Many people who embark on weight loss surgery have come into contact with at least one dietitian in the past and let’s face it, we aren’t on the top of anyone’s Christmas card list! So when your weight loss surgeon suggests you see yet another dietitian, you shudder at the thought! But hear me out. We play a valuable role in your weight loss journey both before and after your surgery, and I’ll show you why.
​By Kate Stoker, ​Principal at Simply Nutrition Dietitians and in-house dietitian with Dr James Askew - Bariatric Surgeon - Sunshine Coast. 

• ​How much food will I be able to eat after surgery?
• Is there anything else I can eat whilst doing the dreaded pre-op diet?
• How long should I drink fluids for after surgery?
• What multivitamins should I take after surgery?
• How do I keep the weight off after I have lost it?

These are the types of questions we’re asked every day…and many more!

Our goal is to support you through the process, help you to achieve your weight loss goals, keep the weight off and to most importantly to keep you feeling well!

What to Expect
To help ease the anxiety often felt when you make an appointment to see us, here is what to expect from your appointments:

Pre-op

• Complete a thorough diet history of what you currently eat, triggers for poor eating habits, pace of eating;
• Outline how to expect eating and drinking to change for you after the surgery;
• Explain any abnormalities in your nutritional screen via your blood test;
• Explain how to follow the pre-op diet, what you can and cannot eat;
• Translate complex information about the surgery in to easy to understand language;
• Assess any current vitamin/mineral supplements you take and provide recommendations on a supplement regime for after your surgery;
• Explain the amounts you can expect to tolerate after the surgery and what fluids you can and cannot have.

Post-op

• Guide you through the different stages of the diet immediately after your surgery providing detailed lists of foods to eat and foods to avoid;
• Teach you about what foods contain protein and develop an individual plan to assist you in achieving this;
• Help you to address the reasons that may be been contributing to your weight before the surgery. This is essential in helping you to keep the weight off;
• Remind you to take your supplements and to monitor nutrition via your blood tests.

As you can see from above, our main role is to support YOU! We are not here to tell you that you’ve done the wrong thing or how badly you’ve eaten in the past. We want you to find the best way of eating to suit you and your life as well as achieving good nutrition to keep you feeling well.
If you'd like assistance please feel free to reach out via phone or email. 

Individuals who suffer from arthritis can gain some relief by having a well-balanced diet. Although there is no food that can cure arthritis, some dietary modifications such as those listed below can lessen joint pain and improve a sufferer’s quality of life.

Healthy eating
A balanced diet rich in foods as described in “The Australian Guide to Healthy Eating” and low in total fats should become a part of an arthritic patient’s daily life. Brightly coloured fruits and vegetables; wholemeal breads and cereals, tea; dark chocolate and some herbs are all rich in

Anti-Oxidants which can help prevent inflammation.

Healthy weight
Having too much weight can put excess pressure on hip, ankle and knee joints. A healthy eating lifestyle combined with low resistance exercise; such as swimming, walking and stationary cycling can assist a patient in getting to a healthy weight range.

Omega 3 Fats
Commonly found in oily fish, (EPA & DHA) and in canola oil, green leafy vegetables and flaxseed (ALA); studies have found that a high intake of omega-3 fats can have a calming effect on arthritis, specifically rheumatoid arthritis. Omega-3 fats also have the added benefit of reducing the risk of cardiovascular disease.

The easiest way to obtain omega-3 is by eating at least 3 fish meals a week or through a high-strength, pure fish oil supplement.

Myths
Cider vinegar; Nightshade vegetables: potatoes, capsicum, eggplant and tomatoes and Acid producing foods: oranges, lemons and tomatoes have not been scientifically proven to worse arthritis symptoms and should therefore not be avoided. 

Glucosamine
Glucosamine helps to regenerate cartilage and lubricate joints. It is extracted from the shells of prawns and shellfish and according to Arthritis Australia can be beneficial for sufferers. 

For more information and or help with your diet and Arthritis please call 07 54448 4459 or email us here.

Additionally please visit Arthritis Australia www.arthritisaustralia.com.au



Reference:
1.      Arthritis Australia. Joint Action – Take Control, Food and Arthritus

Almost 1 in 100 Australians are affected by coeliac disease. However, 160,000 Australians have not been correctly diagnosed. If left untreated or misdiagnosed Coeliac Disease can lead to osteoporosis, iron deficiency, infertility, depression, liver disease, miscarriages, some cancers and autoimmune diseases.

Coeliac Disease can affect people in various ways with some experiencing more severe symptoms than others. Patients who have coeliac disease commonly experience weight loss, anaemia, diarrhoea, constipation, bloating, abdominal pain and lethargy. 

How to diagnose Coeliac Disease?
To correctly diagnose Coeliac Disease it is important for the patient to go through the following steps

1. Prior to testing - Keep eating gluten

If a patient has not consumed gluten for some time it is important to have them complete a ‘gluten challenge” 6 weeks prior to being tested. The gluten challenge must include four slices of wheat based bread or an equivalent food each day.

1. Screen for Coeliac Disease with appropriate blood tests

A coeliac serology blood test measures the antibody levels in an individual who has untreated coeliac disease. i.e. they must completed the gluten challenge and be still consuming gluten at the time of the blood test.

Blood tests are not always accurate and therefore should never be used as a definitive diagnosis for the disease. If the serology is positive, the patient MUST continue consuming gluten and have a small bowel biopsy to confirm the diagnosis. The serology is just a screening test! 

1. A small bowel biopsy is essential

The patient must continue to consume the equivalent of 4 slices of gluten containing bread until the small bowel biopsy has been completed.

1. Gene testing (HLA genes)

Gene testing can be used when the diagnosis of coeliac disease is not conclusive from the results of a blood test or bowel biopsy. This can be caused by the patient not consuming any or the correct amount of gluten for a serology or bowel biopsy.  

What can a Simply Nutrition Dietitian do for a patient with coeliac disease?

• Treatment of symptoms
• Improved nutritional intake

• Improved BMI
• Improved or normal bowel habits

Further information on Coeliac Disease can be found at Coeliac Australia - www.coeliac.org.au

Great video to watch discussing the effects of the fad diets flooding society and people's eating behaviours. Let's focus on eating for health and enjoyment and stop feeling guilty....who's with us?

http://www.sbs.com.au/news/article/2015/03/26/orthorexia-nervosa-when-righteous-eating-becomes-obession 

There has been a lot of media coverage re: the Paleo Diet of late which has meant a larger number of individuals are starting to follow it in attempt to improve their health. Unfortunately we have seen a handful of people in the last 2 months who have been following this diet and have had some adverse effects from it. Namely higher cholesterol results when previous readings were in the normal range prior to the diet, headaches and fatigue. 

So with this in mind we wanted to do some Myth busting - 

What is the Paleo diet

The Paleo diet is based on the diet of our Palaeolithic ancestors and focuses on only consuming foods that our ancestors consumed during this time. The diet is high in protein and fat and lower in carbohydrate– it allows people to consume fruits, vegetables, nuts, seeds, meat, poultry, seafood and eggs, while excluding dairy, grains, alcohol, processed foods, refined sugar, potatoes and salt.  The modern Paleo diet also promotes the use of coconut oil and butter, while recommending legumes be avoided. During this period, food choices also depended on availability which supports that the diet altered between region and season, and revealing there was no one specific Paleo diet.

Risks of following the Paleo diet

It is not recommended that individuals follow the Paleo diet as the exclusion of grains and dairy foods places people at risk of nutrient deficiencies and at risk of chronic diseases such as osteoporosis. By encouraging people to use saturated fats such as butter and coconut oil, the diet also places followers at an increased risk of heart disease. It is great that the diet encourages more fruits and vegetables and some unsaturated fats such as avocado and nuts and encourages the avoidance of processed and refined discretionary foods. The Australian Guide to Healthy Eating also recommends this. Followers of this diet claim that our current dietary guidelines are causing us to be overweight however the recent Australian Health Survey indicates Australian’s are eating less fruits and vegetables and greater than a third of our daily dietary calories come from foods high in saturated fat and refined sugars.

In addition, research also suggests that grains were consumed at some stage during the Palaeolithic era despite the diet encouraging avoidance of them. Research has demonstrated the benefits of wholegrains for managing weight and also for the digestive tract. Research also discussed the importance of dairy for bone health.

Summary

1. Anthropologists know that there was not one Paleolithic diet and evidence exists that shows that during this period of time humans consumed both grains and legumes.
2. The Paleo diet is not recommended as a diet low in carbohydrates, high in fat and high in protein is not supported by the extensive body of research.
   
3. The Paleo diet limits legumes which are rich in fibre and protein, dairy which is rich in calcium and grains which are high in fibre, carbohydrates, Grains have been found to be associated with a lower BMI and waist circumference.
   
4. Coconut oil is high in saturated fat and calories and research recommends this oil not be included regularly in the diet due to the risk of heart disease. Interestingly humans in Paleolithic times would not have consumed coconut oil as they had no means of extracting and refining it!
   
5. Only 5.5% of Australian adults consume the recommended serves of fruit and vegetables every day.
   

We hope this helps with your knowledge and if you need further advice Simply Nutrition Dietitians are able to help with understanding the risks of following the Paleo diet, and provide healthy, balanced nutritional recommendations instead. 

References
Dietitians Association of Australia. Part 2: The modern paleo diet: What is it? Available from: http://daa.asn.au/for-the-public/smart-eating-for-you/nutrition-a-z/paleo-diet/part-2-the-modern-paleo-diet-what-is-it/
Dietitians Association of Australia. Part 1: The paleo diet: What is it?
National Health and Medical Research Council. Australian Guide to Healthy Eating. Available from: http://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating
Osteoporosis Australia. Calcium, vitamin D and osteoporosis.

Therefore, from this, it is evident that the negatives of coconut oil greatly outweigh any possible benefits. It is important to keep in mind, coconut oil is an important cash crop for India, the Philippines and Indonesia and unfortunately, in today’s society, wealth is often placed before health.  Any information, from any human being can be presented on the Internet, however it is important to make sure it is quality evidence and from a reliable source. If you are unsure, always speak to your Dietitian or Doctor before commencing any diet strategies that have conflicting evidence. In conclusion, coconut oil should not be used more than once per month or if possible, completely avoided.