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Food Intolerances and FODMAPs

Access Allied Health - Tuesday, May 19, 2015

Irritable Bowel Syndrome and the low FODMAP diet

Irritable bowel Syndrome or IBS isn't really a dinner table topic of conversation but it affects around one in five people at some time.  IBS is a long term condition that has a long list of symptoms including abdominal pain and distention, bloating, excess wind, nausea, changes in bowel habits (diarrhoea, constipation or a combination of both) and other gastrointestinal symptoms.  The cause is unknown but there are some known triggers such as change in routine, emotional stress, infection and diet. Unfortunately IBS cannot be cured with medication.  The good news is that research by Dr Sue Shepherd from Monash University in Melbourne has proven that there is a very effective dietary therapy for IBS.  It's the low FODMAP diet.

 food map

FODMAPs are found in the foods we eat.  FODMAP is an acronym (abbreviation) of certain molecule collections found in food that are poorly absorbed by some people.  These molecules shoot through to the large intestine (rather than being absorbed by the body) and become a food source for the bacteria that live there naturally.  The symptoms experienced by those with IBS are the outcome of the complex molecules (FODMAPs) being digested or fermented by the bacteria.


The low FODMAP diet has two phases.  The first phase involves eliminating high FODMAP foods for a period of 6 - 8 weeks.  The second phase involves gradually testing these high FODMAP foods to see which ones can be reintroduced and are suitable for each individual.   Obviously each low FODMAP diet is going to look different for each individual.  Tim Black our principal dietitian has completed two training courses at Monash University in Melbourne on the low FODMAP diet and has excellent success helping his clients find relief from the symptoms of IBS.   

Proof of new red wine anti-ageing link

Access Allied Health - Thursday, March 21, 2013

If you ever needed another excuse to pick up a glass of red, then read on.  New research[1] has suggested that ‘a red a day’ is keeping the wrinkles away.  Specifically, a molecule found in red wine has the ability to activate an anti-ageing protein in our body.  This molecule, an antioxidant called resveratrol, has had the attention of researchers for a number of years due to its possible benefits for cancer prevention, diabetes management and cardiovascular risk reduction.  This new finding adds ‘anti-aging’ to growing list of potential benefits to having a quiet red to the delight of many a wine enthusiasts.

But, if you’re reaching into the cellar while reading this, visualising a younger you, then before you find the corkscrew please note: Experts say that the amount of resveratrol contained in red wine is not quite enough to impact on our anti-ageing protein and therefore benefits would be limited.  Still, it adds weight to the mounting evidence that a glass or two is good for us in the long run.  So enjoy today’s cab sav with the knowledge your taking a step towards a healthier you.  For additional steps, please contact the experts – your accredited practicing dietitian.

[1] Hubbard, B.P et al (2013) Evidence for a Common Mechanism of SIRT1 Regulation by Allosteric Activators, Science, 339 (6124), 1216-1219

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Have your Easter bun and eat it too!

Access Allied Health - Friday, March 15, 2013

Weight loss – a taboo topic in most polite social conversation, but even more so in the run up to any festive season.  This has never been truer with Easter just around the corner with the eager anticipation of freshly baked Hot Cross Buns and more chocolate than you can poke a stick at.  Up-sizing our wardrobe seems an inevitable reality and we don’t want to ruin our Easter fun by talking about that now!

 Well, I want to let the rabbit out of the bag when it comes to weight loss over Easter and stake my claim that it can be done!

 For far too long we’ve believed that enjoying ourselves and being healthy are so diametrically opposed that they cannot exist in the same universe together.  Such is our belief in this dichotomy that one little 60-calorie egg-shaped ball of chocolate, can cause intelligent people to make some not so clever decisions.  ‘Oh well, I’ve had one now, I may as well eat the whole packet’.  Sound familiar?

 Well let’s put a stop to it and make those days of ‘all’ versus ‘nothing’; ‘good’ verses ‘bad’; ‘weight loss’ versus ‘enjoyment’; ‘lettuce leaves’ verses ‘elastic waist pants’ a thing of the past.  Let’s make those moderate decisions we know we’re all capable of.  C’mon let’s start a moderation revolution and this Easter let’s have our cake and eat it too.

Malnutrition in Aged Care Facilities

Access Allied Health - Thursday, March 07, 2013

Would you believe that, in Queensland alone, half of all aged care residents are classified as malnourished?[1].  Well, perhaps a little shockingly, this is what current research shows.  However, what’s even more concerning is that further Australian based research shows that malnutrition is not being recognised in these residents and they are therefore not receiving the correct nutrition intervention[2].

Now this is not at all a reflection on the hard working clinical and support staff working in the aged care sector, but rather brings nutrition into the limelight as an area of aged care needing increased attention.

What is Malnutrition?

Malnutrition may be defined as a state of nutrition in which a deficiency, excess or imbalance of energy, protein and other nutrients cause measurable adverse effects on tissue (shape, size, composition), function and clinical outcome.  The predominant form of malnutrition in aged care is Protein Energy Malnutrition (PEM) which simply means that there are inadequate levels of protein and/or energy to maintain good health.

What does malnutrition look like?

A person with malnutrition may have one or more of the following presentations:

  • Reduced body weight
  • Muscle wasting and decreased strength
  • Reduced respiratory and cardiac muscular capacity
  • Thinning skin and loss of skin integrity
  • Decreased metabolic rate
  • Fatigue
  • Oedema and immunodeficiency

These presentations can compound and have a significant health impact such as:

  • delay in recovery from injury or illness,
  • poor wound healing,
  • increased occurrence of complications,
  • reduced quality of life which can lead to depression and
  • increased risk of falls.

As you can see, malnutrition is linked with poorer health, leading to an increased burden on health resources.

What can be done about malnutrition in the aged care setting?

Prevention is the best remedy for this costly and debilitating condition.  There are some simple but very effective strategies that aged care facilities can adopt to combat malnutrition in their residents.

  • Screening all residents for malnutrition on a regular basis
  • Implementing a protocol for malnutrition including both the screening of residents and an action plan when a resident is identified as having malnutrition
  • Seeking assistance from an accredited practicing dietitian when a resident is identified as having malnutrition

To discuss, assess, review or change the nutrition management procedures at your aged care facility, please speak to an accredited practicing dietitian who can assist you in this process.

[1] Banks M, Ash S, Bauer J, Gaskill D. Prevalence of malnutrition in adults in Queensland public hospitals and residential aged care facilities. Nutrition & Dietetics.  2007: 64:172-178

[2] Gaskill, D., Black, L. J., Isenring, E. A., Hassall, S., Sanders, F. and Bauer, J. D. (2008), Malnutrition prevalence and nutrition issues in residential aged care facilities. Australasian Journal on Ageing, 27: 189–194.

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Weight Loss - Diet vs Exercise

Access Allied Health - Thursday, February 28, 2013

In the minds of many a weight loss aspirant, the quest to find the silver bullet often pits diet and exercise against each another in a showdown with all the intensity of a boxing showpiece.  “In the left corner, backed by a multi-million dollar weight loss industry and weighing in less-than-it-did-last-week: DIET! (Cheer) And in the right corner, wearing the not-so-flattering bike shorts and carrying the hopes of personal trainers everywhere: EX-“no pain, no gain”-ERCISE. (Cheer).  And now ladies and gentleman, we are about to see the end of decades of speculation and crown the victor of this bout with the one-size-fits-all title of weight loss king of the world! So let the battle begin!” (And the crowd goes wild).

Now, in my profession, I come across those steadfastly camped in either corner of the ring ready to defend their champion and point out the flaws of the opposing force.  “Diets don’t work” some will say, while in response others will look to point out the unsustainable demands of rigorous exercise both on our knee caps and our time.  So what’s the answer – who wins the fight – who is the champion between these two formidable opponents?

Well, perhaps not surprisingly, I am one of those with both feet planted firmly in the diet camp, rubbing the shoulders and singing the praises of the champ to be (metaphorically speaking).  But my support of food (or less of it) as the superior weight loss process is not just a biased opinion, but rather a position steeped in scientific studies and research.

Now, don’t get me wrong, one of my favourite quotes is from WM Bortz of the American College of Sports Medicine who said, ‘There is no drug in current or prospective use that holds as much promise for sustained health as a lifetime of physical exercise” – well said Mr Bortz!  However, when it comes to weight loss, exercise not only can’t hold its own against diet, but is actually fairly useless.  What?  Useless?  Yes that’s what I said and yes I realise that this is going against the most commonly held assumption going around today (i.e. If you exercise you will lose weight).  So let me explain.

A few years ago, Dr Wayne Miller and his colleagues reviewed 493 weight loss studies to determine whether adding exercise to a restricted calorie diet would accelerate weight loss[1].  25 years of research showed that exercise provided only a marginal weight loss benefit when compared to diet.  That is, from all the studies reviewed, dietary restriction alone resulted in an average weight loss of 7.8kg over a 15 week period. Adding exercise to dietary restriction merely added another 1.2kg giving a total of 9.0kg loss (while 1.2kg is nothing to sneeze at, I know who’s side I’d rather be on in a fight).

Further to this, in their published research[2], Dr Timothy Church’s team described a principle of compensation.  That is, those who exercised more in his study, ate more or compensated in another way (like moving less when they got home from the gym) which resulted in a less-than-expected weight loss.

While I don’t expect the two above mentioned studies to end the discussion once and for all, they are just the tip of the iceberg when it comes to seeing inconsistent (at best) weight loss from exercise.  I do however hope this helps to answer that frustrating question “How come I’m not losing weight?”  Well, it’s probably got less to do with the gym workout you missed and more to do with the muffin you had with your coffee this afternoon.

Again, please don’t get me wrong – exercise has many amazing benefits for our health – so please keep incorporating it into your lifestyle.  However, simply find something you enjoy and if you’d like to lose weight, speak to an accredited practicing dietitian.

[1] Miller WC, et al. (1997) A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention, International Journal of Obesity, vol. 21, pp. 941 - 947

[2] Church TS, et al. (2009) Changes in Weight, Waist Circumference and Compensatory Responses with Different Doses of Exercise among Sedentary, Overweight Postmenopausal Women. PLoS ONE 4(2): e4515. doi:10.1371/journal.pone.0004515

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Should I take nutritional supplements?

Access Allied Health - Thursday, February 07, 2013

In my youth, as newly-graduated dietitian armed with idealistic ambition to make the world a healthier place I would have answered this question a little differently than I will today.  Back then, when the broccoli was greener, I suspected that a lack of education was the main cause of rising fast food sales and the unpopularity of lentils.  “If I tell them,” I thought as I hummed the ‘Rocky’ theme song, “they will change”.  Surely all the motivation one needed to mix cottage cheese into their brown rice was the knowledge that their daily molybdenum requirement will be met (yes molybdenum IS an actual nutrient).

Armed with this belief and my youthful exuberance, I previously would have been quick to state the fact that a good diet will meet all nutritional requirements and the use of nutritional supplements is quite literally money down the toilet.  But now I’m not so young, I’m not so self-assured and while I still fundamentally believe in good nutrition for optimal health, I now consider there to be more than one way to skin a cat so to speak.

Now, don’t get me wrong – I mean, what sort of dietitian would I be if I thought that the food we eat couldn’t be meet our nutritional needs.  Of course it can – but does it?  While I don’t expect our molybdenum requirements to be the major driver of our food choices (anymore), far too often our frantic lifestyle and need of convenience are leading us to form food habits not conducive to meeting our nutritional needs.

Ok, ok – I’ll admit - I’ve only ever met one person in my years of practice that showed clinical signs from a vitamin deficiency and acute symptoms of dietary inadequacy in the developed world are rare.  So maybe it’s just some remaining idealistic ambition that I can’t shake, in continuing to push for dietary change – after all we seem to be doing alright.  However, when we consider non-clinical markers – such as fatigue, malaise and poor workplace productivity perhaps there remains a case for dietary change and a revitalised campaign to meet requirements.

While lifestyle change will always remain the flagship to correcting these dietary deficiencies, perhaps a multivitamin may offer, dare I say it, a reasonable solution.  Or perhaps I'm simply getting old and cynical.  Either way, before attempting dietary change or choosing a nutritional supplement, please speak to an expert - an accredited practicing dietitian.


Detox Diets

Access Allied Health - Thursday, January 31, 2013

There is a vast array of ‘Detox’ diets available – in books and magazines, on the internet, and in your local pharmacy.  However, while they often promise amazing results, there is a lack of evidence to support these results.  So is the ‘detox’ experience worth the high price tag many are willing to pay?

What is a detox diet?

The purpose of a detox diet is to remove toxins from the body.  Although there are many types of detox diets, generally they involve a strict regime of eating raw vegetables, fruit, fruit juices and water.  It may also involve a period of fasting and using herbs and other supplements.  Detox diets also encourage severe restriction of whole food groups such as meat or dairy food, therefore they will not meet nutritional requirements and if used for a prolonged period of time may result in nutritional deficiencies. 

Natural Detoxification

Our bodies have organs and systems in place, designed to filter out toxins.  Our kidneys, lungs, skin, lymphatics and liver all play a role in the removal of toxins.  Excessive consumption of highly processed foods such as sugary snacks and fatty fast food as well as drugs such as caffeine and alcohol make these systems work harder and perhaps leave us feeling a little run down.  If this is the case, simply decreasing our intake of these foods and replacing them with core foods such as bread, fruit, dairy, meat and vegetables as well as increasing our intake of water will have us feeling much better in no time.

Who shouldn’t try a detox diet?

A detox diet can be potentially dangerous.  Pregnant or nursing women or children should not try these styles of diet.  Also, people with health conditions such as liver or kidney disease or diabetes may be putting themselves at risk of serious medical conditions due to the restrictive nature of these diets.

The Bottom Line

This type of diet is not a long term solution and can be quite dangerous for some people.  For lasting results consult an accredited practicing dietitian who can help you achieve healthy eating, everyday – the best health solution there is!

Fast or slow weight loss - which is better?

Access Allied Health - Thursday, January 24, 2013

”Is it better to lose weight slowly?” I get asked this question all the time and the short answer is ‘no’.

I’m not sure where it came from, but there seems to be this idea that losing weight slowly is somehow much more meritorious and honourable than losing it quickly.  And I, for one, don’t buy into it.

Be it fast or slow, weight loss is one of the most effective health improvement strategies for anyone carrying a few too many kilos.  But motivated new-years resolutioner’s beware.  Losing weight will only improve your health if your lost weight stays lost.  In fact, should you pile on the pounds after losing weight you end up unhealthier than if you’d never lost weight in the first place!

Given that reported statistics tell us only five per cent of weight losers are successful in keeping their tummies trim, a maintenance strategy is something that needs to be incorporated into any weight loss plan.

I guess this is one advantage of a slower weight reduction, as it does suggest that some moderate lifestyle changes have been made and stuck to over time.  This, in turn, may make maintaining that loss easier.  Now this doesn’t at all invalidate faster weight loss.  But should it be fast or slow, improvements to your health will only be seen if you keep the weight off long term.

So before you head down to the chemist to pick up a month’s supply of meal replacements, spend some time considering the day-to-day changes you’ll need to make once the replacements run out.

For help with a weight maintenance plan, see the experts – an accredited practicing dietitian.

Label Reading - what do nutrition claims mean?

Access Allied Health - Thursday, April 26, 2012

With so many products to choose from these days, we can take the initiative and time to read the labels to know what we're buying.  The nutritional information can help you to make informed choices about the foods you want to eat.  Here are some common nutrition claims and what they actually mean.

All Natural
This usually means there are no artificial colours, flavours or preservatives.  It doesn't mean it's the best choice as the product may still be high in fat, sugar and/or salt.

'Light' or 'Lite'
This does not necessarily mean less fat or lower in kilojoules.  For example, 'lite' potato chips are thinly sliced and 'lightly' salted but are still high in fat.  Light oils are light in colour/flavour, not in fat.

No Cholesterol or Cholesterol Free
This does not mean low fat.  Foods made with vegetable oil will have no cholesterol, as cholesterol only comes from animal based foods, but can still be high in fat.  E.g. a bottle of olive oil has no cholesterol but is still nearly 100% fat.

Carbohydrate Modified
These products contain sugars other than sucrose (cane sugar).  Sugars like sorbitol, mannitol and sylitol are often used.  These sugars are similar to sugar, i.e. the same calories and are not suitable for diabetics.

'Low-joule' or 'diet'
These terms mean that the product is lower in kilojoules than a similar product - usually due to the addition of artificial sweeteners.

'No Added Sugar'
This means that no extra sugar has been added to the product but it still may contain natural sugar already present in the food.

Reduced Fat
This label indicates that the product contains less fat than standard products but may not necessarily be low in fat.  Usually there is 25-33% less fat than the standard counterpart.

'Creamed', 'Toasted' or 'Oven-baked'
These terms mean that more fat and kilojoules have been added to the original product, as is the case with toasted muselies.

Worried about weight gain this Christmas?

Access Allied Health - Friday, December 23, 2011

With the festive season fast approaching, some of us may be casting a thought as to what the ‘silly’ season will do to our waistline.  And fair enough too!  With the seemingly endless supply of festive food that Christmas has to offer, weight gain seems like an inevitable reality.  And yet weight gain is no-one’s goal, it’s just not something we want to think about in the season to be jolly.   So the approach seems to be ‘eat all you want and worry about it later’.  Now I don’t go for this.  I’m convinced we can enjoy all the culinary delights that Christmas has to offer without needing to up-size our wardrobes up at the New Year’s sales.  Here’s how:

Top 3 tips to keep the weight off over Christmas

1. Eat Breakfast

Simply put, starting the day with a decent breaky will help to control your appetite.

2. Don’t avoid the good stuff, just have one (that is – 1)

One serving of anything (be it Christmas dinner, Christmas cake, Christmas pudding, a glass of wine), will not lead to weight gain – provided that one serving is a sensible one.  If being sensible is not something you’re into over Christmas, you can eat garden salads until they are coming out of your ears and you won’t put on weight.

3. Get outside

With longer days and a little more time on our hands, the Christmas break is an ideal time to increase our activity levels.  Bowl a few overs in backyard cricket, get down to the beach or a park for a stroll or have a hit of tennis – whatever takes your fancy.  Remember, you burn fat exercising at light levels, so it doesn’t need to be strenuous - just have fun.

Need more help?

If you do find that you do gain a few kilos over the holiday period, consider a tailored weight loss program to help get you back in shape.  Access Allied Health is offering comprehensive weight loss programs ranging from three to six months in length.

Contact us to book in for your FREE INITIAL ASSESSMENT to discuss with our dietitians how we can design a program to help you to lose weight and keep it off long term.