Teen Dietitian Advice with Fuelled by Zoe
Here at SKINtween holistic health is everything. Why? Because your skin tells the story of your gut health, your diet, your hormonal health and your mental health. When it comes to teens and food it can be a tricky time with hormones screaming at you for naughty cravings and in some cases a lack of appetite. And we’ve all been there with the lunchbox struggles!
Michelle was lucky enough to sit down with Zoe Martin to gain some professional guidance on common food concerns when it comes to tweens and teens. From lunchbox tips to teen disordered eating signs, you’ll love Zoe’s down to earth and realistic approach when it comes to what your teen should be eating and how to develop a healthy food relationship.
Zoe is a sports and eating disorder dietitian on the Sunshine Coast helping people find food freedom so they can feel strong, confident, & normal around food. Her obsession with food and disordered eating from an early age eventually lead to her to pursue a career in nutrition, where she is now helping teens develop healthy food habits.
"Your diet shouldn't be a source of stress, anxiety and guilt. It should support and empower you to do the important stuff. If it’s impacting your well-being, it’s not healthy diet.”
- Fuelled by Zoe
Watch or Listen to our conversation below or skip to read the highlights below the video.
Michelle:
Your journey to becoming a dietitian is a personal one. Would you mind telling us a little bit about how your relationship with food lead you to this profession?
Zoe:
I am a sports and eating disorder dietician and those two areas are things that I have personal experience with. I originally decided to be a dietician while I had an eating disorder without knowing that I had an eating disorder. That's what drove me to be interested in nutrition. Nutrition, and food as a special interest. It actually came from a disordered place and most dieticians actually have a similar story.
Through that process, I did a bachelor degree in health science, and then I did a master's degree in dietetics. And through that master's degree was when I started to realise that the way that I was eating was very disordered.
All of the health issues that I was having with my gut imbalance and lacking energy and iron was happening because I wasn't eating enough. I wasn't fuelling myself properly. Coming from that space, and then being able to heal from that and get to a really healthy place with food where I was free from all the food and body image noise really drives what I do now.
It's people that have had similar experiences to me that are drawn to work with me and then that lived experience really provides a good perspective. I find it really helps me provide a better service to the clients that I work with. I naturally work with a lot of young people between the ages of 13 to 30 would be 50% of my client base.
Michelle:
It’s such a value that you can give to your clients. It's not something that you've read in a book. Do you find that your personal experience with disordered eating helps you consult with younger clients? I can imagine that would help them feel maybe a little bit more comfortable and you can say “I've been where you are.”
Zoe:
Yeah, definitely. It took me a little while to be able to use that in my sessions to feel like that was an appropriate thing to do.
Eating disorders in general was not something we're really trained in through our dietetics degrees, which is kind of crazy to me looking back because it's an important area to be aware of. It helps me feel a bit more connected and on a similar level and I generally take a less stereotypically professional approach to my consultations anyway. I like to be more casual. And just a little bit more friendly. I want it to feel really comfortable and I think bringing in some of that lived experience really helps with that.
Michelle:
Social media obviously has an overwhelming amount of information, so many different health coaches, nutritionists and dieticians in the health arena. Are you able to briefly explain to us the difference between a nutritionist and a dietician and a health coach?
Zoe:
The biggest difference between a dietician and the other sort of qualifications or titles that you have mentioned is that a dietician is clinically trained, and so that means that they understand from a medical perspective what is happening in your body, how all the systems work and how your hormones work.
Everything from brain function to cardiovascular function. So they can work with people who are deemed not healthy. The biggest difference is how dieticians are trained. A dietician is clinically and medically trained so we can understand blood tests and we can work with people who have disabilities and chronic conditions.
A nutritionist, health coach or personal trainer generally undergo less education. Some of those titles don't have degrees or university qualifications, and so they can only work with the healthy population.
So, if you have no conditions to consider, no disabilities to consider, and you're just looking for support with general health, then those other types of health services would be okay.
Michelle:
Are you able to give us a couple of signs of a teen who may have an eating disorder? If a parent is a little bit worried about their teen, what are some things that they could be looking out for to identify that?
Zoe:
The first thing that often comes up is an interest in dieting. It could be to seek weight loss or body composition changes. It might just be an interest in health all of a sudden, or it could be something more related to body image as well. So sometimes it's a bit more obvious, but often it's quite subtle.
But any changes in diet is always just a little bit of a red flag. That's sort of the behavioural part. Look into things and just keep watching them to see if anything else changes. But physically - changes in mood and gut complaints as well, like gut function and gut digestive symptoms.
Performance dropping in their sport, fatigue and not sleeping as well as they should be. Recurring injuries, lots of physical symptoms, but the gut related symptoms are often the first and most common, and then the, the dieting.
Michelle:
That’s interesting. I never would've thought of that. I know how important gut health is, but I never would have thought to connect it to signs of an eating disorder, so thank you so much for mentioning that.
Michelle:
What is the best way to approach a child or a teen who you are concerned about when it comes to disordered eating?
Zoe:
If you have a really open relationship and you communicate really well with your teen and they are trustworthy of you, you can discuss:
- Are you having concerns around your body image?
- Is there a reason that you are so interested in diet?
- Is there something a little bit deeper?
- Is there something you are worried about?
- Have people been saying things at school about your body?
It really depends on the teen and your relationship, because if they're going to shut down from that and close off from you even more and hide their eating behaviours and habits, it's going to have worse effects. So sometimes it's good to just wait until you're sure.
I often encourage parents to have a chat with me on the phone. If you are concerned, you can give your local dietician a call and just ask, this is what's happening and what I've noticed, what should I do? And then it can be more integral to that situation.
But in general, I think being a little bit more curious whenever a young person is dieting. What are they doing it for? What are they trying to get out of it? Why are they interested? And just to be supervising that a little bit because it's not a normal behaviour for a young person to be dieting in general. And it's definitely not normal for a teen to lose weight at all when they're supposed to be in a growth and development phase.
Michelle:
I’ve noticed a lot more young girls in particular going down the path of not eating as much meat. Particularly when you're getting your first period and going through puberty, how important it is to have iron as a female? If parents are struggling to get their younger daughters to eat meat is there anything you can suggest that they can add in as a food supplement that may help bump that iron and protein up a little bit?
Zoe:
First and foremost we would get regular blood tests for any person who's plant-based, but particularly younger people because they do have additional requirements as they're still growing. So that would then indicate whether there is any deficiencies in specific nutrients. Then we would supplement.
We never blanket supplement. I think the biggest thing is remembering that you are not going to get any outcomes from something if you already have adequate levels. So if you already have really good vitamin D levels, for example, you won't get any added benefits from taking a vitamin D supplement.
But if you do have a deficiency in something, then yes, you will get benefits from it. So I would be really targeted with that approach. And then other things to consider are protein alternatives. So just remembering that restaurants will often have cauliflower or mushroom as the alternative to meat. However, that is not an adequate alternative to meat because it doesn't contain any protein.
Soy is the best protein meat replacement option because it is the same quality as meat. Soy can be good for dairy alternatives, but also soy textured vegetable protein or soy based meat alternatives.
Michelle:
I do remember as a teen going through a stage where I didn't feel like breakfast. Is there something you can recommend as a first meal or snack if teens don’t feel like eating breakfast?
Zoe:
Yes, breakfast is challenging. I also remember really not wanting to eat breakfast when I was younger and my mum used to make me eat it, and I'm glad she did - because now I understand that it is really important. If you're starting school with no fuel in the tank, and then waiting until your fuel tank is empty and then eating, it just causes a lot of issues.
You're not going to be as productive, you’re not going to be as engaged, your energy will be lower, you might need to nap in the afternoon and you might also have increased hunger levels and sugar cravings in the afternoon because you've missed a key eating time.
Breakfast is something that can make a big difference to how you feel. Often when it's really tricky for teens to eat breakfast, I recommend a smoothie or a ready-made protein drink. Something like an up and go or similar - because it's easier to drink something than eat.
And I just find with young people in particular, they will often say that they don't have enough time to eat breakfast, and you can't argue that when you just grab an up and go and have it on the bus on the way to school. Something is always better than nothing as well.
Michelle:
Speaking of school eating, can we quickly touch on lunchboxes? What would a healthy and balanced lunchbox look like in general? What sort of things should we be looking for to cover their daily nutrition needs while they're at school?
Zoe:
A really good way to think about it is ticking the four nutrition component boxes:
- A source of protein
- Carbohydrates
- Fats
- Colour
Whatever else is in there is just fillers. Some kids can have sandwiches and they're not that fussy. They don't have any food aversions and they're happy to just have whatever you might give them such as leftover dinner or sandwiches. However, some kids just don't like sandwiches, so it’s important to put more snack foods in there. You might put five to six snack items, but you’ll still be able to tick those 4 food group boxes.
It might be a yogurt, a piece of fruit, some cheese and crackers, some sliced chicken, and then a little chocolate bar or something fun as well. And they're still getting an adequate amount, but they just prefer to eat their food in smaller bits rather than a large meal.
Michelle:
And I think people forget to look at the whole day as well. Your kid might not have eaten exactly what you wanted them to at lunch, but you've gotta look at what have they eaten over the whole day. Is that the right way of looking at it?
Zoe:
Yes, and when I'm working with young people, that's actually something that we don't have a lot of control over - what they eat at school. They have control over that. We pack the food into their lunch box but at the end of the day, they choose if they eat it or not. And so you can optimise their nutrition outside of school hours if that's something you have to do for your kids, which is something that I do a lot when I'm working with teens.
So, it might mean that they have a really great balanced dinner that's mostly Whole Foods, because maybe they do have a bit more processed food in their lunch. Over the day they're still meeting all their needs and doing everything they need to do.
And that's why I have such a big problem with all the lunchbox chatter and the controversial lunchbox rules with schools, because you can't say this child needs to not bring any chips, for example. Maybe that's the only thing mum can get into this kid while they are at school, and you don't know what they're eating when they get home from school either. It's just not an effective way to encourage healthy eating habits amongst young people because there's no context that's considered.
Michelle:
When it comes to food labels, I want to touch on two topics with you. If a parent is looking at the back of a food label, are there any ingredients that they should be trying to avoid? Should they be avoiding anything like preservatives or high sugar?
Zoe:
I think I'd actually reframe that question. There aren't any specific preservatives or additives that we should avoid completely. They're in such small doses that even if there was some sort of harmful effect, I highly doubt the amount that people are consuming is going to have an effect.
So, I think it's more what to aim for when you’re looking at ingredients and you should aim to have as much whole food in that product as possible. Just looking at the ingredients to see if it's mostly whole foods is always a good choice and a better product to go with. The other thing is thinking about the ratios of protein, good fats and carbs compared to the saturated fats and added sugars. So we want to make sure that it's got approximately 10 to 20 grams of protein for a protein-based snack.
Fats on the back of the label will be separated into total fat and then saturated. If the total fat is a bit high, but saturated fat is low. E.g. If it’s two grams saturated fat, but 10 grams total fat - eight of those grams is good fats. So that's still a great product choice.
The same for the carbohydrates that's separated into total carbs and then sugars. If the added sugars is five, but the total carbs is 30, most of those are good carbs.
Michelle:
One last thing on labels. I was looking at butter the other day. And there was a butter that had 0.5 Health Star Rating. And then I was looking at a processed packet of sh*t and it had a 3 star rating. And the butter I was looking at was literally made from 100% organic butter. Should people be looking at Health Star Ratings or should they just be focusing on what a food product is delivering to their body?
Zoe:
Health Star ratings are probably the least helpful government health initiative we've had in Australia it literally does not help you choose healthy food whatsoever. I've never, ever used it in practice as a dietician and I feel the same - it pisses me off. I'll go to the supermarket, pick up two different flavours of Doritos and one has half a star more than another.
Michelle:
If teens have a balanced diet and they're eating meat regularly, do they really need protein shakes and supplements through the teen years? What are your thoughts on that?
Zoe:
Often, no. However, they’re also not harmful. So what I would do as a parent is I would just make sure that they have ample opportunity to meet their protein needs through food first. We should always have a food first approach, but if we can't and they do have goals, maybe they are a rugby player, for example. I work with a lot of young rugby players and they do want to put on size for their sport. And so then protein needs are probably double that of an average teen. In that case maybe they would benefit from having a protein powder available.
On the days where maybe they don't meet their needs, so they're rushing out the door at breakfast, they've missed a snack, they need to have a protein shake at night just to fill the gaps. It's totally okay and safe for young people to have protein shakes but I would just try to get it through food first.
Michelle:
Now, on a personal note. If you could go back to your teen self and give yourself some advice, what would your advice be to your younger self?
Zoe:
Oh, I so wish I could do this. I would've saved myself a lot of drama. I would really just want to encourage myself to focus on my quality of life and my mental health and my performance over what my body looked like, because that was just the most important thing to me. I sacrificed everything else for that. I didn't care if my health was compromised. I just wanted to be thin.
If I could learn what I've now learned and feel that and have those values, then I would be much better off now. Having taken myself a decade of going through all of that and figuring it out in a very long and hard way.
That’s what I want people to do more, is come from a place whenever you're doing anything for your health, it actually be for your health, not for your body shape because they're not the same thing.
Michelle:
If you could give parents a couple of quick tips on how they can develop healthy eating habits and body image focus from a young age, what are some things they can do to help educate their, their kids or their teens to have better quality of life and focus on the right things through those years?
Zoe:
It's a hard thing to do because we're all victims of it, so it has to be really intentional. But I think the biggest thing is just to role model it. You don't even really need to have these active conversations from the start. You show that there's no moral value with food. You don't talk about your weight or body image. You talk about how food gives you energy or how much you will love it or how exciting it is to try new things.
It works both ways. If you've grown up around parents who have picked apart their body and dieted constantly, it’s very likely that your child will end up with some sort of disordered eating or fixation on their body as well.
In saying that, it's just one environment out of so many that they have access to and you can't control everything. It’s not entirely your fault if your kid does end up with an eating disorder. They have school, they have online influences. But role modelling is the best thing that you can do to control the environment at home.
You can find Zoe at Fuelled by Zoe for online and in person support for Nutrition Coaching, Disordered Eating & Body Image Support along with Performance Nutrition Coaching.
Website:
https://zoemartinapd.com.au/about
Instagram:
https://www.instagram.com/fuelledbyzoe/
Download her free Diet and Body Image Guides here:
https://zoemartinapd.com.au/free-diet-body-image-guide
