Q&A ask the expert

12 August 2019
by Angie Jefferson, Dr Linia Patel (PHD, RD), Caroline Bovey1, Liane Reeves

Our dietary experts are on hand to provide help and guidance on a wide range of dietary issues.

Q1: Liane Reeves - Liane Reeves, BSc (Hons),MSc Allergy, RD is an Adult Allergy Specialist Dietitian in Oxford.

Q2: Caroline Bovey - Caroline Bovey RD, MA (PCET) is a Public Health Dietitian in a South Wales Health Board.

Q3: Linia Patel - Linia Patel, MSc Human Nutrition, BSc Med Hons Nutrition & Dietetics is a dietitian and sports nutritionist.

Q4: Angie Jefferson - Angie Jefferson BSc (Hons) RD, RPHNutr has researched, written and discussed almost every aspect of diet and health.

Q1 think I may be lactose intolerant. How can I tell for sure and what will I need to consider if I am?

Common symptoms of lactose intolerance are diarrhoea, bloating, wind, nausea, tummy rumbling and pain. It is best to see your GP to check for other causes before changing your diet. You could then try replacing your usual dairy products with lactose-free alternatives for 2-4 weeks. You can choose from milk products which have had the lactose removed (these still contain calcium), or completely dairy-free products such as those made from soya, oat, rice, coconut or nuts - make sure these are calcium fortified. If symptoms improve, retry milk and products by building up the amount and frequency to find out what you can tolerate. Level of tolerance will vary from person to person. In the long term, ensure your calcium intake is adequate along with vitamin D and make sure your diet is well balanced. For further support, ask your GP to refer you to a dietitian or contact here.

Q2 I am not sure my diet is OK so I take a vitamin tablet daily ans a few ther supplements most days - is this the right thing to do?

For most of us, the best way to remain healthy is to eat a balanced diet including plenty of fruit and vegetables and starchy foods, and limiting less healthy foods. A varied diet ensures a good range of nutrients including important things such as fibre. It is true that some people do need supplements at certain times in their lives, for example folic acid is important for women who are trying to get pregnant. Some women, and children between six months and 4 years, may need Healthy Start vitamins. Vitamin D is recommended for some too, including women who are breastfeeding, people with darker skin and those over 65. In July 2016, Public Health England released new guidance that individuals living in the UK consider taking a daily supplement containing 10mcg of vitamin D during the autumn and winter as it is hard to get enough from foods that naturally contain vitamin D and/or fortified foods alone during this time of year. My advice is that for most people supplements are not a substitute for a balanced diet, but if you do decide to take supplements always get the best advice you can and speak to your doctor, dietitian or a pharmacist.

Q3 I have deard that gluten if bad for you - is  this true? Should we all be eating gluten-free?

A Gluten-free diets were originally designed for those diagnosed with coeliac disease (a serious illness where the body’s immune system attacks itself when gluten is eaten). Coeliac disease affects 1 in 100 people in the UK. Some people without coeliac disease experience gut symptoms when eating foods containing gluten and this is called gluten intolerance. Unlike coeliac disease there is no definitive diagnosis f QI am not sure my diet is OK so I or gluten intolerance.

As a result, there has been an explosive growth in people “selfdiagnosing” and following glutenfree diets when they actually don’t need to. Before deciding to go gluten-free, consider the following:

  • If you experience gut symptoms when eating foods containing gluten, talk to your doctor before simply giving up gluten.
  • Involve a dietitian who will work through an elimination diet whilst ensuring your diet remains balanced.
  • Gluten-free doesn’t necessarily mean healthier eating. A poorly planned gluten-free diet can lack vitamins, minerals and fibre.

Q4 What foods should I eat and what foods should I avoid during the menopause?

There is no special diet for the menopause, but ensuring your diet is healthy and balanced can help to ease some symptoms. Fluctuating hormones can also tend to increase waist size so staying active is vital around this time to help minimise ‘middle-aged spread’.

Hot Flushes: if these affect you, limit triggers such as hot drinks, spicy foods or alcohol. Evidence is mixed, but an increase in intake of plant oestrogens from soya and linseeds could help reduce the intensity of flushes for some women.

Bone Health: plenty of calcium is important to help keep bones strong and limit loss of bone density (low bone density increases the risk of osteoporosis). Aim for 3 servings of dairy foods a day or speak to a pharmacist about calcium supplements.

Rising Cholesterol: an increase in cholesterol is common around the menopause. Reducing intake of saturated fats (e.g. butter and meat fat), eating more oily fish (e.g. salmon or mackerel), oat fibre and nuts could help to keep cholesterol in check.

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