What is Intuitive Eating?

So…what is Intuitive Eating

Have you heard about Intuitive eating but you’re not sure exactly what is intuitive eating?

Intuitive eating is a framework that can be used to move away from chronic dieting and heal your relationship to food. Intuitive eating has plenty of research behind it, and is now considered an evidenced based approach. It was developed by Dietitian’s Evelyn Tribole and Elyse Resch in 1995.

Intuitive Eating is not a diet and it does not control or restrict food intake. It’s an approach to help you get out of your head, and more into your body. It helps remove the exhausting should / shouldn’t voices that may constantly sit on your shoulders around food choices.

Intuitive Eating includes mindful eating practice, where we eat in a ‘present’ state, free from distraction. That means putting away our phones and laptops, and bringing our attention to the food we are eating. By fully tuning in to what we’re eating means we can listen to our hunger and fullness cues; another important part of this practice.

This practice is also about honouring our body’s physical and psychological needs. Ask yourself, what do I really want to eat NOW? If you feel like a slice of cake, eat the cake. If you feel like a Caesar salad, order the salad. By honouring your body’s needs and not depriving yourself of the thing you really want to eat means you’re more likely to feel satisfied. In turn this helps to reduce binge eating and aid in you in feeling in-control with food. Hurrah!

If you’re thinking…”that sounds great…but if I let myself eat what I want I will surely overeat” then keep reading to the bottom of the article. Here, I address this common fear.

Intuitive eating encourages “putting weight loss on the back burner”. This means allowing our body to settle at its natural weight once eating patterns normalise. This practice is all about learning how to enjoy food and feel satisfied, and therefore decrease binge eating and increase our overall health and wellbeing.

Over 100 published studies have confirmed that many psychological and physiological benefits can arise through this practice. As such, Intuitive Eating has become a buzz term in the social media world as many people discover it can help stop dieting and reduce binge eating episodes. But sadly, it has been misinterpreted by some as being yet another potential tool for weight loss, which it is not.

“Intuitive Eating is not a diet. It does not pursue weight loss and it does not control or restrict food intake.”

Why try Intuitive Eating?

How many attempts have you made in your life to try and lose weight?

How long have you been able to maintain the weight that you’ve lost?

Have you ever considered that it might be time to look for something different?

One of the strongest predictors of weight gain is engagement in weight loss dieting, regardless of the actual body weight of the dieter. And upwards of 90% of people who intentionally lose weight gain it back within five years. Between one third and two thirds of people who lose a substantial amount of weight on a dietary-based weight loss program will regain all the lost weight and more within 5 years

And sometimes I think we’re not always clear on what dieting is. Dieting has become twisted and morphed into “wellness” and it’s sneaky. Dieting is anything that pursues weight loss, whether it be fasting, calorie counting, eating clean, going gluten-free, vegan, or following a Keto plan.

For many of us, we’re lead to assume that diets are safe and harmless. What we’ve come to learn through research and experience is that dieting and restriction for the purposes of weight loss, don’t work for the majority.

For a lot of people, this can sounds completely different and foreign. And if we’re hearing things for the first time, the human response is to think “no that’s not me”.

Robust studies show that restrictive eating can increase disordered eating, make us gain weight, binge eat, become totally preoccupied with food, lower our self–esteem and decrease our overall mental health. Have experienced any of this yourself?

If dieting doesn’t lead to weight loss, and causes so much mental turmoil, why do we do it?

Because we live in a diet culture that is obsessed with thinness. Where it is considered normal to diet and pursue weight loss. We’re sold the idea that when we’re thinner, we will be healthier, more confidence, and more successful.

Stopping dieting can be so hard. There is a lot of unlearning involved. Intuitive eating is a framework that provides structure for this, with research to back it up.

“Intuitive Eating is not a diet. It does not pursue weight loss and it does not control or restrict food intake.”

So how do you actually start Intuitive Eating?

Developed by dietitians Evelyn Tribole and Elyse Resch in 1995, Intuitive Eating is evidence-based with 10 principles underpinning it (3).

Below, I have outlined the 10 principles and some tips to get started implementing them.

1. Reject the Diet Mentality

Unfollow any social media accounts that promote weight loss and push unrealistic body standards. Toss out diet plans, magazines and books that once graced your bookshelf. It’s time to break up with diet culture for good so you can allow Intuitive Eating to become part of your life.

2. Honour Your Hunger

Nourish your body with the right amount of energy to avoid going into starvation mode. Allowing yourself to become excessively hungry triggers a natural intense desire to eat, often leading to unintended binge eating. Try not to skip meals or have long gaps in between eating which can leave you feeling ravenous!

3. Make Peace with Food

Give yourself permission to eat ALL food! No single food is going to make you healthy or unhealthy, and restrictive eating can often lead to extreme feelings of deprivation. This often leads to binge eating which can fill you with guilt. No food should be “forbidden”.

4. Challenge the Food Police

Stand up to the Food Police in your head who create unrealistic food rules (e.g. no sugar, dairy, gluten, eating after 6pm, counting carbs). The Food Police often let you think that only healthy eating is good and eating cake is bad. It’s time to give these guys the flick!

5. Respect Your Fullness

When was the last time you stopped eating when you were comfortably full? Feeling BETTER for eating? When stuck in the diet mentality, we can often swing from being overly hungry (through restriction) all the way to being stuffed.

With intuitive eating, no foods are off limits and there are no rules. You can therefore feel safe in the knowledge that you can eat as much as you need to feel comfortable right now, and eat again when your body is ready for it.

6. Discover the Satisfaction Factor

Eating rice cakes, kale crisps and low-calorie cereal bars probably aren’t going to leave you feeling satisfied. If you’re out at dinner and feel like ordering the chips, order them! If you deprive yourself of the thing you really feel like most, you are fuelling the restrictive diet mentality, which at some point will likely lead to feeling out of control around food.

7. Honour Your Feelings Without Using Food

Emotional eating is perfectly natural and is usually an act of self-care. It should not fill you with guilt. As you move through the intuitive eating journey, honour your hunger and remove the forbidden of foods, emotional eating can dissipate. However, if food is still your only or main coping mechanism, we can work together to identify other ways to soothe your emotions that aren’t just with food.

8. Respect Your Body

It’s time to accept that your body shape and size is special and unique. Your genes are set in stone, so being critical about something that you can’t change is not a helpful exercise. Focus on all the wonderful things your body can do or has done to help rediscover self-love.

9. Exercise – Feel the Difference

Find movement that you love and do it as much or as little as you wish. Ditch rigid exercise plans and certainly don’t pursue activities that you don’t enjoy. If you find movement that you makes you feel good, you’ll automatically want to do it more often without even realising!

10. Honour Your Health

There is no such thing as eating perfectly. It is about making progress to consuming a variety of foods that make your body feel well and also satisfy your tastebuds. It turns out that most people find eating a nutritious balanced diet feels good! And it is about doing this consistently over time.

If you would like some more in depth information on how to implement these, head to my other article with tips on how to start intuitive eating.

With this, please keep in mind that Intuitive Eating is a nuanced framework and how it is applied depends on where you are at as an individual. I would recommend reading the Intuitive Eating book for more detailed info and/or seeking support from a Certified Intuitive Eating Counsellor.

So you’re interested in Intuitive Eating but have some reservations?

Embracing Intuitive Eating can be more of a challenging process than just being given a diet plan or set of rules. But it’s a way to find true freedom so you never have to go back to diets again. Of course, diets and the scales will always be there to go back to…

Here are some answers to common fears:

“If I give myself permission, I may never stop eating”

As a result of years of chronic dieting and under-eating it can be hard to trust that you will ever stop eating. As you move through intuitive eating there may be a short period of time where you eat more than you desire. This is totally normal, and a natural response to restriction. When you start learning to trust that food is ALWAYS available, and there are no weird conditions on this, you will start to trust that you will only eat as much as you need.

“I don’t know what or how to eat”

When you actually stop and pay attention to what you are eating, you may realise that you don’t even enjoy those foods! But rather than being concerned about what to eat, use intuitive eating to explore different kinds of foods and flavours. This is a great opportunity to figure out what you like to eat rather than what you think you should eat.

“If I let myself eat whatever I want, I might lose control”

Imagine if I said you can eat whatever you want all day, every day. You may think you would never stop yourself eating chocolate chip cookies, wine, cheese, crisps and all the foods you consider ‘bad’. Let’s see what happens if I give you an endless supply of cookies.

Day 1, you would eat a lot.
By Day 2, you may still eat a lot, but less than Day 1.
Day 3, you’d most likely eat less than Day 1 and 2.
After a few days, you will start to crave other foods.

This process is called habituation and is another key part of the Intuitive Eating practice.

At the end of the day, the most important thing to remember about Intuitive Eating is that it is not about eating a perfect diet – there is no such thing! The goal is to eat a variety of nutritious food with some ‘play foods’ that truly satisfy you. To remove the noise in your head and make peace with food and your body, so you can move on with other things that matter more in life.

For more on how to start intuitive eating check out my free download This will guide you through some of the first steps to support you through your food problems. You will learn how to stop food obsession, battling with emotional eating, stress eating, and some tips to start intuitive eating.

Why diets don’t work

You may have been told that “diets don’t work”, and questions what weight loss programmes do really work…

I hear you.

And perhaps you’re wondering “what diets really work then?”.

Can you think back to the last time you went on a diet?

And I don’t just mean following Weight Watchers or going to the extreme of ‘juice cleansing’.

A diet is anything undertaken for the purposes of trying to lower your weight. Even if it is reframed as ‘balance’ or a ‘lifestyle change’. Many diets are sneaky and hidden. Here are some examples of fake / hidden / pseudo diets.

Examples of pseudo diets include:

Cutting or counting carbohydrates.

Only eating ‘safe foods’ that are low in carbohydrates, calories or fat.

Only eating at certain times of the day.

Making up for eating certain foods by skipping meals, eating less than you normally would, or telling yourself you will be ‘good’ tomorrow.

Cutting back when you are feeling fat, or in preparation for a special event.

Basing what you are going to eat now, on what you have eaten earlier today, even if you are hungry or desire something different.

Cutting out or restricting certain food groups based on the idea that they are ‘bad’ or not good for you. For example, cutting out gluten, dairy or sugar without underlying reasons for needing to do this.

Pacifying hunger by drinking coffee or diet coke.

Putting on a false food face when out e.g. saying no to pudding/cake/dessert or certain foods in front of others when you actually really want it. You then leaving the meal and overeat on your way home, more than you would have done if you had just eaten the pudding.

So, now you have more insight into what a diet is, let’s get back to helping you understand why diets don’t work for the majority…

Can you think back to the last time you went on a diet?

Did the diet work?

Did you actually lose weight and then keep it off? Was it sustainable? Do you still feel satisfied, fulfilled and free from continuous food and weight thoughts?

My best bet is a no.

It’s become more and more known among individuals and professionals that diets (aka the pursuit of weight loss) don’t work. This article has been written to help you understand why diets don’t work so you can start to break the habit of dieting.

Dieting does’t work for the majority and is associated with:

Weight regain

Yep! It’s been published in the Australian Government Guidelines and is yet to slip into the UK’s. Based on reviewing the highest quality research, they state “Weight regain after intentional weight loss happens most of the time”.

Most weight re-gain tends to occur within 1 year, and the rest within the following 4 years. In Fiona Willer’s words, the evidence is strong, and “we can be as sure of this as we are that smoking causing cancer!”

Binge eating and food obsession

Dieting damages our relationship with food. When our bodies are deprived, our brain doesn’t know that you’re just trying to be ‘good’. It just thinks you are starving.

Have you ever had strong urges to want to eat when dieting? Perhaps scrolling through Instagram or Pinterest, drooling at delicious looking food.

We have biological survival mechanisms that kick in to make us want to eat, and there are a number of hormones that create this. Sorry to be the bearer of bad news, but fighting biology is a losing battle and these normal biological urges to want to eat will kick in at some point.

A loss of ability to detect hunger, fullness and satisfaction

Relying on outside food rules/diet plans/calories/points teaches us to ignore our natural biological signals that were created to help us detect hunger, fullness and satisfaction. This can result in over or under-eating.

For example, if you’re counting calories, what happens if you feel hungry but you’ve used up all of your calorie? You either remain hungry, or beat yourself up for going over and promise you will be ‘good’ tomorrow. Equally, what if you don’t use up all of your calories for the day? It’s unlikely you would let them go to waste, and eat them anyway!

It’s no wonder our hunger and fullness signals don’t hang about any more. If we’re not listening to them, they are seen as wasted energy and don’t show up.

Slowed metabolism

Dieting makes it harder to not only lose weight again next time, but much easier to gain it back. Your body becomes better at storing fat, and more efficient at using less energy.

So what can you do if diets don’t work?

This can all be quite mind blowing, especially if you’ve been dieting for many many years. But there is a way out, I promise.

For more on how to stop binge eating sugar, how to stop, emotional eating, stress eating, yo-yo dieting, and how to start intuitive eating check out my FREE download. This will guide you through some of the first steps to support you through your food problems. You will learn how to stop food obsession, and how to start intuitive eating.

Does eating organic food lower your risk of cancer?

Do any of the following sound familiar?

– You always buy organic food where possible.

– You buy organic food when you can afford it because you’ve heard it’s healthier.

– You’re not really sure whether you should be buying organic, especially when they can cost 10% to 100% more than food grown under conventional conditions.

Last week in the headlines, the Mail Online, The Sun, and The Times (to name a few) stated that eating organic food could reduce our risk of cancer. This headline came off the back of a recently published French study. The media took the findings at face value without acknowledging other factors that could have potentially influenced the results.

In this article I am going to offer the truth about organic food and cancer, so you can make an informed decision.

What does ‘organic’ actually mean?

Organic food is any food that is produced by an overall system of farm management and food production that complies with a set of standards set out by European Law. The EU standards are currently under review. The standards vary across the world, but in general they combine practices that promote ecological balance, conserve biodiversity and strive to cycle resources. The use of pesticides, fertilisers, irradiation and food additives is usually restricted.

Organic production plays two main societal roles. On the one hand, it provides for a specific market and responds to consumer demand. On the other hand, it delivers publicly available goods that contribute to the protection of the environment and animal welfare, as well as to rural development

“Foods may be labelled “organic” only if at least 95% of their ingredients meet the necessary standards.”

What was the research?

The large French study questioned 69,000 French adult volunteers on their consumption of organic food and followed them over 4.5 years to see how many developed cancer. Other studies have identified the potential benefits of eating an organic diet, such as lowered level of pesticides in urine samples. However, few studies have looked at the potential link with cancer. That’s what made this study so exciting to the media.

Data were collected online, via a website based platform. The study participants were asked to provide information on how often they ate 16 labelled organic products. They were also asked to complete three 24-hour food recalls (writing out what they had eaten in the last 24-hours).

What did they find?

In total, 1,340 (2%) of the study participants developed cancer. The cancers developed, included breast cancer (34%), prostate cancer (13%), skin cancer (10%) and bowel cancer (7%). More specifically, significant (notable) links were found between postmenopausal breast cancer, lymphomas overall, and non-Hodgkin’s lymphoma specifically.

Consumption of organic food was more common among:

women
those with a higher education or occupational status
those who did more physical activity and who had healthier diets in general

The researchers found that people who ate the most organic food, had a 25% reduced risk of cancer, compared to those who ate less.

What does this mean?

Despite the encouraging media reports, this study does not prove that eating organic food will protect you against cancer.

Why?

Although this study used a large sample size there were a number of limitations deeming the results not as positive as the media make out.

1) There are a number of potential factors that could explain this link that could be interfering with the results. Other important factors such as high income or physical activity level are especially important when studying the health benefits of organic food, because eating organic is associated with lots of things that also help you live a longer, healthier life.

In other words, people who regularly eat organic food tend to have other lifestyle factors and habits that could easily lower cancer risk as well. Even within just this one study, high organic food consumption was associated with higher income, having a better job, being more active, eating more fruits and veggies, and eating less meat and processed food.

Those are all things that make you more likely to stay healthy than those who can’t afford to take such good care of themselves.

2) The study results were based on volunteers who are already pretty health conscious individuals. This makes it difficult to transfer the findings to other groups of people aside from middle-aged well educated French women who already exhibit healthy behaviours.

3) There are limitations to self- reported food intake. The intake of foods was not actually measured, rather it was reported on an online survey. Also, organic food intake was recorded at a single point in time and self-reported. This may be inaccurate and not reflect lifetime habits.

4) Observational studies (which observe groups of people over time) such as this, are useful for exploring potential links. However, they can’t prove a true cause and effect, as other health and lifestyle factors could be having an influence.

5) Cancers still developed among people who ate the most organic food – it’s just there were fewer cases (269 vs 360 among those eating the least amount of organic food). So even if there is a direct link, eating organic food is not guaranteed protection against cancer.

In summary

The researchers conclude: “A higher frequency of organic food consumption was associated with a reduced risk of cancer. Although the study findings need to be confirmed, promoting organic food consumption in the general population could be a promising preventive strategy against cancer.”

This study is a valuable investigation into potential links between eating organic food and cancer risk. However, the author’s conclusion may be a little premature. Other large and high-quality research has identified no association with overall cancer incidence. This study alone cannot prove that eating organic food will prevent you from getting cancer.

So, if you prefer organic food that’s fine, but there is no strong evidence that it makes a positive difference to our health. There is however, strong evidence that they make a dint in your monthly bank statement!

References – in links throughout the text.

What is reliable nutrition information?

The internet and social media are some of the most powerful tools at our disposal when it comes to answering nutrition questions. However, one thing we often find challenging is how to separate who is posting reliable nutrition information and who is not.

Instagram is a rapidly growing social platform. To give you some frightening statistics, 35% of the UK population are spending an average of 5 minutes per day using it (1). With a booming and unregulated ‘wellness industry’.

Instagram appears to be a particularly thriving breeding place for unqualified (and sometimes qualified) individuals who are irresponsibly communicating poor quality health information. Whilst Registered Dietitians and qualified healthcare professionals are governed by law to uphold standards, the wellness industry is actually unregulated. This means anyone can post about nutrition information.

Social media also given rise to a social media-based healthy eating community (2), who have been identified to have a higher prevalence of Orthorexia Nervosa (ON) (3) (an obsession with eating foods that one considers healthy). Higher Instagram use has identified to be linked to increased ON symptoms.

For individuals using social media platforms, there is limited guidance on how to sift through and eliminate poor quality and irresponsible nutrition information. In this article, I am going to outline, with examples, how you as a consumer can ensure you are engaging in both responsible and reliable nutrition information on social media.

“the wellness industry is actually unregulated. This means anyone can post about nutrition information.”

But how can qualified professionals be posting irresponsibly?

During undergraduate training of healthcare professionals, there is little formal training in how to communicate effectively and responsibly to wider audiences on social platforms such as Instagram. This is of no disrespect to the training. It’s because Instagram is a fairly new and rapidly growing platform that was only established in 2010.

There has been some guidance published for professional (4, 5), however, Instagram has moved forward since then, and whilst these guidelines for professional are useful, they are not rigorous. This means that not only are non-qualified individuals posting irresponsibly, qualified professionals don’t always get it right either.

I have therefore, created this article to help direct you when reading nutrition information on social media.

Responsible communication refers to communication that is appropriate, honest, trustworthy and respects confidentiality (5). Below are examples and checkpoints that outline what to look out for when engaging in nutrition content on social media.

1. Is the content backed up by good quality science?

Content sometimes states “research says” or reports on a single study to make claims. Every claim, argument or opinion should be supported and justified by credible evidence from research or other authoritative sources. This doesn’t mean formal reference techniques need to be used at all times (especially in places like Instagram), however, the content should state what we know, what we don’t know, and how this could be looked at in the wider context of health and nutrition.

A subtle example: “true Iron deficiency will usually show over time”. (This statement needs expanding and evidence to support the claims. How long? How do you know?)

Ask yourself:

Is it clear what sources of information were used to write that content?
Have they given a balanced view? E.g. have they highlighted areas of uncertainty.
Have they provided details of where to access additional information? e.g. links in the Instagram bio, text below the image or references beneath?

2. Does the content sound like they are diagnosing your problem?

Responsible and reliable nutrition information should enable you to choose what is in your best interest. Information that has the direct objective of providing you with advice, needs to be honest, informative, clear and realistic, and not use language which exaggerates or makes assumptions (examples below).

Subtle examples:

“the most common symptoms of Iron deficiency include; fatigue, weakness, pale skin”. (These symptoms could be a result of so many other things too. It is therefore, unbalanced as it has not been highlighted that these symptoms could be from a whole host of other conditions. It could also be perceived as diagnosing your problem, when there could be a whole host of other things going on. It is, therefore incomplete and could be misleading. It has also not been referenced and does not direct you on where to find further information.)

“If you are eating X on most days, you will be doing wonders for your health”. (This statement is misleading and unbalanced. Some people with certain conditions may not be able to eat that certain food, so this statement is too personal).

Ask yourself:

Is the information shared a personal opinion, being presented as fact? (how do they know? what evidence do they have to support this?). This should be clear.
Is the language they are using to communicate facts or recommendations balanced? Do they deliberately chose words that exaggerate or bring out emotion? (e.g. “doing wonders”)

3. Is it within their professional remit?

When sharing nutrition and information and dishing out claims, it is crucial that the author only provides statements that sit within their professional remit and not beyond the boundaries of their qualifications/expertise.

How to know if they are qualified?

You can look at their years of experience, and qualifications in the field. Is the nutritionist a member of a professional body like the British Association for Nutrition & Lifestyle Medicine (BANT) or the Association for Nutrition (AfN)? Is the Dietitian registered with the Health and Care Professions Council (HCPC), and a member of the British Dietetic Association (BDA)? Do they have any industry awards or have they contributed to scientific research? They should not be reluctant to share this information with you. This information is also accessible online.

A subtle example: Dietitian or nutritionist sharing their workout routine on Instagram, or in their stories, for others to replicate.

Ask yourself:

Have they made it clear that they are not qualified and therefore not providing guidance?
Are they open to sharing their qualifications and experience with you? They should not be hesitant about sharing this information.

4. Do they link their body or looks up with messages about health?

Platforms like Instagram are image-focused, which play to the ‘picture-superiority effect’, whereby images are more likely to be remembered than words (6). It’s also a platform where you can select what images you are exposed to. The limited exposure of such images can lead us to believe that one behaviour is more present or normal than is actually the case. This may lead to perceived social pressures to act similarly to such behaviours. Therefore, individuals posting images of only healthy looking food, unbalanced meals, and tying up photo’s of ‘healthy food’ to the ‘thin ideal’ body (e.g. holding a green smoothie posing in a bikini with a think cultural ‘ideal’ body), can be misleading and lead us to believe that we need to behave that way to become something like the image.

Ask yourself:

How does the post make you feel? If it doesn’t make you feel good about yourself, unfollow.
Are there different types of foods in their feed that are reflective of a balanced diet?
Do they regularly cut out large food groups?
Do they promote balance but don’t eat carbs?
Do they push unrealistic body standards?
Do they talk about ‘real food’ or ‘clean eating’?

Summary

Whilst reliable information can sometimes be hard to comeby, it is out there I promise. You just have to have your witts about you, and surround yourself with the right people on social media. This guidance was aimed to give you a more in depth perspective on how to detect bulls**t and sift out reliable nutrition information, finishing up with some suggestions on who to follow on social media. You can follow me on instagram @nudenutritionrd or check out some of my latest blogs below for some more nonsense stripping!

Comments, feedback and suggestions welcome!

Additional suggestions/recommendations

If you are not sure or confused by the content you see, then ask. If they cannot come back to you with more information or the evidence, then unfollow! You can’t control the media, but you do have a say in what you consume.
If you are really not sure about a claim you see, there is an amazing charity called Sense About Science who have set up a campaign called ‘Ask for Evidence’. Ask them for the evidence.
Have you read a headline you are not sure about? The British Nutrition Foundation responds to consultations of major public health importance on a range of food and nutrition-related topics.
NHS choices simplify health topics with a balanced approach, breaking down the research studies with links to more information.
Nude Nutrition – send in your requests and have your questions answered and nutrition nonsense stripped, in particular on Instagram @nudenutritionrd
I have recently been recognised by The WellSpoken Mark to be making a positive impact on the ‘wellness’ industry. They are an independent authority committed to leading high standards in the currently unregulated wellness industry. Anyone else you see holding this mark can be deemed as reliable and trustworthy.
The Rooted Project – funded by two Registered Dietitians, this is an event series set up where they choose speakers who are leaders in their field to translate the science into interesting and practical content.
British Dietetics Association – Tons of food fact sheets written by Registered Dietitians to help you learn the best ways to eat well and stay healthy.

References:

Dairy & Acne – All you need to know

Dairy and it’s link to Acne is a topic that many people seem to be confused about. Some people are convinced dairy makes their skin worse, while some are just not sure.

We all have our individual needs and differences, however, we can’t just say ‘probably true’ and make wild guesses. So let’s look at what the scientific evidence says…

(click away on the links throughout this document for more info & the actual research studies if you’re a research geek like me!)

What is Acne?

It’s a skin condition, that affects between 50-95% of teenagers aged 12-18 years, and adults too. The main method of acne development is through the overproduction of skin oil (sebum) by skin oil (sebaceous) glands. The sebaceous glands are small glands in the skin which secrete lubricating oily matter (sebum) into the hair follicles to lubricate the skin and hair.

Acne can be really damaging socially and emotionally for that individual. Several factors are involved in the development of acne including, genetic, sex-hormonal, disease fighting systems, mental factors, and the environment. Some say that western dietary habits, and in particular – cows milk and dairy products – add to acne development.

What research has been done?

Interestingly, a huge new study came out last month, which is the first large and high-quality study in this area. It was a “meta-analysis of observational studies” which is one of the highest quality study designs out there in food studies like this.

They basically searched huge scientific computer files of information for all of the studies published in this area (a very long process which I am very familiar with) and pulled the studies together to create one overall result.

The observational studies that they pulled together, are a study design where they watch large groups of people over time and look at their dietary intake through food recalls and food diaries. They then see who has/hasn’t developed acne. Observational study designs have their limits, but they are the easiest studies to try when looking at population diets and medicine based results like acne.

“They found that dairy, total milk, whole fat milk, low fat milk, and skimmed milk consumption was connected with the presence of acne.“

So what did they find?

They pulled together 14 observational studies looking at milk, cheese, yoghurt and total dairy intake. The study people ranged from 9-30years old from the USA, Brazil, Italy, Malaysia, Norway, France, Egypt, and Kazakhstan. They found that dairy, total milk, whole fat milk, low fat milk, and skimmed milk consumption was connected with the presence of acne.

The presence of acne appeared to increase with increasing intake of dairy. The low fat products tended to have more of an effect on acne development than the whole milk. Potentially related to the glycaemic index (higher concentration of milk sugars) in the low fat products. But these are speculations. There was no relationship between yoghurt or cheese intake and the presence of acne.

I know what you are thinking… now you want to cut out dairy. But hold fire!!

There were some limits to this study.

Firstly, when looking at individual dairy products (milk, cheese, yoghurt etc.) the number of studies available was very low. For example, only 4 studies looked at low-fat milk, and five at full-fat milk.

Secondly, there were other factors that could have been related to acne development, that were not recorded in the study. For example, genetics, sex-hormones, disease fighting systems, mental factors, and the environment. The association between acne and dairy could therefore, have happened together by accident.

Some of the studies identified acne based on self-reports, rather than official diagnosis by a doctor. A few pimples could therefore, have been mistaken for acne.

Finally, there was lack of data on the preparation of the milk which differs from factory to factory and country to country. In fact, we know that boiling and ultra-heat treatment (UHT) techniques have a protective effect against acne. No studies were done in UK population groups!

How does milk actually affect the skin?

It has been identified that milk and dairy can increase our growth chemicals (hormones) in our body (IGF-1). IGF-1 is a growth chemical that stimulates growth, cell reproduction, and cell regeneration. Milk and dairy products contain IGF-1 that is not broken down by gut enzymes and leads to IGF-1 elevation.

Also, a protein called casein in milk and dairy products stimulates our liver to release IGF-1. Subsequently, this leads to an increase in the production of skin oil by our skin glands. Also, milk contains some sex hormone derivatives and iodine which have been identified to affect acne development.

So should you avoid dairy if you have acne?

I’m going to start by saying… not right now. Firstly, while this study was the largest and highest quality to date in this area, it still had its limits that I have given above. Further studies, especially randomised controlled trials are needed. This is where they randomly assign groups to eat dairy compared to not eating dairy in controlled conditions. These will help to confirm the effect of milk and dairy products on acne development.

Secondly, milk is a very nutritious source of protein, calcium, potassium, magnesium, vitamin A and B12 and is recommended as a part of healthy diet. Previous high-quality studies have showed that milk and dairy products can help reduce the risk of high blood pressure, stomach cancer, stroke and colorectal cancer.

Summary…

Although the large review does suggest a promising link between dairy and acne development, the studies included in the review had their limits. We therefore, cannot say there is an exact causal relationship without further studies.

Everyone’s reactions to what we eat are very personal and therefore, if you are someone who wants to trial changing your diet, it’s important to follow the guidance of a qualified professional. There is unfortunately no one size fits all. I offer FREE 20-minute discussion to advise on things like this!

Also, if you are thinking of going more plant-based and reducing your dairy intake, it’s really important to choose milks that are fortified with calcium.

Finally, we must remember that diet is not going to fix acne alone. Seeking advice from a doctor or consultant dermatologist is a good place to start!

Link to more info:

(Links highlighted throughout the text)

NHS Choices Acne

The large meta-analysis I have referred to throughout this post

Apple Cider Vinegar – All you need to know

I have been asked multiple times recently about apple cider vinegar. Will it help me lose weight? Will it settle my stomach/heartburn? Will it help with blood sugar control? Will it lower my cholesterol? Will it help with inflammation? So I thought I would clarify some things for you.

What is apple cider vinegar?

It’s made by fermenting the sugars from apples which turns them into acetic acid – this is the active ingredient in vinegar that is researched. You may see both cloudy or clear vinegars in the shops, labeled as filtered or unfiltered.

The unfiltered products contain something known as ‘mother’, which apparently has more proteins, enzymes and friendly bacteria in it, giving the vinegar its cloudy appearance. There is not enough research at the moment to demonstrate whether the ‘mother’ variety is any better than the clear.

What’s good about this stuff?

1) If you fancy your dentist, drinking this stuff will give you a great excuse to keep going back!

2) If you need something sharp to wake you up in the morning, this may do the trick.

Joking aside…

3) It’s a good way to spice up your meals without adding salt

4) It contains very small amounts of potassium, copper and magnesium – minerals help turn the food we eat into energy and support controlling the movement of fluids into and out of cells.

5) It provides a small amount of amino acids (building blocks for protein) and antioxidants, which help slow the process of cell damage.

So what does the research say?

1) Will it help with weight loss?

The evidence to support weight loss is mixed and in general, there is very little research conducted on humans. There has been some evidence that vinegar may help to increase the feeling of fullness when consumed with a high-carb meal, which could help with weight loss by preventing overeating later in the day.

A 12-week study conducted on 155 Japanese individuals also found a reduction in body weight, BMI and visceral fat in obese individuals who drank between 15-30 mls per day.

Final verdict: More research is needed before we can confidently make the claim that apple cider vinegar helps with weight loss. If you are having battles with your weight and looking for the answer to feeling better about yourself and your body you can find more about how I support with this here.

2) Will it help lower your cholesterol?

There appears to be no research that has been conducted in humans to demonstrate whether it can support lowering cholesterol. One study has been conducted on rats which demonstrated

To date, only research in animal studies has demonstrated that apple cider vinegar, and its antioxidant chlorogenic acid, can help manage cholesterol and triglyceride levels, which is not robust enough for us to say that this would also be the case in humans.

Final verdict: No studies have been conducted in humans so we don’t know.

3) Will it help your blood sugar levels?

There have been a number of small studies that have demonstrated how vinegar could help improve insulin sensitivity in both healthy subjects, and those with insulin resistance.

Insulin is a hormone which helps control our blood sugar, therefore, if we are more sensitive to it, then that’s a good thing. One study included a small number of participants (29), identified that drinking 20ml of apple cider vinegar with a high carbohydrate meal (white bagel with orange juice), reduced the spike in blood sugar after the meal versus the group who did not consume the vinegar with the meal.

Before we can say that apple cider vinegar helps with blood sugar control, further and larger studies in different groups of people are required.

One small pilot study (12 participants) published by the American Diabetes Association identified better blood sugar control in those taking two tablespoons of apple cider vinegar before bed. They didn’t look into the damaging effects this could have on your teeth though.

Finally, Michael Mosley and Aston University carried out a small study and showed that drinking dilute apple cider vinegar appeared to bring blood sugar levels down.

Final verdict: There is some evidence of benefit, but these studies are small, and large amounts of vinegar would need to be consumed on a daily basis to show benefit, which may have a detrimental effect on other things… like your teeth!

There is no evidence that apple cider vinegar can reverse diabetes, and there is a whole body of research to support of other healthy things you can do to improve blood sugar control aside from sipping vinegar!

4) What about heartburn?

Some people report that apple cider vinegar helps with their heartburn, which, if they have low stomach acid, may be of benefit. However, if you are someone who suffers from high acidity in your stomach, this may make your symptoms worse.

Foods that affect heartburn is often a matter of trial an error and is very individual. One small study with 7 participants in America did find that cloudy apple cider vinegar helped with preventing heartburn in those who did not respond well to antacids, but more research is required in this area.

The verdict: It could make it worse, could make it better… we don’t know.

5) Will it help with arthritis and inflammation?

There appear to be just anecdotal reports of people claiming to feel better and having less pain from arthritis when drinking apple cider vinegar. Unfortunately, there are not currently any scientific reports supporting this claim.

One very small study (30 participants) did measure C-reactive protein (a marker of inflammation) before and after apple cider vinegar consumption and did not find remarkable results.

The verdict: I have a hard time giving recommendations based on purely anecdotal evidence. If you think it works for you, I think that’s just great.

Are there any risks?

Yes…

If you suffer from gastroparesis, (slow emptying of the stomach), this may make your symptoms worse.
If you are diabetic, especially on medications that lower your blood sugar, there is a risk of potential low blood sugars. Speak with your healthcare professional for more information on this.
Apple cider vinegar can affect potassium levels in the body, and also interact with drugs such as diuretics, or other water pills. Check with your pharmacist or doctor for more information.
As apple cider vinegar is an acid, it can damage the enamel in your teeth. Avoid taking it neat, or sipping it throughout the day.
We don’t know much about the long-term effects of taking apple cider vinegar.

In summary…

Although some studies do suggest promising effects, there are generally few, they are small and often conducted in rats. If we could prove all of the amazing benefits that unqualified individuals splash around the internet, doctors would be handing this out to nearly every patient who walked through their door!

If you do wish to include apple cider vinegar in your diet, I would recommend either including it in salad dressings with olive oil, marinades, sauces or baked goods and not drinking it by the glass!