Thursday, 24 March 2016

Module 2: Professional Inquiry Research / MIND OVER MATTER

Module 2: Professional Inquiry Research
Nutrition and Well-Being of a Performer
MIND OVER MATTER 



Food and our relationship with it

OUR RELATIONSHIP WITH FOOD = Fundamental building block of nutritional metabolism

NO 2 people can think the same thoughts regarding a specific food for example, looking at a plate of pasta, chicken and salad:

Women wanting to lose weight                   sees the calories and fat (Pasta is viewed as a fear)

Athletes                                                             Identifies the protein (focuses on the chicken)

Doctor/Scientist                                              Highlights the nutritional content (collection of chemicals)

Farmer                                                               Pride to see a good cut of meat

‘What you think and feel about a food can be as important a determinant of it’s nutritional value and it’s effect on body weight as the actual nutrients themselves’

How your Brain Eats

Step 1
The mind uses the digestive organs to communicate.

Step 2
An image of food (consumed) appears in the higher centre of the Brain – CEVEBRAL CORTEX.

Step 3
Information is relayed electrochemically to the LIMBIC SYSTEM, which is the lower portion of the Brain. It regulates emotions and essential physiological functions and emotions e.g. hunger, thirst, temperature, sex drive, heart rate, blood pressure.

Step 4
A small collection of tissues in the Limbic System, HYPOTHALAMUS, integrates the activity of the mind with the biology of the body.

If you enjoy eating something your digestion will be stimulated, producing a fuller metabolically breakdown, whilst burning its calories more effectively!

If you feel bad for eating something your Hypothalamus will send the negative signals down to the sympathetic fibres of the AUTONOMIC NERVOUS SYSTEM, which initiates responses from the digestive organs. This means that you will not fully metabolise your food intake.
STRESSORS by the Brain include:

·         Food Guilt
·         Shame about the body
·         Judgement about health
You can eat the healthiest meals however if your thoughts are negative it can interfere with your digestion, increasing your fat metabolism storage.

Likewise, if you eat a less nutritional meal but are in a positive heart and mind set, the nutritive power will increase.

The PLACEBO EFFECT

This theory is known as one of the most compelling phenomena’s in Science. The Placebo Effect highlights and focuses on the phrase, ‘Mind over Matter’ and the power of expectation.

In 1983, a medical researcher ran a test on a selection of cancer patients. One group were given the real drug to be tested whilst the remainder of the group received a placebo (fake) treatment (inserting salt water injection). Predictedly 14%  of the patients receiving the actual treatment lost their hair due to the treatment. Surprisingly 31% of the ‘Placebo Group’ lost their hair also. The reason as to why was because they thought they would lose their hair.

This example can correlate with our common lifestyle when we think:

‘This pudding is too fattening ‘
‘I shouldn’t be eating this’
‘I feel good eating this salad because its healthy for me’
‘Fat will make me fatter’
‘I can’t make it through a day without coffee’

Even though some of the examples above are true, using the science of The Placebo effect we may be self instigating these issues or problems, and therefore increasing the outcome based on our expectations.

‘The Placebo Effect is not some rare or unusual creature’
(Marc David)









http://www.nytimes.com/1997/07/16/arts/eating-disorders-haunt-ballerinas.html?pagewanted=all (Article  below)
Eating Disorders Haunt BallerinasBy JENNIFER DUNNINGPublished: July 16, 1997

In the early 1990's, Michelle Warren and Linda Hamilton, two specialists in eating disorders, began a three-year 'intervention' survey of 40 beginning students at the School of American Ballet, affiliated with the New York City Ballet.
'We were trying to see which girls developed or were predisposed to problems,' said Dr. Warren, a professor of obstetrics at Columbia Presbyterian Medical Centre and the director of its Menopause and Hormonal Disorders Centre. But 60 to 70 percent of the students dropped out of the survey, and the study was cancelled after a year. 'Some dropped out because of injury’, Dr. Warren said. 'But basically when the girls started getting into trouble, they didn't want to answer questions.'
Denial, Dr. Hamilton said, is a large part of the problem of eating disorders, a problem that affects a large number of young ballerinas. Determined intervention might have helped avert the sudden death on June 30 of Heidi Guenther, no longer a student but a 22-year-old member of the Boston Ballet. The exact cause is not yet known. But Ms. Guenther had eating problems. She had complained to her family in recent weeks of a racing, pounding heart, but she refused to see a doctor.
Dance is a highly competitive, high-pressure and physically demanding profession. In classical ballet, there is popularly believed to be an ideal 'Balanchine' body type for women, with the jobs going to tall, slender women with long necks, long legs and short torsos. The problem of eating disorders has created a minor industry of nutritionists and therapists specializing in dancer's emotional and physical problems. Despite increasingly sophisticated methods, however, eating disorders in ballet remain extremely difficult to treat.
At a news conference last week in Boston, company officials said that two years ago Ms. Guenther, then a member of the Boston Ballet's junior ensemble, had been encouraged by Anna-Marie Holmes, now the company's director, to lose five pounds. She lost the weight over a summer break and was then told not to lose more weight, they said.
Ms. Guenther was promoted to the senior company last September, Some two months later, she again began to lose weight, and she was told to ''be careful not to get too thin,'' company officials said. A spokeswoman for Ms. Guenther's family said that she had planned to relax and gain weight this summer. At her death, she weighed about 100 pounds, which is low but normal for a ballet dancer of Ms. Guenther's height, 5 foot 3 inches.
'She was smiley, bubbly,' Bruce Marks, director emeritus of Boston Ballet, said. 'That didn't change. She was full of beans, full of life.' But there was recognition that she might be having problems, he said, at a traditionally difficult time when young dancers make the jump into a major company.
Eating disorders range from anorexia nervosa (deliberate self-starvation) and bulimia (recurring binge eating and self-induced vomiting) to 'disordered eating', a term coined by the women's task force of the American College of Sports Medicine for any chronic restrictive and ritualistic compulsive eating problems. Men are not immune to eating disorders. But they are much more prevalent in women, in part because society and the world of ballet place a higher value on women's looks.
'The problem is much more common in middle- and upper-class women, particularly white women and young women under 25,' Dr. Warren said. 'Dance is one of the worst areas. The average incidence of eating disorders in the white middle-class population is 1 in 100. In classical ballet, it is one in five.'
Most are female students and the youngest female professionals, particularly those with less physical facility and less-than-perfect bodies. Older women tend to suffer from less serious eating problems, like yo-yo dieting and the age-old dancer’s regimen of diet soda and cigarettes, which affect about 46 percent of professional ballet dancers, according to Dr. Hamilton.
Men tend to start their dance training later. With fewer in the field, they experience less competition. And a part of their work, partnering, requires solid muscles and strength.
Women begin their ballet training at around age 7, and the crucial point in that training, when they are judged to have the talent and perseverance to become a professional, generally occurs during the already troubled years of puberty. Dancers are reluctant to talk about the problem, the older ones dismissing it as no longer so serious in an era when more information is available about nutrition for dancers.
Ms. Guenther's case may be an isolated incident. But the pressured world of ballet encourages driven personalities, offering a life that is largely confined to the studio and its mirrored reflections, a life that is determined by the orders of authority figures like teachers, choreographers and company directors.
'People attracted to dance may be looking for that kind of structure,' said Marijeanne Liederbach, director of research and education at the Harkness Center for Dance Injuries in Manhattan. 'Achieving a triple pirouette or 105 on the scale are tangible goals in a difficult world.'
Dancers who negotiate the psychological and physical pressures of ballet training and of performing in some companies tend to be eager to please, she said, and may believe they are disciplined and passionate enough about their art to be able to disregard their need for food. What makes the problem even more serious for women is that physiologically, as reproductive mammals, their bodies fight to preserve a minimum amount of body fat.
Moving Toward Greater Diversity
Women dancers must also deal with the reality or perception of the ideal ballet body. In that respect, the pendulum seems to be swinging back toward greater diversity.
'If people can convince me they can move and they can dance, I hire them', said Heinz Poll, director of the Ohio Ballet. One outstanding ballerina in the company had 'the most un-balletic body in the world', Mr. Poll recalled. 'Everything about her was wrong. But the moment she lit up dancing you forgot that. It was very simple.' But Dr. Hamilton pointed out that dancers often get eliminated in auditions before they dance a step because their bodies are not what the director is looking for.
Thinness was not always prized in ballet. Louise Fitzjames, a French ballerina of the mid-19th century, was depicted in a famous caricature as a dancing asparagus in a 'Ballet of the Vegetables' and was described by one French critic as 'having no body at all' and being 'as skinny as a lizard or a silkworm’.
 Balanchine is credited with, or accused of, creating the concept of the ideal ballet body. Gelsey Kirkland has written that as a troubled young dancer at City Ballet in the late 1960's, she was told by Balanchine that he wanted to 'see the bones.'
Dr. Hamilton, the specialist in dancer’s eating disorders, performed with City Ballet from 1969 to 1988. 'Balanchine was interested in tall, thin women who looked like models when I was there', she said. 'And a lot of his dancers run companies today'. But dance, she said, has gone along with societal pressures to look a certain way.
In a statement issued this week, Peter Martins, director of City Ballet, said that the company 'does not currently, nor has it ever, required a specific body type, but rather engages its dancers based on their ability'. He described today's dancers as 'fundamentally very responsible about their own health'.
Spokesmen for the major ballet troupes in New York City said that they offered informal, confidential help to dancers with problems. Dr. Hamilton writes regularly in Dance Magazine about these and other issues, though most of her mail is about eating problems. Workshops on nutrition and health are conducted regularly in the major ballet schools. 'But do you think they listen?' asked Edith d'Addario, director of the Joffrey school. 'They sit there eating yogurt all day.'
'We Have To Fit In'
Even the gentlest and most private intervention can backfire. 'You need to take charge without pushing them off the deep end', said Laveen Naidu, a former member of Dance Theater of Harlem and a longtime teacher at its school. 'Yes, this is a visual art form with certain esthetics. We have to fit in. But everyone is different. We tell the students that they don't have to look like someone else. But it's 'mirror, mirror,' all the time’.
A student who seems to be losing too much weight is questioned quietly about what she is eating, he said. 'But you may in fact be unintentionally doing more damage. The most important thing is to know when to turn it over to a professional'.
Ultimately, Dr. Warren suggested, parents must face the fact that their daughters may not have a chance at becoming ballet professionals. Parents must watch for signs of potential eating disorders, among them recurrent problems with weight, menstruation and stress fractures of the bones. ''The key thing is to catch them before they get into a situation where they have such a distorted view of their bodies that they don't realize they are skinny', she said.
'If the individual goes through puberty and has a lot of problems with her weight, it is very unlikely she is going to make it as a dancer. People have to realize that the child is not going to make it if they are not thin. Mothers must start thinking twice. Is it worth the risk?'
Types of eating disorders
https://www.danceuk.org/media/cms_page_media/204/Dance%20UK%20Eating%20Disorder%20Policy%20Recommendations.pdf

This document offers information and recommendations for the creation of policies to promote healthy eating and to help prevent and manage disordered eating and eating disorders in dance training and professional environments. Dance schools and companies must aim to promote health and not merely to avoid eating disorders.

Anorexia Nervosa

Refusal to maintain body weight at or above a minimally normal weight for age and height, for example, weight loss leading to maintenance of body weight less than 85% of that expected or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected.

Intense fear of gaining weight or becoming fat, even though underweight.

Disturbance in the way one's body weight or shape is experienced, undue influence of body weight or shape on self evaluation, or denial of the seriousness of the current low body weight.

Restricting Type: During the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (self-induced vomiting or misuse of laxatives, diuretics, or enemas).

Binge Eating/Purging Type: During the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior.

Bulimia Nervosa

Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.

A sense of lack of control over eating during the episode, (such as a feeling that one cannot stop eating or control what or how much one is eating).

Recurrent inappropriate compensatory behavior to prevent weight gain, such as self induced vomiting, misuse of laxatives, diuretics, enemas, or other weight controlling medications, fasting, or excessive exercise.
The binge eating and inappropriate compensatory behavior both occur, on average, at least twice a week for 3 months.

 Self-evaluation is unduly influenced by body shape and weight.
The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

Purging Type: During the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.

Non=purging Type: During the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behavior but has not regularly engaged in self-induced vomiting or misused laxatives, diuretics, or enemas.

Binge-eating disorder
Listed in the DSM IV-TR appendix as a diagnosis for further study, Binge Eating Disorder is defined as uncontrolled binge eating without emesis or laxative abuse. It is often, but not always, associated with obesity symptoms.

Night eating
syndrome includes morning anorexia, increased appetite in the evening, and insomnia. These patients can have complete or partial amnesia for eating during the night.

Disordered Eating
Irregular eating patterns, which do not fit into the clinical criteria of Anorexia Nervosa or Bulimia Nervosa, but in some cases, may be classified as an Eating Disorder Not Otherwise Specified. Although disordered eating does not always require clinical treatment, it may be associated with serious issues around food and body image, as well as symptoms of eating disorders, making it a serious issue for dancers.

NOTES TERMS TO USE EXPLAINING PEOPLE’S RELATIONSHIPS REGARDING FOOD
Devil / Angle
Gremlin in head
Guilt
Suppress appetite
Food / Visual / mind games
Restricted
Minimal
FOR SIG GROUP & RESEARCH
Policy Creation: The way in which you create your policy is of utmost importance. Please see below guidelines to assist you with policy writing.
‘Policies need to be constructed by a group, and not just by one individual. Those who shape the policy will be more likely to own it, and be concerned to see that it is made effective. A policy should help to ensure that all team members are consistent with messages getting across to their dancers’                                                                                                                    (Dance UK. 2000)

It may be best to include the following persons within the core group: the director or head of the school or company, the teachers, the pastoral care or tutorial staff, a dietician, a physiotherapist, a doctor or eating disorders specialist, and the head of catering. In more general terms, the group should include representatives of all those who can make a difference to the dancers care. The status, enthusiasm and persistence of this group will determine its success.

With smaller schools and companies, creating a document with a group can prove difficult. If creating a document alone, always ensure that you share the information within it with someone that you work with professionally. You may also consider contacting Dance UK and/or Beat to ensure that your policy is consistent with the best practice guidelines for the sector.

Define eating disorders and disordered eating. There may be misinterpretations and confusion around the differences between eating disorders and disordered eating, so it may be helpful for schools/companies to include clinical definitions (included above) in their policies to ensure understanding.

• It is important to highlight in your eating disorders policy that the school/company will respect confidentiality as far as possible. The matter will need to be shared between the dancer, their parents (if under 16) and designated individuals within the organisation – this may be referred to as the ‘need to know group’ (see Confidentiality below)

• You may want to include in your policy that dancers with a suspected eating disorder will not be blamed or otherwise punished. Instead, they will be supported both within the school/company and in the seeking   dance specific care or using outside help

Prevention
Below is a list of extracts from policies that outline preventative mechanisms in place in dance schools/companies. It is imperative that a section on prevention is included within a healthy eating/eating disorders policy.

‘Most successful eating disorder and disordered eating prevention and intervention programmes in the research literature have targeted eating disorder and disordered eating risk factors, such as self-esteem (Piran. 1999)

‘Encourage an atmosphere of supportive openness where it is recognised that dancers sometimes struggle with food and eating, but dancers can feel sure that they will get support if problems do occur, and where people know where to find help if they have any concerns.(Centres for Advanced Training, 2009)

 • Encourage dancers to ask for advice regarding healthy eating when required and to share any concerns they have regarding their peers’ eating habits with a designated and educated member of staff.

‘Promote healthy eating through the provision of adequate breaks for re-fuelling and hydration. Encourage dancers to take onboard healthy amounts and types of fluids and food before, during and after dancing.’ (Centres for Advanced Training, 2009).

 • Provide regular education and frequent reminders and updates for staff and teachers, dancers, parents and catering services regarding nutrition and healthy eating; eating disorders, prevention and management; and how to motivate people to get help.



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