Tag Archives: dietitian hampshire

There is no perfect way to eat

There is no perfect way to eat. The more I learn about nutrition the more I am convinced of this. The science of nutrition is continually evolving, growing and being researched. We are learning all the time and it’s a lot more complex than it looks on the surface, but also there are simple steps we can take to eat well.
 
Things are not always in your control. Our tastebuds, culture, finances and social circumstances are just somethings that can affect how we eat. The good news is there is no perfect way to eat. There are many, many ways to eat a nutritious diet. It’s not about striving to be perfect or have the best meals. It’s about eating as well as you can with what you have. No guilt. No shame. No judgment.
 
 
Our bodies change and need different things at different stages of life, often our bodies are able to adapt and help with this. As a baby, a mums breastmilk will change depending on what the baby needs.  Teenage bodies are able to absorb more calcium than at any other time of life. In pregnancy our bodies adapt and will absorb more of certain nutrients such as iron to provide for the baby and changes in the body. Isn’t the body amazing, it knows what we need better than we do. So one of my top tips is to focus on trusting your body, listening to your body and learning what your internal cues feel like. What does hunger feel like to you when you are very hungry, a little hungry and not hungry at all? What cues does your body give you about the foods it needs? Do you get cravings or suddenly feel you are drawn to certain foods? Sometimes this can be due to the nutrients in these. For example craving vegetables after a trip away when you have eaten differently, or craving salty foods when you haven’t had any salt for some time. 
 
My favoured approach in my eating disorder work is to focus on reaching a healthy state and not a healthy weight. On reconnecting with your body and not ignoring it’s signals. This can be very hard to do and a long journey. It’s not all about the numbers on the scales. Sometimes shifting the focus away from weight can make a huge difference.  There is no perfect way to eat or perfect way to recover from an eating disorder, but we do have amazing bodies that can help us discover the right way for us. 

If you need any help with this then do get in touch. 

Low Carb Diets

Today has been all about carbohydrates as a new study was published in the Lancet. I’ve spoken on ITV new  and Wave 105 radio about it and  video/audio clips are at the end.

So what’s the low down?  This is a controversial topic as low carb diets have become popular. I’m not against this, but I do think it needs to be properly thought through and planned out. Low carb diets are used by some dietitians clinically for diabetes control, weight loss and for some metabolic disorders. However there is a way to do it right. Let’s break the latest study down:

👉 This was an observational study and it used food frequency questionnaires, so not the best data as this is self reported after the event. It is easy to forget what you eat or under/over-estimate. However the study  was followed over 25 yrs  with over 15,000 people taking part.

👉 A U-shaped relationship was found with increased mortality on a high carb or low carb diet. Low carb being <30% calories coming from carbohydrates. High carb being >60% calories coming from carbohydrates.

👉Eating moderate carbs (50-55% of total calories) was shown to be best. This is what our UK guidlines are based on so we already advise this. 

👉 Swapping carbs for plant based fats and proteins has better outcomes compared to animal products. So if you reduce your carbs it does matter what you replace them with.

👉 This study didn’t look at the type of carbs eaten. We want to be eating #wholegrains and reducing refined carbs (unless you have a medical reason to eat a low fibre diet).

👉 Eating lower carb may help weight loss and with diabetic control but it’s all about balance. Not overdoing it and taking all carbs out. Choose sensible sized portions of wholegrain carbs with meals.

👉 Everyone is individual. If you are more active you may need more carbs. If you are recovering from an eating disorder you may need more carbs. If you on a special diet you may need less carbs. If any of that applies to you then seek advice from a #Dietitan or #registerednutritionist.

One big issue that comes out of all of this is we keep on focusing on individual nutrients. It is not helpful to break food down and count the grams you are eating or the calories from each nutrient and could be triggering for an eating disorder. Food is complex, it is made up of many nutrients some of which we can’t even give a precise measure of. So once again we come back to common sense nutrition, eating sensible portions of balanced meals and listening to your internal cues of hunger/fullness.

 

Book a Consultation

Priya provides one to one consultations from her home consultation rooms in Southampton or online using video calls or phone consultations. See below for the types of issues Priya can help with. Skype/Zoom video calls provide a more flexible way to see Priya face to face but from the comfort of your own home. The software for this is free to use. The majority of Priya’s work is done this way as she works with clients all over the country and internationally too. She also offers dietary analysis via email where a thorough analysis is conducted on your food diary and a report emailed back to you.

As everyone is different and needs differing levels of support Priya does not have a set way of working. However she does work from a non-diet and intuitive eating background. This is based on the concepts that diets do not lead to long term change and that it is better to focus on changing health behaviours rather than just diet and a weight focus.  Retuning your body to listen to its hunger and fullness cues, learning to respect your body and listen to its needs can be a longer route but leads to lasting changes for life.

A initial consultation lasts up to 1 hour and includes an in-depth review of your current and previous diet and food related problems plus your weight and medical history. From this information Priya will give education, advice and help you set goals that are realistic and achievable. All advice is individualised and tailor-made for you. You will receive an email summarising the agreed goals set  along with any agreed information. This may include a meal plan, worksheets or educational literature.

Follow-up sessions can be booked and last for up to 30 minutes. The number of sessions you will need will totally depend on your needs. 

Prices: £95 for an initial consultation and £65 for follow ups.

Package: £260 for 1 x initial consultation and 3 x follow up sessions.

Email dietary analysis with report £65

Eating Disorders:

Priya is renown for her expertise in this subject and the majority of her clients will have an eating disorder. She takes a holistic approach, not just looking at nutrition in isolation but helps clients to look at the wider issues too. Many of Priya’s clients have worked with the NHS and need further support or have not met the criteria for NHS input. If you do not think you have an eating disorder but know your approach to food is not as it should be, then get in touch. Working as part of a team of specialists Priya can recommend a therapist for you to work with or can liase and work with your current therapy team as well as your GP. She works with the Wings Eating Disorders Unit in Romsey and also as part of the Marchwood Priory team. If you need help getting your eating back on track Priya is here to help with education, meal planning, practical help, support and an understanding ear.

Weaning Consultations

One of Priya’s specialist and much loved areas – book a weaning consultation for advice, recipes, top tips and support to help you get your baby off to a wonderful start with food. Having weaned 3 children herself Priya has first hand experience as well as the evidence case and the research to support her advice. If you are struggling with fussy eating Priya can also help with this. Family meal planning and suppoprt can also be supported.

IBS:

Priya can help with advice and support for those with IBS, this includes the low FODMAP diet which is a specialist diet that should be followed under dietetic supervision.

Other consultations topics Priya can help with include:  Chronic Fatigue, Learning Disabilities, Family Meals,  Anaemia, Osteoporosis, brain injury and achieving a healthy balanced diet. If you have another dietary issues please do contact Priya to discuss. If Priya is not able to help she can help point you to someone who can.

Some private medical insurance companies cover dietetic consultations, please check with your insurer. Priya is registered with AXA, AVIVA, WPA, BUPA, Exeter Family, Allianz and Pru Health.

Testimonial:

“The support Priya provided to help me gain weight and overcome an eating disorder was above and beyond what I would expect from a dietician. We met regularly and she never failed to surprise me with creative and interesting ideas to introduce variety into my diet and ensure that the weight gain process was as exciting and smooth as it could be. She encouraged me to face my eating disorder head on and used her incredibly extensive and detailed knowledge on nutrition to challenge disordered thinking. Her holistic approach has been so integral to my recovery that I cannot thank her more! I’d recommend working with Priya to anyone, as her caring, enthusiastic and creative approach is something you don’t find easily.” 

Easy Peasy Paella

With parents who reside in Spain, paella is something my whole family loves, my mum has been taught how to cook it by the locals. This weekend with my mum in the UK at my home I decided to cook her my version. It’s probably not a true paella but hey, it’s tasty family food and a one pot meal that you can put in the middle of the table so everyone helps themselves. 

Of course you could totally add chicken, fish or your own favourite vegetables to this, I used what I had in my kitchen. Make your own version and let me know how it goes.

Easy Peasy Paella
Serves 6
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Prep Time
10 min
Cook Time
40 min
Prep Time
10 min
Cook Time
40 min
490 calories
70 g
105 g
13 g
23 g
4 g
335 g
736 g
5 g
0 g
8 g
Nutrition Facts
Serving Size
335g
Servings
6
Amount Per Serving
Calories 490
Calories from Fat 114
% Daily Value *
Total Fat 13g
20%
Saturated Fat 4g
18%
Trans Fat 0g
Polyunsaturated Fat 2g
Monounsaturated Fat 6g
Cholesterol 105mg
35%
Sodium 736mg
31%
Total Carbohydrates 70g
23%
Dietary Fiber 5g
21%
Sugars 5g
Protein 23g
Vitamin A
88%
Vitamin C
27%
Calcium
9%
Iron
14%
* Percent Daily Values are based on a 2,000 calorie diet. Your Daily Values may be higher or lower depending on your calorie needs.
Ingredients
  1. 1 tsp tumeric
  2. 1/2 tsp paprika
  3. 1/2 tsp cumin
  4. 1 tsp mustard seeds
  5. pinch of saffron (optional)
  6. 1 tbsp olive oil
  7. 100g chorizo, chopped
  8. 3 cloves garlic
  9. 450g basmati rice (you could use paella rice)
  10. 1 tsp Italian mixed herb mixture
  11. 2 dried lime leafs (optional)
  12. 450ml chicken stock (mine was homemade or use a stock cube and water)
  13. 2 large carrots grated
  14. 2 medium courgetes grated
  15. 100g mushrooms
  16. 100g peas
  17. 450-600ml water approx, judge it on the rice as it cooks
  18. dash of lemon juice
  19. 250g frozen prawns
  20. large handful of fresh herbs, chopped
Instructions
  1. Place the spices in a large wide based pan on a medium heat, add the boil and cook for a couple of minutes.
  2. Add the chorizo and allow it to release its oils.
  3. Next add the garlic and rice, cook for 2 minutes. Then add the stock, dried herbs and lime leaf.
  4. Allow this to simmer whilst you prep the veggies, you could use any veggies you like!
  5. Add in the vegetables one at a time and stir in.
  6. Add the water and place the lid on the pan. Allow it to simmer until the rice is cooked.
  7. Finish with the lemon juice and prawns, allowing the prawns to cook in the pan with the rice for a few minutes.
  8. Finally add the herbs, taste and season.
beta
calories
490
fat
13g
protein
23g
carbs
70g
more
Dietitian UK https://www.dietitianuk.co.uk/
Check out a little video of us cooking it here. My 7 year old girl was on “sous chef” duty tonight and she totally enjoyed helping out. Her tasks were to measure the rice using the Carb Spoon, to cut the chorizo up, grate some vegetables, add them and stir the pan. She added the stock, picked the herbs and chopped them too. Plus she got the prawns out of the freezer and added those for me.

I’m trying to get my children to each cook with me once a week, making it a scheduled activity and time with mummy all at once. It slows me down and means more planning is needed but it is also teaching them valuable skills.

 

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Breastfeeding and the Microbiome

Breastfeeding is something I am quite passionate about, partially because I’ve breastfed 3 children, for a total of 4.5 years. That’s a lot of feeds and little sleep 😉 however totally worth it in terms of the impact on their long term health. 

Now this is totally not meant to be a dig at anyone who cannot breastfed or who chooses not to breastfeed. Breastfeeding is blimming hard work. I’ve been through mastitis, blocked ducts, nursing strikes, bleeding nipples, tongue ties x 3, nursing strikes, expressing (such a faff!) and babies who just want to feed forever. So I totally get that how you feed your baby is your choice and for many combination feeding or formula feeding is the way forward. I planned to only breastfeed my first for 6 weeks, then 3 months, then till weaning. Small goals and steps helped me. However I also have ladies in my postnatal pilates classes who just cannot get on with breastfeeding and for them using formula saves their sanity. 

Ultimately we all know breastmilk is amazing stuff, so if you can breastfeed I heartily recommend you do it. Here I’m sharing an article I wrote for Network Health Digest on how breastmilk affects the microbiome of the infant. Fascinating stuff. 

Issue 135 breastfeeding and the microbiome

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You can still eat a jacket potato, here’s how.

So the news on the street is a jacket potato contains 19 sugar cubes. More than a can of coke. Now whilst this may be true on the one level there is a lot more going on here than just the sugar and it is not to say you cannot eat a baked spud.
 
Photo taken from the Sun: https://www.thesun.co.uk/fabulous/6452643/potatoes-obesity-crisis-sugar-baked-potato/
Sugar in food is modified by several factors it is not something that can just be measured by sugar lumps alone. That potato has fibre, potassium (more than a banana), B6 and Vitamin C for starters. The can of coke – well I don’t think we can claim that has much else.
 
There is a system that ranks the effects that feeds have on blood sugars. This is the glycaemic index (GI), it looks at how rapidly a carbohydrate is digested and released as glucose into the blood stream. A food  with a high GI food is one that increases the blood sugars faster, leading to a potential blood sugar spike. Using this ranking  a jacket potato would be high (85) and something like chickpeas would be low (28). This is a really useful system but it has it flaws. If you use it alone you could live off chocolate and ice-cream as these are low GI!  Also this system does not account for the carbohydrate in food and it uses 100 g of food, rather than looking at portion sizes. However it is still a useful way to compare foods and I’d highly recommend you focus on eating more low GI foods. But remember we do  not eat these foods in 100g servings or in isolation. Read on to hear more about this.
 
 
Another good ranking system for those concerned about blood sugar control is glycaemic load. This looks at the effect of food per portion and it does take into account carbohydrates. So for example foods that have a glycaemic index of less than 10 have a low or little impact on bloodsugars, GL of 10 to 20 is moderate and 20+ is high. Again another useful system to keep in mind, but it has it’s flaws (doesn’t everything!). We don’t eat these foods in isolation, so other factors come into play.
 
So let’s think about the nutrients and factors that affect glycaemic index and glycaemic load…
 
These are general rules, there are always exceptions:
 
1. Fibre is something that slows the rate of digestion and therefore stops blood sugars from increasing as fast.
 
2. Protein also has this effect on the body a food that is higher in protein will be a food that doesn’t increase your blood sugar as fast.
 
3. Fat also slows down the rate at which sugar enters the bloodstream, that is why something like chocolate may seem like it will be a food that will increase your bloodsugars fast, but actually that’s not always the case as the fat slows down the digestion.
 
4. Cooking method and processing also affect food, as does the variety of the food. For example, the impact on bloodsugars from a ripe banana will be much higher than in unripe one and it’s the same with a potato. With our baked potato the impact on bloodsugars is higher than when you eat new boiled potato or sweet potato.
 
Now this is where it gets complicated because we can’t just rank certain foods as good and others as bad! So where to go from here? Well these systems of GI/GL give us really good principles that we can use when planning a healthy balanced diet. However that doesn’t mean that we need to be living our lives by a set of tables and numbers (see tables in the links below). Who wants to be doing that? It does mean you could look at the foods you eat regularly and think about making some swaps or improving meals by adding protein, fibre or plant foods.  It doesn’t mean you only have to eat foods that are low in GI or low in GL. What it does mean is it is helpful for blood sugar control to eat more of these foods and to adapt some of your meals that include higher GI/GL items. So for example let’s take the humble baked potato. Now yes it is high in GI (50) and GL (33) but by adding tuna to your jacket potato it will change this from a meal that had a large impact on your blood sugar levels to a more moderate one. Add a bean salad and some veggies in and it gets even lower.
 
Here is my dinner from the other night. A potato the size of my fist, with tuna and sweetcorn (protein), salad and cheese (fat). 
 
 
It’s once again, all about the balance.

Links:

Glycaemic Load Table.

Glycaemic Index Table.

 

 

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Colour up kids restaurant menus

Let’s talk childrens menus when eating out. This can be a topic of division in my mind and in general amongst parents. I doubt many people choose where they eat out based soley on the kids menu but when you are eating out with small ones it is hugely important. 

Often childrens menus are high on beige foods and low on colours. I’m talking fishfingers, nuggets, burgers,  chips, potato waffles with maybe beans or peas but not much else. I totally get why, as a restaurant you want children to enjoy their meal and hey, it’s only one meal. So does it really matter?

 I think it does. Children are little adults, as an adult I want choice, flavour, foods that I don’t usually eat at home, foods that make me think and that my tastebuds explore. Beige food menus are devoid of a variety of  tastes, textures, fibre and colours. All things we want kids to be eating.

Now for my kids eating out is a complete treat. We don’t do it that often. I also don’t tend to offer “beige meals” often at home, unless they are requested. Not that I am against those foods, they have a place. However, I  prefer to go for plenty of veggies and variety, aiming for homemade foods when I can. So we may have fishfingers from the freezer but I’d serve them with a mixture of veggies, potato wedges, with the skin on and thus provide a range of nutrients, fibre and tastes.  Nuggets and fishcakes can totally be offered as part of a balanced diet but do they need to make up the majority of children’s menus when eating out? I think not. Let’s get some balance on the menu please. 

Miss K totally loving her ramen bowl.

If we start to offer variety and treat children as little foodies maybe they will start eating in this way? Having had a boy who was anti-vegetables I’ve had first hand experience of how consistency, being non-judgemental and continual exposure works. So if we only offer beige foods they will only eat beige foods! This is part of the basis behind raising intuitive eaters, as parents we offer a range of foods and let them choose how much and what to have.

My crazy kids actually get a bit excited about a kids menu but at times I get “why is my food not as nice as yours”.  Which has led to us ordering an adults meal for the kids to share or of course sharing our own meals. I do remember at a wedding the sausage and chips being shunned in favour of the delicious buffet. When travelling I encourage the children to try cultural foods and things they have not had before – with varying results but it’s all about continuing to promote these values and ideas.

 Eating out is about pleasure and enjoying meals different to those at home. My 7 yr old especially loves eating “adult meals”. So I love places who make small versions of the adult menu. In my mind this is how it should be. Yesterday we ate out at a restaurant that did an amazing menu with kid friendly versions of their dishes – no chilli, smaller portions and some meals where all the foods were separate for those, like my boy, who would have wanted to pick bits out. They were also happy to make changes to the kids meals. My children were VERY happy. 

This boy, so happy with his meal and he demolished it.

It’s all about enjoyment, choice, variety and #empoweringkids to do this. I see it as part of intuitive eating, letting them choose what to have and how much to eat. My kids are very different in their eating and how they eat but all loved their lunch out today. 

 

 

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How do we know when we are hungry/full?

In a completely perfect world we would eat when hungry, stop when full and eat the foods our body tells us to eat. However few of us are that tuned into our bodies signals. We are bombarded with outside signals for example the media, advertising, other people, shops, restaurants – food is all around us.

You walk down the road and pass someone eating a burger, “hmmm I fancy one of those now”. Then you pass a billboard advertising ice-cream, “oh I could eat an ice-cream later”. Then someone in the office has a birthday so you have a slice of cake. Later on the radio is advertising a meal deal which makes you think of buying one for your lunch. In the shop you are standing waiting to pay and see a cereal bar so pick it up to nibble on. All those extra signals that are overriding your actual body signals. It’s all so easy to be overwhelmed by the external and takes a lot of quietening ourselves to hear the internal cues. 

Many people I work with cannot actually initially  pinpoint what hunger feels like. I ask how hungry they are and am met with a confused look. Hunger on the one hand is quite a simple idea, your body is hungry, it tells you, you eat. Other the other hand it is complex, so complex. There is head hunger, body hunger, stomach hunger, emotional hunger.

Here is my 7 year olds take on how she knows she is hungry. I think this is such an important conversation to have with children AND adults. So have a think this week, how do you feel hunger and how hungry are you before you eat? 

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The non-diet approach for children.

In a time when there is a focus on reducing sugar, countering obesity and improving the long term health of the nation, it can be hard to know how to approach these topics with your family. On the one hand we want children to be aware of what is in food but we don’t want them to be obsessing over it or feeling they need to go on a diet.

Personally I think that teaching children about nutrition, food preparation, healthy behaviours and their bodies early on is really important and can be part of the solution that our society needs. So as a mum I do my best to educate my children on a daily basis.  Simple messages that we use are “There are no good of bad foods but some foods we eat less of as too much of them are helpful for our bodies”. We also talk about what is in a food and why it is good for us – often using “Funky Facts” such as the fibre in bread or the vitamin C in a kiwi. Top facts like this are things I find they store up and remember.  

We may talk about dental health or how out tummy feels if you eat too much of certain foods.  Both my older children (age 4 and 7 yrs) can associate with a time they have eaten sweet foods and felt unwell from it! I love talking to them about how their tummy feels and what do they feel it needs as well as what does it want!

I prefer to focus on these messages rather than focusing on weight/size/shape.  Being a dietitian who works in the eating disorder field I am well aware of the issues that can occur when there is too much of a focus on weight, shape, size and how your body looks.  Instead I like to focus on the enjoyment of food and on healthy behaviours such as being active, getting fresh sunlight, being outside and taking care of our teeth, hair, nails. 

Here is a little video of my 7 year old explaining her thoughts on food:

I’d love to hear your thoughts! 

 

Teaching intuitive eating in family life

It seems a lot of you out there are interested in teaching your children about intuitive eating. Which is absolutely amazing! I’m over the moon. Absolutely loving the little experiments people are doing at home too. 

After a few comments and questions about the last blog post I thought I’d do a post on how we talk about nutrition at home. Again this is not a perfect method and I don’t know it all but I am seeing the benefits in my children. 

For example this week at lunch my boy aged 4

“Mummy why are we having grapes for lunch”

Me: “Because Miss E wanted them” (she is a grape-a-holic, though she hasn’t tried wine yet!). 

J-boy: “We had grapes yesterday and the day before”

Me: “I know, is there a problem with that?”

J-boy: “Well we shouldn’t just eat the same foods we should have different colours and types”. 

Me: in a flabbergasted tone “Ummmm yes exactly” 

Is it just me who is amazed when their children actually listen and take on board what you say?

So here we go, how we chat about nutrition at home:

Take the relaxed road. Several people asked me how can I be sure the kids won’t over eat the food like sweets and biscuits? I guess I can’t ever be sure, but I also cannot be in control of their food intake for ever. I want them to listen to their inner signals and to have a good grasp of nutrition. The more I trust them and let go, the more they surprise me.  So we talk about how sugary foods are absolutely delicious and all foods are great to eat but too many lollipops, cakes, biscuits, dried fruit can lead to tooth decay and tummy ache. On those occasions when the children do over-eat sweeter foods it is a great chance to talk about how that feels.  

A recent example being Eton Mess, my girl had a serving, then came back to ask me if she could have more. I suggested she think about her tummy and decide herself. After another serving she felt a bit sickly and later on reflected on this being due to the sweet, creamy dessert.

Now if I had told her not to have another serving she would have just felt a bit disgruntled, whereas now she understands more about listening to her body. 

Fullness and Hunger Cues. We talk about how it feels to be full and hungry. In the words of my children:

Fullness = my tummy has had enough, it feels uncomfortable, my mouth has eaten enough, I’m not empty. Hungry = rumbles and my tummy aches. Sometimes when I’m hungry I don’t have my energy.

Miss K has always been good at stopping when she is full. the J-boy is another kettle of fish. He will happily keep munching on foods such as biscuits unless you remind him to tune into his tummy. Distraction for him is a biggie. Yesterday in the car he had been given a pack of biscuits, he asked how many to have and I asked him to ask his tummy and see after 1 if he should have another or keep it for later. He happily munched his way through 2 and stopped. Now I’m pretty sure it would have been 3 or 4 biscuits if he had been watching TV whilst snacking or distracted.

 

Nutrition Facts. Now I’m not organised enough to sit down with them and give planned nutrition lessons, I find relaxed or undercover stealth like approach works best.  So don’t feel you need to become a teacher to teach nutrition. When we eat a meal we tend to have a few facts about the food we are eating and talk about the meal. It could be where the meat comes from, how something is grown, the colours on the plate or why something is good for your body. My kids love a handy fact and they will then repeat things back at a later meal. This can prove amusing when someone else is eating a food that they know about.

Your language matters. How you talk about food is so important. Labelling foods as good/bad, healthy/unhealthy, treats or special foods put those foods up on a pedestal. If there are foods that you disapprove of your children will soon pick up on it. I feel like it is a daily occurance that I am having to challenge my own thinking on this and change my words/tone. It seems I am not alone, phew.

Eat using the Senses. Talk about how food tastes, smells and the texture. This can help them to zone in on what they are eating and to not eat it without noticing. One way we have done this recently is to talk about taste buds, where they are in the mouth and what you are tasting when you eat certain foods. My boy enjoys the noises that foods make and how they feel when he eats them with his fingers. Yes it may be not be good table manners but it is a way to get him to connect with his food and think about what he is eating. Later in life people spend lots of time getting back to mindful eating… our children can teach us alot about enjoying our food.

I’d love to know your thoughts. How do you talk about food at home? 

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