How can diet affect our bone health?

Our bones are of course essential for making up the framework of our body, but they are also important for storing calcium. This store is what maintains the levels of calcium in our blood via a very tightly regulated system, which is essential for things like muscle contraction and normal blood clotting. This means calcium (and Vitamin D) are key when it comes to supporting bone and joint health. Calcium and vitamin D go hand in hand as vitamin D aids the absorption of calcium.

RECOMMENEDED INTAKES

  • Calcium recommendation for adults = 700 mg/day
  • Vitamin D recommendation for adults = 10 mcg (micrograms)/day

In the UK, milk and milk products, such as cheese and yoghurts, account for almost half of all calcium intake in adults. But, with more and more people transitioning to a vegan diet or reducing their consumption of animal products, it is important to focus on including vegan sources of calcium in your diet. Luckily, a lot of plant-based foods are high in calcium, such as tofu, soya beans, tahini, nuts and anything made with fortified flour including cereals and bread.

What could 700 mg of calcium per day look like?

  • Breakfast: fortified wholegrain cereal/muesli containing dried fruit with milk/fortified non-dairy milk
  • Lunch: chickpea curry with chapati (fortified flour) and yoghurt/fortified non-dairy yoghurt
  • Dinner: Tofu stir fry with lots of leafy green vegetables such as broccoli, kale, bok choy etc. topped with chopped nuts

Vitamin D is much harder to get from our diet, although it is found in eggs, oily fish and fortified spreads and breakfast cereals. From April to September most people can make enough Vitamin D from sunlight, but since we’re all spending a lot more time inside anyway, you should cover your bases with a supplement. The NHS recommends everyone over the age of 5 to take a daily supplement of 10 micrograms of vitamin D a day.

WHAT ABOUT VITAMIN K?

Vitamin K is also vital for bone health as it produces an amino acid called Gla, which essentially acts like glue to help keep calcium in the bone. Food sources of Vitamin K include green leafy vegetables, meat and dairy products and Japanese natto (fermented soybeans).

A study by Cheung et al. looking into postmenopausal women found that supplementing with high doses of vitamin K (5 mg/day) over 4 years reduced the incidence of fractures. However, lots more research is needed in this area to determine the benefits of vitamin K on bone health.

WHAT IS PEAK BONE MASS?

Bone is a living tissue that is constantly removed and replaced by new bone. Peak bone mass is the greatest amount of bone an individual can attain, and a high peak bone density reduces your risk for osteoporosis later in life. Peak bone mass is around 80% determined by your genetics and the other 20% is down to environmental factors, such as nutrition and physical activity. The majority of peak bone mass is laid down during puberty, so this is an important stage to focus on adequate calcium intake. However, in recent years, data from the NDNS has shown that calcium intakes are actually lowest in 19–24-year-olds, and the average intake for girls is much lower than boys. It’s also important to note that 1-2% of bone is lost during menopause over a 5–10-year time span, so it is especially vital that girls reach peak bone mass to reduce their risk of osteoporosis. 

JOINT HEALTH

Our joints are what allow us to bend our knees to do squats, hula-hoop with our hips and move your thumbs to scroll through Instagram – important stuff! However, arthritis is a common condition causing inflammation in the joints, affecting more than 10 million people in the UK.

One Swedish study in 2013 found that eating long chain n-3 polyunsaturated fatty acids (n-3 PUFAs) aka omega-3 fatty acids could halve the risk of arthritis. They assessed women over a decade and found that those with intakes of more than 0.21 g per day were associated with a 35% reduced risk of arthritis. Even more interestingly, they found that more than a quarter of rheumatoid arthritis cases could be avoided if everyone had an intake of more than 0.21 g a day.

What does 0.21g/day of n-3 PUFAs look like?

  • Less than ¼ of a tin of mackerel  
  • About ¼ of a salmon fillet
  • 2 eggs
  • 2 tbsp of olive oil
  • 1 tsp of flax seeds

We can’t say that n-3 PUFA’s are directly responsible for this result, as other factors are likely to be at play, such as those with high intakes may have had a healthier diet overall or other healthy lifestyle behaviours. However, it is generally recommended that we eat 2 portions of fish a week, one of which should be oily (e.g. mackerel, salmon, sardines, trout etc.)

REFERENCES

https://adc.bmj.com/content/90/4/373

https://www.bones.nih.gov/health-info/bone/osteoporosis/bone-mass

https://www.nhs.uk/live-well/healthy-body/food-for-strong-bones

https://pubmed.ncbi.nlm.nih.gov/21839190

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2566998

https://ard.bmj.com/content/73/11/1949

Contribution from Sophie Gastman ANutr 

My First Trimester

When I found out I was pregnant on the 2nd November I was shocked, nervous, elated, excited and in disbelief! Despite my slightly swollen / tender breasts, I felt fab! I kept thinking ‘it is normal to feel like this’? I was eating all the same foods, working out regularly and going about my day. 9th November came and I was like ‘oh, okay, this is what it feels like’. I cannot explain how ill I felt. Morning sickness is not reserved for the morning. I spent all day feeling like I was fighting the world’s longest hangover. I didn’t know what to do with myself. I usually love being productive, love my routine and hate sitting still. I had to accept that my body was changing. I have to say it made the pregnancy feel much more real. But damn it was hard. I was so grateful to be growing a baby in my tummy but I just kept wishing the days away.

It was definitely worst in the morning and then again in the evening. All I could stomach was carbs. I found myself wanting to eat because my tummy felt quite hungry but it distressed me how much the sight of vegetables would increase the feelings of nausea. Foods, I relied on most were: Marmite on toast, eggs on toast, hummus on toast, and more toast. I couldn’t even drink tea. Often when I managed to eat something other than bread, I would finish it and then be hit with waves of nausea again. This was so far from what I had ever experienced. As someone who normally feels so in tune and connected to their body, I felt like I didn’t know myself at all. It sounds dramatic but it was mentally hard to get my head round.

I spent so much time googling ‘tips for morning sickness’ but very little seemed to have any affect! What I would say to anyone suffering is try and not let yourself get too hungry as this can mess with your stomach acids and cause you to feel more ill. Stomach what you can, and take each day is to comes. It really is survival mode. What kept me feeling somewhat okay about only eating very little variety is that my diet had been very nutritious up until this point, so I knew baby would take what it needed from my nutrient stores.

My energy levels were also low. Before pregnancy I was working out anything from 3-6 times a week and walking every day. Then all of a sudden one workout a week was a huge achievement. Although it is frustrating and miserable, we have to accept our bodies are going through a huge change – I mean we are growing a baby! So try and chill out and know things will get better. Other symptoms that I noticed were: enlarged boobs, heightened sense of smell, needing a wee every hour and mild cramping.

When I hit 10 weeks, the sickness eased a little and by 12 weeks I started to feel a lot more like myself (thank goodness!). I am currently 15 week and aim to workout 3-4 times a week, walk everyday and can eat vegetables again – yay!

For more on Nutrition and Pregnancy check out my previous blogs: Food for Fertility and Pre Natal Nutrition.

 

 

Prenatal Nutrition

If you are reading this and are already pregnant – congratulations! If you have decided you’re going to start trying for baby, this is a very exciting time and I urge you to read my previous blog ‘Food for Fertility’. Before we get going, this article is based on evidence based research and should not be considered as personalised advice. If you have any specific concerns about your diet whilst pregnant please seek help from your GP, Midwife or Registered Nutritionist / Dietitian. 

Depending on how far along you are in your pregnancy, you have likely experienced some of the side effects (fatigue, nausea, mood swings etc.). Our bodies go through physical and hormonal changes when growing a baby and it is important to support yourself nutritionally.   

Your body will require increased nutrient intake when pregnant however the ‘eating for two’ myth does not apply here. Think quality over quantity. The current NHS guidelines advise that you should eat the same (healthy) amount as you would do normally, until you get to your third trimester and consume around an extra 200kcals. This is an estimate and equates to 1-2 extra snacks. 

What to eat… 

There is no specific ‘pregnancy diet’ however there are some key food groups and nutrients you will need to consider. 

Carbohydrates

Particularly, in the first trimester, carbs seemed to be the only thing some women can stomach.  Carbs are needed to provide you and your baby with energy and may also help with nausea in the first 12(ish) weeks. Choosing wholegrain carbs is a good way to increase your fibre intake and may help support your digestion (as this is often affected during pregnancy). 

Protein

It is important to consume enough protein in pregnancy to support the growth and development of your baby. It also plays a role in making antibodies to support their immune system. In line with the current guidelines, its advised to consume 1-2 portions of oily fish a week (salmon) as this is important for omega 3 consumption, and a good variety of both meat and plant proteins. Plant proteins such as beans, pulses, tofu and nuts contain an abundance of nutrients and fibre. 

Dairy

Calcium supports the formation and maintenance of your baby’s teeth and bones (and is needed for the health of your own teeth and bones too). The BDA recommend 3 portions of dairy a day (200ml glass of milk, 150g yoghurt, 30g cheese) as it is a great source of calcium. Non dairy sources of calcium include: tahini, spinach, broccoli, tofu, beans, sardines, almonds and dried fruit.

Fruit and vegetables

Try to consume at least 5 fruits or veg a day and switch up the variety as much as you can for a diverse range of nutrients. Soups and smoothies are a great way to sneak in veggies if you are feeling a little nausea. 

Prenatal supplements: Pre natal supplements are essential. 400mcg of Folic Acid is advised 1-3 months prior to conception and in the first 3 months of pregnancy. You should choose a prenatal supplement to take throughout your pregnancy that also contains 10mcg Vitamin D and 150mcg Iodine. Additional Vitamin A is not advised and you should always check with your GP if you are unsure in regards to which prenatal supplement to choose. If you are vegan / vegetarian you may want to also consider a prenatal supplement that includes omega 3 as well as B12. 

Morning sickness

The dreaded morning sickness! It is estimated that around 70% of women will suffer with nausea and or vomiting in the first 12-14 week of pregnancy. Although it may deter you from eating, an empty stomach can actually make nausea worse so try and eat small and frequent meals (even if it’s just some crackers!). Some additional things you may want to try are:

  • Avoiding foods with offensive smells
  • Limit fried or spicy foods
  • Stay hydrated throughout the day
  • Eat plain carbs first thing in the morning
  • Try ginger tea 
  • Have someone else prepare your meals if possible

Caffeine in pregnancy 

The research around caffeine in pregnancy in relatively inconclusive however the available research we have suggests that it should be limited. This is because Foetuses are less able to break down caffeine than adults, and thus may be exposed to the same stimulant effect as the mother. Research by the CARE Study Group in 2008 suggests that small amounts of caffeine (up to 100 mg/day) are safe during pregnancy, but high levels (greater than 200 mg/day) increase the risk of miscarriage, premature birth and low birthweight babies. So, what does 200 mg/day look like?

  • The average ‘coffee shop’ cappuccino contains around 150-190mg however depending on the coffee beans this may be more or less so be cautious.
  •  A cup of instant coffee is around 95mg
  • A cup of green tea can be between 65-90mg
  • A cup of breakfast tea is around 60mg
  • 50g of dark chocolate (>60%) is around 45mg
  • 50g milk chocolate 10mg
  • Can of coke 35mg 

Remember that energy drinks often contain high amounts of caffeine too, and so do over the counter remedies for cold or flu. 

additional tips  

  • Avoid alcohol throughout pregnancy.  Within minutes of consumption, alcohol travels in mother’s bloodstream and crosses the placenta. When the foetus is exposed to alcohol there is an increased risk of miscarriage, stillbirth and pre-term birth.
  • Don’t smoke 
  • Ensure all meats are cooked properly 
  • Practice good hygiene around food
  • Eat freshly prepared foods
  • Wash all fruits and veggies
  • Avoid soft cheeses and unpasteurised dairy (hard cheese are fine)
  • Stay active when you can 
  • Stay hydrated
  • Do not consume high mercury fish: Swordfish, marlin, shark
  • Consult your GP and / midwife if you have any specific concerns 

  

References

https://www.nhs.uk/start4life/pregnancy/healthy-eating-pregnancy

https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20045082

https://www.bda.uk.com/resource/pregnancy-diet.html

Food for Fertility

Research suggests that fertility issues can affect around 15% of couples. Genetic, behavioural and environmental factors may impact fertility in males and females and improving your diet can be a simple and inexpensive way to support fertility. If you are worried about conceiving, please consult your GP.

Although making changes to your diet does not guarantee conception, we know from a body of research that it may have a positive impact and increase chances of falling pregnant. Improving your diet from a nutrional point of view, can not only enhance your own health but benefit your baby too. 

It is important to note that both males and females have a role to play when it comes to fertility. Often when couples have trouble conceiving, it is assumed that the problem lies with the female which is not always the case… It takes two to tango! 

Healthy eating patterns adopted before pregnancy are more likely to define in the food environment in the household once a child is born and eating a nutrient rich diet in preparation for pregnancy may increase your likelihood of getting pregnant. 

Whilst there is limited evidence for a specific ‘fertility diet’, health professionals remain confident that by promoting a well-balanced diet that includes lots of wholegrain carbohydrates, plant protein, fruits, vegetables and essential fats, they are making a significant contribution to the health of women and their partners and one that may encourage fertility. Nutrition is arguably the most influential non-genetic factor contributing to foetal development.

So what does the research tell us? 

What a mother eats before and during pregnancy directly impacts the nutrients that are supplied to her growing baby and therefore has a primary influence on foetal nourishment throughout each stage of gestation. Macronutrients provide energy and protein for foetal growth, while micronutrients are involved in the metabolism of macronutrients, and the structural and cellular metabolism of the foetus.

One study followed over 116000 women and demonstrated higher fertility rates in women that had diets rich in monounsaturated fats, vegetable proteins and fibre from wholegrains. Data from this study also revealed that women who consumed higher amounts of non-haeme iron (iron from plant-based sources) from foods like nuts, beans and vegetables are at decreased risk of ovulatory infertility.

Interestingly, some research has suggested that consumption of full fat dairy is associated with better fertility outcomes.

Women are also advised to take prenatal supplements prior to conception however the guidelines may differ depending on what country you are in. 

Dietary supplements:

  • 400mcg Folic Acid is advised one month before conception and in first trimester
  • 150mcg Iodine for those considering pregnancy and pregnant 
  • Iron through adequate food sources or supplement 
  • 10mcg Vitamin D daily during pregnancy 
  • Multivitamins are not advised unless other known deficiencies 

What about men?

In men, it was found that consumption of polyunsaturated fatty acids was important for sperm quality and quantity. Sperm production is improved with diets rich in omega-3 polyunsaturated fats but reduced with diets rich in saturated and trans fats. In regards to sperm quality, it is thought that zinc and folate are particularly important in terms of supporting sperm motility and the synthesis of genetic information found in sperm. Oysters, lean red meat, nuts, beans and wholegrains are all good sources of zinc and fruits, veg (especially leafy greens) and cereal products are good sources of folate. 

Sperm also need to be protected from free radicals once they are formed. Antioxidants are molecules that can protect against this damage by neutralising the free-radicals. Antioxidants include nutrients such as vitamin C, vitamin E and selenium and a large number of other compounds found in fruits, vegetables and whole grains.

OTHER FACTORS TO CONSIDER

  • Whilst excessive amounts of intense exercise are not advised, being physically active has been associated with increased rates of fertility. You do not have to get yourself to the gym every day to stay active. Consider taking long walks, workout classes or any type of movement you enjoy!
  • Trying for a baby can be stressful and you might be constantly thinking about whether or not you have fallen pregnant. Try to relax. Research suggests that high stress levels may affect your cycle thus making it harder to know when you are ovulating. 
  • The link between caffeine consumption and fertility is inconclusive however some studies have seen increased amounts of caffeine decrease fertility rates. Consider limiting your intake to 1-2 cups of coffee a day and remember tea and chocolate contain caffeine too.
  • In regards to overall diet, research suggests that a Mediterranean style diet may be the most beneficial. Although researchers are not entirely sure what is it specifically about this diet that seems to best support fertility, it demonstrates that a balance of fibre, essential fats and antioxidants are important. 

Key Takeaways

  • Antioxidants for both men and women are important for pre-conception 
  • Diet in women can affect ovulation, foods that can improve: wholegrain carbs – quality over quantity, increased fibre, healthy fats (Monounsaturated) – nuts, oils, avocado etc.
  • Eating more plant protein over animal protein may boost fertility 
  • Consume plant-based protein and non-haeme iron
  • Choose low-GI carbohydrates
  • Prenatal supplements are important
  • Maintain hydration by consuming plenty of water
  • Achieve a healthy weight (for you)
  • Be physically active
  • Cut down on caffeine
  • Avoid alcohol 
  • Take time to relax 

pre conception weight  

My practice with private clients sees me work with individuals to prioritise their health. When weight loss is one’s primary goal, nutrition can often be neglected and we know from a body of research that weight loss diets are usually not sustainable. Whilst research suggests that being significantly overweight or underweight may make getting pregnant more difficult, a healthy weight is hard to define using just numbers. The research tells us that being overweight or underweight may affect the hormones that regulate ovulation. Following nutrient recommendations and making sure you have a well balanced diet is a good way of ensuring you are supporting your health prior to conception but if you are worried about your weight, please seek advice from a Registered Nutritionist or Dietitian. 

Please also note that if you are suffering with an eating disorder, you will need to seek additional support to help restore a healthy weight if you are thinking about pregnancy. 

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717046

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4981818

https://pubmed.ncbi.nlm.nih.gov/28844822

https://pubmed.ncbi.nlm.nih.gov/28844822

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733907

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192363

https://www.beateatingdisorders.org.uk/your-stories/warnings-fertility-eating-disorder-treatment

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/ 

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:

Mastering 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!