The goal of recovery is not about weight.  

I’m constantly on a journey with my clinical practice and dietetic thinking. One of the keys to a good health professional (or any professional) in my mind is one who constantly evaluates their practice, the evidence, the new trends and uses this to shape how they work and think.  

I started work as an eating disorder dietitian in 2007. On my first day I was handed a box file that contained a few black and white print outs of out of date dietary information and told those were all the resources. There had been no dietitian for 5 years. I built up the resources, my knowledge and educates the team as well as myself. As a lone dietitian on a psychology based team it was at times very tough but it was the making of me and I loved it. When I left that job I had experience of helping run a day care programme, groupwork, meal support, out patients, inpatients and I had gained a whole new language. I am so thankful for those years. 

Now as someone who works in the private eating disorder field I am constantly working to better the support I offer. Not so that I am better, but because I want to do myself out of a job. I want to see my patients recover, I want them to have a good relationship with food, I want them to no longer need my support. 

We live in a weight focused culture. I personally struggle with this. I would love to not weigh anyone who comes to clinic, yet most of the time I have to. Working with people who are very low weight it would be negligent of me to not know what their weight is doing. It has to be a focus, but I don’t want it to be the primary and only focus.  So we get it out of the way, debrief and then move onto other areas. Weight is never an easy topic and is certainly not foolproof. The simple idea of eating so much leading to so much weight gain every week just isn’t that simple  in the community. There are so many factors than can complicate the picture. Activity levels, mental energy used in work/study, looking after children, anxiety etc… So focusing on the weight alone can make it slow, hard and distressing. 

Instead of a weight focus only, I like to work with people looking at their relationship with food. We may look at the their food beliefs, busting any incorrect ones. Ideas such as carbohydrates are fattening or I shouldn’t eat fat are common ones. It doesn’t always work but I try to stay away from calories and strict meal plans and instead focus on eating regularly and including a good balance of foods at meals.  No food is off limits, no food is good or bad. Switching the focus from weight to health has always been one of my aims. Instead of what foods you need to gain weight I look at why food groups are good for your health and how restriction is unhealthy and can cause physical harm. Finding out what foods people have been avoiding and why, is always a good place to start.

 As people make progress it can be so liberating to weigh less often and incorporate more freedom into the meal plan. Learning to listen to those signals of hunger and fullness can be very scary and overwhelming at first but it opens up a whole new future and a way of eating that will see you through life, with no need to restrict, binge or diet every again. Let’s make that the goal. 

Guilt free eating?

This week I spoke to a new client. A lady who has previously had an eating disorder and now has recovered to a healthy weight but has some left over eating traits and food beliefs. She was very relieved and refreshed to hear my viewpoint of:

“All foods can be included in your diet, there are no Good and Bad foods, instead focus on enjoying your food, listening to your body, trusting your body and eating without guilt.”

It got us talking about why there is guilt associated with food. Such a huge and emotive topic.

We all know that food is something our body needs, without it we cannot live, too little food and we lose weight, not eating a balanced diet means our body does not function correctly and can be physically unwell. So where does the guilt come from?

From an early age we learn that some foods are not as good for our bodies. This is often taught in a very black and white manner, labelling foods as good or bad. Now I would agree that something high in calories, fat and sugar, like a slice of chocolate fudge cake, is not something we should be eating daily. However it isn’t a bad food… on the contrary it is delicious and can bring a lot of pleasure. 

Eating for pleasure is important. Lots of our experiences are associated with food. If we only ate for  our physical need think of all that we would missed out on. For example the pleasure of an ice-cream on a hot day or cake at a birthday. These experiences feed our soul, they are part of our social life and our emotional well being too. Food is more than just nutrition.

When we label a food as good or bad it affects the way we think and feel about it. So by labelling that slice of cake as “bad food” we feel we are being naughty/bad when we eat it. It can lead to anxiety before eating, judgement, criticism and then guilt afterwards. Our food rules therefore hold a lot of power and influence.

Having just worked with a TV production company on a food show, this topic also came up when they wanted to label a group of foods as good/bad. This instantly brought a red warning flag up in my mind. It became a great opportunity to talk about some other ways we could soften the language used and how powerful our words can be. This is definitely a journey I am on with my language both at home and as part of my work.

It is time to change the way we categorise foods. Instead of good and bad can we not see all foods as back on the menu, just some more occasionally than others? This is not an easy, overnight change but one that requires practise, patience and plenty of self compassion. The first step is to identity how you see foods, then try to catch those moments when you pass a judgment on a food or on your eating. Can you step in and reframe it. Instead of “I shouldn’t have eaten that ice-cream, now I feel guilty, it is bad for me” Rephrase it as “That ice-cream was really delicious and brought me a lot of pleasure”. Let’s bring all foods back onto the menu and start working towards loving our foods and ourselves.

When your 4 year old cooks dinner…

One of the best things about having kids is knowing that one day they will cook you dinner… well tonight it kinda felt like that happened. The J-boy just got stuck in and took me by surprise. I’m pretty sure this boy is going to be a great cook.

So if you need some encouragement to get your littlies in the kitchen helping you cook, here it is. He has been helping me cook since he was able to stand from his cooking “tower” and he seems to have picked up some tips along the way! My children have all loved helping me cook, at times I’ve certainly wished they didn’t want to help me – it can take twice as long, be noisy and messy, but it teaches them a great life skill and a love of good food. I’ve also found it a good way to get them trying foods too.

Fish fingers are one of the ways my family do not just eat, but really enjoy oily fish. I like to get a portion a week into our meals. Oily fish are good sources of the omega 3 fatty acids (EPA and DHA) as well as providing vitamin A, Vitamin D,  iodine, selenium, protein and calcium.  If you don’t like salmon other oily fish includes:  mackerel, pilchards, fresh or frozen tuna, trout, crab, whitebait, herring, sardines.

 

Omega 3’s benefits include:

  • Reduction in the risk of heart disease. May protect the heart and blood vessels from disease.
  • Supports healthy development of  baby during pregnancy and breastfeeding.
  • Brain function – may help  maintain good memory and also for the prevention and treatment of depression.
     

     

 

Nutribox and Get Fruity. Great OTG snacks.

Snacking is one thing that keeps me going. Life can be a whirlwind of pinging from one thing to the next. An average day for me is a juggle of children, school runs, Pilates clients, dietetics clinics, paperwork and toddler mayhem. Then more Pilates classes and paperwork in the evenings… if the children actually sleep 😉  I totally love the variety but it can be like a frenzied juggling act. On the days I am failing at being a domestic goddess too I need easy to grab on the go snacks. 

So when The Nutribox sent me a healthy snack box and “Get fruity” sent over some of their bars to try as well I was over the moon.

   

The Nutribox is a fabulous idea if like me you are short of time to peruse the supermarket, health food shop and online shop shelves. Yes it come with a bigger price tag than perhaps buying things individually but what I loved was the chance to try items I had seen but not managed to get around to buying and also being exposed to new brands. I had a box of 20 gluten free items delivered to me (I’m wheat free for medical reasons). This included a range of nuts, dried fruit, bars, nut butters, olives, fruit crisps, coconut bits and fruit leather. All the snacks are low in free sugars although being fruit based many were still high in natural sugars.

Use the code: PILATESWITHPRIYA10 for 10% off a box.

I really loved this box, I can see it being a really useful gift for a new mum or helpful if you need something delivered to the office. It is also a fabulous treat to yourself when you need some new snack ideas. Who doesn’t like a parcel to unwrap?

Use code PILATESWITHPRIYA10 for 10% off.

Get Fruity bars are definitely a hit in our house and Pilates studio. Comments from some of our busy mums include:

“Really delicious and great to know it is 100% natural so I am putting healthy food into my body”

“I love the one with ginger in, perfect autumnal flavour”

Made from oats, dried fruit, fruit juices and coconut oil they are delicious and make a great item to keep handy in your bag for those  snack moments. I particularly like the mango flavour. Yes you could make these yourself, but sometime there just isn’t the time, the ingredients or the brain power to do so… having a box of these in your cupboard could be a snack saver.

Disclaimer: This is a sponsored blog post as I was sent these products to review, all views are my own.

 

Apple and Pecan Energy Balls (no bake)

My kids seem to need a 3 course meal to eat after school/pre-school,  so my snack tin needs to be topped up with nutritious and filling foods. These apple energy balls are something I saw another dietitian friend making on Instagram and we adapted it slightly, using different nuts to suit our tastes.

My 4 year old boy literally loved making and eating these. He raved about them and each day after preschool has been asking for them. It has been lovely to see him proudly showing them off to his older sister:

“I made these and they are yummy”.

I’ve not managed to do a vlog for ages… 3 children and work has meant a kitchen that is rarely tidy enough for filming in and few of those moments where we have the right moment with all children quiet and happy to join in. However I’m hoping to get back into it now.  I’d love to know your idea and thoughts for future videos.

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Beef and Red Pepper Noodle Soup.

Red meat is often seen as something to cut down on, but these messages are actually leading to an epidemic of iron deficiency, confusion over how much to eat and how often to eat it.  New research has shown that 51% of people did not know how much red meat you  can safely eat and 85% of people are likely to underestimate the amount of red meat that can be consumed.(1)

This “eat less red meat” message is leading to some of our population not eating enough iron rich foods. 27% of women aged 19-64yrs and 48% of girls aged 11-18yrs are not meeting their iron needs.(2) Why is this a concern? Lack of iron can result in symptoms such as fatigue, weakness, shortness of breath, dizziness, heart palpitations and pallor. It can be quite debilitating for some people. Red meat is also a fabulous source of protein, providing the body with all the amino acids that it needs. Other notable nutrients include the B vitamin complex including B12, zinc, selenium and phosphorus.

What is a portion?

A portion of red meat is 70g of cooked meat. This quite simply is a palm sized portion. I love using hands as a way of measure portions as our hands grow with us, so a child’s portion of red meat is their palm size.

For example (adults portion sizes):

  • A palm size chop or steak 
  • 3 slices of back bacon 
  • 5 or 6 cubes of meat in casserole
  • 6 thin slices of beef, pork or ham 
  • 1 and a half standard sausages 
  • 4 to 5 meat balls

How often can I eat red meat?

If you are sticking to the portion guide above then 70g of red meat can be eaten 5 times a week. This includes red meat at breakfast, lunch and dinner, but it shows how red meat really isn’t something to be avoiding. The Meat Advisory Panel are running a “5 A WEEK” campaign and I think this is a really invaluable and important message to be highlighting.

So to get on board with the campaign here is a super tasty recipe that makes a wonderful lunch time soup:

If you would like to make this recipe at home (and I highly recommend it) then here are the step by step instructions:

Marianade 450g beef strips in 2 tsp chinese 5 spice, 1 tbsp soy sauce and 1 chilli
Place 2 pints of beef stock in a pan, add 2 cm grated ginger, 2 garlic cloves  and simmer for 5 mins.  Then add 7oz of chopped greens and simmer 1-2 mins.
Add the beef, 1 sliced red pepper and175g  noodles in, simmer for 3 minutes. Stir through some spring onions and coriander and serve.

[yumprint-recipe id=’143′]To find out more about the “5 A WEEK” Campaign you can pop to Simply Beef and Lamb on Facebook or to Love Pork.  Twitter: @lovepork.UK @simplybeefandlamb.

 

 

 

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Lentil Lasagne and Lasagne made easy

Lasagne is one of those meals that is loved the whole family. Let’s face it, if you don’t love lasagne then you are very usual! Often seen as hard to make, time consuming and more comfort food than “healthy” I want to share my top tips for making it a standard weeknight family meal.

  1. Pack in the veggies. Lasagne does not have to include meat! I rarely use mince to make lasagne these days. Instead I use lasagne as a way to pack in the veg. You can use lentils, beans or tofu or quorn to get protein in. There is nothing wrong with using the normal beef mince but  if you are looking for more variety with meals or like us, are wanting to eat a greater range of plant based protein sources then it’s time to expand your lasagne repertoire.
  2. Making your own sauce doesn’t have to be complicated. As much as I love a white sauce, if I’m in a rush it always goes lumpy or I burn the bottom of the pan. One of my hacks is to use cottage cheese. Add a little natural yoghurt to thin it down and pour it on the top of the lasagne, top with grated cheese and the jobs done. I wasn’t convinced this sauce would pass the lasagne police in my house  but it did. Phew. The other easy alternative is to use a half fat creme fraiche, simple. 
  3. Embrace your freezer. I totally love my freezer, it saves me on a regular basis. Oh, and it needs defrosting, in case anyone fancies helping me with that. You can either make a double batch of the main filling and freeze it for another meal, or I like to make a whole lasagne and freeze it, makes me feel like a proper domestic goddess. Minus the tidy kitchen, mine is never tidy.
  4. Make ahead. I often make lasagne in stages. so I will either get the main filling out of the freezer and leave to defrost, or make the filling up and leave it. Then later I get a child to help me put it together, layering the filling, pasta and sauce. 
  5. Use pre-bought lasagne sheets. I know most people don’t make their own fresh lasagne sheets, but I sometimes do, it makes the lasagne SO good, literally the best lasagne. But it takes more time that I just don’t have that often. 
So why not transform your lasagne into sometime more inventive. It’s a forgiving dish. Here is a recipe for a wheat free, dairy free version I made this week:
 
 
 
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The golden toolbox of recovery

What’s in your toolbox?! I was recently at a meeting and friend turned to me and said “I have a strange picture that I’ve seen, it’s you with a golden toolbox. It’s like you have everything you need in that toolbox to deal with life”.

This spoke volumes to me as a person and as a health care professional. Having worked in a team which was predominantly psychological I was immersed in the language of the therapists and the word toolbox often came up. I sat in on plenty of group therapy sessions and got to experience a whole range of different therapies.  Also, in our team meetings we used these skills on ourselves as part of the debrief process. It showed me how important it is to look after not just your patients, but yourself. If you have a life with some stress in it (let’s face it that is probably everyone) then you need to have some skills to hand that help you deal with that stress. Stress and anxiety can be a huge factor in an eating disorder, in mental health conditions and also to physical digestive issues such as IBS. When you have a stressful event how do you respond? What does it trigger in you? When you know how you respond you can start to work on a more effective and helpful mechanism. 

 I will never forget my interview for my eating disorder post. I was asked such an eclectic mix of questions that I had no idea how I had done on leaving the room. When I received the call to say I had the job, I asked why I was chosen. The response “we could see you are robust and able to cope with the strains of this work”.  In the eating disorder field this robustness is certainly needed. I continually need to keep on top of my own anxiety and practise what I preach. 

I want to  highlight some skills or tools that we all, health professionals, patients, people, could include in our golden toolbox. Tools you can use regularly for moments of anxiety, tools you can pull out for those emergency moments.

I remember being on a train that got stuck in a tunnel and suddenly feeling trapped and my anxiety levels rising. It was not an experience I was prepared for and suddenly I knew I needed to use one of my tools. At that point visualisation of a calm beach with lapping waves and some square breathing helped immensley. I know if I had not practised these skills  previously, I wouldn’t have been able to use them there and then. So practise really is the key. 

Here are some of my favourite toolbox tools that I use myself and recommend. 

Journaling –

I’m a seasoned journalling fan. This is something I have always done since my teenage years, I now have a lot of full notebooks with a collection of my teen angst, my working life, my spiritual life and my family life in them. Looking back it shows me how I have evolved and where my stress triggers are. I can see the patterns that I fall into and work on improving my reactions. I dig out my journal when I have a moment I need to work through, when my mind feels cluttered or when something erupts! I also love to journal the good and positive, so any life events or just when I get the urge.

If you are on a recovery journey then I recommend that you journal daily  or at least 4 times a week. It needs to become a discipline and a part of your coping mechanism. A good way to start is to write down 3 things that went no so well in your day and how you could have dealt with these better. Then always finish on a positive, so 3 things that have gone well or that you coped with well. You can also take a single scenario and write out alternative endings. Using an eating disorder example: You had an argument with a friend, this increased your stress and you responded by missing your snack. Thinking through why this was not a useful response – restriction of food does not help your emotional well being, it is a quite fix but not a long term cure. Now you have missed out on some nutrition for the day and your body is hungry. Your body needs regular food right now as you work towards recovery. So take a think through how you could have responded instead…. maybe you could have gone for a walk, taken a bath or done some mindfulness to help you reduce your anxiety after the argument instead of turning to food.

Mindfulness and Breathing –

Such a buzz word at the moment, but this is not a fad. I’ve been using mindfulness with eating disorder clients for over 10 years and I’m sure it has been used for far, far longer than this. Just 10 minutes before a meal or after a meal can make a huge difference. It is all about calming your thoughts and body. I personally love just deep breathing, there are so many variations on this so try a few out. For me, the breathing  is something that spills over from Pilates practise and so I get a double benefit from Pilates of exercise and mindfulness. There are some great free resources to help here. 

Exercise –

This is something to decide upon according to your recovery stage. Exercise can be amazing as a mood booster and a de-stresser. However if you are working on weight gain then it will also have an affect on this. If your BMI is less than 17.5 then you will want to modify your exercise so that it is physically safe. 

Distraction – 

I often suggest that people put together a list of distraction techniques that they can use. For example, after a meal,  or when a the urge to binge strikes, at times when anxiety levels are rising it can be useful to have an activity planned. Things like craft, having a friend to call, painting your nails, reading a book, cleaning out a cupboard – something that immerses your mind and changes your thoughts. Puzzles, crosswords, knitting, collage are all great things to have on your list.

Positive thoughts –

Those anxious, negative thoughts are something that we all get. It is how we deal with them that is key. I love the thought of noticing the thought, and finding the opposite reaction. So turn that negative into a positive. If you practise this regularly it can turn into a habit that you hardly notice you are doing. I’m now working on this one with my children too, teaching then that there is always a positive side to things. It is a great skill to learn at a young age but one that you can learn at any age.

I’d love to know what tools you find useful. 

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IBS and the Microbiome

Priya regularly writes for Network Health Digest (NHD Magazine), here is her latest article.  The microbiome is such an up and coming area with so much we are still to research and find out.

Click the link below for the article.

Issue 126 fermented foods IBS and microbiome

A healthier cake – Courgette and sultana (wheat and lactose free).

Each year my love of growing vegetables, well grows. I had a dad who had very green fingers and grew a lot of the vegetables for the small hotel my parents ran. In the summer months our bath water was often emptied by buckets into the vegetable patch! My Sri-lankan grandmother has the greenest fingers in the family. Her windowsills were often covered in seedlings and she would disappear into the garden at mealtime to pick “greens” to make into a family favourite dish. A meal of rice and curry is not right without “greens”. 

One of my first successes was courgettes. Most years I get a good crop, apart from last hear but I blame the baby for that 😉

This year however I have 2 plants that are exploding with monster courgettes and a bountiful supply is on its way.  Follow my instagram stories for pics of the garden and how I cook them.

Personally I love courgettes. Roasted, in a stir fry, ratatouille, on pizza…. only issue is that Miss K and the J boy are not so keen. So it’s been a season of finding ways to encourage them to eat them. I don’t like to hide vegetables so I do tell them it’s in there, once they have tried some. Here are my top ways that they like and eat:

  1. Courgette cake. This has gone down so well. I’ve been making it and freezing it. Recipe below. 
  2. Courgetti. Not because we want to be on trend but because it works. Spiralising courgette, cooking with garlic and lemon juice is a winner. 
  3. Grated courgette in bolognaise, risotto or pretty much any dish!
  4. Roasted and blended with tinned tomatoes for a pasta sauce. 

Hubby and I love a courgette curry so that’s also on the menu but I have to make the children something different on those nights! 

So here is a lovely courgette cake recipe. You really won’t taste the courgette and I’ve lowered the sugar content for you too, it works out at 3g sugar per slice but some of this is the yoghurt and courgette.  Per 100g it is 3.6g sugar so a much healthier alternative to many other cakes. 

I made this for a family party recently and it went down really well! 

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What are your favourite courgette recipes?