Published on 17th December 2016


Nicola Moore looks at how to support troubled skin & how to achieve more nutrition for less spend

A young woman who works very long hours, Sue wants to address a few health concerns. She is taking a progestogen-only pill following an operation to remove cysts from her ovaries, and to manage migraines. She also suffers from Reynaud’s, a condition in which blood vessels in the fingers go into temporary spasm, and has some acne around her jawline. She also wants to reduce her spend on food while increasing nutritional value.

Sue’s day starts at 5.30am, leaving the house at 6.15am for a one and a half hour commute.

Sometimes she grabs a coffee and pastry. If she has more time, instead of the pastry she’ll buy an egg white omelette with avocado, mushrooms and cheese or spinach at work. She avoids cereal and fruit because of the sugar content. Also, raw apple makes her tongue swell and gives her diarrhoea. She doesn’t have any problems with cooked apple.

Lunch is her main meal. She often eats at work where there is a salad bar with a large variety, but she prefers protein to get through the day. She avoid carbs because they make her feel sleepy.

If she’s at work after 9.30pm she orders food in. Otherwise, her husband cooks dinner. If she is horse riding after work, she leaves at 6.30pm and grabs a snack to keep her going until dinner at 9.30pm.

Sue works some weekends, otherwise she’s busy with housework, admin, catching up with friends and seeing her pony. “We are generally busy… and rarely have more than two meals a day.” If she has free time on Sundays, she would rather relax than cook.






1 Small latte
3 scrambled eggs
1 bacon rasher on wholemeal muffin
N/A Grilled chicken burger,
garden salad and
sweet potato fries
Pina colada mocktail
2 Small latte
3 scrambled eggs on wholemeal muffin
N/A Spanish chicken pot roast Mint chocolate tart
4 x cups tea with milk
3 Small latte
Small latte
Roast pork, roast root veg, leafy green salad
Grilled chicken with quinoa salad 3 x cups tea with milk
Yoghurt coated raisins
4 Small latte
Salmon & cream cheese bagel
Small latte
Roast chicken shawarma
Jambalaya 2 x cups tea with milk
2 x green tea
Percy Pig sweets
5 Small latte
Plain croissant
Medium latte
Lamb stew with basmati rice
Grilled chicken with ratatouille 1 x cup tea with milk
1 x green tea, 1 x hot chocolate, 1 x orange poppy seed muffin
Table 1: Sue's pre-consultation food diary

Nutritional Therapist: Nicola Moore

Acne around the jawline is traditionally considered a sign of a hormonal imbalance, so we would want to know more about Sue’s history. We do know that she’s had ovarian cysts and migraines, which may potentially be hormone-related. As she’s been given the pill to support that, her GP may have considered that as a link.

The digestive system and balance of gut bacteria are important for hormone management, and to aid elimination of waste. The gut is also important for supporting the immune system and preventing inflammation, so this is something we would want to address.

Acne is often linked to a food sensitivity, with one of the primary candidates being dairy. Sue consumes a lot of dairy through lattes, teas, hot chocolate and possibly through her sweet treats too. When added up, there is quite a large amount of potentially problematic food going in, so it would be interesting as an experiment to see if we could reduce or eliminate it for a period of time, to see if it would have a positive impact on her skin. There are several alternatives. With soya milk I would recommend choosing organic — and unsweetened to avoid added sugar, which may affect her skin. But as some people are sensitive to soya, she may prefer trying unsweetened almond or coconut milk.

Sometimes it is the thought of that morning latte that gets people out of bed; but it is possible to find something else that gives us that comfort. An Americano is cheaper and will cut out dairy. A black tea is even cheaper. If she wants to reduce the cost even further, keeping a cafetiere at work or a cafetiere mug — one which doubles up as the two — will reduce costs significantly.

If she doesn’t want to give up the morning latte, I would still suggest looking at reducing milk, especially with her hormone history, so maybe cutting out her lunchtime latte and reducing cheese.

Sue’s morning pastry will have both dairy and sugar. She has little time, but I would encourage her to spend just five minutes the night before making something like a salmon or hummus sandwich for breakfast. This will have the protein she wants, important fibre and less sugar than her pastry, so shouldn’t give her the carb-slump she experiences.

I would want to find out why Sue prefers an egg white omelette — some people don’t like egg yolk or are sensitive to it. If it is because of health concerns I would want to discuss the valuable nutrients in egg yolk, and dispel the myth associated with cholesterol — the NHS puts no limit on the number of eggs people should eat. Also, if she eats the whole egg, she may find her breakfast more satisfying.

She has access to a fridge and microwave, so to save money she could keep eggs at work and make her own omelettes in the microwave just by beating an egg and cooking it on a plate for a minute.

Cutting out her midday coffee will increase the nutritional benefit of her lunch. Coffee or tea — even green tea — straight after eating impacts mineral absorption; so from a nutritional perspective, she’s throwing money down the sink. A peppermint tea is cheaper and will give better nutritional value.

Also, caffeine isn’t very helpful because it does encourage sugar into the blood, which is linked to insulin production which, in turn, is linked to acne.

Putting lots of vegetables into her diet is good for supporting skin and the immune system. We would focus on doing this over time so that it eventually becomes second nature. We would suggest adding extra vegetables so, for example, if she’s having an egg at home, we would get her to add something like watercress, spinach leaves or some tomatoes. A little change like that won’t take extra time, but will add a lot to her overall nutrition. She’s eating good things; ratatouille, quinoa salad, sweet potatoes, but we can’t see how much veg is going in. If she’s having two vegetables with her meal, I would get her to add another. We would recommend eating a variety of colours, because the compounds associated with colours are connected with different jobs in the body. By eating a rainbow diet she will, by default, increase her exposure to health-promoting micro-nutrients.

Vegetables are the number one way of improving nutrition and reducing cost. They’re cheap and easy to make into soup or ratatouille that can be kept for later. They can also be roasted with garlic and herbs and used in salads the next day. If she’s worried about losing out on calcium from eliminating milk, this is another reason to increase her vegetable intake. Greens, cabbage, kale, broccoli and rocket are all rich in calcium. Something like sauerkraut is great with salads, takes no cooking — she can just buy a jar — and it’s a fermented food that is good for the gut.

To save money, she could consider taking food to work.

When her husband cooks, she could add any extra vegetables to something like cooked chicken or a tin of tuna the next day. Leftovers can also be easily thrown together with some bagged salad. She could also keep sachets of miso soup paste in her desk — not only are these cheap, but miso is a fermented food which is good for our microbiome. She could also take in fresh veg that can be cooked in the microwave.

It would be cheaper for Sue to roast a good quality whole chicken and use it for lunches — she doesn’t want to spend time cooking but it takes minutes to wrap up a piece of chicken for work. Vegetarian sources of protein will also help support her gut bacteria. Lentils, chickpeas and beans are incredibly cheap to buy dried, but if she doesn’t want to spend time preparing them, they can be bought ready to eat. A small can of chickpeas costs around 40 pence and can be tossed into some vegetables or salad. She could also buy some ready-to-eat oily fish which will be good for her vitamin D levels.

We would also look to reduce sugar because of the impact it can have on Sue’s skin. We can’t expect her to give up everything she likes, but I would suggest she try dark chocolate. People are resistant and switching doesn’t happen quickly; but once you move on to dark chocolate it’s very liberating because you need less of it and it’s not perpetuating the sweet tooth. She could have it with a few mixed nuts, which is both satisfying and nutritious, and she would get the healthy fats and micronutrients from the nuts.

I think a life without chocolate is not worth living, but my long-term aim with any chocolate lover is to get them to move on to at least 70 per cent cocoa chocolate. This is not going to be their favourite chocolate overnight, but generally after a while, milk chocolate begins to taste really sweet.
Engaging with our food is one way to help improve our health. Sue doesn’t like to spend time cooking on Sundays, but even throwing some ingredients into a slow cooker and then portioning it up to freeze and take into work means that she can make healthy and tasty soups and stews. The preparation time can literally be minutes, and even if she takes one or two homemade meals into work each week that will save money in the long run.

The Optimum Nutrition clinic can be contacted on T: 020 8614 7822 and E: [email protected]
Nicola can be contacted at



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