Crumble

I think I know what you're saying about food or feeding being a way of looking after someone you love, or showing them that you care. What would you suggest about instances where people with dementia are eating too much? I know of one person whose husband, instead of forgetting to eat will often forget that they have eaten and so wants to eat almost constantly and is suffering as a result.

Crumble, thank you for your question highlighting a problem that many people living with dementia struggle with. Overeating can be an issue for people living with dementia, as the normal feedback mechanisms which we rely on to tell us when we are full, or have eaten, start to let us down. Having looked after many families living with this, one idea that seems to work is to set mealtimes by the clock – so, having breakfast, lunch and dinner at the same times each day. You can include snack times, if the person enjoys a little something between meals. If their appetite isn’t great, and they don’t cope well with three larger meals, you could schedule five or six smaller frequent meals to ensure they get enough nourishment. The idea is that you check the clock and provide something to eat, or ideally join them in eating, only at the set times and not at any other time.

If your friend’s husband is always hungry, another idea is to give him a small cup of soup or broth (ensuring it’s not too hot, to avoid scalding), or even a simple cup of milky tea, as these provide ‘stomach warmth’ which can settle an overly active appetite until mealtime. They also provide hydration – often the feeling of hunger is actually a confused need for fluid. As well as having fluids between meals, having water with a meal can ensure the food in the stomach swells and sends the right messages back to the brain to register that ‘I’m full’ satisfaction, even if this is soon forgotten.

Finally, if your friend’s husband has lots of visitors who bring him chocolates or cakes as a treat, perhaps your friend could encourage them to bring non-edible gifts instead. Photos of shared times, jigsaws, books and music can all be rewarding and encourage conversation and happy memories.

minimo

Hi Jane
I've had a look at your website and read your story - you've led a remarkable life. I would like to know your take on hospital food and how, if a loved one is in one for any period of time, you can make sure they are eating properly. We all know the NHS is understaffed and poorly resourced. When my mum was ill I had no idea of knowing what she'd eaten in a day. I've been in hospital myself for an overnight stay and the food certainly didn't seem very nutritional. I understand that they are mass producing but as I'm sure you'll agree when you are unwell, good food is very important to help you heal.

Hi Minimo. How I love your question! It is shocking how appalling much of our hospital food is and, as you say, there is no greater need for nourishing, nutrient-rich foods than when we are poorly. Having spent many years myself in hospital, I know there is nothing more depressing than being served dreadful food. I encourage patients, if they are able, to ask relatives to bring in soup in a flask which they can sip during visiting time. For a more substantial meal, pasta, risotto or casserole in a wide-rimmed flask needs only cutlery to be enjoyed (hopefully you can cajole that out of the staff, or bring it in). If taking in hot food isn’t practical, I suggest bringing something savoury from home, like a small quiche and salad or some simple bread and cheese. It can be a welcome relief to taste a familiar food from home and it may help lead to a quicker recovery.

It’s a sad state of affairs and I know the NHS is understaffed but in my mind, we must shout about this now and show by example that the situation in our hospitals needs to change. When I worked with Jamie Oliver on the amazing school meals project we saw that people-power is an incredible force to bringing about social change. With Nourish, I hope people can see there is an alternative to the current food situation in healthcare. I’m encouraging everyone to join our community, to campaign and to share ideas. Together, we can bring about a similar revolution and provide wholesome, comforting food to those who are vulnerable.

Bobbin

hi Jane, a very good friend and neighbour of mine is currently recovering from chemotherapy. I wouild love to know if you have any recommendations for things i could take round that a) she would enjoy (she has a sweet tooth) and b) will still have nutritional value and help her in her efforts to gain some of the weight she lost.

Thanks in advance.

Hi Bobbin. She’s lucky to have you as a friend and neighbour! The perfect answer would be to try my delicious Blood Orange Jelly or Ginger Cake, which are temptingly vivid in colour and flavour, yet are soft and easy to eat (chemotherapy can sometimes lead to a sore mouth). They will provide your friend with a sweet but nourishing boost in calories to help her regain weight. The cake and jelly are proving to be two of the most popular recipes from my Nourish Afternoon Tea; you can download these recipes and more (your friend might also love the drop scones and jam) from the website (http://nourishafternoontea.com).

Alternatively, you could make some small ramekins filled with a fruit crumble. The forced rhubarb is wonderful right now, or a simple apple crumble might work well as apple can help to settle a sensitive stomach, which your friend might have. Make a batch of them, which she can freeze and then take out every couple of days if she fancies a calorie boost. I know she has a sweet tooth but I’d also look at making a few savoury things for her, like some chicken pies, again made in ramekins or small, individual casserole dishes or tart rings.

Our instinct is to want to feed someone up with large portions, but if you make small quantities she won’t feel over-faced by the food in front of her and be put off eating anything, which can often be the case when you’ve been through cancer treatment. If she has a few mouthfuls at a time, her body is far more likely to want more and slowly but surely the weight will creep on.

Granonthemove

I'm finding the need to alter my diet to try to lower cholesterol, combined with a stressful time of downsizing, very debilitating (boring) but I don't want to end up on drugs. Missing chocolate / sausages particularly. Any ideas ?

Hi Granonthemove. Thank you for your question, and I’m glad you’re up for making some changes to the way you eat as I’m sure this will help bring your cholesterol level down. There are two types of cholesterol: the good one, called HDL, and the bad one, LDL, which is the one we try to lower. Foods high in saturated fat, such as butter, cream, cheese and fatty meats, tend to produce LDL, but that doesn’t mean you need to give up your favourite sausages completely. Choose sausages with at least 75% meat content (it will be marked on the label, or ask your butcher) and grill them so that excess fat drains away, and enjoy them as a once-a-week (or less) treat. Ideally, serve them with something high in fibre on the side, such as baked beans, sliced tomatoes, grilled mushrooms, or spinach, as part of an every-now-and-then cooked breakfast. If by making small tweaks and ensuring that 80% of what you eat is a healthy choice, then enjoy a lean sausage!

Pastries and buttery dishes aren’t great as they can lead to too much LDL being produced, so they are definitely things to reduce in your diet. Instead of a pastry topping, enjoy a cottage pie with fluffy mash made from celeriac, swede or sweet potato. And instead of butter and animal fats, swap in heart-friendly olive, rapeseed and avocado oil. But let’s get over the myth that anyone with high cholesterol should avoid eggs and prawns. These foods contain cholesterol but they don’t produce it in the body, so you can still enjoy some as part of your diet.

Fibre can also help to lower cholesterol levels, so be sure to have plenty of vegetables and fruits (peel on, where possible) and wholegrains, such as porridge and wholemeal bread, in your diet.

PamelaJ1

Two years ago I went on a very strict diet recommended by Dr. John Mansfield, he specialised in treating arthritis. Very very low sugar, in fact, practically none. My Dr. poo poohed it but although I don't have arthritis it cleared my psoriasis up enormously. Was I imagining this? I don't think so but he said it was probably due to improve anyway!

Hi PamelaJ1. How some doctors love to pooh-pooh a recovery when the establishment or traditional training can’t explain it. But I love to hear success stories like yours! It’s true that the scientific evidence isn’t there to suggest that a very strict low-sugar diet is the cure for arthritis, or psoriasis. But we are all unique and you have found that it does work for your skin. In my clinic, I have seen some patients’ skin, and arthritis, improve when they lower their intake of sweet foods. However, rather than avoid sugar entirely I tend to steer them to more naturally sweet foods, such as fresh or stewed fruits, rather than those with added sugar. This is because I worry about avoiding all fruits for fear of aggravating arthritis or other conditions, as you can then so easily miss out on essential nutrients, such as vitamin C, which is essential for recovery and healing. It also helps us absorb minerals such as iron, a lack of which in the diet can lead to anaemia and symptoms such as fatigue, which can already be an issue with arthritis.

For anyone wanting to assess how your body reacts to different foods, a good starting point is to keep a detailed food and symptom diary. For a couple of weeks, make a note of everything you eat, how much of it and how it makes you feel. Look for patterns – perhaps one food aggravates how you feel, making your skin react, your digestion worse, or a condition such as arthritis more painful. A diary can also help you to see if you’re eating as well as you thought, as it’s easy to lose track of what we actually take in. Skin problems, for example, can be improved by eating a more nourishing, rounded diet – especially check to see you’re getting enough oily fish, such as mackerel and salmon, which is wonderful for the skin.

Tizliz

I could do with some help on what to eat/or not eat to prevent headaches and migraines. I know what people consider trigger foods but I can't relate to them and wondered if there were any new ideas. I have arthritis but can't take nsai and paracetamol gives me headaches.

Tizliz, as a sufferer of headaches and migraines for many years (before I found my cure) I know how debilitating they can be. The classic trigger foods are cheese, citrus fruits, chocolate, coffee and red wine, but as you have found these aren’t always a cause for some people. I would suggest keeping a diary of what you’re eating, drinking and when your headaches and migraines occur. If they don’t tend to occur daily, it’s worth keeping this diary for, say, a month. Women especially may find they have clusters of headaches during the same time each month, even after the menopause.

Look at your diary and check that you’re well hydrated; ideally, you need to drink 2.5 litres of water or herbal tea a day. You might also look at whether you’re drinking too much coffee. There isn’t an absolute figure, but I tend to think a couple of cups maximum per day is wise, but even this can be too much for people sensitive to caffeine. If you’re drinking more than this, then you need to make sure that you reduce your intake slowly as caffeine withdrawal headaches can be horrible. But it’s worth decreasing the quantity to see if you can obtain a clearer, less painful head. Lack of sleep can be a trigger, too. If this is a key concern for you, then look at your sleep routine and perhaps think of simple things like drinking soothing chamomile tea at night. A glass of milk is a traditional remedy worth trying, as its magnesium content helps us to drop off.

Eating small meals regularly so that you’re not getting hungry can help, as can avoiding sugary foods, such as sweets and cakes, which can make our blood sugar levels wobble – it’s the blood sugar changes that can aggravate sensitive heads. For some people, taking a vitamin B2 and Co-enzyme Q10 supplement combination can decrease migraines - it’s this that has been my saviour – but check with your GP before starting any supplements as you want to make sure they don’t interfere with any over-the-counter or prescription medication you may be taking.

Mamar2

My GS is nearly 6yrs old & eats hardly anything, since he started on solids to be exact. I do worry about him as he's as thin as a rake. I hope you have some advice...even if it's just to point me to a good book on the subject. Thank you so much.

Thank you for getting in touch. Many of the grandparents I look after mention as an aside that they’re worried about a grandchild, so you’re not alone. It’s such a tricky, emotive issue as you can so easily be cast as the nagging grandparent, as mothers can understandably get very defensive about what they’re feeding their child. However, a six-year-old who doesn’t eat much and is as thin as a rake doesn’t seem to be thriving. You might want to look at the Childhood Challenges section on my website, which has lots of ideas about encouraging children to eat and the nourishment they need for their development.

A couple of ideas spring to mind. Firstly, I wonder if you could draw out reward chart together (with the agreement of the parents), to encourage your grandchild to try new foods or eat a little bit more at each mealtime? If you agree with your grandchild what their reward might be – a comic or a trip out with you, say – then it might entice them to tuck in. Making the reward chart something special between you, and separating it from their parents, often works well. And you can feedback any successes to their parents, so they can try similar dishes at home.

Secondly, have you tried cooking with your grandchild? Making something to eat together or as an edible gift for his mother for Mother’s Day or a birthday (see my recipes for Candied Peel and Chocolate Caramel Truffles) can be a wonderful way to encourage trying new flavours. Or flick through magazines with different recipes to see what your grandchild fancies cooking with you. You could also take them shopping to a new store or a market to help get them excited about ingredients. Or start a small vegetable garden or window box, growing herbs, salad leaves or tomatoes. Anything like this can help build up a passion for food. You could also see what their favourite sport or activity is and explain that eating lots of healthy foods can help give them energy to play and do well. A little physical goal like this is another good way to motivate change.

HildaW

I have iron deficient anaemia, have had it most of my adult life (now 60) Doctor has sent me for usual tests so is happy its not something nasty. My problem is that the usual iron tablets (which do bring me back into the normal range) really upset my system and although I eat a fairly vegetable heavy diet with a bit of red meat every 3 or 4 days I'm obviously not getting enough iron into my system. Any ideas please?

Thank you for your question. Iron-deficiency anaemia is very common and I’m glad you’ve checked this out with your GP, as so often we can just get used to feeling tired or off-par, without checking in with a doctor, and sometimes extra investigation and reassurance is needed.

While you’re obviously eating iron-rich foods, it might help to partner them with sources of vitamin C, as this can help to increase absorption of non-meat sources of iron. Try squeezing lemon juice over dark green leafy vegetables such as kale and cavelo nero. As well as meat, why not try vegetarian sources of protein which are rich in iron, such as lentils, beans and egg yolks – you could try my delicious Sweet Potato Frittata [link: www.nourishbyjaneclarke.com/blogs/recipes/158392839-sweet-potato-frittata] . Snacking on iron-rich dried apricots, figs, nuts, sesame and sunflower seeds can also help to increase your intake.

Too much tannin from tea can inhibit iron absorption, so try swapping in some cups of herbal tea. Or don’t drink your usual cuppa straight after a meal, when the tannin can stop you taking in the goodness of what you’ve eaten. Too much bran can also reduce iron absorption, so you might want to swap to an alternative cereal if you have a bran-based breakfast.

Brendaj

Can you please advice me what foods I should avoid .I have I b s and also a hiatus hernia.tried cutting out foods such as salad and onions but it doesn't seem to make much difference.I would appreciate your advice.thank you .

I’m sorry you’re struggling with your gut so much – it can make you miserable, I know. Firstly, I’d keep a food diary for a week, recording what you eat, how much and how it makes you feel. It might help you identify specific foods that aggravate your IBS and hernia – they can both react differently to foods, so I’ll separate them out and hope it helps.

IBS has many symptoms, including constipation, diarrhoea, nausea and bloating. If you’re suffering with bloating, you’re right to avoid broccoli, cauliflower, leeks, onions, lentils and beans, plus fatty foods such as cream, butter and rich, which will trigger this and may also aggravate your hernia. You may also want to eat less wheat, eating rice or rice noodles, for example, instead of pasta. If you let me know which specific IBS symptoms you have, I can answer in a future post.

In addition to tweaking your diet, you could increase your level of prebiotics and probiotics by eating natural live Greek yoghurt, which can help alleviate IBS symptoms.

It’s worth noting that stress and anxiety can increase acid secretion in the stomach, which can change the way food is dealt with. We can become tense and less able to go to the toilet, leading to constipation. Or we may have to rush to the toilet when we’re worried. Anxiety can also lead us to skipping meals, eating on the run, or craving foods that trigger IBS symptoms.

Molly10

Hi Jane, Not sure if you would have any suggestions on this one but talking to a neighbour yesterday we got on to the subject of health and diets and she said she has had for some time a problem with belching. She says she could even just have a sip of water first thing in the morning and she would find herself belching within a short time. She says she does not gulp and is not aware she is taking in a lot of air. There seems to be no particular foods that set it away but she would like to alleviate the problem.
Have you come across this before? Do you have any suggestions about what it could be and ways to cure/prevent this?
Many thanks

Oh dear, this can be embarrassing. The first thing I recommend is that she gets this checked out with her doctor so she can be sure nothing is going on medically, as sometimes hernias and other gut issues present themselves in this way. If nothing obvious appears to be the cause, I suggest she has a look at whether she suffers from sleep apnea and snores – it can be a reason for swallowing a lot of air without realising it. If snoring or sleep apnea appears likely, it could be worth looking at whether she needs to lose some weight; losing excess weight can often result in these conditions disappearing. She might want to keep a food diary for a couple of weeks, noting quantities and frequencies of what she is eating, then seeing if she can cut out excessive calories. The snacks we forget about between meals – especially sweet biscuits and cakes, or high-fat crisps and other savouries – can soon add up. Rather than feeling she has to cut out every treat, she could try to control her portions or to swap in naturally sweet foods such as dates and dried apricots; the fibre in them helps to slow absorption of sugar while helping you to feel fuller, so we’re less likely to overeat them.

Chez

I suffer from a sudden onset of extreme nasal congestion either during or shortly after eating. This lasts from 20 minutes up to an hour. Someone suggested it could be histamine intolerance. My doctor said this does not exist despite it being listed on the NHS website.

Do you have any suggestion/comments about what could cause this problem and what I could do about it?

Many thanks.

I’m sorry you’ve had such a negative response from your GP, as there can be specific histamine-rich foods which can have a negative effect on your breathing. I suggest keeping a food diary for at least two weeks so that you can identify what food trigger your symptoms. High-histamine foods include alcohol, pickled foods, mature cheeses, smoked meat, shellfish, nuts, chocolate and processed foods made with preservatives and artificial colourings. Where you can, eat fresh, homecooked meals made with fresh meat and fish, vegetables and fruits, and wholegrains.

NanKate

Hello Jane,

What wonderful memories you have of your Aunty May. My Aunty Bink baked delicious cakes

Last year I was diagnosed with Polymyalgia Rheumatica for which I need to take steroids. I was advised to eat carefully as I would be susceptible to Type 2 Diabetes.

I have tried to reduce my sugar/carbs and cut down on potatoes, bread etc when I look at the ingredients on packages so many include sugar, even my one Weetabix a day. I do miss toast and marmalade. What are your thoughts on a low sugar diet and is bread bad for you ?

Finally I love fruit and plain nuts what sort of quantities per day can I eat ?

Thanks, Kate

Hello NanKate. I’m glad you have lovely memories associated with cakes and your Aunty Bink – I only hope our future generations look back on our generation with such fondness, hence my huge desire to get the nation baking their own afternoon teas. I’m sorry to hear about you having to take steroids, but I hope they’re helping you feel better. It is a good idea to think about what you’re eating to help reduce your likelihood of developing Type 2 diabetes, but let’s set labels aside for a minute as they can be confusing. With starchy foods such as bread rice, pasta, potatoes and cereals, it’s a good idea to keep the quantity down. For a balanced diet, roughly a third of our food intake each day should be starchy food and less than one sixth of our diet should be made up of fats and sugars; as you are taking steroids, you may want to err slightly less than that for these two food groups. (In addition, at least a third of your daily food should be fresh fruit and vegetables; with protein foods such as meat, fish and dairy products making up the remaining amount; the Eat Well Plate shows how these proportions look.

The glycaemic index (GI) tells us how quickly a food raises blood sugar levels. High-GI foods include the obvious biscuits, sweets and cakes, but also bananas, melons, raisins, grapes, dates, mangoes and pineapples. Instead, focus on citrus fruits and stone fruits, such as apricots and plums. Instead of white rice and pasta, choose wholegrain versions which will have less of an impact on blood sugar levels and will also help you to feel fuller for longer, so you may eat less overall. Wholegrain bread surprisingly has a similar GI to white bread, so I’d opt for rye or pumpernickel. If you want to enjoy that slice of toast, choose a granary loaf and a low-sugar, high-fruit content marmalade to spread on it. I wouldn’t worry too much about your morning Weetabix, as long as you keep your intake of obviously sugary foods low. For a sweet taste, why not try my Instant Banana Ice Cream – freezing the bananas makes them taste deliciously sweet, without adding any sugar.

cornergran

Hello Jane. Thank you for sharing your memories of your Great Auntie May. I'm wondering what your thoughts are about the impact of diet on fibromyalgia. Is there an approach you think can help to manage symptoms? Would be good to hear your thoughts.

Hello Cornergran. I’m sorry to hear you have fibromyalgia as it can be a tricky thing to manage. My advice would be to ensure you eat a well-rounded nourishing diet (incorporating fresh fruits and vegetables, lean protein and complex carbohydrates) that’s rich in Omega 3 fatty acids that may reduce inflammation. Good sources of Omega 3 nuts, seeds and their oils, including rapeseed oil and walnut oil, plus oily fish, such as salmon, mackerel, sardines and pilchards. Why not try my Smoked Trout and Dill Pate?

It may also be worth keeping a food and symptoms diary, to see if there is any link between what you eat and a flare-up of your fibromyalgia. Sometimes people living with the condition feel lousy after having caffeine-rich drinks, alcohol, diet drinks or takeaways, specifically those high in MSG. Finally, fibromyalgia can cause difficulty sleeping, so a warm, milky drink before bed may help you to drop off and get the sleep you need to help cope with the condition.

Teetime

Hello Jane I have SLE and have read that some people believe a gluten free diet helps relieve the symptoms - is there any evidence for this please?

Teetime, researchers are still investigating any relationship between Systemic Lupus Erythematosus and gluten so there isn’t yet a definitive answer. However, in my own practice I have found that many patients find their skin rash lessons, and in some cases virtually disappears, as soon as they cut gluten from their diet. My view, then, is that it’s worth giving it a try, especially as there are so many non-gluten and gluten-free foods now available in supermarkets. Gluten is found in wheat, rye and barley, so avoid products made with these grains. Instead, how about a stir-fry made with rice noodles; creamy chia seed porridge for breakfast; or a delicious cake, like my gluten-free Citrus Polenta and Almond Cake.

cheshiresmile25

What foods should women over 60 be eating to help prevent osteoporosis or slow down its progress?

Are there any proven foods which improve the pain of osteoarthritis?

cheshiresmile25, We tend to think of our bones as being inanimate and something we can’t really influence, but in fact our skeleton is very much a living part of us. Bone cells are busy throughout our lives manufacturing new bone. The foods that help it do this are dairy products, oily fish and vegetable oils, green leafy vegetables, soya products, nut milks (such as almond milk), seeds and dried fruits. There are things we need to avoid in our diet to maintain our bone health – that’s too much of alcohol, salt and caffeine.

When it comes to arthritis, there is more evidence indicating links to specific foods in the case of rheumatoid arthritis than in osteoarthritis. However, those with the latter condition do report that some foods appear to aggravate it and others seem to ease their symptoms. The Mediterranean diet, packed with fresh fruits and vegetables, oily fish and not too much red meat, appears to be the best way of eating. Most people with arthritis often say they can’t eat too many oranges, tomatoes or other acid-producing foods, which make their joints feel worse. Look for links between certain foods and your symptoms (keeping a food diary will help). You may feel better eating white meat than red, for example. I strongly advise eating monounsaturated fats as your main source of fat, as these don’t cause inflammation – try olive oil and avocado oil.

Glosgran

Like Cornergran, I would also be very interested in any dietary help you can give for Fibromyalgia/Chronic Fatigue & Osteoporosis. Suggestions I have heard include cutting out gluten, carbs including potatoes, rice & pasta, sugar & dairy. That doesn't seem to leave much! I do eat quite a lot of fruit but also enjoy eating fruit with yogurt.

Glosgran thank you for your question. Although cutting back on certain foods may be beneficial for people living with specific health conditions, I’m not a fan of exclusion diets unless absolutely necessary and endorsed by your GP or specialist. There’s just too much risk of failing to cover your nutritional bases and get the goodness you need to thrive – plus, it’s just no fun to live on a hugely restricted diet. I’d ask you to look at my responses to both Cornergran and PamelaJ1 as these cover fibromyalgia and osteoporosis.

It’s great that you enjoy fresh fruits (great with natural Greek yoghurt, which is full of beneficial probiotics that aid digestion). You may want to avoid high-GI fruits like mango and pineapple and perhaps try the stewed fruits instead if you fancy something sweet – have a look at my recipe for Stewed Apples and Poached Blackberries, which are lovely on porridge or pancakes. I wouldn’t cut out carbohydrates completely; I would just see if reducing the amount you eat, swapping for wholegrain versions and increasing your intake of lean proteins can help. Finally, do check that you’re drinking enough water – I recommend 2.5 litres a day – as I find this helps boost the energy levels of many of my patients with chronic fatigue.

GrannyO

Hello, I've been taken off HRT the oestrogen only one,after nearly 30 years. Are there any foods would help me counteract the effects of menopausal symptoms such as overheating and mood swings?

GrannyO, foods that contain phytoestrogens – nature’s oestrogen mimickers – could be your answer. There seems to be an absence of menopause symptoms in countries where diets are naturally rich in phytoestrogens, such as the Far East and Japan. Genetics and environmental factors may play a part in this but it could be worth trying if you’re struggling with menopause symptoms. Options include soya milk, soya yogurt, tofu, miso and tempeh. Some women find two large glasses of soya milk beneficial; calcium-enriched soya milk will also help counteract some of the bone-thinning that occurs after menopause.

If soya isn’t your thing, other sources of phytoestrogens include pulses (lentils, chickpeas, beans, etc), beansprouts, peanuts, linseeds and sweet potatoes. Research also shows that fruit and vegetables can be beneficial during menopause (aim to eat eight portions a day). You should also aim to eat up to four 140g portions of omega-3-rich foods each week, as these help ease hormone-induced symptoms such as hot flushes, breast tenderness and mood swings. Good sources include oily fish, such as salmon, mackerel, sardines and pilchards, plus nuts and seeds. Lastly, some women find that cutting out caffeine helps their symptoms, although there isn’t yet any scientific evidence to support this.

Victoria08

Are the sugars found in fruit the same as processed sugars?.
I like to blend fruit and vegetables together, but sometimes it is mainly fruit.
I often worry I might be consuming too much fruit sugars as I have a Nutribullit every day for breakfast.
What is your thinking on sugar consumption?.

Victoria08, my view is that sugars found in fresh fruits are superior to processed sugars, as the fruit they are contained in will also provide you with valuable vitamins and micronutrients. Watch out for higher GI fruits like mango and pineapple, as their sugar is absorbed rapidly into the bloodstreatm, but a freshly made juice or smoothie each day should be fine if you’re not eating too much sugar elsewhere in your diet. Your Nutribullet is a good option as it allows you to blend the whole fruit, rather than just extracting the juice; the additional fibre will help to slow the absorption of sugar into your blood stream. To reduce the sugar content overall, I suggest adding vegetables such as carrot, beetroot and fennel, which add a wonderful savoury taste as well as more goodness – experiment and discover the balance of flavours you prefer. You can use fruit and the sweeter-tasting vegetables to add natural sugar at other times, too. Bananas, apple, pear, carrots and beetroot, for example, add a moistness and depth of flavour to cakes and biscuits, which means you can cook them with less fat. Add a few other beneficial ingredients, such as nuts, and your sweet treat will also pack a nourishing punch. You might want to look at my favourite Carrot Cake recipe for inspiration.

Supergrannyknitknit

Hello Jane,
Five and a half years ago I was struck down with Churg-Strauss Syndrome.As it is such a rare form of Vasculitis I had a late diagnosis and as a result I have nerve damage in my feet and right hand.I feel the damage is slowly getting worse,probably because I getting older,I'm seventy now,but I wondered if there was any food which might help slow the decline.When I was in hospital being treated my consultant said to eat plenty of fat ie cheese,butter,cream etc as our nerves are mainly made up of fat.My cholesterol is high so I am reluctant to eat too much of these things.Any thoughts?

Supergrannyknitknit I’m sorry to hear about your diagnosis. Fat is an essential nutrient for everyone, providing insulation under our skin, producing hormones to ensure healthy growth, and enabling the absorption of fat-soluble vitamins. But you are correct to be concerned about eating too much fat as it can raise cholesterol levels. Rather than eating saturated butter and animal fats, my advice would be to opt for vegetable-based monosaturated or polysaturated oils, such as olive, rapeseed and avocado oils, which are less likely to increase levels of the ‘bad’ LDL cholesterol in your body. Omega-rich fatty foods, such as oily fish, also benefit virtually every part of the body. Dairy products are a good source of vitamin D, so if you’re reducing your intake of these you may want to ask your GP to check your levels and investigate taking a supplement.

Your treatment may involve taking steroids. If that is the case, you will need to take measures to reduce your risk of developing type 2 diabetes and osteoporosis. Please look at my answers to NanKate and cheshiresmile25, where I talk about this.