newsletter

Live Better! • Issue 4

Spring is probably my favourite time of year - I love when the evenings begin to stretch for longer and the fl owers begin to emerge from their winter hibernation... almost like us!

By now, many of your new year’s resolutions may have fallen by the wayside, but don’t worry - we are all prone to overindulging and under exercising during the winter months. The important thing is to leave your guilt behind and to start afresh, full of positive thoughts and goals for summer.

I urge my clients to forget vowing to give things up and, instead, to promise themselves to kick-start some positive and rewarding habits that they are more likely to stick to - such as beginning a new exercise class, signing up for a 10K run or even just experimenting with new fruits and

vegetables (see page 3 for my healthy pasta recipe packed with colourful vegetables!).

This newsletter is full of tips and stories to renew your motivation for spring - turn to page 3 for advice on how to make your lunch healthier and turn to page 4 for even more inspiration to get you walking your way to fi tness this month!

Happy reading!Take care,

Keeping these healthy, low fat snacks close to hand (such as beside the kettle or in the fridge at work or even in the glove compartment of your car) will reduce the chances of you buying higher fat, calorie dense foods that can lead to weight gain. Also, these foods have a low glycemic index so they will keep you full for longer and will stave off hunger pangs as they help to regulate your blood sugar levels.

1 Popcorn

Most newsagents stock air-popped packets which are easy to grab on the go (avoid toffee varieties) or pop your own at home in just a little oil - extremely satisfying yet surprisingly low in calories and fat.

2 Fruit Smoothie

Try low fat yoghurt blended with frozen berries and a banana (throw in some fl axseed for a boost of healthy essential fatty acids!)

3 Dried Apricots

These give a slow release of energy and are high in iron, calcium and beta-carotene.

4 Raw Vegetables

Try sticks of carrot, celery or peppers with hummus, salsa or a yoghurt dip to fi ll a hunger gap healthily!

5 Crackers

Only buy the wholegrain or rye varieties, or melba toast, and spread with a scraping of butter and a thin slice of cheese topped with tomato.

Healthy Eating Guide

( 5 Top Sin-Free Snacks )

Patient Story: Siobhan Moore, 32 years old, Limerick“I fi rst noticed symptoms in March of last year. I read up on them and they seemed to be typical of someone with IBS - bloating, gas, abdominal pain, fatigue, diarrhoea, constipation (alternating bouts of both). “The diarrhoea was awful as it occurred three to four times each day, while there were about two episodes of constipation each week. The bloating was constant, along with a lot of gas and unpleasant abdominal pain and spasms continuously after eating. “The fatigue was a major part of it. Life had become very limited for both me and my six year old son, Sean, in the sense of going anywhere as the diarrhoea and pain had become so bad that, at various times in the day, I would often have to lie down and I would have no energy at all. I had stopped calling to friends’ houses as the symptoms had become so embarrassing. “Depression defi nitely became part

of the problem too as I just didn’t want to leave the house at all at times and I lost my motivation and my get-up-and-go. My son and I usually loved doing things together and he needs to have his life too, so it was getting on top of me. I also lost any interest in socialising because even just having a few bottles of beer would lead to vomiting plus having to spend the next day in bed with abdominal pain, gas and even more severe bouts of diarrhoea. “I felt I couldn’t live my life in this way, and nor could Sean - it wasn’t fair. I felt that life was passing me by and became very withdrawn from my friends. It was unlike me, especially when I was usually known as the person full of life and energy. “The solution fi nally came when I was referred by my consultant gastroenterologist to Elaine after I had my colonoscopy done to receive information on IBS and the diet I needed to follow. To be honest, I never believed in the

Elaine

Elaine McGowanDietetic Clinics

Elaine McGowan Dietetic Clinics www.emgdc.ie

Welcome to Spring/Summer 2010!

usefulness of dietitians before this because I considered my diet to be suffi ciently healthy already but I was prepared to at least listen to what she had to say. “Elaine is fantastic at what she does - she has a very kind and sympathetic manner and is so thorough in her approach. She guided me along with very detailed advice on the best foods for my condition and also the worst foods - the ones to avoid. She also seemed to totally understand how I was feeling; Elaine explained exactly what IBS is and how to control it. “Now my symptoms have disappeared - that is why I say Elaine is a miracle worker! The fatigue is non-existent and, after a year of being unwell,

myself and my son are now enjoying life again. I am feeling great mentally also. “I enjoy the diet and cooking has become so much more enjoyable as I make most things from scratch now, as opposed to out of a jar. I’m actually more experimental in that I’m trying more foods than I would have before and, if I’m going anywhere, I now bring a few snacks with me to prevent symptoms returning. Plenty of water on a daily basis was also recommended by Elaine and that seems to be working. “I would recommend Elaine to anyone because she is very down to earth and understands how diffi cult your life becomes with this condition and reassures you that your life will return to normal

again. And she was right – my life did return to normal. Now I thank Elaine for giving me my life back.”

Patient Story: (cover story continued)

“Now my symtoms have disappeared - that is why I say Elaine is a miracle worker!”

giving me my life back.”

“Now my symtoms have

Facts About... Irritable Bowel Syndrome

Elaine McGowan Dietetic Clinics www.emgdc.ie

Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine (or colon). IBS can cause cramping, abdominal pain, bloating, gas, diarrhoea and constipation. More women than men suffer from IBS. Other symptoms sometimes include: nausea, headaches, belching, poor appetite, tiredness, backache, muscle pains, feeling quickly ‘full’ after eating, heartburn and bladder symptoms. Most people with IBS fi nd that symptoms improve as they learn to control their condition – by managing diet, lifestyle and stress levels. Only a small number of people with IBS have severe signs and symptoms. It is crucial that anyone suffering with any of the above symptoms consult their GP to rule out more serious conditions. A diagnosis of IBS should be made by a professional.

What happens during an episode?The walls of the intestines are lined with layers of muscle that contract and relax in a coordinated rhythm as they move food from your stomach through your intestinal tract to your rectum. If you have irritable bowel syndrome, the contractions may be stronger and last longer than normal. Food is forced through your intestines more quickly, causing gas, bloating and diarrhoea. In some cases, the opposite occurs - food passage slows down, and stools become hard and dry.

What triggers an episode?Many people fi nd that their symptoms worsen when they eat certain foods. For instance, chocolate, milk and alcohol might cause constipation or diarrhoea. Carbonated beverages and some fruits and vegetables may lead to bloating and discomfort in some people with IBS. Also, symptoms seem to be aggravated, or become more frequent during stressful times and, for women, during or around menstrual periods. Any stress reduction techniques, such as meditation or yoga, are useful during a bout of IBS to reduce symptoms, but dietary intervention is crucial.

Elaine’s Advice for IBS Sufferers“I work with my clients to highlight the trigger foods they are consuming. Dietary advice focuses on prevention and management of the clients symptoms. Eliminating or reducing the intake of certain foods is recommended and monitoring to see if symptoms improve. Although IBS does not cause permanent damage to your colon, the symptoms are extremely uncomfortable for people – such as painful bloating or passing a lot of gas – so a change in diet can make a huge difference. Some people have triggers that are quickly identifi ed but some foods are not that obvious, so a consultation is essential in order to discover an individual’s trigger. Patients need to be continually monitored over a period of time, and dietary advice

will be adjusted and tailored to the suit the individual’s symptoms and progress. Although, traditionally, IBS sufferers were advised to eat more fi bre, we now have to be careful about the type and amount of fi bre introduced as it can actually worsen symptoms in some patients. For instance, wheat can aggravate the colon so reducing, not necessarily excluding, wheat in the diet may be recommended.”

Top Tip• During an episode, I always advise my

clients to drink at least eight glasses of fl uid per day, especially water or other non-caffeinated drinks such as herbal teas. Also, restrict tea and coffee during an episode (as caffeine may be a factor in some people).

For more specifi c advice on managing

symptoms, please book a consultation with me at one of my clinics listed on page 4. It is never advisable to follow a restrictive diet (one that eliminates major food groups) without being guided by a dietitian, such as myself, who is a member of the Irish Nutrition and Dietetic Institute (INDI). Some restrictive diets, designed by an individual who does not have professional knowledge of dietetics, can actually lead to vitamin and mineral defi ciencies in the long run.

Elaine’� Recipe of the Month:

Practical Pointers: Lunch

“In the middle of the day, it’s too easy to grab a dull (and often expensive!) sandwich from the local deli or supermarket,” says Elaine. “I advise clients to add a bit more excitement to their lunch by bringing in their own or choosing something with a bit more imagination. Here are some ideas to try.”

Bring your own salad - salads provide the perfect opportunity to show a little imagination. As a base, always use green leafy vegetables such as spinach leaves, rocket or broccoli. Try a feta cheese, hazelnut and olive salad or grilled mackerel with spinach leaves and sun dried tomatoes to boost your intake of essential fatty acids (EFAs).

Make sandwiches with wholemeal bread - this type of bread is higher in fi bre and provides a source of selenium and iron (try a wholemeal wrap with smoked salmon and a sweet chilli sauce for something different). Always garnish your sandwiches with extra salad to liven them up.

Try new sandwich fi llers - go for a thin spreading of hummus with olives and watercress; red kidney beans mixed with tuna and fromage frais; or a blend of avocado, spinach and smoked salmon (put into a good blender and pulse it down to a smooth paste – add pumpkins for an extra kick of selenium).

Try baked potatoes - these are great if you’re feeling particularly hungry (have with tuna, sweetcorn and fromage frais or with simple baked beans for a quick meal with an iron boost).

See the next issue of the Newsletter for my practical pointers on dinners!

Quick ‘n Easy Wholemeal PastaThis recipe is so easy to make and is full of essential vitamins and minerals, including superfoods peppers, garlic and broccoli (see above). Each portion provides just 385 Kcals and only 7g fat.

Ingredients (serves 4):225g/8oz wholemeal pasta (any shape or variety you prefer)1 tbsp virgin olive oil1 onion, fi nely chopped1 garlic clove, fi nely chopped2 x 400g tins chopped tomatoes1 red pepper, deseeded and chopped300g/12oz broccoli, chopped 400g tin kidney beans, drained and rinsed8 pitted black olives, sliced2 tsp fresh basil, shredded (or half a tsp dried basil)2 rounded tbsp reduced fat cheddar cheese, grated

Method1. Boil pasta until tender (‘al dente’). Meanwhile, heat oil in large

pan and add the onion. Cook on medium heat until softened.

2. Add garlic and cook for 1 minute.

3. Add tomatoes, red pepper, broccoli and kidney beans. Bring to the boil and then cover and simmer for about 10-12 minutes.

4. Prior to serving, stir in the olives and basil.

Serving: Place the vegetable mix on top of your cooked pasta and top it with grated cheese.

Elaine McGowan Dietetic Clinics www.emgdc.ie

of the Month:Try

something different!

uperfoods Part 2

What are ‘Phytochemicals’?Phytochemicals are plant chemicals that have protective properties. Plants, such as vegetables, produce these chemicals to protect themselves, but recent research also demonstrates that these plant chemicals can protect humans against diseases. Some of the well known phytochemicals are lycopene in tomatoes, isofl avones in soy and fl avanoids in fruits.

In the last issue of our newsletter, I gave you fi ve top superfoods to include in your diet – namely, tomatoes, spinach, mangoes, Brazil nuts and salmon. Here are the next fi ve top superfoods to include in your supermarket shopping this week – see my next newsletter for a further fi ve!

Red and orange peppers - peppers are an excellent source of vitamin C (just half a red pepper provides you with all the vitamin C you need in one day) in addition to providing useful sources of fl avanoids and beta-carotene (see my recipe using peppers on this page!)

Garlic - full of pungent, active phytochemicals called allylic sulphides which act as powerful antioxidants which may help to ward off cell damage in the body.

Broccoli - this cruciferous vegetable is known for its sulphoraphane content, a phytochemical which helps to prevent free radical damage, as well as its folic acid and vitamin C content.

Onions - onions contain allium compounds and a phytochemical known as quercetin (especially high in red onions), both of which are strong antioxidants capable of fi ghting cell damage within the body.

Sunfl ower seeds - these seeds are particularly rich in the powerful antioxidant vitamin E and also provide healthy essential fatty acids.

What are antioxidants? - they are substances or nutrients in our foods which can prevent or slow the oxidative damage to our body.

Walking for LifeRemember that the greatest benefi ts of walking come with time - soon you will be fi tter and healthier than you have been in years. To help keep you motivated, you could keep a diary which logs the dates and distances of your walks, or the scenery that you took in during your walk. Some people enjoy the extra kick of motivation that a pedometer gives them. Research shows that any tools to help boost motivation, such as the pedometer, can increase the likelihood of sticking to an exercise programme. That’s why I recommend some of my clients to buy and use a pedometer on a regular basis. It is a continual reminder of how

well you are doing and how many steps you have to build up to each week to reach your own, personal target. For good health it is recommended that we take 10,000 steps each day, however many of us are currently well below that level - it is common for many of my clients to be taking only 3,000 steps a day before they come to see me for their pedometer. Then, within just a few weeks, they are motivated when they see how easy it is to build up to the 10,000 steps. Contact the Irish Heart Foundation (Tel: 01 668 5001) or your local sports shop to purchase a pedometer and to go about recording your results.

© Elaine McGowan Dietetic Clinics 2010

Elaine McGowan Dietetic Clinics

Dublin NorthThe Hermitage Medical ClinicSuite 21Old Lucan RoadDublin 20

Tel: 01 645 9617

Dublin SouthThe Park ClinicThe ParkCabinteelyDublin 18

Tel: 01 285 3666

LimerickBarrington’s HospitalGeorge’s QuayLimerick

Tel: 061 490 547

EnnisCahercalla Community HospitalCahercallaEnnisCo Clare

Tel: 065 682 2322

to consult with Elaine, please fi nd your nearest clinic location from list below or visit www.emgdc.ie

Supported by Roundwood and District Community Council, Dublin City Council, Coillte and Wicklow County Council

If you’ve followed my advice in the last issue of the Newsletter, then hopefully you should be now walking for 30 minutes three to four times a week (in fact, the Irish Heart Foundation recommends a minimum of 30 minutes 5 days a week so try to aim for that level). You should also be increasing your endurance by introducing interval training (picking up your pace for fi ve minutes and slowing down, then picking up again etc.,). If you have followed my plan, the chances are that you have lost a few excess pounds, you have increased your aerobic fi tness, you have toned up and you feel better in yourself overall (walking also has many psychological benefi ts!). This month I’d like you to go that extra bit by working on your walking style while picking up the speed once more (remember that you should still be able to hold a conversation though!). Here are some tips to focus on:

1. Be aware of your posture - walk tall, look forward (not at the ground) and keep your chin and shoulders level and your head up.

Focus into the horizon, not downward. Keep your chest raised and your shoulders relaxed (down, back and relaxed). Imagine a string tied to the top of your head, pulling it gently upwards.2. Swing your arms - fi rst, bend your arms to almost a 90 degree angle. Next, cup your hands gently and swing arms front to back (not side to side). Do not swing elbows higher than your sternum (breast bone). Swing your arms faster and your feet will follow.3. Tighten your muscles - specifi cally, your abdominal (stomach) and gluteal (buttock) muscles. Flatten your back and tilt your pelvis slightly forward.4. Focus on your feet - land on your heel, roll through the step and push off with your toes. Use the natural spring of your calf muscles to propel you forwards.5. Breathe naturally - take deep, rhythmic breaths to get the maximum amount of oxygen through your system. Walk fast enough that your breathing is increased yet you are not out of breath.

Route of the Month: Ballinastoe Slí na Sláinte(in Roundwood, Wicklow) Located just over 5km from Roundwood village, the Ballinastoe Slí na Sláinte is a 5km looped route. From the car park and picnic area, the route continues uphill along forestry tracks. The forest consists mainly of mixed conifers on the slopes of Djouce Mountain and provides a habitat for fox, badger, red squirrel and sika deer. Many species of birds, including grouse can also be seen. The clear-felled areas have opened up stunning views of the Sugarloaf Mountain to the north and the Vartry valley and reservoir to the south.

Walking: Part III (Improve Your Style!)