Obese Britain 2015.pdf

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To say that we are currently in
the midst of an obesity crisis
leaves me wondering what
we will call it in 10 to 15 years
times, when it is predicted that
almost three-quarters of men and
two-thirds of women in the UK will
be overweight or obese. And these
figures show no signs of slowing
down with experts predicting that
obesity will soon overtake smoking
as the principal cause of cancer.
The economic burden is crippling.
Obesity costs the country nearly
£47bn a year and at current rates the cost to the NHS could
increase from between £6bn and £8bn in 2015 to between
£10bn and £12bn in 2030. Yet bewilderingly the UK spends
less than £638m a year on obesity prevention programs –that’s
around 1% of what it is currently costing us.
Things do not look good. The environment in which we live is
designed to make us fat; encouraging us to overeat the wrong
foods and discouraging us from physical activity by the many
energy saving devices we have developed. We can blame
an evolutionary mismatch between the way our bodies have
evolved, and the ways the environments in which we now live
and work have evolved. Without bringing about urgent changes
to this environment the crisis is only going to get worse. So we
must act. Getting people to lose weight once they have become
obese is hard; making sure people do not get obese in the first
place should be easier, but will require significant intervention
including government legislation on education, advertising,
food production and healthcare, and hard work for all of us.
Our environment doesn’t change solely through chance but
also through intention, and the source of this change can come
from anyone. It will take a mixture of science, education, and
intelligent collective action. I hope this supplement inspires us
all to get started.
Dr Christian Jessen
3

IN THIS ISSUE
An apple a day Interview
6
The obesity epidemic
The number of children in the UK who are
overweight and obese is on the increase and it’s time
to act fast
Consequences of
8 obesity
Many people are of the understanding
that obesity is a physical disease, but
what they fail to remember, is that it
has a massive impact on other parts
of human life too.
12
with Dr Christian Jessen
Dr Christian Jessen, talks about the UK’s growing
obesity epidemic, what needs to be done to solve it
and why it makes economic sense to offer bariatric
surgery to more obese people
The good stuff
16 Giving your child a nutritious, tasty diet
needn’t be difficult with these handy tips - and the
earlier you start, the better
Start small and work
20 out the safe way
Exercise is known to be essential for your health,
and features in most weight loss programs. However
those who are overweight and out of condition run
the risk of injuring themselves before they lose any
weight and their good intentions stall
The truth about sugar
24 We all want to know the truth about sugar
– is it bad for us? Well the answer is yes, and did
you know that it can be as toxic as drugs and alcohol
according to recent studies…
Obesity and
28 reproduction
Professor Adam Balen talks about the effects of
obesity on fertility and how being overweight may
double your wait for a pregnancy
32
20
48

The dangers of
30 mindless eating
Treating ourselves to our favourite foods in order
to improve our mood and wellbeing is the most
compelling contributor to obesity in the UK
Fighting fit with
32 Jessie Pavelka
With so much emphasis on diets and bikini bodies,
fitness expert Jessie Pavelka suggests that focus
should be placed on the emotional side of health
Bring on the
34 revolution
Tam Fry,talks about the what the new government
must do in order to tackle the rising issue of obesity
in the UK
Make the swap
38 Healthy living is a fantastic way to cope
with stress, improve relaxation and help you and
your family stay fit and healthy. Here’s how to get
started...
Case Study
40 Ian lost 7 stone with the help of his local
health & fitness centre, after being diagnosed with a
life-threatening sleep disorder
Let them eat greens
41 We give you a few sneaky tips on how to
get your kids to enjoy their vegetables
What counts as your
44 five a day?
Jane Michell, explains what counts as your 5 a day
and why following your 5 a day is so important to
maintaining a healthy and varied diet
An introduction to
48 weight loss surgery
Bariatric surgery is one solution that can reverse the
risk of weight-related diseases and give severely
obese people a new lease of life and much improved
health.
HOOP - Helping prevent
52 obesity
Obesity appears in the media on what seems like a
daily basis so it is quite surprising that there are very
few voluntary organisations supporting those who
struggle with their weight on a daily basis
Get your kids off the
54 couch
With the UK seeing a rapid rise in childhood obesity,
it’s more important now than ever to get our kids
moving. If, like many parents, you’re struggling, here
are a few simple and effective tactics to try
Psychology and
58 obesity
Eating the right foods and exercising is vital for
healthy, successful weight loss, but all too often we
give up on our goals because of negative thinking
How to count calories
60 the correct way
You know the formula. Eat fewer calories, do more
exercise, and you’ll lose weight. But for many of us,
the reality of losing weight doesn’t seem to be quite
that simple
Living with type 2
62 diabetes
Diabetes affects 1 in 17 people, equating to
approximately 3.2 million people in the UK alone.
Jane Michell has some useful tips on how to manage
this condition and live a healthy life
12
54

The number of children in the UK who are overweight
and obese is on the increase and it’s time to act fast
L
evels
of childhood obesity in the
UK are a huge concern. Around
43 million children under five
are overweight or obese globally,
and obesity has become one of the
most serious health issues facing the
UK today. It is very much a modern
problem. Did you know that statistics
for obesity didn’t even exist 50 years
ago? The Foresight Report, published
in 2007 revealed that by 2050, nine
out of 10 British adults and two-thirds
of children will be overweight or
obese if everyone continued to live
the unhealthy lifestyles they lead now.
However, the National Obesity Forum
has announced that these predictions
‘’underestimate’’ the scale of the UK’s
obesity crisis. Obesity increases the
risk of high blood pressure, diabetes
and other conditions that usually
present in middle-age, but are
increasingly being seen in children
and young adults. An obese child
is much more likely to be an obese
adult and an obese adult is likely
to have obese children. This vicious
transgenerational cycle has to be
nipped in the bud. If not, for the first
time in history, the life span of parents
may well exceed that of their children.
The price of ignorance
It has been revealed that many of us
simply don’t know what overweight
looks like. A recent study found that
33% of mums and 57% of dads
considered their child’s weight to be
about right when, in fact, they were
obese. In a recent national opinion
poll of 1,000 parents who had
children aged four to seven, only 14%
who had obese children, considered
their child was even overweight. The
rest thought their child was healthy
and a normal weight. But before
you tut disapprovingly and insist that
this doesn’t apply to you, did you
know that a 10-year-old child’s ribs
should be clearly visible? Most of us
would consider a child with stickingout
bones to be underweight, but
that’s how healthy children of that
age should look. Obese children
are more likely to experience healthrelated
limitations and require more
medical care than children of a
normal weight.
The National Obesity Forum says:
The ‘’doomsday scenario’’ set out
in the report does not cover the true
extent of the problem.
The forum’s latest report calls on
health officials to introduce hardhitting
awareness campaigns –
similar to those for smoking – to try to
stem the problem.
The organisation also called on family
doctors to proactively discuss weight
management with patients. GPs
should routinely measure children’s
height and weight and check adults’
waist circumferences.
There is a lot more we can be
doing by way of earlier intervention
and to encourage members of the
public to take sensible steps to help
themselves – but this goes hand in
hand with government leadership
and ensuring responsible food and
drink manufacturing and retailing.
‘’Various initiatives are very well
intentioned and directed, but cannot
be expected to solve one of the great
public health problems of our time on
their own.
‘’We need more proactive engagement
by health care professionals on
weight management, more support
and better signposting to services for
people who are already obese, and
more importance placed on what we
drink and how it affects our health.
‘’We’ve seen hard hitting campaigns
against smoking and it’s time to back
up the work that’s already being done
with a similar approach for obesity.’’
The SOLUTION
The seemingly contradictory reports
in the media about what people
should and shouldn’t be eating
almost certainly don’t help things.
Ultimately, making changes to our
lifestyle is really the only way that we
will combat obesity. You can’t outrun
an unhealthy diet, but an active
lifestyle paired with healthy eating
can certainly make a difference and
help to prevent the problem from
increasing any further.
The NHS recommends that adults
get at least 150 minutes of moderate
intensity exercise per week, as well
as muscle-strengthening activities
at least 2 days a week. Children
aged 5-18 should aim for an hour
of moderate activity a day and also
integrate strength exercises into their
daily routines, such as pushups and
lunges.
Unfortunately our sedentary
lifestyles mean that many of us
get little more than 10 minutes of
exercise a day, never mind 150
minutes a week. Physical education
is still taught in schools, but less time
is focused towards it in comparison
to other academic subjects, children
are also more likely to spend their
free time playing computer and video
games instead of playing outside.
To truly tackle our growing
weight issue, we need to alter our
perceptions of physical activity as a
nation. Instead of thinking of exercise
as a chore, we need to view it as
something enjoyable.
7Photograph: iStock

Consequences of
obesity
Many people are of the understanding that obesity is a
physical disease, but what they fail to remember, is that it
has a massive impact on other parts of human life too
Excessive weight gain causes dramatic change in a person’s physical appearance, but often the
psychological damage can have a huge negative impact on the brain.
The consequences of obesity can be split into three groups:
Psychological
Physical
• Depression
• Type II diabetes
• Anxiety
• A range of cancers
• Low self-esteem
• Strokes
• Body dissatisfaction
• Heart disease
• Low quality of life
• High blood pressure
Dr Denise Ratcliffe Consultant Clinical Psychologist specialised in weight issues working
for Phoenix Health talks about how obesity effects mental well-being:
“Obesity is a life-limiting condition, not just physically but psychologically too. The
relationship between obesity and psychological problems is complex – people with
mental health problems are more likely to become obese BUT obesity also causes
mental health problems.
Being obese is associated with higher rates of depression, anxiety, low self-esteem,
disordered eating and body shame. For some people, eating is their default way
of coping with distressing situations or emotions and over time,their repertoire of
alternative coping mechanisms becomes restricted. Many get trapped in a vicious
cycle of feeling unhappy with their weight and then comfort-eating to manage this
distress which then leads to further weight gain, shame and feelings of failure.
In addition, research has shown that the general public consistently make
negative judgments about obese people, not just in relation to their weight and
shape, but also their personality characteristics and intellectual functioning. This
means that obese people experience negative judgments from others, restricted
life opportunities and are often discriminated against. This combination
impacts badly on mental health and psychological wellbeing.”
The effects of obesity you can’t see:
1. Your Heart
Excess fat tissue in the body requires oxygen to stay alive. This means
your heart recruits more blood vessels to deliver oxygen-rich blood
to that tissue. In addition, the more fat that accumulates inside your
arteries, the harder those arteries get. Thicker walls allow a narrower
space for blood to pass through, so to maintain the same pressure
the heart must work harder. Atherosclerosis, the hardening of the
artery walls, is 10 times more common in the obese than in
healthy people.
There’s no two ways about it; the heart feels the greatest
effect from obesity. The muscle itself works harder; the risk
for blood clots increases; and the resulting blood circulation
throughout the body suffers overall.
Social
• Bullying
• Lower employment
options
2. Your Colon
Researchers haven’t found the connection between
obesity and most cancers to be all that strong — except
for colon cancer. Among both men and women with
obese classifications, colorectal cancers arise with
startling frequency. This could be for two main reasons,
experts suspect.
The first involves a diet high in processed meats and
red meats, a common factor among patients suffering
from colon polyps — an early potential sign of colon
cancer. The other factor is an elevated level of insulin
or insulin-related growth factor in the blood. Why,
exactly, these factors influence cancer development
remains a mystery. But given the intricate relationship
between a person’s digestive system and immunerelated
disorders —70 percent of the body’s
bacteria live in the gut — the side effects of obesity
may explain the link, at least in part.
Photograph: iStock
8

3. Your Brain
The link between body and mind isn’t new, but the latest science
is compelling. A 2010 study found cognitive function showed
negative associations with obesity on measures. One hypothesis
cites the deteriorating white matter that surrounds nerve fibres
in the brain, which send signals around the organ. This white
matter sheathing has been found more damaged in the brains
of the obese.
4. Your Lungs
Like the arteries surrounding your heart, your lungs are at great
risk in the presence of excess fat. A study published in 2010
showed large amounts of adipose tissue diminishes the organs’
overall capacity for air. This in itself poses significant risk for
poor ventilation, which can both exacerbate existing respiratory
diseases or produce the same side effects even in the absence of
those diseases.
Poor lung function means blood vessels may not be getting
enough oxygen. Similarly, obese people face a far greater risk for
obstructive sleep apnea than non-obese people, further limiting
the oxygen their bodies take in. Problematic enough during the
daytime, a failure to breathe at night could turn fatal in a hurry.
Researchers are working on a device that delivers tiny electric
pulses into the tongue, to release the blockage without waking
people up.
It’s not just that obesity reduces life expectancy by an average
of 3 to 10 years, depending on how severe the problem is. It’s
estimated that being overweight or obese contributes to at least 1
in every 13 deaths in Europe, and whatever your age, whatever
your weight, eating healthily and being active are important
weapons in the fight against cardiovascular disease.
Complications that can arise as a result of obesity, include:
• Type 2 diabetes
a condition that causes a person’s blood sugar level to
become too high
• High blood pressure
• High cholesterol and atherosclerosis
where fatty deposits narrow your arteries), which can lead
to coronary heart disease and stroke
• Asthma
• Metabolic syndrome
a combination of diabetes, high blood pressure and
obesity
• Several types of cancer
including bowel cancer, breast cancer andwomb cancer
• Gastro-oesophageal reflux disease (GORD)
where stomach acid leaks out of the stomach and into the
oesophagus (gullet)
• Gallstones
small stones, usually made of cholesterol, that form in the
gallbladder
• Reduced fertility
• Osteoarthritis
a condition involving pain and stiffness in your joints
• Sleep apnoea
a condition that causes interrupted breathing during sleep,
which can lead to daytime sleepiness with an increased
risk of road traffic accidents, as well as a greater risk of
diabetes, high blood Pressure and heart disease
• Liver disease and kidney disease
• Pregnancy complications
such as gestational diabetes or pre-eclampsia (when a
woman experiences a potentially dangerous rise in blood
pressure during pregnancy)
How can it be treated?
1. Lifestyle Changes
The best way to guarantee weight loss is to take in fewer
calories and do more exercise. It is that simple, but for many, the
psychological aspects are just too great.
Eating low fat or low carbohydrate foods cannot provide a short
cut to weight loss unless the result is a reduction in calories (which
may well be the case). Your body can convert fat to carbohydrates
and vice versa so changing the proportion of each in the diet in
an attempt to lose weight is meaningless. It is now believed that
eating a higher proportion of protein rich foods can stave off
hunger for longer, and so help the consumption of fewer calories
overall.
2. Thinking about surgery
For those with a BMI greater than 35 with a health related
problem such as diabetes or high blood pressure, then surgery
will assist with weight loss and could be an option. If you wish to
consider this further you should consult your GP.
There are 2 main types of surgical approach to weight loss:
• Gastric band.
A band is fitted around the neck of the stomach. This
causes a feeling of fullness after eating a very small amount
of food, and causes slow eating which helps with feeling
full after a smaller amount of food.
• Gastric bypass or stapling.
Here, the volume of the stomach is made smaller. This
causes a feeling of fullness after eating small amounts of
food, and reduces calorie absorption.
3. Looking to the future
Obesity rates are escalating to unprecedented levels and there’s
no quick or easy solution. Although the new NICE guidance
on lifestyle weight management services is yet to be finalised,
it’s clear that blaming an individual or indeed society for the
situation is fruitless.
What’s important is providing the help and support that’s
needed now, as well as promoting healthy lifestyles for future
generations.
The best way to guarantee weight loss is to take in fewer
calories and do more exercise. It is that simple, but for many,
the psychological aspects are just too great. Eating low fat or
low carbohydrate foods cannot provide a short cut to weight loss
unless the result is a reduction in calories (which may well be the
case). Your body can confer fat to carbohydrates and vice versa
so changing the proportion of each in the diet in an attempt
to lose weight is meaningless. It is now believed that eating a
higher proportion of each in the diet in an attempt to lose weight
is meaningless. It is now believed that eating a higher proportion
of protein rich foods can stave off hunger for longer, and so help
the consumption
Best way to guarantee weight loss is to take in fewer calories
and do more exercise. It is that simple, but for many, the
psychological aspects are just too great. Eating low fat to low
carbohydrate foods cannot provide a short cut to weight loss
unless the result is a reduction in calories (which may well be the
case). Your body can confer fat to carbohydrates and vice versa
so changing the proportion of each in the diet in an attempt to
lose weight.
9

PROMOTION
KNOW ALL YOUR
NUMBERS
Monitoring your weight and your blood pressure
has never been easier yet so many people
still don’t. So how are these two key
health factors linked?
More and more evidence is now being produced
showing that adult obesity is associated with a wide
range of health problems. Public Health England
note that a raised BMI increases the risk of hypertension
(high blood pressure), which is itself a risk factor for
coronary heart disease and stroke and can contribute to
other conditions.
The “Statistics on obesity, physical activity and diet:
England, 2012” report produced by The Health and
Social Care Information Centre states that in 2009, obese
adults (aged 16 and over) were more likely to have high
blood pressure than those in the normal weight group.
High blood pressure was recorded in 51% of men and
46% of women in the obese group and in 20% of men and
15% of women in the normal weight group.
So what is high blood pressure?
The heart is a very powerful pump that beats steadily. The
pressure created by the heart to pump the blood through
the blood vessels is called blood pressure. When the heart
muscle contracts the blood surges through the arteries - this
is when the systolic (upper) blood pressure value occurs.
The diastolic (lower) value is the resting pressure before the
heart contracts again. If your blood pressure is higher than
140/85mmHG then it is defined as high blood pressure
(hypertension).
Risk Factors
There are a number of risk factors linked to developing
hypertension. Reducing just one risk such as being
overweight can generally decrease our overall risk.
However some risk facts are beyond our control. Gender,
race, ethnicity, age and other genetically determined
factors are built into who we are and cannot be changed.
Stress – Obesity – High Blood Pressure
For many people two of the key lifestyle factors of high blood
pressure, seen in graphic below. Clinical Psychotherapist,
Terri Bodell who specialises in stress and anxiety explains:
“Stressful situations can cause your blood pressure
to spike in the short term. Your body produces a rush
of hormones when you’re stressed. These hormones
temporarily increase your blood pressure by causing your
heart to beat faster and your blood vessels to constrict.
However once what was causing your stress has
disappeared, your blood pressure returns to normal. Yet,
even temporary spikes in blood pressure — if they occur
frequently enough — can damage your blood vessels,
heart and kidneys in a way similar to long-term high blood
pressure.
There’s no evidence that stress alone causes long-term
high blood pressure but if your reaction to stress is to smoke
more, drink too much alcohol or eat fatty or high sugar
foods, then you are increasing not only your waistline but
your risk of high blood pressure, heart attack and stroke.
So you could still say that indirectly stress does cause high
blood pressure.”
Know All Your Numbers - Monitor at Home
Within most homes you will find a set of bathroom scales
giving us the opportunity to monitor our weight and now
with the advanced technology we can also determine BMI,
body fat percentage and skeletal muscle. Yet how many
people regularly measure their blood pressure as well,
either at home or by making a visit to their GP?
Therefore with so many people now becoming
overweight and obese it is so important to know our health
measurements, allowing you to make effective adjustments
to your lifestyles to ensure a healthier future.
There are many key risk factors that we can control, including:
Diet
In particular, our
intake of fat and
sodium
Exercise
Introduce at least
2.5 hours of
exercise a week
Smoking
Smoking doesn’t
directly cause
high blood
pressure but it
puts you at much
higher risk of a heart attack
and stroke
Alcohol
consumption
Stay within the
recommended drinking
levels in order to reduce
your risk of developing high
blood pressure.
Stress
levels
Too much stress can
lead to emotional,
psychological and
physical problems - including
heart disease.
Photograph: iStock
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12
An apple a day
Dr Christian Jessen, presenter of Channel 4’s Supersize vs Superskinny, talks
to Ellyn Peratikou about the UK’s growing obesity epidemic, what needs to
be done to solve it and why it makes economic sense to offer gastric bands,
and bypass operations to more obese people.

There is so much contradictory
advice out there regarding obesity,
it’s no wonder people are confused
about what they should be doing in
order to lose weight. It’s important
to educate people on the matter,
but it’s also vital they receive the
correct information. One day a
report will come out telling people
that the only way to shift the
pounds is by good old fashioned
healthy eating and exercise, and
the next week, a medical journal
has been published telling us that
obesity is a genetic disorder and
there is little we can do about it.
What advice would you give to
someone looking for answers?
It’s probably not that contradictory if you
read the original sources. So much of
what you read in the press is a journalist’s
interpretation of an original document. It’s
often slightly cherry picked so you do have
to be quite careful about what you read.
The single most important thing people
need to know is that you are, to some
degree, in control and that control comes
from the quality and quantity of what you
decide to eat, so anybody who tells you
that there is nothing you can do, is wrong.
When it comes to health, you will find
a million different answers for everything.
We’re learning as we go, and I think for
me, the bottom line is still exactly what it’s
always been - genes or no genes - diet will
always be the single most important factor
when it comes to controlling your weight.
Where genes come into it, is when you’ve
reached that threshold, and it becomes
harder because there are complex
metabolic changes that go on inside the
body, this is when we look at hormones
such as ghrelin and leptin.
Some say that once someone has
crossed that threshold into obesity,
then they’re beyond help. You’ve
seen it yourself on Supersize vs
Superskinny - people are capable
of making positive changes to their
lifestyle, so why is society so quick
to write them off?
You are in control. It is a relatively simple
equation of calories in and calories
out, that’s undisputed. It’s like telling
a depressed person to pull themselves
together or saying to an overweight
person “just stop eating”. It demonstrates
a gross misunderstanding about what is
actually going on, and certain metabolic
upsets mean that people just don’t feel full,
and so they constantly eat. It’s not greed
and it’s not laziness and that can lead to
a point of no return, because it’s almost
self-perpetuating. The bigger you get,
the more disordered the metabolic issue
becomes, and therefore the more intense
the desire to eat feels, certainly when
making TV programs such as Supersize
vs Superskinny, it was apparent that
everyone taking part in that show, had
significant psychological issues that were
driving their eating disorders.
Looking into psychological side of things
is important, and that’s the bit that very
often isn’t done. If you go to your doctor
they will often shove a diet sheet under
your nose and say, “here, eat less” , but
it’s important to identify when you eat.
For example, are you a comfort eater? Do
you graze all day long? Are there times
of days that are dangerous, ie night time?
People are generally very unsympathetic
when it comes to obesity, probably
because a lot of people don’t really
understand it. I think this ‘point of no
return’ idea is probably partly true, but it’s
a dangerous one to put out there because
those naturally prone to depression will
grab onto this notion and claim it to
themselves. But certainly from a metabolic
and scientific perspective, there is a point
where it becomes just impossible to lose
any weight, and that’s due to hormone
disorders, so you do need to make drastic
changes in order to force about those
changes in metabolism.
You’re very much in favour of
bariatric treatment, can you
explain your reasoning behind
this. If we let this issue continue,
what would it mean for the NHS?
All bariatric surgery is remarkable;
the changes are brought about almost
instantly. Things like type 2 diabetes are
reversed within hours of the surgery being
complete, and we don’t have anything
else like it or anything as successful. It’s
not an easy ride and it’s certainly not a
quick fix.
Although it’s a simple operation, it’s
doomed for failure if you don’t have the
psychological before and after care. There
are also moral assumptions being made
about bariatric surgery; people don’t want
their hard-earned cash and taxpayers
money being spent on people who just
can’t stop eating. Again, not only does that
show a gross misunderstanding of what the
problem is, but also a misunderstanding of
the economics behind it. Putting a gastric
band in will pay for itself within the first
few years, whereas the cost of treating
someone long term for illnesses such as
diabetes, are far higher.
Many food companies have come
under fire for marketing their
products as healthy when in fact,
they are packed full of sugar, salt
and fats. Do you think that the
government should introduce some
kind of tax or put some legislation
in place to ensure that unhealthy
products cannot be marketed at
children?
I came up with four words that I thought
might help the obesity crisis. Educate,
legislate, advertise, operate. We need
to start teaching kids about what they
should and shouldn’t be eating. The
government does need to come into it,
not by legislating against consumers,
but legislating against manufacturers.
I don’t think we should punish people
for what they want to buy, we should
be punishing manufacturers for making
unhealthy products, and make it incredibly
cost-ineffective to make unhealthy food.
Businesses are then less likely to want to
make it because the profit margines wont
be good enough. We need hard-hitting
advertising campaigns highlighting the
consequences of obesity. The anti-smoking
campaigns are quite shocking but they’re
also very successful. We need to be doing
more bariatric surgery, because in the long
run, it will be saving the NHS an awful
lot of money. Treating diabetes is highly
expensive to the patient, and cost sensitive
for us. We ultimately provide the doctors
for the eye checks, foot checks, all the
different medications, and then once the
complications set in which they ultimately
do, treating those as well. It just doesn’t
make any sense. If you have a gastric
sleeve or a gastric bypass, your diabetes
is gone the next day. It’s an absolute no
brainer. The cost of an operation is around
£5,000 and that will pay for itself in the
next three years.
I read a recent interview where
you described us as living in an
“obesogenic society”. What do
you mean by this?
Obesogenic, meaning it makes us fat.
I think the key to understanding any
medical problem today, is to look at
where it came from in evolutionary terms.
We basically live in an evolutionary
mismatched environment. We were
designed to be living in caves, hunting
and gathering seeking out sugar, salt and
fat occasionally. There was a drive called
hunger, which made you go out and take
risks and get this food. These were clever
evolutionary adaptions which prevented
us from lying on the floor doing nothing,
but to seek out these foods for our benefit
so that we can then procreate and pass on
our genes. Unfortunately cultural evolution
has moved on far faster than biological
evolution, which means that now we
are surrounded by fatty, sugary and
salty foods. Our drive to eat hasn’t gone
away, our drive to seek out foods hasn’t
gone away and our need to run around
hasn’t gone away, yet everything we do
is energy conserving. We have cars, lifts
and escalators, things that do everything
for us. There is a massive mismatch now
between how we were designed, and the
environment in which we live and I call
that ‘obesogenic society’. In other words,
it’s pretty hard not to be fat! This is where
I think genes come into play, because
some people can eat more or less the
same foods as everyone else and never
get fat. I think some people have innately
better internal calorie counters. Using
myself as an example: I know when I’ve
eaten enough, I just know it. It happens
subconsciously. I get the exercise and food
balance right, and that’s lucky. For others
it’s not the case, but that can be affected
by a lot of things. If someone isn’t feeling
good, then they may decide to sabotage
that calorie counting process, and that’s a
subconscious decision.
A lot of people have hit back
saying that you can be overweight
and still be healthy. As a doctor,
do you believe that someone can
be overweight and still be healthy,
despite the chronic obesity-related
diseases that come hand-in-hand
with being overweight?
I went shopping with a couple of obese
bloggers who blog about the plus sized
fashion industry. The question was “are we
enabling people to be big by providing
them with nicer more fashionable clothes”
We went out shopping, and when they
found clothes that fit them and looked
good, they were really happy, and then
it dawned on me; you don’t get people to
make changes by making them miserable,
you do it by making them feel good
about themselves. A doctor can give you
a lecture about how to stop smoking but >>
13

you’re only going to do it when you want
to. You need to be ready. When you’re
wearing clothes that you feel good in, you
might start to make more positive healthy
choices in your life, and that might lead
to weight loss. If you prevent people from
buying clothes so that they have nothing
nice to wear, they’re going to be socially
isolated, they’re going to sit at home
and eat and they’re going to get fatter.
It’s not the way you’ll get people to lose
weight. With regards to being healthy and
overweight? I’m sorry, I don’t know who it
is that said it, but you can’t be obese and
healthy. With obesity, comes metabolic
change and those changes are for the
worst unfortunately. You may at that very
moment in time be OK, you might go to
your GP and your blood sugar and blood
pressure might be fine, but stay like that for
a year or two and those changes will start
to kick in. It’s a dangerous thing to say.
You have to be careful about what
you say now, as people are so
quick to accuse you of fat-shaming!
I get accused of fat shaming all the time,
because I host a TV show about weight
loss. It’s a silly way of getting attention.
I’ve been called misogenistic, a fat-shamer,
anti-breastfeeding, you name it. It is my job
as a doctor to advise people on making
healthy choices. If someone goes to their
GP about a cough and they point out their
weight, people get angry. But if you go
in with a cough, and your doctor fails to
mention a suspicious looking mole on your
neck, there is no difference. In exactly
the same way, if someone is severely
overweight or obese, it is my job to point
out that this is a significant health risk and
you should be doing something about it if
you want to improve your health. You may
have come in with a sore foot, but it’s my
job to look after your whole health. Is that
fat-shaming? Of course it’s not. If you feel
ashamed then your society is making you
feel ashamed. Fat-shaming is saying we
should stop selling plus sized clothes.
Look at the adverts that are being
defaced recently, what is the difference
between that and celebrating a plus-sized
woman? Come on, it’s the same thing!
It’s just dressed up in different language.
Someone has got to say it and as long as
the debate is being had it’s OK.
Childhood obesity is a huge issue,
with many reports suggesting
that a very high percentage of
parents are unable to recognise
whether their child is overweight
or not. What advice would you
give to parents on what they can
do to tackle the issue in the earliest
stages of development?
We have completely lost touch with what
a normal weight is, especially in children.
In a child of a healthy weight, you should
be able to see it’s ribs. A child where
you can’t see any underlying anatomy at
all because they’re covered in a layer of
fat, is an overweight child, and I’m afraid
that’s the case for most kids that you see
these days. However, tell a mother that,
and they get terribly upset, but it’s my job
to tell the truth. I do think that there are
better ways of saying these things, and
there are many GPs who do it very well
and some who can be very insensitive.
I certainly think there is room for
improvement with all of us in how we go
about addressing these issues, because
it is an attack on how you look, and you
do need to be sensitive to that. However,
that doesn’t mean it shouldn’t be said. Fat
parents tend to breed fat children and fat
children will find it much harder to keep
the weight off. This is where education
is very important, because if we stop
producing overweight kids, then we have
almost broken the cycle.
What are some of the most common
myths and misconceptions you
hear from people who want to
lose weight?
I prefer to call them truisms rather than
myths. What I always say to people is that
it’s so much easier than what it needs to
be; most people do too much too quickly.
They feel they need to radically overhaul
everything and cut out all of the bad stuff
but it’s not sustainable because they start
eating things that they’re really not used to
eating. It doesn’t go down very well and
they find it tough, and start craving the
foods they used to eat until eventually they
slip back into their old eating habits. If you
start to make small changes like leaving
mayo out of your lunchtime sandwich or
introducing more greens and cutting down
on pastry, these little things add up over
time to make a big difference. The best
type of diet to be on is one that your body
doesn’t notice that it’s on. That is perfectly
possible, you don’t need to lose weight
in three months, there is no rush. I would
advise no more than a pound or two a
week; anything more aggressive than that
is going to lead to problems, and avoid
anything like diet pills or potions. Another
important truism is, the key to weight
loss is diet. Not exercise. It is your most
important tool. Exercise comes into play
for maintaining weight loss. But the way
to actually lose weight is through diet.
Abs are made in the kitchen and not in
the gym!
Overall what do we, as a
nation, need to do to ensure a
healthier future for both us and
the future generations?
Educate, legislate, advertise and operate.
Those four things, are going to be the key
to solving the obesity problem.
Photograph: iStock
14

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The good
stufF
Giving your child a nutritious,
tasty diet needn’t be difficult
with these handy tips – and
the earlier you start the better
The first 12 years of a child’s life are vital in
terms of healthy growth. It’s during this period
that his bones, muscles and brain all develop
at a frightening rate which, of course, requires
lots of energy and nutrients. And yet, this is so often a
time when kids are fussy about what they eat, which
makes ensuring they’re getting nutritious meals,
packed full of vitamins and minerals, all the more
challenging.
By teaching your child good eating habits now, you
will be giving him the best chance of staying healthy
into adulthood. There are four main food groups your
child should be eating, plus the occasional fifth.
Starchy carbohydrates
These include wholemeal bread, rice, potatoes, pasta
and wholegrain cereals, all of which can really boost
energy levels. Try making mini minestrone with tiny
chunks of carrot and courgette, vegetable stock and
very small pasta shapes, and finish with a scattering
of tasty grated cheese. Kids love noodles or eating
long pasta – try tossing egg noodles or spaghetti
with a little cooked chicken breast, finely chopped
red pepper and sweetcorn.
Carbohydrates provide the major source of energy
that we need to live, grow and thrive. Every part of
our body uses it for energy; without it, we couldn’t
survive. Carbohydrates should provide 50-60% of
the energy a child needs from food.
There are two kinds of carbohydrates; simple and
complex. Simple carbohydrates are single sugar
molecules and they are found in milk, fruit and
refined sugar. It is best to get simple carbohydrates
from milk and fruit because with these foods you also
get fiber and a host of other great nutrients. With
refined sugar, which you find in candy, white table
sugar and other junk foods, there is not much else
present but the sugar, which is not healthy. Complex
carbohydrates are also called starches and they are
found in grain products, such as bread, crackers,
pasta, and rice. As with simple carbohydrates, there
are healthy options and not so healthy options.
Photograph: iStock
Keep snacks healthy
Limit between-meal snacks – they fill up your toddler,
making him less likely to eat well at meal times. If
he does have a small snack, try healthy options
rather than the obvious biscuits, sweets or crisps. For
instance, a drink of milk and a small cracker with a
slice of cheese; a plain yogurt with a banana sliced
into it. Drinks can also be tummy-fillers, so don’t give
him a drink just before mealtime.
16

Milk and dairy
This group of products is a good source of protein
and calcium and is essential for the development of
strong bones and teeth. Scrambled eggs or boiled
dippy eggs are good served with sesame bread
sticks or toast fingers with Marmite. Smoothies are
a good way of providing a calcium-enriched drink.
Lean red meat, chicken and all types of fish
These are all good sources of protein, necessary for
healthy growth and the maintenance of healthy cells.
Oily fish such as salmon, mackerel and sardines are
a good source of essential omega-3 oils. Make mini
salmon fish cakes with mashed potato and canned,
flaked, or cooked salmon, first making sure to remove
all the bones.
Fruit and vegetables
It’s really important to get children interested in as
many fruit and vegetables as you can at an early age
and to encourage them to eat their ‘five-a-day’. Offer
five small servings a day and make sure they get a
good variety – different fruit and vegetables contain
different vitamins and nutrients, so be adventurous.
One small apple, one small banana, a slice of melon,
one kiwi or a glass of fresh fruit juice all measure up
to one serving. As for vegetables, approximately two
dessert spoons equal one serving. Potatoes do not
count as one of your five-a-day as they belong to the
starchy group.
Fatty and sugary foods
These should only be offered in moderation. Try
serving mini pots of chocolate sauce with sliced fruits
for dunking, or make an ice cream milkshake with
soft fruit as an occasional treat that incorporates
essential vitamins and minerals.
Lunch box filler
It’s a constant challenge to find healthy foods that
your little one will eat at school…
‘I’m always looking for healthy foods for my fouryear-old
daughter, Natasha,’ says Sarah, Mitchell
39. ‘She loves meat, but many sandwich meats are
pumped full of water – or worse. With 100% natural
ingredients and a 97% pork content, I was hoping
Richmond ham would be as tasty as it is healthy! ‘The
ham was meaty, thick and moist, with subtle tones
of gammon flavours coming through. My daughter
asked for second helpings – which rarely happens!
She started school in September, so it’s always on
my shopping list when I’m buying ingredients for
her lunch!’
nutrients your child could be
missing:
Omega-3s
Often known as fatty acids, these are vital for kids as
they have an anti inflammatory property which can
fight asthma and diabetes. Fish is the most common
source of fatty acids but as experts at Vitabiotics
point out: ‘Many children may not like the taste, so
it may be wise to give a supplement that has no
fishy aftertaste.’
fibre
Fibre, or roughage, is crucial for children’s diets.
It ensures their bowels keep moving and prevents bouts
of constipation. Wholemeal bread and cereals are a
great source of fibre, as are brown rice and pasta –
so swap white varieties for those with a higher fibre
content.
VITAMIN D3
Vital for healthy bones, vitamin D3 boosts the immune
system. It’s created by the body in response to sunlight,
but poor weather and sun health warnings mean many
children can be D3-deficient. A lack of the vitamin can
result in various health problems in young children, so
it’s wise to use a supplement to support a child’s health.
calcium
Well known for keeping teeth and bones healthy and
strong, calcium is a must for kids, especially as they
grow. And it’s not only milk that’s a good source:
other dairy products such as cheese and yogurt are
packed with it, as are green vegetables.
17

Promotion
project
Happy, healthy
families
Thanks to our clear and informative labelling on
pack, The Co-operative Food has been helping
customers make healthier choices for 20 years
– conveniently and with fresh, tasty food
Here at The Co-operative Food we,
like you, have become increasingly
aware of worrying headlines about
rising obesity. It used to feel like a
problem for America, but experts
recently warned that a quarter of
Brits are obese, and that figure is going up. More
and more UK children are now overweight too;
The National Child Measurement Programme
found that more than a
fifth of reception class
children are overweight or
obese, and that rises to
33.5% among 10 to 11
year olds. These numbers
came from GP surgeries up
and down the land, so it
couldn’t be closer to home.
The Co-operative has always put health at
the forefront, and we want a nation of happy,
thriving kids who go on to live long lives free
from health problems, so we think it’s time to
tackle this crisis head on. We already fill our
stores with fairly priced, healthy foods and
drinks, to ensure that eating well isn’t difficult
or budget-busting. Now we’ve joined forces
with the NHS-backed Obese Britain campaign
to help stop obesity taking hold. Here’s how
we’re helping you and your family from
becoming part of those scary statistics.
So long, sugar!
Eating too much sugar causes
your body to store more fat,
‘90% of our ownbrand
soft drinks are
low sugar, sugar free
or no added sugar’
which could lead to heart disease, cancers and
Type 2 diabetes, so it makes sense to cut down
on the amount we’re consuming. First, try to
lose the obvious sugars – the ones you add to
tea and cereal by the spoonful. Try sweetening
porridge with cinnamon or a few berries, and
gradually cut back to none in tea or coffee.
We’ve made it really easy for you to find out
exactly how much sugar is present in different
foods, with our handy,
at-a-glance traffic lights
and clear-to-read
ingredients lists.
Look on labels for
‘carbohydrates as sugars’,
and aim for foods with
less than 5g per 100g,
which is low, while 22.5g per 100g is high. In
drinks, 2.5g per 100ml is classed as low and
over 11.25g per 100ml as high. Check the
traffic lights on the front of packs as they
clearly indicate if a product is low, medium or
high in sugar. Also, watch out for words ending
in ‘ose’ – glucose, sucrose, fructose, dextrose,
maltose and high-fructose glucose syrup, as well
as corn sugar, honey, invert sugar and molasses.
These are just different types of sugar, and the
higher up they are in the ingredients list, the
higher the sugar content.
Another simple way to cut your sugar intake
is by choosing healthier drinks. A recent UK
top tips for Simple sugar swaps
SWAP sugary drinks
FOR water or no-addedsugar
drinks eg Co-operative
Loved By Us high juice squash
SWAP sugary cereal
FOR porridge, wholegrain
cereals eg Co-operative
wholewheat biscuits
study found that swapping one sugary drink
a day for water – or unsweetened tea or coffee
– could cut your risk of developing Type 2
diabetes by as much as a quarter. There are
plenty of sugar-free and no added sugar options
in your local Co-operative Food store, too.
Good hydration
It’s important to stay hydrated, and that’s
especially true for children when they’re
having fun and being active. The Department
of Health recommends that they should drink
about 6-8 glasses of fluid per day, but that
can all too easily involve consuming sugar in
liquid form. Getting them used to drinking
water and other non-sugary drinks will form
good habits for healthy hydration when
they’re older. Children aged 11 to 18 can
receive 40% of their added sugar from soft
drinks and fruit juice. That’s why we’ve been
working hard to reduce the sugar in our
Co-operative soft drinks range. In fact, since
July 2014, all of our dilutable drinks have
had no added sugar, and now 90% of our
own-brand soft drinks are either low sugar,
sugar free or no added sugar.
A diet of plenty
Sugar aside, it can feel rather daunting making
sure you feed your family the best foods, but
eating well is easy – and it needn’t cost the earth.
SWAP sugary snacks
FOR fruit, unsalted nuts or
popcorn eg Co-operative Loved
By Us Thai coconut popcorn
words: laura potter. PHOTOGRAPHY: istock, shutterstock

Promotion
When it comes to putting a meal together,
give vegetables – rather than meats and carbs
– the spotlight. It’s an inexpensive way to eat
too, because here at The Co-operative we’ve
lowered prices on fruit and veg and we always
have plenty of seasonal offers on the tastiest
varieties. Look out for these deals when you’re
in store. Eating seasonal is a great way to enjoy
the freshest produce.
To get the balance right,
follow the eatwell plate
based on Department
of Health advice for a
healthy diet: eat roughly
one third fruit and
vegetables, one third
starchy foods (such as
bread, rice, potatoes, pasta), 15% milk and
dairy foods, 12% meat, fish, eggs, beans and
other non-dairy sources of protein, and just 8%
food and drink that is high in fat and/or sugar.
To help you reach your targets, bulk up sauces,
salads and soups with lentils and beans and
choose healthy carbohydrates such as
wholemeal pasta, bread and brown rice.
There’s no need to pile a mountain of
them on to your plate – you may think
carbs are filling, but protein is actually more
filling gram for gram, while vegetables are
packed with fibre, which also makes you
feel full. And if you’re having a sauce, swap
creamy types for tomato-based ones to get
more nutrients and fewer calories.
Room for pud
When it comes to desserts, there’s no need
to miss out. Get creative with fruit – again,
always a good price at The Co-operative Food.
Rather than choosing ice cream, cakes or
sugary desserts, bake bananas in their skins in
the oven for 10 minutes, then split the skin and
pop in one square of dark chocolate to melt. Or
stew rhubarb or apples – or poach pears – and
serve with a dollop of low-fat yogurt and some
flaked almonds. Try yummy kebabs made from
colourful fruits. If you’re stuck for ideas, go
online to co-operativefood.co.uk/magazine for
lots of tasty recipes.
If you’re rushing around the shops against
the clock, make a beeline for our low or
reduced-fat ranges – everything is calorie
controlled and contains less than 3% fat or has
at least 50% less fat than a standard equivalent
product. We make sure that these products are
no more expensive than standard equivalent
lines to make sure that customers aren’t
penalised for making healthier choices.
Green light for health
Getting label savvy is another brilliant way
to ensure you’re going for the good stuff. The
‘We’ve lowered our
prices on fruit and
veg – look out for
the ‘fresh 3’ in store’
traffic light labelling system for nutrition is
genius; showing us at a glance whether a food
is high, moderate or low in fat, saturated fat,
sugars and salt. The Co-operative was one of
the first food retailers to sign up to the scheme
in 2006, realising how easy and useful it would
be, but in fact we have a long history of leading
the way on labelling: it’s 20 years since we
began showing the amount of fat and calories
on the front of packs. We
like to take it further, too,
by putting traffic lights
on all the recipes in
Co-operative Food
magazine and on our
website, letting you see
at a glance which dishes
to choose when you want a healthier option.
Get the kids involved
The system is so accessible it can help you teach
your kids how to spot healthier options in an
instant, so they can make good choices too.
Show them how easy it is by remembering three
simple rules: green means it’s a great choice,
amber is OK, and red means you should try to
limit these to an occasional treat. Turn reading
traffic lights into a game or a competition to
find the lowest calories or highest fats, then
when you go shopping the kids can help by
finding the healthiest versions of foods.
Look out for our ‘green dot’ messages, too.
We use these on packs to highlight healthier
choices, and you can be sure it really is what
it says. People often feel they are misled when
products are labelled as ‘low fat’ but are high in
sugar. Here at The Co-op, we never make a low
fat claim on anything that is high in sugar or salt.
It really is that simple; watch out for added
sugars and go for green or amber traffic lights.
Make sure meals are packed with plenty of
veggies, and ensure healthy eating applies to the
whole family – after all, a recent study found
that children who eat the same healthy meals
as their parents go on to be healthier adults.
And finally, try to eat your meals together
as a family at the table as often as you can;
a recent US study found that families who ate
this way at least three times a week were much
more likely to be a healthy weight.
See you in the fruit and veg aisle!
Did you know it’s
20 years since we first
put nutrition info on
the front of packs?
Snack attack!
It’s easy to spoil a healthy
diet by reaching for unhealthy
snacks like sugary sweets. Fruit and
raw veg make great choices and go
towards your 5-a-day, and you’ll find
lots of treats in our healthier snacking
range, which are all calorie capped…
Co-operative Loved By Us
Thai coconut popcorn
A wholegrain snack to satisfy
those hunger pangs between
meals, or enjoy as a treat on
movie night – and it will only
set you back 94 calories.
Co-operative Loved By Us oriental
rice crackers
Tuck into these for a savoury, spicy crunch. The
best bit is that they only have 114 calories, and
less than 0.5g of fat per pack.
Co-operative Loved By Us chorizo
flavour mini rice cakes
Plain rice cakes can be dull, but these flavoured
ones are scrummy and at just 88 calories and
0.1g saturated fat, they’re a great choice!
Co-operative crazy cola flavoured raisins
A fun, fruity alternative to sweets like cola
bottles, these provide one of your 5-a-day and
are only 74 calories. Perfect for lunch boxes.
co-operative loved by us fruit packs
Tasty fruit ready prepared for
you to enjoy at any time, or
to pop into a lunch box.
Choose from melon and
grapes or apple and
pineapple for 1 of your
5-a-day.
20 p
OFF
Any purchase of
High Juice Squash
Valid from 21-28 June 2015
To the customer Offer expires 28/06/2015. Valid for
redemption against a 1-litre bottle of The Co-operative High Juice
Squash – any flavour. Coupon is not transferable and cannot be
exchanged for cash. Only one coupon per transaction. Only
original coupons are valid. Offer subject to availability, no change
given. Redeemable at The Co-operative Food. To find your nearest
store call 0800 068 6727.
CO-OPERATIVE STORE MANAGER Scan barcode at checkout and destroy coupon in store.
Managers of other societies Follow your coupon-handling procedure.

Start small
and work out
the safe way
Exercise is known to be essential for your health, and features in
most weight loss programs. However those who are overweight
and out of condition run the risk of injuring themselves before
they lose any weight and their good intentions stall
The risk is to the joint structures and the
deconditioned tendons and muscles. When
jogging there is around two-three times body
weight going through each leg on each step. A
mile is about 1,500 steps, which adds up to a lot of
impact on the joints and tendons which are simply
not conditioned to cope with it.
The tendon structure can be strained and become
inflamed and painful. Impact with a lack of control
means the joint surfaces are stressed and can wear
quicker than usual, leading to joint pain. Muscles that
have not been asked to work hard for a long time are
unable to cope with the sudden repeated load and
are again strained. The classic day after soreness
can be quite off putting and debilitating.
The way in which you move when overweight and
unfit also has its threats to your body. When your
tummy muscles are weak your pelvis tips forward.
This is compounded by the front of the hips being
tight from sitting. A tipped forward pelvis makes your
back more arched. This compresses the spinal
joints hard together and impact-related
exercise on a compressed spine quickly
gives back-ache. It is also responsible for the low
back-ache felt when standing for any period of time.
This can all be helped by starting with some easy
pilates, yoga or core-related exercise, to improve
the tummy strength. Add in stretches for the hip
flexors as well as simply trying to hold your
tummy in when walking. Many of the
easy examples you’ll find on YouTube
are fine to start with and progress.
However, if you are unsure, a
review with your Chartered
Physiotherapist will give
guidance and peace
of mind.
Photograph: iStock
20

All these pitfalls do not mean you should not start
to exercise. It is all about giving your body the
opportunity to adapt and strengthen to cope with
the loading.
Muscles condition quite quickly over about four
to six weeks. Tendons and bone takes a bit longer,
about eight to 12 weeks. Start by walking and
other low impact exercise, like running on a cross
trainer. If you feel running is the easiest, quickest
and cheapest route for you then please start very
slowly. Build your walking to a brisk 30 minutes
daily then, at week three or four, add in a 20
second jog every three minutes. Gradually build
the jogging time and reduce the walking over a six
week period to allow the structures to adapt to the
increased loading. Be patient!
The best form of exercise for you is the one you
will enjoy and stick at. It has to become a regular
fun habit, not a painful miserable chore, or it will
only be short lived and achieve
nothing but give you pain and
a sense of failure. Set the
goals small, be realistic
and build slowly.
Good luck!
7morning
exercises to
start your day
For many people exercise is not a priority. But the
importance of movement is vital, especially for those
who lead a sedentary lifestyle.
Experts have found that a mere 30 minutes a day is enough to
ensure a steady weight loss and healthy heart, but which exercises
burn the most calories?
1
Swimming.
You can burn 650-700 calories per hour at your
local swimming pool! Swimming burns a lot of calories because
it forces you to use your entire body, not just your legs!
2
Skipping.
An hour of skipping burns up to 750 calories.
Jumping for 10-20 minutes before you start your work out is
the perfect warm up. The effort it takes to jump rope for 10
minutes is the equivalent of running a mile in eight minutes.
3
Running.
You either love it or hate it, but it’s a great way to
burn a lot of calories. It’s as easy as walking out of your front
door and starting. You don’t need a lot of equipment. It burns
about 550 calories per hour.
4
HIIT
(high intensity interval training). HIIT involves
short quick routines that are done at a fast pace, and you
must alternate different exercises with no rests in between.
You’ll only have to do about 20 minutes to burn around 300
calories, without any cardio at all. You might do jumping jacks for
30 seconds, then hit the floor and do 10 pushups, then jump back
up to do 30 seconds more of jumping jacks, followed by 15 squats,
then 25 sit-ups. This is a great workout for the winter when you’re at
home or if you don’t have a lot of time.
5
Kickboxing.
This is an excellent full body workout. The
cardio-conditioning element of kickboxing is one of the most
effective ways to burn fat—especially that stubborn belly fat
that’s associated with an increased risk of heart disease, diabetes
and some types of cancer. It’s a fun way to burn calories and get
out your aggression. This is great for building muscles as you do
your cardio.
6
Cycling.
This is a fun sport you can do year round,
and as well as decreasing body fat, it increases
cardiovascular fitness, muscle strength and flexibility. In
the winter you can do spin classes, and in the summer you
can get out and go on long bike rides. You can burn about
500 calories per hour.
7
Aerobics class. There are a lot of
different kinds of classes around such
as body pump, step, Zumba, circuit
training, barre. Whichever one you choose
to go to, you can burn around 500-
700 calories per hour if you really
work hard.
About the author
Mark Buckingham is director of Witty, Pask &
Buckingham Chartered Physiotherapists, one
of the UK’s leading physiotherapy clinics.
21

PROMOTION
Why baby swimming is the perfect
exercise (for both of you)
Good habits instilled at a very young
age are likely to last a lifetime – just
as bad ones are. You probably know that
it’s important for mums to begin a gentle
exercise programme soon after giving
birth, but what you might not know is
that it’s equally important you allow your
little one to start flexing their developing
muscles, too!
Exercise is fun – and should be a
way of life
With one in three children in the UK
now overweight (and one in five obese),
getting your baby used to regular
exercise is an increasingly important
consideration, especially as healthy
children are much more likely to grow
into healthy adults. Recent reports
estimate that over 50% of the UK’s
population will be obese by 2050, and
rates are still soaring, so it’s vital that
children see their parents as active role
models.
Swimming’s the only form of exercise
your baby can do literally from birth. ‘It’s
never too early to introduce them to the
water, as long as it’s warm enough,’ says
Paul Thompson who co-founded Water
Babies, the UK’s leading specialist baby
and toddler swim school, in 2002. ‘One
of the things we’ve always been very
proud of at Water Babies is that we’re
introducing children to the benefits of
weekly exercise, right from the very start
– our youngest ever baby was just one
day old!’
Great for physical development
Sessions in the pool are great for
strengthening arm, leg and neck
muscles, and superb for tiny lungs and
cardiovascular fitness. In water, babies
are free of the restrictions of gravity
and will use muscles they’d never even
find on land! What’s more, taking your
baby swimming is also a good workout
for you – moving around the pool with
plenty of water resistance is harder than
you think, while bouncing your baby
throughout the lesson does wonders for
toning those arms!
A study carried out in 2009 by the
Norwegian University of Science &
Technology found that babies who
swim have better balance and can grasp
objects more easily than their nonswimming
counterparts. Babies love the
repetitive movement of bouncing and
splish-splashing in the pool, and this
movement provides fantastic stimulation
for the vestibular system, which allows us
to sense motion and to balance. As this
system matures it will help a baby to keep
their head upright, pull themselves up
onto their feet, balance, and eventually
walk. Meanwhile, chasing after bright
and colourful swim toys in the pool,
and grasping hold of them to bring
them in for a good old chew, is great for
enhancing hand-eye co-ordination.
Develops learning skills
As well as providing a complete physical
workout, each Water Babies lesson also
helps with brain development. In the first
year of life the brain develops more rapidly
than at any other time, and swimming
with your baby can have an extremely
positive effect on this development,
making it even more beneficial to take
to the water as early as possible. ‘When
babies are born, their brains are full of lots
of higgledy-piggledy neurons, rather like
B-roads,’ Paul explains. ‘These need to

PROMOTION
be thickened into super-fast motorways
so that their brain functions more
efficiently. Any kind of movement is great
for this – swings and see-saws being
perfect examples. In water, your baby can
move particularly freely and in lessons
there’s plenty of rocking from side to side,
twirling your baby around.’
Water Babies teaches using repetitive
voice commands and learning to
respond to these can sharpen your
baby’s mental skills and increase their
levels of understanding. Furthermore,
the cross lateral movement of reaching
out when chasing toys in the pool is the
same one used in crawling: this teaches
both sides of the brain to work together,
not only helping to co-ordinate physical
movements but also strengthening nerve
pathways between the two sides, helping
the brain store and retrieve information
more effectively – all great for learning!
Boosts confidence
Exercises that involve moving
independently in water and holding on
to the side are wonderful for your baby’s
confidence.
Many parents also find that handling
their baby in water is great for them, too
– especially if they’re anxious about water
or can’t swim.
A skill for life
Introducing children to water at a very
young age helps prevent a fear of water
developing later. You’ll be teaching your
baby a key skill, right from birth, and it’s
one from which they’ll benefit for the rest
of their lives.
Tragically, drowning is still the third
highest cause of accidental death among
children in the UK. ‘In most cases it’s the
shock of sudden submersion that causes
children to panic,’ Paul explains, ‘and we
believe that by introducing them to water
as early as possible they’re less likely to
be fearful should they fall in.
‘Babies can learn vital life-saving actions
from remarkably early on, and it’s so
important that they do. Over the years
we’ve been incredibly proud to have
helped save more than a dozen young
lives – children who’ve fallen into canals,
ponds, water troughs, swollen streams
and private swimming pools. And they’ve
all survived, thanks to the skills they
learnt with us.’
So what might just seem like a half hour
swimming lesson with your baby actually
gives them so much more, which is why
swimming provides the perfect exercise.
It’s sociable, energetic and really good
fun – good for your baby, and great for
you as well!
Practical tips . . . if you decide to take the plunge!
All swimming is fantastic for your baby, whether you want to do a
specialised course or simply splash around in the pool. Whether you’re
taking your baby to the pool on your own, or to structured classes like
Water Babies, make sure your first visit is a positive, gentle introduction to
this multi-sensory world.
NHS guidelines say babies can swim before they’re vaccinated.
However, if your baby was born premature, then you should consult
your health professional beforehand – as you should if you have any
other medical concerns
Always check the temperature of the water – it needs to be above 30⁰
for a baby older than 12 weeks (or heavier than 12lbs), and above 32⁰
if they’re younger or smaller
It may be worth investing in a little baby wetsuit if you’re visiting your
local pool and you’re unsure of the temperatures
Limit the first few sessions to about 20 minutes – babies tire easily in
the water and there’s lots of new sensations for them to take on board!
Take two towels for your baby – one for when you leave the pool and
one for after their shower – and a little hat for when you go outside
Be ready to give them a big feed after their swim – they’ll be ravenous
after such a good workout!
As you enter the pool together for the first time, smile and talk to your
baby to reassure them it’s a fun experience (and don’t hug them too
close)! Whatever you’re feeling will always transfer to your child,
so the more relaxed you are, the happier they’ll be
Multi-award winning
Water Babies classes run
across the UK, to find out
more visit
www.waterbabies.co.uk

e all want to know the truth about sugar – is
Wit bad for us? Well the answer is yes, and
did you know that it can be as toxic as drugs and
alcohol according to a study.
Sugar regulation in the food industry is a very
tricky issue, but weaning yourself off the sweet stuff
will transform your health.
Sugar taken in high quantities is not only responsible
for obesity but also type 2 diabetes. Scientists
believe that sugar in high doses is a poison and
can contribute to many of the major fatal diseases
including heart disease and cancer. The problem we
have today is sugar in unavoidable in our modern
diet due to increased intake of processed foods,
yoghurts and biscuits, but more surprisingly it is also
in bread and crisps too. Sugars that are not burnt off
lay down as fat, and often lay around the tummy area.
The more sugar you eat the more you crave and it
becomes addictive.
Eating sugary food and high glycaemic
carbohydrates simply raises your blood sugar levels,
which triggers excess insulin production. If the
pancreas is put under too much pressure to produce
insulin, you could be at risk of developing type 2
diabetes. Sugar can mess with your head and
triggers production of your brains natural opioids,
which are key to the addiction process. As soon
as you eat something sweet you immediately want
more, which is why people find it hard to stop at
one biscuit or one chocolate. Instantly your blood
sugar levels rise, then they come crashing back
down making you feel tired and hungry. Sugars
increase levels of a hormone called ghrelin, and
this sends hunger signals to the brain, and stops the
brain detecting the hormone leptin, which regulates
appetite. So, not only are sugars empty calories, but
they then make you want to eat more!
Symptoms of eating too much sugar can lead to
feeling bloated, yeast infection, tiredness, irritability
and a weak immune system. However, cutting out
sugars all at once can leave you with moods swings,
headaches, depression and drowsiness, so take it
slowly and try to balance out your blood sugar levels
and wean off them slowly.
How to cut down on sugars.
The best way to cut down on sugar is to make
positive lifestyle changes and adapt your diet to a
healthy one. Follow these steps to begin:
1. Cut out sugar in tea and coffee – but slowly
taking 1 spoon to half a spoon until you have
none.
2. Cut out biscuits and cakes daily – only have
cake on birthdays or special occasions.
3. Eat fresh food and not processed as sugars are
high in ready prepared meals
4. Cut down on bread and only eat wholemeal
bread as white bread has more sugars.
5. Be careful of bought soups and sauces as these
have many hidden sugars
6. Only eat 2/3 pieces of fruit a day
7. Cut out on orange juice and drink a slice of
lemon in water.
8. Try to avoid fizzy drinks even if they are diet
because of the artificial sweeteners.
9. Eat three meals a day and keep sugar levels up
with healthy snacks that contain more protein to
keep you full.
10. Watch the sugar content in yoghurts that are
low fat, as the sugars are often high.
11. Keep your alcohol intake down as wine and
beer/cider have lots of empty calories – and a
lot of sugars!
12. Watch food labelling and look for the sugar
content – per 100g try to keep below 6g – the
lower the better!
13. Everything in moderation – nothing in excess!
24

PROMOTION
Photograph: iStock
Make sure you eat breakfast every day, but be aware of
hidden sugars in cereals e.g special k with fruit has 11g of
sugar for a 30g bowl. Try to eat natural yoghurts, but not
natural set yoghurt which has more sugars in. Do not drink
probiotic drinks as these contain 9.2g of sugar per 65ml shot.
Cut out as much processed food as you can and try to cook
fresh healthy meals. Increase your protein portions, which
will help dampen sugar cravings, as protein stimulates the
release of glucagon, a fat burning hormone that maintains
stable blood glucose levels and releases stored fat so it can
be burned for energy.
Sugar in fruit is naturally occurring fructose, so only eat 2/3
pieces of fruit a day, and eat the whole fruit to include vitamins,
minerals and fibre. Eat enough healthy fats to help maintain
your energy levels and absorb vitamins. Always choose low
GI carbohydrates which release their sugars slowly and last
longer. Wholegrain fibre rich and low starch foods such as
bean, pulses colourful vegetables, brown pasta, brown rice.
You must stay hydrated by drinking fresh water, as drinking
water helps fill you up when a sugar cravings strike. Be aware
that vitamin water has 23g of added fructose and cane sugar
per 500ml. Remember that caffeine makes sugar withdrawal
worse, so keep coffee and carbonated drinks to a minimum.
Regular exercise will help stabilize your blood sugar
levels. Moderate exercise 3-5 times a week improves insulin
response, so your body can deal with blood sugar highs
when they occur.
When you exercise your energy levels increase, reducing
your need to reach for sugar and caffeine. However,
strenuous exercise on the other hand can cause your body
to release more glucose to fuel your muscles, which raises
blood sugar levels temporarily. So after you have worked out
avoid the call for sugary-laden sports recovery drinks or high
sugar cereal bars and try coconut water, berries and nuts
instead. Make sure your next meal is a mixture of good low
GI carbohydrates and protein so you replace your energy
and repair the muscles.
Keep your alcohol intake under control and remember
there is no nutritional value in alcohol. Wine has a lot of
sugar and so does beer.
Finally, sleep is vital for balancing hormones and ensures
your brain produces enough serotonin to boost your mood
and suppress your appetite. So get enough rest and sleep.
ABOUT THE AUTHOR
Sara Taylor
Sara is a Personal Trainer, Hormone
Rebalancing Coach & Holistic Health
Nutrition Practitioner. She is passionate
about teaching positive lifestyle changes
to achieve optimum health.
www.sk-lifefitness.co.uk
25

No.1 in
Germany
Today in the UK the prevalence of
overweight and obesity continues
to rise; in fact trends predict that by
2050, 60% of adult men and 50% of
women will be classified not only as
overweight, but also obese 1 . What’s
more, being overweight or obese is
associated with an increased risk of
developing chronic diseases such
Almased – more
than just weight loss
Germany’s No.1 meal replacement not only makes you slim,
it also brings a host of positive benefits.
as type 2 diabetes, cardiovascular
disease and cancer. This stark reality
shows the importance of being able to
control and maintain a healthy weight.
Even though almost half of the UK
population have tried various diets as
a means of slimming down, many are
often cited as being counterproductive
or even detrimental to health and can
Lose weight effectively with Almased
actually result in greater weight gain.
However, help is at hand in the form
of a successful food product from
Germany. Almased is Germany’s No.1
weight loss product and not only does
it help manage and maintain a healthy
weight; it also brings a host of other
positive side effects.
This scientifically proven formula has been shown to positively influence metabolic activity,
resulting in a high proportion of fat loss, while retaining the body’s essential muscle mass.
More than 25 years ago,
Hubertus Trouillé a German
holistic therapist and
the creator of Almased,
developed a natural
solution to improve his
patients slow metabolism.
Subsequent improvements
in his overweight patients
metabolism resulted in
a reduction of unhealthy
body fat. Today, Almased is
sold in every pharmacy in
Germany, making it the No.1
selling weight loss product in
the country.
This meal replacement, even
though low in calories, keeps
you full for longer, optimises
fat burning and makes it
possible to lose weight.
With many diets, weight
loss can be achieved but at
the expense of starving the
body from vital nutrients.
Consequently, muscle
wastage and a feeling of
mental and physical lethargy
ensue. In contrast, using the
Almased programme, the
body gets what it needs to
function healthily. Supportive
scientific studies have shown
that Almased nourishes
essential muscle mass,
stabilises thyroid function
and supports appetiteregulating
hormones within
the body.
Made with natural ingredients: What’s in Almased?
The unique production method used to make Almased
ensures that three high-quality raw ingredients provide
optimum nutrition for the body.
Fermented Soya. Easily digested
plant protein, rich in essential amino
acids and low in saturated fat, the
high protein content results in a
longer and improved feeling of satiety.
Importantly, protein contributes to the
maintenance of essential muscle mass and bones.
Probiotic Yogurt. Made from
premium quality milk; it provides the
body with live cultures to improve
digestion and intestinal health.
Moreover, calcium present in the
yogurt helps maintain healthy bones
and the function of digestive enzymes. Additionally both the
yogurt and soya provides very high levels of biotin, which
contributes to energy release as well as the maintenance of
healthy skin and nails.
Honey. Sourced from protected nature
reserves in North America, this honey is
carefully processed in order to optimise the
raw enzymes that aid healthy digestion.
Since the aim of Almased is to produce
a product as wholesome as possible and
free from artificial sweeteners, the small
amount of honey provides natural sweetness
while also enhancing the taste.
What is not in Almased? Almased is free from artificial
flavours, fillers, preservatives, stimulants and added sugars.
It is also gluten free, non-GMO and suitable for vegetarians.

PROMOTION
Clinical Research on Almased
25 years of scientific research
has validated all key claims
about Almased and its benefits
to health and well-being. One
such clinical study conducted
by the University of Freiburg,
showed the effectiveness of an
Almased programme on body
weight and body shape after
a period of four weeks. Twelve
overweight subjects consumed
Almased for breakfast and dinner,
as well as a low-fat regular meal
at lunchtime. The participants lost
an average of 10.6 lbs in weight
which the researchers attributed
to the positive influence Almased
had on hormonal levels 2 . Today,
we know that a multitude of
mechanisms are responsible for
the effect Almased has on the
body (Figure 1).
In a follow-on longer-term
intervention 3 , the effect of
Almased on body composition
was examined. The six- month
study showed participants
lost fat but unlike other diets
they also retained important
muscle mass. This retention
of the muscles integrity is key
to any successful weight loss
programme.
Figure 1: Significant Advantages of using Almased
Did you know?
Almased is suitable for overweight people with Type 2 diabetes
Nearly 4 million people in the
United Kingdom suffer from
diabetes, some of which
have a hard time losing
weight because of their high
insulin level. Type 2 diabetes
makes up the majority of
those affected and it is this
metabolic disorder which
occurs mainly in people who
are overweight. Although
their bodies produce insulin,
their cells do not react to it
in the normal way. Sufficient
glucose is not absorbed
properly, so blood sugar
levels rise. In response to
this, more insulin is produced
to normalise blood sugar
levels. It is this high insulin
level which encourages
fat deposition and inhibits
fat breakdown.
Almased is suitable
for people with Type 2
diabetes because it has
a high proportion of plant
based protein and is low
in carbohydrates. This
is positively reflected in
Almased’s low glycaemic
index (27) and extremely low
glycaemic load (4). Foods
with low GI and GL values
ensure a slower release of
insulin, not only supporting
healthy blood sugar levels,
but subsequently inhibiting
the storage of fat and
stimulating fat loss. As
clinical testing has shown,
a diet supported by Almased
leads to improved weight
loss, reduced fasting and
long term blood glucose
levels, as well as fasting
insulin levels 4 .
Those with diabetes should
measure blood glucose
levels before using Almased
and two hours thereafter.
This way it can establish
how Almased affects the
blood sugar pathway.
Levels should ideally be
below 8.5mmol/L two hours
post shake 5 .
How to use Almased
Almased is a meal replacement
that can be used to replace one,
two or three of your daily meals;
alternatively it can be used as
additional supportive nutrition to
your existing balanced diet.
A 50g serving (5 heaped tbsp)
of Almased mixed with
200-350ml of water or lowfat
milk and 1-2 tsp of oil
(i.e. flaxseed, walnut, rapeseed,
olive) is important to achieve
your energy and nutritional
needs. It is recommended to
add this small amount of oil
to each Almased shake in order
to ensure an adequate intake
of essential fats which our
bodies need.
The Almased programme
offers two different plans which
you can follow; the 14-Day
Figure Plan ensures timely
and effective weight loss, while
the Long-Term Plan can be
used for an extended period
or until you have reached your
desired weight.
Buy Almased at www.almased.co.uk
or your local Pharmacy
Download your FREE 14-day and Long-Term
Figure Plans at www.almased.co.uk.
For more information call 0207 969 1886
or email nutritionist@almased.co.uk.
References:
1
Department of Health (2011). Healthy Lives, Healthy People: A call to action on obesity in England; 1-51.
2
Berg, A et al (2000).Using Almased in an Enriched Soya Diet for Weight Loss. German Journal of Sports Medicine, 51:39.
3
Deibert, P et al (2004). Weight loss without losing muscle mass in pre-obese and obese subjects induced by a high-soya-protein diet. International Journal of Obesity; 28(10):1349-52.
4
Martin S, et al (2013) Protein-rich meal replacement significantly reduces HbA1c, weight and antidiabetic medication in type 2 diabetes patients – a randomised controlled trial. Diabetes 62 (Suppl 1): 768-P.
5
National Institute for Health and Care Excellence (2014).Type 2 diabetes. The management of type 2 diabetes. NICE clinical guideline 87: 1-54.

Obesity and
Reproduction
Fertility and body weight: Being overweight
may double your wait for a pregnancy
Being overweight may affect
the fertility of both men and
women. Professor Adam Balen,
who is Professor of Reproductive
Medicine in Leeds and Chair of
the British Fertility Society, has
been studying the links between
body weight and fertility for
many years.
We have known for many years
that female fertility is very sensitive
to changes in weight whilst this is
a relatively new discovery in men.
For this reason we understand
less about why overweight men
have a tendency to produce less
fertile sperm and where both
environmental and hormonal
factors play a role.
Women who are underweight
stop having periods as they do
not have the nutrition to sustain
a pregnancy. It therefore seems
logical to assume that women with
more body fat should be fertile and
many are.
Going back to ancient
times, fertility symbols were of
overweight women and until
a few years ago the healthy
female form was considered to
be curvaceous rather than slim.
Nonetheless we are now living
in an age of sedentary lifestyles
and increased calorie intake that
this certainly can impede natural
fertility but also lead to significant
risks during pregnancy. The
mother could face diabetes, high
blood pressure, problems during
delivery and even death, whilst
the baby could see an increased
risk of miscarriage, congenital
abnormalities (heart defects, spina
bifida), still birth, prematurity and
neonatal problems.
We also know that the
environment within the ovary that
the egg cell develops in can be
significantly affected by the mother
being overweight – for example,
eggs from obese women are more
likely to be abnormal and less
likely to fertilise. Furthermore the
resulting embryos then have to be
“incubated” during pregnancy in
the safety of a healthy womb. Here
again, if the mother is overweight
this may lead to long term problems
for the baby that may follow him or
her through to adulthood.
A person’s body mass index
(BMI) is calculated by assessing
body weight in relation to height,
normal being between 20-25 kg/
m2. A person is obese if his or
her BMI is more than 30 kg/m2.
There are also degrees of obesity:
class 1 (30.0–34.9 kg/m2), class
2 (35.0–39.9 kg/m2) and class
3 (> 40 kg/m2). Rates of obesity
vary around the world and in the
UK more than 60% of the entire
adult population are overweight or
obese, with rates increasing with
age. A recent survey of women
attending our clinic for the first time
in Leeds, with a mean age of 33,
found 31% to be overweight and
17% obese.
The mechanism which links
obesity to reduced fertility remains
to be fully understood. Obese
women, particularly those with
central obesity (that is fat within
the abdomen that increases waist
circumference, are less likely to
conceive per cycle. Even being
slightly overweight (BMI > 27)
has a negative effect, but if your
BMI is more than 30 your chance
of infertility is increased by two to
three fold.
We also appreciate that ethnicity
plays a role in influencing the
effect of body weight on fertility.
For example in the UK people who
originated from South Asia have
worse fertility and other health
problems (such as diabetes) at a
lower BMI than the Caucasian
population. This may be because
historically some populations have
a genetic make up that protects
them from the effects of food
deprivation in times of famine, but
in times of plenty being overweight
has a greater impact.
Overweight women experience
menstrual cycle disturbance and
are up to three times more likely
not to ovulate than women of
normal weight. Obesity not only
impairs ovulation but has also
Photograph: iStock
28

een observed to detrimentally effect endometrial
development – the development of the womb lining -
and implantation of the embryo, thereby also leading
to an increased risk of miscarriage.
The commonest hormonal problem experienced
by women is polycystic ovary syndrome (PCOS),
an area that has been the main focus of my
research over the years. The expression of PCOS
is regulated, in part, by weight and so obese
women with PCOS often have more severe
symptoms and experience more sub-fertility.
Obesity also impairs the response of women
to all fertility treatments, which is why the
National Institute of Care Excellence
(NICE) advises that NHS funding for
fertility treatment should not be offered
to women with a BMI of more than
30. Weight loss through lifestyle
modification or bariatric surgery
has been demonstrated to restore
menstrual regularity, ovulation
and improve the likelihood
of conception and a healthy
pregnancy, both naturally and
with treatment.
CASE STUDY
Lucy (not her real name) attended
our clinic eighteen months ago at
the age of 29 and with a BMI of 36,
she had irregular periods but otherwise
she and her husband were healthy.
Since puberty she had struggled with
her weight and found it difficult to
exercise. When we explained the
impact this was having on her fertility
she enrolled in a weight management
programme, was careful with her diet
and started to swim and then started
running once her weight started to fall.
She came back to clinic after 6 months
with a BMI of 32, by which time she
didn’t need further encouragement as
she was enjoying feeling fitter. After a
further three months her periods were
regular and she conceived naturally
without the need for treatment.
FACTFILE:
Body Weight and Fertility
• Fertility is most likely in people with a
normal weight
• Women who are underweight stop having periods
• Women who are overweight and obese have a 2-3
fold reduction in their fertility
• Being overweight increases risks during pregnancy and
also may adversely effect the long term health of children
• Fertility treatments are less likely to work in people who
are overweight
• Weight loss is best achieved by a combination of diet
and exercise
About THE AUTHOR
Adam Balen
Professor Adam Balen MB, BS, MD,
DSc, FRCOG is a full time Consultant in
Reproductive Medicine at Leeds Teaching
Hospitals NHS Trust.
29

The dangers of
mindless eating
Mindless eating is one of the most fundamental
reasons for weight gain in the UK
Almost everyone can relate to the term “comfort
eating”. Whether you’re experiencing a hectic
home life or a stressful work environment,
comfort food provides a quick and easy solution
for lifting our moods. But the practice of treating
ourselves to our favourite foods in order to improve
our mood and wellbeing is thought to be the most
compelling contributor to obesity in the UK.
From the moment we are born, we are nurtured and
treated with food, so having an emotional connection
to food is normal. However, it is not uncommon
for people to use food as a way of coping with
negative emotions.
Obesity is as much a psychological problem as it
is a physical one. Many psychological issues can not
only foreshadow the development of obesity, but they
can also cause ongoing struggle to control weight
gain. Because the psychological aspects of obesity
are so important, assessments and interventions
have become an integral part of a multidisciplinary
approach to treating obesity, which includes the use
of bariatric surgery.
Dr Bijal a leading bariatric surgeon at London’s
Nightingale Hospital says:
“Overeating is about physiological needs and
emotional needs. Physiologically, if an individual’s
diet is deficient in macro and micro nutrients then
the brain keeps sending signals for more sustenance
i.e. the hunger signal. Unfortunately we misread
this as a need for more food rather than need for
right food. This is often a trigger for overeating.
Once we start to eat it takes about 20 minutes for
receptors in our stomachs to send a signal back to
our brain that “sustenance has been received” and
to stop the hunger signal. It is in these crucial 20
minutes that we are most likely to overeat beyond
our calorie requirement. The second physiological
process that is linked to overeating is satiety - the
signal from our brain that tells us “I am full, stop
eating”. Research shows that suppressing this signal
by regular overeating or disrupting this signal by
restricting, or yo yo dieting weakens this signal. Lack
of satiety leads to overeating.
Simple habits, for example, only eating at family
meal times around a table can do an enormous
amount in combating obesity because it eliminates/
reduces mindless eating and means that eating
becomes a social occasion, slowing the speed at
which we eat allowing the brain to recognise when
the stomach is full.
Food decisions are based on multiple factors.The
popular theory “your body will give you signals of
what it needs” often explains food decisions. For
instance, we crave warm and more filling meals in
winter as our calorie requirements increase by a
small percentage in winter to keep warm. Individuals
deficient in iron often crave iron rich foods. However
our food choices like many other daily life decisions
are now governed by the trend in urban life style
i.e. easy fixes, quick fixes, quick release energy.
Fast foods, caffeinerich
foods, high
sugar and fat diets
have hence become
popular choices.
“Leptin, known as
the anorexigenic
hormone, mainly
regulates energy
balance thereby
suppressing food
intake. Ghrelin on
the other hand is a
rapid acting hormone
that initiates appetite.
Photograph: iStock
30

People with obesity are known to be leptin resistant
and thereby unable to regulate energy. Ghrelin
levels are known to decrease with eating, essentially
producing the effects of satiety but increase before
meal times producing the effects of hunger. The
regulation of the two hormones combined with other
neurotransmitters is essential in regulating food intake
and body weight,” ays Dr Bijal.
Obesity and over-eating involve both physical and
psychological facets so treatment – and educating
adults in how they feed their children - should bridge
the gap and address both aspects. Currently there is
also too much focus on food with fad diets rather than
addressing the eating process, which causes obesity.
Similar effects have been shown for chronic stress,
but to date, we do not know how this comes about.
Does stress contribute to forming bad habits about
eating, which bias people more towards snack
food? Does stress change how our brains
make decisions? And can we make these
changes visible, or even reverse them?
Interestingly, not everyone reacts the
same way when stressed: While most
people would eat more, German
researchers found roughly one
third of the population they tested
refused eating under stress
altogether. What is it that keeps
these “stress skippers” away
from the buffet, while “stress
munchers” go for an extra
serving of their favourite snack?
We can ask a similar question
when it comes to emotions:
When subjects experience
unpleasant emotions in a
laboratory experiment, they
tend to eat more, and less
healthy snacks after the
study than their peers who experience pleasant
emotions. This seems to support the popular notion
of “emotional eating”, but if one looks closer into
the scientific literature on this topic, we do not have
a good toolkit yet that could help us describe what
exactly is happening. Did emotional eaters learn to
silence their emotions with eating? How do their brains
decide differently if they are in different emotional
states? And why are some people more affected by
this than others? It’s vital that we develop tools to help
us better measure the changes that emotions cause
in the way the brain makes decisions. We hope
this will eventually help us explain why emotional
eating happens and how emotions may affect our
food choices.
31

32
Jessie
pavelka
talks
fighting
fit

With so much emphasis on weight loss, diets and bikini beach
ready body, internationally recognised fitness expert and
trainer Jessie Pavelka suggests that focus should be placed
on the emotional side of good health rather than the visual.
e put ourselves under so much
‘Wpressure to look a certain way but
really, the feelings created by good health
are so much more rewarding, achievable
and better for us in the long term. I tell people
that sexy is ‘strong’ not necessarily ‘skinny’.
Once you take the pressure off just losing
weight, people can focus on overall health
which is so much better in the long run.’
Jessie is known in the UK through his raw
but sensitive documentaries on Sky TV Fat:
The Fight of My Life and Obese: A Year to
Save My Life, through which he works with
morbidly obese individuals on their journeys
to regain their bodies and their lives. He’s also
appeared on ITV Good Morning Britain’s as
their ‘Sugar Free GMB’ Fitness Expert and is
due to appear again later this year.
‘The people I work with are complex
individuals, as we all can be, and need
encouragement and support. They know
what they should be doing. They know they
are harming their bodies. But often, they
feel powerless and turn to food or drink
for comfort.’
‘Food is the most readily available
drug on the high street and those
who feel compelled to eat more
than they need are no different
to others who turn to other
addictive behaviours such as
alcohol addiction or drugs.’
‘I work with those looking for
solutions that they have not
been able to find through all
the diets currently available.
Together we take a holistic
approach to their day to
day habits and behaviours
and look at ways that small
changes can be made
for the long term, more
permanent result.’
Jessie has recently
launched his UK brand,
Pavelka Health Revolution
which offers a range of
workshops, seminars and Bootcamps which
in turn is backed up by an online membership
programme, The Pavelka House, which
creates a 24/7 environment of information,
inspiration and interaction.
‘I base my work around the Four Elements
of Health: Movememnt, Food, Mind Power
and Family. I believe that there has to be
a balance of all four of these areas for
someone to achieve a healthy, permanent life
style. It’s not about losing weight - it’s about
gaining health.’
‘I’m not saying that diets don’t work. They
do. When you change your habits for the
better, reduce your intake of food, move more,
you will reduce weight. But is it sustainable?
Is your new regime something that you can
continue for the rest of your life?’
‘If not, defaulting back to existing behaviours
often means that weight can return and many
people become heavier than they were in
the first place. This can cause emotional
upset, food becomes the comfort and so the
cycle continues.’
‘I believe that focussing on eating well,
moving each day, exercising the mind as well
as the body and surrounding yourself with
supportive like minded friends and family is
the best way to good health. Making small,
positive changes which then become healthy
habits is a far better long term approach.’
This year Jessie is supporting Cancer
Research UK’s Race for Life as the face of the
programme for 2015 encouraging women
everywhere to join the Pink Army and beat
cancer sooner.
‘I’m delighted to have this opportunity. I tell
people to set themselves challenge targets
rather than weight loss ones. So booking a
5k or a Pretty Muddy is a great way to create
an achievable goal. I’m looking forward to
attending the Hyde Park event in July and
taking the warm up.’
For more details of Jessie Pavelka’s
Health Revolution’ go to
www.pavelka.co.uk.
PROMOTION
33

PROMOTION
Photograph: iStock
34

Back in the halcyon days of early 2004 the
Labour government blissfully set a target
of halting the year on year rise of obesity
in children under the age of 11 by 2010.
Even in early 2007 it spoke excitedly
of the enormous progress that had been made
towards achieving the goal as a result of its highlycoordinated
approach to tackle the problem. But
the excitement was short lived. By October of that
year the Foresight Report, with its dire predictions
for UK obesity by 2050, changed everything.
Overnight the 2010 target was quietly dropped
and a new, softer target was set for 2020. Without
announcing any new programme Labour fondly
hoped to position the UK as the first major nation
to reverse the rising tide of obesity with the initial
focus on overweight children. The aim was that
by 2020, their weights would revert back to 2000
levels. Really?
With 2020 now only four and a half years away
the target might still be achieved however if a “
revolution “ called for by Simon Stevens, head of the
NHS, is taken up by the new government. Without
such a revolution in the Whitehall’s attitude towards
obesity, Mr Stevens believes, the financial stability
of the entire health service will be at risk. That
sounds like a crisis, but observing the immediate
aftermath of the May 7th election one wouldn’t have
guessed it. Whilst acknowledging that questions
hanging over the political future of the UK and its
future with Europe may have had to be urgently
considered, there was scant evidence that Downing
St showed any urgency about obesity. In fact, it
took four whole days before the confirmation that
Jane Ellison would remain in post as Public Health
Minister and that it might be business as usual at
the Department of Health. The delay served both
to underline Whitehall’s generation-long lack of
commitment to public health and that Stevens’
message cannot have been properly understood by
No 10. Disaster. How many times does it have to
be stated that, though obesity by itself may not be
an expensive disease, the cost of diseases triggered
by it – diabetes, heart disease, some cancers and
the rest – are crippling?
If it is to be business as usual, that’s a far cry
from “ revolution “ and doing nothing out of the
ordinary is not an option. Stevens has to be listened
to and whatever is on his shopping list has to be
seriously considered at Cabinet level. In a sense,
the Department of Health may even be superfluous
since Local Government is now technically in
charge of sorting out obesity. Though town halls
had to accept this responsibility two years ago
under Andrew Lansley’s ill judged NHS reforms,
they seem more up for a revolutionary job than
anyone in Westminster. They are already quite
clear what they need to deliver their part of the
sea-change, their price is £1bn and they should
get it. The money is a fifth of the income raised
on sweets and sugary drinks VAT and alcohol duty
and would properly supplement the pitiful funding
that they currently receive from the Treasury. The
sum total would allow local councillors to respond
to the specific health needs of the communities
they know best and would be spent particularly on
preventative measures.
Though that might upset many obesity clinicians
who think that prevention already gets too much
cash, its fighting talk to the Stevens who rues the
billions being spent on surgery and treatment when
sizeable amounts should be spent in trying to
stop people from getting fat in the first place. This
therefore brings up the issue of millions of children
whose health, says Stevens, is being put at risk by
our inaction to protect them from an obesogenic
society. The associations representing the nation’s
220,000 doctors would agree with him. In the
opinion of the Royal College of General Practitioners
[RCGP] childhood obesity is a “ state of emergency
“ demanding a COBRA-style emergency committee
to overcome it. The RCGP is joined by the Academy
of Royal Medical Colleges in demanding that a tax
is immediately put on sugary drinks or, at the very
least, a 20% levy is trialled for a year. Anyone
feeling reassured by government that childhood
obesity is levelling out and therefore than a tax
isn’t warranted should take a look at December’s
National Child Measurement programme statistics.
They show that every weight metric is still on the
increase and, worse still, the level of obesity in the
country’s most deprived areas is double that in the
least deprived. It is criminal that 22.5% of primary
school entrants and 33.5% of secondary school
entrants are overweight or obese and that 37.5%
of 15yr-olds are now outside what is regarded as a
healthy weight.
Less than healthy food, and its inappropriate
marketing, is as lethal as real coke and energy drinks
in the view of the doctors and strict limits should be
imposed on the levels of fat, salt or sugar stuffed
into it. “ An entire generation could be destroyed
by a diet of junk food and fizzy drinks “ was the
accusation written into an open letter to England’s
Chief Medical Officer last year and a strategy to
stop the destruction action should be already in
draft form somewhere. The 2020 target might be
achieved if it is. The child conceived to-day and
going to school in five year’s time within the healthy
BMI range could be fact and not wishful thinking if,
together, both central and local government got a
grip. The crucial first 1000 days of a child’s life,
roughly the period from when the baby is planned
to its 2nd birthday, should be at the centre of the
revolution and could overturn the lack of attention
to children by successive governments over the
last two decades. This article is not the place to
itemise all the issues that need to be addressed but
proper oversight of women throughout pregnancy,
a programme to encourage breastfeeding and
appropriate weaning, the shake-up of first foods
and fast foods and education in the responsibilities
of parenthood would be a good start. If you
believe yourself to be a perfect parent you may well
want now to send an outraged complaint to Obese
Britain but the evidence shows that finding perfect
parents is getting more difficult by the minute in
to-day’s society.
ABOUT THE AUTHOR
Tam Fry
Spokesman for the National Obesity
Forum and a frequent broadcaster
on the issue of obesity, talks about
the what the new government must
do in order to tackle the rising issue
of obesity in the UK
35

PROMOTION
What do we mean by
Photograph: iStock
‘overweight’?
L
ast
month a government policy paper
on obesity and healthy eating said that
“excess weight” can make it harder to
hold down jobs and can affect self-esteem
and mental health.
But the obesity crisis that costs the NHS
more than £5 billion a year will not be
helped by people losing weight. What obese
people actually need to lose is fat, and that’s
a completely different ballgame.
“Obesity is not about being too heavy, it’s
about being too fat,” says Phil Chant, director
of Bodyscan (bodyscanuk.com), a company
that accurately measures body composition
with low-dose X-rays known as DEXA.
“Weight is nothing more than your
relationship with gravity and there’s not much
you can do about the force that keeps your feet
on the ground. What you can do something
about, and what you should be focused on, is
changing your body composition – reducing
the amount of fat in your body and increasing
the quantity of lean muscle.”
Unfortunately, the most widely used tool for
classifying someone as obese is the muchmaligned
body mass index (BMI) which is
simply your weight divided by the square of
your height.
BMI is completely blind to how much fat
and muscle you have and how it’s distributed
around your body. “The biggest risks from
obesity are related to fat in the upper body,
in particular visceral fat, which surrounds the
organs,” says Chant. “You can’t measure
visceral fat by standing on a set of scales,
and you can very easily be small and slim
with risky levels of visceral fat.”
Chant pulls out a folder of body composition
reports to make his case against BMI and
weight. The first is that of a 29-year-old
bodybuilder whose BMI of 32.9 makes him
not just ‘overweight’ but ‘obese’. The DEXA
report tells a very different story - he has
lower body fat than 97% of men his age,
more muscle than 99% and a healthy amount
of visceral fat.
Another report is that of a slim 23-year-old
male, 69kg in weight, 177cm tall and a BMI
smack bang in the middle of ‘normal’, ie,
officially healthy.
But DEXA body composition analysis shows
the young man to be 31% body fat – higher
than for 81% of men his age, with very low
levels of muscle and high visceral fat.
And a third report is of a client who lost
7.5kg over 12 weeks but is now fatter than
at the start because almost all of the weight
lost was muscle.
The crazy thing about BMI is that it’s used
by the insurance industry to assess policy
premiums. “As people get leaner and put
on more muscle they get heavier,” says
Chant. “Their BMI goes up and, with it, their
insurance premiums.
“Fit, muscular people are paying more
than fat people for their health insurance. It’s
ridiculous!”
Conversely, the weight loss industry is
making millions by convincing people they
need to be lighter when in reality they need
to be less fat.
Instead of using body mass index,
individuals and industry should switch to
more meaningful indices such as fat mass
index (FMI) and lean mass index (LMI). These
are calculated from the exact quantity of
fat and lean mass in your body, which can
be determined with accurate methods of
measurement such as underwater weighing
and DEXA.
Unlike weight – and even body fat
percentage – a falling FMI is unequivocal
proof that you’re losing body fat.
So forget BMI and stop standing on the
scales to check your relationship with gravity.
Understand instead exactly what you’re
made of – how much fat and how much lean
– because they are things you can change.
HIGH FAT, NORMAL BMI
BODYBUILDER, OBESE BMI
36

“A great healthier
alternative to the other
oils out there. It’s so
pure, gives my food
more flavour and tastes
amazing. I fry my
chicken in it practically
every day and it goes
great in shakes too.”
Shachar Head
World Champion Powerlifter
& World Record Holder

FOOD
sWAPS
Getting fit and active is a fantastic way to cope with stress,
improve relaxation and help you and your family stay fit
and healthy. Here’s how to get started...
Doing exercise releases mood-boosting
feel good endorphins so just watch how
good you will all begin to feel as fitness
levels build. One of the main reasons that
people give up on exercising is because
of boredom, but a 30 minute workout will
fly by if you’re chatting to family. The most
important thing is to have fun! The other
thing to remember is how much of a support
you can to each other. Stay strong, you’ll all
be a tower of strength to each other when
motivation dips.
Healthier swaps at breakfast
• When you’re shopping, look for breakfast cereals
that have wholegrains and that are lower in sugar
(and check the salt and fat levels too.
• If you’re having a little trouble swapping to plain
cereal, you could start by mixing a little sugary
cereal with the plain and increase the plain a little
each day until you’ve totally swapped - and no
one will probably notice!
• When serving up the new plain cereal, try adding
different fruit - like raspberries or blueberries and
low-fat, lower-sugar yoghurt.
• Here’s a great way to start a Saturday or Sunday
- wholewheat soft tortillas wrapped around a
tomato and fresh pepper omelette. It could soon
become a top family breakfast treat!
38

After school swaps
We all know the kids are hungry
after a long day at school. But try
swapping sugary biscuits, sweets,
pastries and chocolate for snacks
with less sugar such as fruit, plain
unsalted nuts, plain rice cakes,
teacakes or toast. These will keep
them going until dinner (plus, you
won’t get nagged for more food
every five minutes!).
• Once you’ve written your
shopping list, why not get your
child/kids to help you find snacks
in the supermarket that are
lower in sugar? Tell them to look
for colour-coded front of pack
nutrition labels that have more
green on them than red. You
could even make a game of it!
• Before you pick up your kids
from school, take a few moments
and put together some healthier
snacks (such as chopped up fruit,
veggie sticks, plain rice cakes,
plain unsalted nuts and carrot
sticks) to take with you. Then if
sweets and cakes tempt them,
you’ve got a handy alternative to
offer!
• Try not to use sugary snacks,
sweets and chocolate as
rewards. Try other rewards such
as stickers, trips to the park or a
visit to a friends.
• Of course, cutting out sugary
snacks is great, but it doesn’t
have to be a total ban. Once
you are on your way to giving
healthier snacks, you could let
your kids pick a favourite sweet
snack once a week.
Drink swaps
When kids get thirsty, very often,
we give them fizzy drinks or
sugary squash and juices. But
around a quarter of the added
sugar in kids’ diets comes from
sugary drinks!
• You could start your swaps
by buying smaller sizes and
swapping some of usually sugary
drinks to sugar free or no added
sugar drinks.
• Instead of sugary, fizzy drinks,
why not try lower-fat milks for a
change? Fresh and ice-cold from
the fridge, not only does it taste
great, it’s a source of calcium,
which helps keep our bones and
teeth strong too.
• When kids want a fizzy drink,
try sparkling water poured over
lots of ice and served with a
wedge of lime or lemon. Add a
couple of straws and it should go
down refreshingly well!
• For a super weekend treat, why
not blend a banana with some
ice cubes and cold semi-skimmed
milk, then sprinkle the top with
cinnamon – scrummy!
how to Cut calories
when cooking:
• A great way to cut down on
your oil intake is to use olive oil
sprays when cooking. Frylight
oil sprays are available in
all major supermarkets. RRP
£2.20.
• Blend low-fat cottage cheese
with skim milk to replace one
cup of whipping cream. Cook
it this way and save: 632
calories.
Healthier pud swaps
A simple pudding swap can be
really tasty and filling, as well as
healthier. Switch from things like
sugary puddings to more refreshing
ones like fruit, which also count
toward your 5 a day.
• Cutting down on sugar doesn’t
mean no more puds! Apple and
blackberry crumble is easy to
make without much sugar. Serve
with a dollop of low-fat, lower
sugar yoghurt sprinkled with
cinnamon and enjoy!
• If you fancy ice cream, choose
low-fat, lower sugar yoghurt
instead. There are some
very tasty fruit options in the
supermarket.
• Manuka honey is a great sugar
substitute with great health
benefits. Add it to your tea or
coffee, spread it on your toast,
add it to your yoghurt! Manuka
honey from Comvita £21.99
(250ml) available at Boots and
Holland and Barratt.
• The difference in calories
between whole eggs and egg
whites is asotunding. You can
make most dishes using only the
whites. You’ll need to use twice
as many, but you’ll save calories!
Photograph: iStock
39

PROMOTION
Photograph: iStock
40
Ian loses 7 stone with
the help of his local
health & fitness centre,
after being diagnosed
with a life-threatening
sleep disorder
arlier this year, Ian Paton, 31, from St Leonards-on-Sea, weighed
E22 stone and had a 42 inch waist. He suffered from sleep apnoea
– a condition obese people are particularly prone to, where you
stop breathing as you sleep. The day Ian was diagnosed was the
wake-up call he needed to lose weight for the sake of his health and
life expectancy.
“I’ve been fat as long as I can recall and particularly over the
last five years my weight kept going up to the point I was wearing
size 3XL clothing,” says Ian. He had previously followed a GP
referral programme and tried gym sessions but they had no
lasting effect. In November 2013, Ian was diagnosed with sleep
apnoea. “Friends alerted me to this after they watched and
heard me sleep. They were worried that I stopped breathing
every few minutes – in fact when I was monitored at hospital,
they discovered I stopped breathing up to 50 times an hour
while asleep!”
Being obese is a major contributing factor to sleep apnoea
and Ian knew he had to lose weight.
“I was 20 stone when I was diagnosed and by February
this year I was 22 stone,” admits Ian. “With the help of a
friend I plucked up the courage to visit Falaise Fitness Centre
in March and thought a new gym and fresh environment
would help.”
“From the minute I walked in, I felt welcome. The team
are very friendly and never judgemental. I felt self-conscious
initially and kept a low profile. People were there to help
but they didn’t impose themselves on me. I started slowly
and built up my time on the cardio machines and increased
my weights bit by bit.”
When Ian started at the gym – which is operated by
Freedom Leisure in partnership with Hastings Borough
Council - he couldn’t run 20 seconds on the treadmill:
now he can run 5 miles outdoors a few times a week
without stopping.
As so often happens, Ian hit a ‘plateau’ and stopped losing
weight in late September. “I sought advice from Julie, a fitness
manager, and she explained I needed to change my routine
and challenge myself to kick start more weight loss.”
Ian has just started an exercise course including abs and
group classes to shift his workouts up another gear. He is
enjoying indoor cycling classes and is beginning to feel and see
the difference.
Ian also changed his diet to aid his weight loss. Before, he used
to skip breakfast, snack through the day and then buy a take away
most evenings after finishing work late.
“Now I eat breakfast every day, have a light midday meal of
around 400 calories and then dinner at 5pm before my evening
workout at 7pm,” says Ian. “I don’t eat much after my workout:
a bowl of cereal at most. Then I wake feeling hungry and have a
nutritious breakfast to kickstart another healthy day.”
Ian’s efforts have paid off - he is down to 15 stone and is aiming
for 13 stone. He has lost 8 inches around his waist and dropped three
clothes sizes. He feels energised and confident to try new things, run
further and keep challenging himself.
“It’s been a privilege to see Ian progress,” says fitness manager Julie
Cowan. “He’s a great inspiration to other members here at Falaise Fitness
Centre and we have no doubt that he will achieve his target weight in the
near future.”
For more information about Falaise Fitness Centre or to speak to one of the
Freedom Leisure team about losing weight, call 01424 457692 or you can
visit www.freedom-leisure.co.uk.
“Being obese is a
major contributing
factor to sleep
apnoea and Ian
knew he had to
lose weight. “

Enjoy the lighter side of cooking...

LET THEM EAT GREENS
Sneaky ways to get your kids
to enjoy their vegetables
Photograph: iStock
42
• Try roasting vegetables such as
carrots, parsnips and potatoes and
toss in a little olive oil and runny
honey for a quick sticky glaze that’s
sweet and satisfying.
• Make homemade beef burgers and
add a little finely grated carrot and
courgette to the mixture. Not only
does this add to their five-a-day
but also keeps the burgers
deliciously moist – unlike some
over-processed types.
• Soups are a brilliant way of disguising
an assortment of vegetables all
in one go. Blend sweet butternut
squash and red lentils for a creamy,
tasty soup.
• Add another vegetable when
cooking mashed potatoes – try
broccoli and potato mash or root
vegetable mash with parsnip, carrot
and potato. Delicious served with
sausages, it’s a healthy and nutritious
winter warmer.
• Chunky pasta sauces or blended
pasta sauces can disguise even
more veggies or how about a pasta
and vegetable bake, just make sure
it’s tomato-based, not cream.
• Kids love a hands on approach.
Prepare meals together. Younger
children can wash, and older ones
can chop vegetables for stir-fry
dishes and salads

PROMOTION
Fabulous
Fish!
Exercising regularly and eating a
balanced, nutritious diet can help
us to manage our weight more
effectively. The good news is that
introducing more fish as part of a
varied diet can make a big difference
when it comes to our waistlines.
If you are looking to lose weight, white fish –
cod, haddock, whiting, hake and many more
varieties – are a great choice. White fish is low
in fat, which makes it easier to control calorie
intake – just make sure it’s not fried or served
in a way that adds extra calories. Shellfish also
tends to be low in calories and high in protein
so there are plenty of options.
Don’t dismiss oil-rich fish either, indeed health
experts recommend everyone should enjoy at
least two 140g servings (cooked weight) of
fish a week, one of which should be an oil-rich
variety. Sardines, mackerel, herring, fresh tuna,
trout and salmon all fall into this category,
containing omega-3 fats, which have been
shown to have many health benefits. Omega-3
fats keep our heart working properly, maintain
normal blood pressure and triglyceride levels
(a type of blood fat), brain function and vision.
Many of us start exercising to help with weight
loss, but while health experts agree this is a good
move, they suggest that best results are achieved
when we combine exercise with a healthy,
balanced diet.
This is never more important than when we
are training hard for a sports event, which can
increase our requirement for nutrients involved
in producing energy in the body such as many
of the B vitamins and iron. Iron is needed by
red blood cells to transport oxygen around
the body which helps to reduce tiredness and
fatigue. Several shellfish including crab and
mussels all contain many B vitamins and iron.
Busy schedules can make it harder to eat
healthily, however, fish is quick to prepare,
quick to cook and is the ideal choice when you
are short of time. Let’s not forget how versatile
and tasty it is, too!
For a full range of delicious fish recipes
and more advice on how eating fish can
complement a healthy and active lifestyle,
visit www.fishisthedish.co.uk.
Information provided by registered
dietitian and nutritionist Juliette Kellow.

What counts as
your five a day?
Jane Michell, nutrition, weight loss expert, author and the
founder of Jane Plan, an award-winning diet delivery company
explains what counts as your 5 a day and why following your
5 a day is so important to maintaining a healthy and varied diet
We hear it over and over again that eating our five-aday
intake of fruit and vegetables is important for our
nutrition, reducing health risks and maintaining a stable
diet, but it can be quite confusing to know exactly what
fruits and vegetables to chose. Some fruits contain high
levels of fructose and higher calories and some starches,
like potatoes, shouldn’t be included at all in your five-aday
allocation. Statistics released by the National Diet and
Nutrition Survey in 2014 revealed that only three in ten
British adults aged between 19 and 64 meet the five-aday
target, with most only eating around four portions of
fruit and vegetables a day. By following the advice below
you’ll be able to chose your five-a-day with ease and know
that you are aiding your diet and general health.
How much is too much?
To put it simply, try and have five 80g portions of fruit
and vegetables every day. That’s five portions of fruit
and vegetables in total, not five portions of each. This
recommendation is based on advice from the World Health
Organisation, which recommends eating a minimum of
400g of fruit and vegetables. But why is this so important?
Well, research has shown that having your five a day
can lower the risk of developing some serious health
problems, such as type 2 diabetes, stroke, obesity and
heart disease and some cancers. You also get essential
vitamins, minerals, fibre and nutrients from eating fruit and
vegetables. As most fresh fruit and vegetables are low in
fat and calories, your 5 A Day target can also help you
maintain a healthy weight and heart. The best advice is to
eat as many different coloured fruits and vegetables as you
can – think of your plate as a rainbow, then you’ll receive
a wider range of nutrients.
A world of choice
So you’re standing in a shopping aisle or looking in your
cupboard, what do you choose? The great news is that you
have so many options as almost all fruit and vegetables
count in your 5 A Day whether they are fresh, cooked,
frozen, tinned, dried or juiced. They also don’t have to be
eaten on their own so remember, they count as part of a
meal or dish. For example if you’re making a stew, pasta
or even a soup and vegetables are included in the recipe,
these can count towards your 5 a day.
Photograph: iStock
44

5 A Day options with
some extra guidance
• Frozen fruit and vegetables
(80g)
• 1 Apple
• 1 Pear
• Tinned or canned fruit and
vegetables in natural juice or
water with no added sugar or
salt (avoid those in syrup)
• Bowl of salad
• 5cm stick of cucumber
• Dried fruit, such as currants,
dates, sultanas and figs (1
heaped tbsp) But note they are
higher in sugar so best had as a
weekly treat rather than every day
• Beans and pulses added to
meals (3 tbps) – remember these
only count as one of your 5 a day, no
matter how much you have
• Sweet potatoes, swedes
parsnips, and turnips (80g)
– remember potatoes do not count
as your 5 a day, neither do yam,
cassava or plantain
• A smoothie containing
all edible pulped fruit or
vegetables – remember to count the
number of fruits and vegetables you
are adding into your smoothie – they
can add up without you noticing
• One glass (150ml) of
unsweetened 100% fruit or
vegetable juice. Juice counts as a
maximum of one portion a day, even
if you have more than one glass. This
is because juice contains less fibre
than whole fruits and vegetables and
crushing fruit into juice also releases
the sugars, which can cause damage
to teeth
45

PROMOTION

An introduction to
weight-loss surgery
Weight-loss surgery, or bariatric surgery to give it the official
medical term, is one solution that can reverse the risk of
weight-related diseases and give severely obese people
– those with a body mass index (BMI) of 40 or greater or
between 35 and 40 in cases of patients with certain medical
conditions – a new lease of life and much improved health.
Photograph: iStock
48

Weight loss surgery, or
bariatric surgery to give it
the official medical term,
is one solution that can reverse the
risk of weight-related diseases and
give severely obese people – those
with a body mass index (BMI) of 40
or greater or between 35 and 40 in
cases of patients with certain medical
conditions – a new lease of life and
much improved health.
A gastric band is a soft and
adjustable silicone band that is
placed around the upper part of your
stomach and closed or locked to
create two chambers; a small upper
stomach with a narrow opening to
the lower stomach. This causes food
passage restriction.
On the inside of the band, is a
balloon. The balloon is connected by
a thin tube to an access point that
sits below the skin on your abdominal
wall called a port site. Through this
port a clinician can make periodic
adjustments to your gastric band,
based on your weight loss, food
cravings and other physical reactions
to the surgery, by inflating or deflating
the inner balloon with saline (often
called a “fill ‘). As the band is inflated
your upper stomach outlet becomes
smaller and this helps reduce the
amount of food you eat and slows
the emptying of food into the lower
stomach.
Am I eligible for gastric banding?
You will usually have gastric banding
if you cannot lose a large amount of
weight and maintain the weight loss
long term by dieting and lifestyle
changes alone; or if you have serious
health problems caused by obesity.
Doctors often use the body mass
index (BMI) to determine your
eligibility. This procedure may be
recommended for you if you have a
BMI of 40 or more, or if your BMI is 35
or more and you have a serious health
condition that might improve with
weight loss. Some of these serious
health conditions are sleep apnoea,
type 2 diabetes, high blood pressure
and heart disease.
Your bariatric surgeon will discuss
the best option of weight loss
with you and if you are eligible for
gastric banding.
49

Types of surgery
Bariatric procedures are divided into restrictive or malabsorptive:
Restrictive procedures:
The stomach is made smaller so that it holds
less food, producing a feeling of fullness.
Adjustable gastric band
Adjustable gastric banding places a hollow, adjustable
band made from silicone, around the stomach. This band
effectively divides the stomach in two with a small upper
pouch above the band and a larger pouch below. The
small pouch restricts the amount of food that a patient
can eat at any one time and will result in a feeling of
fullness after consuming only a small quantity of food.
The band has an adjustment ‘port’ placed under the skin
of the abdominal wall where the surgeon can adjust the
tightness of the stomach banding, if necessary.
About 50-60% of excess weight is lost
Benefits within five years of having the operation
and this means that the risk of Type 2 diabetes is reduced,
high blood pressure and cholesterol levels go down and
mobility, the ability to exercise and sleeping patterns are
all restored. The procedure is fully reversible which means
the band can be removed at any time.
Risks
This procedure is performed during a routine
day procedure appointment. In general, the
risks associated with gastric band surgery are small but
problems that can occur include band slippage, tube
rupture or disconnection, abscesses and infection.
Gastric balloon
insertion
(intragastric balloon)
Gastric balloon insertion is a less permanent type of
surgery which restricts the stomach capacity enabling
you to lose weight. This surgery works best for
patients with a weight problem who
want an intense period of fast weight
loss before returning to more
sensible eating habits. A balloon is
placed on the end of a thin, flexible
tube called an endoscope, which
is inserted into your stomach via
your mouth. Sterile solution or air
is pumped into the balloon so that
it partially fills the stomach, creating a feeling of fullness.
The balloon is usually removed after
six months.
A gastric balloon means that you lose
Benefits weight quickly and easily, because
the capacity for food in your stomach is restricted by
the balloon. The procedure is relatively simple and is
performed under a local anaesthetic, so you don’t have to
stay overnight in hospital. Once you’ve lost the weight
the balloon is removed and you can return to eating
normal portions.
Balloon deflation or bowel obstruction,
however these are extremely rare.
Risks
Malabsorptive procedures”
They limit calorie uptake from the intestine,
which changes the body’s ability to absorb
calories from food.
Gastric bypass
This is the most common form of bariatric surgery. A small
pouch is created at the top of the stomach. Part of the
intestine is then grafted to the top of the pouch so that
food bypasses the stomach and some of the intestine.
Less food is required to satisfy your appetite and fewer
calories are absorbed.
You feel fuller more quickly and for
Benefits longer and because the amount of food
is restricted as well as the numbers of calories absorbed,
there is usually a dramatic initial weight loss. Once you’ve
recovered from the operation you will be able to enjoy a
‘normal’ diet.
Risks
You may feel or even be sick after eating,
especially if you try to eat too much. Sugary
foods can make you feel faint and sweaty – a syndrome
known as ‘dumping’. You will usually need to take vitamin
supplements due to the restricted diet, and your bowel will
absorb less well than before surgery.
Duodenal switch
A duodenal switch starts with a procedure called a
sleeve gastrectomy which reduces the size of the
stomach by about 75%. The stomach is divided
vertically from top to bottom leaving a bananashaped
stomach. A short segment of the
duodenum at the base of the stomach is
left. Because of the reduced stomach
size less food can be eaten and there is
reduced food absorption as only 15%
of the bowel will absorb food. Changes
occur in the hormones released from
the bowel and stomach too, which
control the feeling of hunger.
This procedure
Benefits combines a restrictive
and a malabsorptive aspect and is reported to
give the highest percentage of long-term weight
loss of all the weight-loss procedures. One advantage
of this is that you will be less restricted in the foods you
can eat in the longer term, and you will also have a greater
degree of malabsorption after a duodenal switch, which
means you will absorb fewer calories from your food and
therefore lose more weight.
Risks
Eating high-fat foods can lead to more
undigested fat passing through your system
and, in 30% of people, this leads to foul-smelling wind
and loose stools. Reducing your overall fat intake should
solve this problem. To prevent deficiency, your diet has to
include twice as much protein as normal. It will also be
necessary to take vitamin and mineral supplements for
the rest of your life.
Photograph: iStock
50

Ramsay Weight Loss
Services
Helping you
every step of your
weight loss journey
Ramsay’s expert weight loss specialists have helped
change the lives of patients across the UK.
Our support network sets us apart from the rest.
With access to specialist nurses, nutritionists and
support groups, you’ll receive all the support and
advice to get the most out of your surgery.
Read more about my
weight loss story online.
Michelle
X
Before...
Contact us today to see how we can help
0800 014 9102
www.ramsayhealth.co.uk/weightloss

helping overcome
obesity
Photograph: iStock
Obesity appears in the media on what seems like a daily
basis so it is quite surprising to note that there are very few
voluntary organisations supporting those who struggle with
their weight on a daily basis.
HOOP UK (Helping Overcome Obesity
Problems) was set up in 2012 to support
obese individuals on their journeys and to take
steps to break down the stigma surrounding
obesity. A not for profit with charitable status,
HOOP was started by Lesley McCormack
who found it virtually impossible to access
help and support for her obese 10 year old,
Allie. After years of struggle and distress to
the whole family, Lesley managed to raise
the money required to send Allie to More
Life Weight Loss Summer Camp. Allie has not
looked back and is now a healthy, happy
teenager.
Jill Tipping is the CEO of HOOP and
works alongside Lesley bringing the strategic
element to the organisation. She took the role
in June 2012.
52

HOOP is virtually unique as a member led
charitable organisation. Our aims are simple:
to be the voice of the obese person, to take
action to break down the stigma surrounding
obesity and to support and work with
partners in the health sector who work with
obese people. We are not a fat acceptance
club – we are a group of individuals who
recognise the complexities that surround
obesity and are passionate to take action
and do something about it.
Unfortunately HOOP is not a ‘sexy charity’
and we are unable to shake a tin on street
corners to raise funds because the stigma
that comes along with the condition that we
are involved with is so strong that it is just
not practical. Our fund raising efforts tend to
come from within the group and from public
bodies and corporate organisations who
are willing and ready to hear our voice and
value our members’ experience. We are also
very privileged to have Fitness Expert Jessie
Pavelka as our Patron and his support has
meant that not only were we able to achieve
charitable status but the events he has
supported have raised the money to literally
keep us solvent, especially in the early days.
Our members (currently over 9000) want to
lose weight, improve their health and not be a
burden to society. The group acts as a mutual
support mechanism on a 24 hour basis via
a vibrant closed Facebook Group. There are
currently 34 admins who run the site and the
plight of those struggling with obesity is so
clear to see in the group. Getting the message
out to the general public is not so easy though.
Media coverage of the cost of obesity to the
country is ferocious and consistently regular.
Unfortunately the message is not a clear one
and the general opinion seems to be that
obese people are simply greedy and lazy
and only have themselves to blame – they
should eat less and move more.
Views like this are understandable
considering the lack of information that
is available surrounding the complicated
condition of obesity. It is our aim to break
down that wall of ignorance and to allow
the obese person to have their say and be
able to educate the citizens of this country
about what it can be like to turn to food as
a comfort. Unlike alcohol, drugs or smoking,
you cannot simply give food up. So it’s tricky
at best.
HOOP is now working with a number of
organisations who are ready to hear the
voice of the obese person. It is encouraging to
witness a slight shift in understanding and the
willingness to ask the expert by experience
what it is like to be obese. Understanding
this will then lead to treatments being created
along with a better patient experience
creating a higher success rate for weight loss
and lifestyle changes for the future.
For more details of HOOP UK
visit www.hoopuk.org.uk
PROMOTION
53

Get your kids
off the couch
It’s time to get our tech savvy children to swap video games for sports
With the UK seeing a rapid rise in childhood obesity, it’s more important now than ever to get
our kids moving. Nowadays there are so many distractions around such as television,
internet and video games. Studies have shown that, as well as educating children
about food, just 30 minutes of exercise a day can make all the difference to their
health and well-being. If, like many parents, you’re struggling to get them
excited, here are a few simple and effective things to try
Set an example
Children often emulate the behaviour of their
parents, so if they see that you’re doing very
little in the way of exercise, then they’ll have no
desire to get active.
Make it fun
Kids need to learn from a young age that fitness
can be fun, so don’t limit yourself to traditional
sports such as jogging, they’re not adults, if
it’s not fun you’ll struggle to get them excited.
Take advantage of local spaces such as a trip
to the park. A game of ‘Stuck-in-the-mud’ will
guarantee a much more enthusiastic response.
Dancing is another fun and effective way to get
your children on their feet.
Ditch the wheels
Do your best to walk wherever and whenever you
can. Even if it’s just 30 minutes of extra walking
a day, you’d be surprised how good it will do
both you and your little ones. You already do it,
so just do more of it!
Mix it up
By turning it into a boring routine, kids are
likely to lose interest. Introduce a new form
of exercise every week, but don’t make it a
chore, this will only make them more reluctant
to take part.
Photograph: iStock
54

Motivating children to play sports is
straightforward for some families but a small
nightmare for others, and remember that not
everyone is drawn to organised sports such as
soccer or baseball. Look for other activities your
child will enjoy -- like dancing, rock climbing,
swimming, or martial arts. And have patience
-- it may take some trial and error before your
kid finds the right fit.
The desire to play is a natural part of
childhood and getting young children into the
right environment - whether that’s the local
playground, a friend’s back garden, or out
walking in the woods - will encourage them
to interact with the world around them. It’s not
the exercise alone that’s great for their health.
Encouraging your kids to step outside into
the fresh air after they’ve spent hours in their
bedroom on the Xbox, getting a big breath of
fresh air and feeling the warm glow of the sun
on their skin can be rejuvenating. What you
may not know is that exposure to sunlight and
fresh air actually offers the body health benefits
that can last a lifetime.
55

1. Outdoor fun
As everybody knows, fresh air will do you
good, which is why – if the weather’s nice –
you should encourage your children to play
outside. Outdoor play helps kids to develop
physically, improving your child’s immediate
spacial awareness, core strength, balance
and fitness.
Outdoor play from an early age also
encourages children to be active and healthy
throughout their lives. While at times their
imagination alone can provide hours of fun, it’s
also a good idea to enhance your kids’ outdoor
play time with toys that are fun, safe and sturdy.
Little ones love to make believe in Wendy
houses, drive around the garden in miniature
vehicles such as ride-ons and trikes, create
sandcastles and slip down slides. Little Tikes
toys are especially good for this purpose as they
are built to last through years of fun and games,
meaning you can pass them down to siblings,
family friends and neighbours – and one day,
your little one’s little ones!
3. Get Friends Together
Children will be much more interested in playing
sports when their friends are there too, but they
probably won’t take the initiative to organise this
on their own. Collaborate with other parents and
arrange some kind of sporting activity. This can
be as small scale as signing your child and their
best friend up for weekend lessons together, or
as large as starting up your own local football
team and entering a league
4. Praise Kids for Being Active
Children thrive on positive reinforcement, so
praise your kids for getting involved in sports.
That doesn’t mean pushing them to be the best
shooter on the basketball team, as long as they are
participating and showing good sportsmanship
then they deserve praise. Rewards are also a
good way to keep them motivated. Set small
goals, like making sure they pass the ball to
three different friends or learning a new sportsrelated
skill, and reward them with fun, active
days out.
2. Physical time
The benefits of a bit of rough and tumble are
numerous. While exercise and socialisation are
key factors, games that have rules encourage
kids to understand the concept that life has
laws they’re going to have to obey in everyday
life. Games such as Follow The Leader, Duck-
Duck-Goose and Simon Says are based on
group participation and rule following. For
games to hit their full developmental potential
for kids, they should incorporate problem
solving as well as interaction with others.
Bowling is a really great example of this.
Just make sure you outline the fact
it’s the taking part that counts in order
to avoid competitiveness.
Photograph: iStock
56

PROMOTION
MAJOR FRUIT JUICE BRANDS
FEEL THE PRESSURE FROM COLDPRESS.
It seems the big fruit juice brands are getting a little
hot under the collar.
You could, of course, put this down to the heat
generated by the archaic pasteurisation process that
they still use to make their juices.
Or you could put it down to Coldpress.
Because, being cold pressed rather than heated and pasteurised,
Coldpress juices and smoothies, launched in 2011 in their distinctive
hexagonal bottle, retain more of some things than their pasteurised
rivals: things like more taste, more vitamins and more antioxidants.
Not only that but, because you’ll need to drink considerably less
Coldpress juice than conventional pasteurised juices to get your daily
quotient of lovely essential nutrients, you’ll need to take on board
rather less of a couple of less desirable things too.
Namely sugar and calories.
So it’s hardly surprising that, for some of the biggest names on our
supermarket shelves, the competition really is hotting up.
Life is sweeter with less sugar.
Because, as we’ve seen, with Coldpress less juice really is more, the cost of
getting your daily fix of vitamins and antioxidants will be significantly reduced.
As, of course, will your intake of sugar and calories.
Because of concerns over sugar, public health recommendations stipulate
that we should drink just 150ml of juice to get our five-a-day. But with
Coldpress orange juice, for example, that 150ml would deliver 90% NRV
of Vitamin C, one of the vital antioxidants that fights those rascally free
radicals, compared with just 41% NRV for some pasteurised equivalents.
It’s fair to say that unnecessary sugar and calorie intake is a ‘hot topic’ right
now. As hot as that tired old pasteurisation process, you might say!
Of course, as everyone’s well aware, there are naturally occurring sugars in
fruit. But premium juices make an important contribution towards meeting
our five-a-day needs, in particular our daily dose of Vitamin C, and other
beneficial nutrients like folate and thiamine.
And if we can reduce the sugar and calorie levels in our fruit juice, it really is a
‘win, win’ for us all.
Or in the words of Andrew Gibb: “In the war on needless sugar consumption,
we see it as our responsibility to take a strong moral lead, championing a
new era of juices that work harder and smarter.”
Flavours with more flavour.
DRINK LESS, BENEFIT MORE.
So....more goodness all round, then, but how
much more is ‘more’ exactly?
Well, a whole lot more as it turns out.
The problem is, though, that, while they would love to
explain in glowing detail how Coldpress is cold pressed
to hold in significantly more nutrients than leading
brands of conventional pasteurised juices, our ludicrous
food health and nutrition laws prevent them from telling
the full story. Suffice to say, though, to secure your
80mg recommended daily intake of Vitamin C (NRV)
you only need 167ml of Coldpress Valencian Orange as
opposed to between 250 and 363ml of some of its big
name pasteurised rivals.
Because Coldpress is cold pressed, not pasteurised, and retains the authentic taste of the
fruit, Coldpress juices and smoothies come in a range of single varietals, each with its own
very distinctive flavour.
Which means that, with Coldpress, customers can choose from Golden Delicious and Pink
Lady apple juices instead of merely from ‘apple’ and....er...well.....’apple’.
As Coldpress founder, Andrew Gibb, explains: “ Pasteurisation might be a highly effective,
heat-based treatment for preserving fruit juice but it’s also a heavy-handed, antiquated
process that will remove any fruit’s delicate ‘top notes’ and aromas and significantly
reduce the levels of essential nutrients. In other words, with Coldpress you get more
vitamins, more antioxidants and more flavour because no heat is used in our process.”
ONLY THE BEST FRUIT
(AND VEGETABLES) WILL DO.
Because Coldpress juices and smoothies retain more of the flavour than their
pasteurised rivals, selecting the best possible fruit is especially important.
As Andrew explains: “Making cold pressed juices with high pressure
processing is very unforgiving. If you process really good fruit, it tastes
really good, but the opposite also applies. This is why partnering with
farmers with a ‘no compromise’ mentality has been at the heart of our
ongoing success.”
In addition to its full-bodied smoothies and head-turning fruit blends, this
is also, of course, true of the company’s ’new generation’ veggie juices,
jam-packed with fibre, Vitamin A and iron, that remind us just how flavourful
top-notch vegetables can be.
To end on a final word from Andrew Gibb:
“Once again our ingredient-friendly process allows us to raise the bar in
terms of taste and nutritious density by enabling our veggie juices to be
exactly what they claim to be and not some fruit-based hybrid juice with
only a light trace of veggie input.”
It’s fair to say the pressure’s really on for conventional fruit juice brands. And
right now it really is Coldpress who are doing all the pressing.
Available from Tesco, Waitrose, Sainsbury’s, Morrisons, The Co-op and Ocado.

Psychology & Obesity
It’s not just what we eat, but how we think that affects our weight
Eating the right foods and exercising is vital for
healthy, successful weight loss but all too often we
give up on our goals because of negative thinking
which can then lead to us overeat, or skip an exercise
routine. This is because losing weight isn’t just about
what you eat, it’s also about what you think.
Negative thinking affects our self-esteem and our confidence,
often making us feel powerless, demotivated, lacking energy and
maybe even depressed. Negative words such as “worthless”,
“guilty”, “useless” and “fat” have become a part of our everyday
language, and over time this leads to increasing weight gain as the
daily fight to lose weight becomes too hard and we are therefore
more likely to overeat or put off exercising until tomorrow.
In fact, there is increasing research being done into how our
thoughts affect our food choices. One article recently found that
those associating certain words with certain foods, for example
‘guilt’ and ‘chocolate cake’ lead to unhealthier eating habits and
reduced control over healthy eating choices.
Positive thinking on the other hand is empowering, helping
to motivate and inspire us towards our health goals but more
importantly, boosting our confidence and self-esteem.
So how do you go about changing the positive to
the negative?
This will vary from person to person so you need to find what works
for you, and you need to start listening to yourself. Unfortunately,
some of our thoughts and behaviors around food have been
within us since childhood and can take a while to sift through,
but with a little bit of practice these thoughts can be changed and
you’ll soon be on your way to a happier and slimmer you.
Here are some ideas to get you started:
Create a mood board – This can be either a physical one
or through sites such as Pinterest. By collating a set of images
and quotes that inspire and motivate you personally will help you
visualize your goal and keep you on track. Mood boards work
on the Law of Attraction whereby what you focus on and what
you think you will draw into your life, hence why if you continue
to think negatively you will attract negative outcomes.
Write it down – Writing is extremely cathartic and can be used
to express a wide range of emotions. Research has shown that
those who write down their positive experiences have over time
better moods and better health.2 Keeping a personal journal of
your positive actions, no matter how small, will help to keep you
on track and will build on your self-esteem – this could be putting
less sugar in your coffee today or saying no to a slice of cake and
having a piece of fruit instead.
Practice mindfulness – Have you ever sat in front of the TV and
polished off a bowl of crisps or sweets without even noticing? This
is known as mindless eating. Unhealthy eating habits very quickly
become automatic responses and so we can often eat without
noticing either what we’re eating or how much. Mindfulness
therefore helps you to be more aware and in the now, so that
you can make better decisions around your food choices, for
example. Simply download an app such as Headspace and with
just 10 minutes a day you can start to become more aware and
work towards those weight loss goals
Realistic goal setting – It’s estimated that 80% of us fail at
our weight loss goals because all too often we set goals that are
unachievable or unrealistic, so we are setting ourselves up to fail
before we’ve even started. Setting yourself a series of healthy,
smaller goals with a view to one long-term goals is much more
likely to lead to success as you’ll stay motivated and can celebrate
the small wins along the way. For example, if you are a bit of a
couch potato set a goal of going for a walk every day, even if just
for 5 minutes, rather than setting yourself a goal of running a half
marathon in 8 weeks time which is probably unlikely and also
could cause you injury.
The most important thing to remember in all of this is that this is
about you and how you feel. Feeling great about yourself starts
from within, so surround yourself with the things that you love and
inspire you and start thinking more positively. You’ll soon be on
your way to healthy weight loss.
by Nicola Shubrook
Photograph: iStock
58

WE’RE PUTTING
OTHER FRUIT
JUICES UNDER
PRESSURE TOO.
At Coldpress, we’re not just putting our own juices
under pressure.
Because Coldpress juices are cold pressed not
heated, they naturally cram in more taste, more
vitamins and more nutrients than conventional
pasteurised juices. So, with Coldpress, you’ll need to
drink less juice to get your recommended daily intake
of lovely vital nutrients.
A 150ml serving of this juice is one of your five-a-day.
Antioxidants such as Vitamin C help protect the
vulnerable cells of your body from the damage
caused by those rascally free radicals.
72mg
72mg
766mg
VITAMIN C
(mg)
1.09
PER CALORIE
VITAMIN C
90%
OF NRV*
ANTI-
OXID ANTS (mg)**
11.6
PER CALORIE
l
66kcal
80mg NRV*
66kcal
*Nutrient Reference Value
**As mg of gallic acid equivalents
Always pressing
for Healthier juices.
Find out how at coldpress.co.uk

How to Count
Calories (Correctly)
You know the formula. Eat fewer calories, do more exercise, and you’ll lose weight. Increase
your calorie intake, or decrease your exercise levels, or both and you’ll gain instead. But for
many of us, the reality of losing weight doesn’t seem to be quite that simple
A calorie is the amount of energy needed to
raise the temperature of one gram of water
by one degree Celsius. If you ‘burn’ food,
you can calculate the amount of energy that
is released by measuring the heat and the
ash that is created. In general, if you eat more
calories, you will gain weight. But calories
don’t tell the entire story. For example, if
you eat fruit and vegetables, you get plenty
of nutrients with your calories, whereas if
you eat only high fat food such as cheese
or commercially baked pastries, you
get much fewer nutrients. Not only
that, but rich lean protein sources,
such as high quality cuts of
grilled chicken, fish and
eggs, help you to
feel full for longer,
so you get more
‘bang for your
buck’ with each calorie of high-protein food
you consume.
It’s far easier to learn a food’s calorie count
than it is to understand the complex way that
food interacts with our body. Food affects our
hormones, and hormones have a number of
different effects on the body. Some hormones
help us gain muscle, others cause us to gain
fat. This is the reason, alongside various
genetic differences, that you can eat the same
number of calories, but gain
or lose a different amount of
weight, depending on the
ratio of carbohydrates, fats
and proteins you consume.
Not only that, but different
bodies have different needs
when it comes to calorie intake.
A larger person typically needs
more calories than a slimmer person,
men need more than women, an adult
needs more calories than a child, and an
active person needs more calories than
an inactive person. But our confusion
doesn’t stop there! It’s also very
difficult to judge how many calories
are in your food, especially when
you are eating out at a restaurant.
Often, overweight people are less
able to correctly judge the number
of calories in their meal, which is
certainly a disadvantage when it
comes to losing weight. Overweight
individuals shouldn’t feel too bad
though, dieticians are also rarely able
to reach the right number when put
to the test. Our inability to judge how
many calories we need combined with
our struggle to correctly count our calorie
intake is one reason why calorie counting
simply doesn’t work for some people.
Photograph: iStock
60

So should we stop calorie counting altogether?
It might not be time to throw the towel in just
yet, but it may well be time to sharpen your
know how of why calories in food simply
aren’t equal.
Eat food that you know is good for
you (without counting the calories)
Instead of having a very small portion of
junk food for breakfast, try having a larger
breakfast that consists of healthier foods.
The calorie count might be the same in
both meals, but the effect on your body
will almost certainly be different. Using a
disproportionate amount of your calorie
‘allowance’ on unhealthy foods is a surefire
way to end up with energy highs and lows
triggered by insulin surges and crashes
that will leave you stressed, exhausted and
miserable. And when you’re feeling down,
you’re that much more likely to reach for
another quick fix treat such as your favourite
muffin.
Don’t neglect the ‘calories burned’
part of the equation
Your metabolism, broadly speaking, is the
way that your body burns calories in order
to give your body the energy that it needs.
When you do physical activity, your body
uses more energy than when you are resting,
so the more exercise you do, the more
calories your body burns. Not only that, but
strength training exercise has a positive effect
on your post workout calorie after burn. By
increasing your muscle density via weight
bearing exercise, you also improve the rate
your body burns calories when you are
resting too. Provided that you can commit to
exercising at least three times a week, you
are likely to see an improvement in your
overall metabolic rate.
Eat smaller portions of food - except
for vegetables!
Whether you have a large plate of food in
front of you or a small one, you’re likely to
finish that portion. The problem is that people
tend to have portions that are too big, rather
than too small. If you reduce the size of your
plate (and don’t go back for second helpings!)
you’ll naturally eat much less over the course
of a month. If you’re still unsure about the
amount of food you should be consuming, use
your clenched fist as a guideline to indicate
one portion. The exception to the rule are
vegetables, you can generally eat as many
of these as you like and not gain weight! For
an extra health boost, eat a rainbow of
different coloured vegetables for a diet that’s
rich in antioxidants and contributes a positive
impact on immunity.
In summary, remember that calorie counting
is just one tool that you can use to lose weight,
but it doesn’t tell the whole story. The type of
calorie that you consume is just as important
as the number of them. Combine this with
a little daily exercise and it’s win-win all
the way!
ABOUT THE AUTHOR
Peter Lemon is the Director
of the Academy of Fitness
Professionals, a leading
provider of REPS accredited
fitness instructor and personal trainer courses.
61

Living with
type 2
diabetes
Diabetes affects 1 in
17 people, equating
to approximately 3.2
million people in the UK
alone. Jane Michell, nutritionist,
weight loss expert and author has
some useful tips on how to manage this
condition and live a healthy life
If you are overweight you are at greater risk of
developing type 2 diabetes, particularly if you
have excess weight around your tummy. If left
undiagnosed and unmanaged, diabetes can lead
to severe conditions, including kidney failure and
blindness. It can also make eating healthily and
following a diet a real minefield if you don’t have
help to stay on track and make wise food choices.
Here are some really useful tips on how to manage
your diabetes.
Obesity and diabetes
Insulin (a hormone) usually functions to pull glucose
(sugar in our food) from our blood vessels into
our cells, giving them enough energy to function
properly. Obesity is a major risk factor in type 2
diabetes because excess fat around the cells acts as a
barrier, reducing the ability of insulin to pull glucose
into the cells. The worrying result is high blood
sugar readings.
Managing diabetes
Although you may not experience any symptoms
from having high blood sugar levels, it’s essential
to manage your diet plan and weight consistently to
avoid nasty health complications in the future. While
diabetes is rarely reversible, by managing your sugar
levels, you may delay the need to begin medication
or insulin. Losing weight will not only allow you to
better manage your diabetes, but will also improve
your overall quality of life!
Know your nutrients
Carbohydrates include foods like bread, cereal,
pasta, rice, cakes, biscuits, potatoes and soft
drinks, but also food and drinks including fruit, milk,
yoghurt, chocolate, juice and ice cream. While
really delicious and tasty, these foods and drinks
will raise your blood sugar levels, so it’s essential
to manage these foods effectively and not to
overindulge.
Protein rich foods, including meat, chicken, fish,
tofu, seafood and eggs will not raise your blood
sugar levels and will often keep you feeling much
fuller for longer.
Foods containing high levels of fat should be used
sparingly, to avoid excess weight gain. These include oil,
margarine, butter, coconut products, nuts and avocado.
Foods you can eat freely include green vegetables,
carrots, peppers, onion, garlic and berries. Try
to add these foods to all meals. This will help bulk
of your meals, without raising your sugar levels.
Handy tips
• Become aware of foods containing carbohydrate
• Eat regularly and don’t skip meals
• Switch to some high fibre foods, think bread with
all the yummy seeds and wholegrains, whole fruit
and vegetables, oatmeal and lentils. Avoid juices
as you lose a lot of the fibre from their skin and
gain lots of sugar
• Limit foods high in refined sugar like soft drinks,
lollies, cakes, biscuits and chocolate
• Choose low fat or reduced fat products and limit
the amount of battered or deep fried foods
• Engage in physical activity*
*Always check with your doctor before starting any physical
activity, especially if you are taking insulin
Photograph: iStock
62

A Meal Replacement for
Weight Loss and Maintenance
Nourishes the body and ends the dieting cycle
6 things to know
about Almased
Retains muscle mass while burning fat and
losing weight
Boosts the metabolism
Suitable for Diabetics-Keeps blood sugar
balanced
A diet programme where you won’t feel hungry
Superb Sports nutrition
Does not contain any artificial flavours, fillers,
added sugars or preservatives and is gluten-free
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For more information call 0207 969 1886
or email nutritionist@almased.co.uk.
AImased ® : 10 Proven Statements
All core claims about Almased have now been scientifically validated. Eight scientists have drafted 10 statements
about the effects of this powdered health food.
Almased can do a lot more than just help people
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beneficial impact upon hormone levels and blood
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1. Almased contains pure soya protein, yogurt
and raw honey. A special processing
method preserves the essential amino acids
in Almased.
2. Obesity is associated with a severely
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Summary: Almased has a beneficial effect
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It is recommended that it be used for at least
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Even just 50 g once a day brings about an
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For full scientific data relating to these
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3. Almased supports healthy insulin levels,
while stimulating fat reduction and inhibiting
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This product is not intended to diagnose, treat, cure or prevent any disease.