Frequently asked questions for a healthier you

1. There are so many diet approaches available — I have heard about the low GI and low fat diet, low carb high fat or banting diet and Mediterranean diet approaches. I am so confused as to what approach to follow.

Through the internet and social media, we are faced and confronted with so much information — often conflicting and anecdotal, but most of the time, not scientifically based. It is important to try and see a registered dietician who could put all of this in perspective, backed up by scientifically based evidence. It is important to make an informed decision, as agreed with between yourself and your dietician. It might be harmful and dangerous to follow, and combine, principles of different diet approaches. For example, if you follow the high fat principle of banting, but also consume carbohydrates (even though low GI), this can result in a ‘diet’ not working for you in terms of weight and health management. Also, if you are taking certain medications and injections (for diabetes), that due to its mechanism of action, can increase your risk for low blood sugar episodes (hypoglycaemia) and combine that with a cold turkey ‘low carb’ approach, it can potentially cause very dangerously low blood sugar levels. Whichever approach you decide to follow, please check it with your dietician, doctor and diabetes educator in order to be informed as to how to implement it, especially when taking certain medications and injections.

2. I have tried so many diets before and I don’t eat a lot. Why can’t I lose weight?

Answer: It can be frustrating to feel that you are not getting the expected results when following a diet. It is important to look at weight management in perspective. Over how many years have you gained weight? We cannot expect to have quick results when we consider this. Any diet would work for the time period it is being followed, but as soon as the diet is stopped, weight gain might return. It is always advised to rather change our lifestyle, referring to the way we live — what and how much we eat, what we drink and alcohol guidelines, do we smoke or not, how active or not we are, do we sleep well and do we manage our stress levels. Making lifestyle changes might give us slower results, but could and should be sustained for a lifetime. It is important to have patience and persevere, and set realistic and achievable goals. Even a small percentage weight loss (5–10%) can result in significant health benefits. Certain chronic conditions like Type 2 Diabetes characterised by insulin resistance, makes it harder to lose weight, but with perseverance in a healthy lifestyle, results will set in. Certain medications and injections (in diabetes) may also contribute to weight gain or the inability to lose weight. Please check with your treating doctor what your options are. From a diet perspective, we can lose weight by following a healthy balanced diet, enjoy suggested portions, prepare meals healthily, and limit unnecessary empty calories like frequent sugary drinks and high fat treats. It is important to know that we can still eat too much/too large portions of healthy food, so portion control is key.

3. It is difficult to follow a specific diet approach as I need to prepare a different meal for myself and then for my family. They don’t want to eat with me.

As mentioned before, making a lifestyle change is advised over following a short-term fad diet. A dietician can help you with practical ideas as to how to accommodate both your own and your family’s diet preferences. It might be helpful to include your family in a diet consultation, or to sit down with them to discuss the changes you would need to make to improve your health. Ask them for their support and also explain to them that everyone in the family will benefit from healthy eating. It might mean that you have to give and take, make smaller impactful changes, and can only implement a few changes at a time and build on that as time goes by.

4. How many eggs can I eat in a week?

In previous years, eggs were limited to 3 times a week, even in just a healthy diet (not considering any chronic conditions). But, recent studies have shown that it is safe to consume eggs on a daily basis and that it can even help increase our good cholesterol levels, without increasing our bad cholesterol levels. Omega-3 enriched eggs can especially be heart healthy. Eggs are also non-processed, a great source of protein and many vitamins, minerals and antioxidants (fights inflammation). It is not the cholesterol in food (for example, egg yolks) that increases cholesterol and negatively affects our heart health, but rather saturated and trans fats such as the fat on meat, skin on chicken, cheese, processed meats and baked goods. Most studies on the consumption of eggs were done with people consuming up to 3 eggs daily, which did not lead to a negative impact on blood cholesterol levels and overall heart health.

5. I really cannot drink low fat milk , is that okay?

Unless you consume litres of milk and yoghurt daily, these dairy products when enjoyed in moderation don’t pose a proven harmful effect on blood cholesterol levels and overall heart health, and some studies have even demonstrated the potential protective factor on heart health, irrespective of the fat content of the product. There are more impactful diet changes that can influence your overall health than consuming low/no fat milk and yoghurt. Having said that, by choosing the lower fat versions, it might mean consuming less calories (from fat) and might assist with weight loss.

6. I only check my blood sugar levels in the morning, I actually feel fine and as a result don’t check my sugar levels every day.

Although the fasting blood sugar reading is a very important reading in the management of diabetes, it is important to know that blood sugar levels fluctuate during the course of the day — as we eat, blood sugar levels rise and come down again in response to the insulin still produced by the pancreas, as well as medication circulating/setting in. We should also know our targets. A fasting reading can be between 4–7 mmol/l and a reading 2 hours after meals can be between 5 and 10 mmol/l. The after-meal reading will give us an idea as to how the body is coping with the preceding meal and/or if the medication/injection taken with that meal was sufficient. By checking your blood sugar levels regularly, you can manage your own diabetes to a great extent — make diet changes accordingly or schedule an appointment with your treating doctor to adjust your medication. Even though high blood sugar levels might be associated with certain unwanted symptoms, the body might become used to that level of high or low blood sugar levels and it is therefore potentially dangerous to not check your levels, and only see your doctor every 6 months and monitor an average blood sugar reading by means of a blood test. Because higher levels of blood sugar are linked to causing diabetes related complications, you can identify these higher levels, even in the presence of feeling fine, by means of checking your blood sugar and asking for help and in return lessen your risk for developing these complications.

7. Healthy eating is expensive — I can’t afford all these special foods.

Some special/healthy foods can cost more that the regular alternative that is most often consumed. Making overall healthy lifestyle changes might result in cost savings in one aspect which allows for more leeway in spending on suggested changes. For example, if you decide to stop smoking and consume less alcohol, the cost savings of that will be significant, which might allow for the implementing of healthy diet changes and specific food items. Another example is that of regular and low GI bread — low GI bread per loaf is almost double the price of regular bread. However, you will need to consume more of the regular bread for satiety and less of the low GI bread will be needed for similar satiety levels. So, a regular bread might last 2–3 days, where a low GI bread might last up to a week, resulting in the cost thereof to be on par. A dietician will also be able to assist you to make healthy changes within your budget. Also, you don’t have to implement ALL suggested changes from the start — you can start with the more doable, affordable changes and build on that. We can also consider the investment in your health by making healthy lifestyle changes, which can result in possible cost savings later on in life.

8. What should my weight be?

We are often confronted with BMI (weight for height) measures, resulting in wanting to know what our ideal weight should be for our height. This is often not a realistic number and evidence has shown that 5–10% weight loss could result in health benefits. Very often, an ideal weight for height is a weight that was achieved MANY years ago and just seems so far/out of reach that we give up even before starting to try to achieve it. Your ideal weight can be based on your height, age, level of activity and chronic conditions/illnesses, and this number can be decided on together with your dietician and doctor. As much as weight loss is part of the treatment plan of certain chronic conditions, it is not the only factor playing a role and weight management should be considered as part of the holistic treatment of health conditions.

28 June 2021

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