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What I have learned as a freelance nutritionist

What I have learned as a freelance nutritionist

What have I learned as a freelance nutritionist?

These are my learnings as a freelance nutritionist. I started studying nutrition in 2003 at the ripe old age of 25 after years of trying to figure out what I wanted to do with my life. So, my first bit of advice is that it takes some people a little longer to figure out what to do. Once you find your passion, you will find your drive to succeed in whatever you put your mind to.

After completing my degree, I fancied learning more about public health, which interested me most in my course. Despite the financial challenges, I decided to do a master’s degree on the topic as I knew I would never do it if I didn’t strike while the iron was hot. I worked my socks off and took out a bank loan to cover the substantial fees, then worked five nights a week in a restaurant to support myself. After this, I continued to work in hospitality and volunteered at various charities and NGOs focused on nutrition.

I got a lucky break and found a job with a small tech company that developed software that helped schools, care homes and hospitals analyse their menu plans. Being part of a small company, I had to develop software and pitch the software to local authorities throughout the UK as well as talking at events and delivering training sessions. After several years doing this, I was given voluntary redundancy, which allowed me to set up on my own as a freelance nutritionist.

After paying for a website to be built and buying myself a new laptop and various bits of software, I got myself up and running. I contacted everyone I had worked with in my previous company and got work. At the same time, I also set up a small consultancy on the side called HOPE which was Helping Older People to Eat Well. I worked with many care home groups delivering training focused on older people and dementia through this consultancy. I also started to contact personal trainers and nutrition and wellness companies to offer my services while also building my social media profile on Twitter and Instagram. I also bagged a part-time position as head of nutrition with a leading supplement brand called Healthspan.

My position at Healthspan is very media-focused, working with the press office, which has helped me build my profile further in the media. At this time, I was also introduced to Lily Simpson by a contact and worked with her to help develop her business called The Detox Kitchen working on the food and menu planning side of things. Together we wrote a book called The Detox Kitchen Bible, published by Bloomsbury which has since been a very successful book sold in many languages around the world.

This gave me the platform I needed to get more work in this industry. I have since worked around the globe with many wellness brands, retreats, celebrities, and other high-end clients. Further to this, I also followed another interest of mine which is sleep. I wrote another book called The Art of Sleeping which has also been successful and sold worldwide in many different languages. What I love most about being a freelance nutritionist is that I am always learning as I have to cover so many different areas of nutrition in my work.

It all sounds very glamorous on paper, but I still have to work incredibly hard to make ends meet as a freelancer. I still worry all the time about where the next bit of work is going to come from and to be honest even the best of us are always trying to figure things out.

So, what have I learned, and what are my top tips for being a successful freelance nutritionist?

Here goes (in no particular order) and apologies as this blog appears to have become quite epic so you might want to make yourself a nice cup of tea at this point as you could be here for a while!

Set up

This is where the initial costs are involved. You need a website and it doesn’t need to be fancy to begin with. I did my first website myself then got someone else to do one for me when I had a little more money coming in. Think carefully about what you want to include on your site from the start.

The bare necessities will include a home page and then various pages explaining your services and obviously a contact page with a link to your email. I have a blog which to be honest is more for my own benefit than anything else as I can make them downloadable and use them as factsheets or direct people to them on social media. A place to store recipes is nice if that’s your thing and you may want to include a page to showcase any writing or other media work you have done. Make sure there are links on your site to all your social media.

Make sure you have control of the back end so that you can add stuff to your site easily – my website is built in Word Press. I have someone that hosts the server and also helps with the housekeeping which includes updates to the various bits and bobs (as you can see I have no clue what actually goes on in this department!).

Also, get some business cards made up and remember to keep them on you at all times as you never know who you are going to bump into. I have found the most cost effective place is Moo.com.

Join the AFN

As nutritionists you should join the Association for Nutrition. It’s a faff getting your portfolio together but you need to support this charity as they have your back. You have worked so hard to train in your qualification and this charity helps raise awareness of properly trained nutritionists. Without this type of backing and support anyone can call themselves a nutritionist even those that have done a weekend course on the topic so get with the program and be sure to mention them when you can so people understand who they can use as a trusted source in our industry.

Find your vibe 

This is a really tricky one especially as you start out and look for work in many different areas. I have ended up working in many different areas labelling myself as a consultant and a lot of my work is media based (I also cover the topic of sleep) and my work has always included a huge food/recipe element.

However, I know many very successful nutritionists who have focused in on one particular area which could be weight management or gut health for example. While this may make it more difficult at first as you try to get experience it can make it easier in the long run as you build your profile as an expert in your chosen field. Becoming a trusted voice in one area can also make it easier to focus on things like your social media or give you a platform to pitch book ideas to publishers or collaborate with health and wellness brands as well as getting involved in expert working groups centred around your chosen specialism.

Get to grips with some of the basics 

There are a few good skills you should try and get a grip on when starting out and many of these I still use on a day to day basis. Invest in a recipe analysis program as I always get asked to analyse recipes or menu plans and while this work is a little dull the information is useful to include when writing about nutrition and dealing with private clients. I use Nutritics mostly because its web-based.

Keep a note of foods that are high in one or other nutrients. I know this sounds a little rudimentary but I can’t tell you how many times I have to write about something and refer to foods rich in one or other nutrient. On this point it’s also useful to understand the health benefits of foods, nutrients and key conditions where food has been shown to play a role (e.g. fibre reducing cholesterol). I actually have spreadsheets now with all this stuff on as a quick reference and I organise them in my computer files by topic – it saves me loads of time.

It is also useful to develop your writing skills and learn how to translate the science into something everyone will understand. You should also try to include practical advice where possible as this is most useful thing to most people such as what to cook and how to cook it or include more of it in your diet. I have written tons of stuff in the media as well as copy for websites or PR campaigns. You need to understand your audience but at whatever level try to include references to anything science-related you refer to as this is the easiest way to cover your back should anyone question your opinions. Writing on your blog is a good way to get practice.

Develop a good understanding of public health nutrition. I know it’s not particularly glamorous but it is the grass roots of what is going on in the world to help keep the nation healthy and it provides perspective that can keep you grounded. Honestly, this to me is the most fascinating aspect of nutrition!

I know I work with companies that provide supplements and other such products but I try to get them to stick to the science and always give them the perspective of the population as a whole rather than just the worried well. It does leave me little patience with some clients but at the same time you can’t bite the hand that feeds you so you have to find a balance which is why you have to turn some work down from time to time.

Keep up to date with key nutrition papers and nutrition guidelines so you always have your finger on the pulse. The NDNS survey is a good one to keep track of as this has tons of information as to what the nations diet looks like. The EFSA nutrition and health claims are also good to familiarise yourself with if you are working with food companies. I also keep reports to hand from charities like the British Heart Foundation and I also find factsheets from resources such as the British Dietetic Foundation useful to keep as a reference. Also good to keep abreast of what is trending in the world of health and wellness. On this point…. Don’t get sucked into what the media says… You are scientifically trained in nutrition so use this skill to try and see the wood for the trees!

I also have loads of templates to hand that I have created in powerpoint and other programs to give me a quick way to create new presentations, lectures and reports. I also think it’s a really useful skill to learn how to put together an interesting presentation that isn’t “death by powerpoint”. I know you learn this stuff at uni but it took me ages to understand that I could use a picture or other interesting visual in place of endless bullet points. Honestly, there is nothing worse than presenting something to a sea of bored faces! Don’t be shy to let your personality shine through – I use all sorts of funny gifs and video links as I don’t like to take myself too seriously but of course you still need to remain professional and what you choose to use must be sensitive to the topic in hand.

Get familiar with programs like Canva as it is a really easy way to create things like infographics which you can use in your writing or with clients – you can also create some really nice content for your social media with this program.

Last one….I am really annoying in that I love to pick up the phone and talk to people. This gets things done in half the time and talking to someone is a better way to build working relationships than always corresponding via email.

Social media

Mmmmm, I hate it, but it is something you just have to do. Social media has evolved so much since I started out, and to be honest, I tend to focus mainly on Instagram. I dip in and out of instagram posting pictures and writing content in the feed and do some videos. These days the video content gets much more attention than just pictures and text. Posting on stories is also an easier option and always seems to get more views.

You will ask yourself questions such as “what do I post”, “how do I get more followers”, bla bla bla. Don’t stress yourself out and don’t make this the main focus of how you think you will get work. It’s a nice platform but I have come to realise that I can’t compete with those in the wellness industry with 10’s if not 100’s of thousands of followers. I have a moderately OK number of followers, enough to allow me to do what I want to do.

I hate that the number of followers you have somehow defines your worth to some people as a nutritionist especially for me given my qualification and years of experience, but this is the way of the world! Remember that this is just one way to promote yourself for work but it’s not the only one and to be brutally honest you can spend hours every day on Instagram but it is unlikely to significantly improve your chances of getting work.

Put plenty of more valuable time into using your imagination and follow your passion. Get out there and meet people face to face even if this means doing stuff for free to start with and contact people you have a genuine interest in working with

As a 43-year old, I refuse to film gimmicky videos of myself trying to be funny – there is a limit to what I am prepared to do to get work! I would rather use these platforms to highlight stuff about nutrition I am genuinely interested in.

Structure your day

It’s lovely working at home but it’s easy for things to go awry if you have no structure to your day. I don’t work 9-5 as I am an early riser to prefer to start when I get up at around 6am. I hit the gym or go to yoga early to get out of the house then I work through to about 3pm on a usual day at home. I start by answering emails then spend some time going through the news and various websites to see whats going on and if there is anything new and interesting in the world if nutrition (good stuff to post on social media especially Linkedin). After that its about dividing my time between various bits of work I need to get done for clients and prioritising to (try) and meet deadlines.

I always set time aside to think about how I can get more work. This bit is always a bit painful so I tend to set about half a day week to focus on it. I also set a little time aside every day to do some social stuff although I have to admit my interest in this goes in waves!

If its quiet and you have done everything you need to get done then don’t feel guilty about enjoying your free time. I waste a lot of time when its quiet freaking out about work instead of using these periods to do other interesting stuff –  something I regret when it gets busy again. You can also use this time to focus on any reading or watching podcasts/instagram lives/webinars on things that interest you in your field. Also spend some time looking for events you can attend as these are good places to meet people. Try a mix of events – some are nutrition focused and some of these offer CPD points but look at wellness and fitness events as these are good places to meet people. Eventbrite has lots of things going on (and don’t forget your business cards!)

Linkedin

This is my most valuable source of work. I hate talking about myself or blowing my own trumpet, but you just have to do it here and post everything you are doing or have done. This is where people look for professionals, and they need to see what you’re up to, so don’t be shy. Voice your opinions on anything you have come across as potential employers love to see this and it shows you are passionate about what you do. Also, share anything you have done in the media or achievements at work.

Know when to refuse work

I have really struggled with this over the years, but if you feel you are jeopardising your professional profile and if it just doesn’t feel quite right, then just say no. It’s so tempting some times when a company is offering you lots of money but honestly in the long run it’s just not worth it.

Take control

Again, I have struggled with this. Be mindful of where your work is placed, and always get a copy of anything you have written sent to you to be approved. You can charge for quotes and copy but make sure there is a timescale on this. The information you provide for a campaign should not really be rehashed and used by companies in perpetuity. It just dilutes your worth to future clients. It is often quite helpful to have a freelance contract you can give to the client to agree to your terms and conditions.

Rates

This is the biggest challenge as a freelancer. The problem is that there is no recognised fee structure for a nutritionist. I have a set day rate and costs for other things such as quotes or radio days, but these all end up being negotiable. I weigh up the cost of future work with a brand or company, and I reduce my costs if they offer a retainer. I am happy to do lots of stuff for free if it provides a reasonable quid pro quo which may mean a feature in a leading magazine or quote to help maintain my profile and build relationships with health journalists and PR agencies.

Socialising

There is no point in going freelance if you’re unwilling to get yourself out there and meet people, as this is how you get yourself known. As your career progresses, you may have to do less of this as people start to contact you based on referrals, but you have to put the hard work in at the start.

Create a media pack

Suppose you want to work in the media. In that case, you need a media pack that includes a biography and examples of what you have done alongside a structure of fees. A showreel is also helpful to show what you have done on screen.

Control the narrative

This is one of the most important things to help maintain your integrity as a nutritionist. You’re the expert, and you are employed to provide your expert opinion, so if you disagree with what a client wants you to do, then walk away. On the whole, you can generally find a compromise to help companies deliver the messages they need to promote their products or services. Always stick to your guns when it comes to science and things such as health claims – I have learned the hard way with some clients and been pulled up on some bits of work or something I have said in the media.

Deadlines 

I have to admit that I am totally hopeless when it comes to deadlines, but you need to keep clients in the loop if you cannot deliver on time. This is quite important if you want them to come back to you with more work.

Housekeeping

It’s important to keep on top of invoicing and bookkeeping and things such as tax and VAT. If you can’t do it yourself, then employ someone to do it for you.

Public speaking

It took me ages to build up the confidence to do this, but years of training, delivering talks, and cooking demos at events have made me much more confident. This stuff also gives you the confidence to record videos on social media showcasing what you do. If you are going to work as a freelance nutritionist, you need to get to grips with this  skill. I don’t have many tips to offer here but one thing that has always helped me is to socialise with people during the coffees beforehand as you get to meet people in the audience and this can offer a little familiarity and make you more comfortable. My default when I feel nervous or uncomfortable is humour so I always try to add a little humility to my presentations and always relate them where I can to real life experiences or something the audience can relate to.

Diversity

You need to diversify all the time as a freelance nutritionist in order to increase your worth and open up new opportunities. I am just finishing off a post-grad diploma in sports nutrition as this is an area I fancy doing more work in.

Imposter syndrome

All freelance nutritionists succumbs to this at some point when you feel you are crap at your job and that everyone is doing better than you. Stay confident in everything you are doing and continually refer to the scientific literature to support your opinions and work.

Focus on your own thing and try not to compare yourself to what other people are doing. Instagram is a real bugger for this but always remember that people tend to only post the good stuff. My feed is full of lovely experiences showing fancy press trips or videos with clients, but this is just a snapshot of what is going on at that point in time. I’m not going to post a video of me fretting about where the next bit of work will come from or that I am worried about how my age may prevent me from getting a job in the future!

Explore all avenues of work

I always try to think outside the box as a freelance nutritionist and get involved with new start-up companies I believe may have a chance of doing well. Sometimes they feel like they have little to do with nutrition, but I will always give things a go and offer ways I think I can help.

Private clients

I dip in and out of this as a freelance nutritionist, and one of the reasons I have been doing my course in sports nutrition is because this is an area I feel I would be happy to help people with. I’ll be frank in saying I have very little interest in weight loss and don’t feel qualified to help people with specific health conditions. I like sports nutrition because it’s about performance. Those you deal with are fully committed to acting on your advice. My other bit of advice here is that you have to work out of a practice or somewhere you can rent a room for this to work financially. Traveling here, there, and everywhere to see clients in their homes is not economically viable in most cases.

Offer your services for the greater good.

I go through periods of getting a little bored with what I am doing, so I offer help to charities or other groups. I have delivered talks and cooking sessions to charity organisations and care homes, which I find exciting and inspiring. I have also been working with a para-athlete through my course, which has also been helping me to build my confidence in working with athletes on a one-to-one basis. It’s an excellent way to fill the time when you are quiet and learn new skills and, of course, forging new working relationships.

Create a network

As a freelance nutritionist it’s important to make contact with other people in your field. Freelancing can be lonely, and it’s great to have people to talk to in your field for advice on all work areas. I always have time for anyone who wants to get in touch to talk about anything they are working on. There is plenty of work to go around and ditch the idea that we are in some way all in competition with one another. I hate to say that sometimes I get emails from new nutritionists looking for advice but it can slip my mind to get back and respond. Don’t ever be shy to get in touch with people for help or advice.

Training and competing during Ramadan

Training and competing during Ramadan

Ramadan

I have recently been working with an Para athlete with a spinal cord injury to help with training and competition.

There are lots of consideration to be made in such athletes but one I never fully considered was training and competing during ramadan.

This fact sheet should provide a little insight into how athletes can maintain their training and competition performance while fasting.

 

Why did healthy eating get so complicated?

Why did healthy eating get so complicated?

Why has eating well become such as minefield?

Healthy eating has become a tricky little fellow over the years, but the basic messaging has not changed over the last few decades.  Eat more fruit and vegetables, choose wholegrain foods, choose low fat dairy foods, eat oily fish and opt for lean proteins are a few of the key messages.

Alongside this we are advised to eat less sugar and processed foods while also paying attention to the portion size of foods we choose to eat.  If you stick by these basic concepts, then you are likely to be eating in a way that will benefit your health and reduce the risk of disease.

“Only 30% of adults in the UK eat 5-a-day and only 4% of women and 9% of men achieve the recommended 30g of fibre daily according the NDNS survey”

Despite this simple messaging the majority of the population still don’t manage to eat a healthy balanced diet and are confused about what to eat.  There are also many other factors which influence food choice such as those relating to society, lifestyle, psychology, environment, food access and finances.

How has the food industry and modern culture impacted on food choice?

These basic healthy eating messages have been around long enough for most people to understand what a healthy plate of food looks like while also recognising that a piece of fruit or yoghurt is a better option than a mars bar if you fancy a snack. However, the way food is marketed and how health is interpreted in the media have likely caused some confusion.

The obesogenic environment

The obesogenic environment does not make it easy for people to make healthy food choices.  This concept was fist coined in the 1990’s as a hypothesis to help explain the obesity pandemic.

“The obesogenic environment is defined by the influence that the surroundings, opportunities or conditions have on promoting obesity on individuals or populations”

In 2007 the Government’s Foresight report was published and one of the highlights was the monumentally complex obesity system map. This map illustrates the many factors that contribute to energy balance including psychology, food production, food consumption, physiology, physical activity and physical activity environments (1).

Fast food

Yes, the crux of weight gain is eating less and moving more but you only have to take a look at this diagram to appreciate the many complexities involved in order for people to achieve this ideal (see below).

Foresight report

The complexities of this diagram highlight the fact that we all need to work together to help improve the health of the nation.  While the food industry has become much more transparent in their marketing of foods which is driven by legislation around health claims and food labelling,  supermarkets and other high street outlets are still offering promotions on unhealthy foods more than they are healthy food options.

How have our eating patterns and habits changed?

Modern eating habits have changed and one the most significant is our penchant for snacking.  In part this has been driven by the food industry and an ever-growing number of snacks made available to us.  Many of these snacks are marketed as being healthy or having a health benefit which implies, they should be a part of our daily diet.

“More than two thirds of people snack at least once a day according to Mintel who also predict that snacking will become more pertinent post COVID-19″

However, the reality is that snacking is only beneficial when we need more energy throughout the day to match our requirements.  Outside of this they are simply an opportunity to eat more than we need.

Snacking has also been driven by working hours and lifestyle. Both these factors can influence our ability to eat at set hours across the day and can also result in longer periods of time between meals.  In such instances, healthy snacking may prove useful to maintaining energy levels and overall nutritional intake.

How has the media influenced eating habits and perceptions of nutrition?

The growing interest in nutrition over the last couple of decades has led to an increase in scientific reporting in the media.  Over this time period we have also seen countless books on the topic which include those offering many different ways to lose weight as well as those questioning traditional thinking around nutrition.

In combination these two factors have contributed to skewing basic health messaging and a good example is the way in which dairy and gluten-free eating is now considered by many to be a healthier way to eat when in fact they should still be considered special diets reserved for those with food intolerances or conditions such as coeliac disease.

“Only 5% of the UK population are thought to suffer any degree of lactose maldigestion and 1% are thought to suffer with coeliac disease.  It has been estimated that 1-2% have a diagnosed food allergy”

This is not really a major problem as there is no real harm in omitting these foods as long as you understand how to adjust your diet to make up for any nutritional shortfalls.

The bigger issue is that in light of this foods have started to become labelled as ‘bad’ for us when in fact they are still healthy components of a balanced diet.

Media reporting of new research is often misleading as there is usually a bias towards positive findings.  However, on closer inspection the results are often confounded by various limitations of the research which might include sample size or the type of study and its strength (clinical trials are more reliable that rat studies).

Then there is the fact that the journalist has simply not understood or inaccurately reported the findings (although to be fair many experienced health journalists will take their lead from experts in the field).  I love to read the ‘Behind the Headlines’ section of NHS website (2) which brilliantly discusses some of the more popular scientific findings reported in the press.

What about social media?

Unlike other areas of health, people are surprisingly willing to take dietary advice from unqualified influencers or personal trainers with a hot bod and large social media following.

A survey carried out in 2017 on behalf of the British Dietetic Society showed that 58% of people would trust diet and nutrition advice given to them by their personal trainer or fitness instructor. Amongst young people, 41% said they would trust the advice given out by a healthy eating blogger which highlights the importance for more qualified professionals to have a greater voice on social media platforms (3).

“The UK public do not know who to trust for dietary advice according to research carried out by the British Dietetic Association

Celebrities are also highly influential when it comes to food choice and as such, they are frequently used to support the sale of supplements and diet regimes.

Supplement celeb

These people may know a little about nutrition but where the expert excels is in taking a science-based approach to their practice which means they don’t offer advice based on personal experience or opinions. Why would you take advice from someone not qualified to do so? Would you let your PT take a tooth out?  Probably not.

Got a dodgy gut?  Bloated? Constipated? Someone unqualified told you to eat lots of fibre?  Let’s see how that pans out if what you actually have is IBS or even worse coeliac disease. Trying to lose weight?  Someone told you to cut out carbs and eat a shed load of fat in your diet?  Did they ask you if you had a family history of heart disease or whether you were aware of your cholesterol levels? You get my drift.

What about the trailblazers?

These are the guys who set out to challenge traditional thinking around nutrition.  Books and articles that attempt to question traditional thinking around nutrition can often cause a lot of confusion. I personally find this literature massively interesting, but I am qualified enough to read with a degree of objectivity and an understanding of the science.

Often these books are biased in favour of their topic and without this training and experience in nutrition and research it’s really easy to believe everything you read without question.  Also, if you read too many of these books, they can start to become a little contradictory making it tricky to see the woods for the trees.

Scales

A good example here is the debate around saturated fat in the diet which was sparked by findings of a landmark study in 2014 which found no significant evidence that saturated fat increased the risk of heart disease (4).

The study caused a lot of controversy amongst leading researchers in the field of nutrition who questioned the data analysis. Subsequently a report in 2019 by the Scientific Advisory Committee on Nutrition (SACN) found no reason to change the current advice around saturated fat intake (5).

In the meantime, messaging around saturated fat and fat in general became confused which potentially left many people thinking it was OK to eat lots of saturated fat in their diet. The problem with this type of reporting in the media is that the findings are open to interpretation by the public which can prove detrimental to their health. The other issue with this type of reporting is that people take the initial findings on board pretty quickly which makes it more difficult to reset the message.

As far as this research was concerned. Wholefoods high in saturated fat include full fat dairy and fatty cuts of meat which can form part of a healthy balanced diet but should still be eaten in moderation given their high energy content which can contribute to weight gain (a risk factor for heart disease).

However, other sources of saturated fat include convenience foods often loaded with salt and sugar which in themselves can increase the risk of heart disease. Also, eating lots of red meat and processed meat (often high in saturated fat) is not a healthy option given their association with the increased risk of colorectal cancer.

What about superfoods?

The term ‘superfoods’ was thought up in the nineties.  A handful of people are said to have coined the term including the alternative medical practitioner Michael Van Straten who wrote a book called superfoods.  The idea behind the term is that certain foods have a higher nutritional value deeming them more beneficial for health and well-being.  However, the term has little significance when talking about overall diet.

“There is no official definition of a superfood and the EU has banned the use of the word on product packaging unless the claim is backed up by convincing research”

This term also highlights the attention placed on individual foods in the media based on their supposed ability to prevent disease.  Research into the effects of individual foods on health are very tricky to carry out.  Our diets are hugely complex and it’s difficult to entangle the effect of one particular food or compound from all the others we consume.

Superfoods

Much of this research is carried out in a lab or on animals which can’t be translated to humans.  Often this type of research also involves a very concentrated amount of a compound or large amount of food in a form which is not viably consumed as a whole food in reality.  A good example is the research surrounding beetroot and blood pressure which has used both supplements and juices which represent a huge amount more than an 80g serving of the whole vegetable (6).

Blueberries

While this research is interesting it has to be taken with a pinch of salt.  While blueberries may have been shown to reduce the risk of cancer it doesn’t mean eating a bowl everyday will prevent you from getting cancer.  Besides the fact that the research is not strong enough to prove cause and effect there are many other dietary and lifestyle factors that contribute to an increased risk of the disease.

Can food really heal? 

The food you eat provides you with macronutrients which are used for energy (carbohydrates and fats) and the growth and repair of tissues in the body (protein).  We also glean micronutrients (vitamins and minerals) from foods which are needed for all bodily processes.

If we don’t get enough of any of these nutrients in our diet, then there may be health consequences such as a lack of iron which can cause anaemia.  In terms of healing then these deficiencies and the symptoms that come with them can be corrected by eating more of the foods which contain one or another nutrient in question.

In some cases, certain foods have been shown to be beneficial for specific health conditions.  A good example is high cholesterol which can benefit from increasing the amount of fibre in the diet as well as other specific foods such as oats (7).

So, what’s the take home message?

The thing to remember here is that nutritional science is relatively new and as such ever evolving so what you read at one point in time could be completely different at another.

People love the idea of a quick fix or miracle cure, but the reality is that there is no such thing when it comes to health. Diet has a hugely significant role to play in the prevention of disease and overall health but it’s the balance, moderation and consistency of our diet overall that has the greatest impact.

Getting back to the basics of healthy eating is your best bet and it also helps you to find a baseline which is a useful starting point for nutritionists and dietitians how may adapt you diet to help with a diet-related condition.

References

  1. https://www.gov.uk/government/publications/reducing-obesity-future-choices
  2. https://www.nhs.uk/news/
  3. https://www.bda.uk.com/resource/survey-finds-that-almost-60-of-people-trust-nutrition-
  4. https://www.acpjournals.org/doi/10.7326/M13-1788
  5. https://www.gov.uk/government/publications/saturated-fats-and-health-sacn-report
  6. https://www.ahajournals.org/journal/hyp
  7. https://www.frontiersin.org/articles/10.3389/fnut.2019.00171/full
Diet and PCOS

Diet and PCOS

How can diet help with PCOS?

Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions amongst women and can put them at greater risk of heart disease due to glucose sensitivity and is also a leading cause of infertility.

Research has suggested that many women are not even aware they have the condition which may be due to misdiagnosis or a lack of awareness about PCOS. There is no cure for PCOS and whilst access to information about the disorder has become more freely available, many women still feel unsupported and confused about the best way to manage the condition.

What is PCOS?

This is a health problem that affects women of childbearing age and is considered to be the most common hormonal condition.  Women with PCOS have a hormonal imbalance and problems with their metabolism which can affect their overall health and appearance.

What causes PCOS?

Exactly what causes PCOS is not fully clear but the majority of experts believe that genetics have a role to play in the development of the condition.  PCOS is linked to abnormally high levels of androgens (hormones such as testosterone that regulate the development and maintenance of male traits in the body) which can prevent the ovulation every month and cause extra hair growth and acne.

The condition is also associated with high levels of insulin which is the hormone that helps to regulate blood sugar levels. Many women with PCOS are resistant to the activity of insulin and so their body compensates by producing more.  The effect of this is that it increases the production and activity of testosterone which exacerbates the symptoms associated with PCOS.  Being overweight or obese also increases the amount of insulin the body produces.

Who is affected by PCOS?

Estimates have suggested that the global prevalence of PCOS falls between 6% and 10%.  In the UK it has been estimated that around 1 in 10 women are affected by PCOS.  Prevalence in the US is thought to be similar to the UK although it could vary significantly by region.

US prevalence figures are tricky to gather effectively as a result of the conflicting criteria used to diagnose the condition.

In a study published in the American Journal of Obstetrics and Gynaecology  the authors concluded that women with PCOS are more likely to than those without PCOS to be 25-34 years old, be from the Southern States, be infertile, have metabolic syndrome and have been seen by an endocrinologist (1).

This same study estimated a much lower national prevalence in the US of just 1.6% but admitted that this was likely to be a significant underestimation given the retrospective nature of the study and the fact that PCOS is often undiagnosed.

What are the symptoms of PCOS?

Signs and symptoms of PCOS normally become apparent during late teens and early 20’s and include:

  • Irregular periods (or none at all)
  • Difficulty getting pregnant (due to irregular periods)
  • Excessive hair growth (hirsutism) on the face, chest, back or buttocks
  • Weight gain
  • Thinning hair or hair loss
  • Oily skin
  • Acne

How is PCOS diagnosed?

If any rare causes of the same symptoms of PCOS have been ruled out and you meet at least 2 of the following criteria, then a diagnosis of the condition is normally confirmed as being PCOS.

  • You have irregular or infrequent periods – indicating that your ovaries are not regularly releasing eggs (anovulation).
  • Blood tests indicate high levels of “male hormones” such as testosterone.
  • Scans indicate you have polycystic ovaries.

 How can you treat PCOS?

Fertility medications are available to help treat the symptoms of PCOS such as excessive hair growth, irregular periods and fertility problems.

Making changes to your diet and losing weight can also have a significant impact on the effects of the condition.

Losing weight may help to lower your blood glucose levels and improve the way your body reacts to insulin.  Just a 10% loss in body weight has been shown to improve the regularity of periods and chances of pregnancy in some women with PCOS.

What should women with PCOS be choosing to eat?

The two key ways that diet can help with PCOS is through weight management and blood sugar control (insulin production).  Managing insulin levels is the best way women with PCOS can use food to help manage their condition.

A few different diets are often recommended for PCOS and they all share a similar set of foods which are rich in fibre and protein to help balance out blood sugar levels and lessen the production of insulin.  These diets can also be used as a way of managing or losing weight and are all cardioprotective.

A low glycaemic index diet (GI)

Foods with a low GI are digested more slowly which means they do not cause insulin levels to spike in the same way as they do with other carbohydrate foods such as sugar.

Low GI foods include wholegrains, beans, pulses, lentils, fruits, vegetables, starchy vegetables (sweet potato, yam, corn), basmati rice, quinoa and dairy foods.  Some foods do not have a GI value but are also included such as meat, fish, nuts, oils, herbs and spices.

Many people recommend monitoring the glycaemic load of a food as unlike the GI this takes into account the amount of food eaten (portion size).

The anti-inflammatory diet

This is a balanced diet that includes foods that may help to quell inflammation such as berries, oily fish and extra virgin olive oil.  Many of these foods form a key part of the Mediterranean diet.

Foods that cause inflammation (these foods should be avoided or limited)

  • Refined carbs – sugar, white bread, pasta and pastries
  • Sugary drinks
  • Convenience foods such as chips, crackers and crisps
  • Red and processed meats
  • Spreads and oils rich in omega 6 such as margarine and vegetable oil
  • Alcohol

Foods that help to quell inflammation

  • Vegetables, especially dark green leafy vegetables
  • Fruits, especially deeply coloured varieties such as berries, grapes and cherries
  • Beans, pulses and lentils
  • Wholegrains and psuedograins such as barley and quinoa
  • Extra virgin olive oil
  • Nuts and seeds
  • Oily fish
  • Dried spices

The DASH diet (dietary approaches to stop hypertension)

This is a diet designed to reduce the impact of heart disease and as such is often recommended to women with PCOS who are at greater risk of the condition.  This diet is rich in fruits, vegetables, lean poultry, wholegrains and low-fat dairy produce whilst discouraging foods that are high in salt and saturated fat.

Adopting a healthy approach to the way you eat appears to be beneficial for women with PCOS.  Following an anti-inflammatory way of eating such as that illustrated by the Mediterranean diet is a good place for all women with PCOS to start.

References

  1. Okoroh EM, Hooper WC, Atrash HK, Yusuf HR, Boulet SL. Prevalence of polycystic ovary syndrome among the privately insured, United States, 2003-2008. Am J Obstet Gynecol. 2012;207(4):299.e1-299.e2997.
The basics of plant-based eating to get you through Veganuary

The basics of plant-based eating to get you through Veganuary

Veganuary is a charity campaign encouraging people to try being vegan for January and, if possible, throughout the rest of the year.  Last year (2019) saw the greatest number of people involved in the Veganuary campaign as over 250K from 190 countries embarked on the month-long pledge.

What were the key findings from last year’s Veganuary campaign?

  • For the first time since the campaign began, health became the main driver (46%).
  • 34% of participants stated animal welfare and 12% environmental concerns as drivers for involvement in the campaign.
  • Most participants were women (87%).
  • The majority of participants were aged between 25 and 34 years old (28%).
  • 47% said they plan to remain vegan after Veganuary.
  • 77% said that while not planning to remain vegan after the campaign, they will try vegan again in the future.

How can you make a smooth transition to veganism?

Findings from last years Veganuary campaign showed that 60% found the challenge easier than anticipated.  The rise of vegan food on the high street (including both take-out and restaurant options) as well as the wide range of meat-free alternatives and snacks now available is likely to have helped many people switch to eating plant-based.

Cooking from scratch is always going to be a healthier option and while this may seem daunting it’s not difficult to ‘veganise’ many of your favourite home-cooked meals using these alternatives.

Seek out your preferred dairy alternative

Oat and soya milk have a richness which is similar to cow’s milk while those made from nuts, seeds and rice tend to be waterier.  Each alternative has its own unique flavour and out of all of them, soya has the highest amount of protein which may be an important factor for some people.

What you choose is a matter of personal preference so try all of them to see which one you prefer but always look for fortified varieties to help maintain good intakes of calcium and vitamin B12.

Soya is a good alternative to dairy yoghurt.  Other options include coconut milk and nut varieties including cashew, but they do come with a higher price tag.

Meat alternatives

There are a number of meat alternatives to choose from which include tofu and tempeh (made from soya), seitan (made from wheat gluten) and Quorn.  These foods are all high in protein and also contain a variety of other nutrients including magnesium, iron, zinc and calcium.

These options are available in many forms including mince, pieces and shredded which can be used to replace minced beef, chicken, pork and duck in many common home-cooked dishes.

You can find marinated varieties of tofu which are easier to use for beginners.  Tofu can also be scrambled as a good alternative to egg for breakfast.

Other interesting alternatives include jackfruit, palm hearts and banana blossom which have been used to emulate the look and texture of dishes such as pulled pork, scallops and breaded or battered fish.  While these options make a convincing alternative, they do lack the same protein content.

Fruits and vegetables

It sounds counter-intuitive to talk about fruit and vegetable consumption given the nature of a vegan diet but given only 30% of the population eat five-a-day (1), it’s worth flagging up for those going vegan for January.

This groups of foods are a key source of vitamins, minerals and phytonutrients that help to protect the body from disease.  Including above and beyond five daily servings is important on a vegan diet to glean as many of these nutrients as possible.

Given the availability of vegan processed and ready-made meal options as well as the rise in vegan ‘junk’ food it is easy to exist on this type of diet without eating enough vegetables.

Keep it in mind to always add more vegetables to the dishes you cook.  You can boost your intake with smoothies and dishes such as soups, casseroles, stews and stir-fry’s which can be bulked out with plenty of vegetables.   Varieties such as spinach and peas are really easy to throw into many dishes.

Explore different flavours

The absolute key to great tasting vegan dishes lies in the spices and marinades used to make them. Meat alternatives, beans, pulses and grains can be a little bland so make use of dried spices and spice blends, sauces (e.g. cook-in sauces, soy sauce, sriracha, harissa), fresh herbs, flavoured oils and dried fruit to add flavour.

You can create a strong savoury flavour (umami) by incorporating ingredients such as nutritional yeast, mushrooms (especially dried made into a stock), seaweed, miso paste, tomato puree, sundried tomatoes, soy sauce and nuts into dishes.   Vegetables such as onions, garlic, beetroot, asparagus and tomatoes also help to create umami which is often enhanced when they’re cooked.

Shop-bought dressings are great, but you should explore recipes from cookbooks and on the web for homemade options which are bursting with flavour and include additional ingredients such as tahini, miso, citrus juices, pomegranate molasses and umeboshi paste.

Don’t be put-off by unusual ingredients that seem a bit ‘fancy’ as they are all now widely available  in supermarkets and not too expensive.  Many of these ingredients keep for a while and dressings can be made in bulk and kept in the fridge.

Beans, pulses and lentils

No vegan diet is complete without these highly nutritious ingredients which supply protein, fibre, magnesium, iron, zinc and calcium.

This group of foods are available canned or in ambient packs which is more convenient than soaking overnight and then boiling to cook. They’re really versatile and can be used to make vegan dishes such chilli, curries, soups, stews and salads to bulk them out and increase their nutrient content.  Chickpeas and soya beans make a good snack when roasted with spices.

Grains

All grains are vegan and can be used as a base for many dishes.  These foods are a useful source of protein as well as zinc, magnesium and B vits.  Grains such as rice, barley and spelt as well as pseudo-grains such as quinoa can be used to make salads to which you can add anything to and make in bulk to use across the week. You can also add cooked grains to soups or sprinkle over vegetable salads.

Snacks

Some people may find they need to supplement their diet with snacks across the day if they need to eat more food to meet the demands of their lifestyle.

Easy vegan snacks include dips with pitta or chopped veggies,  dried fruit and nut bars, dairy-free yoghurt (topped with nuts, seeds or dried fruits), rice cakes (topped with nut butter, guacamole or mashed banana), edamame beans, nuts, seeds or roasted chickpeas.  Smoothies and shakes are also good and can be made to be high in protein.

Fortified foods and supplements

There’s no reason why you can’t get everything you need on a vegan diet, but it can be tricky to start with for some people.  Seek out fortified varieties of foods, especially those containing vitamin B12 which is difficult to obtain on a vegan diet.Food should always come first but if you’re worried that your diet may not very well balanced then a basic vegan multivitamin and mineral supplement is a cost-effective way to bridge any gaps.  Young children, particularly fussy eaters and also teenage girls are groups that will probably benefit from a supplement especially when going vegan.

It’s not that difficult to switch to a vegan diet once you know what’s available and how to modify your favourite everyday meals.  Don’t rely solely on ready-prepared vegan dishes and stick to the basic principles of healthy eating (it’s just as easy to eat an unhealthy diet when going vegan).

Try and use Veganuary as an opportunity to explore recipes that use ingredients which may be new to you.  This campaign is also a great opportunity for you to commit to new eating habits that can extend beyond January and help you to improve your overall long-term health.

 

Try this simple one week vegan menu plan to kick start your Veganuary.

 

References

  1. https://www.gov.uk/government/statistics/ndns-results-from-years-7-and-8-combined

How to cater for vegan guests at Christmas

How to cater for vegan guests at Christmas

Planning Christmas lunch can be a huge operation and even more so if it’s your first time at the helm.  So, what do you do when one of your guests tells you they’re vegan?

If you break down the Christmas lunch table then most dishes are actually plant-based and those that are not can easily be adapted without too much effort.

What do you serve in place of roast turkey?

There are many options that can be cooked alongside the turkey for your vegan guests.  

Vegan roasts made from ingredients such as nuts, seeds, beans, pulses and lentils are a good option and you can find many recipes online.  Look for recipes full of flavour which make the most of dried spices and dried fruits. Stuffed butternut squash is also a really nice option and you can make festive fillings using grains and dried cranberries.

Cooking a vegan roast is always going to be full of the key elements of taste including both flavour and texture.  Another option is a meat-free alternative which are normally made using tofu.  

What about the roast potatoes?

The only consideration here is the type of fat that you choose to cook them in.  Animal fats are often used to roast potatoes at Christmas so be sure to switch to olive or rapeseed oil.  Coconut oil can be used and offers an interesting flavour.  You can also roast with garlic and rosemary for something delicious. 

The key to nice and crispy roast spuds is picking a floury variety and giving them a good shake before you put them in the oven.

What about the vegetables?

All veggies are plant-based so there’s no issue here.  Some vegetable options do contain dairy such as parmesan roasted parsnips or cauliflower cheese.  You can adapt these dishes by using nutritional yeast and fortified plant-based drinks made from soy, nuts and seeds.

What about the gravy, savoury and sweet sauces?

No Christmas lunch is complete without a good gravy.  You can make a good vegan alternative using dried porcini mushrooms which give it a strong ‘umami’ flavour.  

Savoury and sweet sauces that use butter, milk or cream can be made using alternatives made from plant oils, fortified plant drinks, soy, nuts and coconut.

What about the Christmas pudding?

Christmas pudding is not vegan as it contains ingredients such as suet, eggs and honey.  You could make your own vegan alternative but buying one in is much easier.

What about the booze?

This is one thing that non-vegans may not even have ever thought about but not all booze is vegan friendly.  

Some drinks may use isinglass (substance obtained from fish bladders), gelatine, eggs white, seashells and other animal products during the filtering process prior to bottling.  Honey may also be used to sweeten certain drinks so worth keeping an eye out for.

You can check out which brand of alcoholic drink is vegan by using the website Barnivore.

Adapting your Christmas lunch to accommodate vegan guests is really not that difficult once you know where to make the changes.  Many of these changes can be used to feed everyone and will likely go unnoticed by your other guests.  

Of course the other option is start veganuary early and go completely plant-based this Christmas!

 

Is Veganuary really worth the effort?

Is Veganuary really worth the effort?

Veganuary is very cleverly positioned at the start of the New Year which is a time when many people are highly motivated to eat a little better and exercise more. 

Veganism is the pinnacle of plant-based eating and often viewed as being superiorly healthy, but is Veganuary really going to make a difference to your health or is it just a flash in the pan?

What are the health benefits of veganism

Meat-free diets have been shown to benefit key areas of health and reduce the risk of diet related diseases. 

Studies have shown that people who follow a meat-free diet have a lower risk of obesity (1), heart disease (2), high blood pressure (3), type 2 diabetes (4) and digestive disorders such as constipation (5) – although lifestyle plays a key role here and this doesn’t mean following a vegan diet will prevent you from developing these conditions.

How does a typical vegan diet differ to that of omnivores?

It has been shown that vegans are more likely to exceed the daily recommended fruit and vegetable intake.  Eating more of these foods means gleaning a greater quantity of micronutrients and antioxidants such as the carotenoids found in orange and dark green vegetables (6).

Veganuary can educate about plant-based eating

Adopting veganism for January is a great way for people to learn more about plant-based eating.  One of the key lessons is learning how to adapt simple everyday dishes such as curries, chilli and spaghetti Bolognese by switching meat for foods such as tofu, beans, pulses or vegan Quorn. 

Given the vast range of alternative foods now on the market it has become easier than ever to go completely plant based and Veganuary is a good opportunity to showcase this.

Should we limit our meat intake?

Many people eat meat on a daily basis and in some cases at every mealtime.  I’m not a vegan but my personal opinion about meat is that we should eat less and choose the very best quality affordable rather than filling our shopping trolley full of cheap over farmed animal products.

Focus on environment as well as nutrition

There are many different foods you can eat in place of meat that supply similar nutrients including protein, iron and zinc.  For me, the focus regarding meat should be placed on the environmental issues over nutrition. 

Findings from a study carried out by Oxford University suggested that if the world went vegan it could save 8 million human lives by 2050, reduce greenhouse gas emissions by two thirds and lead to healthcare-related savings and avoided climate damages of $1.5 trillion (7).

Despite these impressive stats there are still other issues that vegans need to be conscious of that can impact on the environment.

Eating with the seasons is important to cut back on food miles.  The supermarket fruit and veg aisles tend to be suspended in a constant summer season but in order to have access to these foods they must be flown in from around the world.  The demand for these foods has also had a huge impact on the landscape of certain countries which are now dominated by the poly tunnels required to grow them.

Eating with the seasons is a challenge and does require some skills in the kitchen, especially in the winter months when it’s mostly root vegetables on the menu.

Cattle farming uses vast quantities of water but this doesn’t mean that plant-foods are necessarily any better.  Certain plant foods such as nuts and soy still use huge amounts of water.

Crops such as maize, soy and grains can also have a damaging effect on the biodiversity of land and quality of soil by way of pesticide and fertilisers.

You can’t cut out foreign food imports completely as this would have a huge impact on the farmers in countries that rely on selling their goods to the UK.  Simply being more conscious about your foods choices to achieve a balance is the best approach.

What do I think about Veganuary?

You don’t need to go vegan to be healthy but eating less meat is undoubtably a good thing. While going vegan for one month may not have an immediate impact on your health or global environmental issues it does help enlighten people to the plant-based way of eating. 

If engaging in the Veganuary campaign led to some people adopting this way of eating permanently or others simply committing to Meat Free Monday, then long term the impact on health and environment would be significant. 

In short, I’m a fan.  Veganuary is a brilliant campaign that raises awareness of the many current issues surrounding the way we eat while also educating people on how include more plants in their diet. 

 

References 

  1. https://www.ncbi.nlm.nih.gov/pubmed/20622542/
  2. https://www.ncbi.nlm.nih.gov/pubmed/26138004
  3. https://www.ncbi.nlm.nih.gov/pubmed/24636393
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466938/
  5. https://www.ncbi.nlm.nih.gov/pubmed/21983060
  6. https://www.ncbi.nlm.nih.gov/pubmed/26707634
  7. https://www.pnas.org/content/113/15/4146

Summer breakfast salad – Eats and Cheats

Summer breakfast salad – Eats and Cheats

So this is a quick flash back of the cookery videos I recorded with Jackie Wicks.  I had the privilege of working with Jackie on the UK edition of the book.

This is one of the recipes taken from the Eats and Cheats cookbook.

I don’t actually have the recipe from this video but it showcases many of the basic elements to creating a really healthy meal.

The foundations of a salad are the greens so in the summer this may be salad leaves while in the winter you may want to use finely shredded raw kale or cabbage.  Once prepared, massage these leafy greens in olive oil for a few minutes to soften them slightly and make them more palatable raw.

Try and add a few more brightly coloured vegetables in your salad.  My favourites include finely sliced peppers, grated raw beetroot and carrot, and also raw red onion.

Pump up the protein in your salad by adding either lean meat, fish or poultry.  If you’re plant-based then opt for marinated tofu, beans, pulses or lentils.

You may also want to add a carb to give your salad more substance.  Stick to wholegrains (brown rice, pasta) or pseudo grains (quinoa, amaranth, buckwheat), the latter of which are actually seeds and richer in both protein and essential minerals such as magnesium.

Fresh and dried fruits add texture and sweetness to a salad.

Go large on fresh herbs – anything will do, just chuck them in!

Dressing wise – there are many great dressing recipes online.  I like to keep things simple by combining olive oil with lemon juice.  Other favourites include tahini or Asian flavours such as soy and ginger.  My one tips is that olive oil is not always the best oil to use for dressing that include many different flavours.  Good quality olive oil is quite bitter which is OK with lemon juice but can over power other dressings.  My alternative is a light olive oil or groundnut oil.

Chipotle prawn fajitas – Eats and Cheats

Chipotle prawn fajitas – Eats and Cheats

So this is a quick flash back of the cookery videos I recorded with Jackie Wicks.  I had the privilege of working with Jackie on the UK edition of the book.

This is one of the recipes taken from the Eats and Cheats cookbook.

Chipotle prawn fajitas 

Serves 4 

Ingredients

 1 tbsp extra virgin olive oil

450g raw king prawns

Chipotle sauce to taste

Chilli flakes to taste

2 red onions, finely sliced

1 green pepper, deseeded and finely sliced

1 red pepper, deseeded and finely sliced

80g button mushrooms, sliced

1/2 green chilli, finely chopped

Round lettuce

Salsa (optional)

Avocado, diced (optional)

Black beans (optional)

Method 

  1. Heat a frying pan over a medium heat.
  2. Add the olive oil.
  3. Coat the prawns in the chipotle seasoning then place in the pan and cook for 2 mins.
  4. Now add the chilli flakes, onions, peppers, mushrooms and green chilli.
  5. Take the prawns off the heat.
  6. Create your wraps by loading with the prawns, lettuce and optional items including salsa, avocado and beans.

Find more videos like this on my YouTube page.

Orthosomnia: Is your quest for perfect sleep keeping you awake?

Orthosomnia: Is your quest for perfect sleep keeping you awake?

As with any area of health, there is always the risk that some people may take things a little too far.  Balance is the key to maintaining long lasting behaviours that influence our overall wellbeing.

Some people eat better and train harder than others and this may put them in to top 10% but when diet and exercise become a preoccupation it can have a negative impact on their health.

The same appears to have become true of sleep.

How much sleep do we get?

The topic of sleep has become big news in the world of wellness.

It is recommended that the optimum number of hours sleep is around eight per night.  However, research has shown that most of us do not get enough sleep with most getting seven hours a night while some endure less than five (1).

How does sleep deprivation affect your health?

In the short term a lack of sleep can affect concentration, mood and memory but a chronic lack of sleep over time can have more serious consequences on your health.

Research is ever evolving around sleep and it has been suggested that a lack of sleep is linked to an increased risk of heart disease, high blood pressure, stroke, obesity, type 2 diabetes, depression and anxiety (2).

A recent study published in the journal Neurology found that amongst the 487K people involved, sleep deprivation increased the risk of heart attack and stroke by almost a fifth (3).

The rise of sleep trackers

Sleep has now become a huge point of interest for many people, especially as it is now widely viewed as one of the key pillars to maintaining optimal health and wellbeing.

The wellness industry has reacted to this interest by offering us a wide range of wearable devices that help us to monitor and personalise our health.  Many of these devices allow wearers to track their sleep by offering biometric data that relates to the key stages in the sleep cycle which includes brands such as Fitbit.

These devices are hugely insightful and a useful way of mapping our sleep landscape.  However, they have also become a source of obsession for some people who go out of their way to try and achieve the perfect night’s sleep as dictated by their wearable device.

Ironically it appears that this obsession with sleep may in fact be a causal factor in someones ability to sleep well.  This new phenomenon has been identified by researchers who have named it as orthosomnia (4).

What is orthosomnia?

Orthosomnia stems from the  Latin terms ‘ortho’ meaning correct and ‘somnia’ meaning sleep.

This term was coined by researchers to describe the potential risks associated with people who develop an unhealthy preoccupation with improving the data from their sleep tracker (4).

How does it develop?

Sleep trackers can offer useful insight into your pattern of sleep, but the data is not always that precise.  For example, many of them are not hugely accurate at distinguishing between the time spent asleep versus the time spent in bed.

Orthosomnia develops when too much focus is put on this sleep data in an attempt to  achieve the perfect sleep score.  Over time this can lead to unhealthy sleep behaviours.

What are the symptoms?

The obsessive focus on improving sleep in this way may actually cause your sleep to suffer.

Orthosomnia may be recognised in someone who has been using a tracker but finds their sleep has worsened as they attempt to make changes to optimize the data (sleep score) to get the ‘perfect’ sleep.

Some of the symptoms associated with orthosomnia include:

  • Difficulty nodding off and staying asleep
  • Early morning awakenings
  • Unrefreshed sleep
  • Anxiety
  • Depression
  • Irritability
  • Fatigue
  • Poor concentration  

Why is it a problem?

The more you think about sleeping the less easy it can be to actually fall asleep. In the quest for sleep perfection people can develop increased anxiety and stress.  These emotions activate the sympathetic nervous system and can prolong wakefulness.

Research has shown how people become reliant on their tracker to tell them whether they got a restful sleep rather than judging to on how they actually felt (4).

It has also been shown how people self-diagnose and convince themselves they have a sleep disorder based on their sleep data even though they may not (4).

Research has also shown how people may spend excessive amounts of time in bed in an attempt to improve their sleep score.  This behaviour only reinforces poor sleeping habits and can condition the body for sleeplessness which may lead to future issues with insomnia further down the line (4).

How can you manage it?

You could get rid of your sleep tracker, but you could also try and use the tracker in a more useful way to help you adopt better sleep hygiene habits.

Establishing general sleep hygiene habits is a good way to try and get you sleep back on track such as:

  • Keeping a constant bedtime and wake time that also allows you to try and get the number of hours sleep to meet your needs.
  • Trying relaxation techniques before bedtime to help ease and calm a busy mind.
  • Create a calming sleep environment that is dark, cool and clutter-free.
  • Wake time is especially important and try to expose yourself to as much light in the morning to optimise your circadian rhythm.

When may more action be requried?

In some cases, someone may need to participate in treatment such as cognitive behaviour therapy for insomnia.

References 

  1. https://www.sleepcouncil.org.uk/wp-content/uploads/2013/02/The-Great-British-Bedtime-Report.pdf
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845795/
  3. https://n.neurology.org/content/early/2019/11/06/WNL.0000000000008581
  4. http://jcsm.aasm.org/ViewAbstract.aspx?pid=30955