Optimum Nutrition - Winter 2019/20 PREVIEW

THIS ISSUE
12
Kick those winter blues to the kerb by eating well to feel well
Sally Parr looks at how diet and lifestyle can help to perk us up at this gloomy time of year
08
30
What lies within?
The discovery of the microbiome has
changed how many of us think about our
health, but how much do we really know
about what lies within? James Billot writes
22 Interview
In 2012, Alice Herbst won Sweden’s Next
Top Model. Today, she is working as an
artist. She spoke to Louise Wates about
body dysmorphia and recovery
On your plate
Start off 2020 deliciously with these
nutritious and tasty recipes from
nutritional therapist Amelia Freer’s new
book Simply Good For You
44 Food fact file
As many people will be trying out
vegetarianism or veganism throughout
January, we review some of the more
popular protein alternatives
Contents
16 World cuisine
Aran Goyoaga, pastry chef and food
blogger, tells us about food from the
Basque region, and shares a recipe from
her new book
25
Little lives
If telling your child about the health
benefits of veg does little or nothing to
engage their enthusiasm, it may be time
to learn from the fast food industry
34 Different strokes
When it comes to feeling happy, actively
choosing to be thankful for the little things
in life can help. Ellie Smith looks at the
power of gratitude
18
48 Move it 50
Have you ever wondered why people
swim in London’s freezing cold Serpentine
in the winter? Alice Ball did, before going
on to dip in more than a couple of toes
40
All about
From the common cold to sepsis, we find
out how the health benefits of vitamin C
are being investigated for mild and critical
diseases
28
Little lives
After Catherine Morgan’s son showed off
his bendy yoga moves, she asked what the
benefits of this ancient practice might be
for young bodies and minds
Research update
If January finds you thinking about diets
and feeling the lack of sunshine, read our
round-up of research on weight-loss and
on the essential ‘sunshine’ vitamin
Graduate story
Lily Soutter on why studying at ION after
completing a BSc in Food and Human
Nutrition gave her the skills to start up a
thriving business in clinical practice
04 Comment / news | 26 Kids’ pages | 33 Book therapy
36 Product news | 38 Kitchen chemistry | 39 In season
WINTER 2019/20 | OPTIMUM NUTRITION
3

FEATURE
12 OPTIMUM NUTRITION | WINTER 2019/20

FEATURE
I
f the depths of winter have left
you feeling low, you are not
alone. Last year, NHS Digital
figures revealed that an estimated one in
six people in the UK experiences common
mental health problems during an average
week.
Symptoms can differ from person to
person, ranging from what may just feel
like the winter blues all the way through
to an inability to function on a daily basis.
Whatever the symptoms, it is important to
tackle them or seek help, rather than just
hoping they’ll go away.
Looking to nutrition and lifestyle is a
great place to start, but it’s important
to discuss the risks and benefits with a
registered nutritional therapist or your
GP, and never stop taking prescribed
medication without consulting your GP.
Here are some smart strategies to get you
started:
Eat for gut health
Diverse gut bacteria has been linked
positively to mental health, with several
types of ‘good’ bacteria thought to interact
with the nervous system and play a key
role in mood management. Some microbes
even help with production of dopamine, 1
the so-called ‘happy hormone‘.
Probiotic foods, which are generally
fermented foods such as live yoghurt,
provide beneficial bacteria that can help
support digestive health and regulate the
immune system. Some studies have also
found them to be useful in tackling anxiety. 2
Scientists call these “psychobiotics” —
probiotics that can be used to positively
impact mental health by altering the way
the gut communicates with the brain.
It’s thought that in depression, certain
messages don’t get through from the gut
to the brain. In one study, researchers who
noted a correlation between imbalances
in gut bacteria and disorders of the central
nervous system found improved mental
health in healthy volunteers who consumed
probiotic yoghurt and supplements for six
weeks. 3 However, whilst acknowledging
that the study showed promise, the
authors recommended that further studies
into psychobiotics were needed to explore
the findings further.
Good sources of probiotics include dairy
produce such as yoghurt with live cultures,
buttermilk and kefir. The latter is thought
to act as a transport system for other
probiotics, as well as having antifungal,
antibacterial and anti-inflammatory
properties. 4 Other fermented foods that
are a good source of probiotics include
tempeh, natto and miso made from
soya beans; sauerkraut and kimchi from
cabbage; plus kombucha from tea. The
fermentation process produces beneficial
bacteria that enable nutrients to leach
from the food structure, making them
more easily absorbed when we consume
them. Eating foods that are rich in fibre
also helps to feed your beneficial bacteria,
which is another reason to make sure you
are including vegetables, fruit, legumes and
wholegrains in your diet.
Eat 10 a day
Several studies have linked a colourful,
varied diet that includes vegetables, fruit,
wholegrains and omega-3 fatty acids
with good mental health. The standard
western diet, however, including highly–
processed foods, low levels of vegetables
and fruit, and high levels of omega-6 fatty
acids, has been linked with low mental
health. Because high levels of general
inflammation are often seen among
patients with depression, it’s also thought
that the anti-inflammatory and antioxidant
properties of a plant-rich diet can help to
support mental wellbeing.
SMASH it
In one study, researchers set out to see
whether a plant-rich, Mediterranean style
diet could improve mental health. 5 Their
hypothesis was that low levels of omega-3
fatty acids, higher levels of systemic
inflammation in the body and nutritionally
poor diets were common features in poorer
mental health. Participants were given
food hampers, omega-3 supplements
and cookery workshops, and were asked
to include fruit, veg, legumes, seeds,
nuts, olives, olive oil, wholegrains and
fish in their diet, and to restrict red meat,
processed foods and confectionery. The
result was a direct correlation between
better diet and improved mental health,
which was still evident after six months.
One of the best ways to increase dietary
omega-3 levels is by eating oily fish, with
the acronym SMASH (salmon, mackerel,
anchovies, sardines and herring) as a
helpful way to remember which varieties
to eat. Seaweed (in sushi), spirulina (add
to smoothies), flax, chia and hemp seeds
(sprinkled over yoghurt for breakfast) as
well as walnuts and edamame beans are
good sources for non-meat eaters.
On a cautionary note, however, anyone
taking blood thinning medication should
avoid taking omega-3 supplements. A
pharmacist, GP or registered nutritional
therapist can advise on contraindications
with medication you may be taking.
Vitamins and minerals
B vitamins are essential for our mental
health, particularly B12. Because B12 is
only naturally available in animal products,
vegans are at greater risk of being deficient
and so should take in supplements and
fortified foods.
Zinc is also a nutrient that has produced
interesting results. One study found that
healthy young females given zinc plus
multivitamin supplements 6 reported a
greater reduction in depression scores
than those who only took a multivitamin.
This, it is thought, could be due to zinc’s
role in regulating chemical messengers
(neurotransmitters). However, this was a
controlled study and supplements are not
always recommended — the NHS advises
that high levels of zinc reduce the amount
of copper that the body can absorb, which
can lead to anaemia and weakening of the
bones.
Before considering supplements, look
to diet to provide what you need. Good
sources of zinc include cashew nuts, dark
chicken meat, legumes including chickpeas
and lentils, seafood such as crab and
lobster, wholegrains and meat (organic,
grass-fed if possible). Another important
‘feel good’ mineral is magnesium, which
helps to support a healthy ‘sleep/wake’
cycle and to regulate mood. 6 Dark green
leafy veg, beans and peas, seeds, nuts and
wholegrains are all good sources of this
relaxation-inducing mineral.
Vitamin D is also important for healthy
brain function. 7 Sunlight is the best source
but it can also be obtained through SMASH
fish, some types of mushroom, egg yolks
and some fortified foods.
Serotonin
Eating food rich in tryptophan can improve
levels of serotonin — a neurotransmitter
believed to be important for regulating
mood — which, in turn, may help to
regulate sleep, improve energy and mood.
An essential amino acid, tryptophan has to
come from diet because the human body
cannot produce it. Sources include turkey,
chicken, salmon, eggs, spinach, nuts, seeds
and tofu.
Exercise outdoors
Physical activity can be just as effective
as medication for some who suffer with
depression, and recent studies have shown
that it can even help prevent depression
occurring in the first place. 8 For those
already taking medication, exercise may
also work as a ‘replacement’ second
anti-depressant. One study, however,
highlighted that activity does need to be
personalised. 9
Although it can be hard to feel motivated
to be physically active when it’s blowing a
gale outside, in winter, when the amount
of light hitting the back of the eye is
reduced, it is important to get as much
WINTER 2019/20 | OPTIMUM NUTRITION
13

INTERVIEW
Modelling in Los Angeles might seem like a dream job, but for Alice Herbst it only encouraged
disordered eating. She talked to Louise Wates about how using social media as a teenager fed
her anxiety and body dysmorphia, and how becoming a professional artist helped her to heal
22 OPTIMUM NUTRITION | WINTER 2019/20

INTERVIEW
W
hen Alice Herbst won the 2012
Sweden’s Next Top Model, to all
appearances she must have been
living the dream. Yet only six months into
her prize of a modelling contract in Los
Angeles, she was back home in Sweden
and on a very different path. Today she is
an artist with an Instagram following of
79.9k. Although modelling is behind her,
themes of self-image creep into her work
and she describes her paintings as “parts
of stories that could be self-experienced or
inspired by daily observations”.
We meet at the launch of Boogie
Wall, a gallery dedicated to representing
international female artists. Herbst, who
graduated from the Swedish art school
Gerleborsskolan in 2017, is in London
to showcase her paintings but I want to
find out about her experience with body
dysmorphic disorder (BDD), a mental
health condition which leads to anxiety
over physical appearance. She kindly
accepts this request and talks openly but
thoughtfully.
Herbst has spoken about her BDD
before and about her concerns over social
media and apps that appear to be driving
mental health problems. The press release
accompanying the Boogie Wall launch
explains: “Alice heavily criticises modern
apps like Facetune that are advertised
to young women to make themselves
look slimmer. ‘Today people are able to
bring their Facetuned photos to a surgeon
to transform their appearance to their
internet persona for good,’ she says as
she addresses the importance of open
discussions and awareness of mental
health and eating disorders.” Yet it seems
ironic that somebody who had suffered
with BDD would put themselves forward
for a career in modelling, especially
through reality TV in which contestants
are judged and eliminated on a weekly
basis.
But by the time Herbst entered the
competition, she had been considered
well for a year and a half, having already
undergone therapy. The roots of her BDD
go back to when she was 13 and changing
schools. Her father worked in shipping, she
explains, and so the family would move for
his work. Being the new kid on the block,
she found it difficult to make new friends
and found herself to be isolated from
friendship groups. “I felt very insecure. It
was different from the town I was living in
before... I was so tired with adapting,” she
says.
For many, however, social media
can provide a route to friendship that
the classroom does not always offer.
Although Herbst tried to make friends,
she eventually started talking with people
“I started to paint my own experiences and there was... very
symbolic... food pieces everywhere in my paintings...”
online. Then, because photos were
prominent on the platform that she was
using, she began uploading photos of
herself — in what became a trigger for
BDD. Herbst says she suddenly found that
what she thought she looked like, how
she felt, and what she saw in her photos
didn’t match. “I started to despise my face,
I started to see things I didn’t like, my eye
was hanging down — I just saw ridiculous
things but they really had an impact on
me.
“In the end I wanted to have surgery. I
just compared myself to everyone around
me and wanted to look like what was a
local ideal in my school. The boys liked a
certain look — they wanted [a girl] to have
a fuller face and a curvy figure and I was
the opposite of that.”
Makeup and mirrors
Herbst began spending more time in
front of the mirror trying to change
her appearance. “I just wanted to be
appreciated, so I started with makeup to
change things and started to wear hair
extensions.” Like so many others, she also
tinkered with her photos to make herself
look better, which only fuelled the bullying
that she already faced. People who knew
her would comment anonymously that she
looked nothing like her photos, making her
feel worse about herself.
Herbst says that “it was five years
becoming more and more worse before it
got better”. Eventually, her parents got her
help with a psychiatrist.
Having recovered from BDD, it may
seem odd that Herbst might throw herself
into a world where appearance matters.
“I would never ever today say that anyone
who suffers from BDD should go and
apply for a show like [Next Top Model]
even though I felt very strong at that time.”
But modelling agencies had told her that
she was very skinny and tall, and that she
looked like a model. “I didn’t want to look
like that, I wanted to have curves all my
life and I wanted to have another facial
structure,” she says. “The agencies, on the
other hand, appreciated my look.”
During therapy, she says that she had
started to expose her fears and pretend
to be more secure and confident than she
felt. “And then I started to feel that way for
real so when this show was announced,
that it was going to be Next Top Model, my
friends said that I should apply.”
Winning the show and starting a
modelling career, however, only became a
trigger for disordered eating — something
from which she had not suffered before —
because of the pressure to become even
thinner. “I was free from BDD because
that’s one part of the self-image issue,
then I just got the other one — anorexia.”
This time, however, Herbst knew that
something was wrong and quit modelling.
Painting became an outlet for Herbst
as she recovered. “I started to paint in
watercolours when I was coming home
from Los Angeles, actually as a therapeutic
way to heal.” Initially, her work reflected
her anxiety with food. “I was thinking
about food and food only, and all the
anxious feelings I had about that, so I
started to paint my own experiences and
there was... very symbolic… food pieces
everywhere in my paintings.”
She completed high school and applied
to art college. “I didn’t think that I would
pursue an artist’s career but I wanted to
have just one year to do something that I
really loved, and it was the one thing that
really helped me. I could stop thinking
about all the body issues with the painting.
So I continued and it healed me more.”
Counting calories
She now has a much healthier relationship
with food, eats what she wants, will
have an occasional indulgence, but aims
for healthy balance. She also no longer
obsesses over calories, which she had
started to do whilst modelling.
“It was such a long time before I could
stop thinking about the calories. It took
two years before I could finally feel like
I’m not seeing the calories, because when
I was a model — actually this is the first
time I would ever tell anyone this — I
had in my phone this calculator and was
adding on all the calories every day.” Her
target was to eat no more than 1,200
calories. “And I felt very good when I got to
600 only. So starvation mode,” she says.
“Today I don’t want to count calories,
I just know that if I feel healthy I want to
have a body that I can walk with and I
can work with, and feel I just want to be a
healthy person. I want to go back to where
I was before all the modelling, just eat and
don’t think about that.”
For others who might be suffering from
BDD, Herbst urges them to find something
else to focus on. “So many girls or boys are
thinking ‘If I do this I will be healthier, I will
feel better if I change my looks this way…’,”
she says. “But if you switch your focus
onto something else and try to make a goal
out of that — it doesn’t need to be painting
— a sport, anything that makes you feel
WINTER 2019/20 | OPTIMUM NUTRITION
23

ON YOUR PLATE
Fish
provençale
Serves: 4
Amelia says:
“Provençale sauce is a really versatile and
fragrant sauce that can be used to liven up
the most basic of meals from pasta, jacket
potatoes, chicken or fish, as here. If you
feel you need something more filling, add
some wholegrain rice or pasta or a serving
of courgetti.”
Ingredients
• 1 onion, peeled and diced
• 1 clove of garlic, peeled and crushed
• Olive oil
• 1 x 400 g tin of cherry tomatoes
• 70 g pitted black olives
• 4 fish fillets, frozen or fresh
• Fresh basil, torn, to finish
Method
This works best in a shallow frying pan
with a lid, although a large cast-iron
casserole dish with a lid can also be used.
Sauté the onion and garlic together in
a little olive oil for 8 to 10 mins, until soft.
Add the cherry tomatoes and black olives
and bring to a very gentle simmer.
Top with the fish fillets and cover
with the lid. Poach for 10 to 20 mins
(depending on the size of the fish and if it
is fresh or frozen. It is done when opaque
all the way through and flakes easily).
Serve hot, sprinkled with basil leaves.
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