In Conversation With… An interview with Terri Nagib, Nutritional Therapist

As part of our series of blogs, meeting the people who work at Bedford Consulting Rooms; BCR’s Helen caught up with, Terri Nagib, to find out more about her journey into becoming a Nutritional Therapist, what she does in her everyday practise, and what inspires her in her work.

Helen: What brought you into training as a Nutritional Therapist?

Terri: After studying politics and economics I took a working holiday in Canada which was a fascinating revelation to me in terms of attitudes to food and health.  Having grown up in Ireland, I’d lived amidst a “just get on with it” approach when it came to matters of health, and with little variety in food.  This was a complete contrast to living with a naturopath in Vancouver, where I was struck by the openness of people regarding health; both mental and physical, and the diversity of foods & international cuisines, and the whole lifestyle approach – I started practising yoga whilst living there.

Intrigued and motivated, upon returning to the UK I enrolled in the Naturopathic College in London and started my journey towards the practise that I have today.

Helen: What’s the Middle Way?

Terri: “The Middle Way” is actually a Buddhist philosophy which lends itself perfectly to how we approach life, health and consumption. When people talk about food and lifestyle, they can get stuck in all or nothing thinking, making statements like “I can never…”, or conversely “I always have to…”. Somewhere between these two polarities sits the philosophy of a middle way, where it doesn’t have to be all or nothing, we don’t need to reach perfection, and there is a definite balance to be found in how we nourish ourselves; discovering that an accumulation of small changes can reap big rewards.

Helen: What is your approach as a Nutritional Therapist?

Terri: Within my practise I’m looking at the whole picture, the whole person, to formulate a plan for the client, based on scientific evidence.  This not only includes nutrition, but takes into consideration issues around lifestyle such as sleep; the nervous system; immunity; the function of other bodily systems; and medical, and family medical history.

When it comes to family medical history & our genetics, it is said ‘Genetics loads the gun, but lifestyle pulls the trigger’. What we eat and our lifestyles can affect how our genes express themselves, and we aren’t powerless in the face of ‘bad genes’, there are many things that we can do to influence our health – more than people often realise.

In terms of nutrition, I look at what’s missing and what’s excessive, this can include minerals, vitamins and food groups.  I take into account likes and dislikes when making a plan for a patient, as well as thinking about the practicalities of a daily schedule, focusing on blood sugar for example how this affects energy and mood at different times of the day.

The plan, or protocol will be different for every single person and the focus is to affect change in an easy way.  A key thing to remember is that the body is always wanting to move towards homeostasis, towards health! – so by working with it we’re working towards that, keeping it simple. 

Helen: What might a protocol look like?

Terri: For each patient, there is a unique blueprint behind the scenes, and with all of that in mind, they will receive a unique protocol.  The protocol centres around two main symptoms, and is rooted in science, based upon how pathologies are expressed in the patient.  We look at food and lifestyle, so that also encompasses includes sleep, movement, how stress presents in them, and how they deal with it – in other words their response and resilience.   

Alongside making changes to diet, we might also examine sleep hygiene; so the circadian rhythm, the process by which we wind down to sleep, the first and the final 30 minutes of our daily routine, and how it impacts sleep hormones and energy levels.  Seeing sunlight in the morning helps us to wake up, so there could be things like using a light box, in the morning, blue light filters at optimum times, and so on.  Quality of sleep is also as important as the number of cumulative hours.

Changing things about diet and lifestyle could be overwhelming if you try to do too much at the time, so it’s important to avoid that overwhelm. When I’m making a protocol with a patient, I bear in mind their motivation, and what they are capable of at the moment.  Key factors could include introducing and increasing whole foods and fresh, seasonal foods.

When we make a protocol I also bear in mind the client’s time and interest, and the cooking ability.  I can give them recipes and ideas in particular about what to include on a plate, such as sources of healthy fats.  We start with what they’re already eating, and work from there.

Supplements have a place, but they are only suitable and appropriate in specific circumstances for the short term.  This is complicated by the fact that if we have impaired digestion, we may not even be efficiently absorbing what we ingest. Furthermore, the growing conditions of many of the foods these days have resulted in there being less minerals such as selenium and copper in the soil, and also the fact that pesticides sprayed on most crops does affect the nutritional outcomes of the food grown, which is why organic foods can be more nourishing. 

Sometimes, to put it simply, going to the farmers market could be part of the medicine they need.  The other aspect about whole foods, and the farm shop, is sustainability.  Shopping locally, for local products can be cheaper, and better for the local economy and food miles.

Helen: How many sessions, or for how long would a client come to you?

Terri: I have different programmes depending upon what the client is looking for, as well as an element of flexibility to allow the client to come back to me for maintenance in future.

I do a mini-MOT which can be standalone, whereby the patient gets an idea of what’s going on for them by completing a 5 day food diary & health questionnaire, followed by a consultation and personalised recommendations, simplified advice that’s easy to implement, with resources and recipe handouts.  From there, they may wish to go on to a longer programme.

I offer an 8-week Reset Package, which is a helping hand in the right direction, with initial 90-minute consultation, as well as unlimited email support (during working hours) over 2 months.  The 12-week Nourish Package is for those clients who are looking to manage specific symptoms; with additional follow-ups and unlimited email support (during working hours) over 3 months. 

For clients with long-term conditions who want regular one-to-one support, as well as functional testing recommendations and interpretations, I offer the 6-month Rebalance Package, with additional check-in calls, and again the email support for the duration.

I offer optional Personalised Breathwork Plans at additional cost.

Helen: You mentioned breath work, is that something you have a special interest in?

Terri: As my work incorporates aspects of the rest of the client’s lifestyle, I can also bring to it my experience as a yoga teacher and in teaching breath work.  Breath work, also known by its traditional name, pranayama, can help you develop focus, reduce overwhelm and take you out of your head and back into the body. 

On the technical side, breathwork has been shown to stimulate the parasympathetic nervous system – sometimes known as the “rest and digest” system – a state where the body can relax, heal and conserve energy.  This is as opposed to, and balancing with, the sympathetic nervous system, or fight and flight state, which is very often over stimulated and predominant in today’s world.

I am currently working on an NHS research project in Letchworth, about pranayama for long Covid patients, in seeing if breath work can help their outcomes.  It’s early in the research, but this is a very exciting area.

Helen: Have you seen a change as regards to people’s attitudes towards health and nutrition in recent years?

Terri: Yes I think the last few years have opened people up to the ideas behind health, preventive medicine, and in particular mental health.  There were a few aspects to COVID that I think made people focus on these things, for example having more homemade food and baking make people become more tuned-in to their nutrition, rather than eating on the go outside of the home.

I also think it started the conversation, with the background of the NHS being so overloaded for people to start to think about how there is so much they can do to also help themselves.  Knowing that there are things, like nutrition, movement and breathwork, for example, that can empower them to improve their own health and well-being.

This can be empowering for clients; for me it’s about thinking about things the clients can do – daily small changes, awareness and simple swaps, when it comes to food choices, or other small cumulative lifestyle changes.

Helen: What are the most challenging and rewarding aspects of your work?

Terri: Regarding the challenge – it can be quite difficult trying for clients to change the habits of a lifetime when it comes to food, so for the patient throughout this process it is important that they also look after themselves.  Self-care is something to really bear in mind because no-one can give from an empty cup.  This can be transformative on many levels.

Something I think that we also have to bear in mind is that food is not just a fuel for the body, we eat for all sorts of reasons; food is part of our culture and family life, this can bring with it many different issues, such as emotional eating.

On the other hand, a surprising change that can happen is that when you change the way that you eat, and have fewer processed foods, your taste buds change!  Effectively they’re being retrained, so you not only get used to eating the new foods, but have new and different appreciation if some of the other foods that you’ve taken for granted in different ways.  This can be quite an eye opener.

On the plus side, it is empowering for a patient to be able to look holistically at their own lifestyle.  Patients with multiple chronic conditions will be under several different consultants, as the NHS is siloed into departments that look after different systems of the body.  A siloed system reduces interaction between different departments, even though all of these things are happening within the same patient and that preventive medicine is hard to achieve.

With the aging population, there’s a lot of polypharmacy – so, people having a number of medications, with additional medications to address side effects of these, for example. 

Looking at the whole picture, as I do, working with their GP and passing the information through, can give a different view, where preventive medicine becomes part of the plan for the patient, and there are things the patient can do for themselves. 

Helping people find change in a manageable way, with things they can do for themselves is very rewarding. 

Helen: Do people come to you with specific issues, such as food intolerance?

Terri: Yes, this can be part of the picture.  Specific issues where people have intolerances to foods, where these are not true allergies, could be due to a leaky gut.  So it is not always about excluding certain foods forever, but first repairing the gut so that it may be able to handle foods better.  What people experience as intolerances are different from allergies and coeliac disease.  Microbiologists, beginning with Pasteur, whilst understanding germ theory, went to far as to say “the terrain is everything, the germ is nothing”, to reinforce how the condition and integrity of the immune system, and in this specific case, gut lining, influences how microbes are processed in the body, and how pathogens are handled in our immune system. 

Inflammation in the lining of the gut can open up the cells in the walls and allow substances through that should not get through, including pathogens.  This can provoke an inflammatory response in the body, and it can be parts of many different conditions that present in different ways, where an intolerance can be is a symptom of the gut health.  Healing the gut, can therefore have a profound impact or many different systems and disease states.

A case in point was as we saw with Covid, can see many different bodily responses to the same pathogen, including inflammation of different bodily systems in different patients. 

Helen: What are some interesting things that people may not realise about nutrition?

Terri: That society has made it very complicated! There are so many brands and flavours, advertising and new health claims…most of this is just marketing and designed to get you to spend money. Interestingly, good nutrition can be surprisingly simple to get right. It’s the habit formation and changes which poses a challenge. In addition to this – people’s perceptions of food and nutrition are fascinating.  So, where people feel they have potential issues with gluten (outside of coeliac disease), there is a perception of gluten-free as being healthy or desirable.  But in actual fact, gluten free products can contain many other processed ingredients which have widespread effects throughout the body. Sticking to mostly whole foods is not only simpler; it’s far healthier & often cheaper.

The way to look at where our food has come from is to think about how many processes it has been through to get to my plate; so how many machines and human hands have been involved with its growth, harvesting, processing, packaging and transport?  We are now thinking more about the increasing presence of ultra processed foods, or UPFs, which have not only been through a number of processes, but have been potentially chemically modified and are very far away from the Whole Foods that our bodies prefer.

Helen: Thank you so much for taking time out to talk to me today!

Starting this week – Terri will regularly be giving us a seasonal recipe and tips – so do keep an eye on her page and our social pages for updates!

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