How to tackle obesity head-on

By Melanie Leyshon

25% of adults in the UK are already obese and two-thirds are overweight. Worrying statistics, which, according to Professor David Haslam, National Obesity Forum chair and Healthy Food Guide expert, means we could be facing a ‘doomsday scenario’. At the start of National Obesity Awareness Week (13–19 Jan), David wants to see campaigns for obesity becoming as hard-hitting as those against smoking.

‘There’s a lot more we can be doing by way of earlier intervention and to encourage members of the public to take sensible steps to help themselves,’ says David. ‘But this goes hand in hand with government leadership and ensuring responsible food and drink manufacturing and retailing. We need more proactive engagement by healthcare professionals on weight management, more support and better signposting to services for people who are already obese, and more importance placed on what we drink and how it affects our health.’

To tackle obesity successfully, health experts believe all the elements of the condition must be addressed. One successful scheme has been trialled in Rotherham, South Yorkshire.

The town’s weight management programme brought together health authorities and commercial enterprises such as WeightWatchers, with a focus on healthy eating and exercise. Its community approach encouraged overweight people to request a referral to the Rotherham Institute of Obesity from either their GP, nurse, pharmacist or dietitian, or to refer themselves.

Of the patients who completed the six-month weight-loss programme, 93% lost weight and 66% met or did better than their targets. Overall weight-loss results were up to 29% of the original starting weight.

‘It worked because once assessed, patients could see a weight management professional, dietitian, exercise physiologist or talking therapist, or whatever they needed,’ says David. There were three stages to the scheme: stage one identified people at primary care level; stage two was community based, where nutrition and lifestyle and exercise advice was given by trained staff; and stage three looked at specialist interventions, such as bariatric surgery. For children, this included residential weight management camps.

David believes the Rotherham approach is utterly cost effective and should be used across the country. ‘People are sitting in the wrong clinics. They’re in the cardiology clinic and the diabetes clinic or liver clinic, when really they should have started in the obesity clinic so that the problem could really be dealt with.’

‘If you rolled out the Rotherham programme everywhere, it would cost far less than the amount obesity is going to cost us in 25 years’ time, according to Government predictions,’ he says. The programme costs under £1m and if it were rolled out nationally, it would cost around £250m - a small fraction of the bill we will be faced with in 2050 if the obesity crisis continues at its current pace.’

For advice on tackling obesity, check out the National Obesity Awareness Week website www.noaw2014.org.uk/recipes - Healthy Food Guide has a week’s worth of recipes available for you to try.

For more everyday recipes - all 500 kcal or less - get a copy of Healthy Food Guide’s Make it Special 100 Speedy Suppers Recipe Collection (£3.99), out now at branches of Tesco, Sainsbury’s and WH Smith, or download the iPAD edition from iTunes. 

Easy ways to cut down on sugar

The Action on Sugar campaign was launched yesterday to tackle concerns that we’re all consuming too much sugar. 

While the debate rages on what can be done about the national obesity problem, here are Healthy Food Guide’s practical tips on how to reduce your own sugar intake – plus we reveal which foods are higher in sugar than you may have thought.

7 ways to replace the white stuff:

1.     Get baking – if you like the occasional cake or biscuit, make your own so you can control the ingredients (you can normally halve the sugar content without affecting the quality). Look out for healthier sweet recipes in the pages of HFG.

2.     Try sugar substitutes – natural products like stevia are sweeter than sugar, with fewer calories.

3.     Use spices for flavour without the sugar – try cinnamon, mixed spice and ginger in stewed fruits, porridge and puddings.

4.     Watch the drinks – alcohol, fizzy drinks and juices are an easy way to overload on sugar without noticing. Try sparkling water with lemon slices and fresh mint sprigs, chilled herbal teas or diluted juice.

5.     Look out for hidden sugar in unlikely foods (see below) – look for ingredients ending in ‘ose’ on the ingredients label and check out the value for sugars: less than 5g per 100g is considered low in sugar while more than 15g per 100g is considered high (although this value refers to all sugars, not just added ones).

6.     Choose lower-sugar versions of cereals, baked beans, soups, canned tomatoes and ketchup.

7.     Eat fewer processed carbohydrates such as white bread, croissants, muffins, biscuits, cakes, chocolate and sweets. These convert rapidly to glucose in the blood, so high levels may contribute to energy highs and lows and cravings. Switch to wholegrains instead.

Do you know where sugar is lurking?

Food doesn’t have to taste sweet to contain sugar. Check out some of the more unlikely products you’ll find it in if you look closely…

* 30g cornflakes = ½tsp

* 1tbsp salad cream = ½tsp

* 1tbsp balsamic vinegar = ½tsp

* 1 slice bread = ½tsp

* 1tbsp tomato ketchup = 1tsp

* Half a large tin mushroom soup = 1tsp

* 2tbsp coleslaw = 1tsp

* A third of a jar of salsa = 1tsp

* 30g branflakes = 1½tsp

* 125g ready made Bolognese sauce = 2tsp

* 400g lasagna ready meal = 3tsp

* 400g chicken tikka masala ready meal = 3½tsp

A breakthrough for type 2 diabetes?

By Tracy Kelly

Can we put type 2 diabetes into long-term remission? It’s a question that’s asked often and to date we don’t have the answer – but that could all change within a few years. 

That’s because Diabetes UK has recently awarded a £2.4 million research grant to look into whether losing weight – and keeping it off – through a low-calorie liquid diet is a feasible long-term treatment for putting type 2 diabetes into remission.  

As part of the Diabetes Remission Clinical Trial (DiRECT) study, researchers will recruit 280 overweight people with type 2 diabetes and put them on two separate diets. This new trial follows a 2011 study that found that 11 overweight people with type 2 diabetes saw their insulin production return to normal and their type 2 diabetes put into remission after eight weeks on a low-calorie liquid diet. 

Following the huge media interest in this study, many people with type 2 diabetes were interested in this approach. But as exciting as these findings were, the study did not focus on the effects of the diet in the long term and there is still much about low-calorie diets that we are yet to understand.

As part of the new trial, one group of 140 people will spend between eight and 20 weeks on a low-calorie diet of 800 calories a day – mainly nutritionally complete diet soups or shakes, plus ample fluids. Then, as normal food is reintroduced, they will learn how to change their lifestyles permanently. 

The results of this group will be compared with an equal number in the second group, who will follow what is currently accepted as the best advice for weight loss and weight maintenance. 

Both groups will be monitored for two years to study the long-term effects of their diets on weight. MRI scans will look at what’s happening inside their bodies during the diet.

The aim is to see whether the stress and effort of following a restrictive diet for several months is beneficial in the long run. After all, 800 calories is not a lot – people following such a diet are likely to feel hungry quite a lot of the time. Also, will they be able to stick to it for long enough for it to be successful? Even more fundamentally, this kind of diet is not an easy option or a ‘quick fix’ and people will still have to follow a healthy lifestyle afterwards to stop their type 2 diabetes coming back. It’s a fact that weight regain after liquid diets is common.

Type 2 diabetes will always be a serious condition, but perhaps it won’t always be seen as a condition that people have to manage for the rest of their lives – and that inevitably gets worse. If this study shows that low-calorie liquid diets can be used safely, on a bigger scale and as part of routine care, it could completely change what we know about type 2 diabetes and how it is treated by the NHS. It could also provide an accessible way to help people with this condition live longer, with a better quality of life and a reduced risk of serious health complications.  

For more information about the trial visit www.diabetes.org.uk/DiRECT

Break the diet cycle

Diet is a four-letter word that often spells failure. In the November issue of Healthy Food Guide, our experts explain how you can lose weight for good by breaking free of the vicious cycle of deprivation and disappointment caused by fad diets.

Successful weight loss is all about creating healthy relationships with food and your body. We asked nutritionist Zoe Wilson for her top tips for healthy eating…

1 It’s OK to have an ‘imperfect’ meal or snack

You eat three meals a day, seven days a week – so if one or two of these meals aren’t great, it’s no big deal!

2 Before you eat ask yourself, ‘Am I actually hungry?’

That’s the grumbling, empty tummy hungry — not the ‘I don’t want to sit at my desk anymore’ hungry. If you’re not really hungry, is there something else you could do? Maybe you could step outside for some fresh air or make that phone call you’ve been putting off for a while.

3 Turn off the TV, computer or phone to enjoy food
By eating with distractions such as these you won’t register you’ve had your meal or snack, leaving you wanting more when you don’t need it. Take time out and sit at a table so you can concentrate on what you’re eating.

4 Have what you really want

There’s no point in choosing a yogurt or piece of fruit if you really want a piece of chocolate — you’ll feel cheated! Have that piece of chocolate (but not the whole bar) and savour every moment of it.

5 Take note of the ‘sigh moment’
There comes a point, when eating a meal, when our stomach says it’s full – we will often pause and take a deep breath. But many of us miss this cue because there’s still food on our plate. Be mindful of this cue, then put down your knife and fork.

6 Eat slowly!

Try to take at least 20 minutes to eat your meal. This gives your stomach enough time to tell your brain it’s full. Put your knife and fork down between mouthfuls, cut your food into smaller pieces and focus on tasting your food.

7 Don’t deprive yourself in social settings

Food is at the centre of many social occasions, and it’s fine to join in. But if you’re not hungry, don’t feel pressured to go to the buffet table or to take that canapé. And in restaurants, order a starter instead of a main or share something with a friend.

8 Leave the table satisfied but not full

There’s a difference between not feeling hungry anymore and feeling stuffed to the brim. Listen to your stomach as you eat and try to finish on a hunger scale of about 7/10 — with 0/10 being starving and 10/10 being full-to-bursting.

9 Pretend you’re a critic

Think about the flavour and texture of each mouthful, and assess how appealing the meal is to your eye. By appreciating the elements of your food you will feel more satisfied.

10 Use smaller crockery and glassware

This makes a smaller portion look bigger, helping you eat less but still feel satisfied. Replace dinner plates with starter-sized plates, and swap 500ml wine glasses with 250ml glasses. 

For more advice on breaking the diet cycle, check out the November issue of Healthy Food Guide magazine.

Comforting crumbles

At HFG we love finding ways to make our favourite dishes healthier. From satisfying pies to decadent desserts, we believe that with a bit of nutritional tinkering most culinary treats can be enjoyed as part of a balanced diet.

In our November issue, we put the spotlight on fruit crumbles and our chefs surpassed themselves when experimenting with healthier fillings and toppings. In fact, they managed to concoct so many delicious variations there wasn’t enough room for all of them in the magazine. But we didn’t want you to miss out, so we thought we’d share the leftovers with you here. A serving of either crumble contains one of your 5-a-day and is low in saturates and salt.

Apple and raspberry

Serves: 6

Prep: 5 min

Cook: 20 min

400g tin sliced apples

200g frozen raspberries

60g caster sugar, plus 1tbsp extra

60g self-raising flour

40g rolled oats

30g low-fat spread

1tsp vanilla extract

6 small scoops low-fat ice cream, to serve

1 Preheat the oven to 190°C/fan 170°C/gas 5. Combine the tinned apples, frozen raspberries and the 1tbsp caster sugar in a 1.25 litre baking dish.

2 Put the flour and oats into a mixing bowl, then rub in the spread with your fingertips until the mixture resembles breadcrumbs. Stir in the remaining 60g sugar.

3 Sprinkle the vanilla extract over the fruit, then add the crumble topping. Bake for 20 min or until golden. Serve with the ice cream.       

Per serving: 238kcal, 3.7g protein, 4.9g fat, 2.4g saturates, 35.1g sugar, 3.9g fibre

Strawberry and almond

Serves 6

Prep: 10 min

Cook: 25 min

125g reduced-calorie strawberry jam

500g strawberries, halved

25g toasted flaked almonds

60g caster sugar, plus 1tbsp extra

60g self-raising flour

40g rolled oats

30g low-fat spread

1tsp vanilla extract

6 small scoops low-fat ice cream, to serve

1Preheat the oven to 190°C/fan 170°C/gas 5. Warm the jam in a saucepan, then add the strawberries and stir to combine. Transfer to a 1.25 litre baking dish.

2Put the flour and oats into a mixing bowl. Rub in the spread until the mixture resembles breadcrumbs, then stir in the sugar and almonds. Sprinkle over the strawberry mixture, then bake for 20 min or until golden. Serve with the low-fat ice-cream.

Per serving: 258kcal, 4.8g protein, 7.2g fat, 2.6g saturates, 34g sugar, 3.1g fibre

Pick up the November issue of Healthy Food Guide magazine for eight more variations including a classic apple and sultana and an exotic pineapple, rum and raisin.

Get all your five-a-day in one dish!

By Harry Eastwood

This salad is a deconstructed version of ratatouille, which makes for a delicious, fresh and full-flavoured alternative to the traditional vegetable stew. It can be made ahead – and, in fact, tastes even better. It ticks plenty of health boxes as it’s high in fibre and low in calories, fat, saturated fat, sugar and salt. Most people can enjoy it, as it’s vegetarian, gluten-free and dairy-free. And the best thing about it? One serving counts as a full five portions of your five-a-day.

Ratatouille salad with anchovies and lemon

Serves 4

1 large aubergine, cut into small cubes

2 medium courgettes, topped, tailed and cut into very small cubes

4tbsp olive oil

1 large Spanish onion, peeled and finely diced

1 medium yellow pepper, cored and chopped into small cubes

1 medium orange pepper, cored and chopped into small cubes

2 garlic cloves, crushed to a paste

3 anchovies, very finely chopped

10 medium ripe tomatoes on the vine

Freshly squeezed juice of ½ lemon

Handful of basil leaves, torn from the stem

1. Heat a large frying pan until very hot.

2. Toss the aubergine and courgette cubes in the olive oil until evenly coated. Add them to the hot frying pan and cook over a high heat for 5 min, until the edges have turned a golden colour. You may find that you need to do this stage in two batches.

3. Tip the hot vegetables into a large bowl with the onion, peppers, garlic and anchovies. Season generously with pepper, then cover with clingfilm. Set aside for 10 min, while you prepare the tomatoes.

4. Chop the tomatoes in half and scoop out the seeds and centre with the help of a spoon. Finely chop the flesh, then add to the bowl with the rest of the ingredients.

5. Finally, squeeze the lemon juice over the salad. Set aside (wrapped in clingfilm) for 1 hr in the ambient temperature of your kitchen to let the flavours mingle and develop. Scatter the basil leaves over just before serving and add more pepper if needed. Serve with crusty bread, if you like.

SWAP IN/SWAP OUT

I love the savoury flavour the anchovies bring, but you don’t have to add them – this ratatouille is delicious without. You could include pine nuts if you want the salad to be a little more hearty and reduced-fat feta or mozzarella chunks are lovely thrown in at the last minute, too.

Per serving: 210kcal, 6g protein, 12.8g fat, 2g saturates, 19.2g carbs, 17.1g sugar, 9g fibre, 0.3g salt, 77mg calcium, 2.7mg iron

 

Harry’s supporting our mission to Fight the Fads – Make Every Meal Healthier. To find out why she’s rallying against the fad diet industry, pick up our October issue.

For more substantial salad recipes, check out Harry Eastwood’s A Salad For All Seasons (Bantam Press, £20).

Beat the barbecue binge

By Juliette Kellow

Last week, I enjoyed my ninth barbecue of the year. To be fair, we started early with our first one on a very chilly and windy February afternoon (new kitchen, loads of people for Sunday lunch – and no electricity! You get the picture). But, I’m not alone in my love of the griddle. Apparently, Brits hold more barbies than any other European country, with the average family hosting nine each year.

And it’s not surprising that we love them so much – they’re the perfect opportunity for relaxing and enjoying sunny days with family and friends. But at the risk of having a burger or two thrown at me, if you want to stay looking good in your swimsuit, it’s time for a waistline warning.

A study carried out three years ago revealed the average person consumes around 3,000 calories at a barbecue – one and a half times what a woman needs in a day; twice the amount if she’s trying to lose weight. On average, we munch our way through two sausages, one and half burgers, two chicken drumsticks, one-and-a-half meat skewers, a small piece of fish, a small jacket potato, green salad, pasta salad and two spoonfuls of mayo, all rounded off with double dessert. And that’s without any booze!

So how can you cut calories without cutting enjoyment? To start with, it’s usually the sheer abundance of food and drink that makes it so easy to overindulge – as the aforementioned study showed. My advice: if you’re holding a BBQ, buy the same amount of food as you would for a dinner party and fire up the barbie just once; if you’re at a BBQ, fill your plate just once, then step away from the trays of cooked food that are constantly being added to.

Most BBQs are a meat feast, so swap fatty burgers and sausages for low-fat versions (or make your own burgers with lean beef or turkey mince). Try chicken, turkey, lean pork, salmon, mackerel, fresh sardines, white fish, prawns or tofu as alternatives – and keep portions small. A serving should be about the size of a deck of cards (see the September Healthy Food Guide magazine, out now, for my guide to portion sizes). Alternating chunks of meat with veg on skewers makes a small amount of meat go a long way. And fill the grill – and your plate – with low-cal, antioxidant-rich veggies like aubergines, courgettes, peppers, asparagus, corn on the cob and mushrooms.

White rolls and French bread are low in nutrients and fibre. Instead, I make a ‘healthier’ potato salad – new potatoes in their skins, low-fat Greek yogurt, reduced-fat soured cream, spring onions, chives and lots of black pepper. For the kids, I cook jacket potatoes – and for burger lovers, I buy granary rolls. Bowls of green leaves usually end up in the bin so I make a Greek salad with cucumber, tomatoes, green peppers, reduced-fat feta and olives. Olive oil and white wine vinegar are on the side if anyone wants to add them. The mayo stays in the supermarket.

Chips and dips can be a calorie disaster, so I buy just one or two bags of crisps (depending on how many people there are) – once they’re gone, they’re gone – and put out carrot and pepper sticks with reduced-fat hummus, tzatziki and salsa, which are lower in calories than creamy or mayo-based dips.

Finally, it’s worth remembering booze calories aren’t even included in the average 3,000 calories we consume at a barbecue. Plus large amounts of alcohol can give us the munchies so we eat even more (and forget just how much we’ve eaten). If you’re heading to a barbie, offering to drive means you can stick to alcohol- and calorie-free drinks. And if you’re hosting, stock up on soda water, diet lemonade, slimline tonic and plenty of ice – great calorie-free ways to dilute the booze.

Rethink your drink

By Emer Delaney, British Dietetic Association spokesperson 

We all know that giving children fizzy drinks is never a great idea because they are high in sugar and have very little nutrients. Some contain the equivalent of eight heaped teaspoons of sugar, which can not only contribute to weight gain as they don't make your child feel full, but can also damage their teeth. And now health experts have calculated there's even more sugar in some smoothies and health drinks. While there are no recommendations on the number of sugary drinks that are allowed, parents should limit them as best they can.

Research has shown that children aged four to ten years get 16% of their sugar intake from soft and fizzy drinks and soft drinks were the largest contributor to sugar intake for children aged four to eighteen years.  These are frightening figures because when kids drink too much juice, juice or sport drinks their intake of milk declines and they get too little calcium for their growing teeth and bones.

Whether its fruit juice or fizzy drinks, the source of the sugar doesn't matter as any sugar the body doesn't need will be converted to fat. Also, when children have these drinks on an empty stomach, the body takes in sugar so quickly, insulin spikes and then drops suddenly, leaving them feeling hungry.   50% of UK children are now overweight so limiting these drinks is more important than ever.

So what can parents do? Limit the drinks for special occasions only like parties or holidays; dilute fruit juices with water; try flavoured water or de-caffeinated tea for a change. But the easiest and clearest message for all - milk or water should be a child's only choice.

We need to empower our children to make their own decisions and to teach them that too many fizzy drinks, fruit juice or sweet drinks are bad for their bodies. Change doesn't happen overnight, but we can start making small steps today and make it happen today.