FAQ’s

Each month we’ll have 2 video-based lectures on a relevant issue in nutrition science, accompanied by more in-depth research articles for the bibliophiles amongst you. Every week there will be an in-depth research critique of a recent and/or relevant study, put into the context of relevance to clinical practice.

First, joining is open to anyone who has a passion for learning about nutrition, HCP or not. The emphasis on HCP’s evolved over the past 2 years from my relationships with practitioners in different modalities – nutrition, medicine, personal training – and the realisation that many of them simply didn’t have the time to keep up to date with research, or spend as much time as they would like dissecting the conflicting information available. While many HCP’s are turning to their own education and taking courses in nutrition at various levels, this isn’t always an option for everyone – and if it is, the demands of clinical practice often supersede everything else. The focus on HCP’s is an attempt to bridge this gap, improving clinical outcomes through enhanced knowledge and translatable information.

Great, you’ll find shorter, open access articles with new content constantly coming.

There are a lot of great resources out there, each do things a bit differently. If you want to save time and have a large quantity of research on a given topic distilled into a succinct 10-20 min video lecture, then I’m not sure there is anywhere doing that outside of taking a course. I’m also not sure there is anywhere where there is a dynamic evolution of content with input from you. The benefit of doing weekly study reviews, rather than monthly or periodically, is that papers can be selected that are relevant to you, and not arbitrarily chosen.

Don’t worry, there is no minimum commitment and you can cancel your subscription anytime.

As it stands, no. It may emerge in the future.

€11.99/m. This is relative to the overall industry standard, and also relative to what we value.

No, dairy is not bad for you, nor does it contain pus or antibiotics. The decision of whether to include dairy produce in your diet should more appropriately be informed by your own ethical framework, not a fear mongered response to misinformation. Be careful not to conflate an objective assessment of the health effects of the food group with moral/ethical considerations for whether you would include it in your diet. There are a range of health benefits to dairy, and this can be acknowledged even in the context of choosing not to consume it based on your personal beliefs. Dairy is not inherently ‘bad’ for you, because food doesn’t have moral value, it has nutritional value. Should you choose to consume it, the nutritional value of the food group is beneficial, and healthy.

Of course, you can eat any food. The associations with high levels of processed meat consumption and certain health outcomes, in particular colorectal cancer, are based on mechanistic understanding (nitrates, heme iron, etc.) of the role of certain compounds in carcinogenesis together with consistent epidemiological data.

Taken together, it might be prudent to limit the amount processed meats in your diet. This is not to say avoid, but having bacon and chorizo every single day doesn’t appear to be ideal. Unprocessed red meat, on the other hand, does not appear to be an issue in the context of a wider diet pattern with plenty of fibre (vegetables, fruit, wholegrain), and unsaturated fats.

The diet pattern as a whole is what matters. The other consideration here is environmental, and there is a high cost to the production and global consumption of meat. You could consider the source of your meat, and aim to higher welfare and/or locally sourced produce. While this may be more expensive, the extra expense would reduce frequency of consumption, in turn benefiting the environment. Again, that’s not an order, just my personal take on the situation.

That depends on what you mean by ‘plant-based’, which doesn’t have a real definition, but implies a diet absent any animal produce. That is itself misleading, as really a diet inclusive of animal produce can be ‘based on plants’. There is relatively little that is incontrovertible in nutrition, but eating more plants overall, irrespective of the balance of your diet, is one such fact. From a sustainability standpoint, plant-based diets and a reduction in overall meat production and consumption are likely to play an important role in the future. Food for thought. However, increasing the ‘plant-based’ element of your diet does not by implication necessitate elimination of animal produce altogether. There is flexibility to manoeuvre within your own moral, ethical and environmental principles.

Around 1-2% of the population have a diagnosed autoimmune condition known as Coeliac Disease, and for this subset of the population even trace amounts of gluten will cause a reaction. There is emerging evidence of a ‘Non-Coeliac Wheat Sensitivity’, but it is difficult to estimate prevalence and it may extend to a further 8-10% of the population. And the ‘leaky gut happens in everyone that eats gluten’ is a lie that is half a truth, which is ever the blackest of lies: this is not pathological in a majority of people. So unless you have a diagnosis of Coeliac, or NCWS, there is no evidence-based reason to avoid gluten. If you have Irritable Bowel Syndrome, you may find benefit to a dietitian-led low-FODMAP diet. FODMAP is the acronym for a group of a particular type of carbohydrates, which are fermented by bacteria in the large intestine. The gas production as a byproduct, and distension of the gut as a result, may be an underlying driver of symptoms in a subset of people with IBS. As gluten and FODMAPs may be commonly found in the same foods – for example bread – people with IBS may often believe they are gluten intolerant, when in fact it is more particularly FODMAPs causing these issues. Don’t guess on any of this: if you’re having serious gut issues, see an appropriately qualified nutrition professional to work through it, and get off Dr Google.

You’re not alone, this issue has been muddied recently. Many diet patterns from after the Second World War to the 1970’s had up to 20% energy from saturated fats, including the UK. This reflected an overall diet pattern lower in plant-derived unsaturated fats, and with heavy emphasis on animal fat food sources. Controlled feeding experiments in the 1950’s and 1960’s showed that saturated fats raised blood cholesterol levels to a greater degree than other nutrients, while polyunsaturated fats reduced cholesterol levels. Given that blood cholesterol levels lie on the causal chain between diet/lifestyle and heart disease, this became a public health focus to reduce cardiovascular and coronary heart disease risk. And including reductions in risk factors like smoking, there has been a significant reduction in mortality from heart disease over the past 50-years.

However, despite it being known that the risk from diet was an interrelationship between fat subtypes, and that replacement of saturated fat with unsaturated fats resulted in the greatest reduction in blood cholesterol levels and heart disease risk, this was not adequately translated to public health advice. In reducing total saturated fat content in the diet, the key determinant of health outcomes is what nutrient replaces it. Given that at population levels diets have been characterised by largely refined carbohydrate for the past 30-years, this does not yield any benefit and in large part explains the ‘null’ associations in recent studies between saturated fat and heart disease.

However, we have a consistent body of evidence showing that where saturated fats are reduced from higher levels in the diet and replaced with unsaturated fats and wholegrain carbohydrates, heart disease risk and mortality is reduced. This is supported by evidence of overall diet patterns, which reflect this overall balance: lower total saturated fat, higher unsaturated fats, wholegrain and high fibre carbohydrates. While there is nothing wrong with any single food that contains saturated fat in the context of an overall diet pattern, the totality of evidence supports that a diet high in total energy from saturated fat increases heart disease risk. So, you can certainly enjoy foods that contain saturated fat, in the context of a wider diet pattern where a majority of fat intake comes from unsaturated fats, and you consume a healthy fibre intake [30g+/d] from wholegrain carbohydrate sources.

You don’t need to worry about dietary cholesterol, i.e., the cholesterol founds in foods like eggs, of shellfish. The concern over dietary cholesterol originated from early feeding studies looking at impacts of diet on blood cholesterol levels, however, the foods used were foods high in saturated fat. This coupled the two together into ‘reduce saturated fat and cholesterol’, however we now know that the cholesterol-raising effect was from the saturated fat content of foods, not the dietary cholesterol in foods. Certain foods that high in dietary cholesterol, like eggs or shellfish, are low in saturated fat, and together with poor absorption of dietary cholesterol, do not negatively impact blood cholesterol levels. So, you don’t need to be concerned about cholesterol in these foods (unless you have familial hypercholesterolemia), but do pay attention to the total saturated fat content of your diet and if you have high cholesterol, you could reduce the frequency and/or serving sizes of foods like red meats and butter, in favour of oily fish and extra-virgin olive oil.

No, it is not toxic. Like the example of saturated fat above, if we take diet as the sum of its parts, then the pertinent questions are how high is added sugar in your diet, and what is being displaced in the diet from those food sources of added sugar. What do we mean by ‘added sugar’? The sugars naturally found in fruit or milk are not what anyone should be concerned with; it is sugars added to foods like soda’s, candy/jellies, refined baked goods [including cereals], etc., that is the primary concern. Profoundly negative impacts of high sugar diets may be seen when 20% of energy is derived from added sugars, and limits have been placed in the UK for 5% energy from added sugars, 10% in the US.

However, limits as a percentage are unhelpful, so let’s come back to diet as a whole: if foods like fruit, vegetables, and nutrient-dense carbohydrates are being displaced from the diet in favour of refined breakfast cereals, sugar-sweetened beverages, refined baked goods, then the overall diet pattern can be improved by replacing these foods with wholegrain versions, fruits, and nutrient-dense unrefined starches. If these are your main carbohydrate sources, then some sugar on top of that is not going to have any adverse effects on your health. Worrying or stressing about something being ‘toxic’, however, would have more of a negative impact than the food itself.

Because the pendulum swings in nutrition are extreme, and we like simple scapegoats to blame for complex issues. The emphasis on total fat content of the diet through the 1980’s has swung back to a demonization of dietary carbohydrates. The problem is, not without irony, that many people advocating for low-carb diets seem happy to make the same mistake made with dietary fat. Most dietary guidelines now have removed emphasis on total fat intake, instead focusing on the types and food sources of fat in the diet. We should be doing the same with carbohydrates. You do not need to go on a low-carbohydrate diet. There are certain clinical conditions in which one may be beneficial – androgen-dominant Polycystic Ovarian Syndrome, or Type-2 Diabetes – are two examples. But let’s be clear: “low” is not “zero”, as is often the case when people adopt the diet themselves, including certain amounts of non-starchy veg but in effect excluding beneficial food groups, including wholegrain carbohydrates, legumes, and fruit, and often adopting a diet high in animal produce in lieu. Low-carb diets provide gratification in short-term weight loss, but do not appear to confer additional benefit over the long term. If you’re eating a Standard Western Diet, with 60% energy coming from largely refined carbohydrate sources, then lowering overall carb intake would likely benefit your health: however, this lowering can be achieved by changing the sources of your carbohydrate to complex, unrefined and wholegrain sources. The quality of carbohydrate thus in turn influences the overall quantity. Healthful diet patterns all include carbohydrate sources, and there is no need to exclude the entire food group for health purposes.

We could talk in terms of the type of fat, in which case plant-derived monounsaturated fats and polyunsaturated fats from both marine and plant sources would be preferred to form the majority of fat intake in the diet. However, let’s talk in terms of food, because you don’t eat ‘monounsaturated fat’. So, sources like extra-virgin olive oil, rapeseed oil, different nuts, different seeds, oily fish, avocados (if you actually like them), are all good sources for unsaturated fats. Also, if you consume dairy you don’t necessarily have to opt for low or non-fat versions, as the fat in yogurts, milk, and cheese may have benefits of its own. And as we said earlier, you don’t have to fear any one food source of saturated fat, like a steak, or your roast lamb. In the totality of diet, you want more unsaturated fats than saturated. Do not put butter in your coffee. And no, coconut oil is not a panacea (although it’s not toxic either). Generally, use plant-based oils for dressings and cooking.

There is a regulatory framework in which artificial sweeteners are approved for use, governed by the European Food Standards Agency in the EU, and Food and Drug Administration in the US. In 2009, the EFSA mandated a full revaluation of all AS currently in use, including toxicology data and technical information, concluding that the body of AS currently in use are safe for human consumption having regard to levels of intake in the population. Most of the scaremongering or sensationalist headlines you see are based on cell culture studies or animal toxicology studies, in which enormous doses are used that are far beyond anything habitually consumed by humans in the food supply. Let’s use aspartame as an example: the No Observable Adverse Effect Level from animal toxicology studies is 4g/kg bodyweight…using this figure the Acceptable Daily Intake is set by dividing this number by an uncertainty factor of 100, giving us an ADI of 40mg/kg…and average population levels of consumption is around 4mg/kg, which is 1/10th the ADI. Now, with that context we can’t say definitively that AS are benign or biologically inert. However, using the presumption that AS may not be biologically inert as a basis for suggesting harm is illogical. The best statement we can make is this: within the current regulatory framework in which AS are approved for us, and having regard to habitual levels of intake in the population, AS are not likely to have adverse effects on health.

Coffee isn't bad for you, unless you listen to the “functional” health crowd who’ll say it’s ‘stressful for your adrenals’. Tolerance to caffeine does develop, but again this is usually a consideration only relevant to athletes (and may not even be as important as once thought in this respect). Coffee may have protective effects against neurodegenerative disease, and conditions like diabetes. It is rich in polyphenolic compounds, and ultimately is a drink with healthful attributes. Obviously there is a difference between black coffee and a pumpkin spice latte, and the latter may not be too great if consumed excessively due to its caloric content, just something to be aware of.

That’s bound to happen when a whole food group is vilified. Just like with dietary fats, we’re moving more to food-based recommendations rather than talking about the nutrients, so it is – and should be – with carbs. Obviously any diet pattern should maximise vegetable intake, and a diverse range of fruits. On top of that, wholegrains – oats, bulgur, buckwheat, polenta, couscous, wholegrain rice and pasta, wholegrain breads –, and legumes and pules – different beans, chickpeas, and lentils – and starches like squashes, potatoes, and other roots – are all food groups rich in fibre, micronutrients, phytochemicals, and staples of healthy diet patterns around the world. There is no legitimate scientific reason to exclude these food groups for health purposes.

An interesting area of research, but as far as practical application goes, there is no specific need for you to engage in IF beyond providing a means to control energy balance. There may be some additional underlying benefits to IF in various forms, however, much of this remains to be concretely established in humans. Time-restricted feeding is similar to IF, but TRF takes into account timing of food intake from a circadian rhythms perspective. TRF doesn’t have to be extreme, but would emphasise an earlier timing of the last meal and avoidance of late-night eating. Many people in the population may have a daily eating duration of 13-15hrs. In this sense, TRF could be useful for someone to adopt an 11hr eating window. That is much more moderate and achievable than many IF variants.