When Wellness Comes to the Dinner Table

From digestive health to the changes that accompany menopause, food has an important part to play in how we feel. Registered dietitian Laura Tilt explains what eating for your health can realistically achieve, and how to make the advice work beyond the shopping list.

When you are trying to manage digestive discomfort, make sense of changes in midlife or simply eat well around a demanding working week, deciding what to have for dinner can become surprisingly fraught. A meal is expected to deliver enough protein, look after the gut and fit into a life that rarely leaves much time for planning it. Add the language of hormone balancing, food sensitivities and supplementation, and an ordinary shopping list can start to feel like a set of clinical instructions.

For Laura Tilt, registered dietitian and Head of Science at Field Doctor, the idea of “food as medicine” begins with a more practical question. “I think about "food as medicine" as answering the question: how can I eat to benefit or manage my condition, or how can I eat to reduce my risk of chronic conditions like heart disease?”

Those are useful ambitions, provided the promise stays proportionate to the evidence. Managing a symptom, reducing the likelihood of future illness and curing an existing condition are very different things, although the language used to sell a product can make them sound interchangeable. As Tilt explains: “The marketing begins when those effects get overstated, or when a single food or supplement is sold as a cure. The truth is that diet can be a powerful lever, but it works alongside other forms of healthcare, not instead of it. It's not a substitute for prescription medication - it's about what food can do alongside it.”

The gut offers a good example of both the possibilities and the temptation to promise too much. Alongside digestion and nutrient absorption, Tilt draws attention to the organisms living in the digestive tract: “On top of that, there's your microbiome: the community of microbes living in your gut. What you eat influences those microbes and the compounds they produce, which can in turn influence immune function, the health of your gut lining, and potentially even your mood.” Understanding those relationships is valuable; translating them into a promise that one food will resolve a particular person's symptoms requires much more specific evidence.

For people with irritable bowel syndrome, or IBS, dietary advice also has to account for the fact that foods commonly recommended for general health can be difficult to tolerate. A low-FODMAP diet limits certain fermentable carbohydrates and can help manage symptoms, but following it involves more than removing a few obvious ingredients. As Tilt points out: “But the diet is tricky to follow - it temporarily eliminates lots of common ingredients like wheat, onion and garlic - and fibre from fruit, vegetables and wholegrains often takes a hit.”

That is why the stages of the diet matter. Monash University, whose researchers developed the approach, recommends an initial two-to-six-week period of substituting lower-FODMAP options, followed, if symptoms improve, by structured reintroduction. Different FODMAP groups are tested to establish what a person tolerates and in which amounts. The eventual aim is to restore as much variety as possible while keeping symptoms manageable, with support from a dietitian experienced in IBS. A restricted menu is a temporary part of that process, and individual tolerances determine what happens next.

Turning those requirements into a meal someone actually wants to eat is the practical challenge behind Field Doctor's low-FODMAP range, where they adapt familiar dishes, including meatballs, cottage pie and curries, while retaining vegetables, fibre and flavour. For someone already having to reconsider everyday ingredients, being able to eat recognisable food matters. Nutritional advice becomes much easier to use when it answers what to cook on a Wednesday evening, as well as explaining what to leave out.

During menopause, the discussion often begins with a changing waistline, although the nutritional priorities extend to muscle, bones and cardiovascular health. Falling oestrogen levels accelerate bone loss, while cholesterol levels can rise across the transition. The British Dietetic Association highlights adequate calcium, vitamin D and protein alongside resistance exercise as important considerations. These needs deserve attention even when the bathroom scales have become the most immediate concern.

Tilt is particularly keen to bring muscle into that conversation. “One of the most important things we can actually do for metabolic health in menopause is maintain muscle through strength training, staying active and adequate protein intake.” In everyday meals, that means making space for protein sources such as fish, eggs, tofu, beans or yoghurt, according to preference and tolerance. Calcium-rich foods also need a regular place; for those choosing plant alternatives to milk or yoghurt, checking for calcium fortification is useful.

Her broader approach draws on a Mediterranean-style pattern, with olive oil, vegetables, wholegrains and pulses featuring regularly. There is room here for varied, satisfying food and for meals that suit different appetites and budgets. Claims about treating hot flushes need more care: the Menopause Society's 2023 evidence review did not recommend dietary modification as a treatment for vasomotor symptoms. Eating well remains relevant to health through menopause, but that should not become a promise that a particular menu will reliably control every symptom.

Across these conversations, fibre deserves considerably more attention than it tends to receive. The UK's National Diet and Nutrition Survey for 2019 to 2023 found that 96 per cent of adults fell short of the recommended intake. For adults aged 19 to 64, average consumption was 16.4g a day, against a recommendation of 30g. The gap gives some perspective to the attention paid to elaborate eating regimes when a basic nutritional need remains so widely unmet.

Asked which eating habit she would most like people to change, Tilt's priority is including more foods that supply fibre. “Fibre helps keep us full, nourishes our gut microbiome, and long term protects against heart disease, type 2 diabetes and bowel cancer.” The NHS likewise links higher fibre intake with a lower risk of these conditions, alongside benefits for digestion and preventing constipation. Its value extends well beyond whether the stomach feels comfortable after lunch.

Building it into the day can be as familiar as porridge at breakfast, lentils stirred into a tomato sauce, a potato cooked with its skin on or fruit and nuts between meals. Getting fibre from several sources helps maintain variety, and changes should be introduced gradually, with enough fluid. For people with IBS, the type of fibre and the portion size may need individual adjustment. A sudden increase that leaves someone uncomfortable is unlikely to become a habit they want to keep.

Supplements require the same attention to individual need. There are sound reasons to use them in particular circumstances, and UK advice is that adults should consider 10 micrograms of vitamin D daily during autumn and winter, with year-round supplementation appropriate for some groups. Other choices depend on diet, life stage and health circumstances. Tilt suggests seeking advice before committing to a routine: “If you're unsure whether you actually need them, a registered dietitian can give you guidance on what's worth taking based on your specific life stage, dietary preferences and any conditions.”

Before adding another product to a daily routine, it helps to establish which need it is intended to meet and whether that need is already being addressed. Tilt returns to the ordinary foods that can be overlooked when attention is fixed on supplements: “Supplements aren’t a replacement for the basic principles that go a long way and that most people aren't doing: eating enough fruit, veg and fibre.”

The concept of wellness in food provides a useful basis for conversations that increasingly touch on how clients eat as well as how they look and feel. General education can help people understand dietary patterns, recognise exaggerated promises and know when individual advice would be useful. A consultation can acknowledge the frustrations of bloating or changes in midlife without turning those experiences into a presumed deficiency or a reason to recommend a restrictive diet. The advice also has to survive contact with family dinners, work commitments and the pleasure of eating with other people. Tilt considers that a meaningful test of any approach: “Be wary of anything that asks you to cut out lots of food groups, or any approach you couldn't realistically maintain in daily life - anything that requires so much counting and measuring it starts to interfere with eating with your family or having a normal social life. If a way of eating can't fit into real life and makes it difficult to get all the nutrients you need to stay healthy, it's a red flag.” Newsletter Block This newsletter signup form needs a storage option. Edit the block and enter a storage location via the Storage tab.

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