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Healthy eating: Recipes & dietary advice

Grain salad

If you’re stuck for some healthy meal ideas - or need some help getting started, our dietitians can help! 

Here, specialist dietitians from Hounslow and Richmond Community Healthcare NHS Trust present various healthy recipe ideas - along with tips and advice on how to eat well and achieve a balanced, nutritious diet.  

Developing healthy eating habits is not as hard as many people think. The essential steps are to eat mostly foods derived from plants - including vegetables, fruits, whole grains and legumes (beans, peas, lentils) - and to limit highly processed foods.  

Find out more about the trust’s nutrition and dietetics service at:
www.hrch.nhs.uk/nutrition-dietetics 

Vegetables
Blog by Veronica Mitchell, Gastroenterology Dietitian: 


Bowel Cancer Awareness Month takes place throughout April 2017.   Bowel cancer, also known as colorectal cancer affects the large bowel which is made up of the colon and the rectum.  Cancer starts when something goes wrong in the cell and it starts growing uncontrollably to form a tumour. Bowel cancer is the fourth most common cancer in the UK after breast, prostate and lung cancers.  It is also the UK’s second biggest cancer killer due to late diagnosis. 

According to Bowel Cancer UK, 41,200 people are diagnosed with bowel cancer every year in the UK.  More than 9 out of 10 people diagnosed with bowel cancer are aged over 50 years old.  Your risk of developing bowel cancer also increases if you have a strong family history of bowel cancer or you have a genetic condition or bowel condition such as Crohns and ulcerative colitis.

Screening is a way of testing healthy people for early stages of an illness before they get any symptoms.  It aims to detect cancer at an early stage when treatment is more likely to be successful.  In England, Wales and Northern Ireland, people over the age of 60 are invited for screening, whilst in Scotland, screening starts at the age of 50.

Symptoms of bowel cancer can include:

  • Bleeding from your rectum or blood in your stool
  • A persistent change in your bowel habits, lasting 3 weeks or more
  • Abdominal pain or lump in your abdomen
  • Unexplained weight loss or tiredness

However, all is not lost as over 50% of all bowel cancers could be prevented through lifestyle changes such as:

  • Stop smoking
  • Take regular exercises (at least 30 minutes, 5 days of the week)
  • Maintain a healthy weight
  • Eating less red meat and processed meats
  • Increase fibre intake by eating wholegrain foods and at least 5 portions of fruits and vegetables daily
  • Drinking less alcohol (no more than 14 units a week).The less you drink, the lower the risk

Practical dietary tips to include more fruits, vegetables and grains into your diet and reduce your risk of bowel cancer:

  • Choose higher fibre breakfast cereals such as whole oats, shredded wheat or wholewheat cereals
  • Choose wholemeal or granary breads over white bread and go for whole grains such as whole wheat pasta, bulgar wheat or brown rice
  • Eat potatoes with their skin on such as baked potatoes or boiled new potatoes
  • Add pulses like beans, lentils or chickpeas to stews, curries, soups and salads
  • Include plenty of vegetables with your meals either as a side dish or added to sauces, stews or curries
  • Have fresh fruits or dried fruits for dessert
  • Use fruits, vegetables sticks, oatcakes, rye crackers, unsalted nuts, seeds as snacks and use houmous and avocados as dips
Food and drink

Nutrition & Hydration Week (13 – 19 March 2017):
Blog by Veronica Mitchell, Gastroenterology Dietitian

The importance of nutrition and hydration
It is that time of year again when we highlight the need to have good nutrition and to stay well hydrated.  You may wonder why we focus on nutrition and fluids.  It is well documented that over 3 million people in the UK are at risk malnutrition at any one time and the associated cost of malnutrition equates to over £13 billion a year. 

The consequence of malnutrition includes:

  • Increased risk of infection
  • Risk of pressure sores
  • Delayed wound healing
  • Reduced muscle strength
  • Low mood
  • Recurrent and longer hospital stay

Some of the best ways to improve nutrition is through:

  • Eating little and often
  • Fortifying meals by using high calorie foods such as cheese, oil, butter, milk powder and cream
  • Having high calorie snacks such as nuts, crisps, avocados, cheese or hummus on toasts or crackers

Less is known about the prevalence of dehydration especially in the elderly. 

Poor hydration has a negative impact including:

  • Dehydration
  • Tiredness and confusion
  • Constipation
  • Headaches
  • Dry mouth, lips and eyes
  • Urinary tract infections

To improve your hydration, try the following:

  • Aim to drink at least 8 glasses of fluids per day.Any fluids – water, milk, tea, coffee, squash or fruit juice count. Alcohol does not count and will increase dehydration further
  • Most fruits and vegetables have high water content, so have them as part of a healthy snack
  • Have soup as part of your meal


If you feel you need assistance with improving your nutrition, ask your GP to refer you to a dietitian.

Salt image

Salt and hypertension (high blood pressure)
By  Veronica Mitchell, Gastroenterology Dietitian

People often ask me if salt is bad for you.  By now you know my principle of “there is no bad food, just bad diets”!   

Salt, also known as sodium chloride is made up of two parts, sodium and chlorine.  Sodium is an essential nutrient, but the body is unable to produce it naturally.  It has a role in regulating many bodily functions including the transport of oxygen and nutrients.  It also facilitates other functions such as fluid and acid – base balance.  Salt is found naturally in many foods like meat and vegetables.  It is also used in foods to make it more palatable and as a preservative to extend its shelf life. 

The problem is we are consuming too much salt.  In fact we don’t need to add salt to our diet because we could derive all the salt our bodies need from natural sources.  Too much salt in our diet has a negative effect on our health.  It could increase blood pressure and contribute to the risk of stroke and heart disease.  It has also been implicated in increasing the risk of developing osteoporosis, stomach cancer, obesity and kidney problems. 

The current recommended daily salt consumption is no more than 6g, which is about one teaspoon of salt.  However, the average daily intake of salt in the UK is about 8.1g, the equivalent of one and a half teaspoon.  About 75% of our salt intake comes from added salt mainly from processed meat, ready meals, soups, ready – made sauces, breads, cereals, and snacks such as crisps, biscuits and salted nuts. 

There are several strategies you can employ to reduce your salt intake: 

  • Either add salt at the table after you have tasted your food or add a moderate amount of salt during cooking and remove the salt shaker at the table. 
  • Gradually reduce the amount of salt and use more black pepper, herbs and spices to make your food more flavoursome.  Garlic, ginger, chilli, lime and lemon juice are ideal low calorie flavours you could use instead of salt.  Your taste will adapt surprisingly fast! 
  • Try to reduce the amount of processed foods from ready meals and snacks you are eating.  The main foods that are high in salt include salted meats such as bacon, ham, sausages, pate, salami and smoked or tinned fish such as salmon, tuna or pilchard.  Canned foods especially those in brine, packet and instant soups are also high in salt.  In addition, stock cubes, gravy powders or granules as well as condiments like soy sauce, ketchup, mayonnaise and pickles also add to your salt consumption. 
  • Ask in restaurants and takeaways for low salt options or request for salt not to be added. 
  • If you have to rely on ready – made foods, read the food labels and choose the lower salt options. 

Reading food labels could be a bit of a minefield.  Previously, salt was either labelled as such or as sodium.  From December 2014, all food labels will only list salt.  This would make it easier to see and compare how much salt is contained in food products.  So, how much salt is too much?  Below is a practical guideline you can use when reading labels and using the traffic light system of labelling: 

  • Foods high in salt will have more than 1.5g salt per 100g (RED)
  • Foods with moderate amount of salt will have between 0.3g and 1.5g salt per 100g (AMBER)
  • Foods that are low in salt will have 0.3g or less per 100g (GREEN) 

It is important to remember that we don’t often eat foods that are in 100g packages.  So, as a guideline, if you are having ready meals or sandwiches, try to choose those that are less than 1.25g salt per meal.  For individual foods such as soups or sauces, aim for 0.75g salt per serving.

Dietitian, Veronica Mitchell

Blog by Veronica Mitchell, Gastroenterology Dietitian.  

Detox diet for the new year

With a new year upon us, are you inspired to embark on a healthier and more active lifestyle?  Tempted by all the “detox diets” promising to cleanse and help you lose weight?  Do you really need to clear toxic waste from your body and relieve your wallet of your hard earned cash? 

With the popularity of celebrity bloggers and nutrition gurus, detoxing or clean eating has recently been the “go to” solution for the health – conscious public.  However, the idea that by fasting, cutting out food groups such as dairy or  wheat, consuming only fruits & vegetables or taking a range of detox solutions, potions or pills is going to rid your body of toxins and help you lose weight is a total nonsense.   

Juice & medication

There is no scientific evidence to support the need to detox.  Fortunately, our body has its own well – developed system equipped to detoxify and remove toxins and waste products including alcohol, bacteria, chemicals and digestive by products.  The body’s numerous organs including the skin, gut, liver and kidney constantly work hard to break down and eliminate toxins and internal waste products. 

If you wanted to make positive changes to your lifestyle, detoxing is not the answer.  Changing a habit of a lifetime is not easy.  So, it is useful to have a plan.  Start with a SMART goal. 

  • Specific – make a couple of specific goals.  Saying you want to lose weight is quite vague.  Commit to a specific amount of weight you aim to lose such as 5kg or drop to a size 12 dress in 3 months.  Make it a goal that defines precisely where you want to be at the end. 

  • Measurable – include exact amounts or quantities to make it easy to measure your degree of success such as “I will include 1 fruit and 1 vegetable in every meal. 

  • Achievable – make sure that it is possible to attain the goal you have set.  Otherwise, you may lose confidence and give up.  This could be something simple like “I will drink a glass of water before each meal” or “I will walk 10 minutes after dinner every day”.  You could always build up from your initial goal.   

  • Realistic – try to be ambitious and make it challenging to increase motivation, but don’t make it overwhelming as it may set you up for failure.  Your goal should be set high enough that it is realistically achievable.  Instead of saying I will become fully vegetarian.  Your goal may be to have 1 or 2 meat free days a week. 

  • Time specific – a goal is not very useful unless it has a timeframe.  Saying that there is always “tomorrow” is not going to help you achieve your goals.  Committing to a date when you want to have achieved your goals will keep you focused, gives you a sense of urgency and accountability.  Something like, “I will build up from my 10 minute daily walks to a 5km walk once a week by the end of 3 months”. 

Finally, I recently read an interesting study done in the University College, London that said it takes an average of 66 days for health behaviour to become a habit.  That means repeating the health goals you have set every day for just over 2 months.  So, don’t give up just yet.  Make the habit stick and see what happens!

Marinated chiekcn skewers
Dietitian Michelle Jones presents a healthy, nutritious and delicious recipe idea for marinated chicken skewers with couscous.  
 

“This meal is very tasty and is quick and easy to prepare. Served with a fresh salad or frozen or fresh steamed vegetables, it contains all the components of a healthy balanced meal; protein (chicken), carbohydrate (couscous) and vegetables.   It is also low in total and saturated fat which is healthier for your heart and helpful if you want to lose weight.”

Serves 4 

Ingredients:

  • 4 chicken breasts cut into chunks

  • Wooden skewers

  • 2 courgette cut into half-moon chunks

  • 1 red pepper cut into 1 inch squares

  • 4 tablespoons of plain yoghurt

  • 1 tablespoon of garam masala

  • 1 tablespoon of lime/lemon juice

  • Handful of chopped fresh coriander

  • 200g couscous

  • 200ml boiling water with a little vegetables stock added

  • 3 spring onions chopped

Method:

To make the marinade, mix together the yoghurt, garam masala, lime/lemon juice and coriander in a bowl.  Add a little salt and pepper and the chicken pieces.  Marinade for 1 hour in the fridge. 

Place the couscous in a shallow bowl, then pour over 200ml boiling water. Cover the bowl with cling film, then leave for 5 mins until the couscous has swelled up and absorbed all of the water. Ruffle with a fork to separate the grains, then stir through the chopped spring onions. 

Thread the chicken, courgette, red peppers and chicken onto the wooden skewers, and cook on the BBQ or a griddle pan for 7-8 mins each side or until the chicken is thoroughly cooked.

Serve the skewers with the couscous and a salad or steamed vegetables.

Grain salad

Grain salad and the low FODMAP diet for Irritable Bowell Syndrome (IBS)

Dietitian Veronica Mitchell provides a specific diet to help those with troublesome gut problems: 

“Irritable bowel syndrome (IBS) is a tricky condition to treat.  There are 3 common modes of treatment for IBS – diet, drugs or psychological therapy.  A recent innovative dietary treatment for IBS is the low FODMAP (Fermentable Oligosaccharide, Disaccharide, Mono-saccharide and Polyols) diet.  It is an elimination diet that aims to reduce the sugars that trigger IBS symptoms such as abdominal pain, bloating, gas, diarrhoea and others. Studies show the low FODMAP diet is very effective for people with IBS, providing relief from symptoms in around 75% of people who try it. 

"If you are struggling with IBS and would like to follow the low FODMAP diet, please ask your GP to refer you to a dietitian trained to deliver the low FODMAP diet.

“This recipe proves you can eat a healthy balanced diet while adhering to an elimination diet. The meal provides at least 3 of your 5 portions of vegetables a day as well as a portion of dairy, protein and plenty of slow releasing carbohydrates." 

Serves 4 - 6 people 

For the grain salad:  

  • ¼ cup of mixed red and white quinoa

  • ¼ cup of red rice

  • ¼ cup of wild rice

  • ¼ cup of brown basmati rice

  • 1 small aubergine, sliced, roasted & chopped into chunks

  • ½ cup of blanched broccoli

  • ½ orange coloured pepper, cubed

  • ½ yellow coloured pepper, cubed

  • 10 cherry tomatoes, quartered

  • 100g of feta cheese, cubed or crumbled

Method 

Cook all the grains until tender, drain and combine with all the other ingredients including the salad dressing. 

For the salad dressing: 

  • 2 tbsp of garlic infused oil (1 tablespoon if you don’t want a strong garlic flavour)
  • 2 tbsp of lemon juice
  • 1 tsp of brown sugar
  • ½ tsp of grainy mustard
  • salt & pepper to season


Serve the salad with a good helping of green leaves.  Make sure that if you buy a bag of salad leaves, you check that all the ingredients included are low FODMAP.  In this meal I used a packet of babyleaf herb salad.  Although I served it with sliced lamb steak, you could use any protein that you like - such as chicken, beef or fish, lightly pan fried with small amount of pure vegetable oil. 

 

Mediterranean vegetables

Mediterranean vegetables with couscous – the perfect accompaniment for salmon or lamb.

Dietitian Veronica Mitchell presents a healthy recipe idea for Mediterranean vegetables – the perfect accompaniment for salmon or lamb. Serve with couscous.

"If like most people, you have overindulged and enjoyed too many Christmas treats, you will be keen to get back on the healthy eating wagon. 

"Personally, I don’t believe in dieting per se.  It is important to enjoy a variety of foods.  Instead of concentrating on foods you want to limit such as saturated fats, processed, sugary and salty foods, include good fats and watch the portion sizes of foods that provide too many calories without adding much nutrient.  Supersize your meals with plenty of your favourite fruits and vegetables as they add vitamins, minerals and fibre to your diet. 

"I love the Mediterranean style of eating and this is one of my “go to” quick recipe ideas for when I get home from work or the gym.   You could double up the recipe for the Mediterranean vegetables and store in the freezer to be taken out in the morning and reheated when you get home.  It goes well with any protein especially lamb or salmon.

"Serve with flavoured couscous like lemon and coriander from Waitrose or Sainsbury's or brown basmati rice."

Serves 6  

Ingredients 

  • 1 medium red pepper

  • 1 medium yellow pepper

  • 1 medium orange pepper

  • 2 red onions

  • 1 large aubergine

  • 2 large courgettes

  • 2 cloves of garlic, chopped

  • 1 small punnet of cherry tomatoes around 300g

Method

  • Pre-heat oven to 180 degrees
  • Chop the vegetables roughly and drizzle 1 tablespoon of pure vegetable oil
  • Bake in oven for 30 – 35 minutes
  • Remove from the oven and stir in 2 heaped tablespoons of olive and tomato pesto
  • Serve vegetables with salmon, lamb – and a portion of couscous.

 

Dietitian, Veronica Mitchell

Dietitian Veronica Mitchell provides tip son how to enhance 'saiety' - the feeling of fullness - helping you to eat well and keep to a balanced diet. 

"As a dietitian, I try to find ways to eat healthily all year round - whatever the season. In the autumn and winter, I try to think of recipes that incorporate lots of grains and vegetables that will warm my belly and keep me satisfied.   

‘"Satiety’ is the feeling of fullness after eating that will suppress the urge to eat for a period after a meal. This feeling of fullness is the key to controlling the amount of food we eat.  If we are satiated after a meal, we can go much longer before we feel hungry and may eat less at the next meal.   

"Here are some tips I use to enhance my feelings of fullness:

  • Include some form of protein in every meal such as eggs, meat, fish, beans or pulses.
  • Include high fibre foods as they bulk up your meals and enhance the feeling of fullness.
  • Reduce the amount of alcoholic drinks as they provide very little nutritional value, but increase your appetite and calorie intake.
  • Eat foods that contain a lot of water such as fruits and vegetables or have water added to it during cooking such as soups and casseroles."  

See the classic recipe for chicken and corn soup, below, which uses the above principles to help with satiety.

Chicken & corn soup
Dietitian Veronica Mitchell's classic recipe for chicken soup uses the above principles to help with 'satiety' - the feeling of fullness.

 

Chicken & Corn Soup

Serves 4 – 6 as main or 8 as starter.

Ingredients

  • 500g fresh, frozen or tinned sweet corn
  • 3 teaspoons finely grated ginger
  • 2 cloves of garlic, crushed
  • 4 spring onions thinly sliced
  • 1 can of cream styled corn (418g)
  • 2 tablespoons of soy sauce
  • 2 litres (8 cups) chicken stock either from cubes or homemade (add 1 chicken stock cube if homemade)
  • ½ a cup of cooked barley
  • 250g of broccoli florets, blanched
  • 600g of chopped skinless cooked chicken
  • 2 egg whites beaten lightly


Method 

  1. Heat a large non – stick saucepan over medium heat and cook the corn kernels, ginger, garlic and half the spring onions. Stir until fragrant.
  2. Add the creamed corn, soy sauce, barley and stock. Add the chicken.
  3. Reduce the heat, simmer uncovered for 10 minutes.
  4. Gradually stir in the egg whites. Add the blanched broccoli florets.
  5. Serve the soup topped with remaining spring onions.
  6. Season with salt and pepper to taste.


Note – you can boil skinless chicken thighs or on the bone with the barley and reserve the liquid and the barley to use for the stock in the recipe.

Christmas dinner

Dietitian Veronica's advice on how to resist temptation and eat a healthy diet over the festive season! 

"Like most people, I’m excited about Christmas and the festive season, but also dread the excessive amounts of food and alcohol on offer that would derail any healthy eating habits my subconscious is willing me to adhere to.  

"Instead of wrestling with my conscience I have decided to put together what I call my “Christmas Survival Kit”, so I can enjoy the holiday season without feeling guilty.  After all, it only comes once a year!":

  • Start your day with a healthy breakfast to guarantee some goodness already in your system such as porridge or poached eggs on toast.
  • If you are attending the office Christmas lunch/dinner, you will normally have to pre – order your meal. Spend time to choose the healthier options and stick with it. Opt for baked, grilled, steamed and not fried or confit for your main meals.Choose soup, melon or cold meats or fish as a starter and finish with a small plate of cheese with fruit or fruit salad instead of a sugary dessert. Fill your plate with vegetables to reduce the likelihood of wanting dessert. And remember, you don’t have to eat everything on your plate!
  • Use a smaller glass for your alcoholic beverages and try and drink water in between to stay hydrated.Or have white wine spritzers to make the wine last longer. If having spirits, use a low calorie mixer.
  • If going to a buffet style Christmas party, choose a smaller plate to help with portion control. Make sure you fill your plate up with salads and vegetables first, add some proteins such as chicken, smoked salmon or shellfish. Avoid foods coated in pastry such as pork pies, pasties, samosas or sausage rolls and breaded fish or chicken nuggets.
  • Canapes while drinking can add plenty of calories and be easily forgotten. Choose crudités, olives or breadsticks and dip into tomato base dips like salsa or yoghurt base dips like Tzatsiki or baba ganoush. Equally guacamole and houmous are also good choices.
  • If someone else is hosting a party, offer to bring something to add to the feast. This will ensure that there will be something remotely healthy on the table for you to eat.
  • Keep active during the holiday season. Find ways to work off the foods you are about to indulge in by scheduling in some walks whilst the turkey is in the oven or playing some active games like boules, croquet or even charades.  Try to limit the time you spend sitting around watching videos or holiday programmes on TV. 

"Finally, keep things in perspective.  Remember, there is no good or bad food, just bad diets, so enjoy all foods in moderation.  If you ordinarily eat healthily and exercise regularly, don’t beat yourself up by indulging for a small period of time at Christmas.  You will soon be back in your routine and could work off the small amount of weight you may gain over Christmas."

The importance of a balanced diet

 

The Eatwell Guide depicts a healthy, balanced diet, which includes:

  • eating at least 5 portions of a variety of fruit and vegetables every day
  • basing meals on potatoes, bread, rice, pasta or other starchy carbohydrates, ideally wholegrain
  • having some dairy or dairy alternatives (such as soya drinks) choosing lower fat and lower sugar options
  • eating some beans, pulses, fish, eggs, meat and other proteins (including 2 portions of fish every week, one of which should be oily)
  • choosing unsaturated oils and spreads and consuming in small amounts
  • drinking 6 to 8 cups or glasses of fluid a day

 

If consuming foods and drinks high in fat, salt and sugar then have these less often and in small amounts.

A visual guide to heathy eating from Public Health England