Exam nutrition tips

Typical, it’s sunny and probably the hottest weather we’ve had in Ireland for a long time but many of you are today starting your exams. Well firstly best of luck and I’ve put down some nutritional tips below to help you give your brain key nutrients through this time…

Nutrition during exam time is very important. Ensuring three balanced meals a day and healthy snacks that produce a steady release of energy throughout the day are imperative for exam performance and maintaining energy and concentration levels. Avoiding sugary snacks and drinks that give you sugar highs and lows and choosing plenty of hydrating fluids like water and fruit juices and slow release snack foods like fruit and nuts will help keep energy levels up.

1. SLEEP
try not to stay up too late as sleep is so important. Avoid eating too late at night especially foods with a high sugar content. Try drinking some warm milk or Ovaltine which is full of B vitamins and folic acid. Herbal teas containing camomile are also effective. Avoid stimulants such as in coffee, tea, and cola drinks, which contain caffeine that keeps the body awake.

2. STRESS
B vitamins are very important for people under much stress. B vitamins are also very important to help us break down the proteins and carbohydrates in our diet. Deficiency signs include tiredness and poor concentration. Good sources of B vitamins include meat, wholegrains, seeds, beans, peas, brown rice, nuts, wheat germ, porridge, dairy produce, green leafy vegetables, prunes, fruits, cereals, millet, eggs, bananas, fortified soya products,

3. ENERGY
Keep blood sugars level. Poor concentration can be due to low-blood sugar levels, so eating regularly is hugely important. The brain needs glycogen which is supplied most efficiently through complex carbohydrates. Snacking regularly on healthy foods is essential to maintain energy levels. PICK foods that contain slow-release carbohydrates that can help eliminate mid-morning and afternoon lethargy. Good snack choices: bananas, bagels, sugar-free breakfast cereals, dried fruit, nuts, popcorn, Eat extra wholegrain breads and cereals – particularly ones with added nuts and seeds – apples, beans, lentils, porridge, oatcakes.

4. Make sure you eat breakfast. Skipping breakfast may have a detrimental effect on performance. Having a bowl of porridge for breakfast or a sugar free muesli, even a protein-rich breakfast such as eggs or beans on toast will feed the brain and keep it alert.

5. Keep hydrated; the first sign of dehydration is tiredness. Aim to drink at least 1.5L of hydrating fluid like water per day, avoiding caffeine rich drinks like coffee, tea, colas & energy drinks. People often drink coffee to wake themselves up whereas what they actually need is water.

GOOD BRAIN FOOD INCLUDES;

Antioxidants; foods high in antioxidants are good for the brain, heart and immune system. Ensure a good intake to prevent getting sick during exams. Antioxidants vitamins A and C are present in fruits and vegetables ( peppers, spinach, tomatoes) and good sources of vitamin E include nuts, seeds, avocado and oily fish e.g. salmon.

Omega 3 fatty acids; Omega-3s help improve general brain functioning and restore memory. Foods high in Omega-3 include oily fish; tuna, salmon, mackerel, sardines, herring, seeds and nuts.

Iron; Inadequate levels of iron are known to cause a drop in concentration and energy. Including lots of iron rich foods in the diet will help keep up concentration. Good sources of iron: lean red meat e.g. beef, leafy green vegetables, eggs, nuts, pulses, fortified breakfast cereals, wholegrains, spinach, broccoli, and peas,

Vitamin C helps the body absorb iron from plant sources so eat peppers, oranges, and tomatoes, or drink a glass of fresh fruit juice with iron rich foods

Coeliac disease – May 2009

The Afternoon Show recently invited me to chat about coeliac disease; I’ve put down some of the areas we discussed below…

Coeliac disease results in abnormal immunological reaction to dietary gluten
causing tissue damage. Symptoms of Coeliac Disease can include;

• Weight loss
• Diarrhoea
• Bloating
• Abdominal cramps
• Anaemia
• Fatigue
• Failure to thrive in children
• & occasionally some individuals are asymptomatic

So what is gluten? Gluten is a protein found in wheat. It gives dough made from wheat flour its elasticity and therefore its good baking properties. Gluten is also used to describe similar proteins in rye, barley and oats. The prolamins in wheat (i.e. gliadin), rye (i.e. secalin), barley (i.e. hordein) and oats (i.e. avenin) are not identical, although they are closely related in structure. For this reason those with coeliac disease must avoid wheat, barley, rye and oats. There is controversy regarding the avoidance of oats but current recommendations in Ireland state that oats must be avoided unless they are specifically described as gluten free oats.

The only treatment for coeliac disease remains a strict lifelong gluten free diet. Once a strict gluten-free diet is commenced, the villi in the gut begin to re-grow and symptoms begin to improve.Assessment with a qualified dietitian is essential to ensure proper avoidance of gluten while maintaining nutritional adequacy in the diet.

Correct diagnose should only come from your doctor. Your doctor will look for symptoms of coeliac disease and take a blood test that can identify the presence of serum antibodies to gliadin, endomysium or transglutaminase. A small bowel biopsy remains essential and diagnosis should not be based on symptoms or serological tests alone.

The good news is that there are many foods which are naturally gluten free.

• Fresh and frozen fruit and vegetables
• Eggs
• All meat: lamb, pork, beef, venison. (except sausages).
• Poultry and fowl
• Shellfish/fish: (except those that have breadcrumbs or coatings)
• Dairy products: milk, plain cheese, some yogurts.
• Pulses, nuts and seeds
• Non-alcoholic drinks: fruit or vegetable juices, soft drinks.
• Alcoholic drinks: wine, sherry, brandy, rum, whiskey, vodka, cider.

There are also gluten free alternatives for breads, pastries, pastas and
cereals…so a gluten free diet can be a tasty healthy diet.

What foods should I avoid?

As well as obvious gluten sources (breads, pastas, noodles, cakes, pizza, sausage meats, some soups and gravies), there are a number of hidden sources. Look out for the following ingredients;

Wheat, Rye, Barley, Oats, Bulgar, Most soya sauces,
Spelt, Pearl Barley, Couscous, Rusk, Cereal Fillers, Durham wheat,
Most mincemeat, Wheat starch*, packet suet, Farina, semolina, baking powder
Hydrolysed vegetable protein, Starch and modified starch (unless Codex standard)*
Malt, malt extract and flavouring, wheat grass, wheat germ oil, wheat germ, wheat bran

*Where starch appears in an ingredient list on a label and the source of the starch is not declared, it is best to avoid eating that product just in case.

It is advisable for anyone who suffers with coeliac disease check labels carefully and to use a Gluten Free Food List from the Coeliac Society as a guide.

Following a strict gluten free diet is vital for those with coeliac disease. Dietary non compliance can lead to can lead to both minor and major long-term complications;

• Anaemia
• Osteoporosis/ Osteopaenia
• Poor nutritional status
• Impaired fertility
• Dental enamel defects of permanent teeth
• Arthritis or other joint symptoms
• Lactose intolerance
• & malignancy

Research has shown that a significant proportion of people on a gluten free diet are not getting enough calcium and iron.

Osteoporosis means thinning of the bones and can be a complication of coeliac disease due to reduced absorption of calcium in the gut when the gut is damaged. The best way to prevent osteoporosis is to stick to a strict gluten free diet, include weight bearing exercise daily and eat calcium rich foods.
It is recommended that all people with coeliac disease take 1500mg of calcium per day = 5 portions of calcium rich foods.

People with coeliac disease are also at a higher risk of iron deficiency anaemia secondary to malabsorption. The best way to prevent this is to stick to a strict gluten free diet and include iron rich foods in the diet regularly e.g. lean red meat, dark green vegetables, pulses, nuts, raisins & eggs.

Common Queries for those with celiac disease…
1. I’m feeling better so…can I relax my gluten free diet now? No, a lifelong gluten free diet is required in the
treatment of coeliac disease. Reintroduction of gluten will cause gut damage again and malabsorption.
2. I don’t seem to be able to take dairy…sometimes lactose intolerance can occur temporarily in coeliac disease when the gut has been damaged. Lactose is the sugar present in dairy and occasionally people can suffer problems digesting lactose when first diagnosed with coeliac disease as the gut has been damaged. Symptoms include diarrhoea, nausea, bloating and cramps after consuming dairy. If you are unable to tolerate dairy try calcium enriched soya products. You need to take extra care to meet your calcium requirements. You can discuss this with your dietitian when going through your gluten free diet.

Top tips
Join the coeliac society
Have a dietary assessment with a qualified dietitian
Avoid cross contamination; Storing food separately, Using a separate toaster, Use a separate chopping board, Use a separate butter container or jams, Always inform restaurants that you are suffer from coeliac disease.
Read food labels
Eat a healthy diet
Exercise regularly
Keep hydrated
And your main motto; If in doub
t…leave it out!

Vitamin D – the sunshine vitamin

I was recently invited to dicuss vitamin on RTE’s The Afternoon Show and thought it woudl be a good idea to share some of this inoformation….

Vitamin D is a fat-soluble vitamin that is naturally present in a few foods, added to others, and available as a dietary supplement. Vitamin D plays an essential role in the absorption and use of calcium and phosphorus, so it is imperative for the formation and health of bones, teeth and cartilage. Without sufficient vitamin D bones can become thin, brittle, or misshapen. Prolonged vitamin D deficiency can cause rickets in children and osteomalacia (softening of the bones) in adults. More marginal vitamin D deficiency is likely to be a significant contributing factor to osteoporosis risk. A good dietary intake of calcium and vitamin D can help protect against osteoporosis.

High risk groups for vitamin D deficiency include elderly people who do not get sufficient skin exposure to sun along with a poor dietary intake, those who cover themselves for religious or cultural reasons, those with malabsorption conditions and those with kidney disease. Also certain medications may interfere with the body’s conversion of vitamin D.

According to a recent study undertaken at UCC it was found that Nearly 75 per cent of adults in Ireland have an average daily intake of Vitamin D that is less than half of what is recommended, while 88 per cent of primary schoolchildren don’t meet recommended Vitamin D levels.

In the UK and Ireland, the recommended daily allowance (RDA) for vitamin D is 0-10µg/ day depending on how much sunlight you obtain. For those aged over 51 years the RDA is 10µg/ day. The absorption of vitamin D from sunlight can vary at different times of the day and year. Very little if any vitamin D is absorbed through sunlight from October to end of March. During the summer months we absorb vitamin D from the sun especially between the hours of 11am and 3pm.1 Therefore extra care needs to be taken with dietary sources of vitamin D in wintertime. Sunscreen can also reduce vitamin D absorption from the sun as ultraviolet rays are prevented from penetrating the skin. With both our climate and safe sun protection practises possible factors in affecting our vitamin D status, a good dietary intake, supplements and food fortification are important to help prevent low vitamin D status.

Good dietary sources of vitamin D include;

Oily fish e.g. herring, salmon, tuna, sardines, pilchards and mackerel, fish liver oils and egg yolks are among the best sources. There are also fortified foods available including; dairy produce e.g. supermilk, breakfast cereals and margarines.

When are supplements necessary?
Supplements are necessary among certain vulnerable groups;
1. The FSAI now recommend that all babies aged from 0-12months in Ireland are supplemented with
vitamin D. It is particularly important for exclusively breast fed babies. We know that breast is the best
start for a baby and is recommended for at least the first six months of life. Breast milk is nutritionally
complete and contains immunological agents that promote the development of a baby’s immune system.
However breast milk is a poor source of vitamin D, especially if the mother herself has a low vitamin D
status. Supplementation is recommended in;
a. All exclusively breast fed babies (particularly those with dark skin). They should receive a vitamin
D supplement daily from birth to 12 months. This provides 5µg of vitamin D.
b. Partially breast fed babies should also be supplemented with vitamin D particularly if they do not
receive more than 500mls of formula per day.2
c. All babies no matter how they are fed would benefit from having extra vitamin D as foods
containing vitamin D are rarely included in weaning diets.
d. There are vitamin D drops available from your pharmacy that are suitable for babies
2.Those who are confined to indoors may benefit from a vitamin D supplement.
3. Elderly adults may benefit from supplements for two reasons. One is that negligible absorption of vitamin
D occurs between October and the end of March but the second factor is that skin syntheses of vitamin
D can decrease with age. A daily intake of 10 µg is recommended for adults aged 51-70 years. However
recent Irish research has shown that 89% of 51-64 year olds do not achieve the 10µg/day
recommendation, with mean daily intakes (MDI) of vitamin D from food sources being 4.01 µg in men and
3.39 µg in women.3 Results like this show us that we need to concentrate on good dietary sources in
the diet and supplementation should be promoted amongst our older population.

References;
1. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom, 1996
2. Vitamin D – new recommendations from the food safety authority o f Ireland, www.fsai.ie
3. UCC vitamin D research group; www.ucc.ie/en/vitamind