Hashimoto’s and me……. Part 1
I have been planning to write about Hashimoto’s Hypothyroidism for quite some time, but somehow I haven’t been able to pick the right moment or feel the time was right. This year has seen big changes for me and I have consciously been trying to rebalance my life. The last few weeks has really pushed me into feeling the time is right to write. In my youth, I thought I was invincible, I tried to be everything to everyone, I empathised and sympathized with others on their poor health or misfortunes and tried to rebuild or improve them, but never in a million years thought that ill health could happen to me. My lack of truly listening to my body over many years caught me out, and with a family history of auto-immune disorders I regret now this stubborn inner me. However, as I live with a chronic auto-immune condition I feel that if anything positive has come out of it, is that it has really allowed me to understand my patients at a level deeper than ever imaginable before. Hashimoto’s thyroiditis, for those unfamiliar with this condition, is in which the body’s own immune cells attack and destroy the thyroid gland. There can be up to 300 different symptoms and so there can be many of these symptoms that cross over into other illnesses. It can be slow progressing for some and so blood test may not detect it in the early stages making lives unpleasant with symptoms and no answers. Hypothyroidism is the most common outcome for a Hashimoto’s sufferer and medication is used to help treat this condition end of story. That is what I was taught when learning about the Thyroid at Uni and during my hospital career. Take a tablet and all will be fine, next…. NOW I KNOW THAT SADLY THIS IS NOT ALWAYS THE CASE…. My Story is a common classic: I had not been to the GP in years, I had no time and no reason to see him, I had strangely and uncharacteristically booked to get my Vitamin D checked mainly due my Dietetic curiosity with the media hype. Don’t get me wrong I had felt rubbish for years but put that down to long hours running my business, caring for 3 small kids, getting older and was involved weekly in caring for my disabled mother. My husband, a fabulous man, was hardly around with his job. I was a “no time for me person” to whom I used to say if I met someone like this: If you don’t look after your health you will have “plenty of time in the future”, as you won’t be able to work! A total Hypocrite I know. I just did not see it for myself or maybe I chose to ignore it. I remember when my blood panel came back I was shocked and if honest relieved. I was not surprised that something showed up and that all my symptoms that I tried to ignore or had secretly stressed about were valid. In addition to a Hashimoto’s diagnosis I had a very low Vitamin D level and suboptimal levels of B12. My diagnosis was in Dec 2012 and I thought that was it, all fixed. I was commenced on Levothyroxine and I slowly built up the dose as guided by my GP and I sat back and waited to get better. Did I feel better? Psychologically maybe a little as I started to take more interest in myself and others around me had to also consider my health. However this feeling did not last long; 4 weeks later and I was worse and so the GP increased the tablets and so the story went on until my bloods were in NORMAL range but I was feeling worse than ever. My GP made an urgent appointment for me with an Endocrinologist who assessed me and said “go take a holiday”. OMG I didn’t see that coming. I was hoping to be taken seriously but clearly I was not ill on the small panel of thyroid blood tests taken and so it had to be in my head….any of you who have been there will know the score. From that moment onwards, as best I could, I did my research. I was so unwell I did not see how I could make it to my next birthday: I was 1 month away. Some major symptoms: severe headache like a vice, walking in concrete, mixing up words, brain fog, exhaustion not able to get out of the car to lift my kids or shop, back pain, chest pain, lots of sighing, brittle nails and hair, skin on chin irritated, sensitive teeth and gums, low moods, insomnia, tearful, constipation, freezing cold, heart palpitations….my adrenal glands were struggling too. I bought a medical thyroid book book which was a great starting point and I commenced the recommendations. I know you would think that as a Dietitian I would be an expert in nutrition, which I am! but the subject of auto-immune and supplements was lacking in my knowledge and so all news was new and I ate it all up. (With these new skills I now successfully treat patients today) Anyway; I took a summer holiday with my family but sadly as a shadow of my former self in vitality, stamina and energy. Sitting at 40c I was cold and wrapped up, but the headaches were gone and that was one step in the right direction. I came home from my holiday and began to fix myself further. I joined the Health Unlocked forum which again has been instrumental in my recovery. I requested further blood tests and from this I commenced a medication which had a combination of T4 and active T3. This along with the daily regimen of supplements made a noticeable difference and some of the significant symptoms began to settle. At the same time I made a difficult but important decision that I
“Healthy working Lives” NI 2015 – how are we shaping up??
Healthy working lives. Well, that was a morning I wasn’t expecting, all in a good way that is. I was invited to speak at a Business in the Community event for improving employee health and wellbeing in the workplace on Tuesday. I had my hat on as nutrition specialist as part of the Support 2 Perform team human performance specialists. My plan was to dip in and present the exciting and important need to using wearable technology for staff health, and then head away to attend to my business demands and what comes with that, however I was drawn in to stay by the programme line-up and the venue, and I am glad I did! I must congratulate the Business in the Community team who arranged an excellent set of speakers all of whom were informative and had fresh ideas and information. I hope I can include myself in this line-up! Minister Wells MLA set the scene with Dr Carolyn Harper providing informative stats. It was then the break out session and my turn under the spot light. Thanks to Dr Jonathan Bloomfield’s information the presentation I felt was extremely well placed, allowing the audience of HR from the public and private sectors to understand and realise the opportunities for their staff with a real return of investment – long term. The next sessions were close to my heart with the 12 week weight loss programmes presented by Tanya Kennedy and Dr Declan Bradley. A great idea and an excellent starting point for business to test the water with staff health and weight loss. Progression then to the niche and real long term effective programmes like Counterweight weight management, stress, mental health and nutrition, firstbeat, garmin would then be understood and appreciated for adding value when costing long-term staff health benefits. It was great to see some of the companies that 121 Dietitian have worked with at the event, chatting to these key influencers their feedback made it clear how valuable the advice Dietitian’s provide the quote “best received” “most talked about by staff ” and looking to rebook soon again. The final speaker of the event was Susan Hayes Cullerton, an economist from Cork (a place of my family origins) had passion, drive and great humour and she stole the show. She spoke in real terms of her feelings, experiences and future plans on health and wellbeing for herself, her workforce and her future. As a non-health professional she was a breath of fresh air, she had researched intensively and presented the hard core details effortlessly with a real magnetic charm. I will even forgive her for not promoting those hard working companies who pick up from the free services she mentioned! As a specialist dietitian I too am passionate, driven and determined and share Susan’s transparency. I don’t shy away from looking in the mirror regularly. Susan pushed home the importance of needing to look at ones self before being able to advise others. She discussed 5 key areas that she found important to ask herself and she challenged the audience to answer them too. To rise to this challenge and be transparent, confirming the deep commitment I have to helping and treating people, here are my questions and answers: 1) Is my health good? Yes; I monitor it closely: I eat healthy, exercise, drink water, take supplements based on my bloods. I am unfortunate to have an auto-immune disease, but the positive I draw from living with this is having been a patient I know how difficult and lonely it can be……Do I eat ‘bad’ foods – yes sometimes. It is important to have balance. I am a scientist, cook, business owner, food experimentalist, mother of 3, wife, work long hours but I also LOVE Food. I have thus spent the past 20 years creating very clever tasty fast meals, recipes and snacks to allow all the flavours, tastes and enjoyment and variety of food to be had using the healthiest combinations possible. I educate to eat clever: nutrient focus not kcals focus. I find people judge me as a Dietitian’s assuming that I do not know what it feels like to be faced with unhealthy eating dilemma’s, or they feel that I maybe judgemental towards them because I am slim. If only they could realise that all I ever hope for is that they are inspired to make a change. Dietitian’s can’t win: If we are thin we are not accepted if we are overweight we are not credible! But for the majority of people interested in us it is thankfully often as simple as wanting to know what is in MY fridge and My cupboards!!! 2) The changes I have made to improve my overall health and well being for 2015 is to unsubscribe from unnecessary websites, take up ice-skating with my kids, switch off from work at 10:30pm/11pm at the latest and not the 12pm+ as in previous years. ( I work now 9am-3pm in the office and clinic, pick up the kids 3pm answer emails and calls while homework’s and sporting activities and food cooking takes place and then return to the office/clinic 8pm – 11pm, then its back to unpack the dishwasher, sandwiches and sleep….. 3) I go to bed extremely satisfied and wake up raring for the day ahead. 4) My commitment long term, so as not regret anything when I am 80; is that I have helped many people in my job, raised my kids to do their best and be humble. I also have for many years now look after (with great time and energy) my mother who is my inspiration to keeping focused and happy. Incapacitated with MS for 40 years she never complains and always has a smile on her face despite her pain and suffering. I can switch off like Susan when I take the 3 hour trip to visit my parents and although it is a full time job, those memories I have stored
Eat right for mental health and overall wellbeing
How and what we eat has an overarching effect on the mental health and body. We all know that, don’t we? But really have you been doing anything about it? If you are in the camp of the invincible guts of steel, or “never taken a day off in my life” type person then you are either in luck, on borrowed time or in a minority! More and more people we find are attending 121 Dietitian’s clinics with symptoms they just can’t get answers/pills or potions for, and its having a detrimental effect on their mind and body so I thought I would write a little about it and how we have been able to help. For some people it may not have been an overnight change but crept up over a few years, or for others it may have been a bolt out of the blue. Everyone and their circumstances are different, however the symptoms are often similar, or cross over with other illnesses making diagnosis vague and frustrating. But ultimately the most detrimental outcome for each person sitting beside me is that the problem is ongoing and impacting on their quality of life. Work suffers, family life is stressed, holidays become an idea of hell than heaven…. One recent example: Jen, she attended our clinic Jan 2014, a woman in her 30’s, busy life, young family and working a full-time job, full of life, shopping wasn’t always a priority and food was from ready-made meals for her and her partner. She started out in March 2012 with some episodes of feeling tired, low in mood, then progressed to feeling very low all the time coupled with some aches and pains, loss of appetite, change in bowel habits, unable to sleep well, feeling real fatigue, colder than others, weight gain, brain fog, forgetfulness, hair thinning……. She felt alone, worried and isolated. She had been for some tests and told she had fibromyalgia, Irritable Bowel Syndrome (IBS) and needed to exercise more. She didn’t get the answers she needed so attended our clinic. She had a life before this and wanted it back. We requested a series of blood tests for her re: her nutritional status, full thyroid function and antibodies, cholesterol profile, etc, we took her body composition and waist circumference. Jen also completed our questionnaire and 7 day food diary. Tests showed that Jen was in poor nutritional health, she had multiple low levels (not out of range but very low levels sub-optimal for health) of essential nutrients in her blood. She had an elevated glucose and triglyceride level. Her macro and micro vitamins intake were minimal with a high sugar/salt, sat fat intake. These problems, you may be surprised to read, however were not addressed at this stage. This was not until we got her GUT working again, if the gut isn’t absorbing then those expensive vitamins and minerals pills and potions that you are encouraged to buy (and Jen had stack loads in her bathroom cabinet) would be a waste of time. Having a poor gut function like IBS impacts on more than the GUT and as mentioned above it has a negative effect on overall health, with prescribed antidepressants, antacids, laxatives…..being common. To fix this we guided Jen through our excellent Low FODMAP elimination programme. 8 weeks later with full support she came back a changed lady her IBS symptoms had improved significantly. Next we were ready to address the diet for her mood, total health and for her life back. As Jen was carrying extra weight she decided to enrol in our Counterweight Weight management programme, a 12 month fully supported evidence based programme. Returning for the last appointment she has now lost the weight she had been so desperate to shift, she had fixed her GUT, and is now eating a nutrient rich diet. This in turn has helped her low mood, her family life, energy levels and is now looking forward to a holiday abroad with her family, something she feared greatly when we first met her. Jen is one of many we see men, women and children are all reporting problems. Mental Health – So why is this happening? Many factors can play a part here but certainly modernisation is a big one. We are living faster lives with fast foods and less down time to relax. We have over recent centuries moved from a whole foods diet to one that is based on processed and refined foods. These processed foods are leading not only to greater ill health: obesity, heart disease and inflammatory diseases, they are also leading to greater emotional distress in the form of depression, anxiety and insomnia. Eating a diet filled with chips, fast food and fizzy drinks is leading to an epidemic of “mental illness.” We also eat too quickly, chewing food has declined and food is beige, soft and gulped down, not allowing our mouth enzymes a look in. Good Nutrition is vital for your mind and body. This does not have to be difficult, so many people are confused with all the shouting and pushing of some extremes. Adhering to veganism, vegetarianism, Low carbs or paleo is not required. If the first changes you make are by concentrating on cutting out industrial based processed foods and eating more from scratch, cooking meals in the kitchen, focusing on a whole foods diet filled with wholesome prepared meals then you are doing well. Sitting and savouring food with family and friends is a part of life and its importance should not be overlooked for total happiness and health. At 121 Dietitian we look at the full person. We spend a large amount of our time building a profile of the individual’s health by using blood results, checking symptoms, assessing the diet and body composition and most importantly discussing with the patient how they feel. Our programmes are detailed but we get the results to get people’s lives back. If your GUT is down so
5:2 Fasting diet – my thoughts and experience after completing it…
Hi I am Clare writing as part of the 121 Dietitian team. Below is my own assessment of Michael Mosley’s fasting diet. Why I did 5:2 fasting diet I’m soon to graduate as a Dietitian and I have a keen interest in weight management and awareness of food content. When I heard about this diet, I knew that I would be asked about it and decided the best way to be able to give my view/understand what people were dealing with, would be to try it out myself. “Dietitians should take into account what people actually do rather than what we would like them to do” – Dr Krista Varady Note: I didn’t do the fast diet with the aim to lose weight; simply to see how it would feel and the effect it would have on my health and lifestyle. In the UK, nearly 2 in 3 adults, and 1 in 2 children, are overweight or obese. (2012) Having a BMI above 25kg/m2 puts you at higher risk of many other diet-related diseases including Type 2 Diabetes, Heart Disease and Cancer. this is something to be taken seriously and probably one of the biggest reasons for our world’s growing obsession with diets. * To work out your BMI: divide your weight (kg) by your height squared (m)2 e.g. if you are 57kg and 1.62m, it would be 57/2.62 = 21.8kg/m2 Dieting is no new thing; a quick search in google brings up some odd historical diets ranging from the self explanatory ‘chew and spit diet’ to eating tapeworm eggs… So what about this 5:2 fasting diet from Michael Mosley? Fasting is no new concept either. it is an important practice in a number of religions (consider lent, Yom Kippur, Ramadan) carried out to fulfill a number of purposes that include practicing self-control and purifying oneself. In the early Christian church, Wednesdays and Fridays were traditionally fast days, and those partaking would abstain from meat, fish, eggs and butter. ‘i fast twice a week’ – Luke 18:12. “gluttony makes a man gloomy and fearful, but fasting makes him joyful and courageous” – Saint Nikolai of Zicha I have a nagging suspicion that there’s some wonderful underlying truth about improved health with fasting just waiting to be discovered. Does the 5:2 fasting diet work? Start – 4.3.13 – weight 127lbs; BMI 21.8 kg/m2; serum cholesterol 3.8mmol/l Finish – 12.4.13 – weight 127lbs; BMI 21.8kg/m2 This is interesting. My weight stayed stable. Admittedly, on a couple of occasions I cheated, going a little bit over the 500kcal allowance or being sneaky and ‘fasting’ from 2pm one day to 2pm the next day and still allowing myself 500kcal in between (and having a takeaway pizza for lunch at 1.30pm just before i started). Also, this period in my life has been one of celebration and freedom from structure and responsibility. Therefore I have been eating out, throwing dinner parties and having coffee dates much more frequently than usual. So what I have found is that this diet has allowed me to do is to maintain a happy weight whilst eating in a ridiculously undisciplined fashion 5 days a week. It has also shown me that I am disciplined enough to work around food all day (in a cafe on my days off) and not give in to temptation 2 days a week. It required effort in planning and calorie counting and commitment but it brought a sense of achievement and self-control when mastered. I am aware that lowered cholesterol and blood sugars are supposed to be the other health benefits in the fast diet. Prior to starting, and in the name of science I visited my GP to measure my blood sugar and cholesterol levels, but it turned out they only measured my cholesterol (as seen above). Because of this I did not return post fast period because my cholesterol was at a healthy level on starting and I had nothing to compare my sugars to! Not very scientific after all. For anyone else wanting to try out this diet, please make sure to get your bloods checked before and after! Did I over-compensate for my fast days? Yes. Definitely. However, I think that had I started the fast diet with a genuine desire to lose weight, I would easily have been able to refrain from over-compensating. in Mike Mosleys book, Dr Krista Varady carried out a study which showed people generally did not compensate for their fast days by having 175% on a feed day. personally, because I wanted to push boundaries with this diet, I think I have proven that to see all the results you need have a motivation and be very, very strict. What are the benefits of 5:2 fasting diet? Bearing in mind that there have been no long term studies carried out in humans, here is a list of some of the believed benefits of fasting: · longevity (in mice: lowered IGF-1*) · weight loss (i have spoken with a number of people who have lost between 8lbs and 21lbs) · improves learning and memory in mice (possibility of reduced risk of Alzheimer’s?*) · improves nutritional awareness (constantly reading labels) · reduced risk of cancer (due to weight loss and decreased % body fat*) · lowered blood sugar and cholesterol levels · choose your days/ make it suit you · improved self discipline *The science bits. 1) this is a quote from Mike Mosley’s book. “The IGF-1 hormone (insulin-like growth factor) is one of the drivers which keep our bodies in go-go mode, with cells driven to reproduce. This is fine when you are growing, but not so good later in life. There is now evidence suggesting that IGF-1 levels can be lowered by what you eat. Studies on calorie restrictors suggest that eating less helps, but it is not enough. As well as cutting calories you have to cut your protein intake. Not entirely – that would be a very bad idea. It’s about sticking to recommended guidelines, something most of us fail to do. The reason seems to be that when our bodies no longer have access
Salt – Sea salt & rock salt -healthier options?
What is salt? Have you ever considered certain salt e.g Sea Salt or Rock Salt, may be better for you than others? At 121 dietitian we have been asked this very question. So you can see why we came to our conclusion we have provided some background info first. What is salt made from? Salt is made up of two minerals (sodium & chlorine). Sodium naturally occurs in many plant and animal foods but for most of us it is the salt in our diets which is our main source of sodium. 1g of sodium is the equivalent to 2.55g of salt. If you see sodium on a food table the easiest way to decide how much salt the food contains is to multiply the sodium by 2.5. Sodium x 2.5 = Salt in grams Why do we use salt? Salt is used in cooking to add flavour to foods, boost the flavour of other ingredients and to act as a preservative. Most of the salt we eat comes from pre-prepared foods (75%) rather than the salt we add at the table. Sea salt, rock salt or table salt is there a difference & which is better? Sea salt, rock salt and table salt all contain around 100% sodium chloride which means that too much of any of them will have a negative effect on your health. However rock salt & sea salt are often marketed as being a healthier or tastier option than table salt. Both are considerably more expensive than table salt. Sea salt is produced by the evaporation of sea water. It is argued that sea salt contains more minerals than table salt so is better for your health. However, just because it may contain extra minerals does not mean it is good for you. It would better to get these minerals from a balanced diet containing lots of fruit and vegetables than to consider sea salt as a healthy food. Rock salt is also known as halite. It is different to sea salt because it is already found in a solid form and then mined. Table salt (refined salt) can also be produced from solid salt which is found underground and then refined to remove any impurities. When the salt is being refined minerals such as calcium and potassium are often considered as impurities and so are removed in the refining process. Since 75% of the salt we eat is already in the foods we buy and no salt is a “healthy” option, we here @ 121 Dietitian suggest the cheapest and best decision you can make is to not add any extra salt at all. Instead try experimenting with other flavours such as herbs, spices, garlic, chillies, lemon & ginger. Which foods contain high levels of salt? We mentioned that 75% of the salt we consume is already in the foods we buy. Foods which often have a high salt level include bacon, cheeses, ready-made stocks, soy sauce, tomato ketchup, mustard, ham and ready-made sauces. Try to limit how often you use these products and where possible choose the reduced salt options. You can also use nutrition labels to compare salt content when no reduced salt options are available. What are the health effects of salt? In the body sodium is actually essential, it is required to maintain fluid balance and for nerve signalling. Despite this, as a nation we needn’t worry about deficiency. It is recommended that adults have no more than 6g salt per day. But the average intake shown in the last national diet & nutrition survey was 8.6g per day (with many people consuming more than this). Really all we need to maintain our health is only around 1g of salt (a pinch). Getting too much salt can be bad for our health. High intakes of salt are linked to increased blood pressure, which in turn can increase the risk of stroke and heart disease. Salt has also been linked to other conditions including osteoporosis, stomach cancer, kidney disease, kidney stones and obesity. It may also exacerbate the symptoms of asthma, Alzheimer’s and Diabetes. How much salt is too much? Recommended maximum salt intakes Age Maximum Salt Intake 0-6 months Less than 1g / day 6-12 months 1g / day 1-3 years 2g / day 4-6 years 3g / day 7-10 years 5g / day 11 years and above 6g / day If you found this article interesting you can find more information on the Action Salt website www.actionsalt.org.uk or chat to us @ 121 Dietitian: info@121dietitian.com Make sure you have the correct nutritious foods to get you off to a great start. Check out the 121Dietitian Shop Please visit my YouTube Channel. If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Instagram Facebook Youtube X-twitter Linkedin
Workplace Nutrition
Answer the following to identify your workplace nutrition: Do you buy your food at work? Do you struggle to eat healthy choices at work? Do you find there is a lack of healthy options provided? Do you find healthier choices to be more expensive? Do you fail to drink enough fluids? Do you eat at your desk? If you answer yes to more than 3 of these questions then you need to read on to improve your workplace nutrition………. With over 29 million people working in the U.K and spending up to 60% of their waking hours in work it seems obvious that the eating decisions and habits we form at work could have a significant impact on our health. In 2006, the National Institute for Health and Clinical Excellence (NICE) recommend that workplaces have policies which encourage healthy eating and promote healthy choices. If you have answered mainly yes to the questions above you are not alone, despite the guidelines many people still feel it is difficult to make healthy choices in the workplace. The verdict by the Royal College of Physicians in 2011 that little action has been taken to promote healthy eating would come as no surprise then. Well 2 years on, has there been any improvement? A study on motivations and barriers to healthy eating in public sector workplaces was recently published in the Journal of Human Nutrition & Dietetics. It identified some important views from public sector workers. The article ‘A qualitative study to investigate the drivers and barriers to healthy eating in two public sector workplaces’ A Pridgeon & K Whitehead (2013) JHum Nutr Diet, 26, 85-95 can be accessed online using this link http://onlinelibrary.wiley.com/doi/10.1111/j.1365-277X.2012.01281.x/full . So should employers be doing more to improve workplace nutrition? Or should it be our own responsibility to tackle the obstacles in the way of making healthy choices in the workplace? Certainly here at 121 Dietitian we are of the opinion that employers should be doing more to promote healthy workplace nutrition choices, if they aren’t already. As a specialist nutritional team we are passionate about providing staff nutritional assessments and menu improvement, workshops etc. Our workplace nutrition programmes reduce absenteeism, improve moral and improve company finances. We also encourage staff to take responsibility, driving new ideas forward and to remain healthy outside the workplace. If you struggle to make healthy choices at work, find there is a lack of healthy options available at your work or feel that healthy options are too expensive, then preparation is the key. Boring you may yell, No, is our reply as with 121 Dietitian = Clever, quick and tasty. Just to wet your appetite!! Here are just a few popular tips on Workplace Nutrition to get you started…. If you’re always short on time why not cook an extra portion of dinner in the evening? The leftovers can be eaten for the next day’s lunch. Alternatively use the time while you’re in the kitchen anyway to prepare a tasty meal for the next evening. Stock up on lots of healthy ingredients such as salad vegetables and fruit, cooked fish, lean cooked unprocessed meats, wholegrain breads & pastas and dips. Having plenty of options will prevent you getting bored and help you resist the temptation of the canteen or vending machine. Fruit, vegetable sticks, yogurts, seeds & nuts are nutritious and great for snacking; keep these handy at your desk for when you are feeling peckish to tide you over until the next meal. If you are on a budget fresh fruit can be bought cheaper in bulk. You could buy a bag of fruit especially to keep in the workplace for snacking, remember to wash it well. How to improve Workplace Nutrition at your desk It is good to get away from the desk during your breaks for your body to relax, if you are eating at your desk; are you working through your break? This is not good for long term health or productive for your job. Bringing your own lunch can save you time rather than queuing in the canteen so push away when you can. It is important you maintain your energy to keep focused on your work. healthy snacks at your desk are recommended. Exercise is as important as eating right when wishing to maintain our health. We should be trying to get around 30 minutes exercise most days, so break the bad habits and start with manageable targets. 121 Dietitian’s are experts in diet and health and are leading the way in making positive changes in companies across Northern Ireland and saving their hard earned cash along the way. Why not find out how we can help you by getting in touch. We have a range of programmes to suit all requirements and budgets. Usage of KPI’s allowing success to be charted. If you are unsure of how to change your eating habits, or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition related queries big or small. In the meantime do please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your family and friends on your social media channels. Why not visit our YouTube Channel for more on keeping your health optimal. How can a Dietitian help Book a consultation via our Online Portal About Gillian Killiner Check out our tailored dietary programmes Gillian x [instagram-feed] Information checked & correct on 16th May 2018.
