LEC Nutrition is the private practice of Laura Clark, Registered Dietitian and Sports Nutritionist. Through consultations and other nutrition services Laura educates, motivates and inspires people to lead healthy, balanced lives.
Dairy free living is gaining in popularity with the supermarket aisles making room for many plant-based alternatives to milk. Undoubtedly beneficial to the planet but what about from a nutritional perspective when there are many mouths to feed?
You may have a child with a diagnosed cow’s milk protein allergy or lactose intolerance and be under a healthcare professional*. Or as a parent you may suffer with irritable bowel syndrome or have a sensitivity to dairy for another reason. Or dairy alternatives may have simply caught your eye and you’re wondering where they fit in. Let’s take a look.
A glass of milk is a source of protein, calcium, potassium, phosphorus, iodine, vitamin B2, B1 and B12. So, you’re basically drinking the periodic table! A 200mls glass (or much-needed latte) provides around 30% of our calcium for the day. Interestingly this same glass will provide 40% of our iodine needs. Iodine makes our thyroid hormones which regulate our metabolism and growth. So, it’s vital for children and adults alike and worryingly, iodine deficiency has re-emerged in the UK with 15% of potentially impressionable teenagers not meeting their requirements. Pregnant women are also susceptible as needs are higher.
Plant based alternatives will usually be fortified with B2, B12, vitamin D and calcium which is great. It’s worth knowing that organic varieties cannot legally be fortified. The calcium present won’t be as available to the body so keep in mind other calcium sources in the diet – pulses and lentils, dried apricots, fortified breakfast cereals and dark green leafy vegetables, tinned fish with edible bones and of course animal dairy products if appropriate.
So, the main differences between dairy and plant-based options lie in the iodine contents, bone minerals such as phosphorus and of course protein and calorie contents. Vegans in particular need to be conscious of iodine and may benefit from a supplement, as the other main iodine source in the diet is white fish.
Protein quality is lower with plant-based milk – soya milk is the most similar to cow’s milk in terms of protein and is similar in calories to semi-skimmed milk. Sweetened varieties will have added sugar though so watch out for this.
Almond milk has become very popular although it is more of a nut water than a milk as the content of actual nuts can be as little as 2%. Protein contents are very low (0.4g/ 100g compared to 3.3g for cow’s milk). This isn’t ideal at breakfast time, where protein can play a vital role in regulating blood sugar levels and keeping you full for longer. It’s a tasty milk for flavour but I would be cautious to give this and other nut milks as a main milk drink for young children as milk is a major energy and protein source in their diets.
Rice milk is also lacking in protein and should not be given to children under 5 years of age due to its arsenic levels.
Oat milk fairs slightly better for protein and is suitable as a main milk drink aged 2 and over. It is also useful for parents with high cholesterol as it contains a third of your beta-glucan requirements which has been shown to reduce cholesterol levels.
Plant based milks are naturally lactose free so can be a good alternative for those with lactose intolerance but there are also lactose-free cow’s milk alternatives available. 1 in 20 people may suffer from lactose intolerance due to not having enough of the enzyme lactase to break it down. Undigested lactose passes into the large bowel where it becomes food for our trillions of bacteria and as they merrily digest away they release gas causing wind, bloating and diarrhoea. In IBS, lactose can contribute to the symptoms caused by other fermentable carbs in the diet (known as fodmaps) but in many cases is not the culprit at all so it’s worth seeking advice from a registered dietitian if you have IBS.
Milk purchase checklist
Double check plant-based milk is fortified.
Consider whose drinking it and therefore the importance of energy and protein contents. For comparison semi -skimmed cow’s milk contains 46 calories and 3.5g per 100mls.
Children need 2-3 serves of dairy or suitable plant-based alternatives per day.
Remember plant-based milks are not nutritionally superior but can provide a balanced nutritious addition to the diet whatever your reasons for choosing.
*The information in this article is designed for general family advice and is not intended to replace the advice given by your specialist team. Most children with diagnosed milk protein allergy or lactose intolerance will remain on specialist milks until at least 2 years of age.
I have adapted these from the Sainsbury’s website in my quest to get more fibre in!
2 cups of flour (1 plain, 1 wholemeal flour) or 175g and do a mixture of flours for added health benefits
1 tbsp granulated sugar
1 tsp baking powder
¼ tsp bicarbonate of soda
Carton of buttermilk (300mls)
1 medium egg
25g unsalted butter, melted and cooled
100g spinach whizzed up or use frozen with excess water squeezed out
Olive oil for frying
I’ve also experimented with other veg too alongside the spinach – grated carrot and courgette seemed to work well and I use a mini food processor to cut down on preparation time.
Combine the flour, sugar, baking powder and bicarb of soda in a bowl.
In another bowl or jug mix buttermilk, egg and melted butter.
Mix it all well together – add a dash of water if mixture is too thick.
Heat oil in large frying pan. Place dollops of mixture about 7.5cm in diameter and cook for about 2 mins on each side until golden.
Making a meal of it
These go well with some added protein like cubes of cheese such as cheddar or mozzarella, slices of meat such as ham or chicken or baked beans (choose reduced salt, reduced sugar). Alternatively you could spread cream cheese onto the pancake itself.
You could also try making a large pancakes and rolling it like a wrap with filling inside. I’ve haven’t managed to flip this size successfully yet though!
You could also add some carrot sticks or tomatoes or a corn on the cob.
Cheese and Spinach Muffins
This is an adapted recipe from numerous tried over the years. In my opinion it balances the faff factor with a positive outcome i.e. the bit of effort I put in is worth it because they do get eaten.
125g grated cheese (I use cheddar)
225g wholemeal self- raising flour (I’ve built up to this – for a lighter perhaps more acceptable muffin to the taster use white self- raising or half and half.
½ tsp baking powder
175mls semi-skimmed milk
50mls olive oil
60-75g spinach (3 blocks if frozen) – defrost and squeeze out excess water.
1 small courgette
If you were feeling really brave you could throw in a handful of oats too.
Mix the dry ingredients
Mix the wet ingredients in a separate bowl or jug.
Combine together adding the wet ingredients bit by bit and stir well.
Bake 20-25 mins at 180 degrees.
Remember any veg are worth trying – I tried a cup of butternut squash which had been roasted. That got picked out so I haven’t done it since. I’ve also been known to try whizzed up kale – not because its a so called ‘Superfood’ but because texture wise its very similar to lots of other veg when its whizzed. I got away with it…
I’m not even sure my husband really gets what I actually do, let alone the people hitting google in search of nutrition advice so thought it might be helpful to explain.
Historically, dietitians seem synonymous with diet plans – strict calculated plans telling you what to eat along with a wagging finger if you dare stray from it. At social events, people eat nervously around us, show horror when we tuck into a brownie and frequently ask us to ‘put them on a diet’.
The images of dietitians on google are quite frankly horrifying – we seem to have clipboards, stethoscopes round our necks and are surrounded by mounds of fruit. Oh lordy, I would not want to see her.
So who are dietitians? And what do we do if it’s not this?
Well firstly we have studied in a faculty of biomedical sciences so we like the science bit…
The science of nutrition is ever evolving – it’s a very young science compared to medicine with new research contributing new parts of the jigsaw puzzle all the time. There’s a huge amount we do know but people who make it out to be very black and white don’t know the half of it. The correct interpretation of research is key and combining results from different places to draw conclusions is helpful – one study will not hold the ‘secret’ (despite what the newspaper headline says).
Of course food can’t be tested in the same way as new drugs. It’s harder to blind people to what they’re being given (especially out of a lab in the real world). There are also a huge number of variables – from food-gene interactions, to the hundreds of hormones which govern appetite and metabolism. We also know how nutrients interact with each other at a cellular level is different to how they respond when you stick them in a test tube and watch them through safety specs. And of course when testing things on free living individuals there are other factors to consider such as everything else that influences our food choices, from our environments, to our upbringings to our moods.
The psychology of our food behaviours and choices is massive and behavioural science research and how it relates to what we put in our mouths is really interesting and evolving.
So come on, what do I do?
Well, firstly I bring the science to life and make it relevant for the individual. It’s not about broad public health recommendations or what the tabloid reckons we should ‘all’ do. It’s about you and what’s going to fit with you. Pulling together all of the factors which influence your food choices and of course your nutritional needs. If I assumed you were 2 dimensional I might be persuaded that an off the shelf diet plan taking the control out of your hands and dictating your every food decision might work.
But in reality life is more varied and often throws curve balls. I am interested in what’s sustainable and what facilitates you to have a happy, healthy relationship with food to give symptom improvement, or help you achieve that health or well-being goal.
Of course we talk food, and meal plans designed together can come to life with meal ideas, guidance on balance and portions, snack options, or a hunt through the online supermarket shelves to shed light on ideal choices for your shopping basket. I want you to feel empowered to make the right choices for you, not over whelmed by conflicting information and stuff that doesn’t make sense. It may be appropriate to talk body composition, or to delve deeper into your thoughts around food. Other professionals may come in handy if different expertise is required.
The role of blood tests
Yes, often these may form part of the picture and such tests may be carried out by your GP or at your own instigation through blood testing companies. It is important though to consider what is clinically relevant to test when assessing the value of blood tests.
The role of supplements
At times there may be a need for a particular supplement if your diet can not supply the necessary nutrient you need. But my priority is considering what is at the very core of your nutritional needs and how this can be achieved primarily through food, not to sell you supplements and big promises that aren’t stacked up with evidence.
The role of genetic testing
An exciting development in nutrigenomics – what do our genes indicate we should do differently diet wise? We’re some way off this being as specific and therefore as useful as it might first appear to be but that time will come. Meanwhile if a look beneath the surface is of interest to, it may help to form part of your motivation to make lifestyle changes.
So when working with you on a one to one basis think of me like a food coach – on your side and working holistically with you to get the best outcome. Besides dietitian sounds so strict and I have no idea what to do with a stethoscope!
P.s. This is what I do on a one to one basis. I do other stuff too, from workshops, to working with brands, to vlogging with my 4 year old. And today I filmed a programme for the BBC with Ainsley Harriott!
I am a really good dinner guest, honest! I don’t take my work home with me, and consider myself to have a very normal attitude to food. I enjoy all things – healthy or otherwise. I don’t get preachy about nutrition most of the time but if you serve me the following I reserve the right to give you my evidence based, matter of fact opinion with a smile!
This has been cruising on a wave for quite some time and despite a barrage of evidence the wave doesn’t seem to be crashing. Fact: if we decrease our saturated fat intake and substitute for polyunsaturates and monounsaturates we will reduce our risk of high cholesterol and heart disease. Coconut oil is full of saturated fat -13g per tablespoon to be precise (which is 65% of our recommended maximum intake) and unlike the saturated fat in dairy which has been shown to have a protective effect, this is not the case for coconut oil. I’d rather my saturated fat quota go on something else and stick to rapeseed or olive oils – these are stable when heated and boost healthy fats in the diet.
A detox antioxidant juice
Firstly I am not on a dialysis machine – my liver and kidneys are working fine, I’m detoxing all the time even as I type this, I am that good at multi- tasking. Secondly, antioxidants are indeed very powerful but as yet we cannot demonstrate that higher levels taken in the form of a drink translate into higher levels at cellular level where all the magic actually happens. Nutrient- nutrient reactions within foods are very complex and this is where there are gains to be made. Isolating one of thousands of disease fighting compounds, sticking it in a drink and charging £4 for it doesn’t unfortunately improve our health.
48% of people attribute weight gain to carbs and this has led to a rise in ‘fake carbs’. I’m not against noodling my courgettes or whizzing up my cauliflower – we don’t have to eat carb at every meal in order to be healthy but if we’re deliberately avoiding them because we think they’re bad for us I think that is misguided. Wholegrain carbs help us to meet our fibre requirements – I don’t utilise this fibre of course – my bacteria do. You’re feeding all trillion of them as well as me! Wholegrains lower risk of diabetes, support healthy weight management and help me feel full so I don’t snack endlessly between meals. I should be eating 2-3 serves a day so if they’re missing at dinner I won’t hit the target.
Broccoli is a staple in my household and thanks to the online food order, it’s common to buy the same veg week in, week out. That’s not what my bacteria like though. To keep them healthy and diverse they like lots of variety. Gut health experts recommend we aim for 20 different fruits and veg per week. So come on help me out…
Why am I so bothered about my bacteria? Well 70% of my immune system is in my gut – there’s more of them than there is me (in cells) and they are really powerful in regulating my appetite, protecting my health and lowering my disease risk.
Chia seed pudding
As you may have seen in my vlogging series with my son Sam, seeds aren’t popular with all the family. I love them though, sprinkling them onto salads and into stir fries really does boost my micronutrient intake but in a pudding I’m just not convinced. With puddings for me it’s all about the taste. If it’s gluten or dairy free I couldn’t care less because this doesn’t define its healthiness. Some puddings we know full well are loaded with fat and sugar but this doesn’t mean we shouldn’t eat them occassionally. I don’t come to your house very often, so let’s have a small portion and savour every mouthful (perhaps with some berries on the side)?
I feel confident now that those invitations will come flooding in!
Nutrition is always an interesting subject to talk about with the older generation for many reasons.
Our nutrition knowledge has come on in leaps and bounds in the last 20- 30 years. When I was a child we didn’t know as much about nutrition as we do now and maybe with all the controversy and eating problems that arise from scrutinising our every mouthful that was no bad thing.
However, we do know so much more now and we can and should use this to our advantage.
Nutrition in the older generation doesn’t get talked about as much on social media – perhaps because they’re not as vocal as others are. Nevertheless as our longevity improves, nutrition will continue to play a vital role in our healthy aging and it pays to get it right.
Food availability and dietary traditions were different ‘in the olden days’. When you first give solid food to your baby there’s often a relative in the wings marvelling at the variety of foods around these days, baulking at all the equipment we have access to or itching to impart their own special remedy to settle your little one in seconds (apparently).
When we talk about the older generation those aged 60 and over can find the whole thing rather patronising – I have just spent the first half of the Easter holidays with a group of 60 somethings who have far more stamina than me that’s for sure. But as the decades roll on, the composition of our body undeniably changes and with it comes different nutritional needs. Today I wanted to put the spotlight on protein and flag to Grandma that ‘just having a bit of toast’ at any meal of the day might not be a good idea…
Protein requirements increase as we get older due to age related sarcopenia. Basically this means our muscle mass declines with age which reduces strength, function and flexibility and increases risk of falls and fractures and loss of physical function generally. To combat this loss, Grandma needs to include adequate protein in the diet and if she can keep as active as possible this will increase the preservation of muscle mass further.
To eat enough protein in a way which is of most use to the body it should be included at every meal and as I’ve yet to find a protein fortified marmalade, breakfast definitely has a gaping hole. It’s not just breakfast though – tomato soups, apple on toast, even marmite won’t support these higher protein needs.
Good options at breakfast would be eggs in any form, Greek yoghurts which are traditionally higher in protein, milky drinks as well as the usual meat, fishes and pulses at other meals.
Snacks also provide a valuable opportunity to top up on intakes – peanut butter, cheese, nuts and seeds. Sometimes it’s simple swaps that can make all the difference. Seeded bread will have slightly more protein for example, and mixed nuts would provide a useful afternoon snack. Pulses and lentils should be used in soups and skimmed milk powder can be used to give a protein boost to a wide variety of foods and drinks include milk itself.
It’s also important to keep going with the sunshine vitamin. We are coming into the season where our bodies can begin to make enough vitamin D through the action of the sun’s rays on our skin and the general population no longer needs a supplement but this is not the case for older people. 10 micrograms per day as a supplement should continue for those over 65 as their skin isn’t as efficient at converting it, and daily routines may mean less time outdoors. Vitamin D preserves muscle strength and functional ability especially in older people so is a really important part of the puzzle.
Vitamin D don’t necessarily need to be accompanied with calcium though if the diet contains good sources and they haven’t been identified as in need of additional calcium for bone density reasons.
Please help spread the word to all the Grandma’s and Granddad’s out there!
P.s. My recent appearance on Holding Back the Years got me thinking about nutrition and the older generation. here’s my behind the scenes chat with good old Ainsley!
When it comes to feeding my children, I sometimes feel like I spend much of my time stuck between a rock and a hard place. The rock is the wealth of nutrition knowledge I have at my finger tips and the hard place is the children and that kitchen table EVERY SINGLE DAY.
So I cast the net wide and quizzed my dietitian friends on the other side of the world – this can’t just be an issue in London, England. Hell no, there must be rocks and hard places in kitchens everywhere and I want to cheer myself up! I wondered what is there go to meal when pushed for time and what nutrition gem will they continue to plug no matter what resistance they come against? Let’s find out.
Quick meals that work
With a quick and easy cheese sauce you can really go places. Mix with tuna and veg or any fish that you want to try. Vary the pasta shapes and types of veg used and use it as an opportunity to throw some pulses in too. Fry some onion and garlic (which you could blitz first) or use frozen garlic. Cook the pasta and steam veg above it, make the sauce, throw together with veg and fish (cook first or take from a tin already cooked) and a tin of mixed pulses. A teaspoon of oregano works well too. Scatter with cheese and bake for around 20 mins.
Or the sauce can be more tomato based – using a tin of chopped tomatoes and little puree instead of making a cheese sauce.
The bake works for Catherine and her lively son in Australia
Use roast leftovers or pan fry some chicken pieces.
Toss carrot sticks, pepper sticks, sugar snap peas, peas, sweetcorn (frozen) broccoli – any veg you fancy with a little nut oil for flavour. Keep veg raw if preferred.
Serve with drizzle of reduced salt soya sauce and honey (allow them to self- pour from an egg cup if this aids compliance) Add wholewheat noodles (mine can’t taste the difference) or rice.
Could also put some chicken pieces on a skewer – marinade in the honey and soya sauce and then grill turning until done. If it’s on a skewer it is somehow more ‘fun’ – whatever.
The stir fry works well for Claire and Laura and their clans in South Africa
Taco self- serve
Choose you meat – chicken leftovers, turkey mince, beef mince. Pick your pulse: red kidney beans, black beans, decide on your crunch: red peppers, carrots, lettuce, cucumber, spinach, shredded beetroot, tomato, avocado, top with low fat sour cream, crème fraiche or natural/ greek yoghurt or tzatziki and grated cheese.
This one was a top choice and took on various forms for Jenny in America, Catherine in Australia and Jess in Dubai. A global hit!
The simple chicken curry
Definitely a chicken theme forming here! Fry an onion (likely mine would pull it out but worth it for flavour!) Add a tsp turmeric and a couple tsps of mild curry powder, reduced salt stock and a little cornflour to thicken to chicken leftovers or pan fried pieces. Allow the sauce to bubble and thicken before adding around 100mls low fat cream. This mild flavoursome sauce helps plenty of steamed veg on the side slide down alongside some rice.
This works for all 4 children in Lindy’s crazy household, Australia.
Frittata – don’t underestimate the nutritional value of an egg!
Great for Monday after a roast dinner. Use leftover potatoes and veg (make extra to guarantee useful leftovers for the pain of a Monday night). Stir fry them up in a little oil and add about 6 eggs – allow to set, sprinkle with grated cheese and put under the grill until bubbling and cooked on top. Also scrambled egg withfrozen spinach mixed in with a slice of toast is probably one of the most nutritious meals I manage to get into Sam.
Prawn pasta (my masterpiece)!
Cook some wholewheat or white with added fibre pasta. Take frozen prawns which are quick to defrost under a tap. Heat them through by stir frying with some garlic and ginger paste or just butter/ oil if preferred. Defrost 1-2 cubes frozen spinach and mix together with a little crème fraiche and a squeeze of lemon juice if feeling fancy.
Variations: Could use any fish it doesn’t have to be prawns.
So as I say this one is mine, the day they first tried prawns and liked them I wept tears of joy I think.
What we continue to make our mission
Oily fish – Definitely get them on a supplement if they’re not keen on fish. Interestingly not many of our quick go to meals were fish based so need to work on that for next time!
Pulses – feeding them, feeding their bacteria, providing protein, fibre and iron. Keep throwing them in. They may pick them out and try flicking them in their sister’s eye but keep on giving them.
Water – keep normalising it because drinks don’t have to taste sweet, liquid calories do not turn on appetite regulation and because there’s not much juice that can be consumed before it doesn’t count towards fruit and veg targets.
Normalise – this is what healthy looks like, it’s important to feed our bodies the stuff it needs to make it grow and glow and give context to the treat foods. This is what we’re all doing little Jonny, join in if you fancy because the world (no matter which corner of it) doesn’t revolve around you (theoretically).
Hopefully this post has shown that even for dietitians, meals aren’t particularly ground breaking or fancy but that key health eating messages can still come through under time pressure. Thanks for the inspiration and reassurance ladies! For more advice to keep you sane you could always check out my 7 habits of highly nutritious parenting!