Food itself can directly affect a client’s mood and self-esteem, it is vital for you to recognise that when it comes to confidence considering a client’s habitual diet and recommending any necessary changes can help reduce any anxiety they may have. This in turn can boost their mood and increase confidence levels.
Ensuring the client is consuming a nutrient dense diet rich in vitamin, mineral and good fat sources is a starting point when reviewing their current nutrition. It is beneficial if the majority of their intake comes from whole foods as these are highest in nutrients. Whole foods are foods which have undergone minimal processing such as fish, eggs, poultry, pulses and vegetables.
Requesting the client to keep a food and mood diary can help both them and the fitness professional to understand how specific foods work for their bodies. Every client is unique but there are some common nutrients that support a positive mood and therefore may be beneficial to include in the diet to increase self-esteem.
Staying within your scope of practice you can review this food diary to ensure the client is consuming starchy carbohydrates at at least one or two meals per day. As carbohydrates fuel the brain and muscles, too little carbohydrates may cause the client to feel fatigued, irritable and lacking in concentration. Recommending the client to choose unrefined carbohydrates such as potatoes, rice, fruit and vegetables is advised as these help sustain energy levels for longer than processed carbohydrates such as cakes and biscuits.
Carbohydrate rich foods also have a direct role in improving mood by helping the brain receive a higher level of mood boosting hormone serotonin. Serotonin is produced from the amino acid, tryptophan found in eggs, cheese, pineapple, tofu and nuts and consuming these foods with a carbohydrate will increase absorption rate so more serotonin can reach the brain.
Foods rich in omega -3 such as mackerel, salmon and fresh tuna are recommend for everyone, however at least one portion per week should be advised to clients with low self-esteem as these foods have been shown to affect neurotransmitter pathways and prevent depressive symptoms (Frasure-Smith 2004).
Vitamin D is also known to increase serotonin levels in the brain and is a common deficiency for many people living in the United Kingdom as it is largely obtained through sunlight (Patrick 2015). However, you can advise their client to consume eggs, oily fish, yoghurt and fortified cereals to increase intake of vitamin D.
A key vitamin for energy production and depression prevention is vitamin B (Kennedy 2016). So recommending clients to incorporate spinach, broccoli, dairy and poultry will help improve their vitamin B intake.
Deficiencies in the mineral selenium have been shown to increase low mood, therefore the fitness professional could recommend a client consume natural dietary sources such as whole grains, brazil nuts, beans, seafood and oats on a regular basis (Brenton 1991).
In addition to mood boosting foods, it is important for you to understand the foods which have the potential to decrease a client’s mood and potentially their self-esteem. It is quite common for a client with low self-esteem to be consuming some of these foods on a regular basis, so discussing a plan to reduce them over a period of weeks or months is recommended.
Refined sugar is something that you should recommend to reduce. Many clients will reach for a sugary snack when they feel low in confidence about themselves because it quickly raises blood sugar levels and increases mood, however this is only temporary. Blood sugar levels soon fall and the client feels fatigued and is likely to want to reach for another sugary snack, leading to an emotional eating cycle. This is extremely unbeneficial for self-esteem and self-efficacy. Replacements for these snacks should be recommended such as nuts or seeds and ensuring adequate starchy carbohydrate consumption in main meals.
Caffeinated drinks and alcohol should also be limited, with the former increasing energy when consumed and the latter increasing confidence. However, both effects are only short lived and in the hours or days following consumption the client is likely to have mood swings, anxiety and irritability which over time can decrease their confidence further.
Lindsey is new to exercise training, she trained for short periods when she was younger but due to her Crohns disease was always very slim. Crohn’s disease is an inflammatory condition of the intestines causing chronic diarrhoea, nutrient deficiencies and fatigue. Her Crohns disease is now controlled through medication and has been for 10 years but she has always been very self-conscious because previous medication had caused her face to become very puffy, nutrient deficiencies caused her hair to become very thin and her stomach was often bloated. She is now self-conscious because she is overweight and does not feel happy with the way she looks.
Lindsey is motivated to lose weight but is anxious about using the gym. She arrives for her initial consultation and first training session in a black oversized t-shirt and baggy gym leggings. She brings with her a food diary which shows a regular intake of toast and jam with a glass of orange juice and flavoured yoghurt for breakfast, nothing for lunch and a jacket potato with beans and cheese for dinner. She snacks on homemade cakes and biscuits and enjoys a glass of wine most evenings.
The fitness professional should consider;
How are they going to make Lindsey feel more comfortable in the gym environment?
What short term goals are they going to suggest?
How are they going to improve Lindsey’s diet whilst remaining within their scope of practise?
Is it relevant to discuss emotional eating at this stage?
How are they going to measure progress?
After Lindsey and trainer have had their consultation they have set the following dietary goals together. Due to having low self-esteem it was difficult for Lindsey to come up with new goals so the fitness professional had to show empathy and patience.
Week 4: Start meal planning to ensure the three main meals contain a source of protein, starchy carbohydrate, healthy fat and fruit or vegetables – this goal allows four weeks for the trainer to educate Lynsey on proteins, carbohydrates and fats so she has the self-efficacy that she can do this. Meal planning allows Lynsey to take time to consider the foods she likes; the trainer could provide Lynsey with example choices. For example, porridge topped with Greek yoghurt and mixed berries for breakfast, a salmon, salad and avocado wrap for lunch and chickpea, vegetable and wholegrain rice curry for dinner.
During those four weeks Lynsey attended two training sessions with the trainer who taught her how to progress basic movements and use machine and free weights and also did one cardio based session alone. After four weeks she had successfully reached her set goals and was confident enough to do an additional resistance based training session independently and felt ready to set a weight loss goal of 0.5kg per week.
There were small observations that the trainer was looking out for to see if Lynsey’s self-esteem was improving. After 8 weeks of working closely with the trainer to make small weekly dietary changes and progressions with training Lynsey came to a session in some new trainers. The week after she arrived with some headphones and a brightly coloured, tighter fitting t-shirt. Lynsey had lost weight but she explained to her trainer that she had fallen in love with resistance training and decided her new goals were going to be based on strength targets. She had increased the frequency she was training independently to three sessions per week and regularly spoke about new healthy recipes she had been creating.
All these are indications that the client’s self-esteem has increased, she felt worthy enough to purchase some new shoes for herself, she is confident enough to wear clothes that might attract people to look at her, she is being decisive with her own goals and she is coming up with her own ideas to improve her healthy lifestyle. At this stage the trainer must continue to praise her progress but also consider that goals can be a little harder as Lynsey’s confidence in herself has grown dramatically.
This case study is quite a common example how the right support by a fitness professional can have a huge impact on a client’s psychology and perception of themselves. Setting small goals and watching for signs of increased self-esteem are important to ensure the client progresses at their optimal pace and improves their daily lifestyle.
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