Food Label Reading

Reading food labels is valuable as it allows you to make the best food choices.  Food labels allow you to compare the nutrient composition and volumes of different food components.  The task of reading food labels on products can be time consuming and confusing, so here is some information to make it easier. The  things to look for on a food product label include nutritional claims, the nutrition panel and the ingredients list.

Nutritional Claims

Many nutritional claims (such as “96% fat free”) are made on food packages and some are misleading to the consumer, so check carefully. If you are able to understand the terms, it allows you to check that the product is what you assume it to be.  The claims must meet nutritional guidelines in order for them to be used.  The following lists common nutritional claims on food products and their meaning:

Lite or light

This does not necessarily refer to the fat content of the food.  It can refer to colour, taste, or texture.  The exact fat content should be checked on the nutritional panel.

Reduced fat/salt

The fat or salt content must be at least 25% less than the original product.  The product may still however have a high fat/salt content.

90% fat free

The product contains 10% fat.  This can be a good or a bad choice depending on the food product.  For example, a cheese that is 90% fat free is good (normally only  70-75% fat free). However,  if milk claims to be 90% fat free, it wouldn't be a good choice as full cream milk is normally 96% fat free. 

Low fat/fat free

To advertise ‘low fat’ the product must contain less than 3% fat, and for ‘fat free’ there must be less than 0.15% fat.

No added sugar

Products have no added sugar, but may be high in energy due to natural sugars or a high fat content.

All natural

The product has no colourings, flavourings, or preservatives added, but the claim does not relate to the fat, sugar, or energy content.

Cholesterol free/low cholesterol

Refers to the cholesterol content, not the fat content.  Often seen on foods produced from plants such potato chips, however this is a meaningless claim as all plant foods contain no cholesterol. Remember that saturated fat contributes more to high cholesterol than dietary cholesterol.

Baked not fried

Words make products sound healthy, but in fact the product can have just as much fat.  Checking the nutrition panel is vital.

Nutritional Information Panel

The nutritional information panel shows the amount of certain nutrients, ‘per 100g or 100 mL’ and per serving size. Every panel must include levels of energy (kilojoules or calories), protein, total fat, saturated fat, carbohydrate, sugars, sodium and any nutrient referred to in the nutrition claim. An example of a nutrition panel is the one below from a “lite”, 99.7% fat free strawberry yoghurt.

Analysis of nutrition panel with strawberry yoghurt

Energy

It is important to first look at the total energy and the amount of fat in the food.  If the energy is high whilst the fat content is low, you can assume the majority of the energy would be coming from carbohydrate (sugar). 

The nutrition panel shows one column as the serve size of 100g.  Take note, the total yoghurt tub is advertised as two serves, so if you are consuming the whole tub you must double the nutritional content. This means that you would really be consuming 768kJ, not 384kJ.

Carbohydrate

Foods with less than 15g of sugar per 100g are a good choice. 

The total amount of carbohydrates and the percentage of it that comes from sugar is another thing to look for.  In this yoghurt, all the carbohydrate is from simple sugars and we know from the ingredient list this is mainly in the form of sucrose.

Fat

Foods with less than 10g fat per 100g are a good choice. 

The types of fat listed are also important.  The bad fats are saturated fats and trans-fatty fats.  The good fats are polyunsaturated and monounsaturated.

Salt

A low salt food will have less than 120mg per 100g.

The daily recommended amount of salt intake should be 920-2300 mg/day. 

Ingredients List

Ingredients must be listed from greatest to smallest by ingoing weight including water.  When there are small amounts of a multi-component ingredient (under 5%), it is permitted to list the ‘composite’ ingredient only, for example the chocolate (rather than cocoa, cocoa butter and sugar) in a choc chip cookie. Food labels will show the percentage of the key ingredients if they are present.

Example with strawberry yoghurt:

Ingredients: yoghurt [skim milk, milk solids (non fat), sugar, vegetable gums, gelatine, live yoghurt culture], fruit preparation [strawberries (9%), sugar, flavour, vegetable gums, preservatives, food acids, water added]

This is a deceiving list of ingredients as it only shows the list of the two main ingredients and then the ingredients within these.  It does not truly reflect relative  quantities of the ingredients and therefore the amount of sugar in the food is disguised. If the list of ingredients was put in order of quantity, sugar would probably be near the top and more obvious.

Other things to look for in the ingredient list are the disguised names for fat sugar and salt:

References

www.betterhealth.vic.gov.au, www.foodstandards.gov.au

http://www.nutritionaustralia.org/

Disclaimer

This Fact Sheet is provided for your information only and does not replace qualified medical advice. The information provided may not apply to every person or all situations. A medical practitioner should be consulted for all treatment and medication.

 

Metabolic Syndrome (or "Syndrome X")

What is Metabolic Syndrome?

The metabolic syndrome is a cluster of risk factors that increases the risk of coronary heart disease and type two diabetes. It is characterised by raised fasting plasma glucose, low HDL (protective/good) cholesterol, high LDL (poor) cholesterol, raised triglycerides, abdominal obesity and high blood pressure.

Current estimates suggest around 20-25% of the worlds population have the metabolic syndrome (1). Those who have the metabolic syndrome are twice as likely to die from and three times as likely to have a heart attack or stroke compared to non metabolic syndrome sufferers(1). Additionally those with metabolic syndrome are five times more likely to develop type two diabetes at some point in their life (1,3). Current Australian estimates produced by the 2005 AusDiab study state that 1.7 million Australians have diabetes, but nearly half of all cases of type two diabetes remain undiagnosed (2). Approximately 275 Australians develop diabetes every day (2). Diabetes is the fastest growing chronic disease in Australia and one of the most common world wide and is the fourth leading cause of death in the developed world 1,4).

This cluster of cardiovascular disease (CVD) risk factors that represents metabolic syndrome is expected to create a tsunami of heart disease and stroke cases creating a CVD epidemic of biblical proportions.

The Link: Diabetes and Metabolic Syndrome

Globally 3.2 million people die from complications associated with diabetes (1). Type two diabetes accounts for 90% of all cases of diabetes and has total financial cost of 10.3 billion dollars (2). Type two diabetes is a leading cause of premature death and illness due to it’s association with CVD, and is now responsible for up to 80% of all CVD deaths (1,2,3). 

The metabolic syndrome and its cluster of risk factors is most commonly experienced is those who are suffering from glucose intolerance or type two diabetes. This factor leads to substantial disease burden due to the additional cardiovascular disease risk of the metabolic syndrome, which has been suggested to be beyond the risk of each abnormality (1,3,4).

The metabolic syndrome is not however just limited to those suffering form diabetes and impaired glucose  tolerance. In fact many individuals experiencing the first signs of metabolic syndrome do so well before any formal diagnosis of type two diabetes has been made. These initial signs are represented by a elevated blood glucose (hyperglycemia) and triglyceride level and a decreased HDL (protective/good) cholesterol. These factors in there own right significantly increase an individuals risk of CVD. In fact those individuals with either or both type two diabetes or metabolic syndrome have the same CVD risk as a current cigarette smoker.

What Causes Metabolic Syndrome

What causes metabolic syndrome is a hotly debated topic amongst experts however most would agree that central obesity and insulin resistance are significant factors (1,3,4). Additional factors that may also have a casual effect include genetics, physical inactivity, poor nutritional status, ageing, a pro inflammatory state and hormonal changes (1). The role of these aspects do however appear to be greatly influenced by the ethnic origin of the individual (1).

1. Insulin Resistance

The pancreas's beta cells are responsible for the bodies production of the vital hormone insulin. Insulin is the key hormone responsible for driving glucose into the bodies cells to be utilised as a source of fuel. Insulin resistance occurs when cells in the liver, skeletal muscle and adipose/fat tissue become less sensitive and eventually resistant to insulin (1,3,4).  As a consequence glucose remains in the blood stream as it is no longer being taken up by the cells. This leads to further production of insulin (hyperinsulinlaemia)  in order to remove the high levels of blood glucose, which over time weakens the beta cells of the pancreas and eventually leads to beta cell failure (1). If the pancreas can no longer produce insulin then a person’s ability to control their blood sugar is lost which subsequently leads to a diagnosis of type two diabetes. Prior to this occurring the body is already in a pro inflammatory state and an accumulation of triglycerides has begun to occur. This leads to cellular damage and is characterized in it’s early stages by low HDL (good) cholesterol, high triglycerides,  high alanine transaminase (liver function test) , increased waist circumference and potentially raised serum uric acid levels.

2. Central Obesity

Many experts believe that central obesity is the catalyst to metabolic syndrome and insulin resistance (1,3,4,5). Obesity is an important independent CVD risk factor that is routinely associated with high cholesterol levels, high blood pressure, raised blood sugar and low HDL (good) cholesterol. Research indicates that obesity is associated not only with an increased risk CVD but also type two diabetes, some forms of cancer and osteoarthritis. Obesity is internationally recognized as a body mass index of equal to or greater than 30kg/m2. However, more indicative of metabolic syndrome is an individuals waist circumference or the accumulation of fat around the abdomen (1).  

Criteria of Metabolic Syndrome in Adults

The International Diabetes Federation Definition

International Diabetes Federation”: Worldwide Definition of the Metabolic Syndrome. www.idf.org/idf-worldwide-definition-metabolic-syndrome

Ethnic specific values for waist circumference

How is it diagnosed?

General investigation should include blood tests of cholesterol and lipids, blood sugar, liver function and kidney function (these tests require you have to have been fasting overnight). Analysis of the urine and a urine albumin to creatinine ratio (looking for protein in the urine as a sign of kidney damage).

Ways to reduce your risk.

Incorporate as many lifestyle changes as you can. Eating a healthy diet, exercising regularly, and losing weight will all dramatically reduce your risk of diseases associated with Metabolic syndrome.

Make dietary changes. Eat plenty of natural wholegrain foods, vegetables and fruit,  reduce portion sizes and limit foods high in sugar and fat. Reduce saturated foods such as meat, full cream dairy and many processed foods. This will help improve your cholesterol levels. Reducing alcohol consumption to less than 2 standards drinks a day may help lower triglyceride levels.

Increase your physical activity level- regular exercise raises the level of HDL (‘good’) cholesterol in the blood, which helps remove excess cholesterol from your body and protects against heart disease. Exercised muscle cells are also more sensitive to insulin.

Manage your weight– increasing physical activity and improving eating habits will help you lose excess body fat. As a result, your blood pressure will drop and your cells will be more sensitive to insulin.

Quit smoking– smoking increases your risk of heart disease, stroke, cancer and lung disease. Quitting will have many health benefits, especially if you have Metabolic syndrome.

Medication may be required– Lifestyle changes are extremely important but sometimes medication may be required to manage the condition. The most     important thing is to reduce your risk of heart disease, stroke and Type 2 diabetes.

How will it affect me?

Metabolic syndrome can present with a variety of symptoms depending on the associated medical  conditions. Some people with Metabolic Syndrome may not have any symptoms initially. You may experience the following symptoms:

· Tiredness and fatigue.

· Sleep apnoea (transient periods of breathing sensation and snoring during sleep) associated with obesity.

· Headache (due to high blood pressure)

· Frequent urination, thirst, weight loss or gain due to high blood sugars.

· Chest pain or shortness of breath on exertion  (i.e. poor blood supply to the heart).

· Collapse or other neurological symptoms due to blockage of the vessels that supply the brain with blood.

Where do I get help?

· Your doctor.

· An accredited practicing dietician (contact the dieticians Association of Australia: http://www.daa.asn.au)

· International Diabetes Institute. (03) 9258 5000.

· Diabetes Australia (www.diabetesqld.org.au) 1300 136 588

· Quitline (137 848) www.quit.org.au

References

1.)“International Diabetes Federation”: Worldwide Definition of the Metabolic Syndrome. www.idf.org/metabolic-syndrome

2)”Diabetes Australia”. www.diabetesaustralia.com.au.

3)“National Heart, Lung and Blood Institute”. www.nhlbi.nih.gov/health/dci/Diseases/ms/ms_whatis.html

4)“Mainstreaming the Metabolic Syndrome: a definitive definition”.www.mja.com.au/public/issues/183_04_150805/zim10442_fm.html

5)“Metabolic Syndrome”. www.heart.org/HEARTORG

For More Information

Wesley Corporate Health

Level 2 / 46 Edward Street

Brisbane  Qld  4000

Phone:  07 3234 2600

Email: wellness@weshealth.com.au

Disclaimer

This Fact Sheet is provided for your information only and does not replace qualified medical advice. The information provided may not apply to every person or all situations. A medical practitioner should be consulted for all treatment and medication.

Formal vs. Incidental Exericse

When most people hear the word exercise they think of gym programs, organised sport and brisk morning walks. Whilst this is exercise, it is more accurately defined as ‘formal exercise’.

In addition to this however, the exercise you obtain from going about your daily activities is known as ‘incidental exercise’. Everyday tasks such as shopping, gardening, and hanging out the washing can also offer health benefits similar to the benefits of a structured exercise program.

Regular exercise can:

· Help prevent heart disease, stroke and hypertension or high blood pressure

· Reduce the risk of developing Type II Diabetes and some cancers

· Help build and maintain healthy bones, muscles and joints, reducing the risk of injury

· Promote psychological well-being

Although formal and incidental exercise are different, they are both important.  It is therefore recommended that you should partake in a combination of both types  of exercise according to the Australian recommendations, which are outlined below: 

Formal Exercise

The Australian Guidelines recommend that you partake in 150 minutes of planned formal exercise per week.  Ideally, you should aim to build up to five sessions per week for 30+ minutes each. Exercise should be performed at a moderate-intensity; this should cause a slight but noticeable increase in your breathing and heart rate.  If you’re exercising to lose weight as well as keeping healthy, it is recommended that you exceed these recommendations.  A general guideline for weightloss is:

Energy expenditure > Energy intake

This means that you should burn more energy than you consume through eating. Aim to accumulate 300minutes per week, such as five one hour sessions. 

Formal exercise should consist mostly of aerobic activities such as running, brisk walking, cycling, and swimming as they are best for cardiovascular health. Some resistance exercise should also be included in your program to build and maintain muscle strength, and to keep bones and joints strong. 

The recommendation is complete 10 strength exercises, with 8 to 12 repetitions at least twice a week.

Remember: If you haven’t been involved in formal exercise recently, or you have a problem with your health, you should always see your doctor before starting an exercise program.

Incidental Exercise

It can be hard to find time to exercise in today’s world with busy work schedules, family obligations, and hectic weekends.  But maintaining good health is vital and should not be overlooked.  Reaching the recommended amount of physical activity may not be as difficult as you think!  The key is to increasing incidental exercise, and therefore change some of your daily lifestyle habits to promote more movement.

The following are some ideas to assist you in reaching your exercise goals:

· Take the stairs – instead of taking the lift or escalator, use the stairs and give your glutes and thighs an extra workout!

· Shop till you drop – whilst shopping use a basket when possible and carry your shopping bags to the car instead of using a trolley

· Extra walking – when driving to work or shopping, park your car further away than normal and walk the extra distance. If you take public transport, hop off one stop early and walk the extra distance

· Whilst at work - walk and talk if you are on a cordless or mobile phone; go for a short brisk walk during lunch; speak to someone in person instead of sending an email or calling them on the phone

· Around the home – ditch the remote control and stand up to change the channel, or exercise during the ad breaks.  Do the gardening, hang the washing out instead of using the dryer, or take the dog for a walk

· Involve the whole family – organise weekend activities which encourage the whole family to be active and spend quality time together. Some suggestions include bush walking, cycling, learning to surf, indoor rock climbing, and backyard cricket

Stay Motivated

Sticking with your fitness program can be a hard task! Many start their exercise regime and then stop because they are bored or the results come too slowly. People begin exercise for different reasons. You need to decide why starting exercise is important to YOU!

Here are some tips to keep you from throwing in the towel:

· Set goals - be SMART therefore set specific, measurable, attainable, realistic, and time focused goals.   Challenge yourself through your exercise program whilst still being SMART. Consider both the short and the long term to give yourself something to strive for.

· Start slowly - you’ve heard the saying “too hard, too fast”, you don’t want to burn out and be forced to abandon your program due to injury or pain. Begin your exercise at a comfortable level and slowly progress as you feel you start to improve.

· Think variety - consider various types of exercise to keep boredom at bay. Alternate walking or running with swimming, or move your indoors routine outside - weather permitting!

· Track your progress - an exercise diary may be useful to keep a record of each session; track what you did, how long you exercised for, and how you felt afterwards. Documenting your efforts can help you work towards your goals and  serve to remind  you that you’re making progress

· Have fun - what makes you tick? You’re more likely to stick with an exercise program if you’re doing something you enjoy. There is a wide array of choices out there if you think outside the square. If you’re not sure, have a go and you might just discover a new love!

References

www.health.gov.au 

www.mayoclinic.com/health/fitness/sm99999

www.haddinsfitness.com.au/

For More Information

Wesley Corporate Health

Level 2 / 46 Edward Street

Brisbane QLD 4000

T: 07 3234 2600

E: info@weshealth.com.au

W: www.weshealth.com.au

Disclaimer

This Fact Sheet is provided for your information only and does not replace qualified medical advice. The Information provided may not apply to every person or all situations. A medical practitioner should be consulted for all treatment and medication.