1. Susan Hargreaves Registered Dietitian Obstructive Sleep Apnoea (OSA) Healthy Eating & Lifestyle

2. OSA & Associated Health Risks Asthma Stroke Obesity Heart Disease T2 Diabetes Metabolic Syndrome Hypertension Dyslipidaemia Inflammatory Diseases Risk Factors: Genetic Male Middle age Sedative drugs Snoring Heart Disease Metabolic Disorder Obesity Smoking Excess Alcohol Associated Health Risks Depression

3. Healthy Lifestyle: Mental Health Physical Diet Activity

4. Individualised Advice

5. Main Messages Healthy Well Balanced Diet & Lifestyle – Regular Eating Pattern & Physical Activity – Food Portion Control – Glycaemic Index – Smoking, Alcohol & Caffeine Media Headlines – fact or fiction?

6. 5 > portions 3 portions 6-8 portions? Foods high in salt

7. Food Portions 55g/87kcal39g/48kcal 58g/44kcal58g/60kcal

8. Food Portions: 1993 vs 2014 Medium Slice of White Bread Chicken Curry with Rice Steak & Kidney Pie 1993 Weight 36g260g160g Calories 85kcal305kcal425kcal 2014 Weight 40g395g240g Calories 95kcal460kcal640kcal Increase 11%52%50% Source: Informed No.53 Spring 2014 WCRF

9. Glycaemic index 7 mmol Time Blood glucose Pasta (40) Low GI White bread (70) High GI

10. Low/Medium GIHigh GI Breakfast Cereals Porridge Oatbran All Bran Special K Muesli (no added sugar) Corn/Bran Flakes Rice Krispies Coco Pops Puffed Wheat Cheerios Breads Stoneground, Wholemeal Seeded/Multigrain/Granary Rye Pitta bread Ryvita White/Brown bread Bagel Baguette Rice cakes Crisp bread Water crackers Rice/Pasta/ Potatoes Pasta / Macaroni Noodles Brown or Basmati Rice Couscous New Potatoes Quinoa Mashed potato White Rice Jacket Potato French Fries Oven Chips Instant Mash Pulses/Legumes All Low/Med GI All types of Beans, Sweetcorn, Peas, Chick peas Lentils, Pearl barley

11. Alcohol What’s the limit? Women: 2 – 3 units per day Men: 3 – 4 units per day 1 or 2 alcohol-free days per week Extra calories 1 pint strong lager = 280kcal ½ pint lager = 90kcal 125ml glass white wine = 83kcal 125ml glass red wine = 85kcal Vodka and tonic = 85kcal Gin and slimeline tonic = 52kcal 1 glass (50ml) dry sherry = 58kcal

12. Caffeine ProductCaffeine Instant Coffee45 - 75 mg/190 ml cup Brewed Coffee (Filter or Percolated)100 – 115 mg per 190 ml cup Decaffeinated Coffee (Brewed or Instant) 4 mg per 190 ml cup Tea33 - 50 mg per 190 ml cup Drinking Chocolate 1.1 – 8.2 mg per 200 ml cup (as per manufacturer’s instructions) COLA (Regular & Diet)11 – 70 mg per 330 ml can Energy Drinks (With added caffeine and/or guarana) 28– 87 mg per 250 ml can Chocolate5.5 – 35.5 mg per 50g bar Source: MAFF Food Surveillance Information Sheet 144, March 1998 & FSA Survey of Caffeine Levels in Hot Beverages, Food Information Sheet 53/04 April 2004.

13. Special Diets? Gluten or Wheat Free Polymeal (Anti-inflammatory/Paleodiet/Hunter-gatherer/Ape diets) – 2 ½ cups of beans – ½ cup fresh blueberries - antioxidant – 1 cup cooked or ½ cup raw broccoli – 3 servings of whole grain – 1 serving soy – 1 cup cooked spinach – ½ cup sweet potatoes, carrots, pumpkin - beta-carotene antioxidant – 1 whole tomato – 1 ½ oz nuts – 1 tbsp. extra virgin olive oil – 1 oz dark chocolate – (flavonoids) – 150ml glass red wine – (resveratrol) – Wild salmon 4 times a week

14. Any Questions? Susan Hargreaves, Dietitian, St Mary’s Hospital