Get active with a disability

A guide to getting active if you have an impairment or a long-term health condition.

This guide will help you:

• build activity into your day
• search for activities or classes
• browse activities and sports

Build activity into your day

To improve your health, try to put some time aside to do activities that improve your heart health and your muscle strength.

The Government recommends doing at least 150 minutes of activity a week as well as strength exercises on two or more days a week.

But don't worry about hitting these targets straight away: every little helps. What's more important is choosing an activity you enjoy.

The easiest way to increase your activity levels is to build activity into the things you do every day, like going to work, shopping and seeing friends.

Tips to build activity into your day:

• walk or ride part of your journey to work or the shops
• get off a bus or tube stop before your destination
• if you drive, park further away from your office and walk or ride the rest of the way
• go for a walk or a ride with your friend rather than meeting for coffee
• exercise before or after work, or during your lunch break.
• lots of gardening can provide a good workout
• exercise in front of the TV
• try an online video workout

Some charities have their own workouts online, for example the Multiple Sclerosis Society.

Get more activity tips.

Search activities and events

Accessible gyms
Find an inclusive gym on the English Federation of Disability Sport (EFDS) website.

Event finder
Use the EFDS event finder to find an activity in your area.

Get Inspired
Browse through activities on the BBC's Get Inspired section.

Get into Paralympic sports
Find a sport based on your impairment and find a club near you using the Parasport website.

Disability sports listings

Most sports organisations actively encourage disabled people to get involved. The list of organisations below is by no means exhaustive.

Sport-specific organisations

Angling
The British Disabled Angling Association supports disabled people of all ages and abilities to get into fishing in the UK.

Archery
The British Wheelchair Archery Association supports archers with all impairments from grassroots to elite level with expert advice and coaching.

Athletics
If you're looking to start in athletics, Parallel Success offers great opportunities for disabled athletes.

Badminton
England Badminton Players Association for Disabled aims to get more disabled people into badminton at any standard or level.

Boccia
Boccia England is responsible for all aspects of the sport, from beginner to expert, providing for all levels of participation.

Bowls
Disability Bowls England aims to be the first port of call for anyone with a disability looking to get into bowls.

Cricket
Organisations working to boost participation in cricket include the English Cricket Board, the Cricket Federation for People with Disabilities and the England Cricket Association for the Deaf.

Cycling
Organisations helping disabled people get into cycling include Cycling UK, Hand Cycling UK and Companion Cycling.

Dancing
If you enjoy dancing for fun or to stay active, find a disability dance class near you with the Wheelchair Dance Sport Association.

Football
Find out where you can play disability football near you using the Football Association's Play Football section and the Disability football directory.

Sledge hockey
Find out how to get into sledge hockey with the British Sledge Hockey Association.

Fencing
Look up clubs and find out more about getting into disabled fencing with the British Disabled Fencing Association.

Goalball
Visit Goalball UK to find out more about the sport and how to get involved.

Golf
Golf organisations supporting and promoting disability golf are listed on England Golf's disability section.

Gymnastics
Find an accessible gymnastics club near you using the British Gymnastics website.

Horse riding
Find a riding group near you using the Riding for the Disabled Association.

Karate
Find a club near you using the English Karate Federation website.

Rowing
Find out how to get into adaptive rowing at British Rowing.

Sailing
Find an accessible sailing venue near you using the Royal Yachting Association website.

Shooting
Look up accessible shooting clubs on the Disabled Shooting Project website.

Snow sports
Find a local ski group, book lessons and find skiing activities near you at Disability Snowsports UK.

Strength and flex
Improve your strength and flexibility with this five-week exercise plan. Not adapted for wheelchair users.

Swimming
Find a swimming pool near you with disability access and local disability swimming clubs at Swimming.org.

Table tennis
Table Tennis England works to increase the numbers of disabled people participating in table tennis.

Tennis
Find out about how to take part in tennis if you have a disability with the Tennis Foundation.

Volleyball
Find a sitting volleyball centre near you using the Volleyball England website.

Walking
Several websites provide information about local walking groups for the disabled, such as Disabled Ramblers and Walking for health.

Wheelchair basketball
Find a club near you and all you need to know about wheelchair basketball with British Wheelchair Basketball.

Wheelchair rugby
If you want to give wheelchair rugby a try, find your local club on the GB Wheelchair Rugby website.

National bodies

Back Up – supporting people with spinal cord injury

British Amputee & Les Autres Sports Association

British Blind Sport

Cerebral Palsy Sport

Dwarf Sports Association UK

LimbPower – supporting amputees and people with limb impairments to reach their sporting potential

Mencap Sport – supporting people with a learning difficulty

Metro – London-focused resource for blind and partially sighted people

Special Olympics GB – supporting people with learning disabilities

UK Deaf Sport

Transplant Sport UK

UK Sports Association for People with Learning Disability

WheelPower – supporting wheelchair sport

Disability Sports Wales

Scottish Disability Sport

Disability Sports NI

'I did 10 diets in 50 days and found one that really worked'

Andy Leeks set out to lose weight by doing 10 diets in 50 days, and found the only one that really worked was the NHS weight loss plan.

The father of two came up with the pick-and-mix diet idea to see if it would help him remain motivated to keep losing weight.

"By changing my diet regularly, the idea was I'd never get bored, thereby giving myself every chance of success," says Andy, 35, from Kent.

His starting weight was 16 stone (101kg). Over the course of the 50-day experiment, he lost 30.5 pounds (nearly 14kg).

Behind Andy's search for the perfect weight loss method was the desire to put an end to 15 years of yo-yo dieting.

While he lost weight on all of the diets, he felt that the NHS weight loss plan was the only one designed as a plan for life.

"There was only one way of eating out of the 10 that I could stick to long term – and that's the weight loss plan set out by the NHS," he says.

To fit it in with his 50-day timescale, Andy applied the principles of the NHS 12-week weight loss plan, instead of following it to the letter.

The plan is designed to help you lose weight at a safe rate of 0.5kg to 1kg (1lb to 2lb) each week.

"The NHS weight loss plan is basically all the NHS's healthy eating and exercise advice distilled into one handy little structured plan," says Andy.

"It isn't so much a diet as a healthy lifestyle plan that helps you lose weight, but at the same time helps you to develop new, healthier habits."

Diet and exercise

Andy, with the advice of a nutritionist, selected 10 diets that could be easily researched on the internet and did not involve payment.

They were the:

• 5:2 diet
• Special K diet
• NHS weight loss plan
• juice fast
• Atkins diet
• raw food diet
• baby food diet
• calorie counting
• grapefruit diet
• cabbage soup diet

Andy followed each diet for five days before moving on to the next one – hoping the approach would keep him interested.

The exercise component of his weight loss journey was to run 5km during each five-day diet phase. "I ended up running 50km in total and my time improved by just under seven minutes from the first run to the last," he says.

During his five days following the NHS advice, Andy applied the weight loss plan's healthy eating principles, which include:

• planning meals using the advice depicted by the Eatwell Guide
• eating at least five portions of a variety of fruit and veg a day
• eating smaller portions
• not skipping meals, including breakfast

He says the NHS advice helped him get a better understanding of food labels, which proved useful when trying to make healthier choices at the supermarket.

Some of the meals Andy ate while on the NHS regime included:

• homemade chilli con carne
• butternut squash risotto
• pasta with homemade vegetable sauce
• chicken salad with a jacket potato

For more healthy meal ideas, check out Smart Recipes.

'No more guilt'

Andy says following the NHS advice had minimal impact on the rest of his family because he was eating the same food they were.

"Unlike many of the diets I tried, no foods were banned," he says. "You simply eat the same meals – healthy, balanced meals – but in smaller portions.

"If I had a craving for something sweet, I would give in to that craving, but I'd only eat a small amount. I never felt guilty about it."

Apart from the NHS advice, many of the diets he tried involved avoiding certain foods or eating the same type of food over and over.

"By restricting anything, it leads to resentment and anxiety, and makes you crave the very food you're trying to avoid," he says.

"While these diets were easy to stick to for five days, I just couldn't see myself following them for very long.

"For me it was clear that for long-term success, the NHS weight loss advice is the diet that should be followed.

"The beauty is that once you've reached your desired weight, you carry on eating this way. There's nothing to change."

A plan for life

Andy's experiment was fuelled by a desire to find a lifelong healthy eating plan to manage his weight as an alternative to crash diets.

"I was forever losing weight by dieting and then subsequently regaining it, because once I came off the diet I was back to square one," he says.

"I was still the same person with the same sweet tooth, the same appetite, but no better equipped to manage my weight."

After completing his 50-day weight loss adventure, Andy says he is now managing his weight by applying the principles of the NHS weight loss plan.

"The NHS plan equips you with the skills to keep the weight off by helping you to develop healthier habits and teaching you to make healthier choices."

He has recorded his dieting tribulations in detail in his book Minimize Me – 10 Diets to Lose 25lbs in 50 Days.

Further reading

Beware of buying fake or unlicensed medical products sold as slimming products. Get informed and know what you're buying.

'Running helps manage my blood pressure'

Andrew Watson took up running after a routine medical check-up revealed he had high blood pressure.

Overweight and with a family history of high blood pressure, Andrew, aged 49 when interviewed, knew he needed to be more active.

With a mainly desk-bound job and a busy family life, the father of three from Devon was leading a largely sedentary lifestyle.

But the unexpected blood pressure readings were a wake-up call for Andrew, and prompted him to take up running.

Since graduating from Couch to 5K and progressing on to free, weekly 5km timed parkruns, he has lost two stone and says running has given him a "new lease of life".

With his father already a seasoned parkrunner and his three teenage sons getting a taste for the timed 5km runs, Andrew says running has become a family affair.

Why did you start Couch to 5K?

I have a history of raised blood pressure, which is being managed by my GP surgery. I went for a routine check-up just before Easter [2014] and my reading was up again. I was advised to lose a bit of weight, which was a wake-up call. I'd started cycling and watching my portion sizes, but felt I needed to do more.

How active were you before starting Couch to 5K?

I wasn't a complete couch potato and I'd recently started cycling to work, but my job is mainly desk-based and I found it hard to incorporate exercise into my lifestyle. I knew I needed to increase my physical activity, but I never seemed to get round to it.

How has Couch to 5K changed you?

I feel fitter now than I have done for years, and regular exercise is now part of my lifestyle. The exercise and better diet also help me manage my blood pressure. I've lost over two stone since I started Couch to 5K in April. I also feel better in myself, less stressed and in a better mood. I think it's down to the sense of achievement I get from running.

What do you like about the Couch to 5K plan?

I'm the sort of person who needs a bit of structure, so I found the podcasts and the commentary and encouragement really helpful. Knowing I had to fit three runs in each week really helped me get into a routine.

How did you hear about parkrun?

I first heard about parkrun's timed 5km runs from my dad, who is a keen runner and a proud wearer of his 50 parkruns t-shirt! A parkrun was recently set up in Parke Estate, near Bovey Tracey, about a mile or so from my home.

Did you start parkrun after completing Couch to 5K?

I didn't feel confident tackling a 5km run from scratch, as I had tried running in the past and never enjoyed it. I tended to go too fast too soon, and ended up feeling defeated. Parkrun gave me a goal to aim for while doing Couch to 5K. Once I reached week 7 of the programme and was running continuously for 20 minutes, I felt ready to give parkrun a go.

How often do you do parkrun?

I've now completed 15 parkruns since starting in June, and I try to go as much as possible. According to other runners, Parke Estate is quite a hard course compared with other parkruns, with plenty of ups and downs.

What do you like about parkrun?

Lots of things! Anyone can give it a go, no matter what level of fitness they are. It's free and convenient for me, being close to home, and as it starts at 9am you still have the rest of the day to do other things. I have a busy job and family life, too, so fitting in exercise has been a challenge in the past.

Have your running times improved?

Yes. With my first parkrun, I was hoping just to get round, but secretly hoping it would be in less than 40 minutes. I was thrilled to achieve 34:25 for my first attempt. The following week I shaved about 2.5 minutes off that, and I've kept improving my personal best.

Do you do parkrun alone?

My son has run with me a couple of times, but he usually finds friends from school on the start line to run with. I tend to run on my own, but will see quite a few familiar faces, including work mates and neighbours, along the course. My other two sons are showing an interest in parkrun, so it's turning into a family affair.

Have you made new friends doing parkrun?

Yes, parkrun is quite sociable and friendly. The course volunteers give you encouragement on the way round, and a few people head up to the cafe afterwards for a coffee and a chat. I've started volunteering on some days, which is another way of getting involved in the whole social aspect.

How does parkrun keep you motivated?

Couch to 5K got me into the habit of running three times a week, so doing a parkrun on Saturdays and a couple of midweek runs helps me maintain that routine. The fact parkrun is a timed run is also great motivation. It drives you to improve your times.

'I took up running after losing a friend'

The death of a close friend from a heart attack was the life-changing event that led father-of-two Aftab Sarwar to reassess his lifestyle.

Overweight and unfit, Aftab, 29 when interviewed, embarked on a structured plan to get fit by going to the gym and watching his calories – losing 20kg (3.1st) in seven months.

He then started the NHS Couch to 5K (C25K) running programme as a way to keep losing weight, and he soon caught the running bug.

He is an active member of his local parkrun – free, weekly 5km timed runs – in Barking, east London, where he has clocked up more than 40 runs and is a regular volunteer.

"C25K got me running, and parkrun keeps me running," says Aftab, who can always be seen proudly sporting his C25K graduate T-shirt while running.

How active were you before starting C25K?

In October 2012, I weighed 94kg (14.8st) and had been living a sedentary lifestyle for about 10 years. A good friend of mine recently passed away from a heart attack. He was 29. That prompted me to change my lifestyle.

I started to calorie-count to lose weight and began going to the gym two to three times a week. Seven months later, I had lost 20kg, and I took up running to keep losing weight.

How has C25K changed you?

I began C25K as a way to continue to lose weight and improve my health. I didn't expect to particularly enjoy running because I had never run before apart from cross country at school, and I hated that!

However, I soon got the running bug and began telling everyone I knew about how great C25K is. By the time I graduated, my weight was down to 69kg, and I have maintained that ever since.

I have kept active by running three to four times a week, and running has become a hobby. I have also gone on to do 10km runs and half marathons.

I make sure to wear my C25K graduate shirt at each event to remind myself of what got me running and to promote this great programme.

How did you hear about parkrun?

I found out about parkrun on the HealthUnlocked C25K community while doing C25K, but I didn't feel confident about running 5km at that stage, so I thought I'd wait until I completed the nine-week programme.

I did my first parkrun on June 29 2013, about a month after graduating from C25K.

How often do you do parkrun?

I do parkrun almost every week, and when I can't – because I'm running in another event the next day, I'm injured or I'm fasting for Ramadan – I volunteer at the runs. So far, I have volunteered seven times. My local parkruns are Barking and Valentines; I have run Barking 41 times and Valentines just the once.

"I always hang around after finishing to cheer everyone on as they finish their 5km"

Aftab

Have your running times improved since starting parkrun?

I ran my first parkrun in 25 minutes and 24 seconds, and that was my fastest 5km at the time.

I have steadily improved my time, and my personal best is now 21:45.

Do you do parkrun alone?

I run alone the majority of the time; however, I have encouraged many people to do C25K, including my dad and a friend at work. They have both graduated, and they join me at parkrun on occasions.

When they do, I tend to run with them to set the pace, so they can achieve their target time. I helped my dad set a personal best of 31 minutes a few weeks ago.

Have you made new friends doing parkrun?

Barking parkrun has a great community. The parkrun is organised by members of the Barking Road Runners club, and they are very friendly.

I always try to arrive a bit early to catch up with everyone, and hang around after finishing to cheer everyone on as they finish their 5km.

"I began C25K to lose weight and improve my health"

Aftab

How does parkrun keep you motivated?

I tell everyone that C25K got me running, and parkrun has kept me running! C25K gave me the structure to build up to 5km, while the parkruns give me something to aim for every week.

I'm motivated by my desire to improve on my time, achieve 50 parkruns and collect points towards the annual points competition.

I was also recently named Barking parkrunner of the month and got a voucher for a free pair of trainers. It was great to get that recognition from the organisers.

What do you like about parkrun?

Where do I start? The community, people giving up their own time to put on an event for others, the advice that more experienced runners give to help me along, running in a group to help me improve my times and seeing others work hard and keep improving their times.

A junior parkrun has been set up near me, and I have been taking my four-year-old daughter along – so parkrun has also allowed me to have some good moments with my daughter.

The top five causes of premature death

Thousands of people in England could avoid an early death from one of the five most common killers:

• cancer
• heart disease
• stroke
• lung disease
• liver disease

A child born today should expect to live a longer, healthier life than ever before. Yet, a Government report, Living Well for Longer (PDF, 1.6Mb), blames the top five killers for more than 150,000 deaths a year among under-75s in England alone and the Department of Health estimates two-thirds of them are entirely avoidable.

This chart shows the premature death toll by illness. Heart disease and stroke are together referred to as cardiovascular disease.

Reduce your risk of cancer

Are you at risk of early death?

The 10 main risk factors that make you more likely to die prematurely are:

• Smoking
• Having high blood pressure
• Being overweight
• Not doing enough exercise
• Drinking too much alcohol
• Eating too little fruit
• Having high cholesterol
• Not eating enough nuts and seeds
• Having high blood sugar levels
• Consuming too much salt

More than one in three people will develop some form of cancer during their lifetime. Although there are more than 200 different types of cancer, lung, breast, prostate and bowel cancer account for more than half of cases.

According to Cancer Research UK, an unhealthy lifestyle is the root cause of about a third of all cancers.

Smoking causes almost all lung cancer. Poor diet has been linked to bowel cancer, pancreatic cancer and oesophageal cancer. And heavy drinking has been implicated in the development of breast cancer.

While healthy lifestyle changes can prevent many cases of cancer, screening aims to drive down cancer cases even further.

National programmes for breast cancer screening, cervical screening and bowel cancer screening help identify cancer at an early stage when it's more treatable.

• make sure you know the key symptoms of the main cancers
• take up the offer of cancer screening. Find out more about the NHS screening programmes for breast cancer, cervical cancer and bowel cancer
• lifestyle changes to reduce your risk of cancer

Prevent heart disease

Experts say most cases of premature death from heart disease are completely preventable.

Smoking, being overweight, having high blood pressure and/or high cholesterol, heavy drinking and physical inactivity are all key risk factors.

• If you're over 40, ask your GP about the NHS Health Check, a free five-yearly mid-life MOT to look for things like high blood pressure and high cholesterol.
• Exercise reduces your risk of heart attack by 30%. Try to do more exercise, especially aerobic exercise like walking, swimming and cycling. Find out how you can benefit from being more physically active, and try this 12-week exercise plan for beginners combining running and strength and flexibility workouts.
• Carrying extra weight puts a strain on your heart. For help losing weight sign up to Change4Life's healthy eating smart swaps campaigns and the NHS-approved 12-week weight loss plan.

Reduce your risk of stroke

Stroke is the third leading cause of death in England each year and the leading cause of disability.

More than 150,000 people have a stroke every year in the UK but, according to The Stroke Association, up to 10,000 of these could be prevented if more people were aware of the symptoms and sought out emergency treatment.

High blood pressure is the main cause of stroke. Almost one in three people in England have high blood pressure and nearly half of them aren't receiving any treatment for the condition, says the British Heart Foundation.

• watch out for the symptoms of stroke
• a good way to reduce high blood pressure is to reduce your salt intake. Find out how to cut down on salt and read articles on how to have a healthy diet

Reduce your risk of lung disease

Respiratory disease covers a variety of conditions ranging from asthma to chronic obstructive pulmonary disease (COPD) one of the most common causes of death.

COPD is almost completely avoidable. Most cases (around 85%) are caused by smoking. The other 15% of cases are triggered by exposure to fumes, chemicals and dusts at work or, very occasionally, because of a rare genetic tendency to develop COPD called alpha-1-antitrypsin deficiency.

• find out how the NHS can help you to stop smoking including how stop smoking advisers can help you quit and the benefits of stop smoking treatments
• download this free NHS Smokefree app for daily tips and support
• read how to stop smoking in pregnancy

Reduce your risk of liver disease

Liver disease is on the increase in England with a 20% increase in cases over the last decade. The disease develops silently and many people have no idea there's anything wrong until they develop liver failure and it's too late.

The three main causes of liver disease are heavy drinking, obesity and viral hepatitis (inflammation of the liver).

• More than a third of men and over a quarter of women regularly exceed the recommended level of alcohol intake. Find out how to cut down.
• Get Change4Life tips on how to take control of your drinking.
• Use our BMI calculator to find out if you are a healthy weight and read articles on how to lose weight including the NHS-approved 12-week weight loss plan.
• Have a hepatitis B vaccination if you're at risk of infection.

The British Liver Trust has more information on looking after your liver.

How to cut down on sugar in your diet

We Britons really do eat too much sugar: 700g of the sweet stuff a week. That's an average of 140 teaspoons per person.

Added sugars, such as table sugar, honey and syrups, shouldn't make up more than 5% of the energy you get from food and drink each day. That's about 30g a day for anyone aged 11 and older.

Below are some simple tips to help you gradually cut down on the amount of added sugar in your diet:

• Sugar's many names
• Breakfast
• Main meals
• Snacks
• Drinks
• Dessert

Sugar's many guises

There are lots of different ways added sugar can be listed on ingredients labels:

• sucrose
• glucose
• fructose
• maltose
• fruit juice
• molasses
• hydrolysed starch
• invert sugar
• corn syrup
• honey

Nutrition labels tell you how much sugar a food contains:

• high in sugar – 22.5g or more of total sugar per 100g
• low in sugar – 5g or less of total sugar per 100g

Some packaging uses a colour-coded system that makes it easy to choose foods that are lower in sugar, salt and fat. Look for more "greens" and "ambers", and fewer "reds", in your shopping basket.

Breakfast

Many breakfast cereals are high in sugar. Try switching to lower-sugar cereals or those with no added sugar, such as:

• plain porridge
• plain wholewheat cereal biscuits
• plain shredded wholegrain pillows

Swapping a bowl of sugary breakfast cereal for plain cereal could cut out 70g of sugar (up to 22 sugar cubes) from your diet over a week.

Porridge oats are cheap and contain vitamins, minerals and fibre. Make porridge with semi-skimmed, 1% or skimmed milk, or water.

If you usually add sugar to your porridge, try adding a few chopped dried apricots or a sliced or mashed banana instead. Or you could try our apple-pie porridge recipe.

For a more gradual approach, you could eat sugary cereals and plain cereals on alternate days, or mix both in the same bowl.

If you add sugar to your cereal, you could try adding less. Or you could eat a smaller portion and add some chopped fruit, such as a pear or banana, which is an easy way of getting some of your 5 A DAY.

Read our guide to choosing healthy breakfast cereals.

If toast is your breakfast staple, try wholemeal or granary bread, which is higher in fibre than white bread, and see if you can get by with a little less of your usual spreads like jam, marmalade, honey or chocolate. Or you could try sugar-free or lower-sugar options.

Main meals

Many foods that we don't consider to be sweet contain a surprisingly large amount of sugar. Some ready-made soups, stir-in sauces and ready meals can also be higher in sugar than you think.

A third of an average-sized jar of pasta sauce (roughly 150g) can contain more than 13g of sugar, including added sugar – the equivalent of three teaspoons of sugar.

When eating out or buying takeaways, watch out for dishes that are typically high in sugar, such as sweet and sour dishes, sweet chilli dishes and some curry sauces, as well as salads with dressings like salad cream, which can also be high in sugar.

Condiments and sauces such as ketchup can have as much as 23g of sugar in 100g – roughly half a teaspoon per serving. These foods are usually served in small quantities, but the sugar count can add up if eaten every day.

Get tips on making healthier choices when buying takeaway food and eating out.

Snacks

Healthier snack options are those without added sugar, such as fruit (fresh, tinned or frozen), unsalted nuts, unsalted rice cakes, oatcakes, or homemade plain popcorn. For more ideas, check out these quick and easy 100-calorie snacks.

If you're not ready to give up your favourite flavours, you could start by having less. Instead of two biscuits in one sitting, try having one. If your snack has two bars, have one and share the other, or save it for another day.

If you're an "all-or-nothing" type person, you could find something to do to take your mind off food on some days of the week.

When shopping, look out for lower-sugar (and lower-fat) versions of your favourite snacks. Buy smaller packs, or skip the family bags and just go for the normal-sized one instead.

Here are some lower-calorie substitutes for popular snacks:

• cereal bars – despite their healthy image, many cereal bars can be high in sugar and fat. Look out for bars that are lower in sugar, fat and salt. Or try this fruity granola bar recipe to make your own.
• chocolate – swap for a lower-calorie hot instant chocolate drink. You can also get chocolate with coffee and chocolate with malt varieties.
• biscuits – swap for oatcakes, oat biscuits, or unsalted rice cakes, which also provide fibre.
• cakes – swap for a plain currant bun, fruit scone, or malt loaf. If you add toppings or spreads, use them sparingly or choose lower-fat and lower-sugar varieties.

Dried fruit, such as raisins, dates and apricots, is high in sugar and can be bad for your dental health because it sticks to your teeth.

To prevent tooth decay, dried fruit is best enjoyed at mealtimes – as part of a dessert, for example – rather than as a snack.

Drinks

Nearly a quarter of the added sugar in our diets comes from sugary drinks, such as fizzy drinks, sweetened juices, squashes, and cordials.

A 500ml bottle of cola contains the equivalent of 17 cubes of sugar. Try sugar-free varieties, or – better yet – water, lower-fat milk, or soda water with a splash of fruit juice.

If you take sugar in tea or coffee, gradually reduce the amount until you can cut it out altogether, or try swapping to sweeteners instead. Try some new flavours with herbal teas, or make your own with hot water and a slice of lemon or ginger.

Like some fizzy drinks, fruit juice can be high in sugar. When juice is extracted from the whole fruit to make fruit juice, sugar is released, and this can damage our teeth.

Your combined total of drinks from fruit juice, vegetable juice and smoothies should not be more than 150ml a day – which is a small glass. For example, if you have 150ml of orange juice and 150ml smoothie in one day, you'll have exceeded the recommendation by 150ml.

Fruit juices and smoothies do contain vitamins and minerals and can count towards your 5 A DAY. However they can only ever count as a maximum of one portion of your 5 A DAY. For example, if you have two glasses of fruit juice and a smoothie in one day, that still only counts as one portion.

You could try flavouring water with a slice of lemon, lime, or a splash of fruit juice. But watch out for the sugar content in flavoured water drinks: a 500ml glass of some brands contains 15g of sugar, the equivalent of nearly four teaspoons of sugar.

Dessert

Work out some ground rules. Do you need to have dessert every day? How about only having dessert after your evening meal, or only eating dessert on odd days of the month, or only on weekends, or only at restaurants?

Do you have to have chocolate, biscuits, and cake every day? If you had this type of sugary snack less often, would you actually enjoy it more?

Less sugary desserts include fruit – fresh, frozen, dried, or tinned, but choose those canned in juice rather than syrup – as well as lower-fat and lower-sugar rice pudding, and plain lower-fat yoghurt.

However, lower fat doesn't necessarily mean low sugar. Some lower-fat yoghurts can be sweetened with refined sugar, fruit juice concentrate, glucose, and fructose syrup.

If you're stuck between choosing two desserts at the supermarket, why not compare the labels on both packages and go for the one with the lower amount of sugar.

The truth about carbs

"Carbs" are a hotly-debated topic, especially in the weight loss world, due in no small part to the popularity of low-carb diets such as the Atkins, Dukan and South Beach.

The "carbs are bad" mantra from Dr Atkins and co. has left many people confused about carbohydrates and their importance for our health, including maintaining a healthy weight.

Dietitian Sian Porter says: "Carbohydrates are such a broad category and people need to know that not all carbs are the same and it is the type, quality and quantity of carbohydrate in our diet that is important.

"While we should reduce the amount of sugar in our diet, particularly added sugars, we should base our meals on starchy carbs, particularly the less processed wholegrain varieties.

"There is strong evidence that fibre, found in wholegrain versions of starchy carbs for example, is good for our health.”

On this page you can find out all you need to know about carbohydrates, their health benefits, healthier sources of carbohydrates and how they can help you lose weight.

Many people don't get enough fibre.

We are advised to eat about 18g a day.

What are carbs?

Carbohydrates are one of three macronutrients (nutrients that form a large part of our diet) found in food – the others being fat and protein. Hardly any foods contain only one nutrient and most are a combination of carbohydrates, fats and proteins in varying amounts. There are three different types of carbohydrates found in food: sugar, starch and fibre.

• Sugar is found naturally in some foods, including fruit, honey, fruit juices, milk (lactose) and vegetables. Other forms of sugar (for example table sugar) can be added to food and drink such as sweets, chocolates, biscuits and soft drinks during manufacture, or added when cooking or baking at home. Find out more about sugar.
• Starch, made up of many sugar units bonded together, is found in foods that come from plants. Starchy foods, such as bread, rice, potatoes and pasta, provide a slow and steady release of energy throughout the day. Find out more about starchy foods.
• Fibre is the name given to the diverse range of compounds found in the cell walls of foods that come from plants. Good sources of fibre include vegetables with skins on, wholegrain bread, wholewheat pasta and pulses (beans and lentils). Find out more about fibre.

Why do we need carbs?

Carbohydrates are important to your health for a number of reasons.

Energy
Carbohydrates should be the body's main source of energy in a healthy balanced diet, providing about 4kcal (17kJ) per gram. They are broken down into glucose (sugar) before being absorbed into the bloodstream. From there, the glucose enters the body's cells with the help of insulin. Glucose is used by your body for energy, fuelling all of your activities, whether going for a run or simply breathing.

Unused glucose can be converted to glycogen found in the liver and muscles. If more glucose is consumed than can be stored as glycogen, it is converted to fat, for long-term storage of energy. High fibre, starchy carbohydrates release sugar into the blood more slowly than sugary foods and drinks.

Disease risk
Vegetables, pulses, wholegrain varieties of starchy foods, and potatoes eaten with their skins on are good sources of fibre. Fibre is an important part of a healthy balanced diet. It can promote good bowel health, reduce the risk of constipation, and some forms of fibre have been shown to reduce cholesterol levels.

Research shows diets high in fibre are associated with a lower risk of cardiovascular disease, type 2 diabetes and bowel cancer. Many people don't get enough fibre. On average, most people in the UK get about 18g of fibre a day. We are advised to eat an average of 30g a day.

Calorie intake
Carbohydrate contains fewer calories gram for gram than fat, and starchy foods can be a good source of fibre, which means they can be a useful part of a weight loss plan. By replacing fatty, sugary foods and drinks with high-fibre starchy foods, it is more likely you will reduce the number of calories in your diet.

Also, high fibre foods add bulk to your meal helping you feel full. "You still need to watch your portion sizes to avoid overeating," says Sian. "Also watch the amount of fat you add when cooking and serving them: this is what increases the calorie content."

Should I cut out carbohydrates?

While we can most certainly survive without sugar, it would be quite difficult to eliminate carbohydrates entirely from your diet. Carbohydrates are the body's main source of energy. In their absence, your body will use protein and fat for energy.

It may also be hard to get enough fibre, which is important for a healthy digestive system and to prevent constipation. Healthy sources of carbohydrates such as starchy foods, vegetables, fruits, legumes and lower fat dairy products are also an important source of nutrients such as calcium, iron and B vitamins.

Cutting out carbohydrates from your diet could put you at increased risk of a deficiency in certain nutrients, leading to health problems, unless you're able to make up for the nutritional shortfall with healthy substitutes.

Replacing carbohydrates with fats and higher fat sources of protein could increase your intake of saturated fat, which can raise the amount of cholesterol in your blood – a risk factor for heart disease.

When you are low on glucose, the body breaks down stored fat to convert it into energy. This process causes a build-up of ketones in the blood, resulting in ketosis. Ketosis as a result of a low carbohydrate diet can be linked, at least in the short term, to headaches, weakness, nausea, dehydration, dizziness and irritability.

Try to limit the amount of sugary foods you eat and instead include healthier sources of carbohydrate in your diet such as wholegrains, potatoes, vegetables, fruits, legumes and lower fat dairy products. Read the British Dietetic Association's review of low-carb diets, including the paleo, Dukan, Atkins, and South Beach diets.

Don't protein and fat provide energy?

While carbohydrates, fat and protein are all sources of energy in the diet, the amount of energy that each one provides varies:

• carbohydrate provides: about 4kcal (17kJ) per gram
• protein provides: 4kcal (17kJ) per gram
• fat provides: 9kcal (37kJ) per gram

In the absence of carbohydrates in the diet your body will convert protein (or other non-carbohydrate substances) into glucose, so it's not just carbohydrates that can raise your blood sugar and insulin levels.

If you consume more calories than you burn from whatever source, you will gain weight. So cutting out carbohydrates or fat does not necessarily mean cutting out calories if you are replacing them with other foods containing the same amount of calories.

Are carbohydrates more filling than protein?

Carbohydrates and protein contain roughly the same number of calories per gram but other factors influence the sensation of feeling full such as the type and variety of food eaten, eating behaviour and environmental factors, such as portion size and availability of food choices.

The sensation of feeling full can also vary from person to person. Among other things, protein-rich foods can help you feel full and we should have some beans, pulses, fish, eggs, meat and other protein foods as part of a healthy balanced diet. But we shouldn't eat too much of these foods. Remember that starchy foods should make up about a third of the food we eat and we all need to eat more fruit and vegetables.

How much carbohydrate should I eat?

The Government's healthy eating advice, illustrated by the Eatwell Guide, recommends that just over a third of your diet should be made up of starchy foods, such as potatoes, bread, rice and pasta, and another third should be fruit and vegetables. This means that over half of your daily calorie intake should come from starchy foods, fruit and vegetables.

What carbohydrates should I be eating?

Data from the National Diet and Nutrition Survey, which looks at food consumption in the UK, shows that most of us should also be eating more fibre and starchy foods and fewer sweets, chocolates, biscuits, pastries, cakes and soft drinks with added sugar. These are usually high in sugar and calories, which can increase the risk of tooth decay and contribute to weight gain if you eat them too often, while providing few other nutrients.

Fruit, vegetables, pulses and starchy foods (especially wholegrain varieties) provide a wider range of nutrients (such as vitamins and minerals) which can benefit our health. The fibre in these foods can help to keep your bowels healthy and adds bulk to your meal, helping you to feel full.

Sian says: "Cutting out a whole food group (such as starchy foods) as some diets recommend could put your health at risk because as well as cutting out the body's main source of energy you'd be cutting back essential nutrients like B vitamins, zinc and iron from your diet."

How can I increase my fibre intake?

To increase the amount of fibre in your diet, aim for at least five portions of a variety of fruit and veg a day, go for wholegrain varieties of starchy foods and eat potatoes with skins on. Try to aim for an average intake of 30g of fibre a day.

Here are some examples of the typical fibre content in some common foods:

• two breakfast wheat biscuits (approx. 37.5g) – 3.6g of fibre
• one slice of wholemeal bread – 2.5g (one slice of white bread – 0.9g)
• 80g of uncooked wholewheat pasta – 7.6g
• one medium (180g) baked potato (with skin) – 4.7g
• 80g (4 heaped tablespoons) of cooked runner beans – 1.6g
• 80g (3 heaped tablespoons) of cooked carrots – 2.2g
• 1 small cob (3 heaped tablespoons) of sweetcorn – 2.2g
• 200g of baked beans – 9.8g
• 1 medium orange – 1.9g
• 1 medium banana – 1.4g

Can eating low GI (glycaemic index) foods help me lose weight?

The glycaemic index (GI) is a rating system for foods containing carbohydrates. It shows how quickly each food affects glucose (sugar) levels in your blood, when that food is eaten on its own. Some low GI foods, such as wholegrain foods, fruit, vegetables, beans and lentils are foods we should eat as part of a healthy balanced diet. However, using GI to decide whether foods or a combination of foods are healthy or can help with weight reduction can be misleading.

Although low GI foods cause blood sugar levels to rise and fall slowly, and which may help you to feel fuller for longer, not all low GI foods are healthy. For example, watermelon and parsnips are high GI foods, while chocolate cake has a lower GI value. Also, the cooking method and eating foods in combination as part of a meal, will change the GI rating. Therefore, GI alone is not a reliable way of deciding whether foods or combinations of foods are healthy or will help you to lose weight.

Find out more about the glycaemic index (GI).

Do carbohydrates make you fat?

Any food can be fattening if you overeat. Whether your diet is high in fat or high in carbohydrates, if you frequently consume more energy than your body uses you are likely to put on weight. In fact, gram for gram, carbohydrate contains fewer than half the calories of fat and wholegrain varieties of starchy foods are good sources of fibre. Foods high in fibre add bulk to your meal and help you to feel full.

However, foods high in sugar are often high in calories and eating these foods too often can contribute to you becoming overweight. There is some evidence that diets high in sugar are associated with an increased energy content of the diet overall, which over time can lead to weight gain.

"When people cut out carbs and lose weight, it's not just carbs they're cutting out, they're cutting out the high-calorie ingredients mixed in or eaten with it, such as butter, cheese, cream, sugar and oil," says Sian. "Eating too many calories – whether they are carbs, protein or fat – will contribute to weight gain."

Can cutting out wheat help me lose weight?

Some people point to bread and other wheat-based foods as the main culprit for their weight gain. Wheat is found in a wide range of foods, from bread, pasta and pizza, to cereals and many other foods. However, there is no evidence that wheat is more likely to cause weight gain than any other food.

Unless you have a diagnosed health condition such as wheat allergy, wheat sensitivity or coeliac disease, there is little evidence that cutting out wheat and other grains from your diet would benefit your health. Grains, especially wholegrains, are an important part of a healthy balanced diet. Wholegrain, wholemeal and brown breads give us energy and contain B vitamins, vitamin E, fibre and a wide range of minerals.

White bread also contains a range of vitamins and minerals, but it has less fibre than wholegrain, wholemeal or brown breads. If you prefer white bread, look for higher-fibre options. Grains are also naturally low in fat.

Find out if cutting out bread could help ease bloating or other digestive symptoms.

Should people with diabetes avoid carbs?

Diabetes UK recommends that people with diabetes should try to eat a healthy balanced diet, as depicted in the Eatwell Guide, and to include starchy foods at every meal. Steer clear of cutting out entire food groups. It is recommended that everyone with diabetes sees a registered dietitian for specific advice on their food choices. Your GP can refer you to a registered dietitian.

Diabetes UK says there is some evidence which suggests that low-carb diets can lead to weight loss and improvements in blood glucose control in people with type 2 diabetes in the short term. However, it is unclear whether the diet is a safe and effective way to manage type 2 diabetes in the long term.

Weight loss from a low-carb diet may be because of a reduced intake of calories overall and not specifically as a result of eating less carbohydrate. There is also not enough evidence to support the use of low-carb diets in people with type 1 diabetes.

Douglas Twenefour, Diabetes UK clinical adviser, says: "When considering a low-carbohydrate diet as an option, people with diabetes should be made aware of possible side effects such as the risk of hypoglycaemia (low blood sugar). We also advise that people with diabetes discuss the amount of carbohydrate to be restricted with their healthcare team.

"The best way to manage diabetes is by taking prescribed medications and by maintaining a healthy lifestyle that includes plenty of physical activity and a balanced diet that is low in saturated fat, salt and sugar and rich in fruit and vegetables, without completely cutting out any particular food groups."

Read Diabetes UK's review of the evidence on low-carb diets and their conclusions.

What's the role of carbohydrates in exercise?

Carbohydrates, fat and protein all provide energy, but exercising muscles rely on carbohydrates as their main source of fuel. However, muscles have limited carbohydrates stores (glycogen) and they need to be topped up regularly to keep your energy up. A diet low in carbohydrates can lead to a lack of energy during exercise, early fatigue and delayed recovery.

When is the best time to eat carbohydrates?

When you should eat carbohydrates particularly for weight loss is the subject of much debate, but there's little scientific evidence that one time is better than any other. It is recommended that you base all your meals around starchy carbohydrate foods, try and choose higher-fibre, wholegrain varieties when you can.

Bodybuilding and sports supplements: the facts

Millions of people take sports supplements hoping for a range of health benefits, from weight loss to muscle building. But some supplements are being sold illegally and can be very harmful.

Sports supplements have become increasingly popular among gym-goers. People who are interested in fitness and improving their physique may opt for supplements that can enhance their muscle growth when combined with exercise, such as weightlifting. They may also look for ways to control their appetite when they're trying to lose weight, as part of a bodybuilding diet.

There is a growing industry in sports nutrition supplements available on the high street and online. Illegal supplements, including some claiming to be "fat burning" or "slimming", have been linked to a small number of deaths. Despite being illegal to sell, there is evidence that these are still available to buy online, mainly from suppliers based outside the UK.

It's important to be aware that products sold from a website or supplier based outside the UK or Europe may not pass the same safety standards as those within Europe.

Building muscle through protein

Protein is an important part of our diet and is key to building and maintaining all types of body tissue, including muscle. It contains amino acids, the building blocks used for muscle growth.

Protein powders, available as shakes, bars and capsules, are one of the most popular muscle-building supplements.

They are legally available to buy over-the-counter as well as online. They are marketed as helping to promote your body's muscle growth, aid metabolism (helping with weight loss), help you reach peak physical performance, boost energy and fight the ageing process.

"Users may choose to take them before, during and after training to enhance performance and improve recovery, add them to meals to boost their protein or drink them between meals as a high-protein snack," says Azmina Govindji from the British Dietetic Association (BDA).

"But they could get the same benefits from introducing high-protein foods to their diet as snacks or adding them to their normal meals to enhance the protein content. Although protein shakes are convenient, not all of them are suitable to be used as a meal replacement, because they don't have all the vitamins and nutrients that a balanced meal would contain."

This means that bodybuilders who turn to protein supplements, instead of simply eating protein-rich foods, could be wasting their money.

There is also evidence that, in the long term, consuming too much protein can lead to an increased risk of osteoporosis and can also worsen existing kidney problems. The Department of Health advises adults to avoid consuming more than twice the recommended daily intake of protein (55.5g for men and 45g for women).

Protein-rich foods include:

• red meat, such as beef, lamb and pork
• poultry, such as chicken, duck and turkey
• eggs
• dairy, such as milk, yoghurt and cheese
• beans
• tofu

Find out more information about eating a healthy balanced diet.

Advice for gym-goers taking protein supplements

Rick Miller, clinical and sports dietitian from the BDA, has the following advice for gym-goers and bodybuilders who want to take protein supplements:

"A simple change in foods (such as Greek yoghurt in the morning with muesli and fruit, rather than plain breakfast cereal and milk) will help enhance the protein content of a meal. After you've taken this step, fill in the gaps with a reputable brand of protein supplement. Always read the label carefully, take the recommended serving size and don't be tempted to take far more than is necessary, as this is not supported by the current evidence.

"If you're unsure, ask your GP to refer you to a registered dietitian for advice. Protein supplements are not recommended for children due to the lack of research into long-term effects."

Chris Gibbons, a competitive powerlifter from Chesterfield, says there is a danger that people may mistakenly view supplements as a quick fix to achieve their goals.

"There is a tendency to think that there is a magic powder or supplement that will give you the physique of your dreams, but there is no substitute for hard work and commitment," he says.

"Building strength takes years, not weeks or months. It is an act of discipline and must be earned through commitment to hard training and a good diet."

For more on all kinds of dietary supplements, read the Behind the Headlines special report Supplements: Who needs them?

If you're worried or you have experienced side effects after taking any supplements, especially any that you have bought online, make an appointment to see your GP.

Illegal bodybuilding and sports supplements

UK drug regulator the Medicines and Healthcare products Regulatory Agency (MHRA) has warned people to be wary of buying illegal sports supplements, because they might contain dangerous ingredients that could cause kidney failure, seizures and heart problems.

An MHRA investigation found that 84 illegal products, such as energy and "muscle-gain" products, were being sold containing dangerous ingredients such as steroids, stimulants and hormones. Among products that were taken off the market was a steroid product called Celtic Dragon. This product left two men hospitalised with severe jaundice and liver damage.

David Carter, the MHRA's manager of the borderline medicines section, says: "People need to be aware that buying illegal sports supplements can seriously damage your health. The products may claim to boost your energy or muscle but they could contain unapproved ingredients that can cause kidney failure, heart problems or seizures."

Even legal, over-the-counter supplements can cause you harm. For example, if you are taking any medicines as well as the supplements, the supplements could stop the medicine from working properly. Always read the label and, if in doubt, talk to your pharmacist.

In addition, many health claims made about products, foods and medicines sold online are not proven.

Find out more in Avoid medicines scams.

Risks of steroid use

Although available with a doctor's prescription for a variety of clinical reasons, some steroids are misused when taken as performance-enhancing drugs. They are attractive because they are based on the male hormone testosterone and can therefore improve endurance and performance, and stimulate muscle growth.

"But they can also enhance aggression," warns Rick Miller, in reference to what is commonly called "roid rage".

"Other major effects of steroid use include increase in blood pressure, direct kidney and heart damage, liver damage, acne and sexual promiscuity," he says.

Weight loss drug DNP linked to deaths

One product being sold illegally but still available online, mainly from suppliers based outside the UK, is 2,4-Dinitrophenol (DNP). DNP is an industrial chemical that isn't fit for human consumption. It is highly toxic and causes significant side effects, and has led to at least three reported deaths.

DNP is thought to be particularly popular among bodybuilders, who are attracted to its promises of quick-fix rapid weight loss.

Other names for DNP, which comes in a pill or powder form, include:

• Dinosan
• Dnoc
• Solfo Black
• Nitrophen
• Aldifen
• Chemox

DNP is dangerous because it speeds up the metabolism too quickly. This can trigger harmful side effects, such as:

• restlessness
• flushed skin
• yellow skin
• headaches
• having an unusually fast heartbeat
• breathing too fast
• dizziness
• sweating a lot
• feeling very thirsty (dehydration)
• feeling sick (nausea)
• fever
• vomiting

Using DNP over a long period of time can lead to cataracts and peeling skin, and may cause damage to the heart and nervous system. Animal studies have suggested that DNP may also cause cancer and increase the risk of birth defects.

If you think you have taken DNP, you should seek medical advice immediately.

The Food Standards Agency (FSA) is working with the police and local authorities to prevent DNP being sold illegally to the public, particularly online.

However, many websites offering DNP for sale are based abroad, making this work harder. Some of these sites offer illegal products alongside legal weight-loss drugs, making it very difficult to tell the difference.

Get informed about dodgy diet pills sold online.

Find out how to speed up your metabolism safely.

'I ran a marathon after losing weight'

After losing a close friend to cancer, Christine Schofield went on a health kick, which culminated with her crossing the finish line of her first ever marathon.

Essex-born Christine put on weight over 20 years ago, after she stopped smoking. Over the years, her weight gradually increased.

After losing 22lbs (10kg) and running a marathon, she credits the NHS weight loss plan with setting her life on a new course.

Why did you want to lose weight?

I put on weight over 20 years ago, when I gave up smoking, and it gradually increased over the years. I had also reduced the amount of exercise I did, which didn't help. I used to do a lot of hill walking with a friend – but when he developed cancer, I stopped. His death last year made me think about my own health.

How did you find calorie counting on the plan?

I use a book called Pocket Calorie Counter by Carolyn Humphries. A lot of people use apps, but I found using the book and a spreadsheet easier. I know some of the apps allow you to scan the barcodes on your food, but most of what I eat doesn’t have a barcode.

Did you find the weight loss forum helpful?

Yes – I got a lot of encouragement from other people who had lost weight. There are people in the weight loss community who were obese but have managed to turn their lives around, and that gave me a lot of inspiration. I would occasionally share tips that were working for me, such as eating smaller portions, using smaller plates and how to avoid getting hungry.

What exercise did you do on the plan?

During the plan, I attended aquafit classes and a running group once a week. I walk a lot anyway, and do a lot of heavy gardening. I also signed up for a 3x30 fitness challenge, which for me involved walking 3km each day for 30 days in a row, but you can also do it by jogging, rowing or swimming. I also went to the gym a couple of times a week for strength exercises.

Are you still exercising regularly?

After completing the weight loss plan at the end of 2013, I started Couch to 5K in January 2014. A friend had entered me into the 2014 Callanish Stones Marathon as a 59th birthday present. I had eight months to get from the "couch" to 26.2 miles, so I had no time to waste! I was daunted by the prospect at first, but once I started the training plan, I felt it was achievable.

I had lost weight and was feeling fitter than ever. Friends commented on how fit I looked. Everyone in my village [Carloway, on the Isle of Lewis] was so encouraging. All of that gave me confidence, and I completed the marathon in 6 hours and 34 minutes by a combination of running and walking. I really surprised myself by what I could do with a bit of grit and determination. When I was younger, I was never into running. When I crossed the finishing line, my father said he would have been less surprised if I had swum the Channel!

How did you plan your meals?

I planned my meals a few days in advance and worked out the calories. I always wrote a shopping list and usually only bought what was on it. Everything I bought was accounted for in my calorie count. I didn’t really change what I ate; it was more a case of eating smaller portions. A good trick I found was to eat with smaller plates.

How did following the plan impact on your home life?

As I live alone, it was relatively straightforward. However, I didn’t radically change what I was eating, just reduced portion sizes, so it's fine when I'm cooking for others.

How did you manage eating out?

I basically ate what I wanted and worked out the calories afterwards. As I don’t like sweet things, the huge amount of calories in most puddings didn’t affect me, and I was not tempted.

How did you deal with slip-ups?

If I go over my allowance one day, it doesn’t make much difference. I’ll make sure I even out my calorie intake over the week.

How did you deal with cravings?

Savoury things like crisps and cheese are my weakness, so I make sure I don’t buy them unless I have visitors. I'll have the occasional bag of crisps when I'm out, but not having them to hand is a big help. If I crave the crunch of crisps I'll have a crispbread with some reduced-fat soft cheese, or peanut butter with rice cakes. Celery with hummus is good, too.

How did you keep yourself motivated?

My motivation has been the tremendous change in my fitness, strength and body shape. People do a double take if I haven’t seen them for a while. I'm fitter than I've ever been as an adult, and it makes life so much easier. I'm now able to do heavier work in the garden, go upstairs without getting out of breath and carry heavy things.

How has following the plan changed you?

I now think about what I eat in terms of quantity, rather than just eating whatever's on my plate, so I make sure to weigh portions of rice and pasta etc. The plan is more than a diet – it’s a lifestyle plan, which teaches you the principles of healthy eating and exercise, and helps you develop healthier habits.

Do you still need to lose weight?

I lost 22lbs (10kg) on the plan. To get my weight in the healthy range, I need to lose another 4lbs (1.8kg). My main aim though is to reduce my belly fat. My arms and legs are really good, but I still find the tummy wobbles when doing exercise. Now the marathon is over, I'm going back to being stricter with my calories and I'll be adding a bit of variety to my exercise routine.

'My gastric band weight loss surgery'

Vicky Finch tells how she had a gastric band fitted after years of weight gain was starting to put her long-term health at risk.

"My weight had begun to creep up when I was 25, after having children, and in spite of numerous attempts to lose weight, I got heavier with each decade.

"By the time I reached my fifties, I was having to take medication to control my blood pressure and underactive thyroid.

"I've never been one for sport or exercise and have had a sedentary office job my whole life. While bringing up children and working full-time, I developed bad eating habits.

"I ate too fast, had large portions, snacked on sugary treats and didn't sleep enough. I love cooking, but I'd become obsessed by food.

"I tried combining dieting with going to the gym, and went on various slimming programmes.

"These approaches all worked initially, but I found dieting hard and couldn't keep the weight off long term. I'd soon put it all back on, and more.

"At my heaviest, I weighed 17.5 stone (111kg) and as I'm 5ft 1in, this gave me a BMI of 47. I began to have serious concerns about my health.

"I already had high blood pressure and kidney problems, and had had two knee replacements. I knew I was at risk of stroke, heart disease and developing diabetes."

The road to weight loss surgery

"I visited the GP several times about my weight and was encouraged to lose weight through dieting before choosing weight loss surgery (also called bariatric surgery).

"I was also offered regular appointments with the nurse to weigh myself and discuss my diet.

"Eventually, I learnt about gastric band and gastric bypass surgery. A gastric band is where a band is fitted around the top of your stomach.

"This causes a feeling of fullness after eating a very small amount of food, and means that food must be eaten very slowly.

"My surgeon gave me lots of information about weight loss surgery, including all the risks as well as the benefits.

"Following an assessment of my suitability, and after a lot of time considering the advice, I opted to have a gastric band as it's reversible, and I felt a gastric bypass – where a smaller stomach is made – was too extreme for me."

The gastric band procedure

"I was put on a liquid diet two weeks before the operation [in February 2012], to shrink my liver and to get me used to being on a liquid diet afterwards.

"The operation went very smoothly. I stayed in hospital overnight, but I felt well enough to go home straight away.

"I was left with an access port under the skin, which is attached to an upper rib. This is so that saline can be injected into the gastric band through the port every six to eight weeks, until the right level of restriction is achieved.

"The follow-up I received after the operation was good. I could discuss my progress, including any difficulties I was having, with a team of dietitians and nurses.

"After I'd followed a liquid, then soft food, diet for a few weeks, the nurse injected the first 5ml (one teaspoon) of saline into the port.

"After eight months, I now have 10.5ml in my band out of a possible 14ml, and I'm really starting to feel the restriction. I thought the feeling of restriction would be immediate, but it has taken time."

Living with a gastric band

"Before the operation, I thought: 'This gastric band is going to be the magic wand'. However, people need to be able to commit to making necessary changes following surgery.

"I didn't realise what big efforts I'd have to make to change the way I eat. For example, as well as eating more healthily, I always have to take small mouthfuls and chew slowly and thoroughly. To help me control my portion sizes, I have to eat from a tea plate rather than a dinner plate, and spend no more than 20 minutes on each meal.

"It's not easy. If I'm hungry, I tend to fall back into bad habits of eating fast and not chewing properly. When this happens, I quickly become very uncomfortable and have to stop eating and wait until some food moves through the artificial neck in my stomach sac. Sometimes, if I have a bad reaction, I end up retching saliva, which is quite antisocial.

"Having a gastric band has made me more cautious towards food. Although I still get hungry, I know that if I don't take smaller mouthfuls I'll feel uncomfortable or be sick.

"I'm lucky, though – I can now eat almost anything, which not everyone who has a gastric band can. The only food I have to avoid is crusty bread, as I react badly to it.

"So far, my only regret has been that I couldn't lose the weight without the surgery. It was difficult telling family and friends about my decision at first.

"But since having my gastric band fitted, the weight is slowly but steadily coming off. I've lost two-and-a-half stone and dropped two dress sizes.

"After eight months, I'm now 15 stone (BMI 39). My target weight is 9-9.5 stone (BMI 24). I'm trying to introduce more exercise, which will make me lose weight more quickly, and I look forward to a healthier, more fulfilled life, with less need for medication."

Vicky's advice to people considering a gastric band

"For anyone considering gastric band surgery, my advice is to read up about it and spend time thinking it through first.

"It's important to be realistic about what will happen after the surgery, to understand that you'll never be able to eat the same way as you did before, and to appreciate that the weight loss process takes time.

"You also have to do a lot of the hard work yourself. I think it's easy to be swayed by gastric band success stories in the media, which can hold people back from accepting what the realities of the surgery are.

"If you don't think you'll be able to make permanent, healthy changes to your diet, then it's probably not for you.

"Personally, the restriction of the band has actually made me feel more liberated in general. I now have control over food; it doesn't control me. And my husband has noticed that I'm slimmer and can move around better!"

Editor's note: Vicky was 66 when interviewed for this article.