Scales Mary is 62 and works as a personal assistant in Lancashire. At 5 ft 3 inches tall, Mary weighs 12 stone 2lbs, giving her a Body Mass Index of 31, which officially classes her as obese.
Mary has several health problems including high blood pressure and raised blood cholesterol, both controlled with tablets, and she has an arthritic knee. Despite this, she enjoys playing golf and swimming. She admits to being a 'nibbler' and enjoys chocolate and biscuits as between-meal snacks, and wonders if I can help her improve her diet.
The evidence
Day 1 (week day)
Breakfast
Porridge, tea
Lunch
4 crackerbread, cottage cheese, tomato, coffee
Small mince pie
Evening
Sirloin steak, roasted vegetables, parsnip, carrot, turnip, onion, mushrooms
Chocolate Flake
Bedtime
Hot milk with honey
4 glasses water during day
Day Two (weekend)
Breakfast
Porridge, tea
Mid morning
Coffee/biscuit
Lunch
Roast chicken meal
Apple crumble with custard
Evening
Slimline tonic
Coffee
2 pieces Cheddar and crackers
2 glasses red wine
3 glasses water during day
The Diet Detective reports
Mary's three health problems are all often linked with overweight. Much research shows that if you are overweight or obese, shedding excess pounds will also reduce high blood pressure, high cholesterol and ease pain in the weight-bearing joints. So I recommend that Mary loses enough weight, slowly over the months ahead, to get her BMI down to 27 or 28 - that means a loss of around 1 - 1½ stones.
Sometimes people who are on tablets to control their blood pressure and/or high cholesterol tend to take things a little easy, diet-wise, perhaps under the impression that if medication can 'cure' the problem, it no longer matters what they eat. But the right type of diet can indeed help some people to reduce the amount of medication that they need.
That said, she does eat a lot of fat and saturated fat and little of the types of fat that can help keep cholesterol under control.
I rate Mary's diet 5 and out 10.
Here are my recommendations for Mary
- Try to reduce your daily calorie intake by around 250 a day to lose about half a pound a week. You could do this by, say, removing all visible fat from meat (eg fat band on the steak, skin from the chicken), by limiting red/fatty meat to no more than 3 - 4 times a week (and eat more fish instead) and by having smaller portion sizes of items such as apple crumble and cheese, and by choosing low-fat versions of items such as custard, spread and milk.
- While you do this, increase the amount of fruit and veg that you eat - at the moment you're averaging about 2 - 3 portions a day while 5 - 6 would be good to help with blood pressure and cholesterol. They will help fill you up for few calories. Try to get at least 3 - 4 portions of leafy greens in your diet every week rather than just plumping for root veggies and think about adding some chopped fruit or dried fruit to your porridge.
- Help to reduce the amount of sodium (salt) in your diet, which can help lower blood pressure, by choosing low-salt crackers and don't add salt to your meals.
- As you enjoy snacking, have plenty of easy-to-eat fresh and dried fruit and fresh shelled nuts available to nibble on instead of too many chocolate bars (mostly sugar).
Conclusion
No-one needs to give up their favourite treats in order to have a healthy diet. Mary has been doing quite well but these tips will help her live into a slimmer, fitter old age. As she loses weight and her bad knee, hopefully, improves, she will find herself able to take more exercise which, in turn, will help her keep her weight under control and her heart healthy.