Of all the nutrition experts we have interviewed on The Grace Tales (and there have been many), we think Biostime expert and founder of Smartbite Karina Savage may be one of our favourites...
We recently met her at a round table discussion for Biostime, which is new to Australia offering a Toddler Milk Drink which is proudly certified organic in both France and Australia (this means all ingredients are sourced without the use of pesticides, herbicides, hormones or antibiotics). The milk and cream are sourced from select organic farms located in Normandy, France (of course, the French always do it better – find out more here).
As a paediatric dietician and the brains behind Smartbite, there’s no doubt that she’s qualified to give us advice on all things food related from organic foods (and milk – hello Biostime) to sugar intake. But what we love most is that Karina is a woman living in a modern mother’s reality. That means, while of course she’s all about gut health and limiting refined carbohydrates, she also openly admits to indulging in chocolate (perhaps even every day) and endorses a glass of wine or two… Because goodness knows, sometimes we just need it.
We spoke to Karina at length about all things nutrition. From the food that will make our skin glow, to how to manage fussy eaters, and why sugar doesn’t need to be avoided completely … This is going to be our go-to guide for a year of health (in realistic moderation).
For more information, go to www.smartbite.com.au
What led you to become a nutritionist – talk us through your career journey?
My love of nourishing food stems from my childhood. I have such fond memories of spending hours in the kitchen with my amazing Nonna. She was a fantastic cook and she taught me how to create the most delicious gnocchi and other delicacies from her home town in the North of Italy.
Growing up, I was always very sporty. I played state league tennis and coached children which I really enjoyed. My love of being fit and healthy led me to my first degree which was a Bachelor of Science (Exercise and Sports Science). I then went on to study a degree in Nutrition and Dietetics.
I spent my first 12 years working clinically as a paediatric dietitian. My favourite patients were always the kids with tricky gut issues. For this reason, I followed my passion moving into researching babies and children with gut issues such as reflux, colic and food allergy.
Since having two children of my own (Sophie is 6 and Lachie is 4), I have focussed my efforts on growing my business (est. 2007) – Smartbite Nutrition. Whilst we have clinics in Adelaide and Sydney, we love helping clients worldwide via Skype.
I’m a people person (and huge dog lover) and honestly love helping to improve people’s lives. My vision is to support mums by taking the stress out of feeding, replacing anxiety with feelings of relief and motivation. Being a busy mum myself, trying to juggle a million things, I truly understand how crazy life can get and how we all need to support each other.
Since moving to Sydney four years ago, I’ve had a great time working with media and global nutrition companies. The filming opportunities have been a blast, as have other fun events such as mum’s retreats where I’ve met some really lovely people.
How vital is gut health for our overall wellbeing?
The gut is a truly phenomenal and integral part of our being. It plays a critical role in digesting and absorbing food to keep us alive and healthy. It plays a huge role in our immunity – up to 80% of our immune function is in the gut.
The communities of microbes (bacteria) in our gut are collectively known as our “gut microbiome”. Like a fingerprint, each person has their own unique “microbiome”. These bacteria have the capacity to significantly influence our health and well- being and we know that gut bacteria are linked to the probability of developing a wide range of health conditions such as diabetes, obesity and depression.
What are some symptoms of poor gut health in children? And adults?
In babies, we know that poor gut health is directly linked to colic, irritability and risk of developing allergies. Children with poor gut health usually have weaker immune systems and are more likely to get sick.
Many children I see suffer food intolerance (malabsorption) such as lactose, fructose, sucrose). They experience pain, discomfort and irritability, their sleep and behaviour are also often affected.
The teenagers and adults I see commonly have symptoms related to Irritable Bowel Syndrome (IBS) which include bloating, abdominal discomfort, lethargy, brain fog and constipation. Some also experience urgent loose bowel actions which can be quite socially debilitating, but usually fixable.
What’s the first thing you do with your clients who have poor gut health?
When I see a child with gut issues, I always start with asking their parents a few questions about the child’s first few years of life. The reason being, there are numerous factors in a child’s first 3 years that significantly influence how well the gut and immune system develops and somewhat predict lifelong gut health.
Each nutrition plan I provide is personalised and workable for that person. There is no one size fits all – what may be healthy for one person, may not be good for another. My ultimate goal is to completely remove their symptoms and work towards healing their gut completely.
Children’s tummies are also very different to adults, so need to be managed by someone who specialises in children. It’s the most rewarding feeling when children return to my clinic smiling from ear to ear, no longer in pain, with normal bowel actions, sleeping well and feeling wonderful. It’s what my job is all about.
Do supplements such as probiotics work?
Probiotics can be very effective in certain situations; however, they have to be prescribed correctly (correct strain, correct dose, correct brand).
Whilst there is a phenomenal amount of options out there in the marketplace, there are probably only a handful of strains that I would actually recommend.
Situations where there is evidence for the use of specific probiotic strains include: preventing antibiotic-associated diarrhoea, helping to reduce irritability in infant colic and helping children to outgrow allergies.
Mothering an infant with colic/reflux and allergy is tiring to say the least – what is your approach here and what are the biggest strategies you put in place for these kinds of infants?
Having been there myself with my daughter Sophie, I know that reassurance and empathy are key. I start with reassuring them that it is very normal for an infant to be colicky – in fact irritability peaks at around 4 months of age.
It’s also very natural for an infant to have reflux and this will usually naturally resolve itself by the age of one year. Having said that, an irritable, colicky baby is incredibly exhausting and parents want a quick fix.
If the baby is breastfed, we first need to make sure that they are attaching properly to the breast to ensure they aren’t sucking in a whole lot of air each time they feed. I often recommend a trial of removing cow’s milk and soy for a 2-4 week period (as supported by research) – this often does wonders. An important role for me here is to ensure that the breastfeeding mother still gets all the nutrition she needs whilst eliminating food.
In some situations where I think the baby may have poorer gut health, I will recommend a trial of a specific probiotic. We know that colicky babies often have an imbalance or “dysbiosis” of bacteria in their gut with more pathogenic than beneficial bacteria. Probiotics aim to help to restore this balance.
For more information on this topic, I have written a blog on this on my website.
How do you tackle constipation in children?
Constipation can be caused by many things so often it’s a lengthy journey. Increasing soluble fibre (think oats, fruit, legumes) and also increasing water intake are a great place to start. Many other factors, however, can contribute to constipation such as holding on and poor toileting routine.
Holding on is a big issue, especially when kids start school and don’t want to do a poo in the school toilet. Once a child starts holding on, the faeces become harder and drier and just makes the situation a whole lot worse.
I always talk about toileting routine as it is so important and often poorly done. Constipated kids need the opportunity to relax on the toilet morning and night for a good 10 mins each time (books or screens are OK here). It is also very important to make sure that their feet are supported appropriately on a stool so their knees are up higher than their waist – this is the best position to enable their bowels to empty.
If all else fails, there are other dietary elimination strategies that will be effective in specific cases.
What are your thoughts on eating organic foods/milk? Where should we go organic if we can?
With fruit and vegetables, the jury is still out in terms of how much we benefit from going organic. FSANZ (Food Standards Australia and New Zealand), our national food authority, report there is no risk to consuming “non-organic” fruit and vegetables. They comment that agricultural standards in Australia for the use of herbicides and pesticides are very strict. FSANZ regularly test fruit and vegetables and report that it is very safe and healthy to be eating these foods on a daily basis.
Foods, where I think we would benefit most from going organic, include animal products such as meat, dairy and eggs. Generally, organically produced milk and meat contain up to 50% more omega-3-fatty acids which we know are important for cardiovascular and neurological health.
In my opinion organic milk, meat and eggs are more beneficial for many reasons. Firstly, the animals eat more natural food and are treated in a more humane way. Secondly, they are not exposed to growth-regulating drugs, steroids and hormones and their antibiotic use are minimised. We certainly choose organic meat, eggs and dairy wherever possible in our family.
Have you always had a healthy approach to food and wellbeing?
I feel very lucky that my mum always cooked us such yummy wholesome food and I have fond memories of us sharing family meals together at the table.
My parents were both fit active people, so our family was often outdoors on bush walks or playing tennis. I remember having obstacle course competitions against my brother in our back yard which was so much fun! I was always playing some kind of sport, and when I look back now, I am really grateful to my parents for giving me all of those experiences.
I’m definitely mindful of passing healthy behaviours onto my own children. I think the best way of doing this is to role model them yourself.
Are there any foods you’d never eat yourself?
Probably the main one I never go near is fast food. Fast food contains very little nutrition and is honestly pretty toxic to your body – it is created to be addictive, which is just wrong! I’m also not a big fan of Brussels sprouts and pretty much avoid them every Christmas!
What are some of the more common food and health ailments people come to see you about?
Many parents come to me desperate for support with fussy eaters, which is an incredibly common issue. I also work with a lot of irritable babies with suspected cows milk allergy, together with other young children with multiple food allergies. It’s my role to make sure they are still getting all the nutrition they need to grow and flourish.
Many children I see have tummy troubles. They are often in pain with loose bowel actions (sometimes constipation), but are unsure what is causing it. I truly love the challenge of “fixing them” – and we often do. It’s the best feeling when they walk back into your room telling you they feel fantastic!
The notion of health and wellbeing comes attached with expensive foods, meditation, vitamins… Most of which are often out of reach to so many mothers due to time and budget restraints. How can we all attain good health minus these common burdens?
You’re right, unfortunately some nutrition companies have huge budgets to spend marketing supplements, potions and powders. For this reason, we have a society that feels they need to spend money on superfood blends and vitamins to stay healthy where they really don’t. Mother nature is enough, she really is. It’s just not as “sexy” or “cool” to market bananas and broccoli.
Good health comes from eating basic wholesome food – as close to its original form as possible. A plant-based diet rich in fruit, veg, nuts, seeds, legumes and good fats (oily fish, eggs, extra virgin olive oil), is really what we need to be eating.
Plant-based foods are so valuable because they provide amazing nutrients (vitamins, minerals, antioxidants and prebiotics) which nourish our gut supporting a healthy microbiome and immune system.
How should we all be approaching things such as snacks and treats for kids - is avoiding sugar altogether really the answer?
I don’t think so – because depriving children of all sugar will come back to bite us when they are older. Kids that are deprived of food in their childhood are at risk of having a poorer relationship with food and potentially disordered eating as an adult.
It’s human nature to want the forbidden fruit – kids are no different. Teaching them that these “sometimes foods” actually do fit into our life, is important. We should be able to enjoy sweets with our kids – teaching them along the way to savour it and enjoy it, just don’t have it all the time.
Mothers often skip meals – what effect does this have on our bodies/energy levels?
It just happens, doesn’t it?! I know it did with me especially when mine were babies. Skipping meals can definitely reduce energy levels, exacerbating feelings of tiredness and weaken the immune system.
Some simple strategies to keep our energy levels and nutrition up “on the run” include:
- Having a bowl of nuts on the counter that can be grabbed on the way past.
- Eating that piece of fruit as you run past – aim for 2 pieces every day.
- Snacking on homemade biscuits or banana bread that are loaded with nutrients– cooking up a big batch on the weekend (or asking your mum to!) and having them on hand just to grab is really useful.
- Chomp on that carrot whilst you are preparing dinner – it’s a way to keep your veggie intake up. Raw veg straight from the crisper during the day is another good option – literally, grab, run and chomp!
What are some quick, kid-friendly meal ideas that work well for time-poor families?
3 quick healthy options that work well for time-poor families include:
- Stir fried veg with chicken and Hokkien noodles
- Kebabs with steamed/raw veggies and pasta spirals
- Scrambled eggs with baked beans and chopped raw veggies
Young kids often like their food separate on a plate and this is backed up by research, so don’t stress if this is your child – it’s totally normal. Children need roughly 1/3 of each on their plate: quality protein, veggies and carbohydrate.
Breakfast - often hyped as the most important meal of the day yet sometimes so hard to manage. What are some great breakfast ideas for women who usually skip it?
Pre-prepared bircher muesli is one of the quickest and best cereal options – make up a big batch that can last a few days in the fridge. Another quick breakfast is a tub of yoghurt topped with nuts and muesli.
If you prefer savoury, 2 eggs scrambled with a piece of grainy bread is a great option, made even more nutritious by adding extras such as avocado, tomato or baby spinach. If you’re super time poor, simply grabbing a banana and a milky coffee can be a good start, followed by a homemade goodie such as banana bread later on.
Skin health and gut health are often intertwined - what are some foods we should eat and avoid for optimum skin health?
Avoid refined carbohydrates (think white sugary foods) and processed high fat foods (think fast food) as they are linked to an imbalance of gut microbes which in turn increase our risk of skin problems.
By choosing whole foods (predominantly plant-based) we are providing our body with amazing nutrients including vitamins and minerals which are important for all our organs including our skin. The fibre from plant foods (fruit, veg, nuts, seeds, legumes) are called prebiotics and help to nourish our bowel. They keep our community of gut bugs balanced and happy, which in turn may also show through radiant skin.
Avoiding packaged snacks for both kids and adults is often unavoidable - what are some of the best ones to select if we do have to succumb?
Great question – as I feel society really has succumbed to an acceptance of giving our kids refined packaged carbs on a regular basis. Foods such as rice crackers, puffed potato sticks, potato crisps, rice wheels are all snacks that fit into this category. I don’t have much respect for those types of foods because they are very processed/refined and rarely resemble the food that they originally came from. They release sugar quite quickly into the bloodstream (high GI) and we know that this is linked to weight gain and poorer metabolic health. These foods usually contain very little fibre and nutrients.
Better choices of “packet” carbohydrate snacks include lightly salted popcorn, dried legumes (chickpeas, Fava beans), vita wheat crackers, rye cruskits with avocado, wholegrain breakfast cereal dry (such as Weetbix bites, sultana bran buds)
On my website I have a free healthy lunchbox guide which has lots of these ideas included.
Ketogenic diet - is this the way of the future (and optimum health?). Can you break down how it works and why it’s so popular at the moment?
A ketogenic diet is an extremely low carbohydrate diet that is sometimes used to treat certain medical conditions. It is sometimes confused with a general “low carb” diet or promoted as a weight loss technique for healthy people.
On a ketogenic diet, people eat a very small amount of carbohydrate, a moderate amount of protein and a large proportion of fat per day. This means that the body uses fat as its main source of fuel and in doing so, breaks it down into “ketone bodies” in a process called ketosis.
Evidence shows that the diet may be suitable (under medical supervision) for some people with certain conditions such as Epilepsy or Type 2 Diabetes, but should not be used for the general population, or as a long-term diet as we still don’t know how safe it is long term. The diet is also a lot higher in unhealthy saturated fats and much lower in fibre, often lacking important vitamins and minerals.
Wine - how many glasses and how often is considered healthy?
Let’s face it, most of us mums feel like a drink some nights and this is fine as long as you limit to 2 glasses (unless you have a pre-existing health condition where you may need less). It’s also ideal if you can have a few alcohol-free days per week. Higher intakes of alcohol have been linked to increased risk of cancer and other health conditions such as cardiovascular problems and Type 2 Diabetes.
Often eating family meals together with kids means eating earlier in the evening, at 5 or 6 pm. How can parents avoid the 8 pm hunger attack after the kids have gone to bed?
Firstly, can I say, well done to you, if you eat with your kids earlier – it does wonders for their nutrition. Research shows that parents who eat with their children, develop much more competent (less fussy) eaters.
From personal experience, yes you do get the munchies later on, so I often like to have a bowl of organic yoghurt with nuts or I grab a homemade muffin/biscuit with my cup of tea. This may also be the time when I grab that bit of chocolate!
A little bit of chocolate every day, and not always the dark kind … How bad is this habit?
When I read through the questions, this was the first one I answered! I think it’s a mother’s right to have a little bit of chocolate every day – goodness knows we need the psychological pick-up.
Yes, dark chocolate is more nutritious for us, however any chocolate is OK in small amounts. I don’t think the habit is a problem if you are able to just have a couple of squares and stop at that. It can definitely fit into a healthy balanced diet. The issues only arise when you can’t stop at a few squares and that’s when you may need to move to another option.
What are some great food options for increasing energy levels throughout the day?
Here are some great options to choose from:
– Piece of fruit
– Raw veg with hummus
– A handful of almonds and sultanas
– A chunk of homemade banana bread or healthy oat cookie, bliss balls
– Bowl of yoghurt with fruit or nuts/granola
– Vitawheats with avocado, peanut butter, vegemite or cream cheese
If you head to my website you will be able to download some amazing immune boosting recipes for kids – they taste great (my kids love them) and also offer loads of nutrition. I’m here to help fellow mums and always happy to chat!
Karina Savage is an expert with Biostime
Go to www.biostime.com.au and check out the ‘Parent Lounge’ for advice on how to parent the next generation
Biostime® acknowledges breastfeeding is best for babies as it provides the optimal balance of nutrition and protection. To be prepared for and during breastfeeding, it is important that mums eat a healthy and balanced diet.
With this in mind, please consider the financial and social implications when deciding on a feeding method for your baby. If you are considering bottle-feeding, seeking professional advice is important because bottle-feeding may adversely affect your ability to breastfeed by reducing your own breast milk supply, which can be difficult to reverse if you change your mind. In addition, consider the convenience and cost over time. When using infant formula, always prepare following the instructions, as improper or unnecessary use may affect the health of your baby.
Always consult your health care professional for advice about feeding your baby.