When a new baby comes home there is often a significant shift in home dynamics and the focus becomes one of supporting the baby’s needs. As a consequence, the needs of parents often come second to baby. Disrupted sleep patterns and eating on the run (whilst juggling a number of competing demands) often leads to a lack of vitality and fatigue. Parents may end up feeling incredibly exhausted and as though they have no time to take care of their own needs and requirements.

It is important for parents to be eating well, especially breastfeeding mothers who require extra energy for the production of breast milk. This extra energy is about 2000 kJ (500 cal) per day. This can be achieved easily via a few simple additions to the diet. The key is to eat 3 meals each day and have 2-3 healthy snacks. Being mindful of hunger cues, thirst and fullness can help guide your needs.

Creating Balanced Meals

To create balanced meals with good levels of nutrition you can use your plate to help structure all your meals. Follow these four simple steps.

1.    Use half the plate to serve plant foods such as non-starchy vegetables (or fruit). This half of the plate will provide loads of nutrition including good levels of vitamins, minerals and beneficial antioxidants. Foods such as broccoli, berries, mushrooms and tomatoes belong here.

2.    Use one quarter of the plate for a variety of lean protein sources. This section of the plate will help with satiety and can be provided via lean meat, seafood, dairy, eggs or legumes. Include a variety of protein sources throughout the week. Try and include two serves of seafood and one main meal that is vegetarian each week.

3.    Use the other quarter of the plate for low GI carbohydrates, these will provide the body with a steady stream of energy to cope with daily demands. Go for wholegrain, wholemeal breads and cereals, carb rich grains, and vegetables such as corn, quinoa and oats.

4.    Include healthy fat as part of each meal from sources such as olive oil, avocado, nuts, oily fish and seeds.

For those who require a more structured approach the following table is an example of how good nutrition and extra kilojoules can be incorporated into the diet.

Sample Meal Plan for New Mums and Dads

*NOTE: Bold indicates additional energy requirements for new Mothers

Breakfast

Wholegrain breakfast cereal

Skim milk

1 banana or ½ cup berries

1TBS natural yoghurt

1 tsp nuts/seeds

+ 1 slice of wholegrain toast with a smear of avocado

Snack

1 pear + 1 handful of almonds

Lunch

Wholegrain wrap

1 cup salad greens, grated carrot, tomato, beetroot

Thinly sliced chicken

1 tbs hummus or some olive oil spread

+ 1 tall glass of skim milk

Snack

1 low fat yoghurt + 1 sliced banana

Dinner

Salmon fillet

Served with quinoa, barley or brown rice

1 cup non-starchy vege (baby spinach, steamed carrots, yellow squash, mushrooms)

+ 1 cob of corn


New mothers can often become constipated, so it’s important to remain hydrated throughout the day. NHMRC recommend women have 9 cups of water to support lactation. Fibre from breads, cereals, legumes, oats, fruit and vegetables will also help with constipation.

Drugs, alcohol and tobacco

Drugs, alcohol and tobacco can all affect the quality of breast milk. When a mother consumes alcohol during lactation it is passed quickly into her breastmilk. According to Ho et al (2001) it takes a 60kg female about 2 to 3 hours to eliminate alcohol from the body after one serving of beer or wine. It is important for a mother to plan all her drinking ‘occasions’ after breastfeeding the baby.

Amir et al (2002) state that nicotine levels in breast milk of women who smoke are between 1.5 and 3 times higher than the level in the mother’s blood so it is important for a woman to quit or reduce her smoking habits, especially during the hour prior to breastfeeding. The benefits of a mother’s breast milk however (even when smoking) are of higher nutritional value to the baby than bottle feeding and smoking (Brown 2008). Breast milk is the ‘gold standard’.

Looking after yourself

During challenging times when the baby is particularly distressed, it is important to have measures in place so that you are consuming good nutrition to maintain your vitality.

Here are a few tips.

·      Have ready-made meals prepared and frozen ahead of time; casseroles, soups and hot pots are particularly useful.

·      Have a supermarket roast chicken and salad mix on hand that is already prewashed and prepared for a fast, no fuss meal. Remove the chicken skin and make good use of the lean meat.

·      Have quick meals in mind such as boiled eggs or baked beans on wholegrain toast, with a side of vege/salad for those times when you need a meal but have little time.

·      Put roughly chopped vegetables and lean meat/chickpeas into a slow cooker early in the day with some stock or tinned tomatoes for a warm meal ready by night.

·      Create meals like frittatas that can be eaten hot or cold, or can be packed into transportable lunchboxes for outings.

·      Keep your fruit basket well stocked and have yoghurt, nuts, vege sticks and hummus on hand for healthy snacks during the day.

References:

Amir, LH & Donath, SM (2002), ‘Does maternal smoking have a negative physiological effect on breastfeeding? The epidemiological evidence’, Birth vol. 29, pp.112-23

Brown, JE (2008), ‘Nutrition Through the Lifecycle’ 3rd ed’n, Wadsworth, Cengage Learning, Belmont CA.

NHMRC Nutrient Reference Guides: http://www.nrv.gov.au/

Jenelle Croatto APD

After an influx of referrals last week for clients wanting advice on following a Candida Diet to prevent and/or treat thrush, I only thought it was appropriate to discuss the science surrounding this idea.

The theory that by following a ‘yeast free’ diet will prevent excessive growth of candida was particularly popular during the 1980’s and was commonly recommended.  However it gradually faded as a form of treatment in orthodox medical circles following a study which was released in 1990[1], and subsequent research into the area. 

One reason that the idea of a ‘yeast free’ diet gained traction is because some women with intolerances to natural food chemicals (most commonly, salicylates) will often experience vaginal irritation and mouth ulcers, sometimes with tongue coating.  Based on clinical presentation only, many medical practitioners have come to the misdiagnoses of thrush.   To properly diagnose thrush a swab needs to be conducted.  If candida has been identified then it is treatable with an anti-fungal agent.  However, if the result is negative then diet may be explored as a possible cause of symptoms.   

Another area of confusion surrounds that of allergy testing.  Individuals who present with a positive skin prick test (SPT) to yeast/candida may be lead to think that they are allergic.  In fact this is only indicative of exposure, which is universal, and not a clinical diagnosis of an allergy, or a valid reason to commence a ‘yeast free’ diet. 

At times the line between food and clinical symptoms can be quite blurred, and I can appreciate that it can be tricky to pin point what may be causing issues.  For this reason, if anyone is suspecting that they may have some form of sensitivity to food I strongly encourage involvement with a medical practitioner and Dietitian who are experienced in the area of food sensitivities.  Following a restrictive diet without the guidance of a Dietitian may lead to a diet that is nutritionally inadequate and inappropriate.


[1] A RANDOMISED, DOUBLE-BLIND TRIAL OF NYSTATIN THERAPY FOR THE CANDIDIASIS HYPERSENTIVITY SYNDROME. N Engl J Med (1990); 323:1717-23

Beating the achy breaky pain of heartburn

Jenelle Croatto APD

The fittingly appropriate name of heartburn (or gastro-oesophageal reflux) is a common condition which affects up to 1 in 5 Australians at least once per week.  It can affect men, women and children!  Heartburn is often experienced as a burning sensation behind the breastbone which is caused by a reflux of stomach acid into your oesophagus (the tube that connects your mouth to your stomach).

 Connecting the oesophagus to the stomach is the lower oesophageal sphincter, which acts as valve to prevent stomach contents from rising back up through oesophagus.   Heartburn occurs when this valve is weakened or not working properly.  Although this condition is not life threatening, left untreated it can cause changes in the oesophagus which may lead to cancer.  If you are experiencing chronic reflux it is best to have it checked out as it may be sign of another health condition.

Luckily relief is at hand...

10 Simple Steps to Manage Heart Burn

1.     Lose excess weight – Being overweight, especially around the abdominal area places extra pressure on your stomach

2.     Avoid big meals – Spread your meals throughout the day by having smaller portions

3.     Elevate the head of your bed AND don’t lie down immediately after eating – Prevents ‘reflux’ of stomach contents

4.     Avoid sleeping on your right side - How does it work? Gravity! Quite simply your stomach is situated on your left hand side of your abdomen

5.     Don’t drink with your meals – By doing so you will avoid additional pressure on your stomach.  Aim to drink fluids ½ hour before or 1 hour after meals

6.     Low fat options – Fatty meals and snacks will likely aggravate symptoms

7.     Avoid spicy and citric food and drinks - These foods are known to irritate the stomach and oesophagus, especially if the oesophagus wall is already irritated from a recent episode of reflux

8.     Limit coffee (including decaffeinated) and alcohol– These both increase stomach acid secretion.  Additionally alcohol relaxes the lower oesophageal sphincter.

9.     Don’t smoke – Not only does smoking relax the lower oesophageal sphincter it also prolongs the removal of acid from the stomach

10.  Avoid peppermint, spearmint and chocolate – Common triggers that also relax lower oesophageal sphincter

Hopefully by following this advice you will be on your way to settling your inner dragon!

I love quinoa and I love porridge... So it won't be a surprise that Quinoa Porridge is regular breakfast for me.

I love it because it tastes great and has all the nutritional 'checks' I need. 

With my dietary requirements, it's a sure fire winner. Plus it keeps me satisfied for hours. Each seed of quinoa contains smart carbs and protein... So this little seed has a strong nutritional punch. It's a winner amongst those wanting a 'Paleo' style diet and those who require a gluten free diet. 

What you see above is my breakfast this morning. Warm, creamy porridge with some lovely fresh peach, blueberries and a sprinkling of cinnamon. You can top it with whatever you have on hand. Here are just a few ideas :

• Grated apple with cinnamon
  
• Date and walnut
• Banana and yoghurt
• Berries and chia seeds
• Poached pear and sunflower seeds
• Prune compote and almonds
• Apricot, coconut and pepitas

My husband thought it looked great... but being my resident 'Heston' he came up with his own version below. A smooth porridge using ground quinoa. He used the coffee grinder to make the quinoa 'fine' before cooking it. It looked a little like a thick yoghurt and we think it would make great baby food! 

For those that don't like the texture of quinoa, the ground version might be worth a try! 

Before I pass on his tips let me explain how to make basic quinoa porridge on the stove top or in the microwave. You can tailor this recipe for your own dietary requirements or tastes using any type of milk... Skim, soy, coconut, almond, oat, rice or just water. So when I refer to 'milk' it can be any type of milk or even water.

STOVE TOP: MAKES 3-4 SERVES

Combine 1 cup of quinoa to 2 cups milk. Boil gently and let simmer for about 20-25 mins, stirring occasionally to check that it hasn't burned or boiled dry. You will know when it is cooked because it will be translucent and form little tails. Serve with your desired topping. 

MICROWAVE: MAKES 3-4 SERVES

Combine 1 cup of quinoa to 2 cups milk. Cook on high for 2-3 mins. Stir and then cook on low for 15mins. You will know when it is cooked because it will be translucent and form little tails. Serve with your desired topping. All microwaves are different, so first time round, keep watch for that translucent look. 

SMOOTH QUINOA: Heston Husband Tips! :)

• Half a cup of ground quinoa goes a long way - easily enough for 2 people
  
• I ground half a cup of quinoa to flour in a coffee/spice "grinder" for about 30 seconds (the type with blades rather than a grinding mechanism)
  
• I added a teaspoon of psyllium husk to the flour for a more porridge-like consistency
  
• Cooking it with soy or cow milk helps to balance out the slightly sappy taste of the quinoa
  
• Other ingredients were walnuts, chopped dried apricots, sunflower and flax seeds, blueberries and peaches, cinnamon
  
• Dates or prunes might be a better flavour match for the quinoa than dried apricots were. 
  
• I left the flaxseed whole for the photo, but would normally grind flax seed up coarsely (5 seconds in the grinder), so that they're digested more easily and don't get stuck in your teeth.
  

So, have a play! Quinoa is such a great little seed and we love it. It is a versatile cooking ingredient (just see my recipe page) and it's very nutritious. 

So many Australians don’t do regular exercise and lastest research is highlighting how bad this is for our overall health and vitality.

You don’t have to be an athlete to go for a run, a swim or a cycle. You don’t need a gym membership to get yourself fit… and you certainly don’t need a new Nike outfit. All you need is a pair of joggers and some comfortable clothing and you will be well on your way to a healthier you.  When you exercise regularly you feel great, your vitality improves and you sleep better.  New research also suggests it could add years to your life.

In a recent study conducted by the National Cancer Institute (NCI) in the US, it was found that people who were obese and inactive had a life expectancy that was between five to seven years shorter (depending on their level of obesity) than people who were normal weight and moderately active. In another study published in the European Heart Journal researchers examined 43,265 people in America between 1979 and 2003 and highlighted physical fitness as a health marker. Dr Ortega said: “Based on the data that our group and others have collected over years, we believe that getting more exercise broadly and positively influences major body systems and organs and consequently contributes to make someone metabolically healthier, including obese people”.

A new term ‘skinny fat’ has been coined to describe those that appear thin but who have a high level of body fat and low muscle tone; these people have a higher risk of poor health than those who are physically fit and ‘obese’.

So, what do you need to be moderately active? We suggest moving for at least 30 mins every day and try to mix it up so you don’t get bored. Make one session longer and have one day of rest.

Here is a simple exercise program for you to try from home or in the local park:

Monday: 30 min walk after work

Tuesday: 10 min skipping rope and 20 mins of squats, lunges and push-ups

Wednesday: 30 min walk after work

Thursday: 10 min repeated stair climbs and 20 min abdominal strength (basic crunches and planks)

Friday: 30 min morning walk (you know you might get tied up socially on a Friday afternoon, so do your exercise first thing on a Friday morning)

Saturday: 60 min long walk or bike ride: Choose a coastline, a mountain or a lake to stroll/ride around and take the whole family

Sunday: Rest day

It’s as easy as that! Try and mix up what you do so that you keep interested in your exercise and add years to your life.

Send a Twitter Pic to @lise_simpson of you out and about exercising. Remember 30 min of light walking is better than nothing at all. 

Lisa xoxo

White bread

Made from just the starchy inner part of the grain with all the fibre and many nutrients removed this is the least nutritious bread. 
It almost always has a high GI meaning the carbs are absorbed almost as quickly as if you drank pure glucose in water! 
This gives you big rise in blood glucose levels and needs a lot of insulin to be dealt with. Not good news for heart health, weight control or reducing risk of or controlling diabetes. 
However there are now a few low GI white breads on the market. These are a step in the right direction if you must eat white bread. Sourdough white is also much better having a lower GI. Many also have fibre added but these are still not the same as eating a wholegrain bread.

Wholegrain bread

These are the best types of bread as the grain is processed intact. Usually these have a lower GI, all the fibre and most of the nutrients preserved from the intact grain.

Wholemeal bread

It’s important to recognise the difference between wholemeal and wholegrain. Wholemeal are more processed – often the fibre component is added back, making them more nutritious than white bread, however the GI is often still high.

Multigrain bread

Multigrain bread is often white bread in disguise, dressed up with a few seeds and grains thrown in! Take a bite of a multigrain slice and feel it dissolve in your mouth. It is rapidly absorbed, just like white bread. Go for wholegrain rather than ‘multigrain’.

Flat breads

Joanna loves Mountain bread and Sorj bread – no preservatives and literally just flour water and salt. Joanna uses Tannour bread for making homemade pizza for the kids – made by Old Time Bakery Pty Ltd and described as “first made by Ancient Phoenicians”. There has been a real move back to these kind of old fashioned breads. Good old wholemeal pita is also good and tends to be low GI.

Sourdough bread

Longer dough fermentation aids in restoring the function of the digestive tract and supporting the immune system. Sourdough bread is a low GI food. This has been proven to provide many health benefits for medical conditions such as diabetes while also assisting in weight control by improving appetite control and delaying hunger. These breads are best eaten cut fresh, rather than as a sandwich later in the day. Sourdough doesn’t hold together as well over time.

How to Make a Healthy Wrap!

Bursting with colour, fibre, low GI carbs, lean protein and a dash of healthy fat this wrap will keep the hunger under control and provide loads of nutrition.

Ingredients

1 wholegrain Mountain bread

1 grated carrot

1 generous handful of baby spinach

1 thinly sliced tomato

+ any other salad vegetables you enjoy

100g thinly sliced chicken breast

¼ avocado used as healthy spread

Cracked pepper to taste

Method

Slice up all salad vegetables and place on a paper towel to absorb excess moisture. In doing so this will stop your wrap going soggy by lunchtime!

Arrange your ingredients down one end of the Mountain bread to allow a tight and easy roll. Roll with care and to be environmentally friendly, wrap in some aluminium foil, as it can be recycled.

Enjoy, Lisa xo

Kilojoules, calories, kilocalories, cal, kJ… Huh? 

If that’s you, than you are in luck. A new website has been launched by the NSW Food Authority in Australia to help us all understand a little more about kilojoules. The new website is www.8700.com.au .

kJ (kilojoules) is the Australian measure of how much energy we get from consuming a food or drink. Nearly everything we eat and drink provides our bodies with energy. Some foods provide loads of energy/kJ and other foods provide little energy/kJ.

Energy from food provides fuel for walking, running, skipping and breathing. When we take the dog for a walk we use more energy than when we are on the couch watching the television. If we eat more energy than our body requires, we put on weight and that energy is put into storage (usually as fat).

Simply, active people require more energy than inactive people.

The average Australian adult consumes about 8700kJ a day and that’s why the new website was titled 8700. Large, active men typically require more energy than small, inactive women.  You can work out how much energy your body requires by going to the ‘Your Ideal Figure’ tab on the www.8700.com.au website. This section of the website will estimate your total requirements after you fill in your age, gender, weight and activity levels.

NOTE: kJ are similar to Calories:

• 1 kJ = 0.2 Calories (Cals)
• 1 Calorie = 4.2 kJs

Large restaurants and cafes now prominently display the kJ count where you can see them on their menu boards so you can make the best choice for your requirements. If you want to check how many kJs are in your meal before you head out, you can by using the website. The 8700 database includes many products from the brands affected by the NSW kJ display laws, and a small number of similar, common foods. You can even download the new 8700 phone application for easy reference when out and about…

Tips from the website:

Remember that healthy eating is all about what’s right for your body’s needs and balancing the amount of kJs you take in with the activity required to burn them up.

Make regular physical activity part of everyday: It helps you maintain good health and manage your weight and reduces your risk of chronic diseases.

Get active: You should try being active in as many ways as you can throughout the day. Aim for at least 30 minutes of physical activity a day.
 Don’t spend so much time sitting.

Losing weight: 60 – 90 minutes moderate-intensity physical activity most days of the week. Start small and within you level of fitness, gradually work your way up.

Finding out how much energy your body requires might come as a surprise, and if it does, you now have a tool to help you understand where the energy in your diet is coming from and make some positive changes.

Take a good look at the website and have a tour. Explore, click and play… But, as always, choose foods close to nature, make informed decisions but don’t get too hung up on counting and calculating.

Eat well, be well… Lisa xo

About ten years ago I was diagnosed with Coeliac Disease. At the time I wasn’t sure what that was, but I recall my gastroenterologist saying “No more breads and cereals for you”. A decade ago I hadn’t heard of Coeliac Disease and the term ‘gluten free’ wasn’t something I had ever come across.

I remember thinking I would starve to death. Each morning I’d consume two Weet-Bix for breakfast and always had a salad sandwich from the school canteen for lunch. After going to the gym in the evenings I’d eat a bowl of untoasted muesli as I prepared a vegetarian dinner that usually featured pasta or couscous. Back in the day (before becoming a dietitian) I thought my diet was pretty ‘bang on’; but it was making me sick, it was full of gluten and I was always hungry. My Coeliac Disease meant that I wasn’t absorbing certain nutrients and my intestines were in a bad way.

All that seems like a lifetime ago, but I remember feeling overwhelmed and unsure about what I should eat. There wasn’t a shopping aisle devoted to gluten free goodies back then. I started out devouring bucket loads of rice to fuel my training as a group fitness instructor. My rice cooker was used almost every night. Let me tell you, there are loads of nutrient dense gluten free carbohydrate sources other than rice!

Ten years after my diagnosis there are now hundreds of gluten free products available and strangely eating ‘gluten free’ has become some sort of trend. People seem to think that eating gluten free will make them lose weight or that it’s healthier, but to be honest, some gluten free products are ghastly and are often high GI and laden with fat or sugar.

Fact is, eating gluten free won’t help you lose weight and isn’t always the best option; that is unless you have gluten intolerance or Coeliac Disease.

Dr. David Katz, director of the Yale University Prevention Research Center, said people who cut gluten to stay slim are relying on a strategy common to almost all quick-fix diets: restricting food choices. “When people have fewer choices, they tend to eat less and lose weight accordingly,” he said. “But you could accomplish the same thing by consuming only healthful, wholesome foods, including whole grains that do contain gluten. The result would be an easier, more sustainable, and potentially more nutritious diet overall.”

There is nothing unhealthy about gluten unless someone has a true sensitivity or Coeliac Disease like myself. Gluten is simply a protein that has been in the human diet since the dawn of agriculture and acts like a ‘glue’ in baked goods; giving stretch and rise to foods like breads.

If you suspect you have a gluten intolerance or Coeliac Disease you need to be tested. If the results come back positive, I promise you, you won’t starve to death and you will feel so much better. It’s important you seek advice from an Accredited Practising Dietitian like Dr Joanna or myself to help you establish a well balanced gluten free diet. If your results come back negative, don’t cut out wholegrain breads and cereals because you think you’ll be healthier. Wholegrains are a superb source of fibre and minerals that will keep your gut and bowel healthy for life.

For more information about symptoms and testing, I highly recommend checking out this website:http://www.coeliac.org.au/ . Here you will learn about symptoms, diagnosis and following a gluten free diet if you are diagnosed with an intolerance or Coeliac Disease like me.

Live, love, life… Lisa x