Author: Stephanie Achar

3. Do we go back to “normal” with HRT?

Yes, absolutely. However, it depends on the dosage. I always start with a low dose, regardless of the formulation, and then gradually increase it. The goal is for the woman to come back and tell me: “I have the energy I used to, I can sleep well again, my brain and concentration are better, I feel great, and I’ve started exercising because I now have the energy for it.”

When I hear this, I know we’ve found the right dosage. Yes, a woman can feel exactly as she did in her 30s, without any issue.

There’s no reason why women shouldn’t feel like themselves again, as long as there are no contraindications. However, with dosages high enough to achieve this, some form of bleeding is likely—either a proper period or light spotting. I mention this because when we provide a dose that brings these benefits, I recommend introducing a short “window” at the end of each month. I advise patients to stop the treatment for 4 to 5 days during this time to allow the uterus to shed, which will result in either light bleeding or a regular period.

4. What is the difference between synthetic hormones and bioidentical hormones? 

I only prescribe bioidentical hormones because I believe they are better suited for long-term use. In my view, women should not stop bioidentical HRT (bHRT) once they reach a certain age, such as 60 or 70. If they stop, they immediately face an increased risk of cardiovascular disease, osteoporosis, Alzheimer’s, and dementia. These risks naturally rise as we age, so why stop taking bHRT, which protects against these conditions, at a time when the risks are already higher?

There is a well-known group of endocrinologists in the US, with prominent schools of thought, though unfortunately, not many gynaecologists are involved. They have continued prescribing bioidentical HRT to women well into their 90s, perhaps at a lower dose, and the women report loving the effects. Personally, I have several women in their early 80s still on HRT, though I prescribe them lower doses than for women in their 50s, often opting for creams.

In the UK, and in most other countries, only two doses of progesterone are available—100mg and 200mg. For this reason, I rely on compounded pharmacies, which unfortunately are not accessible through the NHS. However, any private doctor—whether a GP, gynaecologist, or endocrinologist—can prescribe through these pharmacies and offer lower doses. Even at these lower doses, women notice a marked improvement and feel much better.

“I have the energy I used to, I can sleep well again, my brain and concentration are better, I feel great, and I’ve started exercising because I now have the energy for it.”

There’s also a formulation I don’t typically use but feel is worth mentioning: the vaginal route. Many gynaecologists prescribe vaginal oestradiol, particularly for women experiencing vaginal dryness or recurrent bladder/urinary infections. Oestriol is also excellent for supporting vaginal health. Some gynaecologists even prescribe vaginal progesterone, though I do not, as oral progesterone is more beneficial for the brain, heart, and bones.

When using vaginal oestradiol or oestriol, the initial dose is usually daily for one or two weeks, then reduced to once or twice a week. This is often recommended for women using creams or patches, as these forms of oestradiol may not provide enough coverage for the entire body. In such cases, local bioidentical hormones can offer additional support. However, this is not my preferred method unless the woman requires temporary relief for specific symptoms.

5. How long should you take it for?

As I’ve mentioned, as women age, their risk of cardiovascular disease, osteoporosis, dementia, Alzheimer’s, Lewy body disease, and other degenerative brain diseases increases. So why stop a treatment that helps prevent these conditions? I don’t understand the medical or scientific reasoning behind stopping HRT. As long as the woman is happy to continue and hasn’t developed any side effects, I see no reason to stop HRT.

The dosage can be reduced as the woman ages, particularly if she wishes to stop having periods. Regular follow-ups are crucial to monitor the effects and make adjustments as necessary.

It’s also essential to inform women that they should have a breast examination every year. They should undergo an ultrasound annually and a mammogram every three to four years. In some countries, women are offered an MRI of the breast, which is less aggressive than a mammogram. In London, there are clinics offering thermography, and the technology has greatly improved, providing clear images of the breast.

Additionally, women should be examined by a gynaecologist annually and have an ultrasound of the uterus to check its thickness. It shouldn’t be thicker than it was during their menstrual cycles. It’s important to have breasts and uterus checked every year, not necessarily with a mammogram, but through examination or ultrasound during gynaecological visits.

At the start of treatment, it’s important to assess how the woman’s body detoxifies hormones and provide dietary support and supplements to aid hormone detoxification.

Another key step at the start of treatment is a DEXA scan (bone density analysis). Numerous studies, even before 2001, have shown that bioidentical HRT helps prevent osteopenia and osteoporosis. It’s recommended to check bone density every five years.

 

If you missed Part 1 of this Q&A, make sure to check it out here for essential insights into hormone replacement therapy (HRT). In addition, you can explore more about Dr. Isabelle Martineau’s expertise in HRT by visiting her website at Medical Art Practice

 

READ PART 1 HERE

 

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1. Can you explain the potential benefits of HRT for women in perimenopause and menopause?

Menopause typically occurs around age 51, defined as having no periods for one year. If it happens between ages 40 and 45, it’s called early menopause; before 40, it’s premature menopause. The timing affects our approach to hormone choices.

For women experiencing premature or early menopause, supporting them with bioidentical hormones for several years is important. The benefits of bioidentical hormones are significant. They help alleviate symptoms like hot flushes, night sweats, insomnia, irritability, mood swings, and brain fog. These symptoms can be quite debilitating. It’s essential to understand that, at 50, many women are at the peak of their careers, with significant responsibilities, managing teams, and making important decisions. Suddenly, they can feel like they are not functioning properly, and we cannot let this happen.

So, when there are no contraindications, we begin to substitute the hormones that the body is no longer producing. When a woman has not had a period for a year, it means her ovaries are no longer producing oestrogens or progesterone.

During perimenopause, which precedes menopause, cycles become shorter and shorter due to a decline in ovulation quality. As the corpus luteum (the structure that secretes progesterone) becomes less effective, progesterone production decreases, resulting in shorter cycles. Eventually, oestrogen levels also start to decline. It is like a rollercoaster for oestrogen levels, fluctuating up and down, while the progesterone decline is steadier. Eventually, cycles become longer and longer until they stop altogether. While this is a general pattern, not every woman experiences it in the same way. Typically, by the age of 45, cycles may shorten from 28 days to 26, 24, or even 21 days, as progesterone secretion diminishes.

What are the implications of the loss of these hormones?

• Bone Health: Hormone replacement is crucial for bone protection. The process of bone turnover, which involves bone construction and destruction, is significantly affected by the loss of oestrogen and progesterone. Without these hormones, bone loss accelerates, leading to osteopenia and, eventually, osteoporosis. In advanced age, osteoporosis increases the likelihood of fractures. For example, in your 80s, a simple fall can easily result in a fracture due to fragile bones. This often leads to hospitalisation, and studies show that fractures in the elderly significantly increase the risk of death. It also reduces the chances of regaining independence if one becomes wheelchair-bound after a fall.
• Brain Protection: Oestradiol and progesterone receptors are abundant in the brain. We see this clearly in cases of postpartum depression, which can occur due to a sudden drop in oestradiol and progesterone after childbirth. Although the decline in hormones is slower at menopause, it can still lead to depression and anxiety, particularly due to progesterone loss. Progesterone metabolites in the brain increase the expression of GABA, an important neurotransmitter for relaxation and sleep. This is why women who don’t supplement may experience insomnia, which can range from mild to severe, often exacerbated by night sweats. Poor sleep can lead to concentration issues, memory problems, and brain fog, all of which can be challenging for women managing demanding work responsibilities. Studies have also shown that women on bioidentical hormone replacement therapy (BHRT) have a significantly lower risk of developing dementia and Alzheimer’s disease. While other factors, such as exercise, also play a role, oestradiol and progesterone have a profound impact on brain health.
• Cardiovascular Protection: Today, the leading cause of death in women is cardiovascular disease, which surpasses breast cancer. Before menopause, women have a much lower incidence of cardiovascular disease than men, due to the protective effects of oestradiol and progesterone. Once these hormones decline, a woman’s cardiovascular risk equals that of a man. By supplementing with oestradiol and progesterone, we can reduce cardiovascular disease risk by improving insulin resistance, lowering apolipoprotein levels, and positively impacting the lipid profile—thus reducing the risk of strokes and deep vein thrombosis (DVT).
• Quality of Life: Vaginal dryness, often alleviated by HRT, can affect sex life and relationships. Moreover, HRT reduces the risk of bladder infections, as natural oestradiol and progesterone protect the mucosa of the bladder and vagina. Postmenopausal women tend to have more urinary infections because their mucosa is not as well-protected as before. Skin and hair also benefit from continuing with bioidentical oestradiol and progesterone.
• Weight Gain: Many women gain weight around menopause, especially visceral fat, which can be a major concern. Even with changes to diet and lifestyle, some women struggle to lose weight. This difficulty is partly due to increased insulin resistance, which can be improved with oestradiol.

It is essential to address both the immediate symptoms of hormone decline and the long-term benefits for the bones, brain and heart.

At 50, many women are at the peak of their careers… Suddenly, they can feel like they are not functioning properly, and we cannot let this happen.

2. If I decide to try HRT, what should I take?

What hormones are available to doctors, and which ones do I prefer to prescribe? There is a range of different hormones and formulations. The types of hormones fall into two main categories:

• Those produced by the pharmaceutical industry.
• Those produced by compounded pharmacies.

The pharmaceutical industry can provide bioidentical hormones, available on the market through regular pharmacies, including the NHS. This is important to note. We also have progestins, which are synthetic forms of progesterone. Progestins are created by modifying the progesterone molecule slightly, which gives them different properties. Oestradiol, a key hormone for menopause, can be produced either in the pharmaceutical industry or by compounded pharmacies and is bioidentical. When you examine it under a microscope, it’s the same molecule that a woman naturally produces.

Formulations of Oestradiol:

In terms of formulations, there are several ways to absorb oestradiol:

• Creams or patches applied to the skin.
• Oral formulations, such as capsules or lozenges.
• Vaginal pessaries.

Progesterone is mostly available as a capsule, either from the pharmaceutical industry or compounded pharmacies.

Choosing Between Options for Oestradiol

How do we choose between the options, particularly for oestradiol? Should we opt for the skin-based (percutaneous) route like creams and patches, or go with a lozenge or capsule? Many studies since 2000 have shown that using creams or patches can lower the risk of breast cancer. Personally, I haven’t seen any studies suggesting that the lozenge (which bypasses the liver) has the same breast cancer risk reduction as the patch or cream. This is a common concern for women due to a study published in 2001 (likely referring to the Women’s Health Initiative study in the USA).

Absorption and Hormone Levels

It’s important to understand that when oestradiol is given through the skin, the hormone levels that reach the body’s systems are often lower than with oral forms. While the percutaneous route avoids the liver the first time it’s absorbed, eventually, all hormones pass through the liver to be detoxified and eliminated via the gut, just like with oral formulations. What’s key here is not just the liver bypass but how well the liver detoxifies hormones.

Breast cancer existed long before HRT, and one risk factor is the liver’s ability to detoxify hormones.

The Role of the Liver in Hormone Detoxification

Breast cancer existed long before HRT, and one risk factor is the liver’s ability to detoxify hormones. A key enzyme in this process is COMT. Depending on the genes inherited from your parents, your enzyme could be fully functional, partially functional, or working at only 25% or less. Women with lower enzyme activity are less able to detoxify hormones. In functional medicine, we use urine tests to evaluate how well someone is detoxifying hormones and can also conduct genetic tests.

Gut Microbiome and Detoxification

Another crucial factor in detoxification is the gut microbiome. If the microbiome isn’t healthy—for example, if certain bacteria secrete too much beta-glucuronidase, an enzyme that recycles hormones like oestradiol—it can disrupt hormone detoxification. This can be more significant than whether the hormones are absorbed through the skin or orally. Analysing the microbiome helps us understand if these bacteria are present in high levels, and we can modify a woman’s diet to lower them. Similarly, with the liver, while you can’t change your genes, you can adjust your diet to support better hormone detoxification, for instance, by increasing foods that promote liver function. I often recommend a supplement called DIM (an extract of broccoli) to aid in oestradiol detoxification. It’s crucial to explain these mechanisms to women, even when they are on bioidentical HRT.

Post-Menopausal Hormone Use

When it comes to formulations, some women have been post-menopausal for 5-10 years and may benefit from reintroducing hormones. For these women, I tend to favour percutaneous options (creams or patches), as they deliver lower concentrations of hormones. Most women don’t want to restart their periods after years of being menopausal. For women in their early 50s who are still cycling, they often don’t want to experience periods again either. To manage this, I prescribe lower doses of oestradiol and progesterone, often via a cream or patch.

When Patches May Not Be Suitable

However, there are cases where patches may not be suitable. Women who have experienced severe PMS, mood swings, or depression may find that patches trigger these symptoms again because of the fluctuations in hormone release. In those cases, an oral formulation might be better.

Tailoring Hormone Formulation Choices

Ultimately, choosing the right hormone formulation requires understanding a woman’s hormonal history and current symptoms. We tailor the approach and dosage accordingly.

 

Part 2 is now available! Dive deeper into our conversation with Dr. Isabelle Martineau, as we continue exploring invaluable insights into managing perimenopause and menopause through Hormone Replacement Therapy (HRT). You can visit Dr. Martineau’s website at Medical Art Practice

 

READ PART 2 NOW

They are chemicals produced by glands in the endocrine system and released into the bloodstream. They work together as an ensemble in an orchestra and impact your body’s functioning. When there is an imbalance (either too much or too little of a hormone), it shows.

For example, in a woman’s life, the balance between the sex hormones, progesterone, and oestrogen, is critical. A relative excess of oestrogen, called oestrogen dominance, is associated with an increased risk of endometriosis, fibroids, oestrogen-sensitive cancers, and polycystic ovarian syndrome (PCOS). When your hormones are out of balance in your 40s and 50s, it can present as a change in your periods, weight gain, mood fluctuations, anxiety, hot flashes, insomnia, lower sex drive, water retention, brain fog, and fatigue.

Here are five steps you can take to support your hormonal health:

1. Manage your stress levels

What does have stress got to do with hormones? Any event that you find stressful (i.e., a deadline at work) activates your body’s production of stress hormones. Cortisol and adrenaline are released. This “fight or flight response” causes more blood to flow, increases your heart rate, blood pressure, and breathing so you can get more oxygen and power away from the “perceived” tiger chasing you.

Your body can’t tell the difference between a work deadline and an actual physical threat. Our immediate survival is prioritized over our ability to reproduce. While short-term stress is fine, chronic, constant stress will cause your body to release more and more cortisol, which will disturb the natural balance of your hormones and may lead to weight gain, disturbed sleep, appetite changes, and anxiety.

TIP Practice some form of self-care daily to help you effectively manage stress. While some of us relax with a skincare routine, others may enjoy walking in nature, practicing meditation, yoga, and breath work… Managing your stress levels is essential to balance your hormones.

2. Eat to beat blood sugar imbalances

One of the most important dietary factors for balancing hormones is to keep your blood sugar level even. Have you ever wondered why, in your 40s and 50s, you may not get away with eating the same food you used to? Your body has changed, and you may need to change the way you eat.

The changes that happen in relation to oestrogen and progesterone during perimenopause, as well as the drop of oestrogen that occurs during menopause, are likely to make your body less sensitive to insulin, the fat storage hormone. Insulin is produced in response to us eating sugars and carbohydrates. As a side effect, we tend to redistribute body fat and excess pounds around the abdominal area.

TIP Switch to a low GL (glycaemic load) diet that balances your blood sugar levels. This means you will be eating foods that do not trigger as much insulin secretion in response to what you eat. A blood sugar-balancing diet focuses on “real” food: meat, fish, eggs, tofu, lentils, beans and chickpeas, lots of vegetables, some fruit, nuts, seeds, and wholegrains.

3. Eat functional foods

These are foods that support optimal health in the body. During midlife, that means incorporating “phytoestrogens” into your daily routine. Phytoestrogens are natural plant-based chemicals, which are structurally similar to oestrogen. They resemble oestrogen in the body yet have a much milder effect. Research suggests that they help regulate hormonal balance. Phytoestrogens are particularly helpful for women because they can both modulate excess oestrogen and exert low estrogenic activity when needed.

TIP Consume a variety of foods rich in phytoestrogens such as soybeans (and related products such as tofu, tempeh, miso, and natto), flaxseeds, sesame, sunflower or pumpkin seeds, lentils, beans, chickpeas, broccoli, onions, garlic, etc.

While short-term stress is fine, chronic, constant stress will cause your body to release more and more cortisol, which will disturb the natural balance of your hormones and may lead to weight gain, disturbed sleep, appetite changes, and anxiety.

4. Support your liver and gut health

An essential pillar of hormonal balance is your liver and its ability to detoxify hormones. The liver is the body’s detoxification system: it absorbs everything you ingest or put on your skin and removes waste and toxins. For instance, oestrogens, whether natural or “synthetic” (e.g., contraceptive pill, HRT) are transformed by the liver so that they can be excreted in urine and/or bowels. If the liver is not functioning optimally, oestrogen may recirculate in your blood instead of being eliminated, which may lead to excess oestrogen in the body.
Sex hormones are also connected to your gut health. The estrobolome is a collection of bacteria in the gut responsible for detoxifying and metabolising oestrogen. A healthy, diverse gut microbiome with a rich collection of different bacteria is critical for hormonal balance.

TIP Increase your fiber intake through vegetables, fruits, wholegrains, and legumes to support a healthy gut microbiome and promote regular stool frequency. Eat cruciferous vegetables such as broccoli, Brussels sprouts, cabbage, cauliflower, radishes, and kale to support your liver’s ability to process oestrogen. Cruciferous vegetables are rich in indole 3-carbinol, a substance that promotes oestrogen detoxification.

5. Limit your exposure to hormone disruptors

One of the fundamental root causes of hormonal imbalances is endocrine disruptors. These toxic chemicals are found everywhere in our environment (e.g., cosmetics, plastics, polystyrene, pesticides, herbicides, meats, dairy products, etc.). They disrupt normal hormone function and have been linked to health effects such as infertility, early menopause, polycystic ovarian syndrome, endometriosis, uterine fibroids, and hormonal cancers.

TIP
– Eat organic as much as possible to reduce your exposure to pesticides and hormones.
– Limit toxic substances in your cosmetics and cleaning products.
– Avoid heating food in plastic containers and using plastic food wrap. Choose glass instead. Stay away from buying water in plastic bottles and invest in a good water filter.
– Visit the Environmental Working Group (www.ewg.org) to determine which fruits and vegetables are best to buy organic and ensure the safety of cosmetics and other personal care products.

 

Whether you decide to reduce your sugar consumption, increase your vegetable intake or go for a ten-minute walk every morning, these nutritional and lifestyle interventions will contribute to restoring a natural hormonal balance and improve the way you feel physically and mentally. Simple changes can lead to big results.

 

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Eat a balanced diet

From the Paleo to the Atkins and the 5:2, there are so many diets out there that it can be hard to know what to eat for the best. The short answer is a GL (glycaemic load) diet. This balances out blood sugar levels – something which is even more important when you are over 40 as this is when it becomes harder to shift unwanted weight – and is based around proteins. These include meat and fish, eggs, pulses like beans and also lentils and other vegetarian sources of protein such as tofu. Eating plenty of vegetables, and natural fats (and fat containing foods) like oily fish, nuts and seeds, and avocados are also good for you. When it comes to carbs like bread, pasts and rice, choose wholegrain varieties instead of white – and be mindful of the quantities.

Take care of your liver

One of the biggest factors that affects whether you’re going to lose weight is what’s going on in your liver. The liver is involved in many functions and contributes to, among other things, our ability to use the fats we store as fuel and transform toxins (such as alcohol, caffeine, transfats, refined sugars, synthetic substances) in order to eliminate them. If you want to help your body lose or maintain a healthy weight, make sure your liver works as optimally as possible. Drinking at least six glasses of water a day, reducing caffeine and alcohol, and avoiding sugar and processed foods all help the liver. Also, everything you put on your body is absorbed by the skin so avoid cosmetic products (shampoos, shower gels, lotions) that contain parabens which play havoc with your hormones.

The more you look after yourself, the less you will rely on chocolate (or alcohol) to make you happy.

Get a proper night’s sleep

Sleep and weight are intimately related. If you are not getting enough sleep on a regular basis, you are setting yourself up to be hungrier, eat more, weigh more, and have a harder time losing weight. Sleep deprivation (less than seven and a half hours of good slumber a night) causes hormone imbalance: ghrelin (which makes you feel hungry) and leptin (which tells you when you’ve had enough) are majorly disrupted. Lack of sleep also messes with the levels of stress hormones and your body’s sensitivity to insulin, both of which contribute to weight gain. So, after a night of bad sleep, if you feel ravenous, it’s not all in your head, but rather in your hormones. And it’s the carb-heavy, starchy foods that are going to be calling, not the healthy ones.

What are you doing to look after yourself?

Don’t worry, there is no right or wrong. Stress and anxiety not only make you miserable, they can contribute to making you put on weight too – which is why looking after yourself properly is so important for wellbeing. Research shows that people who take time to recharge are more creative, happier and successful. The more you look after yourself, the less you will rely on chocolate (or alcohol) to make you happy. These instant gratifications are short lived and, if you want lasting change, I recommend building in more robust ways of making yourself feel good, such as looking forward to non-food related treats. For instance, choose to spend five minutes relaxing in the fresh air to recharge your batteries rather than grabbing a handful of biscuits.

Ask for help

There’s no need to struggle along on your own. Sometimes even though we know what we should be doing, it’s hard to stay motivated and make changes without support. In clinic, I am used to working with the best private laboratories to provide tests that reveal which hormones are out of sync, so that we can come up with a bespoke nutrition and supplement programme to address your unique needs. My programmes combines both nutrition and lifestyle elements, to give you the best chances of reaching your health goals.

 

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What is mindful eating?

It might be easier to say what it’s not. Which is no scrolling through Instagram on your phone as you mindlessly tuck into a bowl of steaming soup. No television dinners. Or tapping away on a laptop as you gulp down a sandwich at lunch. Instead, mindful eating is all about consuming food with intention, really savouring each mouthful and understanding why you are feeling hungry in the first place. What I’m interested in though, is intuitive eating which is a broader philosophy that works towards synergising mind, body and food, and using nutrition to improve the relationship between all three. It’s not a diet; it’s a mindset.

What makes us hungry?

Whether eating as part of socialising, out of boredom or as a way of cheering ourselves after a bad day, there are many reasons why we feel hungry. Some people eat to calm nerves; others, in case their stomach might start rumbling later. Either way, intuitive eating for physical (rather than emotional) reasons involves not manually and mentally overriding our natural instincts but rather listening to our bodies and their internal cues to tell us when, what and how much to eat.

How does a hunger scale work?

Using a hunger scale is a handy way of being able to tell the difference between feeling mildly peckish and absolutely ravenous. Registering as one or two on the scale (painfully hungry or very hungry) means you’ll want to eat soon; those who often find themselves at eight, nine or 10 (a little over-full, very full and uncomfortable, painfully full) are often experiencing weight gain and likely eating for emotional reasons rather than what the body actually needs. As it takes the stomach a little while to realise it’s full, try to stop eating when you reach five – ie. feeling neither full nor hungry – and wait for your mind and body to align.

Over time, you may end up eating less because the food is experienced more fully.

Talk us through mindful eating…

First you need to slow down and focus – that’s the goal – by taking a few moments to tune into your environment and with the desire to eat. Pick one meal during the day when you can block out 20-minutes to eat and, at the beginning at least, try to be alone. Really pay attention to what’s on your plate, noticing the colours, shapes, textures and smells of food. Try to identify the flavours in your mouth and chew thoroughly. It sounds simple but don’t be surprised if your mind wanders – it’s perfectly normal. Just try and bring your thoughts back to your plate and the experience of eating. Over time, you may end up eating less because the food is experienced more fully.

Any mindful eating rituals?

One of the best ways to prepare for mindful eating is to cook for yourself, rather than reheating leftovers from the freezer or phoning for a takeaway. The act of preparation, the smell of vegetables sizzling and the sight of a sauce simmering, all ignite that part of the brain that readies our bodies for nourishment. Other rituals could include setting the table, listening to relaxing music or writing a daily journal of your feelings and experiences around mindful eating. Finally, be patient: it can take weeks or months for mindful – or intuitive – eating to become part of your routine. Enjoy the process of building a stronger mind-body connection and improving your relationship with food along the way.

 

As a nutritional therapist I love helping people improve their relationship with food. Book your COMPLIMENTARY 30-MINUTE CALL with me and together we can discuss ways I can help you.

 

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Get in touch with the way you feel

The first step to improving health – and understanding the degree to which it’s under pressure – is by acknowledging how you feel right now. In other words, paying attention to your emotions and physical being. Think about how often you feel stressed, anxious or depressed. Do you have digestive problems or are you noticing weight gain? Once you become aware of the external pressures and physiological triggers, it’s much easier to consciously choose not to accept niggling symptoms as the norm and properly commit to making changes that will improve your sense of wellbeing.

Kick the carb cycle

If you don’t eat well, you don’t feel well – it’s as simple as that. Reaching for a sugary snack or simple carbs can cause blood sugar to spike then crash, which wreaks havoc not just on your appetite but your energy levels, mood and stress levels too. Cravings (hands up: who finds themselves reaching for the biscuit tin at 4pm?) often come from blood sugar dysregulation: essentially, the more you eat foods containing sugar or refined carbohydrates (such as fizzy drinks, cakes, bread, rice or pasta), the more you’ll want of it. One way to avoid being tempted is to keep junk foods that can trigger you to overeat out of reach, out of sight or even out of the house completely (that includes buying treats for the kids and then eating them yourself). If you know you’ll be ravenous by teatime, plan a healthy snack around this time for both you and the children instead.

Practice mindfulness

When juggling many different elements – work, looking after children, managing the family diary – it’s all too easy to forget to eat a proper lunch, to stay up too late and react to situations without thinking. Lacking self-awareness and living on autopilot can lead to poor decisions and poor health. A trick to increasing self-awareness, as well as improving both physical and mental health, is by practising mindfulness and listening to your inner self. Whatever form of mindfulness you prefer (slow, gentle breathing exercises, yoga, tai chi or even mindful walks), it’s a way of anchoring yourself in the present and offers the space to reflect on your emotions and how they are reflected in your body.

One way to avoid being tempted is to keep junk foods that can trigger you to overeat out of reach, out of sight or even out of the house completely.

Plan mealtimes

One of the easiest areas to make an impactful change is in what you eat. Planning ahead is vitally important in order to avoid overeating or grazing because there’s nothing useful in the fridge. That begins with setting aside a regular time each week to plan a menu so that you are in control and reduce your mealtime stress when stepping into the kitchen to prepare lunch or dinner. Follow the basic rules – include protein into every meal and snack, add in as many vegetables as you can, and be careful with starchy carbs such as potatoes, rice and pasta that often affect energy levels and your weight. Stick to speedy yet nutritious dishes that everyone (even fussy eaters) will happily tuck into: mild curries, soups or traybakes, say. Make extra portions so there are leftovers for lunch (which means one less meal to worry about). It’s also good to plan ahead in other areas too, such as when you will exercise and take time out for yourself.

Don’t scrimp on self-care

Every waking moment may be jam-packed with household chores, ferrying children from after-school clubs to parties (and overseeing homework), followed by answering work e-mails in the evenings and it’s crucial to carve out some time for yourself. And there is nothing selfish about self-care. Whether it’s setting aside half an hour to read a book or disappearing off for a soak in a hot bath at the end of the day, it’s essential to dedicate a portion of the day just for you. Taking regular time out means you’ll feel better able to cope with the stresses and busyness of life – and, let’s face it, that benefits everyone else in the family too.

 

Often the knowledge of what to do doesn’t always help you to take action where there is no accountability. If you’d like to make changes in a way that fits with your unique personal challenges, click below to book a COMPLIMENTARY 30-MINUTE CALL with me.

 

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Start planning

Ever looked in the fridge before preparing dinner and felt totally uninspired by the array of ingredients in front of you? It might sound obvious but planning meals ahead is the easiest way to gain, not only a sense of control over your eating behaviour (and body weight), but also to stop unnecessary impulse supermarket spending. Decide on your meals and snacks, make a list of ingredients needed – and stick to it. By creating structure, you’ll reduce stress in the kitchen and feel an immediate sense of relief.

Fulfil your nutrient needs

Feeding your body with the right combination of nutrients will help restore physiological balance, leaving you feeling more energised and productive. Protein is essential (for everything from healthy skin to helping the body repair itself) and should make up a quarter of a typical meal. It can be found in meat, fish, seafood, eggs, beans, pulses, quinoa, nuts and seeds; for an economical protein fix, stick to the vegetarian options. Omega-3 fats are positively good for you – literally mood boosting, in fact – and found in foods such as oily fish, avocados, coconut oil and flaxseeds while fibre from vegetables keeps energy levels stable and hormones balanced. Don’t rule out choosing frozen over fresh either: eating your five-a-day this way is more affordable and minimises the likelihood of having to throw away wilting cabbage or yellowing broccoli that’s been left forgotten at the back of the vegetable rack.

Cut down on carbs and sugar

Pasta, bread, potatoes, rice…. all of these are quick and easy, go-to comfort foods for many of us but if we eat too much of them, they can spike blood sugar levels and cause the body to store fat. The answer? Swap white varieties for wholemeal or brown and fill-up on vegetables instead. The other big no is sugar (who hasn’t had a 4pm craving for a bar of chocolate?) which creates an energy imbalance and a craving for more. Healthy nibbles – a piece of fruit with a small handful of nuts, carrots and houmous, a couple boiled eggs – make brilliant substitutes.

Planning meals ahead is the easiest way to gain, not only a sense of control over your eating behaviour (and body weight), but also to stop unnecessary impulse supermarket spending.

Cook from scratch

Of course, convenience foods such as ready-made meals (and take-aways) will cost more than if you make supper from scratch. A few simple balanced recipes – and keeping an eye on portion control – is all you need to spend smarter and eat healthier. And, if you’re time poor, make a large batch of your favourite spaghetti with oven roasted tomatoes or vegetable casserole so it can be used again for lunch or supper later in the week.

Do you have a family member who you are worried about who is eating inappropriately and do you want to help them find the right support for their needs? Book your COMPLIMENTARY 30-MINUTE CALL with me and we can discuss the best nutritional approach.

 

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With warmer days and longer nights, our bodies are calling out for fresh and delicious meals packed with seasonal goodness. What better way to get all that than with a refreshingly light salad?

For many, the concept of a salad might consist of wilted leaves in a bowl, maybe with some packaged salad dressing and little else to add either flavour or nutritional value.

This month, you will find the essential building blocks for a salad that is not only nutritious, but tasty too. The key is to make sure that you include a balance of protein, healthy fats, slow releasing carbs, and plenty of vegetables. You can also adapt the flavours throughout the seasons, incorporating warm vegetables and dressings made with seasonal produce.

Add plenty of vegetables

Lettuce | Rocket | Green Leaves | Sprouted Seeds | Roasted Red Peppers | Steamed Broccoli | Sugar Snap Peas | Cucumber I Tomatoes | Roasted Eggplants  | Avocado | Courgette | Red Onion | Garlic | Scallions 

When building your salad, choose a base that comprises two handfuls of lettuce, rocket or spinach, and add as many vegetables as you can.

Vegetables contain plenty of vitamins and minerals, and are rich sources of phytonutrients, which are natural components of plants that support whole-body health. Studies show that people who incorporate more plant foods into their diets have a reduced risk of chronic diseases such as diabetes, heart disease and cancer.

Making it a goal to include all the colours of the rainbow in your bowl will get you well on your way to good health, as each colour offers a variety of nutrients.

Add protein

Chicken | Turkey | Salmon | Prawns | Tuna | Eggs | Tofu | Chickpeas | Beans | Quinoa

The building blocks of protein are vital for the growth and repair of body tissue; when you are exercising, under the weather, or even fast asleep, the amount of protein you consume will have a fundamental impact on your health.

The average adult’s diet needs to contain around 15-25% of protein, so don’t worry about going overboard with half a chicken and a side of greens. Simply add some slices of barbecued chicken, garlic-marinated shrimps, cubes of marinated tofu, or smoked salmon to your bowl, and you will feel satiated for hours.

The key is to make sure that you include a balance of protein, healthy fats, slow releasing carbs, and plenty of vegetables.

Add carbohydrates

Grated Carrots I Chickpeas | Lentils | Quinoa | Millet | Soba Noodles | Pearl Barley I Roasted Sweet Potato 

While carbohydrates are the main source of fuel for the body, in today’s typical Western diet, fast-releasing carbohydrates tend to be consumed in excess, and this results in too much sugar in your blood. We store the excess as fat and leave our bodies craving a more sustainable form of fuel.

These fast-releasing carbohydrates (found in white pasta, rice, sugars, fruits and some starchy vegetables) give us a sudden burst of energy, followed by a slump, while slow-releasing carbohydrates (found in whole grains, seeds, nuts, beans and legumes) provide us with more sustained energy over a longer period.

When building your salad bowl, try dressing cold soba noodles with coriander and soy sauce, or add in some cooked quinoa, lentils or left over hummus.

Add healthy fats

Olives | Avocado I Pine Nuts | Pumpkin Seeds | Sunflower Seeds | Almonds | Hazelnuts 

That’s right: you need fats to thrive. There are of course different types of fats – natural ones and unnatural ones – and it’s the natural ones you want to be adding to your salad. They not only keep you feeling full for longer and provide your body with energy, but they also support your heart health, your brain and nervous system, your immune system, your joints and your skin, as well as helping your body to absorb the fat-soluble vitamins A, D, E and K.

Your diet should consist of approximately 35-50% of fat, so try adding avocado, olives, chopped nuts or a handful of seeds to your bowl, and your skin, hair and hormonal system will thank you.

Pick a dressing

Miso | Tahini | Yogurt | Tzatziki | Tamari | Pesto

Dressings have greater health benefits when homemade, rather than poured from a shop-bought bottle. You can use them to add flavour, as well as provide some extra nutrients.

You can create a simple dressing of cold pressed extra virgin olive oil with either apple cider or balsamic vinegar, or lemon juice. Usually, the trick to a delicious dressing is to mix one part acid with two parts oil.

Add fresh herbs and spices

Parsley | Coriander | Mint | Dill | Basil | Tarragon | Chervil I Chives I Oregano I Chillies I Turmeric I Ginger

Fresh herbs and spices have plenty of medicinal properties. While parsley and coriander help reduce fluid retention, turmeric contains anti-Inflammatory properties and cinnamon lowers your blood sugar levels. Experiment with your herbs and spices, and see how you can add more nutrients to your salads.

After all, salads needn’t be dull and lifeless. Incorporating texture will ensure your bowl is as stimulating to your senses as it is nutritious.

 

Want more SIMPLE + HEALTHY meal ideas to inspire you this summer? Book your COMPLIMENTARY 30-MINUTE CALL with me and we can discuss the best nutritional approach for you, and not just for summer.

 

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Plan ahead

One of the best ways to remain mindful of your health while eating out is to plan ahead. For instance try to avoid turning up ravenous which may lead to overeating. Instead ensuring you have a moderate appetite by having a healthy snack, like two hard boiled eggs or an apple with a small handful of nuts or seeds, will afford you more control when you arrive at the restaurant. You can also consider looking up the menu before you arrive and spending time perusing the options ahead of time to help prevent feeling overwhelmed by having to make a choice with a waiter, well, waiting.

Fill up on the good stuff

And no I don’t mean from the bread basket. The temptation when out at a restaurant or cafe is to over order on large and rich starters or to ‘save space for dessert’, because when we are hungry we’d eat anything. Instead, choose a salad as a starter to calm any extreme hunger and a main course based on animal protein (such as fish, poultry, game, meat) or vegetarian protein (like tofu, beans or lentils), and plenty of vegetables (restaurants always offer plenty of side dishes for you to choose from). Limit breads and starchy carbohydrates (such as pasta, potatoes, rice, etc.) and avoid dessert or opt for the strawberries or a cheese plate with a side salad (without the crackers!). Opting for these choices will mean you fill up on the nutritious stuff and won’t be left feeling hungry for more, so you can relax and enjoy your dining experience. 

Make the menu your own

Want to avoid the cream sauce or anything fried?  Fancy introducing your own healthy twist to something already on offer? Don’t feel shy about ordering off-menu, no one will thank you for being a menu purist. Try swapping ingredients in and out of the listed options or asking for an addition to what’s on offer to suit your taste, for example instead of chips, choose to have 3 new potatoes or a side
salad. Consider ordering two starters instead of a main course, request that sauces and dressings are served separately and ask for your food to be steamed, grilled, or roasted. Don’t be afraid to refuse the bread basket – ask for olives instead. 

Feel free to get playful with the menu, unless you have a French waiter of course, in which case don’t even think about mucking about with a thing! 

How do we eat out ?

While some of us tend to overeat when going to a restaurant, others exert ultimate control over what they eat. They will have perfected the art of eating healthy (very common on social media) and they will astound you with discipline and perfectionism at the restaurant, but will binge secretly on biscuits the minute they arrive back home. No matter where you think you sit in terms of your eating behavior, don’t beat yourself up, simply be mindful of the thoughts that drive you to overeat or starve yourself.

Limit your alcohol intake

It’s easy to drink more alcohol than you realise when eating out, with your wine glass constantly getting refilled, or to get carried away, with ‘just one glass’ leading to plenty more. Remember alcohol is high in sugar and also lowers your resistance to temptation (of all kinds!). If we want to remain mindful and reduce overeating, let’s remember the effects of alcohol on our appetite. Make a plan for what you want and how much you are choosing to drink. Drink slowly, with food, and alternate with water. You might want to start with one large glass of water or a non-alcoholic drink before you start drinking alcohol, and then stick to just one glass of good quality wine. Remember to drink plenty of water throughout your meal.

 

As a nutritional therapist I love helping people eat more mindfully, including when dining out. Book your COMPLIMENTARY 30-MINUTE CALL with me and together we can discuss ways to increase mindful eating habits.

 

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