Perfect Nutrition is Imperfect

It is the end of another year. Working in nutrition therapy has continued to be a great privilege: Clinics have remained packed throughout the year and I have worked hard to give my very best to each and every patient. I want to thank you all for your trust and the blessings you bring to my own journey, in allowing me to work with you.

I remain in love with my work. Nutrition therapy is truly unique: like our breath, it spans the full expanse of the physical and mental self – it is a truly holistic force for healing. As with previous years, a broad range of health conditions filled my clinics. I continued to bear witness to the different ways nutrition therapy can help us, as I have done for 14 years. 2020 provided an extra dimension of witnessing the impact of lockdown on the body and mind and how we relate to food when there have been enforced changes to our daily routine.

2020 has been, for many, a winter of our collective souls: the coronavirus crisis, Brexit, increased environmental disasters and more added a different level of challenge to our daily lives. Challenges often expose our deep inner wounds and nutrition plays a central role in reflecting back to us how we feel about ourselves: how, what, when and why we feed ourselves provides a unique, regular rhythm of glimpses into our self-esteem, knowledge, existential anxiety and coping mechanisms (to name just a few inner spaces within all of us). Lockdown gave some people a feeling of more freedom and less stress (granting space to employ healthful behaviours), while others had to cope with drastically increased stress and a sense of feeling imprisoned (opening the floodgates to less healthful behaviours as a way to try to cope): I bore witness to this through fascinating food diaries and hundreds of emotional consultations.

Nutritional choices, like many other life choices, flow in spirals. If we take a moment to step back and review the various dimensions of our lives (physical health, mental health, relationships, career, self-development and more), we can all see that we are either making choices which feed into upward spirals (towards a place which feels better in the body-mind) or downward spirals (towards a place which feels worse). An example: common responses to feeling a lack of autonomy over the direction life is taking us in include reducing health giving behaviours (those which feed into an upward spiral). People may exercise less, drop hobbies and interests, crave and eat more processed food. A lack of nutritious, whole food can biochemically feed into higher levels of anxiety and low mood (due to fluctuating blood sugar levels and a lack of important regulatory nutrients). It can also make us feel rather at sea, because over snacking reduces our meal rhythm and meal rhythms give a helpful shape to our day and family life. I will often meet patients at the bottom of this spiral – feeling depressed, anxious and out of shape. Their internal dialogue is painful to listen to – it is rife with self-loathing, which is the last thing anyone needs to be subscribing to after going through a rough time. Be kind to yourselves.

It is in this rocky, cold, barren inner space that nutrition, with all its life-giving physical, mental and spiritual benefits steps in as the best medicine! The foundation of good nutrition typically consists of three square meals a day and some snacks – it has the very realistic capacity to provide a wonderful set of anchors throughout the day. One of my favourite things to do is to help a patient (whose work or family life often feels like a freefall roll with the punches) to discover the joy of creating easy, healthy meals. If a person has entered a downward spiral due to stress, with erratic, imbalanced meals and a lack of healthful behaviours, it is absolutely essential to ensure that the narrative that healthy meals require a lot of work is smashed into smithereens! A healthy plate can be made up within a few minutes of preparation – and sometimes when we are feeling very low, a few minutes is all we can manage. I want everyone whose nutrition has suffered in 2020 to know: a few minutes per meal is enough time to make a very big difference to which spiral you’re moving through. Don’t be intimidated by the endless bombardment of complicated, life swamping plans social media provides.

I often describe the day as if it is a paragraph of writing – meals and snacks offer the punctuation: the pause, the think, the inhale before the next step – or sentence in this analogy. The rhythm provides a sense of autonomy, of true physiological satisfaction (think: a beautiful plate of colourful vegetables, whole carbohydrates and protein and the balance it provides), a connection to our food chain, our planet and a way to show ourselves love and care. These are not luxuries – they are true human needs in order to feel vital. Children observe these patterns and absorb them as truths which they can return to later in life when seeking to anchor themselves in stressful times: the subconscious remembers. If your eating patterns feel stormy and erratic don’t feel it is hopeless – there are many ways to also give you, and your family, a rhythm which suits your day. Good nutrition therapy is person centred – generic plans are a big no. Don’t accept less.

For some, 2020 provided space to enter a beautiful upward spiral. We saw a rise in meals cooked from scratch, breads baked at home and family meals. Many have realised this has benefits way beyond the body and will take this as essential behavioural ‘punctuation’ into 2021. These regular, thought out meals and snacks also provide a sense of control in a world which can often feel like it is swirling around us. Nutrition, therefore, can give us a lifeboat to hold on to, when we feel we are at sea.

This is a phenomenon I have witnessed throughout my years of clinical practice. Oftentimes, patients who are told their conditions/diagnoses are degenerative feel immense despair. They become depressed and see a greying road ahead, rife with increasing amounts of pharmaceutical medications and their side effects. Building healthy meals (and yes, this can be done without even having to cook!) gives a patient not only the physical benefits (food as medicine) but also the mental benefits which we all need in life: to control the things we can and to surrender to those we cannot. The empowerment this brings leaks into other aspects of lifestyle choices which benefit the health – reducing smoking to nil, walking more, gaining confidence and it is (those of us who are clinicians can vouch) an upward spiral of immense beauty: The word ‘degenerative’ fades into the background as the patient learns to reclaim all the aspects of health they had forgotten existed. Food IS medicine, as well as pleasure and connection – use it! Your body will thank you. I remember with great fondness a patient of mine, in her 60s, who claimed to always hate walking and came to me deeply entrenched in inflammatory bowel disease and type 2 diabetes – within a few months she couldn’t be without her walking or newly acquired whole foods (and she still had a treat food every night) – she was deeply attached to her renewed health and all it brought her. We are all capable of great change at any age, we just have to learn to take the baby steps towards it and a non-diet (think non drastic) approach: enjoy the journey – every step. If 2020 gave you the opportunity to take better care of yourself - keep going into 2021: your health is your most precious asset – guard it fiercely.

Using nutrition as a way to control can unfortunately also have a very dark and difficult side. This has never been more clear to me than in 2020 when my patient load for disordered eating sky rocketed. This consisted of newly diagnosed eating disorder patients as well as patients who had been in a remission of sorts. The stressors raised by 2020 rejuvenated their dormant coping mechanism – disordered eating. The wonderful thing about the dormant patients was that as it turned out, during our conversations, they realised they had actually been in ‘functional eating disorder mode’ for the years in between acute disordered eating and the 2020 flare – and it had been exhausting for them. 2020, again, provided the opportunity to clean these disordered dietary cobwebs from deep within the patient’s minds and help us work towards a 2021 with a healthy relationship to food. For those newly diagnosed with an eating disorder, 2020 offered us the opportunity to explore the triggers of these very difficult conditions (toxic relationships, perfectionism, trauma and more). Hand in hand with helpful GP’s and invaluable psychotherapists we have worked hard to support the important lifestyle changes to help the healing path begin. If your 2020 involved the development, or the flare up, of disordered eating please remember you deserve a healthy relationship with food – it is your right - keep fighting for it!

One of my favourite kinds of documentaries to watch are of surgeries. I feel chills of admiration running through my body while observing how perfectly, and with what precision, the surgeon works. Perfectionism, as a character trait, is a gift in the operating room. I am struck, also, by how much perfectionism is, ironically, a curse in the work of nutrition therapy. Nutrition choices are with us every day, through all kinds of stresses, strains and celebrations: how can perfectionism exist in such a changeable space? The real skill is learning how to make it good enough: Healthy nutrition means doing our best (for body and mind) with what we have and what we know. It means embracing pleasure and self-care. It employs our self-regulatory skills. Importantly, it also means abstaining from applying moral values to eating choices.

Perfectionism literally paralyses progress in terms of improving a relationship with food. This is true irrespective of which part of the nutrition realm you currently stand. It is perfectionism which contributes to the yo-yo patterns of chronic dieters, the agony of eating disorders, the painful binges, the obsession with ‘clean eating’ and much, much more. Perfectionism triggers oceans of shame.

We are sure to be bombarded with endless diet plans now that the new year is upon us: remember - there are no quick fixes to be had with eating behaviours: I can promise you that. Why do we want quick fixes anyway? Nutrition is a beautiful river that flows deep within us all – it contains our childhood, our culture, our wounds, our triumphs, our careers and our loves – it needs to be approached with curiosity and sensitivity. Transformative, long lasting change can be made and it is beautiful – but gradual. Please turn away from diets, and turn towards bite sized changes made out of self-respect – every person deserves a healthy relationship with food.

Perfect nutrition is imperfect at its core – choose imperfection as you care for yourself in 2021.