The potential for mindful eating interventions

Lately I have become very interested in the application of mindfulness to eating behaviours.  Mindfulness seems to have really crept into the public conscious these days and I am forever seeing new articles on its varied applications cropping up.  Although there is a danger that it is being seen as a panacea and could be viewed as a bit of a fad, my own personal experience of mindfulness has been resoundingly positive.  I completed the MBSR (mindfulness based stress reduction) 8 week course a couple of years ago and can honestly say that I found it life changing.  During the course we practiced mindfulness breathing exercises which help you to develop awareness and acceptance of the present moment.  I found that by simply noticing moment by moment body sensations, thoughts, feelings and emotions  I became more grounded and seemed to shed a lot of the general anxieties and stress I had been experiencing.  At risk of sounding all hippy dippy I think the key breakthrough was realising that thoughts coming and going and are just thoughts and it’s a choice whether you jump on an emotional roller coaster and go with them.  You are taught to ‘turn towards’ difficult thoughts  and feelings allowing them to ‘pass through the landscape of your mind like clouds floating by in the sky’ –well quite! I know it’s not everyone’s bag but for me it’s been great.

Love this picture – I have no doubt that dogs are the ultimate zen masters.

A mindfulness based eating intervention might be a good idea for several reasons.  One of the things that has struck me from my experience of working with overweight and obese patients is the number who overeat or binge due to an emotional trigger.   Many of those trying to lose weight and struggling might identify themselves as ‘stress eaters’.  I had a chat with a lady a while ago who had had gastric bypass surgery and lost a huge amount of weight but had found that slowly it crept back on and she had rebounded to her original size.  She said to me ‘they should have operated on my brain, not my stomach’ which left me feeling quite sad as no doubt this patient has been let down by our current weight management services.  So a mindful eating  intervention might be useful if it helps people to recognise and find new ways of dealing with their emotional eating cues.  Mindfulness may also be helpful in emotional regulation and bringing down overall anxiety and stress levels.  It might also be useful for fostering self compassion.  In a recent NHS-delivered weight loss group which I was visiting I became really aware of how hard people were being on themselves.  There was so much negative talk about ‘being rubbish at dieting’ or negative statements around body image that I went away feeling a real heaviness about how much of a hard time people were giving themselves.  At the heart of mindfulness is compassion, non-judgement and self acceptance and my personal favourite mindfulness exercise is a ‘loving kindness’ meditation where you foster compassion for all living beings, remembering that you too are a living being! And not to be too hard on yourself.  An increase in compassion might also mean an increase in self esteem and overall acceptance which can help a person to feel better about themselves which might ultimately help them to feel that their health is worthwhile prioritising. Other benefits of mindful eating might be becoming more attuned to internal cues for hunger and recognising and reducing automatic eating.


How can dietitians incorporate mindfulness into their practice?


This is the question I have been grappling with.  There seems to be a general feeling amongst mindfulness teachers that in order to preserve the integrity of the intervention it should be delivered by trained mindfulness professionals who have had their own professional practice for at least 2 years.  I can understand this point of view, just as dietitians buckle at the thought of people taking 1 day nutrition courses and setting up shop as nutritional therapists, mindfulness teachers are also expected to adhere to a high standard of training. However,  the mindfulness training courses I have seen seem to be very expensive (approx £9k!!), full of silent residential retreats (impossible with a 1 year old at home!) and the commitment seems to be at least 2 years full time.  Whilst I would love to do this, I don’t feel the need to become a fully accredited mindfulness teacher rather I would just like to be able to use elements of mindfulness if working with a patient and it seemed appropriate.  So, I’m not sure what the middle ground is.  In the US there seems to be some ‘off the peg’ mindfulness programmes such as MB-EAT (mindfulness based eating awareness training) which will qualify dietitians to deliver a specially designed course but I have not been able to find anything of good quality in the UK.  For wider dissemination of mindful eating interventions, there does seem to be a need for further research into whether they are actually effective (obviously the first priority – emerging evidence does seem very positive for short term weight reduction), who should be delivering them and how those people should be trained?  I am very interested in this, and hoping to do some research into this area myself.  Watch this space!


Further reading

Mindless eating – Brian Wansink

Mindful eating – Jan Chozen Bays

Mindfulness – a practical guide to finding peace in a frantic world– Mike Williams

Centre for mindful eating website

Wholegrain without the cardboardy pain

One of the problems with being a dietitian is that you know exactly the things you should eat and sometimes you don’t really want to eat them.  For me, it’s wholegrains.  I know I should eat wholegrains.  I know they are so good for you in so many ways.  Knowing what I know it’s completely daft not to eat more wholegrains.  Even worse, I tell other people to eat wholegrains and I don’t want to be hypocrite with wholegrain induced guilt .  Our group published a paper recently that found that an increase of 7g of fibre a day reduces risk of strokes by 7% (ref 1).  So it’s definitely worth it.  Wholegrains are a major source of fibre and there is a list as long as my arm of health benefits with really strong evidence behind them; reduction in hypertension, cholesterol reduction, reduction in risk of type 2 diabetes and insulin sensitivity, reduction in risk of colorectal cancer…I could go on.  Pre 1900 most grains consumed were wholegrain but then processing became the norm, stripping 75% of the goodness away with the fibre rich husk of the grain.

erm… don’t wholegrains just not taste that great?


So how much wholegrain should we eat?

Surprisingly there are no UK recommendations on how much.  The Food Standards Agency just recommend the somewhat wooly ‘eat a variety of wholegrains whenever possible’.  In the States people are advised by the USDA to consume 3 servings of wholegrain and at least half of grains consumed should be wholegrain.  A serving would be considered for example; one slice of medium wholemeal bread, 2 heaped tbsp cooked brown rice, 3 tbsp of wholegrain cereals.  So the message is to eat a fair bit of wholegrain but according to the National Diet and Nutrition Survey in 2000/2001 only 5% of the British population were managing the recommended 3 portions a day.  So, it would seem it’s not just me, most of the country are not eating enough wholegrains.


This could be to do the elephant in the room when it comes to wholegrains.  I’m a dietitian so I’m  not meant to say this but, well, don’t they just taste a bit cardboardy?  If I could have a lovely bowl of white starchy tagliatelle or some brown pasta it’s a bit of a no brainer for me to be honest.  Taste is subjective of course but there are some easier ways to get 3 serving a day that are acceptable and palatable.



Here are 3 ways to get 3 servings a day. 

1)      Popcorn.  Yes you read that right.  Popcorn is a wholegrain.  3 cups of popcorn is the equivalent of one serving of wholegrain.  Ditch the lashings of sugar, salt, butter or toffee of course and you are on to a winner.  Other wholegrain snacks might include oatcakes, wholegrain cereal bars, wholemeal scones.

Popcorn – unbelievably, one serving of wholegrain!


2)      ‘Interesting’ grains – quinoa (pronounced keen-wa, I was calling it ‘quee-no-ah’ for long enough for it to be embarrassing), bulgur, millet, spelt and barley (not pearl).  All seem to be having a bit of a renaissance and all whole grain.  I find these to taste really nice and with minimal fuss.  For example, you can chuck some barley into a chicken stew near the end and quinoa makes a lovely salad.


3)      Oats – porridge oats taste nice and an easy way to get wholegrain. In fact choosing a wholegrain breakfast cereal (e.g. weetabix, shreddies, bran flakes, wholegrain museli) is probably one of the easiest ways to increase wholegrains.  Breakfast is one of those things where we tend to eat the same thing by routine so it’s easier to build it into your life automatically.


How do you know something is wholegrain?

To call itself wholegrain in the UK a product must have at least 51% wholegrain content. If you look at a food label the first word on the product should be ‘whole’ (as in wholemeal or wholegrain) or ‘oats’ and then you know it’s high in wholegrain.


So these are my secrets for increasing wholegrain without feeling like you are eating cardboard. Would love to hear any other tips?


1) Threapleton D et al. (2013) Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ: 347. 


Congratulations you have lost weight! So now, why is it so difficult to keep it off?

In long term clinical weight loss trials, it’s a sad fact that the majority of participants regain their initial weight loss.  Both scientists and patients know that losing weight can be difficult but keeping that weight off in the long term is a whole different ball game.  The reasons for this are complex.  Perhaps one of the biggest issues is the challenge in making permanent lifestyle changes.  Although most people set off on a weight loss attempt with high motivation and enthusiasm it tends to drop over time and new habits are abandoned in favour of the old lifestyle.  Even if a new dietary habit is established, something can happen that will trigger a relapse.  We all live busy lives and changes is inevitable so for a lot of people getting back on track after a stressful event or even a holiday and not throwing in the towel is the key.

Researchers also argue that our biology can lead to more weight regain in a formerly obese person.  Studies with rats show that if a rat is fattened up and then sent to rat fat camp to lose weight, there are several metabolic changes that seem to make the rat predisposed to regain the weight – things like a reduced metabolic rate, increased drive to eat, and changes to hormones we know to be involved in metabolism such as insulin.   It’s tempting to be fatalistic about it, but let’s not.  We are not rats after all and evidently there are people out there that seem to defy the forces working against them and lose weight and keep it off for good.

So who are these people that defy the odds and keep the weight off? Luckily for us, researchers are on the case.  The ‘National Weight Control Registry’ was set up in 1994 at the University of Colorado and studies people that have lost at least 13.5kg (about 2 stone/30 lbs) and managed to keep it off for at least 1 year.  There are over 10,000 people on the registry and researchers have found several key things that people have in common:

The 3 key secrets of successful weight loss maintainers are:

  • 78% eat breakfast daily.
  • 75% weigh themselves weekly.
  • 90% exercise, on average, about 1 hour daily.

So I look at this list and think, breakfast? Ok I like breakfast, I can do that.  Breakfast consumption is often viewed by researchers as an overall indicator of a healthy diet.  It might not be anything special about breakfast itself but those who are eating breakfast regularly are perhaps more likely to be having a regular meal pattern and eating other healthful foods.  So really it’s no surprise that people who are keeping their weight off are also following a healthy diet.

They are also weighing themselves once a week.  Again, this seems do-able. Self monitoring is one of the few behaviours where there is good solid evidence that it will help with weight management.  If you are weighing yourself regularly you are paying attention to your weight and bringing it into the forefront of your mind to keep yourself on track.  So many of our diet and exercise behaviours are passive, we tend to eat and drink mindlessly and not pay real attention to what we are doing so if you are weighing yourself weekly you can see the weight creeping up and react to it.

But oh dear the third point, an hour a day of exercise! And this is the rub with weight maintenance.  The key seems to be exercise.  When losing weight, research has shown exercise to be quite frankly of little importance compared to food and drink intake.  For overall fitness exercise is massively beneficial but it’s highly unlikely that you will actually lose weight through working out alone (you just don’t expend enough energy). But AFTER you have lost the weight then exercise becomes vitally important.

If you have been doing really well losing weight through changing your diet and you are at a point where you feel like the weight is creeping back on, it’s important to also look at your exercise.  An hour a night in the gym is not realistic for most people but finding ways to increase general activity as part of your day such as going for a walk on your lunch break or taking the stairs instead of the lift will play a part.  The key point here is that if you are struggling to keep the weight off and you don’t know why, it might be that what worked for you to lose weight in the first place is not what you need to do now.  Although our busy lifestyles and even our biology might be making things more challenging there are lots of people that have made 3 key changes that have worked.  So after all that hard work to lose weight, why not grab your weetabix, weighing scales and trainers and take the lead from those on the registry and keep the weight off for good.


Is there enough evidence to recommend smartphone apps for weight loss?

Obligatory picture featuring food, smartphone and thoughtful person


I spent 4 years developing and testing a smartphone app for weight loss and writing about it as part of my PhD work.  When we get a visitor to the house I look wistfully over to the bookcase where my thesis has sat untouched since the day I brought it home and wait for someone to say “oh wow, that enormous book full of statistics looks interesting, what a fantastic way to spend 4 years of your precious life that you will never get back.  You could have been doing anything in that time but you chose to dedicate it to writing this wonderful book.  I’d love to spend some of my time reading it and giving you a thoughtful and gushingly complimentary critique”. 


Surprisingly, this has not happened yet.  In fact, I can count on one hand the number of people who have read it (or at least said they have read it).  So I’ve decided to write about a blog post in the vain hope that this might be read instead.


Intuitively, it makes perfect sense that a smartphone app might be able to help you to lose weight –  smartphones are popular, convenient and portable, but is there any evidence that they work?  Well, actually not as much as you might think.  There are a few issues to think about when doing research in this area.  For a start, there is an enormous lag time between researchers writing a proposal for funding,  writing a study proposal, recruiting participants, collecting the results, conducting analysis, writing up, going through peer review, publishing (you get the picture, basically it takes forever).  Couple this with the fact that technology changes so quickly that as a researcher you are out of date before you can even say ‘linking with social media’ yet alone do it.  I used HTC Desire smartphones in my trial which were the top of the range at the time but now they just look pretty dismal in comparison to newer handsets.  Therefore, a lot of the published studies actually used other forms of retro handheld electronic device such as ‘personal digital assistants’ (PDAs).  On a side note – in an ideal world, researchers might want to test an existing smartphone app such as ‘my fitness pal’ which we know to be hugely popular but unfortunately they ignored my emails (which kinda hurt my feelings – thanks my fitness pal).  One of the biggest and longest running trials in the area was conducted by researchers at the University of Pittsburgh who compared 3 groups overweight people trying to lose weight (there were 210 in total, quite a large sample for the trials in this area).  They got them to track their diet in 3 different ways; a pda, a pda (with feedback messages) and writing in a paper diary.  After 6 months the results looked pretty good.  All 3 groups had lost at least 5% of their initial body weight, although perhaps unexpectedly all 3 groups had done as well as each other, so recording in the paper diary wasn’t any worse than the two PDA groups.  But, by 2 years the results were not impressive.  Although the PDA and feedback group had lost more weight it was really quite tiny, an average 2% of initial body weight.  When comparing between the groups statistically speaking the PDA groups had not performed better than writing in a paper diary (1).


But hang on I know what you are thinking – using a PDA isn’t really that much like using a smartphone.  I carry my smartphone around with me as a matter of course and I could be sat recording my lunch on it and no one would be any the wiser.  But, I might have got a few raised eyebrows if I’d have pulled out a PDA alongside my dinner in a restaurant, and that might make me less likely to use it.   A few more recent studies have used actual smartphone apps but none of these are longer than 6 months. For example,  researchers at the University of South Carolina got 96 overweight people to use podcasts to help them to lose weight.  Half of these people also used twitter and an app called ‘fatsecret’ to record their diet alongside the podcast.  After 6 months the amount of weight loss was minimal (about 2% of body weight) and there wasn’t much difference between the people that had used the app and those that didn’t.  In this case the app didn’t seem that effective (2).


In the trial I conducted I did see weight loss in people using the ‘my meal mate’ smartphone app.  In fact, it was quite a good amount for 6 months considering that they didn’t have any other input or advice apart from using the app. There were 49 people using the app and after 6 months the average weight loss was about 5kg (11lbs) (3).   Interestingly, I also found a trend in that the people who used the app the most were the ones who lost the most weight.  So in this case, you really do have to use it to lose it.  But, this study was just a pilot.  Despite what might have been reported in certain media (daily mail I am looking at you) I was conducting it purely to see whether using the app was practical and whether people would like it.  The intention was not to actually look at weight loss and I was very clear about that up front, so this study is not particularly strong evidence for effectiveness.  The good news is that it did seem to be a feasible and acceptable approach, people used it a lot and liked it.


So where does it leave us?  With a lot of unanswered questions.  There is no definitive long term and big enough study which gives us enough evidence to recommend to overweight people to use a smartphone app to lose weight.  In the long term using a PDA device was not all that successful but in the short term the pilot trial I conducted did give some promising results.  There are a few interesting issues that come out of this research.  We don’t know if there are certain kinds of people that are more likely to do well with using an app.  Personally, I’d probably be able to last a couple of days writing my diet down and then get bored or forget.  Is there something about the personality of people who are able to do this over the long term, and if there is some kind of personality trait which lets them do it, is that personality trait associated with weight loss anyway.  Are they the most determined, fastidious, etc, who knows?  And what if any additional support do people need?  Is it enough just to give someone an app and let them get on with it or would it work better if they were part of a group or getting support to use it?  We also don’t know what kind of app would be best and what the app should contain, is it necessary to link it to social media?, should it include feedback text messages? Do you need to record your diet or could you just take pictures?  I think an app might be a useful way of tracking your dietary intake but it’s probably only going to be a tool to help you if you are already committed to a weight loss attempt.  As much potential as apps might have I don’t believe they will be a ‘magic bullet’ cure for obesity.  There are so many factors that lead to a person being overweight that a one size fits all approach is never going to fly.   Anyway, it’s all food for thought.


And if you found this interesting…I can always email you my PhD thesis…or post it? or come round and I will cook you dinner while you read it? or I could express it in interpretive dance for you on you-tube or text it?….anyone??


1              BURKE, L. E., STYN, M. A., SEREIKA, S. M., CONROY, M. B., YE, L., GLANZ, K., SEVICK, M. A. & EWING, L. J. 2012. Using mHealth technology to enhance self-monitoring for weight loss: a randomized trial. Am J Prev Med., 43, 20-6.

2              TURNER-MCGRIEVY, G. & TATE, D. 2011. Tweets, Apps, and Pods: Results of the 6-month Mobile Pounds Off Digitally (Mobile POD) randomized weight-loss intervention among adults. J Med Internet Res., 13, e120.

3              CARTER M C, BURLEY V J, NYKJAER C, CADE J E.  Adherence to a Smartphone Application for Weight Loss Compared to Website and Paper Diary: Pilot Randomized Controlled Trial. J Med Internet Res 2013,15(4):e32

Walking a mile in the patients’ shoes –going dairy free


“You never really know a man until you understand things from his point of view, until you climb into his skin and walk around in it.”

Harper Lee To Kill a Mockingbird (1960)



For the first three months of my son Noah’s life he cried pretty much non-stop. Well-meaning relatives and friends assured me that this was just ‘colic’ (a catch-all term for ‘my baby won’t stop crying and no one knows why’) and that it would get better with time. In my sleep deprived and frankly utterly exhausted ‘new mom state’ I failed to make the connection with Noah’s other symptoms – a red bumpy rash on his face, sickness and positing after feeds, green diarrhoea and a severe aversion to being laid on his back. After multiple teary visits to various GP’s, one eventually took us seriously and referred us to a paediatrician. We were given a diagnosis of gastro osophogeal reflux (GOR) and advised that in approximately 40% of cases this is due to cows’ milk protein intolerance (CMPI).  We learned that in some cases, babies are so sensitive that the protein travels through the breast-milk which seemed to be the case with Noah.  I removed dairy from my diet and after two weeks we had a completely different baby, the transformation was miraculous!


Going dairy free

Just one problem then, I really wanted to continue breastfeeding which would mean the ongoing removal of dairy from my diet. Given my previous experience as a community dietitian, I knew the basics – which foods to avoid, what to look for on food labels, non-dairy sources of calcium and vitamin D and how to deal with eating out. I remember feeling pretty blasé about it actually. But, how wrong I was.


For a start, all of my favourite foods were out. Cheese, cream cake, chocolate – NO! So many foods were now off limits that I started to feel a bit sorry for myself. It dawned on me that my relationship with foods was much more complex than I had known. These foods were my comforts: when I was tired, stressed or down I craved them. Eating out became a minefield.  What was the point of going to our local Italian restaurant when I would just be pining so much for the carbonara?  I really hated making the fuss of having to ask for food to be prepared in a certain way.  Every time I asked for a sandwich without any spread on it I felt a bit like I was putting the staff out (very British of me I know).  Shopping took forever.  We had to plan meals much more carefully and really think in detail about everything that we cooked.  The social impact was hard too, I felt left out at social occasions when I couldn’t join in and have a piece of cake at my mother-in-law’s house. I’d listened to patients telling me about these problems previously, so perhaps I hadn’t always been as empathetic as I had thought or maybe you just really need to experience something to know what it’s actually like.


Very quickly, things did start to get a lot easier. I learnt the dairy free essentials and found that they weren’t as bad as I thought, for example, almond milk in tea and vitalite on toast were indispensable. I discovered through trial and error the dairy free products that were terrible and needed to be avoided at all costs and the ones that made life bearable again. I learnt to adapt my normal recipes and researched new places to eat out. I was touched by how kind and accommodating people could be. The friend that popped round one day just to drop off some bourbon biscuits as she had noticed they were dairy free and the friend who made me some dairy free donuts (oh the joy!). There is also nothing quite like discovering something that you didn’t think you could eat, is actually ok. I almost hugged the lady standing next to me in M&S when I discovered I could eat the raspberry iced buns.  Of course, the biggest motivator was knowing that if a small amount of dairy passed my lips my precious baby would be ill, there was no question of slipping. Very gradually this way of eating became the new normal, I established a different dietary pattern and now after a year I hardly give it a second thought.


Restricted diets as a learning opportunity

On reflection, I can see the positive in quite a difficult year.  My practice as a dietitian will be affected dramatically with my deeper understanding of following a restricted diet.  Hopefully for me and Noah this is just a temporary measure as most babies grow out of CMPI by three-year-old but I have so much admiration and respect for those who follow a restricted diet long-term and for those for whom the restriction is more extreme. I was surprised at how it felt to be in the patient’s shoes and how the attitude and treatment by health professionals in my exhausted, vulnerable state was sometimes quite difficult to deal with. There are obvious training needs around the issue of infant reflux and CMPI in general practice and health visiting services.


As dietitians, this is our bread and butter, this is what we do. Of course, these are the issues of following a restricted diet; we all try our best to be empathetic. But, after this experience, I sincerely call for following a restricted diet to be something that all dietitians (if they haven’t already) should try. In fact, wouldn’t it be great if it was part of student training? That way, students could come back and swap ideas of recipes they had tried, places they had eaten and the best alternative products. We could build up fantastic real life tried and tested resources for educating and sharing with patients. Perhaps this is already the done thing with student training but I hope that this article will strike a chord with any dietetic educators who might want to challenge our dietetic students to a short walk in the patient’s shoes.













Move over Mediterranean diet, is it time to eat like a Scandinavian?

The health benefits of the traditional Mediterranean diet (high in fruit and vegetables, oily fish and with healthy fats such as olive oil) are well established in the public conscious.  Ever since a meta-analysis (a study compiling and analysing results from a number of other studies) found evidence that it was associated with better health (1),  the Mediterranean diet has been the focus of attention and health advice.

But now a new dietary pattern is creating a buzz in the nutrition community – the Nordic diet.  The traditional Nordic diet is low in processed meats and high in wholegrain (oatmeal, barley and dark rye bread), root vegetables and cruciferous vegetables (e.g. cabbage) oily fish (such as herring and salmon), rapeseed and wild Nordic berries (i.e. the evocatively named cloudberry, bilberry and loganberry). It’s important to note that research is focusing on the traditional Nordic diet as ironically the modern Nordic diet is actually considered to be linked with poorer health, featuring high fat dairy products, red meat and low in vegetables.  Basically, we are talking herring and rye bread rather than the meatballs you get at Ikea (although they do have their own merits!).

Cloudberries – who knew?


Recent studies suggest that the traditional Nordic diet might be beneficial for health in terms of longevity (2).  There are other advantages to the Nordic diet pattern too for Northern Europe in terms of cost and sustainability.  The Mediterranean diet pattern might be easy to follow whilst you’re on holiday in Greece but on a rainy day in Leeds….not so much.  Back home in Northern Europe, the non-native foods of the Southern European Mediterranean diet can be perceived as exotic and often costly.  No wonder then in research studies those asked to commit to a Mediterranean diet often cannot last the duration of the study.  The bottom line is that despite the potential health benefits, very few people are able to stick to a Mediterranean diet outside of Southern Europe.  There is also the issue of air miles and carbon footprint involved in transporting non native foods and the issue of overall sustainability of food supply for the future.


Could the Nordic diet catch the British public’s imagination?

In terms of public health, I’m not sure initially how acceptable the idea of the Nordic diet would be.  I’d never even heard of a cloudberry before and I can’t remember the last time I ate rye bread.  In general we have a limited fish culture in the UK, ironic really given that we are an island nation.  On the surface, the Nordic diet appears to be a very different way of eating to what we are used to but actually it might be easier to adapt and put into practice than at first glance given our more similar climates.   We do have lots of wild species of berry in this country and foraging seems to be quite en vogue at the moment.  We also have a tradition of consuming root vegetables and rapeseed is grown throughout the country.   If the popularity and reputation of the Danish restaurant ‘Noma’ is anything to go by then the traditional Nordic diet might become a more palatable health recommendation than the Mediterranean diet.


So is it time to don your best Sarah Lund woolly jumper, strap on your cross country snow shoes and go and forage for some berries?  Of course, there isn’t enough evidence yet to fully recommend this pattern of eating.  However, it’s likely that we will be (warning – you are about to hear a fish based pun) herring more about the Nordic diet in the future and I for one would quite like to try some cloudberries.

Time to don your best Sarah Lund jumper?

1)     Sofi FCesari FAbbate RGensini GFCasini A.  Adherence to a Mediterranean diet and health status: Meta-analysis. BMJ. 2008; 337:a1344

2)      Olsen A, Egeberg R, Halkjaer J, Christensen J, Overvad K, Tjonneland A. Healthy aspects of the Nordic diet are related to lower total mortality. J Nutr. 2011;141(4):639–44