Nutrition for cognition

March 15^th to the 21^st was officially brain health awareness week. You may or may not have noticed this but most people I meet know someone, or have a family member suffering from conditions such as Alzheimer’s or dementia. I recently did a ‘nutrition for cognition’ training course with PharmaNord UK and thought I would summarise some key take aways. Some of them may surprise you.

Sleep is very important but too much sleep is not beneficial as it spikes (raises) cortisol.
The gut-brain connection plays a huge role, think diet diversity and the microbiome.
Genes play a role but the environment is key which includes, diet, exercise, stress levels, emotions etc.
Metabolic conditions such as obesity, diabetes and cardiovascular disease all have an impact on brain function.

Depending on my clients’ issues and symptoms I tend to focus on the following

Lowering inflammation.
Stabilising blood sugar and addressing any insulin resistance.
Correcting any dietary issues and specifically making sure there is enough protein in the diet, at least 1g per kg of body weight.
Making sure there is healthy fat in the diet and optimising any omega 6:3 ratios (we will test this if there is enough budget).
Correcting micronutrient deficiencies with a personalised and targeted supplement programme.

We may also look at hormone balance; toxicity levels and liver function; the microbiome balance and gut function; as well as levels of fatty acids in the blood.

It all depends on what my client needs at this point in time.

My advice is always personalised and tailored to my client’s life circumstances, budget and personal preferences. We are all so unique. It’s also designed to be practical with many recipes, handouts and hints to simplify the changes they need to make.

You can contact me here or find out more about the process here and here.

Minerals matter for cognition

A recent study examined the data from the UK National Diet and Nutrition Survey (2019-2023) and found that average intakes of 7 minerals were below the recommended nutrient intake (RNI). They included iron, selenium and magnesium, three important cognition minerals.

Reference

Iron and cognition

Iron is important for cognition because iron rich haem groups in the red blood cells carry oxygen to the brain. In 2023-24 there were 191,927 hospital admissions where the main reason was a lack of iron. This is almost 10 times the admissions in 1998-99.

I prefer to check ferritin levels (of iron storage) before supplementing however as too much iron is toxic to the cells.

Magnesium and cognition

Average magnesium intakes fell below the RNI benchmark. Over one in 10 adults aged 20-59 had magnesium intakes below the lower reference nutrient intake (LRNI). Most people require the RNI, the LRNI only applying to 2.5% of the population the majority require the RNI. This deficiency was split 15% males and 12% females but for adults in their 20’s this figure rose to 1 in 5 (19%).

Magnesium levels below 0.75 mmol/L are associated with an increased risk of cognitive decline whilst those in the upper-normal range were protective.

Reference

Selenium and cognition

Research shows that in cases of selensium (Se) deficiency, the organ which remains Se replete for the longest is the brain. This suggests that Se plays an important role in brain function. After supplementation of Se plus other nutrients, improvement in cognitive tests was observed in both Alzheimer’s and mild cognitive impairment patients. The window for over prescribing is however very small. I like to utilise food source to avoid any risk of toxicity.

Reference 1; Reference 2

Are you concerned about your cognitive function? Perhaps you forget things here and there or experience brain fog. The good news is there is so much that can be done. You can get in touch here for more information or to see if I can help you. There is more information here on nutritional therapy in general.

Pre-operative nutrition

I frequently support clients who have either had or are going to have operations.

It is common knowledge that your nutritional status and health prior to an operation has a big impact on the outcome of surgery and your recovery post operation. It is estimated that between 24% and 65% of patients are malnourished and unfortunately this tends to increase during hospital stays. Nutritional supplementation has been shown to reduce hospitalisation costs being associated with fewer complications and shorter stays.

I have recently been researching this area for a client with impending surgery This blog is focused on protein and carbohydrate requirements pre-operation. I will consider micronutrient status in a future blog.

Surgery is stressful and our energy demands increase. To cope with this our sugar stores (glycogen) are rapidly burnt from the liver and muscle. This can lead to significant skeletal muscles loss and some degree of this post-surgery is inevitable.

There some easy strategies you can implement though to help with muscle preservation and to support and accelerate healing. Carbohydrate consumption pre-operation helps to:

Support increased energy demand during the initial period and to cope with the initial inflammatory state.
Reduce muscle wastage and preserve lean body mass.
Manage the insulin resistance which is common post-surgery. Remember insulin resistance will prevent glucose entering your cells. This is important because the body will generate its own glucose (gluconeogenesis) due to the stress and it is important that the cells can absorb this.

General guidelines for nutrition before surgery

The goal is to prepare the body for the stress of surgery, support increased metabolic demand, whilst offsetting the consequences of the breakdown of body protein. The goal of pre-operative nutrition is to ensure adequate energy stores to meet the demands of the stress state. The guidelines given here are aimed at minimising some of the metabolic consequences of surgery, using nutritional supplementation to overcome some of the issues that whole foods would otherwise present.

7-10 days prior to surgery - emphasise high-quality carbohydrate and protein intake to ensure optimal nourishment. To maximise glycogen stores, the sports nutrition model suggests consuming ~60% of total energy (8 g per kg body mass) per day of carbohydrate for a minimum of 3–4 days. Protein intakes of 1.2–2.0 g/kg/day, from high-quality protein sources distributed throughout the day (20–40 g of protein per meal) is recommended to help ensure protein needs are met.

6-12 hours before surgery – consume a well-rounded meal emphasising complex carbohydrates and high-quality protein.

6 hours before - begin abstaining from whole foods, but continue to consume protein and carbohydrate containing beverages, such as a protein shake, a sports drink, or chocolate milk. Since modified carbohydrate supplements rapidly empty from the stomach, consumption may sustain glucose levels for the duration of surgery.

2-4 hours before – It is suggested to ingest free form essential amino acids (EAA’s) to promote a positive protein balance. EAA’s contain all nine essential amino acids and do not require digestion.

Conclusion

In conclusion carbohydrate intake supports the increased post-surgical metabolic (energy) demand and wound healing. Protein intake supplies the amino acids needed for wound healing, immune function and preservation of muscle mass. Combined amino acid and glucose intake can help to mitigate muscle loss and strength, especially prior to surgery. Depending on proximity to surgery different sources of carbohydrate and protein can be used to maximise nutritional intake. Supplemental sources can be useful to support intake during periods when whole foods are not tolerated.

This blog is written to help inform about nutritional needs pre-surgery and is based on scientific rationale. However much of this research is relatively new and further research and trials are needed to elaborate. Therefore this information does not override any medical guidelines given directly to prepare for planned surgery. These will supersede this information unless your medical team are happy to sanction otherwise.

References

https://pmc.ncbi.nlm.nih.gov/articles/PMC8156786/figure/nutrients-13-01675-f003

What do Nutritional Therapists help with and how to find one?

You might be someone who gets bloated after every meal. Or someone who feels exhausted by mid-morning despite a full night’s sleep. Maybe your skin flares up regularly, or you’re dealing with unpredictable mood or energy changes.

These are just a few of the reasons people turn to nutritional therapists.

Common concerns supported by nutritional therapists include:

Digestive issues (IBS, bloating, reflux, gall bladder issues, gout etc.)
Fatigue or low energy
Pre diabetes and heart health especially cholesterol
Osteoporosis and issues with bone density
Skin conditions
Female hormonal health (PMS, perimenopause, PCOS)
Stress and mental wellbeing
Autoimmune conditions such as arthritis
Healthy ageing and preventive healthcare
Optimising athletic performance

You don’t need to be diagnosed with a condition to work with a nutritional therapist. Many clients seek support for prevention, performance, or simply to understand their bodies better.

Why People Seek Nutritional Therapy

Many people turn to nutritional therapists after trying multiple solutions—diets, supplements, or private testing—without clarity or consistent results. Others feel dismissed by standard medical care or overwhelmed by conflicting online advice.

Nutritional therapy offers a structured, evidence-informed approach to identifying patterns and making progress that lasts.

It’s ideal for anyone who:

Has symptoms that don’t have a clear medical diagnosis
Feels like they’ve tried everything but still don’t feel well
Wants to optimise health before issues become problems
Prefers natural, lifestyle-based strategies alongside medical care

How to Find a Qualified Nutritional Therapist

To ensure you’re working with a properly trained practitioner:

Look for CNHC registration – this confirms they are qualified and regulated
Check for BANT membership – this indicates high standards of ethics, education, and science-led practice
Use BANT’s Find a Practitioner tool
Visit the CNHC public register to verify credentials

Discover the Value of Working with a BANT-Registered Nutritional Therapist

Nutritional therapists play a vital role in bridging the gap between general wellness advice and personalised healthcare. They take time to understand how your diet, genetics, environment, and lifestyle interact and use that insight to guide tailored, evidence-based recommendations that help you feel better, for longer.

Generic nutrition tips and one-size-fits-all plans can fall short. Working with a Registered Nutritional Therapist puts your individual needs at the centre. For many clients, it’s the first time their symptoms, history, and goals have been fully explored and connected into a clear plan.

This approach supports symptom improvement while also helping you reconnect with your body, increase daily energy, and take charge of your long-term wellbeing.

If you’re ready to stop guessing and start understanding what your body really needs, a Registered Nutritional Therapist could make all the difference. Please feel free to get in touch or book a call via my website.

What qualification dose a Nutritional Therapist have? Are they different from a "nutrionist"?

In the UK anyone can call themselves a “nutritionist”. The title is not legally protected so regardless of training anyone can call themselves a “nutritionist”.

However, Registered Nutritional Therapists including me are:

Fully trained in nutrition science and functional medicine
Required to register with the Complementary and Natural Healthcare Council (CNHC), a PSA-accredited regulatory body
Members of professional organisations like BANT (British Association for Nutrition and Lifestyle Medicine)
Required to follow a strict code of ethics and maintain Continuing Professional Development (CPD)

This level of regulation ensures clients are receiving safe, evidence-based advice from a qualified professional.It’s important to remember that only those registered with CNHC are recognised to deliver one-to-one clinical care.

In my case I trained with the Institute of Optimum Nutrition (ION) in London and gained a diploma (DipION, Distinction). I also did some preliminary training at the University of Westminster.

What does a 'Nutritional therapist' do?

What Does a Nutritional Therapist Do?

Have you been dealing with ongoing symptoms and feel like no one’s joining the dots? Maybe you’ve tried diets, supplements, or read endless articles online, yet nothing seems to stick. If this sounds familiar, you might be wondering if a nutritional therapist what could help.

With growing public interest in functional medicine and personalised, preventative care, nutritional therapy is gaining interest. There’s still confusion about the role, who is qualified, and how it differs from general nutrition advice. This blog explains it all.

Nutritional Therapists Offer Personalised, Evidence-Based Health Support

A nutritional therapist applies the science of nutrition and lifestyle medicine to support individuals with a wide range of health concerns. This can include digestive problems, fatigue, hormonal imbalances, immune issues, and more.

They work in a one-to-one setting, assessing each client’s health history, symptoms, diet, lifestyle, and environment to identify potential imbalances. Then they create a tailored plan that supports the body’s ability to heal and function at its best.

Nutritional therapy is:

Personalised – considering your unique biology, history, and lifestyle
Science-informed – based on the latest research in nutrition, epigenetics, and systems biology
Holistic – looking at the whole person, not isolated symptoms

The aim is not to diagnose or replace medical care, but to complement it with targeted nutritional and lifestyle recommendations.

What a Nutritional Therapy Consultation Looks Like

A consultation with a Registered Nutritional Therapist typically involves:

Detailed case history – exploring symptoms, medical history, family history, diet, lifestyle, and environment
Analysis of diet and nutrition status – sometimes supported by laboratory testing
Individualised plan – including food, supplementation, lifestyle changes, and referrals if needed
Follow-up support – adjusting the plan over time based on response and progress

This process helps the therapist and client build a picture of how different factors may be contributing to the client’s health status and how to support improvement in a structured, measurable way.

What fats can I cook with?

This blog is a reminder of which fats to use for cooking and which ones are best used cold in salad dressings. It also covers which ones to avoid.

Fatty acids are classified according to the presence and number of double bonds in their carbon chain. Saturated fatty acids (SAFA) contain no double bonds, monounsaturated fatty acids (MUFA) contain one, and polyunsaturated fatty acids (PUFA) contain more than one double bond.

This table above shows the fatty acid composition of various culinary oils.

You can see from the table above that oils tend to be classified according to their largest constituent. We need to cook with oils which are stable when heated and therefore have a high smoke point. The more double bonds a fatty acid has, the more unsaturated and unstable it will be, especially when heated.

The most stable fats are solid at room temperature, so lard etc. Olive oil (virgin/extra virgin) is pressed straight from the seed or fruit without further refining. There is research to show that the phenols in unrefined olive oil protect it from degradation during cooking (Ramirez-Anaya, 2015).

Oils such as rapeseed, sunflower and vegetable are obtained by washing and crushing the seeds, and then using processes such as heating, hexane, solvents, extraction, processing, bleaching, deodorization and peroxide to maximise production volume. As these oils are highly unsaturated (many double bonds) the risk of oxidation from processing is high, either during processing or if used to cook with. Most of these oils are also much higher in omega-6 than omega-3. As our diets tend to be more deficient in omega-3, I focus on hemp and flax (small amount) which have a 4:1 and a 0.3:1 ratio respectively (o-6:o-3) to try to redress this. I also advocate cold pressed and organic versions to preserve quality and nutrient content.

The following table is a guide Whether you wish to cook with animal fats will depend on various criteria including your health and dietary preferences as well as your ability to digest and absorb fat.

Which fat to cook with and which to use for dressings and drizzles

REFS: Del Pilar Ramírez-Anaya, J. et al (2015) Phenols and the antioxidant capacity of Mediterranean vegetables prepared with extra virgin olive oil using different domestic cooking techniques. Food Chemistry Vol 188; pp. 430-438.

Do your cells need an oil change?

Today’s modern diets can often mean we eat too much or too little fat, or frequently just the wrong type. Our cell membranes consist of lots of oil aka. fat. For optimal performance they require quite a specific ratio of different types of fats, especially with regard to the essential fatty acids (EFA’s), omega 3 and 6. If these are out of sync, cells can malfunction a bit like trying to run your car on the wrong type of oil or petrol.

Cell membranes are your cells’ border control. They control what gets in and what gets out. They act as both the gatekeeper and the hostess.

Every cell in your body has a cell membrane and your body has a lot of cells. Experts think we have in the region of 30 trillion, and we want every one of these to have a healthy cell membrane. If your cell membranes are working correctly, they will let micronutrients in and waste products out. As well as supervising which molecules can enter and exit, most cell metabolism takes place in, on, or around this location. It’s like your very own production line inside you, manufacturing energy and proteins, and churning out waste products such as urea and toxins.

The next thing to understand is that their structure is critical to how well they function. We don’t want them to be too rigid or nothing will get in, or out. We also don’t want them too soft and floppy. This might allow too much in or too much out and over time this could cause multiple issues.

So how can we nourish them and maintain their structure so they can function properly? Firstly, the fat they contain needs to be eaten, as the body cannot make it. Some of these fats have special functions such as the EFA’s. There are many arguments about the correct ratio of fats to eat in the diet but researchers generally agree that we tend to be more deficient in omega 3 which is found in fish, nuts, seeds and vegetable oils.

So by now I think you get the idea that I like my clients to achieve healthy cell membranes because “the stronger our cells the more resilient our selves”.

It’s easy to check our ratios with a simple finger prick test because the concentration in our blood has been found to strongly reflect our dietary intake. The current European average for our omega 3 percentage is less than 4% but research confirms that 8% is optimum, and that this ratio is associated with a 90% reduction in risk of sudden cardiac death.

There is nothing like analytics to demonstrate to my clients (and me) that we either need to work harder on our diet or take targeted supplements to give our cells what they need to function tip top.

https://pubmed.ncbi.nlm.nih.gov/18541601

10 super healthy switches to boost nutrition

Here’s some simple easy changes to boost your nutrition. Check my website for recipes and to sign up to my newsletter.

Salad dressings - swop salad dressing for olive oil and lemon/apple cider vinegar (ACV) or balsamic vinegar. Mixing 1 tbsp of tahini with 6 tbsp olive oil plus 1 tbsp of lemon juice or ACV is a delicious alternative to mayonnaise. Thin with water if needed.

Crispy stuff – make your own popcorn with popcorn and olive oil plus some butter or ghee and a little salt. Alternatively roast pumpkin seeds with paprika, salt and a dash of cumin or cayenne pepper, Remember all crisps tend to contain trans-fats as they are deep fried with non-stable vegetable oils.

White for brown – this goes for rice, bread, pasta and crackers. The glycaemic index may still be high, although this is depends on the individual. But whole grain foods will retain more micro-nutrients the glycaemic response is likely to be lower, they will contain more fibre and protein and some folks do fine with them. If you soak brown rice overnight it will cook almost as quick as white.

Oats – go for steel cut or larger flakes. They are less processed and will take the body longer to breakdown, supplying a source of energy to longer.

Rice – for cauliflower rice. It’s actually very easy and it works, I’ve tried it. More fibre, more veg and less processed than rice.

Baked beans – swop your standard variety for low sugar and salt or make your own and freeze in portions.

Cow milk – for oat, rice, almond, soya or coconut. Cow milk is a major source of allergens, which are inflammatory and growth promotors. Plus many of us do not possess the lactase enzyme to digest lactose properly. It is also associated with an increased risk of osteoporosis, heart disease and auto-immunity.

Snacking on cakes, biscuits and pastries – switch to oat cakes and nut butter, nuts and seeds, one piece of fruit or a handful of berries with yogurt and hemp seeds, apple slices with a squeeze of lime juice, some nuts or seeds and a dollop of nut butter. Cakes and biscuits are full of processed ingredients and high in sugar so they will spike blood sugar and therefore insulin. They are also addictive, one is never enough.

Bread – switch to breadmaker bread and use rye flour or ancient grains such as spelt or kamut which have less gluten. You need a breadmaker that has these specialist options and it can take a while to perfect the recipe. If you are really up for the challenge switch to flax seed bread –I guarantee one slice will take you about 5 minutes to eat and you will struggle to eat a second.

Dessert – make a rule it has to be home made. I made this rule for all cakes and puddings when I first got into nutrition and as I am a lazy baker this immediately cut our consumption. Dessert, pudding, biscuits, cakes etc. need to be the exception not an expectation. But hey rules are made to be broken and a paleo crumble now and then is a great option. See my website for the recipe.

Heart burn, acid reflux, GERD – what is the difference?

All of these conditions occur when acid from the stomach escapes into your oesophagus, via the sphincter at the top of the stomach, creating a burning sensation.

All of these painful digestive conditions are related and tend to cause similar symptoms, however, they usually develop in stages.

In the case of acid reflux, stomach acid leaks out of the stomach and into the oesophagus. When this progresses, it can be diagnosed as gastroesophageal reflux disease (GERD) which is considered to be more severe. Heartburn is also commonly called GERD.

The most common symptom of GERD is frequent pains in the chest and burning sensations hence the name “heartburn”. Other signs of GERD are difficulty swallowing or keeping down food and liquids, coughing, wheezing and chest pain. Often these symptoms occur or are much worse at night.

An alarming finding from one study conducted in Norway found that the incidence of acid reflux rose from around 11 percent of the population to over 17 percent over a period of 11 years. A similar rise is happening in other industrialised countries too.

It might not be the biggest deal to have acid reflux symptoms on occasion but research shows that people with long-standing, chronic heartburn are at greater risk for serious complications. These include stricture (narrowing) of the oesophagus and inflammation of the oesophagus or oesophagitis. Other developments can include chronic infections and there are concerns re fracture risk and pneumonia (linked to PPI medication).

If we have low stomach acid our food isn’t broken down as quickly or completely so proteins stay in the stomach longer than is normal. This means the acid also stays longer and this can cause digestive issues, especially when we start moving around following a meal. Slowing our digestion down is also a problem as it gives food time to ferment and putrification can occur. This means bacterial balance can become problematic as certain undesirable species thrive (pathogenic) and yeast and fungus can also start to proliferate. This in turn can lead to more serious problems from an unhealthy microbiome balance and conditions such as IBS and multiple digestive issues.

So we need our stomach acid but we need it in the right place.

Nutritional therapy can really help to support and often resolve this condition. It's best to work with a BANT qualified nutritionist. Do get in touch if you would like to understand more about how I work with this condition or if you have any questions.