The Food Medic - S3 E2 - Nutrition Q&A with Dietitian Maeve Hanan

Episode Date: July 16, 2019

This week Dr Hazel Wallace is joined by Maeve Hanan who is a Consultant Dietitian and Health Writer. She also runs the blog DieteticallySpeaking.com, as she is passionate about promoting evidence-based nutrition and fighting nutritional nonsense. Maeve is also The Food Medics resident dietitian and writes monthly articles on the website, so make sure to check them out. This week Maeve and Dr Hazel tackle 10 of the nutrition questions you have sent in. Tune in for topics on:- Intermittent Fasting - Celery juice- Dairy and The China Study- Metabolism boosting foods... And many more Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

What's better than a well-marbled ribeye sizzling on the barbecue? A well-marbled ribeye sizzling on the barbecue that was carefully selected by an Instacart shopper and delivered to your door. A well-marbled ribeye you ordered without even leaving the kiddie pool. Whatever groceries your summer calls for, Instacart has you covered. Download the Instacart app and enjoy $0 delivery fees on your first three orders. Service fees, exclusions, and terms apply. Instacart. Grocer $0 delivery fees on your first three orders. Service fees, exclusions, and terms apply. Instacart, groceries that over-deliver. Hello, and a very big welcome back to the Food Medic podcast. I'm your host, as always,

Dr. Hazel Wallace, a medical doctor and founder of The Food Medic, which is an educational platform sharing evidence-based advice on how you can live a healthier and happier life while cutting through the confusing information that we find online. In this podcast, we will hear from experts in the fields of nutrition, medicine, and other areas of healthcare, who will be sharing their invaluable experience and research with us. Today, I'm joined by Maeve Hannan who is a consultant dietitian and health writer. She also runs the blog dieteticallyspeaking.com as she is passionate about promoting evidence-based nutrition and fighting nutritional nonsense. Maeve is also the FoodMedics resident dietitian and writes monthly articles on our website so make sure to check them out.

This week, Maeve and I are going to be taking some of the most commonly asked questions which we get in social media with regards to nutrition and try our best to dispel any of the confusion and bust some myths. P.S. Don't forget to keep listening to the end of the show where I will be answering this week's listeners question. And this week it is, do I need to take a protein supplement if I'm going to the gym? So today I'm joining the studio with Maeve who is the resident dietitian from the Food Medic so it's actually really nice to have you here today. Oh thank you I'm delighted to be here. So we've got loads of questions to go through today so I'm just going to deep dive and get started. First question is evidence for intermittent fasting. Is it beneficial for your health and weight loss? So first of all,

I think it's important to explain the different types of intermittent fasting that we have. So we have the daily intermittent fasting and we have the alternate day fasting. So the alternate day fasting, that's like the 5-2 diet, where there's, you know, maybe one or two days a week where you fast or you eat a low amount of calories, like say 500 calories in that day. Then with the daily time restricted feeding or the daily intermittent fasting, that's where you have a fasting window and a feeding window within the same day. So for example example the 16-8 diet. So we have these two different types but if we're talking about the evidence overall

you know there is some evidence to show that intermittent fasting can help some people to lose weight and may improve heart health or reduce the risk of diabetes. But when we're thinking about this evidence it's important to say that for the most part, these benefits seem to be related to weight loss rather than the fasting itself, with the exception of some studies that look at early time restricted feeding. So if we're looking at having most of our calories earlier in the day, so that feeding window, say from 6am to 3pm, there's additional benefits there seen in terms of a lower risk of diabetes and other improvements in metabolic health. Yeah, I think people are latching on to it as like the new holy grail. But like you said, when it comes to weight loss, for example,

is it really the fasting element that's actually giving people the results that they're looking for? Or is it the fact that you're actually just cutting out, you know, a proportion of your calories per day? But you did say that in certain kind of studies, especially when we're looking at early time restricted feeding, we're seeing benefits. But is there enough evidence on humans or is most of this done on animals? Yes, very good point. So a lot of this research has been done in animals, in rats in particular. So obviously we can't directly apply that to humans.

There is more evidence coming out, but we don't know a lot about the long term. So it is something that we don't know for sure whether it's a good idea for everyone. And actually for some people, it's definitely not a good idea. So if somebody say has an eating disorder, or if we're talking about a pregnant woman or a child or somebody who's malnourished,

you know, there are certainly situations where it's not appropriate as well. So I think it is something that shouldn't be taken lightly. And it's not something, you know, we don't have the evidence to say that we should all certainly be doing this. Okay. So advice for someone who is a healthy individual individual who just wants to give it a go, what would you say? What advice can you give them? So I think the safest and most practical way of doing it really is the daily time restricted feeding. And I would say start low. So start

with maybe 12 hour feeding, 12 hour fasting window. And for most people, that would just be a little tweak. So your feeding window might be between 8 a.m. and 8 p.m. So for a lot of people that might just cut out a little bit of snacking. So that can be one way of doing it. And then some people may gradually want to reduce down to stop eating at 6 p.m. instead of 8 p.m. So that could be a way. Otherwise, I suppose the best thing is

to get individual advice from a registered dietitian to make sure you're doing everything safely and they can understand your medical history, maybe the medications that you might be on and if there's any other risks involved. Yeah. And I guess the other benefit of stopping eating a couple of hours before you go to bed is the fact that it won't have an impact or shouldn't have as much of an impact on your sleep quality. And I get like a lot of people who will say like, you know, I'm struggling to fall asleep. And one of the things we look at is what time are you having your dinner or your last meal? Because when you do eat, then you're digesting throughout the night. So that's something to bear in mind.

Also, people with gastric reflux having food late at night is not a good idea. Absolutely. So that's intermittent fasting in a nutshell. Right, next question. Artificial sugars or artificial sweeteners? This is something that I'm constantly asked. And the question that we got asked is, are they better than sugar? And do we know if they're safe? Yes, this is also something that I get asked quite often. So with artificial sweeteners, so they're substitutes for sugar that contain little to no calories. And again, we do have a few different types of sweeteners. But if we're talking about them as a whole,

one of the most important points is that any sweeteners that we have in the food supply have been rigorously tested. And, you know, if any artificial artificial any additive in our food has an e-number which gets a very bad name that actually means it's been through a lot of safety testing so you know there's a lot of fear mongering around about sweeteners but we don't have evidence to say that we need to avoid them that they're particularly harmful the only evidence I suppose coming through is they may not be so good for the diversity in our gut microflora. So that is quite new research, but that's a potential there that might have an impact on our health. But there isn't good evidence to say that they cause cancer

in humans or anything like that. Again, those kind of headlines came from very old studies that were done in rats that were given mega doses of supplements that we would really struggle to consume if we were talking about in a human scale yeah so we definitely don't need to be scared of sweeteners we don't necessarily need sweeteners either and I suppose it depends on the individual and what their goal is there is some evidence that they're good for our oral health, so for our teeth, especially if we're switching sugar for sweeteners

and for maintaining more stable blood sugars. But then there are some cases where people should avoid sweeteners and that's if somebody has a medical condition called PKU. In that case, they need to avoid aspartame. And also the sweeteners haven't really been tested in children under three so they're not advised for children or for babies and also children and babies they need lots of energy to help them to grow and these have very few calories in them so that's not a good

idea and then some people as well who have IBS can be a bit intolerant or you know they don't do well with some of the sugar alcohol sweeteners so that would be sorbitol and mannitol in particular but in a broad sense you know we don't need to worry about them but if you're consuming say you know a lot of sugar in your diet there may be a benefit from you know switching to some products that have sweeteners in them. Yeah again all comes down to moderation as boring as that answer is um but like you said the evidence that we have currently is that it's not dangerous the only thing is that possibility that it may disrupt the gut microflora so the good good bacteria that we have but again it depends on how much you're taking of this stuff. So next question is, what can I do to prevent bloating?

And now I get this question probably every day on social media. I also see it a lot in the hospital and questions that patients have for me. Now, just to kind of put everyone on the same page, bloating essentially is the term used when your stomach or your tummy just feels a bit bigger than usual, may feel tighter, it may feel full of gas and it tends to be quite uncomfortable. The thing is, if you've eaten a big meal, if you've been stressed, if you've been traveling, it's actually quite normal to get a bit of bloating and I think we kind of over pathologize this quite normal phenomenon. However, it can be abnormal and it can be a

symptom or sign of a disease or condition which is normally related to the gut, but it can be related to other things like gynae problems, fibroids, ovarian cysts and things like that. So if it is ongoing, if it's causing you a lot of discomfort, if you have other symptoms, 100% go to your doctor and just have it sussed out, even if it is nothing to worry about. It's always good for peace of mind to just go speak to your GP and they can just do some basic tests, give you a quick examine. But say we've ruled out all of that, Maeve, and we're just having some kind of intermittent bloating here and then, what can we do?

Why might it be our diet? we're just having some kind of intermittent bloating here and then what can we do why might it be our diet? So there are some general things that people can do if they're having trouble with bloating and as you said if they've ruled out other medical conditions so for example regular meals and relaxing at meal times that's one of the really key things and that's something that a lot of us can benefit from regardless of whether we have problems with bloating or not. So chewing slowly at least 20 times per mouthful, relaxing, making time for meals, you know avoiding distractions at meals, those kind of things can be really helpful. Sometimes using straws as well can draw in extra air into the stomach. So for some people simply just not using straws can make a difference.

And then there are some common triggers that can irritate the gut in general that can lead to bloating. So for some people, that might be too much caffeine, too much alcohol, spicy foods, very greasy foods,

a lot of fruit juice sometimes. And some of those kind of gassier vegetables. So like cabbage, broccoli, cauliflower, those kinds of gassier vegetables so like cabbage broccoli cauliflower those kinds of things cauliflower for me yes such a common one absolutely and sometimes as well having using a lot of protein powders for some people can cause an issue and you know some protein powders fine but it depends on the quality of the protein powder and the rest of the diet and again the dose you know the dose makes the poison so I think it's looking at all of those sort of first line things. So sometimes a few little tweaks can make all the difference. But then it

is important to mention as well that it can be a symptom of issues in the overall lifestyle. So it can be related to stress, if we're not moving very much sometimes. And, you know, sometimes so something like meditation or yoga or just getting out for a walk or just any way we can find to relax, sometimes that can really make all the difference as well. And then there are a few extra little things as well that some people can add on. So I think it's always important to do things one at a time so you know what's making the difference. But say you try a lot of these first line things, you're still having trouble. Sometimes eating some more oats can help and linseeds as well. Yeah. So I would start low with linseeds. So, you know, start with like a teaspoon and then you can build up to a maximum of four tablespoons a day. You also need to drink a lot of fluid while you're

having that. Yeah. So it doesn't cause constipation and make things worse. Peppermint oil as well. So the peppermint oil capsules in particular, there's some evidence that they can help. And for some people, probiotics as well can be helpful. So you can get, you know, individual advice about that from a dietician or, you know,

you can try some of those first line things. So I think it's a case of, you know, just really trying to identify your triggers and see, do any of those little tweaks make a difference? Yeah, absolutely. Okay, next question. Is there any evidence for anti-inflammatory diets and autoimmune diseases? So autoimmune diseases, this is when the body's immune system is taking aim at its own tissues. So inflammation does go hand in hand with these type of conditions. But it's not really clear what the relationship is. So is it that inflammation

causes an autoimmune disease? Or is it that an autoimmune disease leads to inflammation? Or, you know, a bit of both. It's most likely a complex relationship. But there is some sort of relationship there. And including a lot of antioxidants in the diet is advised for our overall health for, you know, reducing the risk of heart disease and just for keeping us healthy. So really including a good amount of these antioxidants in the diet, you know, it's unlikely to do harm and it may be helpful. And there's also in some autoimmune conditions, sometimes low levels of antioxidants are found in the body, such as vitamin E. So it's something, you know, that it can be worth thinking about.

But a lot of the time when this is put across, it's put across as, you know, kind of a miracle cure or like a quick fix kind of thing. And, you know, it's not that. It's basically having a healthy diet that includes lots of fruit and veg that will also then include antioxidants and healthy fats and that kind of thing you know that's going to be helpful for overall health which then might be beneficial with some of these conditions but it's by no means a quick fix or anything like that. Yeah and just on the topic of antioxidants can you explain

kind of what they are because some people might not be fully aware. And I think sometimes that word's thrown around a little bit. Yes. So antioxidants, they are these natural chemicals found in certain foods. So particularly in fruit and veg, especially in like dark berries and in green leafy veg. So in the more sort of colorful fruit and veg, the different colors can kind of be related to some of the different antioxidants they contain yeah and you might hear polyphenols as well they're kind of used interchangeably and they're not quite the same but it's used to describe these substances that mop up harmful chemicals in the body and some of the most common

ones would be like vitamin e or selenium these These kind of things are spoken about a lot. Vitamin C would be another one too. So if you think about it, having a varied diet that has lots of different plants in it, you're going to be getting a variety of these different, you know, vitamin C, vitamin E,

and a lot of these different polyphenols as well. Yeah. So then you're getting the benefits of the different vitamins and minerals that the foods contain, but also you're getting the benefits of the different vitamins and minerals that the foods contain, but also you're getting the sort of bonus of these antioxidants that might help to mop up some of the harmful substances in the body, which then might have an extra benefit for our health. Yeah, and that's essentially what we mean by an anti-inflammatory diet.

And I think some people call it the Mediterranean diet again. So colorful fruits and vegetables, oily fats from like nuts and seeds and fish, small amount of protein, some dairy in there, but essentially just having those principles, which isn't really a diet per se. It's just more of kind of keep these small principles under your belt and focus your diet around that. But I think one thing that we could touch on here is the link between gluten-free diets and autoimmune diseases. Now, celiac disease is an autoimmune disease. So essentially, the body sees gluten, which is a protein that you get in like breads and wheat-based products. And essentially, the body sees that as something that's harmful and it creates antibodies towards that. So it almost kicks off its immune system

when someone eats gluten. Now, this happens in people who have celiac disease, not in all of us. So gluten isn't harmful for the majority of people. I just want to make that point clear. But then there's some evidence to say that gluten-free diets can be helpful in people with other autoimmune diseases. And a lot of people ask me this question and it'd be good to discuss it with you. So my understanding is that the reason that people who have other autoimmune diseases find gluten-free diets beneficial is because they also have celiac disease. And this is quite common in that if you have one autoimmune diseases find gluten-free diets beneficial is because they also have celiac disease. And this is quite common in that if you have one autoimmune disease, you're also at risk of other autoimmune diseases. So it's not essentially removing gluten just for the hell

of it. It's if you have an autoimmune disease, you can go and be tested for celiac disease and therefore a gluten-free diet might be beneficial. Yes, that's exactly what the case is. And it's actually really important that say if you do have an autoimmune disease, so if you have hypothyroidism or something, that you don't just automatically go on a gluten-free diet because then if you do want to get tested, you won't get an accurate result. So you need to have that gluten in your diet for six weeks, the equivalent of about two slices of bread for that test to come back accurate. And it's really important to actually get that diagnosis because then you know your decision making is so different if you know that actually I have celiac disease and there's some serious risks associated with

that if I eat some gluten or whether it's oh I'm not really sure I might feel a little bit better if I avoid it you know that's a really different decision that you're making. Yeah that's a really good point and I'm sure lots of people who have celiac disease who are listening will agree that it's actually quite an expensive diet. It can be quite tricky in terms of when you're eating out. So there's a lot of things to consider before you just decide to take the leap and cut it out for the hell of it. Okay, next question. Another biggie. Is sugar really that bad for me so sugar has definitely been vilified a lot recently as I'm sure everybody listening will realize so first of all sugar is the main fuel for our body if you think that in a car it needs to run on fuel or electricity or whatever

type of car it is for us that, that fuel is carbohydrate. So it's really, really important for our health. And in fact, our brain, for example, uses five grams of glucose, so a simple sugar every hour. So this is a really important nutrient for us. It's not a case that sugar is bad. We need to avoid sugar, anything like that. So then there are different types of sugar to think about. We have sugar which is found naturally in fruit, in starchy vegetables, in dairy, in grains. And in fruit and veg in particular, this type of sugar is bound up within the cell with other nutrients, so like with fiber and that kind of thing. So that's why it's very different if we had a tablespoon of sugar compared to eating an apple or something. It's going to hit the bloodstream so much more

slowly because of the fiber that's in there and because of the way it's bound up within the cell. That's why it's not called a free sugar when it's found within a fruit or a veg. But if it's like table sugar or if it's in a sugary drink or in a cake or something, then that's a free sugar. And it's those free sugars that we need to reduce our intake of. So our recommended limit of those per day for an adult is about seven teaspoons per day. And in some of the studies that have looked at the intake of sugar in the UK and Ireland, we can be almost double this. And in some of the studies that have looked at the intake of sugar in the UK and Ireland,

you know, we can be almost double this. So we do need to think about our free sugars and reducing the free sugars. And just important to mention on that, like honey and syrups and that kind of thing, they are free sugars as well, as are the sugars that's found in fruit juice. So we don't need to avoid fruit juice, but just limit it to that 150 mils per day. Yeah. And one of the other things that's important to say is also things like coconut sugar and those kind of healthier sugars like date syrup or whatever they're marketed as, they count as free sugars also. And there's nothing about them that makes them healthier than like normal table sugar. Some of them have like a marginal amount of

extra minerals and things, but like you'd want to be eating buckets of that sugar to get the benefits. So it's not going to make a difference. Yeah. So when it comes to even like the refined sugar-free, that's not exactly a term, is it? No. And it's something that I've been hearing more often, but you know, the actual term is we have free sugars and then we have the natural sugars as I was saying that are bound within fruit basically the non-free sugars so we have the free sugars and the non-free sugars and that's it this other term this you know refined sugar free term is just really confusing because it's putting it on a bit of a health pedestal that it doesn't deserve

yeah so keep with those simple terminology. Just try to limit your amount of free sugars, but also don't get too stressed. Don't feel like you need to spend a lot of money on these fancy other sugars. Yes. But if you enjoy them, then include them. Okay. So next question, which is going to be quite a controversial one. Dairy and the China study. Are humans meant to drink milk? So yes, this one is controversial. So first of all, when I'm talking about dairy here, it's in the context of health. So there are very valid arguments when it comes to reducing our dairy intake in terms of the environment and for ethical reasons. But I think for somebody to make an informed choice about that, it's important to just be really clear about the facts when it comes to nutrition and health.

So talking about this study in particular, the China study. So this is, it was popularized really by this book that was released in 2005. So it was written by a professor of nutritional biochemistry and his son, and it was related to Chinese villages and they were looking at these villages and they reported that those who consumed the least amount of animal protein had lower cancer rates and you know a lot of it was related to dairy so then it recommended a vegan diet and it also incorporated studies again a lot of them that were done in rats related to milk intake so casein so a type of protein that we get in milk and cancer risk in rats again so not in humans. So there's a few things that we really need to bear in mind with this study I mean there are some

messages from it that are fine so encouraging more plant-based foods you know we know that is really good for our health but this goes a bit too far in saying that you know we should all follow a vegan diet for health it's just not the case and in terms of the study itself it's observational so it's looking at a group of people so that can't tell us the cause and effect relationship so it can't tell us that you know milk is directly associated with cancer risk. It can tell us there's possibly an association there. So that's the first point to mention. And then there's other factors that the study didn't take into account.

So these differences could have been related to things like the financial status of the people in the different groups, pollution that was there, other dietary factors. So, you know, nutritional studies are really complicated was there, other dietary factors. So, you know, nutritional studies are really complicated because there's so many factors to take into account. And importantly, there's now evidence that consuming dairy might actually reduce the risk of certain types of cancer. So there was a meta-analysis from 2016, which found that there was quite a strong link between dairy consumption and a potential lower risk of bowel cancer for example. So we don't quite have enough evidence to say that we have to consume dairy to reduce the risk of cancer but it's just showing that there isn't evidence to say

that dairy causes cancer certainly not and there's a potential link there that it may reduce the risk of cancer but we do need more research. Yeah okay I think that was a good roundup and in terms of the like unnatural to consume dairy argument and that like we're the only animals that drink another animal's milk what's your response to that? So again if we're talking about this from a health point of view I think that's quite a weak argument because we're the only species that do a lot of things. I mean, we're the only species that would make a smoothie, I don't know, make some hummus, cook our food. You know, there's lots of things that only we do. So I don't think that's a particularly strong argument. I mean, we're a complex species. We've had an agricultural revolution. You know, we've evolved over time.

As I said, if it's from an ethical or environmental point of view, that's a different thing. But from a health point of view, it's really about what does the study say and what is the nutritional composition? And dairy is a really complete food. It's one of the most complete food groups that we have. If we're talking about, you know, contains all the essential amino acids. It's a great source of calcium. it's our main source of iodine yeah it's you know phosphorus in there it's a really nutritious food so yeah if you can consume it and you know you don't have any issues with regards to kind of like ethical reasons for not or religious or whatever it may be

that you don't want to consume it then that's fine but if you have no issues consuming it then it's actually such a good food to have in your diet okay cool now next question we are literally getting all of the big questions today what's the deal with celery juice i'm so sick of seeing celery juice everywhere okay so let's take it back to basics celery juice so the juice of a celery is nutritious you know it's going to provide you with fluid with a range of vitamins minerals and some antioxidants like we were discussing earlier for example it's a good source of vitamin c vitamin a folate potassium it. It has some nutritional benefits. But there's no studies that have actually looked at the effect of humans consuming celery juice and what impact that has

on our health, which people might be surprised to hear considering how strongly it's pushed as this panacea. Yeah. And I think the reason why people probably feel like there must be a lot of evidence for it is because of the magnitude of the claims that are made. Like celery juice can cure everything. And there's some really big influencers pushing it, drinking it every day. And I don't feel like they fully understand the impact that that has on some people. And it's like with any of the juicing diets actually, so many people might find that they see improvement in symptoms for whatever condition they may have because

they've started including a juice or they're going on a detox or whatever. But to say that that's down to celery juice is just, you cannot make those claims, you know, maybe you've changed the medication you're on. There are so many variables that we can't just put it down to celery juice and I think you've hit the nail on the head we have no evidence to say that it's to do with celery if you just think about it logically do we really think that celery juice is curing all of these conditions no I mean you know people will be making a fortune if that was the case it would be you know there'd be celery medication there'd be you know I think people would really like this to be true and I can see why people are drawn to this but unfortunately there just isn't evidence to show that and

actually it can be a really dangerous message because as you're saying there's been some huge claims and if somebody thinks okay I'm going to try some celery juice instead of taking medication for this condition that could have lethal consequences so although it can seem like you know kind of a silly funny thing sometimes it has this really dark side to it as well that you know that's where I suppose you know influencers just have to be extra careful that they are being responsible in their messages. Yeah so that's the thing if you want to have celery in your diet and you're absolutely dead set on having a juice in the morning, absolutely go for it. But when people choose to forego important medical treatment for celery juice in the belief that it's going to be superior to that, that is something that's very dangerous. And with regards to the people who promote this, some people may have

valid reasons for doing so. But in terms of the likes of the medical medium, just be aware that he is not actually a doctor. So I'm not going to make any comments. I don't want this to be a podcast where we bash other people. But yeah, his claims are unfounded. We'll leave it there. Leave it there and move back on. Okay, so on to another kind of food which is often put on a pedestal is coconut oil. And the question is, is it good or is it bad for you? So this is one that's been around for a while

and it seems to just keep coming back around. We have our different types of fats. So we have our unsaturated fats and our saturated fats. Consuming more unsaturated fats in the diet is associated with better heart health and better overall health. So the unsaturated fats would be things like found in olive oil and rapeseed oil and in oily fish and in avocados and in nuts, that kind of thing. Whereas the saturated fat, consuming more saturated fat in the diet is associated with a higher risk of heart disease. And saturated fat is found in foods like butter, in lard, in the visible fat that you would see on meat and that kind of thing.

Where coconut oil sits within these different types of fats is within the saturated fat group. And people are often surprised to learn that it contains 82% saturated fat. Whereas if we compare that to say butter, which is 52%, or lard, which is 39%. So it's much higher. It's a really, really high source of saturated fat. So it's not something that we need to add to the diet to add extra benefits. And again, as with anything, if you enjoy coconut oil, you like the taste of it, you know, it's perfectly fine to include that within a balanced diet. It's just it doesn't

have extra health benefits from adding it into the diet. No, it's good for removing eye makeup. That's true. It's a nice moisturizer. Yeah. And also, and also again like you said like if you enjoy using it so cooking with it and things like that like it is quite nice in curries for example then that's fine but adding it on top of your diet just for the perceived health benefits it's probably not a good idea especially if you are someone who is susceptible to heart problems or having raised cholesterol because we know that saturated fat is associated with poor heart health outcomes and just on that note for a while there and actually even now there's still a trend to create bulletproof coffee by stirring in coconut oil and sometimes butter into your coffee. And I get

into quite deep arguments with people over this. What are your views in terms of its benefits of giving people energy? I mean, unless you're desperately trying to gain weight, I don't see the benefit of this. I mean, a cup of bulletproof coffee can have about 500 calories in it. You know, in some cases, people are like replacing their breakfast with this. So it's not a balanced breakfast. And it's just really high in saturated fat. And most of us already consume too much saturated fat. So it's definitely not the case that we would need to add this in. And I think some of the arguments around this come from saying, oh, it's MCT fat. And you know, that's why it's beneficial. And it has all these

benefits of mental clarity and this kind of thing but actually so if we're talking about coconut oil first of all the scientists don't all agree on whether it's an mct so a medium chain triglyceride or a lct a long chain triglyceride and that's because the the length of the chains is 12 carbons and it's kind of right on the borderline of which group it fits into. And it's also, it's a solid fat at room temperature rather than a liquid, which also suggests that it's a long chain rather than a medium chain. But either way, I mean, there's no benefit that in a healthy person consuming extra coconut oil or even MCT oil itself,

that you get extra mental clarity from that as I was saying the brain runs off glucose that's its preferred fuel there are certain medical conditions so if a child has epilepsy and they can't tolerate medication or the medication isn't working sometimes the ketogenic diet can work in that case and in that case there might be a benefit from the MCTs but if we're talking healthy population there's really no need for this at all. No and if you want more information on the ketogenic diet which I know lots of people have been asking do check out the website because Maeve has written an article on that for us and I know that I'm going to get lots of questions about that so make sure to read that article first and then ask us any questions if you've got more. Okay, so the next

question is, is there such thing as metabolism boosting foods? Okay, this question comes up all of the time. And I think people either refer to it as metabolism boosting or fat burning foods. Okay. Okay, so let's start off with metabolism. So metabolism is the number of calories we need to fuel all the chemical reactions that are going on in our body. And then we have different components within our metabolism. We have our resting metabolism, so the calories to keep our body going while we're at rest. So to keep the heart beating and our temperature regulated and everything. Then we have our metabolism related to physical activity. So basically burning calories related to physical activity. And then we have the thermic effect of food. So the calories that

are used to digest our food. And that's the smallest part of our metabolism. So we have these three different parts. So there are some stimulants, so like caffeine, chilies, spices, that may slightly increase our heart rate, which then might have a small impact on our metabolism. But when I say small, I mean very, very small. So there was a study that looked at caffeine intake over the course of 12 years, and it compared people who consumed more caffeine and people who consumed less caffeine. And those who consume more, they did have a slightly faster metabolism. But in terms of the weight they lost it was only one pound difference over 12 years oh my god it's ridiculous absolutely insignificant

so those kind of things they make just no difference in real life terms yeah then there's the more dangerous side of it i suppose the supplements, some of the fat burning supplements. So two of the most common and most popular ones would be DNP. So that's the dinotrophenol. And then there's the green tea supplements. And DNP has been associated in the news with cases of comas and deaths. And green tea as well, the green tea supplements associated with liver failure and death so not ideal so i had a look into this and it was first found in the 1930s and they were using it for something else but realized that the people who were taking it were like losing rapid amount

of weight and they realized it was actually ramping up their metabolism because it does a thing where it uncouples your mitochondria so they're kind of like the powerhouses in your cells so you actually your temperature goes up super high and that's really what causes people to go into organ failure and death and so they banned it but then it kind of creeped back onto the market and is used amongst the bodybuilding community and also people with eating disorders but it's come under different names and it's just something to be aware of and I think if you've got your head screwed on you probably wouldn't go looking for it and you probably won't come across it but it's something to bear in mind I think with green tea extract that's really interesting as well

and high high levels of green tea and now you'd want to be drinking tons of the stuff for it to be toxic to your liver but if you're taking it in a concentrated supplement form that's far more difficult to know how much you're taking so again when it comes to supplements they're not the same as foods absolutely not if you can get what you need from your healthy diet then do that first but I think we've covered the fat burning food myth there okay now the next question is it's a bit more of a medical one and quite specific are there any foods which help or worsen hypothyroidism so i suppose this actually kind of ties into the last one a little bit because i suppose our

thyroid is related to our metabolism 100 and a nice little segue there so first of all if somebody is taking certain kinds of medication for an underactive thyroid now of course it's always best to get individualized advice from your doctor dietician pharmacist but there is you know quite standard advice for many of the hypothyroidism medication to basically leave a gap between certain foods and this medication and also to take it ideally 30 to 60 minutes before breakfast is when it seems to work best. But in terms of the foods themselves, the ones to leave a gap between would be with soya, with walnuts, there's iron supplements, calcium supplements, coffee and there's a supplement called chromium picolinoleate. So that's the first thing to sort of think about, but not everybody with an underactive thyroid will be on medication. So then another thing to

bear in mind is these foods that are called goitrogens. So these are foods that can disrupt the production of thyroid hormones. And basically what that does is interfere with the thyroid being able to take up and use iodine and thyroid hormones are actually made of iodine so then that can have a big impact. The types of foods that contain these goitrogens are cabbage, cauliflower, kale, spinach, millet, sweet potato, bok choy and soya. So it's not that you need to avoid these foods but for some people especially if maybe if they're taking their medication and they're still having trouble and you know the doctor is happy with the dose and everything it might be a case of looking

at these so in terms of trying to limit them to maybe three to four times a week and if you cook or steam them it can reduce the goitrogens in there as well so it's for some people they may need to keep an eye on these and maybe limit them to that three or four times a week. But it's only really an issue if you're taking these foods in either high amounts in a concentrated form, again, like the soy supplements, or if your iodine levels are low. So for people who have a good intake of iodine, this tends not to be so much of an issue. So as I was saying, iodine is really important for producing the thyroid hormones and in the UK and Ireland our main sources are in dairy and then also in seafood mainly in white fish. So if you're having for example your dairy foods three times a day to get a good calcium intake and if you were

having seafood twice a week then you know you'd be getting plenty of iodine there. So that would have you covered. For some people say who don't consume dairy or seafood, sometimes iodine supplements can be useful. Again, I would always speak to your doctor just to make sure they're happy because there can be interactions between medications and there's certain ones that would be recommended over other types. You can also get iodine in foods like seaweed. But there is a bit of a caution on that in the UK because you can actually overdo it in terms of iodine with seaweed, and then that can actually be bad for your thyroid too. So you don't want to go overboard. Yeah, absolutely. Cool. Well, that is our kind of all of the questions that we've decided to take on. And I think we've probably overloaded everyone at home.

So you might want to listen to this episode a second time and take notes. But thank you so much for coming on. It was really, really useful. Thank you so much, Hazel. I enjoyed it. If people want to hear more from you, where's the best place to find you?

I have a website, which is called dieteticallyspeaking.com. And I'm on social media at dieteticallyspeaking on Instagram and Facebook and on Twitter I'm at dieteticspeak. Amazing. And like I said, Maeve writes once a month for the website, so make sure to check out her articles because we've covered some big topics already

like the ketogenic diet, dairy, soy, some really interesting things and also PCOS. So it's not all food. Make sure to keep listening for the end of the show for this week's question. Okay, guys, so that was Maeve. I know we packed a lot into that episode, but I'm sure it's going to help a lot of people. Now for this week's question. At the beginning of the podcast I mentioned that every week I'm taking a new listener question that I'm going to tackle on the podcast. So this week it is do I need to take a protein supplement if I'm going to the gym? Okay so in short very few people need a protein supplement and a well-balanced diet is usually enough providing you're getting

enough calories. But saying that protein supplements can be useful for people who may have certain dietary restrictions which limits their protein intake or those who have increased requirements. For example they exercise a lot. Protein supplements are also very convenient and they're relatively cheap proportions so they can be very useful in a diet. You might be thinking, well, how do I know if I'm actually getting enough protein through my diet alone? Well, the reference nutrient intake, also known as RNI, is 0.75 grams per kilogram body weight per day for adults. Now, what does that mean for you? If you're about a 70 kilogram person, 0.7 grams would mean that you need about 52 grams of protein per day.

So a chicken fillet has about 20 to 30 grams of protein in it. So to make things easy, that's about two chicken fillets a day. Or if you don't eat meat at all, it's probably about three portions of beans or pulses a day. This amount will vary depending on your age, whether you have any medical conditions. Also, the amount, type, duration and intensity of exercise you do will alter your protein needs. So if you strength train or you do endurance training, you may require a little bit more protein. Now you absolutely can meet this through protein rich sources alone and that doesn't necessarily mean that you need to have supplements. So focus on food first, getting things in like meat, fish, eggs, dairy or if you don't eat any

animal products, lentils, beans, pulses, whole grains or soy based products. Focus on that first and then if you feel you need to fill in the gaps, then protein supplements can be a really useful way to meet those needs. So guys, that was this week's question. Remember, if you do have a question for me, you can send them in on social media. You can tweet me, you can Instagram DM me, you can send me messages on Facebook. Just make sure to use the hashtag thefoodmedicpodcast. Thanks again for listening, guys. Make sure to use the hashtag thefoodmedicpodcast. Thanks again for listening guys. Make sure to subscribe, leave a five-star rating and a review if you're loving the show. And I'll see you again next time where we hear from Kimberly Wilson, who is a chartered psychologist and also a great

British Bake Off finalist, where we chat about the link between food and mental health.