Intuitive Eating: Where do I start?

One of the most common questions I get asked when it comes to Intuitive Eating (IE) is – ‘how do I start?’

The truth is, our bodies are pretty clever in regards to knowing what they want and need and when they want and need it but the thing is, for most of us, diet culture has interrupted our bodies’ signals and has convinced us to believe that those internal cues cannot be trusted.

When you stop fighting your own mind and body, you are able to tune in to these internal messages and meet your psychological and biological needs. However, understandably, when you have spent years dieting and ignoring or trying to drown out what your body is asking for, it is going to take you a while to relearn everything. But if you are patient and compassionate towards yourself, you will get there.

So, where is a good place to start? There are 10 Intuitive Eating principles however, before you put pressure on yourself to learn them all, the tips below may help ease you in to it…

  1. Start thinking about your food choices…

Are you eating food because you genuinely like and WANT it, or, are you listening to your inner critic and choosing it because you think it’s ‘healthier’ or lower in calories? Once you start to identify this, you can start to challenge it. If you are choosing low cal foods to fill you up instead of SATISFY you, you will likely end up overeating anyway because you are eating to feel full and not comfortable. For example, you feel like something sweet after your main meal. You tell yourself you are ‘not allowed’ your favourite chocolate bar so you choose to eat 3 packs of low cal popcorn instead. You may feel unsatisfied and eat the chocolate bar anyway and then feel guilty… BUT, if you had just had the chocolate bar you wanted, you’ll likely feel satisfied! Now, this is not to say one food is more satisfying than the other, it is an example of how you might pick one food over the other but still feel like your body is asking for something else. Additionally, the moment you label a food ‘off limits’ your body will want it even more which will likely lead to an ongoing argument in your head – exhausting right!? So try choosing foods that your body is asking for. You will likely find that once you’ve had as much chocolate as you want, your body will then fancy some veg and protein – because like I said, our bodies are clever and are aware of what it needs to thrive.

  1. Shut down the ‘Food Police’!

Following on from point one, try and become more aware of when that voice (the food police) is interrupting your food choices. This voice has come from environmental situations that you’ve been exposed to (AKA DIET CULTURE) and uses misinformation to question your decisions around food. When you become aware of this, you can tell it to F*** off! Only you have the ability to become completely in tune with your body’s needs so do not let misinformation get in the way of that. Also, stop comparing yourself to what others are eating. Your body is unique and comparison will get you nowhere.

  1. Throw your scales away!

Are you someone that weighs yourself everyday? If the answer is yes, answer this – does it bring happiness to your life? I am guessing the answer is no. Health and happiness cannot be measured on weighing scales and they should not dictate how you feel about yourself!

  1. Try eating mindfully

Mindful eating encourages you to slow down, acknowledge what you are eating and how you are eating. A lot of time we are in a rush or eating with distractions that draw our attention away from the whole eating experience. Eating mindfully allows you to be more present and actually enjoy and focus on what you are eating which may also help you become more in tune with your satiety signals. Check out my blog to discover how you might incorporate mindful eating in to your routine and how it may help.

Although it may take some time and practice to feel in tune with your body again, research shows that those who eat intuitively experience improved levels of self esteem, less time preoccupied with food, improved body satisfaction and long term sustainable health.

 

Helpful resources:

 

#Headstrong

This week I was delighted to attend the Headstrong event with Richie Norton (aka the Strength Temple) in partnership with AXA PPP healthcare. Headstrong is an initiative that encourages us to look at our physical and mental health as one, something we can often neglect to do,, and overall, wellbeing is something I am extremely passionate about. Health is about so much more than what you are eating… It is about what you are thinking, how you are thinking, how you speak to yourself and how you feel. Mental and physical wellbeing go hand in hand and it was nice to take an hour out of my busy schedule at the Headstrong event  to stretch, re focus my mind, and calm my brain down for just an hour. 

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I am someone that stretches daily but the class that Richie Norton led was a lot more focused and I really felt the benefit. There are many different physical and mental aspects that stretching and moving may have an impact on: ⠀

 

  • Research suggests that stretching regularly may help improve your circulation, thus increasing blood flow to your muscles (1). This may also decrease your recovery time after an intense workout. 
  • Whether we are sat at a desk all day or lifting heavy objects, back pain is extremely common and become a problem if you are moving too much or not enough. Studies suggest that stretching can help release tension and reduce risk of muscle strain (2).
  • Stretching may help reduce stress levels. When we stress, our bodies tend to tense, even if we don’t realise it! This includes both physical and emotional stress. Stretching it out may help the body release tension. 
  • As well as calming the body, research suggests it may help calm your mind too! Practicing some kind of stretching or breath work daily may help you focus more, be more productive later on in the day and give you a mental time out.

AXA PPP healthcare have some excellent videos led by Richie Norton that you can practice and easily incorporate in to your every day life… Try it and see if you feel a difference!  

 

References

  1. https://www.ncbi.nlm.nih.gov/pubmed/23676363 
  2. https://www.health.harvard.edu/healthbeat/stretching-and-strengthening-are-key-to-healing-and-preventing-back-pain

 

 

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Body image and mental health

Have you ever been on a diet that encourages you to put your health on the back seat? By this, I mean the number on the scales takes priority, and your physical and mental health don’t have a chance. And in fact, this is what all diets do! Even if they are marketed as ‘a lifestyle change’ more often than not you are being sold a way of eating that encourages you to restrict in some way and cut out a whole food group.

The truth is, all diets will likely lead to one thing – an unhealthy relationship with food and perhaps even poorer body image. And when we have an unhealthy relationship with food, we often have an unhealthy relationship with ourselves. It becomes a vicious circle: we want to change our body, so we go on a diet, we may adopt some disordered eating habits and end up doing more harm than good, to then hating on our bodies again. But what if we learnt to just LOVE our bodies? As they were, as they were supposed to look like!?

If you wake up every day to look in the mirror and criticise how your body looks, you will never feel happy and healthy! Remember that health is about more than just what you eat!

I have asked Body Image Research Nadia Craddock to talk about the importance of accepting our bodies and why we are so susceptible to being so critical in regards to what we look like…

Is there a specific reason that individuals struggle with body image?

We live in a society that privileges thin, white, young, smooth, physically-able bodies and places undue value on one’s appearance to symbolise a person’s success, happiness, desirability and worth. Sociocultural theory and research suggests than people struggle with body image concerns when they both internalise these messages (believing that to be beautiful, we need to fit an unrealistic and narrow ideal, and that to be worthwhile, desirable, and loved we need to be beautiful) and make upwards social comparisons (with peers, celebrities, strangers on social media who are perceived as closer to society’s appearance ideal).

Pressure to achieve unrealistic appearance ideals can come from the media, social media, our friends, family, and partners. Appearance-based teasing or bullying can also result in negative body image.

According to feminist theory and research, when our (currently particularly women’s) bodies are positioned as a key symbol of worth, we start self-monitoring our bodies, viewing them as objects, purely for their aesthetic value from someone else’s (often men’s’) gaze. This hyper-vigilance and self-scrutiny of the body can also result in body image concerns.

Why can ‘hating’ on our bodies be detrimental to our mental health?

Hating our bodies (often referred to as body dissatisfaction in the research literature) can have a negative impact our mental *and physical* health. Research has found that body dissatisfaction can predict later depressive symptoms, anxiety, low self-esteem, and eating disorders.

It’s often the case that when people are unhappy with the way they look, they try and change their appearance in some way through, for example, restrictive diets, unhealthy weight control behaviours (such as diet pills/supplements), tanning, skin lightening, or even through cosmetic procedures. All can compromise our physical health. Research also indicates that people with negative body image are less likely to look after their bodies (e.g., using sunscreen, going to the GP, eating fruit and veg etc.).

How can we learn to love and be more accepting of our bodies?

Positive body image refers to accepting, appreciating, respecting, and having favourable opinions of one’s body, including its unique characteristics, functionality, and capabilities.

Increasing research is focusing on identifying evidence-based ways to improve our body image.

Engaging in embodying activities (such as yoga) may be helpful as they promote a sense of agency and connection with one’s body, and an appreciation of one’s body beyond its aesthetic characteristics.

Critical media literacy is another important mechanism (knowing images are photoshopped, that brands profit of people’s insecurities) that is useful in improving body image.

It is also important to acknowledge (and dismantle) oppressive ideologies that uphold narrow appearance ideals (e.g., weight stigma, racism, homophobia etc.).

 

You can follow Nadia on her instagram page https://www.instagram.com/nadia.craddock/ and make sure you check out her podcast ‘Appearance Matters’.

Mindful eating

Mindful eating  is based on mindfulness, a Buddhist concept. It is something that is suggested to be beneficial AND something I like to practice myself. Although it may not be for everyone, there is research to suggest that it may be a very helpful tool and has also been associated with increased enjoyment whilst eating and reduced episodes of bingeing.(1)

Additionally, it may be helpful for individuals who suffer with eating disorders, depression and / or anxiety. (2, 3)

Mindful eating encourages you be more aware of your senses and acknowledge your mind and body’s response to the food you are eating. By slowing down and eating mindfully, it may help you identify and become more in-tune with your hunger and satiety signals and appreciate the taste and textures of the food, thus increasing enjoyment!

The fundamentals of mindful eating include:

  • Eating slowly and without distraction.
  • Listening to physical hunger cues and eating until you’re full.
  • Distinguishing between actual hunger and non-hunger triggers for eating.
  • Engaging your senses by noticing colors, smells, sounds, textures and tastes.
  • Learning to cope with guilt and anxiety about food.
  • Eating to maintain overall health and well-being.
  • Noticing the effects food has on your feelings and figure.
  • Appreciating your food.
  • Enjoying your food.

The concept allows you to replace automatic thoughts and reactions (may also be distractions) with more conscious responses. (4)

Although it is not realistic to eat mindfully at every meal – (we lead busy lives and sometimes there is just no time to sit down and enjoy your food properly) – but perhaps practicing this X amount of times a week, may be helpful to you. Now like I said, this may not be everyone’s cup of tea, but I personally make an effort to eat breakfast and dinner in a mindful way. I enjoy the whole experience so much more! But hey, that is just me!

How to practice mindful eating

Practicing mindfulness includes a series of exercises and meditations.

If committed, some may find it helpful to attend a seminar, online course or workshop on mindfulness or mindful eating.

However, the points below make a good starting point if you want to experiment with eating mindfully:

  • Slow down: Eat more slowly and try not to rush your meals.
  • Chew thoroughly.
  • Get rid of any distractions by turning off the TV and putting down your phone.
  • Eat in silence, or try having the radio on in the background if you prefer some background noise.
  • Focus on how the food makes you feel.
  • Focus on the taste and texture of the food.
  • Savour each bite.
  • Try and identify when you start to feel full.

To begin with, it is a good idea to pick one meal per day, to focus on these points.

Once you’ve got the hang of this, mindfulness will become more natural. Then you can focus on implementing these habits into more meals.

References

  1. https://www.ncbi.nlm.nih.gov/pubmed/22888181/ 
  2. https://www.ncbi.nlm.nih.gov/pubmed/21181579
  3. https://www.ncbi.nlm.nih.gov/pubmed/15256293/
  4. https://www.ncbi.nlm.nih.gov/pubmed/19241400
  5. https://www.thecenterformindfuleating.org 

How to put on weight in a healthy way

I often get messages from people, particularly on instagram, who are looking for advice on how to gain weight in a healthy way. There are so many ‘tips’ out there in regards to losing weight (but do keep in mind if found on instagram they may not be the most reliable ways to ‘lose weight’). When it comes to your health and weight, please do not consult Google or social media as your reliable source. Your health is not worth sacrificing so please make sure you seek advice from a Registered Nutritionist or Dietitian.

Talia, is a lovely friend of mine and Registered Dietitian currently working on an inpatient eating disorder unit, so I thought she was an amazing person to ask to write this blog with me. She dedicates her job to helping individuals who are very underweight, restore their weight in a safe way. Here we are going to provide you with some information in regards to weight gain.

Is it simply a case up of upping your portion sizes?

You will need to increase the amount of food that you’re eating to gain weight, but the type of foods eaten need to be considered as well. What you are currently eating will influence what dietary changes might need to occur, for example, if you’re cutting out a food group or avoiding particular foods this will need to be addressed to ensure you are taking in the right balance of nutrients from all food groups. Normalising eating behaviours can be challenging so simply being asked to increase portion size is not as straight forward as it might seem for many people, especially as hunger and fullness signals can’t always be trusted if you have been restricting dietary intake for a while. It is likely that activity levels will need to reduce too so that your body can divert energy to restoring weight.

Should you just ‘binge’ until you restore your weight?

No, this isn’t recommended. Intake should increase gradually so that weight gain is steady and better managed from a mental health and physical health perspective. ‘Binging’ to restore weight can actually be very harmful to your health if you have a severely low BMI and have restricted your carbohydrate intake over an extended period of time. This increases your risk of developing re-feeding syndrome which although rare, can be critical due to a shift in fluids and electrolytes. It is best to consult your Doctor or Dietitian to assess this before starting weight restoration.

Is there a certain food group you should be focusing on?

I see a lot of clients that are very focused on meeting their 5-a-day of fruit and vegetables during weight restoration. For weight gain, these foods are of a lower priority as they don’t provide the main fuel source and building blocks your body needs to gain weight. Getting a balance of macronutrients (carbohydrate, fat and protein) from enough wholegrains, starchy foods, meat and alternatives and added fats should be emphasised in the initial stages.

Is there a certain amount of kilos that is considered ‘safe’ in regards to gaining weight gradually?

Yes, generally between 0.5kg-1kg of weight gain per week is considered safe. Weight gain can be more rapid at the beginning due to fluid shifts, increased gastrointestinal content and the development of oedema (swelling due to build-up of fluid). It is not uncommon to gain up to 2-3kg in the first couple of weeks as a result of this which can be distressing but it is important to know that the rate of weight gain does normalise. It is difficult to know how your body will respond during weight restoration as weight gain can fluctuate and some weeks you might even experience weight loss which can be confusing, but is a normal part of the weight gain journey.

Should you cut out exercise whilst restoring weight?

This really depends on your weight/BMI and your physical health (heart rate, blood pressure, blood tests etc). The amount and type of exercise allowed should be decided in collaboration with your Doctor (either your GP or Psychiatrist) and Dietitian. We know that physical activity has a positive impact on anxiety, depression and social connections but at a severely low BMI, minimal exercise or “bed rest” is generally recommended to allow the body to conserve energy, start restoring bodily functions and re-build muscle tissues. The next step once some weight gain has been achieved would be to incorporate low intensity activities such as a gentle, short walk or yoga and continue to build up from there. High intensity activities like HITT, running, gym classes and team sports should be avoided until BMI is back within a healthy weight range, your physical health is normalised, and you get the all clear from your Doctor. For some people, it can take several months or years to return to this level of activity. It is also important to note that when activity levels increase (this might even be returning to work or studies), the amount of food you need to continue gaining weight will likely increase.

Do I have to eat high sugar/high fat (“junk foods”) to gain weight?

Although it is not 100% necessary, most of the time the answer is yes and there are a few reasons why:

  1. To gain weight you have to eat more food and increasing portion size can be quite challenging. Incorporating nutrient dense foods that are high in energy, or high fat/high sugar within a balanced diet can help to reduce the volume of food required
  2. These foods are part of a normal diet so there is no reason why they should be avoided
  3. These foods can be targeted (falsely) as the cause of weight gain and can be feared and cut out of the diet. Gradual exposure to these foods and regular inclusion in your diet will help to develop a more positive relationship with food over time as this fear decreases

What are some of the common side effects of gaining weight?

It is very common to experience several physical and psychological side effects during weight restoration. You may experience an increase in anxiety, abdominal pain and bloating, feeling full all the time and constipation and/or diarrhoea. These physical symptoms can occur as a result of the abdominal muscles and muscles of the gastrointestinal tract losing tone and strength after a period of undereating. The stomach is hyper-sensitive to larger portion sizes, food takes longer to empty from the stomach and due to loss of muscle tone, the abdomen can appear rounded after eating.

Some strategies to help make this process more comfortable include wearing clothes that are lose-fitting, using distraction and self-soothing activities after meals, limiting fluids consumed with meals (have them between instead), including energy dense foods to reduce portion.

You can follow Talia on Instgram and check out her website www.taliacecchele.com. 

 

If you are suffering from an eating disorder, having support can be an essential part of recovery. https://www.beateatingdisorders.org.uk have some excellent resources.

Lunch time meal prep

Need to prep your lunch? Can’t think of something quick, easy and deliciously nutritious? I got you covered!

To get the most out of a lunch box, I like to make sure its well balanced and contains carbs, protein, essential fats and veggies! And of course tastes delicious! I always get messages on Instagram asking for on the go lunch ideas and whilst I have many recipes, I thought it would be helpful to put them all in one place! So below are my top 5 lunch box recipes to help get you through the week… (I recommend making

Herb tofu with mixed grains, wheat berries & greens

Simply steam the veg and add the tofu and grains cold, ready to heat up at work!

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Veggie box

This one is super easy to cook and then reheat at work but you can also eat it cold and on the go!

Ingredients: 125g cooked quinoa, 3 beetroot falafels, 100g cooked black beans, 80g steamed asparagus

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Bean & Lentil stew

This can be made in batches to freeze in lunch boxes too!

  • BEAN & LENTIL STEW (serves 3-4)
  • 1 x 400g tin of Black beans, drained
  • 1 x 400g tinned chickpeas, drained
  • 2 cloves Garlic, finely chopped
  • 200g Green lentils, dry
  • 1 medium onion, chopped
  • 1 x 400g tinned Tomatoes
  •  400ml Vegetable broth
  • 1 tbsp Chili powder
  • 1 1/2 tsp paprika
  • 1 red pepper, chopped
  • 1 tbsp Olive oil
  • Salt and pepper to taste ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀

    1. In large pot add vegetable broth and lentils.
    2. Bring to a boil, then reduce heat to med-low and simmer for 20 minutes.
    3. While lentils are cooking, in a large pan add olive oil, onion, red pepper, and garlic.
    4. Saute 5-6 minutes until softened.
    5. When lentils have simmered for 20 minutes, add the mix from the pan and remainder of ingredients to lentils pot.
    6. Simmer the stew for 40 minutes, stirring occasionally.
    7. Do occasional taste tests and add more or less spice to your liking. Add to your lunch boxes!
    8. Serving mine with freekah – Enjoy!

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Plant based box

  • 125g mixed brown rice and quinoa (cooked)
  • 100g black beans, cooked
  • 100g chickpeas, cooked,
  • 160g mixed greens
  • 3 tbsp tomato and basil pasta sauce – I use one straight from the jar!

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Buddha bowl style

Here it is pretty simple – you choose a grain, a protein and some veggies! For this bowl you will need a mix of brown rice and lentils (around 125g in total – cooked), 30-40g of grilled halloumi, 4 veggie falafels, spinach leaves and steamed broccoli. Bang it in a lunchbox and you’re good to go!

 

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My Vegetable pasta recipe is also a great one to box up and enjoy hot or cold!

To keep up with new recipes, make sure you follow me @sophieshealthykitchen

Healthy New Year

It is just so predictable – January hits and we are bombarded with weight loss diets, juice cleanses, meal replacement shakes with 20% etc. And it doesn’t help when you see the likes of the Kardashians jumping on board and promoting this rubbish! But let me remind you, these celebrities are PAID (A LOT) to promote these products and they have no interest at all in your health.

The word ‘diet’ is often used in the month of January as it the most popular month for purchasing gym memberships and embarking on a new meal plan you may have come across online, in a book or in a magazine. You should know, that many of the ‘diets’ available to the public (such as ones published in magazines) are not recommended by qualified nutrition professionals. Unfortunately, it’s usually an ‘influencer’ or celebrity who is promoting their ‘amazing new diet’ that helped them ‘lose 10lbs in 2 weeks’.

So, as a qualified nutritionist, I am here to tell you why you DO NOT need to buy in to any of this diet b*ll****.

Let’s think about this for a minute; what will you get out of a ‘detox’ diet or a calorie restricting diet, or even just a 3 day ‘juice cleanse’? I can confidently answer this question with the response: absolutely nothing positive! Embarking on some sort of fad diet will most likely hinder your relationship with food and leave you feeling worse than when you started. Ultimately, fad diets are not sustainable. I can tell you that there is no research that promotes a positive outcome in regards to the long-term effects of low fat, low calorie, restricting fad diets. In fact, the relevant research actually tells us that weight loss achieved by a non-sustainable diet will most likely lead to additional weight gain in the long run, thus causing you to be more dissatisfied with your body than before.

Now think about this: what about if we learn to LOVE our bodies and BE KIND to ourselves and not feel the need to restrict!? How great would that be! Now I know that’s easier said than done, but I really do believe that the first step to having a healthier relationship with food IS ditching diet culture. Just opt out. If you see it, unfollow it, ignore it, pay no attention to it – because all they want is your money!

I am also going to let you in on my ‘top tip’ to help you start loving your body more –throw away your scales!

Your happiness and perception of your body should not be determined by the number on scales. Period. As individuals, we come in different shapes and sizes; that is what makes us unique. We are not all meant to be the same weight because we are all biologically different. Plus, have you ever stepped on the scales and had it ruin your whole day? If the answer is yes, throw them away now!!

If you feel you need nutrition support, please only ever seek advice from a registered and qualified nutrition professional.

 

Gut health & fibre

Fibre is becoming more and more talked about particularly in relation to gut health… I also get a lot of questions about gut health so wanted to bring you guys the latest research on it –

What we do know, is that fibre has a positive impact on gut health. Here in U.K., stats show that we need to boost our fibre intake by around 60%. We are recommend to eat 30g of fibre a day and the countries estimated intake is currently around 18/19g.

The UK get most of their fibre from cereals and cereal products such as bread, rice and pasta. It is important to note that refined grains such as white bread, have been stripped of their fibre. This is not to say we shouldn’t eat white bread, but opting for wholegrain the majority of time provides us with more nutrition. Other foods high in fibre include fruit and veg! Often people forget about this.

How does fibre work?

Fibre plays many different roles including helping to improve glycemic controls, blood sugar balance and stimulating the colon. And as know, it is also becoming increasingly famous for its effect on gut microbiota

Fun facts

  • Our gut microbiota, is something we develop with age and it weighs as much as our brain!
  • It has been estimated that we are 45% human and 55% microbes /bacteria by number of cells
  • The gut produces vitamins and hormones, it strengthens the intestine and trains the immune system.
  • It can also communicate with our Central Nervous System

Health benefits

Research by Rossi & Dimidi found that for every 7g increase in fibre:

  • 9% lower risk of cardiovascular disease
  • 7%lower risk of colon cancer
  • 7% lower risk of stroke
  • 6% lower risk of type 2 diabetes

What does 7g look like?

  • a potato with skin
  • bowl of baked beans
  • a portion of veggie sticks (carrots / cucumber)

Jacka et al. 2017 looked at gut brain axis in mental health. The study looked a patients diagnosed with depression and found that dietary intervention may help with symptoms. (Note these patients were still on medication but the study showed that a high fibre diet helped their symptoms further). This diet included 50g fibre a day!

Diet in general (added omgega 3s may also have helped) so were looking at whole diet -not just reliant on one nutrient but it is helpful to look at the specific mechanisms behind it.

Barriers in regards to including fibre

  • perceived as more expensive
  • perceived as boring

But, it doesn’t have to be boring or more expensive…

How to increase fibre in diet –

  • Include more nuts, legumes, whole grains, fruit/veg in your diet
  • Freeze your fruit and veggies – it tends to cheaper and they may retain more nutritional value
  • Buy tins of lentils, beans and chickpeas – they’re cheap and easy to add to meals.

Please note that those who have been diagnosed with IBS may need more guidance in regards their diet and fibre intake and should seek advice from a registered health professional.

References

https://kclpure.kcl.ac.uk/portal/en/publications/irritable-bowel-syndrome-and-diet(d6c9322c-5079-4073-add7-b803f15131f4).html 

https://kclpure.kcl.ac.uk/portal/en/publications/dietary-fiber-intervention-on-gut-microbiota-composition-in-healthy-adults(f9b2521e-1513-43f5-9739-777023204fbc).html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/ 

Anorexia and Gut Health… What Does the Research Say?

Having attended a conference at the Royal Society of Medicine looking at the role of diet in mental health last week, I have had a lot of requests to talk more about gut health and anorexia. I always think it is beneficial to team up with other professionals in the field so I have invited the wonderful Bari the Dietitian (@barithedietitian) – (who also happens to be my best friend!) to help me document what we know about this area of research. Bari and I met on our postgraduate MSc programme and she happened to do her final research project looking at this exact area! We hope you enjoy the read!

What is Anorexia?

Often misunderstood as a disorder of vanity, Anorexia Nervosa is the mental health disorder with the highest mortality rate of all psychiatric disorders. It is characterized by extremely low body weight, insufficient food intake and intense fear of weight gain… Anorexia does not discriminate based on age, gender, race, socioeconomic status, etc., but the demographic with the highest prevalence rate in females of 0.4%. As the exact cause remains unknown, treatment is a complex obstacle.

Additionally, what makes treating this disorder so difficult, is the fact that different individuals respond differently to various forms of treatment.

Consequences of anorexia include a range of both physical and psychological side effects. Some of these include malnourishment due to extreme weight loss, feeling tired, faint or dizzy, osteoporosis, digestive issues, and weakened immune system.

What is Gut Health and Why Is It Important?

Gut health seems to be a term that is thrown around a lot these days, as it has become “on-trend” in the media, and for good reason! Our guts are home to billions of bacteria, viruses, and fungi, which have a combined weight of approximately 1kg – fundamentally the same weight as the human brain. The gut microbiome (all the microorganisms and their genetic material) has a strong impact on digestion, immunity, metabolism, as well as mental and brain functions.

A “healthy” gut is described as having a wide range of diversity! On the other hand, a sub-par gut is described as the loss of beneficial microorganisms, the expansion of harmful microorganism, and/or the loss of overall microbial diversity.

The microbes in your gut also communicate with your brain via the “gut-brain-axis”. This means the bacteria that inhabit your gut can talk to, and influence your brain regarding mood, stress, and anxiety.

Interestingly, new research is now suggesting that our gut microbiome may be affected and ‘altered’ by various different factors. We know that antibiotics can have a negative effect on gut health, and it is advised that probiotics are taken alongside them, particularly if taken for a prolonged period of time. A body of research also tells us that our gut loves fibre (found in fruit, veg, and whole grains). In fact, it is recommended that we eat around 30g of fibre a day and the average intake in the UK is only around 18g.

What Does the Research Tell Us About Gut Health In Individuals Who Suffer From Anorexia?

Our gut bacteria are greatly influenced by the foods we eat. Therefore, the lack of food and associated malnutrition can alter the gut microbiome and result in sub-optimal conditions. Here are some negative side effects of Anorexia Nervosa (AN) in relation to the gut:

  1. Decreased intestinal wall thickness, which leads to increased permeability of the gut, can increase the risk of infections and inflammation, and cause GI symptoms, such as bloat, pain, and inevitable “leaky gut”. This also increases the risk of developing an auto-immune disease.
  2. Microbial diversity decreases and the quantity of harmful bacteria increases. For example, those with Anorexia have higher concentrations of M. smithii, which has been shown as an adaptive mechanism in patients with AN to achieve optimal extraction of calories from very low-calorie diets.
  3. Dysbiosis (sub-optimal bacteria profile) also exists in those with depression, OCD, and anxiety, all of which are co-morbidities of Anorexia. Additionally, the low mood experienced by those suffering from Anorexia may be due to the poor nutritional intake. Thus, AN may promote low mood, which then contributes to the progression of the disease, which makes treatment more difficult.
  4. A gut-healthy diet rich in fermented foods and low in processed foods has been shown to reduce symptoms of stress and anxiety.
  5. Recently, however, there has been compelling evidence that the intestinal microbiota may regulate symptoms and maintaining factors of AN, including weight, energy metabolism, immunity, anxiety, and depression. Variations in gut bacteria may be associated with extreme weight loss, thereby perpetuating AN via direct effects on weight and mood.

Why Is This Important

Good gut health is important for digestion and AN sufferers usually experience a lot of digestive discomforts. What we don’t know yet is the types of anorexia that may have a more detrimental effect on the gut. More research is needed to identify whether or not gut symptoms are worsened by prolonged periods of food restriction and purging, for example. Although AN behaviors and symptoms differ from person to person, the present research strongly indicates that poor gut health is associated with this mental health disorder and when treating this illness, gut health research should be used as a tool for recovery.

So, the big question remains: Is an altered gut microbiota simply an obvious result of long-term reduced food consumption, potential dietary deficiencies, and weight loss? Or, alternatively, does microbial composition have the potential to cause these metabolic outcomes and possibly, to contribute to disordered eating behavior? We need more large-scale follow-up studies to clarify these relationships. However, this may offer novel ways to treat eating disorders, specifically Anorexia!

If you are suffering from disordered eating patterns and digestive issues as a result, please seek help from a qualified professional. Other helpful resources can be found at https://www.beateatingdisorders.org.uk/

To book a Nutrition Consultation with me in clinic, please email me at Sophie@rhitrition.com