FOOD FOR THOUGHT

We have never been so obsessed with food - and never so obese

We have never been so obsessed with food - and never so obese. How do our diets measure up against the ideal? Alison Healy introduces the food diaries of six brave readers, whose eating habits are assessed overleaf by nutrition experts Sheena Rafferty and Paula Mee.

How do we eat our food? Let me count the ways. A probiotic yogurt drink because there's no time for breakfast. A double espresso for elevenses. A panini and a smoothie for lunch. A packet of crisps to distract from the long commute home. Dinner far too late, with a bottle of wine to forget the stressful day.

We have never been so obsessed with what we eat, yet we have never been so obese. Our fridges are getting bigger as our families get smaller. Dr Patrick Wall, associate professor of public health at University College Dublin, says we are heading in the same direction as the US, where 15 per cent of all food is eaten in cars. "Half the ads on the telly are about food and the other half are for cholesterol-lowering products, because you are eating too much. People want an instant fix, and they ignore the obvious solution. But, as a Cavan farmer told me, the only way to lose weight is to take your snout out of the trough. Pull back from the table."

Anti-alcohol campaigns are focusing on young people, yet their parents are drinking more than the medicinal glass of wine a day. "They forget that the first glass of red wine might be good for you but the second glass cancels the first and the third glass is doing damage, and then there's no point leaving the last bit in the bottle, so you have to finish it."

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In the UK, the average time spent "cooking" a weekday evening meal is just 12 minutes, he says. "And we probably do it in 10 minutes, because we can rip open the packets quicker." His main advice is to eat less overall but with a bigger proportion of nutritious food, such as fresh vegetables and fruit. "When you are going to bed at night you should ask: 'What did I do for my health today?' Most of us don't do much."

Keeping a food diary for a week is one way of doing something for your health, according to Margot Brennan, spokeswoman for the Irish Nutrition and Dietetic Institute. She says everyone should keep a food diary for a week, detailing everything they eat and drink and giving the reasons why. They should then compare it with the food pyramid to see if they meet recommended guidelines for fruit and vegetables, calcium and iron. "It's particularly useful if you are one of the people who engage in passive overconsumption, picking food as you clear the plates," she says.

Brennan, who has been a dietitian for 20 years, says that food diaries kept two decades ago show a vastly different diet. "A glass of wine is the norm now, but then it was the exception. It was something exotic, with a bottle only brought into the house at Christmas, perhaps." Portion sizes are much bigger now. "Two tablespoons of cooked pasta are counted as a portion. But I can assure you that the majority of people are taking three or four tablespoons," she says.

And although we are more aware of our diets, we also like to indulge ourselves.

"Back then, biscuits were only in the house if someone was calling. Ice cream was bought after Mass on Sundays. If you were lucky you got one or two treats a week.

Now, kids are getting one or two treats a day, after every meal in some cases.

Keeping a food diary highlights these issues and might shock you into modifying your eating regime."

We took Brennan up on her challenge and found six people who were brave enough to have their diets publicly scrutinised. They agreed to keep scrupulously honest food-and-drink diaries for analysis by two experts: Sheena Rafferty, community dietitian manager with the Health Service Executive, and Paula Mee, a dietitian and presenter of RTÉ's The Health Squad. If you'd like to keep a food diary, you can download a template from www.indi.ie.

''There's something to be learned from all this'

JIM O'BRIEN, 48

O'Brien lives with his wife and their three young daughters in Rosenallis, Co Laois. He divides his time between being "a hands-on daddy" and a communications and community-services consultant, working from home. He says he was "painfully honest" in keeping the diary, which is why crisps and ice cream feature. He is an enthusiastic cook; typical dinners include pasta with cream-and-bacon sauce, risotto or roast chicken. Two mugs of coffee kick-start his days; they are followed by another mug or two during the morning. Wine and beer also make an appearance, usually at night, while watching TV.

Sheena Rafferty says he should be on about 2,000 calories a day, instead of about 2,800. She advises people who want to lose weight to think back to a period in their 20s when they had a stable weight. "Some people are never going to make their recommended weight. They should aim for a weight that they were happy with once."

O'Brien walks for half an hour every second day; Rafferty suggests that he dedicate more time to exercise. "Maybe he could do something active with the kids, like walking or cycling, or playing football. And men of his age should remember that golf is not exercise, it's just strolling," she says. "He needs to reduce his treats to one to two per week, not per day." She would like to see him eating more fibre and trying wholegrain pasta and fermentable fruits, such as plums and apricots. "Cut down on rich sauces and get a low-GI recipe book."

Paula Mee calculates that if O'Brien cut out alcohol, he would lose half a kilo (one pound) a week. He has about eight glasses of wine a week - and had a bottle of beer on most of his diary days, but says he did this only because of warm weather. "There's lots of animal protein and high-fat meals. This is a risk factor, because of his age and the possibility of heart disease," Mee says. "And he drinks too much coffee. I suspect he's comfort-eating a little. Maybe he should have a hot drink at night, with low-fat milk, to take his mind off the snacks." She recommends he prepare tomato-based sauces instead of cream sauces.

O'Brien thinks the dietitians were a little unforgiving, as he has lost three kilograms (a stone) since he left an office-based job. "I'm not eating lunches out like I used to, and I'm cooking my own meals instead of eating carvery lunches," he says. After a "horrifying" visit to the dentist he cut out sweets, but now he finds that crisps have sneaked in to take their place. "I'll think about what they have said. There's definitely something to be learned from all this."

'As a family we have a wide variety of things for tea - of which Shane will eat none'

SHANE MCMAHON, 8

Shane, from Monaghan, is "a very fussy eater" according to his frustrated mum, Alice. "As a family we have a wide variety of things for tea - of which Shane will eat none," she writes in the food diary. "He sticks to toast, rolls, yogurts or custard. It's a real fight to get him to take dinner."

A typical dinner is a very small amount of potato with a barbecued breast of chicken and no vegetables. Both dietitians note that his height and weight are good and that he takes regular exercise. But they throw up their hands in horror when they see he has eaten Coco Pops for breakfast one day and for supper another. "Coco Pops are a treat, not a cereal," says Sheena Rafferty. "There's no fibre in it. It's full of sugar and low in micro-nutrients."

A typical day for Shane on school days is a bowl of cereal at about 8.30am; a bread roll with jam, a biscuit and a bottle of sugar-free orange at 11am; a tiny piece of chicken and potato at 3pm; a yogurt at 4pm; a Frube at 4.30pm; a tub of custard, a mini KitKat and a glass of diluted orange at 6.30pm; and a bowl of Coco Pops at 8.30pm.

Rafferty advises Alice to "throw out the treats, clear the house. If it's in the house they are going to want it. I think he is filling up on his favourite foods and then not eating the foods that he doesn't particularly like". She says Alice should tackle the problem head-on and devote several weeks to trying to modify his behaviour.

"Introduce it as 'this is what's on offer today'. Ignore moans and groans. If he doesn't eat it after 20 minutes it goes in the bin and he gets nothing to eat until his next meal. You have to be very strict about it even though they will whinge and cry. Don't let him fill up with yogurts. No child will starve, no matter what parents think."

She advises all parents to try to get schools to implement healthy-lunch policies, so children are not allowed to bring biscuits or fizzy drinks. "Get a bit of fruit in there instead." Paula Mee has an interesting theory about Shane. "Everything points to food neophobia, a fear of trying new food," she says. Apparently we are all born with a fear of new food, to protect us from accidental poisoning, a throwback to the times when we picked berries from trees. "It goes a little bit askew in some kids." Typical habits include saying you don't like a food you have never tasted, or refusing to eat a food you like, such as chicken, because it is presented in a different way, perhaps in a pasta dish. And although it affects many savoury foods, "they never seem to go off cake, biscuits, potatoes or pasta".

She advises Alice to get Shane eating with friends. Watching them enjoy a wide variety of foods will reassure him that he has nothing to fear. She also advises allowing him to use something he likes, such as ketchup, as liberally as he likes when a new food is being introduced. Humour him if he wants parts of his dinner on different plates, she says. Reward him with non-food treats, such as renting a DVD, when he makes progress. Alice is interested in the neophobia theory and says Shane does like to keep certain foods on different plates when he's eating them. She says there might be some value in getting him to eat with friends, as he started eating chicken curry when he saw other children eating it. She has thought about getting rid of all the treats and yogurts but can't help worrying that he will go hungry. "I'll try a few of those recommendations, and I'll definitely look up neophobia. I had never heard of it."

'All teenagers eat much the same stuff. I'm no different from anyone else'

DAVID MACKEY, 19

Mackey, from Dublin, gave our dietitians plenty to chew on when he submitted his food diary. One day involved a large fry for breakfast, a generous selection of barbecued meats for dinner and a McDonald's Mega Mac Meal later that evening. Snacks in between included a chocolate bar, crisps, Maltesers and chocolate mousse.

A shocked Paula Mee calculates that he ate more than a kilo of meat that day. "That is hugely in excess of the recommended intake. You need about two portions of protein a day, and a portion is quite small, only about 2oz [ 60g]," she says. "His diet is very high in carbohydrate, and there's no plant protein, such as peas, beans, lentils or nuts. There's an awful lot of snacking, and snacks such as crisps have a very high salt content, too. Instead of crisps, take a handful of unsalted nuts or a muesli bar. He drinks a lot of Coca Cola. He'd be better off choosing a smoothie, a glass of natural juice, milk or water. And he's not getting enough calcium." (In Mackey's defence, he was doing the Leaving Cert when he kept the diary, so his snacking levels were higher than normal, particularly as his school is close to Liffey Valley Shopping Centre.)

The dietitians were pleased with his exercise levels, as he had been spending an hour and a half a day at rugby training. That has stopped for the summer, but he hopes to start again when he goes to college. Mee recommends that he take an isotonic drink during and after sport, to stop him becoming dehydrated and fatigued; Sheena Rafferty advises him to take a carbohydrate before he starts training, to improve performance and stamina. She says this is a crucial time for Mackey's health. "If he can improve his eating pattern now, he won't have any weight issues in adulthood if he continues his exercise. But if he enters adulthood overweight, it's much more difficult to lose weight."

Mee praises him for taking an omega 3 supplement. "Most of our diets are low in omega 3, which is most commonly found in oily fish. If you are not taking the fish, this is the next best thing. So this is good, because his diet needs all the help it can get." But she warns him against falling into the trap of believing that he can eat whatever he wants because he plays a lot of sport. "It doesn't mean that you can dump anything into your body and expect it to perform."

Mackey, who plans to study arts at University College Dublin, says he has cut back on the snacks and McDonald's meals since his exams finished. Mee says she would be surprised if this was a typical teenager's diet, but Mackey says he's not unique. "When we eat together we all eat much the same stuff. I'm no different from anyone else."

'Magazines are always giving contradictory advice on alcohol'

CATHERINE CARAHER, 33

Caraher, a Dundalk-based teacher who recently gave birth to a baby boy, Conor, was in the last trimester of her first pregnancy when she kept her food diary.

She is a regular exerciser and has run a marathon and several mini-marathons. She tries to eat healthily and is a keen cook, so most meals are homemade. Caraher is particularly interested to hear our dietitians' advice on drinking alcohol during pregnancy, as she continually hears different opinions from doctors and in magazines. Because of the lack of guidance, she has taken her own counsel and decided that one or two bottles of lager a week will do no harm.

Sheena Rafferty agrees that it is confusing, as there's no consensus on a safe limit. "If you go to the United States they would put you in the electric chair for taking alcohol while pregnant, but Australia is more moderate. No scientist can stand up and say alcohol doesn't affect your baby, so on that basis I would err on the side of caution," she says. "I would recommend people to avoid alcohol, except for an occasion - if you are at a wedding, say - and want a glass of wine at a meal." Paula Mee agrees and reminds people that most home-poured glasses of wine contain more than a single unit of alcohol.

Mee is impressed with Caraher's diet, not least because it is very varied. "You could see her making an effort to increase her fibre with her breakfast cereal and wheaten bread. She manages to cook every evening, which is good, too." But Rafferty says that, as a pregnant woman, she is not taking enough calcium. "You need 33 per cent extra calcium, particularly in the last trimester and when you are breastfeeding. She needs five portions a day, a portion being a glass of milk, a yogurt or a portion of cheese. Fortified milk might be a good idea." Mee says Caraher's iron intake isn't bad but she should take a glass of juice with her meal, to aid absorption, especially in the first six weeks after the birth and if she's breastfeeding. "The redder the meat, the higher the iron content, so pork chops or ham are not as high in iron as minced beef," she says. "She should try to take one green vegetable every day, to boost iron and folic-acid levels. The crucial time for folic-acid intake is in the weeks before conception and the first 12 weeks of pregnancy, but it's a necessary nutrient throughout pregnancy." And she recommends more vegetable protein, such as peas, beans and lentils, perhaps in a casserole.

Caraher says she expected to hear that she was not getting enough calcium. "I can't eat cheese at all unless it's melted over something like lasagne," she says. "On the drinking during pregnancy, I'm disappointed that there aren't clearer guidelines on it, because magazines are always giving out contradictory advice." She is interested in the advice on peas, beans and lentils and says she will definitely try to include more of them in her diet.

'Dinner at lunchtime wouldn't work. It would make me tired in the afternoon'

ELEANOR LINDSAY, 23

Lindsay is a student who also works in a solicitor's office in Dublin. Her diet is typical of many young office workers, with cappuccinos, smoothies and paninis featuring regularly. Her dinners tend to be late in the evening, usually from 7.30pm onwards. Paula Mee is very impressed with her exercise regime, which includes tag rugby, basketball, swimming and jogging. "That's absolutely excellent. A lot of young women find it difficult to fit exercise into their day, and to see a busy young woman making room for this variety of exercise is fantastic. Tag rugby is brilliant exercise." But she frowns at Lindsay's calcium intake. "This is very low, and this is typical of many young women. She should be having three portions of calcium a day. And she has long periods between lunch and her evening meal."

While waiting for her dinner, Lindsay might have a slice of bread with butter, but Mee recommends a handful of nuts or dried fruit. Lindsay snacks on crisps and biscuits, but not too much; Mee says this isn't a problem, because of her active lifestyle. "She doesn't eat an awful lot for someone so active. There is room for improvement in her intake of fruit and vegetables, and I'd like to see her eating more fibre."

She advises busy working women to plan their meals for the week and perhaps prepare one or two at the weekend and freeze them. Otherwise they come home exhausted, see nothing in the fridge and end up eating convenience foods, high in salt and fat and low in nutrients.

Sheena Rafferty zones in on Lindsay's alcohol intake, which averages out at 14 units a week, a mixture of beer, spirits and wine. She highlights the trend of young women drinking more and says that Lindsay is typical of many, in that her intake is at the upper end of what's recommended. "The recommended level is not a target. It's the maximum advised," she says. "It should be spread over seven days, you should always have alcohol-free days and, of course, binge-drinking is very bad for your health."

Rafferty is also impressed with the exercise regime but says the pattern of meals is not great, with a long gap between lunch and dinner. "She should think about having dinner at lunchtime or a smaller meal at teatime, like a scone or sandwich, and eat fruit between meals, so that the gap isn't as long," she recommends. "She should try to take more fruit, vegetables and fibre and less animal protein." As an HSE dietitian, Rafferty also gives a public-health message for any woman of child-bearing age. "Take 400mg of folic acid a day if you think there is even a slight risk you might get pregnant."

She also advises Lindsay to take some form of carbohydrate about three-quarters of an hour before exercise. "She hasn't had anything since lunchtime. She must be falling out of her standing," she says.

Lindsay says she normally eats before exercising but may have been particularly busy on the days she kept the diary. She says the suggestion to have dinner at lunchtime is not really an option. "Timewise, it wouldn't work. It would make you tired in the afternoon," she says.

Was it worthwhile to keep the food diary? "I suppose that I knew most of the recommendations anyway, but it's still good to hear it."

'I do eat fairly well, I suppose. Dinner is my most important meal, but I just eat what I like, really'

MARY MOSTYN, 87

It's fair to say that Mostyn's diet is not typical of many 87-year-old grandmothers'. Mostyn, who lives in Carrick-on-Shannon, drinks green tea, sprinkles linseed on her breakfast and loves a Chinese meal every so often. Of our six contributors, she wins the most praise from the dietitians.

"This is an absolutely amazing diet," says Paula Mee. "She takes exercise every day by walking, and she has a really balanced diet. She's an inspiration to us all."

Mostyn has arthritis, so adding linseed to her porridge or Weetabix is a good idea, according to Mee, as it is high in omega 3 and has an anti-inflammatory effect. Walnuts are also high in omega 3, if she is looking for more variety in her diet, Mee says. She also recommends flaked almonds, for the heart, and brazil nuts, which help thyroid function and keep the metabolism functioning properly.

Mostyn is slightly underweight, so Mee recommends a little more snacking, with snacks left on display to remind her to take them. "Because her diet is so nutritious there's nothing wrong with a slice of fruit cake here or there," she says. Dried figs and prunes are also a good choice for nutrition and to prevent constipation.

Rafferty agrees that Mostyn is slightly underweight but says that elderly people are expected to lose a bit of muscle mass, which makes them lighter. She notes the regular cups of green tea, which she says contains antioxidants, chemicals that prevent cell and tissue damage from free radicals in the body. "She could have a bit more variety in her diet, perhaps, but I thought she was brilliant."

She says that the linseed is a good idea and that Mostyn is taking it the right way, with lots of water. Linseed and bran expand in the bowel, so you need to take plenty of water to move it on.

Mostyn was surprised but pleased by the praise for her diet. "I do eat fairly well, I suppose. Dinner is my most important meal, but I just eat what I like, really."

She began drinking green tea about two years ago, when she heard about its health benefits, and says she is always keen to try foods that might improve her health. She says she might try the flaked almonds but worries that the brazil nuts might cause problems with her dentures. She was also surprised to hear that she was slightly underweight, as she has maintained the same weight for most of her life. "I feel fine anyway, so I'm not complaining."