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)
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.
