The Dietitian's Blog

Parsnips

2006-12-03T01:04:00.000Z

I had started a little mini-series on the merits of various foods some time ago. Then a lovely email from the Bibliocook brought my attention to the excellent Eat the Seasons website, which already does the job!

You can sign up for email updates on what's good to eat right now and the site has lots of useful info on buying, storing and cooking it.

Right now, parsnips are it. My favourite root vegetable. Good stuff

Nua Amarach

2006-12-03T00:26:00.000Z

People who know me think it's hilarious that I have my own country.

I think it's the way forward. We should each have an opportunity to run things for a bit!

Since I'm not allowed to get my hands dirty at the political coalface without a complicated process of nomination, election and at least a nod to democracy, I have to be content with a fairly rudimentary online game community.

Turns out it's a heck of a lot easier to discuss what 'they' are doing wrong with healthcare/education/crime in the pub or at the dinner table than it is to run things fairly and efficiently, even online. Who knew?

But things are a lot better these days in the Republic of Nua Amarach, and we're working on the government corruption issue. Trust me. I'm not a politician.

Philosophiæ Doctor

2006-12-02T23:43:00.000Z

By the time it's over I'll be a doctor. Not an MD mind, but a PhD. Literally, a Doctor of Philosophy. Isn't that odd? It'll be in the field of Nutrition, but I'll be a doctor of philosophy because, apparently, years ago, any research outside of the fields of theology or medicine was referred to as 'philosophy'.

Three years it'll take, but I've a feeling it'll seem like more. And we still haven't got the funding properly sorted. And I'll be so specialised within my profession at the end of it as to be virtually unemployable outside of my current area of work, continuing my regressive career trajectory in pursuit of what is interesting and away from financial progress.

Husband will need to be fantastically tolerant.

Must be crazy.

But it has to be done.

Obesity in Young Women- Higher Risk of Premature Death

2006-07-29T12:20:00.000+01:00

Research published in the Annals of Internal Medicine uses data from the Nurses Health Study (NHANES II) to show that women who had a high Body Mass Index (BMI) as teenagers are more likely to die prematurely from conditions like heart disease.

While the study has it's limitations, the authors emphasise the importance of preventing and addressing childhood obesity early to minimise the negative effects on long term health.

Wouldn't it be nice to see some public policy and investment in local programs from the Department of Health? Instead there is nowhere in the country which has a community paediatric dietetic service. Community dietitians say that paediatrics is not in their remit.

Children have to be referred to specialist services at acute hospitals- where departments are understaffed with huge waiting lists and cannot prioritise obesity over metabolic defects, diabetes, malnutrition, cancer etc. Even at risk premature infants 'graduating' from a neonatal centre have no resource for nutritional follow up- a disgraceful situation as the crucial window of opportunity for these children to maximise their 'catch-up' is very tight.

There's an embargo on recruitment due to 'capping' of staff numbers in the tertiary hospitals which is based on such a stupid assessment of staffing that it makes me furious to think about it.
One fine day, a lowly civil servant in the Department of Health & Children phoned every hospital in the country to ascertain how many staff were present for work at that time. A mini-census, if you will.
Staff numbers were then capped at this number- irrespective of uncovered leave, vacant posts, additional agency staff etc. Genius! No need to waste time looking at service demands or patient:staff ratios or anything more complex or effective.
A perfect approach to Healthcare Management that ties in nicely with budgets for 2006 being made available to hospitals in June/July 2006 (yes, 2006) rather than in September 2005- never mind Jan 06- to completely avoid any possibility of planned effective financial management.

Why we aren't rioting on the streets sometimes amazes me.

Bad Food Guide

2006-06-20T19:26:00.000+01:00

Very interesting little documentary on BBC2 tonight about Raymond Postgate, the socialist historian and crime-writer, who was also the originator of the 'Good Food Guide' in 1951.

The insight into the awfulness of post-war British eating is truly fascinating, from Brown Windsor Soup and horsemeat to South African snoek and whale steaks.

Postgate railed against the complacency and often downright rudeness of catering provision, as it coasted along on the atmosphere of restriction and lack of flavour synonymous with WW2 rationing.

He was the founder and sole member of the 'Society for the Prevention of Cruelty to Food' - his rallying article in the weekly magazine The Leader- which led to the Good Food Club. Postgate simply asked that individuals anonymously rate eating establishments on a short form, nominating good ones to membership of the Good Food Club. The response was overwhelming, with nominations coming in from all over the country.

When The Leader shut down, Postgate undertook to compile the nominated restaurants, cafes and hotel dining rooms into a reference guide. As a method of quality control, he traveled around to each of them with his son as a dining companion and co-taster, including in the book those that satisfied his down-to-earth tastes and met his not unreasonable standards of service.

The first Good Food Guide included 'Tips for Eating Out', extremely patronising by today's standards, but designed to arm the middle class diner of the 1950's against 'the enemy' of the snotty waiter, careless chef and mercenary restauranteur. As such, it is credited with being the forerunner of the consumer movement.

The Guide captured the zeitgeist of eating out in post-war Britain, including many ethnic restaurants and in particular, local Indian restaurants, like Veraswarmas in London.

It also encapsulated the rise of the 'knowledgeable amateur' chef patrons, such as George Perry-Smith, and his restaurant The Hole in the Wall in Bath. Perry-Smith was a hip, bearded bohemian whose quality menu was inspired by the young food writer Elizabeth Davis. Together, they are seen by many as the vanguard of a new confident British cuisine and the move away from Brown Windsor Soup and surly service, championed by Raymond Postgate.

Good for them, I say, and for the British dining public!

Disordered Eating, Self Esteem

2006-06-17T18:24:00.000+01:00

Does anyone think it's increasingly rare that women are happy in their skins?
So many women I meet seem to almost completely tie up their self worth in their appearance. Oh I know it's always been the case that women have been judged on what they look like rather than who they are, but we're supposed to have moved on a bit since the 1950's.

In my line of work, I am more likely than most to be encountering dissatisfaction and poor body image on a regular basis, but among my friends and acquaintances, body shape, looks and dieting are a perennial pre-occupation, some of them to quite a pathological degree.

The conference on eating disorders in Barcelona recently was stimulating and worrying in almost equal measure.

Eating disorders are on the increase. The incidence is increasing in men as well as in women, and the onset is at an earlier age (though the most vulnerable time overall is still puberty).

The causes are multifactorial. Some researchers are looking at possible genetic predispositions which could make individuals more likely to develop an eating disorder under certain environmental conditions (ie stresses such as poor family support, bullying etc). Societal attitude to the beauty ideal is certainly a factor, as are the prevailing messages about food and eating. Media portrayals of 'ideals' and 'norms' are an influence on girls as young as 5.

Role models are important. Mothers and peers are enormously influential. A girl whose mother is always 'on a diet' and whose friends discuss Brittany versus Christina in terms of their looks rather than talent, is much more likely to suffer from poor self esteem and to have a distorted perception of her own body.

Parents of overweight children are frequently anxious about how to address the overweight without promoting body dissatisfaction and possibly triggering and eating disorder. In fact, overweight children are most likely already dissatisfied with their appearance.

This all probably sounds a bit 'heard it before- yaaaawn'.
We've had the Karen Carpenter biopic and Susie Orbach's 'Fat is a Feminist Issue'. We're jaded with the how skinny is Nicole/Lindsay/the one with the dark hair who used to be in Twin Peaks.

Here's the thing- eating disorders are a tragic psychiatric condition about stress and control and because as a society we contribute in some way, as individuals, we each need to start somewhere and do our bit.

I'm happy that I actively promote a move away from dieting behavior towards healthy relationships with food both in my work and my life, but I also resolved in Barcelona to get over myself.

For a start, I'm going to do my very best to
1. be less self-critical- of my abilities, my skin, my thighs...
2. not avoid going to the doctor because I'm self conscious about any/all of the above (I know, I know! I was barely aware that I did that and how ridiculous it is)
3. avoid engaging in discussions with or about others on the basis of weight or appearance
4. find a way to support and encourage my very good friend who I know in my heart has been suffering from anorexia nervosa for years to get the help she really needs

For health professionals; for ED suffers; for friends & family.
See if there are any resolutions you can make.

Food Preference Starts Early

2006-06-14T23:22:00.000+01:00

An ongoing pan-european research project called INFABIO is looking at infant feeding practices and the development of food preferences. (You can read about other food preference research here).

There is quite a bit of evidence that babies who are breastfed have less neophobia about foods- they take to new tastes more easily than bottle-fed babies. The possible reason is that the flavour of breastmilk is subject to subtle changes, depending on the mother's diet, whereas formula milk always tastes the same.

Apparently, there is also evidence that babies can taste and smell some strong flavours, like garlic, while still in the womb as the phenol compounds responsible for the distincive taste can be found in amniotic fluid.

I'm glad that they know about the flavours by measuring phenols. Being a researcher is difficult enough.

Bad Science

2006-06-13T01:02:00.000+01:00

Oh I love this site!
It's Dr. Ben Goldacre's 'Bad Science' online presence and includes an archive of his columns of the same name in The Guardian.

I laughed out loud so many times at the comments on 'That Awful Poo Lady' clip from YouTube that my stomach hurt.

And he's the image of my friend Vinnie. Have a look.

(PS if you need any more convincing about the ridiculousness of El McKeith, the archives in Ray Girvan's Apothecary's Drawer blog are also pretty good on de-bunking bunkum spouted by the Scottish 'nutritionist')

Normal Weight?

2006-06-11T10:58:00.000+01:00

We're probably all aware of the historical chestnut that Marilyn Monroe was a size 16.

However, based on her measurements, she would have been a US 10 (UK 12) and had a healthy BMI of just over 20kg/m2.

(The healthy range is 20-25, though for women, 18.5- 24.9 is recommended by the National Institutes of Health in the U.S.)

The perception seems to be that Monroe would be considered 'fat' by today's standards- yet she is at the lower end of a healthy BMI range.

Looking at the national statistics on BMI for the USA, it looks like the population is redefining 'normal'. Fewer people have a body mass index in the healthy range (18.5-24.9) and more and more fall into the overweight, obese or underweight categories.

This trend in body sizes away from the norm has led some to seek a re-definition of the healthy range, and anyone advocating this change is proposing a move upwards.
Current weight for height charts are still based on the Metropolitan Insurance tables from the 1950's.

While I do understand the rationale which says that we are taller and heavier now, and that comparison with data for the 1950's might not be a realistic reference for people today, this argument doesn't take account of the fact that 50% of the population have a much thinner 'norm' to which they aspire; social pressures are for women to maintain a body size substantially smaller than what was considered 'normal' or even attractive in the 1950's. And remember, Monroe was not overweight.

Apparently, the couture sample size aspired to by all of Holly wood is '0'. Size zero! 'No size', effectively. Just think for a second about how ridiculous that is- never mind how tiny. To my mind, adjusting BMI or weight reference ranges is moving the goal posts. We would be 'normalising' unhealthy weights and addressing the wrong issue.

Guru, Barcelona

2006-06-10T18:02:00.000+01:00

I experienced a series of firsts on Friday night in Barcelona. Fairly mundane firsts, it must be said (before anyone gets excited), but firsts all the same...

I found my destination straight off without any detour or stress.
I was there ahead of my dinner partner.
I was waiting for close to an hour and didn't get irritated.
I was the ONLY person in a popular restaurant aside from the staff!

Guru bar/restaurant/club at Nou de la Rambla 22, Barcelona, is very cool indeed. There is a long narrow bar on the way in, where they play mellow, ambient tunes and have an excellent cocktail list.
At the back is the restaurant, a grotto-like room, with white 'palm tree' columns and hanging globe shaped lights. The lighting is low and a pinkish neon glow and concrete flooring adds to the surreal grotto feel. The furniture is completely white too and ultra-modern, with leather banquettes down the sides of the room for larger groups and tables of four in 2 rows down the middle.

The menu is nicely straight-forward, with a choice of 4 appetisers, 6 starters, 6 mains and 4 desserts. I had the guacamole while waiting , then a pumpkin and rocket risotto to start followed by fillet steak with asparagus and delicious waxy potato and brie stack (called something much more appetising on the menu, but plenty of cava reserva and a glass or 2 or chilled rose muddled my memory).

The empty dining room filled up with a funky stylish crowd of mixed ages, and from 1230 or so, the central tables were cleared back and the restaurant gradually morphed into a laid back loungey club. The bar outside had been buzzing from about 1030 too, with the separate DJ there revving things up by degrees.

We had to go before things really integrated, but it's open till 6 apparently, and I'd definitely love to go back with a larger crowd; though I'd start later..... and I'd make sure that no-one ended up in Guru bar on Josep Anselm Clav by mistake......

Eating Disorders Conference in Barcelona

2006-06-09T18:04:00.000+01:00

I'm here in Barcelona at a conference on Eating Disorders and I'm exhausted. The sessions start from 830- 930am and go on till 7pm.

On Wednesday, I was at a teaching session on what is categorised officially as Eating Disorders Not Otherwise Specified (EDNOS for short)- basically, everything except Anorexia Nervosa or Bulemia Nervosa. There was Binge Eating Disorder, Night Eating Syndrome (with various sub-categories) and Purging Disorder (which can be Bulemia-like or Anorexia-like). At the end of the session, I felt that almost 100% of all the women referred to me have an eating disorder, as do about 80% of all the women I know, and about 20% of the men.

Yesterday, there were some fantastic presentations and workshops in the area of pregnancy, early development, infant feeding and gene/ environment interactions.

And today, my brain was overloaded with ED in childhood/ adolesence and prevention programs.

I'll post summaries of the most interesting stuff as I go through my notes, but suffice it to say that we're massively under-resourced for ED in Ireland.

Of course, Barcelona's great. Staying at the B Hotel- great value, good location & interesting modern decor. Had some pretty good tapas last night in the Barri Gotic off las Ramblas, and am looking forward to a night at Guru restaurant/ club later on, as recommended by my other half, who is always astonishingly up to date on what's happening in any number of cities. He calls it research. And here am I thinking that 'Protein repletion post-refeeding in female patients with severve low-weight Anorexia Nervosa' is research.......

Summer Eating

2006-06-06T15:50:00.000+01:00

Well it looks like the summer has finally reached Ireland!
I'm back in sunny Dublin after a fabulous weekend boating on the Shannon.

How five women survived not only the technicalities of navigating and handling a 6 berth cruiser, but also confinement in close quarters for 3 days is beyond my other half, who is still shaking his head in disbelief.

But we did, and it was fun and relaxing and the weather was amazing and we didn't break anything much and apart from a minor bump with a 6 week old, 300,000 euro shiny cruiser (sharp intake of breath)- no damage to either boat- (and exhale), it all went well. We were blessed with ridiculously sunny weather every day, and ate on deck or at the riverside for every meal.

Outdoor cooking and eating really is something special. Everything seems to taste better. From the fresh watermelon at breakfast to the glorious salads, the barbecued haloumi, corn on the cob, flat mushrooms with pesto and vine tomatoes with tapenade, and lovely chargrilled fresh salmon, it was all delicious. Fresh fruit like pineapple and bananas all went on the barbie and I think it's almost replaced my yearning for the Scandinavian berries and white chocolate dessert at Bang Cafe.

Summer barbecuing really doesn't need to be all about the meat. Lots of vegetables do very well and if you don't want to go to the bother of skewering up some veg and haloumi or even fruit kebabs, you can spread out chunks of the cheese with red pepper and onion on disposable aluminium trays with a drizzle of oil, salt & pepper or marinade and they'll cook away over the cooler part of the grill. Leave good ripe little tomatoes on the vine if you can -simply because it looks lovely- but you can snip them into bunches of 3 or four with a scissors to make it easier for turning and serving.
The big flat mushrooms would make a great veggie alternative to a burger. We had them in freshly baked crusty baps with haloumi and the tomatoes mashed in like a relish. They need some fat to cook well, and although we used a dollop of pesto, a smear of garlic & herb butter would be equally delicious.
Barbecuing is quite a healthy way to cook as it uses very little additional fat or oil. Of course, marinades for vegetables, fish and meat are fantastic- they increase the flavour and decrease the cooking time- but always be sure to drain off any excess before putting food on the grill as drips onto the coals will cause 'flares' and excessive charring.
Use your imagination and be adventurous this summer.
Look here for recipe suggestions and here for food safety guidelines.

The Jack Spratt Advantage

2006-06-01T14:32:00.000+01:00

You've heard of Jack Spratt? He of nursery rhyme fame who could eat no fat, and whose wife could eat no lean?

This nicley laid out article cleverly titled 'The Jack Spratt Advantage', details some research from the Medical College of Georgia which showed that people with more lean muscle than fat regulated their blood pressure better.

Strengthening your muscles through resistance training (such as Pilates or using weights) has numerous advantages, and I've talked about some of them, such as NEAT, before. Cardiovascular workouts (like running or aerobics) burn calories and are great for your lungs and heart, but don't forget to work on those muscles too. You'll burn calories more efficiently, even when at rest, and it's good for your blood pressure.

Crochet...yes, that's right, crochet.

2006-06-01T13:40:00.000+01:00

Nothing to do with nutrition or food, but crochet is my latest vice. There, I've said it.

When clearing out an old filing cabinet in my (still awaiting refurb) office, mixed in with the carbon copies of journal articles from the 1970's left by my predecessor, I bizarrely found a crochet pattern for a baby blanket. It brought me back to my crochet passion phase of 1979 when my entire family got birthday and Christmas presents fashioned by my own fair hands in mushroom and beige coloured wool- including a particularly fine tie for my businessman father. Imagine their pleasure!

Well, my friends and family are again awaiting gift-giving occasions with trepidation, because I'm finding it very, very relaxing to dc, dtr, ch and rep. Fortunately, most of my friends are now in a baby-booming 'phase' themselves, and crocheted baby blankets, hats and booties are less 'let's hope it's a passing crochet phase' than the neck-ties, glasses-cases and fruit bowls (!) of the past.

If I've ignited the same passion in you, you might like to read more about the origins of crochet here.
Or not....normal service should resume shortly.

Healthy Lunches

2006-06-01T13:28:00.000+01:00

A lot of my clients need direction on simple recipes and suggestions for quick and easy meals.

Bibliocook has a super blog with lots of wholesome simple things to try.

I'm really, really pleased to see such quality food blogs originating here in the Emerald Isle - or at least in Biblocook's case, from an Irish native abroad. Good stuff.

Ice Cream Ireland

2006-06-01T12:47:00.000+01:00

Now, this is nice. From Kieran Murphy of Murphys Ice Cream in Dingle, Co.Kerry.
Someone who loves what they do. And a passion for food- lovely recipes for delicious desserts in his blog- and Mojitos, the loveliest summer drink.

I'm harking back to my theory that eating healthily is easier for people who know and love food.('What if....?' Aug 05)
Nations that are still connected to food production and preparation and taking pleasure in eating appear to me to be the ones that have fewer problems with obesity and the other nutritional ills.
The 'disconnect' in the UK, USA and here between where food comes from and how to prepare it is shocking.
I see people every day who never prepare a meal from scratch, ever.

And yet on the other hand, the humourless, anti-pleasure 'diet nazis' thrive...ho hum. (I just love Howard's rant on Gillian McKeith)
Come the revolution, there'll be changes! And ice-cream for everyone!

Another reason to eat local?

2006-06-01T10:21:00.000+01:00

Funny article by Pim of Chezpim blog fame on another faaaabulous reason to eat locally produced food.

As if you needed another reason! My erudite post on local markets convinced you aaaaaages ago...er, I never made that post did I? Just a quick link to Slowfood sometime last year.
The path to hell is paved with good intentions, as they say.

And speaking of intentions, I will be returning to my limited 'This Season..' posts as soon as I can.

Where's my previous post on asparagus????
Oh....hmmmmm.

Hell, I tell you.

The Mac is back! (and why caesarian sections are bad for you)

2006-06-01T00:37:00.000+01:00

I have missed my lovely white machine SO much! Can't believe it's finally back! This poor blog has gathered dust and cobwebs....

Here's a link to get things going; it's about the risks associated with repeat cesarean sections.
Of course, a cesarean section is a necessity for safe delivery of many complicated pregnancies and difficult labours, but I'm increasingly bothered by the numbers of women who seem to believe that a c-section is the 'easy' option for delivering their healthy babies.

We're doing something badly wrong as a society when we're fostering an attitude that sees the pregnant woman as an oven in which to cook up the genetic recipe written by both parents, ignoring the potent dynamic interaction between the mother's body and her developing baby, from the very start to the very end of pregnancy.

'Role models' like Jordan, Liz Hurley and Vicky 'Posh Spice' Beckham are appalling examples of how to 'do' pregnancy- minimal weight gain, maximum emphasis on appearance, c-section (preferably early, to minimise stretching the skin) and back in your pre-pregnancy jeans within a week.

Awful, awful, awful.

Unhealthy for mother and baby in the immediate and in the long term, entirely unrealistic for any normal woman, and unethical by any sane measure.

Big Babies

2005-10-15T10:30:00.000+01:00

Large babies or those who gain a lot of weight early are at greater than average risk of becoming obese as adults. Read more at the BBC health website here.

Maternal Diet

2005-10-12T00:53:00.000+01:00

BBC health carries a simplified summary of new research from the University of Southampton on the influence of a mother being underweight or having poor nutrition in pregnancy on the long term outlook for her baby's health.

They are linking 'liver-sparing' blood flow in pregnancy with a potentially increased risk of heart disease and diabetes for the baby as an adult (an insight into the Barker Hypothesis- fetal origins of adult disease).

SPAM!

2005-10-05T01:12:00.000+01:00

I've been infested with comment spam!

Don't go clicking on any dubious links in comments on recent posts. I've re-set word verification, so should be ok from now on. Sorry.

Step counting

2005-10-05T00:01:00.000+01:00

I've been using step-counters (pedometers) at my own clinic for a while now, and I definitely feel that they are an effective educational and motivational tool.

Everyone needs some sort of baseline measure and an indication as to progress when trying to make lifestyle changes. Using a step counter allows clients to assess their activity in the way that food diaries help to assess dietary intake.

This Medscape article shows how a simple research project on the use of pedometers demonstrates their efficacy as a dietetic tool.

Foodie Ireland

2005-10-04T17:36:00.000+01:00

This article by Rachel Cooke in the Observer describes her trip to Cork with the Irish chef Richard Corrigan from the Michelin starred Lindsay House in London.

While Corrigan's larger than life personality and unbounded enthusiasm for every morsel of food encountered along the way appears to have been exhausting for Cooke, the gastronomic journey they took sounds like heaven to me.

You'll also get the contact and supplier details for some wonderful local products, such as the delicious Macroom Oatmeal and Gubbeen Cheese.
Enjoy!

Long time no Blog....

2005-10-04T16:41:00.000+01:00

Been deprived of my beloved iBook for a while- but it's back!!! Yay!

It's a little irritating to find myself such a fan of something techie and trendy, but I got a present of a pretty little pink iPod mini for my birthday, and I'm now a total addict.
I've always loved radio and having spent a lot of time in the car in a previous incarnation, I developed an appreciation of audiobooks and language tapes, and I now find myself loving podcasts.

Still in it's infancy in Ireland, podcasting is a fabulous addition to the audio- media scene here. Our Adam Curry figure has yet to emerge, but we're keeping our ears open.

Exergaming

2005-08-30T13:58:00.000+01:00

Now here's a novel way to get the exercise in....hook an exercise bike up to your Playstation or X-box. The joystick controls are in the handlebars and the bike reacts to the game you're playing. Get the teenagers moving maybe? Or drive you mad? Check it out here at endgagdet or at NexFit.

NEAT

2005-08-29T00:57:00.000+01:00

There is a physiological process which may help in part to explain why some people are 'naturally slim' while others who eat no more calories seem to accrue excess weight more easily. Non-exercise activity thermogenesis or NEAT for short. NEAT includes muscle tone, maintaining posture and fidgeting.

Basically, people burn 'incidental' calories through activity that doesn't count as exercise, and quite probably they are unaware of. This influences how much of excess calories taken in will be burned off or how much will be stored.

Small potatoes individually, (thermogenesis accounts for 10% of Total Energy Expenditure), but over a month, a year, a life-time, it could mean a significant accumulation of body fat; as little as 100kcal per day for a year leads to 10lb (4.5kg) weight gain.

It also explains the benefit of muscle toning exercise aside from calorie expenditure. Get into that pilates class today!

More on foetal nutrition...

2005-08-27T13:22:00.000+01:00

We encourage women to improve their health as much as they can before becoming pregnant. A small weight reduction improves fertility and I see a lot of women who achieved a pregnancy unexpectedly having made improvements to their diet and lost some weight.

The whole arena of weight and obesity is fraught with difficulty in Women's Health. Obesity reduces fertility and then increases the risk of pre-eclampsia and gestational diabetes in pregnancy. There is also an increased incidence of twin pregnancy in obese women, and a twin pregnancy is a higher risk pregnancy for both mother and babies. Overweight and obese women often have bigger babies who then have associated delivery problems such as shoulder dystocia and an increased likelihood of an instrumental delivery or cesarian section.

The maternal metabolomics of obese women appear to have even further consequences as reported at a conference on fertility in Denmark earlier in the summer. Daughters of obese mothers are more likely to have reproductive and menstrual problems as teenagers and adults.

I still belive we have to focus on prevention, and I strongly belive that the professionals working in Women's Health are in a unique position to help. Healthier mothers mean healthier babies. Positive messages at a receptive time such as pregnancy can be implemented far into the future.

But we also need to be researching and recording the implications of our interventions and sharing information as widely as possible.

Amarach

2005-08-21T16:12:00.000+01:00

With the way things are going for the still appalling economy of Amarach, I'm thinking of trying a corrupt dictatorship approach next time.

Elly's Onion

2005-08-21T15:41:00.000+01:00

For anyone involved in teaching drama or with an interest in the creative process, Elly McCrea's book is an excellent tool.

Mahnamahna

2005-08-21T14:47:00.000+01:00

doo dooo do doo doo......

Man Dancing

2005-08-21T14:42:00.000+01:00

Go Matt Harding. Love it. Posted in honour of Helen's skidance 2004.

Skiing 2006

2005-08-21T14:24:00.000+01:00

Planning next year's ski-trip....soooo looking forward to it. Missed it this year for the first time in ages. Now that we've ruled out the U.S., the chalet v hotel, France v Austria, or back to Italy debates just add to the anticipation.
Plus some people might bring their children this year, which would be a first for all of us.

I know it's only August.....been a quiet weekend.

The Clarendon

2005-08-20T18:32:00.000+01:00

I almost feel like not sharing this one, but there's a great little bar on the very top floor of the Clarendon (on, you guessed it, Clarendon St., off Grafton St). Lots of people will have been to the ground floor and first floor bars, but not everyone goes up the 4 more flights.

No good for the single girls (who evacuated after a respectable period of time last night) as there's no single traffic- that all happens on the ground floor and the tables outside- but very mellow, very airy and very pleasant staff.

Also, smokers have 6 flights of stairs to contend with. That'll test the lung capacity.

They do really good food at the Clarendon, but not on Fridays (dammit!).
Mao is right next door for good asian mish mash and Chatham Brasserie is near enough with designer burgers and wings, and it's fairly easy to get a table at either.
And there's always The Steps of Rome across the road for a slice of pizza.......

Exercise in Pregnancy

2005-08-20T17:28:00.000+01:00

Looks like aerobic exercise may be beneficial during pregnancy, even for overweight previously sedenatry women.

'Mad Chow Disease' ?

2005-08-15T21:13:00.000+01:00

If you don't already, it is worth getting the Observer on Sunday at least once a month - if only for the 'Food Monthly' magazine supplement.

This great article by Mimi Spencer had me laughing and groaning by turns.

More on supplements

2005-08-13T19:20:00.000+01:00

The EU ban may also help to focus peoples attention on the composition of 'natural' supplements.

I think people often make the mistake of believing that because something is natural, it's safe to take at any stage of their lives in any amount. Indeed, I think most people believe that something labeled 'natural' is safer than a pharmaceutical product, which is just not true.

Now, I take issue with the pharmaceutical industry on several fronts, but the manufacturing and distribution of of their products is so regulated that the type of contamination discussed in this article is unthinkable.

EU ban on Supplements

2005-08-13T14:52:00.000+01:00

I have to say I'm in favour of very tight legislation in the area of OTC supplements. Too much snake-oil out there.

This European-wide legislation doesn't mean that vitamin and mineral supplements will not be available, but it will help to ensure proper labeling and standards regarding composition, which can only be a good thing for the consumer.

Foetal Programming and the Metabolic Syndrome

2005-08-07T17:27:00.000+01:00

A very technical review paper on Epigenomics from the journal Diabetes looks at how a mother's diet at certain stages of prenatal development can adversely affect gene expression, ultimately leading to the Metabolic Syndrome in her offspring.

The effect is passed on through future generations, indicating that a grandmother's nutritional status, in particular periconceptually and throughout pregnancy and lactation, can have a lasting effect on future granchildren's health.

Good maternal nutrition increasingly looks like having significant and ever more far-reaching effects.

Health at Every Size

2005-08-03T10:50:00.000+01:00

Now this is interesting.

I have long felt that improved nutritional balance and more activity is just as valid as weight loss for most people. As little as 5-10% reductions are of proven medical benefit for diabetes and heart disease.

I also firmly believe that helping people move away from yo-yo dieting would be a huge benefit to both mental and physical health. A stable BMI that's higher than average is far preferable to one that drops and rises haphazardly.

The Health at Every Size (HAES) approach holds that weight loss is often actually a destructive aim which promotes dieting behaviour, body image problems and frank eating disorders.

A cursory look through any women's magazine or a google search with 'diet' or 'weight' anywhere in it lends credence to this. The fact that dieting doesn't work is the backbone of the diet industry. How many people attending WeightWatchers or Unislim are back for the second third or fourth time? How many people 'doing' Atkins or South Beach have tried countless other plans or programmes only to regain the pounds within a year? And the guilt......how productive is that?

Let's stop the madness, people!
Food is food;
dieting is trouble for your body and your mind....
but eating well is good for your soul- whatever size you are.

All better!

2005-08-02T19:40:00.000+01:00

Fixed it!
Phew...got to keep up the standards for my reader (all one - count 'em - one of them).

You can check out her super honest blog on her Supersize Day by following this link......and thanks for my first ever, ever comment Nytro.

Pear-shaped

2005-08-02T00:15:00.000+01:00

Some of my links have gone pear-shaped! It appears to be only for the last 2 posts....this learning curve is getting steeper and steeper.

So much to learn!

2005-08-01T22:00:00.000+01:00

Oh my goodness, I am such a blog-novice!

I've been gradually trying to expand my knowledge over the past months....
While these tips for better blogging and links at Simon World are fantastic, a tiny bit of me feels overwhelmed.

Of course, this is all exacerbated by the fact that I got my first ever comment. I feel there should be an award- like the 1000th customer gets all their stuff for free or something.

After I got over the excitement, it suddenly frightened the life out of me. It's really ridiculous, but it seemed fine when I was rambling away in oblivion. Now I have to shape up and know about all the technical stuff. For my reader! Ooooh, the responsibility.......how sad is that?

Fast Food Nation

2005-08-01T18:30:00.000+01:00

Just in case there's anyone who hasn't read Eric Schlosser's 2001 book, it's been through reprints and a new cover and is still widely available, including a version for children.

It's not the whole story, but it did seem to herald the start of an increased public awareness that all was not necessarily well with processed food provision- particularly with the ubiquitous fast-food chains.

Then there was Moragn Spurlock's surprise hit film in 2004, Supersize Me.

Does anyone really still think that a completely processed fast-food diet is ok?

Childhood Obesity

2005-08-01T18:03:00.000+01:00

The U.S. Paediatric Academic Societies 2005 Annual Meeting recently addressed the issue of childhood obesity in America.

The statistics are frightening:
-The prevalence of obesity has doubled since the 1970's for children aged 2-5yrs and aged 12-19
- It has trippled in the same time for children aged 6- 11

The consequences of this are, amoung other things, an increased rate of Type 2 Diabetes in children and an emerging increase in the
Metabolic Syndrome (also known as Syndrome X).

While contributiong factors have been identified, a definitive list of risk factors for childhood obesity is still elusive and more well conducted research in the area is much needed.

The integrated approaches suggested for tackling the issue are interesting, as no-one - whether govenment policy maker, food producer, marketeer, school, parent, or healthcare provider is exempt from responsibility.

One suggestion is that health carers (doctors, nurses, dietitians etc) really must lead more by example. Physician heal thyself or practice what you preach? How refreshing would that be?

Upgrading

2005-08-01T14:16:00.000+01:00

I've been looking at a number of other blogs and it's really interesting to see the diversity, creativity and intelligence represented by the medium.

I thought that not being a techie and being relativly new to the blogosphere gave me immunity from dressing up my blog- but it really doesn't. Lots of people make their blogs look interesting and easier to read without much technical know-how. Or are they all closet web-designers?

Nation States

2005-08-01T14:04:00.000+01:00

My ego and idealism have managed to run my nation's economy into the ground. (Amarach is a Socialist Democracy in the region of Europa, if you're interested).

What's that you say? Grey areas? Unforseen consequences of broad policy decisions? Surely not in real life.......

What if......

2005-08-01T11:35:00.000+01:00

I really feel passionately that having an interest in food- where it comes from, cooking, tasting, sharing, enjoying- without obsessing and restricting - adds immeasurably to health, pleasure and quality of life.

I feel in my gut that the problems of disordered eating and extreme obesity are exacerbated in societies (like Ireland, England, USA) that are increasingly disconnected from the whole cycle of earth to table.....children who don't know that milk comes from cows or that vegetables grow in the ground.....adults who have never ever cooked something and who rely on packets and take-aways.....no shared family meals....no time or priority given to mealtimes in a pressured work environment....the disappearance of local grocers, butchers and bakers.

It is also one of my fundamental objections to the 'health food' quinoa freaks. Where's the pleasure? Why does it need to be difficult and extreme?

What a relief it would be if the paradigm shift was made away from noshing and dieting and towards nourishment and taste and pleasure.

This season I will mostly be eating........Avocado

2005-07-30T13:19:00.000+01:00

Avocado
This goes against the 'eat local produce' thing, but I just lu-uuh-uuve avocados.
Spain is the only commercial producer of avocados in the EU, although they do grow in southern european countries. Most of the avocados available here are imported from Central America or Israel.

The wikipedia link has great info on the fruit that's really a berry.

Nutrition
The nutritional profile of avocados makes them a very interesting addition to a healthy diet. They are high in folate and have more potassium than bananas (good for blood pressure regulation if you keep your sodium intake down too). The fat content is mainly of the 'good' monounsaturated variety, and helps to promote the absorbtion of lycopene. Another reason to eat salsa, anyone?

Of course, the fat content also means waaaaay more calories than your average fruit - so perhaps caution with the amounts of guacamole if you're watching your weight.

Recipes
I'm not so sure about avocado ice-cream like they eat in Brazil (they love their avocados so much that none make it for export), but I have what's amounting to a borderline avocado fetish at the moment.
A lunch favourite is ripe avocado, fresh vine tomato and buffalo mozzarella with a little balsamic. Or just ripe avocado mashed onto bread. Or fresh guacamole with warmed pitta.......mmmmmmmmmmmmmmmmmmmmmmmmm.
Avocado also goes well in many sushi favorites ....Califonia rolls....mmmmmmm. All this drool can't be good for the computer- time for lunch.

I think I've found next year's holiday.

2005-07-30T11:44:00.000+01:00

I love the sound of agriturismo.....how come the Italians seem to know how to do this kind of thing so well?

There are quite a few working farms in Ireland who've been doing the farmhouse accomodation thing very successfully for a while. Not so many offer dinner, and I'm intrigued by the fact that the owner of this farmhouse in Cork won the 'Housewife of the Year' title in 1990.

MSG

2005-07-30T11:38:00.000+01:00

From this month's Observer Food Monthly, an article on MSG.

Good news for anyone in search of umami......

Wealthier not healthier.

2005-07-24T20:11:00.000+01:00

This article summarises some recent European research published in the British Medical Journal looking at socioeconomic status and insulin resistance in children.

Talbot 101

2005-07-24T16:31:00.000+01:00

Located, as the name suggests, upstairs at 101 Talbot Street, this is one of the few good places to eat in the area. It surprises me that it remains unknown to a lot of Dubliners, but it's far from a hidden treasure with a loyal clientele since it opened in 1991.
The Talbot 101 still does what it does well without much fuss. It's a good value, great buzz restaurant with a healthy variety of vegetarian dishes on the menu alongside the steak, chicken and seafood.
Highly recommended for pre-theatre (The Abbey is around the corner) or post- cinema (The Savoy on O'Connell Street). And there's always an exhibition of paintings or photography to admire or buy. Not a fancy place, but delivers far more than it promises foodwise.

This season I will mostly be eating.......Tomatoes

2005-07-24T15:43:00.000+01:00

Tomatoes
Why?
The wonderful fruits of the tomato plant are at their best from now until September. Tomatoes are so easy to grow; one year, I managed to have delicious cherry tomatoes well into October from a plant supported in a large sunny apartment window. They just need a lot of water and a lot of food. There's great satisfaction in eating something you've grown yourself- even if it's easier, or cheaper to buy it. (Which it isn't, incidentally!)
It's great fun for children to watch something grow and to have an active role in caring for it. I also think it's worthwhile for them to have a sense of where food comes from and may have some fringe benefits: my little 18 month old nephew can be bribed far to easily with a cherry tomato.

Nutrition
Apart from the nutritional value of fresh tomatoes, dried, semi-dried tomatoes an tomato pastes and purees have an extremely high concentration of the antioxidant lycopene - even higher than the fresh fruit. Lycopene is what gives tomatoes their red colour and a high intake of lycopene has been shown to help prevent prostate cancer making it another 'nutriceutical' of interest. Lycopene absorption is improved in the presence of fat, making even more sense of the Mediterranean tomato salad with olive oil.

Recipes
How easy are tomatoes?
For an impressive Insalata Caprese starter, simply slice ripe vine tomatoes and some buffalo mozarella and arrange on a plate with some fresh basil leaves. Drizzle with a good quality extra virgin olive oil and a tiny little bit of sea salt if needed.

As a great side dish, try this salsa which is a feature at our friends Helen & Brendan's wonderful barbeques.

Tinned tomatoes and sieved tomatoes (passata) should be a mainstay of any store cupboard. Apart from the extra high lycopene content, the easiest pasta sauces can be made from them in minutes- minus the trans-fatty acids and salt content of commercially prepared sauces. Try this recipe and add to it whatever you like.

Eating Disorders

2005-07-19T23:34:00.000+01:00

BodyWhys is a support organisation for people suffering from eating disorders, their families and friends. Their website is an extremely helpful starting point if you know someone struggling with food and weight- or if you need some support yourself.

For health professionals and helpers, Marilyn Duker & Roger Slade's book Anorexia Nervosa and Bulimia: How to Help is a very useful guide to what can be a bewildering condition. It is available through McGraw-Hill.

Slow Food

2005-07-19T23:15:00.000+01:00

This is a good resource website for anyone interested in organic produce or sustainable living.

Folic Acid

2005-07-19T19:37:00.000+01:00

Public consultation on the question of whether to fortify foods with folic acid has closed.

In my opinion, there is no question.

There is incontrovertible evidence that it results in fewer of the birth defects spinabifida and hydrocephalus, which have a higher than average prevalence here in Ireland due to genetic susceptiblility as it is.

The real questions are how to do it and how soon can it be done.

The useful website which facilitated the consultation process remains a good source of information on folic acid.

Holistic Dietician?

2005-07-19T18:35:00.000+01:00

Oooooooooooooooooh!!!! I know I should rise above it, but every so often the nonsense put out by 'alternative' practitionners makes me grind my teeth.

Only the under-qualified and over-confident could set themselves up in business and claim to have solutions to all sorts of common ills that have perplexed the best minds of several generations. It takes a lot of training and professional experience to recognise the limitations of your expertise, but even the greenest new graduate in one of the therapy professions would have more sense than to advertise that they can provide a guaranteed solution to obesity.

I also take issue with how the terms 'holistic' and 'natural' have been co-opted by the largely unqualified practitioners as if the rest of us don't look after the whole person in a natural way....grrrrrrr.

There is currently no protection of title for the therapy professions Nutrition & Dietetics, Physiotherapy, Occupational Therapy and Speech & Language Therapy. Each of these professions has a recognised University level qualification (BA or BSc) and a recognised under and post-graduate training structure - and an established career path within the Health Services.
Though many suitably qualified individuals will choose to work outside of the hospital or community health care setting, either in private practice or consultancy roles, they are eligible to work in the public sector hospitals and health authorities.

People who have no qualification at all can call themselves a dietitian without even so much as the 6 week 'comprihensive'(!) diploma course offered by some well known home-grown snake-oil gurus, but they absolutely cannot work in health care. Nor can they be a member of the national professional organisations. All that takes is a 5 year degree with 6 months hospital and community based training and a research thesis.

Caveat emptor when seeking professional services- whether it's your doctor, solictitor, accountant, physiotherapist or dietitian, you should check that the person is suitably qualified before you pay good money for questionnable advice.

I should say that there are Nutritionists whose course of study and career path follows a different trajectory. They tend to have a BSc and to work more in an industrial or advisory capacity rather than as 'diet therapists' which is essentially what a dietitian does .....and since I'm all riled up- it's DIETITIAN anyway....2 't's not a 'c'.............hrrrrrrrrmph.

'GI Jennie'

2005-07-19T17:29:00.000+01:00

Great interview with Prof Jenny Brand-Miller,the Australian research nutritionist who has been to the forefront of research into the glycaemic index of foods for the past 25 years.

The original research was patchy internationally and tables of the G.I. of foods were of questionable use as they listed a value for the food items tested alone; composite meals, cooking time and method and combinations of foods all affect the overall G.I.

Additionally, different methods of assesing G.I. compared foods with either glucose or white bread; it's always preferable to have things measured against the same standard if you are trying to compare them.

There are now updated tables available (Brand-Miller 2003) which makes life much easier for everyone.

There has been an interesting antipathy for years between Brand-Miller in Australia and the Toronto based researcher David Jenkins, who conducted the original studies quantifying the effects of specific foods on blood sugars. Both have made G.I. their life's work and published their own books on the topic including 'the New Glucose Revolution' and 'What Makes my Blood Sugars Go Up and Down?'.

To my mind, it doesn't really matter which of them is more correct in their approach. The fundamental advice using the G.I. principles is a useful basis for a healthy diet. As I said before however, one principle is never the only story when it comes to nutrition.....

Metabo-what?

2005-07-10T20:01:00.000+01:00

Metabolomics.
The fine pointy end of nutritional research.
The science that examines various metabolites, the end products of metabolism, at a cellular level, at the same time.

It's a very new science and is being used as part of The Human Genome Project, in conjunction with other new nutritional research diciplines, to provide insights into how cells regulate gene expression.

It's part of the new field of Nutrigenomics.....which sounds like an utterly futuristic concept, but in fact we're closer and closer to a world where Personalised Nutrition is the norm. I first heard of it in any detail at a keynote presentation by Professor Mike Gibney, who was a charismatic lecturer of ours at university and who continues to be a respected figure in nutrition research.

So, it's 2010. You get up in the morning and check your inbox. Your updated meal plan has just been sent from your nutrition lab. You had the 6 monthly urine test done 2 days ago, and there aren't too many changes to make but as you've been under a lot of stress at work recently, your antioxidant needs have gone up, so more berries and oranges on your shopping list. You still need to avoid specific foods to minimise your diabetes risk, but you've been fine tuning that for some time based on your nutrigenomic profile from your annual blood test.

Don't be seduced by the above scenario just yet though. There is no laboratory capable of providing the 'personalised nutrition' service on a commercial basis at the moment, and those that offer diagnosis of disease or food intolerance based on finger-prick testing are peddling bad medicine.

'Just as pharmacogenomics has led to the concept of “personalized medicine” and “designer drugs”, so will the new field of nutrigenomics open the way for “personalized nutrition.” In other words, by understanding our nutritional needs, our nutritional status, and our genotype, nutrigenomics should enable individuals to manage better their health and well-being by precisely matching their diets with their unique genetic makeup.'

Low birthweight and insulin resistance.

2005-07-10T11:14:00.000+01:00

Small numbers in this Dutch study, but it's an interesting look at how poor growth in utero may be a risk factor for diabetes and heart disease in adult life.

The researchers examined insulin resistance in 28 pre-pubertal children born small for gestational age (SGA) who were still short for their age. Despite being lean, these children had significnatly reduced sensitivity to insulin.
Other researchers have shown that healthy children with reduced insulin sensitivity tend to have an inreased fat mass over time.

Again, small numbers mean that these current results are statistically underpowered, but it points to more prenatal and childhood influences on adult diseases.

Promoting a healthy active lifestyle and avoiding weight gain have even more relevance where individuals start at a health disadvantage.

London- dignity in the face of tragedy.

2005-07-10T09:07:00.000+01:00

Such a strange week for London. Such elation with the successful bid for Olympics 2012....such devastation with the terrorist bombings....and today the ceremonies to mark the 60th anniversary of end of the Second World War.

My heart goes out to the bereved in London. And my respect to the people of London and their political and religious leaders who have shown such dignity in the face of tragedy...again.

What's the skinny on........The G.I. Diet?

2005-07-06T21:43:00.000+01:00

The G.I. Diet
Based on the theories of the Glycaemic Index of foods, this is the must do diet of the moment.
So what's the story? Is it the miracle solution millions of overweight people have been praying for?

Well, the truth is that there are no miracle solutions, but as eating plans go, the principles of the G.I. are balanced and based on reasonable nutritional science. However, the whole story with any healthy eating plan is never based on one principle alone and most dietitians will have been incorporating the basics of G.I. or, more appropriately, Glycaemic Load into healthy eating and weight management advice for some time; other considerations such as low and healthy fat, correct portions and sufficient fruit, veg and micronutrients remain important.

There is a proliferation of G.I. recipe books, diet books, tapes and e-diets as the scientific information and even the term G.I. are not protected- i.e. anyone can write a G.I. diet book without infringing on copyright.

The I.N.D.I. has an information sheet to download free of charge.

The Mermaid Cafe

2005-07-06T21:32:00.000+01:00

Another review- such consistently good food here! And great staff.....gotta love it.

WildLight

2005-07-06T12:35:00.000+01:00

Off topic, but I love this.........innovative and fresh and miles away from crazyfrog

This season I will mostly be eating.....Blueberries

2005-07-06T10:40:00.000+01:00

Blueberries
Why?
One of the most delicious fruits is also one of the most nutritious and summertime means that all the best berries are in season. While I haven't signed up as a bone fide 'fan', I do love these sweet little gems.

Nutrition
Blueberries have an extremely high antioxidant content (anthocyanidins are responsible for the blue colour- they put the blue in blueberry). Wild (or lowbush) berries have the highest antioxidant activity, but all are good, including dried and frozen.
-High in antioxidants
-High in vitamin C
-High in fibre- mainly the soluble fibre pectin
-Very low in calories

Th white-ish bloom on fresh berries is a natural protective coating. They should be washed just before eating rather than straight out of the pack to keep them as fresh as possible, but they do last much longer than other berries and also hold their shape well in baking and cooking.

Recipes
The simplest thing is to enjoy the little berries like little sweets as a snack.

I like to add them to cereal in the morning or to yogurt with strawberries and raspberries for a delicious low calorie dessert.

Mixed frozen berries are also a great 'storecupboard' item. Add them to smoothies or yogurt straight from the freezer or heat them to have with ice-cream or as a sauce with many desserts.

Blueberries, like strawberries, raspberries and oranges go very well with chocolate and children will love this:
Chocberries
Melt some good quality (70% or more cocoa solids) dark chocolate in a bowl over a pot or bowl of boiling water.
Gently add the rinsed and dried blueberries and stir lightly. Spoon them out onto a baking tray or shallow dish dredged with cocoa powder.
Shake, shake, shake to coat and separate the berries and leave to stand in a cool place or in the fridge. The chocolate will harden very quickly.

The chocberries need to be used within 10 days if stored in the fridge- but this isn't usually a problem. Dark chocolate is also high in different antioxidants- an added nutritional bonus if you need justification.

You Are What You Eat??

2005-06-14T21:59:00.000+01:00

Hmmmm......lovely to see- you'll excuse a qualified nutritionist a wry smile at this interview with "Dr" Gillian McKeith.....never mind the very weak science, she has always seemed joyless and undernourished to me.

It still baffles and worries me at times that respected professional advice (thank you Catherine Collins of the BDA) can be less valued by the public than the views of self-promoting extremists.......but like Hollywood Starlets, there's always another one waiting in the wings.

This season I will mostly be eating.....Asparagus

2005-06-11T08:46:00.000+01:00

Asparagus....

Why?
Apart from being most delicately delicious, the asparagus season is very short (late April- June) and finishes soon. So make the most of it!

Nutrition
Asparagus, like most vegetables is very low in calories but provides a lot of vitamins and fibre.
- a rich vegetable sources of folate (pregnant women should still take a supplement)
- also provides beta-carotene, a range of B vitamins and vitamin C
- contains glutathione, an antioxidant
- contains rutin, associated with 'strengthening' blood vessel walls
- contains a type of fibre that acts as a fuel source for gut bacteria, promoting a healthy gut flora. A healthy gut is a key organ in immune function

Recipes
There is a plethora of websites devoted to asparagus- a testament to how passionately asparagus lovers feel about their favourite vegetable. In Italy, asparagus season hotels are available where you can combine your love of the spears with luxury accomodation...and sad to say, I think it sounds wonderful.
My all time favourite meal would be roast leg of spring lamb with minted new potatoes and grilled asparagus, and I love it in quick pasta dishes, but asparagus simply steamed with butter or hollandaise is hard to beat.
Try it- and enjoy!

Detox schmeetox.

2005-06-07T23:50:00.000+01:00

A-Ha! I knew it! It made zero difference to anything when I tried avoiding some specific foodstuffs for a while during a bout of insomnia a few weeks ago. While personal experience satisfies curiosity,it hardly qualifies as scientific evidence.

But, they've studied it, and it is a load of ol' cobblers...
'Detox-ing' diets are no faster and no better than a body's natural processes at eliminating wastes.

They just don't work.

Healthy sensible eating is still the only proven way to go.

I can't help but think that this fact will make absolutely no impression on the thousands spent on detox kits and weird and wonderful regimens purchased from a very profitable and unregulated 'health food' industry.

Anthropometry

2005-06-02T17:03:00.000+01:00

Right. Here's what I think needs to be done to get better information on the degree and implication of over/underweight in pregnancy.

BMI for everyone........

Weight gain for everyone- ie prepregnancy, at booking and weight on admission to delivery....

Mid-upper arm circumference measurements for women with hyperemesis to assess possible prexisting under-nutrition and better identify those who need nutritional support.....also for women with BMI < 19kg/m2 at first visit.......

Triceps skinfold for BMI>30kg/m2 at first visit to differentiate between obese and fit/high lean muscle mass...........

Basically, refer the latter groups for dietetic assessment. Now for further literature review and a policy and a protocol document....fun, fun,fun!

Maternal Weight

2005-05-25T21:46:00.000+01:00

I am currently wrestling with the question of the influences of maternal weight, weight gain and BMI on birth weight- again.

Thanks to the consultant obstetritian who appears in my office like Monty Python's Spanish Inquisition - usually when I'm watering the pot plant, answering email or halfway through a packed lunch - never when I'm looking like I know anything about clinical nutrition- I've been looking for reliable ways to assess women's body composition in pregnancy.

Mid-upper arm circumference is useful as it is closely associated with prepregnancy weight and stays relatively constant, so the stage of gestation is less relevant than for weight. But without a triceps skinfold to estimate fat, it's probably more useful to assess undernutrition than overweight / obesity. Should I just do triceps skinfolds?? So difficult to get accurate measurements and needs the same observer to take measurements for it to have any validity.

Centile growth charts for height go up to age 20 so should be ok for adults...but the sample size of 20 year olds that they're based on was tiny, so I think national averages are more representative.

The norms for BMI don't cover pregnancy anyway - we look at pre-pregnancy BMI and percentage weight change based on individual requirements as a guide for women. But BMI is simple and universal......

Bioelectrical impedence is not of value in pregnancy - surely confounded by the amniotic fluid...... and on I go.

Probably just need to stick with weight/height.....or BMI and MUAC....or measure the lot and see what outcomes are like for an Irish population.(Sigh) More 12 hour days ahead. Lucky that I'm interested in my job.

Probably need to sleep on it and clear my head.

Some days.....

2005-05-24T02:00:00.000+01:00

What happens some days?
There you are, doing what you do, with no less effort or professionialism, but not one single person coming back for review manages to make one meaningful change ...plus several cancel at the last minute (I think I need to charge for appointments cancelled at short notice- it breaks my heart and costs me in rent and frustration)...and you wonder if you're any good at this and maybe they should just buy another diet book....

And then, other days, there you are, putting in no extra effort, and every single person has reached or exceeded a target, made the changes and is feeling great! And you think "why haven't I got a book out?".......

Bistromatics.....

2005-05-20T20:56:00.000+01:00

Another review, but I just love Dunne & Crescenzi's on South Frederick Street. Always buzzing, but never stressful. Good honest to goodness Italian antipasti and a couple of pasta specials....and an amazing wine selection.

Spent so much time there at the end of the beautiful hot summer of 2003 that every time I've gone since, I expect sunshine.

Another great spot along the same lines is Hunger's Mother- only lunches though, so doesn't get the same path worn to it from my office as Dunne & Cresc's......

Both places are prime examples of the 'keep it simple' principle. Don't mess with good food too much and you won't go too far wrong.

Bang

2005-04-24T23:43:00.000+01:00

Such a good meal last night at Bang Café on Merrion Row. Seven of us, and not a false note with anyone's meal plus the best service we've had at a Dublin Restaurant in quite a while. Delicious asparagus to start, perfectly cooked loin of lamb to follow and woke up today dreaming of the Scandanavian Iced Berries with hot White Chocolate Sauce......mmmmmmmmmmmmmmmmmmmmmmmmmm

oh lordy....yaaaawwwn

2005-04-19T03:50:00.000+01:00

I'm suffering from terrible insomnia lately. It's a killer. No massive mystery- stress related- but I'm really thinking that hormones have no small part to play for me. I can't remember if this was always the case, or if I'm just more aware of the effect of hormonal blasts these days.

Of course, the ironic thing about stress related insomnia is the fact that not sleeping seriously increases stress levels......not to mention all the extra wrinkles....sigh...

So, while trying to minimise stressors(!) and practicing good sleep hygiene, I'm going to try some different 'detoxy' diet things that I wouldn't previously have considered. And I'm going to try a few other dietary changes that don't necessarily have scientific support. And we'll see.....

Confession

2005-04-11T21:19:00.000+01:00

I've recently decided to put my money where my mouth (so to speak) and started an exercise program.

Alright, alright ...when I say 'program', I mean that I'm walking with a friend at a reasonable clip for over an hour a few times a week. My bum is aching today, which I'm taking as a clear indication that using muscles in my backside for sitting on for the last 3 years simply hasn't been the workout required to keep it up above my knees.

But I am so satisfied with how good I'm feeling with just this simple change that I'm at risk of turning into an exercise enthusiast in practice as well as in theory.

School Dinners

2005-04-10T01:49:00.000+01:00

Anyone who watched Jamie Oliver's efforts to change English school meals for the better (Jamie's School Dinners) cannot fail to have been impressed.It was like a mini sociology experiment.
Quite aside from the awfulness of the food the children ate, so many things struck me: the total lack of knowledge of the parents featured about food and nutrition basics; the innovation and almost psycological warfare needed to expand children's horizons in food choices; the success of peer to peer education for both children and cooks; the dramatic difference dietary change made to behaviour........and the Irish dinner lady was a central casting representative of a generation of emigrants whose values and work ethic reflect a different era.....and oh my goodness, the Clinton 'South Beach Diet' snub.....

Compelling viewing. And making a differnce to government policy, public attitudes and nutrition knowledge; as if the Rosemary and Garlic Roast Leg of Lamb recipe from his first book wasn't enough to make me like the man- Jamie, you're a legend.

Good News!

2005-02-28T18:15:00.000Z

I love the increased availability of locally produced food on sale through farmers markets. Bord Bia has produced a listing of markets by county.Their site is also great for info on how to buy direct from producers. 2 ways to bypass the supermarkets.

The recipes are great too...and I can tell you from experience, that they're well thought out, fairly easy and delicious.

Happy New Year....

2005-02-09T22:46:00.000Z

Happy Chinese New Year!
It's the year of the rooster, so all of you born in 1969 are in for a year of good fortune and prosperity. I'm a dog, but I have a good inside track with a rooster ...now there's a thing you'd find hard to explain out of context.

Nice to see the celebrations here in Dublin and the interest in Chinese traditions, when not that long ago all most people in Ireland knew about anything Chinese was imitation sweet and sour chicken. I really can't abide the plastic in gloop that still passes for food from a lot of Chinese restaurants in Dublin; feels like a joke at our expense. The first time I saw some Chinese people at a nearby table order from a completely different menu as I struggled with my stringy chow mein, I knew there was an inside track.
My friend's husband Ron, with his 1/2 chinese blood, gave us some inspiration with a dim sum lunch locally some years ago, and while I 've had some great stuff since, I'm still ignorant when it comes to the huge scope & range of asian food. I still love to eat with someone who knows what they're at so I don't feel like I'm stuck with the tourist menu. Lots of real Chinese food to check out this week.

My favourite short film last year was Daniel O'Hara's Yu Ming Is Anim Dom produced 'as gaeilge' with TG4 and Filmbase, and it's being shown as part of the 5 day festival at Collins Barracks...really funny and sensitive film.

Supermarkets

2005-02-06T19:26:00.000Z

I am increasingly frustrated with the way that supermarkets display their pricing. Having a price per kilo or per item price posted but no price stickers on stuff makes it very difficult to keep track of how much i'm spending, even though I shop from a list. For some reason, I don't get much from the bar code...it it just me??
I find 'price per kilo' useful when comparing the relative cost of things, but most of the time i find myself scanning around the shelves, looking for where the price is displayed, often getting fed up and chucking the stupid thing in the trolley anyway- which i'm sure is the idea.

loads more bugging me about supermarkets..........

Weight loss

2005-01-31T13:25:00.000Z

For anyone serious about loosing a few pounds or kilos to improve your health, there are a few basic things I find work very well for my clients:

Prepare before you start making changes. Have a reasonable idea as to what you are trying to achieve and write your target down. Bear in mind that a 5 - 10% loss of weight improves your health if you are overweight; so although your ideal weight may seem like a tough target, you are going to benefit from even a relatively small weight loss
Keep a food diary and use a pedometer for a week so that you have a clear assessment of what you eat and how active you really are
Don't do anthing drastic that you won't make a part of your daily life. Look honestly at where you can make changes to the amounts of food, your way of cooking and your food choices and substitute a smaller serving or a 'lighter' option next time
Eat regularly- don't skip meals and don't cut out groups of foods (dairy, starches etc) or you'll be hungry and you'll miss out on nutrients. Go easy on the low nourishment/ high kcal usual suspects - sugary drinks, fried foods, sweets, savory snacks and alcohol.
Get some activity into your daily routine...anything! Just decide never to take the lift again, but move more and use your pedometer to check what you're doing. We suggest that people should be taking 10,000 steps a day minimum.
Drink plenty...it doesn't burn calories or melt fat, but most people are dehydrated a lot of the time, and a lot of people mistake thirst for hunger.

Basic stuff, but it does work. Trust me - I'm a dietitian.

Food for thought?

2005-01-30T22:40:00.000Z

I had a wonderful home cooked lunch today in London with Sarah and Adam....(a mixed bean and veg soup, spelt bread and a truly delicious red winter salad -thanks Adam!)....it sparked a discussion about how out of touch a lot of us are with shopping for, cooking and really tasting food. Stuff doen't always have to be as wholesome as what we had today, and rarely needs to be complicated or expensive, but I think a lot of us have forgotten that it can at least be tasty.

Apparently, in a lot of countries we've gotten so used to the artificial taste of processed foods that we no longer recognise the real thing...in some cases, we don't even like it. Pastuerised apple juice from concentrate tastes nothing like the real thing, but it's what we've come to expect.

The SlowFood movement, founded in Italy (where else) promotes a sustainable attitude to the production, cooking and enjoyment of food. Some frightening statistics from their site are food for thought..........

75% of European food product diversity has been lost since 1900
93% of American food product diversity has been lost in the same time period
33% of livestock varieties have disappeared or are near disappearing
30,000 vegetable varieties have become extinct in the last century, and one more is lost every six hours

Collaboration with schools, teachers and parents in taste education has extended to adult education projects for food industry professionals and food writers as well as enthusiasts.

Now, world hunger is a terrible and terrifying issue and being concerned that we don't enjoy our food enough might appear relatively unimportant, but by looking at the production issues, it's apparent that our move away from seasonal and local produce has a profound implication for developing countries too.

I would dearly love to see more parents both cooking more often themselves and encouraging their children to cook and take an interest in food. We're at risk of loosing so much.

And coming at things from a different perspective, for anyone who can, make a donation to suppport the worthwhile work of the United Nations World Food Program..........

Foetal Nutrition

2005-01-28T01:57:00.000Z

A very interesting article in the Guardian magazine supplement on exercise/ nutrition for kids...

The current focus on the obesity epidemic is producing a lot of opportunistic dross (of the I'm a Big Fat Celebrity who Needs the Cash and Lets Make the Disgusting Fatties Eat Grass with the Skinny 'Doctor' variety) so it's good to see informed and well written stuff on nutrition in the news-media.

The Guardian carries articles on 2 topics close to my heart- maternal/ foetal nutrition and it's impact on the baby for life and the benefits of breastfeeding in preventing childhood overweight.

Good advice

2005-01-28T01:43:00.000Z

For anyone interested, there are some good sites where the info on diet and nutrition is moderated by qualified professionals without a book or snake oil 'fat busting' product to flog .

The Food Standards Agency in the UK is one of my favourites for answers to all sorts of food related questions, but the INDI is the professional body representing properly qualified dietitians in Ireland. They provide a listing of dietitians by area and by speciality.

And while they have their own stuff to sell, both the VHI and Irish Health sites have good information too.

Rant!

2005-01-28T01:38:00.000Z

There's been interest in the potential for 'programming' of the foetus to be prone to obesity since the publication of Barker's research into birth weights and the incidence of heart disease in adults, but to my mind women are really not getting the message about what a healthy diet in pregnancy can help to achieve- or what the aims of a healthy diet should be.

While the old 'eating for 2' still prevails, with some women abandoning all attempts to balance their food intake since they'll be getting 'fat' during pregnancy anyway, a more sinister and apparently increasingly common practice is for women to restrict their food intakes to minimise their weight gain and to have a smaller baby.The thinking seems to be to minimise the difficulty of labour - which is misguided, but understandable- but also not to loose their figure.

Coupled with an attitude to breastfeeding that focuses on the down sides in terms of inconvenience and cosmetic changes to the breasts, it makes me want to shake perfectly intelligent women for the superficiality of their decision making but even more so makes me question what in god's name those of us working in health care are doing to redress the balance.

Rant over...I do see the majority of women trying their best and am impressed time and again by the changes a pregnant woman will make to improve her diet and lifestyle for her baby- stuff we all should do all the time but never seem to focus on...........ask me how my so-called exercise program is going for instance.....erm...maybe don't.

Welcome to my blog

2005-01-24T21:08:00.000Z

Hello and welcome to my blog.