An A-Z of Nutrition for my Beautician. And a Fig, Almond, and Ricotta Honey Cake

The other day I was laying on a treatment bed whilst the beautician worked her magic and made my one eyebrow into two eyebrows. Like usual, the small talk went a little something like this: Beautician: So, what do you do for work? Me: I’m a dietitian at a community health centre. Beautician: Oh, how wonderful! Nutrition is very important to me, I always take multivitamins as my body doesn't get all the nutrition it needs from foods- foods these days are lacking in nutrition compared to the way the used to be. Me: Oh, ok.  

Yep, I bit tongue. I often get told ‘nutrition facts’ and unless people ask for advice, I try to respect their opinions and not preach with passion (unless you’re a family member or my boyfriend- they usually get an uncensored rant whether they’ve asked for it or not). Nutritional talk is so common amongst us, with so many sources of information out there. We feel comfortable throwing around words like “metabolism” and “vitamins” and “antioxidants”, but how much do we really know or understand? Are they just words that we know mean something along the lines of healthy? This thought brought me to compline this list- an A-Z of nutrition. It may debunk a myth or two, clarify something you once vaguely heard about, or help you out at the next trivia night. Being such a long list, I had a baking break (the best kind of break), an created a cake I’d long been dreaming about: Fig, Almond, and Ricotta Honey Cake. It is dense and moist and not overly sweet and full of nutrient dense ingredients. Enjoy, and happy reading…

A: Vitamin A

Eat your crusts and your hair will become curly! Eat your carrots and you will have a bunny’s night vision! At least some of mum’s word’s of wisdom hold truth. Beta carotene, the orange pigment in carrots, is a precursor to Vitamin A. This means when beta carotene is digested, it is split to form retinal- retinal is then used to generate electrical messages from the back of eye to the brain, allowing us to see. In fact, night blindness is one of the first detectable signs of Vitamin A deficiency. In many developing countries, night blindness is very common- the Indonesian’s have a word meaning “chicken eyes”, as chickens cannot see at night. 

B Brown adipose tissue

When God created fat, not all fat was created equally. Sure, there’s unsaturated and saturated fats in food, but body fat was also created unequally. The body has two types of fat: brown adipose tissue which releases stored energy as heat, and white adipose tissue which stores fat for other cells to use as energy. The brown fat is vital for animals in cold weather; less important for humans who wear clothes and have heaters- and as such we are 99% white tissue and 1% brown tissue. Interestingly, the higher someone’s BMI, the lower their brown adipose tissue- people who are obese have lower amounts of brown tissue. This makes it a potential target for anti-obesity research- watch this space! 

C: Vitamin C

In the past, poor sailors had it tough. On top of sea sickness and lack of a nice shower, they had to deal with teeth falling out and death. Not from a lack of toothbrushes and big storms, but from a lack of fruit and veg. Vitamin C helps in forming collagen- the protein forming the foundation for bones and teeth. It is also vital for holding together cell walls, such as in arteries- so a kind of important vitamin.  A deficiency of Vitamin C in sailors from a lack of fruit and veg meant this collagen couldn’t be properly produced, creating horrible side effects. The problem is, though, being a water soluble vitamin these days a lot of Vitamin C ends up down the toilet. The Recommended Dietary Intake of Vitamin C is 45mg for adults (up to 60mg during pregnancy). A serve of most colourful fruit or veg (broccoli, oranges, kiwi, capsicum, to name a few) already exceeds this amount. So when the supermarket is selling Vitamin C pills at 500mg- that’s over ten times what the body needs- and if you’ve already eaten some sort or fruit or veg you can bet your body’s saying “thanks but no thanks”.

D: Vitamin D

TRAITOR! Vitamin D has left all it’s hormone friends and is masking itself as a vitamin- but we’re on to you! Vitamins are consumed in foods and then go work in different ways in the body, whilst Vitamin D is a hormone as it is actually made in the body- a vitamin D precursor is activated by UV rays in the skin, moves to the kidneys then to the liver to be finished off being made. Once made, Vitamin D works across the body, mainly in ensuring bones develop to be strong and dense. Very few foods naturally contain Vitamin D, including meat, egg yolks, and oily fish. Most of the population rely on sunlight to get their fix. But as a negative side effect of successful sun smart campaigns, one in four Australians are now Vitamin D deficient. Such a problem, some industries have begun lobbying for strict sun smart rules to be relaxed, before we have a population full of soft, brittle bones.

E Electrolytes

Gatorade promises to deliver these to you in the form of a tasty, brightly coloured drink, but what actually are electrolytes? They are salts (such as sodium and potassium) dissolved into water, vital in the body for fluid balance- keeping the right amount of water in cells, and the right amount outside cells. Our body is quite good of keeping the amount of electrolytes in water balanced- by altering the amount minerals are absorbed from food, and how much water is absorbed or excreted through urine. However these can be lost rapidly, such as through sweat. When do we need to go out of our way to replace these? Sports drinks contain sodium to increase fluid absorption and retention and potassium to assist with muscle contraction during exercise. The recreational netballer needn’t rely on these; it is generally when exercise is intensive and greater than 1 hour that they may become beneficial.

F Folate

Got to love a word that helped you through your uni exams- folate sounds like foliage, and green, leafy plants are great sources of this micronutrient. Why is this so important? Well, if you’re planning on starting a little family, it is recommended you take a daily folic acid supplement (aim for one with at least 400mg) at least one month before and three months after conception. This has been proven to reduce the risk of neural tube defects in bub. Most women don’t eat enough folate (tell me you’re having five serves of veg daily?), and requirements increase significantly during pregnancy. Knowing we don’t always plan life/ pregnancies, the Australian government has made it a legal requirement in Australia that all bread-making flour, except organic flour, contains added folic acid. Still, the more you can chop down some foliage, the better!

G Ginger, Garlic and Ginkgo

Not only would these make a great stirfry base, they’re three common ingredients used in alternative nutrition therapies. This thought of therapy is used worldwide, though just because something is natural, doesn't mean it is safe, nor a miracle cure. Sipping a herbal tea won’t cure cancer, but is less likely to harm than geophagia (eating clay) which can cause GI impaction. Ginger, garlic and ginkgo are overall considered safe and may have health benefits. Ginger products may be helpful to help pregnant women with nausea, garlic may prevent occurrences of the common cold (but more studies are needed to validate this) and trials involving ginkgo suggest possible benefits on vision. The point being, whilst herbs may have health benefits, don’t rely on them to solve all your problems, the way some alternative nutrition therapies suggest.

H Heme Iron

Iron deficiency is the most common nutrient deficiency in the world. Meeting requirements (especially in a diet without red meat) can be challenging; women in reproductive years loose iron monthly through menstruation, and the high need for iron in infants who have a high milk diet (which has little iron) are two causes. Eating spinach alla Popeye won’t help all that much. Iron in food occurs in two forms: Heme iron (from meat, chicken and fish), and non heme iron (in plant foods such as spinach, dried fruit and legumes, as well as meat). Heme iron makes up a small amount of the average iron a person consumes, but it is well absorbed, whereas non heme iron makes up a large amount of what a person eats, but only around 17% of it is absorbed. Eating foods with Vitamin C (brightly coloured fruit and veg are a good start) will help iron be absorbed, whilst phytates in legumes and grains, calcium, and tannins in tea bind to non heme iron and inhibit it being absorbed. So as a tip, those taking their iron supplements with a cup of milky tea in the morning would benefit from taking it at night with their steak and veg. 

I Intermittent fasting

The 5:2 diet has become quite well known recently, based on the principal of intermittent fasting.  Two days a week women consume around 2000kJ/500 calories and men around 2400kJ/600 calories. The other 5 days are “whatever, whenever, to however much your heart desires”. Pros: scientific evidence suggests intermittent fasting can have health benefits including weight loss and improving insulin resistance. However, little is said about nutrition- the quality of what is actually eaten, which means there is lots of room for variety in what is eaten during the feast vs famine days. Similarly, it promotes a potentially unhealthy attitude to foods- the starve and binge cycle common in frequent dieters, and we don’t yet know the long term effects. Conclusion: No one way of eating is the holy grail or answer to everyone’s problems. Eat in a healthy way that you can sustain. 

J Joule

Joule, kilojoule, calorie- better not eat too many of them! But what do they actually mean? Are the kilojoules in food the same as the calories? A calorie is a unit of measurement, in the same way inches and pounds are. 1 kilocalorie (or Calorie, which is 1000 small calories) is the amount of energy needed to heat 1 gram of water 1 degree celsius, to be technical. Just like the Americans use inches and pounds and Aussies use centimetres and kilos to measure the same thing, joules and kilojoules are the same- two units of measurement for the same thing. One Calorie is equal to 4186 Joules- but because this is a large number we speak in kilojoules- 4.186kJ. In case I’ve lost you, this may help: 

4.184 kilojoules = 4,184 joules = 1 Calorie = 1 kilocalorie = 1,000 calories

K Ketogenesis

Carbs, the root of all evil, right? The brain requires a constant source of carbohydrates (glucose) to function. The liver can only store enough to last a few hours, so a person should be eating carbohydrates frequently. Many don’t though (thanks Mr Atkins). The body has a clever way to adapt, and that is through gluconeogenesis- when the body breaks down its protein stores (eg. muscle) to form new glucose to feed the body. This is why carbohydrates are known as protein-sparing- they allow protein to be used for other purposes whilst carbohydrates provide energy. Similarly, fat stores can also form an alternate source of fuel, kentone bodies, during times of starvation through ketoneogenesis. This can be dangerous- if their production exceeds their use, ketone bodies accumulate in the blood, disturbing the acid-base balance, which can lead to a coma. To protect protein stores and prevent ketosis, it is vital to consume 50-100g of carbohydrates a day.

L Lactose intolerance

Though not an allergy and not doing harm to the body, many people struggle to digest milk, and the struggle is real. Lactose, the natural sugar in cows milk, requires an enzyme called lactase to break it down and be absorbed. Our intestines produce lactase, and whilst we produce large amounts during infancy (convenient, considering our milk diet), as we become adults less is produced- in fact only around 30% of adults in the world have retained enough lactase to digest and absorb lactose efficiently. Is the solution to avoid dairy? No- firstly that would leave us more vulnerable to nutrient deficiencies. Secondly, having some lactose in the system allows the body to continue to produce some amounts of lactase. Most people with lactose intolerance can manage around 1/2 cup of milk spread through the day, as well as hard cheeses (most of the lactose has been removed during production), as well as yoghurt (the bacteria in it digests the lactose for us). So, it’s not gloom and doom!

M Mediterranean Diet

There are so many diets out there: Lemon detox, Atkins, Dukan, Paleo, No Sugar… but there are few ‘diets’ I have the energy to write about- I’m generally not a fan. But I’ll always have energy for the Mediterranean Diet. Large, well designed studies are continuously coming out with support that this type of diet increases longevity and decreases diseases such as heart disease, some cancers, and Alzheimers. More of a way of life than a diet, it promotes eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts, replacing butter with healthy fats, such as olive oil, limiting red meat and eating fish and poultry at least twice a week, and drinking red wine in moderation (optional). So pass the vino!

N Non essential amino acids

Our body is pretty clever. It can remember the lyrics to songs we haven’t sung for years, make us cry over the most small things, and make nutrients our body needs. There are 20 different amino acids our body uses as the building blocks to protein. 11 of these are called ‘non essential’- whilst we get them from foods, our body can also make them itself.  The other 9 the body cannot make in sufficient quantities to meet our needs, so we must get them from food. High quality proteins contain all the essential amino acids in the overall appropriate amounts the body uses. These are found in animal foods (eggs, fish, chicken, meat), as well as soy- making tofu great for vegetarians and vegans.

O Omega 3 fatty acids

Eat fish twice a week. A simple nutrition message many of us fail to do. Fish (especially deep sea fish like mackeral, salmon, tuna, herring, sardines and anchovies) contains a type of polyunsaturated fatty acid called omega 3, (which is also found in other foods such as canola oil and nuts). Omega 3 has a huge range of health benefits, including reducing the risk of heart attacks and strokes by lowering blood pressure and preventing clots, and may help in the prevention of dementia and cognitive decline. The Heart Foundation recommends adults have 500mg of omega-3 (2-3 serves of 150g of oily fish a week) to reduce their risk of heart disease; for people who already have heart disease, the Heart Foundation recommends having about 1,000mg of omega-3 fats every day- in which supplements may be a more realistic source.

P Phytochemicals

Not only does ‘Phyotchemicals’ sound impressive, they are impressive. These are compounds found in foods that have biological activity in the body, but are not nutrients. For example, phytoestrogens are compounds found in soybeans which behave very similarly to the body’s oestrogen, and may have benefits such as reducing osteoporosis. Lycopene is an phytochemical in many red fruits and veggies, such as tomatoes and watermelon, which is an antioxidant and may inhibit the growth of cancer cells, similar to tannins- a photochemical in wine, tea and lentils. Because many thousands of phytochemicals exist, and a food may contain thousands of varieties of these, it is difficult to identify which foods, or parts of foods, are specifically responsible for their certain health benefits. And that is why we eat real, unprocessed foods in a wide range of varieties- we don’t simply eat nutrients. 

Q Questions?

As soon as you tell someone you’re a dietitian, they’re full of questions (usually about the diet the read in last month’s New Idea). It’s great people take such a keen interest in their health. The internet is a great place to help answer some, but PLEASE be careful what sites you go to. Anyone can write anything- why I could hop onto Wikipedia now and edit the page on chocolate to say “Numerous studies have concluded that milk chocolate has been proven to increase iron serum levels in iron deficient anaemia”, making many of my clients, and myself, very happy. It sounds legit, but that sentence just came out of the creative juices of my brain, because I could really go for some chocolate now. So if you’re after answers, considering who wrote the information. Do they have a hidden money-related agenda? Are they appropriately qualified? Some good sites include: http://daa.asn.au/, http://www.betterhealth.vic.gov.au/, http://www.sportsdietitians.com.au/ and http://www.eatright.org/

R Resistant Starch

For some reason the word “starch” is almost a dirty word- “oh, I don’t eat starchy foods” is not a rare statement these days. Starches are simply a plant’s way of storing energy- starch is thousands of glucose molecules which our body can break down for energy. Grains like pasta, wheat and rice, legumes, and root vegetables such as potatoes all contain starch. A resistant starch is one that is not digested, so is a fibre- plant food that is not digested by the body so is excreted in poo. Legumes, unripe bananas and raw potatoes all contain resistant starch and no, they are not unhealthy foods. 

S Saturated fatty acids

Ah, the source of so much public confusion. Friend or foe? Whilst studies have long indicated they increase cholesterol levels, newer studies are coming out indicating there are different types of saturated fats in foods, and some may have a positive benefit on lowering cholesterol. The verdict is still out, and large health organisations are very good at reviewing a large amount of studies to base their recommendations on- not just a handful of studies that may have poor study designs. Currently, recommendations remain to limit intake. The real health benefits come when a person swaps foods high in saturated fat, for foods high in unsaturated fats, such as swapping butter for olive oil, or potato chips for nuts. But again, watch this space (isn’t that the beauty of food- we never stop learning about it, and enjoying it!)

T Tongue

Not only is the tongue very handy if you want to kiss or eat (my two favourite pleasures in life), it can tell us a lot about our health, in particular B vitamin deficiencies. A purplish red tongue, along with cracked corners of the lips? It may be riboflavin (Vitamin B2) deficiency. Sore tongue? One of the signs of Vitamin B12 deficiency.  A smooth tongue? May be a lack of folate. Whilst there is no need to become obsessive with every sign and symptom, it’s important to know your body and listen when it’s telling you something.

U Upper limit

You can never have too much of a good thing, right? Wrong. Many nutrients have been scientifically proven to be toxic in certain amounts, leading to the development of an Upper Limit for many micronutrients for different ages and genders. For example, liver is naturally very high in Vitamin A as this is where it is stored in the body, and one serve of beef liver contains significantly more than the Upper Limit. In the 1900’s Arctic explorers died of Vitamin A toxicity from eating the livers of their dogs, or polar bears. One serve of liver won’t kill, but over time the free Vitamin A will damage cells. So buying the most concentrated doses of supplements and taking more to increase the benefits may be doing your body more harm than good.

V Vitamin

What is a vitamin and what is a mineral? And will they make me put on weight? Can’t say I haven’t been asked that a few times. In short, vitamins and minerals belong to the same group- micronutrients. Micronutrients are substances required in trace amounts for our normal growth and development, yet they contain no energy so have no effect on weight. Minerals exist as single elements- calcium, iron or zinc, for example, whilst a vitamin is made up of many elements, such as vitamin c which is made up of carbons, hydrogens and oxygens. That’s the technical explanation, in practice all you need to do is eat a variety of foods to get these, but at least you now know the difference!

W Water

Drink 8 glasses of water a day. Drink 2 litres. Drink 30mL for each kilogram you weigh. I’ve had juice, does that count? Even our most basic need- water, creates confusion! Whilst there are plenty of adequate rules of thumb, our body is quite good at telling us what we need. Thirst is an indication, but this means you’re already becoming dehydrated. Plus, a thousand or so other factors come into place. Is it hot or humid? Are you exercising? Have you just eaten a sandwich or eaten a big bowl of soup? My rule? Keep an eye on your urine. If it’s concentrated- drink more (preferably water). If it’s a pale color, you’re doing well! During exercise, you can lose up to 2% of body weight in sweat before thirst kicks in, and at this point performance is already affected. So as my spin instructor says, always hydrate before you dehydrate!

X Xerophthalmia

There’s not many words starting with ‘X’, but this is a fancy one that is the scientific name for the night blindness explained right at the start for ‘A’. You made need it in a trivia night in the future. Otherwise, just remember to eat your carrots and you’ll be right!

Y Yoghurt

This is a fab food. Not only does it have all the goodies of dairy- calcium, riboflavin, protein, potassium etc. - it has the added benefit of bacteria. We have trillions of bacteria in our gut which have many benefits- such as assisting in digestion, preventing bad bacteria from colonising in our gut, in immunity and lowering cholesterol. Bacteria in yogurt acts as a probiotic- substances that help create a healthy microbial environment (not to be confused with prebiotics, which is food, usually from carbohydrates, that feed these microbes). 

Z Zzzzzzzzzzzzz

25 fun facts later and I’m exhausted. Considering you’re still reading this, I bet you are too! Getting a good amount of sleep can have a huge influence on weight- there is mounting evidence that people who get too little sleep have a higher risk of weight gain and obesity than people who get seven to eight hours of sleep a night. Reasons include altered hormones that control hunger, the less you sleep, the more time there is to eat, and being tired can mean less physical activity. So I’m off for a nap!