2023!

Well what is this year going to bring to the table?

Another year begins!

For myself and my patients I wish for a healthy and happy 2023. I am so aware of the problems caused directly and indirectly by Covid 19 and I am still inundated with queries regarding loss of taste and smell, upset stomachs and bowels, and various mental health and emotional issues.

For many a lack of exercise, boredom, fear of going out and the consequent inactivity, even from normal every day going to the shops activities, has meant weight gain and loss of confidence. Do not simply put up with this. get back on that horse, remember the joy mixing with others brings, isolation is a killer and can easily creep up on us, especially during the winter months.

If you need some confidence boosting, some current topical advice, if you want peace of mind around your diet, if you know your gut is not at its best and are just living with mild symptoms, or worse…. Get in touch for a dietary review that will put a spring back in your step.

We at Diet Scotland have years of experience of the link between our gut health and our psychological health. A few specific changes can make a huge difference to your mood and physical well being.

For those who struggle with Eating Disorders of any type the role of your gut biome is key to helping nutrient absorption and can be a helpful non threatening approach to initiate recovery.

Call us now and make an appointment, it may be the best thing you do in 2023!

Heartburn! The on line shopping for food in a pandemic disease!

I know I am not the most prolific blogger, writer or whatever, but my New Years resolution was to pay attention to my web-chat and share my knowledge and experience with anyone who chooses to seek my site out.

I hope to get better at this, I also hope to get better at making anything I write look more attractive, but for now I am limited by my lack of IT savvy, please bear with me.

So, why heartburn you might ask? Why on line food shopping?

Well apart from my experience as a Dietitian dealing with gastritis, heartburn, GORD, or GERD if you are American ( they spell oesophageal esophageal), I had my own awful bout of the worst heartburn EVER, just a few days ago. Here is the sorry tale.

Times are strange just now, living in a pandemic has impinged on all of our freedoms, necessarily. I am one of those sad folk who actually enjoys going to my supermarket, butchers, baker and candlestick maker and I have made a step change in that process and have my victuals…vittels delivered. I didn’t think too deeply about what ordering on line might change as regards my food choices but, for sure my choices actually have been hugely affected.

The heartburn story begins as I choose my butchers order.
Free range eggs, some Belfast smoked bacon, a Popeseye steak ( I’ll share with my husband, he would rather I bought 2 but they are huge and he is greedy),

A free range chicken, some potato scones. Some lean beef mince, some turkey mince to mix with it for my weekly spaghetti Bolognese.

Normally that is my order for two weeks or possibly three, we are not huge meat eaters. However, on line as I look in the Beef section I see our local Butchers award winning steak pies. Now, pies in our house are a rare treat, I may be a Dietitian, of more years duration than I can believe, but I am human and I love a pie and beans with green chilli like any other Hooman !

I also note that they are bigger and much more expensive than your average pie. Does that stop me? No. Two of your award winning pies please Mr Butcher, I deserve a treat, after all it’s a pandemic. Purchased!
Due to my natural curiosity I stroll through the rest of the site, the lamb section, no, can’t eat a woolly lamb lamb, pork section, mmmm, those pork Lorne sausages with onion sound interesting. I do hesitate, as I rarely buy sausages. But, I think, butchers sausages, 97% pork, not your cheap fatty sausages, sold 1/2 kilo of your finest 97% pork sausages please. I stroll on through to sundries. There I buy the butchers locally sourced award winning black pudding, 4 slices please! Oh, I’ll have that wee pot of peppercorn sauce, some potato scones, (unaware I had already purchased these in the bacon and sausage page) a Chinese curry powder and finally a wee bit of liver for my Maine Coon George Cooney, he likes a bit of liver cooked in milk no less.

Dear reader, this not only cost me an arm and leg, it bears no resemblance to my normal meat and poultry order. I am supposed to know better. I work with psychologists, psychiatrists, therapists, GP’s doctors from various specialities. I do know the allure of on line shopping. But, I feel I did not have my guard up at all. After all its Butcher-meat, not Dolce and Gabbana,

So, as I said, the pies were “award winning”, I was caught up in the rarity of the occasion and looked forward to my steak pie and beans with green chilliest in.

To say they were good would be an understatement. My pie was crispy, piping hot, full of lean delicious beef and gravy to die for. No comparison to your average pie. Magic!

I spend my life telling people to be mindful when eating, to stop when you begin to feel full, to be aware of portion control, to slow down the eating process etc etc.

The pie was huge for me. I would NEVER normally have finished it. But, it was the butchers award winning steak pie, it cost me more than two chicken breasts, I will finish this pie. I did!

Never again.

At first it was a feeling of being stuffed, a feeling I hate, I rarely go there. Then about 2 hours later I felt gassy, burpy and bloated. I felt that my digestive system had stopped.

Four hours passed and my eyes were watering with the pain of reflux. I still felt bloated, I drank water and though I felt thirsty, I had no capacity.

I knew exactly what was going on. Why did I lose all inhibitions over a pie?

I ate too much.

The high fat (though delicious) pastry was a huge fat overload compared to my normal diet. Fat takes ages to leave the stomach, it’s presence increases acid production, the perfect storm.

At least I know my demon in this case. My heart goes out to those individuals who regularly have reflux or worse.

I will never have a combination of high fat and overly large portion of anything again. Learned the hard way and totally own it, should have known better, well did know better, but chose to park my knowledge using the pandemic as an overarching excuse.

The key fact here is my behaviour around food changed, albeit temporarily. Online presentation meant I saw more than I would normally think of looking for if I was standing in the butchers. The presentation appealed. The Award Winning tag worked. The high cost, in my head screamed quality for a product rarely purchased and normally considered a low quality item ( common pies of commercial ilk).

I ignored my observation that it was too large a portion for me. I pushed beyond my capacity, Why? I think a combination of flavour, it was special, cost, I am not wasting it, and, this background pandemic excuse for everything that allows us to self indulge despite all of our inner alarms screaming STOP!

So, to end, I hope this saves some souls from themselves. Lesson learned in the McCreary household!

I will do a short check list following this for those who suffer from reflux and don’ want to read this blurb!

Stay safe!

Seasonal Affective Disorder SAD

Anyone who knows me will know that I start the day as I enter my NHS office with a remark about the weather. If its sunny my comments are light and bright and positive, if its dark and gloomy, wet, windy, snowy, sleety, rainy, misty, or any other descriptive word you can use for typical Scottish weather, I'm peeved, annoyed and fairly negative.

For me this does not last all day and does not severely affect my day to day living, I just need to moan to get it out of my system. However for some, this is an Autumn - Winter into spring ordeal, affecting enjoyment of life and living.

Approximately 1 in 16 Brits suffer from this disorder a form of depression triggered by lack of sunlight. Feeling down, lack of energy, listless, poor concentration, easy to irritate and  anger. Increased desire to sleep yet less quality of sleep, and for me as a dietitian I observe in many, a change in behaviour around food. Cravings, mindless eating, seeking out comfort from food and often employing covert behaviour to satiate those cravings as if all control around food has ceased.

It would be simplistic of me to say there is an answer to this and like magic there are foods you can eat that will lift your mood and make you happy. However, part of this picture is that feeling of loss of control and lack of insight as to why!  

 In fact there is a contributing external factor affecting our mood, and that factor involves a chemical/biological process driven by sunlight that allows humans to produce not only Vitamin D but also important 'feel good' neurotransmitters.  Understanding this means we can look to see if there are any other ways of up-regulating our production of these transmitters.  In a previous blog I have looked at foods that help promote serotonin and foods that block its production, but just to recap:

Low serotonin levels result in low mood, poor sleep, lethargy and a feeling of disconnection or lack of involvement with those around you. Foods that help boost serotonin levels are: fish, fruit, eggs, avocado, wheat germ, cheese and lean poultry.

Alcohol is a depressant and unhelpful.

Dopamine is another neurotransmitter and lack of its production leaves you lacking drive and motivation....your get up and go, got up and went!  Importantly low dopamine increases cravings and can be behind weight gain.

Steer clear of caffeine in all its forms.

Eating an abundance of fast acting carbohydrates, sweeties, cakes, biscuits, stodgy potato based meals, large carbohydrate portions  and sugary drinks , may give you a short term feeling of satisfaction but the effect post consumption is one of lethargy, tiredness and that confirmation that once again you have lost control. This behaviour can be mood driven and you may often be unaware of what drives your food choices  especially in winter months.

Being aware is half the battle. Knowing what foods would be better for your health, weight and mood is the other half. Lean meats, poultry, eggs, dairy and fish (especially oily) whole-grains in small portions. Many cereals are reinforced with vitamin D most people in the northern hemisphere (Scotland) will benefit from a vitamin D supplement (10mcgs) in our winter months and those who are elderly or housebound should have this prescribed by a GP and dosed as their individual requirements indicate. Vital for the skeleton and important for many other biochemical and neurological functions Low vitamin D levels are prevalent in Scotland in the winter months.

There are other changes that you can make in the winter months to help boost your mood.

Keep your environment light and bright, dull gloomy rooms are not conducive to a good mood.

Get outside. Psychologically, natural light even in the winter is important.

Social interaction. Less time to think of your self. Expanding your social circle can reap life long rewards.

Exercise. Being sedentary can lead to insular thinking and reinforces low self esteem. The less you move the less you want to move.  Inactivity drains confidence..

Most importantly. There is a huge difference between SAD syndrome and true depression. If you recognise the scenarios above and know that they are transient that is one thing, if you are suffering in silence, whether in winter or summer and cannot shift your low mood, seek help.

There is nothing to lose in getting checked out, don't put up with something that can be helped by medicine, therapy or small changes in behaviour.

Thinking about Dietetics!

It's that time of year again when you have done all of the background work and are preparing for college access to get the qualifications you need to then go on to university to study Nutrition and Dietetics. This route to the career was my route .....back in the day, a way to change my life and create a stable future for me my husband and our young family and do the very thing that held my interest.

Many undergraduates enter university straight from school and that's great that you leave school focussed and knowing what you want to do, your degree of choice is actually a key to one of the most malleable career pathways available.

Whatever your route to university, Dietetics and nutrition related careers are numerous. While at university you will study a wide array of subjects from anatomy and bio-sciences to sociology and psychology. Many dietitians will be targeting careers in the NHS. This was my route. This was my clinical grounding without which I could not have branched into any of the other pathways that  I tread on a daily basis.

Of course this is not the only way to form a career in dietetics. Some students decide that the acute medical side of the discipline is not appealing, some will diversify to other areas like research, higher education, journalism and the commercial world of business there are multiple career opportunities.

If you are making up your mind, or unsure check out The British Dietetic associations website and have a brows.

For those of you who are sure, good luck, enjoy university give 100% and you will get it back magnified.

For those who are already heavily committed with young families who are hesitant to take the leap, all I can say is I did it, aged 34 with a 7 and 3-year-old. I met the best people who support me still, I made life long friendships and I love what I do both in the NHS and within the private sector.

Carpe Diem!

Simon Sinek lecture. Looking at Neurotransmitters and our behaviour.

What motivates us and why?

(Taken from Leaders Eat Last by Simon Sinek)

Endorphins.

The primary role of endorphins is to mask pain. Endorphins are released under physical stress/effort. They give the runners high. They allow humans to push levels of endurance beyond the pain barrier. They give us that edge to keep going beyond exhaustion, beyond fear, beyond pain. Its production is what motivated cave men to go back out and face death when hunting, the soldier to risk all for his brother soldiers. Without endorphines we would not stretch boundaries or push beyond comfort zones. They are part of the reason you feel what you feel when you know you have done a job above and beyond others expectations. They give you a boost. Together with Dopamine....

Dopamine

Feel good factor. Finish a task, achieve a goal, win a game, tick off a check list. Dopamine helps us have staying power. It gives us incentive to carry on to complete monumental tasks, solve problems; it gives us a competitive streak. When we are trying to lose weight the production of dopamine can keep us on target. Creating goals that are achievable, giving and receiving recognition of a job well done, we all seek that feeling of approval, peer recognition of achievement. Driven people are hooked on the production of dopamine.

Unfortunately there are artificial stimulators of dopamine production. Alcohol, and drugs, most addictions come down to dopamine addiction.

Social media, texting, awaiting emails or responses, number of likes on face book all of the above stimulate dopamine production.

DOPAMINE IS ADDICTIVE BECAUSE IT REINFORCES BEHAVIOUR LINKED TO SOMETHING THAT WAS IMPORTANT TO OUR BIOLOGICAL GROWTH. Sedentary lifestyle (physical and psychological) will lead to low production of dopamine. There is no biological incentive to do nothing!

Dopamine creates  incentive and is what we need to get things done.

Endorphins and Dopamine are essential for human survival. But, we need other incentives to be social and to work collaboratively with others, another key to the success of our species.

These are social chemicals, without which we would not form groups or emotional attachments to others, or be able to be cooperative with others.

Without these social chemicals we cannot trust, we have no team spirit, stress increases we isolate ourselves and leadership qualities cannot grow. We have no motivation or desire to help others.

Serotonin

Serotonin gives us the feeling of pride, that feel good factor, when we appreciate that someone else likes us, we crave that approval from the tribe because it makes us feel good and is essential for our well being.

Serotonin is what we feel when we graduate.

People who produce a lot of serotonin due to bonding and interaction from others do not crave the effect of dopamine (the feel good chemical from alcohol, drugs and addictive behaviour).

It is why a live performance is always better than a streamed production on screen, why a letter is better than an email, why a phone call is better than a text.

How would you feel if after a job well done your boss sent an email saying well done? You would think ok, that’s good.

If your boss came to speak directly to you or called you how would you feel? Wow!! That’s serotonin. It bonds us to others. Allows us to work for and with others it’s why we want to impress our bosses, family peers. It binds the family together when we selflessly want to make another happy for no other reason at all.

Serotonin is a prerequisite for leadership. They help create a culture of trust and security where in adverse conditions individuals will work together selflessly to achieve a goal, just for that end point.

Endorphins and dopamine would not induce this response.

Oxytocin

The chemical of love. It’s what we feel when we relax in the company of trusted friends, safe secure and relaxed. It is produced when someone does something nice for or to us and also when we do something nice for or to someone else.

Essential for survival. Without it there would be no acts of generosity, benevolence, kindness, empathy no bonds of friendship or trust. We would not form social groups or bond with family.

Oxytocin makes us social.

Dopamine gives us instant short term gratification, oxytocin is long lasting.

Oxytocin makes us need social interaction. It reduces stress, makes us feel good and helps us accomplish more as a team in that environment.

It bonds mothers to babies.

Cortisol

Anxiety and stress.

Essential for our survival it helps us recognise immediate danger. The feeling that something is wrong is down to cortisol, without which we would not recognise danger until it was upon us.

Cortisol is meant to peak and ebb within 24 hour phases. It rises in the presence of danger and should fall.

However in the modern work place it can be responsible for feelings of anxiety and stress.

As humans we try to understand why we feel anxiety and stress, and release of cortisol in stressful situations at work maintain your body in that high alert phase (which in cave man times was needed for the stamina to fight or flee).

A cortisol induced state of anxiety causes other systems to reduce efficacy. Our immune system being one. If sustained or if you are in an unhelpful unfriendly environment where cortisol levels will be inducing anxiety almost constantly your risk of developing disease states like Diabetes, high blood pressure or heart disease is increased.

Cortisol stops sleep. Stops you being able to relax.

If you are in environments at home or at work where you are anxious and stressed your cortisol levels will be high, this reduces your ability to trust, increases paranoia, reduces levels of serotonin and oxytocine and makes you feel less secure, less loved and less likely to work collaboratively or feel empathy for others.

Taken from the book and presentation by Simon Sinek. July 2016

Some thoughts!

The following has been taken from extracts of a book called The defining Decade by Dr Meg Jay.

There was so much in a small extract that made me think " yes" "That's so true" that I had to have a wee bit of exposure here. The book is aimed at people in their 20's, having a daughter in her 20's I was drawn, but actually, the jist is relevant to most, and important to many..

THE TYRANNY OF 'THE SHOULD'

 We all have potential. Part of realising that potential, is recognizing how our gifts and our limitations equip us to cope with challenges and opportunities.

It becomes a quest for glory when we learn MORE about what is IDEAL  than what is REAL.

Influences of parents, peers, social media abound, the influential source is often easily spotted because its propelled by the tyranny of THE SHOULD!.

Work should be wow! My life should look better, I should have a partner, I should be thinner, I should have known better, I should be able to afford that!

Shoulds are paralysing judgements and they set up a false dichotomy  between an  ideal and failure.

Especially for those in their 20's who feel they SHOULD......remember, reaching your potential is rarely achieved in your 20's.

Personal, intellectual, financial and psychological growth takes time and the art of recognizing all that lies in between the SHOULD and FAILURE or SUCCESS. Growth comes from investing in what is in front of you. To do that you have to see the potential in that which confronts you.

Remember, confidence actually does not come from the inside out. Confidence grows with wins and losses, moments of success and yes,  failure, as both tend to make us rethink our current stance in the light of our strengths and weaknesses..

I have never met a successful human who has not failed repeatedly.

Thinking of Bariatric Surgery?

Diet Scotland  has been advising individuals regarding their choice and scope of choice when considering surgery for obesity.

Together with our psychology collegues we ensure that you have the right information at the right time to support and inform your decision.

No one should enter into the world of surgical intervention lightly and we know that for most this is not a quick decision, many patients have been thinking about the process for two or three years.

Whether you are considering this now, or have had surgery in the past and are in need of support and advice, contact us here, at Diet Scotland for an appointment that will effectively change your life.

New Look Website!

Well this is exciting. This is my first blog on my new site. I will be transferring some of my info from before but this is a fresh start with a new base. I think what I would like to chat about today is how difficult it must be to find your way through the maze of nonsense out there. May be its best to give you a whistle stop tour of what to look for if you do feel you need to take up some nutritional advice. How do you know that you are dealing with a professional? How do you know that what is being advised is based on fact not fiction?

Here are some easy to follow steps to guide your choice of advisor.

1. Look for a Registered Dietitian. A Registered Dietitian holds at minimum, a BSc degree, has been at university for at least  4 years and is duty bound to maintain his/her knowledge through ongoing training throughout his/her career. The  title DIETITIAN is a protected title in law. You cannot legally call yourself a Dietitian if you have not earned that title through study. A Dietitian will assess the situation, diagnose the problem and treat as appropriate. A dietitian knows that she or he has to work within their areas of expertise and will refer on to the appropriate professional if, and when, required.. A  Dietitian will work within many fields and will deal with individuals, groups, classes and different bodies in varying arenas, NHS, public, private, commercial, corporate, education, research and within TV and media. 

A nutritionist may also be highly qualified and many are, but, there are many pseudo experts  who adopt that title NUTRITIONIST, because it is not a protected title in law and ANYONE can call himself a nutritionist with no training, no knowledge no expertise.

2. Beware the celebrity expert. From the Reality TV star spouting advice to the press releases based on "the very little fact and no truth" formulae.

3. Sharpen your "Bull...." antennae. If it's too good to be true.. well it's too good to be true. There is no magic tea, pill, grain or drink that will reduce your weight. YOU need to do that. One day of course there may be something that really does help speed up the process. That day is yet to come. When it comes we will all know about it, it will be the answer to the biggest threat to health that we have in the western world and the most expensive drain we have on the NHS in Britain. Don't be suckered in by celebrity endorsement, there are no detox diets that do that job. Our liver takes care of that very nicely thank you. Be smart don't wast your time and money.

4. Key indicators that what you are about to read is tosh!

Intense claims based on specific foods or behaviours around foods... Like The cabbage diet. Coconut oil benefits spanning every aspect of life. Banana diet, Raw diet. pH diet. Blood type diet. Extreme fasting diets, Deprivation diets. Diets that remove a whole food group. like dairy, wheat, gluten when there is no disease process diagnosed.. Combination diets, only having protein with fruit or carbohydrate with dairy or any such combination. Elimination diets, completely removing a food or foods for no medical reason.

Extreme claims.Lose a stone in a week. Look younger by cutting out wheat. Shakes that contain ketones to burn thigh fat. Shrink your tummy in ten days.... drink this!

Magical thinking. Esoteric cures and potions to break down stubborn fat deposits in specific areas.

Detox claims, I must say this is my bug bear I can set my watch and wait to see the usual run out of tosh come every January by the same celebrity, no doubt being paid a fine fee to talk nonsense.

Physical interventions with little or no evidence. Colonic irrigation.. Kinesiology,  allergy testing, sensitivity testing, aura reading, hair and nail analysis, pooh analysis. Pressure to buy into a long term commitment to these practises or to the follow up literature drivel.

There are a good few areas that I have not included in great detail that do require a closer look. I think I will leave that for another day and go and get myself a cup o' tea. Back soon.