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Weight loss takes place when there is a deficit created between the energy intake and energy expenditure.

There are a couple of different routes that can be taken to achieve weight loss but as a dietitian, I would never recommend cutting out entire food groups to achieve this deficit, as this can lead to nutritional deficiencies.

Here are a few dietary patterns that have proven to result in weight loss .

1. Higher protein, moderate-carbohydrate diet

Protein helps to control your appetite. It also helps build muscle which burns more calories at rest. Sources of protein include meat, legumes, fish, eggs and nuts.

When we consume carbohydrates such as bread, rice, potatoes and pasta, the pancreas in response, secretes the insulin hormone which allows the carbohydrates to be used as energy. Excessive intake of carbohydrates causes a surge in the production of the insulin hormone which promotes fat storage. It is also important that the carbohydrates consumed are primarily low GI carbohydrates such as wholegrain bread, fruits and low fat dairy and not processed or refined carbohydrates such as white bread and refined snacks. High GI carbohydrates cause an increase in the blood sugar level which increases the amount of insulin released into the blood. While, low GI carbohydrates have a stable effect on the blood sugar levels and therefore reduce the amount of insulin secreted into the blood ( See article, ‘Carbohydrates are not your enemy’ to learn more about carbohydrates) .

2. Lowering the energy density of the diet.

This involves altering the foods eaten rather than the amount. For example, a big meal with healthier foods may not result in weight gain as a small meal with processed, high fat and high sugared foods would. This is because foods such as fast food, confectionary and cakes have a calorie density of more than 4 calories per gram. In comparison, non-starchy vegetables, broth based soups, cooked grains and legumes have a calorie density of less than 1.5 calories per gram.

Here are a few tips on how-to lower the energy density for each meal:

  • “The plate model” Build your plate to have ½ of non starchy vegetables, ¼ protein, ¼ low GI carbohydrates. Examples of starchy vegetables that should not be included are potatoes, corn, peas, parsnips, sweet potato and yams.
  • Limit sugar and fat. Such as, deep fried foods, soft drinks and high fat dressings.
  • Consume more water and less sweetened beverages.

As you can see from the pictures above, the calories are equal but the energy density from both the meals are different. This means the body will metabolise each meal differently.

On the left, you have a small meal that is high in saturated fat and refined carbohydrates. That can also raise your blood sugar, cholesterol, cause weight gain and make you feel sluggish.

Whereas on the right, you have a meal that contains a greater quantity of food but covering a wide range of food groups (e.g. wholegrain carbohydrates, protein, fruit, vegetables and low fat dairy). The lean meat and wholegrain carbohydrates give you the energy you require and help keep you full for a longer duration of time. The fruit and vegetables provide vitamins, minerals and fibre that allow hormones to work properly and the metabolic process in the body to work efficiently.

3. Intermittent fasting (5:2 Diet)

This involves alternating between eating and fasting. The three common ways of intermittent fasting includes:

  • 16/8 method which involves eating for a period of 8 hours and fasting for 16 hours.
  • The 5:2 diet involves having a normal calorie intake (about 2000 calories) for 5 days and eating between 500-600 calories for 2 days.
  • Fasting an entire day once or twice a week.

Fasting is a common method to reduce calories. Intermittent fasting is an easier version of the traditional method. The other benefits, are that your body may physiologically get used to a lower calorie diet which makes it easier to curb unwanted food cravings.

Contact us for results focused on nutritional advice

This article was written by our dietitian and nutritionist Juhi Bhambhaney.If you have any questions regarding health and nutrition, make an appointment with one of our dietitians. We‘ll provide you with a simple and effective routine targeted to your concerns. Contact us today.

The post Tips on how-to lose weight without extreme diets appeared first on ENT Wellbeing Sydney.

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When visiting a speech pathologist for the first time, as you might guess, one of the first questions your clinician will ask you is what the reason for the visit is. If you are seeing a voice specialist, then most your concern will most likely be due to changes or issue that you have noticed with your voice. Once you have established what your concerns are your speech therapist may then ask you some questions about your voice.

Some examples of questions that your speech therapist may ask include:

  • How often you use your voice (teachers and singers have a lot more chance of vocal strain and fatigue due to the amount of voice use required in their profession)
  • When did you first notice the change in your voice?
  • Do you have any lifestyle or medical concerns that may impact your voice (e.g. mouth breathing, allergies or smoking)

Next, your clinician will assess your voice while you speak and listen out for qualities such as vocal strain, roughness and breathiness.

You may then be asked to complete a number of exercises that assess how long you can produce a sound such as ‘ahh’, your pitch range as well as your volume range. Measures taken during these exercises can help to determine the extent and reason for the changes you may have noticed in your voice.

You may also be asked to fill out a self-rating scale where you will provide feedback about the extent of your voice changes and the impact they have had on your daily life. All of these measures serve as a baseline to measure change against, once you have completed therapy.

After the assessment has been completed, your therapist will provide you with the results, which will include a diagnosis and education about the likely causes of the diagnosis. You should also be provided with education about how to improve your voice such as through voice therapy exercises or vocal hygiene recommendation. Each diagnosis is different and based on the individuals presenting symptoms which guide the type of therapy provided. For this reason, it is essential that your voice be assessed properly by a qualifies voice therapist prior to commencing therapy.

Contact us for results focused on speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have questions about language activities, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post What to expect in an initial voice therapy session appeared first on ENT Wellbeing Sydney.

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Lymphadenopathy is caused by an infection that occurs in one or more of the lymph nodes in the neck. This common childhood infection occurs in up to 45% of healthy children, and up to 90% of those aged four to eight years. The initial symptoms are swollen lymph nodes in the neck, which may or may not be tender depending on the cause.

Causes of cervical lymphadenopathy are usually viral or bacterial infection, which can include:

  • Adenoid and tonsil infection
  • Respiratory infections
  • Rhinovirus
  • Otitis media
  • Epstein-Barr
  • Infectious mononucleosis
  • Streptococcus
  • Staphylococcus

There are also other more serious infections that can cause swelling in the cervical lymph nodes. However they are rare. They include:

  • Tuberculosis
  • Lymphoma
  • Fungal Infections

If your child is sick, the virus or bacteria can travel to the lymph nodes via the lymphatic system. The swelling and tenderness is the result of an inflammatory reaction that occurs when the body is trying to fight off an illness or infection.

Duration of cervical lymphadenopathy

The swollen lymph nodes in your child’s neck may be classified based on how long the problem lasts. This may be acute, sub-acute or chronic. An acute condition can be defined by a short, often < 1 month duration. This usually responds well to therapy with return to normal health. Subacute is defined as within the interval between acute and chronic, so from one to three months time. A chronic condition is one that lasts 3 months or more.

Diagnosis

The diagnosis of lymphadenopathy requires a few different steps to determine the actual cause of the problem. You will need to provide a medical history for your child, as well as allow a physical exam of the head and neck area, and other areas as needed.

History

When you take your child to the doctor, you will need to be able to answer any questions concerning recent illnesses, ear nose or throat infections, insect bites, or tooth infections/abscesses. The doctor will also ask if your child is currently ill, or if they seem lethargic and fatigued. You should also tell the doctor if your child is taking any medications, or if they have recently had any immunisations.

Examination

The doctor will begin by palpating the swollen lymph nodes to see how large they are, whether they are tender to the touch, whether they move around, and whether they are soft or hard. He or she will also check for a fever or other signs of illness such as a rash or high temperature. The doctor will also assess the lungs and abdomen in the exam to make sure there is not an illness present that is affecting other organ systems. A neck ultrasound scan may also be needed.

Treatment

In most cases, acute cervical lymphadenopathy does not require immediate treatment, unless there are other signs or symptoms that a bacterial infection is present. If your child is suffering from a bacterial infection, he or she will be placed on antibiotics to treat the illness. If there are no other illnesses present, the doctor will simply keep an eye on the swollen lymph nodes to see if they change or go away on their own.

In cases where the swelling does not go away over time, the doctor may decide to run imaging tests or use a small needle to collect a sample of fluid from the node for further testing. In severe, longer-term cases, an ENT doctor may recommend excision of the nodes for formal diagnosis by pathology – this would only be performed if absolutely necessary.

Outcomes

In most cases, cervical lymphadenopathy in children is a benign condition. Those suffering from benign lymphadenopathy will generally see improvement within two weeks, depending on the cause. Uncommonly there are situations where the swelling may be due to malignancy. In all situations the best course of action to ensure thorough assessment by your doctor, with specialist referral to an ENT surgeon or paediatrician where needed. Follow your doctor’s advice, and make sure to keep all follow up appointments until the issue is resolved.

The post Cervical Lymphadenopathy in Children appeared first on ENT Clinic Sydney.

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There many possible areas of difficulty that lead to a literacy delay, and while this should not be taken as an exhaustive list, here are some of the most likely possibilities that would affect a child’s literacy development, specifically with reading.

Poor letter to sound correspondence

This one is the most obvious and is often easily picked up at school, however not as easily rectified. Understanding the link between the letters and their paired sounds or letter to sound correspondence is common in individuals with dyslexia. For these individuals, it takes a lot more intervention that the amount provided at school. For these children especially, specialised techniques such as The Spalding Program are recommended.

Poor phonological awareness

Phonological awareness refers to the representation of sounds in our brain and the ability to manipulate these sounds. For example, in the word ‘CLAP’, there are 4 sounds the ‘C’, ‘L’, ‘A’ and ‘P’. For a child with poor phonological awareness, it may be hard to distinguish the ‘CL’ cluster into two different sounds and therefore they may leave of one sound and instead read the word as CAP instead. For these children, phonological awareness training is recommended to improve their ability to read and spell a range of word types.

Poor verbal comprehension

When reading a passage, a child is expected to not only decode (sound out individual sounds to make a word) but also string each word together to understand a sentence, which they must then tie together to understand the story in its entirety. Underpinning all of this is the child’s ability to understand verbal language. This is because if a child is not able to understand a spoken passage then even if they are able to decode the symbols into the words and sentences, if they are unable to process these words and sentences, then they cannot decipher meaning from it. For these children we recommend specific receptive language therapy, depending on the level where understanding has broken down.

These are some of the areas a speech pathologist assesses, in order to determine the individuals area of weakness. This allows us to provide the correct intervention that will have the greatest benefit for literacy development.

Contact us for results focused on speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have questions about language activities, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post Possible causes for literacy delays – Part 1: Reading appeared first on ENT Wellbeing Sydney.

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There many possible areas of difficulty that lead to a literacy delay, and while this should not be taken as an exhaustive list, here are some of the most likely possibilities that would affect a child’s literacy development, specifically with reading.

Poor letter to sound correspondence

This one is the most obvious and is often easily picked up at school, however not as easily rectified. Understanding the link between the letters and their paired sounds or letter to sound correspondence is common in individuals with dyslexia. For these individuals, it takes a lot more intervention that the amount provided at school. For these children especially, specialised techniques such as The Spalding Program are recommended.

Poor phonological awareness

Phonological awareness refers to the representation of sounds in our brain and the ability to manipulate these sounds. For example, in the word ‘CLAP’, there are 4 sounds the ‘C’, ‘L’, ‘A’ and ‘P’. For a child with poor phonological awareness, it may be hard to distinguish the ‘CL’ cluster into two different sounds and therefore they may leave of one sound and instead read the word as CAP instead. For these children, phonological awareness training is recommended to improve their ability to read and spell a range of word types.

Poor verbal comprehension

When reading a passage, a child is expected to not only decode (sound out individual sounds to make a word) but also string each word together to understand a sentence, which they must then tie together to understand the story in its entirety. Underpinning all of this is the child’s ability to understand verbal language. This is because if a child is not able to understand a spoken passage then even if they are able to decode the symbols into the words and sentences, if they are unable to process these words and sentences, then they cannot decipher meaning from it. For these children we recommend specific receptive language therapy, depending on the level where understanding has broken down.

These are some of the areas a speech pathologist assesses, in order to determine the individuals area of weakness. This allows us to provide the correct intervention that will have the greatest benefit for literacy development.

Contact us for results focused on speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have questions about language activities, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post Possible causes for literacy delays – Part 1: Reading appeared first on ENT Wellbeing Sydney.

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