From Leanne and Susie on The Nutrition Couch this episode:
- We review the new range of weight management medications (Ozempic, Wegovy and Rybelsus, collectively known as Semaglutide) and whether they are suitable for you;
- We reveal our top tips for healthy, budget friendly lunch boxes;
- We examine why you might be one of the many people who just never get hungry.
So sit back, relax and enjoy this week’s episode!
Tune in on Wednesday for our next episode road-testing 2 common supermarket products.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
In the past couple of years, the management of weight
issues have changed significantly with the emergence of a new
range of weight loss medications. You may have seen one
of the many media stories of people who have suddenly
been able to drop twenty or thirty kilos with the
help of these new drugs. So what exactly are they
and why are they revolutionizing weight management around the world. Hi,
(00:20):
I'm Suzy Barrel and Only and we bring you The
Nutrition Couch, the bi weekly podcast that keeps you up
to date on everything you need to know in the
world of nutrition as well as weight loss medication. It
is lunch box season, which means it is time to
talk the best ways to not only pack a healthy lunch,
but also one that is budget friendly. And our listener
question is all about hunger and what to do if
(00:41):
you haven't seen or felt yours for a while. But Leanna,
I don't think that's the case for you, because my
experience is that you're a hungry human and don't have
any trouble locating that hunger of yours. That a fair call.
Speaker 2 (00:53):
That's a fair call. You know. It's like a little
gremlin rears its ugly head.
Speaker 1 (00:57):
You know too often we'll enjoy it white last. I
am in my mid forties. Let me tell you, I
don't feel hunger like I used to. Like I remember
being in clinic as a dietitian and rushing out mid
morning to have a snack and then rushing for my lunch,
whereas now I can kind of go all day. So
certainly metabolism does change as we go through different life
stages and ages. And I spend a lot of time
(01:18):
with my clients on hunger, and I think the question
we're looking at later today in this potty is very
relevant because I do have a number of clients who
don't experience hunger, particularly till they much later in the day.
So I thought that was a really good one to
work through. But to kick us off, weight loss medication.
And we have kind of covered this before a little bit,
But you said to me a great summary article that
(01:39):
was published on the Sydney Monty Herald dot com probably
the Age as well, which summarized a weightless medication. Now
it's in the group of weightless medications which are called
the semiglukatides. Now it's an interesting area because I actually
don't think the reason that they have such a profound
effect on weight has been well disc gust in the
(02:00):
media because they've been popular as weight loss medications. And
originally I think when we covered it here on the
Podilea and we talked about them appearing on TikTok and
you would see girls come on and say that suddenly
they've had pcos and they've lost twenty or thirty kilos
really quickly because suddenly they've had this weight loss medication. Now,
the first thing I want to say is that the
(02:23):
medications we're talking about are actually specifically weight loss medications. Now,
if you look out through the history of weight loss medications,
people would be familiar with things like duramine, which is
a nervous system stimulant acts on the brain to significantly
reduce appatite. That's been around her I want to say
twenty thirty years. There was also xenecaw, which was a
fat malabsorper in the gut, so if you had fat,
(02:44):
it basically that you excraded it out. That was probably
about twenty years older. I remember working in it when
I first graduated, and then we've always had from a
number of years medications that have been used in glucose management.
So that would be things like you met Foreman Direfman,
which were traditionally used in peopleople who had type two diabetes,
and they're what we call insulin sensitizing agents, so they
basically help the cells be more receptive to the hormone insulin,
(03:08):
and insulin is the central regulator of both glucose and
fat metabolism in the body, so they have an indirect
effect on weight management, but they're not specifically what we
would call appetite suppressants or weight loss drugs. They're more
secondary to the hormones that manage our glucose and fat metabolism.
Then leanne. In the last few years, we've had a
couple of profound appetite acting agents, things like contrave and Saxender,
(03:31):
which are injectibles that impact some of the hormones in
the gut which regulate appetite and indeed can have quite
profound effect on appetite, so suddenly you don't feel so
hungry all the time. And certainly people who are overweight
or used to overeating, or are who have and all
glucose management issues will be very hungry humans, and those
appetite suppressants can be very powerful. That's significantly reducing their
(03:54):
appetite and drive and craving for glucose and carbohydrates, which
means they can be more diet compliant and get the
results they're looking for long term. And certainly I've had
clients who have been on Taxander and Contrave who have
lost twenty thirty kilos in conjunction with diet exercise over
a two to three year period. So it's not quick
weight loss, but it's consistent weight loss and certainly much
greater weight loss than they've been able to achieve with
(04:14):
diton exercise prescription. Now that leads lean to the drugs
we want to talk about today, which are these ones
in the media, these semi glucotides. Now they're not weight
loss drugs, but the reason they're so powerful is that
many people who have significant weight gain through their middle years,
abdominal weight gain, issues with glucose regulation and long term
(04:37):
will get diabetes, have issues with inchulin. Now, insulin is
I said, it is the hormone that regulates glucose metabolism,
and inchulin is secreted by the pancreas in response to carbohydrate.
So why these medications are so very powerful is that
they not only have a significant appetite acting effect. So
they suddenly mean that people who are always hungry and
(04:58):
always craving sweet food are not hung and don't crave
at all. Profound reduction in appetite, but leanne they encourage
and the production of insulin in the pancreas and help
it to work better. So this suddenly means that the
hormone in all these people who have had weight gain
through their thirties and forties because they've got early stage diabetes,
(05:18):
suddenly the underlying reason that these people gain weight so
quickly and crave carbohydrate and can't lose weight easily is
being targeted. And I don't actually think it's addressed well
in the media, and quite possibly because the people writing
the articles don't understand that. So the reason it's so
powerful is that it's directly acting on the reason these
people struggle with weight because in the case of insulin resistance,
(05:41):
clinical insulin resistance or impaired glucose tolerance or pre diabetes,
calories in versus calories out doesn't work anymore because the
hormone that should do its job in terms of allowing
carbohydrate and glucose to enter the cell and be burnt
as energy and fat isn't working very well. It's inefficient,
and so that explains why people who might be quite
(06:02):
overweight don't eat so much really and are carrying significant
amounts of weight. They also struggle to lose body fat
and weight easily because their insulin is high in insulin
blocks fat metabolism, so their basic energy balance equation is screwed.
So this medication, this type of medication, which was traditionally
initially used for type two diabetics, also has a profound
(06:23):
effect on those with insulin resistance and pcos in some cases,
and pre diabetes. The insulin is encouraged to work better
in the pancreas they're not hungry, and so all factors
of weight management are working now. It requires diet compliance,
but diet compliance is easy because you're not hungry all
the time, and people who have been hungry their whole
(06:43):
adult life suddenly say I don't feel like food and
I'm not looking for it. It's incredibly freeing. But that
is the reason they're so powerful now. They I believe
Leanne will revolutionize weight management in the country because they
are actively targeting the underlying hormonal imbalance and issue which
may be genetic, may also have a significant lifestyle component.
Likely does because many people eat too much and don't
(07:05):
exercise enough, and that's of course for you and I
come in because these drugs also don't work as well
if they're people the clients are not exercise and diet compliant.
They work in conjunction with that. But they will absolutely
revolutionize weight management in Australia. And as I said, I
just haven't seen it discussed in terms of why they're
so powerful. So they're not weight loss medications, but they
support weight loss because they actively target the hormones that
(07:27):
aren't working well in people with insulin resistance. But if
you don't have intulin resistance, they won't work. You've got
to have that issue. Now a lot of people will,
but that's why they're not for everyone. And in some cases,
if you're just an overeater, a contraver or saxender will
will work. Or if you can eat through these medications
as well, if you keep eating, they won't work. But
(07:48):
in conjunction with the right diet and exercise they can
work beautifully and for the right client, and they will
in many cases around the world prevent diabetes. So really
interesting but also complicated, and I wanted to talk about
it because when when you sent me that article or
how to read, I thought, oh my god, they haven't
even mentioned that it's an insulin. It works on improving
insulin action, and that's the underlying raising many of us
(08:08):
will struggle through our forties and fifties when it comes
to fluctuating glucose levels and weight gain.
Speaker 2 (08:14):
And it's also the underlying reason it's not available because
GPS are prescribing at left, right and center to how
I'm going to say this nicely, very entitled people women
in particular, who just want to lose three and five
kilos to look good in a bikini. So it's not
a weight loss drug. As you mentioned, a lot of
women are taking it when they really shouldn't be, and
the supply is very, very difficult to get, not just
(08:34):
in Australia but worldwide. The supply chain is down everywhere,
so it's very difficult to get your hands on it.
But I think it was well worth a discussion from
your point for actually describing who what the drug does
and who it's for, which I think is really really important.
But secondly, it actually does have some great results like
you said, there's a lot of I guess case studies
on social media of women who have lost twenty thirty kilos.
(08:56):
So this isn't just a small amount of weight loss.
For some people, it's a significant portion of their body weight.
You know, it's twenty thirty percent of their body weight,
which makes a significant difference to the health outcomes long
term if they are pre diabetic, or even if they're
struggling with things like fertility as well. So it is
a very powerful drug and in the right hands of
someone who needs it, with the right type of healthy
(09:17):
eating program and exercise, it can get great results. And
I just wanted to quickly go through the journal article
that was referenced in this article because I do think
it has some fabulous results and it really does show
how powerful lifestyle modification plus medication is sometimes, like I know,
as dieticians, well i would say that I'm anti medication.
I would say that, but for the right person, and
when we've tried everything else, it can be sort of
(09:40):
that last missing piece of the puzzle that really gets
people those results that they want. So this was a
very large clinical trial. It was published in the Journal
of Drama, so Jama early last year, and there were
six hundred and eleven volunteers in this trial. That's a
big study. You know, often we look at studies or
clients ander stuff and say, oh, have you seen this research,
and it's based on like the thirteen people, and it's
(10:01):
like it's just not enough. So six hundred and eleven
people is a great study. And those volunteers, all those
people as part of the study were giving intensive behavior
therapy for eight weeks with a very supervised, low calorie
diet from a dietitian and followed up for more than
a year. During this time, they were asked to do
one hundred minutes of exercise a week, so it's not
a lot. It's maybe two three sessions a week. And
(10:22):
over the course of the year they had thirty visits
from a dietitian. That's like them seeing a dietitian more
than you know, every one to two weeks essentially. So
for most people it's unsustainable. They wouldn't be able to
afford that, they wouldn't be able to access that. These
people had intensive support. Put it that way, and with
that intensive support through the behavior therapy, through the exercise,
through the diet, they lost on average five point seven
(10:44):
percent of their body weight. And this is in a year.
That's not that great, Susie, is it like, it's not
a very large amount, Let's be honest. And on average
that was about them losing five to six kilos. And
let's be honest, these people are one hundred, if not
well over one hundred kilos, So you know, five point
seven percent of their body weight is what we would
call a clinically significant difference. So they're clinically making positive
(11:04):
benefits for their health, but for most of them it's
just not enough for after a whole year of hard work.
We just want to see that a little bit more
so when they were given that intensive behavioral support plus
a Lowcaloie diet, plus the visits from the dietitian, plus
the exercise program plus the medication, their participants actually lost
on average sixteen percent of their body weight, which averaged
(11:25):
basically about seventeen kilos. So you can see the difference.
It's you know, three times from basically doing the same thing. So,
as you said, these medications work for the right person,
but at the moment, it's really just an access issue
and who it actually is right for versus everybody who
wants it.
Speaker 1 (11:41):
Absolutely, you know, it's not for a three to five
kilo weight loss with an exception. So I had a
client recently talking about medication, and when I checked her bloods,
even though she's not overweight, she's got pre diabetes. And
it turns out, yeah, her mum at sixty had diabetes.
She got a hyde genetic risk. But that client is
(12:01):
a preventative medication can be implicated. We want to stress
that in some medical instances, diet exercise may not be enough,
but we do have medications that can be used for
the right person and the right circumstances. So absolutely we
always try and manage things diet and exercise. But if
I know that someone will ultimately not get diabetes if
you keep them on a light insulance sensitizing agent like
(12:22):
a met foreman, absolutely I'm going to want a client
on that with in condunction with endocnologists, because that's going
to ultimately prevent them from getting diabetes. Ever, and that's
why it comes down to that whole genetic risk. You
know what your lifestyle behaviors are like in general, But
absolutely I don't like that it's referred to as a
weight loss medication because it links it to all. This
is a medication that acts on the hormones, which are
(12:44):
often disrupted in people who have significant weight issues. So
you know, in someone who's three to five kilos overweight,
they'll hypo out. It could be quite dangerous. So it's
certainly not off everyone, and hence you know, working with
a dietitian or endocnologist to really look at your glucose
and insulin levels and to see if that could be
the d LANG reason. And that's I reckon in that
Jama study, they would have been insulin resistant and that's
(13:06):
why they're not losing weight on direnex sise because they
also need that third level, which is a hormone controller
to help them with that. So it's complicated like anything,
but yeah, I think it's really interesting, and poor Nova
nor Disco were making it. I just must be running
around the clock trying to get as much out around
the world. And I really struggle to understand how anyone
in pharmaceuticals didn't see this as a it's going to
(13:26):
be the greatest breakthrough ever. You know, how could you
not understand the insulin? Oh, it acts on insulin. We've
got all these insulin resistant people around the world. It's
going to be gangbusters if we market it the right way.
I just questioned, what's going on there, Like, what were
they thinking? Of course, it was always going to revolutionize
weight management.
Speaker 2 (13:41):
I remember reading something and it came out that it
wasn't as you said, it's not meant to be a
weight loss drug. But it wasn't even I don't even
know if it was designed for insulin resistance. I think
it was originally designed for something else. And then somebody
just stumbled upon the fact that it helps people with
weight loss, and it blew up on TikTok, and here
we are.
Speaker 1 (13:57):
I just feel, does everyone forget their basic physiology? Then
number one regulator of glucose metabolism and fat metabolum is insolent.
If you've got into the resistance, you're not going to
lose weight like Nova. Nor just give us a call.
We can do some consulting for you. We could have
told you many years ago that this was the way forward.
But they'll catch up with supply, will catch up with demand.
But you know, land for every client who I have
on one of these new drugs, I'll have another client
(14:19):
who doesn't do well on it because they're not compliant
with lifestyle changes. You know, they don't want to do
their steps and their exercise, and they don't want to
get their heart rate up high enough, and they don't
want to keep their carb controlled all the time. So
you know, it's not for everyone. It works in conjunction
with lifestyle change, and we want to be very very
clear on that. And also when people are losing large
amounts of way twenty thirty kilos and not eating a
(14:40):
whole lot, their nutrition becomes really important. You know, as
I said to my client who is pre diabetic, you know,
I now need to keep your carb load at thirty percent,
which means I need to really be smart with your
snack choices because I need to get all your nutrition
in a very small amount of food. So there's a
real art to that. So, as I said, there's a
lot to be said for working with a dietitian on
those very specific dietary outcomes, because if you do it yourself,
(15:02):
you're often deficient in a number of key nutrients, which
isn't good for health long term.
Speaker 2 (15:06):
Twenty twenty three is the year that people are actually
choosing to sign up with dietitians, it's our years, eusy, Well,
I think.
Speaker 1 (15:11):
There's plenty of work to go around, plenty of work
to go around.
Speaker 2 (15:14):
Well, our year is dietitians. I mean it's the time
our profession gets to shine. I think I think people
have realized that.
Speaker 1 (15:19):
Oh it is in conjunction with these new weight loss
drugs absolutely because they just won't work as well unless
you're working with a dietsian one hundred percent all waste
your money because they're not cheap.
Speaker 2 (15:26):
I think for so long people think, you know, everyone
eats nutritions easy, I'll do it myself. But I think
people are coming to realize that there really is an
art and a science to nutrition and dietitians. Can you
know we can work wonders, So give us a buzz.
Speaker 1 (15:37):
Well, it's an investment because the other thing we should say, Leanne,
is that they're not cheap. They're expensive, these medications, so
you really want to be making sure you're using it
the right way to maximize any results.
Speaker 2 (15:46):
On dred percent. All right, moving on to lunch box season.
We are about to go back to school, but you
know we're big fans of adult lunch boxes as well,
so you know I both pack our own adult lunch boxes.
Me not so much these days I work from home,
but a big fan of lunchboxes anyway. So we wanted
to go through some of our best tips and tricks
for packing a healthy but affordable lunchbox, because, let's be honest,
(16:09):
the grocery prices are insane. At the moment. My grocery bill,
no joke, has gone up one hundred dollars from where
it was a year or two ago. And it's just
David and I and one tiny human. Granted she's for
a tiny human, she's good eater, she's eating all of them,
but still there's like two point twenty five of us
in the household, and it's just it's it's ridiculous. And
(16:30):
I'm like you, I'm very budget conscious. I'm a budget queen.
I love a good bargain. I shop in bog you know,
I go between different stores. I got aldi, I go
to the farmer's markets, I got to Cohl's. I do
all the right things. And despite that, grocery bills are
going through the roof. So, you know, snacking in general,
snacks can be four six eight dollars for single packet
of snacks. We just need to be a little bit
smarter when it comes to packing our lunch boxes, particularly
(16:53):
with school aged kids as well, because the more packet
Fooji gives them the high that's going to drive your
grocery bill. So let's talk about tips for lunch boxes.
Are we doing this in more an adult focus format
or a kid focus format?
Speaker 1 (17:05):
I think it's relevant kind of to both because I
think that the key areas we're targeting. I think the
concern I have with lunchboxes for adults and children alike
is they tend to be carbohydrate heavy. So you know,
kids at school will have fruits, and it's often fruit
and veggie break, but it's always more fruit in there
than veggies. And then they'll have snack food, so bars
and biscuits and bites, which are the ones we're talking about,
(17:27):
you know, six eight dollars for these tiny packs of
them that barely last the week. And then they'll have
the sandwiches and the wraps which are heavy carb load.
And because you can't send things like nuts or even
meats to school, if we're worried about things being fresh.
You know you're in Queensland, it's incredibly hot. You know
you're worried about the freshness and food safety, so we
tend to put plain things like veggimite on the bread.
(17:47):
You know, the bulk of that is carbohydrate. And the
issue of course with that is the kids get sort
of quick acting fuel through the day and then they
come home absolutely starving and eat you out of house
and home right through to dinner time. So I think
for me that the key focal points for both adults
and kids is to make sure there's enough protein in
the lunch box, and the way to do that is
(18:08):
to focus on, in my experience, some kind of snack
like a dairy which does have a protein base, whether
it's cheese or crackers or yogurt, and then using ice
blocks smartly. I do use flavored milks, and I find
buying them in bolk can be cost effective. Yes, they
contain smatted sugars, but at least you're getting the calcium
in the protein. Or in some cases you can use
the new protein breads for adults or even wraps for
(18:31):
kids to try and get a higher proportion of protein there.
And I think it's being really smart with the use
of packaged snacks, because you know, if we look purely
nutritionally at them land they're mostly just refined grains. There's
not much in them, you know, and you're paying a
fortune for puffs of air which don't have many calories.
So I use them in moderation because I think then
(18:53):
the kids have them in their lunch box and they
are you know, fitting in with other kids, and they're
not feeling like their lunchbox is boring. But I would
put a maximum of one package snack per lunch box
and really try and get some decent nutrition going in there,
whether it's the roasted broad beans, or whether it's sort
of the whole grain rice crackers or the veggie type
chips or a whole grain snack bar, or as I
(19:15):
do with my own kids is stock up when snacks
are on sale and then use a couple. So between
the twins, I would split say a bag of pretzels
or a bag of messy monkeys all the I like
those ones that will use the veggie bites. I think
there's like carrot bytes or beetroo bytes and split them
over too. So really a packet or two last me
a good couple of weeks, so not wasting it on
(19:37):
things like you know, mini biscuits and rice crackers and
rice puffs which have literally nothing in them and they're
not inexpensive, and I think it's a really good time
if you do have some time to bait get your bacorn,
because you do mini muffins or banana breads, you can
freeze them so that you don't throw them and they're
not wasted and going to be much more cost affordable,
you know, if you're not using bananas each week, some
(19:59):
whole meal flower, some plain yogurts, some eggs, you know,
and you're getting you know, two weeks worth of morning
teas with that, and like a relatively healthy cake, that
would be a much for me better spend. I think
leftovers for adults work really well, you know, rather than
buying lunches. Using either the tunas when they're on half
priced sale at colds or Woolies, or cooking up extra
(20:20):
chicken breast and using that on sandwiches and wraps is
a really good way of doing it. And for older kids,
loading up on the sandwiches and bread rather than putting
in more and more snack foods. I see a lot
of mums of teenagers and the lunch boxes are packed
full of chips and biscuits because they're trying to fill
them up. You're much better to put in either the
thermos of warmer food it keeps warm and a couple
(20:42):
of sandwiches as opposed to just adding up more and
more of the snack food.
Speaker 2 (20:47):
Yeah, I agree, And you made an important point where
it's like those rice space puffs and the chips and
the crackers, you're right, Like I remember someone listening to
someone once and they called them like flavored air, and
you're right, like you just have to eat so much
them to fill you up. Like I love popcorn, but
let's be honest, it's not really a filling snack. It's
got to go with like a couple of boiled eggs
or a big handful of nuts or something like that.
(21:08):
So I think focusing less on the package based carbs,
like you said, not even from a health perspective, but
just from a fill up your kids, fill up yourself,
and a budgeting perspective, because these things are expensive, so
you've got to have a good fat serve in there,
whether that's some olives, whether it's some avocado, whether it's
some cheese, whether it's some nuts. And nuts are something
that a lot of people will shy away from from
(21:29):
a budgeting perspective, but they're so incredibly healthy. There's so
much good quality research around them, and they do provide
that satiating factor because they've got the protein, the fiber,
and the fat, the healthy fats in there as well.
So I'm a big fan of nuts. Obviously, we can't
take them to schools and daycares, but if you're an
adult and you're just going into the workplace, or they're
really good to fill your kids up on weekends. Depending
(21:49):
on the age. Obviously we're not going to give nuts
to young children or toddlers. It's quite dangerous from a
choking perspective, but I think nuts are a really good
thing to put an adult or teenage lunch boxes. Were
going to you need that sort of thing, and then
looking at as you said, the homemade snacks, but making
them in mini portions, so making forty eight mini muffins
versus six or twelve cupcakes in the bigger sizes, so
you get more out of it. You know, kids learn
(22:12):
that that's not something that goes in the lunch box
every day. It's on a massive slice of banana, but
it's not this huge chocolate muffin. It's just a mini
serving of it because it's more like a treat, and
then you can freeze them so you're not spending you know, yourself,
baking two three times a week. You're kind of baking
once a month, and you're really getting through with it.
And then the protein option is really really important. Like
I get that people don't want to put tuna into
their lunchboxes because it's smelly. Like I never if my
(22:34):
mom mate gave me tuna when I was at high school,
I never used to eat it. Everyone would be like, oh, tuna, gross,
don't eat that. So I'm a big fan of things
like boiled eggs. I love some Greek yogat. I think
yoga is just like a staple. Pretty Much every single
client of mine has yoga at least once, if not
twice a day unless they specifically say to me, I
hate it or I'm vegan and I won't eat it.
So I'm like, that's cool. But unless you know, most
(22:54):
of my clients will have yoga in their lunchbox basically
daily because it's so filling. We're getting in some great
protein and also some good calcium as well. I love
just doing like some turkey and rolling in some lettuce leaves,
things like little mini kishes. You mentioned the roasted broad
beans and the chickpeas. You can do them yourself as well.
Like a tin of home brand chickpeas, what a dollar
twenty like? Drain it, put it onto a tray, put
(23:17):
it in the in the oven on low heats. Put
them in the air fry and put some spices on,
some garlics, some chili, some smoke paprika. You can really
do them yourself, and you can get you know, one
to two weeks worth out of that. You mix a
few nuts with a bit of roasted chickpeas and a
couple of pretzels together a little bit of popcorn, that
is so much of a more satiating snack to get
you through a few hours. And if you just put
a bag of rice crackers and a bag of popcorn
(23:38):
into a lunch box. True.
Speaker 1 (23:39):
And I think the other trick at home is that
if anyone who's got small kids, you know, they go
into the cupboard and they rummage around, and particularly as
they get teenagers. So I think when you're buying those
more expensive school snacks to have in some proportions. Only
get them on their half price and pack them away.
So when you buy them, you know that you've got
to supply, but you've got to stock them away because
otherwise they lead them with week because they're there. It's
(24:01):
like anything, it's availability. So keep a separate school snack section.
Put it in a child, put the lid on it.
Kids are lazy, they won't go looking really until they're
cotton on that they're there. So that helps a lot
the baking on the weekend, as I said, because that
gives something nice and you know, don't as we said,
remember little kids in particular, so those early primary years,
they don't eat a whole lot, so a few pieces
of something is often more than enough. You don't need
(24:22):
to put the entire packets in. I think you can
definitely shop bread a lot cheaper, you know, if you're
I myself lean like the whole meal for kids, I
don't tend to opt for the white high fiber. I
think you better try and get them onto whole meal.
But you can buy no name whole meal bread for
half the price of the regular one. So I think
stocking up on that and using it and keeping it
(24:44):
in the freezer even and making sandwiches in bulk is
a much smarter way of doing it because that really
can add up savings wise, And the same with things
like fruit and veg. When you're loading up the lunch box,
I don't put a whole apple in, or a whole
bitana even, or even a whole carrot, because a chance
that they'll eat it is them to none. But if
you cut one carrot between two into pieces, or cucumber
(25:05):
or a few baby tomatoes or an apple and squeeze
some lemon onto it, it will stretch the fresh food
out as well, and they're more likely to eat cut
and pieces. Whereas you go to the end of the
day and there's a squish banana, the haven't even touched it,
Whereas if you cut it in half, you've got two
serves out of it, and they're more likely or eaten it.
So just all those little tricks go a long way
with food budget. And yeah, and as you alluded to,
(25:25):
I tend to use the dairy as the protein or
in older kids, the protein wraps and things to bulk
it up a little bit there, given that it can
be a little bit tricky with meats and stuff. Mind you,
my boys tend to have a lean sausage or a
piece of shitz all left over from dinner. But I
do put it in a nice block, so they're quite
easy because they really like that kind of protein. And
then I can get away with a plain veggiemte on wholemeal.
(25:46):
Then I'll do the fruit veggie, use a little bit
of snack food, and I always put a little treat
because I find if they've got one little thing, they'll
eat the rest of the healthy stuff if they've got
one little treat. And that can be just a simple
leftover chocolate from Christmas or East which is one piece,
but the of what's going in is really good and
nutritious and not you know, blowing heaps of cash on
processed snacks that you know, as we said, they're just
(26:08):
so expensive for what they are. You know, five or
six dollars for puff rice or biscuits like that are
made with refined wheat flour, sugar and palm oil, like
terrible nutritionally.
Speaker 2 (26:19):
Yeah, And I like the tip for kids as well,
like adding a little treatin that goes the same for adults.
I think most of us are just trying to be
like one hundred percent clean and lean Monday to Friday.
Then we get to Friday night and we're just blowing out,
or we get to the nighttime we've been so good
all day and we're inhaling half a block of chocolate,
or we're rummaging through the pantry after dinner. Let's be honest,
we're not hungry because we just say dinner, but we
feel like we need or we deserve a treat, or
(26:41):
we want to reward ourselves after a hard day. So
I feel like actually adding in a little treat to
your lunchbox is a great idea because we're not talking about,
you know, half a block of chocolate or anything. We're
talking about a couple of squares. And for a lot
of people, that can then make them feel satiated and
make them feel happy, and you know they've had their
kind of treat, they don't feel the need to go
and blow out after dinner because of that. So I'm
(27:01):
a big fan of giving adults little treats as well.
I used to often when I worked at the hospital,
pack like a little chocolate, whether it was like a
little Ferrero rochet or a little thing of Favorites or something,
and you can see the difference between I used to
know so many of the nurses who used to always
ask me for like diet advice. On the ward, you
could see that the ones who had a great relationship
with food and used to do similar things and pack
themselves a little treat. You know, there'd be a boxes
(27:23):
of favorites on the ward. They just have one, and
a dietiian would have one. Then you'd see the other
nurses who are in that kind of restrict, restrict, restrict
overreat mindset, whether it's six, seven, eight, ten of those
mini favorites and the one go because they were just like, oh, well,
I've started, now I can't stop. So I'm a big
fan like you of actually adding in treats regularly so
that you don't get into that mindset where it's like
(27:44):
I can't have it, I can't have it on being good,
and then the minute you start, you're like, oh, I'm bad,
I'm off track. Let me eat it all.
Speaker 1 (27:49):
Yeah. Lots of people are nodding at the thought of that,
And I will say, just on that note, two things
sprung to mind. The first is my favorite Preleine Easter
eggs are now in the supermarket that are Ferrara shair
so expensive that you wouldn't be able to eat many
of them, let me do you? And number two Hot
Cross buns are also fantastic for kids. So when Willies
and Coles do the two for seven dollar packet, they
freeze really beautifully. You can cut half into the lunchbox
(28:11):
and kids love a cheeky bit of hot Cross bun
in their lunchbox, so that can be quite a smart
addition that's relatively inexpensive as well. Alright, Leanne, our final segment,
moving on from overeating favorite to our final segment of
the show. A question on hunger and what to do
if you don't feel it, which is common. You know,
I had a client earlier today and she said to me,
(28:33):
she only has a cup of tea and a biscuit
because she's not hungry for breakfast, and she doesn't actually
feel hunger until you know, one or two o'clock. So
why does this happen, Leanne? Why may you not be
experiencing hunger?
Speaker 2 (28:44):
Yeah, I've had so many clients say it, and I've honestly,
like hand on hardhead, clients say I haven't been hungry
for fifteen years and I'm like, why are you eating?
Children and babies have this wonderful, like inbuilt ability to
say I'm full or I've enough, or I'm hungry now,
Like it's so funny. I look at Mia like she's
one now and someday she just like the kid smashes food.
(29:06):
I'm like, where are you putting that? And other days
she's just like not interested. You'll pick it up, fling
it off the high chair, like flinging around the room,
and I'm like, did you even eat anything? Like what's
going on? They just have this wonderful in built system
of being, like they know when they're hungry, they know
when they're full, and all babies do. All kids do.
And it's somewhere between growing up, whether it's the destructured
(29:29):
eating times at school, whether it's UNI when a lot
of us will start to get bombarded by a diet culture,
whatever it is. By the time we reach adulthood, most
of us have switched off that ability to know if
we're truly hungry or not. So we're eating because we
woke up. Everybody else is having morning tea at work,
everybody's going for lunch. We're eating it as well. Everybody's
(29:49):
passing around the office chocolates in the afternoon, we're having them.
Then we sit down with the family and we all
have dinner together. So most of us are eating on
the clock and not eating because we're necessarily hungry. So
I think the first thing is to really just take
away all of the snacking, all of the drinks. So
many of us when they say, oh, I'm never really hungry,
I say, well, what are you drinking, And sousie, it's
like two or three massive lattes a day, and that's
(30:13):
like if you're having it on four cream milk, it's
like five hundred calories just going in through coffees alone.
And so I think for a lot of us, we're
drinking our calories. We're having massive cups of teas and
coffees made of milk, maybe with sugar, maybe with syrup
in them. You know, we're having juices, we're having smoothies,
we're having those delicious bubble teas, whatever it might be.
We've got a lot of calories going in from liquid,
(30:34):
so that tends to dapen down our hunger a lot
as well. But I think for most of us it's
the yoyo darting over time, it's a slow weight gain
over time, and for some of us it's a bit
of hormone or even thyroid disruptions as well, which tends
to turn off that switch for the hunger. So yes,
there may be a medical reason why you're not hungry,
or it may just be a metabolic reason where over
(30:56):
time you've slowly gained weight, you're not moving as much
as normal, you're eating too many calories, yet you never
actually feel hungry. So I sort of like to just
scale everything back, get rid of all the drinks, get
rid of all the snacks, and say to my clients,
here's three small, balanced meals. I want you to eat
them even though you're not hungry, but I want you
to eat it, you know, sometime in the morning, sometime
(31:17):
around you know, between eleven and three pm, and another
meal sometime at dinner between sort of four and eight
pm when you feel like that, and it's amazing when
you just like scale back the bulk of food that
they're having. That hunger. It might not return of a night,
but over a couple of weeks, and then clients will
text me and they say, oh my goodness, I woke
up hungry for the first time in ten years, and
it's amazing. So I think for so many of us,
(31:39):
I get it that you don't feel hungry, but there's
still too much food and too many calories going in.
And you might think, well, I barely eat anything, and
that might be true from a volume perspective. You're barely
eating anything, but you're getting those calories in. Whether that's
from liquids like wines every night or large coffees throughout
the day, or whether that's just that you're snacking and
grazing all days. A lot of us are just snacking
(32:01):
versus eating properly balanced meal. So you're having, you know,
just a muffin in the morning, but you didn't know
that that muffin's like four five six hundred calories, Or
you're having a large coffee which is one fifty two
hundred calories as well, So the calories are going in,
yet you're not eating that much. So I think if
we scale it back and build better balanced meals, a
lot of times that hunger does naturally return over time.
(32:22):
So I do want my clients to eat. I do
want them to tune and listen to their hunger, and
hopefully it returns over time. But the combination of upping
the exercise tends to bring back that hunger as well,
because the more you move, the more the body tends
to need a little bit more fuel. Yeah.
Speaker 1 (32:37):
True, And I see it commonly with some hormonal issues
where people will start and it's also habitual, is it
hormones or is it her bit sual where they basically
don't eat for several hours and then they overeat all
night and they don't have a long fast. So it
presents to me all the time, so that the strategy
I have for working through it is I want a
minimum of a twelve hour fast overnight, so I try
(32:59):
and move that that dinner meal earlier. It is a
bit of a reprogramming and try and say right, try
and have the final calories by seven eight pm. Then
if you're not hungry within two hours of waking, which
means if you're up at five by seven or if
you're up at six or seven by nine, you must
have something, and just have something small. So it has
(33:19):
to be a bit of protein and a bit carbohydrate.
And if you're a coffee replacer, so if you're someone
who does the latte, the cappuccino, and then reckons you
don't feel hungry. I want you to actually eat a
proper breakfast, So have the latte or cappuccina, but you
must have it with a slice of toast and protein
or some plain yogat and berries to actually make that
a small meal at three hundred calories. And then I
(33:40):
guarantee you by eleven twelve you'll notice that gurgling this stomach.
So in some cases it may be feeding a little
bit more. In some cases it may be actually forcing
something in to get you moving, but that would be
the premise. And of course try and lighten the overnight
because by the time you have the afternoon snacks, plus
the glass and wine, plus the dinner, plus the tree
eat plus the dessert. You know, sometimes people are eating
(34:02):
six eight thousand calories. That's why you're not working out hungry.
I promise you you cut it back to a three
four hundred calorie meal and be quite strict on that.
You'll notice the difference twelve hours later. So there's a
few easy steps that can easily reprogram it. But you're right,
if you're not losing weight, and you're not hungry in
the morning and not eating until late in the day,
it certainly needs some work to get you burning, because
(34:22):
we're programming on a circadian rhythm and hunger is a
sign that you're burning your food. So no hunger is
not a good sign and we need to.
Speaker 2 (34:29):
Work on it absolutely well.
Speaker 1 (34:30):
That brings us to the end of the Nutrition Couch
for another Sundaily end. If you haven't done so, please
tell all your friends about us, so our numbers continue
to grow and we keep being able to bring you
this content each week, and of course each Wednesday when
we have our product review. We still have our recordings
available on Hormones, gut health and fat loss, as well
as our brand new Supermarket Guide which goes through our
current product favorites that are available at the supermarket and
(34:54):
that's available on the Nutritioncouch dot com. And can I
reveal here we're working on a new one of these
lyan a little of a teaser you can very exciting.
We had so many people enjoy our Supermarket Product Guide
and it's still selling really well, so we know people
love this content that we are working on another cheeky
one which will be out in a few weeks time,
(35:15):
and we'll let you have a little bit of a
think about what that might be. I don't think we
should say what it is. But we've got a new
book in the works that we'll make eating a little
bit easier.
Speaker 2 (35:25):
Getting delicious food a little bit easier.
Speaker 1 (35:27):
So watch this space and have a great week. We
will see you on Wednesday.
Speaker 2 (35:31):
Hatch you guys next week.
In the past couple of years, the management of weight
issues have changed significantly with the emergence of a new
range of weight loss medications. You may have seen one
of the many media stories of people who have suddenly
been able to drop twenty or thirty kilos with the
help of these new drugs. So what exactly are they
and why are they revolutionizing weight management around the world. Hi,
(00:20):
I'm Suzy Barrel and Only and we bring you The
Nutrition Couch, the bi weekly podcast that keeps you up
to date on everything you need to know in the
world of nutrition as well as weight loss medication. It
is lunch box season, which means it is time to
talk the best ways to not only pack a healthy lunch,
but also one that is budget friendly. And our listener
question is all about hunger and what to do if
(00:41):
you haven't seen or felt yours for a while. But Leanna,
I don't think that's the case for you, because my
experience is that you're a hungry human and don't have
any trouble locating that hunger of yours. That a fair call.
Speaker 2 (00:53):
That's a fair call. You know. It's like a little
gremlin rears its ugly head.
Speaker 1 (00:57):
You know too often we'll enjoy it white last. I
am in my mid forties. Let me tell you, I
don't feel hunger like I used to. Like I remember
being in clinic as a dietitian and rushing out mid
morning to have a snack and then rushing for my lunch,
whereas now I can kind of go all day. So
certainly metabolism does change as we go through different life
stages and ages. And I spend a lot of time
(01:18):
with my clients on hunger, and I think the question
we're looking at later today in this potty is very
relevant because I do have a number of clients who
don't experience hunger, particularly till they much later in the day.
So I thought that was a really good one to
work through. But to kick us off, weight loss medication.
And we have kind of covered this before a little bit,
But you said to me a great summary article that
(01:39):
was published on the Sydney Monty Herald dot com probably
the Age as well, which summarized a weightless medication. Now
it's in the group of weightless medications which are called
the semiglukatides. Now it's an interesting area because I actually
don't think the reason that they have such a profound
effect on weight has been well disc gust in the
(02:00):
media because they've been popular as weight loss medications. And
originally I think when we covered it here on the
Podilea and we talked about them appearing on TikTok and
you would see girls come on and say that suddenly
they've had pcos and they've lost twenty or thirty kilos
really quickly because suddenly they've had this weight loss medication. Now,
the first thing I want to say is that the
(02:23):
medications we're talking about are actually specifically weight loss medications. Now,
if you look out through the history of weight loss medications,
people would be familiar with things like duramine, which is
a nervous system stimulant acts on the brain to significantly
reduce appatite. That's been around her I want to say
twenty thirty years. There was also xenecaw, which was a
fat malabsorper in the gut, so if you had fat,
(02:44):
it basically that you excraded it out. That was probably
about twenty years older. I remember working in it when
I first graduated, and then we've always had from a
number of years medications that have been used in glucose management.
So that would be things like you met Foreman Direfman,
which were traditionally used in peopleople who had type two diabetes,
and they're what we call insulin sensitizing agents, so they
basically help the cells be more receptive to the hormone insulin,
(03:08):
and insulin is the central regulator of both glucose and
fat metabolism in the body, so they have an indirect
effect on weight management, but they're not specifically what we
would call appetite suppressants or weight loss drugs. They're more
secondary to the hormones that manage our glucose and fat metabolism.
Then leanne. In the last few years, we've had a
couple of profound appetite acting agents, things like contrave and Saxender,
(03:31):
which are injectibles that impact some of the hormones in
the gut which regulate appetite and indeed can have quite
profound effect on appetite, so suddenly you don't feel so
hungry all the time. And certainly people who are overweight
or used to overeating, or are who have and all
glucose management issues will be very hungry humans, and those
appetite suppressants can be very powerful. That's significantly reducing their
(03:54):
appetite and drive and craving for glucose and carbohydrates, which
means they can be more diet compliant and get the
results they're looking for long term. And certainly I've had
clients who have been on Taxander and Contrave who have
lost twenty thirty kilos in conjunction with diet exercise over
a two to three year period. So it's not quick
weight loss, but it's consistent weight loss and certainly much
greater weight loss than they've been able to achieve with
(04:14):
diton exercise prescription. Now that leads lean to the drugs
we want to talk about today, which are these ones
in the media, these semi glucotides. Now they're not weight
loss drugs, but the reason they're so powerful is that
many people who have significant weight gain through their middle years,
abdominal weight gain, issues with glucose regulation and long term
(04:37):
will get diabetes, have issues with inchulin. Now, insulin is
I said, it is the hormone that regulates glucose metabolism,
and inchulin is secreted by the pancreas in response to carbohydrate.
So why these medications are so very powerful is that
they not only have a significant appetite acting effect. So
they suddenly mean that people who are always hungry and
(04:58):
always craving sweet food are not hung and don't crave
at all. Profound reduction in appetite, but leanne they encourage
and the production of insulin in the pancreas and help
it to work better. So this suddenly means that the
hormone in all these people who have had weight gain
through their thirties and forties because they've got early stage diabetes,
(05:18):
suddenly the underlying reason that these people gain weight so
quickly and crave carbohydrate and can't lose weight easily is
being targeted. And I don't actually think it's addressed well
in the media, and quite possibly because the people writing
the articles don't understand that. So the reason it's so
powerful is that it's directly acting on the reason these
people struggle with weight because in the case of insulin resistance,
(05:41):
clinical insulin resistance or impaired glucose tolerance or pre diabetes,
calories in versus calories out doesn't work anymore because the
hormone that should do its job in terms of allowing
carbohydrate and glucose to enter the cell and be burnt
as energy and fat isn't working very well. It's inefficient,
and so that explains why people who might be quite
(06:02):
overweight don't eat so much really and are carrying significant
amounts of weight. They also struggle to lose body fat
and weight easily because their insulin is high in insulin
blocks fat metabolism, so their basic energy balance equation is screwed.
So this medication, this type of medication, which was traditionally
initially used for type two diabetics, also has a profound
(06:23):
effect on those with insulin resistance and pcos in some cases,
and pre diabetes. The insulin is encouraged to work better
in the pancreas they're not hungry, and so all factors
of weight management are working now. It requires diet compliance,
but diet compliance is easy because you're not hungry all
the time, and people who have been hungry their whole
(06:43):
adult life suddenly say I don't feel like food and
I'm not looking for it. It's incredibly freeing. But that
is the reason they're so powerful now. They I believe
Leanne will revolutionize weight management in the country because they
are actively targeting the underlying hormonal imbalance and issue which
may be genetic, may also have a significant lifestyle component.
Likely does because many people eat too much and don't
(07:05):
exercise enough, and that's of course for you and I
come in because these drugs also don't work as well
if they're people the clients are not exercise and diet compliant.
They work in conjunction with that. But they will absolutely
revolutionize weight management in Australia. And as I said, I
just haven't seen it discussed in terms of why they're
so powerful. So they're not weight loss medications, but they
support weight loss because they actively target the hormones that
(07:27):
aren't working well in people with insulin resistance. But if
you don't have intulin resistance, they won't work. You've got
to have that issue. Now a lot of people will,
but that's why they're not for everyone. And in some cases,
if you're just an overeater, a contraver or saxender will
will work. Or if you can eat through these medications
as well, if you keep eating, they won't work. But
(07:48):
in conjunction with the right diet and exercise they can
work beautifully and for the right client, and they will
in many cases around the world prevent diabetes. So really
interesting but also complicated, and I wanted to talk about
it because when when you sent me that article or
how to read, I thought, oh my god, they haven't
even mentioned that it's an insulin. It works on improving
insulin action, and that's the underlying raising many of us
(08:08):
will struggle through our forties and fifties when it comes
to fluctuating glucose levels and weight gain.
Speaker 2 (08:14):
And it's also the underlying reason it's not available because
GPS are prescribing at left, right and center to how
I'm going to say this nicely, very entitled people women
in particular, who just want to lose three and five
kilos to look good in a bikini. So it's not
a weight loss drug. As you mentioned, a lot of
women are taking it when they really shouldn't be, and
the supply is very, very difficult to get, not just
(08:34):
in Australia but worldwide. The supply chain is down everywhere,
so it's very difficult to get your hands on it.
But I think it was well worth a discussion from
your point for actually describing who what the drug does
and who it's for, which I think is really really important.
But secondly, it actually does have some great results like
you said, there's a lot of I guess case studies
on social media of women who have lost twenty thirty kilos.
(08:56):
So this isn't just a small amount of weight loss.
For some people, it's a significant portion of their body weight.
You know, it's twenty thirty percent of their body weight,
which makes a significant difference to the health outcomes long
term if they are pre diabetic, or even if they're
struggling with things like fertility as well. So it is
a very powerful drug and in the right hands of
someone who needs it, with the right type of healthy
(09:17):
eating program and exercise, it can get great results. And
I just wanted to quickly go through the journal article
that was referenced in this article because I do think
it has some fabulous results and it really does show
how powerful lifestyle modification plus medication is sometimes, like I know,
as dieticians, well i would say that I'm anti medication.
I would say that, but for the right person, and
when we've tried everything else, it can be sort of
(09:40):
that last missing piece of the puzzle that really gets
people those results that they want. So this was a
very large clinical trial. It was published in the Journal
of Drama, so Jama early last year, and there were
six hundred and eleven volunteers in this trial. That's a
big study. You know, often we look at studies or
clients ander stuff and say, oh, have you seen this research,
and it's based on like the thirteen people, and it's
(10:01):
like it's just not enough. So six hundred and eleven
people is a great study. And those volunteers, all those
people as part of the study were giving intensive behavior
therapy for eight weeks with a very supervised, low calorie
diet from a dietitian and followed up for more than
a year. During this time, they were asked to do
one hundred minutes of exercise a week, so it's not
a lot. It's maybe two three sessions a week. And
(10:22):
over the course of the year they had thirty visits
from a dietitian. That's like them seeing a dietitian more
than you know, every one to two weeks essentially. So
for most people it's unsustainable. They wouldn't be able to
afford that, they wouldn't be able to access that. These
people had intensive support. Put it that way, and with
that intensive support through the behavior therapy, through the exercise,
through the diet, they lost on average five point seven
(10:44):
percent of their body weight. And this is in a year.
That's not that great, Susie, is it like, it's not
a very large amount, Let's be honest. And on average
that was about them losing five to six kilos. And
let's be honest, these people are one hundred, if not
well over one hundred kilos, So you know, five point
seven percent of their body weight is what we would
call a clinically significant difference. So they're clinically making positive
(11:04):
benefits for their health, but for most of them it's
just not enough for after a whole year of hard work.
We just want to see that a little bit more
so when they were given that intensive behavioral support plus
a Lowcaloie diet, plus the visits from the dietitian, plus
the exercise program plus the medication, their participants actually lost
on average sixteen percent of their body weight, which averaged
(11:25):
basically about seventeen kilos. So you can see the difference.
It's you know, three times from basically doing the same thing. So,
as you said, these medications work for the right person,
but at the moment, it's really just an access issue
and who it actually is right for versus everybody who
wants it.
Speaker 1 (11:41):
Absolutely, you know, it's not for a three to five
kilo weight loss with an exception. So I had a
client recently talking about medication, and when I checked her bloods,
even though she's not overweight, she's got pre diabetes. And
it turns out, yeah, her mum at sixty had diabetes.
She got a hyde genetic risk. But that client is
(12:01):
a preventative medication can be implicated. We want to stress
that in some medical instances, diet exercise may not be enough,
but we do have medications that can be used for
the right person and the right circumstances. So absolutely we
always try and manage things diet and exercise. But if
I know that someone will ultimately not get diabetes if
you keep them on a light insulance sensitizing agent like
(12:22):
a met foreman, absolutely I'm going to want a client
on that with in condunction with endocnologists, because that's going
to ultimately prevent them from getting diabetes. Ever, and that's
why it comes down to that whole genetic risk. You
know what your lifestyle behaviors are like in general, But
absolutely I don't like that it's referred to as a
weight loss medication because it links it to all. This
is a medication that acts on the hormones, which are
(12:44):
often disrupted in people who have significant weight issues. So
you know, in someone who's three to five kilos overweight,
they'll hypo out. It could be quite dangerous. So it's
certainly not off everyone, and hence you know, working with
a dietitian or endocnologist to really look at your glucose
and insulin levels and to see if that could be
the d LANG reason. And that's I reckon in that
Jama study, they would have been insulin resistant and that's
(13:06):
why they're not losing weight on direnex sise because they
also need that third level, which is a hormone controller
to help them with that. So it's complicated like anything,
but yeah, I think it's really interesting, and poor Nova
nor Disco were making it. I just must be running
around the clock trying to get as much out around
the world. And I really struggle to understand how anyone
in pharmaceuticals didn't see this as a it's going to
(13:26):
be the greatest breakthrough ever. You know, how could you
not understand the insulin? Oh, it acts on insulin. We've
got all these insulin resistant people around the world. It's
going to be gangbusters if we market it the right way.
I just questioned, what's going on there, Like, what were
they thinking? Of course, it was always going to revolutionize
weight management.
Speaker 2 (13:41):
I remember reading something and it came out that it
wasn't as you said, it's not meant to be a
weight loss drug. But it wasn't even I don't even
know if it was designed for insulin resistance. I think
it was originally designed for something else. And then somebody
just stumbled upon the fact that it helps people with
weight loss, and it blew up on TikTok, and here
we are.
Speaker 1 (13:57):
I just feel, does everyone forget their basic physiology? Then
number one regulator of glucose metabolism and fat metabolum is insolent.
If you've got into the resistance, you're not going to
lose weight like Nova. Nor just give us a call.
We can do some consulting for you. We could have
told you many years ago that this was the way forward.
But they'll catch up with supply, will catch up with demand.
But you know, land for every client who I have
on one of these new drugs, I'll have another client
(14:19):
who doesn't do well on it because they're not compliant
with lifestyle changes. You know, they don't want to do
their steps and their exercise, and they don't want to
get their heart rate up high enough, and they don't
want to keep their carb controlled all the time. So
you know, it's not for everyone. It works in conjunction
with lifestyle change, and we want to be very very
clear on that. And also when people are losing large
amounts of way twenty thirty kilos and not eating a
(14:40):
whole lot, their nutrition becomes really important. You know, as
I said to my client who is pre diabetic, you know,
I now need to keep your carb load at thirty percent,
which means I need to really be smart with your
snack choices because I need to get all your nutrition
in a very small amount of food. So there's a
real art to that. So, as I said, there's a
lot to be said for working with a dietitian on
those very specific dietary outcomes, because if you do it yourself,
(15:02):
you're often deficient in a number of key nutrients, which
isn't good for health long term.
Speaker 2 (15:06):
Twenty twenty three is the year that people are actually
choosing to sign up with dietitians, it's our years, eusy, Well,
I think.
Speaker 1 (15:11):
There's plenty of work to go around, plenty of work
to go around.
Speaker 2 (15:14):
Well, our year is dietitians. I mean it's the time
our profession gets to shine. I think I think people
have realized that.
Speaker 1 (15:19):
Oh it is in conjunction with these new weight loss
drugs absolutely because they just won't work as well unless
you're working with a dietsian one hundred percent all waste
your money because they're not cheap.
Speaker 2 (15:26):
I think for so long people think, you know, everyone
eats nutritions easy, I'll do it myself. But I think
people are coming to realize that there really is an
art and a science to nutrition and dietitians. Can you
know we can work wonders, So give us a buzz.
Speaker 1 (15:37):
Well, it's an investment because the other thing we should say, Leanne,
is that they're not cheap. They're expensive, these medications, so
you really want to be making sure you're using it
the right way to maximize any results.
Speaker 2 (15:46):
On dred percent. All right, moving on to lunch box season.
We are about to go back to school, but you
know we're big fans of adult lunch boxes as well,
so you know I both pack our own adult lunch boxes.
Me not so much these days I work from home,
but a big fan of lunchboxes anyway. So we wanted
to go through some of our best tips and tricks
for packing a healthy but affordable lunchbox, because, let's be honest,
(16:09):
the grocery prices are insane. At the moment. My grocery bill,
no joke, has gone up one hundred dollars from where
it was a year or two ago. And it's just
David and I and one tiny human. Granted she's for
a tiny human, she's good eater, she's eating all of them,
but still there's like two point twenty five of us
in the household, and it's just it's it's ridiculous. And
(16:30):
I'm like you, I'm very budget conscious. I'm a budget queen.
I love a good bargain. I shop in bog you know,
I go between different stores. I got aldi, I go
to the farmer's markets, I got to Cohl's. I do
all the right things. And despite that, grocery bills are
going through the roof. So, you know, snacking in general,
snacks can be four six eight dollars for single packet
of snacks. We just need to be a little bit
smarter when it comes to packing our lunch boxes, particularly
(16:53):
with school aged kids as well, because the more packet
Fooji gives them the high that's going to drive your
grocery bill. So let's talk about tips for lunch boxes.
Are we doing this in more an adult focus format
or a kid focus format?
Speaker 1 (17:05):
I think it's relevant kind of to both because I
think that the key areas we're targeting. I think the
concern I have with lunchboxes for adults and children alike
is they tend to be carbohydrate heavy. So you know,
kids at school will have fruits, and it's often fruit
and veggie break, but it's always more fruit in there
than veggies. And then they'll have snack food, so bars
and biscuits and bites, which are the ones we're talking about,
(17:27):
you know, six eight dollars for these tiny packs of
them that barely last the week. And then they'll have
the sandwiches and the wraps which are heavy carb load.
And because you can't send things like nuts or even
meats to school, if we're worried about things being fresh.
You know you're in Queensland, it's incredibly hot. You know
you're worried about the freshness and food safety, so we
tend to put plain things like veggimite on the bread.
(17:47):
You know, the bulk of that is carbohydrate. And the
issue of course with that is the kids get sort
of quick acting fuel through the day and then they
come home absolutely starving and eat you out of house
and home right through to dinner time. So I think
for me that the key focal points for both adults
and kids is to make sure there's enough protein in
the lunch box, and the way to do that is
(18:08):
to focus on, in my experience, some kind of snack
like a dairy which does have a protein base, whether
it's cheese or crackers or yogurt, and then using ice
blocks smartly. I do use flavored milks, and I find
buying them in bolk can be cost effective. Yes, they
contain smatted sugars, but at least you're getting the calcium
in the protein. Or in some cases you can use
the new protein breads for adults or even wraps for
(18:31):
kids to try and get a higher proportion of protein there.
And I think it's being really smart with the use
of packaged snacks, because you know, if we look purely
nutritionally at them land they're mostly just refined grains. There's
not much in them, you know, and you're paying a
fortune for puffs of air which don't have many calories.
So I use them in moderation because I think then
(18:53):
the kids have them in their lunch box and they
are you know, fitting in with other kids, and they're
not feeling like their lunchbox is boring. But I would
put a maximum of one package snack per lunch box
and really try and get some decent nutrition going in there,
whether it's the roasted broad beans, or whether it's sort
of the whole grain rice crackers or the veggie type
chips or a whole grain snack bar, or as I
(19:15):
do with my own kids is stock up when snacks
are on sale and then use a couple. So between
the twins, I would split say a bag of pretzels
or a bag of messy monkeys all the I like
those ones that will use the veggie bites. I think
there's like carrot bytes or beetroo bytes and split them
over too. So really a packet or two last me
a good couple of weeks, so not wasting it on
(19:37):
things like you know, mini biscuits and rice crackers and
rice puffs which have literally nothing in them and they're
not inexpensive, and I think it's a really good time
if you do have some time to bait get your bacorn,
because you do mini muffins or banana breads, you can
freeze them so that you don't throw them and they're
not wasted and going to be much more cost affordable,
you know, if you're not using bananas each week, some
(19:59):
whole meal flower, some plain yogurts, some eggs, you know,
and you're getting you know, two weeks worth of morning
teas with that, and like a relatively healthy cake, that
would be a much for me better spend. I think
leftovers for adults work really well, you know, rather than
buying lunches. Using either the tunas when they're on half
priced sale at colds or Woolies, or cooking up extra
(20:20):
chicken breast and using that on sandwiches and wraps is
a really good way of doing it. And for older kids,
loading up on the sandwiches and bread rather than putting
in more and more snack foods. I see a lot
of mums of teenagers and the lunch boxes are packed
full of chips and biscuits because they're trying to fill
them up. You're much better to put in either the
thermos of warmer food it keeps warm and a couple
(20:42):
of sandwiches as opposed to just adding up more and
more of the snack food.
Speaker 2 (20:47):
Yeah, I agree, And you made an important point where
it's like those rice space puffs and the chips and
the crackers, you're right, Like I remember someone listening to
someone once and they called them like flavored air, and
you're right, like you just have to eat so much
them to fill you up. Like I love popcorn, but
let's be honest, it's not really a filling snack. It's
got to go with like a couple of boiled eggs
or a big handful of nuts or something like that.
(21:08):
So I think focusing less on the package based carbs,
like you said, not even from a health perspective, but
just from a fill up your kids, fill up yourself,
and a budgeting perspective, because these things are expensive, so
you've got to have a good fat serve in there,
whether that's some olives, whether it's some avocado, whether it's
some cheese, whether it's some nuts. And nuts are something
that a lot of people will shy away from from
(21:29):
a budgeting perspective, but they're so incredibly healthy. There's so
much good quality research around them, and they do provide
that satiating factor because they've got the protein, the fiber,
and the fat, the healthy fats in there as well.
So I'm a big fan of nuts. Obviously, we can't
take them to schools and daycares, but if you're an
adult and you're just going into the workplace, or they're
really good to fill your kids up on weekends. Depending
(21:49):
on the age. Obviously we're not going to give nuts
to young children or toddlers. It's quite dangerous from a
choking perspective, but I think nuts are a really good
thing to put an adult or teenage lunch boxes. Were
going to you need that sort of thing, and then
looking at as you said, the homemade snacks, but making
them in mini portions, so making forty eight mini muffins
versus six or twelve cupcakes in the bigger sizes, so
you get more out of it. You know, kids learn
(22:12):
that that's not something that goes in the lunch box
every day. It's on a massive slice of banana, but
it's not this huge chocolate muffin. It's just a mini
serving of it because it's more like a treat, and
then you can freeze them so you're not spending you know, yourself,
baking two three times a week. You're kind of baking
once a month, and you're really getting through with it.
And then the protein option is really really important. Like
I get that people don't want to put tuna into
their lunchboxes because it's smelly. Like I never if my
(22:34):
mom mate gave me tuna when I was at high school,
I never used to eat it. Everyone would be like, oh, tuna, gross,
don't eat that. So I'm a big fan of things
like boiled eggs. I love some Greek yogat. I think
yoga is just like a staple. Pretty Much every single
client of mine has yoga at least once, if not
twice a day unless they specifically say to me, I
hate it or I'm vegan and I won't eat it.
So I'm like, that's cool. But unless you know, most
(22:54):
of my clients will have yoga in their lunchbox basically
daily because it's so filling. We're getting in some great
protein and also some good calcium as well. I love
just doing like some turkey and rolling in some lettuce leaves,
things like little mini kishes. You mentioned the roasted broad
beans and the chickpeas. You can do them yourself as well.
Like a tin of home brand chickpeas, what a dollar
twenty like? Drain it, put it onto a tray, put
(23:17):
it in the in the oven on low heats. Put
them in the air fry and put some spices on,
some garlics, some chili, some smoke paprika. You can really
do them yourself, and you can get you know, one
to two weeks worth out of that. You mix a
few nuts with a bit of roasted chickpeas and a
couple of pretzels together a little bit of popcorn, that
is so much of a more satiating snack to get
you through a few hours. And if you just put
a bag of rice crackers and a bag of popcorn
(23:38):
into a lunch box. True.
Speaker 1 (23:39):
And I think the other trick at home is that
if anyone who's got small kids, you know, they go
into the cupboard and they rummage around, and particularly as
they get teenagers. So I think when you're buying those
more expensive school snacks to have in some proportions. Only
get them on their half price and pack them away.
So when you buy them, you know that you've got
to supply, but you've got to stock them away because
otherwise they lead them with week because they're there. It's
(24:01):
like anything, it's availability. So keep a separate school snack section.
Put it in a child, put the lid on it.
Kids are lazy, they won't go looking really until they're
cotton on that they're there. So that helps a lot
the baking on the weekend, as I said, because that
gives something nice and you know, don't as we said,
remember little kids in particular, so those early primary years,
they don't eat a whole lot, so a few pieces
of something is often more than enough. You don't need
(24:22):
to put the entire packets in. I think you can
definitely shop bread a lot cheaper, you know, if you're
I myself lean like the whole meal for kids, I
don't tend to opt for the white high fiber. I
think you better try and get them onto whole meal.
But you can buy no name whole meal bread for
half the price of the regular one. So I think
stocking up on that and using it and keeping it
(24:44):
in the freezer even and making sandwiches in bulk is
a much smarter way of doing it because that really
can add up savings wise, And the same with things
like fruit and veg. When you're loading up the lunch box,
I don't put a whole apple in, or a whole
bitana even, or even a whole carrot, because a chance
that they'll eat it is them to none. But if
you cut one carrot between two into pieces, or cucumber
(25:05):
or a few baby tomatoes or an apple and squeeze
some lemon onto it, it will stretch the fresh food
out as well, and they're more likely to eat cut
and pieces. Whereas you go to the end of the
day and there's a squish banana, the haven't even touched it,
Whereas if you cut it in half, you've got two
serves out of it, and they're more likely or eaten it.
So just all those little tricks go a long way
with food budget. And yeah, and as you alluded to,
(25:25):
I tend to use the dairy as the protein or
in older kids, the protein wraps and things to bulk
it up a little bit there, given that it can
be a little bit tricky with meats and stuff. Mind you,
my boys tend to have a lean sausage or a
piece of shitz all left over from dinner. But I
do put it in a nice block, so they're quite
easy because they really like that kind of protein. And
then I can get away with a plain veggiemte on wholemeal.
(25:46):
Then I'll do the fruit veggie, use a little bit
of snack food, and I always put a little treat
because I find if they've got one little thing, they'll
eat the rest of the healthy stuff if they've got
one little treat. And that can be just a simple
leftover chocolate from Christmas or East which is one piece,
but the of what's going in is really good and
nutritious and not you know, blowing heaps of cash on
processed snacks that you know, as we said, they're just
(26:08):
so expensive for what they are. You know, five or
six dollars for puff rice or biscuits like that are
made with refined wheat flour, sugar and palm oil, like
terrible nutritionally.
Speaker 2 (26:19):
Yeah, And I like the tip for kids as well,
like adding a little treatin that goes the same for adults.
I think most of us are just trying to be
like one hundred percent clean and lean Monday to Friday.
Then we get to Friday night and we're just blowing out,
or we get to the nighttime we've been so good
all day and we're inhaling half a block of chocolate,
or we're rummaging through the pantry after dinner. Let's be honest,
we're not hungry because we just say dinner, but we
feel like we need or we deserve a treat, or
(26:41):
we want to reward ourselves after a hard day. So
I feel like actually adding in a little treat to
your lunchbox is a great idea because we're not talking about,
you know, half a block of chocolate or anything. We're
talking about a couple of squares. And for a lot
of people, that can then make them feel satiated and
make them feel happy, and you know they've had their
kind of treat, they don't feel the need to go
and blow out after dinner because of that. So I'm
(27:01):
a big fan of giving adults little treats as well.
I used to often when I worked at the hospital,
pack like a little chocolate, whether it was like a
little Ferrero rochet or a little thing of Favorites or something,
and you can see the difference between I used to
know so many of the nurses who used to always
ask me for like diet advice. On the ward, you
could see that the ones who had a great relationship
with food and used to do similar things and pack
themselves a little treat. You know, there'd be a boxes
(27:23):
of favorites on the ward. They just have one, and
a dietiian would have one. Then you'd see the other
nurses who are in that kind of restrict, restrict, restrict
overreat mindset, whether it's six, seven, eight, ten of those
mini favorites and the one go because they were just like, oh, well,
I've started, now I can't stop. So I'm a big
fan like you of actually adding in treats regularly so
that you don't get into that mindset where it's like
(27:44):
I can't have it, I can't have it on being good,
and then the minute you start, you're like, oh, I'm bad,
I'm off track. Let me eat it all.
Speaker 1 (27:49):
Yeah. Lots of people are nodding at the thought of that,
And I will say, just on that note, two things
sprung to mind. The first is my favorite Preleine Easter
eggs are now in the supermarket that are Ferrara shair
so expensive that you wouldn't be able to eat many
of them, let me do you? And number two Hot
Cross buns are also fantastic for kids. So when Willies
and Coles do the two for seven dollar packet, they
freeze really beautifully. You can cut half into the lunchbox
(28:11):
and kids love a cheeky bit of hot Cross bun
in their lunchbox, so that can be quite a smart
addition that's relatively inexpensive as well. Alright, Leanne, our final segment,
moving on from overeating favorite to our final segment of
the show. A question on hunger and what to do
if you don't feel it, which is common. You know,
I had a client earlier today and she said to me,
(28:33):
she only has a cup of tea and a biscuit
because she's not hungry for breakfast, and she doesn't actually
feel hunger until you know, one or two o'clock. So
why does this happen, Leanne? Why may you not be
experiencing hunger?
Speaker 2 (28:44):
Yeah, I've had so many clients say it, and I've honestly,
like hand on hardhead, clients say I haven't been hungry
for fifteen years and I'm like, why are you eating?
Children and babies have this wonderful, like inbuilt ability to
say I'm full or I've enough, or I'm hungry now,
Like it's so funny. I look at Mia like she's
one now and someday she just like the kid smashes food.
(29:06):
I'm like, where are you putting that? And other days
she's just like not interested. You'll pick it up, fling
it off the high chair, like flinging around the room,
and I'm like, did you even eat anything? Like what's
going on? They just have this wonderful in built system
of being, like they know when they're hungry, they know
when they're full, and all babies do. All kids do.
And it's somewhere between growing up, whether it's the destructured
(29:29):
eating times at school, whether it's UNI when a lot
of us will start to get bombarded by a diet culture,
whatever it is. By the time we reach adulthood, most
of us have switched off that ability to know if
we're truly hungry or not. So we're eating because we
woke up. Everybody else is having morning tea at work,
everybody's going for lunch. We're eating it as well. Everybody's
(29:49):
passing around the office chocolates in the afternoon, we're having them.
Then we sit down with the family and we all
have dinner together. So most of us are eating on
the clock and not eating because we're necessarily hungry. So
I think the first thing is to really just take
away all of the snacking, all of the drinks. So
many of us when they say, oh, I'm never really hungry,
I say, well, what are you drinking, And sousie, it's
like two or three massive lattes a day, and that's
(30:13):
like if you're having it on four cream milk, it's
like five hundred calories just going in through coffees alone.
And so I think for a lot of us, we're
drinking our calories. We're having massive cups of teas and
coffees made of milk, maybe with sugar, maybe with syrup
in them. You know, we're having juices, we're having smoothies,
we're having those delicious bubble teas, whatever it might be.
We've got a lot of calories going in from liquid,
(30:34):
so that tends to dapen down our hunger a lot
as well. But I think for most of us it's
the yoyo darting over time, it's a slow weight gain
over time, and for some of us it's a bit
of hormone or even thyroid disruptions as well, which tends
to turn off that switch for the hunger. So yes,
there may be a medical reason why you're not hungry,
or it may just be a metabolic reason where over
(30:56):
time you've slowly gained weight, you're not moving as much
as normal, you're eating too many calories, yet you never
actually feel hungry. So I sort of like to just
scale everything back, get rid of all the drinks, get
rid of all the snacks, and say to my clients,
here's three small, balanced meals. I want you to eat
them even though you're not hungry, but I want you
to eat it, you know, sometime in the morning, sometime
(31:17):
around you know, between eleven and three pm, and another
meal sometime at dinner between sort of four and eight
pm when you feel like that, and it's amazing when
you just like scale back the bulk of food that
they're having. That hunger. It might not return of a night,
but over a couple of weeks, and then clients will
text me and they say, oh my goodness, I woke
up hungry for the first time in ten years, and
it's amazing. So I think for so many of us,
(31:39):
I get it that you don't feel hungry, but there's
still too much food and too many calories going in.
And you might think, well, I barely eat anything, and
that might be true from a volume perspective. You're barely
eating anything, but you're getting those calories in. Whether that's
from liquids like wines every night or large coffees throughout
the day, or whether that's just that you're snacking and
grazing all days. A lot of us are just snacking
(32:01):
versus eating properly balanced meal. So you're having, you know,
just a muffin in the morning, but you didn't know
that that muffin's like four five six hundred calories, Or
you're having a large coffee which is one fifty two
hundred calories as well, So the calories are going in,
yet you're not eating that much. So I think if
we scale it back and build better balanced meals, a
lot of times that hunger does naturally return over time.
(32:22):
So I do want my clients to eat. I do
want them to tune and listen to their hunger, and
hopefully it returns over time. But the combination of upping
the exercise tends to bring back that hunger as well,
because the more you move, the more the body tends
to need a little bit more fuel. Yeah.
Speaker 1 (32:37):
True, And I see it commonly with some hormonal issues
where people will start and it's also habitual, is it
hormones or is it her bit sual where they basically
don't eat for several hours and then they overeat all
night and they don't have a long fast. So it
presents to me all the time, so that the strategy
I have for working through it is I want a
minimum of a twelve hour fast overnight, so I try
(32:59):
and move that that dinner meal earlier. It is a
bit of a reprogramming and try and say right, try
and have the final calories by seven eight pm. Then
if you're not hungry within two hours of waking, which
means if you're up at five by seven or if
you're up at six or seven by nine, you must
have something, and just have something small. So it has
(33:19):
to be a bit of protein and a bit carbohydrate.
And if you're a coffee replacer, so if you're someone
who does the latte, the cappuccino, and then reckons you
don't feel hungry. I want you to actually eat a
proper breakfast, So have the latte or cappuccina, but you
must have it with a slice of toast and protein
or some plain yogat and berries to actually make that
a small meal at three hundred calories. And then I
(33:40):
guarantee you by eleven twelve you'll notice that gurgling this stomach.
So in some cases it may be feeding a little
bit more. In some cases it may be actually forcing
something in to get you moving, but that would be
the premise. And of course try and lighten the overnight
because by the time you have the afternoon snacks, plus
the glass and wine, plus the dinner, plus the tree
eat plus the dessert. You know, sometimes people are eating
(34:02):
six eight thousand calories. That's why you're not working out hungry.
I promise you you cut it back to a three
four hundred calorie meal and be quite strict on that.
You'll notice the difference twelve hours later. So there's a
few easy steps that can easily reprogram it. But you're right,
if you're not losing weight, and you're not hungry in
the morning and not eating until late in the day,
it certainly needs some work to get you burning, because
(34:22):
we're programming on a circadian rhythm and hunger is a
sign that you're burning your food. So no hunger is
not a good sign and we need to.
Speaker 2 (34:29):
Work on it absolutely well.
Speaker 1 (34:30):
That brings us to the end of the Nutrition Couch
for another Sundaily end. If you haven't done so, please
tell all your friends about us, so our numbers continue
to grow and we keep being able to bring you
this content each week, and of course each Wednesday when
we have our product review. We still have our recordings
available on Hormones, gut health and fat loss, as well
as our brand new Supermarket Guide which goes through our
current product favorites that are available at the supermarket and
(34:54):
that's available on the Nutritioncouch dot com. And can I
reveal here we're working on a new one of these
lyan a little of a teaser you can very exciting.
We had so many people enjoy our Supermarket Product Guide
and it's still selling really well, so we know people
love this content that we are working on another cheeky
one which will be out in a few weeks time,
(35:15):
and we'll let you have a little bit of a
think about what that might be. I don't think we
should say what it is. But we've got a new
book in the works that we'll make eating a little
bit easier.
Speaker 2 (35:25):
Getting delicious food a little bit easier.
Speaker 1 (35:27):
So watch this space and have a great week. We
will see you on Wednesday.
Speaker 2 (35:31):
Hatch you guys next week.
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