I’m delighted to introduce Natalie Goodchild as CyFi Life’s first guest! Natalie’s website, Natalie Johanna, is a must read site (for anyone with or without CF) dedicated to nutrition and healthy living. She works as a fitness professional and, in her own words, she’s “on a mission to better her body from the inside, out”.
Martin) Natalie, thanks for taking the time to share your wisdom with us! How long have you been living an ultra-healthy lifestyle? Was it instilled in you by your parents or was it something you decided to do yourself?
Natalie) I wouldn’t say I’m ultra-healthy – I would choose Haribo over Kale any day! But I do try hard to prioritise my health wherever I can. To be fair, even Haribo has its place in being healthy – because deprivation is just as unhealthy as a naughty treat here and there!
When I was younger, I wasn’t super fit in the conventional sense. I couldn’t even leapfrog until I was in my teens and definitely wasn’t picked first in P.E. class, but my parents worked incredibly hard to keep me healthy and it’s something that I will always continue.
Because I wasn’t very sporty when I was at school, my parents would encourage me to take up more musical activities instead. I did singing lessons, learnt to play woodwind instruments and took dance classes to ensure that I was doing activities that required me to breathe actively to keep my lungs clear.
In terms of healthy eating, my mum has always been brilliant at making big, balanced and nutritious home cooked meals too, so I always had a good appetite growing up and that has stuck with me.
My parents also used to invest a huge amount of time (probably almost 2 hours a day on average) doing my chest physiotherapy and keeping an eye on me taking my medication. This definitely helped to keep my lungs clear through my childhood, and has instilled in me good habits that I keep today.
I’m not sure where my genuine passion for fitness and for researching health and nutrition in a more in-depth way came from, but I’m grateful that I found that enthusiasm as it only ever helps me to keep motivated to take care of myself.
M) Eating healthy is a big part of your ethos – how do you manage that with the high calorie diet CFers require?
N) I eat nutritious and unprocessed foods a lot of the time, but I eat a lot of them. It’s a bit of a joke in my office that people will ask me ‘which number lunch are you eating now?’. I like to eat often because it keeps my energy levels up.
To get in the calories, I will have protein shakes with my breakfast and after working out, as they are an easy way to get in extra calories and a very important macronutrient. I’ve used other prescribed shakes in the past, like Fortisip, but protein shakes simply suit me well right now and I love all of the different flavours!
I will also include lots of healthy fats in my diet to add in calories – fats are much more calorie dense with around 9 calories per gram compared to 4 calories for protein and carbohydrates. I cook with a lot of coconut oil and olive oil, snack on nuts, use nut butters to make snacks, sauces and smoothies, put avocados and olives on salads and get in some oily fish like salmon at least once a week too.
I will eat ‘naughty’ foods too. I have an absolutely huge sweet tooth, which probably comes from a childhood of indulging in mars bars and mini rolls as that was what my parents were instructed to feed me for extra calories! As much as I love sweets, I do try to make these less of a dietary staple now as I don’t want to run into any other health complications because of them.
M) So what does a typical breakfast look like?
N) Breakfast starts with a whey protein shake, which I have because after a night of fasting, I know that my body needs it to keep repairing itself. Without this, my breakfast would be lacking this main macronutrient. I have written a comprehensive guide to protein and one on protein supplements which explain why this is so important.
I also have a bowl of porridge (oats and coconut or almond milk) with a good mixture of tasty toppings. My favourites are: nut butters, cinnamon, nuts, dried fruit, fresh berries, flaxseed, chia seeds, other seeds and honey.
M) How about snacks?
N) I tend to visit the gym before I head to the office in the morning and so when i get to my desk, I will have a protein shake, banana and perhaps some rice cakes (dark chocolate covered ones are my favourite!)
I sometimes have a handful of nuts too, although these may come a little later – but that’s more of a sports nutrition decision.
My other go-to snacks are protein bars (I like quest bars), Pepperami, nuts (I often get Thai sweet chilli nuts for variety), nut butter with rice cakes or fruit or veg, hummus and crudités, dried and flavoured fava beans (like the ones from Dilly and Wolf).
M) And what about lunch and dinner?
N) I always pre-prepare meals for lunch because I work away from home. I like to know what goes into my food so sometimes this can mean my boyfriend and I cooking up 12 meals in one go to cover us for just half a week! My favourites are fajita chicken (using a packet spice mix) with a heap of vegetables, or something using mincemeat, such as a beef, cashew and vegetable stir fry with chilli sauce (again, I use chilli con carne packet spice mixes for convenience as I have so many meals to prepare in one go). I will try to add extra calories to meals with a sprinkle of nuts and seeds or a dollop of hummus.
For dinner, I love variety. My meal will always be based around a good protein source, like fish (salmon or white fish are my favourites) or meat (usually white meat or beef). I’ll either turn them into a curry, stew, casserole or stir-fry packed with veg, or pair them with steamed or roasted vegetables. I tend to serve dinners with white potato, sweet potato or rice, in different forms.
M) You eat gluten & lactose free food – is that due to intolerance or do you do it to live healthier?
N) I don’t eat lactose-free (although I would find it interesting to be tested for lactose intolerance) but I do tend to avoid dairy as I have a high sensitivity to casein, which is one of the proteins in milk, which can make me feel unwell, but this isn’t directly linked to CF.
I eat gluten-free where possible. As far as I am aware, I’m not coeliac so I think that I am able to tolerate a small amount in my diet, which allows me to enjoy the occasional pancake or waffle! I eat gluten-free because I notice uncomfortable side effects when I eat large quantities of gluten containing foods (specifically wheat-based foods, as wheat also contains other proteins which I don’t handle well). That makes me wonder what damage these things are doing to my insides. And, having had a lifetime of antibiotics, I know that my gut health may not be in the strongest condition, so I want to avoid irritating it with anything needlessly.
M) Exercise is another big part of your life. What exercise do you find works best for you to clear your lungs?
N) What works best for me is whatever I enjoy enough to stick at! I personally really enjoy weight training. However, rather than training for strength (which would involve low reps – think the 1-3 lifts that power lifters work with!) I try to include high-reps, short rest periods between sets, and will often superset in order to keep my heart rate high and my lungs working hard. For example, I will do 8-10 heavy squats, and then superset that with 10-12 squat jumps to get me out of breath before a short rest of 60 seconds before I go again.
I also really enjoy dancing, so I try to take the occasional dance class that is high-intensity and will be an enjoyable cardio session.
M) Does the coughing and clearance usually happen after the activity or during? If during, does it affect your dancing having to take constant breaks?
N) Neither really! I’m not very productive and don’t generally cough a lot, thankfully! Sometimes I will feel something ‘shift’ during a workout and have a quick cough – but never enough to stop me doing what I’m doing.
M) And what advice do you have in terms of the exercise that works best for increasing/maintaining lung function?
N) HIIT (High intensity interval training) is great for improving lung function, and general performance, really quickly. There’s plenty of research to back it up too. My favourite form of this is an exercise protocol called a Tabata. It’s based on a scientific study and I wrote an article on it that explains it in full (click here for Natalie’s article on Tabata).
M) OK, moving on to rest. Too much intense exercise can weaken your immune system and rest days are an important part of anyone’s exercise regime – do people with CF need to factor in more rest days? What’s your rest day:work out day ratio like?
N) This is an incredibly important point and one I am really glad that you brought up! A lot of fitness fanatics will exercise 5, 6 or even 7 days a week, but I do find that my body needs more time to recover. I work out 3 or 4 times a week.
I feel like if I wasn’t working full time and juggling so many side projects that I might be able to tolerate more frequent and intense sessions, but it’s not worth the risk right now! I’ve got incredibly good at listening to my body. Being so aware of small changes is great because I know when not to push myself and when to give myself extra recovery time so that I don’t get unwell, or so that I don’t get injured and am forced to take time off.
M) How important is sleep in maintaining a healthy body, and do you find as someone so active with CF that you need more than the recommended 7-8hrs a night?
N) This is also a really important point on recovery. I have always loved my sleep and it’s only recently that I have become tolerant of mornings.
Generally I like to go to bed between 10 and 10.30pm and wake up between 6 and 6.30am (sometimes as late as 7am when I’m not training at the gym before work). This usually gives me 7 and half hours of good quality sleep, which suits me really well unless I am recovering from being unwell.
I aim to get really good quality sleep by having a good mattress, good pillows, avoiding using my phone in bed before I sleep, taking supplements such as magnesium to help my body relax and recover (check that any supplements you take won’t interact with any medications first!), enjoying a night time tea (I like Pukka’s blend best) and a small carbohydrate snack, like a small bowl of oats or some rice cakes with banana. A good night time routine is important for me.
To wrap up that question a bit more succinctly, I don’t get more sleep than 7-8 hours, but I do get a bit nervous if I think I’m going to come up short! I’m a really positive person and don’t really suffer from anxiety, but the thought of not getting enough sleep, or not getting good quality sleep does stress me out. I notice that it has a huge impact on how I feel in myself and how I perform during the day.
M) What supplements do you take and why?
N) I take…. AquaDEKs – prescribed – never miss a dose! They are your key micronutrients and an insurance policy that you are getting in all of your crucial vitamins and minerals that enable your body to function normally.
Curcumin – I take this for its anti-inflammatory properties (I take a blend including bioperine which helps absorption – I use a brand called Love Life Supplements)
Omega 3 – also for its anti-inflammatory properties
Probiotics – to keep my gut in good health, especially with antibiotic usage
Vitamin C – to help keep my immune system supported (I like the tasty chewable tablets from HealthSpan).
Vitamin D – because we never get enough in the UK!
I will also sometimes take extra fibre (just from a probiotic brand, that I still into a drink) and the amino acid L-glutamine. Both of these for gut health.
M) So we’ve spoken about the high calorie meals and exercise – what with eating so much and not overdoing exercise, do you have any advice on balancing both for those of us who want a good figure?
N) Having a good body composition is all about having good overall health and a balanced diet. If you are sleeping right, eating nutritious foods in balance with more processed ones, and ensuring that your hormones are balanced (such as that you aren’t too stressed!), you will be in a good place to have a balanced-looking body too.
Really the best thing that you can do for a good body composition while maintaining a steady weight (or even gaining weight!) is to training using weights. Increasing your muscle mass is really beneficial for your health, including weight management, as well as your physique! That applies to women too!
When introducing any form of exercise to keep your body in good condition, you will be expending more energy, and therefore need to consume more energy in calories. But, lifting weights to improve my muscle mass is the best decision I ever made for my health and my body shape. I’ve lost track of how long I’ve been lifting weights for now. It must be over three years now! But I’m still not ‘big’ or ‘bulky’ – in fact I would still like to increase in size in some areas. I like that I can use that type of fitness to sculpt my body in whatever way I like.
M) With all this exercise, as well as other healthcare requirements, how do you manage to fit it all in as well as having a balanced work, social and family life? Any tips for us?
N) I try to schedule things where possible. I have to force myself to form good habits and I have to plan my time realistically. I have lists ALL OVER THE PLACE!
I have to be honest and say it is hard. And a lot of people will never understand what we have to go through with CF and how time-consuming and mentally draining our treatments can be.
I work out before I go to the office in the morning, and I try to do my physiotherapy in the morning too, so that if any social commitments, workload or even just my mood changes during the day, I know that the important stuff is taken care of.
Then, I use a system of lists and planners to help me fit in my passion projects while keeping time free to spend with the people I care about. Time is my scarcest resource so I have started doing things like order my groceries online, or speaking to my Dr to set up a digital prescription service, so that some work is taken off my hands
M) Right – colds – the bane of all our lives – do you take any extra precautions to avoid them?
N) I eat healthy foods and avoid unhealthy food in excess (sugar, alcohol, and foods that you are intolerant to can negatively impact your immune system).
I dose up on Vitamin C and never miss out on any of my medications or supplements.
I rest when I need to – like I said, I am very aware of my body so I can sense if my appetite changes, if I am more tired, or feel like my head is getting a bit blocked up and I will dial things back.
I try to avoid people with colds too, although this is difficult when living, working and commuting in London.
M) Do you use any appliances to help increase/maintain lung function, etc? (e.g. altitude masks, etc)? Or just good old fashioned hard work?
N) Just the hard work! I’m not adverse to trying new gear, but honestly, with the time that I would spend researching them, buying them, trying to get used to them, I could have been powering on with the things that I’ve already found to work effectively.
I would like to try an altitude mask at some point, but it’s not a priority for me. I will be covering that on The Blonde Ethos though!
Also on that question – I’d love to have my own set up at home. I’d like to be able to monitor my lung function more frequently and conduct experiments on myself, but the equipment is expensive and again, time is a factor.
M) Is there anything else that you, as a person with CF, has had to do differently to people without CF to reach peak fitness?
N) I actually think this is the most difficult question so far! SO MUCH has to be done differently, and I’m still not sure I’ve reached peak fitness either – there’s always that feeling that there’s always something more you could do.
The biggest difference is obviously all of the behind the scenes work. All of the medicines and therapies that keep you well enough to get into the gym in the first place. Like I mentioned before, I also have to deal with the fact that people without CF will never understand what this feels like and the dedication that is required. I have to earn myself every single day of my life.
As a side note, I think consistency and adherence to treatments is EVERYTHING. I hear at my clinic that they have a lot of problems trying to get people to do simple thing like take their multivitamins. Working in the fitness industry, I hear people paying hundreds of pounds trying to get their vitamins and minerals right, buying the right products and getting their supplement stack tailored to their needs. We are handed it by specialist consultants, so we should all take advantage of that and see it positively.
M) Are there any other parts of your routine that help you manage CF that we missed?
N) Workouts, sleep, meal preparation, medicines, sorting tablets (I do this every 4 weeks by the way to save time!), doing nebulisers and physio… that’s everything!
M) Finally, do you know of any personal trainers that specialise in people with CF? I often worry about getting a PT that they won’t understand my needs.
N) I have yet to find a personal trainer who ‘specialises’ in people with CF, but there is certainly a calibre of personal trainer who will have the traits required to accommodate someone with CF. What I mean by this, is that some PTs have had more intense training (a sports science or biology degree, as opposed to just a vocational PT qualification) and some also have a greater drive to keep learning and researching to be top of their field, whereas other PTs may not be as naturally curious and fail to continue actively researching and learning once they have their initial qualification.
In my experience, the PTs who have been better suited to my needs have worked out of an independent fitness studio, or personal training studio, and place a much higher emphasis on optimising overall health and movement. One example of this kind of studio is Six3Nine in Covent Garden, London.
You could also simply ask a potential PT whether they have any experience of Cystic Fibrosis – it may simply be that they have a friend or family member with the condition and so are better able to understand your needs from that perspective!
A huge thank you to Natalie for sharing her expertise. You can find out more about her on her website or follow her on Twitter on @_nataliejohanna
Disclaimer: This site is not a substitute for medical advice – we are not medical professionals and neither are most of the people interviewed (unless otherwise stated). There is not a ‘one size fits all’ approach to managing CF, what works for some people won’t work for others. If you plan on making any significant changes to your lifestyle based on this site, make sure you run it past your CF Team first.