Advice on nutrition

By Aude Cholet

My name is Aude Cholet and I'm a dietitian working at the Royal Brompton hospital in London. Part of my job is to give dietry advice to people on the GUCH unit.

The small sample of GUCHs I met had a lot of ideas about their nutrition and what healthy Eating. Unfortunately, I think there's a lot of confusing information and conflicting messages out there. So I thought I'd write a few words about what healthy eating really is all about.

Healthy eating is about enjoying your food: so non need for "This tastes so bad, it must be good for me".

Healthy eating is about being the right weight for your height.

Anybody heard of Body Mass Indexes? No? Well, take your calculator and type in your weight in Kilos, dry if you suffer from fluid retention/oedema (e.g 65), divide by your height in meters (e.g. 1.68) and divide again by your height in meters (1.68). If the value you read is between 20 and 25, you are probably a healthy weight for your height. If however your BMI is below 20, you are underweight. If you are underweight, it is important to try and put on weight as poor nutritional status will negatively effect your health: so forget about the low fat, low sugar, high fibre 'healthy eating' message, it is certainly not healthy for YOU.

Facts

Low fat diets are only appropriate for people who want to lose weight, as it is more energy-dense that protein or carbohydrate. Fats and oils especially from vegetable source (nuts, seeds, olives, cereals) or fish can actually be beneficial to your health.

Red meat is NOT bad for you. In fact many GUCHs at the hospital have low iron levels, which is found in very good amounts in read meat.

Fresh fruit juice and dried fruit are as good as fresh but not as filling, so they can be included as part of your five portions of fruit and veg.

Are you going to hospital to have an operation soon? Do you know what nutritional status have shown to have an impact on surgery and recovery? Studies have shown that up to 40% of people coming to hospital are malnourished. This may be due to you feeling unwell before surgery and therefore reducing your nutritional intake, or the nature of the problem. Your heart may work extra hard and therefore burn more energy.

While you are in hospital, long fasting times for investigations and not always appreciated hospital foods mean that it is very important to have optimum nutritional status before you arrive to hospital.

Nutrition plays a very important part in wound healing, tissue repair and fighting infections, which in turn can help, shorten hospital stays and decrease complications. Some nutrients are not stored in the body in great amounts so it is important to eat foods rich in these daily.

I have listed some of many nutrients that are particularly important before, during and after surgery.

Vitamins and minerals supplements should not be necessary. Taking large doses of only one or two vitamins and minerals can actually effect the absorption and effects of other vitamins and minerals. Contact your local State Registered Dietitian for more info.

Vitamin E

Antioxidant, helps fight damage caused by surgery and drugs - eggs, fish, meat, seeds & grains, spreads and vegetable oils.

B Vitamins

Essential for energy production and cell division via carbohydrate, fat and protein metabolism - yeast and yeast extract, nuts, pulses, wholegrain cereal foods (wholegrain breakfast cereals, wholegrain breads), meat and fish, liver and offal meat, green leafy veg, milk and diary products.

Vitamin C

Structure and maintenance of blood vessels, cartilage, muscles and bones - fruit and veg (fresh, frozen or juice).

Calcium

Bone strength, muscular contraction, nerve transmission, blood clotting - milk diary products, canned fish, green leafy veg, pulses, tap water.

Phosphorus

Calcium and protein metabolism - milk and diary products, meat, fish, eggs, nuts fruit and cereals.

Magnesium

Energy and protein metabolism, muscle contraction - green veg, meat, pulses and wholegrain cereals.

Iron

Oxygen carrier in the blood, energy metabolism, skin (collagen) repair - red meat, liver and offal, fortified breakfast cereals, cockles, nuts and seeds.

Zinc

Wide range of action, including major role on the immune system, wound healing, taste buds - read meat, fish and shellfish, milk and dairy products (including eggs).

Copper

Strength of elastin and collagen found in blood vessels and skin - shellfish, liver, nuts cocoa.

Menu Ideas

Breakfast

Cereals (muesli, porridge, weetabix, honey-nut branflakes...) and milk;Smoothie/fruit shake made from fresh/frozen/tinned fruit thrown in blendar. Add yoghurt for extra protein and calcium.

Lunch

2 slices of granary bread with spread and salmon/sardines/mackerel;

Side salad (tomato, lettuce, cucumber + nuts and/or seeds + fresh lemon juice and vegetable oil dressing);

Plain chocolate coated digestive biscuit.

Dinner

Minced beef, kidney beans and vegetable casserole (onions, carrots, mushroom, celery, tomatoes, marmite for stock, peanut butter for exotic hint);

Broccoli/cabbage, can be stir fried in olive oil with pine nuts/sesame seeds; Potatoes with skin, can use Greek yoghurt, chive and spices for a great dressing);

Fruit Salad with ice cream.

NB: Snacks and nourishing drinks are important if your appetite is small.

Breakfast

Multigrain bread + spread and marmite; Yoghurt (fruit or plain with walnuts and honey);

Lunch

Jacket potato with side salad (tomato, lettuce, etc. + nuts and/or seeds + chopped egg + fresh lemon juice and vegetable oil dressing)

Flapjack

Dinner

Stir fry salmon chunks, cashew nuts, broccoli, carrots, mangetout, red pepper use marmite/peanut butter/sesame seed paste (tahini) to the spices and olive oil.

Brown rice with fresh lemon juice, black pepper and butter

Banana with melted chocolate and almonds.

First Printed in GUCH News, Issue 35 - Winder 2002