‘Pie hole’, colloquial for one’s mouth, is believed to have evolved in the USA in the 1980s from the British expression ‘cake hole’ (coined in the mid 20th century). Pie hole refers to a mouth, as in: shut your pie hole or, in this case: put less in your pie hole.

Thursday, August 14, 2014

Food Adventures of Costa Rica

"Globesity": the term used to describe the predominance of obesity throughout the world. No longer only a #FirstWorldProblem, but something far reaching to all corners of the globe. Here are my experiences from a recent adventure through Costa Rica as both a foodie and dietitian.

Selfie in San Jose, Costa Rica
But first, let me take a selfie... And give some background stats: In Costa Rica, 60% of women aged 24-45 are overweight or obese, compared to only 2% in 1982. Women 45-64 have an incidence of obesity 128 times greater than in 1982. Overall, 62% of women and 60% of men are overweight or obese.

In the USA as of 2011-12, 69% of adults were overweight or obese. Australia is in hot pursuit with around 63% of adults overweight or obese in 2011-12. The life expectancy in Costa Rica is almost 78 years, which is about the same as the US. Australians are living an average of 82 years.
Sodas and fruit markets in San Jose, Costa Rica
But back to Costa Rica: The traditional 'soda' (small market-style eatery) was typically empty. Instead, urban Ticos were swarming American fast food stores like Mc Donald's, Pizza Hut, Quizznos, Wendy's, Subway and KFC. The interesting aspect of this is many menu items adapt to embrace local food culture, for example a KFC plate often comes with beans, rice and plantains (see below).

How the menus change.
In all our previous travels, we live by a couple of simple rules:
  1. Eat street food where there's a line
  2. Eat where the locals eat
Fast Food in Costa Rica
If we had done this in CR, we would have found ourselves dining on Mc Donald's ice creams, KFC, burgers, hot dogs and pizza. Needless to say, we're not the type who travel abroad to eat low-quality American food.
Daily rain in Costa Rica

CR produces and grows so many beautiful fruits and vegetables- it's hard not to given it rains daily. Yet, the majority of meals comprise mostly of (oily) starches and meat with a small side of shredded cabbage salad or stir fried veg.

We definitely got the feeling that urban Ticos love desserts. Pretty much every block in downtown San Jose and Herradura was home to numerous Panaderias (bakeries) and lots of advertising for desserts like ice cream, cakes and pastries.

Because I love sweets and admiring beautiful cakes and desserts, I stopped at many of them to look (and sample) some of the sweet, flaky offerings (which were quite delicious). The dietitian part of my brain immediately noticed the absence of whole wheat or whole grain bread- something worth mentioning.
Cakes, dulce de leche/crema pastries, meat pastries, bread
Fruit on the other hand, was everywhere. Fruit venders were all over the San Jose streets, at bus stations (even the rural ones) and most meals we ate included fruit. This was rambutan season (a Malaysian fruit related to the lychee). We pretty much bought a bag of them everywhere we traveled.
In terms of traditional Costa Rican fair, here's the best of our food porn pictures:
A collection of fish, fried yucca/plantains, vegetables, meat and rice.
To me, the picture below best captures the cycle of obesity we saw in CR and is also the unfortunate truth for most of the world: The unhealthy habits of parents, often from outside influences like persistent advertising of convenient food, transferring through the generations.
Costa Rica is a wonderful, lush, beautiful country. This article only focuses on our food experiences, not all the other tremendous encounters we were fortunate enough to experience.
Beautiful countryside in Costa Rica
And finally, it wouldn't be a proper trip without a couple of circus pictures:

Wednesday, July 30, 2014

Revelations of a Food Diary

Pie Hole devotees will have noticed that we've been on a hiatus of sorts the last few weeks. The good news is, we're back. Pie Hole rarely does personal pieces, but today a partially personal piece has a particularly powerful appeal...

Recently I started a new job as a nutrition professor at a community college. I've tremendously enjoyed my first semester of students and the opportunity to impart some of my nutrition knowledge and, more importantly, passion. Don't think I've frightened anyone off yet... But there's always next semester!

So, you think your diet is healthy? You think you're getting enough omega 3 fatty acids? What about calcium? Iron? Fiber? Well sure, you have a bowl of cereal with milk for breakfast. Your cereal should tick the fiber box, milk should tick the calcium box, if the cereal is fortified it might even tick the iron box. But chances are, no, you're not meeting your needs.

Many of my students, intelligent people with an interest in nutrition, found they weren't meeting theirs. And to almost all of them, this was a revelation.

Their major project was a 3-day food diary analysis. The students had to accurately enter portion sizes for meals and beverages into food analysis software. They then analysed it to see how their diet met individual macro and micronutrients requirements... A classic nutrition project and a rite of passage.

Many students commented that it was difficult and time-consuming to keep accurate records: Welcome to life as a nutrition professional. A majority of students expressed one of two revelations: 
  1. They thought their diet was healthier than it was
  2. They often didn't pay attention to what they were eating
There's a lot of research that shows keeping a food diary helps improve diet and also aids with weight loss and maintenance (1, 2, 3, 4). Diaries make people accountable for what they put in their pie holes. They're an easy and inexpensive way to track eating patterns, portion sizes and they support intuitive/mindful eating. You may realise your diary is turning into a chocolate love letter or a deranged multivitamin mantra... The latter being the ultimate evil.

 Basically it boils down to this:
  • Thinking your diet is healthy doesn't make it so
  • When you track your intake, you're forced to actually think about what and how much you're eating
  • Analysing the nutrient data to see if your supposedly 'healthy' diet is actually healthy and meeting your macro and micronutrient needs is the best way to be sure
Guesstimates, wishful thinking and reading an article in Cosmo about multivitamins doesn't make your diet healthy. It also doesn't make you a health professional... Just saying.

Lastly, well done to all my students, and it's great to be back writing on Pie Hole. Hopefully my hiatus is forgiven!

Wednesday, June 25, 2014

A Few Things You Didn't Know About Sleep


Although you might not think so, sleep is integral to overall health. Drowsily yawning, dozing, snoozing and nanna-napping are indications that you might be a bit sleep deprived. When my niece and nephew are visiting and get put to bed at 8pm, all they want to do is stay up... My response? Ok, you guys stay up and I'll go to bed. Gone are the days of wanting to fight sleep. Well, for some of us anyway.


Adults are recommended to get 7-8 hours of sleep a night. Children require even more, you know, because they're growing and stuff. Poor sleep is associated with several health complications including high blood pressure, increased risk of heart disease, poor immune function and... wait for it: Obesity. This is a nutrition blog after all. So to all those pulling all-nighters and slinging the expression "I'll sleep when I'm dead", you might be there sooner than you think.

Sleep is important for so many aspects of our ability to function in life: Storing memories, clearing toxins from our brains, hormone and appetite regulation, cognition, decision making, reflexes and more. You might think sleep is for the weak, but in the end, those who sleep aren't weak of mind.

Research shows sleep deprived people consume more calories, exercise less and, as a result, are more likely to be overweight or obese. On the flip-side, there's research showing that losing weight helps you sleep better. A new study found that participants who lost 5% of their body weight had better sleep quality and increased their sleep time by almost 22 minutes. Maybe we should update the phrase "work hard and play hard" to "work hard, play hard and sleep harder".


So what do you do to prevent... or rather, induce world war zzzzz?
  • Avoid large meals close to bed time
  • Avoid late night alcohol and caffeine (yep, Captain Obvious at your service)
  • Unplug from your phone (computer, tv and other devices)
    • Yes, research shows these interfere with circadian rhythms
  • Foods like grains, bananas and chickpeas contain potassium and vitamin B6, which are needed to make melatonin, a hormone related to sleep
  • Relax with caffeine-free tea, a bath or some yoga
  • Don't go to bed hungry
Avoid being the unlikable Hulk, get your beauty sleep and sleep like you're dead to avoid becoming dead.