ADD 10 YEARS

TO YOUR LIFE checkmybodyhealth.com

CREATED BY
THE CHECK MY
BODY HEALTH
NUTRITION, MEDICAL
DIETS, DIABETES, ADVISORY
CALORIES, MENTAL BOARD.
HEALTH, SLEEP,
YOUR PASSPORT TO
STRESS, GUT
A REJUVENATED,
HEALTH, VEGAN,
RESILIENT, AND
FAMILY. MORE FULFILLING
Including medical
EXISTENCE.
Q&A's for each section
Join us on this journey
from our GP and
and embrace the
medical advisory board.
secrets of longevity, one
bite at a time.
Add 10 years
to your life
Welcome to “Add 10 Years to Your Life,”
an insightful eBook brought to you
by our esteemed team of experts—
an accomplished BANT registered
Nutritionist and a dedicated GP.
This guide delves into the multifaceted
realm of nutrition, offering valuable
insights to not only extend your lifespan
but improve its quality. Through a
marriage of scientific knowledge and
practical advice, we equip you with the
tools needed to unlock the potential of
nutrition in shaping a longer, healthier life.
In this empowering guide, we’ll explore
ten crucial aspects of nutrition. From
understanding calorie-controlled diets
to effectively managing diabetes with
the right nutritional choices, optimizing
dietary habits for mood, mental health, and
sleep, and even addressing family nutrition
concerns.
We’ll also delve into specialized areas like
FODMAPS, gut health, and the rationale
behind the increasingly popular vegan
diet. Our goal is to provide a holistic
understanding of nutrition’s power to
positively influence your journey towards
a longer, healthier, and more vibrant
existence. Join us as we unravel the secrets
of longevity, one bite at a time.’
2
Contents
2 - Introduction

4 - Meet our advisory board

Add 10 years to your life:

5 - All Things Nutrition

26 - Understanding the Calorie-controlled Diet

34 - Diabetes and Nutrition

41 - Eating for Mood and Mental Health

52 - Eating for Sleep

62 - Eating for Stress

71 - Family Nutrition

81 - FODMAPS

87 - Gut Health

99 - Why the Vegan Diet?

3
 Meet our medical
advisory board
Sian
Sian graduated with a distinction from the Institute for Optimum Nutrition in
Baker London, a world leader in the field of nutritional therapy.
Dip ION mBANT
mCNHC
She is a full member of the British Association for Applied Nutrition and `
Nutritional Therapy and is registered with the Complementary and Natural Healthcare
Council.

Prior to becoming a Nutritional Therapist, Sian worked in the health and fitness industry
for over 10 years. She worked as a Personal Trainer and a trainer/educator for a leading
fitness company.

Dr Gareth James is a 3/4 time Senior Partner and Management Lead GP in

Daventry, Northamptonshire. He has undertaken over 3000 vasectomies (over
2000 via the MIV/NSV method).
Gareth
James He is passionate about audit and research, and has been the Audit lead for ASPC
GP, GMC,
DRCOG, DFFP, since it joined with BANSV. He was instrumental in setting up the standardised
MRCGP questionnaires for patients following their vasectomies allowing a wealth of data to
be collected over the past 8 years.

He has also now put together Carpel tunnel patient surveys, and a more patient
centred Skin Surgery survey.

He is a member of the following professional groups or societies:

• Member of the Royal College of GP’s
• Diplomat of the Royal College of Obstetrics and Gynaecology
• Diplomat of the Royal College of Family Planning and Reproductive Medicine
• Member of Association of Surgeons in Primary Care
• Medical Protection Society member

As a Certified Nutrition Therapy Practitioner, Personal Trainer, and Holistic

Jaci Health Coach, I’m passionate about promoting well-being through a harmonious
Salley blend of natural foods, physical activity, and advanced cellular health testing.
CNTP
My holistic nutrition and wellness background has driven me to empower others
to take charge of their overall health. Utilizing years of experience, education and
coaching, I assist my clients in cultivating a balanced and healthy lifestyle centered
on proper nutrition, exercise, and cutting-edge cellular health assessments. My
integrative approach emphasizes the significance of adding positive elements to
one’s life while gradually phasing out the negative, spanning food choices, physical
fitness, relationships, careers, and spirituality.

At the core of my philosophy and business is the belief that fresh, local, organic, and
GMO-free foods form the foundation of excellent nutrition and holistic wellness. I
am committed to enlightening people on the vital role carbohydrates, fats, proteins,
vitamins, and minerals play in fueling the body and optimizing performance.

Dr.
Kristin M.
Kidgell Dr. Kidgell’s passion and dedication to natural healing started over 25 years ago
DC
when she witnessed the transformative power of natural therapies firsthand.

Her family’s journey to wellness led her to pursue a career in total body restorative
care, where she combines her extensive knowledge of natural healing with the latest
technology and science to identify any imbalances or issues. Dr. Kidgell believes
everyone has the power to take charge of their health and offers a compassionate,
personalized approach to healthcare.

4
Section 1 -
Introduction
to all things
nutrition
Welcome to our 12 step introduction
to nutrition and the importance of
eating well.

Nutrition is required to help us grow,

heal and support our physical and
mental health. Food gives us energy,
fuels our adventures, provides comfort
and brings joy through shared meals
or from experimenting with new
recipes and ingredients.

5
Step 1

Food processing
Processed foods are often maligned in the
health and wellness sphere, but there are
different types of food processing.

The majority of the processes are often designed
to extend the shelf life of foods and preserve or
increase the nutritional value of foods, however it is
important to be aware that heavily processed foods
can contain a large number of additives and offer
little nutritional value.
Food processing is a common process in the food
and beverage industry. It allows nutrients to be
sealed in after harvesting and ensures you receive
the most nutrients possible from the food you eat.
Processing allows food to be fortified with additional
nutrients such as vitamins and fibre to increase the
nutrient content of foods and food processing allows
it to be preserved so it will last for longer.
There are many other food processes: canning,
fermentation, baking, freezing, drying and modified
atmosphere packaging. Canning involves food in jars
or tins being heated to destroy the microorganisms
that cause food to spoil, fermentation converts
carbohydrates to alcohol (beer, wine, gin, vodka)
or organic acids using microorganisms (yeasts
or bacteria) under anaerobic conditions (vinegar,
yogurts, cheese, kimchi, sauerkraut) and freezing
lowers the temperature of food to inhibit
microorganism growth.
Drying uses heat to remove the water present in
food to extend the shelf life of foods and modified
atmosphere packaging changes the gaseous
atmosphere surrounding it to preserve the food such
as salad leaves or prepared fruit pieces.

Be mindful when
choosing processed
foods, check the labels
and packaging and
avoid consuming too
many foods that are
high in free sugars,
saturated fats or
unnecessary additives.

6
Step 2

Chronic conditions
modifiable
through diet
There are many health conditions that can be
supported or exacerbated by nutrition.

Nutritional intervention can help to reduce

elevated ‘bad’ LDL cholesterol levels which will
reduce the risk of heart disease,
metabolic syndrome and stroke and/or improve
non-alcoholic fatty liver disease. `

Type 2 diabetes can also be managed through

a controlled diet and may result in you no
longer having to take medication. However,
there are genetic components to these
conditions so nutrition can only offer a certain
amount of support.

When trying to manage health conditions, `

it is important to focus on eating a nutrient
dense diet, high in fibre with lots of colourful
fruits and vegetables, lean proteins and healthy
grains. A personalised nutrition plan can help
support specific diseases or conditions, it can
also help you to achieve personal goals less
directly related to health such as improving
energy levels, improving your mood or reaching
fitness goals.

7
Step 3
Common deficiencies
in the Western world
Vitamins and minerals are essential in the diet for their
varying functions within the body.
Deficiencies in the diet can occur for a number
of reasons; the type of diet followed, vegan or
vegetarian for example, if any food groups are
avoided, like dairy or fish, location in the world,
some countries have greater prevalence of certain
deficiencies than others. Across the western world it
is common for fruit and vegetable consumption to
be below recommended levels, likewise with
vitamin D, oily fish (omega-3 fatty acids) and fibre.
Vitamin D3: Sunshine is an excellent source but it is
not reliable, especially in some areas of the northern
hemisphere such as the UK.
Some of the best food sources are oily fish (tuna,
mackerel, salmon, trout, halibut), sun-dried tomatoes,
mushrooms (they produce vitamin D when exposed
to sunlight, include portobello, maitake, morel
and oyster mushrooms), cheese, whole milk, egg
yolks and fortified foods. Vitamin D3 supplementation
is recommended for those living in the U.K. during the
winter months from October to March. Wherever you live
it is recommended that you supplement all year round
if you stay indoors for extended periods of time, have
darker skin or are pregnant or breastfeeding. Vitamin D
increases calcium absorption which supports healthy
bones, teeth and muscle function. Low levels of vitamin D
can lead to low mood, low energy and insomnia.
Omega-3 fatty acids: oily fish (sardines, mackerel, tuna,
salmon, trout and herring) is recommended twice a
week. If you don’t eat fish, it is recommended that you
take omega-3 supplements.
Fibre: Dietary fibre is an incredibly important part of
your diet with many health benefits as well as improving
your digestion and reducing the risk of chronic disease.
You should aim to eat 30g a day. It can be divided
into two categories; soluble fibre and insoluble fibre.
Insoluble fibre isn’t digested but helps to regulate bowel
movements and provides bulk to help form the stool.
Insoluble fibre foods include nuts/nut butter (almonds,
walnuts, cashews), seeds (flaxseed/linseeds), wholegrains,
vegetables and dark green leafy vegetables (broccoli,
spinach, kale). Soluble fibre can be digested by the body
and helps to keep stools soft. Foods high in soluble fibre:
vegetables (onions, carrots, potatoes), avocados, beans
(pinto, kidney, chickpeas), pulses, lentils and oats.
If you are following a vegan diet, we would recommend
that you take vitamin D, vitamin B12 and omega-3
supplements (vegan algae options are available).
You may benefit from other supplementation but
personalised recommendations should be made based
on your diet, age, health status and any symptoms.
8
Step 4
Gut health
The digestive system is a vitally important organ in
the body, not only is it needed for digesting and absorbing
food but it is home to the gut microbiome.
Research into the gut microbiome has exploded
recently with a healthy gut linked to digestive
function, mood and mental health, immune system
and weight management.
Your gut microbiome is completely unique and the
composition of your gut microbiome is influenced
by your birth, diet, environment, lifestyle and any
medications you may take. The gut microbiome is
found in the large and small intestine and is made
up of trillions of microorganisms (bacteria, fungi and
Foods to improve
your microbiome
Foods high in fibre: wholegrains,
legumes, fruit and vegetables
Prebiotic foods: artichoke, onions, garlic,
leeks, cabbage, asparagus, bananas,
pulses, root vegetables, apples and oats
Probiotic and fermented foods: good
quality live yogurt, kefir or coconut kefir,
sauerkraut, miso, tempeh, kimchi, goat’s
cheese, olives, quality dark chocolate and
spirulina
Take a good quality probiotic supplement
Eat less sugar and fewer refined foods
Aim to eat 30g of fibre from colourful
vegetables (peppers, pumpkin, carrots,
apples, cherries, cabbage, sweetcorn,
tomatoes, citrus fruits, spinach, kale,
purple sprouting broccoli, blueberries)
Eat raw or steamed vegetables rather
than boiled
viruses etc.) The microbiome helps breakdown
food and toxins, absorbs nutrients, makes
vitamins and supports our immune system and
regulates your metabolism. Nourishing the gut
microbiome is incredibly important for a healthy,
resilient gut so you should eat lots of prebiotic
and probiotic foods. Many of these foods are high
in non-digestible fibre (fruits and vegetables)
which are broken down by gut bacteria to
produce Short Chain Fatty Acids (SCFA), a major
source of energy for colon cells.
The microbiome benefits the immune
system, mental health and mood. The
gut microbiome contains 70% of the
body’s immune system cells and
is one of your body’s first lines of
defence against harmful bacteria,
viruses and parasites. A healthy,
diverse gut can lead to good
overall health and fewer cases of the
cold or flu. If your gut microbiome is
unbalanced, there may be lower levels
of beneficial bacteria, less diversity and
an overgrowth of pathogens which can
affect your overall health and lead to
digestive issues.
The Gut Brain Axis explores the idea
that gut health can have a positive and
negative effect on your mood and
mental health. 90% of the ‘happy’
hormone Serotonin is made in the
gut and some studies have found
that several species of bacteria were
missing from the gut microbiome of
people with anxiety and depression.
The variety in your diet will increase the
diversity in your gut microbiome which
will benefit your overall health!
Step 5

Eat a rainbow
Eating a colourful and varied diet is an excellent way to
support your health, this is because different coloured
items are rich in different vitamins and minerals.
Try to include lots of different coloured fruits and vegetables in your diet each day to
benefit from a breadth of nutrients.

10
Step 6

BANT healthy
eating plate
The BANT healthy eating plate is a great example of a
guide to help you to create balanced meals providing the
necessary macro and micro nutrients, non-starchy fruits
and vegetables, wholegrains or starches and protein.

Multi-vitamins and Eat root

extra vitamin D benefit vegetables
most people. Your and whole grains
nutrition professional such as wild/
may recommend more brown rice. Limit
supplements. refined grain like
bread and pasta.

Limit dairy to a
small matchbox-
sized serving of
cheese or a small
glass of milk daily.
Include 1-3
portions
of seasonal fruit
Fish, poultry & eggs
the size of your
should make up the
palm each day.
bulk of your protein
intake. Pulses, lentils
and beans are good
vegetable proteins.

HEALTH AND WELLBEING EXERCISE

Sleep/meal times are an important factor in Standing rather than sitting at a desk, walking an extra
overall health. 7-9 hours of sleep, beginning before stop and taking the stairs are easy ways to increase general
midnight is ideal. Focus on regular meals and activity levels. Stay active for improved overall health.
avoiding snacking.

DRINKS
Drink mainly water, along with tea (black/green/
fruit/herbal). Avoid drinks high in sugar or artificial
sweeteners, including fruit juice.
OILS
Use olive oil as your daily oil for cooking as well as
seasoning. Butter can be used in moderation but
margarine and trans fats should be avoided. Nuts and
seeds are a great source of healthy oils.

11
Step 7

Bristol stool chart

Your bowel habits and stools are a great way to gain
insight into your current diet, fluid intake and lifestyle.

You should have regular bowel movements,

which means you should have a bowel movement
at least once a day to once every three days, of soft,
formed stools that are easy to pass. Everyone does
have their own ‘normal’.

Take a look at the Bristol Stool Chart below and see

what ‘type’ is most common for you. Ideally your
stool should be soft and easy to pass (type 3 or 4).

Type 1 and 2 suggest that you have

constipation and need to increase your daily
fluid intake. The stool may be difficult and
painful to pass and has probably spent too long
in the colon so the fluid has been absorbed.

Type 5 and 6 indicate that your diet is lacking
in fibre so you need to increase your fibre
consumption (vegetables, fruits, wholegrains)
to pass a more formed stool.
Type 7 is diarrhoea which means your stool
moved through your bowels very quickly and
hasn’t formed a stool.
Good Bowel Function:
You should be able to hold on for a short time after you
feel the first urge to go to the toilet and pass a bowel
motion within a minute of sitting on the toilet. You may
benefit from placing a stool under your feet to help you
pass a bowel movement. You shouldn’t have to strain
or struggle to pass a bowel movement and your bowel
should feel empty after a bowel movement. Increasing
water intake, fibre and exercising can all help to keep
bowel movements more frequent.

Red flags: please notify

your doctor if your bowel
habits have suddenly
altered or if you pass
fresh blood or black,
tarry stools (melena).

12
Step 8

Nutritional
impact
As previously discussed,
it’s so important to include a
variety of food in your diet and
ensuring you’re eating enough
protein, carbohydrates, healthy
fats, fruits and vegetables.

Very often food choices can be driven by the calories load

rather than the nutritional value. Dietary choice motivated
by calories can lead to a diet that’s higher in processed
produce and lower in nutrient dense foods. Try to ensure
that when you’re making food choices they aren’t purely
driven by the calories, you also consider the nutrients
within the food.

A further benefit to nutrient dense foods is that many

are antioxidant-rich, these are an important component
of a healthy diet. Antioxidants are molecules that can
prevent or slow damage to cells caused by free radicals
in the body and are vital for good health. Free radicals are
unstable molecules that can cause oxidative stress when
they accumulate. They can be damaging if the levels in
the body become too high. This damage has been linked
to different conditions including diabetes, heart disease
and cancer. The body can naturally produce antioxidant
compounds and eating a diet rich in antioxidants can
help increase your blood antioxidant levels to fight
oxidative stress.

Foods high in antioxidants include leeks, onions, garlic,

aubergines, grapes, blueberries, strawberries and
raspberries, green tea, dark chocolate, peppers, pumpkins,
mangoes, apricots, spinach, pecans, artichokes, kale red
cabbage, spinach, pinto beans and carrots.

13
Step 9
Healthy habits diary
Actively changing
your behaviour and
healthy habits diary.
creating healthy habits
is a huge part of making
significant changes in
your diet and lifestyle.
We have already explored some of the dietary
changes you can make to improve your health or
vary your diet. Now let’s consider how to
make changes.
There are many social, cultural or financial
reasons why someone may struggle to change
their behaviour. If you have a specific goal you
want to achieve, it is important to understand
the motivation behind the desire to reach that
goal e.g. add more variety to your diet, improve
your training, or for health reasons e.g. a recent
diagnosis. It’s important to write your goals down
as well as ways in which you can make these small
changes, then you will be more likely to commit to
the lifestyle change.
It usually takes up to 12 weeks to form a new habit
and you may occasionally fall back into old habits,
so it is important to not be too self critical and to
keep making small, positive steps. One way to stay
motivated is by tracking your process using our
Tips for behaviour
change:
Understand the reason why you want to
make the changes and start by making small
achievable goals
Plan your meals for the week to limit making
poor food choices
Don’t exclude any foods you enjoy, aim to
reduce your consumption
Keeping a food and exercise diary may help
you track weekly goals and changes
Include movement in your day and take
regular stretching breaks from your desk
Batch cook and freeze portions
Include more physical activity into your
routine - an exercise schedule with a
friend or joining a group can improve your
commitment to change
Include rewards for reaching goals that are
not focussed on food
We often use food and drink as a way to celebrate
so emotional eating is not always considered a
negative, however sometimes we use food as a way
to distract, procrastinate or to handle emotional
situations. Adults make hundreds of decisions about
food each day but the majority of decisions are
unconscious and habitual and only a small number
of decisions are conscious. Taking a pause before
you eat to acknowledge any emotional triggers,
like being stressed, bored or upset, can help you to
make healthier choices.
14
Step 10
Personalised
nutrition
The global diet industry
is estimated to be worth
£254 billion, with a range
of diets topping the most
googled lists;
from the Mediterranean diet which is often
recommended in Western medicine, the
rebranded WW (Weight Watchers) to intermittent
fasting with the popular ‘5:2’ option or the
Ketogenic ‘Keto’ diet. However, there are many
factors that influence how successful a certain way
of eating or diet is. It’s not just down to compliance
and some of this is also linked to the reason for
choosing a particular way of eating.
For some, certain diets, particularly those
motivated by the desire for weight loss, don’t
suit their body or lifestyle. This can be incredibly
frustrating and lead to a feeling of failure, when
despite following a certain diet, the desired
outcome has not been achieved. Genetics, how
you metabolise different macronutrients, gut
bacteria, lifestyle and health conditions are all
possible factors that may alter the efficacy of a
particular diet.
Nutrition guidelines are designed to benefit whole
populations however the recommendations are
standardised and this doesn’t suit everyone.
This can apply to our optimum nutrient intake,
you may need higher consumption of certain
nutrients such as vitamin B12 or vitamin Dl. Whilst
equally generalised, dietary factors are recognised
as contributing to common diseases including
type 2 diabetes and heart disease but the impact
a diet has on an individual
varies. The importance
of choosing foods, which
specifically benefit you, is
becoming more apparent.
We are all unique and each
person responds to the
same food differently. These
differences can range from
certain foods which may cause
some digestive discomfort to foods
which spike your blood sugar levels.
Nutrition research currently supports
the idea that people would benefit from
a personalised diet designed to suit
their physiology, lifestyle and health
aims rather than following a generic
diet or way of eating. Research also
suggests that motivation to adapt to
personalised nutrition can depend on
your current behaviour, preferences,
resources and understanding your
barriers to making changes to your
eating patterns.
Take a moment to consider your
current relationship with food. Do you
enjoy eating and cooking? Or is food
something that is purely functional?
Do you experience guilt about eating
certain foods? Do you have a history
of yo-yo dieting? Is your diet lacking
variety? Reflecting on your current
diet and making personalised food and
nutrition choices can produce greater,
more sustained changes.
15
Step 11
Tips on how to
improve your diet
We’ve given you an insight into the importance of nutrition.
Meal plans
Putting a meal plan together and creating a
shopping list can be a great way of maintaining
a healthier diet, especially if you have limited
resources such as time, money or skill. Some people
prefer to plan and batch cook over the weekend for
the following week, whereas others may prefer to
plan weekly and prepare their meal every evening.
If food has already been prepped, you are more
likely to make healthier choices, use portion control,
save money and save time. In step 12, we will explore
an easy way to create a meal plan.
In step 3, we discussed common nutrient
deficiencies. Alongside these common deficiencies,
a typical Western diet often contains an excess
of sugar, processed foods and saturated fats. To
support your health, reduce the consumption of
red and processed meat, reduce free sugar intake
(free sugars are found in sweets, cakes, biscuits,
chocolate and some fizzy drinks and juice drinks)
and reduce saturated fatty acids (butter, ghee, suet,
lard, coconut oil, cakes, biscuits, sausages, bacon,
cured meats and cheese).
Commonly low in the western diet is fibre, which is an
incredibly important part of the diet with many health
benefits as well as improving digestion and reducing the
risk of chronic disease. Fibre feeds your gut bacteria, lowers
your cholesterol levels, reduces the rise in your blood sugar
after a meal, eases constipation and lowers your risk of
developing heart disease, type 2 diabetes and colorectal
cancer. You should aim to eat at least 30g a day.
If your diet has been low in fibre then you may experience
some bloating or discomfort as the bacteria in your gut
ferments fibre and produces gases. This will settle down
as your body adjusts to a higher fibre diet, just be sure to
increase your dietary fibre gradually.
Meal prep
It can also stop you reaching for unhealthier options
when you’re hungry or relying on options such as
take-aways. One of the easiest meals to prepare is breakfast,
we would recommend overnight oats which can be stored
in the fridge. Preparing lunch (salads, wraps, soups or
grain bowls) and snacks (yogurt, nuts, granola bars, popcorn,
fruit) the evening before can also ensure healthy meals are
available during the day.
Use time saving cooking methods
There are many different cooking methods you should
consider when you’re incorporating a healthier diet into
your busy life. Prepared steam bags of vegetables or
chopped vegetables can be used to save time and frozen
fruits can be used in smoothies or porridge. Using a slow
cooker can also be beneficial as you can prepare a healthy
meal and it would be ready for the end of the day.
Aim to eat without technology
Try to avoid eating your meals while you’re on your
computer or phone. If you’re not present while you’re eating,
you’re more likely to overeat as you’re not paying attention
to your fullness or hunger cues. If you take a break to eat,
it should reduce stress levels and improve digestion.
16
Step 12

Food plan
Meal Plans are a fantastic way to eat healthily,
save time and reduce the constant decisions
around what to eat every day.
Creating a successful meal plan
Meal planning can save time as it reduces the time
spent food shopping, prepping meals, and cooking.
It can often be difficult to prioritise healthy eating,
especially if you’re busy, however, consistently
planning at least a few meals a week can make a
significant difference to your diet. If you are working
towards a particular goal, creating a meal plan can
help you reach those goals.
If you are trying to stick to a budget, meal planning
can help you save money and try new foods.
This includes eating inexpensive grains including
rice, couscous, quinoa, bulgar wheat, oats and
vegetarian sources of protein such as lentils, beans,
cheese and tofu. Focusing on seasonal fruits and
vegetables can also be cheaper and better for the
environment.

Make time to plan a menu and create a list of your
breakfast, lunch, dinner and snack options. Check
what you have in your cupboards to avoid food
waste and prioritise the use of leftovers. Remember
to be realistic about the time you have, for example,
if you are usually pushed for time in the morning,
choose an easy, quick meal such as a smoothie or
overnight oats.
Prepping food is an important part of meal planning.
You can prepare food for the upcoming week to save
time and encourage healthy eating. For example,
chop your fruits and vegetables and cook your grains
and/or beans to add to meals. Having good quality
Tupperware is important as it helps preserve food for
longer. It can also encourage better choices when it
comes to snacks and portion control.

Allow some flexibility within

your plan and do not feel
obliged to follow it too strictly.
Don’t include too many new
recipes in your meal plan and
remember to include recipes
full of flavour and taste.

Food keeps us fuelled but it is

also something to be enjoyed!

17
 Nutrition
course
quiz
FOOD PROCESSING

1 Why is food processing used in food manufacturing?

a. To extend shelf life

b. To reduce shelf life

c. To take nutrients out of food

d. To make the ingredients list longer

2 Is food processing bad?

a. Yes, always

b. No, never

c. It depends upon why the food is being processed, how it’s processed and the nutritional

content of the food

Are there any types of food processing that you should keep to
3
an absolute minimum in your daily diet?
a. Canned foods

b. Frozen foods

c. Heavily processed foods

d. Fermented foods

4 Now for a moment of self-reflection…what percentage of your

weekly shop is processed foods? Of those items which are
heavily processed?

Answers 18
CHRONIC CONDITIONS

1 Chronic conditions can never be supported through nutrition.

True

False

2 Which chronic conditions can* be linked to nutrition?

a. Type 2 diabetes

b. Metabolic syndrome

c. Elevated cholesterol

d. Fatty liver disease

e. All of the above

*not all cases will be linked to nutrition choices, some will be due to genetics

COMMON DEFICIENCIES

1 Deficiencies can be caused 3 Omega-3 fatty acids are found in:

through dietary choice. a. Bread

True b. Apples

False c. Past

d. Oily fish

2 Vitamin D deficiency is
common in certain countries 3 You should aim to eat how many
in the northern hemisphere. grams of fibre per day?
a. 10g
True
b. 30g
False
c. 50g

d. 100g

GUT HEALTH

1 Your gut microbiome is unique and influenced by:

a. Your taste in music

b. Everyone is the same

c. What you watch on TV

d. Birth, diet, lifestyle, environment and medications

19
2 Gut bacteria is found in:
a. The liver

b. The stomach

c. The small and large intestine

d. None of the above

3 The gut:
a. Contains 10% of immune system cells and doesn’t make serotonin

b. Has nothing to do with the immune system

c. Contains 70% of immune system cells and makes 90% of serotonin

d. Contains 20% of immune system cells and makes 50% of serotonin

4 Which foods are beneficial for the gut?

a. Prebiotic and probiotic foods

b. Sugar

c. Processed foods

d. Everything is equally beneficial

EAT A RAINBOW

1 What is meant by eating a rainbow?

a. Eat different coloured sweets

b. Eat fruit and veg on days when there’s a rainbow

c. Eat different coloured fruit and veg

2 Why is it beneficial to eat a rainbow?

a. Looks pretty

b. Different colours mean different nutrients

c. For fun

3 Now for a moment of self-reflection…how varied are your fruit and

veg choices? Do you eat a rainbow or even part of a rainbow on a
daily basis?

20
BANT HEALTHY EATING PLATE

1 According to the BANT plate how many portions of fruit and veg
should you ideally have per day?
a. 0 fruit, 5 veg

b. Doesn’t matter if you eat fruit and veg or not

c. 6 fruit, 1 veg

d. 2 fruit, 5 veg

According to the BANT plate how much of your plate

2
should be protein?
a. 70%

b. 10%

c. 90%

d. 25%

3 Good examples of whole grains to include in your daily diet are

(more than 1):
a. White bread

b. Brown rice

c. White pasta

d. Oats
e. Quinoa

4 Excellent sources of healthy fat include:

a. Margarine

b. Products containing trans fats

c. Nuts, seeds, avocado

21
BRISTOL STOOL CHART

1 Your bowel habits and stools tell you nothing about your current
diet, fluid intake and lifestyle.
True

False

2 Ideally your stool type should be:

a. Type 1 or 2

b. Type 3 or 4

c. Type 4 or 5

d. Type 5 or 7

3 Now for a moment of self-reflection…what’s your usual type of

stool? How often do you have a bowel movement? Can you hold
on for a short time after you get the first urge to have a bowel
movement?

NUTRITIONAL IMPACT
Being guided by calories alone when you make food
1
choices is the ideal way to shop.
True

False

2 Antioxidants are important molecules that:

a. Speed up damage in the body

b. Help free radicals to increase in number

c. Are bad for your health

d. Prevent or slow damage caused by free radicals

22
 3 Foods high in antioxidants include:
a. Strawberries, green tea, dark chocolate and garlic

b. Milk chocolate, pasta and cheese

c. Fast food

d. White chocolate, fizzy drinks and white bread

HEALTHLY HABITS
It usually takes how long Which of the following ways can
1 2
to form a new habit? help to change behaviour:
a. 1 week a. Don’t think about it, just do it

b. 12 weeks b. Reward yourself with food when you do well

c. 6 weeks c. Understand why you want to make a change

d. 3 weeks d. Exclude all foods you enjoy

3 Adults make a large number of decisions about food everyday and

the majority are unconscious and habitual decisions.
True

False

PERSONALISED NUTRITION

1 All diets and ways of eating suit everyone.

True

False

2 What is personalised nutrition?

a. Eating the same as your best mate

b. Eating a diet designed for your lifestyle, health goals and physiology

c. Following the Keto diet

d. Eating any food you like

23
 3 Now for a moment of self-reflection…what’s your current
relationship with food like? Do you enjoy cooking and eating or do
you see food as a functional necessity? Do you experience guilt
about eating certain foods?

TIPS ON IMPROVING YOUR DIET

Your diet can hugely support your health, to do this it’s
1 recommended to:
a. Enjoy lots of free sugars in cakes, biscuits, fizzy drinks and chocolate

b. Eat lots of red meat and processed meat

c. Reduce consumption of fruit and vegetables

d. Reduce free sugars, processed meat and saturated fat

2 Pre-prepping food for meals can help you not to grab unhealthy
choices when you’re hungry or short of time.
True

False

3 Being ‘present’ whilst you’re eating means:

a. Eating when you’re watching TV

b. Eating whilst on your computer or tablet

c. Eating without technology

d. Eating whilst you read messages on your phone

24
CREATING A SUCCESSFUL MEAL PLAN

1 Meal planning is a great way to save time, money, reduce decision

making, reduce food waste and make your diet healthier.
True

False

2 Now for a moment of self-reflection…how much time do you spend

planning and shopping each week? Do you have a large amount of
food waste? Do you pre-prep any meals like making lunch the night
before or do you just grab something when you’re out? How could
you improve your meal planning?

25
Section 2 -
Understanding
the calorie
controlled diet
A comprehensive guide designed to
equip you with essential knowledge
and practical insights for embarking
on a calorie-controlled dietary
journey. In the following steps, we’ll
demystify the concept of calories,
delve into calculating your individual
calorie requirements, highlight the
importance of nutrients beyond
calories, and guide you toward
crafting a sustainable, effective, and
health-conscious calorie-controlled
diet. Join us in this educational
exploration to make informed
choices, prioritise your well-being,
and attain your dietary goals.

26
Step 1

All about calories

and nutrients
Before embarking on any new way of eating or trying
a diet it’s advantageous to understand the origins and
benefits of the diet as well as the possible drawbacks.

Calorie control is a term you’ve probably come
across many times, but do you know what a calorie
is, what calorie deficit is, how recommendations like
the ‘1500 calorie diet’ came about and if this is the
right fit for you?
A calorie is a unit of energy and specifically it is
the amount of energy that is required to raise the
temperature of one ml (also one gram), of water by
one degree Celsius. And to be very specific it is the
energy required to raise the temperature from 14.5
to 15.5 degrees C.
Originally a calorimeter was used to determine
the number of calories in an item of food. This is a
process that worked by evaporating the water in the
food, sealing it in a container with a set quantity of
water, igniting it with oxygen and then measuring
the rise in temperature of the water. Nowadays
rather than using the water temperature raising
method the Atwater system is used; this uses the
known calorie values for protein, carbohydrate, fat
and alcohol of 4kcal, 4kcal, 9kcal and 7kcal per gram
respectively; to work out calories in an item.
Calories are highly relevant because they reflect the
amount of energy available from food. Each individual
needs a certain amount of energy per day for their
body to function effectively, for example the brain
alone uses roughly 20-25% of daily energy, this could
be up to 450 calories per day, in a 5-6-year-old the brain
can use a whopping 60% of calories consumed. Any
physical activity requires further energy on top of that
required for basic body function.
When an excess of energy is consumed, so more
calories are taken in than the body requires to function
in a day, the energy needs to be stored somewhere,
and the body does so in the form of body fat. When less
calories are consumed than the body requires stored
energy is used to enable the body to function.

So you can see that having an

understanding of your daily energy
requirement is crucial to know
when you might be taking in
too much, as this will lead to an
increase in body fat and equally
can allow you to create a calorie
‘deficit’ to encourage the body to 27
use its stored energy.
Step 2
Working out your
calorie requirements
Most people are aware of the
general recommendation of
2000 kcal per day
For the average woman and 2500 kcal for the average
man, this can often be found on food packaging and
is meant as a guideline. However, this is VERY general,
in fact energy or calories required per day is highly
individual because each person functions differently.
Individual calorie requirement is based on something
called the basal metabolic rate (BMR). This is the
amount of energy, or calories, the body requires in
a day whilst at rest to maintain its most basic vital
functions such as breathing, maintaining circulation
and keeping warm.
The Harris-Benedict formula is often used as a
method of estimating BMR, it takes height, weight
and age into consideration, which begins to shape a
more individual energy requirement.
Women
BMR = 655 + (9.6 × weight in kg) + (1.8 × height in cm) –
(4.7 × age in years)
Men
BMR = 66 + (13.7 × weight in kg) + (5 × height in cm) –
(6.8 × age in years)
Once BMR has been calculated daily activity level
needs to be factored in, this can account for great
variations in energy requirements. For example an
office worker who is sat at their desk for 7.5 hours
of the day would require far less energy than a
landscape gardener who spends the day walking,
digging and lifting.
Sedentary. If you get minimal or no exercise,
multiply your BMR by 1.2.
Lightly active. If you exercise lightly one to three
days a week, multiply your BMR by 1.375.
Moderately active. If you exercise moderately three
to five days a week, multiply your BMR by 1.55.
Very active. If you engage in hard exercise six to
seven days a week, multiply your BMR by 1.725.
Extra active. If you engage in very hard exercise six
to seven days a week or have a physical job, multiply
your BMR by 1.9.
As well as gender, height and weight there are other
factors which affect BMR such as ethnicity, weight
history, body composition and genetic factors. Body
composition measuring devices are an excellent
way to calculate BMR. These give a more accurate
estimation of BMR because body composition, so how
much muscle mass (as well as fat mass and water),
is measured. Muscle mass has a great impact on the
amount of energy required in a day and the calories the
body uses at rest and is why doing resistance training is
always recommended as part of a fat loss programme,
as preserving or building muscle mass means more
calories used at rest therefore a higher BMR.
If you’re considering a calorie-controlled diet working
out your own BMR and then adding your activity on
top will give you a more accurate estimation of your
daily energy requirements. To bring about weight loss
a calorie deficit is needed, this means taking in less
calories than you need in a day.
A piece of research from 1958 is still used today that
shows creating a deficit of 500 kcals per day across a
week, by taking in less energy or increasing physical
activity, or ideally both, can lead to a loss of 1lb body
fat. The 1500-calorie diet is based upon this theory, and
takes the average daily requirement of 2000 kcals and
reduces it by 500 kcals.
Step 3

A diet based
on calories
Calories, providing energy,
from food is of course vital, but
food also contains macro and
micro nutrients in the form of
carbohydrates, proteins, fats,
vitamins and minerals.
These nutrients are equally essential in the diet as they each
have different and important jobs in the body beyond just
providing energy.

Food choices purely driven by calorific value can lead

to little or no consideration for the nutrient value of the
food, so what the food provides in terms of carbohydrates,
protein, fats, fibre, vitamins and minerals. Dietary choice
motivated solely by calories can result in a diet that’s
higher in processed products and lower in nutrient dense
food, that provides essential fatty acids, fibre, vitamins
and minerals. Diet foods, in particular, may appear to be
healthier as they contain fewer calories however fewer
calories doesn’t always mean a food is healthy.

Taking a broader approach to food choice is definitely

recommended rather than making a choice based on
just how many calories are in an item. If you look solely at
calories you could be making a choice between 2-finger
Kit Kat and a banana, each containing roughly 105 kcals. In
doing so many people would choose the Kit Kat but choices
like this mean losing out on many important nutrients.
You can see that
Comparing these two items the chocolate bar and consistent choices
banana have roughly the same amount of sugar 10g and
14g respectively, however the sugar in the chocolate bar
like this across a day,
is called ‘extrinsic’ so added whereas it’s ‘intrinsic’ in a a week or year totally
banana, so part of the fruit itself. The chocolate bar contains
fat whereas the banana doesn’t, but they both contain
change the makeup and
roughly the same amount of protein. However, where they nutrient value of a diet.
completely differ; the banana is an excellent source of fibre
and potassium, and additionally contains magnesium,
29
vitamin C and vitamin B6.
Step 4

What does a good

calorie-controlled diet
look like?
Before anything else a good calorie-controlled diet needs
to be individualised to ensure it works.
The 1500-calorie diet for example is based upon
the average daily requirement of 2000 kcals and
reduces it by 500 kcals, however this may not be the
right fit for you as an individual as your daily energy
requirement may be 1600 kcal, therefore, to create a
deficit of 500 kcal you would need a 1100-calorie diet.
One of the cited benefits about calorie-controlled
diets is that no foods are disallowed, so you don’t
necessarily have to change what you eat, just
use portion control to eat less of it and for some
this is perfect as they already have a nutritious
diet, it’s just they have too much of it. However,
for those who don’t have a nutritious diet calorie
control means they can continue to eat the bad
diet, one that’s devoid of nutrient value, but just
eat it in smaller quantity. This doesn’t bring about
habit or behavioural change or encourage an
understanding of how to put together a cleaner
and healthier diet for the long term. And in the
absence of habit or behavioural change or learning
about what constitutes a good or bad diet, when
the individual ceases the calorie-controlled diet
they simply continue to eat the way they did before.
This very likely means that in time they will regain
any weight they lost. It’s this lack of long-term
behavioural change that frequently leads to many
people finding themselves in a continual cycle of
dieting, eating ‘normally’ again and after a period of
regaining weight back to dieting.
Therefore, learning how to eat a generally cleaner
diet and bringing about behavioural change. This
can mean a more enjoyable experience whilst eating
a calorie-controlled diet as in switching to a more
whole foods diet you may find you are able to eat far
more than you thought. But also this should result
in longer term change, and in doing so negating
the need for dieting in the future. Ideally a daily diet
should be full of good protein sources, essential
fatty acids (omega-3 and 6), fibre, vitamins and minerals
and so could include whole grains, pulses, legumes, root
vegetables, leafy greens, salads, fruit, nuts, seeds, avocado,
good quality oils, fish, eggs, poultry, lean red meat, tofu,
tempeh, and good quality live yogurt.
There are of course there are exceptions to the rule, when
it’s good to just enjoy the moment and treat yourself, like
going out for afternoon tea with friends, having a slice of
birthday cake or enjoying a beer. But these ideally should
be exception to the rule rather than the rule.
Tips for an effective and healthy
calorie-controlled diet
What’s your BMR? Work out your individual
calorie requirement per day.
Start small with portion control At the
beginning of a meal, take slightly less than
what you think you’ll eat.
Use fibre and protein. Stock up on fibrous
foods and protein, these will help you to stay
fuller for longer. If you’re still hungry, eat
more vegetables or fruit.
Eat from a plate, not from packaging
Putting all your food onto one plate allows
you to see how much you’re eating whereas
eating directly from a packet gives you no
sense of the quantity you’ve eaten. Consider
also using a smaller plate or bowl.
Check food labels. Use nutrition labelling
to tell you the number of calories but also
look for fibre, protein, essential fatty acids,
vitamins, and minerals as these are all
important in a good daily diet.
 Calorie-
controlled
diets quiz
ALL ABOUT CALORIES AND NUTRIENTS

1 Why are calories relevant?

a. They represent the number of times you have to chew food

b. They aren’t

c. They tell you the amount of energy available in a food item

d. They are just a random number given to a food

2 What is the value of a gram of protein, carbohydrate and fat

a. 3,4,10

b. 4,4,4

c. 4,4,9

d. 6,5,5

3 What happens when you take in more calories than you need?
a. You lose weight

b. You gain weight

c. Nothing happens

WORKING OUT YOUR CALORIE REQUIREMENTS

1 BMR stands for

a. Base metabolic response

b. Basal metabolic rate

c. Basal mental rate

d. Base mechanical rate

Answers 31
 2 Muscle mass has no impact on the amount of energy the body requires
True

False

3 In addition to height, weight and age which other factors affect your
basal metabolic rate?
a. Nothing else

b. Genetics and ethnicity

c. Ethnicity, weight history, body composition and genetics

d. Weight history and body composition

A DIET BASED ON CALORIES

1 What are the macronutrients?

a. Carbohydrate, protein and fat

b. Carbohydrate, fat and vitamins

c. Vitamins, minerals and protein

d. Protein, fat and minerals

2 Choosing foods purely based upon calorie content…

a. Is the only way to make food choices

b. Always means you’re eating healthily

c. Guarantees that food is more nutritious

d. Sometimes means a diet that’s lower in nutritious food

3 A moment of reflection, do you make choices purely based

upon the number of calories in a product? Do you think this is
leading to a nutritious diet or could it be improved?

32
WHAT DOES A GOOD CALORIE-CONTROLLED
DIET LOOK LIKE?
If you were to follow the 1500-calorie diet what needs to be worked out
1
to understand whether this would work for you?
a. How long to do the diet for

b. If you could eat you favourite foods

c. Individualised calorie requirement

d. Which day of the week to start on

2 What is good about behavioural change around food?

a. Helps change the way you think and feel about food

b. Helps you make better food choices

c. Helps you to make changes for the long-term

d. All of the above

3 A moment of reflection, have you spent many years yo-yo dieting or

using calorie controlled diets? Do you think behavioural change could
help you to make more long-term change and prevent your weight
from going up and down?

33
Section 3 -
Diabetes
and
nutrition
In this exploration of “Diabetes
and Nutrition,” we’ll delve into the
intricate relationship between
blood sugar levels and nutrition,
shedding light on the essential
hormones that influence glucose
metabolism. We’ll distinguish
between Type 1 and Type 2 Diabetes,
highlighting their characteristics,
diagnostic factors, and associated
risks. Understanding the vital role of
nutrition in managing pre-diabetes
and diabetes is key, emphasizing
recommended diets and lifestyle
changes. Delving into Type 1
Diabetes, we’ll explore essential
skills like carbohydrate counting and
insulin management, ensuring a
holistic understanding of nutrition’s
impact on overall well-being for
both types of diabetes. Join us as we
navigate the crucial intersection of
nutrition and diabetes management
for a healthier, informed lifestyle.

34
Step 1

Getting to know
blood sugar
Glucose is a simple sugar
contained in some food
and drink and absorbed
under hormonal control.
It is used as a primary source of energy. The body
keeps glucose levels, also known as blood sugar,
under tight control as it can only operate when
glucose levels in the blood remain within a certain
range. Blood glucose levels vary greatly during the
day, and are of course dependant on what was
eaten and when.

The two hormones most crucial to the metabolism

of glucose are insulin and glucagon. Following
a meal, blood glucose levels rise quickly, the
body releases insulin to bring the level back to
the individual’s normal level. Insulin is produced
in the pancreas by the beta cells of the Islets of
Langerhans and released to store glucose in the
body’s cells and use peripheral glucose. Glucagon
is in the pancreas by the alpha cells of the Islets
of Langerhans and released in response to low
glucose levels, such as during fasting.

Very low levels of glucose

circulating in the blood is
called hypoglycaemia, and
can be a cause of fainting.

35
Step 2
Type 1 versus
Type 2 Diabetes
There are two types of
Diabetes Mellitus (DM)
that are essentially two
different conditions.
Type 1 diabetes is where insulin is no longer being
produced in the body. This is an autoimmune
condition, meaning that the body’s immune
system has attacked and destroyed the beta cells
of the Islets of Langerhans, which would ordinarily
produce insulin. In type 2 diabetes insulin is
secreted normally, however the tissues do not
appropriately respond, this is known as insulin
resistance.
Type 1 DM is usually diagnosed in children and
young adults, although it can appear at any age.
Once diagnosed an individual with type 1 will
need to take insulin for the rest of their life. It is
not uncommon for type 1 DM to be diagnosed
when an individual suddenly becomes very ill and
requires emergency medical attention. Type 1 DM
is not linked with age or being overweight, unlike
type 2 DM.
Type 2 DM is the most common form of DM
and normally develops over time in middle
aged individuals. It is usually linked to being
overweight, having a sedentary lifestyle or having
a family history of type 2 DM.
There is a further type of diabetes called
gestational diabetes, this can occur in some
women when they are pregnant. Once the baby
has been delivered usually the diabetes resolves
itself. However, this individual would now have a
greater chance of developing type 2 DM later in
their lifetime.
Pre-diabetes and diabetes are
often associated with:
• A sedentary lifestyle
• A bad diet
• Obesity
• Pancreatitis or pancreatectomy
• Polycystic ovary syndrome (PCOS)
• Cushing’s syndrome.
• A personal or family history of gestational diabetes
Diabetes can present with
symptoms such as:
• Frequency of urination (10+ times a day)
• Dizziness
• Blurred vision
• Increasingly fatigued
• Excessive persistent thirst
• Dry eyes or mouth
• Itchy skin (especially in the genital region)
• Pain or numbness in the hands
• Yeast infections
• Slow wound healing
• Frequent infections
Over time being diabetic, whether it be type 1 or 2,
can lead to serious long term ill health, and increase the
risk of having a heart attack or stroke, and kidney, dental
and nerve complications. Whilst type 1 DM cannot be
prevented, positive steps can be taken to reduce the risk
of developing type 2 DM.
Testing
Glucose or HbA1c blood testing is the best method of
understanding the presence of diabetes. It can also
show when an individual is at risk of developing
diabetes, this is called pre-diabetes.
Pre-diabetes is a critical point in the
development of type 2 DM, when blood
sugars are increasing to levels, which
indicate that unless changes are made
to the diet and lifestyle type 2 DM will
develop at some point in the future
along with the serious long term
complications it brings. However early
action can slow down or even stop the
chance of ever developing type 2 DM.
36
Step 3
Nutrition and Type
2 Diabetes
Diet plays a huge role in the prevention of developing
pre-diabetes and type 2 diabetes.
Whilst reducing sugar intake is an important part of
preventing the development of diabetes, there are
more steps that need to be taken.
People are unique so there isn’t one diet alone that
should be followed to prevent prediabetes and
diabetes, however the most highly recommended
diets are similar to those associated with preventing
cardiovascular diseases, with the Mediterranean diet
being the most famous.
The Mediterranean diet includes:
• Reduction of fried foods, sweets, sugary drinks, or
anything too salty or fatty
• Eating more vegetables, whole grains, low-fat dairy
products, nuts and wholegrains
• Eating more fruit, and whilst fruit is seen as sugar,
its natural sugar so far healthier than added sugar
• Swapping red or processed meat for turkey or
chicken or other lean protein
• Eating heart-healthy fish at least twice a week, such
as salmon, mackerel, tuna or sardines
• Replacing butter with olive oils
Eating a healthy and nutritious diet is
important for everyone, regardless of diabetes
status but for those individuals who have diabetes,
or are at risk of developing diabetes, further
recommendations include:
• Watch portion sizes and the amount of calories
consumed
• Aim to reduce snacks and keep them as occasional
treats only
• Look at alcohol intake, as most alcohol is very high in
sugar content
• Regular exercise – 2.5-3 hours per week
Taking these steps can lower blood glucose levels and
promote weight loss, both of which help to reduce
diabetes symptoms and in some cases can put diabetes
into remission. They can also lead to a reduced risk
of other health complications such as heart attacks,
strokes, and even certain cancers.
There are many other diets, which are advocated for
preventing prediabetes or type 2 diabetes such as:
• DASH (Dietary Approaches to Stop Hypertension)
• Zone diet (where meals are 40% carbs, 30% protein,
and 30% fat)
• Vegetarian or vegan diets
• Weight watchers
• The Atkins diet
• Extreme low-calorie diet (800 to 1200 calories a day for
12 weeks)
It is always recommended to seek advice from a
nutritionist or dietician before embarking on any
major change in diet. If you are diagnosed pre-diabetic
or diabetic your doctor may offer you a structured
educational course to help you understand how the
food you eat and drink affects your body.
37
 Diabetes
and nutrition
quiz
GETTING TO KNOW BLOOD SUGAR (STEP 1)

1 Blood glucose levels stay the same all day long.

True

Flase

2 What are the two hormones most critical to metabolism called?

a. Glucagon and TSH

b. Insulin and glucose

c. Glucagon and insulin

d. Adrenaline and insulin

3 What is glucagon released in response to?

a. High glucose level

b. Low glucose level

TYPE 1 VERSUS TYPE 2 DIABETES (STEP 2)

1 Type 1 diabetes is an autoimmune condition that cannot be prevented

True

Flase

2 Type 2 diabetes is just a factor of age and cannot be prevented.

True

Flase

Answers 38
 3 Common symptoms of diabetes include:
a. Frequent urination and blurred vision

b. Fatigue and slow wound healing

c. Excessive thirst and frequent infections

d. Itchy skin, dry eyes or mouth, yeast infections

e. All of the above

NUTRITION AND TYPE 2 DIABETES (STEP 3)

1 The Mediterranean diet is the only diet that helps to prevent

prediabetes and diabetes.
True

Flase

2 How many hours of exercise are recommended per week?

a. None

b. 30 mins – 1 hour

c. 1.5 – 2 hours

d. 2.5 – 3 hours

3 How can diet and lifestyle changes help to prevent diabetes?

a. By increasing blood sugar

b. By lowering blood sugar

c. By lowering blood sugar and helping weight loss

4 A moment of reflection…what’s your daily diet like? Do you have

prediabetes or suspect that you may have? Have you ever had your
blood glucose levels tested?

39
NUTRITION AND TYPE 1 DIABETES (STEP 4)

1 What is carb counting?

a. Counting how many calories are in a meal

b. Counting how many carbs are in a meal

c. Counting how much protein is in a meal

Continuous glucose monitors allow a type 1 diabetic to understand

2 exactly what their blood sugar level is at any one time?

True

Flase

3 When should a type 1 diabetic use sugary drinks?

a. Never

b. Anytime

c. If they are hypoglycaemic

40
Section 4 -
Eating for mood
and mental health
Exploring the realm of “Eating for Mood and Mental
Health,” we investigate the vital relationship between
nutrition and mental well-being. Anxiety and depression,
prevalent worldwide, can significantly impact one’s
daily functioning and quality of life. Through extensive
research, we uncover the intricate links between the
food we consume and how it influences our mood. The
gut-brain axis, a crucial connection between the gut and
brain, plays a pivotal role, showcasing how a healthy gut
can profoundly impact mental health. We venture into
dietary choices that foster a balanced gut microbiome,
offering insights into probiotics, prebiotics, and dietary
fiber. Furthermore, we illuminate the Mediterranean
diet’s positive correlation with improved mental health,
emphasizing key nutrients like protein, calcium,
magnesium, and Vitamin B12 that play a crucial role in
mood regulation. Concluding with practical tips to uplift
mood and enhance mental health through mindful
dietary choices, this guide provides a holistic perspective
on nourishing both the body and mind.

41
Step 1
Eating for mood
and mental health
Anxiety and depression are the most common
mental health issues worldwide.
Whilst there is far greater recognition, diagnosis,
and treatment for these conditions in today’s
society, there are still a large number of people
who aren’t clinically diagnosed but still experience
the symptoms of anxiety and depression, which
for many affects their wellbeing, daily function and
quality of life.
Many research studies have looked at the
relationship between nutrition and mental health
showing that there are strong links between the
food we eat and how we feel.
The gut brain axis
When considering mental health and mood it’s
logical to focus on the health and function of the
brain, however there’s increasing evidence showing
that improved gut health can have a significant
impact on mental health symptoms like anxiety,
with dietary patterns and food choices having a role
to play.
The gut and brain are closely linked through both
physical and chemical connections. The gut-brain
connection, or axis, is two-way communication that
occurs between the gut and the brain, linking the
As well as dopamine, norepinephrine,
acetylcholine, and gamma-
aminobutyric (GABA). studies have
shown that several species of bacteria
are missing from the gut microbiome of
people with anxiety and depression.
enteric and central nervous systems and involves
the nervous system, immune system and a system
of chemical messengers called neurotransmitters.
Physically the brain and gut are connected via the
vagus nerve, which runs from the brain to the colon.
It’s been shown that the vagus nerve plays a vital
role in carrying signals between the brain and gut.
The gut is home to the gut microbiome or gut
bacteria; found in the small and large intestine,
the microbiome is made up of trillions of
microorganisms including bacteria, fungi and
viruses. Extensive research into the gut microbiome
in recent years has shown that it is not just
important for digestive function, but also for mood
and mental health as well.
Scientists have found that gut bacteria help to
regulate and produce certain neurotransmitters
that are extremely important for mood regulation
and emotional wellbeing, these form a large part of
the gut-brain connection. Some 90% of serotonin,
sometimes referred to as the ‘happy hormone’,
which is important for mood, emotions, sleep,
appetite, and digestion, is made in the gut.
42
Step 2

Keeping the
gut healthy to
boost mood
With research showing the strong
links between nutrition and
mental health, dietary choices
become even more important, to
help keep the gut healthy and the
levels of bacteria balanced.
Certain foods, containing bacteria, can boost the diversity
and number of bacteria in the gut, these are called probiotics.
Whilst others provide much needed fuel to help the bacteria
to multiply and flourish, known as prebiotics. Conversely a
diet high in sugar, refined and processed foods can negatively
impact the balance of gut bacteria.

Probiotics are found in foods that have been through a

fermentation process or have had probiotics added to them.
Good probiotic foods include good quality plain yogurt, kefir,
kombucha, sauerkraut, miso soup, pickled vegetables, tempeh,
kimchi, sour dough bread, goat’s cheese, olives, good quality
dark chocolate and spirulina.

Prebiotics are classed as such because they stimulate the

growth or activity of certain ‘good’ bacteria in the large intestine.
Prebiotic foods include onion, garlic, leeks, cabbage, asparagus,
chicory, artichoke, banana, apple, wheat bran, flaxseed and root
vegetables.

Dietary fibre is an incredibly important part of the diet

which helps to keep the gut healthy, improves digestion and
reduces the risk of chronic disease. Fibre is a non-digestible
carbohydrate found in foods, that can be divided into
two categories; soluble fibre and insoluble fibre. The daily
recommended amount of fibre is 30g a day.

43
Step 2
Keeping the gut healthy to boost mood
Soluble fibre dissolves in water and forms a gel
in the gut, it can be digested by the body and
helps to keep stools soft. Soluble fibre ferments
in the large intestine and produces short-chain
fatty acids which are an energy source for colon
cells and help keep the gut healthy. Foods high
in soluble fibre include:
Vegetables – onions, carrots,
potatoes, Avocados
Beans – pinto, kidney, chickpeas
Pulses and lentils
Whole grains – oats*, barley, rye
*Oats contain beta glucans which have
been strongly linked to lowering cholesterol
levels and boosting heart health. Aim to
include more oat-based products in the
diet such as porridge, muesli and oat cakes.
Beta glucans can also be found in bran,
wheat and barley
Insoluble fibre adds bulk to the stool and is needed
for proper elimination of toxins and hormones.
Insoluble fibre isn’t digested but helps to regulate
bowel movements and provides bulk to help form
stools. Insoluble fibre foods include:
Nuts/nut butter – almonds, walnuts, cashews
Seeds – flaxseed, linseeds
Wholegrains
Vegetables – asparagus, peppers
Dark green leafy vegetables – broccoli,
spinach, kale
Increasing the amount of fibre in the diet gradually is
recommended as a sudden increase can sometimes
lead to bloating or discomfort as bacteria in the
gut ferments the fibrous food and produces gases.
The body will adjust more easily if fibre intake is
slowly increased. It is also important to remember to
increase fluid consumption to support the increase in
fibre in the diet.
Tips for increasing fibre intake:
Choose a high fibre breakfast cereal or porridge
Eat wholemeal or granary breads, wholewheat
pasta or brown rice
Add beans, lentils and chickpeas to stews, curries
and salads
Keep the skins on potatoes (baked potato or
boiled new potatoes)
Include plenty of vegetables with meals and
snacks
Add fresh fruit, vegetable sticks (carrot, cucumber,
celery), oatcakes and seeds to the diet
44
Step 3

The mediterranean
diet for mood and
mental health
Research has shown that certain diets are associated with
a reduced risk of depression and anxiety.

The Mediterranean diet, as a pattern of healthy The protein sources in the Mediterranean diet are
eating, has been associated with better mental excellent for vitamin B12 and l-tryptophan, both of
health than an “unhealthy” pattern of eating, such as which are important in mood regulation. Being rich in
the Western diet. vitamins, minerals and antioxidants, this way of eating
is also excellent for calcium and magnesium intake,
The Mediterranean diet is generally based upon the again important for mood.
daily intake of fruit and vegetables, whole grains,
legumes, nuts, fish, white meats, and olive oil, with The amino acids, which are the building blocks of
fermented dairy products, red meat, and red/white protein, are used in the body for a number of vitally
wine being included but sparingly. As a way of eating important roles.
the Mediterranean diet is low in saturated fats and
animal proteins, yet rich in monounsaturated fats and
omega-3 fatty acids, which are linked to brain health
and mood. This dietary pattern is also high in fibre,
which improves digestive health and helps to control
blood sugar.

45
Step 2

Key nutrients for

mood and mental
health
Protein is of particular importance in the diet when
looking at mood and mental health.
L-tryptophan, is an essential amino acid, meaning
that it cannot be made in the body and must be
consumed through the diet. This amino acid is
converted into serotonin, a neurotransmitter that
helps regulate mood and sleep as well as a whole
host of other functions in the body: social behaviour,
learning, cognition, memory, cardiovascular function,
sensorimotor function, pain sensation, appetite,
bowel motility, bladder control, and sexual desire.
Phenylalanine and tyrosine are amino acids that
are used in the body to make dopamine, as well as
epinephrine and norepinephrine. The dysfunction
of dopamine, epinephrine and norepinephrine can
cause depression. Dopamine influences motivation,
pain and pleasure.
Magnesium rich foods include buckwheat, rye, millet,
brown rice, whole wheat, kelp, almonds, cashews, Brazil
nuts, peanuts, walnuts, tofu, coconut, soya beans, figs,
apricots, dates, prawns, corn, avocado, spinach, kale,
broccoli swiss chard, turnip greens and collards.
Vitamin B12
Vitamin B12 and insomnia have been linked for some
time however the evidence around the effect of
vitamin B12 levels on sleep is inconclusive. B12 does
play a role in the production of melatonin and it is
possible that a deficiency of B12 could lead to disrupted
sleep patterns.

Good sources of protein include; chicken, turkey, red

meat, pork, duck, tofu, tempeh, salmon, tuna, trout,
mackerel, shrimp, sardines, eggs, milk, cheese, yogurt,
nuts and nut butters, seeds, lentils, kidney beans,
black beans, chickpeas, butter beans, edamame
beans, whole grain rye and wheat, quinoa and oats.

Magnesium
Magnesium is a natural relaxant in the body and
is recognised as playing an important role in sleep
regulation. Studies show a lack of magnesium in the
body can negatively affect sleep with low levels being
associated with anxiety and depression.

46
Step 3
Key nutrients for mood and mental health

Research has also shown that people with higher levels

of vitamin B12 are less likely to suffer from depression
and those with depression very often also have
insomnia and sleep problems.

Vitamin B12 rich foods include oysters, mussels,

scallops, liver, mackerel, tuna, salmon, sardines, crab,
beef, eggs, yogurt, Swiss cheese and fortified products.
Excluding fortified products Vitamin B12 sources are
all from animal sources therefore if you follow a vegan
or predominantly plant-based diet it may be worth
considering supplementing vitamin B12.

Top Tips to Boost Mood and Improve

Mental Health
Eat a variety of fruit and vegetables, wholegrain
cereals or bread, nuts and seeds. Fruit and
vegetable consumption was found to be the health-
related behaviour most consistently associated with
mental wellbeing in a study population

Eat more essential fatty acids (oily fish), aim for at

least 2 portions a week

Aim for regular meals throughout the day to

balance your blood sugar. If your blood sugar drops
you may feel tired, flat and irritable

Choose unsaturated oils (olive oil, avocado oil,

vegetable oils)

Include a good protein source in every meal

Purple and blue plant foods contain polyphenols

and antioxidants that benefit mood and brain
function, as well as reducing oxidative stress and
inflammation. Include aubergines, blueberries,
blackberries, purple carrots, beetroot, cabbage in
your diet.

Support your digestive health and microbiome,

including probiotic and prebiotic foods your
daily diet

Include food sources of B vitamins, magnesium

and calcium on a daily basis

47
 Eating for mood
and mental
health quiz
THE GUT BRAIN AXIS (STEP 1

1 Which systems in the body are involved in the gut-brain axis?

a. The cardiovascular system and nervous system

b. The immune system and cardiovascular system c.

c. The immune system, nervous system, and neurotransmitters

d. The nervous system and neurotransmitters

2 What’s the name of the nerve that connects the brain and gut
a. Vagus nerve

b. Femoral nerve

c. Sciatic nerve

d. Axillary nerve

3 Roughly 90% of which neurotransmitter is made in the gut?

a. Testosterone

b. Serotonin

c. Melatonin

d. Dopamine

Research has shown that the gut microbiome is only important for
4
digestive function.
True

Flase

Answers 48
KEEPING THE GUT HEALTHY TO BOOST MOOD (STEP 2)

1 Which sort of foods can help to increase the number and diversity of
bacteria in the gut?

a. Prebiotic

b. Probiotic

c. Fatty

d. Sugary

Prebiotic foods aid gut health by providing good bacteria with fuel,
2
stimulating growth and activity.
True

Flase

3 What is the recommended intake of fibre?

a. 5g

b. 10g

c. 20g

d. 30g

4 Insoluble fibre isn’t digested therefore serves no purpose.

True

Flase

5 Now for a moment of self-reflection…what’s your fibre intake like?

Do you have enough in your diet? How could you improve your
intake?

49
THE MEDITERRANEAN DIET FOR MOOD AND MENTAL
HEALTH (STEP 3)

1 Which dietary type has been associated with better mental health?
a. The Western diet

b. The Middle Eastern

c. The Mediterranean diet

d. The ketogenic diet

2 Which foods are included sparingly in the Mediterranean diet?

a. Fish, nuts and legumes

b. Wine, white meat and olive oil

c. Whole grains, dairy products and fish

d. Wine, red meat and dairy products

3 Monounsaturated fats and omega-3 fatty acids are linked to…

a. Brain health

b. Digestive health

c. They aren’t beneficial

d. Ear health

KEY NUTRIENTS FOR MOOD AND MENTAL HEALTH

(STEP 4)

1 An ‘essential’ amino acid means that it can be made in the body

a. True

b. False

2 Which amino acid is converted to serotonin in the body?

a. Phenylalanine

b. Tyrosine

c. Leucine

d. Tryptophan

50
3 Which mineral helps the conversion of serotonin and melatonin in the
brain?

a. Zinc

b. Copper

c. Magnesium

d. Calcium

Research shows that people with higher levels of vitamin B12 are more
4
likely to suffer from depression
True

Flase

3 Which foods are the richest sources of vitamin B12?

a. Fruit and vegetable sources

b. Vegan sources

c. Animal sources

d. Grain sources

51
Section 5 -
Eating
for sleep
Sleep, a fundamental component
of overall well-being, is explored
comprehensively in this guide on
“Eating for Sleep.” Exploring
the importance of sleep
for physical and mental
health, we highlight the
factors that can disrupt
sleep and the nutrients
that positively influence
it. From L-Tryptophan
to melatonin-rich foods
and essential nutrients
like magnesium and
calcium, we shed light on
dietary choices that promote
better sleep. Moreover, we
emphasize the bidirectional
relationship between sleep
and weight management,
offering practical tips for a
restful night’s sleep.

52
Step 1

Why is sleep
important?
Sleep is essential for every process in the body and
important for both physical and mental health.

Whilst the physical state of the body is quiet, sleep is

a time when the body recovers and rebuilds, and the
brain is incredibly active carrying out many important
functions. Adults are recommended to get between
7-9 hours of sleep a night but more than half (51%) of
adults worldwide report that they get less sleep than
they need on an average night.

Poor sleep affects the ability of the body to function

physically and mentally the next day, but also it affects
metabolism, increases chronic disease risk and reduces
the body’s ability to fight disease and develop immunity.
Sleep issues have been associated with obesity,
diabetes, depression, hypertension, cardiovascular
disease, lack of concentration and memory problems.
Sleep is of particular importance for maintaining
baseline mental health

A chronic lack of sleep quality

is associated with depression
and anxiety. There is also a
bidirectional association, this
means that often experiencing
anxiety and depression can lead
to poor sleep this then impacts
the ability to cope with the
anxiety and depression.

53
Step 2

What can
affect sleep?
Sleep can be disrupted in a number of different ways

Some people with sleep issues struggle to fall
asleep, whereas others have sleep that lacks quality
due to frequent waking and for some they wake
early and are unable to fall back to sleep.
Sleep problems and
insomnia can due to a
variety of reasons:
Mental health disorders such as stress,
anxiety, and depression
Medication (some can disturb your
natural sleep cycle)
Physical discomfort such as chronic
pain or restless leg syndrome
Whilst alcohol can mean falling asleep more
quickly, it disrupts the circadian rhythm and
prevents the body from reaching the deep sleep
needed for proper rejuvenation. Other negative
eating patterns such as skipping breakfast and
eating irregularly have been associated with poor
sleep quality.
Growing evidence indicates that taking in enough
of the right nutrients is important for sleep. One
large study found a lack of key nutrients, such as
calcium, magnesium, and vitamins A, C, D, E, and K
to be associated with sleep problems. This supports
the likelihood that diet affects the hormonal
pathways involved in sleep.

Lack of sleep hygiene such as too

much light or noise, blue light from
screens before bed and a lack of regular
bedtime

Nutrition such as a diet high in caffeine

or sugar

It is well-known that certain substances, such

as caffeine, can affect one’s ability to fall asleep
but the quality of sleep can be affected by
frequent consumption of energy drinks and
sugar-sweetened drinks, as well as having
high-carbohydrate meals with high glycemic
load. High-carbohydrate meals can impair
sleep quality and high carbohydrate intake
has been shown to increase the number of
awakenings at night and reduce the amount of
time spent in deep sleep.

54
Step 3
How can
nutrition
positively
affect sleep?
Along with sunlight, certain
nutrients in food provide the
body with the constituents
it needs to produce the
neurotransmitters and
hormones that regulate sleep
in the body.
Protein is of particular importance and specifically
L-Tryptophan, this is an amino acid, one of the
building blocks of protein. L-Tryptophan, is an
essential amino acid, meaning that it cannot be
made in the body and must be consumed through
the diet.
L-Tryptophan is converted into serotonin, a
neurotransmitter that helps regulate mood and
sleep as well as a whole host of other functions in the
body: social behaviour, learning, cognition, memory,
cardiovascular function, sensorimotor function, pain
sensation, appetite, bowel motility, bladder control,
and sexual desire. Rich sources of L-Tryptophan
include; chicken, turkey, red meat, pork, tofu, salmon,
tuna, milk, cheddar cheese, peanuts, edamame
beans, pumpkin seeds, oats, bananas, and eggs.
Serotonin is also the precursor, so the building
block, for melatonin, and is converted to melatonin
in darkness. Melatonin is a hormone which regulates
the body’s sleep-wake cycles and whilst it doesn’t
actually make us fall asleep, it plays the essential role of
letting the brain know that it’s time to go to sleep.
Melatonin deficiency or dysfunction is associated with
sleeping problems that typically involve difficulty falling
asleep, frequent waking and inability to stay asleep,
and waking up too early and not being able to fall
back to sleep. Low melatonin levels play a role in stress
and mood disorders, with the resulting lack of sleep
increasing the stress hormone cortisol.
Melatonin-Rich Foods
Tart Cherries - Tart cherry juice is one of the
best-known sleep aids. Researchers have found
that it increases melatonin levels in the body
and enhances sleep. Eating cherries instead of
drinking their juice is a healthier way of getting
melatonin but if you do drink it do so in small
quantity.
Goji Berries - High in melatonin and may
improve sleep, they also have anti-aging
properties!
Eggs - one of the best animal sources of
melatonin.
Milk - Warm milk is a traditional remedy for
insomnia and is high in melatonin.
Fish - The best sources of fish rich in melatonin
are oily fish like salmon, tuna and sardines.
Nuts - Most nuts have a good amount of
melatonin with pistachios and almonds being
the richest nut sources highest.
55
Step 4

Other nutrients
that aid sleep
Magnesium is a natural relaxant in the body and is
recognised as playing an important role in sleep regulation.
Studies show a lack of magnesium in the body can often wake up several hours after falling asleep and
negatively affect sleep with low levels being associated can have difficulty getting back to sleep.
with poor sleep quality and insomnia, as well as anxiety
and depression which can both contribute to insomnia. Calcium rich foods include watercress, kale, broccoli,
low fat mozzarella, low fat cheddar, yogurt, pak choi,
Magnesium rich foods include buckwheat, rye, millet, tofu, sugar snap peas, almonds, tinned sardines in oil
brown rice, whole wheat, kelp, almonds, cashews, Brazil with bones and tinned pink salmon.
nuts, peanuts, walnuts, tofu, coconut, soya beans, figs,
apricots, dates, prawns, corn, avocado, spinach, kale,
broccoli swiss chard, turnip greens and collards.

Vitamin B12 and insomnia have been linked for some

time however the evidence around the effect of vitamin
B12 levels on sleep is inconclusive. B12 does play a role
in the production of melatonin and it is possible that a
deficiency of B12 could lead to disrupted sleep patterns.
Research has also shown that people with higher levels
of vitamin B12 are less likely to suffer from depression
and those with depression very often also have
insomnia and sleep problems.

Vitamin B12 rich foods include oysters, mussels,

scallops, liver, mackerel, tuna, salmon, sardines, crab,
beef, eggs, yogurt, Swiss cheese and fortified products.
Excluding fortified products Vitamin B12 sources are
all from animal sources therefore if you follow a vegan
or predominantly plant-based diet it may be worth
considering supplementing vitamin B12.

Research has shown that kiwi fruit could also aid sleep
due to its high serotonin content.

Calcium aids the conversion of L-trytophan in the brain

to serotonin and melatonin, in doing so helping sleep.
It’s been shown that people with low-calcium levels

56
Step 5

Sleep and weight

management
Just as nutrition can positively or negatively affect sleep so
in turn sleep can positively or negatively affect nutrition.
Specifically a lack of sleep can affect nutrition to a vicious cycle of poor sleep and low energy. Low
choices and food consumption and in doing so lead energy can lead to low motivation to exercise or make
to weight gain. nutritious food choices.
Even after short periods of inadequate sleep normal
Many studies have shown that insufficient sleep levels of the hormones ghrelin and leptin can be
is associated with an elevated risk of obesity. affected. These hormones regulate appetite and hunger
Lack of sleep has also been connected to greater and when disrupted can result in poor nutritional
waist circumference, which is considered to be an choices and an increase in hunger, which can result in
indicator of numerous cardiovascular problems. weight gain. Studies have shown that people who are
trying to lose weight have better results when they get
A lack of energy in the daytime due to poor sleep good sleep.
can lead to the temptation to use stimulants
such as caffeine and sugar to boost energy to To ensure good weight management but also to aid
get through the day. However caffeine and sugar mental and physical health there’s no doubt that
can further negatively impact sleep and lead improving sleep is of utmost importance.

Tips For A Better Night’s Sleep

Create a good night time routine that allows you to wind
down effectively

Try to avoid blue light from screens in the hour before bed

If you enjoy an evening bath try adding Epsom salts to

help you relax

Avoid alcohol on a nightly basis and keep for occasions

Follow a balanced diet, ensuring an intake of a variety of

vegetables and fruits

Avoid caffeine after 4pm each day (you may need this to
be earlier)

Ensure you have a supportive mattress and pillows

Include exercise on a daily basis

Get outdoors everyday if you can, morning is shown to be

the best time for being outdoors to boost serotonin levels

Try to avoid exercising too close to your bedtime as it can

lead to a poor night’s sleep, make you more energised and 57
raises your body temperature 57
 Eating for
sleep quiz

WHY IS SLEEP IMPORTANT?

1 Adults are recommended to get how many hours of sleep per night
a. Doesn’t matter

b. 5-6 hours

c. 6-8 hours

d. 7-9 hours

2 Poor sleep…
a. Doesn’t affect physical health only mental health

b. Helps the body fight chronic disease

c. Affects metabolism, reduces the body’s ability to fight disease and develop immunity and

increases chronic disease rick

d. Affects metabolism, helps the body fight disease and develop immunity

3 Chronic sleep issues are associated with anxiety and depression

True

Flase

4 Now for a moment of self-reflection…what’s your sleeping like?

How many hours of sleep do you get per night?

Answers 58
WHAT CAN AFFECT SLEEP?

1 Stress has no bearing on sleep

True

Flase

Energy drinks, sugars-sweetened drinks and meals with high

2
glycaemic load can all affect sleep
True

Flase

3 Alcohol…

a. Disrupts the circadian rhythm and but gets the body into a deep sleep

b. Disrupts the circadian rhythm and prevents the body from reaching deep sleep

c. Helps you sleep because you can fall asleep quicker

d. Helps you get into a deeper sleep

HOW CAN NUTRITION POSITIVELY AFFECT SLEEP?

1 L-Tryptophan is found in which type of foods?

a. Fat

b. Fibre

c. Protein

d. Carbohydrate

2 Serotonin is the precursor for which hormone?

a. Insulin

b. Thyroid stimulating hormone

c. Growth hormone

d. Melatonin

3 Low melatonin levels can mean what?

a. You can have difficulty sleeping

b. You can get to sleep quicker

c. You feel less stressed

d. You feel refreshed when you wake up in the morning

59
4 Amongst other items melatonin-rich foods include:
a. Pistachios, red meat and pineapple

b. Only meat

c. Eggs, cherries and fish

d. Apples, bananas and cherries

OTHER NUTRIENTS THAT AID SLEEP

1 Magnesium is a natural stimulant in the body

True

Flase

2 Vitamin B12 is found mostly in which types of foods?

a. Vegetables

b. Animal products

c. Carbohydrates

d. Plant-based

3 What does kiwi fruit contain to make it good as a sleep aid?

a. Sugar

b. Fibre

c. Serotonin

d. Minerals

4 Which mineral helps the conversion of serotonin and melatonin in

the brain?
a. Zinc

b. Copper

c. Magnesium

d. Calcium

60
SLEEP AND WEIGHT MANAGEMENT

1 There is no evidence to say that sleep and obesity are linked?

True

Flase

2 How can sleep sometimes lead to weight gain?

a. It motivates you

b. It can lead to better nutrition choices

c. It can lead to low motivation and bad nutrition choices

d. It can’t

3 Now for a moment of self-reflection…what’s your sleeping routine like?

Do you think your sleep has ever affected your weight management?
Which tips could you implement to improve your sleep?

61
Section 6 -
Eating
for stress
We explore the intricate relationship
between stress and nutrition,
examining how chronic stress
affects mental and physical well-
being. Stress triggers a hormonal
response, often referred to as
the “fight or flight” reaction.
Prolonged exposure to stress
progresses through stages
of alarm, resistance, and
exhaustion, impacting the body
in various ways.

Nutrition plays a crucial role in

managing stress by supporting
adrenal function and hormone
production. Key nutrients such as
vitamin C, magnesium, B vitamins,
protein, and omega-3 fatty acids
are essential in this regard.
Making informed dietary choices,
including avoiding caffeine,
alcohol, and high-sugar processed
foods, is vital in effectively
managing stress and its effects on
overall well-being.

62
Step 1

Understanding
stress
There are many big events, both positive and negative,
that are associated with stress;
Moving house, starting a new job, having a baby, This response is designed to protect the body in an
a bereavement or ill health. But actually in today’s emergency situation and prepare it to act quickly if
world daily life itself can be incredibly busy and needed. Once the stress has passed, the body will return
often stressful. Chronic low level stress can result itself to normal function, however in the case of chronic
from day to day life; a relentless work schedule or low level stress, the body doesn’t get a break from the
busy family life, relationship problems, financial stress response and it can continue at a low level. It is this
issues, overtraining or a just combination of continuation that have a negative affect on wellbeing.
commitments.

The body’s stress response is not designed to be

constantly called upon and constant low level stress
can lead to range of issues including, mood swings,
irritability, anxiety, loss of concentration, disturbed
sleep, increased blood pressure, skin conditions
(eczema, psoriasis), muscle tension, loss of libido,
food intolerances, menstrual disturbances and
digestive problems such as bloating, diarrhoea,
constipation, indigestion and acid reflux.

What Is The Stress Response?

Stress is a natural hormonal response in the body,
controlled by the central nervous system and often
referred to as the ‘fight or flight’ response. When
the body is under stress, the hypothalamus, in the
brain, sends a signal to the adrenal glands to release
the stress hormones. The main hormones involved
in the stress response are adrenaline, noradrenaline
and cortisol. Adrenaline and noradrenaline dilate
pupils, increase heart rate and blood pressure.
Breathing rate increases, blood vessels to the
digestive system and kidneys constrict which
reduces urine formation and digestive activities and
blood flow to organs required for exercise increases
(skeletal muscle, heart, liver and adipose tissue).

63
Step 2
What are the
effects of long
term stress?
The physiological changes that take place in the body
when it’s exposed to chronic stress have been termed
general adaptation syndrome (GAS).
GAS is described as having three stages; alarm
reaction stage, resistance stage, exhaustion stage.
So what’s going on in the body at these stages and
if you or a friend or family member are experiencing
prolonged stress, do you recognise which stage you
may be at?
1. Alarm reaction stage
The alarm reaction stage refers to the initial
symptoms the body experiences when under stress.
This is the “fight-or-flight” response, described
previously. This natural reaction prepares the body
either to run away or to protect itself from whatever
the danger may be. Stress hormones are released
in the body increasing the heart rate and available
energy.
2. Resistance stage
After a stressful event has passed, the body resets
itself; cortisol release decreases, heart rate and
blood pressure return to a pre-stress state. However
if stress becomes prolonged and continues for an
extended period of time, the body will remain on
high alert and eventually adapts to live with this
new state of a higher stress level. To cope with
chronic stress the body continues to secrete stress
hormones and blood pressure remains elevated. If
the chronic or prolonged stress continues for too
long to the exhaustion stage. Signs of the resistance
stage include irritability, frustration and poor
concentration.
3. Exhaustion stage
The exhaustion stage is the result of prolonged or
chronic stress, where the body no longer has the
resources to fight stress. Signs of exhaustion include
fatigue, burnout, depression, anxiety and decreased
stress tolerance. The physical effects of this stage also
weaken the immune system and put the body at risk
of stress-related illnesses.
64
Step 3

How are stress and

nutrition linked?
Part of the stress response
is to increase of cortisol
production. Cortisol makes
sure the body is ready to
react to a stressor by ensuring
it is full of energy through
elevating glucose levels.

If stress is prolonged and cortisol remains elevated it is

continually producing glucose and pushing up blood
sugar levels. Cortisol can also lead to insulin resistance
over time as its further role is to inhibit insulin
production to prevent glucose from being stored.

During acute stress, the hormone adrenaline

suppresses the appetite, however with chronic or
prolonged stress, elevated levels of cortisol can cause
cravings. Often the foods the body craves are high in
sugar, fat, and calories; this can then lead to weight
gain over time.

Cortisol also lowers the levels of the hormone

leptin, which promotes the sensation of satiety after
eating and increases the hormone ghrelin, which
increases appetite.
Chronic stress has a number of health implications;
it can lead to depression, weight gain, high blood
pressure, insomnia, heart disease, type 2 diabetes, joint
pain, digestive issues, inflammation, reduced nutrient
absorption and reproductive problems. It can also
weaken the immune system and leave the body more
vulnerable when it comes to fighting infections.
Nutrition Stress Support For The Body
Nutrition can support a body under stress
by providing it with the nutrients it requires
to produce stress hormones and to help
reduce inflammation in the body which can
contribute to stress. But equally nutrition
can exacerbate and contribute towards
stress by further elevating blood sugar or
creating blood sugar imbalance, creating an
inflammatory state and lead to a lack of the
key nutrients for stress hormone production.

65
Step 4

Getting the
right nutrients
in the diet
The main stress hormones – Foods rich in magnesium include kelp, wheat
bran, almonds, cashews, buckwheat, brazil nuts,
adrenaline, noradrenaline and peanuts, millet, pecans, rye, walnuts, tofu, coconut
meat, soya beans, brown rice, figs, apricots, dates,
cortisol are produced by the collard greens, prawns, corn, avocado and leafy

adrenal glands. green vegetables.

Prolonged stress can lead to these glands becoming

overworked, exhausted, and leaving them struggling
keep up with demand. There are key nutrients which will Ideas for adding more
help to support the adrenals; vitamin C, magnesium, B magnesium to the diet:
vitamins and protein. Research also shows that omega-3
Snack on nuts or nut butters with fruit
fatty acids may help to regulate cortisol levels.
or oat cakes

Vitamin C Add nuts and seeds to porridge or

Vitamin C is a nutrient required to produce cortisol. yogurt
It is also an antioxidant important to the immune
Add dark chocolate to porridge,
system and functions as an antioxidant within the smoothies, snacks or enjoy as a dessert
adrenal glands.
Include dark green leafy vegetables in
salads and meals
Foods rich in vitamin C include red peppers, guavas, kale,
kiwi, broccoli, Brussel sprouts, strawberries, raspberries, Houmous and vegetable sticks are
blackberries, blueberries, oranges, tomatoes, peas, great snack and travel well
mange tout, papaya, mango, pineapple, melon, limes
and grapefruit. Herbs such as thyme and parsley are very
high in vitamin C and easy to include as a seasoning or
garnish on meals.

Magnesium
Magnesium is a natural muscle relaxant. It is a hugely
valuable nutrient in the body, playing an essential role in
energy and hormone production and it supports adrenal
function. Magnesium is dramatically depleted in times of
stress, and symptoms of deficiency often include fatigue,
anxiety, insomnia and predisposition to stress.

66
Getting the right nutrients in the diet
B-vitamins
All B vitamins are used to support adrenal function,
B5 is of particular importance as it directly supports
the adrenal cortex and hormone production.
Foods rich in B vitamins include brewer’s yeast,
wheat bran, peanuts, swordfish, wild rice, sesame
seeds, sunflower seeds, brown rice, pine nuts,
buckwheat, peppers, whole wheat, barley, almonds,
split peas, eggs, soybeans, oatmeal, lentils, rye,
cashews, chickpeas, broccoli and hazelnuts.
Protein
The amino acids, phenylalanine and tyrosine are
used to produce adrenaline and noradrenaline. In
order to support the body in times of stress aim to
include protein with every meal, this will help to
improve blood sugar balance as well as providing the
amino acids needed for hormone production.
Protein-rich foods include milk, eggs, cheese, soy
products, turkey, fish, nuts, cottage cheese, red,
green, yellow and brown lentils, chickpeas, black-
eyed peas, broad beans, kidney beans, butter beans,
haricots, cannellini beans, flageolet beans, pinto
beans and borlotti beans, walnut, almonds, brazil
nuts, cashew nuts, hazelnut, macadamia, pine nuts,
peanuts, pistachio, sunflower, pumpkin, sesame, flax,
chia, tofu, tempeh, edamame.
Omega-3
Omega-3 fatty acids can help support the body
through the stress response as they have been shown to
regulate the release of cortisol. Compounds known
as prostaglandins produced from omega-3 are also
anti-inflammatory.
The richest source of Omega-3 is oily fish – salmon,
mackerel, tuna, herring, and sardines, but it is also found
in flaxseed, chia seeds, walnuts, flaxseed oil, soybean oil,
canola oil, walnut oil and fortified foods.
The anti-inflammatory compounds eicosapentaenoic
acid (EPA) and docosahexaenoic acid (DHA) are found
in oily fish but also in algal oil (that comes from certain
marine algae). Algal oil is used to make vegan omega-3
dietary supplements. For those who follow a vegan or
predominantly plant based diet EPA and DHA vegan
omega-3 dietary supplements are recommended,
alongside an intake of flaxseed, chia seeds and walnuts
through the diet.
Food and drink to avoid
Caffeine
As a stimulant caffeine can elevate cortisol
levels so if possible have caffeinated drinks in
small quantity and swap for decaf or herbal
options where possible.
Alcohol
Whilst alcohol can lead to relaxation and
positive feelings in the short term relying
on it to relieve stress can have negative long
term effects. It’s disruptive to sleep, which
may already be disrupted if stress levels are
elevated, it is a depressant and can suppress
the immune system.
High sugar and processed foods
Cortisol can increase the hormone ghrelin,
which increases appetite, this in itself can lead
to weight gain. If the food choices are then
high sugar and processed foods the likelihood
of weight gain is even greater. Stress can
lead to a desire to eat more comfort food as a
coping mechanism, so it is important to plan
meals and snacks to reduce excess calories.
67
 Eating for
stress quiz

UNDERSTANDING STRESS (STEP 1)

1 What is the natural hormonal response often referred to known as?

a. Fit to fight

b. Flight or flight

c. Fight and fight

d. Fight or flight

2 What are the glands called which release the main stress hormones?
a. Thyroid gland

b. Pineal gland

c. Adrenal gland

d. Hypothalamus

3 Adrenaline and noradrenaline decrease heart rate and blood pressure.

True

Flase

WHAT ARE THE EFFECTS OF LONG TERM STRESS? (STEP 2)

1 General adaptation syndrome (GAS) has how many stages?
a. 2

b. 3

c. 4

d. 5

Answers on page
68 44
 2 Signs of the resistance stage include:

a. Irritability, frustration and poor concentration

b. Motivation, better concentration and good memory

c. Better sleep and feeling happy

d. All of the above

3 Now for a moment of self-reflection…what are your stress levels like?

Do you think you are experiencing prolonged or chronic stress? If so
which stage do you think you’re at?

HOW ARE STRESS AND NUTRITION LINKED? (STEP 3)

1 What are the roles of cortisol in the stress response?

a. Increases heart rate and blood pressure

b. Increases insulin production and stores energy

c. Increases energy availability and inhibits insulin production

d. Suppresses appetite and promotes satiety

Elevated levels of cortisol can reduce the feeling of fullness after a meal
2
and increase appetite leading which can lead to weight gain over time.
True

False

3 With regards to stress nutrition can…

a. Support the body by providing the necessary nutrients for the stress response

b. Exacerbate stress by further elevating blood sugar

c. Help to reduce inflammation

d. All of the above

69
GETTING THE RIGHT NUTRIENTS IN THE DIET (STEP 4)

1 Why is vitamin C important in times of stress?

a. It helps to protect the adrenal glands

b. It’s required for the production of cortisol

c. It’s important for the immune system

d. All of the above

2 Which B vitamin is of particular importance for the stress response?

a. B1

b. B3

c. B5

d. B7

3 Amino acids are the building blocks of which nutrient?

a. Carbohydrates

b. Protein

c. Fat

d. Fibre

4 What are the best sources of EPA and DHA?

a. Animal products

b. Vegetables

c. Oily fish

d. Dairy products

5 During times of stress what is it best to limit consumption of?

a. Carbohydrates and protein

b. Herbal teas and snacks

c. Homemade food

d. Caffeine, alcohol, high sugar and processed foods

Answers 70
Section 7 -
Family
nutrition
Encouraging regular family
meals brings numerous benefits,
including improved vocabulary for
young children, better academic
performance, heightened self-
esteem, and lower risks of various
health issues. Understanding the
distinct nutritional needs of each
age group is key to instilling lifelong
healthy habits. From breastfeeding
and nutrient-rich diets for infants
and toddlers to balanced nutrition
for children and specialized
requirements for teens, tailored
approaches are crucial.

Practical steps include gradual

dietary changes, making nutritional
choices relevant, and creatively
incorporating vegetables into meals.
Leading by example, involving
the family in meal planning,
and creating a positive dining
atmosphere are also essential for a
healthy family lifestyle.

71
Step 1

The importance of
family mealtime
Eating as a family should be
a time to cherish and enjoy
each other’s company whilst
having a meal.

Studies show that having mealtimes together between

5-7 times per week has huge benefits for children of all
ages as well as the adults. Family mealtimes have been
shown to have physical, emotional, social and academic
benefits, including:

Bigger vocabulary in young children

Better academic performance in older children

Higher self esteem

Greater sense of resilience

Lower risk of substance abuse and teenage

pregnancy

Lower risk of depression and improving mood

Lower risk of developing eating disorders

Better cardiovascular health in teenagers

Healthier eating patterns in young adults

Conversely watching television whilst having dinner

has been associated with children being overweight in
numerous studies.

It is of course not just the act of eating food together

but the atmosphere around the table, which helps
to confer the positive benefits and strengthens
relationships away from the table. It is important
therefore to make mealtime as enjoyable, positive, and
stress-free as possible.

72
Step 2

Nutrition
requirements
by age group
In addition to eating as a Babies to 2 years
Babies and toddlers grow fast, and they need calories,
family unit in a positive protein, fats, and iron for this growth and for providing
energy. At this age their stomachs are very small,
environment mealtime is so they can’t eat a lot of food all at once, it is for this

an opportunity to create reason that infants and toddlers should eat every few
hours throughout the day.
healthy habits for life and
Children
ensure that all the family Over two years of age, children can start to have lower

get the nutrients they need fat dairy products. As children become more mobile
and active they require more calories for growth, as
from their food. well as a good range of vitamins and minerals from
fruit, vegetables and wholegrains, and protein is of
Regardless of age a varied diet that includes plenty of
particular importance for building muscle mass.
nutrient-dense foods is recommended for everyone.
However, the nutritional requirements of the body
do change as children grow so when considering
nutrition for the younger members of the family what
is it important to be aware of?

Infants
In the first six months of life, medical experts agree
that the food of choice is milk from the mother.
Breast milk contains exactly the right proportions of
fat, cholesterol, protein, and carbohydrates for babies.
It also helps to build a baby’s immunity by populating
the gut with key bacteria. If breast feeding is not
possible for whatever reason baby formula provides
a convenient option. Cow’s milk is only suitable for
infants from the age of 12 months as a drink, though
it can be used to make food with from 6 months.

73
Step 2
Nutrition requirements by age group

Iron-rich foods include rye, whole wheat, pumpkin

Forming healthy eating habits at a young age
is the best way to ensure that children grow up
making healthier choices.
Children who are raised on whole grains
rather than white bread products won’t
turn up their noses at whole grain products
and won’t have to make a switch or change
later on.
Try to keep fizzy drinks out of the house,
even the diet kind as there isn’t anything
good about artificial sweeteners.
Avoid adding salt and sugar to children’s
food. It gets the child accustomed to the
natural taste of foods and doing so means
that they will find processed foods to be
overly sweet or salty.
seeds, sunflower seeds, sesame seeds, chicken
liver, oysters, mussels, clams, cashews, pine nuts,
hazelnuts, peanuts, almonds, beef, lamb, lentils, white
beans, soybeans, kidney beans, chickpeas, lima beans,
oats, spinach, Swiss chard, kale, dark chocolate.
The teenage years are also when girls build their
skeletal strength, so it is important to eat a well-
balanced diet rich that includes the following
nutrients:
Calcium - low-fat dairy products, canned fish with
soft bones which you eat, almonds, leafy green veg
and fortified products.
Vitamin D - tuna, mackerel, salmon, trout, halibut,
mushrooms, some whole milk, egg yolks, fortified
foods and sunlight exposure.

Teens
Phosphorous - brown rice, oats, rye, whole wheat,
When children are younger boys and girls have the
chicken, turkey, pork, liver, sardines, scallops,
same nutritional requirements, however as they
salmon, mackerel, crab, milk, yogurt, cottage cheese,
reach their teenage years they start to diverge and
sunflower seeds, pumpkin seeds, Brazil nuts, pine
have different needs.
nuts, almonds, pistachios and cashews

Boys
When teenage boys reach puberty, their growing
accelerates and whilst the timing and rate of growth
varies, it is at this time when boys will build their
muscle mass. As a result, the calorie requirement
for teenage boys increases greatly. Protein, as the
building block for muscle growth, as well as calcium
and vitamin D are of particular importance during
this time.

Girls
During the teenage years for girls, they are growing
but also begin to have periods. As a result, teenage
girls have the highest iron requirement of all ages,
therefore including plenty of iron-rich foods in the
diet becomes particularly important at this time.

74
Step 3

Tips for feeding

the whole family
1. You’re in control of the shopping choices
In doing the shopping you make the choice of the
foods to stock the fridge and cupboards with. Try to
resist buying lots of junk food as if it’s in the house
it will be eaten. Instead choose healthier snacks and
meal ingredients.
2. Allow family members to choose what to eat
Having stocked up on healthier choices allow
everyone in the family the freedom to look through
the fridge and cupboards to choose what they would
like to eat, and allow them to control the quantity
of their portions. While this may not seem sensible
at first glance, when you’re in control of the supply
pretty much every choice is going to be a good one.
3. Involve family members in meal planning
Involve the family – especially children – in meal
planning and preparation. Help children to develop
decision-making skills by offering specific healthy
choices for meals and desserts. For example ask
children to choose between a piece of chicken or
salmon for dinner and a banana or apple for dessert,
rather than asking the open question “what would
you like to eat”.
4. Lead by example
Be a role model to the family through making
healthy choices. For example eat a healthy breakfast
rather than sugary cereals. Eat sweets in moderation
and encourage your entire family to do the same.
7. Keep healthy snacks within view
Keep ready-to-eat produce, including bananas, apples,
and oranges, within plain view. Move unhealthy snacks
out of sight, preferable to top shelves where nobody
will see them.
8. Remove the salt from the table
More than 75% of salt in the average individual’s diet
comes from processed foods therefore try to avoid
adding further salt. Try to reduce the family’s intake
of processed foods and replace with fresh fruits,
vegetables, whole grains, and lean meats and fish
whenever possible.
9. Avoid arguments related to food choices
Avoid battles over food with the children. Arguing
with your children about food can lead them to feel
negatively about making healthy choices regarding
nutrition.
10. Avoid meals with large platters on the table
Avoid family-style meals featuring large platters of
food on the table. Instead, encourage each family
member to serve up a plate of food in the kitchen and
carry it to the table. Putting a little distance between
the table and the food discourages unnecessary
second helpings.

5. Eat meals at the table together

Eat family meals around a table instead of in front of
a television. Eating in this way has huge benefits for
all the family, encourages mindful eating habits and
allows for quality family time.

6. Work as a team to improve

Include the whole family in making nutrition
improvements. If one person needs to lose weight or
wants to adopt a healthier lifestyle, it can help if the
household support this goal and work towards it too.

75
Step 4

Making practical
changes
Gradual change
Once the decision has been made to make changes Steaming vegetables fractionally longer can reduce
to the family diet or the children’s diet it can be very the bitterness in vegetables and give them a sweeter
tempting to completely change everything, removing flavour.
all sugar, white flour products, or processed items.
However, this could lead to far more resistance from Avoid using reward foods
children of any age (and potentially the adults too). Coercion and force feeding can be very stressful for
Instead making gradual change can allow everyone both adult and child, but also it’s very often ineffective.
to adjust slowly and enable longer term habits to be It can seem like a good idea to incentivise children to
formed. But how? eat certain foods by offering treat foods as a reward,
however this seems to make children dislike the food
• Decrease the quantity and frequency of treats they’ve been incentivised to eat even more.
(sweets, chocolate, crisps)
• Combine brown rice with white rice, gradually
increasing the ratio of brown to white
• Use a multigrain pasta/bread before moving
to wholegrain
• Reduce processed meats to a treat, and change
from frying to oven cooking or grilling of those
which are included
• Swap oven chips for potato wedges or
jacket potato

Make the Reasons for Food Change Relevant

Making food choice relevant to an individual is
important and this is also the case for children. If they
know why a certain food benefit them they may be
more likely to understand and embrace the change.
Relevance could be to get stronger/ faster for a sport
or hobby, being able to focus more learning a musical
instrument or having more energy for playing.

Vegetables
Vegetable intake can be low in many children.
They often dislike those vegetables that have a
more bitter taste like broccoli, cabbage and kale.
Hiding vegetables in dishes is certainly one way
to increase intake, because the child is unaware of
eating the vegetable it doesn’t actually improve their
relationship with vegetables and mean they’ll actively
choose to eat them.

76
 Step 4
Making practical changes

Food
Swaps Swap From Swap To

Breakfast

Chocolate cereal Wheat biscuit cereal - Weetabix

Frosted cereal Wholegrain cereal – shredded wheat, shreddies
Honey coated granola Porridge with berries
Croissants and white toast Wholegrain toast
Cereal bars Plain yogurt with chopped fruit
Jam and honey Nut butter

Lunchboxes or Lunchtime

Split-pot yogurts, pudding Plain yogurt with chopped fruit

pots and fruit yogurt
Cake bars and cereal bars
Muffins and chocolate
Crisps
Fizzy drinks
White bread sandwiches
Malt loaf or fruited teacake
Fresh or tinned fruit (in juice, not syrup)
Plain popcorn, rice cakes
Fresh fruit juice, water with berries or chopped fruit
Wholegrain sandwiches

Dinner

Sausages Lean beef mince, chicken or turkey

Pizza Homemade pizza
Oven chips Sauté new potatoes (with skin on) or jacket potato
Ketchup and brown sauce Reduced salt and reduced sugar versions of sauces

Snacks

Biscuits Malt loaf or fruited teacake

Chocolate and cake bars Wholegrain bagel with banana (and peanut butter)
Chocolate puddings Wholegrain toast with low-fat cheese
Doughnuts Vegetable sticks and houmous
Muffins Fruit salads
Crisps Plain popcorn or rice cakes
Salted peanuts Unsalted cashews, almonds
Split-pot and high sugar yogurts Plain yogurt and berries or chopped fruit

Drinks

Fizzy drinks Water or sparkling water with chopped fruit

Fruit juice Smoothies (in small quantity)
Squash Plain milk
77
Milkshake Homemade milkshake (using fresh fruit)
 Family
nutrition
quiz
THE IMPORTANCE OF FAMILY MEALTIME – STEP 1

1 At least how many times a week is it recommended to eat together?

a. Doesn’t matter

b. Once

c. 2-3 times

d. 5-7 times

2 What kind of benefits have studies shown that eating together can bring?
a. None

b. Emotional and social

c. Physical, emotional, social and academic

d. Academic

3 What has eating in front of the television been associated with in

studies of children?
a. Being overweight

b. Being healthy

c. Being informed

4 Now for a moment of self-reflection…how many times a week does

your family eat together? Do you enjoy mealtimes together? Do you
need to make any changes?

Answers 78
NUTRITION REQUIREMENTS BY AGE GROUP – STEP 2

1 Nutritional requirements stay the same from birth to old age.

True

False

2 Why would children older than two years of age require more calories
a. They become less active and mobile

b. They become more active and mobile

c. They don’t need more

3 Why are the nutrients protein, calcium and vitamin D particularly

important for teenage boys?
a. To slow growth down

b. To make sure they feel full

c. They aren’t important

d. For muscle development

4 Of the different age ranges who has the greatest iron requirement?
a. Teenage boys

b. Teenage girls

c. Toddler boys

d. Infant girls

TIPS FOR FEEDING THE WHOLE FAMILY – STEP 3

1 Never let the family choose what to eat.
True

False

2 Eating at the table as a family is beneficial for adults and children alike
True

False

3 Hide all snacks from view

True

False

79
4 If children don’t eat what you’ve chosen to serve argue about this
True

False

MAKING PRACTICAL CHANGES – STEP 4

1 Why is it best not to make severe overnight changes and instead

changes things gradually?
a. Means more food shopping

b. Hard to come up with enough ideas of new meals

c. Can result in change being embraced more readily

d. Can result in more resistance to change

2 Why do children often not like the taste of vegetables like broccoli,
kale and cabbage?
a. Too sweet

b. Too salty

c. Too bitter

d. Too sour

3 Why is using reward foods often not effective?

a. Makes children like the food they’ve been incentivised to eat even less

b. Wastes food

c. Makes children like the food they’ve been incentivised to eat even more

d. Is too much fun

4 What could honey coated granola be swapped for?

a. Chocolate cereal

b. White toast

c. Frosted cereal

d. Porridge with berries

5 Now for a moment of self-reflection…Are there food swaps you think

your family would benefit from making? What could you swap in to
replace the food items with?

80
Section 8 -
FODMAPS
FODMAPs, short for Fermentable,
Oligosaccharides, Disaccharides, Monosaccharides,
and Polyols, are a group of carbohydrates that
are not fully digested in the intestines, leading to
fermentation by gut bacteria and the production
of gases. This fermentation process, particularly
in individuals with irritable bowel syndrome
(IBS) who have a more sensitive gut, can cause
abdominal pain, discomfort, and other digestive
symptoms. The FODMAP acronym represents
different types of these fermentable carbohydrates
found in various foods.

Managing FODMAPs involves a diet that

temporarily restricts high-FODMAP foods,
followed by a reintroduction phase to identify
specific triggers for symptoms. The goal is to
find a personalized, less restrictive diet by
understanding which FODMAP foods can be
tolerated and which should be limited or
avoided in the long term to alleviate
IBS symptoms. This
approach has been
shown to reduce
pain, bloating,
and improve
bowel habits
in individuals
with IBS.

81
Step 1

What are FODMAPs?

FODMAPs stands for Fermentable, Oligosaccharides,
Disaccharides, Monosacchardies and Polyols.

These are a collection of short-chain carbohydrates Disaccharides

(sugars) that are not completely digested or absorbed
in the intestines. When FODMAPs reach the small
intestine, they move slowly, attracting water. When
they pass into the large intestine, FODMAPs are
fermented by gut bacteria, the bacteria use FODMAPs
as fuel. This fermentation process naturally produces
gases as a result. The extra gas and water causes the
intestinal wall to stretch and expand in some people
with irritable bowel syndrome (IBS) as they generally
have a more sensitive gut. The ‘stretching’ of the
intestinal wall causes exaggerated sensations of pain
and discomfort as well as digestive symptoms.
What does the FODMAP acronym mean?
Fermentable
This natural process occurs in the large intestine.
Gut bacteria ferment undigested carbohydrate
resulting in the production of gases.
Oligosaccharides
Fructans and GOS found in foods such as wheat,
rye, onions, garlic and legumes/pulses
Lactose found in dairy products like milk, soft
cheeses and yogurts
Monosacchardies
Fructose found in honey, apples, high fructose
corn syrups
Polyols
Sorbitol and Mannitol found in some fruit
and vegetables as well as being used as artificial
sweeteners
A FODMAP diet is about removing foods that are
high in FODMAPs and replacing them with foods that
are low in FODMAPs. This is not a long-term solution
as fermentable carbohydrates are used by the gut
bacteria as fuel and will enable beneficial bacteria to
flourish. Rather, in using a FODMAP diet an individual
can identify the foods or groups of foods that trigger
symptoms. Aggravating foods or groups of foods will
vary from person to person and the FODMAP diet
provides an excellent opportunity to understand these.

There are High FODMAP foods Low FODMAP alternatives

high FODMAP Aubergine/eggplant, beans (green) bok choy, green
Vegetables Artichoke, asparagus, cauliflower, garlic, green
capsicum (bell pepper), carrot cucumber, lettuce,
vegetables, fruits, peas, mushrooms, onion, sugar snap peas
potato, zucchini
dairy, breads,
Apples, apple juice, cherries, dried fruit,
cereals, protein Fruits mango, nectarines, peaches, pears, plums,
Cantaloupe, kiwi fruit (green), mandarin,
orange, pineapple
sources, sugars, watermelon

sweeteners,
Dairy & Cow’s milk, custard, evaporated milk, ice Almond milk, brie/camembert cheese, feta
confectionery, alternatives
cream, soy milk (made from whole soybeans), cheese, hard cheeses, lactose-free milk, soy milk
sweetened condensed milk, yoghurt (made from soy protein)
nuts and seeds.
Likewise there Most legumes/pulses, some marinated meats/ Eggs, firm tofu, plain cooked meats/poultry/
Protein sources poultry/seafood, some processed meats seafood, tempeh
are low FODMAP
alternatives for all Wheat/rye/barley based breads, breakfast
Corn flakes, oats, quinoa flakes/rice/corn pasta,
Breads & cereals rice cakes (plain), sourdough spelt bread, wheat /
of these items. See cereals, biscuits and snack products
rye/barley free breads
the table to find
Sugars, sweetners High fructose corn syrup, honey, sugar free Dark chocolate, maple syrup, rice malt syrup,
out more: & confectionary confectionery table sugar

Macadamias, peanuts, pumpkin seeds/pepitas,

Nuts & seeds Cashews, pistachios walnuts
82
Step 2
IBS and FODMAPs
Irritable bowel syndrome
(IBS) is a very common
gastrointestinal disorder
and affects 1 in 7 people.
It is characterised by abdominal pain and abnormal
bowel habits and was once known as ‘spastic colon’.
The symptoms that may also be
experienced include:
Abdominal pain or discomfort
Constipation, diarrhoea or both
Bloating
Distension of the gut
Excessive flatulence
Urgency to go to the toilet (poo)
Sensation of incomplete bowel emptying
Mucus in stools
The exact cause of IBS is unknown, though there
are several factors, which are believed to contribute
towards causing the condition. In fact it may well be
that the set of circumstances causing IBS is different
for each individual. Factors include; gut sensitivity –
those with IBS often have a more sensitive gut; altered
gut motility, meaning the food may move unusually
fast or slow through the digestive system; leaky gut,
this is a slightly inflamed intestinal lining.
For some there is a triggering event such as
gastrointestinal infection, food poisoning, diarrhoea
after foreign travel, surgery, dietary changes, a course
of antibiotics or new medication. This event causes
disruption in the normal functioning of the intestines.
Imbalances in intestinal bacteria, also known as gut
dysbiosis, changes in hormones and neurotransmitter
signaling have also been identified as causing IBS.
Foods, medications, hormones and stress can all be
triggers for IBS. In order to manage IBS effectively
it is important to rule out certain conditions such as
coeliac disease, lactose intolerance, carbohydrate
malabsorption, allergies and intolerances. It’s also
very important to talk to your doctor about certain
symptoms, this is because these can be considered
‘red flags’ in IBS and can sometimes be present in
more serious conditions like coeliac disease and
inflammatory bowel disease:
Blood in the stool
Anaemia
Weight loss that is unintentional
Fever
Symptoms that are severe or getting progressively
worse
Daily diarrhoea
Bowel movements in the night
Having a family history of other bowel diseases
Understanding the trigger or triggers is key to
management of IBS and this can be where the
FODMAPs diet can help. Symptoms and triggers of
IBS are highly individual so it is a case of looking at
the patterns you personally experience. As well as
analysis of diet, it can be very useful to record stress
levels and emotions in addition to considering your
monthly cycle, if you are female, as all of these factors
can be contributing factors in IBS and the worsening of
symptoms.
A low FODMAP diet has been shown to:
Reduce pain and discomfort
Reduce bloating and distension
Improve bowel habits (reduce diarrhoea or
constipation)
Improve quality of life
These benefits are usually seen within 2-6 weeks of
following a low FODMAP diet.
There are other ways of managing IBS that work.
Certain probiotics that have been heavily researched
and linked to improvements in IBS symptoms help
some people, particularly if the triggering event may
have been antibiotics, diarrhoea after foreign travel or
gut dysbiosis. Other simple techniques people find
useful include ensuring good water consumption
if you experience constipation; using peppermint
teas to help reduce muscle spasms; management of
time or expectations to reduce stress levels and deep
breathing techniques.
83
Step 3

How does the

FODMAP diet work?
A FODMAP diet has 3 phases to it and is often used by
those looking to manage the symptoms of IBS or those
experiencing digestive issues. Through the diet the aim is to:
Understand whether symptoms are triggered by
FODMAP foods. Not everyone with IBS or digestive
issues will find that symptoms improve on a low
FODMAP diet. 75% of those with IBS improve on the
The 3 phases
diet whereas 25% do not.
Phase 1 – Low FODMAP diet
• Follow for 2-6 weeks
Understand which FODMAP foods can be • Swap high FODMAP foods for low FODMAP
tolerated, and which trigger symptoms. Having alternatives
this understanding allows a less restrictive diet
Phase 2 – FODMAP reintroduction
to be followed, with only those foods that trigger
• Follow for 8-12 weeks
symptoms being restricted. • Reintroduce one FODMAP type at a time
(lactose for example)
• Reintroduce one food at a time
• Test food for 3 days
• Monitor tolerance and any symptoms

Phase 3 – FODMAP personalisation

• Long term
• Understand over time which FODMAP
foods can be tolerated and which should be
reduced and/or restricted
• Some FODMAP foods are important in the
diet in the long term both for nutrient
• variation but also as they provide prebiotics
for the gut bacteria

84
 FODMAPS
quiz
WHAT ARE FODMAPS?

1 FODMAPs are short-chain what?

a. Fats

b. Proteins

c. Carbohydrates

d. All of the above

2 What happens when the gut bacteria ferments FODMAPs?

a. They get absorbed

b. They pass into the blood stream

c. They turn into alcohol

d. They produce gases

3 What does the gut bacteria use the FODMAPs for?

a. For fuel

b. It doesn’t

c. For hydration

IBS AND FODMAPS

1 IBS stands for

a. Intimal bowel syndrome

b. Itchy bowel syndrome

c. Irritable bowel syndrome

d. Icey bowel syndrome

Answers 85
2 Triggers for IBS can include:
a. Only food items

b. Foods, medications, hormones and stress

c. Hormones and stress

d. Medications, hormones and stress

3 A low FODMAP diet has been used by many to

a. Make quality of life worse

b. Increase bloating and pain

c. Make bowel habits worse

d. Reduce pain and bloating

HOW DOES THE FODMAP DIET WORK?

1 A FODMAP diet has how many phases to it?

a. 1

b. 2

c. 3

d. 4

2 What percentage of people feel their symptoms are improved by the

FODMAP diet?
a. 55%

b. 75%

c. 85%

d. 95%

3 The order of the 3 phases is

a. Low FODMAP diet, FODMAP reintroduction, FODMAP personalisation

b. FODMAP personalisation, low FODMAP diet, FODMAP reintroduction

c. FODMAP reintroduction, low FODMAP diet, FODMAP personalisation

86
Section 9 -
Gut health
Gut health is fundamental for overall
well-being, intricately tied to the gut
microbiome—a diverse community of
microorganisms residing in the digestive
system. These microorganisms
play crucial roles in digestion,
nutrient absorption, and
neurotransmitter production.

Research increasingly
connects gut health not
only to physical wellness
but also to mental well-
being. Diet, notably
incorporating probiotics
and prebiotics, plays a vital
role in influencing gut
health. Among dietary
components, fiber stands
out for its crucial role in
digestion and disease
prevention. Additionally,
understanding bowel
habits and integrating
fermented foods rich in
probiotics are key steps
toward maintaining a
robust and thriving gut
microbiome, ultimately
benefiting overall health.

87
Step 1

What is gut health?

The digestive system is
a vitally important organ
in the body, not only is it
needed for digesting and
absorbing food
but it is home to the
gut microbiome.
Found in the small and large intestine, the
gut microbiome is made up of trillions of
microorganisms including bacteria, fungi and
viruses. These microorganisms in the gut, also
known as gut bacteria, help to breakdown food
and toxins, absorb nutrients, make vitamins,
support the immune system, and regulate the
body’s metabolism. Scientists have found that
gut bacteria also produce neurotransmitters
such as dopamine, norepinephrine, acetylcholine,
and GABA, which are essential for mood, anxiety,
concentration, reward, and motivation.

Research into the gut microbiome has exploded

in recent years with the gut being linked not just
to digestive function but also mood and mental
health, the immune system and weight loss.
There’s now recognition of the great importance
of nourishing the gut microbiome for a healthy,
resilient gut as well as general health.

The gut microbiome

contains 70% of the
body’s immune system
cells and is one of the
body’s first lines of
defence against harmful

88
Step 2

How is the gut

microbiome
influenced?
Each person’s gut microbiome
is completely unique, its
composition is influenced by
birth, diet and environment.
The colonisation of the gut is established in the first 1000 days
of life, however its composition and balance can be altered and
influenced throughout life with diet, environment, lifestyle,
stress and medications all impacting the type and number of
microorganisms present in the gut.

The diet plays a vital role in keeping the gut healthy and levels
of bacteria balanced. Certain foods, containing bacteria, can
boost the diversity and number of bacteria in the gut, these are
called probiotics. Whilst others provide much needed fuel to
help the bacteria to multiply and flourish, known as prebiotics.
Conversely a diet high in sugar, refined and processed foods
can negatively impact the balance of gut bacteria.

Probiotics are found in foods that have been through a

fermentation process or have had probiotics added to them.
Good probiotic foods include good quality plain yogurt, kefir,
kombucha, sauerkraut, miso soup, pickled vegetables, tempeh,
kimchi, sour dough bread, goat’s cheese, olives, good quality
dark chocolate and spirulina.

Prebiotics are classed as such because they stimulate the

growth or activity of certain ‘good’ bacteria in the large
intestine. Prebiotic foods include onion, garlic, leeks, cabbage,
asparagus, chicory, artichoke, banana, apple, wheat bran,
flaxseed and root vegetables.

89
Step 3
Dietary fibre
Dietary fibre is an
incredibly important part
of the diet which helps
to keep the gut healthy,
improves digestion
and reduces the risk of
chronic disease.
Fibre is a non-digestible carbohydrate found in
foods, that can be divided into two categories;
soluble fibre and insoluble fibre. The daily
recommended amount of fibre is 30g a day. The
benefits of getting dietary fibre are many:
Fuels gut bacteria
Lowers cholesterol levels
Reduces the rise in blood sugar after a meal
Eases constipation
Fermentable fibre forms short-chain fatty acids
which nourish the colon wall
Lowers risk of heart disease, type 2 diabetes
and colorectal cancer
Soluble Fibre
Soluble fibre dissolves in water and forms a gel in
the gut, it can be digested by the body and helps to
keep stools soft. Soluble fibre ferments in the large
intestine and produces short-chain fatty acids which
are an energy source for colon cells and help keep
the gut healthy. Foods high in soluble fibre include:
Vegetables – onions, carrots, potatoes
Avocados
Beans – pinto, kidney, chickpeas
Pulses and lentils
Whole grains – oats*, barley, rye
*Oats contain beta glucans which have been
strongly linked to lowering cholesterol levels and
boosting heart health. Aim to include more oat-
based products in the diet such as porridge, muesli
and oat cakes. Beta glucans can also be found in
bran, wheat and barley
Insoluble Fibre
Insoluble fibre adds bulk to the stool and is needed for
proper elimination of toxins and hormones. Insoluble
fibre isn’t digested but helps to regulate bowel
movements and provides bulk to help form stools.
Insoluble fibre foods include:
Nuts/nut butter – almonds, walnuts, cashews
Seeds – flaxseed, linseeds
Wholegrains
Vegetables – asparagus, peppers
Dark green leafy vegetables – broccoli, spinach,
kale
Increasing the amount of fibre in the diet gradually is
recommended as a sudden increase can sometimes
lead to bloating or discomfort as bacteria in the gut
ferments the fibrous food and produces gases. The
body will adjust more easily if fibre intake is slowly
increased. It is also important to remember to increase
fluid consumption to support the increase in fibre in
the diet.
Tips for increasing fibre intake:
Choose a high fibre breakfast cereal or porridge
Eat wholemeal or granary breads, wholewheat
pasta or brown rice
Add beans, lentils and chickpeas to stews, curries
and salads
Keep the skins on potatoes (baked potato or boiled
new potatoes)
Include plenty of vegetables with meals and snacks
Add fresh fruit, vegetable sticks (carrot, cucumber,
celery), oatcakes and seeds to the diet
90
Step 4
Gut health and
weight loss
Research is being conducted
to explore the possibility
of gut microbes being
partially responsible for
helping to maintain a
healthy body weight and
potentially, influence body
fat composition and appetite.
The microbiome of those who are overweight or
struggle to lose weight showed an increase in
inflammation and a lack of diversity in the microbes.
This is commonly associated with a diet low in fibre
and high in levels of processed foods, sugar and fat,
which is typical of a Western diet.
Interestingly, those who are overweight tend to
have low levels of Bacteroidetes and higher levels
of Firmicutes. This is associated with inflammation
and the ability to extract more energy from the food
eaten which can lead to elevated blood sugar and
an increase in fat storage. Acetate and butyrate are
the two main SCFAs that regulate fat metabolism
by increasing fat burning, decreasing fat storage
and influencing appetite signals. SCFAs also help
to protect from inflammation and maintain the
integrity of the gut lining. Butyrate can stimulate the
release of gut hormones that signal to the brain the
sensation of fullness.
Research has shown that satiety-signal transmitters
increase considerably when foods that the body’s gut
bacteria prefer are eaten. Eating a rainbow diet full
of fruit, vegetables and wholegrain foods increases
microbiome diversity and reduces calorie intake
which can lead to weight loss and lowers metabolic
markers such as blood sugar and cholesterol levels.
A lower blood sugar level means less likelihood of
craving sweet foods. Fruit, vegetables and whole
grains are also higher in fibre, which give a feeling of
fullness for longer resulting in less snacking.
Improving The Gut Microbiome
Daily tips to improve the gut microbiome:
Eating slowly and chewing each mouthful can
aid digestion and help the body absorb nutrients
Aim to eat 30g of fibre from colourful fruits and
vegetables – peppers, pumpkin, carrots, apples,
cherries, cabbage, sweetcorn, tomatoes, citrus
fruits, spinach, kale, purple sprouting broccoli,
blueberries
Include probiotic foods (or a probiotic
supplement) on a daily basis
Eat raw or steamed vegetables rather than
boiled Keep hydrated
Eating a variety of probiotic foods as well as
fruit, vegetables, pulses and wholegrains will
increase the diversity and number of bacteria
in the gut microbiome which will benefit
overall health. The gut microbiome is incredibly
complex and has a huge impact on the body.
Aside from the diet, there are possible lifestyle
changes to support gut health:
After a course of antibiotics, repopulate
the gut microbiome with a good quality
probiotic supplement and prebiotic and
probiotic foods
Aim for 7-8 hours of sleep a night
Exercise regularly
Take steps to manage stress like walking,
meditation or yoga 91
Step 5
Understanding
bowel movements
Whilst not everyone’s favourite subject, bowel habits
and stools are actually a great way to gain insight into an
individual’s overall diet, fluid intake, lifestyle and gut health.
Most people only know how their own bowel works
so it’s good to understand what constitutes good
bowel function and equally what’s not so good?
You should pass a bowel movement regularly,
at least once a day to once every three days
You should be able to hold on for a short time
after you feel the first urge to go to the toilet
You should pass a bowel movement within a
minute of sitting on the toilet
You shouldn’t have to strain or struggle to
pass a bowel movement
Your bowel should feel empty after a bowel
movement
You shouldn’t experience lots of bloating or
abdominal pain
Your stools should be soft, formed and easy
to pass
Using the Bristol Stool Chart below identify your stool
type to see if it’s the ideal type. Stool should be soft
and easy to pass like type 3 or 4.
Type 1 and 2 suggest constipation and the need to
increase daily fluid intake. The stools may be difficult
and painful to pass and has probably spent too long in
the colon so the fluid has been absorbed.
Type 5 and 6 indicates that the diet is lacking in fibre
so fibre intake (vegetables, fruits, wholegrains) needs
to be increased to pass a more formed stool.
Type 7 is diarrhoea which means the stool has
moved through the bowels very quickly and hasn’t
formed a stool.
Red flags: please notify the doctor if bowel habits
have suddenly altered or if passing fresh blood or
black, tarry stools (melena).
92
Step 6

Making fermented
foods
Fermented foods have long Health Benefits
Fermented foods bring a range of health benefits.
been used to preserve food They are a wonderful source of probiotics with
the ‘friendly’ bacteria including Lactobacillus and
and for health for centuries, Bifidobacterium, which can be added as part of the
fermentation process or occur naturally in the food.
and more recently fermented
food and drinks have grown Ingredients
1 whole cabbage, such as savoy, white, Chinese, kale
in popularity. or other brassicas (about 900g), very finely sliced
1 tbsp grated garlic (optional)
1 tbsp grated fresh turmeric or 2 tsp ground turmeric
Fermented products include: cultured milk and
Fine sea salt
yogurt, kombucha, sourdough, sauerkraut, kimchi,
beer, tempeh and miso. Tempeh is made from
Equipment
fermented soy beans, sourdough bread is made from
2 x 500ml glass preserving/fermentation jars
fermented dough, yogurt is made from fermented
Rolling pin
milk, kombucha is made from fermented green or
Fermentation weights, sterilised
black tea.

Ferment Your Own Vegetables

It is incredibly easy and inexpensive to ferment your
own food. It’s also a great way to improve the gut
microbiome and add more vegetables to the diet.
Some of the easiest foods to ferment are vegetables
such as cabbage, beetroot, radishes, turnip and
carrots. Feel free to add in herbs and spices to create
specific flavours. Including prebiotic foods such as
garlic can add flavour and extra health benefits.

How It Works
The fermentation process involves the controlled
microbial growth of non-harmful bacteria to transform
the flavour, increase the shelf life of the food and
increase the health benefits. Vegetables are usually
fermented in a salt-brine which kills off harmful
bacteria while allowing ‘good’ bacteria, Lactobacillus
to survive. The Lactobacillus organisms convert lactose
and other sugars in the food to lactic acid, it is this
acidic environment that preserves the vegetables and
gives them a distinct flavour.

93
Step 7
Making Fermented Foods
Method
1. Set a large mixing bowl or oven dish on a set of
scales. Put the sliced cabbage into the bowl with
the garlic (if using) and turmeric and weigh. Our tips:
2. Calculate 2 per cent of the total weight to find
the amount of salt you need (total weight in Don’t forget to sterilise your glass jars
grams ÷ 100 x 2 = the amount of salt in grams). before fermenting
Cover the veg evenly with the salt, then massage
the cabbage with your hands to break down Add grated fresh ginger or chopped dill
for extra flavour
the cellulose.
3. Lightly cover and leave at room temperature Store in the fridge after the initial 10-
overnight. In the morning, use a pestle or rolling 14 days to slow the fermentation. It
pin to ram the salted cabbage into the sterilised will keep unopened for 1 month in the
fridge
jars, ensuring you squeeze out air pockets and
completely submerge the cabbage in its own Once opened, keep chilled and use
brine. If necessary, press the cabbage beneath within a week
the surface of the liquid with fermentation
weights.
4. If using fermentation jars, open the valve. If
using preserving jars, leave the lids loose enough
to allow gases that build up while the kraut
ferments to escape.
5. Leave to ferment at room temperature (18-22°C
or warmer for a fast ferment, cooler for a slower,
more full-bodied ferment) for 10-14 days. Once
fermented, seal, label and store until you want to
serve.
6. As an alternative to using fermentation weights,
ensure the top layer of cabbage is covered with
a small disc of baking paper that you push down
underneath the brine.

94
 Gut health
quiz
WHAT IS GUT HEALTH? (STEP 1)

1 Where is the gut microbiome found?

a. Stomach

b. Brain

c. Small intestine

d. Small and large intestine

2 What percentage of the immune system cells are found in the gut?
a. 20%

b. 40%

c. 60%

d. 70%

3 Gut health can have a positive or negative effect on the brain, mood
and mental health.
True

False

4 How much of the happy hormone serotonin is made in the gut?

a. 10%

b. 90%

c. 25%

d. 80%

Answers 95
HOW IS THE GUT MICROBIOME INFLUENCED? (STEP 2)

1 The gut microbiome develops through the first 1000 days of life
and is then unmodifiable.
True

False

2 Which type of foods provide fuel for the gut bacteria?

a. Prebiotic

b. Probiotic

c. Processed

d. Homemade

3 How do foods contain probiotics?

a. They are added

b. They grow in the food

c. All of the above

d. None of the above

DIETARY FIBRE (STEP 3)

1 How much fibre is recommended daily to keep the gut healthy?

a. 10g

b. 20g

c. 30g

d. 40g

2 Dietary fibre has been shown to lower cholesterol levels as well as the
risk of developing heart disease, type 2 diabetes and colorectal cancer.
True

False

3 What does insoluble fibre help to do?

a. Provides bulk to stools

b. Enables the proper elimination of hormones and toxins

c. Helps regulate bowel movements

d. All of the above

96
4 What else do you need to ensure you increase along with fibre?
a. Protein

b. Alcohol

c. Water

d. Fat

GUT HEALTH AND WEIGHT LOSS (STEP 4)

1 What has been seen in the microbiome of overweight individuals?

a. Greater bacterial diversity

b. Bacterial strains associated with reduced fat storage

c. Bacterial strains associated with inflammation and increased fat storage

d. Bacterial strains associated with reduced inflammation

2 What are acetate and butyrate?

a. Short chain fatty acids

b. Long chain fatty acids

c. Bacteria

d. Food additives

3 How does gut bacteria help with weight loss?

a. Helps to maintain a lower blood sugar level
b. Helps you to feel fuller for longer

c. Decrease fat storage

d. Protect from inflammation

e. All of the above

UNDERSTANDING BOWEL MOVEMENTS (STEP 5)

1 Bowel habits and stools give no insight into an individual’s diet,

lifestyle, fluid intake, or gut health
True

False

97
 2 The ideal stool type should be soft and easy to pass like…
a. Type 1 and 2

b. Type 3 and 4

c. Type 5 and 6

d. Type 6 and 7

3 A moment of reflection, what are toilet habits like? Which type of

stool do you have? Do you think you need to make any changes to
your diet and/ or lifestyle to improve your gut health?

MAKING FERMENTED FOODS (STEP 6)

1 Fermenting foods for health benefits is a recent trend.

True

False

2 Which type of bread is made using a fermentation process?

a. Baguette

b. Wholegrain

c. Sourdough
d. No bread uses fermentation

3 Kombucha is made by fermenting which drink?

a. Tea

b. Juice

c. Smoothie

4 Give it a try. Have you ever tried a fermented food? Why not try one
this week or if you regularly eat fermented foods why not try our
recipe and have a go at making your own?

98
Section 10 -
Why
the vegan
diet?
The vegan diet is gaining traction
globally, currently embraced by
approximately 79 million people,
constituting about 1% of the
population. This number is
projected to climb to 10% in
the next decade. A vegan diet
excludes all animal products,
including meat, dairy, eggs,
and often honey.

Motivations for embracing

veganism range from health
and animal welfare concerns to
environmental sustainability and personal
preference. Notably, the “reducetarian” and
“flexitarian” approaches offer alternatives
for those not fully committing to veganism.
Understanding the diet’s benefits and
addressing potential nutrient gaps through
supplementation is vital for a well-rounded
plant-based diet.

99
Step 1

Introduction to the
vegan diet
A vegan diet is becoming more and more popular, with
roughly 79 million people worldwide eating vegan
This represents only 1% of the worldwide population Following a vegan diet can be healthy, affordable and
but at the current rate of growth it’s set to be 10% of easy to achieve. But it can also be a big change for
the population in the next 10 years. some, feel daunting and impossible to achieve. Meal
planning and recipe inspiration can really help the
A vegan diet involves only eating food that comes transition to a plant-based diet and the enjoyment of it
from a plant source, avoiding all animal products, on an ongoing basis.
including meat, dairy, fish and eggs, with some
vegans also avoiding honey. For some, veganism is
a dietary choice and for others it is a lifestyle choice
meaning the avoidance of clothes, cosmetics,
supplements and other products that use or contain
animal ingredients.

The most common reasons for going vegan are

because of health concerns about meat, for animal
welfare reasons both in terms of how animals are
kept and how they are slaughtered, for environmental
reasons and to help slow climate change, to improve
health and finally because of personal preference.

Not everyone wants to go fully vegan but they

may want to make meaningful change either to
help the environment, for animal welfare or health
reasons. Many are getting behind followings like
Meatless Mondays or Veganuary, but also some
other neologisms have come about that are about
increasing plant-based eating but don’t entail going
fully vegan:

Reducetarian – committed to eating less meat

and dairy and fewer eggs
Flexitarian – veggie or vegan on flexi-time.
Maybe 6 days out of 7 a vegan diet is followed
Plant-strong – predominantly basing the diet
on plant-based, moving towards going vegan in
the future (maybe)

100
Step 2

Benefits and
drawbacks to
a vegan diet
Vegan diets tend to be
nutrient dense and low in
saturated fats.

Research suggests that the diet can improve heart

health, protect against cancer, and lower the risk of
type 2 diabetes.

The vegan diet also appears to enhance the levels

of protective bacteria strains such as F. praunsnitzii
and reduces the levels of pathogenic strains such
as Enterobacteriacea. Such changes stemming
from the vegan diet are thought to have protective
health benefits; the key may be reduced levels of
inflammation. Additional health benefits from the
vegan diet appear to stem from a marked increase in
fibre in the diet through pulses, grains and vegetables.

However, there are certain nutrients that are found

only in animal sources and some that are found in
their most bioavailable form in animal products.
Therefore, those following a vegan or even flexitarian,
reducetarian or plant-strong diet need to be more
aware of how to obtain certain nutrients including
vitamin B12, vitamin D and omega-3. It may also be
necessary to review intake of the important nutrients
iron, calcium and vitamin A as well as protein as
these can be lower in a vegan diet. For some it may
be necessary to supplement some of these nutrients
whereas others may be able to get enough through
their diet if it is well thought out and planned.

101
Step 3
Nutrients to consider
supplementing
Certain nutrients are easier than others to take in through the
diet if you’re going vegan or have a largely plant-based diet.
Vitamin B12, vitamin D and omega 3 are all potentially
required in supplement form, read on to find out why.
Vitamin B12
Vitamin B12 (also known as cobalamin) is an essential
water-soluble vitamin. It is necessary for the normal
formation of red blood cells, nerve health and
function, as well as DNA synthesis. It plays a key role
in energy production and the reduction of tiredness
and fatigue.
The best B12 food sources include meat – beef, liver,
chicken, fish – mackerel, tuna, shellfish – mussels,
eggs, cheese, milk and yogurt, which is why those
following a vegan or predominantly plant-based diet
are at risk of deficiency.
Low levels of vitamin B12 can lead to the body
producing abnormally large red blood cells that
are not able to adequately carry oxygen. This is a
form of anaemia and can cause tiredness and low
energy. Other symptoms can include mouth ulcers,
muscle weakness, pins and needles in fingers and
toes, disturbed vision, depression, confusion, poor
cognitive ability and memory problems.
Whilst some foods are now fortified with B12 such as
plant milks, tofu and some cereals, supplementation
is still beneficial and recommended for vegans to
support the brain, mood and energy as well as the
heart, fertility and immunity. Vegans with conditions
affecting the stomach or small intestine such as coeliac
disease, Crohn’s disease and ulcerative colitis should
speak to their doctor about supplementation as these
conditions can mean inadequate B12 absorption when
consumed orally.
Vitamin D
Vitamin D is fat-soluble vitamin that plays an important
role in immune system health and the formation
and maintenance of bone, muscle and teeth. It has
the properties of both a vitamin and a hormone and
is essential for maintaining normal blood levels of
calcium and phosphorus.
The best sources of vitamin D are predominantly
from animal sources such as oily fish - tuna, mackerel,
salmon, trout, halibut, cheese, whole milk and egg
yolks. Vegan sources of vitamin D include sun-dried
tomatoes, mushrooms and fortified foods. Sunshine
is a further excellent source but depending on where
you live not necessarily a reliable one, additionally too
much sun can also lead to skin ageing and skin cancer.
Low levels of vitamin D can result in rickets in children
and osteomalacia in adults, as well as low mood and
Seasonal Affective Disorder (SAD), disturbed sleep,
insomnia and low energy.
Even with mushrooms, tomatoes and fortified
foods in the diet most vegans would benefit from
supplementing vitamin D to prevent low levels, this is
particularly true for those with darker skin as they are
more likely to be deficient in vitamin D3.
102
Step 3
Nutrients to consider supplementing
Omega-3
The membrane of every human cell is formed from
fatty acids so our fat consumption is literally present
in our cells. Certain fats are ‘essential’ and cannot
be synthesised in the body, they are omega 3 and
omega 6 fatty acids.

Omega-3 (alpha linolenic acid or ALA) is a

polyunsaturated fat. The body uses it to produce
prostaglandins, which are regulatory compounds
involved in the allergic response, blood clotting, blood
pressure regulation, heart function, inflammation
regulation, kidney function and fluid balance, nerve
transmission, steroid production and hormone
synthesis. Prostaglandins produced from omega-3
are anti-inflammatory.

The richest source of Omega-3 is oily fish – salmon,

mackerel, tuna, herring, and sardines, but it is also
found in flaxseed, chia seeds, walnuts, flaxseed oil,
soybean oil, canola oil, walnut oil and fortified foods.

To produce the anti-inflammatory compounds ALA

can be converted to eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA) in the body. The process
of converting ALA effectively to EPA and DHA relies
on the presence other nutrients and therefore the
best way to get EPA and DHA is to consume these
through the diet directly. EPA and DHA are found
in oily fish but also in algal oil (that comes from
certain marine algae). Algal oil is used to make vegan
omega-3 dietary supplements.

To ensure an intake of EPA

and DHA vegan omega-3
dietary supplements are
recommended, alongside an
intake of flaxseed, chia seeds
and walnuts through the diet.

103
Step 4
Nutrients to monitor
Having looked at those nutrients, which are
recommended to supplement whilst following a vegan
diet, there are further nutrients that vegans should
monitor their intake of.
Some nutrients can easily be low in the vegan diet
depending on food choices, likes and dislikes.
Vitamin A
Vitamin A is also known as retinol and is a fat-soluble
vitamin. Vitamin A is important for supporting
the normal structure and function of the skin and
mucous membranes such as in the eyes, lungs and
digestive system. It is vital for vision, embryonic
development, growth and cellular differentiation. It
also supports the immune system.
Vitamin A is found in animal products such as cheese,
eggs, oily fish – tuna, mackerel, cod liver oil , fortified
low-fat spreads, milk, yogurt, butter, liver and liver
pâté. However, the precursor to vitamin A, which
can be converted to retinol and it is a plant-based
source called beta carotene. 6mg of beta carotene
is equivalent to 1mg of retinol. Beta-carotene is a
red-orange pigment found in fruit and vegetables
including carrots, sweet potatoes, peppers, butternut
squash, spinach, mango, papaya, cantaloupe, broccoli
and apricots.
With a good amount of beta carotene in the diet
vegans may not require supplementation. Some
vegans do supplement however intake should
not exceed 1.5mg (1500µg). Older men and post-
menopausal women are more at risk of osteoporosis
should avoid having more than 1.5mg of vitamin
A per day from food and supplements as this may
negatively affect bones. Vitamin A supplements
should also be avoided during pregnancy or if trying
for a baby as excess vitamin A (retinol) intake during
pregnancy can increase the risk of birth defects.
Calcium
Calcium is a mineral strongly associated with healthy
bones and teeth. It also plays an important role in
blood clotting, helping muscles to contract, and
regulating normal heart rhythms and nerve functions.
About 99% of the body’s calcium is stored in bones,
with the remaining 1% found in blood, muscle, and
other tissues.
Milk and dairy products are most widely known as
being sources of calcium but there are many more
plant-based sources including fortified plant-based
milks – almond, soy, and rice, calcium-fortified orange
juice, winter squash, edamame beans, tofu, almonds,
leafy greens – collard, mustard, turnip, kale, bok choy
and spinach.
In fact, many plant-based sources have a greater
bioavailability of calcium than dairy. Bioavailability
means how much of something is available for the
body to absorb. Dairy products have a bioavailability
of about 30% so if a food label on milk lists 300 mg
of calcium per cup, about 100 mg will be absorbed
and used by the body. Whereas plant foods like
leafy greens contain less calcium overall but have a
higher bioavailability than dairy, about 50% will be
absorbed. Calcium-fortified orange juice and calcium-
set tofu have a similar total amount of calcium and
bioavailability as milk, while almonds have slightly
lower total calcium and bioavailability of about 20%.
104
Step 4
Nutrients to monitor
The body keeps blood levels of calcium under tight
regulation and if there is inadequate dietary intake
the body will release calcium from the bone into the
blood. It’s for this reason that no symptoms usually
occur if dietary intake is low and consuming enough
through the diet is important to prevent this from
happening.
Iron
Iron is a mineral that the body requires for growth
and development. Iron is used to make haemoglobin,
that is a protein in red blood cells that carries oxygen.
It also contributes to normal cognitive function,
energy metabolism and the formation of red blood
cells.
There are two forms of iron in food, heme and non-
heme. Heme iron is only found in animal products like
meat, poultry, and seafood whereas non-heme iron
is found in plant-based foods like whole grains, nuts,
seeds, legumes, leafy greens and dark chocolate. The
body absorbs heme iron more readily than non-heme
iron, so vegans require roughly twice as much iron
from non-heme sources to meet the iron needs in the
body.
The absorption of iron from plant-based foods can
be improved or inhibited by other nutrients and
foods in the diet. Vitamin C rich food eaten alongside
non-heme iron food can improve its absorption,
whereas large amounts of calcium particularly from
supplements, and plant substances like phytates and
tannins can inhibit the absorption of non-heme iron.
growth and repair of the body, muscular recovery
and important for the hair, nails, tendons, muscle
and ligaments.
Protein comes from both animal and plant sources.
The best sources vegans sources include red, green,
yellow and brown lentils, chickpeas, black-eyed peas,
broad beans, kidney beans, butter beans, haricots,
cannellini beans, flageolet beans, pinto beans and
borlotti beans, walnut, almonds, brazil nuts, cashew
nuts, hazelnut, macadamia, pine nuts, peanuts,
pistachio, sunflower, pumpkin, sesame, flax, chia,
tofu, tempeh, edamame.
Low protein levels in the diet can cause weakness
fatigue, skin, nail and hair issues, mood changes,
loss of muscle mass, increased risk of illness and
fractures. Most vegans will get enough protein
through the diet, but it worth being aware of
the amount required. As a rule 0.8g of protein is
required per kg of bodyweight per day however
certain populations do require more than that;
children, athletes, post-operative patients and those
with illness. It is a good idea to work out roughly how
much you require and how much you get from your
diet each day just to ensure you are getting enough
of this important nutrient on a daily basis.

Low levels of iron in the diet can result in symptoms

such as fatigue, paleness, shortness of breath, and
dry or damaged hair and skin and can lead to iron-
deficiency anaemia. The vegan diet or largely plant-
based alongside being female and having periods can
mean a greater likelihood of iron-deficiency anaemia,
if this is you make sure you speak with your doctor
about it.

Protein
Protein is essential in the diet, it provides energy but
it is also an important component of every cell in the
human body and provides the building blocks for
hormones and enzymes. Additionally, it is vital for the

105
 Why the
vegan diet
quiz
INTRODUCTION TO THE VEGAN DIET

1 A vegan diet involves avoiding what sort of produce?

a. Bread, cakes and pasta

b. Meat, dairy, fish and eggs

c. Bread, meat and eggs

d. Fish, milk and tomatoes

2 Why do people choose to follow a vegan diet?

a. Health concerns about meat

b. To help slow climate change

c. To improve health

d. All of the above

3 You can’t do the vegan diet by halves, you’re either in or out.

True

False

4 Now for a moment of self-reflection…how much meat do you eat?

Have you ever tried plant-based meals or recipes, or followed a plant-
based diet for a number of days?

Answers 106
BENEFITS AND DRAWBACKS TO A VEGAN DIET

1 The vegan diet tends to higher in saturated fats and lower in

nutrient density
True

False

2 What impact in the body can changes that come from the vegan
diet like increased levels of certain gut bacterial strains have?
a. Increase levels of inflammation

b. Reduces levels of inflammation

c. Increases blood pressure

d. Increases type 2 diabetes risk

3 Which nutrients do you have to be particularly aware of getting into

the diet or supplementing if you follow a vegan or predominantly
plant-based diet?
a. Vitamin B12, vitamin E and omega-6

b. Vitamin D, vitamin E and omega-9

c. Vitamin B12, vitamin D and omega-3

d. Vitamin D, vitamin K and zinc

NUTRIENTS TO CONSIDER SUPPLEMENTING

1 Most of the best sources of vitamin B12 are:

a. Vegetables

b. Nuts

c. Animal products

d. Bread products

2 Vitamin D is a water-soluble vitamin

True

False

107
3 Omega-3 is what sort of fat?
a. Polyunsaturated

b. Monounsaturated

c. Saturated

d. All of the above

4 It is impossible to get vegan Omega-3 supplements.

True

False

NUTRIENTS TO MONITOR

1 What is vitamin A also known as?

a. Retaina

b. Retina

c. Retinol

d. Reptile

2 Approximately how many mgs of beta carotene is equal 1mg of retinol?

a. 3mg

b. 6mg

c. 10mg
d. 16mg

3 What is the bioavailability of calcium in dairy?

a. 10%

b. 20%

c. 30%

d. 50%

3 Vitamin C rich food eaten alongside non-heme iron food can

hinder its absorption
True

False

108
Quiz
answers

109
 Nutrition
course
quiz - answers
FOOD PROCESSING

1 Why is food processing used in food manufacturing?

a. To extend shelf life

b. To reduce shelf life

c. To take nutrients out of food

d. To make the ingredients list longer

2 Is food processing bad?

a. Yes, always

b. No, never

c. It depends upon why the food is being processed, how it’s processed and the

nutritional content of the food

Are there any types of food processing that you should keep to
3
an absolute minimum in your daily diet?
a. Canned foods

b. Frozen foods

c. Heavily processed foods

d. Fermented foods

4 Now for a moment of self-reflection…what percentage of your

weekly shop is processed foods? Of those items which are
heavily processed?

110
CHRONIC CONDITIONS

1 Chronic conditions can never be supported through nutrition.

True

False

2 Which chronic conditions can* be linked to nutrition?

a. Type 2 diabetes

b. Metabolic syndrome

c. Elevated cholesterol

d. Fatty liver disease

e. All of the above

*not all cases will be linked to nutrition choices, some will be due to genetics

COMMON DEFICIENCIES

1 Deficiencies can be caused 3 Omega-3 fatty acids are found in:

through dietary choice. a. Bread

True b. Apples

False c. Past

d. Oily fish

2 Vitamin D deficiency is
common in certain countries 3 You should aim to eat how many
in the northern hemisphere. grams of fibre per day?
a. 10g
True
b. 30g
False
c. 50g

d. 100g

GUT HEALTH

1 Your gut microbiome is unique and influenced by:

a. Your taste in music

b. Everyone is the same

c. What you watch on TV

d. Birth, diet, lifestyle, environment and medications

111
2 Gut bacteria is found in:
a. The liver

b. The stomach

c. The small and large intestine

d. None of the above

3 The gut:
a. Contains 10% of immune system cells and doesn’t make serotonin

b. Has nothing to do with the immune system

c. Contains 70% of immune system cells and makes 90% of serotonin

d. Contains 20% of immune system cells and makes 50% of serotonin

4 Which foods are beneficial for the gut?

a. Prebiotic and probiotic foods

b. Sugar

c. Processed foods

d. Everything is equally beneficial

EAT A RAINBOW

1 What is meant by eating a rainbow?

a. Eat different coloured sweets

b. Eat fruit and veg on days when there’s a rainbow

c. Eat different coloured fruit and veg

2 Why is it beneficial to eat a rainbow?

a. Looks pretty

b. Different colours mean different nutrients

c. For fun

3 Now for a moment of self-reflection…how varied are your fruit and

veg choices? Do you eat a rainbow or even part of a rainbow on a
daily basis?

112
BANT HEALTHY EATING PLATE

1 According to the BANT plate how many portions of fruit and veg
should you ideally have per day?
a. 0 fruit, 5 veg

b. Doesn’t matter if you eat fruit and veg or not

c. 6 fruit, 1 veg

d. 2 fruit, 5 veg

According to the BANT plate how much of your plate

2
should be protein?
a. 70%

b. 10%

c. 90%

d. 25%

3 Good examples of whole grains to include in your daily diet are

(more than 1):
a. White bread

b. Brown rice

c. White pasta

d. Oats

e. Quinoa

4 Excellent sources of healthy fat include:

a. Margarine

b. Products containing trans fats

c. Nuts, seeds, avocado

113
BRISTOL STOOL CHART

1 Your bowel habits and stools tell you nothing about your current
diet, fluid intake and lifestyle.
True

False

2 Ideally your stool type should be:

a. Type 1 or 2

b. Type 3 or 4

c. Type 4 or 5

d. Type 5 or 7

3 Now for a moment of self-reflection…what’s your usual type of

stool? How often do you have a bowel movement? Can you hold
on for a short time after you get the first urge to have a bowel
movement?

NUTRITIONAL IMPACT
Being guided by calories alone when you make food
1
choices is the ideal way to shop.
True

False

2 Antioxidants are important molecules that:

a. Speed up damage in the body

b. Help free radicals to increase in number

c. Are bad for your health

d. Prevent or slow damage caused by free radicals

114
 3 Foods high in antioxidants include:
a. Strawberries, green tea, dark chocolate and garlic

b. Milk chocolate, pasta and cheese

c. Fast food

d. White chocolate, fizzy drinks and white bread

HEALTHLY HABITS
It usually takes how long Which of the following ways can
1 2
to form a new habit? help to change behaviour:
a. 1 week a. Don’t think about it, just do it

b. 12 weeks b. Reward yourself with food when you do well

c. 6 weeks c. Understand why you want to make a change

d. 3 weeks d. Exclude all foods you enjoy

3 Adults make a large number of decisions about food everyday and

the majority are unconscious and habitual decisions.
True

False

PERSONALISED NUTRITION

1 All diets and ways of eating suit everyone.

True

False

2 What is personalised nutrition?

a. Eating the same as your best mate

b. Eating a diet designed for your lifestyle, health goals and physiology

c. Following the Keto diet

d. Eating any food you like

115
3 Now for a moment of self-reflection…what’s your current
relationship with food like? Do you enjoy cooking and eating or do
you see food as a functional necessity? Do you experience guilt
about eating certain foods?

TIPS ON IMPROVING YOUR DIET

Your diet can hugely support your health, to do this it’s
1 recommended to:
a. Enjoy lots of free sugars in cakes, biscuits, fizzy drinks and chocolate

b. Eat lots of red meat and processed meat

c. Reduce consumption of fruit and vegetables

d. Reduce free sugars, processed meat and saturated fat

2 Pre-prepping food for meals can help you not to grab unhealthy
choices when you’re hungry or short of time.
True

False

3 Being ‘present’ whilst you’re eating means:

a. Eating when you’re watching TV

b. Eating whilst on your computer or tablet

c. Eating without technology

d. Eating whilst you read messages on your phone

116
CREATING A SUCCESSFUL MEAL PLAN

1 Meal planning is a great way to save time, money, reduce decision

making, reduce food waste and make your diet healthier.
True

False

2 Now for a moment of self-reflection…how much time do you spend

planning and shopping each week? Do you have a large amount of
food waste? Do you pre-prep any meals like making lunch the night
before or do you just grab something when you’re out? How could
you improve your meal planning?

117
 Calorie-
controlled
diets quiz
- answers

ALL ABOUT CALORIES AND NUTRIENTS

1 Why are calories relevant?

a. They represent the number of times you have to chew food

b. They aren’t

c. They tell you the amount of energy available in a food item

d. They are just a random number given to a food

2 What is the value of a gram of protein, carbohydrate and fat

a. 3,4,10

b. 4,4,4

c. 4,4,9

d. 6,5,5

3 What happens when you take in more calories than you need?
a. You lose weight

b. You gain weight

c. Nothing happens

WORKING OUT YOUR CALORIE REQUIREMENTS

1 BMR stands for

a. Base metabolic response

b. Basal metabolic rate

c. Basal mental rate

d. Base mechanical rate

118
 2 Muscle mass has no impact on the amount of energy the body requires
True

False

3 In addition to height, weight and age which other factors affect your
basal metabolic rate?
a. Nothing else

b. Genetics and ethnicity

c. Ethnicity, weight history, body composition and genetics

d. Weight history and body composition

A DIET BASED ON CALORIES

1 What are the macronutrients?

a. Carbohydrate, protein and fat

b. Carbohydrate, fat and vitamins

c. Vitamins, minerals and protein

d. Protein, fat and minerals

2 Choosing foods purely based upon calorie content…

a. Is the only way to make food choices

b. Always means you’re eating healthily

c. Guarantees that food is more nutritious

d. Sometimes means a diet that’s lower in nutritious food

3 A moment of reflection, do you make choices purely based

upon the number of calories in a product? Do you think this is
leading to a nutritious diet or could it be improved?

119
WHAT DOES A GOOD CALORIE-CONTROLLED
DIET LOOK LIKE?
If you were to follow the 1500-calorie diet what needs to be worked out
1
to understand whether this would work for you?
a. How long to do the diet for

b. If you could eat you favourite foods

c. Individualised calorie requirement

d. Which day of the week to start on

2 What is good about behavioural change around food?

a. Helps change the way you think and feel about food

b. Helps you make better food choices

c. Helps you to make changes for the long-term

d. All of the above

3 A moment of reflection, have you spent many years yo-yo dieting or

using calorie controlled diets? Do you think behavioural change could
help you to make more long-term change and prevent your weight
from going up and down?

120
 Diabetes
and nutrition
quiz - answers
GETTING TO KNOW BLOOD SUGAR (STEP 1)

1 Blood glucose levels stay the same all day long.

True

Flase

2 What are the two hormones most critical to metabolism called?

a. Glucagon and TSH

b. Insulin and glucose

c. Glucagon and insulin

d. Adrenaline and insulin

3 What is glucagon released in response to?

a. High glucose level

b. Low glucose level

TYPE 1 VERSUS TYPE 2 DIABETES (STEP 2)

1 Type 1 diabetes is an autoimmune condition that cannot be prevented

True

Flase

2 Type 2 diabetes is just a factor of age and cannot be prevented.

True

Flase

121
 3 Common symptoms of diabetes include:
a. Frequent urination and blurred vision

b. Fatigue and slow wound healing

c. Excessive thirst and frequent infections

d. Itchy skin, dry eyes or mouth, yeast infections

e. All of the above

NUTRITION AND TYPE 2 DIABETES (STEP 3)

1 The Mediterranean diet is the only diet that helps to prevent

prediabetes and diabetes.
True

Flase

2 How many hours of exercise are recommended per week?

a. None

b. 30 mins – 1 hour

c. 1.5 – 2 hours

d. 2.5 – 3 hours

3 How can diet and lifestyle changes help to prevent diabetes?

a. By increasing blood sugar

b. By lowering blood sugar

c. By lowering blood sugar and helping weight loss

4 A moment of reflection…what’s your daily diet like? Do you have

prediabetes or suspect that you may have? Have you ever had your
blood glucose levels tested?

122
NUTRITION AND TYPE 1 DIABETES (STEP 4)

1 What is carb counting?

a. Counting how many calories are in a meal

b. Counting how many carbs are in a meal

c. Counting how much protein is in a meal

Continuous glucose monitors allow a type 1 diabetic to understand

2 exactly what their blood sugar level is at any one time?

True

Flase

3 When should a type 1 diabetic use sugary drinks?

a. Never

b. Anytime

c. If they are hypoglycaemic

123
 Eating for mood
and mental
health quiz - answers
THE GUT BRAIN AXIS (STEP 1

1 Which systems in the body are involved in the gut-brain axis?

a. The cardiovascular system and nervous system

b. The immune system and cardiovascular system c.

c. The immune system, nervous system, and neurotransmitters

d. The nervous system and neurotransmitters

2 What’s the name of the nerve that connects the brain and gut
a. Vagus nerve

b. Femoral nerve

c. Sciatic nerve

d. Axillary nerve

3 Roughly 90% of which neurotransmitter is made in the gut?

a. Testosterone

b. Serotonin

c. Melatonin

d. Dopamine

Research has shown that the gut microbiome is only important for
4
digestive function.
True

Flase

124
KEEPING THE GUT HEALTHY TO BOOST MOOD (STEP 2)

1 Which sort of foods can help to increase the number and diversity of
bacteria in the gut?

a. Prebiotic

b. Probiotic

c. Fatty

d. Sugary

Prebiotic foods aid gut health by providing good bacteria with fuel,
2
stimulating growth and activity.
True

Flase

3 What is the recommended intake of fibre?

a. 5g

b. 10g

c. 20g

d. 30g

4 Insoluble fibre isn’t digested therefore serves no purpose.

True

Flase

5 Now for a moment of self-reflection…what’s your fibre intake like?

Do you have enough in your diet? How could you improve your
intake?

125
THE MEDITERRANEAN DIET FOR MOOD AND MENTAL
HEALTH (STEP 3)

1 Which dietary type has been associated with better mental health?
a. The Western diet

b. The Middle Eastern

c. The Mediterranean diet

d. The ketogenic diet

2 Which foods are included sparingly in the Mediterranean diet?

a. Fish, nuts and legumes

b. Wine, white meat and olive oil

c. Whole grains, dairy products and fish

d. Wine, red meat and dairy products

3 Monounsaturated fats and omega-3 fatty acids are linked to…

a. Brain health

b. Digestive health

c. They aren’t beneficial

d. Ear health

KEY NUTRIENTS FOR MOOD AND MENTAL HEALTH

(STEP 4)

1 An ‘essential’ amino acid means that it can be made in the body

a. True

b. False

2 Which amino acid is converted to serotonin in the body?

a. Phenylalanine

b. Tyrosine

c. Leucine

d. Tryptophan

126
3 Which mineral helps the conversion of serotonin and melatonin in the
brain?

a. Zinc

b. Copper

c. Magnesium

d. Calcium

Research shows that people with higher levels of vitamin B12 are more
4
likely to suffer from depression
True

Flase

3 Which foods are the richest sources of vitamin B12?

a. Fruit and vegetable sources

b. Vegan sources

c. Animal sources

d. Grain sources

127
 Eating for
sleep quiz
- answers

WHY IS SLEEP IMPORTANT?

1 Adults are recommended to get how many hours of sleep per night
a. Doesn’t matter

b. 5-6 hours

c. 6-8 hours

d. 7-9 hours

2 Poor sleep…
a. Doesn’t affect physical health only mental health

b. Helps the body fight chronic disease

c. Affects metabolism, reduces the body’s ability to fight disease and develop immunity and

increases chronic disease rick

d. Affects metabolism, helps the body fight disease and develop immunity

3 Chronic sleep issues are associated with anxiety and depression

True

Flase

4 Now for a moment of self-reflection…what’s your sleeping like?

How many hours of sleep do you get per night?

128
WHAT CAN AFFECT SLEEP?

1 Stress has no bearing on sleep

True

Flase

Energy drinks, sugars-sweetened drinks and meals with high

2
glycaemic load can all affect sleep
True

Flase

3 Alcohol…

a. Disrupts the circadian rhythm and but gets the body into a deep sleep

b. Disrupts the circadian rhythm and prevents the body from reaching deep sleep

c. Helps you sleep because you can fall asleep quicker

d. Helps you get into a deeper sleep

HOW CAN NUTRITION POSITIVELY AFFECT SLEEP?

1 L-Tryptophan is found in which type of foods?

a. Fat

b. Fibre

c. Protein

d. Carbohydrate

2 Serotonin is the precursor for which hormone?

a. Insulin

b. Thyroid stimulating hormone

c. Growth hormone

d. Melatonin

3 Low melatonin levels can mean what?

a. You can have difficulty sleeping

b. You can get to sleep quicker

c. You feel less stressed

d. You feel refreshed when you wake up in the morning

129
4 Amongst other items melatonin-rich foods include:
a. Pistachios, red meat and pineapple

b. Only meat

c. Eggs, cherries and fish

d. Apples, bananas and cherries

OTHER NUTRIENTS THAT AID SLEEP

1 Magnesium is a natural stimulant in the body

True

Flase

2 Vitamin B12 is found mostly in which types of foods?

a. Vegetables

b. Animal products

c. Carbohydrates

d. Plant-based

3 What does kiwi fruit contain to make it good as a sleep aid?

a. Sugar

b. Fibre

c. Serotonin

d. Minerals

4 Which mineral helps the conversion of serotonin and melatonin in

the brain?
a. Zinc

b. Copper

c. Magnesium

d. Calcium

130
SLEEP AND WEIGHT MANAGEMENT

1 There is no evidence to say that sleep and obesity are linked?

True

Flase

2 How can sleep sometimes lead to weight gain?

a. It motivates you

b. It can lead to better nutrition choices

c. It can lead to low motivation and bad nutrition choices

d. It can’t

3 Now for a moment of self-reflection…what’s your sleeping routine like?

Do you think your sleep has ever affected your weight management?
Which tips could you implement to improve your sleep?

131
 Eating for
stress quiz
- answers

UNDERSTANDING STRESS (STEP 1)

1 What is the natural hormonal response often referred to known as?

a. Fit to fight

b. Flight or flight

c. Fight and fight

d. Fight or flight

2 What are the glands called which release the main stress hormones?
a. Thyroid gland

b. Pineal gland

c. Adrenal gland

d. Hypothalamus

3 Adrenaline and noradrenaline decrease heart rate and blood pressure.

True

Flase

WHAT ARE THE EFFECTS OF LONG TERM STRESS? (STEP 2)

1 General adaptation syndrome (GAS) has how many stages?
a. 2

b. 3

c. 4

d. 5

132
 2 Signs of the resistance stage include:

a. Irritability, frustration and poor concentration

b. Motivation, better concentration and good memory

c. Better sleep and feeling happy

d. All of the above

3 Now for a moment of self-reflection…what are your stress levels like?

Do you think you are experiencing prolonged or chronic stress? If so
which stage do you think you’re at?

HOW ARE STRESS AND NUTRITION LINKED? (STEP 3)

1 What are the roles of cortisol in the stress response?

a. Increases heart rate and blood pressure

b. Increases insulin production and stores energy

c. Increases energy availability and inhibits insulin production

d. Suppresses appetite and promotes satiety

Elevated levels of cortisol can reduce the feeling of fullness after a meal
2
and increase appetite leading which can lead to weight gain over time.
True

False

3 With regards to stress nutrition can…

a. Support the body by providing the necessary nutrients for the stress response

b. Exacerbate stress by further elevating blood sugar

c. Help to reduce inflammation

d. All of the above

133
GETTING THE RIGHT NUTRIENTS IN THE DIET (STEP 4)

1 Why is vitamin C important in times of stress?

a. It helps to protect the adrenal glands

b. It’s required for the production of cortisol

c. It’s important for the immune system

d. All of the above

2 Which B vitamin is of particular importance for the stress response?

a. B1

b. B3

c. B5

d. B7

3 Amino acids are the building blocks of which nutrient?

a. Carbohydrates

b. Protein

c. Fat

d. Fibre

4 What are the best sources of EPA and DHA?

a. Animal products

b. Vegetables

c. Oily fish

d. Dairy products

5 During times of stress what is it best to limit consumption of?

a. Carbohydrates and protein

b. Herbal teas and snacks

c. Homemade food

d. Caffeine, alcohol, high sugar and processed foods

134
 Family
nutrition
quiz - answers
THE IMPORTANCE OF FAMILY MEALTIME – STEP 1

1 At least how many times a week is it recommended to eat together?

a. Doesn’t matter

b. Once

c. 2-3 times

d. 5-7 times

2 What kind of benefits have studies shown that eating together can bring?
a. None

b. Emotional and social

c. Physical, emotional, social and academic

d. Academic

3 What has eating in front of the television been associated with in

studies of children?
a. Being overweight

b. Being healthy

c. Being informed

4 Now for a moment of self-reflection…how many times a week does

your family eat together? Do you enjoy mealtimes together? Do you
need to make any changes?

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NUTRITION REQUIREMENTS BY AGE GROUP – STEP 2

1 Nutritional requirements stay the same from birth to old age.

True

False

2 Why would children older than two years of age require more calories
a. They become less active and mobile

b. They become more active and mobile

c. They don’t need more

3 Why are the nutrients protein, calcium and vitamin D particularly

important for teenage boys?
a. To slow growth down

b. To make sure they feel full

c. They aren’t important

d. For muscle development

4 Of the different age ranges who has the greatest iron requirement?
a. Teenage boys

b. Teenage girls

c. Toddler boys

d. Infant girls

TIPS FOR FEEDING THE WHOLE FAMILY – STEP 3

1 Never let the family choose what to eat.
True

False

2 Eating at the table as a family is beneficial for adults and children alike
True

False

3 Hide all snacks from view

True

False

136
4 If children don’t eat what you’ve chosen to serve argue about this
True

False

MAKING PRACTICAL CHANGES – STEP 4

1 Why is it best not to make severe overnight changes and instead

changes things gradually?
a. Means more food shopping

b. Hard to come up with enough ideas of new meals

c. Can result in change being embraced more readily

d. Can result in more resistance to change

2 Why do children often not like the taste of vegetables like broccoli,
kale and cabbage?
a. Too sweet

b. Too salty

c. Too bitter

d. Too sour

3 Why is using reward foods often not effective?

a. Makes children like the food they’ve been incentivised to eat even less

b. Wastes food

c. Makes children like the food they’ve been incentivised to eat even more

d. Is too much fun

4 What could honey coated granola be swapped for?

a. Chocolate cereal

b. White toast

c. Frosted cereal

d. Porridge with berries

5 Now for a moment of self-reflection…Are there food swaps you think

your family would benefit from making? What could you swap in to
replace the food items with?

137
 FODMAPS
quiz - answers
WHAT ARE FODMAPS?

1 FODMAPs are short-chain what?

a. Fats

b. Proteins

c. Carbohydrates

d. All of the above

2 What happens when the gut bacteria ferments FODMAPs?

a. They get absorbed

b. They pass into the blood stream

c. They turn into alcohol

d. They produce gases

3 What does the gut bacteria use the FODMAPs for?

a. For fuel

b. It doesn’t

c. For hydration

IBS AND FODMAPS

1 IBS stands for

a. Intimal bowel syndrome

b. Itchy bowel syndrome

c. Irritable bowel syndrome

d. Icey bowel syndrome

138
2 Triggers for IBS can include:
a. Only food items

b. Foods, medications, hormones and stress

c. Hormones and stress

d. Medications, hormones and stress

3 A low FODMAP diet has been used by many to

a. Make quality of life worse

b. Increase bloating and pain

c. Make bowel habits worse

d. Reduce pain and bloating

HOW DOES THE FODMAP DIET WORK?

1 A FODMAP diet has how many phases to it?

a. 1

b. 2

c. 3

d. 4

2 What percentage of people feel their symptoms are improved by the

FODMAP diet?
a. 55%

b. 75%

c. 85%

d. 95%

3 The order of the 3 phases is

a. Low FODMAP diet, FODMAP reintroduction, FODMAP personalisation

b. FODMAP personalisation, low FODMAP diet, FODMAP reintroduction

c. FODMAP reintroduction, low FODMAP diet, FODMAP personalisation

139
 Gut health
quiz - answers
WHAT IS GUT HEALTH? (STEP 1)

1 Where is the gut microbiome found?

a. Stomach

b. Brain

c. Small intestine

d. Small and large intestine

2 What percentage of the immune system cells are found in the gut?
a. 20%

b. 40%

c. 60%

d. 70%

3 Gut health can have a positive or negative effect on the brain, mood
and mental health.
True

False

4 How much of the happy hormone serotonin is made in the gut?

a. 10%

b. 90%

c. 25%

d. 80%

140
HOW IS THE GUT MICROBIOME INFLUENCED? (STEP 2)

1 The gut microbiome develops through the first 1000 days of life
and is then unmodifiable.
True

False

2 Which type of foods provide fuel for the gut bacteria?

a. Prebiotic

b. Probiotic

c. Processed

d. Homemade

3 How do foods contain probiotics?

a. They are added

b. They grow in the food

c. All of the above

d. None of the above

DIETARY FIBRE (STEP 3)

1 How much fibre is recommended daily to keep the gut healthy?

a. 10g

b. 20g

c. 30g

d. 40g

2 Dietary fibre has been shown to lower cholesterol levels as well as the
risk of developing heart disease, type 2 diabetes and colorectal cancer.
True

False

3 What does insoluble fibre help to do?

a. Provides bulk to stools

b. Enables the proper elimination of hormones and toxins

c. Helps regulate bowel movements

d. All of the above

141
4 What else do you need to ensure you increase along with fibre?
a. Protein

b. Alcohol

c. Water

d. Fat

GUT HEALTH AND WEIGHT LOSS (STEP 4)

1 What has been seen in the microbiome of overweight individuals?

a. Greater bacterial diversity

b. Bacterial strains associated with reduced fat storage

c. Bacterial strains associated with inflammation and increased fat storage

d. Bacterial strains associated with reduced inflammation

2 What are acetate and butyrate?

a. Short chain fatty acids

b. Long chain fatty acids

c. Bacteria

d. Food additives

3 How does gut bacteria help with weight loss?

a. Helps to maintain a lower blood sugar level
b. Helps you to feel fuller for longer

c. Decrease fat storage

d. Protect from inflammation

e. All of the above

UNDERSTANDING BOWEL MOVEMENTS (STEP 5)

1 Bowel habits and stools give no insight into an individual’s diet,

lifestyle, fluid intake, or gut health
True

False

142
 2 The ideal stool type should be soft and easy to pass like…
a. Type 1 and 2

b. Type 3 and 4

c. Type 5 and 6

d. Type 6 and 7

3 A moment of reflection, what are toilet habits like? Which type of

stool do you have? Do you think you need to make any changes to
your diet and/ or lifestyle to improve your gut health?

MAKING FERMENTED FOODS (STEP 6)

1 Fermenting foods for health benefits is a recent trend.

True

False

2 Which type of bread is made using a fermentation process?

a. Baguette

b. Wholegrain

c. Sourdough
d. No bread uses fermentation

3 Kombucha is made by fermenting which drink?

a. Tea

b. Juice

c. Smoothie

4 Give it a try. Have you ever tried a fermented food? Why not try one
this week or if you regularly eat fermented foods why not try our
recipe and have a go at making your own?

143
 Why the
vegan diet
quiz - answers
INTRODUCTION TO THE VEGAN DIET

1 A vegan diet involves avoiding what sort of produce?

a. Bread, cakes and pasta

b. Meat, dairy, fish and eggs

c. Bread, meat and eggs

d. Fish, milk and tomatoes

2 Why do people choose to follow a vegan diet?

a. Health concerns about meat

b. To help slow climate change

c. To improve health

d. All of the above

3 You can’t do the vegan diet by halves, you’re either in or out.

True

False

4 Now for a moment of self-reflection…how much meat do you eat?

Have you ever tried plant-based meals or recipes, or followed a plant-
based diet for a number of days?

144
BENEFITS AND DRAWBACKS TO A VEGAN DIET

1 The vegan diet tends to higher in saturated fats and lower in

nutrient density
True

False

2 What impact in the body can changes that come from the vegan
diet like increased levels of certain gut bacterial strains have?
a. Increase levels of inflammation

b. Reduces levels of inflammation

c. Increases blood pressure

d. Increases type 2 diabetes risk

3 Which nutrients do you have to be particularly aware of getting into

the diet or supplementing if you follow a vegan or predominantly
plant-based diet?
a. Vitamin B12, vitamin E and omega-6

b. Vitamin D, vitamin E and omega-9

c. Vitamin B12, vitamin D and omega-3

d. Vitamin D, vitamin K and zinc

NUTRIENTS TO CONSIDER SUPPLEMENTING

1 Most of the best sources of vitamin B12 are:

a. Vegetables

b. Nuts

c. Animal products

d. Bread products

2 Vitamin D is a water-soluble vitamin

True

False

145
3 Omega-3 is what sort of fat?
a. Polyunsaturated

b. Monounsaturated

c. Saturated

d. All of the above

4 It is impossible to get vegan Omega-3 supplements.

True

False

NUTRIENTS TO MONITOR

1 What is vitamin A also known as?

a. Retaina

b. Retina

c. Retinol

d. Reptile

2 Approximately how many mgs of beta carotene is equal 1mg of retinol?

a. 3mg

b. 6mg

c. 10mg
d. 16mg

3 What is the bioavailability of calcium in dairy?

a. 10%

b. 20%

c. 30%

d. 50%

3 Vitamin C rich food eaten alongside non-heme iron food can

hinder its absorption
True

False

146
 ADD 10 YEARS
TO YOUR LIFE
Add 10 Years to Your Life” is your essential guide to unlocking the potential of nutrition, written by our
distinguished BANT registered Nutritionist and medical advisory board. By following the expert guidance you
will embark on a transformative journey towards a longer, healthier, and more vibrant life.
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quality. The guidance provided within these pages is designed to empower you with knowledge and practical
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dietary habits for mood, mental health, sleep, and stress management, and addressing family nutrition
concerns, the wisdom of our medical advisory board covers a wide spectrum of topics. You will also explore
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By incorporating this expert guidance into your life, you will be equipped to make more informed, health-
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Life” is your passport to a rejuvenated, resilient, and more fulfilling existence. So, join us on this journey and
embrace the secrets of longevity, one bite at a time. Your well-being, and an extra decade of life, await you.

Sian
Baker
Dip ION mBANT
mCNHC
Sian graduated with a distinction from the Institute for Optimum
Nutrition in London, a world leader in the field of nutritional therapy.
She is a full member of the British Association for Applied Nutrition and
Nutritional Therapy and is registered with the Complementary
and Natural Healthcare Council

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