Nutrition as a Performance Tool

Science and in particular nutritional science is fast advancing and evolving. What we know is that nutrition plays a huge part in our performance as human beings, whether that’s Sport, academic or employment. It has an integral role in regulating immune, bone, hormonal and physical health.

“In high pressure environments, chronic stress and competition can have a negative impact on mental and physical health, resulting in poor performance and outcome.”

This may manifest in different forms from dysfunctional relationships with food; compulsive obsessive traits; poor sleep or a depressed immune system, increasing prevalence of infections and illness.

The crux of the issue is usually more management of stress and anxiety. We all know that anxiety can be crippling and the desire to succeed in the work place, can heighten this considerably. In my work I am often approached by high profile individuals who have suffered “burn out” and are struggling with all aspects of their life.

Some examples include those who take up exercise as means of managing stress; there are numerous studies that demonstrate the link between improved mental well being and physical activity. It is a dose related response, to a point.

When you are someone who is ambitious, driven to succeed, I regularly observe that you put the same effort into your “hobby”. I have worked with many individuals with high pressurized roles who have taken up endurance sport- running, triathlon or cycling as a means of managing stress levels. What starts out as a means of “down time” soon, due to their personality traits, can become something else to fixate and obsess over; 5am long runs after 4 hours sleep or cramming in 3 sporting disciplines around a 12 hour work day become the norm. That need to succeed the driving force like a task master. In all the cases I have worked with, this soon transpires as over training resulting with the physical body and mind no longer responding.

Similarly, I have worked with young graduates, starting out on their career path, eager to please in order to get ahead in the competitive world of employment. They feel the stress and anxiety and run on adrenaline; but somehow its still not quite enough. Anxiety makes us feel uncomfortable –its our body’s way of responding to threat and so when we feel physically anxious, its only natural that we want to stop it. However, here is the thing, you can’t actually control anxiety –you have to learn to manage it. People use many ways to control –alcohol, exercise and the one I see, food. What sets out as a means of trying to “help” can soon turn into a list of food rules that help them feel in “control” and “safe”. Sadly, this dysfunctional relationship with food, while may have improved their anxiety momentarily, just comes back to bite them, resulting in social isolation and a complete inability to step outside of their box of food rules.

Most companies want productivity and consistency – and in order for this to happen, they need to be mindful of the welfare of their employees.

Good nutritional practices are one way to support this.

My seminars and workshops are designed to support a healthy attitude to food, living and work.

I will first and foremost debunk the myths around nutrition and help to re-educate your mind to understand what it is to have a healthy attitude towards food, rather than looking for the next so called “superfood” or “wonder supplement”

I will discuss nutrition strategies to prevent stress but equally look at interventions for those of you who may have already identified that you may be at risk of burn out.

I can offer practical demonstrations and recipes to inspire you to eat well and fuel appropriately, encouraging a healthy gut microbiome which has been linked to reducing the incidence of depression and low mood; improved immunity and weight management.

My biochemistry background means that I can interpret blood biomarkers and provide feedback that can help to devise bespoke nutrition plans.

Similar my dual experience of working in high performance sport both as head of performance and also nutrition means I can help you to identify how to monitor your progress and look at any potential barriers that may be preventing you from meeting your goals and targets

To Run or Not to Run

This wkd I was due to “race”- it has been a year since I last decided to test my lungs and don my racing shoes.

For those of you who know me well, will understand how hard this is- Two and a half years ago, out of nowhere, my running became compromised- after a lot of tests, I was diagnosed with the autoimmune condition, Sarcoidosis. Basically this means my immune system is attacking itself and in my case affecting my lungs; I had developed a small amount of scar tissue within my lungs. I was informed that best case scenario I would go into remission within 2 years, worst case I would need on going treatment with steroids for a more chronic condition. I was told to keep running but perhaps reduce my 60 mile week by at least half if not more.

This was devastating- not only because running has always been my release, as well as my way to socialise but, it was also something that I was pretty good at- I’m no elite athlete, but I did ok so to a degree, I guess I allowed it to define me.

For those of you who are runners, you will understand the huge adjustment this has meant. However, worse than reducing my mileage, what has been harder still is the knowledge that there was absolutely nothing I can do to make myself feel better. There is no “cure” for autoimmune conditions, regardless of all the nonsense we are exposed to with regards to changing diets and eating certain types of food, there really is no evidence that any of this works. Instead, I have had to learn to manage my symptoms and expectations. In the past I thought nothing of setting the alarm for 5.45am and heading out the door for a 6-8 mile run before work and life took over. However not only has sarcoidosis stripped me of my lung function, it has also brought with it a constant malaise- my muscles ache some days even after just doing 30 minutes of yoga and on some days fatigue like I have never known.
Outwardly I still look healthy and because I am stubborn I have refused to let this illness get in the way of my life- many of you will know my love of mountains and seen pictures of me running happily on the trails- however what you don’t see, because social media masks it so well, is how long it takes me to recover and how much slower I am getting up a steep climb- like I said- I have had to learn to manage my expectations.

While my condition is by no means the worst it can be- in fact initially, I looked liked one of the few individuals where it would pass and resolve itself. Over the first 18 months of my diagnosis, my lung function remained around 80% and my consultant was positive- while this was still below par for me it was on the very cusp of normal parameters; meaning that for some people, who are not as physically active as me, this would actually be a normal status- thus it was acceptable.
However this year things have taken a turn for the worse and my last two lung function tests have shown a significant deterioration to the point where my consultant is now concerned.

How did it get so bad I hear you ask?
Did you not realise?

In reality I knew that I wasn’t feeling amazing- I have constantly felt a mix between the burn you experience after running really hard, or like I have a chest infection brewing, even after only jogging for 30 minutes.
However my mind would not let me believe or accept that this could be related to being physical unwell- I put it down to work and life stress- how could my body be letting me down when I follow as many aspects of healthy living as I can?
I don’t smoke and never have; I drink very little alcohol; I eat well and I exercise regularly- nowhere near as much as I would like but still enough.

So back to racing this wkd- my aim was to get around the exmoor trail half. When I signed up several months ago I knew it would be a challenge- madness that it was only 3 years ago that I had a podium finish at my first 50 mile race! And now I was nervous about whether I would be able to get around a fraction of that distance. However with just a few days to go, I have had to seriously think about whether this is the right time for me to race or not.
On the one hand I don’t want this condition to dictate what I can and can’t do; I want to once again not only feel part of the wider running community but also my immediate friendship circle- so many of my close bonds with people has been developed over our love of exploring trails. If I don’t run then how will they perceive me? will i be considered weak or a failure if I don’t turn up to the start line?
On the other hand, only I know how physically rubbish I feel- I’m pig headed and determined- that’s Capricorn’s for you- and so have insisted on trying to push through. Im not going to lie, some days I genuinely feel good- running provides me with that release and freedom it always has. However more often, around 75% of the time, the opposite is true, I’ve come back from runs feeling worse than when I left the house.

So why am I choosing to share this with you now? I guess since talking to friends about my options for this wkd’s race, I’ve realised that I’m not alone; many of us sign up for races, some of us even start them but half way round know it’s just not our day and we are unlikely to get the outcome we had hoped for. There is a pressure that every race needs to be a positive experience- on social media we rarely hear when things go wrong. And yet we are human- we can’t be in a good place physically and mentally all the time- it is important to remember that life is transitional. So where we are on one day, is not necessarily where we will be on another. What happens one one day does not define your future. I have a huge respect for runners and athletes who are true to themselves- my friends Robbie Britton, Natalie White, Holly Rush and Eloise Du Luart, to name just a few, all phenomenal athletes but also so good at being open and honest. When a race is not going to plan- even with the best preparation in the world, some may push on regardless but these individuals have learnt to accept that there is little value in stressing the body on a day when it’s not going to happen. Best to cap it when you can, restore energy and rebuild ready for the next.

I have always believed that instead of treating failure as a negative, it is just another experience to learn from.

For me race day is not going to happen this wkd- in all honesty, I do feel a bit defeatist not even starting- however at any given time,
“ only we can know what is going on for ourselves.”
And right now my body is working hard everyday, without me putting my trainers on- racing this wkd would actually be more like a punishment. It has taken me a long time to understand this and get to this point- the runners natural instinct is to always push regardless. However I’m starting to learn that for longevity, listening to your body and providing it with the compassion is deserves is a far better win.

Debate or Cult: The Clean Eating Movement

An Open Mind is A Healthy Mind

Last Friday I was invited to the Cheltenham Literature Festival to take part in the nutrition panel on “The Clean Eating Debate”.

I was asked to be involved as the expert who could provide the scientific reasoning behind whether such a way of eating is suitable or not, based on my work and publications as a Clinical and Sports Dietitian.

The other panellists included Madeleine Shaw, who has been hugely successful with her books, “Ready, Steady, Glow” and “Get the Glow” promoting the idea of a “cleaner” more wholesome way to eat.

The final Panellist was Bee Wilson a highly esteemed food writer, historian and author of 4 books, including her latest, “The First Bite, How we learn to Eat”, a fascinating book that looks closely at the psychology around how and what we eat.

The Panel was headed up by chair Eleanor Mills, Editorial Director of The Sunday Times.

So a great mix of backgrounds to discuss a controversial topic so that the audience could leave armed with facts and the ability to make their own minds up about “Clean Eating”.

Unfortunately this is not how the evening unfolded. When you sit on a panel for a debate, you would like to think that you have an open minded audience. On Friday, it seems that the majority of the audience were there not to be educated but to hear Madeleine speak about her approach to nutrition. Trying to debate in front of a closed audience is an incredibly difficult task and while Bee and I only stated facts, we were met with huge hostility.

For those of you who follow me regularly, will know that my main issue with food bloggers, of which Madeleine is only one of many and I actually want to praise her for coming forward and attending the debate, is that they don’t have a nutritional qualification between them and yet their popularity in the #EatClean market is huge. This is increasingly frustrating when you come from a background with a biochemistry degree and post graduate degrees in both Dietetics and Sports Nutrition.

These Non-qualified food bloggers base their nutritional preaching on n=1. That is, something that has worked for them, will work for the rest of the population. However this is not science and indeed can result in dangerous consequences from nutrient deficiencies, to poor growth and development in teenagers. I appreciate that the majority of these individuals started off posting pictures on instagram, writing blogs and doing the occasional vlog as a completely innocent past time. However what they have attracted is a huge following, sadly not based on scientific reasoning but based on their ability to sell a lifestyle – “eat like me and you will look like me”.

This is where I take issue – I worry about the nonsense nutrition that is being spouted. On Friday, I wanted to have the opportunity to provide the counter argument against the rules that have been created, demonstrating that they were not based on sounds scientific findings.

Some of the key messages I wanted to get across are based on the guidelines they encourage their followers to live by.

This in itself sets up the mentality that if you don’t follow them, then somehow you are not conforming and you have failed.

The majority of food bloggers insist that we should go sugar free; however, within their books, there are ample recipes that contain honey, maple syrup or coconut sugar that again suggests that these are superior to the humble table sugar.

All of these are sugar and the body utilises them in exactly the same way as table sugar –it cannot differentiate. Additionally they also all provide the same amount of energy per 100g. Often these alternatives are promoted as “healthier more nutrient dense” options. However, in order to benefit from the slightly higher mineral content of coconut sugar for example, you would need to consume it in huge quantities, which defeats the object. The main difference is that Coconut sugar costs 10 times the amount of table sugar.

Similarly many of these bloggers encourage you to remove dairy form your diet often promoting almond milk in its place. If you’ve got the time and inclination to make your own almond milk, then perhaps you can accept the claim that with regards to calcium and protein they almost stack up. However the majority of us do not have this time luxury and so resort to buying it from the supermarkets where it costs double the amount of cow’s milk but is devoid of nutritional value – it is just expensive water, containing 0.1g of protein per 100ml in comparison to cows milk that provides 3.4g of protein per 100ml.

The Clean Eating brigade often talk about “inflammation” within the body and how certain foods can “affect your body’s pH” and so encourage a gluten free diet as well as avoiding foods that can cause acidity within the body.

So firstly, having conducted a serious systematic review on the subject of Gluten, I am yet to find a credible article that demonstrates than anyone who is not Coeliac will benefit from a gluten free diet. Thus in my practise as a Dietitan, it is not something I advocate.

When it comes to acidity and alkalinity within the body; the body is an incredibly clever machine and has the ability to keep homeostatic control; that is it has the ability to monitor the body and ensure that a balanced environment is always achieved, without making changes to your nutritional intake.

What we do know that if you eat certain foods, like animal protein, it can cause the PH of our blood to rise.. However the body also has the amazing ability to control this and neutralise so that it maintains a constant environment. It does this in a number of ways but one of the key methods is release of calcium ions from our bones. For healthy body’s this is not a problem, and the body soon returns back to normal. The problem comes in those individuals who are not taking in sufficient calcium, particularly from dairy protein; they do not have sufficient calcium within their diets to replace what has been released from the bone. This in turn can lead to poor bone density and an increase risk of osteoporosis and stress fractures.

I don’t doubt for a minute that these bloggers truly believe what they are saying is true but the bottom line is, it isn’t and as seen, it can actually be dangerous. These individuals are role models to many; people look up to them and so in my mind with such a huge following, there also needs to come responsibility.

One of the key points I wanted to get across on Friday was the potential danger of “clean eating”. I was very clear to point out that I don’t think food fads such as these cause eating disorders – I have worked in the area for long enough and I know it is a very complicated multifactorial mental illness. However individuals with eating disorders make up food rules to live by – this is to maintain their eating disorder, which they feel is keeping them safe but that we know is the complete opposite. The problem with “clean eating” is that it promotes fads such as being gluten, dairy or sugar free. They see the beautiful image of the food blogger that is encouraging this way of eating and it not only glamorises but also consolidates their rules as a way of life, endangering their physical and mental health further. Pretty much every single eating disorder individual I have worked with, young, old, male, female, athlete, no-athlete, talks about the rules; the rules that started, from following food/celebrity bloggers and that now feel difficult to overturn. So many of them believe that if they eat gluten or drink milk then something awful is going to happen to them.

In my practise, I define healthy eating as unrestrained eating; where you eat everything but in moderation and I think here lies the problem: moderation is not innovative; it is not glamorous or sexy and is actually quite difficult to achieve.

Individuals want something new and exciting to follow and while I take my hat off to Madeleine, she has created some really delicious and inspiring recipes, which would encourage even the most resistant to try vegetables; my main worry is that a lot of her suggestions of meals and meal plans are not balanced, increasing the risk of nutrient deficiencies.

I went into Friday’s debate concerned about how big “Clean Eating” has become and hoping to provide information to help individuals make educational decisions around food choice. Sadly I was met by a hugely closed audience who really just wanted to evangelise the benefits.

I stand by my word that being healthy is not just about food; it is also a mind set. The most important lesson I try and teach my daughters and clients is self-acceptance and self worth. This doesn’t come from eating a certain way or following a certain practise, self esteem comes from accepting you are good enough just the way you are. Shouldn’t this be what we try to encourage and in still in each other rather than a sense of failure because we choose to eat food that is deemed “Not Clean”.

Performance Costs

The art of caring…

Those of you that follow me regularly on social media will know that my two areas of specialism within nutrition are sports and Eating Disorders. More and more though I’m being drawn to the middle ground of this venn diagraph – athletes with eating disorders.

No matter whom I work with, elite, paralympians, football academy players, junior/development/talent pathway or recreational athletes, one of the main outcomes required from my input will be optimal performance.

Of course this is to be expected. The same is true of any sports practitioner; whether that be coach, S&C, psychologist or performance analyst.

The desire to achieve those marginal gains is always top priority –athletes want to be the fastest, the strongest;the need to be the best outstripping all other aspects of their life.

As a practitioner working within a team, it is easy to get caught up in this drive to be the best – with each member helping the athlete to achieve.

But at what cost?

I have come across many practitioners who are so fixed on the performance outcomes that they lose sight of the athlete as an individual.

Often the consult between athlete and practitioner becomes a well rehearsed script; the need to be associated with a gold medal or an athlete’s personal best performance becomes the driving force and the potential to pick up on tell tale signs of stress are missed.

As a dietitian with both clinical and sports qualifications and experience, my responsibility lies with helping the athlete to achieve optimal performance, but awithout losing sight that an athlete is still a person. I have an important role to play in safe guarding them from potential health risks.

I’m fortunate that I have worked with some great practitioners and coaches who really do look at an athlete as a whole person – yes they want then to train hard but they also take time to listen to the athlete; if an athlete is saying I have a pain in my foot –it is not shrugged off –it is taken seriously and some additional rest days are added in; if an athlete mentions that they are sleeping badly – nutrition and training load is checked. If a female athlete discloses that she has skipped menstruation for several months, this is not just accepted as a norm – it is investigated.

Sadly this is not true of all cases – over the last 12 months I have been approached by several athletes, where the need to achieve by them and their support team has over looked signals that they were struggling. Some arrive with persistent injury; not being given enough time to heal and rehab before going straight back into training. Others have put their bodies under huge stress with large training loads but insufficient energy intake; some have adopted fads – diets, supplements in an attempt to hit those marginal gains with poor supervision by their support team.

Athletes are not just about numbers –like a plant, in order to thrive they need support, understanding and nourishment –sometimes this doesn’t fit in with performance gains.

There are always going to be times when you do need to support an athlete in order to reach a target weight or body composition but it is also important to ensure that the disruption this causes is limited to the shortest time possible.

That said, as a practitioner working in elite sport, it is important to know your boundaries and there are occasions where you need to take a stand and suggest that an athlete takes some time out.

Athletes are driven and in order to make it to the top, are often associated with extreme behaviours. This trait is not too dissimilar to those associated with an Eating disorder –extreme behaviours in the form of rules and rituals around food and exercise in order to maintain their eating disorder because it makes them feel safe and secure, even though this far from the reality.

However in both cases, these individuals need to be told to stop –when they are doing more harm than good, even if it means they will be missing out of a major competition. What good is a podium finish if it’s the only one of your career because the stress you have put your body through has meant that it will never return to its previous form?

It’s great that more and more athletes are speaking out about the pressures they have felt to train in a certain way, be a particular weight or body composition and the lack of support they received. However, what we need is more education around this; how to listen, how to pick up on signs and then how to have that difficult discussion.

I always want to help an athlete achieve their true potential but not at the cost of their long-term health.

I’m not always popular with my approach –its never easy telling an athlete that their training or their nutritional choices are doing them more harm than good but I take pride in always seeing the human in an athlete and not just as a performance outcome!

And for the record, all those I’ve worked with have thanked me in the long run as it has meant they can return to training and a winning form!