Mar 06

Eating Disorders: Types and Indicators

Recently I posted about common myths surrounding eating disorders.  I had a wonderful response to this, and I’m so grateful to all of you for taking the time to read it.  Whilst it delighted me that people are informing themselves, it saddened me when people wrote to me about some of the things that had been said to them.  Before I go on to descirbe different types of eating disorders, I’d like to mention two more myths that have been brought to my attention since my original post.
Myth: an eating disorder is something you can ‘snap out of’.
Reality: An eating disorder is a mental illness just like depression or anxiety. We can’t just ‘snap out’ of those, so why should we be able to do so for an eating disorder?  A mental illness is just as real and challenging as a physical one.  You wouldn’t ever tell someone to ‘snap out of it’ if they had a broken leg or a heart condition.  To do so for a mental illness is equally ludicrous and insensitive.
Myth: Eating disorders are a sign of vanity.
Reality: I could hardly believe my eyes when I saw this one!  People with eating disorders are the opposite of vain.  Many of them believe their bodies are disgusting and can’t stand to look at themselves.  They may even believe that they are so overweight it’s unhealthy.  Like the friend I wrote about in an earlier post they may wear frumpy or baggy clothes to cover themselves up and hide their issues.  There’s no vanity here at all, folks.  Quite the reverse.
So, what types of eating disorder are there, and what sort of behaviour in yourself or someone else might give cause for concern?
Anorexia
Distorted body image

People with anorexia often see themselves as being bigger than they really are.

Anorexics often see themselves as much larger than they really are, and aim to control their weight by extreme calorie restriction, often coupled with over-exercising.  They may fear and avoid certain food groups, most often carbohydrates and fats.  They are terrified of gaining weight, and will do almost anything to avoid doing so.  Some anorexics have cycles of bingeing and purging, whilst others severely limit what they eat at all times.  Anorexia often stems from a need to be in control; if the sufferer is not able to control certain aspects of their lives they use restricted eating to regain a feeling of control.
It’s very common in our society for people to be concerned with weight.  However, if someone seems excessively obsessed with being overweight when in fact they are of normal weight or underweight, and shows fear towards eating all foods or certain food groups, this could be a cause for concern.
do not feed

Eating disorders are real. Can we help young people master healthier ways of thinking?

You might also be concerned if someone exhibits sneaky or obsessive behaviours around food.  These include pretending they’ve eaten when they haven’t, avoiding eating around others, obsessive calorie counting, taking diet pills or laxatives when there is no clinical need or hiding food. You might also be concerned if the person shows knowledge of or spends time on pro-ana websites.  For those of you who don’t know, these are websites that promote anorexia as a lifestyle choice rather than recognising it as an illness. I’ve seen young girls who have started to exhibit medical symptoms of anorexia, such as hair loss, and stopping their periods.  If this happens to a young woman you know, please seek help for her as soon as possible.
Bulimia
Bulimia is a pattern of binge eating followed by purging via vomiting and/or laxitives and/or excessive exercise.  Binge eating is not to be confused with overeating; many people overeat occasionally or regularly, but are quite aware of what they’re doing.  Bulimics feel out of control or disconnected with how much or how quickly they’re eating, and then feel terrible about it and resort to purging.  Bulimic binge eating may involve eating foods that the person would normally avoid.  Bulimics may have a distorted body image, which makes them believe they are much larger than they reallly are.
Bulimia can be hard to spot because the sufferer rarely looks excessively thin.  Probably the most famous bulimic ever was Princess Diana, who was lauded as a style icon for many years.  In the later stages of bulimia, the vomiting may cause stained teeth.  You may also notice changes in mood and behaviour, and secretive behaviour around food.
Emotional Overeating and Binge Eating
Which emotions make you want to eat?

Which emotions make you want to eat?

Lots of people are emotional eaters from time to time.  It’s common for people to eat when they’re upset, angry, lonely, bored, or even happy.  It sometimes involves cravings for particular ‘comfort foods’, and will occur even if the person isn’t hungry.  Emotional eating on occasion isn’t necessarily a problem; it becomes a problem when it happens frequently, when the eater no longer feels in control of what they’re eating, and when it’s used as a coping strategy instead of addressing the issue which has triggered the eating.
Binge eating is when a very large amount of food is eaten over a short period of time, but the eater feels out of control of what they are eating.  Some people plan their binges, whilst others binge spontaneously.  Bingeing is not pleasurable; often binge eaters want to stop eating during their binge but can’t.  Sometimes they find it diffiuclt to remember what they’ve eaten afterwards. Binge eaters can experience huge guilt, embarrassment or shame during or after the binge.
Binge eaters may avoid eating in front of others or show shame or anxiety around food.  They may be obsessed with food, and structure their whole lives around eating episodes. They may buy much larger quantities of food than they need or hoard food.  They can eat very rapidly, eat even when they’re not hungry, not stop eating even when they are uncomfortably full, and not be able to recall what they’ve eaten.  A lot of these behaviours happen in secret, so they can be very hard to notice.
Orthorexia
An interest in healthy food is great, but it shouldn't dominate your life

An interest in healthy food is great, but it shouldn’t dominate your life

It may sound like a contradiction, but orthorexia is an unhealthy obsession with healthy eating.  From personal experience, this isn’t taken as seriously as other eating disorders, or even recognised.  I’ve even heard some therapists refer to it as a ‘good thing’ and question whether they should address it at all.
Many people are interested in healthy eating, and that’s generally a positive thing.  If I didn’t think so I wouldn’t be here!  But if people become phobic about certain foods, describing them as ‘dirty’ or ‘poison’ and have an excessively restricted diet all the time for no medical reason it could be a sign of trouble.  As you know, I’m not a fan of the whole ‘clean eating’ movement (read more here), especially because it can trigger this type of obsessive behaviour.  Orthorexia can have a serious impact when it stops people from having social interactions because they are too worried about their food, or when their relationships suffer because they disengage from people who don’t share their dietary habits or beliefs.
'clean eating' on a post-it note

Is someone you know obsessed with ‘clean eating’? What does “clean eating” even mean?

Very restrictive eating can also lead to nutrient deficiencies and mental health issues.  Sounds pretty serious to me.
Other Specified Feeding or Eating Disorder (OSFED)
Mental illnesses are complex, and many people present differently with symptoms that are unusual or unexpected, but still have an eating disorder.  Eating disorders that don’t fit neatly into any of the other categories are known as OSFED.  Examples can include purging without bingeing, and night eating (eating large amounts of food at night after their evening meal, sometimes coupled with eating little during the day).  These disorders are just as important and serious as other eating disorders, and should be regarded accordingly.
Eating Disorders versus Disordered Eating
It’s possible for people to have disordered eating habits without having an eating disorder.  Disordered eating may mean, for example, being the victim of cravings, yo-yo dieting, self-worth based on size or body shape and obsessive calorie counting.  Disordered eating may, but doesn’t necessarily become an eating disorder.  As a nutritional therapist, I can work with disordered eating, but I’m not qualified or insured to work with eating disorders, which absolutely need the support of a medical practitioner.
What’s Normal?
chocolate cake

Would you enjoy this occasionally? Me too. Fabulous; we’re both completely normal…

If these are considered aberrant behaviours then what’s normal?  Does everyone have a degree of disordered eating?  Of course there will be lots of variation between individuals, but here are some perfectly normal and healthy behaviours around food.
  • It’s normal to enjoy food
  • But it’s also normal not to obsess about it, and to treat it as one element of a balanced life
  • It’s normal to eat more on some days and less on others
  • It’s normal to eat every day
  • It’s normal to take an interest in healthy eating
  • It’s normal to enjoy foods just because they taste good

    Array of healthy foods

    …especially when we can enjoy some of these delights every day.

  • It’s normal NOT to anthropormorphise food; food is not ‘good’, ‘bad’, ‘clean’ or ‘dirty’.  It has no personality
  • It’s normal to dislike some foods and to have different preferences from others around you
  • It’s normal that people of certain religions will avoid certain foods
  • It’s normal to enjoy a huge slice of cake on your birthday!
What if you’re concerned?
If you know anyone who may be suffering from an eating disorder, or you may be that person yourself, it’s important to get help, and the sooner you do so the sooner you can make a full recovery.  The BEAT Eating Disorders website is a good place to start, and has a helpline.  Find it here.
If you think you may have disordered eating patterns I may be able to help you put things in perspective and find a more balanced way.  Let’s talk!
For recipes, tips and links to informative articles from myself and others, body positivity, celebration of great food and plenty of fun, please join my FREE Facebook Group, ‘Susannah’s Nutrition Kitchen’.

Feb 26

Eating Disorders: Myths and Realities

When I was younger, I had regular contact with at least two people who I later found out were anorexic.  I had no idea.  Many of us think that, because of high-profile cases such as the late Princess Diana, we are all highly aware of eating disorders, who gets them, and how to spot them.  In fact, this could not be further from the truth.

Eating Disorders Facts

How many of these factoids about eating disorders did you know?

Did you know that in Britain around 8% of adults over the age of 16 have been diagnosed with an eating disorder?  I didn’t.  It’s a frightening figure, and it’s getting worse.  A rise of around 7% a year in hospital admissions for eating disorders has been reported.  Eating Disorders Awareness Week aims to raise awareness of the issues surrounding eating disorders and ensure that people in this situation have access to appropriate, effective help.  So, this week I’m talking about what eating disorders are, how to tell if somebody has one, and what you can do about it.  But firstly I’d like to bust some commonly-held myths.

What are Eating Disorders?

An eating disorder is a serious mental illness.  It’s played out in ongoing, highly disordered behaviours around food, but the underlying cause may not be related to food at all.  Instead, it’s connected to the way the person feels.  Extreme food behaviours may help the person to feel better, or more in control.

Eating Disorders: Myths and Realities

Many eating disorders may go unrecognised because there are many stereotypes around who has an eating disorder.  Here are just a few.

Distress

Eating disorders can affect people of any age; not just teens

Myth: Eating disorders are a teenage problem.

Reality: Although eating disorders do primarily affect young people, you can develop an eating disorder at any age.  Some people have been known to develop eating disorders in their 70s, and in 2015 15% of calls to the BEAT eating disorders helpline were from people aged 40 or over.

Myth: Only girls have eating disorders.

Reality: It’s estimated that 15-25% of people with eating disorders are male.

Woman with hula hoop

Being very slim is not necessarily an indication of an eating disorder; people come in all shapes and sizes!

Myth: You can tell who has an eating disorder because they are very skinny or very fat.

Reality: People come in all shapes and sizes, and being over or underweight does not mean you have an eating disorder.  In fact, around 80-85% of people with eating disorders are not underweight.  People with bulimia, for example, are very often within the ‘normal’ weight range.

 

 

Myth: Eating disorders are a ‘white person’s illness’.

Reality: Around 39% of us believe that white people are more likely to suffer from eating disorders than other ethnicities.  The truth is that eating disorders are ‘colour blind’, and affect all ethnicities equally.  However, the stereotype can prevent people from seeking help because they think eating disorders aren’t ‘supposed’ to happen to them.  In a recent survey only around 52% of minority ethnic people felt comfortable asking help from a health professional in relation to an eating disorder compared with 64% of white people.  Of course, this may reflect cultural or social differences relating to how different groups relate to health professionals in general, but it’s also likely to mean that eating disorders in the minority ethnic community go unrecognised.

Eating disorders are about feelings, not about food

Eating disorders are about feelings, not about food

Myth: Eating disorders can be corrected with dietary advice.

Reality: An eating disorder is a mental illness. Whilst dietary advice may help change misconceptions around food or give people tools to distinguish what they think they are eating from what they are really eating, or support them on the road to recovery, dietary therapy does not deal with the underlying issue.  For this reason myself and other nutritional therapists are not qualified to work with anyone with a diagnosed eating disorder; they must be referred to a medical professional.

Myth: You can’t get better from an eating disorder

Reality: Current research shows that around 45% recover fully from anorexia or bulimia with many others showing significant improvement.  Obviously this figure is still much lower than it should be, but it does offer hope that eating disorders need not necessarily be for life.

Would you like this information and more on video?  Join my FREE Facebook group, and get this and much more, including recipes, tips and chat.

Would you like more information on eating disorders?  Visit the BEAT website.

Next time: What are eating disorders and how do you recognise them?

 

Feb 13

Food of Love – a Post for Valentine’s Day

If an object’s appearance reminds you of a sexual organ, is it likely to stimulate your sexual appetite?  This was certainly believed to be the case in ancient times.  Our ancestors believed that anything resembling a sexual organ would increase libido and potency when eaten.  Over the years, anything vaguely sexy, from chillis to pomegranates, has been labelled an aphrodisiac.  Is there any truth behind these claims?  I had some fun finding out about some of the most well-known love foods, and hope you will too.

Oysters

Oysters

Oysters are one of the richest sources of zinc, vital for sperm health

A dozen oysters may be marketed as the ultimate food of love, but there’s barely any evidence that this is really the case.  Oysters are probably most useful as a source of zinc, which is one of the nutrients required for sperm quality.  I did track down an experiment where oyster extract was fed to male mice to see if it would make them more virile.  A low dose had a mild aphrodisiac effect, but it wore off after 3 hours.  So, if you start your romantic evening with oysters, don’t expect your man to keep going hours after dessert!

Chocolate

Heart shaped chocolate box

Is it your chocolate, or your chocolate box, which stimulates desire?

Chocolate as an aphrodisiac has a long and noble history.  The Aztec emperor Montezuma used to consume large quantities of cacao beans to allow him to perform mighty sexual acts.  The Victorians saw chocolates as an expression of courtship and love; a man giving chocolates to a woman was considered romantic, but a woman giving chocolates to a man was considered extremely risqué and inappropriate.  Unwrapping the elaborate layers of a Victorian chocolate box was said to resemble the unwrapping of the many layers of clothing which concealed a woman’s modesty.

Surprisingly, chocolate does not contain any substances which have a direct effect on libido.  Its most active compound is phenylethylamine, which helps boost mood, give you a burst of energy and increase stamina.  These pleasurable sensations could contribute to a great sexual experience, but chocolate eaters don’t experience increased arousal or sexual performance compared with non-eaters.

Whole and grated chocolate

Always buy the best quality chocolate you can – it will be worth it!

Women are more susceptible than men to chocolate’s effects, so, gents, you know what to buy your lady this year.  You’ll be in good company; In the States 58 million lbs of chocolate are sold on Valentine’s day.  But never buy cheap chocolate; it may be the mouth-feel of chocolate that is the most exciting in terms of stimulating pleasure.  This melt-in-the-mouth experience is best in expensive chocolate because of its higher cocoa butter content.  You have been warned.

Avocados

The Aztecs were clearly a sexy lot.  Our word ‘avocado’ derives from the Aztec word for an avocado tree ‘ahuacatl’ (testicle), named for the shape of its fruits, and because they tend to hang low in pairs.  When the Spanish conquered Spain, the Catholic priests banned the population from eating avocados because they were considered too provocative.

Sliced avocado

Too sexy by half?

I don’t think the priests need have worried.  Avocados are highly nutritious, containing a range of vitamins and minerals, for example potassium, magnesium and Vitamin E, which support overall health, including sexual health.  But there’s no objective evidence at all that avocados increase libido or fertility.

Maca

Maca powder

Magical Maca? Maybe…

Maca has been cultivated in the Andes and used in Peru as a medicine famed for its libido and fertility enhancing properties for over 2000 years.  Today it has gained huge popularity in the West, which has led to it being mass-produced with intensive farming methods.  Whatever the properties of traditional maca may or may not have been, it’s doubtful whether they are replicated in the product you can buy in health food shops today.  Studies of the aphrodisiac properties of maca are mostly small and poorly conducted, so it’s hard to draw any conclusions.  However, one small study suggests that using maca may reduce blood pressure and depression in older women, who could be more interested in bedroom fun as a result.

You generally buy maca in powder form.  It tastes sweet, so it would be great to use as part of a dessert without the need to involve sugar.  Your honey may love you more for that alone.

 Asparagus

Green asparagus stems

It’s all about that shape – ’bout that shape – no trouble.

Greek love poetry contains references to asparagus and the Kama Sutra recommends asparagus paste.  There’s a rumour that French bridegrooms used to eat three meals of asparagus before their wedding night to keep them in the mood all night.

Asparagus probably gets its reputation from its shape – no need to say what it might remind you of.  But there’s very little evidence to uphold its reputation.  Asparagus is a source of B-vitamins, which are needed for the energy production cycle, and so might keep you alert for longer.  Asparagus extract may reduce feelings of depression, promote general speed and accuracy and enhance sleep quality, all of which might be useful if you’re planning a night of fun and games in the bedroom.

Why are Aphrodisicac Foods Popular?

Do you see a pattern emerging here?  It’s fun to talk about aphrodisiac foods, but there’s little biochemical reason for their popularity.  So, how might we account for their reputation?  Folklore certainly plays a part, but I think there’s more to it than that.  The aphrodisiac properties of food are not about what they contain, but about how it feels to eat them.  Consider the sensual mouth feel of chocolate; the satisfaction of crunching an asparagus spear (I suck mine, but perhaps we shouldn’t go there), or the silky texture of an avocado.  I think it is these factors, more than the chemical composition, which underpin the enduring reputation of the foods of love.

Chocolate lover

What should you feed your love on Valentine’s Day? Whatever (s)he loves best, of course!

The best thing you can do for your beloved this year is to serve them foods they really love to eat.  Maybe something that’s a treat, or rarely available to you.  If your partner usually does the cooking, do it yourself for a night, or order a meal from a private chef (I’d be happy to help).  Dim the lights, play some soothing music and make your other half feel special.  I can’t guarantee that any of this will lead to a night of untrammelled desire, but it will certainly make your partner feel cherished, which is what this time of year should be all about.

Would you like to try a dessert featuring some of these foods?  I’ll be posting one in my FREE Facebook group.  Head over here to join.

Jan 30

Food Trends for 2019

This week I decided to check out the flagship store of a certain ‘natural’ food and products chain.  After all, an afternoon in a food shop counts as research, right? In this case my aim was to identify food trends for 2019 in the health food industry.  Obviously a little browsing (even with a good bit of tasting thrown in) doesn’t make me an expert, but here’s what I’m noticing this year.
Fermented Foods
fridge of kefir

Not so long ago we had never heard of kefir. Now here’s a fridge full

Perhaps I’m noticing these more because I’m currently trying out a protocol which encourages them, but I don’t think I’ve ever seen a whole fridge of kefir before.  In case you’re wondering, kefir is a fermented milk product.  Apparently, make-your-own kefir kits are flying off the shelves.  For vegans there’s sauerkraut, fermented soya, miso, nato and probably many more.  These are supposed to be the new wonder foods for promoting a healthy microbiome – in other words, for nourishing the beneficial bacteria that populate the gastrointestinal tract.  Personally, I’m not keen on the ‘pickled vegetable’ varieties of fermented food, but I’m trying to get my head around kefir, and I’m developing a taste for miso.  With a greater range of products available, everyone is sure to find something to suit.
Vegan Ranges
Vegan food

There are masses of vegan products on the market, but they can’t beat whole foods for nutritional value

Veganism is currently the fastest growing food trend with the UK vegan market exceeding £310 million a year.  Naturally, retailers have jumped on the bandwagon.  More ranges than ever are suitable for vegans, and there are more products aimed at vegans than I’ve ever seen.  In some ways this is fantastic, because it means that there’s more variety out there, and it’s easier than it’s ever been to have a healthy and varied vegan diet.  Gone are the days when “I’m a vegetarian” (‘vegan’ wasn’t even known 30 years ago) resulted in a blank look and a slightly singed nut roast.  Now, the shelves, chiller cabinets and freezers all vie to attract the green pound.
A word of caution, though.  ‘Vegan’ doesn’t always mean ‘healthy’ or ‘good for the planet’. I see a lot of vegan products that are highly processed, meaning that they’ve created a heavy carbon footprint, and probably aren’t the healthiest.  Many of them have never seen a vegetable in their lives.  There are a lot of soya ‘fake meat’ products that I’d be a bit wary of, especially if you’re not used to them, as the jury is still out over whether they have a positive or negative effect on hormones, and vegan burgers which contain refined grains, sugars and preservatives don’t impress me either.  Furthermore, they’re encased in layers of plastic and cardboard. If you’re aiming for a lifestyle that’s as good for your body as it is for the planet, you may want to go back to basics and stick with whole foods in their original form.
Creatively Gluten Free
Gluten Free

If you need or want to do without gluten there’s plenty of choice available. But is it all healthy?

It seems that the gluten free trend hasn’t gone away.  You could even say that we in the nutrition world encourage it, as we often recommend a period of gluten exclusion as part of a ‘healthy gut’ protocol.
Unfortunately, gluten free breads and other similar products have a history of containing highly refined ingredients and tasting like cardboard.  I encourage my clients to avoid them, and not to try and imitate bread, but to find something completely different.
However, manufacturers have started to up their game.  Last week, a friend told me about some kale bread she had tried.  It sounds absolutely horrible, but she loved it.  The biggest improvement I’ve noticed is on the pasta shelf.  Gluten free pasta used to be pale and stodgy, lacking in fibre and incredibly difficult to cook without it turning to mush.  Now, the shelf is a riot of colour and a pleasure to look at.  Who could have dreamed a year or two ago of edamame pasta, black bean pasta or red lentil pasta?  Yet here they are, and, dare I say it, some of them are a really good substitute for the real thing.  And that’s coming from an Italian!
Corn Products and Mexican Food
Corn

Corn seems to be the new food of choice in snacks and breads this year

Corn tortillas have been around for a long time, but I’ve noticed that corn seems to be the ingredient du jour in just about everything at the moment.  I even found a whole rack of different kinds of corn.  In school, the kids are bringing in popcorn snacks as an alternative to crisps.  Air-popped corn without added flavourings could indeed be a healthier option; it’s a useful little source of fibre, with a cup containing 1g, and on its own it’s low in salt and sugar.  However, most people don’t eat it like that.  When you start frying it in cheap oil and adding flavours, the stuff becomes less healthy (surprise, surprise).  For example, a third of a packet of ‘sweet and salty’ popcorn contains 8.9g fat, 0.47g salt and 6.4g sugar. A snack-sized pack of bog-standard crisps scores about the same for salt, but is lower in both fat and sugar. Not that I recommend crisps, but it’s just an illustration that what we perceive as ‘healthy’ may not always be as healthy as we think.  Remember that the fat in these products is of poor quality from a nutritional perspective; certainly not a ‘healthy fat’.  So, corn may be a great addition to a varied diet to increase your daily fibre, but I’m happy to retain a healthy scepticism around corn snacks.
Protein Powders
Protein shake

Who needs protein powders?

There’s a dazzling array of these products on offer at the moment; more than ever before, and in an eye-watering selection of flavours and formulations.  How do you choose?  In all honesty, you probably don’t.  Most of us get sufficient protein without needing ‘add-ons’.  Nevertheless, there are circumstances in which protein powders are useful, and I’ll happily confess to using them myself when I need to.  If you do need one, it’s largely a matter of personal preference which one you go for, although there are a few things to take into consideration.  But that’s a subject for a blog post all on its own.  Stay tuned.
What have you spotted on the shelves in 2019 that may become the next best thing?  Send me a comment and let me know.

Would you love a little help going sugar-free for February?  Click here to kick the sugar and kick start your energy.

Do recipes, tips, inspiration, special guests and nutrition-related chat sound like your idea of fun?  If so, come and join me in my FREE Facebook group. I’m excited to welcome you.

Jan 23

Is Obesity a Disease? A Post for National Obesity Awareness Week

Is obesity a disease or a lifestyle choice?  That is the question.  More and more countries are considering obesity as a disease, and calling on other nations to do the same.  Currently, Portugal is the only country in Europe that classifies obesity as a disease, joining America, Canada and, to a certain extent, Japan.
obesity statistics uk

Obesity statistics & projections for the UK

Obesity is a major public health issue.  In 2016 13% of adults around the world were obese, putting them at greater risk of diseases such as heart conditions, diabetes and certain cancers.  Most of the world’s population now lives in countries where obesity kills more people than being underweight.  It’s certainly a weighty situation, but will calling it a disease make any difference?  Today I’m sharing my thoughts with you.

‘Disease’ is a public health concern

Availability and affordability of healthy food need to be addressed at national level

Availability and affordability of healthy food need to be addressed at national level

The rationale behind classifying obesity as a disease is essentially a positive one.  It is proposed that calling obesity as a disease will remove the blame culture which surrounds people with weight issues.  From a medical perspective, diseases are caused by harmful agents in the environment.  From this perspective, obesity is not caused by the choices an individual makes, but by a harmful environment which, if changed, can reduce or even eliminate the incidence of the disease.  Recognising obesity as a disease puts more pressure on governments to deal with industry regulation, cost and availability of healthy food, detrimental workplace practices and safe spaces in which to be active, all of which have a role to play in healthy living for everyone.  These factors are beyond the remit of any individual, but need to be tackled at national level.
We also know that obesity is very poorly understood and most of the current options available to people if they choose to address it are unsuccessful.  Perhaps if obesity was understood as a disease rather than being put down to greed or laziness, we could develop more effective options for people who need them, and challenge the prejudices commonly found in the medical profession and beyond.

What’s in a Name?

Reclassifying obesity has not been shown to reduce discrimination or fat shaming.

Reclassifying obesity has not been shown to reduce discrimination or fat shaming.

But is it correct to call obesity a disease?  Will it really shift patterns of thinking or reduce bullying?  I’m sceptical.  Discrimination against fat people seems to be the last socially acceptable form of bullying, and those who like to belittle others are not going to give it up without a fight.  I think there’s a danger that re-classifying obesity will simply change the language of bullying and increase the tendency to label obese people as ‘scroungers’.  Sadly, it won’t make bullying disappear.  Since obesity was reclassified as a disease in America, fat shaming has not decreased. If anything, it has become more prevalent.
plus size woman exercising

Not all plus size people are unhealthy or have unhealthy lifestyles. We love healthy living too!

Furthermore, there’s a tendency to pity and patronise those who are considered to have a disease.  “Oh, poor you; you can’t help it – you’re ill, and you’re a victim of society”.  Personally, I hate being patronized and I certainly have no need of pity or any desire to be seen as a victim.  Even though obesity is a risk factor for many diseases people with obesity are not automatically unwell, or even physically impaired.  I am very fortunate in that I enjoy good health.  In fact, I have fewer health problems than many people my age.  I am lucky to be able to be physically active, full of energy, and enjoying healthy eating.  I know a lot of people like me.  I certainly don’t consider myself ‘diseased’, and neither should you.

‘Disease’ and ‘Cure’?

Considering obesity as a disease could lead to over-simplistic thinking.  The current model is ‘one disease, one cure’.  This could never be true of obesity, because obesity is not one disease, or indeed any disease, and there is definitely not one solution which works for everyone.  Instead, I think it’s more useful to think of obesity as a symptom of a variety of conditions, from disadvantageous genetics to hormone imbalances to social disadvantage.  People who seek to address it need bespoke solutions which take account of what underpins their specific situation.  We plus-sized folks are breaking the mould (literally!) and a cookie-cutter ‘remedy’ will never be a ‘one-size-fits-all’ solution.
It’s also worth considering that having a ‘disease’ implies that you need a ‘cure’.  Many people who are plus-sized don’t want to be ‘cured’; they’re happy with the way things are.
Obesity - Causes and Effects

Obesity is a multifactorial situation

Obesity is very frequently a symptom of some other state of suboptimal wellbeing.  It is undeniably a risk factor for several diseases.  And there are some diseases which cause obesity directly, such as Prada Willi Syndrome.  But I can’t see how classifying obesity as a disease in its own right is helpful or beneficial, either for practitioners or, more importantly, for those who experience obesity.  And at the end of the day, it’s their needs that count.
What do you think?  Is obesity a disease, a symptom or a lifestyle choice?  And how do your views influence your thinking? Let me know.

 

Would you love to chat about healthy food in an environment that’s body-positive?  Do you enjoy healthy recipes, tips and inspiration, and well-informed articles?  If so, come and join the conversation in my free Facebook group ‘Susannah’s Nutrition Kitchen’.

 

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4988332/

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(17)30191-2/fulltext

https://obesitymedicine.org/why-is-obesity-a-disease/

https://www.jstage.jst.go.jp/article/circj/66/11/66_11_987/_pdf

 

Jan 15

How to make Resolutions STICK

I’ve been hearing a lot this year about people deciding against making New Years resolutions.  They reason that you don’t need a new year to try something different; you can do it at any time.  I can certainly see where this is coming from, but I do think there is something quite motivating about getting excited about the start of the year and making new plans along with everyone else.

List of New Years Resolutions

Have you made resoulutions this year, or decided against it?

I think that part of the backlash against resolutions may come from knowing that only 8% resolutions are actually kept.  I’ve written about this elsewhere (read my previous post here).  If you’re not going to keep your resolutions, why bother?

Very often, people make a resolution having only a rough idea of what it actually entails, and how they will achieve it.  Big mistake.  Like anything else, successful resolutions need a strategy.  So, if you’re already swaying from your resolutions this year, or if you want to make a resolution at any other time of year, here’s my handy guide for what to do to make your resolutions STICK.

Specificity isn’t everything.

If you’re used to management speak, you’ll be familiar with SMART goals, and you’ll know that the ‘S’ stands for ‘Specific’.  It makes sense.  After all, if you don’t know what you’re aiming for, you’re very unlikely to get there.  However, I’d suggest avoiding specificity when it comes to numbers.   So, for example, many people say, ‘I’d like to lose 10lbs this year’.  This number may or may not be meaningless.  You may have plucked it out of a hat, or it may be the amount of weight needed to get you from ‘overweight’ to ‘within range’.  But either way, what happens if you are able to lose 8 or 9lbs, but don’t quite make 10?  Or if your body just won’t cooperate (that’s why I don’t like weight loss goals; not everyone can achieve them)?  Or if you have to take steroids for 3 months? Are you a failure?  Of course not!  You’ve still done the work and achieved more than a lot of people, but you might feel bad because you didn’t make your target, which was fairly arbitrary in the first place.  You will be causing yourself stress for no reason, and nobody wants that.

SMART goals

SMART Goals can work in certain circumstances, but sometimes numbers can get in the way

Instead, I believe the specificity should focus on what the outcome will be, what you will be able to do, and how you will feel.  For example, you might say, “I want to be within my desired weight range, because then I will be able to run up 2 flights of stairs, not feel bloated after I eat, and feel incredible in my skinny jeans”.  See how much more exciting that is than a number, and how it gives you a certain amount of ‘wiggle room’ in case life gets in the way?

Triumph over objections

Overcoming objections

People will always object when you make a change. Decide in advance how you’ll overcome this

Does it annoy you that as soon as you resolve to do anything someone comes up with a reason that it’s a bad idea?  Or, if nobody does, you do it yourself?  In my opinion the number 1 reason that people don’t follow through with their resolutions in the long term is because they don’t have a strategy for overcoming objections.  As soon as you want to make a dietary change, someone is bound to say, “You can’t expect people to accommodate that”, or “That’s a fad”, or “Everything in moderation…”.  If you haven’t planned for this it can seriously derail you.

What you need to do to triumph over these objections and come closer to acing your goals is to make your health (or your business or your family depending on what your resolution is) your number one, unequivocal priority.  That means that when an objection presents itself, you can say, “I am not going to let this objection be more important than my absolute priority, which is my health (or family or business)”.  If you know what is most important to you and make that something on which you will not compromise, things will fall into place.

Implement a plan

Interactive planning schedule

How do you like to do your planning?

As with everything else, planning is everything, but it’s not enough.  You need to implement your plans, or they will stay on paper, and not become a positive part of your life.  So, once you’ve defined your resolution and got specific about the outcome and how you will feel as a result, make a detailed plan for how you want to get there.  If you want to reach a business goal, for example, what are the steps you need to take to get there?  Write them down.  I love pretty planners but a notebook or even your computer will do just fine.  Tell someone about it who will be truly supportive.  Do you need any assistance to achieve this goal?  Who can provide that for you?  Is there someone in your friendship circle or do you need a professional?  If you’re worried about the cost of a professional, remember that nothing should get in the way of your absolute priority, and that the right assistance will be worth it in the end.

Compelling ‘Why’

Although I covered this earlier, it is worth a category of its own.  If the reason for the resolution isn’t compelling enough it won’t see you through the bad times.  If you can’t think of a ‘why’ that’s compelling for you, maybe the resolution you’ve chosen isn’t the right one.  If you’re having trouble choosing, consider what would happen if you were granted one wish that would make the biggest positive difference to your life a year from now.  Imagine in as much detail as possible what that difference would be like and build your ‘why’ around that.

Kick setbacks to the kerb

Stress

Major setbacks need time and patience. Give yourself those things, and make sure you seek out the assistance you need.

Nobody ever said life was easy.  The road to achieving your resolution may be longer and harder than you think.  That’s perfectly normal.  The key to your success is not whether you experience setbacks, but how you deal with them.

I’m not one of those people who believes in pushing through no matter what the circumstances.  Even with your number one priority, there are a few things that sometimes need to take precedence.  One is your health, and another is the people dearest to you.  If either of these are suffering you need to attend to them, and that might take some time.  These are major setbacks and need major attention.  Be kind to yourself and understand that they are not going to divert you from your number one priority for ever (unless that priority changes as a result); you’re just having to take a different route to get there.

This is a minor setback - honest!

This is a minor setback – honest!

On the other hand, there are minor setbacks.  The time you had a lie-in instead of working on one of your goals.  Or you lost your temper when you had resolved to be calmer in stressful situations.  Or you had a slice of that incredible cake your colleague bought to work – and then another just to make sure it was really as good as you thought.  Too many people make too much of these setbacks and end up thinking of themselves as someone who can’t follow through.  This thinking then becomes reality.  The best thing to do with a setback is to forget that it happened as soon as it did.  You’ll be used to hearing people say ‘draw a line under it’, which is fine, but I think gives the setback more attention than it needs.  It’s such a minor thing that it’s not even worth a line.  The bigger your mind makes it, the more important it will become.  Make it insignificant, and that’s what it will be.  If the setback looks like becoming a habit, it needs addressing. Otherwise, don’t feed the troll.

What do you think?  Are you ready for your resolutions to STICK this year?  Do you have a strategy that’s worked wonders for you?  Let me know.

Would you love some support with your health goals this year?  Do you enjoy recipes, tips, inspriation, well-informed articles and a body-positive community?  If so, please join me in my free Facebook group, ‘Susannah’s Nutrition Kitchen’.

Jan 03

Spruce up your Sleep Routine

Today is the Festival of Sleep Day.  Not heard of that one?  Neither had I.  Apparently it’s a day when we’re encouraged to get some extra sleep in order to recover fully from the festivities before the year really gets going.

To get you started, here are some things you might like to know about sleep:

  • Sleeping on a cloud

    How many of these fun facts about sleep do you know?

    It should take 10-15 minutes to fall asleep at night.  If you are falling asleep faster than this you may be sleep deprived.

  • Higher earners (over £65,000p/a) get the best sleep.

  • Pain tolerance is decreased when you don’t get enough sleep.

  • The longest recorded time for going without sleep and living to tell the tale is 11 days.  Some people who’ve attempted this have died trying; in the short term going without sleep may be even more dangerous than going without food.

  • Having trouble getting up in the morning?  You’re suffering from dysnia.  It may indicate a nutritional deficiency, or a hormonal or mental health issue.

  • Gaining weight on a healthy diet?  Take a look at your sleep.  Lack of sleep can cause levels of the appetite-regulating hormone Leptin to fall, making you hungrier.

  • Regular exercise can help regulate your sleep, but exercising sporadically or working out shortly before bed can disrupt it.

  • Stress

    What issues in your life might hinder your sleep?

    Stress, illness, living arrangements, family history, shift work, diet and exercise patterns can all contribute to insomnia, which is not lack of hours slept, but the symptoms it causes, such as headaches, irritability and difficulty concentrating.  Did you know that 16 hours without sleep has the same negative effect on your concentration as a blood alcohol level of 0.05%?  The legal limit is 0.08%.

Everyone knows that good-quality sleep is an essential element of healthy living, but what can you do if you have difficulty sleeping?  Here are some tips for improving your sleep routine, so that you can get better-quality shuteye and have more energy, concentration and productivity throughout the day.

  1. Food sources of tryptophan

    Tryptophan with your evening meal can help promote quality sleep

    For your evening meal, make sure you include turkey, chicken, soya eggs or fish, as these contain tryptophan. Tryptophan is an amino acid (building block for protein), which is used to make 5HTP, which converts to serotonin, which in turn is used to make melatonin, the chemical your body makes to promote sleep. Tryptophan is more available to your brain in the presence of carbohydrate (Shabbir et al, 2013), so ensure that you also include a little carbohydrate (e.g. one small potato, or a spoonful of rice).  Fill the rest of your plate with colourful vegetables.  Avoid sugar and alcohol.

  1. Do not drink any caffeinated or sugary drinks. Instead choose water or herbal tea.  Some people find chamomile soothing, but be careful with it if you’re taking antidepressants, as it could strengthen their effect (Natural Medicines Database, 2017).  Some people also report good results with viridian tea.  Try and finish all fluids at least an hour before bed to reduce the chances of having to wake up to wee in the middle of the night.

  1. Aim to do at least 30 minutes of moderate physical activity on most days. Physical activity may be associated with better sleep quality, and also with feeling more satisfied about your overall health, particularly in young adults (Chang et al, 2016).  But stop exercising at least 4 hours before bed.

  1. Avoid all electronic devices 2 hours before bed. Turn them off, and put your phone on airline mode.  Instead, listen to an audio book, read a physical book, take a bath (anecdotally, an Epsom salt bath may be helpful for relaxation, especially if you suffer from restless legs or muscle cramps), or talk to a friend or family member.

  1. Aim to go to bed at a similar time each night, so that you accustom yourself to a specific

    Factors affecting sleep

    Which of these factors influence your sleep?

    time being the time to sleep. Having a regular sleep time may be helpful as part of a sleep routine (Kaczor & Skalski, 2016).

  2. Do a ‘brain dump’ before you go to bed; write down everything that’s in your mind so that it’s out on paper and not racing around in your mind.  Then make a list of what you will action the next day.  Taking a few moments to plan can make all the difference.  If you don’t like that way of getting rid of your worries, the South Americans have a tradition of telling their problems to tiny ‘worry dolls’, which they then put under their pillow before they go to sleep.  This is supposed to make the worries go away.  Obviously it’s just a superstition, but getting worries out of your head in whichever way works for you does seem to have an effect.

  3. Play sleep sounds, or relaxing music before you go to bed, and use low-level lighting in your room to help you transition to a sleep state.  You can also use a hypnosis recording designed specially for those who have difficulty sleeping. Ensure that your room is suitably dark, and you are neither too hot nor too cold at night.

  4. If you are bothered by a partner’s snoring try going to bed earlier than they do, so that you fall asleep first and aren’t kept awake by the sound.  If it’s serious and persistent your partner should have a chat with their doctor, as it could be an indicator of sleep apnoea, which is potentially serious.

Do you have any top tips for perfect sleep?  I’d love you to share them in the comments below.

Sweet dreams!

 

References

Chang, S.P., Shih, K.S., Chi, C.P., Chang, C.M., Hwang, K.L., & Chen, Y.H., (2016).  Association between exercise participation and quality of sleep and life among university students in Taiwan.  Asia-Pacific Journal of Public Health, 28(4), 356-367.

Kaczor, M., & Skalski, M., (2016).  Treatment of behavioural sleep problems in children and adolescents – literature review.  Psychiatria Polska, 50(3), 571-584.

Shabbir, F., Patel, A., Mattison, C., Bose, S., Krishnamohan, R., Sweeney, E., Sandhu, S., et al, (2013).  Effects of diet on serotonergic neurotransmission in depression.  Neurochemistry International, 62(3), 324-329.

https://health.clevelandclinic.org/22-facts-about-sleep-that-will-surprise-you-infographic/

Nov 30

Vitamin D and You

As winter draws in, there’s a lot of talk in the air about Vitamin D.  But what is it, where can you get it, and do you really need a supplement?  This article aims to take you closer to the answers to these questions, and more.

What is Vitamin D?

Vitamin D is a dietary component which is needed to maintain the right balance of calcium in the body.  This is obviously important for bone health, but could be a factor in heart health as well.  Vitamin D also regulates the levels of serotonin, the ‘happy hormone’, in the body, and may also help to regulate the expression of genes which regulate dopamine and noradrenaline, other hormones that play a role in mood.  This is why lack of Vitamin D has been linked to problems with mood and mental health.  The best quality evidence is found for the role of Vitamin D in bone health, although it’s likely that Vitamin D plays a role in many other areas of our wellbeing too.  Some studies have linked Vitamin D insufficiency to autoimmune conditions, food allergies, type 2 diabetes, some cancers, neurological disorders and dementia.  It’s thought that optimizing Vitamin D levels throughout Europe could cut healthcare costs by 16.7%.

Where can I find Vitamin D?

Sunlight is our principle source of Vitamin D, and spending time outside is good for health in so many ways.

Sunlight is our principle source of Vitamin D, and spending time outside is good for health in so many ways.

Our primary source of Vitamin D is sunlight, specifically sunlight which includes ultraviolet B radiation.  Due to the ozone layer, as well as the climate, sunlight in many parts of the world does not contain enough UVB light for our Vitamin D needs throughout the year.
In order to get enough Vitamin D, you need to expose your arms and legs to sunlight for 5-30 minutes between 10am and 3pm twice a week.  People with darker skin may need longer.  You should still practice sun safety and ensure you don’t burn.  This assumes that you have access to good-quality sunlight with sufficient UVB.  If not, it’s wise to consider diet and supplements as well.  Ideally, we make 90% of our vitamin D ourselves, and get 10% from elsewhere, but that’s not always possible.

Vitamin D and Diet

Fresh fish

Oily fish is one of the dietary sources of Vitamin D

Vitamin D is the only vitamin that can be both made in the body and eaten in the diet.  However, there aren’t many dietary sources.  The best-known is cod liver oil, which has been used successfully to treat rickets (the disease caused by Vitamin D deficiency), but Vitamin D can also be found in freshwater oily fish (e.g. mackerel, sardines) and some oily sea fish (tuna and salmon), as well as eggs, butter and cheese.  Some foods, such as certain margarines and cereals, are fortified with Vitamin D. The best vegan source of Vitamin D is wild, dark-coloured mushrooms.  Dark green leafy vegetables contain Vitamin D too, but not in the most useful form for the body.

 

Do you need Supplements?

During the winter months it’s unlikely that you’ll get sufficient Vitamin D from sunlight, and you may not enjoy the dietary sources regularly enough to keep your levels topped up.  There’s conflicting advice about whether you should supplement, but the following groups are still advised to supplement between October and April:
  • grandmother and baby

    Elderly people and children may need extra Vitamin D

    The elderly
  • Pregnant or breastfeeding women
  • Babies and children up to the age of 4
  • People with dark skin
  • People who do not spend much time outside
  • People who cover their entire body for religious or health reasons
If you’re not in one of these groups, you might want to consider testing to see whether a supplement would benefit you.  Your doctor can test once a year, but if you want to test more often (for example, to monitor how effective your diet or supplement changes have been) and your doctor isn’t able to help, you can buy a very reliable, affordable test that’s analysed in an NHS laboratory.  You can find more information here: https://betteryou.com/vitamin-d-testing-service.
Testing your Vitamin D levels will tell you if you're getting enough

Testing your Vitamin D levels will tell you if you’re getting enough

All you need is a spot of blood, so if, like me, you’re needle-phobic, this might be a better option for you than a blood draw at the GP, and it can be done in the comfort of your own home.
To avoid deficiency, your blood level of Vitamin D should be at least 75 nmol/L.  Often, practitioners like to see a level of 100-150 nmol/L, as this gives a margin for error; if your Vitamin D level should drop, you’re unlikely to become deficient before the balance can be redressed.
When choosing a supplement, you should always choose D3 (cholecalciferol) as opposed to D2.  This is the form that is most effective at improving overall Vitamin D status.  Furthermore, Vitamin D2 supplements tend to be less high quality.
If you’re a vegan, be aware that many quality Vitamin D3 supplements are not vegan-friendly, so choose with care.
Vitamin D can be one of the easiest supplements to take, as it doesn’t involve swallowing pills or capsules.  Instead it can be taken as drops, spray or, my personal favourite, tiny lemon-flavoured melt-in-the-mouth tablets.

Are you likely to lack Vitamin D?

There have been at least 13 studies done in the UK to assess the Vitamin D levels of the population.  Of the 13 studies, none suggested that the average person has enough Vitamin D.  Most suggested that we don’t have optimal levels, and one small study even suggested that many of us might be deficient.
How the body processes Vitamin D from food and sunlight

How the body processes Vitamin D from food and sunlight

Deficiency and Insufficiency

Deficiency of any nutrient occurs when the levels of that nutrient are so low over time that they cause a specific deficiency disease.  In the case of Vitamin D, the deficiency disease is rickets, characterised by weakened bones and malformed limbs.  Rickets had been eliminated in the UK by the late 1940s, but has started to return in the last decade.  Insufficiency is when levels of a nutrient are not low enough to cause a deficiency disease, but are low enough to have the potential to contribute to other problems linked to the nutrient, or to inhibit optimal health.  It is better to address insufficiency well before it becomes deficiency, as deficiency diseases are nasty!
A recent review examined nearly 200 studies from 44 countries involving 168,389 participants, mostly from the northern hemisphere.  It was found that 6.7% of the population were deficient in Vitamin D, while 88.1% of the population are insufficient according to the criteria of the Endocrine Society.  No wonder some people call Vitamin D insufficiency a pandemic!

Conversion Aversion

Confused about how much Vitamin D you need?  I was.  Part of the problem is that everyone seems to work in different units. The active form of Vitamin D is not actually measured in the blood.  Instead the circulating form (25-hydroxyvitamin D) is measured in nanomoles per litre (nmol/L).  In food and supplements Vitamins D2 and D3 are measured in either microgrammes or international units.  That’s why you won’t see any relationship between the numbers on your blood results and the amounts on your supplements.  But in case you’re trying to compare different brands of supplements or recommendations, or you want to use food as much as possible, here’s a handy conversion table.
Value
Value in Microgrammes
Value in International Units
Possible food equivalent
Recommended Daily Allowance (RDA) – newborns-adolescents (1)
10
400
 110g salmon
Recommended Daily Allowance (RDA) – general population (2)
15
600
120g sardines
Recommended Daily Allowance (RDA) – over 70s (2)
20
800
 160g sardines
Safe Upper Daily Limit (2)
100
4000
 3tbls cod liver oil (but don’t try this!)
 (1) American Academy of Paediatrics
(2) Institute of Medicine (UK)
So, how does this relate to blood levels?  In order to raise your blood level by 25nmol/L you would need to take 25 microgrammes or 1000 IU of Vitamin D a day for 3 months.  This assumes that your levels are below 100nmol/L.  If they are higher, you may need a higher dose of supplementation to maintain or raise your levels.
Should anyone avoid Vitamin D?
People with sarcoidosis can be particularly sensitive to Vitamin D, so should be cautious about higher doses and be carefully monitored.  Doctors can prescribe very high doses of Vitamin D if you have a deficiency (one friend is on 25,000 IU).  If you’re on this dose, please ensure that you’re monitored every 3 months, and don’t stay on it indefinitely; irreversible kidney damage has been reported from Vitamin D overdose over time.
Women walking & holding hands

Spending time in nature has many benefits, not least exposure to sunshine, which is needed for Vitamin D production

In summary:
  • Spend time outside when you can, but practice safe sun
  • Seek out foods with a Vitamin D content
  • Consider supplementing in the winter, particularly if you’re in a vulnerable group
  • Remember newborns; the current advice is to supplement within a few days of birth
  • If in doubt, test!

 

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Oct 11

Blood pressure lifestyle advice? Take it with a pinch of salt.

Today I look at why the conventional wisdom about lifestyle and blood pressure may not be particularly helpful, and what else to bear in mind when taking care of your blood pressure.

I was reading a public post recently from a lady who wanted to know how to reduce blood pressure naturally.  I shouldn’t have been surprised to read that the top answers to her question were:

  1. Lose weight (at no point had she said she was overweight)

  2. Exercise (we don’t know anything about her exercise routine either)

  3. Eat less salt (oh, guess what? We don’t know what her diet’s like).

So, all rather unhelpful, really.  There’s no doubt that being overweight can contribute to hypertension, but if someone isn’t overweight, weight loss hasn’t been shown to help.  And if someone does need to lose weight, how much should they aim for?  The answer may surprise you.

How much weight do you really need to lose to help support healthy blood pressure?

How much weight do you really need to lose to help support healthy blood pressure?

It’s been observed that for every 1kg of body weight lost, systolic blood pressure (the big number) will fall by just over 1 point.  Losing 5-10% of your body weight could decrease your risk of developing diabetes or heart disease significantly.  So, depending on what your blood pressure was to start with, particularly if you don’t yet have high blood pressure, but are pre-hypertensive (see my earlier post to see what this means) a relatively modest weight loss might be enough to bring you into a normal range.

Man doing tai chi

Looking for an exercise to help with blood pressure? Try Tai Chi or Yoga.

You might also be surprised when we take a look at exercise.  Someone with high blood pressure might be tempted to hit the gym or try brisk walking.  However, at least one study has shown that something gentler, specifically Tai Chi, achieves more impressive results than moderate aerobic exercise.  Similarly, isometric exercise, of which yoga is an example, achieves better results than either aerobic exercise or other forms of strength training.  We don’t really know why this is, but I might speculate that these types of exercises are helpful for reducing stress, and that it is that, rather than the exercise itself, which has the biggest effect.

Pills

Remember that medication can affect mineral absorption. Look at what you’re taking and get tested if you’re not sure.

I’ve covered salt in a previous post, so take a look here if you’re interested in salt reduction.  You do need to be aware that if you’re on medication to lower your blood pressure, you may need to get your salt levels checked, because the medication you’re taking may reduce your ability to absorb salt from food.  If you find that you’re urinating more frequently than usual this may be an indicator that your salt levels are not what they should be, so ask your GP for a test.  People on blood pressure medication should be checked every 6 months.  Remember that frequent urination may also be an indicator of diabetes, but if you are in a high risk category or above a certain age, the GP will check this as a matter of course.

potassium-sodium-ratio

Are you getting enough potassium in your diet to support healthy blood pressure?

However, salt isn’t the full picture.  Many people in the West have suboptimal levels of potassium in their diet. Potassium and sodium act together to regulate cell communication, and levels of fluid in the body, so both are important.  It’s thought that the ratio of sodium (salt) to potassium may be more important than levels of dietary salt in determining who will develop heart disease.

So, as well as reducing the amount of salt eaten, if that’s appropriate, a person with high blood pressure may also want to consider increasing the amount of potassium they eat.  Increasing your intake of potassium by 780mg or more a day (a medium sized potato or 1 ½ regular-sized tomatoes) could decrease your blood pressure by up to 4.9 millimetres of mercury if your blood pressure is higher than it should be.  In particular, someone looking to improve their dietary potassium might want to consider including the following foods:

Did you know that certain medication, including blood pressure medication, may reduce your absorption of potassium as well as sodium?  We found, for instance, that this is the case with my husband, whose potassium blood levels are very low, even though he loves bananas and we eat quite a bit of beetroot and spinach.  If you’re on regular medication, it’s worth getting these levels checked.

In my final post I’ll be looking at 5 foods which may be useful if you’d like to consider dietary ways of managing your blood pressure alongside what your doctor can do for you.  Stay tuned!

Would you love more energy, glowing skin and a really positive relationship with food?  All this can be yours as part of my ‘Stronger Without Sugar’ challenge.  Find out more here.

References:

Carlson, D. J., Dieberg, G., Hess, N.C., Millar, P.J., & Smart, N.A., (2014).  Isometric exercise training for blood pressure management: a systematic review and meta-analysis.  Mayo Clinic Proceedings, 89(3), 327-334.

Castro, H., & Raij, L., (2013).  Potassium in hypertension and cardiovascular disease.  Seminars in Nephrology, 33(3), 277-289.

Chan, A.W.K., Chair, S.Y., Lee, D.T.F., Leung, D.Y.P., Sit, J.W.H., Cheng, H.Y., & Taylor-Piliae, R.E., (2018).  Tai Chi exercise is more effective than brisk walking in reducing cardiovascular disease risk factors among adults with hypertension: A randomised controlled trial.  International Journal of Nursing Studies, 88, 44-52.

Ndanuko, R.N., Tapsell, L.C., Charlton, K.E., Neale, E.P., & Batterham, M.J., (2016).  Dietary Patterns and Blood Pressure in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.  Advances in Nutrition, 7(1), 76-89.

Sabaka, P., Dukat, A., Gajdoski, J., Bendzala, M., Capmda, M., & Simko, F., (2017).  The effects of body weight loss and gain on arterial hypertension control: an observational prospective study.  European Journal of Medical Research, 22(43). Published online 25 October 2017.

Stockton, A., Farhat, G., McDougall, G.J., & Al-Dujaili, E.A.S., (2017).  Effect of pomegranate extract on blood pressure and anthropometry in adults: a double-blind placebo-controlled randomised clinical trial.  Journal of Nutritional Science, 6(39), 1-8.

 

 

 

 

 

Sep 25

Know Your Numbers: 6 Ways to Reduce Salt

There’s been a bit of controversy about the salt/blood pressure issue in the last couple of years.  Critics claim that the obsession with reducing dietary salt has been harmful, we have gone too far, and that there’s no real evidence that reducing salt is helpful in reducing blood pressure.

Is salt as harmful for blood pressure as we've been led to believe?

Is salt as harmful for blood pressure as we’ve been led to believe?

In fact, there have been many studies, both large and small, throughout the world, which show that 1) too much salt has a harmful effect on blood pressure, and 2) reducing salt has a helpful effect, in conjunction with other measures.  So, I largely disagree with the arguments that we can enjoy plenty of salty food without consequences.  Of course, a ‘one nutrient’ focus is over-simplistic, and that’s where problems can arise.  I’ll be talking about other considerations in a future post.

Everyone does need some salt in their diet, as it helps to maintain the correct balance of fluid in cells and blood vessels, and is needed for communication between cells.  However, the Government recommends no more than 6g or 1 teaspoon of salt a day.  If you’re eating a Western diet it’s easy to exceed this.  If you’re eating a Far Eastern diet, you may also find things tricky.  Just 1 teaspoon of soy sauce contains your entire recommended intake.  Remember that most vegetables contain a little sodium, even if you’re not adding salt to your cooking, and fish has a notable sodium content too. So, if you’re eating plenty of vegetables, as I’m sure you are, you’re likely to be doing well, especially if you also eat fish.

Fresh foods have a salt content of their own, so you don't necessarily need to add salt to your food to have sufficient sodium in your diet

Fresh foods have a salt content of their own, so you don’t necessarily need to add salt to your food to have sufficient sodium in your diet

The Government guidelines are quite cautious, but that doesn’t mean it’s OK for everyone to exceed them all the time.  If you’re concerned about your salt intake there are some simple ways to keep it low without sacrificing flavour.  Here are some of my favourites.

  1. Reduce processed meat. You’ll be aware that bacon and salami have a high sodium content (just one serving can exceed your recommended daily salt intake), but did you know that those meats that you buy in slices and put in your sandwiches can also be packed with salt?  Instead, make your own sandwiches from leftover chicken or beef that you’ve roasted at home, or better still, put a good portion of your leftover meat in a lunchbox with loads of veggies.  Love bacon?  I discovered a ‘vegan bacon’ recipe last week made with aubergine.  As I don’t eat bacon I have no idea if it tastes like the real thing, but I’m going to try it, and if it tastes delicious I’ll let you know.

  2. Cakes and breads

    Watch out for the hidden salt in bread, particlarly speciality breads and crackers

    Ditch the bread products. Whatever your feelings are about gluten, bread products, including sliced bread, rolls and pizza account for the top 3 sources of salt in the Western diet.   Instead, try salads in your lunchbox (you can make them very substantial, so you won’t be hungry) or, if you’re in need of something sandwich-like, try egg wraps, lettuce wraps or rice pancakes.

  3. Ready, steady, salt. If you’re reading this blog, I assume you don’t rely heavily on ready meals, but if you do, the salt content is something you’ll definitely want to consider.  One of the biggest culprits is ready-made soups, even if they’re in those nice cartons with the veggies all over.  They’re temptingly convenient, but they won’t be doing your blood pressure any favours if you eat them regularly.  Instead, make your own soup.

    Don’t use a stock cube if you can avoid it; 1 teaspoon of a well-known chicken stock powder, for instance, contains 21% of your recommended daily sodium.  Next time you have a chicken, boil its bones to make broth, and freeze it in ice cube trays.  That way you’ll be able to use what you need when you need it.  If you’re a vegetarian, include a tin of tomatoes in your soup.  They’ll contain enough salt that you shouldn’t need to add much more from stock products.  You can, of course, make your own vegetable stock, but it’s difficult to do so without it tasting like dishwater.

  4. Ease off the cheese.  I do love cheese but it can be a salt-laden luxury (that’s probably why it’s so good).  If you can, buy really good-quality cheese.  Not only is it good practice to buy from ethically reared herds but although you pay more for the cheese, you use less of it, so you can reduce your salt intake without having to sacrifice flavour.  Cheeses contain on average between 1.5 and 2g salt for a 30g portion.  There’s not a huge amount of difference between creamy cheeses and hard cheeses in this respect.  So, from a salt point of view, if you’re not eating other high-salt foods, a small portion is totally fine. The question is, can you stop at a small portion?

  5. Fresh fish

    Choose fresh fish rather than smoked where you can

    Choose your fish with care. Smoked fish is delicious, but it’s extremely salty.  If you eat smoked fish, or even some forms of canned fish on a regular basis, try swapping with fresh fish.  Fresh mackerel, trout and sardines can be both economical and delicious.  They also contain omega-3 fatty acids, which are important for heart health.

    6.

    Miso Soup

    It’s so easy to make your own Oriental food; you can whip it up in less time than it takes to deliver a takeaway and you can be completely in control.

    Ease off the Chinese. Chinese food is so delicious, but it can be very salty, and in a restaurant you’re not in control.  Instead, ditch the takeaway and make your own Oriental food. It’s very easy, and some of the fastest cooking on the planet.  You can control the amount of salty ingredients, such as fish sauce, bean paste and soy sauce you use, and you can even buy a reduced salt version of soy sauce.  Do stay away from the sweet and sour, though.  It’s not authentic Chinese food, and it’s high in sugar and less beneficial fats.  Instead, try stir fries, steam fries and soups.  My top tip is to whip up a batch of home-made peanut sauce and use it in stir fries, laksas and satays for an instant flavour hit.  It will keep in a sealed jam jar for a good couple of weeks.

Of course, salt isn’t the full story; it’s never all about one nutrient.  In the final blog post of this series, I’ll be telling you why, and suggesting some great foods you can eat if you’re interested in maintaining a healthy blood pressure.

 

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