Eggs: Cracking the Misconceptions

There are so many confusing messages about eggs. How many you should eat? And will they increase your cholesterol levels or your intake of dietary fat? Here we set the record straight:

How Many Eggs Can I Eat per Week?

You can eat up to six eggs a week - even if you have heart disease or Type 2 Diabetes (1).
You should eat eggs on a regular basis as part of a healthy, balanced diet.

Will Eggs Increase my Cholesterol Levels?

No. The main factors that increase blood cholesterol are saturated and trans fats, and eggs contain very little saturated fat and absolutely no trans fat.

Should I Eat Eggs if I am Trying to Lose Weight?

Eggs are a great source of protein, and protein-rich foods help you feel fuller for longer which can help with weight control.

Furthermore, eggs are nutrient dense, meaning that they contain a high percentage of vitamins and minerals compared to the amount of energy they provide. They contain the highest quality of protein of all foods, as well as more than a quarter of your recommended daily intake of iodine. Eggs also provide a rich source of nutrients that protect you from disease and promote cell regeneration, including omega 3 (healthy) fats, selenium and the antioxidants lutein and zeaxanthin (2).

So go ahead and enjoy eggs any way you like them - poached, sunny side up, scrambled, in an omelette or just plain boiled. Eggs are cheap, easy to prepare, tasty and nutritious!

References:
1) Egg Nutrition Advisory Group, 2008, Position Statement: The Role of Eggs in a Healthy Diet
2) National Heart Foundation of Australia, 2009, Dietary Fats and Dietary Sterols for
Cardiovascular Health

Healthy Eating for Healthy Weight Loss

To lose weight the healthy way you need to eat a balanced diet at all times. The following tips will help you lose weight without compromising your health:

- Eat every three hours so you don't feel hungry (as an added bonus, your metabolic rate increases by approximately 5% every time you eat). Don't skip any meals (especially breakfast) and try and finish your last meal before 8.00pm.

- Your main meals should be portioned as follows: at least half of a small plate of vegetables, a quarter of a plate of starch type products (e.g. rice, pasta, potato, corn, and noodles) and a quarter of a plate of lean cooked meat. See the graphic to the right.

- Limit your intake of dietary fat, especially saturated fat. You can achieve this by choosing low fat dairy products, trimming visible fat off meat, taking the skin off chicken and choosing lean cuts of meat (meat with minimal visible marbling). When you are preparing your meals, choose low fat cooking methods such as dry baking, roasting, barbecuing, stir frying, steaming, poaching or microwaving.

- Consume at least two pieces of fruit every day (avoid dried fruit and fruit juice as they are high in calories). A calorie counter book is a useful tool for finding fruits that are low in calories, or visit the Calorie King online calorie counter.

- Eat at least five cups of salad and vegetables every day. Salads and vegetables are great for adding bulk to your meals.

- Limit your intake of foods that are high in sugar and fat. Not only are these foods high in calories, but they won't sustain your energy levels for periods of time. Examples of foods that are high in sugar and fat include cakes, biscuits, chocolate, lollies and takeaway meals.

- Maintain variety in your diet by experimenting with different herbs and spices, sauces and marinades.

- Drink 6 - 8 glasses of water every day. Limit drinks that are high in energy such as soft drinks, cordial, sports drinks, flavoured milk drinks and cafe drinks such as full cream lattes, cappuccinos and hot or iced chocolates.

Planning Nutritious Meals

Good nutrition requires planning:

- Make a shopping list of foods that you need to purchase, then take the shopping list to the supermarket and stick to it. Don't shop when you are hungry as you are likely to purchase foods that you don't need.

- Read food labels and choose alternatives that are lower in fat and sugar.

- Prepare healthy meals at home and take them to work: you may need to purchase an insulated lunch box.

- Look through recipe books or find healthy online recipes through Taste or the National Heart Foundation. It's important to enjoy variety in your diet.

- Modify your favourite recipes by substituting high fat ingredients with low fat alternatives, or by reducing the amount of high fat ingredients.

And don't forget that you can't lose weight the healthy way through calorie restriction alone. If you try and lose weight through calorie restriction alone you will lose more water and muscle tissue than body fat. Losing muscle and water may look great on the scales, but it slows your metabolism and makes it easier for you to regain weight (see our article Can You Lose Weight Without Exercise for details).

To lose weight the healthy way you need to eat well AND exercise, specifically perform 250 minutes of moderate intensity activity per week. (Moderate intensity exercise is defined as a level where your breathing rate is elevated, but you can still carry out a conversation.) A great way to start an exercise program is to walk around your neighbourhood.

If you need professional assistance with your eating and exercise program, it's a good idea to make an appointment with a Dietitian.

How Much Dietary Fat Should You Consume During Weight Loss?

Fat contains twice as many calories as carbohydrate and protein, so it makes sense to reduce the amount of fat in your diet if you want to lose weight.

However you shouldn't eliminate all fat from your diet. Your body needs some fat for vitamin absorption, hormone regulation, the health of your heart and the protection of your vital organs. And you need some fat in your diet to enjoy the flavour and texture of your food.

How Much Dietary Fat Should I Consume During Weight Loss?

Females:
Fairly healthy with normal cholesterol and triglycerides: 40g fat per day
At risk of heart disease, high blood pressure or diabetes: 30g fat per day

Males:
Fairly healthy with normal cholesterol and triglycerides: 50g fat per day
At risk of heart disease, high blood pressure or diabetes: 40g fat per day

How Much Dietary Fat Should I Consume to Maintain a Healthy Weight?

Fats should not contribute to more than 30% of your daily calorie intake, but many Australians consume more than 40% of their daily calorie intake from fat.

Assuming that you will remain fairly active when you reach your weight loss goal, you should consume the following levels of dietary fat:

Females: Fairly healthy with normal cholesterol and triglycerides: 65g fat per day
At risk of heart disease, high blood pressure or diabetes: 55g fat per day

Males: Fairly healthy with normal cholesterol and triglycerides: 85g fat per day
At risk of heart disease, high blood pressure or diabetes: 70g fat per day

To find out how much fat is in your favourite foods, visit the Calorie King website.

In summary, it's important to moderate your intake of dietary fat but don't eliminate it completely. Choose foods that are high in healthy fats such as monounsaturated, polyunsaturated and omega-3 fats. And limit your intake of foods that contain unhealthy fats (saturated and trans fats) as they increase your blood cholesterol levels.

Alcohol and Weight Loss

At the Wesley Weight Management Clinic we're often asked if drinking alcohol can hinder weight loss. Here's our answer:

To lose weight, you will probably need to moderate your alcohol consumption. We don't want to demonise alcohol (or any other food or drink) - we're strong believers in the saying "all things in moderation" and you still need to go out and enjoy yourself when you are losing weight. But it's important that you appreciate that drinking alcohol will hinder your weight loss efforts.

Alcohol is High in Calories

Alcohol contains 70 calories per serve. To put this into perspective, the following meals contain the same number of calories as three standard drinks:

- 100g lean pork/steak/chicken breast + 2 cups of salad
- 1 x 95g can tuna (98% fat free) + 4 Vita Wheat crackers
- 1 Weight Watchers Beef Burgundy frozen meal + 2 cups of vegetables

These meals provide important nutrients, vitamins and minerals, which can't be said for alcohol: alcohol calories are 'empty calories', or energy without any substantial vitamins or minerals. Additionally, alcohol may directly promote fat storage by slowing fat and carbohydrate digestion and increasing appetite (1).

If you were on a 1500 Calorie a day meal plan during weight loss and chose to consume 500 of these calories from alcohol (approximately 4 x 375mL cans of regular beer), you would need to provide all your essential nutrients from the remaining 1000 Calories. This may be difficult; and it's possible that nutritional deficiencies may occur over time.

And if you consumed 1500 Calories of food per day plus 500 Calories of alcohol per week (approximately 4 x 375mL cans of regular beer), you might gain 5kg of weight per year!

Can Alcohol be Beneficial to My Health?

The risks of consuming alcohol far outweigh any possible benefits. There are health benefits from drinking alcohol, but these can be obtained by drinking as little as half a standard drink per day (2).

How much Alcohol is Safe to Consume?

The Australian Alcohol Guidelines have recently been updated (3) and consist of four recommendations:

1. For healthy men and women, drinking no more than two standard drinks on any day reduces the lifetime risk of harm from alcohol-related disease or injury (note that it is no longer considered safe for men to drink four standard drinks per day).
2. For healthy men and women, drinking no more than four standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion.
3. For children and young people under 18 years of age, not drinking alcohol is the safest option. 4. For women who are breastfeeding, pregnant or planning a pregnancy; not drinking is the safest option.

What is a Standard Drink?

See the image to the right. Note that there is no standard glass size used in Australia: you will often be served more than one standard drink.

How can I Reduce My Alcohol Intake?

Try the following practical tips for reducing your alcohol intake:

- Eat before you drink alcohol: food fills you up, slowing your drinking pace and possibly slowing your absorption of alcohol
- Drink water or a diet soft drink before drinking any alcohol and avoid salty foods while you are consuming alcohol
- Sip alcohol slowly and put your glass down between sips
- Intersperse your alcoholic drinks with non alcoholic drinks such as water or diet soft drinks
- Dilute wine with ice, water, juice or natural mineral water; dilute beer with diet lemonade or soda water and mix spirits with diet soft drinks or soda water
- Choose light beer over full strength
- Don't let other people 'top up' your glass: be more assertive and do not to let peer pressure make you drink more than you want to
- Avoid 'shouts' or get a glass of water when it's your turn to buy a round
- Volunteer to be the designated driver to avoid peer pressure to drink.

So go easy on the alcohol when you are trying to lose weight and you'll reap the rewards.

References:
1.National Health and Medical Research Council (2003), Dietary Guidelines for Australian Adults Commonwealth of Australia
2.Lewis S, Campbell S, Proudfoot E et al (2008) Alcohol as a Cause of Cancer, Cancer Institute NSW, Sydney
3.National Health and Medical Research Council (2009) 'Australian guidelines to reduce health risks from drinking alcohol' Commonwealth of Australia

Eating Out: How to Keep it Healthy

With large portion sizes and high fat foods filling many restaurant menus it can be difficult to make healthy choices when you eat out. But it's certainly not impossible. Here are some practical tips to help you stay in control when you are eating out:

Choosing a Restaurant

If you are organising a night out at a restaurant, research the options and make an informed choice:

- Look at restaurants' menus online and choose a restaurant that offers low fat and low calorie dishes such as grilled fish and chicken, salads, vegetables and pasta with tomato-based sauces.
- Choose a restaurant that is willing to support your eating goals. Call ahead and ask if the restaurant has a flexible chef who is willing to reduce the fat content of their dishes.
- Avoid restaurants that feature 'all you can eat' specials or buffets. Even with good intentions, it's hard to resist the variety of foods on offer. Studies show that most people will eat more when offered a variety of appetising foods, often with the intention of maximising their value for money.

At the Restaurant

Even if you don't choose the restaurant you eat at you can still control what you eat:

- Have a healthy snack before you leave home (e.g. fruit, dry biscuits or a sandwich). That way you won't arrive at the restaurant feeling hungry, you be more selective about your food choices and feel satisfied with a smaller amount of food. You can save money - and calories!
- Request a glass of water upon being seated instead of nibbling bread or consuming a high calorie alcoholic drink.
- Eat slowly to enjoy your meal and the restaurant's atmosphere. Allow 15-20 minutes to eat your meal and take a break when you begin to feel satisfied. If you feel satisfied after this break, take the rest of your meal home to enjoy later.
- Focus on non-food related pleasures such as the fact that you do not have to cook or clean up. Concentrate on the conversations you are having with family or friends.

Choosing Dishes

- Order first to maintain your resolve. Avoid discussing the menu with other people and if you know what you want before you arrive at the restaurant don't even look at the menu.
- Ask your waiter questions about the restaurant's ingredients and preparation techniques. Customise your meal and have it prepared to your liking. Don't be afraid to assert yourself - you are paying for the meal!
- Refuse side orders if you don't want them: if they appear on your plate you are likely eat them.
- Request minimal oil or butter in your meal (even when you are ordering vegetables, as chefs often add oil or butter). Ask to forgo cream, dressings or sauces, or at least ask for them on the side.
- Choose potato dishes carefully. If you are having baked potato as a main dish, choose low fat toppings or ask for sour cream on the side. If you are having potato as a side dish, your best choice is boiled potato, followed by mashed.
- Choose lean steak with cuts such as fillet Mignon, flank steak or sirloin. Try splitting the steak into two smaller portions: you may find that you have enough for another meal!
- Refuse bread altogether; or at least ask for plain bread instead of garlic or herb bread.

So you can stay in control of what you eat, even when you are eating out.

Healthy Eating on a Budget

You don't have to compromise your health to reduce your food bill. Here are some tips to help you buy low fat and nutritious food without paying top dollar:

Shop from a list Make a meal plan at the start of each week and decide what you need to purchase to make your meals. If you can be organised at the beginning of the week you won't need to shop at smaller, more expensive food stores. And if you have a weekly menu plan and ingredients to hand, you will be less likely to eat out at restaurants or buy take away foods on the way home from work.

Shop at fresh fruit and vegetable markets Fresh fruit and vegetables from specialty markets last longer (and taste better) than items purchased at large supermarket chains. Purchase fruit and vegetables that are in season (see the seasonal availability of fruits and vegetables).

Don't shop when you are hungry If you are hungry when you shop, you are more likely to buy items you don't 'need'.

Buy in bulk Buy non perishable items such as cereal and pasta in bulk at large supermarkets.

Shop online You'll be less likely to make impulse purchases if you shop online. And if you shop online from home you can check what is in your fridge and pantry to save doubling up! Woolworths and Coles have shops online.

Prepare meals yourself Buy fresh ingredients and prepare meals yourself rather than buying takeaway foods or pre-prepared items. By preparing your own food you can save calories - and dollars. Take a look at the following items that become more expensive as the amount of processing increases:

Potatoes (150g)
Potatoes 25c
Frozen chips 50c
150g potato crisps $2.99

Oats (40g)
Rolled oats 10c
Corn Flakes25c
Breakfast bar 95c

Chicken (100g)
Frozen whole chicken 35c
Raw whole chicken 50c
BBQ chicken 70c
Pre-made chicken kebabs $1.80

Apple (100g)
Apple 40c
Packet of sultanas 90c
Fruit bar $3.20

There are lots of online resources for quick and healthy recipes, including the National Heart Foundation Recipe Guide.

So it's no more expensive to eat healthy food - it just takes a bit of preparation and planning.

Fast Weight Loss: Why it Doesn't Work

Fasting diets generate fast but false results. Here's why:

You lose fluid, not fat And any fluid lost will return as soon as the fast is completed, in other words you'll re-gain any weight that you lost.

Lowered metabolism During fasting your metabolism slows by up to 40% to prepare for starvation, so when you eat normally again your body burns fewer calories and you gain weight.

Hunger and lethargy Fasting leads to hunger and cravings - not what you need when you are trying to lose weight! And when you drastically cut your calorie intake you will feel weak, making it even more difficult to maintain your resolve to lose weight.

Yo yo dieting Fasting often leads to cycles of weight loss and weight gain called 'yo yo' dieting. 95% of people who go on fast weight loss diets regain any weight lost - plus more - within two years (1).

Abstinence leads to binging When your food intake is restricted you experience physical and emotional deprivation. This compels you to eat, which commonly leads to overeating or binging. As a result, you are likely to feel sensations of guilt and failure. This often becomes a cycle which is difficult to break and has devastating effects on your self esteem (1).

Nutritional deficiencies Prolonged fasting may lead to nutritional deficiencies. For example, if you don't consume enough calcium you may be at risk of osteoporosis, or if you don't consume enough fibre you may experience constipation.

Poor Health Fast weight loss is bad for your health because it:
- Increases your risk of medical complications such as gallstones, gout and constipation (2)
- Lowers your immunity
- Leaves you deficient in important vitamins and minerals.

Impracticalities Fast weight loss involves restricting food intake to the point where you are constantly hungry and lack the nutrients you need to maintain physical health and energy levels. This situation can't be sustained in the long term. Plus fasting makes it difficult to carry out normal social interactions - people who are dieting often avoid social situations and family mealtimes, leading to feelings of isolation and loneliness.

Some people claim that fasting can help rid your body of 'toxins' (i.e. the food you eat). 'Toxins' occur naturally in your body, and your body has fantastic systems to cleanse itself (your kidneys and liver).

Healthy Weight Loss

A sensible weight loss goal is 0.5 - 1kg per week, and the best way to achieve this is to make healthy changes to your eating and exercise habits. These changes should always be sustainable - that way you will lose weight and keep it off.

References:
1. Why Diets Don't Work, Eating Disorders Foundation of Victoria
2. Rapid Weight Loss Linked to Gallstones, Flinders Medical Centre

Meal Timing for Weight Loss

If you are trying to lose weight (or maintain a healthy weight) you need to eat approximately every 3 hours and consume five small meals a day. If you consume less than five small meals a day your metabolism will slow making it difficult for you to lose weight. At the Wesley Weight Management Clinic we recommend eating at the following times:

• Breakfast: 6.00am - 8.00am
• Morning Tea: 10.00am - 11.00am
• Lunch: 12.00pm - 2.00pm
• Afternoon Tea: 3.00pm - 5.00pm
• Dinner: 6.00pm - 8.00pm (try and finish your last meal before 8.00pm).

If you leave more than three hours between your meals you may feel hungry - and it's very difficult to maintain your resolve to lose weight when you feel hungry all the time! Plus when you know when your next meal is, you are less likely to turn to convenience foods.

Healthy Meals

A healthy meal or snack is small in portion size but fills you up for at least 2-3 hours. So next time you are tempted to grab fast food on the run or reach for the biscuit jar at work, ask yourself, "Is there a better choice I could make to help me get through the day?". Then try the following:

- If your meal or snack won't fill you up for at least two hours, consider more healthy options. Low fat, low GI snacks with protein will help you feel full for longer: try low fat yoghurt, fruit, light cheese and wholegrain crackers.

- If it's less than three hours before your last meal, think about your real motivation for eating. Ask yourself questions such as, "Am I really hungry?" and "How will I feel afterwards?". You may find that you are engaging in non hungry eating.

- If you have a tendency to eat out of habit, i.e. you tend to snack at certain places or times of the day, think of ways to break these habits. For example, don't keep a stash of chocolate in your top drawer at work.

- Don't attach emotions to food. If you eat when you are stressed or bored; think about alternate, non food-related ways to improve your mood such as going for a brief walk.

- Before you eat, sit down and place your food on a plate: that way you are more likely to acknowledge the calories.

Eating the right foods at the right time can make a huge impact on your weight loss efforts. For more information, see our article Five Tips for Easier Weight Loss.

Meal Replacements: A Great Tool with the Right Advice

Meal replacements are designed to assist in controlling calorie intake, a critical plank for weight loss. But they can also be confusing, frustrating and disappointing and leave you back where you started.
That's because most meal replacements are sold without any advice, or any supervision from a health professional; as demonstrated by a recent CHOICE Magazine study. This lack of advice leaves you to work out your own treatment plan, adding to the increased chance of failure.

The Benefits of Using Meal Replacements

Used correctly, meal replacements can be a great short term weight loss tool. At the Wesley Weight Management Clinic we've found that meal replacements:

• Help you to become accustomed to eating smaller portion sizes
• Promote independence from food
• Narrow your food choices, allowing you to manage the amount and type of food you consume (people consume fewer calories when presented with a smaller selection of food)
• Increase your rate of weight loss
• Help you to feel satiated (not hungry) for longer
• Can provide all of the essential vitamins and minerals that your body needs if you choose a nutritionally balanced formulation (at the Wesley Weight Management Clinic we use Optifast 800)
• Help to regulate your blood sugar levels and maintain energy levels
• Help you form a habit of eating at regular intervals and focusing on one meal or snack at a time
• Require minimal preparation and fit easily into a busy schedule.

Get the Right Advice

If you want to use a meal replacement as a tool for weight loss, you should engage the assistance of a suitably qualified health professional such as a Dietitian or Doctor.

A health professional can help you work out an appropriate schedule of meal replacements, monitor your rate of weight loss and the nutritional quality of your diet, provide advice if you experience any side effects and help you transition back onto normal food when you reach your weight loss goal.

This advice is critical if you have Diabetes or Hypertension: meal replacements can change your symptoms or impact upon the effectiveness of your medication.

Life After Using a Meal Replacement

Meal replacements aren't a long term weight loss solution. When you reach your weight loss goal you need to transition back onto 'normal' food gradually. You also need to learn the skills you need to keep your weight off for life, including meal planning, healthy grocery shopping, meal portioning, exercise and low fat cooking.

For more information about the healthy use of meal replacements, talk to your Doctor or you can ask the health professionals at the Wesley Weight Management Clinic about our weight loss program.

How to Read a Food Label

Reading food labels is a useful skill for weight loss and it's simple to master. There are three components to a food label you need to be aware of; its nutrition claims, ingredients list and nutrition information panel:

1. Nutrition Claims

Manufacturers use nutritional claims on their packaging to encourage us to buy their products. These need to be factual by law but they can still be quite misleading unless you read the whole label. Here are a few examples:

Lite/Light – does not necessarily refer to the fat content, it can refer to the colour, taste or texture
Reduced/Lower/Less Fat – product may still be high in fat but lower in fat than its competitors’ products
90% Fat Free – contains 10% fat
No Added Sugar – may be high in calories due to natural sugars or fats
Cholesterol Free – May contain saturated fats which can increase your blood cholesterol levels

2. Ingredients List

Ingredients must be listed from largest to smallest by ingoing weight, therefore it makes sense to avoid products that contain fat or sugar at the top of the list.

A trick that manufactures to disguise the presence of fat, sugar and salt is to call them different names. Here are a few common examples:

Fat – vegetable oil, shortening, dripping, coconut oil, milk solids, monoglycerides
Sugar – glucose, dextrose, lactose, fructose, glucose syrup, sorbitol, xulitol
Salt – sodium, Na, MSG, sodium phosphate, vegetable salt, sea salt

3. Nutrition Information Panel

This is the best source of nutritional information on a food label. The Nutrition Information Panel lists the amount of protein, fat, saturated fat, carbohydrate, sugar and sodium in a product. It also lists any nutrient referred to in the product’s nutrition claim.

First, look at the total amount of energy and fat in the product. Compare the serve size recommended to the amount you would consume. It can be deceptive!

Nutrition information is provided for two measures of the product: per 100g and per serve. The ‘per 100g’ column is very useful as it allows you to compare different products and calculate the percentage of fat that they contain (for tips on what to look for see our article How to Make Healthy Choices at the Supermarket).

Next time you visit the supermarket practice reading food labels. You may be shocked by the fat and sugar content of some of your favourite products - and then pleasantly surprised at how easy it is to find alternatives that are lower in fat and sugar.

Fructose: Weighing in on the Debate

Fructose has been demonised in the media recently, touted as the cause of obesity and cardiovascular disease. We believe this is misleading. Wesley Weight Management Clinic Managing Director, Neil Holt, explains why:

The obesity epidemic of the last 30 years is not due to a single cause and there is no magic solution: it is misleading to say otherwise. People who are overweight and have struggled to reach and maintain a healthy weight understand that very well.

The obesity epidemic in developed and developing countries is because we are consuming too much of everything: too much fat, protein and carbohydrate, calorie dense snacks, sugary drinks and alcohol. Reduced activity levels also plays a part, but the overconsumption of everything is the real world culprit.

Food has an energy content measured in calories and in our experience many overweight adults are consuming in excess of 3000 Calories per day when necessary levels for weight maintenance are in the order of 1700 - 2200 calories depending on age, gender and activity level. The overconsumption of food - including calorie dense snacks and sugary drinks - leads to increased weight, obesity and many adverse health outcomes including diabetes, heart disease and cancer. Any food - either natural or processed - when over consumed will have adverse outcomes and these are documented daily by health professionals and researchers worldwide.

A proponent of low fructose diets has accused Wesley Weight Management Clinic of advocating the use of meal replacements that are high in fructose, which he claims causes obesity and cardiovascular disease. We believe this criticism is wrong and based on a misunderstanding of how our clinical weight loss program works.

Wesley Weight Management Clinic is not a conspiracy or a product, it is well balanced clinical program designed to help people achieve and maintain a healthy weight. The Clinic is staffed by Doctors, Dietitians, Exercise Physiologists and Psychologists who work as a clinical team to help people lose weight and learn the skills to maintain a healthy weight. Our ownership group and our staff are committed to providing evidence based, ethical and high quality preventative health services and we continuously track and share our results with our clients, their Doctors and the community at large to demonstrate the benefits of investing in health. I believe we conduct the best weight loss service in Australia demonstrated by our outstanding weight loss results.

Meal Replacements - Optifast 800

Meal replacements, when used properly under medical supervision, are very beneficial at the commencement of weight loss. Moving people safely from 3000 Calories per day to 800 - 1000 Calories per day places them in a negative energy state and so their bodies start to process their fat stores for energy and they lose weight. In combination with moderate exercise, women can lose up to a 1kg per week and men up to 2 kg per week.

There are up to 15 meal replacements available on the market and some are nutritionally balanced and others are not. We have used Optifast 800 safely for 10 years and it is supplied by Nestlé Healthcare Nutrition.

Meal replacements are made from processed milk, similar to baby formula. They contain milk protein (14gm), fat (3gm), milk sugars (lactose 8-10gm) and added fructose (8-10 gm) for flavour and energy, vitamins and minerals. The percentage of each component is similar to a healthy balanced diet but the total portion size of the shake is 160 calories when made up with water. The energy content of 1 sachet is similar to 2 slices of bread.

Meal replacements fall into the category of low carbohydrate diets as their purpose is to switch on the oxidation of fat stores for energy, resulting in weight loss. But because our brain and nervous system require sugars that are metabolised from dietary carbohydrates for energy; meal replacements must have some carbohydrate content.

At the Wesley Weight Management Clinic people can safely consume up to five sachets of Optifast 800 per day, or 800 Calories, and that provides them with all their essential daily vitamins and minerals and keeps their hunger controlled. We monitor our clients' blood chemistry and the results of these blood tests tell us that the meal replacements used in our Clinic are safe and not causing any harm, and importantly, our clients lose weight.

Fructose

Fructose is a natural sugar found in 50 different fruits and vegetables - all of us have been consuming fructose our whole life. Fructose has been part of the food chain since man evolved.
Fructose is present in Optifast 800, but there is no more fructose than is in an apple. In five sachets per day of Optifast 800, total fructose does not exceed 50gms, a quarter of the levels of fructose that people consuming 3000 calories per day would consume (including two cans of soft drink).

It is wrong to say there is danger to health at the low levels present in Optifast 800. In fact 50gms of fructose a day is beneficial particularly to diabetics. It is only a danger to your health at artificially high levels, as seen in some published trials where already overweight and obese adults were fed artificially high levels in addition to their normal diet. These trials are conducted in a similar way to toxicological studies as opposed to food safety studies and no food would be considered safe under these conditions. Even pure water triggers adverse health at high repeat dose levels!

It is very difficult to consume high levels of fructose on its own because as a food additive it is combined with glucose in the form of sucrose (sugar) or as high fructose corn syrup (HFCS), a roughly equal mixture of glucose and fructose. The point is that in consuming sugary drinks or snacks on a daily basis, the total calorie content from their total sugar content is doing harm, not just the fructose content. Our bodies convert any excess calories in our diet to fat - it doesn't matter if the calories are from carbohydrate, fat or protein. At the Wesley Weight Management Clinic we teach our clients how to avoid processed foods and drinks with a high sugar content from whatever source, and this is a critical plank of our success.

Our Results from Using Optifast 800 in Weight Loss

At the Wesley Weight Management Clinic we have recorded the weekly visits of more than 6000 clients and their weight loss results for 10 years. We believe we have the largest database on weight loss in Australia and we publish our results on our website and in credible health journals and forums.

The main reason for recording weekly progress is to make sure that weight loss is done in a safe and sustainable way. All clients who use Optifast 800 are medically counseled by a Doctor and their blood is tested prior to commencing Optifast 800. Those who are not suited to meal replacements are prescribed a meal plan with a set calorie level.

We know that Optifast 800 used in our clinic is safe, effective and well tolerated by clients. All clients transition off Optifast 800 during their weight loss program back to normal healthy meal plans. They are taught and counseled on healthy food choices, correct portion size and good exercise - habits that will last them a lifetime. Their challenge will be to continue those good habits when they leave our environment.

Our results show that our clients lose weight, lose fat, reduce their waist lines, maintain lean tissue (muscle), lower their blood pressure, lower their total cholesterol, LDL (bad cholesterol) and blood triglycerides, lower their blood glucose and lower their cardiovascular risk (risk of heart attack) by up to 47%. We have presented these results to the International Congress of Obesity, the National Heart Foundation and the Federal Parliamentary Enquiry into Obesity and we are rightly proud of them.

In conclusion, we unashamedly stand by our Clinic, our staff, our clients and our results. The obesity epidemic, its causes and solutions, are complex and multifaceted but we know what we do is safe, effective and sustainable. While articles that implicate fructose in obesity and cardiovascular disease are right to highlight the dangers of overconsumption of sugars, the assertions in relation to our clinic, our stakeholders, our staff and our clients are factually incorrect and misleading.

Like good health, it's all about balance.

Low Fat Makeovers: How to Modify your Favourite Recipes

Low fat cooking doesn’t have to mean bland, boring food. Even though removing fat removes some flavour, there are plenty of delicious options to replace it with! In this article we’ll show you three easy ways to modify your favourite recipes: substitute high fat for low fat ingredients, reduce the levels of high fat ingredients and eliminate high fat ingredients:

1. Substitute

The following low fat options can be substituted for their high fat counterparts:

Butter and margarine (1 Tbsp = 16g fat)
- Cottage cheese, mustards, chutneys, fruit spreads or honey
(If you use butter use mono or polyunsaturated margarine and spread it thinly.)

Oil (1 Tbsp = 20g fat)
- Experiment using soy sauce, lemon juice, wine or stocks to stir fry or sauté
- Use non-stick pans and no oil at all
(If you use oil choose vegetable oils such as canola, olive and sunflower. Use small amounts and brush or spray rather than pour.)

Cream (1 Tbsp = 7g fat)
- For soups and casseroles stir in non-fat natural yoghurt
- For desserts use low fat ice cream, yoghurt, ricotta cheese or low fat custard. Add a little icing sugar, honey, fruit or liqueur for sweetness

Sour cream (1 Tbsp = 7.5g fat)
- Use low fat natural yoghurt, buttermilk or evaporated skim milk mixed with a little lemon juice

Coconut cream/milk
- Use evaporated skim milk with a little coconut essence.

Cheese (variable fat content)
- Use smaller amounts of lower fat varieties such as mozzarella, bocconcini, ricotta or cottage cheese
- Mix cheese with oats, breadcrumbs or wheat germ for toppings on casseroles and baked dishes

Mayonnaise/dressing (1 Tbsp = 6.5g)
- Use low fat yoghurt, ricotta or buttermilk with added garlic, lemon, mustard, tomato paste, vinegars, fruit juices, pepper or herbs

Pastry (1 sheet puff pastry = 18g fat)
- Use filo pastry and moisten between the layers with egg white, water, stock or low fat yoghurt
- Make low fat pastry by mixing two cups of self raising flour, 250g ricotta cheese and 4 Tbsp low fat milk. Mix and knead.

Meat and Poultry
- Choose lean cuts of meat and keep your portions small
- Make your own mince or ask your butcher to mince lean cuts of meat for you
- For a bit of variety and to add bulk to mince dishes, add grated vegetables such as carrot and zucchini
- Remove visible fat before cooking
- Use marinades, herbs and garlic to add flavour

Cakes and Biscuits
- Choose recipes with less fat and use poly/monounsaturated margarine
- Experiment with using buttermilk or low fat milk to replace some of the fat, using egg whites instead of whole eggs and adding fruits and vegetables such as banana or carrot.

If you find it difficult to modify your own recipes there are a range of low fat cookbooks available from supermarkets, newsagents and bookstores. You can also try online recipe collections from Taste and the National Heart Foundation.

2. Reduce

If a high fat or high energy ingredient can’t be substituted, try using a little less of it. When baking you should be able to reduce the amount of fat or sugar by a quarter to a third without changing the final product too drastically.

Remember that if you remove moisture you need to replace it. So to make up for less oil, add a little more water or low fat milk.

3. Eliminate

If a high fat or high energy ingredient isn't strictly necessary (i.e. it is used for presentation or extra flavour) you can remove it. For example you can omit bacon from pasta sauce.

With these ideas you should be ready to experiment with new low fat dishes at home. But if you need further inspiration, speak to a Dietitian.

Savvy Supermarket Shopping

At the Wesley Weight Management Clinic we’re often asked how to avoid the temptation of high fat, high energy foods at the supermarket. Our answer is simple: don’t take these foods into your home. Decide what you want to buy before you leave home and stick to it - don’t decide what you want to purchase inside the supermarket.

We’ve prepared 10 tips to help you become a savvier supermarket shopper:

1. Plan meals and snacks for the week or fortnight ahead, and use this plan to make a shopping list (then don’t forget to take this shopping list to the supermarket!)

2. Don’t shop or make a shopping list when you’re feeling hungry

3. Choose a store that has a wide selection of fresh produce, grains, meats and poultry: avoid convenience stores, milk bars and delis

4. If you only need a few items, use a shopping basket rather than a trolley

5. Only carry a limited amount of cash to avoid buying unnecessary items

6. Limit your supermarket shopping to the aisles that contain items you need to purchase

7. Be aware of the strategies that supermarket owners use to encourage you to purchase high fat, high energy foods:
Bakery goods such as breads, donuts and cakes are highly profitable for the supermarket owner. They are therefore prominently placed, often at the entry where their aroma is designed to bring you into the supermarket and entice you to purchase something immediately.
Impulse items such as lollies, biscuits, peanuts, chocolates and chips also provide the owner with a high profit. They are also displayed prominently, generally at the end of the aisle or at the checkout counter to make it ‘easier’ for you to purchase them while you wait for service.
Fresh foods such as meats, fruits, vegetables and dairy products are usually found in the outside aisles. Supermarkets only make a small profit on these items, but as they have a short shelf life they need high exposure to ensure adequate turnover.
Canned and packaged foods are found throughout the remainder of the aisles. As these foods usually have a longer shelf life, they don’t need to be turned over as quickly.
Take a look around the supermarket next time you visit. Notice how it’s designed to optimise the appearance and aroma of certain foods. You’ll see tactics such as signs and displays, specials and taste tests.

8. Review your shopping list while you're waiting at the checkout. Is there anything in your trolley that’s not on your list or vice versa?

9. Put your shopping away in the fridge or pantry as soon as you arrive home. Don’t leave it out and expect not to be tempted by it!

10. If you shop with children use the parent friendly, or confectionary free checkout (these are available at the more socially responsible supermarkets). Children are aware that there are lots of brightly packaged, ‘yummy’ foods at their eye height at the checkout and they may pressure you to buy them.

By following these tips you’ll remove the temptation of high calorie foods in your fridge and cupboards, and as a result you’ll find losing weight much easier! For more tips see our article five tips for easier weight loss.

Healthy Snack Ideas

If you are trying to lose weight you should eat a snack for morning tea and afternoon tea. Snacking means you’ll be less likely to overeat at lunch and dinner, and as an added bonus it boosts your metabolism.

It's advisable to plan your snacks in advance so you have healthy options available. We've listed some ideas below:

Savoury Snacks

- Vegetable sticks (carrot, celery, capsicum and snow peas) with low fat dip such as hummus
- A toasted pita pocket cut into triangles with 2 Tbsp low fat tomato salsa dip
- 3 Ryvita, 4 x 9-Grain Vita-Weats, 2 rice cakes or 5 corn thins topped with 1-2 Tbsp cottage cheese and a slice of low fat cheese or vegemite
- A mini can of baked beans
- A small handful of unsalted raw nuts (30g)
- A small low fat savoury muffin
- Up to 20 rice crackers (plain or flavoured)
- A sushi roll
- An English muffin topped with fresh tomato slices and low fat cheese
- Celery boats filled with cottage cheese, low fat peanut butter or low fat hummus
- Continental Cup of Soup
- 2 cups of cooked microwave popcorn (plain or low fat with flavouring)
- 1/2 – 1 cup salt reduced pretzels
- A snack packet of low fat corn chips (1 snack packet)
- Dried cereal - ¾ cup Mini Wheats or ¼ cup natural muesli

Sweet Snacks

- Two low fat biscuits (Weston Oatmeal, Weight Watchers or Arnott’s Snack Right Full o’Fruit biscuits)
- A slice of raisin toast or multigrain bread
- A piece of fresh or frozen fruit (banana, apple, orange or pineapple)
- A cup of fruit salad (tinned or fresh)
- 200g tub of low fat or diet fruit yoghurt or a 150g tub of Fruche Light
- A pikelet, crumpet or English muffin topped with 100% fruit jam or red gum honey
- A low fat sweet muffin
- An Uncle Toby’s Real Fruit bar
- 200g low fat custard, or half a cup of custard with a piece of fruit or a cup of fruit salad
- Half a scone (fruit or plain, topped with 100% fruit jam)
- A breakfast bar such as Kellogg’s K-Time
- A muesli bar such as Nature’s Own with nuts and seeds

A healthy snack should fill you up for at least two hours, so next time you’re tempted to reach for the biscuit jar at work ask yourself, “Will this fill me up for at least two hours?”. If the answer is no, try some of the options above.

How to Make Healthy Choices at the Supermarket

To lose weight you need to reduce your calorie intake, which means selecting foods that are low in fat and sugar. Here’s a quick guide to making healthy choices at the supermarket to save you time sifting through the shelves.

The trick is to locate the product’s food label, find its nutrition information panel and look for the ‘per 100g’ column. Good choices are foods that contain the following amounts of fat and sugar:

Fat Content

Less than:
Cereals – 8g/100g
Biscuits – 5g/100g
Cheese – 15g/100g
Milk and yoghurt – 2g/100g
Mayonnaise and sauces – 3g/100g
Spreads such as cream cheese – 10g/100g
Meat products – 8g/100g
Frozen/packaged foods – 5g/100g

Sugar Content

Less than:
Cereals and biscuits – 5g/100g

For more detailed information see our article How to Read a Food Label.

Portion Distortion: How to Avoid It

The size of a typical portion of food is increasing. ‘Mega serves’, ‘all you can eat’ and ‘up-sizing’ of meals has resulted in portion distortion, or confusion about how much food you should eat.

It’s important to know what an appropriate portion (serve) size looks like, because if you can train yourself to eat an appropriate amount of food you’ll be much more likely to enjoy a healthy weight.

What Does a Serve of Food Look Like?

Food Serve / Size / Looks Like
Vegetables / 1 cup / an adult fist
Fruit / 1 medium piece or ¾ cup chopped / a tennis ball
Milk / 250mL / an adult fist
Yoghurt / 200g / a child's fist
Cheese / 30g / a matchbox
Cereal and pasta / ¾ cup / a tennis ball
Bread / 1 thick slice (55g) / an adult man’s hand
Rice / ½ cup cooked / 2 golf balls
Fats (oil and butter) / 1 tsp / a large button
Beef, pork, chicken and lamb / 120g / the palm of an adult hand

How Many Serves Should I Eat Every Day?

It’s best to consult a Dietitian as the number of serves you should eat per day is dependent on your size, activity level and any special dietary requirements. However to give you a rough idea, the average person consuming 1800 Calories a day should eat:

Food / Number of Serves
Breads, cereals, rice and pasta / 5-7
Fruit / 2-3
Vegetables / 5-6
Beef, pork, chicken, lamb and fish / 1 ½ - 2
Milk, yoghurt and cheese / 2-4

Practical Tips for Reducing Your Portion Sizes

• Serve your meals on a small plate
• Eat slowly
• Buy a scale and a set of measuring cups and measure the amount of food that you are consuming for a few days
• Look at the Nutrition Information Panel of the foods you are eating – are you eating more than one serve size?
• Buy smaller packets of food at the supermarket. If you want to buy in bulk divide the content into smaller bags before you store it
• Don’t eat directly from a food packet - place your food on a separate plate and then put the packet away

Salt and Childhood Obesity

The more salt your child consumes, the more likely they are to gain weight. That's because for each additional gram of salt consumed, children drink 100mls of extra fluid - a third of which is high calorie soft drink (1,2,3,4).

Children's weight can be reduced by removing soft drinks from their diets and decreasing their daily salt intake by 3g (about 50% of the average child's intake). The recommended daily intake of salt for children is:

Age (years) / Recommended salt intake (mg/day)
1-3 / 200-400
4-8 / 300-600
9-13 / 400-800
14-18 / 460-920

Vascular Disease

Excess salt consumption raises blood pressure and predisposes adults to vascular disease. Children may not suffer the effects of vascular disease, but excess salt consumption raises their blood pressure which tends to continue into their adult life (4).

How to Reduce Your Child's Salt Intake

- Prepare their meals with fresh fruits and vegetables
- Minimise the amount of processed food in their diet: more than ¾ of dietary salt is hidden in processed foods (2)
- Don't add salt when cooking and encourage your children not to add salt to their meals
- Minimise take away meals and fast foods
- Include healthy snacks in your children's lunch boxes. Boiled eggs, vegetable sticks and fruit are great options
- Check the food labels on your children's snack foods. Salt is often called sodium, or Na. As a general guide, a sodium level of less than 120mg/100g is low and above 500mg/100g is high
- Season their food with lemon juice, vinegar, garlic and herbs instead of salt.

References:
1.Neal B. 2008, 'Salt: Contributing to Childhood Obesity' Paediatrics and Child Health in General Practice, 26
2.James J, Thomas P, Cavan D and Kerr D. 2004, 'Preventing Childhood Obesity by Reducing Consumption of Carbonated Drinks: Cluster Randomised Controlled Trial' British Medical Journal, 328:1237-41.
3.He F, Marrero N, MacGregor G. 2008, 'Salt Intake is Related to Soft Drink Consumption in Children and Adolescents- a Link to Obesity?' Hypertension, 51:629-34.
4.Simons-Morton D, Obarzanek E. 1997, 'Diet and Blood Pressure in Children and Adolescents', Paediatrics, Nephrol (11)