Eating Disorders

This week is National Eating Disorders Awareness Week. Eating Disorders are serious mental illnesses which can affect a person physically, psychologically and socially. They can also affect the people around them such as family and friends. There are various types including the more commonly known Anorexia and Bulimia as well as lesser known conditions such as Binge Eating Disorder and Orthorexia. In this blog, I will be talking about the different types of eating disorders.

eating-disorders2

 

Types of Eating Disorders

Anorexia Nervosa is one of the most common types of eating disorders. Anorexia is characterized by a sufferer attempting to keep their body weight low through refusal of food/dieting, vomiting, laxative abuse or excessive exercise. Anorexia can have behavioural and physical signs including:

Behavioural:

  • Fear of putting on weight or “getting fat”
  • Constant thoughts about body weight
  • Body dysmorphia; a distorted body image (i.e. being extremely underweight but believing you are overweight)
  • May lie about why they can’t eat or that they have already eaten earlier
  • Constant thoughts about food
  • Rigid eating behaviours; hiding food, excessive calorie counting, only eating low-calorie food, avoiding food they believe is fattening, cutting food into smaller pieces, squashing food down, using a teaspoon to eat, skipping meals, avoid eating with other people
  • Taking diet pills or appetite suppressants
  • Excessive exercise
  • Purging; vomiting or laxative misuse
  • Social withdrawal and isolation
  • Feeling irritable or moody
  • Being a perfectionist
  • Can be associated with other mental health problems such as depression or Obsessive Compulsive Disorder (OCD)

Physical:

  • Severe weight loss (which may often be hidden under baggy clothes)
  • In girls and women, periods become irregular or stop altogether (amenorrhoea)
  • Lack of sexual interest
  • Difficulty sleeping and tiredness
  • Dizziness
  • Stomach pains, constipation and bloating
  • Feeling cold
  • Growth of downy hair (soft and fine) all over the body (Lanugo)
  • Hair falling out
  • Difficulty concentrating
  • Feeling week and loss of muscle strength
  • Reduced bone strength (can eventually lead to osteoporosis)
  • Effects on the endocrine system (the collection of glands that produce hormones)
  • Low blood pressure

Bulimia Nervosa is another common eating disorder. Bulimia is characterized by a sufferer getting caught in a vicious cycle of eating large quantities of food “binging” then partaking in purging behaviours such as vomiting or taking laxatives to prevent weight gain. This can cause the sufferer to feel like they have “lost control” and can dominate their everyday lives. Unlike Anorexia, a Bulimia sufferer can appear to be a healthier weight so it can be more difficult to spot. Behavioural and physical signs on Bulimia include:

Behavioural:

  • Binging
  • Purging after binging; vomiting, over exercising, using laxatives or diuretics, fasting
  • Constant thoughts of food
  • Usually secretive about bulimic episodes
  • Mood swings
  • Feeling anxious and tense
  • Body dysmorphia
  • Feeling of loss of control over eating
  • Feelings of guilt and shame after bulimic episode
  • Can be associated with other mental health issues such as depression and self-harm
  • Disappearing soon after eating

Physical:

  • Fatigue/lethargy
  • Feeling bloated
  • Stomach pain and constipation
  • Swelling of the hands and feet
  • Amenorrhoea
  • Enlarged salivary glands
  • Calluses on the backs of the hand from forcing down throat to vomit
  • Damage to teeth enamel through vomiting
  • Electrolyte abnormalities/ imbalance
  • Gastric problems
  • Regular changes in weight

Binge-Eating Disorder (BED) is characterized by a sufferer losing control and binging on large quantities of food over a short period of time, even when they aren’t hungry. It is not about eating extra-large portions and binges are usually planned and the sufferer make have special “binge foods”. Binges are usually done in private and the sufferer will often feel guilt and disgust at their lack of control. Unlike Bulimia, BED sufferers do not purge after a binge. BED is associated with a sufferer binging at least once a week over a period of three months or more. Signs of BED include:

  • Eating more rapidly than normal during an episode
  • Eating until uncomfortably full during an episode
  • Eating large amount of food when not hungry during an episode
  • Eating alone through embarrassment
  • Feelings of guilt, shame and disgust
  • Feeling distressed
  • Low self-esteem and lack of confidence
  • May suffer from other mental health conditions such as depression and anxiety
  • Many sufferers are overweight or obese (this can lead to health issues such as type 2 diabetes and heart disease)

Other types of eating disorders include:

  • Orthorexia – A term used for obsessive behaviour in pursuit of a healthy diet. Sufferers will obsessively avoid food which they deem unhealthy such as food with artificial colours, high fat, high sugar or pesticides. Sufferers may experience obsessive concerns over the relationship between food choices and health concerns, limiting themselves to a small amount of acceptable food choices, feelings of guilt if they deviate from their “healthy diet”, constant thoughts about food, social isolation to avoid situations where they deviate from their diet such as eating out at a restaurant and other mental health conditions such as anxiety.
  • Anorexia Athletica – This disorder is characterized by excessive, obsessive exercise. It is more commonly seen in athletes who participate in sports where having a small, lean body is advantageous. Signs include; obsessive exercise, obsession with food, calories and fat, obsession with weight, self-worth being determined by physical performance and guilt over missing a workout.
  • Drunkorexia – This disorder is characterized by a sufferer skipping meals and starving their bodies of food in order to make up for the calories in alcohol.
  • Pregorexia – A condition where sufferers attempt to control weight gain during pregnancy through obsessive dieting or exercise.
  • Diabulimia – This disorder is characterized by a type 1 diabetes sufferer reducing their insulin intake in order to lose weight. Signs include; high blood glucose levels, persistent thirst, frequent urination, unexplained weight loss, increased appetite (especially in sugary food) and secrecy about blood sugars, insulin injections and eating. Sufferers can risk losing their eyesight, diabetic ketoacidosis, diabetic coma and even death.
  • Some disorders combine behaviours from more than one disorder or do not exactly fit the criteria of the “typical” eating disorders. These fall under the umbrella term “Eating Disorder Not Otherwise Specified” (EDNOS)

Getting help

Eating disorders do not discriminate. While it more commonly effects teenage girls, they can also effect boys, men, children, elderly, etc. If you suspect that you have an eating disorder, the first step to recovery is to tell someone. This can be a parent, friend, doctor, teacher or even a support service/charity website such as B-EAT. Treatment differs depending on the diagnosis but can include inpatient care, Cognitive Behavioural Therapy (CBT), diet and nutrition advise or medication.

The important thing to remember is that recovery is possible so if you are worried about your eating behaviours, do not feel ashamed and hide away; talk to someone and take that first step towards recovery.

The Facts on Fats

With the rise of low fat products, you’d be forgiven for thinking that fat is the enemy. With constant reports toing and froing between fat being good for us and fat being bad for us, it’s understandable for us to not know what to do for the better. So, here’s the skinny on fat (pardon the pun).

skinny-on-good-fats

Examples of “good” fats

What is dietary fat?

Fat is a source of energy. Fat provides us with 9kcal/g (compared with carbohydrates and protein which provide 4kcal/g). 99% of dietary fats are in the form of a triglyceride. A triglyceride is a chain of 3 fatty acids – which are made of carbon, hydrogen and oxygen – which is attached to one glycerol molecule. When we digest these fats, the body has to break down the bonds between the fatty acids and molecule in order for them to be absorbed in the intestine. Guidelines advise us to get no more than 30% of our daily calories from fat.

Types of fat

There are two main types of fat; saturated fat and unsaturated fat. Unsaturated fat can be broken down into other sub-types of fat known as monounsaturated fat and polyunsaturated fat.

Saturated fat is found mostly in animal products and some plants. Animal products include beef, beef fat, veal, pork, lard, poultry fat, butter, cream, milk, cheeses and other dairy products made from whole milk. Plant products include coconut oil, palm oil and palm kernel oil (also known as tropical oils), and cocoa butter. Saturated fat increases the LDL (bad) cholesterol and the amount of total cholesterol in the blood. This increases the risk of heart disease and diabetes. It is recommended to keep this type of fat to a minimum with the recommended daily allowance being no more than 10% of our daily calories.

Monounsaturated fat can be found in canola, olive oils, peanut oils and avocados. This type of fat lowers total cholesterol and LDL cholesterol and increases HDL (good) cholesterol. This lowers the incidence of heart disease. Research indicates that it may also lower blood pressure and reduce the inflammatory response. It is recommended to get no more than 12% of our daily calories from monounsaturated fat.

Polyunsaturated fat can be found in safflower, sesame and sunflower seeds, corn and soybeans, fish, fish oil, many nuts and seeds, and their oils. It is recommended that we get 7% of our daily calories from this type of fat.

Polyunsaturates contain a group of fats known as Essential Fatty Acids (EFA). These fatty acids are Omega 3 (Alpha Linolenic Acid or ALA) and Omega 6 (Linoleic Acid or LA). They are essential because our bodies cannot manufacture them so we need to get them from our diet. They are needed in our bodies to enable vital bodily functions.

Omega 3 sources:

  • Flaxseeds and oil
  • Hempseeds and oil
  • Walnuts
  • Pumpkin seeds
  • Brazil nuts
  • Sesame seeds
  • Avocados
  • Some dark leafy green vegetables (kale, spinach, mustard greens, collards)
  • Canola oil (cold-pressed and unrefined)
  • Soybean oil
  • Wheat germ oil
  • Salmon
  • Mackerel
  • Sardines
  • Anchovies
  • Fresh tuna

Omega 6 sources:

  • Flaxseeds and oil
  • Hempseeds and oil
  • Grapeseed oil
  • Pumpkin seeds
  • Pine nuts
  • Pistachio nuts
  • Sunflower seeds (raw)
  • Olive oil
  • Olives
  • Borage oil
  • Evening primrose oil
  • Black currant seed oil
  • Chestnut oil
  • Chicken

Essential fatty acids have the following effects on health:

  • Prevents blood clots (anti-coagulant) and decreases the stickiness of blood
  • Acts as an anti-inflammatory
  • Lowers blood triglycerides
  • Helps control blood pressure
  • Lowers LDL and raises HDL
  • Enhances transport of oxygen by red blood cells
  • Enhances immune responsiveness
  • Maintains the quality of cell membranes
  • Essential for overall health and brain development

The brain is more than 60% structural fat and those used are high in Omega 3 fats. This shows why getting a good source of EFAs are required for cognitive function and mental health.

Signs of Fatty Acid imbalance are:

  • Dry skin
  • Dandruff
  • Frequent urination
  • Irritability
  • Attention deficit
  • Soft nails
  • Alligator skin
  • Allergies
  • Lowered immunity
  • Weakness
  • Fatigue
  • Dry, unmanageable hair
  • Excessive thirst
  • Brittle easily frayed nails
  • Hyperactivity
  • “Chicken skin” on back of arms
  • Dry eyes
  • Learning problems
  • Poor wound healing
  • Frequent infections
  • Patches of pale skin on cheeks
  • Cracked skin on heels or fingertips

Trans fat is most commonly formed when an unsaturated oil (mono or poly) is blasted with hydrogen atoms at high temperature and pressure (also known as hydrogenated). This causes the fatty acid chains to change structure which causes the molecule to act more like a saturated fat. The majority of trans fats can be found in hard margarine, cookies, crackers, snack foods, fried foods (including fried fast food), doughnuts, pastries, baked goods and other processed foods made with or fried in partially hydrogenated oils.

Trans fats have the following health effects:

  • Raise LDL cholesterol and lower HDL cholesterol
  • Promotes the formation of arterial plaque which leads to circulation problems, high blood pressure, heart disease and stroke
  • Decreases the response of human cells to insulin which can lead to type 2 diabetes and obesity

Trans fats should be used sparingly or avoided altogether. Trans fatty acids are not always listed on food ingredient labels. They may be listed as hydrogenated or partially hydrogenated oils so look out for these ingredients. They should make up <1% of your daily calories.

junk-food

Examples of “bad” fats

The bottom line

Rather than cutting fat out altogether, it is better to replace saturated fat with unsaturated fat. This can be done through reducing the intake of fast food, takeaways and sweet treats, using methods of cooking which use little or no fat such as boiling and grilling, swapping to reduced fat dairy products reducing processed and fatty meat and eating more fish, avocados, nuts, seeds and plant-based oils and spreads such as flaxseed oil. As previously stated, being deficient in fat can cause problems such as cognitive problems and lowered immunity so it is important to make sure that it is included but in moderation and in the right form.

The Power of Protein

In this blog, I am going to be telling you all about protein; what it is, where you get it and why it’s important to include it in your diet (even if you’re not aiming to look like Arnold Schwarzenegger).

close up of different food items on table

What is Protein?

Protein is a nutrient which is used for growth and repair. Protein makes up our muscles, organs, skin and hair. Like carbohydrates, protein contains 4kcal/g.

When we eat protein, it is broken down in the gut into amino acids. There are 20 amino acids which are split into two groups; non-essential and essential.

Twelve of the 20 amino acids are considered non-essential because they can be manufactured in the body. These include:

  • Alanine
  • Arginine
  • Asparagine
  • Aspartic Acid
  • Cysteine
  • Glutamic Acid
  • Glutamine
  • Glycine
  • Proline
  • Serine
  • Tryosine
  • Histidine

The remaining 8 of the 20 amino acids are considered essential. This is because they cannot be made in the body and therefore need to be obtained from our food. These include:

  • Isoleucine
  • Leucine
  • Lysine
  • Methionine
  • Phenylalanine
  • Threonine
  • Tryptophan
  • Valine

Once they are absorbed, these amino acids are found in the bloodstream where they are taken up by the body cells. They are then re-assembled into new proteins which may be used for:

  • Building, maintaining and repairing body cells and organs
  • Making hormones and enzymes which will regulate body functions
  • Making antibodies and important components of the immune system

Good Sources of Protein

In the UK diet, the main sources of protein are animal sources. These include:

  • Meat – poultry and red meat
  • Fish
  • Eggs
  • Dairy products – milk, cheese and yoghurt

Don’t worry if you’re a vegetarian or vegan as protein can be found in many plant sources including:

  • Pulses
  • Beans
  • Nuts
  • Seeds
  • Cereal products
  • Meat substitutes such as Quorn

As long as you get a regular intake of a variety of different foods and ensure you substitute animal products which these plant-based sources of protein, there is no reason why you can’t maintain a healthy diet. The danger of not making these substitutes is that you could be at risk of suffering nutrient deficiencies such as iron, B vitamins and calcium.

The Bottom Line

You don’t need to fear becoming a bodybuilder overnight from protein consumption. You would need to eat large amounts and do heavy strength training to gain large amounts of muscle, especially if you’re a woman. It is important to ensure you’re getting a regular supply of protein to make sure you’re getting a regular supply of amino acids in the cells. The amount needed depends on age, gender, activity level, etc. Protein deficiency is not very common in the UK, especially with certain diets asking for a high protein intake as a replacement for other food groups. The risks of consuming insufficient protein include:

  • Growth failure
  • Loss of muscle mass
  • Decreased immunity
  • Weakening of the heart and respiratory system

However, consuming too much protein can be dangerous with some health risks including:

  • Can be a burden on the kidneys and liver
  • As high protein often means low carbohydrate – and carbohydrate is the only fuel that the brain can use – the brain can be deprived of energy
  • Very low carbohydrate diets can lead to ketoacidosis (a metabolic state which is associated with high concentrations of ketone bodies. These are formed by the breakdown of fatty acids and the deamination of amino acids. It is more commonly associated with type 1 diabetes and alcoholism. In extreme cases, it can be fatal)
  • High protein foods such as meat and dairy usually have high levels of saturated fats which can lead to conditions such as Coronary Heart Disease
  • High protein diets are low in fibre which can lead to constipation and colon diseases

High protein foods can help stave off hunger pangs because they have been known to act as a mild appetite suppressant and can decrease hunger. This will help if weight loss is your goal as you will be less likely to feel the need to snack out of hunger between meals.

At the end of the day, ensuring that you get regular intakes of protein in each of your meals from a variety of sources along with adequate sources of carbohydrates and fats will provide you with all that you need for a healthy and balanced diet.

The Lowdown on Carbohydrates

Carbohydrates are often demonised in the health and fitness industry as a cause of weight gain and obesity. Because of this, it can be confusing to know which carbs are best to have (and whether you should have them at all). Here is some info about the different types of carbs and what happens when we eat them (warning; here comes the science bit).

carbohydrates

What are Carbohydrates?

Carbohydrates are energy foods. They provide 4 kcal/g. They are needed to support our growth and fuel our activity. Carbohydrates are broken down into glucose which circulates in the blood. Excess carbohydrates are stored in the liver or muscles as glycogen. The glycogen in the liver is gradually released to maintain glucose levels in the blood. The glycogen stored in muscles provides fuel for them to do work. However, carbohydrates which are consumed in excess of needs are converted to fat.

There are two types of carbohydrates; simple (sugars) and complex (starches).

Simple Sugars

Simple carbohydrates consist of one or two molecules with a maximum of one bond which needs to be broken down in order to become their simplest form. Once this process has taken place they are then ready to be absorbed across the gut wall. There are two types of simple carbohydrates; intrinsic sugars and extrinsic sugars.

Intrinsic sugar means that the sugar is locked inside cells. Fruit contains simple sugars found in their natural state within their cells known as fructose and milk contains the natural sugar lactose. These simple sugars are accompanied by good quantities of fibre and other vital nutrients such as vitamins, minerals and phyto-chemicals.

Extrinsic sugars are added sugars which can also be referred to as refined sugars. These sugars are not contained in cells but have been added to foods at some stage. Examples of these are table sugar, soft drinks, sweets, cakes and biscuits. These contain “empty” calories which means that they provide small burst of energy in the form of sugar but very little or no vitamins, minerals or essential fatty acids. They also lack fibre which means they break down much more swiftly which can destabilise blood sugar. These types of sugars should be kept to a minimum in our daily diets.

Complex Carbohydrates

Complex carbohydrates consist of larger chains of a thousand or more molecules. Because of this, they take longer to break down into their simplest form to be ready for absorption through the gut walls. These carbohydrates contain food components such as vitamins, minerals, protein, fibre and water. Examples of these are bread, pasta, rice, some breakfast cereals, porridge oats and starchy vegetables such as potatoes and sweet potatoes.

What is GI and GL?

Glycaemic Index (GI) is a tool used to inform us of a carbohydrate’s potential to raise blood sugar levels due to the speed it breaks down and glucose is released into the bloodstream. Food which is rated as low GI will produce a more steady and prolonged rise in blood sugar levels while high GI foods will produce a more rapid and high spike in blood sugars. Some examples of low GI carbohydrates are porridge oats, peas and long grain brown rice while some examples of high GI carbohydrates are white bread, chips and jelly babies.

Glycaemic Load (GL) tells us the relative amount of carbohydrate in food. For example, watermelon has a high GI but low GL as it only contains a small amount of carbohydrate per serving. This measure was developed by researchers as they believe that looking at glycaemic index alone may not tell us everything we need to know about a food item’s impact on blood sugar levels. This method takes into account both the amount of carbohydrate in the food and the impact it has on blood sugar levels.

The Bottom Line

To achieve a healthy, balanced diet, it is vital not to cut out whole food groups. We need carbs in our diet in order to function day to day to the best of our ability. They won’t make you fat or kill you. The amount of carbohydrate you should get in your daily diet is individualised and depends on a number of factors. For example, an athlete in training will need more carbs than a sedentary person. Complex carbohydrates breakdown slower so will keep your blood sugar levels stable, will keep you fuller for longer and provide a steady release of energy. This will help if weight loss is your goal as you’ll be less likely to reach for the biscuit tin. They also provide a good amount of fibre which will keep your bowels in working order. Intrinsic sugars in the form of fruit and dairy products (as long as you aren’t lactose or dairy intolerant or have an allergy) will provide vital vitamins and minerals such as calcium and B vitamins. It is ideal to get a mixture of these two carbohydrate sources in your daily diet. Extrinsic sugars – in the form of refined carbs such as white bread and sweet treats – provide little to no nutritional value so should be kept to an occasional treat.

For people who have coeliac disease or a gluten/wheat intolerance or allergy, the tendency is to avoid carbs but there are many substitutes out there in freefrom sections of big chain supermarkets and health food shops and you can still have rice, grains like quinoa and starchy vegetables.

So fear carbs no more and enjoy your scrambled eggs on (wholegrain) toast on me x