When it comes to weight loss, "people have good intentions but get their messages mixed up", says dietitian MaryRose Spence. Photo / Getty Images
When we decide we want to lose weight, for our appearance, our health, or both, often we begin by asking ourselves “which diet should I try to achieve this?”
We might adopt a keto or paleo diet, start hitting the gym and stocking up on what we believe are healthy snacks to help us on our journey.
But MaryRose Spence, a dietitian in New Zealand for more than 35 years, explains to the Herald the pitfalls of these commonly assumed aids in many Kiwis’ attempts at positive change.
“People have good intentions, but they get their messages mixed up,” says Spence, who predominantly works with people to assist with weight management, often related to type 2 diabetes, raised cholesterol or blood pressure issues.
Despite these good intentions, when it comes to New Zealanders’ health and obesity rates over the past few decades, “there hasn’t been any progress made in our statistics, but our lifestyles have changed tremendously”, says Spence, the author of two books on weight management and the founder of Auckland’s The Nutrition Consultants.
In fact, New Zealand has one of the highest numbers in the world of adults living with obesity and Spence says our rates of pre-diabetic and type 2 diabetes “is an epidemic. It’s a real problem in our community.”
“We have this incredible access to food that I don’t think we realise is detrimental to our health.
“We’ve got these big food barns, supermarkets, where we can buy foods from all around the world”, and where items made from “natural ingredients” are considered a healthy choice when they can actually be quite the opposite.
“We have UberEats. You don’t even have to get off your couch … if you’re not an active person, that’s going to get you into problems, if you do it too often.
“Just going back in the years, chocolates were a luxury food item and now they’ve become a cheap, everyday item in some households.”
And the portion sizes we’re served up, either by way of takeout, restaurant meals or from leftovers at home can be problematic too, says Spence, even if we’re choosing healthier dishes.
So while New Zealand’s food landscape is arguably difficult to navigate for any Kiwi trying to manage their weight and improve their health, there are some key things we should know as we try to get it right.
One of the most popular weight loss methods of the moment is intermittent fasting which encourages eating your meals within a short window during your day. But when it comes to most New Zealanders, it’s not a suitable or sustainable option, says Spence.
“Most New Zealanders have a high muscle mass. Muscle mass plays a big part in determining our metabolic rate, which is really how many calories we need to consume.
“And if you look at putting somebody with a higher muscle mass or a higher metabolic rate onto an intermittent fasting diet, it’s just another delightful temporary diet. It’s not sustainable.”
Neither, she says, are other popular diets such as keto, paleo and the “plethora over the years ... there was the cabbage diet and the grapefruit diet. The greenlane heart diet ... celebrity-endorsed diets which I see clients following and they come to see me because they have health issues.”
Spence recalls a client who was 150kg and was referred to her after losing 50kg by cutting out carbohydrates and eating a high-protein and high-fat diet. But it sent his cholesterol through the roof.
“Usually somebody with a total cholesterol of eight or nine is high. His was 18. That’s incredibly high. I’d never seen that in all my years of practice. Then I saw another gentleman who did a similar thing and his was 15. People come in and say they want to take the carbs out of their diet. They just haven’t got an understanding of what can happen behind the scenes.
“We’ve got to stop people dieting, because it’s a temporary fix,” says Spence. “We’ve got to help people to live the life of a smaller person. You want to be saying every time you lose a kilo, not how fast have I lost it but is it going to be gone for good?”
Rather than following a trending diet, Spence says for Kiwis wanting to make a change “there are some good people out there who can help them with weight management”.
Thanks to clever marketing and convenient packaging, there are plenty of foods we assume are good for us but in reality, aren’t. Spence notes that “in our food culture at the moment, snacking is a huge area of development”.
“There’s big money to be made out of selling food. They’re going to push some health benefits, but they often don’t push the calorie density of foods, that’s sort of outdated.
“They want a sale, so they’ll pick up on aspects of their food that are really not that relevant but may appeal to people.”
Among her examples are “natural” products such as nuts and oils.
“This country doesn’t really use lard anymore because of its saturated fat content, which is only about 45 per cent saturated fat. Now you’ve got people using coconut oil thinking it’s a good thing to be using. But it’s 92 per cent fat. It should really come with a big red label on it.”
Similarly, she says snack packs of nuts are perceived as a healthy option for between meals.
“They’re a fine snack for some people, but there are people who don’t have high body fat. Now the majority of our population, especially adults, do have a high body fat.
“And yet these people are sitting in an office snacking on nuts in the afternoon because they believe they’re making a good food choice.”
In fact, if you’re snacking on almonds, you may be interested to note they’re 55 per cent fat. And if you’re into peanut butter, that’s 50 per cent fat too.
Another snack that might seem like a healthy choice is the “all-natural ingredients” bliss ball.
“They’re high calorie. About the smallest Frooze ball you can find is the equivalent to a slice of bread,” says Spence, noting they’re sold with a few in a pack which many of us would be inclined to eat in one sitting.
In reality, “people have got to be pretty fit and active to get away with snack foods that aren’t going to be detrimental to their health in the long run”.
The vast majority of us would do well to move away from snacking and instead, refocus on eating a good breakfast, lunch and dinner, says Spence.
“I think that in terms of managing weight, managing appetite, breakfast, lunch and dinner does it very nicely. But the snacking - people snack and over-eat from 4 o’clock onwards, wake up in the morning and they’re not hungry. Then they’ll start snacking at about 10.30. Then they’ll have lunch. Then there’ll be more snacking at about 4 o’clock.”
Often, Spence sees clients who ask, “Is this a good food or a bad food?”
But she says what’s more important is “understanding how foods work for you and what level of fullness they give you and for how long”.
“If you have just a carbohydrate, it’s not going to last you that long. Whereas if you put a carbohydrate with some protein, it’s going to give much longer-lasting fullness.”
While it can be individualised further, when dishing up a plate of food aim to structure it so that half your plate is green vegetables, a quarter has protein and the other quarter a combination of white or yellow starchy carbohydrate.
Another simple rule to follow is to shop from the outside of the supermarket and avoid the products on the shelves in the middle as much as is practical.
“The inside aisles of the supermarket are where the processed foods are: the higher fat, higher sugar, higher salt and they are more like to cause issues,” says Spence.
“When people say it’s cheaper to eat junk food, I can’t always agree with that. When you actually start looking and buying some of the meat cuts when they’re on special, I think we can get some pretty good deals, and with frozen vegges and seasonal produce.”
“The majority of people who go to the gym will go with one thing in mind. They want to actually lose weight,” says Spence.
“They might not vocalise that but there will be an underlying intention of weight loss. Good on them for saying, ‘okay, right. I’ve got to start exercising.’
“But if they go to the gym twice a week, it’s not going to be enough. They probably need to start doing some walking, which is free. You can fit it in at times that suit you.”
However, exercise is about “20 per cent of the weight loss equation”, she says.
“It’s the food that goes in your mouth. But the exercise is there because people who exercise will make better food choices and they’re more likely to identify portions that are suitable for them.
“You’ll find that fitter people are less likely to choose fattier meals. And you even see that as the weight comes down, they move away from fattier foods and into quite different food choices.”
“It’s about being frugal with our portions,” says Spence. “Something I have noticed in my practice over the last couple of years is that people often come in and say they have leftovers for lunch and you think, gosh, how things have changed. A generation ago people took sandwiches.”
Leftovers are problematic, she says, because they often see us consuming more.
“If they’ve got enough at dinner and they want to eat more at dinner, they can. Or there will be some to take to work the next day, so the opportunity of overeating is there.”
Eating out also poses problems for the one-size-fits-all offerings.
“When we go out for a meal or when we go and purchase something, there’s only one size, so that has to cater for the 25-year-old guy who’s well-muscled and plays soccer two or three times a week and he’s on the go, and that also caters for somebody in their 50s, 60s, who’s in an office job.
“You have to know your portion sizes and unless somebody talks to you about portion sizes, you’re not going to see it when you go out and order food … people aren’t sort of catered for individually. So, it does worry me that there’s so much access to food.”
Essentially, says Spence, if you’re overweight, your portion sizes are too big.
Water intake is important for anyone wanting to lose weight and maintain it, says Spence.
“The biggest symptom [of not drinking enough] is lethargy and fatigue and people will often feel hungry before they identify that as thirst.”
During winter, when people’s water consumption often wanes, Spence says we should be aiming to drink a minimum of a litre a day. In summer this should extend to about a litre and a half, and more if we’re being active.
“But it’s no use to tell someone to go and drink a litre of water. You need to say, it’s going to be four glasses so you should probably have one after breakfast, one mid-morning, one after lunch and one mid-afternoon. It has to be realistic like that.”
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