We need to talk about maternal obesity.

This week is national fertility awareness week. What a great cause; an issue that is hard to speak about but affects so many. In the UK, 1 in 6 couples struggle to conceive. That’s one in six families who have to deal with the pain that fertility issues bring. And fertility issues can affect anyone. So are we protecting ourselves well enough against infertility?

It is no secret that we are in the midst of an obesity epidemic, and heading rapidly into a crisis. In 1993, 16.4% of women were overweight or obese; this has rocketed to 26.8% in 2014. And what does the future hold? Public Health England estimates a whopping 50% of women will be obese by 2050. Obesity influences not only the chance of conception but also the response to fertility treatment. It increases the chance of miscarriage and pregnancy complications such as Gestational Diabetes and need for a caesarian section. It can affect the long-term health of mother and baby. I can’t help feeling that with a predicted rise in obesity, a reduction in fertility is a ticking time bomb. So I am going to argue that no, we are not doing enough.


So what can we all do in the face of the obesity crisis to help fertility?

  1. Offer support to all people who struggle with their weight. The days of announcing ‘I’m fattest’ or negatively commenting on other people weight should be long behind us. People who struggle with their weight will be more likely to seek support and be successful in their weight loss attempts if they do not feel stigmatised.
  2. With predicted rise in obesity rates, we must be encouraging the younger generation to talk about their weight. They are the generation that we going to be most affected. We must help them acknowledge the effect they could be having on their long-term health, including fertility.


And if you struggle with your own weight, what can you do?

  1. Know that if you are not alone. Where both fertility and weight issues might feel stigmatised, talking to someone in confidence can help. Psychological support has been recommended to help aid weight loss in pregnant women, so find out what local support is available or speak to your GP.
  2. Some people who want to lose weight think that dramatic weight loss is the only way forward, and yearn to reach a healthy weight. While a great long-term goal, moderate weight loss of 5-10% can be sufficient to restore fertility and improve metabolic markers. Find a local dietitian who can help you achieve your weight loss goals.
  3. Find online forums and support groups such as the NCT, where you can meet other people with similar issues and view points. Group camaraderie can really help with any weight loss attempts.
  4. Moderate exercise can help your fertility and weight loss attempts. Not only does exercise help burn calories, but it can also boost your mood and give you time outside the house and away from temptation of unhealthy eating. It can be a really helpful way to change your eating habits. Look for local gym offers, fitness classes or ask your GP for a referral.


Please share your thoughts below. This is only the beginning of what I hope will be a much larger discussion for many years to come. If there is anything you have read that you would like to discuss with me, please do not hesitate to get in touch.



Public Health England (2014). Adult Obesity. Available at: http://www.noo.org.uk/NOO_about_obesity/adult_obesity

Balen, A.H. and Anderson, R.A. (2009). Impact of Obesity on female reproductive health: British Fertility Society, Policy and Practice Guidelines. Human Fertility: 195 – 206.

Mindfulness and mindful eating – how can they help you?

What is mindfulness?

Mindfulness is a form of meditation is based on the idea that there are two main ‘modes:’ doing and being. Mindfulness allows you to shift from the former to the latter. The suggestion is that it increases awareness and the ability to respond to experiences that cause emotional distress or negative behaviour; overeating may fit into this. It also helps you to recognise negative thoughts and emotions before they cause a downward spiral of mood. Mindfulness helps you to ‘live in the moment.’

Currently, mindfulness has been shown to be an effective intervention for depression and anxiety. The National Institute for Clinical Excellence (NICE) recommends it for people who are currently well but have experienced three or more previous episodes of depression. There is a wealth of evidence suggesting it an be used in Binge Eating Disorder, and a limited but ever growing body of evidence that it might be helpful for overweight or obese individuals. Increasingly it is being recognised in the world of dietetics and is supported by the Association for Nutrition.

I personally believe there is a benefit of introducing mindfulness into your life as a parent. It can help you sleep, help you relieve stress and recognise feelings of ‘baby blues’ before they escalate.


Being mindful everyday allows you to appreciate the here and now – so glad I didn’t let this amazing day on the beach with my dog recently pass me by!

What is mindful eating?

There is a model called the ‘dysregulation model of obesity’ that forms the cornerstone of the mindful eating approach. The model suggests that obese individuals have lost the ability to recognise and respond to internal cues of hunger, taste and fullness. Mindful eating simply involves applying the mindfulness principles, of switching from ‘doing’ to ‘being mode,’ to eating; thus, it offers a chance to change eating behaviour in the long-term. Simply put, it’s being present and aware of what you are eating.

Speaking from my own personal experience, I’m sure I used to eat through feelings of fullness all the time, simply by not eating mindfully. And I don’t think I’m alone. How many times have you finished all the food on your plate when before the meal you really weren’t that hungry? By promoting awareness of sensations and emotions, mindfulness may allow us to respond to feelings of fullness earlier and (possibly!) distinguish cravings from hunger. It may help people to discover a healthy relationship with food, replacing guilt and self-blame with pleasurable eating and self-compassion.

As a parent, it is so common for people to say that during their pregnancy they gained weight and after birth they haven’t been able to lose it. So could mindful eating be the answer?

How is it different from other diets?

I’m sure if you are reading this you are interested in food and wellbeing. I am also pretty confident you will have tried dieting. But so often diets fail; in the short-term you restrict your calories, lose weight and feel better. But in the long-term your weight creeps back up, leaving you feeling defeated. This may be partly because your eating behaviour hasn’t changed. Mindful eating allows you to restore the body’s natural ability to regulate eating behaviour.


With mindful eating, your favourite foods don’t have to be ‘off limits!’ Plan them, cook them and eat them mindfully.

What does the science have to say?

Most of the evidence for mindfulness is based on eating disorders, predominantly binge eating disorder. However, I am going to look at a study based on obese people with no diagnosis of an eating disorder. 10 obese people had 2-hour mindful eating sessions specifically designed for obesity over 6 weeks. The programme emphasized brief daily meditation and pairing meditation with eating, enabling the people to examine hunger and fullness cues, which foods they crave and emotional states associated with eating. This study was only short, but all participants lost weight, with an average loss of 4 kilos (roughly 8 lbs) over 12 weeks, which is brilliant! An inflammation marker known as CRP also decreased. Increases in restraint and mindfulness were also seen. Although we cannot generalize this study to overweight or normal weight people (and we should never assume normal weight people do not have a negative relationship with food), this study offers a refreshing, different approach to treating eating behaviour, moving away from the calorie-restricting diets that so often fail us.

So how has it helped me?

I first became interested in mindfulness meditation just over a year ago when I visited Myanmar. The relaxed and happy attitude of the Buddhist people was truly amazing. By eating mindfully I lost 6 kilos last year; by appreciating my food more, I found I got greater satisfaction out of it, so didn’t need to eat as much. It also stopped me mindlessly ‘grazing,’ a habit which affects so many of us, particularly if we spend a long time chained to a desk or running around after children.

IMG_1916Getting started may seem daunting, especially when you don’t know which way to go! (This road sign near my house was useless when I was lost…)

Getting started:

My interest was sparked, but I didn’t know where to begin. ‘Mindfulness: The Eight-Week Meditation Programme for a Frantic World’ offered the solution. It is available as an audiobook from Audible or the iTunes store and really gripped me for two reasons. Firstly, it is written by academics who are knowledgeable in the field but good at interpreting it in an accessible and engaging way. Secondly, setting off into the unknown world of meditation for life may seem daunting; a short-term course seems more manageable. The hope is, of course, that after the 8 weeks you will want to keep it going for life.

I love to hear your views – please share your experiences of weight loss diets, meditation and mindfulness with me!


Dalen J, et al. Pilot study: Mindful Eating and Living (MEAL): Weight, eating behavior, and psychological outcomes associated with a mindfulness-based intervention for people with obesity. Complement Ther Med (2010).

Sugar: the new white powder?

Cutting sugar is the ultimate trend in the ‘nutrition’ world at the moment. But why? And what are we in Britain doing about it? And how can you at home do something about it?

The link between sugar and obesity:

The British Medical Journal published a systematic review and meta-analysis (thats a big review of lots of different studies!) in 2013 looking at the association between dietary sugar and body weight in both adults and children. Simply put, that means combining the results of many studies over different time periods, places and population groups and looking at the overall results. 68 studies were looked at, showing:

  • Adults with ad libitum diets (that is, with no strict control of food intake), reduced sugar in the diet with a decrease in body weight of 0.80 kg. This compared to iincreased sugar intake associated with a comparable weight increase of 0.75 kg. If the energy from sugars was exchanged with other carbohydrates, there was no change in body weight.
  • Studies in children involving dietary advice to reduce sugar intake had low participant compliance to dietary advice and no overall change in body weight. No surprise there; if people don’t comply then their weight doesn’t change. However, children with a higher intake of sugar-sweetened beverages after 1 year were more likely to be overweight or obese compared with children with the lowest intakes.

Enough of the scientific garble. What does this show us? Firstly, sugar in the diet is a determinant of body weight in adults. Secondly, the change in body weight is likely due to a lower total calorie intake in people with low sugar diets, as swapping sugar for other carbohydrates with the same calorie content does not reduce body weight. Thirdly, sugar sweetened beverages in children should be limited due to their effect on body weight. And last, but by all means not least, for the weight of our children to be affected by dietary advice to eat less sugar, it needs to be followed! To me, that means we need to get better at finding low sugar alternatives that kids like and helping them (and in my view adults too although this is not based on evidence from the study!) ENJOY low sugar dietary habits.

The change in guidelines for carbohydrate and sugar consumption in the UK:

So recently SACN (The Scientific Advisory Committee on Nutrition) published recommendations which were accepted by the Department of Health regarding carbohydrate, sugar and fibre intakes. This means that the UK has new, evidence-based guidelines for sugar intake. Pretty exciting stuff!

  1. Carbohydrates should make up 50% of the total dietary energy. Before it was recommended that carbs should make up 40% of the total dietary energy. Bare in mind, this is to maintain a healthy weight, not for weight loss or gain.
  2. No more than 5% of total dietary energy should come from free sugars (that basically means sugars that are added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey syrups and unsweetened fruit juices). Before the recommendation was no more than 10%; halving the recommendation is a very big change! Free sugars do not include fruit.
  3. Consumption of sugars-sweetened beverages should be minimised, in both children and adults
  4. Fibre intake should be approximately 30g per day for those 16 years+. This is up from a previous recommendation of 18g per day – another huge change!

How can you reduce your sugar intake?

  1. The first big step is to cut out sugar sweetened beverages (squash, juice ‘drinks,’ sugar-sweetened carbonated drinks). These can be replaced by sugar free alternatives. There is a lot of hype in the media around the evils of sweeteners, but the evidence just really isn’t there when you compare them to sugar.
  2. Find alternative snacks. Try downloading the ‘snack swapper’ app from Change4Life; particularly handy if you have kids!
  3. Read your food labels! In the UK a lot of pre-prepared food has front-of-pack ‘traffic light’ labelling. Learn to read it and you could save yourself a lot of time in the supermarket and improve your health.
  4. Don’t be fooled by health ‘gurus’ and ‘bloggers’ who tell you to fill up on honey, molasses or maple syrup. They are just the same as sugar with a different name!


A delicious, sugar-free jam alternative:

Everyone (and especially kids!) love jam, and backberry chia jam is totally delicious! Every bit as good as jam, even easier to make and keeps for a few weeks in the fridge. I was lucky enough to make this with blackberries I picked from the garden, making it extra delicious. But any other berry would do; shop-bought, fresh or frozen!



  • 500g blackberries
  • 3 tablespoons chia seeds
  • 1/2 teaspoon vanilla extract


  1. In a small saucepan, gently heat the blackberries for five minutes. When soft, mash them with a fork or potato masher.
  2. Add the vanilla extract and chia seeds, stir over the heat for a further few minutes.
  3. Remove the saucepan from the heat and tip the jam into a sterilised jar.


Find out more:

Te Morenga, L., Mallard, S., Mann, J. (2013). Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ; 346.