Category Archives: Dietitian Advice

Bread is one of the foods that I end up talking most about. Probably due to the fact it is a major component of the Western diet. Most lunches are bread based, many breakfasts have toast in them and it’s not uncommon to snack on a slice of the loaf. It also seems to be one of the food people love, but people say it doesn’t love them! As a carbohydrate food it is usually right up the top of the foods that cause anxiety for those with an eating disorder.

So let’s look at it in more depth.

Am I Intolerant to it?

Bread is made from wheat, which contains gluten. So instantly we have 2 substances that can cause a reaction in people. Those with coeliac disease will definitely need to avoid bread. For some people bread can lead to bloating due to the wheat content. Wheat is a high Fodmap food which means that for some people, with IBS, it may be poorly digested and absorbed. Instead it will pass through to the large intestine where it will ferment. Bacteria will feed on it, releasing Co2 which causes the bloating. I myself am in this category with a wheat intolerance and any more than 1/4 slice of bread will cause me issues the next day.

However for some people, it is not the wheat of the gluten that is caused the issues. It is the portion size. Eat too much of anything and you will be bloated, have tummy ache, feel lethargic and pretty awful. It can be all too easy to overdo the bread products and therefore have a reaction. Some common sense is needed to work this one out, is it the bread or is it the amount? If you can eat plenty of other wheat/gluten foods (pasta, cous cous, pitta, wraps, crackers) then I would suspect it is the portion size. Everyone has different levels of tolerance to different foods, so even if you are sensitive you may be able to eat a small amount regularly. Test it out, keeping a diary of how much you have and what symptoms you get.

Food allergy/intolerances are actually less common than you may think, less than 2% of the population suffer from one. A much larger proportion of people think they have a problem and will cut food groups out without medical advice however.

As a dietitian, I certainly don’t want people to be cutting bread out of their diet. Bread is a convenient and can be a nutritious food to be eating. In this day and age of living life on the run and wanting instant everything, easy grab and go food is often a necessity. Being able to grab a sandwich or make a slice of toast quickly can be very helpful.

The nutrition, crusts and all:

2 slices of wholemeal bread will provide (% of the RNI):

20-25% Calcium
20-30% Vitamin B1
5-18% Niacin
10-20% Vitamin B6
10-16% Folate
5-7% Vitamin E

Bread also contains some iron, zinc, magnesium and manganese. So it is actually a nutritious food to have in our diets. Wholemeal bread provides some fibre, about 1.9g per slice and this is about the same for half white, half wholemeal brands, whilst white bread is lower in fibre content. Going for the wholemeal is always the better option, but there are occasions I recommend white bread too and it is often on the food challenges list for my eating disorder clients.

Is bread fattening?

Bread is actually not fattening, 2 slices provide around 190kcals and 2g fat. So it is not the bread but what we spread on it and the portion size. 4 slices of buttered toast with melted cheese on top will be very different to 2 slices of toast with a thin spread of margarine and marmite. For some people bread is one of those foods that they struggle to stop eating, so 1 slice turns into 6. If that is you, remember it is not the bread that is the issue here! One tip is to try keeping the bread in the freezer and only keep out the slices you need for the day.

How to beat the bloat:

Yes bread can 100% cause bloating. Often that is due to the portion size of carbohydrates eaten at that meal. Take a look at see how much of your meal was taken up with carbs. I eat carbs at every meal but they may up 1/4 to 1/3 of my daily intake. On days when I haven’t eaten as many starchy foods I can definitely feel the difference, my energy levels are sapped and I don’t feel as satisfied, leading to more frequent snacking. I live an active lifestyle with 3 small children and a Pilates business (I am teaching or exercising every day), so carbs are my friend.

If your portion size is sensible, take a look at other factors. Is it really the bread or is the bread an easy target? Stress, anxiety, inactivity, fizzy drinks, beans and pulses, alcohol and caffeine can all lead to bloating.

Have you increased your fibre intake in a bid to improve your diet? When you increase the fibre content you can initially suffer from some bloating, but your body will adapt. Avoiding the bread can actually lead to constipation and a deficit of fibre in your diet. Few of us in the UK meet the fibre recommendations as it is and bread is an important fibre provider.

Try chewing well and eating slowly.

Sitting down to eat and having good posture.

Having a calm mealtime, away from work related activity.

Be more active during the day.

Stay hydrated with water, steer away from fizzy drinks, too much caffeine and alcohol.

So should you eat bread?

Unless you have coeliac disease or are one of the few who suffer from an intolerance, then Yes. Just be aware of the portion size, be sensible what you spread on it and go wholegrain. As with most things, Enjoy it sensibly.

Dietitian Advice, Nutrition Education

Is fresh food better than frozen?

14 August, 2016 Priya Leave a comment

There is a common misconception that frozen food is not as good, that it lacks nutritional quality and it is not the gold standard of food. I think this comes from the fact that when a lot of people think of eating a meal from the freezer it consists of beige foods. You know what I mean? Nuggets and waffles, fish fingers and chips, smiley faces, pizza.

When you look at the range of frozen foods now available it is a really huge and varied market. I recently went for a wander in a frozen food store, a shop that I don’t tend to frequent and I was really surprised. There was so much there that I could use to make a quick, healthy, nutritious meal for my family. In fact I came out with a large bag of different food products for us to try out.

Freezing is a natural process that preserves food, removing the need for preservatives to be added. Research shows that although decreases the overall nutrient content of foods, it is only slight. So those vegetables that are picked and frozen straight away will actually be fresher and potentially more nutritious than the veg that has flown half way around the world and sat on a shelf in the shop. Vegetables lose a lot of nutritional goodness once they are picked, those supermarket fresh foods can be sat around for up to a month before you buy them. So these fresh versions can end up with less in them than the frozen equivalents.

A research study compared 8 freshly picked fresh fruit and veggies against versions that had been in the fridge for 3 days and the frozen versions. Obviously freshly picked veggies are the best to have, but the frozen came out of the analysis as being comparable and were in some cases even better than those that had been stored. The Leatherhead Food Research team found frozen broccoli and carrots contained more vitamin C, lutein and beta carotene for example. However, fresh broccoli scored better on polyphenols, which are thought to help prevent cancer. Frozen raspberries and blueberries had higher levels of polyphenols, vitamins C and anthocyanins, showing for soft fruit it can often be better to eat frozen versions.

So am I saying we should all be eating frozen foods? No. Not at all. What the research does highlight is that there is not reason to not be eating frozen foods. They can be highly nutritious, convenient and easy to use. However you do lose some of the texture, taste and fibre content in the frozen versions. If you can grown your own, or get fresh, in season fruit and veggies that will therefore not have travelled as far or been stored as long then that is fab, but if you want asparagus in the off season you are best off getting a frozen version.

Dietitian Advice, Family Meals, Travel

Easy Holidays Meals for families

24 July, 2016 Priya Leave a comment

Holidays. In my mind they are meant to be about relaxing, having adventures, exploring new places, lazing around, tryIng new foods, cocktails, having family funtimes, having me-times.

Life with 3 children means they are actually full of early dinners, constant requests for snacks, children struggling to sleep in different beds, packing the whole house to take but forgetting the vital teddy, overtired toddlers and the delightful “mummy, how many minutes” in the car.

For us, self catering works out so much easier. Don’t get me wrong, I love being cooked for… but finding a restaurant that serves food I can eat (wheat free) and will let us eat early enough, along with it being that moment in the day that one child will be wailing, well it’s just not as relaxing as it could be. Being able to have breakfast when everyone fancies it and a ready stock of snacks available just makes life a bit better. Picnics for lunch tend to be our staple, it means we can get out, stay out and not worry about what time the first person’s tummy starts to rumble! A small cool back with crackers, cheese, ham, hummus, raw veggies, fruit, crisps, drinks and my bunch are happy.

When we are away, I like to keep the cooking simple and instead look around at the local food or farm shops for some special ingredients to make it interesting. Often that means buying some nice cheeses for hubby and I to enjoy after the small ones are in bed, or getting nice veggies and meat. I tend to pack the basics so there is less shopping needed on holiday, plus there is nothing worse than a long journey and having no tea bags and milk when you arrive.

So here are some of my easy cook evening meals, nothing gourmet, but filling and tasty:

The first night, I always take something already cooked from home. Then I don’t have the stress of arriving somewhere and having to unpack, amuse kidlets and cook.
Jacket potatoes. You can cook these in the microwave in 10-12 minutes, finish in the oven for 15 minutes at Gas mark 4 if you have time. My family love: baked beans and cheese or tuna, sweetcorn and mayo. Serve with a salad.
Pasta with pesto and veggies. So simple. If you use frozen veg it can be a one pot job. Cook the pasta, in the last few minutes add the veg to the water too. Drain and stir in the pesto.
Tacos. This holiday I bought a taco kit, then just cooked it up with some mince and a pile of veg. It went down a treat. Serve with a salad and you will be getting those veggies in.
Sausage casserole. Chop the sausages and cook in a pan with a pile of veggies (leek, carrot and pepper work well), add 1 tin chopped tomatoes and some mixed herbs. Simmer and serve with rice. Take microwave rice to save a job!
Salmon fish fingers, with potato wedges and corn on the cob. All of this can go in the oven. I slice the potatoes into wedges and spread on a plate then microwave for 5 minutes. Heat the oven to gas 8. Put in the wedges, then 10 minutes later add the fish fingers and corn on the cob, wrapped in foil. Or totally cheap and treat yourself to chips to go with it!

Dietitian Advice, Eating Disorders

5 tips for recovery from an eating disorder.

7 July, 2016 Priya Leave a comment

1. Make recovery a priority:
This may mean taking a break from normal life. A year out. Recovery takes a lot more energy and effort than you may originally think. It needs to be right up your priority list. Time off work, school, certain friendships, travelling, exercise. Whatever it takes, this is important for this season.

2. Find yourself again:
What do you like to do? It’s often hard to know what things make you, you. The busyness of life gets in the way of our identity.
Book out some time to find you again. Try some activities you used to enjoy. Often creative projects can be a useful part of recovery. Maybe photography, baking, sewing, painting, collage, scrap booking, gardening, I love the phrase “Find what makes you come alive, then go and do it”.

3. Mindfulness:
Sitting in silence and paying your full attention to your breath and body can help you bring an awareness of your thoughts and feelings. This practise helps you let go of the unhelpful thoughts and be more compassionate to yourself. Practising letting thoughts go in your mindfulness practice will enable you to take this into everyday life so when an unhelpful thought comes along you are in a better place to acknowledge it, but not to act on it.

4. Value yourself :
Take time to look after your body: nutritionally and physically. Some self care time in your week can make a real difference and can remind you that you are important and worth looking after. For some people an eating disorder can be a form of self neglect and may have some punishment aspects to it. Creating the emphasis on it being good to care for yourself and give yourself pamper occasions helps build self esteem and love for your body.

Some ideas: A long bath, a manicure, pedicure, haircut, moisturising your body, shaving. Taking time to tidy your home, buy yourself flowers or something nice to look at each day, light candles in the evenings.

5. Fuel your body:
The right fuel at the right times of the day is vital. This may mean going against your feelings and thoughts, but with repetition a routine will evolve and habits will form.
It is likely your have no idea what normal eating should be for you now. Plan out 3 meals and 3 snacks a day with general timings to stick to if you can. There will always be days things don’t fit into your plan, that is also part of normal eating! For more advice take a look at my healthy eating in Anorexia post.
Go for as much variety as you can. There is no perfect meal plan, it’s all about making small steps and challenging yourself as often as you can.

Dairy Free, Dietitian Advice, Gluten Free, Nutrition Education, Snacks, Special Diets, Vegetarian, Wheat Free

Make your own healthy “graze” snack boxes

27 June, 2016 Priya Leave a comment

So snacking, it’s one of those things I definitely do. I tend to eat my 3 meals and at least 2 snacks a day. Which means my snacks need to be healthy, well most of them! Currently I am breastfeeding which makes me quite hungry at times. It is those moments when I have children clamouring for me, a baby wanting to feed and I know I need to eat that I need a ready to grab and go snack. That moment when it could be biscuits. Although I do eat my share of those too, I’ve recently discovered a wheat free dark chocolate and stem ginger cookie… dangerously nice. So to keep me on the straight and narrow I’ve started making snack boxes. This is something I often recommed to clients and many find them so useful. You can literally make a pile up for the week and take one to work each day, keep them in your bag or just on the worktop if you are at home.

Here are some of my favourite combos:

Cranberry.almond.choc — 15g Dried cranberries, 15 almonds and 10g dark chocolate

Cashew.mango — 15g cashews, 15g dried mango, 1 tsp mixed seeds

Brazil.apricot — 5 brazil nuts, 3 dried apricots, 1 tsp mixed seeds

Here is me trying out Facebook Live and showing off my not so great phone video skills:

Love to hear your healthy snack box combos. Leave me a message/comment so I can steal your ideas too 😉

I tend to buy my nuts and dried fruit in bulk online (it is cheaper per kg but costs a bit up front) and I store a supply in the cupboard and a supply in glass jars on my shelf. Which looks pretty and also means we all see them and are more likely to eat them instead of reaching into the biscuit tin.

“Keep healthy food – In plain sight so it is in your mind to eat it”

A good example of this is my toddler boy who often asks for “prawns” and points at the jars… he means prunes!

SaveSave

Dietitian Advice, Family Meals, Nutrition Education, Weaning

Childhood Obesity – due to larger portions or eating too frequently?

22 June, 2016 Priya Leave a comment

One of the big connundrums around obesity is whether people put on weight because they:

1. Eat more at each meal/snack (larger portions) so eat more calories or…

2. Eat more frequently, so eat more calories.

With levels of childhood obesity rising at an alarming rate, young children is an area we need to focus more on and study in more depth. If you become overweight as a child you are more likely to be overweight as an adult too. Habits learnt in childhood are hard to change.

A study of the UK 2011 Diet and Nutrition Survey of Infants and Young Children (DNSIYC) looked at the eating habits of 2564 young children (aged 4-18 months) by asking to parents to complete diet diaries to report the childrens food intake. The results were presented in an oral presentation at the European Obesity Summit in Gothenburg (1-4th June 2016). They show that overweight children consume larger portions at meals (141 calories versus 130 calories, respectively at each eating occasion), but do not eat more frequently, than healthy weight children. This may seen small, only 11 kcals higher but if a child is eating 5 times a day this could be 56 kcals extra per day, 393kcals a week and 1703kcals extra a month. It soon adds up, so the overweight children were eating an extra 2 days worth of food each month. For every extra 24 calories (100 kJ) consumed during each meal, there was a 9% increased risk of overweight/obesity.

It was LARGER PORTIONS that were shown to be the main issue. The overweight children were eating more of the same foods: (160g of a food versus 146g).

The authors conclude: “Larger portions rather than eating more often may be a risk factor for the development of childhood overweight in early life. Further prospective studies that look at the development of excess weight over time are needed to establish causation.”

My Viewpoint:

The UK Diet and Nutrition Survey of Infants and Young Children (DNSIYC) suggests that portion sizes are larger in overweight children. I would agree that this is often the case but it is not the only issue. The research used diet diaries which are subject to under and over reporting errors.

From my experience as a dietitian and a mum, the other issue is the type of snack foods being offered to children. There are a lot of sugary snack foods available to buy in the shops and these foods seem to be used regularly as a snack item instead of fruit and vegetables. Biscuits, juices and cakes are also frequently given at toddler groups and have become the normal foods to have. Parents need to focus on the balance of the diet, ensuring children get a good intake of fruit, vegetables, wholegrains and protein foods.

Being overweight now will mean that the child is likely to struggle with their weight throughout their adult years too. So the quicker a good lifestyle of eating and being active can be established the better things will be.

On the one hand we want children to learn to eat according to appetite and to be able to regulate their intake. However that is not always possible. Some children do this intuitively and others need to be taught. I find it fascinating that if I give my 2 older children a piece of cake, my boy will eat nearly all of it very quickly, then stop when he has had enough. My girl will eat it slowly and leave some to have later on. Both eat according to their appetite but eat in a very different way. Parents need to teach children that it is ok to leave food when they are full, that all foods are healthy in moderation and that listening to their appetite cues is essential.

Second helpings is a tricky issue. I do let my children have seconds if they ask but it may only be a small spoonful if I know they have had enough. Or I may talk through with them “Are they actually still hungry, do they want to wait for the next eating occasion instead, would having fruit or vegetables be a better option?” Think through how much your child had had to eat and if it should have been enough. Are they asking for more because it is a specific meal? (my children always ask for seconds of risotto and pasta). If you feel that they have had enough then keep seconds to vegetables or salad. We have started having salad on the table each night and it is making a huge difference to my girl who is really enjoying have seconds and thirds of salad!

Good guidance on portion sizes is available here from the Infant and Toddler Forum, here is a little snap shot, you can click through to get the full guidance.

As a general rule for fruit, vegetables and wholegrain starchy foods you can use your child’s fist or palm as a portion size. I’m planning on doing a blog post showing the portions I give to my children very soon.

Dietitian Advice, Nutrition Education, Weaning

Priya speaks out on the sugar in children’s drinks on Wave 105 radio

24 March, 2016 Priya Leave a comment

A Southampton dietitian has told Wave 105 how many parents are unaware of just how much sugar is in supposedly “healthy” fruit drinks for children.

Priya Tew is offering mums and dads advice on healthy alternatives to make sure their children are not exceeding their recommend daily intake (RDA) of sugar.

It comes as a new study shows many fruit drinks for children are “unacceptably high” in sugar.

The research, published in the journal BMJ Open 24th March 2016, found that 42% of fruit juices, juice drinks and smoothies surveyed contained at least 19g of sugars, 5 tsp, this is almost a child’s entire maximum recommended intake per day.

Action on Sugar is asking for a reformulation programme to reduce sugar in children’s drinks by 50% in 5 years and restrict them to 150ml serving sizes. Only 6 products surveyed were found in 150ml servings, meaning children are likely to be consuming more.

“The research doesn’t surprise me. Although it [fruit juice] is high is natural sugar, it’s a very accessible form of sugar.

“I do think parents are unaware of how much added sugar there is in fruit juice and smoothies, and they’re seen as a healthy option. I would beg to differ on that. I think a healthy option for a drink for a child is water or milk, perhaps some no added sugar squash.

“If you’re going to give your child fruit juice then my advice would be to water it down, make it half juice and half water, and only have that as an occassional treat rather than a daily option.”

When processed into fruit juice drinks, the sugars (fructose) in the fruit cell walls are released as ‘free sugars’ which damage your teeth and provide unnecessary calories; you take in more calories without feeling full (i.e. A 200ml glass of orange juice can contain 3 oranges).

Co-author of the study Kawther Hashem, Registered Nutritionist and Researcher of Action on Sugar says: “It is highly concerning that many parents are still buying fruit juices and juice drinks for their children thinking they are choosing healthy products; children should be given as little juice as possible (maximum of 150ml/day).These juices rot children’s teeth and give children a ‘sweet tooth’ that will affect their general health in later life.

“What is more concerning are the products with added sugar and glucose-fructose syrup. We call on all manufacturers to stop adding more sugars to already sweet juices, particularly in children’s products and to restrict children’s drinks to only 150ml bottles/cartons.

“Our advice is to eat the fruit, don’t drink the juice. Juice should be an occasional treat, not an ‘everyday’ drink. These processed drinks are laden with sugars and calories and do not have the same nutritional benefits of fresh fruit and vegetables.”

Dietitian Advice, Nutrition Education

The NEW EatWell Guide

20 March, 2016 Priya 4 Comments

Finally. A moment that we’ve been waiting for in the nutrition world. The EatWell Plate has been updated. Remember this is aimed at the general population… so it is not for those on special diets for medical reasons but is a nationwide healthy eating message. It gives the public sensible, evidence based information on what should be in their diet. Very timely in light of the rise of health bloggers and other unqualified “nutrition experts” who are suggesting we reduce carbs, sugar, gluten, meat etc…

Here is the old version:

And the new version:

5 top differences:

1. SUGAR:

After the SACN report the new plate has an emphasis on sugar reduction. So the high sugar foods have been removed from the model and are now emphasised as foods to eat less of. What I like is the fact these foods are very much still included. So going completely sugarfree is definitely not advocated. We can all enjoy sugary foods in moderation 🙂

2. FAT:

Quite a change for fat with the change in the purple segment size and now a focus on unsaturated fats. It would have been nice to have a larger range of these fats, however they often cross over into other food groups so it can be a little confusing. Other foods include: avocado (also a veggie), nuts, seeds and oily fish (also a protein), olives (also a veggie), olive oil.

3. FIBRE:

Hooray for more of a focus on fibre! With all the sugar madness that has been flying around, fibre has had to take a backseat. It is good to see the wholegrain message being highlighted. Recommendations are that we eat 30g of fibre a day, which is a lot. Eat wholegrain foods at meals, snack on fruit and veg and include 2 high fibre snacks (homemade flapjack with seeds in would be one of mine) and you will just make it.

4. CARBS:

The segment sizes have very much been revisited. Linear modelling (which I am not an expert on) was used to look at the guidelines and compare this to what the population currently eats. We have this data from the NDNS – regular dietary surveys that are carried out on the UK population. So what we have is an achievable version of the guidance, rather than the “perfect diet”. I like this, as a dietitian it is how I work, translating the science and guidelines into achievable bite size pieces of advice.

5. HYDRATION:

The inclusion of a drink is a positive step towards helping education people on sensible choices of fluids to drink. It was also a change to make a change to the advice on fruit juice and smoothies, so you can see that now a smoothie will only count as 1 portion of your fruit and veggies a day. That’s 1 portion total, so if you drink 5 smoothies a day that is still only 1 portion of fruit and veggies…..and a lot of sugar. This has the aim of helping us reduce sugar intakes in light of dental health.

Other changes are there being less red meat and processed meat on the plate. So the 70g of red meat per day guidance has been integrated in. Drawn foods have been used after focus groups consulted on the images. I’m not so much a fan of this. To me the model looks very simplistic but perhaps that is what we need? A return to basics and simple, sensible advice?

What are your thoughts?

Do you like the new model?

Does it help you think about how to eat healthily?

Dietitian Advice, Nutrition Education

The rise of nutrition social media.

10 March, 2016 Priya 1 Comment

Since I qualified as a dietitian in 2005, the way nutrition information is communicated has changed at quite a pace. The basics of nutrition are still the same but we have moved from….

Books, journals and written journals to ebooks and blogs.

Face to Face meetings have become online meetings, virtual hangouts and video calls.

TV chefs have been challenged by food bloggers and YouTube cookery channels.

With social media being a huge knowledge driver it is clear that how we communicate affects language. So nutritional professionals with the RIGHT message need to be actively on social media, shouting about it.

The History:

1999 : Rise of Blogs.

2004 : Facebook begin and is now worth hundreds of billions.

2005 : YouTube started up.

2006 : Twitter, rising to more than 100 million users in 2012.

2012: : Health Bloggers emerge.

53% of consumers check their smart phones within 5 minutes of waking. Health bloggers are now prolific and widely followed, some are fast becoming household names with their own recipe books and published in the media. However many of these bloggers are giving out their own nutrition advice but with no real qualifications.

What do people now want?

Evidenced based nutrition knowledge presented online, in an easy to access format. Bite sizes snippets that is scientifically correct.
Ethical products.
Natural foods.
Homemade, fast recipes.
Artisan ideas.
A unique story on food.
Smaller independent brands in a move away from the mass produced products.

As dietitian’s/registered nutritionists we have a huge role here.

My thoughts:

How we communicate counts. Be present, be a part of the conversation.
Be authentic. Dietitian’s eat cake! Model healthy eating, balance, moderations and all the things we preach about.
Working with brands is ok as long as you are one about it using the hangtags #ad #spon and a disclosure in any blog posts.
Share your tips, what you eat, your recipes, your work, your stories, new foods, your meals, the research you read, live tweet study days. Show your passion, shout about it.
Keep abreast of the food trends. We can’t get left behind. Be current, be topical, be present.

Dietitian Advice, Eating Disorders, Nutrition Education

Anxiety Techniques for Eating Disorders

13 February, 2016 Priya Leave a comment

Anxiety is one of the biggies when you are working on recovery from an eating disorder. I’ve worked through this with many clients: either whilst they are eating, after a meal or whilst choosing a meal. It can feel totally overwhelming and be quite debilitating. So you need tools available to help you deal with those consuming anxious moments. One thing I alway like to remind people is that anxiety is a natural body response. It may feel like it will overtake you and spiral out of control, but it has to peak and then lessen. Give it 10-20 minutes to pass.

Distraction

Find something that can change your focus. If you are eating you may need someone to start a conversation, the radio may help or watching a candle burn.

If it is away from a mealtime then crafty activities, a good book, a bath or a phone call to a friend could help. Write out a list of things to try out.

Do a Body Scan

A Body Scan is a a great way to reconnect to your body. In moments of anxiety your parasympathetic nervous system can take over, dry mouth, heart beating faster, harder to swallow, feeling hot, a pounding head, tunnel vision – none of it will help when you are trying to eat or to relax after a meal. By working through your body from feet to head you cab bring your awareness back to your body and reduce the anxiety.

Here is a free video version from Elisha Goldstein.

I particularly like progressive muscle relaxation, probably because it is a more active form or relaxation so I have something to do! It works by tensing the muscles in a body part, holding for 30 seconds and then releasing. This leads to a sense of relaxation in that area.. The whole process makes your think about your body and not that anxious event and helps you slow down your breathing too.

Here is a useful script you can use.

Or you can just work from your toes through each muscle you can think of going up to your jaw. Or pick large muscle groups such as your fists, feet, legs, jaw and just do those for a few minutes.

Being Barefoot

Walking barefoot can be a good exercise in thinking about movement, feelings and breathing. Slowly walk around on difference surfaces, working slowly through the foot and focusing on using as many of the small muscles in the foot as possible. Use deep breathing through the ribcage whilst you walk.

Try using a tennis ball to massage and release through your feet first to increase the amount of movement through your feet.

Mindfulness

I often ask clients if they have tried mindfulness. Some people love it and others struggle with it. If you haven’t tried it then good apps include Headspace and Breathworks. It can take time to really get your focus and practise will improve it. Try and find a set time to practise each day, even if it is only 5 minutes.

Breathing

I know this is something we all do, all of the time, but there are some good breathing techniques that can help reduce anxiety. Deep breathing reduces the fight/flight response that occurs when you are stressed. So simply focusing on your breath and slowing it down can help. When you are sat eating and the anxiety starts to mount up, threatening to overwhelm you, try refocusing on your breathing.

In Pilates we use thoracic breathing, where you bring yourself into a neutral posture – stacking your ribcage over your pelvis, breath in deeply expanding through the chest and breath out letting the chest fall back. It always amazes me that just deep breathing uses the right muscles can make a difference.

Another one I like is square breathing – think about or look at a square. Breathing in for 4, hold for 4, breath out for 4 and hold for 4. The counting can be helpful and you can do this without anyone noticing.

Dietitian UK

Category Archives: Dietitian Advice

Is bread bad?

Is fresh food better than frozen?

Easy Holidays Meals for families

5 tips for recovery from an eating disorder.

Make your own healthy “graze” snack boxes

Childhood Obesity – due to larger portions or eating too frequently?

Priya speaks out on the sugar in children’s drinks on Wave 105 radio

The NEW EatWell Guide

Anxiety Techniques for Eating Disorders

Freelance Dietitian specialising in helping those with Eating Disorders and a Media Spokesperson for the profession.