Today is National Toothache Day, but nobody wants to have toothache or any form of dental disease. Although other nations joke about the poor state of ‘British Teeth’, data suggests that our oral health as a nation is improving. However, there’s still room for progress. It’s estimated that 1 in 4 children has tooth decay and misses an average of 3 school days a year due to poor dental health. Dental problems are the most common cause of hospital visits in 5-9 year olds.

In 2018, 49% of adults in the UK had not seen a dentist in the last 2 years. Post-pandemic figures are not yet available, but my guess is that more people than ever haven’t had access to a dentist.  Around 2 million of us have to travel 40 miles or more to get to a dentist, and around 1 in 3 adults have tooth decay.

I’m the worst for dental phobia so I like to stay away from dentists as much as possible (no offence to anyone reading this who is a dentist – I’m sure you’re a delightful person). A lot of oral health is down to genetics, but there are things we can do with diet to help optimize the cards that nature dealt. Most people know the general advice about limiting free sugars and getting enough calcium in the diet, but here are three dietary oral health tips you might not know about.

1.      Take care with acid

Acidic drinks may be associated with higher rates of tooth decay. Most of you probably avoid fizzy drinks and squash, but acidic liquids you may enjoy include vinegar, fruit teas and even a glass of wine or cider. To minimize their effects, drink them ice cold, and only at mealtimes. If you’ve had an acidic drink, wait at least an hour before brushing your teeth, as teeth are more vulnerable to abrasion up to an hour after the drink has been consumed.

2.      Bring on the Bacteria

We’ve been brought up on the idea that bacteria cause tooth decay and are therefore bad news for teeth. However, this isn’t true of all bacteria. Recent research suggests that taking probiotics may protect against tooth decay, gum disease and bad breath in both adults and children. The theory is that probiotic bacteria compete with the bacteria responsible for dental disease and help reduce their numbers. However, this is a relatively new area of research, and we know very little about which strains of probiotics are helpful, or which doses are needed. If you currently take a probiotic and have noticed an effect on your dental health, do let me know.

3.      Don’t be D-pleated

Both tooth decay and gum disease have been associated with Vitamin D deficiency. There is also evidence suggesting that if you have dental implants and you are deficient in Vitamin D, there is a higher chance of early implant failure. Lack of Vitamin D may lead to lack of minerals in the tooth, making teeth more vulnerable to damage. Again, this is quite a new area of interest, but trials of supplements in people who are deficient in Vitamin D have been promising. If you are deficient in Vitamin D and you are planning treatment or surgery on your gums, it may be helpful to raise your Vitamin D levels before treatment, as being deficient at the time of treatment is associated with less good outcomes, even if you’re taking supplements. If you’re supplementing, remember to use D3, and ensure that there is sufficient K2 either in your diet or in your supplement to enable you to absorb it.   As always with supplements, use the usual cautions. If you’re taking medication, check that there are no contraindications. And don’t assume that ‘more is better’ or that any supplement is completely safe. Excess Vitamin D can and does damage kidneys.

Which of thee tips do you think will be useful to you, or did you know about them already? Do you have any pearls of wisdom to share? Let me know.

Today is National Cheese Lovers Day.  I’m a cheese lover for sure.  Brie, mozzarella, goat’s cheese, feta, Parmesan; you name it, I probably love it, even if I don’t enjoy it all that often. So, today seemed like a good day to talk about dairy.

Dairy can be quite a contentious subject.  Amongst people who grew up on farms, and also amongst many who did not, it’s considered a wonderful source of nutrients.  However, in the wellness world it can get a bad press, and a lot of practitioners advocate giving up dairy.  But what does the evidence say?  Today I’m taking a look at some of the popular beliefs around dairy products and trying to distinguish the myth from the reality. Which of these statements do you think are true, and which are a load of old cheese?

1. You can get all the calcium you need from non-dairy products

TRUE (but with difficulty)

It’s really important to say that almost any diet can be a nutritionally dense diet.  Whether you choose to eat dairy or whether you don’t, it’s fine.  A plant-based or vegan diet can absolutely be a healthy one in terms of all nutrients, including calcium.  I’m here to support your dietary choices and make sure they’re serving your needs, not only in terms of nutrition but in terms of fitting in with your life and giving your tastebuds a good time.  So, yes, you absolutely can get sufficient calcium on a dairy-free diet.

That doesn’t mean it’s easy.  It’s not just a matter of finding equivalent amounts of calcium in non-dairy products. It’s also a matter of their bioavailability – in other words, how available a nutrient is for your body after the food is digested and absorbed.  The bioavailability of calcium in non-dairy foods seems to be much lower than in dairy foods.  So, not only would you have to know which foods to eat, but you would have to eat them in larger quantities to get an equivalent amount of calcium.  You may be absolutely happy to do that, or you may not.  I personally like tahini and edamame, but I’m a bit odd that way.

2. Dairy products are inflammatory

FALSE (but a little bit true)

Chronic inflammation is a physiological process thought to underpin many of today’s chronic diseases.  Quite often, when practitioners are aiming to support healthy inflammatory processes, they will advise giving up dairy.  But does dairy really promote inflammation?

A systematic review in 2017 evaluated 52 clinical trials. It concluded that, not only do dairy products not have an inflammatory effect on most people, but certain products, in fact, have anti-inflammatory properties.  The non-inflammatory effect applies to both high and low-fat dairy products, whereas fermented dairy foods may have anti-inflammatory benefits. A 2019 review which considered inflammatory biomarkers agrees, and notes anti-inflammatory effects both in healthy individuals and those with metabolic diseases.  A 2021 review also supported these findings, and noted the possible anti-inflammatory effects of probiotic yoghurt in the short and medium term.  Generally speaking, dairy products have not been found to have an inflammatory effect.

However, if you have an allergy to cow’s milk, some evidence indicates that all dairy products may have a pro-inflammatory effect for you, even if you can tolerate yoghurt or cheese without an allergic reaction. In this case, it may be better to limit your intake or avoid them altogether if inflammation is a concern.

3. Dairy products are mucus-forming

PROBABLY FALSE

Both anecdotally and in studies, people with colds report that dairy makes them produce more mucus, and avoiding dairy reduces mucus production.  Many people with asthma find their symptoms improve with a dairy-free diet.

Self-reported data is an interesting thing, because it’s notoriously unreliable, as you’re about to discover.

WARNING: This next bit isn’t particularly pleasant.  Please don’t read it if you dislike talk of body fluids.

There’s an old, but interesting study where 60 people with a cold were studied over 10 days.  There was no difference in the amount of mucus produced by those who ate dairy and those who did not (yes, someone had to weigh all those tissues). Those who believed that dairy was mucus-forming reported that they had more coughs and congestion than those without those beliefs, but in reality they produced the same levels of snot. In 2019, people with colds were asked to report their level of mucus production. Some were assigned to a dairy supplement, and others to a dairy-free equivalent.  Those on the dairy supplement reported significantly higher mucus production. But in this study, nobody weighed the tissues, so it’s not clear whether this was a real effect, or just a matter of perception.

Furthermore, these studies relate to people with colds.  It doesn’t mean that they are transferrable to healthy people, or even to those with respiratory conditions such as asthma.  The alleged mucus-forming properties of dairy don’t fit the normal allergy pattern.  There’s a hypothesis that if certain conditions are met in the colon, dairy may increase mucus production for some individuals but not others.  One of these conditions is that significant inflammation must already exist, which may explain why this effect is more noted in people with asthma.

Of course, not all mucus is produced in the nose. We can produce mucus at the other end of the body too, and believe it or not, that’s also been studied.  Back in 1998 someone compared the rectal mucus of subjects allocated either a high-dairy diet (6 servings per day or more) with those given a low dairy diet (half a serving or less per day) over a 12-week period. They found no difference between the two groups.

So, in the general population, it’s probably not true that dairy forms mucus, but if you already have an inflammatory condition, you may indeed notice a mucus-forming effect.

4. Dairy products are full of antibiotics

MOSTLY TRUE

Every year, over 63,000 tons of antibiotics are given to livestock worldwide.  Importantly for humans, the residue of up to 70% these antibiotics still has active properties when it is released into the environment.

The antibiotics in milk mainly come from treating infections in cows.  However, they can also be added to animal feed.  If antibiotic residues enter the human diet in harmful amounts, they can contribute to the risk of diseases such as cancers, as well as allergic reactions and general antibiotic resistance.  Although developing countries are currently more at risk of this happening than developed ones, the possibility still exists in developed countries, and methods for detecting these residues aren’t particularly reliable.

Nevertheless, there are things consumers can do to reduce the risks of antibiotic residues.  Pasteurisation neutralises many of the antibiotic residues. Organic farms are not allowed to use antibiotics, and therefore organic milk will be antibiotic-free.  It may also contain a higher percentage of beneficial omega-3 fatty acids than regular milk.  So, if you’re concerned about antibiotics, either from an ethical or a physiological perspective, organic dairy may be a good option.

If you’re taking antibiotics, remember to avoid dairy while you’re taking them, as the calcium can bind to the antibiotic, inhibiting it from entering the bloodstream and reducing its effectiveness.

5. Low-fat dairy products are healthier than full-fat ones

FALSE (but it depends how you define ‘healthy’)

Many diet books will tell you to eat low-fat dairy foods because they are lower in calories than their higher-fat counterparts. It’s true that a high-dairy diet may show a slight increase in fat mass over several weeks when compared with a low-dairy diet.  However, in the long term this may not be significant, and dairy may in fact help to limit weight gain in rats.  In humans no significant associations have been found between dairy consumption and weight gain.

Of course, weight isn’t a measure of health.  There are plenty of measures which are much more valid.  For example, an imbalance of blood glucose can be an early warning sign not only for chronic illnesses like insulin-resistant diabetes and some cardiovascular problems, but for mental health issues as well.  Low-fat dairy products often contain higher levels of sugar than their full-fat counterparts (something has to make the product palatable), so they may be less beneficial for long-term health if eaten regularly.  Additionally, it’s the fat in dairy products that carries the fat soluble vitamins (A, D, E and K) that underpin so many aspects of health.  Of course, you can find other sources of these, but dairy products are pretty convenient.

Full-fat dairy may not be suitable for you if you have issues with fat digestion, gall bladder or some forms of cardiovascular disease. In this case, low-fat dairy in small amounts may be an alternative.  If you are watching your sodium, hard cheeses and blue cheeses are best eaten in small amounts if you eat them at all. Fortunately, with these cheeses, a little goes a long way.

Other Considerations

Your concerns over dairy may have less to do with health and more to do with animal husbandry and environmentalism.  This isn’t my area of expertise, but if this is the case, you’ll want to choose any dairy products you include with care. It’s interesting to note that pasture-reared cattle may have less environmental impact than cattle reared indoors and fed dairy and soy, because the pasture absorbs the carbon dioxide produced by the cattle when methane breaks down and uses it for photosynthesis.

I like to buy goat’s cheese from my local market.  Goat tends to be more environmentally friendly than cow, local products have a lower carbon footprint, and I can trace the provenance of the product and the quality of life of the goats. But I realise that this is a massive privilege that’s not available to nearly enough people.

If you love the taste of dairy but you have an allergy or don’t want to eat dairy for ethical reasons, yeast flakes can give you the flavour, and are a great source of B-vitamins, particularly B12, which can be lacking in a vegan diet.  It won’t give you the texture of cheese, but you can’t have everything.

One Final Word

When it comes to human health, there’s no such thing as an exact science.  High-quality studies and reviews are the best way to assess what happens at population level, but your own response to dairy foods will depend on the amount and type of dairy you consume, as well as your personal genetics, physiology and circumstances.  That’s why it’s important to remember that nutrition is never a ‘one size fits’ all (or even ‘most’).

Has this blog given you a new perspective on dairy?  Is there anything here that came as a surprise?  Let me know.

Do you love spaghetti?  I certainly do.  There’s nothing quite like it as a comfort food.  I love to twirl it round my fork; it’s been a small pleasure of mine since childhood.

Spaghetti is the most popular type of pasta in the world.  It’s possible that the Etruscans made pasta as early as 400BCE, but we can be sure that noodles, the precursor of spaghetti have been made by the Chinese for at least 4000 years. Spaghetti is made from durum wheat, and Italy remains the biggest producer.

Spaghetti, like other pasta can be a surprisingly nutritious food.  As well as providing around 12% of your daily protein needs, 100g cooked wholemeal pasta is a useful source of dietary fibre, B-vitamins, magnesium, manganese and selenium.  For many people, spaghetti, particularly the wholewheat variety, which is higher in fibre than its white cousin, is a useful, economical, and of course utterly delicious part of a balanced diet.  The sky’s the limit when it comes to sauces.  One of my favourites, which was one of the first dishes I ever learned to cook, was a sauce made from tomato, tuna, garlic and fresh basil, finished off with a wee knob of butter.  No need for any cheese; back in my younger days, this was a staple storecupboard meal.  I still enjoy it occasionally.

However, 100g spaghetti also contains 30g carbohydrate.  This probably isn’t as high as you thought, but for those who need or choose to follow a low-carbohydrate diet, it may not be the best choice. White spaghetti by itself has a glycaemic load (GL) of around 23-28.  Any single food with a value of 20 or more is considered to be high GL. The higher the GL, the less desirable the food will be for someone looking to manage blood sugar levels. Traditional spaghetti, of course, contains gluten, so is not suitable for coeliacs or those with a gluten intolerance.  Gluten free spaghetti doesn’t taste bad at all, but if you want a low-carb alternative, preferably with as much or more nutritional value as the real thing, or you just fancy a change, here are the top 5 alternatives which have passed my taste test.

Edamame Noodles

These lovely green noodles have about half the carbohydrates and twice the protein of regular spaghetti.  They’re good with green or tomato-based sauces, and especially good in Oriental dishes.  They would be less good with a creamy-style sauce.  Unlike lentil pasta, I don’t find them grainy.  They do contain soya, so watch out if you’re sensitive.

Sweet Potato Noodles

These are most suitable for Oriental dishes where you want an alternative to rice or glass noodles, which have a higher glycaemic load.  Although these noodles aren’t as nutrient dense as my other choices by any means, they’re easy and convenient. They’re also colourless, which may suit picky eaters better (sometimes they come in purple, which I think is even more fun).  I like to throw them into broth with some veggies for a quick and effortless supper.

Black Bean Noodles

These ink-black noodles (not to be confused with squid ink pasta) contain 46g protein and 21g fibre but only 13g carbohydrate per 100g, making them an impressive choice if you’re trying to reduce your carbohydrate intake without going extreme.  They do have quite a distinctive taste, but they would work well with vegetable-based sauces rather than cheese-based ones.  They’re also available in Aldi, so they could be a good choice economically too.

Courgetti (or perhaps Zoodles)

If you don’t already know, these are courgette spiralized to look like spaghetti.  Admittedly, they are not like the real thing, and Nigella Lawson won’t go near them, but that’s no reason to throw them out altogether.  Courgetti lack the protein and fibre of some of the other choices, but they contain helpful amounts of B-vitamins, Vitamin-C, potassium and manganese. With a glycaemic load of 2, they’re a great choice if you’re working on blood sugar management.  They do need careful handling; you barely need to cook them at all; never boil them, just give them a quick heat through in a large-based frying pan, otherwise they will turn to watery mush and be hideous.  Great with all types of sauces, particularly raw sauces in the summer.

Spaghetti Squash

This is a kind of miracle vegetable.  Bake it in the oven, cut it in half lengthways, remove the damp stuff from the middle, and run a fork through the rest of the flesh.  Behold – spaghetti-like strands will appear!  This is one pasta alternative that’s absolutely great with a cheese-based sauce as well as all the vegetable-based ones, and it has the fun factor as well, which is lovely for children.  Although it doesn’t score quite as well on the nutrient front as courgetti, it has the same glycaemic load and a higher amount of dietary fibre.  The downsides are that it can be hard to get hold of, and it takes a long time to cook.

Will you be trying out some of my alternatives, either for National Spaghetti Day or later this month, or sticking with the traditional product?  Let me know.  Or, tell me about your favourite way to eat spaghetti.

This is a long post, but then it’s been a big year.

Do you write Round Robin letters at Christmas? I don’t.  I’m too lazy, and I can’t imagine that anyone else would be interested in my year. My late cousin Janet was an absolute master at them; hers were always informative, engaging and fun.  I miss them.  Perhaps her memory is inspiring me to write a little about my year today.  On the other hand I’m also inspired by coach-extraordinaire Julie Creffield, who wrote a rather marvellous review of her own.  #iblamejulie.

We’re all accustomed to hearing how this year has been the most difficult ever for a lot of people, and how they are miserable.  That’s led me to keep quiet somewhat, because the truth is, although I can’t claim to have been super-successful in terms of either my professional or my personal life, I’ve been happier this year than I’ve been for a very long time. I had intended for 2020 to be my best year ever.  I’m not sure that it quite makes the grade, but I can think of a great many years that were far, far worse.

I think this is mainly for two reasons.  During the first lockdown, when I was on my own in London, I felt useful.  I was part of a massive effort to provide meals (or in my case, baking) for key workers.  I shopped for vulnerable people.  I was part of a group effort to raise money for Echo, a charity for children with congenital heart conditions which I’ve supported for many years.  I certainly didn’t work tirelessly (except during my sponsored bake) and I know that what I did probably didn’t make much difference.  But it felt useful and important.

This was also the year I started ‘Lunchtime in Lockdown’, my live cookery series on Facebook.  Every weekday during first lockdown, I would cook a quick, healthy meal with the ingredients I was able to find in the shops (there were some shortages during those first months).  I had a great time, and I know that people enjoyed watching.  At the moment, I’m only making occasional recordings, but I’m working on a ‘Lunchtime in Lockdown Cookbook’, which will include my best recipes, and tell you a bit more about my experiences during lockdown.

The second reason things have improved with me this year is that in July, I moved to Scotland.  The move isn’t permanent, but until I need to work in-person in London I’ll be staying here in the Highlands.  This is where my heart has always been.  I never thought I’d get the opportunity to spend any length of time here.  Living here for almost 6 months has been a joy, even with the restrictions.  Yes, there are things we can’t do, but having more living space, better quality air and food and an abundance of nature on our doorsteps has been a godsend.  My husband is happier and more relaxed here, and that makes things easier for me.  It has truly been a wonderful opportunity to experience a new way of life, and I’m so grateful to have been granted it.

I tend to be like the child who comes home from school whose parents ask them what they’ve done that day, and they reply, “Nothing”.  I tend to feel like that about my life; nothing has changed or improved, and it’s all a bit hopeless. But when, as part of my planning for 2021, I had the opportunity to look back on 2020 I realise that’s not entirely true.  I know that I’m not where I want to be in terms of life or career, but I haven’t entirely stood still.  Here are some of the things I’ve achieved.

• Become clearer on my niches of healthy eating for early-stage high blood pressure and for depression, all within a size-friendly framework.

• Written and delivered e-courses on meal planning, and on nutrition for hypertension.

• Written two e-books on nutritious food for people who feel too depressed to cook.

• Become nutritionist-in-residence for two large and popular social media groups where potential clients – and generally really awesome people – hang out.

• Taken the first steps on the road to becoming a professional speaker by delivering paid talks online (and in person at the start of the year) to the Women’s Institute and the Croydon Seniors’ Association, as well as being a regular speaker for the Athena network.

• Launched ‘Kids in the Kitchen’, my healthy (but not preachy) cooking club for children aged 7-14.

• Devised a range of recipes which I’m sharing online, in my cook book and, when it’s permitted, at my retreats.

• Started teaching 2 new language classes with the most wonderful group of students.

• Connected with some fantastic women (and men) who’ve supported me in my business and kept me going with ideas, inspiration and support.

• Gained some truly wonderful and special clients, who are getting results, because we ‘get’ each other and work well together.

• Furthered my own professional development with a combination of e-lectures and self-study, and made a plan of action for professional development focusing on my special areas of interest in 2021.

For a ‘nothing year’, that’s really not too bad.

Of course, it wasn’t all plain sailing.  I was supposed to appear in two amateur shows this year and was thrilled to have my first principal roles since returning to acting last year.  I was devastated when they were cancelled. This might not seem like much in the great scheme of things, but for those of us who eat, sleep and dream theatre it’s a huge blow.  But I’m confident that the shows will return, and so shall I.

I’m continually concerned for my mother and was torn between returning to London to be closer to her and remaining in Scotland.  I know she is well cared for or I could not be here, but this is much harder for her than it is for me.  Bear in mind that my mum has just turned 88 and is writing her autobiography and still running her own business.  When people say that ‘the elderly should shield’ they assume that older people no longer have an active and gregarious life, when, in many cases, nothing could be further from the truth.

I worry, too, about the asylum seekers who I used to volunteer for.  Our volunteer centre has had to close during the pandemic and our guests, who rely on our support, have had a lifeline taken away.  I’ve been able to speak to some of them and have been so inspired by their courage and positivity. I look forward to being with them as soon as it’s permitted.

I’ve also had to shelve something that would make a major positive difference to my life, which can’t be done in lockdown. That’s been so, so hard, and I’ve shed many a tear over it.  However, the extra thinking time and ability to focus on myself has made me more determined than ever to carry out this plan as soon as it becomes remotely feasible.

As in any year, there have been losses.  These can be even more difficult to cope with when you don’t have a chance to say goodbye.  We’ve lost family and friends both to the coronavirus and to other causes.  We miss you deeply.

And yet, there have been personal gains too.  For example, I have:

• Appeared in e-plays and readings with my community – including a memorable evening filming in the woods.

• Supported neighbours and friends with shopping and a smile during first lockdown.

• Started studying in a language class again and met some lovely people.

• Started reading for pleasure again. And, yes, it’s a pleasure.

• Kept up with my dance, taking between 4 and 7 classes a week.

• Explored some beautiful areas of the Highlands on foot.

• My mental health has been better than it’s been in years. For someone who’s spent the majority of the last few years feeling worthless and suicidal, I can’t tell you how good that feels.

Of course, I have plans and aspirations for 2021.  These include:

• Publishing a book – a real one, not an e-book.

• Writing and launching my signature e-course on nutrition for depression.

• Re-starting my retreats. Some of them are already almost fully booked – people can’t wait to spend time in the Highlands!

• Making ‘Kids in the Kitchen’ the best online cookery club for young people.

• Starting a new project in my Scottish garden.

• Continuing my growth as a professional speaker and writer.

• Getting back on stage again as soon as it’s allowed.

• Getting the most from life and having some FUN!

My word for 2021 is ‘Indomitable’.  If there’s one thing this last year has taught me is that there is so much that is beyond our control.  But what is within our control is not to be beaten by it.  I know I am incredibly lucky in so many ways.  But there are also ways in which I am not lucky at all. Sometimes the tough things in my life are overwhelming.  It’s fine not to be fine.  As long as not being fine isn’t a permanent state of affairs.  God willing, this too shall pass.

I wish you light at the end of your tunnel, and everything good that you wish for yourself and others in the year ahead.

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

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.

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?

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

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.

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?

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

  

  …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’.

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.

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.

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.

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

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?

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 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

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.

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.

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

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

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.

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.

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

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

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

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 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

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.

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