Being #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. 


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!  






Body Image & 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 and make sure you check out her podcast ‘Appearance Matters’.

Get to know your Gut!

There is more and more research emerging when it comes to gut health and I often get lots of questions on my instagram page about the gut and digestive health. I thought it would be beneficial for a lot of you if I dedicated a blog post to this topic, and I am delighted to introduce the lovely @TheMissionDietitian AKA Kaitlin Colucci, Registered Dietitian and gut health specialist, to give you the low down on gut health…

What do we mean by ‘gut health’?

When you type ‘Gut Health’ into Google, you get more than 1 billion results returned. From books, to blogs, to the BBC – everyone is talking about gut health.

The gut is referring to the function of your gastrointestinal (GI) tract. The GI tract starts at your mouth, and finishes…down the other end. So includes your oesophagus, stomach, small intestine, large intestine, rectum and anus.

The main function of the gut is to absorb nutrients from the food we eat, whilst also ridding solid waste from the body. As well as this, the gut also hosts a huge amount of bacteria – both good and bad, which is better known as the gut microbiome.

Approximately 100 trillion micro-organisms exist in the human GI tract and these can all aid with digestion of nutrients, support a healthy immune system, and more recently have even shown a link between stress, anxiety, insomnia and weight gain via something called the Gut-Brain-Axis. This is essentially a pathway in which the gut talks to the brain and vice versa.

Bad bacteria does find it’s way into the gut and when it does can cause symptoms such as diarrhoea or constipation, excessive gas, and irritable bowel.

There is no universal definition for ‘good gut health’ and no two people’s gut microbiota are the same. The absence of gut symptoms such as bloating, constipation, diarrhoea, excess flatulence, abdominal pain etc. may be an indicator of good gut health. However, research has shown that 1 in 3 people suffer from one or more of these symptoms.    

What sort of factors may influence our gut health?

Studies looking at human twins have shown that although there is a heritable component to the gut microbiota, there are many factors that independently influence the composition of the gut microbiota.

There are many causes for this, some of which can’t be helped such as ageing and becoming ill. However stress, unhealthy dietary habits, antibiotics, mood, sleep and smoking are among the causes that can be helped.

Aiming to reduce and manage your stress levels can do wonders for your gut health. Aiming to do 30 minutes of exercise every day, or even 10 minutes of mindful meditation can help to reduce stress levels. Lifestyle factors such as stress and sleep have been shown to have a significant impact on the gut bacteria, which may explain the association between lack of sleep and weight gain.

We all become ill at times when antibiotics are a necessity, but avoiding antibiotics unless absolutely necessary saves healthy gut bacteria from being wiped out and causing long term changes to your gut microbiota.

Healthy eating is also key to good intestinal health. Studies done in animals have shown that eating a diet low in fibre and high in processed foods has been linked with alteration in gut microbiota and increased chronic disease risk.

A variety of plant foods are necessary to have a variety of strains of good bacteria in the gut. Try to eat the rainbow when it comes to fruit and vegetables, or eat the alphabet when it comes to plant based foods.

Can IBS symptoms be controlled through our diet?

Some people, particularly those with IBS have a very sensitive gut and can’t tolerate some types of fermentable carbohydrates termed FODMAPs (fermentable oligosaccharides, di-saccharides, mono-saccharides, and polyols) and may be recommended to trial a low FODMAP diet. FODMAPs are types of prebiotics. Prebiotics are types of dietary fibres that reach the large intestine undigested where the bacteria ferment them. Foods rich in prebiotics include artichokes, onion, garlic, asparagus and leeks.

The low FODMAP diet is a diet that is recommended for 4-8 weeks and should be delivered by a Registered Dietitian. The diet aims to reduce the amount of these fermentable fibres from the diet and therefore reducing IBS-like symptoms. Research has shown that the low FODMAP diet can be effective in up to 70% of people with IBS. However, once your symptoms have reduced to below your tolerance threshold, it is important to trial a structured reintroduction of each high FODMAP food, again with guidance from a Registered Dietitian. This is because not everyone responds to high FODMAP foods in the same way, and it is important to reintroduce some fermentable foods that don’t trigger symptoms back into your diet to increase variety, and help keep your good gut bacteria happy.

Are probiotics really worth it?

Probiotics are foods that contain live beneficial bacteria such as yogurt, kefir, kombucha and kimchi. You can also buy probiotic capsules or drinks. However, evidence for the effect of probiotics is mixed and the most convincing evidence is in the prevention of antibiotic associated diarrhoea and treatment of travellers diarrhoea.

Nevertheless, it is important to remember that these types of foods have been eaten as part of a healthy diet for centuries and lack of evidence does not always equate to lack of benefit.

We know that probiotics do not cause harm. Therefore if you want to trial a probiotic supplement you should trial one for at least four weeks whilst monitoring the effect. Always take at the dose recommended by the manufacturer.

Are there certain things we can be doing or certain foods we should be eating to help with our digestion?

  • Eat a varied diet rich in fibre

Adults should be aiming to eat 30g of fibre each day, but most of us are only achieving around 18g. Aim to eat plenty of fruit, vegetables, wholegrains, legumes and pulses. Aim to gradually increase your fibre intake and ensure to drink plenty of fluid as well.

  • Experiment with new foods

Try a new food each week, especially those containing natural probiotics as these can help the good bacteria in your gut and don’t come with a big cost that some supplements do.

  • Avoid unnecessary medications

Particularly overuse of antibiotics as these can wipe out your good bacteria and cause long term changes to your gut microbiota.

  • Stop smoking and drink alcohol in moderation

Cigarette smoking has a bad impact on your gut bacteria and alcohol can alter the balance of bacteria within the GI tract.

  • Exercise

Ensure to exercise regularly as this can help to regulate bowel habits. We should be aiming to do 150 minutes moderate aerobic activity every week such as cycling or brisk walking. You can break that down into 30 minutes five times a week. We should also aim to do two additional days of strength exercises that work all major muscles.

  • Simple habits

Digestion starts in the mouth, so chewing our food really well is an important part of digestion. Take your time to eat and enjoy food sat at a dinner table where you can.

Also avoid wearing excessively tight clothes, especially high-waisted trousers that sit right by the stomach as external pressure can worsen your symptoms.

  • Create time to relax

Due to the Gut-Brain-Axis, if we are stressed this can have a negative impact on our gut bacteria. Therefore aim to find time in your day to relax and de-stress.

  • Know when to seek medical advice

Always be on the look out for red flags, and if something doesn’t seem right, talk to your doctor or GP. Red flags include:

  • Unexplained and unintentional weight loss
  • Blood in your stool
  • Family history of coeliac disease, bowel cancer, or inflammatory bowel disease
  • Anaemia
  • A change in bowel habit lasting more than six weeks if you’re over the age of 60years.

Make sure you follow Kaitlin over on her Instagram page @TheMissionDietitian!

The ups & downs of social media & the impact on mental health

Over the past decade and more so in the past few years, social media has had a big impact on the way in which we communicate with each other. There has been a variety of research that has looked at whether or not social media platforms such as Facebook and Instagram have a positive or negative effect on mental health.

Most of us are aware that apps like Instagram can be a wonderfully inspiring platform to be a part of however these social media networks may also have a negative influence on how we feel about ourselves…

I find with a lot of my clients, that they fall into the trap of comparing themselves to other people on social media which may bring out their inner critic.

Several studies have suggested that the prolonged use of social media, may be associated with signs and symptoms of depression. Additionally, some research has indicated that social media usage might be associated with low self-esteem, especially in children and adolescents. But, other studies have presented opposite results in terms of positive impact of social networking on self-esteem. The relationship between social media use and mental problems to this day remains controversial, and research on this issue is faced with numerous challenges.

I am delighted to have the lovely Sarah, who is currently studying Medicine, to share her personal views on the role of social media and her experiences in regards to mental health…

 I started my Instagram when I was in Year 9 in high school, which was 6 years ago when I was 14 years old. I initially created the page to share my passion for health and fitness, so I focused on posting motivational quotes, healthy recipes, workout tips etc.

Over the years, my account became really popular and I was lucky enough to amass a large following! My followers began to take interest in MY fitness routine, MY diet and what I was doing personally. As such, my account shifted to become more about myself and MY lifestyle.

When the account became more personal, it began to have a detrimental effect on my mental health. I would compare the posts of myself to my other posts or to other influencers and stress over why “I didn’t get as many likes” or “as many followers”. Ultimately, I blamed in on the way I looked – I tricked myself into thinking that I just wasn’t as “fit” or “pretty” as them. To change the way I looked, I began to excessively restrict my diet and cranked up my exercise routine to an unhealthy, absurd level. This amalgamated into the development of a pretty serious eating disorder & exercise addiction which almost took my life.

Ever since I revealed my diagnosis and I shared by recovery, the role of social media on my mental health has done a complete 180o. For a long time, I was terrified of sharing what I was going through. I was terrified of revealing that I had an eating disorder because of the stigma that surrounds mental illness. I thought that my followers would think I was “weak” and that I “did this to myself”, so I only ‘had myself to blame”.

In actual fact, the response from my following was SO positive and supportive. Everyone just seemed to want me to get better. There was no blame, only understanding. Thus, I find that my following played (and still plays) a MAJOR part in my recovery.

Whenever I have doubts about the way I look or whenever I start comparing myself to others, I just have to read the comments on my photos. Seeing something like “You look so healthy and full of life” or “It makes me so happy to see your recovery” encourages me to push those depressing thoughts away and remember that I perfect the way that I am. I don’t need to look like someone else. I don’t need to be anyone else.

 I’ve also taken steps to unfollow accounts that idolise a certain body-type (think girls with 6-packs or thigh gaps) and instead, only follow accounts that celebrate ALL body types.

This is just one example of the ups and downs of social media and that is NOT to say it will be the same for everyone and have the same level of impact. Along with the research linked in this blog and with Sarah’s contribution, it simply demonstrates the potential power of platforms such as Instagram and it is so important to remember that at the end of the day – social media is not the real world. It is also important to note that your ‘Instagram world’ may depend on the people you follow… If the posts on your feed are not making you feel good about yourself, perhaps unfollowing them is a good idea.

If you are someone who struggles with the negative effects of social media, please seek help from a qualified professional.


Pantic I, Damjanovic A, Todorovic J, et al. Association between online social networking and depression in high school students: behavioral physiology viewpoint. Psychiatria Danubina 2012; 24:90–93  [PubMed]

Jelenchick LA, Eickhoff JC, Moreno MA. “Facebook depression?” Social networking site use and depression in older adolescents. The Journal of Adolescent Health 2013; 52:128–130  [PubMed]

Blascovich J, Tomaka J. (1991) Measures of self-esteem. In: Robinson JP, editor; , Shaver PR, editor. , eds. Measures of personality and social psychological attitudes. San Diego, CA: Academic Press, pp. 115–155

Kuss DJ, Griffiths MD. Online social networking and addiction—a review of the psychological literature. International Journal of Environmental Research & Public Health 2011; 8:3528–3552 [PMC free article]  [PubMed]

Other resources

When does healthy become unhealthy?

When does healthy become unhealthy?

by Sophie Bertrand BSc, MSc and Dr Alison Colville MbCHb, MRCGP, LFHom (med) 

Having completed an MSc in Nutriton and eating disorders, I am very family with the research surrounding the topics of anorexia, bulimia and binge eating disorder. However, we are now being faced with the rise of a condition named ‘orthorexia’ which describes an individual that will avoid all foods that they consider to be ‘unhealthy’ thus becoming extremely restricitive in regards to their eating habits. Being that this condition is not yet listed in the Diagnostic and Statistical Manual of Mential Disorders (DSM-5) it can be somewhat difficult to diagnose. Being that my ethos is centred around encouraging idividuals to have a healthy relationship with food, I wanted to ask for General Pracitoners perspective and her understanding of orhorexia to help educate individuals who find it difficult to separate the idea of being healthy and having a good relationship with food from only eating ‘healthy foods’. Myself and GP Alison Colville (also known as ‘The Wholehealth Doctor’) have teamed up to hopefully clear up and answer any questions surrounding this topic.

When does healthy become unhealthy?

Is it when we start choosing organic over non-organic? Is it when we turn down dinner with a friend because you know they won’t have dairy free options? Or perhaps it’s when you spend your day planning your meals for the following day? The truth is, it is very hard to tell. Individually, these can be health conscious behaviours to have but when they start to negatively impact your mental state, relationships or day-to-day life then perhaps things have gone too far.

What is Orthorexia Nervosa?

ORTHOREXIA NERVOSA was first described in 1997 by a man called Bratman who found his behaviour around food and health becoming obsessive whilst running a health retreat. [1]

After a year or so of this self-imposed regime, I felt light, clear headed, energetic, strong and self-righteous.  I regarded the wretched, debauched souls about me downing their chocolate chip cookies and fries as mere animals reduced to satisfying gustatory lusts.  But I wasn’t complacent in my virtue.  Feeling an obligation to enlighten my weaker brethren, I continuously lectured friends and family on the evils of refined, processed food and the dangers of pesticides and artificial fertilizers.’

Does this sound familiar?! You can read the rest of his story at

Although not currently recognised as a disease by Psychiatric diagnostic guidelines, Orthorexia is a condition which is becoming increasingly diagnosed. There are differing views as to whether it is a ‘disorder’, a ‘behavioural addiction’ or an ‘extreme dietary habit’[1]. Particularly amongst those with a history of mental illness or in recovery from other eating disorders. Essentially, the condition is characterised by obsessive behaviour surrounding the perfect diet and other healthy actions such as excessive exercising, use of supplements, and extending into ritualistic selfcare practices.

As I wrote this article, I realised that in my GP practice I have never diagnosed this condition, or in fact, come across it all. Does that mean perhaps it doesn’t exist? Well, the evidence suggests the otherwise, so clearly, we are not aware of its existence, both the individual and the healthcare professionals. When we are eating ‘healthily’ and striving to improve our health or fitness we think we’re far from having a problem and so this is not something that we would seek help about. Interestingly, Orthorexia is a condition where the individual talks freely about their food habits, quite the opposite to those suffering with Anorexia Nervosa.

How do I know if I have it?

The ORTO-15 is a questionnaire which has been developed to identify those who may have Orthorexia[6]. It clearly has it’s limitations, namely in it’s lack of standardisation and also cultural variations. However, it is a useful tool to make a general assessment of someone’s attitude towards their food and health. As a practitioner of lifestyle medicine and promoter of health, some of the questions I believe to be health conscious behaviour rather than specifically destructive e.g. ‘Are you willing to spend more money to have healthier food’ but see how you score….

  Always Often Sometimes Never
When eating, do you pay attention to the calories in the food?
When you go in a food shop do you feel confused?
In the last 3 months, did the thought of food worry you?
Are your eating choices conditioned by your worry about your health status?
Is the taste of food more important than the quality when you evaluate food?
Are you willing to spend more money to have healthier food?
Does the thought of food worry you for more than 3 hours a day?
Do you allow yourself any eating transgressions?
Do you think your mood affects your eating behaviour?
Do you think that the conviction to eat only healthy food increases self-esteem?
Do you think that eating healthy food changes your lifestyle? (frequency of eating out, friends…’?
Do you think that eating healthy food may improve your appearance?
Do you feel guilty when transgressing?
Do you think that on the market there is also unhealthy food?
At present, are you alone when having meals?

L.M. Donini, D. Marsili, M.P. Graziani, et al. Eating Weight Disord. 10: e28-e32, 2005


Scoring grid

Question Responses
Always Often Sometimes Never
2 – 5 – 8 – 9 4 3 2 1
3 – 4 – 6 – 7 – 10 – 11 – 12 – 14 – 15 1 2 3 4
1 – 13 2 4 3 1


The impact of social media

Probably the most shocking research I discovered was a study done by Turner et al[5] who used the ORTO-15 questionnaire on 680 social media ‘health food’ account followers and found that a staggering 49% of them fit the criteria for Orthorexia. A similar study was done on random members of the public and found only 1% to fit the criteria. Interestingly, these figures are only linked to Instagram and not to other social media platforms. A further Austrian study by Kinzyl et al[4] found that up to 55% of the dieticians they examined also exhibit behaviour consistent with Orthorexia.

Anyone on social media promoting food, wellness or any other practice of healthy lifestyle is potentially feeding into this. So, this begs the question… Are we feeding into this? As a doctor my goal is clearly to make people BETTER or restore their health and certainly not to drive an eating disorder. Ultimately, we need to be aware that this condition does exist and promote self-reflection in our eating/health habits to ensure that we don’t slide into more unhealthy habits. It is so important to have balance in all aspects of life and practicing mindfulness, meditation and journaling are fantastic ways to help us see through our actions and become more self-aware.

How to keep a healthy mindset

Try to go easy on yourself from time to time. You don’t have to be perfect, because perfection never ends. If you forget to meditate one day, or you’re invited to eat at a friend’s house, or even if you just need to sleep and have a bath rather than exercise, forgive yourself and move on. The 80:20 rule is a very useful rule to stick to: eat well, exercise, 80% of the time, and allow some flexibility for the other 20% of the time.

What we have to remember is that good food makes us happy, and being incredibly restrictive around food will ultimately leave you feeling unhappy. Food is to be enjoyed, it is fuel, it is energy, and cutting out food groups such as diary, is not going to have any positive impact on your health unless of course you are intolerant to it. Variety is key, and the more colours and varitey of foods you have in your diet, the better your gut health will be thus the healthier you will be. So try not to stick to such a restricted way of eating because the truth is, it is not healthier!

If you feel that your behaviour around food is becoming destructive to your life then please seek help from your GP, even if it’s just to talk things through. Some other supportive resources include:

Co- Written by Sophie Bertrand MSc and The Wholehealth Doctor

Dr Alison Colville MbCHb, MRCGP, LFHom (med)

Public speaker and GP with a specialist interest in lifestyle medicine and wellness


[1]            Orthorexia nervosa and self-attitudinal aspects of body image in female and male university students / Donini et al / Journal of Eating Disorders 20153:2 / January 2015

[2]            The stigma of clean dieting and orthorexia nervosa / Nevin et al / Journal of Eating Disorders20175:37 / July 2017

[3]            The interrelationship between orthorexia nervosa, perfectionism, body image and attachment style / Barnes et al / Eating and weight disorders – studies on anorexia, bulimia and obesity / Vol 22 Issue 1 pp 117-184 / March 2017

[4]            Orthorexia nervosa in dieticians / Kinzyl et al / Psychother Psychosom 2006;75:395–396 / October 2006

[5]            Instagram use is linked to increased symptoms of orthorexia nervosa / Turner et al / Eating and weight disorders – studies on anorexia, bulimia and obesity / Vol 22 Issue 2 pp 227-284 / June 2017

[6]            On orthorexia nervosa: A review of the literature and proposed diagnostic criteria / Bratman et al / Eating Behaviours Vol 21 pp 11-17 / April 2016