What motivated you to start making lifestyle changes?
In part my partner who’s always eaten a healthier diet than me. I had young children when I started down this path and was particularly motivated to stay as healthy as I could, to be around for them and to be able to fully participate in physical activities. I’d also experienced some recent and significant bereavements that left me wondering how much our lifestyle may or may not affect certain diseases.
What did you find out?
That many of the chronic illnesses we have come to accept as inevitable in the West are much less common and sometimes virtually unheard of in other parts of the world. Additionally, I learned that this isn’t because of different genetic traits but would seem to be linked to lifestyle.
How do you know they are not linked to genetic differences within populations?
Because evidence shows that when individuals move abroad and adopt new diets they soon become susceptible to the same diseases that plague their adopted society. The same happens to populations whose traditional diet is changed by western influences.
But genetics do play some part for some individuals don't they?
Yes, scientists have learned a huge amount in recent years about how certain genes predispose us to higher risk of some diseases. The study of epigenetics tells us that we have the power to affect how are genes are expressed. I'm not saying we can control everything with our health, but many studies have shown that we can substantially reduce our risk of disease whatever we’ve inherited in the genetic lottery. Our personal behaviours can outweigh our genes or family history when it comes to predicting our future health and I hope that's an empowering message.
What did your lifestyle look like before you started making changes?
I ticked all the boxes: binge drinking (10 pints or more) at weekends; enjoying curry takeaways (still do from time to time); McDonald's, KFCs and pre-packaged meals; chocolate and ice cream binges etc. In short, a high fat, high sugar diet very rich in processed food. I did exercise occasionally but pretty sporadically. There was no consistency to my sleep routine.
So what changed for you when you made changes to your lifestyle?
I lost about 3 stone in weight which I've kept off for over a decade now. My blood pressure dropped from prehypertension to now reading around 110/70. Last time I was tested I was registering a low overall cholesterol reading. My energy increased and my mental health improved. I feel really privileged to have had this opportunity to turn my health around. I also feel constantly surprised at what I've achieved, as looking back I don't think I was a likely candidate to overhaul my lifestyle. I believe, with patience, kindness and sufficient support anyone can achieve health gains. Changes don't have to feel overwhelming, small changes can make a difference and overtime can often ripple out to larger change.
Cholesterol levels are often mentioned in the news and media, why are they so important for our health?
Cholesterol is the primary risk factor relating to cardiovascular diseases. Raised levels cause fatty substances to stick to the insides of artery walls creating plaques and narrowing these vital passageways. These plaques can rupture creating an internal clot that can block blood flow. Depending on where the blockage is, this can result in either a heart attack or a stroke. This is also a key reason why managing our blood pressure is so important. If we imagine cleaning dried food off a pan with the jet of water, we know the higher the pressure the easier it will be to dislodge the food. In our arteries we don't want high pressure dislodging plaques and causing life-changing or fatal events. The great news is that lifestyle changes can lower blood pressure and arrest the build-up of plaques. With the right conditions, our amazing bodies can even start reducing and healing existing plaques.
So, do you think everybody should know what their cholesterol and blood pressure is?
Absolutely; knowledge is power! I also advise clients to ask their GP to print out their cholesterol results for them. GPs are very short of time and often only give patients the headline result of ‘normal’ or ‘high’. It can be empowering and motivating to understand your full results. I always take the time to explore cholesterol results with clients and there are good resources available online to explain more about what the figures mean.
Are you happy to share your own results?
Definitely, I want to be completely open and transparent with clients. I was last tested four years ago by my GP and my total serum cholesterol was 4.1. I'm 55 this year and I intend to get tested again when GP practices start resuming routine testing. I'll be happy to release those results whether my levels have increased or decreased.
Is a cholesterol reading of 4.1 good?
My GP was impressed. It's also important to look at the ratio between 'good' and 'bad' cholesterol within the total result which is why it's important not to look just at the headline figure. My ratio was around fifty/fifty (good cholesterol/bad cholesterol) which is ideal as the 'good' cholesterol helps remove any excess 'bad' cholesterol. While I'm happy with my results, I'd still be hoping to improve on them in the future.
Did you find it hard work changing the habits of a lifetime?
Some changes were easier than others and most happened gradually over a period of time. If my changes were plotted on a graph there would be a number of peaks and troughs. The troughs would be me regressing back to old habits but overall the trajectory would be in the right direction. Now the troughs are more dips and I come out of them quicker. In a world where we’re surrounded by temptation, often experience peer pressure and the consumption of highly processed foods has become normalised it's essential we’re kind to ourselves even when we may be feeling disappointed in something we have or haven’t done. That's why it's important for everyone to have goals that are achievable and realistic for them. Everyone's environment, resources and genetics are different so it can never be a case of one solution fits all.
Do you think it's important for everyone to make changes gradually?
There’s evidence that some people find it easier to make big changes all at once and for others it needs to be gradual. That's why it's essential to work at your own pace and to experiment and find out what’s right for you. Also, some changes you may be able to implement straight away while others need a more measured approach. There are many factors affecting how quickly or to what extent we feel change is possible. For example our psyche, home situation, influence of peers and available support all have an impact. Whatever approach we take we need to be gentle with ourselves and set objectives that feel manageable: this is a key to progress.
What was the most surprising aspect of changing your diet?
The fact that my taste buds changed so quickly as I adapted to less processed food. Evidence supports this: eating highly processed foods actually blunts our ability to taste a subtle sweetness in other foods such as fruit.
Do you think losing weight is the most important pathway to improved health?
Yes and no. The evidence is clear that even a relatively small weight loss can have significant health benefits. This appears to be linked to the fact that the body prioritises shedding visceral fat around our organs first. That said, traditional weight loss diets tend to focus solely on calorie reduction and can only be sustained for limited periods. The evidence demonstrates that, for the majority of people, this weight loss is short-lived. Also traditional weight loss diets don’t necessarily encourage significant improvement in the quality of the food we consume, merely the quantity. That is why I’d always prioritise sustainable lifestyle changes over short fix diets, both for overall health and for anyone wanting to manage their weight. Once you shift the focus to health then the weight will take care of itself.
Don't we not need to reduce calories to lose weight?
Yes, but there are many tricks and tweaks that can make this sustainable and sidestep the pitfalls of yo-yo dieting. For example, by finding ways to add more fruit, vegetables and whole grains to our meals we provide bulk with relatively few added calories. If we feel full and satisfied we have much more chance of maintaining a healthful diet that overtime will lead to effective weight management. I really enjoy working individually with clients to see what will work best for them. Food needs to be appetising and healthy food can still be delicious!
So what else do you mean by lifestyle changes?
When health professionals talk about lifestyle changes they tend to broadly fall under 4 categories: what we eat; quality of sleep; managing stress; and taking sufficient exercise. I also focus on the transformative potential of how we breathe, drawing on evidence highlighted by James Nestor in his book, ‘Breath’.
Other than nutrition, what sort of changes might you advise?
Sleep is a bedrock of health and the science of sleep is fascinating. There are lots of evidence-based ways to improve quality of sleep and ensure we get enough of it. If you’re someone who’s tried the common suggestions, for example, installing a blackout blind, limiting late-night use of electronic devices etc, and are still having trouble sleeping we may need to look at more tailored support. Some people love exercise and want to improve fitness. Others struggle to fit exercise into a busy schedule. Those who hate ‘exercise’ might prefer to look at overall physical activity and ways of moving more in daily life. All movement counts - even the effort of standing rather than sitting – and simple changes can make significant differences. As more of us work from home it may be committing to a lunchtime walk two or three times a week. Walking has added benefits of giving us a break, reducing stress and improving sleep quality. Starting small might be a few basic exercises you can do at home without any equipment or special sports clothes. Many lifestyle changes, if not all, are interwoven and benefit multiple aspects of our health and well-being at the same time.
So what changes do you think people should make to their diets?
All the evidence suggests that eating more fruit, vegetables and whole grains brings huge benefits, not only for the prevention and reversal of diseases but also for sustainable weight management. This means becoming more plant-centred, but there’s no reason why meat and dairy can’t still be included. The key factor is moving towards a diet that’s more 'centred' on plants compared to many people’s present-day norm. An extra one or two pieces of fruit or veg a day is moving in the right direction. Changes will look different for different people depending on where their starting point is, how fast they want to go and the changes they’re hoping to achieve. It’s important to distinguish between minimally/un-processed whole plant foods like baked beans, fresh fruit/veg/salads, hummus and highly processed plant based hot dogs, burgers, pizzas etc or more common foods like crisps, white bread and French fries. All these foods may come from plants but the last two categories can be high in sugar, salt and fat and low in fibre, vitamins, minerals and phytonutrients – essentially all the things we’re hoping to add to our diets.
What is the benefit of eating more whole plant foods?
By eating more plants we consume more fibre, more vitamins, more minerals and more phytonutrients. This all means our bodies are better able to function and in turn this can help to reduce cholesterol, blood pressure and prevent or improve other chronic diseases. Laboratory studies show that blood from individuals who eat more plants is comparably more efficient at killing cancer cells. Evidence, based on thousands of studies, is why the NHS encourages us to eat more plants and whole grains.
Does the NHS suggest we eat a plant centred diet?
Yes, the NHS Eatwell guide advises us to fill the larger portion of our plates with are either whole grains or whole plant foods. The advice is to moderate consumption of animal products.
Why do you think people struggle to follow the Eatwell guidance?
I think one of the problems is the pictorial guide shows ingredients rather than meals. It doesn't look like a plate full of food we would want to eat. With support, tailored input and handy cooking tips, we can learn to take the ingredients, combine them with herbs and spices and turn them into quick, delicious and nutritious meals. Exploring and experimenting can be fun and the reward is eating meals that taste great and are good for us. We can start by focusing on just one day or one meal a week and if that sounds too much right now we can start even smaller by choosing the best of pre-prepared foods and adding healthy extras to improve quality.
Eating a vegan diet is becoming more popular – is this a healthy diet?
The British Dietetic Association state that a well-planned vegan diets can support healthy living in people of all ages. The key here is the inclusion of the words ‘well-planned’ as thought needs to go into planning a balanced diet that excludes animal products. However, it’s worth bearing in mind that individuals who eat animal products also commonly suffer dietary deficiency too so we all need to give careful thought to what we eat. I can help vegans, vegetarians and everyone else to thrive on a diet that fits their lifestyle and meets all their needs.
What would you say to people who feel overwhelmed by the prospect of changing habits?
I’d suggest start small. We can all do things to help improve our nutrition, physical activity, stress levels or sleep. Some changes take only a few minutes a day e.g. sprinkling a tablespoon of flaxseed on breakfast or doing a few squats in the kitchen while the kettle boils. Really small changes like this help change our attitude and approach to create a ripple effect where it’s easy to add in other small changes or expand on existing ones. Over time this creates big improvements in our health. That's what I think when I look back myself: it all started with small changes and when I'd made those changes it made it easier for me to make some more.
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