gibson, S (2012) Proc Nut Soc 71
Published on the 18th Jun, 2014 by Azmina
Since the beginning of this year, I’ve been involved in the debate around sugars and fruit juice, and have been trying to build a consensus of expert opinion from key nutritionists and dietitians, as summarised in my sugar debate blog. June and July are packed with sugar seminars, and the UK Scientific Advisory Committee on Nutrition (SACN) Draft Report on dietary recommendations on carbohydrates (including advice on sugar), is due out imminently.
My biggest aspiration about debates around sugar is that they need to be evidence-based and balanced. Government recommendations are devised from quality research, and nutritionists need to be constantly up to date so we can better inform the public and help minimise mixed media messages, which only lead to confusion and a lack of confidence in “the experts”. So, when I saw the programme for The Sugar Reduction Summit, I knew I had to be there. (more…)
Published on the 7th May, 2014 by Azmina
I am passionate about the value yogurt brings to balanced nutrition and when I was invited to attend the 2nd Global Summit on the Health Effects of Yogurt in (wait for it) San Diego, I didn’t need much arm-twisting.
San Diego Convention Centre
The programme was packed with eminent speakers including Angelo Tremblay (Laval University Canada), Nita Forouhi (University of Cambridge School of Clinical Medicine) and the distinguished Professor John Bienenstock (McMaster University). The morning started as you’d expect it, with a refreshing yogurt and berry parfait, just enough to get those digestive juices ready for an avalanche of evidence-based insights on yogurt and health.
Here I’ll share some key learnings and give you a flavour of the #YINI2014 twitter conversations during the 4-hour seminar. (more…)
Published on the 17th Apr, 2014 by Azmina
I’m often asked about the world of freelancing and how easy it is to get noticed, or not! One of the areas that nutritionists and dietitians are keen to dabble in is the area of private practice, so I thought I’d share some of my learnings on which websites I have found helpful in increasing my reach, and indeed my business.
Registering with reputable websites is a cost-effective way to promote your services, especially if you don’t have your own site. Here are a couple for you to try out: (more…)
Published on the 3rd Apr, 2014 by Azmina
From the start of 2014, the media frenzy over sugar has heightened… January started off with British Dietetic Association spokespeople contributing to major newspapers, and it’s still a hot topic with no sign of cooling down. Since the start of the year, I’ve been leading twitter chats, giving a presentation to media medics and providing quotes to newspapers and magazines to see if I can get some sort of expert consensus. Here’s a summary of my three months debating whether sugar really is the new tobacco.
12 January 2014 – you may remember the headline in The Sunday Times: “Obesity tsar calls for tax on juice”. Soon after that, I was asked for my opinion in The Guardian’s equally sensational headline “How fruit juice went from health food to junk food”. My opinion then (and now) is that fruit juice is perfectly acceptable in the appropriate portion size of 150ml a day and that ideally you should drink it with a meal to reduce the impact on teeth. (more…)
Published on the 1st Apr, 2014 by Azmina
The hot story today is about research published in The Journal of Epidemiology & Community Heath suggesting that we should be eating seven or more portions of fresh fruit and veg a day. The British Dietetic Association phone lines have been jammed and as a BDA spokesperson, my day so far has been spent on the frozen and canned fruit story.
The study asked more than 65,000 middle-aged people in England about how much fruit and vegetables they ate over the last 24 hours and evaluated their risk of death from diseases like heart disease and cancer. There is enough scientific evidence to persuade me that eating more fruit and veg is protective against these non-communicable diseases, period. But I do have issues with lumping frozen fruit with tinned fruit,whether it’s in natural juice or syrup.
Published on the 14th Jan, 2014 by Azmina
January is diet month and this is National Obesity Awareness Week, so a perfect time for the British Nutrition Foundation’s symposium on popular diets. I like to make sure I am convinced by the science before I recommend any weight management system, so I couldn’t wait to hear the latest insights from key researchers on the 5:2 diet, low GI diet, high protein low carb diets, Palaeolithic diets, and more.
We know that you get significant health benefits from losing just 5% of your body weight, and that miracle diets offering speedy and massive weight loss are doomed to failure. But let’s face it, the mantra of eating a sensible varied diet is dull, and one size doesn’t fit all. So the evidence behind popular diets needs to be considered and each one is part of a toolset that dietitians can use to suit the individual; different people will require different strategies that fit with their culture and lifestyle habits.
Published on the 29th Oct, 2013 by Azmina
I’ll be speaking at this year’s Nutrition & Health Live conference on 2 November and am busy planning the content so we ensure the session is engaging and informative. Well, of course it will be engaging when it’s about my pet subject, Social Media! The workshop is aimed at nutritionists and dietitians, especially those who haven’t yet caught the social bug, and I’ll also be chairing the Expert Panel. I’m partial to this conference as it’s a great networking opportunity and the lectures are usually very insightful (and I was lucky enough to be short-listed for Nutritionist of the Year Award 2012).
Here’s what me and my colleagues have in store for delegates this year:
I’ll kick off to spread some Twitter basics, get the group to create a tweet or two, and I’ll introduce the successful RDUK Twitter chats, which are supported by the British Dietetic Association. Then Emma Carder takes it up a notch as she discusses multiple social media interaction using Facebook, Twitter, and LinkedIn. Nichola Whitehead later shares her journey on how she works and how to increase your number of followers.
The Expert Panel Discussion points will include: (more…)
Published on the 9th Aug, 2013 by Azmina
This is a recovery tool for getting over Food Addiction or Binge Eating; it’s probably one of the most important tools.
Dieters tend to plan to lose weight for something in the future….the celebration, the holiday, the job interview, etc. This type of goal focuses on the future and it is this which can cause many people to relapse. The simple concept of taking things One Day At A Time is that the person trying to recover from overeating has to think about what they need to do for that day only. They do not have to project further forward than that. (more…)
Published on the 24th Jul, 2013 by Azmina
I was tempted to learn more about food addiction as I believe many people are somewhere along the spectrum of some sort of distorted relationship with food. So I enrolled on this fab course and summarise my learning here for you. There was something special about Rochelle Craig’s LinkedIn profile that attracted me to her way of thinking…
Published on the 6th Jun, 2013 by Azmina
I’ve been helping Duncan Walker at BBC online with his article on the rise of protein drinks for ordinary people, published today.
If you look at dietary surveys we are actually doing okay for protein and there’s no reason for dietary supplements unless you are in a vulnerable category. But who is vulnerable?
Nutrition and Diet surveys are based on people recording what they eat – if you’ve ever tried to do that, you’ll know how difficult it is to remember every mouthful. And food eaten outside the home, including sandwiches and takeaways, are estimates of portion size rather than accurate weighed measurements. So it’s not a complete picture of what we’re eating.
Protein as we get older…
Protein shakes could be important, or popular, with middle aged people. On average, between the age of 50 and 70, you will lose about 30% of your muscle strength. That’s why we look flabby as we get older! Protein is the nutrient that helps to re-build your muscles. And I think that’s probably one of the reasons why there’s this growing attention – we’re an ageing population and 50 is the new 30. We all want to be as active as we once were. (more…)
Published on the 30th May, 2013 by Azmina
I was asked for my views on this proposed ban today by ITV Daybreak. Salford City Council is proposing that fast food outlets (like MacDonald’s and local fish and chip shops) near schools should be banned from serving hot food before 5pm, in an aim to reduce the obesity crisis. The ban would only prevent new outlets that apply for a licence and the public is being asked for their views before the ban is implemented.
If unhealthy food is within easy reach, you’re more tempted to go for it. And when you’re hungry, the smell of hot food can be even more alluring. I advise people wanting to lose weight to remove the temptation by not keeping unhealthy snacks accessible– out of sight is out of mind.
But this proposed ban only addresses new businesses, so children who frequently visit existing outlets are unlikely to change their habits. Hence, I doubt this ban would have a significant effect. (more…)
Published on the 16th May, 2012 by Azmina
We’ve been here before; I remember being interviewed about this by the BBC during last year’s National Obesity Forum conference. This time new research from Oxford has hit the headlines. There have been reports in the press today about how a “fat tax” applied to unhealthy foods could help combat obesity.
Oliver Mytton and colleagues at the University of Oxford examined the evidence on the health effects of food taxes. It’s suggested that a tax on unhealthy food could help improve health, but the tax would need to be fairly heavy to make a difference – up to 20%. Ideally, a move to make fruit and veg cheaper would have to accompany such tax.