It is great fun to watch Max enjoy new foods and textures. He seems quite confident now with a spoon which still amazes me! We started off wearing a standard bib which covers his arms and body...but quickly realised that the food making it into his mouth, certainly in the early days, more often than not will be spat out or thrown around! These bibs allow food to slide down into their lap onto their seat and the floor...lovely. So asking around and reading some reviews, we came across the BiBADO. Lots of mums rave about this bib which not only covers the baby, but is stretched across the high chair to create a 'well' where food can be caught. The bib was created by a mum with twins who was sick of clearing up the mess after meal times, after several redesigns this 'award-winning' bib was launched. The bib is wipe clean, waterproof and states that it will save 20-30 minutes of cleaning up after meal times. We managed to find a £5 off code so the bib cost us £15. It fits Max well, though I find the velcro fastener slightly difficult at the back. It certainly catches his food which is a lot less messy and does save time afterwards. However, one thing I did notice that because of the brightly coloured and detailed design of the bib coverall Max seemed to find it more difficult locating the food in front of him. This may be because his weaning journey is just starting and he is learning that the items in front of him are food..but I would be interested to hear if anyone else found this with their babies? we solved it pretty quickly by only placing a small section of the bib on the eating area so the food wasn't lost. The downside is that sometimes food slips off and defeats the whole purpose of the bib! Hopefully, this will improve in the future!
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It is fascinating to think that environmental factors such as nutrition from conception to the age of two can have such a profound impact on your lifelong health. There is strong research which shows that a good maternal diet is important not only for the prevention of neural tube defects (spina bifida for example) but also to set the blueprint for their baby's health and disease risk. Scientists talk about the importance of the first 1000 days in terms of a child's ability to thrive, specifically related to the growth and development of the brain. Pregnant women are well versed in taking folic acid, but other nutrients such as Vitamin D, iron, iodine, and omega-3 are also integral for foetal development. During my pregnancy I had 'morning' sickness (i.e. horrific all day and evening nausea) for about two months where I ate plain pasta, cheese, quorn sausages and yoghurt; not the balanced diet I normally enjoy! Luckily I was taking a supplement...and luckily the sickness only lasted 2 months as my diet was the only source of nutrition for Max! Within these 1000 days are key stages. The weaning stage is of particular importance. Moving a baby on from breastmilk and/ or formula milk onto solids is an interesting time for babies and parents! It is also a key opportunity to expose babies to a range of different, nutritious foods. Taste exposure is critical to ensure that babies are more willing to eat a variety of wholesome foods setting them up for life, and on an aside, reducing the risk of fussy eating. It is startling to know that in 2012 the National Obesity Observatory reported that most children aged 5–15 years eat just one portion of vegetables each day, and 7% of children ate no fruit or vegetables at all. This highlights the importance of weaning babies onto a good range of fruit and vegetables (whether the parents like them or not!) at the time when they are most receptive to them. Interestingly a study published in the journal Appetite in 2015 highlighted the improved acceptance of vegetables in quite a complex trial involving infants starting their weaning journey. The babies had repeated exposure to individual vegetables such as green beans, spinach and broccoli, which on the whole improved acceptance, and led to the babies trying and accepting other vegetables. Additionally, this team of scientists argued that whilst hiding veg in meals can lead to increased intake, the child will not learn to like, eat and recognise vegetables and their distinctive tastes. So perhaps keeping the vegetable whole rather than mixing it in with other flavours initially is of some benefit? Over the last two decades there are countless studies which show that repeated exposure up to 10 times can increase acceptance of fruit and vegetables. So when your baby spits out foods, rejects them or simply pulls a 'what the!?' kind of face...don't give up..try that food again (and again and again!). I was disappointed today that Max tried avocado and wasn't massively fussed about it. I LOVE avocado and am hoping it will become a staple in his diet. So based on the above he will certainly be trying it a few more times...lucky little fella. There are so many benefits to baby-led weaning. You know me, I did my research! Your baby gets to try different food textures, they have fun exploring and holding different foods, supposedly this can help later down the meal journey...and it is certainly fun watching them! Max has tried a whole range of vegetables individually. I decided to choose the evening (5pm) slot as our meal time and started our journey with the following veg..carrots, broccoli (not so successful!), green beans...you can see from the list we've got through quite a few. There's loads of weaning charts you can purchase and download but I just created my own. I also thought it would be helpful to keep tabs on how many times he tries the veg (though mainly the ones he wasn't keen on) to ensure that he doesn't become avoidant. They say it takes 10 tries/exposures to foods before they except them! So Max has more broccoli to look forward to in the future! It is advisable to chop the veg into baton shaped portions so the baby can hold and place part of the vegetable or fruit into their mouth. It is incredible that a baby is born with the innate ability to grasp objects. I waited until Max was 6 months to start baby led weaning as I wanted to give him the best chance of success! The above picture of Max shows him using what is called a 'palmar grasp' which he then draws to his mouth. He hasn't mastered the 'pincer grasp' just yet so I placed peas slightly squished onto a spoon for him to place in his mouth. He loved them! It was great seeing him use a spoon so confidently as well. Certainly a surprise to me!
Just before I started my maternity leave, I attended an interesting session on synbiotics and their use for babies and children. We learnt that Synbiotics (a combination of pre and probiotics that work synergistically) are now being used (though not routinely!) to help with allergies in children and can help to restore a healthy gut composition following use of antibiotics. I suppose to a certain degree this was a pharma company showing off their products, so they were keen to emphasize the positives, but it did get me thinking about the role of our gut in our key development years. The slide below was from a virtual talk I attended recently. It highlights the stages of development of our gut bacteria which starts pre-birth stabilising in adulthood. The pharma company were suggesting that babies delivered by c-section would benefit from some kind of pre/probiotic intervention as they would not have been exposed to their mother’s bacteria in the same way as a vaginal delivery. There is ongoing research in this area so it will be interesting to see whether this emerges as official guidance for mothers having c-sections. So, this leads me onto my question from Part I - how can we be kind to our gut? If you’ve read my published article Gut Health you will know it’s partly to do with gut diversity; fibre, pre and probiotics! Poor fibre intake reduces our gut diversity which in turn affects our immunity (read the article for more detail!).
But where do we get fibre from? Well I’m sure you know that we get a range of different fibres from vegetables, fruit, wholegrains, etc. etc! Therefore, we can be kind to our guts by feeding them a range of different fibre in the form of whole fruits and veg. And when better to start than when our babies are being weaned from milk to solids...yes you can see the link now, and why I’m enjoying this weaning stage so much with Max! The gut microbiome is a fascinating topic and thankfully more and more research is being completed within this area. Back in 2014 I attended a Nutrition conference in Glasgow and first heard about some interesting research regarding the role of our gut microbiome in influencing our health and immunity. The chap talking at this conference said that 'Our gut bacteria have their own circadian rhythm' (a mechanism that times daily events like our sleep-wake cycle, temperature, hormone secretion etc.) which at the time I thought was amazing! How incredible they could even know that!?
Our little gut bacteria have particular functions which occur during the day and night, and get busy with them based on environmental cues (light /dark etc). But what I found interesting was that if we alter our rhythm due to lack of sleep for example (something I know a lot about!) it can influence our health, immune system and metabolism. >> if we are altering our sleep patterns...(shift work/feeding babies etc,) it often means we are altering our eating patterns>>which means that the gut microbiota are receiving food at times which don’t correspond to their own schedule >> which can affect the breakdown and absorption of nutrients by the gut bacteria>>possibly then having an adverse effect on our health and immunity….(type 2 diabetes as one example) with 70% of our immune system residing in our gut….it certainly pays to be kind to our gut microbiota! But how can we be kind to our gut?...I reflect on that in part II. It's incredible to think that irritable bowel syndrome (IBS) effects 10-20% of the population worldwide. To be honest, I can believe this as we have seen a year on year increase of referrals to our gastro dietetic clinic for patients newly diagnosed with this debilitating condition.
This functional gastrointestinal disorder is characterised by symptoms of altered bowel habits (for example, constipation and/or diarrhoea), abdominal pain, and bloating without evidence of organic disease. I often see patients in clinic at the end of their tether after years of presenting to their GP with these symptoms over and over without any understanding or answers to all of their questions. These symptoms have often taken over their life, dominating social activities which are driven by locating the nearest toilet, or having painkillers to hand 'just in case'. A thorough GP should be taking a detailed symptom history, listening out for any red flags, and may refer to a consultant for investigations to rule out conditions such as coeliac disease, inflammatory bowel disease to name a few. Often a long way down the road with investigations all proving 'normal' patients are dismissed, or the 'It's just IBS' diagnosis is rolled out. I am lucky at Arrowe Park Hospital that my team have a great relationship with the gastro consultants, working closely with them to help patients who are newly diagnosed. They will often refer to us for the detailed elimination diet therapy called 'The Low FODMAP' diet. This diet removes the highly fermentable oligo-, di- and monosaccharides and polyols (FODMAP)-containing foods which can cause symptoms within this IBS spectrum. The elimination period can be for 4-8 weeks depending upon symptom relief, before reintroducing them systematically to identify any trigger foods. Research into the efficacy of such a dietary approach has shown positive results with patients experiencing improvement in symptom control and quality of life. The combination of working with a healthcare professional and accessing the relevant smartphone app, improves the likelihood of success of completing this elimination diet to identify whether food is in fact the trigger. However, before we even get to that stage there are a lot of basics to cover to ensure that the patient has at least the foundations right. Pharmacological therapies can be effective, but often patients are keen to explore dietary manipulation either first, or alongside medications such as Mebeverine and peppermint capsules. I find it rewarding to analyse, discuss and work with patients to improve their dietary approach to help reduce symptoms. Both the basic 'first line' advice, and the more involved dietary therapies such as the Low FODMAP diet are effective, and patient's have experienced success to varying levels depending upon their own medical situation, environment and other aspects. You can never underestimate the joy from hearing a patient say 'I've got control of my life again'. I undertook the training to become certified in providing the Low FODMAP diet therapy and found the process detailed and fascinating. I am looking forward to using it in my private practice having found it very useful in my clinic at Arrowe Park. Does it really matter what, how and when we eat and drink? Does it effect my health? It would seem that I am not the only one asking these questions. Gastroenterology as a specialism is a fascinating area. It is fast becoming the focus of scientists around the world as they seek to understand more about the impact of nutrition by investigating the gut and the microbiome; whether pre and pro-biotics have a role in our health; the complexities of the gut-brain axis i.e. the impact of the mind on our gut, to name but a few. What is surprising about organs such as the gut, the pancreas and the liver, are the integral roles they play throughout our lifetime to help us function, perform and live day-to-day. On a more fundamental level though, you may not think twice about what you eat, choosing foods blindly from a buffet, or attending a friends wedding or even just eating out at a local cafe. You may feel full and sluggish after a large meal or ‘tender’ from over-indulging on alcohol but get over it after a day. We can choose to include the next ‘superfood’ shake or feast on fibrous fruit and vegetables to meet that elusive 30g target per day. We take those choices and our health for granted. Sadly, for some people, this is not the case. Nutrition is far from nourishment and has become more of a nightmare. I have met countless patients over the years who mourn for their old relationship with food and drink; navigating through food choices to avoid experiencing terrible symptoms. Choice, this somewhat simple process dominates their lives. The impact of this can take its toll on their health both physically and mentally, even in the short-term. Indeed, some people restrict their diets to the extent which makes their health worse, without much improvement. Whether people remove food groups, add in ‘interesting’ herbal supplements or simply live off toast, our food choices when we have a medical condition that impacts on our gut, pancreas or liver, are not so simple. This may resonate with you?
Foods which may not be the best for our health, but are part of our culture taunt you! Conversely, foods we may deem as ‘healthy’ may have a completely different effect on you because of your medical condition. This is why I find the area of gastroenterology dietetics so fascinating and rewarding at the same time. Nutrition, (alongside any required medication) can play a huge role. So many of my patients have been amazed at the impact of a nutritional assessment to help them improve their understanding of how their nutritional (solid and liquid!) choices impact their health, and their quality of life. It is very rewarding to work with patients at all different stages in their lives, managing their condition. Sometimes they just need reassurance that they are doing everything they can, sometimes it’s starting from scratch as they have become lost. This is my aim with Wholefoods1st nutrition consultancy. Spending quality time navigating these ‘choices’ together and understanding what they mean to you. What, how and when we eat and drink can effect our health and particularly if we have a medical condition that complicates the picture. Sometimes making dietary changes just takes a bit of patience and trial and error, but nutrition can mean nourishment again.
What I like about this product is the simple ingredient list. You add your own eggs, apple and an optional two tbsps of oil. Admittedly, I am not a fan of the label ‘Paleo conforming’ as I find it can put off because it sounds faddy. However, the recipe is simple to follow and fool proof for people like me who tend to mess around with recipes to make them healthier (usually with disastrous consequences!). Whatever your dietary requirement this product covers most of them! A 50g slice is considered a medium-sugared, medium- fat food. However, they are natural sources of sugar and fat, and contain a good amount of protein which helps you to stay fuller for longer. My attempt is shown in the picture above. It smelt and tasted delicious! I had a slice with a cup of green tea at lunch time today. “Ugg’s Fruit and Seed Loaf makes the perfect start to any day. Delicious toasted and smothered in a little conforming olive oil spread or just nibble when warm from the oven. The Fruit and Seed Loaf mix can also be used to make other recipes including fruit and seed cookies for healthy snacks and a sweet and tasty base to desserts such as Ugg ‘bread’ and ‘butter’ pudding! Almond meal, raisins (32%), pumpkin seeds (6.4%), sesame seeds (6.4%), sunflower seeds (6.4%), chia seeds (6.4%), xylitol, poppy seeds (1%), flax seeds (1%), spices (cinnamon, coriander, cassia, nutmeg, fennel, cloves). CONTAINS NATURALLY OCCURRING SUGARS * Xylitol is a naturally occurring sugar alcohol. It’s often found in gluten free products and chewing gum. If you have IBS-D it is recommended that you avoid this product. See the BDA IBS guidelines for more information here. Each 50g serving (one slice) contains: 147Kcals, 12.7g carbs (7.2g sugars), 7.2g fat (1g SF), 6.4g protein, 2.9g fibre.
1. Unfortunately the price would put me off purchasing this regularly. However, I recognise that the ingredients are not cheap! 2. You need to spend £40 on the UGG food website before receiving free postage and packaging. So either buy a few bits to try them out or pair up with someone to share the cost! UGG foods have kindly provided readers with a discount code ALLERGY15 for 15% off, valid until March 2015.
Food Matters Live, held in ExCel London, was a fantastic event to attend. It was great to have the opportunity to listen high profile speakers such as public health specialists, healthcare professionals, academics and representatives from industry, debate wide-ranging topics from ‘Changing eating behaviours’ to ‘Nourishing our next generation’. My musings on this event are currently with an editor of the BDA magazine Dietetics Today for consideration. So I will post the link as soon as it's published. There were a whole host of solutions proposed to improve the health of our nation, from local level, to broad nationwide initiatives that could potentially have an impact. Hopefully there will be some follow up to show where these suggestions are being implemented, and report any success achieved. In addition to the conferences, seminars provided opportunities to hear about new research in heart health, weight management, the exciting future of nutrigenomics, and advances in health technology, to name a few. There was also a variety of interactive talks, innovative cooking demonstrations and interesting exhibition stalls to visit. Over the days I attended, there was so much going on; I wish I could have been in three places at once! In particular, there were four products that caught my eye whilst wandering around the hall. As samples were available from each of these companies, I was able to try them, and found they all passed my taste test! However, looking into their health claims, nutrition value and costs away from the hype of the exhibition, is a different matter. The following reviews are all my own opinions. I received these items for free at the exhibition and have no benefits from sharing my review. P.s A rather cool moment for me was having my pic taken with Dr Mosley. I like his energy and passion for investigating health issues. He came across as a decent person with very honest opinions! He was keen to highlight the need for nutrition education for medical students which you would hope will help to improve awareness and patient care. |
AuthorAmy Gittins, BSc Registered Dietitian Categories
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