Why you don’t need to stop eating sugar to improve your health

Why you don’t need to stop eating sugar to improve your health

RELATIONSHIP WITH FOOD

Why you don’t need to stop eating sugar to improve your health 

KATHERINE KIMBER, Registered Dietitian

March 3rd 2019

First it was salt. Then fat. Then carbohydrates.  

Now we’re told to stop eating sugar.

All these foods have been demonised at one point or another over the years and we’ve been taught to fear them due to the implications they can have on our health. But sadly, this is more fear mongering, than fact. 

Let’s talk about the facts, specifically regarding sugar.  

Even though some “wellness experts” would have you believe that we need to “stop eating sugar” completely for the sake of our health, it is actually nothing to be feared, unless it is consumed in huge quantities (like anything, really!). 

The problem with the idea that we should “stop eating sugar” is that not all sugars are equal. If we stop eating sugar, we’d be quitting entire food groups and all the important vitamins and minerals found in them! 

Hang on, I thought sugar was bad, because it’s the stuff in cakes, biscuits and sweets, I hear you ask?  

Yes and no.  

Yes, there is sugar in our favourite sweet treats, but this is usually refined sugar (table sugar). Consuming this type of sugar in small amounts is not harmful to our health (1)It is recommended that we consume sweet foods with meals as much as possible to protect our teeth, however, cutting out sugar from our diet all together could backfire and we could end up eating more than desired. Especially in those who want to stop food obsession, or who struggle with binge eating and want to stop emotional eating (2, 3, 4).  

The other type of sugar that shouldn’t be feared, is the naturally occurring sugar found in fruits, vegetables, dairy products and wholegrains. But more about these two things later.   

Let’s first look at what a sugar actually is. I apologise, but there is a little bit of chemistry ahead. 

The chemistry…

A sugar is something that is made up of carbon, hydrogen and oxygen atoms (a sugar molecule). The number of these atoms and how they are arranged, will determine the kind of sugar it ishow it behaves in food and then how it interacts once it is in your body. 

There are many different types of sugars found in foods. 

For example, the sugar found in dairy products (lactose) is different to the sugar in fruit (fructose) – they are completely different sugars and digested in different ways, but they are sugars nonetheless. 

If we were told to quit eating sugar, we’d essentially be eliminating dairy and fruit out of our diets!  

And we’d also be eliminating cereals, pasta and rice … because the complex carbohydrates found in those foods are also made up sugar molecules – lots of them (hence the name “complex”).  

Sugar, at its most basic level, is what our body needs for fuel.

But what about blood sugar levels?

One reason why there is fear surrounding sugar is because of its impact on our Blood Glucose Levels (BGLs). You might have heard someone say “oh don’t eat that, it makes your blood sugar spike”?? This is semi-true. Yes, dramatic spikes in our BGLs can affect our energy levels. Also, eating foods that are high in sugar and low in fibre could cause hunger to reappear more quickly after eatingBut this all depends on the type of the sugar that is in the food and what we eat the sugar with (e.g. protein and fats).   

We can measure how quickly a carbohydrate food makes your BGLs rise by using an international standard called the Glycaemic Index (GI) (5). Carbohydrates are rated on a scale between 0 – 100 depending on how quickly the body breaks it down to be used for energy.  

Foods with a higher GI are broken down more quickly and can cause a sharp rise in BGLs – things like a glass of sugary drink on an empty stomachwhite bread, white rice and white potatoes. However, who just eats a plate of white rice, or a whole lot of bread without a topping? No judgement if you do, but most of us prefer these with other foods most of the time. We usually eat these foods with some proteins and fats which naturally lower the GI.  

Foods with a low GI number break down more slowly and help to keep your BGLs stable – things like wholegrain bread and pasta, fresh fruit, lentils and legumes, yoghurt and milk. In fact, chocolate is low GI because it contains a high amount of fat and protein… I bet you never realised that!  

So, what’s important is the type of sugar and what we pair it with, to determine its nutritional quality and impact on your body, rather than tarnishing all sugars with the same brush!  

Naturally occurring sugars vs “free sugars”  

Now that we know what a sugar is, we can talk about naturally occurring sugar vs “free sugars”.  

Natural sugars, as the name would suggest, are those already found in the food. These often come with a host of other beneficial nutrients. For example, milk and yoghurt contains the sugar lactose as well as calcium and protein. Fresh fruit contains fructose, as well as vitamin C and fibre.  

So, what exactly are “free sugars”?  

The World Health Organisation (WHO) defines it as those that are added in by either the consumer or the food manufacturer and the sugars naturally found in fruit juice, honey, syrup and fruit juice concentrates. Things like bakery items, cakes, cookies and soft drinks. It also includes the table sugar you add to your coffee in the morning.  

The WHO recommends limiting free sugars to no more than 10% of total daily energy intake (about 10 teaspoons) to reduce the risk of dental carries, chronic disease and poor diet quality (6). 

What about alternative sweeteners then?  

If we’re told that we need to reduce our sugar intake, should we turn to sugar substitutes instead? Well there are loads of sugar alternatives being used, many so that recipes can claim they’re “sugar free”, but it’s difficult to know whether they’re any better than just your regular old table sugar. 

Let’s have a look at some. 

Maple Syrup 

What it is: More commonly used as a weekend breakfast item, but it is also used in recipes as a table sugar replacementThe syrup is formed after the sap is extracted from the wild maple tree and concentrated. 

Nutrients: Contains traces of vitamins and some minerals such as potassium, iron and calcium. 

GI: 54 (7).  

Brown rice malt syrup 

What it is: An expensive replacement often used by people who follow a “sugar free” lifestyleIt is produced by cooking brown rice flour or starch and breaking it down into simpler sugars to produce a liquid.  

Nutrients: It is low in fructose and could be suitable replacement for people with fructose malabsorption.  

GI: 98 (7)  

Agave syrup 

What it is: A very sweet sugar alternative with minimal impact on BGLs. Processed from the agave plant grown in the south west of the USA and northern parts of South America. 

Nutrients: Is high in fructose, which could cause digestive distress for people with fructose intolerance. Has slightly higher calories than table sugar, 60 calories per tablespoon compared to 40 calories for the same amount of table sugar (8). 

GI: 10 (7) 

Dates 

What it is: A whole fruit  

Nutrients: Contains fibre, potassium (essential for maintaining fluid balance in the body and controlling electrical activity in the heart) and magnesium (essential for proper nerve function, muscle contraction and regulation of blood glucose level and blood pressure) 

GI: 50 (7) 

Stevia 

What it is: Made from the leaves of a native plan in Paraguay in South America, is often used in coffee as a replacement for table sugar in coffee.  

Nutrients: It is much sweeter than table sugar, with negligible calories and does not raise blood sugar.  

GI of 0 

Coconut sugar 

What it is: Made from the sap in the flower buds of a coconut palm. The sap is boiled to allow the water to evaporate and then dried to form a concentrate. It is  

Nutrients: Contains potassium, iron, zinc, and calcium according to research conducted by the Philippines Government research body, but you need to eat a lot to make a difference (9). It also contains the same number of calories as white sugar. 

GI: low GI of 54 (7) 

So, while there are many pros and cons on just this short list of the many alternatives that are available, the reality is that they are all still sugars and most of them contain energy, with little vitamin or minerals (10). And whilst sweeteners are low in calories, there is some evidence that sweeteners may actually increase our appetite (11). 

Summary

So, with all the scaremongering around sugar being harmful, the reality is that a diet that has a limited intake of sugar (whatever sugar that may be) is not harmful for a healthy individual.  

There are many foods with naturally occurring sugars that contain nutrients that are highly beneficial, so let’s not go cutting those just yet.

And then as for those free sugars which have little nutritive value? Well, a little bit of honey on toast or glazed on roast carrots can fit into a healthy diet. These foods are there for the enjoyment and satisfaction of eating and cutting them out completely could backfire and result in food obsession and binge eating. After all, who was it that once said a spoonful of sugar helps the medicine go down?   

Note: this article is not designed to replace individual advice from your healthcare provider.  

References 

  1. The British Dietetics Association. (2017). Sugar. Retrieved from https://www.bda.uk.com/foodfacts/sugarAccessed on 1/03/2019.  

2. Keeler, Chelsey L., Richard D. Mattes, and Sze‐Yen Tan. “Anticipatory and reactive responses to chocolate restriction in frequent chocolate consumers.” Obesity 23.6 (2015): 1130-1135. 

3. Konttinen H, Haukkala A, Sarlio-Lahteenkorva S, Silventoinen K, Jousilahti P. Eating styles, self-control and obesity indicators. The moderating role of obesity status and dieting history on restrained eating. Appetite (2009): 53:131–4.  

4. Jansen, Esther, et al. “From the Garden of Eden to the land of plenty: Restriction of fruit and sweets intake leads to increased fruit and sweets consumption in children.” Appetite 51.3 (2008): 570-575.

5. International Organisation for Standardisation (2010). Food products — Determination of the glycaemic index (GI) and recommendation for food classification. Retrieved from https://www.iso.org/obp/ui/#iso:std:iso:26642:ed-1:v1:en. Accessed on 1/03/2019.  

6. WHO. (2015). Sugar intakes of Adults and Children. Retrieved from. https://www.who.int/nutrition/publications/guidelines/sugars_intake/en/. Accessed on 3/03/2019. 

7. The University of Sydney. (2017). Search for the Glycemic Index. Retrieved from http://www.glycemicindex.com/foodSearch.phpAccessed on 1/03/2019.  

8. Web MD. (2014). Agave: Calories, Nutrition Facts, and More. Retrieved from https://www.webmd.com/diet/features/the-truth-about-agave#1Accessed on 1/03/2019.  

9. Medical News Today. (2018). Coconut sugar. Is it good for you? Retrieved from https://www.medicalnewstoday.com/articles/323047.php. Accessed on 1/03/2019. 

10. NHS Choices. (2016). Are sweeteners safe? Retrieved from https://www.nhs.uk/live-well/eat-well/are-sweeteners-safe/. Accessed on 1/03/2019.  

11. Web MD. (2018). Is there such a thing as healthy sugar? Retrieved from  https://blogs.webmd.com/food-fitness/20181004/is-there-such-thing-as-healthy-sugar. Accessed on 1/03/2019.  

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Additives and Preservatives – Are They Really That Bad?

Additives and Preservatives – Are They Really That Bad?

RELATIONSHIP WITH FOOD

Additives and Preservatives – Are They Really That Bad?

KATHERINE KIMBER, Registered Dietitian

February 19th 2019

Often, we hear that we should avoid all foods with additives and preservatives (aka chemicals). 

Let’s be clear. This is virtually impossible, because: 

a) all food contains chemicals

b) we as humans are made entirely of chemicals; and

c) we require chemicals to function! In fact, our very existence is due to thousands upon thousands of chemical reactions happening inside us right now which … you guessed it, need specific chemicals from food to be able to happen!  

So, let’s look at exactly what the chemicals are in food and try to strip the nonsense.  

Firstly, there are naturally occurring chemicals in food, such as vitamins and minerals.  

Secondly, there are synthetic chemicals made in a lab – these are often the additives and/preservatives we find in food. 

We often fell that we should avoid additives and preservatives… particularly those ingredients with long scientific names that you can’t pronounce.  

If we did that, then we’d be missing out on a lot of foods, or our foods just wouldn’t taste so great (as outlined in the image below).

Let’s look at some examples…

  • Take for example tocopherols and ascorbic acid (I.e. 3001, E3002, E3004) – if you saw these listed in the ingredients, what would your reaction be? They sound scary (particularly as one contains acid!) but in actual fact, these are just the chemical names for Vitamin E and Vitamin C which are commonly added to foods to help prevent microbial growth, and keep foods fresh, free from spoilage.  
  • Citric acid also sounds like one to avoid, but it is naturally found in citrus fruits and berries and used as a tart flavouring and decrease enzymatic browning of fruit. 
  • Now what about polyethylene and beeswax? Would you still eat something with these two ingredients? Well, these are used as edible coatings on fruit and vegetables to increase shelf life (1). 
  • What about guar gum, xanthan gum or pectin? Would you eat those? These three chemicals are stabilisers used in cloudy fruit juice beverages to stop pulp settling at the bottom of the bottle (2).  
  • Lactic acid also sounds pretty scary, but it is simply the byproduct of corn or cane sugar being fermented and it is used to add tang to frozen desserts or fruit drinks.  
  • There is a lot of negative hype around emulsifiers too, which is a substance used in foods like almond milk, ice-cream, mayonnaise, and salad dressings. It essentially stops the oil from separating so we can enjoy these wonderful foods! There are some studies conducted in mice that suggest the consumption of these could be linked with gut inflammation and the development of inflammatory bowel disease (3, 4, 5). However, we don’t have sound human studies to support these claims. More studies are currently underway in this space, and in particular, links between the gut bacteria and additives and preservatives. Based on the most up-to-date research, the Food Standards Agency (who are responsible for food safety and hygiene in the UK) deem emulsifiers safe in healthy individuals.  

Now as for whether additives and preservatives are harmful or cause disease, it’s important to consider the amount consumed.  

Additives and preservatives are used in food production, but they are used at levels that are safe for human consumption. Having too much of anything is not good, for example dihydrogen monodioxide (aka water) is harmful in high levels and so too is sodium chloride (aka table salt).  

The only additives for which evidence has shown a link with cancer are nitrites and nitrates, which are used as preservatives in processed meat such as ham, bacon and chorizo. Eating processed meat is strongly associated with an increased risk of bowel and stomach cancer (6), (7).  

So, it’s all about the quantity. That is why the amount of additives used in food is tightly regulated by the Food Standards AgencyAlso, any additive must be listed in the ingredients list (in decreasing order of weight) if it performs a function, such as giving food its colour or preserves its shelf life.  

Foods contain lots of additives and preservatives for a variety of reasons. They can come both naturally and synthetically and are not only important for killing or slowing down the growth of harmful bacteria, but can also act as a gelling agent, a thickener, a shortener, an emulsifier, a sweetener, yeast food… the list is endless (8).  

So, should you still eat foods with additives and preservatives?  

As it is all about the quantity consumed, it’s important to look at your overall dietary qualityIyou have a diet high in processed foods that use a lot of additives and preservatives, then you may be missing out on fresh fruit and vegetables or fresh whole grains that are full of important vitamins and minerals.  

However, if you use a jar of stir-in pasta sauce with a pot full of fresh vegetables and wholegrain pasta, then this small amount of additives in the sauce jar will not be an issue.  

Essentially, unless you only eat fruit or vegetables that have been picked fresh, you’ll most likely be consuming foods with additives and preservatives. It’s about considering your overall dietary pattern and striking a balance between consumption of fresh produce and processed products. You can have your apple as well as your apple cake 

References 

(1) Ruelas-Chacon, X., Contreras-Esquivel, J. C., Montañez, J., Aguilera-Carbo, A. F., Reyes-Vega, M. L., Peralta-Rodriguez, R. D., & Sanchéz-Brambila, G. (2017). Guar Gum as an Edible Coating for Enhancing Shelf-Life and Improving Postharvest Quality of Roma Tomato (Solanum lycopersicum L.). Journal of Food Quality, 2017, 1-9. doi:10.1155/2017/8608304 

(2) Ashurst, P., Hargitt, R., & Palmer, F. (2017). Soft Drink and Fruit Juice Problems Solved. Cambridgeshire, England: Woodhead Publishing. 

(3) Chassaing, B., Koren, O., Goodrich, J. K., Poole, A. C., Srinivasan, S., Ley, R. E., & Gewirtz, A. T. (2015). Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome. Nature519(7541), 92.

(4)  Bhattacharyya, S., Shumard, T., Xie, H., Dodda, A., Varady, K. A., Feferman, L., … & Tobacman, J. K. (2017). A randomized trial of the effects of the no-carrageenan diet on ulcerative colitis disease activity. Nutrition and healthy aging4(2), 181-192.

(5) Levine, A., Boneh, R. S., & Wine, E. (2018). Evolving role of diet in the pathogenesis and treatment of inflammatory bowel diseases. Gut, 67(9), 1726-1738.

(6) World Cancer Research Fund. Colorectal (bowel) cancer. 2011. 

(7) World Cancer Research Fund. Stomach cancer. 2016. 

(8) Food Standards Agency,  Food Additives, 9th January 2018, [Accessed on 19th February 2019], retrieved from  https://www.food.gov.uk/safety-hygiene/food-additives  

Links to further resources:  

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Eating To Save The Planet Whilst Building a Better Relationship with Food

Eating To Save The Planet Whilst Building a Better Relationship with Food

RELATIONSHIP WITH FOOD

How to eat to save the planet whilst building a better relationship with food

KATHERINE KIMBER, Registered Dietitian

January 23rd 2019

We hear a lot about the small changes we can make to help save the planet.  

– Limiting use of single use plastic bags. 

– Using a keep cup when we buy coffee.

– Catching public transport to work.   

But what about when it comes to eating? Are there some simple things we can do to eat more sustainably?  

Yes, there are.   

A new report released by the EAT-Lancet Commission has recommended a number of ways that we can reduce our carbon footprint through our daily eating patterns 

In a nutshell (no pun intended), the report suggests that we eat: 

  • mostly fruits, vegetables, whole grains, nuts, legumes and unsaturated oils 
  • a low to moderate amount of poultry and seafood; and  
  • low amount (or none at all) of starchy vegetables, red meat, processed meats, added sugar, refined grains 

The report states that this way of eating would not only improve the health of the environment, but humans too. Food systems would change accordingly and result in being able to feed a healthy diet to the global population of nearly 10 billion by 2050. 

In theory, this sounds amazing!  

But this type of eating will not work for everyone. And that’s totally ok!  

 

While eating more wholegrains, fruit, vegetables and legumes is a great step forward to increase health, following a plant-based diet can sometimes be a cover for disordered eating. Becoming vegetarian or vegan can often be the diets that people who have weight concerns turn to in bid to lose weight.  

These recommendations could be triggering for people who are still working to heal their relationship with food. It’s important that any time we talk about rigidity in eating, that we be mindful of how that could lead some of us into the trap of restriction and deprivation in an attempt to lose weight.

As soon as we start cutting out certain things, whether it’s red meat or dairy products as in this casewe may find ourselves in the restriction-deprivation-binge eating cycle.  

So if you’re really keen to adjust what you eat based on this new report, I’d encourage you to double check the reasons why you’d like to do it.

If we start restricting ourselves, we’re going feel deprived. And if we’re deprived, we’re unlikely to feel satisfied when we eat.

This can then lead to a binge eating episode where we eat past the feeling of comfortable fullness. Which then turns to guilt and feelings of failure to “stick to the diet”. But just remember, restriction is not sustainable. If you’d a like a little reminder on why diets don’t work, feel free to have a read of this blog post

While this report is to be commended for its commitment to helping save the planet, it is still ok for us to eat and enjoy all foods, particularly if we’re still learning to find food peace.  

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Nutrition content on social media – who’s posting reliable information?

Nutrition content on social media – who’s posting reliable information?

NONSENSE STRIPPING

Nutrition content on social media – who is posting reliable information?

KATHERINE KIMBER, Registered Dietitian

29th October 2018

The internet and social media are some of the most powerful tools at our disposal when it comes to answering nutrition questions. However, one thing we often find challenging is how to separate who is posting reliable nutrition information and who is not. 

Instagram is a rapidly growing social platform. To give you some frightening statistics, 35% of the UK population are spending an average of 5 minutes per day using it (1). With a booming and unregulated ‘wellness industry’.

Instagram appears to be a particularly thriving breeding place for unqualified (and sometimes qualified) individuals who are irresponsibly communicating poor quality health information. Whilst Registered Dietitians and qualified healthcare professionals are governed by law to uphold standards, the wellness industry is actually unregulated. This means anyone can post about nutrition information.

Social media also given rise to a social media-based healthy eating community (2), who have been identified to have a higher prevalence of Orthorexia Nervosa (ON) (3) (an obsession with eating foods that one considers healthy). Higher Instagram use has identified to be linked to increased ON symptoms.

For individuals using social media platforms, there is limited guidance on how to sift through and eliminate poor quality and irresponsible nutrition information. In this article, I am going to outline, with examples, how you as a consumer can ensure you are engaging in both responsible and reliable nutrition information on social media. 

“the wellness industry is actually unregulated. This means anyone can post about nutrition information.”

But how can qualified professionals be posting irresponsibly?

During undergraduate training of healthcare professionals, there is little formal training in how to communicate effectively and responsibly to wider audiences on social platforms such as Instagram. This is of no disrespect to the training. It’s because Instagram is a fairly new and rapidly growing platform that was only established in 2010.

There has been some guidance published for professional (4, 5), however, Instagram has moved forward since then, and whilst these guidelines for professional are useful, they are not rigorous. This means that not only are non-qualified individuals posting irresponsibly, qualified professionals don’t always get it right either.

I have therefore, created this article to help direct you when reading nutrition information on social media.

Responsible communication refers to communication that is appropriate, honest, trustworthy and respects confidentiality (5). Below are examples and checkpoints that outline what to look out for when engaging in nutrition content on social media. 

1. Is the content backed up by good quality science?

Content sometimes states “research says” or reports on a single study to make claims. Every claim, argument or opinion should be supported and justified by credible evidence from research or other authoritative sources. This doesn’t mean formal reference techniques need to be used at all times (especially in places like Instagram), however, the content should state what we know, what we don’t know, and how this could be looked at in the wider context of health and nutrition.

A subtle example: “true Iron deficiency will usually show over time”. (This statement needs expanding and evidence to support the claims. How long? How do you know?)

Ask yourself:

  • Is it clear what sources of information were used to write that content?
  • Have they given a balanced view? E.g. have they highlighted areas of uncertainty.
  • Have they provided details of where to access additional information? e.g. links in the Instagram bio, text below the image or references beneath?

2. Does the content sound like they are diagnosing your problem?

Responsible and reliable nutrition information should enable you to choose what is in your best interest. Information that has the direct objective of providing you with advice, needs to be honest, informative, clear and realistic, and not use language which exaggerates or makes assumptions (examples below).

Subtle examples:

  • the most common symptoms of Iron deficiency include; fatigue, weakness, pale skin”. (These symptoms could be a result of so many other things too. It is therefore, unbalanced as it has not been highlighted that these symptoms could be from a whole host of other conditions. It could also be perceived as diagnosing your problem, when there could be a whole host of other things going on. It is, therefore incomplete and could be misleading. It has also not been referenced and does not direct you on where to find further information.)
  • If you are eating X on most days, you will be doing wonders for your health”. (This statement is misleading and unbalanced. Some people with certain conditions may not be able to eat that certain food, so this statement is too personal).

Ask yourself:

  • Is the information shared a personal opinion, being presented as fact? (how do they know? what evidence do they have to support this?). This should be clear.
  • Is the language they are using to communicate facts or recommendations balanced? Do they deliberately chose words that exaggerate or bring out emotion? (e.g. “doing wonders”)

3. Is it within their professional remit?

When sharing nutrition and information and dishing out claims, it is crucial that the author only provides statements that sit within their professional remit and not beyond the boundaries of their qualifications/expertise.

How to know if they are qualified?

You can look at their years of experience, and qualifications in the field. Is the nutritionist a member of a professional body like the British Association for Nutrition & Lifestyle Medicine (BANT) or the Association for Nutrition (AfN)? Is the Dietitian registered with the Health and Care Professions Council (HCPC), and a member of the British Dietetic Association (BDA)? Do they have any industry awards or have they contributed to scientific research? They should not be reluctant to share this information with you. This information is also accessible online.

A subtle example: Dietitian or nutritionist sharing their workout routine on Instagram, or in their stories, for others to replicate.

Ask yourself:

  • Have they made it clear that they are not qualified and therefore not providing guidance?
  • Are they open to sharing their qualifications and experience with you? They should not be hesitant about sharing this information.

4. Do they link their body or looks up with messages about health?

Platforms like Instagram are image-focused, which play to the ‘picture-superiority effect’, whereby images are more likely to be remembered than words (6). It’s also a platform where you can select what images you are exposed to. The limited exposure of such images can lead us to believe that one behaviour is more present or normal than is actually the case. This may lead to perceived social pressures to act similarly to such behaviours. Therefore, individuals posting images of only healthy looking food, unbalanced meals, and tying up photo’s of ‘healthy food’ to the ‘thin ideal’ body (e.g. holding a green smoothie posing in a bikini with a think cultural ‘ideal’ body), can be misleading and lead us to believe that we need to behave that way to become something like the image.

Ask yourself:

  • How does the post make you feel? If it doesn’t make you feel good about yourself, unfollow.
  • Are there different types of foods in their feed that are reflective of a balanced diet?
  • Do they regularly cut out large food groups?
  • Do they promote balance but don’t eat carbs?
  • Do they push unrealistic body standards?
  • Do they talk about ‘real food’ or ‘clean eating’?

Summary

Whilst reliable information can sometimes be hard to comeby, it is out there I promise. You just have to have your witts about you, and surround yourself with the right people on social media. This guidance was aimed to give you a more in depth perspective on how to detect bulls**t and sift out reliable nutrition information, finishing up with some suggestions on who to follow on social media. You can follow me on instagram @nudenutritionrd or check out some of my latest blogs below for some more nonsense stripping!

Comments, feedback and suggestions welcome!

Additional suggestions/recommendations

  • If you are not sure or confused by the content you see, then ask. If they cannot come back to you with more information or the evidence, then unfollow! You can’t control the media, but you do have a say in what you consume.
  • If you are really not sure about a claim you see, there is an amazing charity called Sense About Science who have set up a campaign called ‘Ask for Evidence’. Ask them for the evidence.
  • Have you read a headline you are not sure about? The British Nutrition Foundation responds to consultations of major public health importance on a range of food and nutrition-related topics.
  • NHS choices simplify health topics with a balanced approach, breaking down the research studies with links to more information.
  • Nude Nutrition – send in your requests and have your questions answered and nutrition nonsense stripped, in particular on Instagram @nudenutritionrd
  • I have recently been recognised by The WellSpoken Mark to be making a positive impact on the ‘wellness’ industry. They are an independent authority committed to leading high standards in the currently unregulated wellness industry. Anyone else you see holding this mark can be deemed as reliable and trustworthy.
  • The Rooted Project – funded by two Registered Dietitians, this is an event series set up where they choose speakers who are leaders in their field to translate the science into interesting and practical content.
  • British Dietetics Association – Tons of food fact sheets written by Registered Dietitians to help you learn the best ways to eat well and stay healthy.

 

References:

  1. Ofcom (2018). Communications Market Report. Ofcom. https://www.ofcom.org.uk/__data/assets/pdf_file/0022/117256/CMR-2018-narrative-report.pdf
  2. Freeman H (2015) Green is the new black: the unstoppable rise of the healthy-eating guru. Guardian
  3. G. Turner & C. E. Lefevre (2017). Instagram use is linked to increased symptoms of orthorexia nervosa. Eating and Weight Disorders. 22:277-284.
  4. Murphy et al. (2014). Engaging responsibly with social media: the BJUI guidelines. BJU International. 114: 9–15.
  5. HCPC (2017). Guidance on Social Media. Health and Care Professions Council.
  6. Childers TL, Houston MJ (1984) Conditions for a picture-superiority effect on consumer memory. Journal of Consumer Research. 11(2):643–654.

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Dairy & Acne – All you need to know

Dairy & Acne – All you need to know

NONSENSE STRIPPING

Dairy & Acne – All you need to know

KATHERINE KIMBER, Registered Dietitian

3rd July 2018

Dairy and it’s link to Acne is a topic that many people seem to be confused about. Some people are convinced dairy makes their skin worse, while some are just not sure.

We all have our individual needs and differences, however, we can’t just say ‘probably true’ and make wild guesses. So let’s look at what the scientific evidence says…

(click away on the grey text throughout this document for links to more info & the actual research studies if you’re a research geek like me!)

 

What is Acne?

It’s a skin condition, that affects between 50-95% of teenagers aged 12-18 years, and adults too. The main method of acne development is through the overproduction of skin oil (sebum) by skin oil (sebaceous) glands. The sebaceous glands are small glands in the skin which secrete lubricating oily matter (sebum) into the hair follicles to lubricate the skin and hair. 

Acne can be really damaging socially and emotionally for that individual. Several factors are involved in the development of acne including, genetic, sex-hormonal, disease fighting systems, mental factors, and the environment. Some say that western dietary habits, and in particular – cows milk and dairy products – add to acne development.

What research has been done?

Interestingly, a huge new study came out last month, which is the first large and high-quality study in this area. It was a “meta-analysis of observational studies” which is one of the highest quality study designs out there in food studies like this.

They basically searched huge scientific computer files of information for all of the studies published in this area (a very long process which I am very familiar with) and pulled the studies together to create one overall result.

The observational studies that they pulled together, are a study design where they watch large groups of people over time and look at their dietary intake through food recalls and food diaries. They then see who has/hasn’t developed acne. Observational study designs have their limits, but they are the easiest studies to try when looking at population diets and medicine based results like acne.

They found that dairy, total milk, whole fat milk, low fat milk, and skimmed milk consumption was connected with the presence of acne.

So what did they find?

They pulled together 14 observational studies looking at milk, cheese, yoghurt and total dairy intake. The study people ranged from 9-30years old from the USA, Brazil, Italy, Malaysia, Norway, France, Egypt, and Kazakhstan. They found that dairy, total milk, whole fat milk, low fat milk, and skimmed milk consumption was connected with the presence of acne. The presence of acne appeared to increase with increasing intake of dairy. The low fat products tended to have more of an effect on acne development than the whole milk. Potentially related to the glycaemic index (higher concentration of milk sugars) in the low fat products. But these are speculations. There was no relationship between yoghurt or cheese intake and the presence of acne. 

 

I know what you are thinking… now you want to cut out dairy. But hold fire!!

There were some limits to this study.

Firstly, when looking at individual dairy products (milk, cheese, yoghurt etc.) the number of studies available was very low. For example, only 4 studies looked at low-fat milk, and five at full-fat milk. 

Secondly, there were other factors that could have been related to acne development, that were not recorded in the study. For example, genetics, sex-hormones, disease fighting systems, mental factors, and the environment. The association between acne and dairy could therefore, have happened together by accident. 

Some of the studies identified acne based on self-reports, rather than official diagnosis by a doctor. A few pimples could therefore, have been mistaken for acne.

Finally, there was lack of data on the preparation of the milk which differs from factory to factory and country to country. In fact, we know that boiling and ultra-heat treatment (UHT) techniques have a protective effect against acne. No studies were done in UK population groups!  

 

How does milk actually affect the skin?

It has been identified that milk and dairy can increase our growth chemicals (hormones) in our body (IGF-1).  IGF-1 is a growth chemical that stimulates growth, cell reproduction, and cell regeneration. Milk and dairy products contain IGF-1 that is not broken down by gut enzymes and leads to IGF-1 elevation. Also, a protein called casein in milk and dairy products stimulates our liver to release IGF-1. Subsequently, this leads to an increase in the production of skin oil by our skin glands. Also, milk contains some sex hormone derivatives and iodine which have been identified to affect acne development.

So should you avoid dairy if you have acne?

I’m going to start by saying… not right now. Firstly, while this study was the largest and highest quality to date in this area, it still had its limits that I have given above. Further studies, especially randomised controlled trials are needed. This is where they randomly assign groups to eat dairy compared to not eating dairy in controlled conditions.  These will help to confirm the effect of milk and dairy products on acne development.

Secondly, milk is a very nutritious source of protein, calcium, potassium, magnesium, vitamin A and B12 and is recommended as a part of healthy diet. Previous high-quality studies have showed that milk and dairy products can help reduce the risk of high blood pressure, stomach cancer, stroke and colorectal cancer.

Summary…

Although the large review does suggest a promising link between dairy and acne development, the studies included in the review had their limits. We therefore, cannot say there is an exact causal relationship without further studies.

Everyone’s reactions to what we eat are very personal and therefore, if you are someone who wants to trial changing your diet, it’s important to follow the guidance of a qualified professional. There is unfortunately no one size fits all. I offer FREE 20-minute discussion to advise on things like this!

Also, if you are thinking of going more plant-based and reducing your dairy intake, it’s really important to choose milks that are fortified with calcium.

Finally, we must remember that diet is not going to fix acne alone. Seeking advice from a doctor or consultant dermatologist is a good place to start! 

Link to more info:

(Links highlighted throughout the text)

NHS Choices Acne

The large meta-analysis I have referred to throughout this post

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Apple Cider Vinegar – All you need to know

Apple Cider Vinegar – All you need to know

NONSENSE STRIPPING 

Apple Cider Vinegar – All you need to know 

KATHERINE KIMBER, Registered Dietitian

29th June 2018

I have been asked multiple times recently about apple cider vinegar. Will it help me lose weight? Will it settle my stomach/heartburn? Will it help with blood sugar control? Will it lower my cholesterol? Will it help with inflammation? So I thought I would clarify some things for you. 

What is apple cider vinegar?

It’s made by fermenting the sugars from apples which turns them into acetic acid – this is the active ingredient in vinegar that is researched. You may see both cloudy or clear vinegars in the shops, labeled as filtered or unfiltered.

The unfiltered products contain something known as ‘mother’, which apparently has more proteins, enzymes and friendly bacteria in it, giving the vinegar its cloudy appearance. There is not enough research at the moment to demonstrate whether the ‘mother’ variety is any better than the clear. 

What’s good about this stuff?

1) If you fancy your dentist, drinking this stuff will give you a great excuse to keep going back! 

2) If you need something sharp to wake you up in the morning, this may do the trick. 

Joking aside…

3) It’s a good way to spice up your meals without adding salt

4) It contains very small amounts of potassium, copper and magnesium – minerals help turn the food we eat into energy and support controlling the movement of fluids into and out of cells.

5) It provides a small amount of amino acids (building blocks for protein) and antioxidants, which help slow the process of cell damage.

So what does the research say?

 

1) Will it help with weight loss?

The evidence to support weight loss is mixed and in general, there is very little research conducted on humans. There has been some evidence that vinegar may help to increase the feeling of fullness when consumed with a high-carb meal, which could help with weight loss by preventing overeating later in the day.

A 12-week study conducted on 155 Japanese individuals also found a reduction in body weight, BMI and visceral fat in obese individuals who drank between 15-30 mls per day.

Final verdict: More research is needed before we can confidently make the claim that apple cider vinegar helps with weight loss. If you are having battles with your weight and looking for the answer to feeling better about yourself and your body you can find more about how I support with this here

2) Will it help lower your cholesterol? 

There appears to be no research that has been conducted in humans to demonstrate whether it can support lowering cholesterol. One study has been conducted on rats which demonstrated

To date, only research in animal studies has demonstrated that apple cider vinegar, and its antioxidant chlorogenic acid, can help manage cholesterol and triglyceride levels, which is not robust enough for us to say that this would also be the case in humans.

Final verdict: No studies have been conducted in humans so we don’t know.

3) Will it help your blood sugar levels?

There have been a number of small studies that have demonstrated how vinegar could help improve insulin sensitivity in both healthy subjects, and those with insulin resistance.

Insulin is a hormone which helps control our blood sugar, therefore, if we are more sensitive to it, then that’s a good thing. One study included a small number of participants (29), identified that drinking 20ml of apple cider vinegar with a high carbohydrate meal (white bagel with orange juice), reduced the spike in blood sugar after the meal versus the group who did not consume the vinegar with the meal.

Before we can say that apple cider vinegar helps with blood sugar control, further and larger studies in different groups of people are required.

One small pilot study (12 participants) published by the American Diabetes Association identified better blood sugar control in those taking two tablespoons of apple cider vinegar before bed. They didn’t look into the damaging effects this could have on your teeth though. 

Finally, Michael Mosley and Aston University carried out a small study and showed that drinking dilute apple cider vinegar appeared to bring blood sugar levels down. 

Final verdict: There is some evidence of benefit, but these studies are small, and large amounts of vinegar would need to be consumed on a daily basis to show benefit, which may have a detrimental effect on other things… like your teeth!

There is no evidence that apple cider vinegar can reverse diabetes, and there is a whole body of research to support of other healthy things you can do to improve blood sugar control aside from sipping vinegar!

3) What about heartburn?

Some people report that apple cider vinegar helps with their heartburn, which, if they have low stomach acid, may be of benefit. However, if you are someone who suffers from high acidity in your stomach, this may make your symptoms worse.

Foods that affect heartburn is often a matter of trial an error and is very individual. One small study with 7 participants in America did find that cloudy apple cider vinegar helped with preventing heartburn in those who did not respond well to antacids, but more research is required in this area.

The verdict: It could make it worse, could make it better… we don’t know. 

4) Will it help with arthritis and inflammation?

There appear to be just anecdotal reports of people claiming to feel better and having less pain from arthritis when drinking apple cider vinegar. Unfortunately, there are not currently any scientific reports supporting this claim.

One very small study (30 participants) did measure C-reactive protein (a marker of inflammation) before and after apple cider vinegar consumption and did not find remarkable results.

The verdict: I have a hard time giving recommendations based on purely anecdotal evidence. If you think it works for you, I think that’s just great.

Are there any risks?

Yes…

  • If you suffer from gastroparesis, (slow emptying of the stomach), this may make your symptoms worse. 
  • If you are diabetic, especially on medications that lower your blood sugar, there is a risk of potential low blood sugars. Speak with your healthcare professional for more information on this.
  • Apple cider vinegar can affect potassium levels in the body, and also interact with drugs such as diuretics, or other water pills. Check with your pharmacist or doctor for more information.
  • As apple cider vinegar is an acid, it can damage the enamel in your teeth. Avoid taking it neat, or sipping it throughout the day.
  • We don’t know much about the long-term effects of taking apple cider vinegar.

In summary…

Although some studies do suggest promising effects, there are generally few, they are small and often conducted in rats. If we could prove all of the amazing benefits that unqualified individuals splash around the internet, doctors would be handing this out to nearly every patient who walked through their door!

If you do wish to include apple cider vinegar in your diet, I would recommend either including it in salad dressings with olive oil, marinades, sauces or baked goods and not drinking it by the glass!

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