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:

 

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.

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! 

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/ 

Vegetable Casserole

Growing up, my Mum would always make these incredible casserole dishes that she would ‘pack full of goodness’! I was a very fussy eater growing up but I could always reply on my Mum’s heart casserole dish to help with my veggie intake! Now, I have decided to create my own recipe (inspired by hers of course) and share with you my signature veggie casserole! Carbs, protein, essentials fats, plenty of micronutrients – all packed into one dish!

As a little bit of nutrition information to go along with this recipe, I have listed some of the ingredients below with a bit about their nutritional value…

Butter beans – Good source of protein, dietary fibre, copper and manganese. They also contain folate, phosphorus, protein, potassium, vitamin B1, iron, magnesium and vitamin B6.

Chickpeas – Chickpeas also provide a variety of vitamins and minerals, as well as a good amount of fibre, protein and iron.

Lentils –  Good source of folate, fibre, copper, phosphorus and manganese. Additionally they are a good source of iron, protein, vitamin B1, zinc, potassium and vitamin B6.

Onions – Onions are a natural source of the prebiotic inulin, which helps your body produce colon-protecting butyrate.

You’ll love this filling meal!

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INGREDIENTS (Serves 4)

  • 1 tablespoon olive oil
  • 1 medium onion, chopped
  • 80g celeriac, chopped into small cubes
  • 6 cloves of garlic, minced
  • 2 tsp paprika
  • 1/4 tsp cayenne pepper
  • 1 x 400g tinned tomatoes
  • 250ml vegetable broth
  • 1 x 400g can chickpeas, rinsed and drained
  • 1 x 400g can butter beans, rinsed and drained
  • 1 large sweet potato cut into chunks
  • 2 large parsnips cut into chunks
  • 2 large carrots, chopped
  • 400g green lentils, rinsed well
  • 1/2 teaspoon salt
  • Freshly ground black pepper
  • Optional: a few basil leaves, chopped

METHOD

  1. Pre heat the oven to 160 degrees celsius.
  2. Heat the oil in a large casserole dish over medium-high heat. Add the onion and garlic. Cook a few minutes or until the onion becomes softened.
  3. Next stir in the paprika and cayenne pepper – cook for 30 seconds to a minute until spices are fragrant. Add the tinned tomatoes, broth, butter beans, chickpeas, celeriac, lentils, carrots, parsnips and sweet potato and salt & pepper. Bring to a boil, then cover, reduce heat to low and simmer for about 20 minutes.
  4. Remove from the heat and cook in the oven for 30-40 minutes.

Enjoy!

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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

 

Plant Proteins

Vegetarian, Vegan, Pescatarian, paleo, lacto-vegetarians… there are so many different diets out there that people will choose to live by for a variety of reasons. These could be a lifestyle choice or for ethical reasons or to benefit our environment. Whatever food choice you decide to make for whatever reason, I do not judge. As a nutritionist I am here to educate you on how to achieve and maintain the best version of you and to help guide you to ensure you are getting all the right nutrients your body needs regardless of your dietary preferences.

I don’t particularly like ‘labelling’ and I support any decisions people make about why they may want to go ‘vegan’ or ‘vegetarian’ however, a concern of mine is that some people make the decision to become ‘vegan’ or ‘vegetarian’ and forget to consider the nutrients that they may have lost from cutting out certain food groups. To address some- vitamin D, omega 3, calcium and vitamin B12, all need to be found from alternative sources.

On the other hand, you may eat meat but just want to increase the variety in your diet and perhaps lower your meat consumption by switching in some plant proteins which is great. Here I will tell you what you need to know about plant proteins and give you some examples too.

In short, protein is extremely important for building and repairing the body’s tissue. Proteins are used to make hormones and enzymes, and are essential for building muscles, cartilage, bones, skin and blood cells.

Amino acids are the building blocks that make up protein and essential amino acids must be derived from food as they cannot be made by the body (unlike non-essential amino acids). ‘Complete protein’ means that it contains all of the essential amino acids; animal proteins are complete proteins and these include- meat, poultry, fish, eggs and dairy. There are also a few non animal complete proteins which are -soy, hempseed, quinoa and buckwheat, however you are also able to pair different plant based proteins together, in order to achieve ‘complete proteins’….

  • Red beans with rice
  • Black beans and polenta
  • hummus and seed crackers
  • Chickpeas and quinoa
  • Peanut butter and wholegrain bread

Making an effort to consume a variety of plant based foods (variety being the key word), like wholegrain, legumes, fruits, vegetables, nuts and seeds, should see that you’re getting enough of the nutrients that you need.

I have a listed a few specific plant based proteins below-

Quinoa- 1 cup contains more than 8 grams of protein and includes all nine of the essential amino acids that our body needs for growth and repair. Quinoa is great of either lunch or dinner, and is flavoursome mixed with different herbs or spices and vegetables.

Beans- Black, white, soy, kidney beans etc. all contain high amounts of protein. 2 cups of kidney beans will provide us with around 26 grams of protein. I regularly have kidney beans with my dinner- mixing them with rice, lentils and plenty of veg.

Nuts and nut butter (such as peanut butter)- They are great sources of protein, and contain essential fats.  I LOVE peanut butter paired with apple, or just snacking on a handful of raw almonds.

 

Tofu- Contains around 10 grams of protein per 100g. You can either bake of make into a stir fry with veg and noodles. Soy is also a complete protein.

 

Green peas- legumes are sources of plant based proteins. Green peas provide 8 grams of protein per 1 cup.

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For a high protein veggie dish, check out my vegetable pasta bake and follow my instagram page for daily recipes!

Who to trust for nutritional advice

Dieticians, Nutritionists, Nutritional Therapists, Nutrition Advisors… who do you go to and who can you trust?

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Individuals with these titles have all undergone some kind of nutritional training (we would assume) however, not all titles are equal and not all qualifications are equal. The level of study and qualifications required to respectably use each title differs tremendously. You will find some professionals that have undergone years of further study whereas some have simply signed up to a 2-day course on the internet.

Unfortunately, when it comes to food and being ‘healthy’, a lot of individuals think they know everything because they have done a google search. the difference between someone using Google and trained professionals such as dieticians and nutritionists, is that these professionals have undergone extensive and intensive further education to practice evidence based nutrition.

However in terms of people using various different ‘nutritionist’ titles, it can be difficult to know who to trust and to identify who really knows what they’re talking about!

So who is qualified to give nutritional advice in the UK?

Registered Dietitian (RD)

Registered Dieticians will have completed a minimum of a BSc in Nutrition and Dietetics that is accredited by the British Dietetic Association. Many will undergo further education specialising in different areas in order to treat certain medical conditions. Their practice is based on nutritional science and they typically work within the NHS, in the industry or in research. They are also regulated by the Health Care Professions Council (HCPC).

Registered Nutritionist (ANutr & RNutr)

Associate Registered Nutritionists (ANutr) are recent graduates who require 3 years relevant experience in the field on Nutrition before applying for the title Registered Nutritionist (RNutr). Registered Nutritionists will have a minimum of a BSc and usually an MSc qualification in Nutrition. They will also be members of the government-approved Association for Nutrition (AFN) and practice in an evidence based way, understanding the ethics code of practiced provided by the AFN. AFN membership is only obtained if individuals provide proof of accredited qualifications that meet the specific and rigorous criteria required by the AFN.

Nutritional Therapists 

Nutritional Therapists will have typically obtained a diploma accredited by the British Association for Nutritional Therapists (BANT). Where Nutritional Therapists differ from Dieticians and Nutritionists, is that their way of practice tends to be a complimentary medicine and is not always evidence based. It is also likely that they do not have a BSc or MSc in Nutrition. Don’t get me wrong there are some good Nutritional Therapists out there just be more weary of their qualifications.

To conclude, if you think you have underlying health issues or are in need of a nutritional plan to cater to certain health problems, you will need to see a dietitian. If you are looking for evidence-based nutritional advice to improve your overall wellbeing you should seek a qualified nutritionist.