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How to alleviate anxiety

People often use the terms “stress and anxiety” interchangeably, but they actually mean different things. Stress is the body’s natural and protective response to a potential danger. It puts the body into a heightened state of awareness to keep it out of harm’s way. Unfortunately, stress is difficult to avoid these days; we all lead hectic lives and stress has become a part of everyday life.

The most common sources of stress for most people are work-related — huge workloads and balancing long work hours with the wants and needs of family life — not to mention the burdens of health, relationship problems and money-related matters.

It is when stress becomes constant and prolonged that you run the risk of developing anxiety and causing damage to your health and quality of life.

Stress is not necessarily always a bad thing, though. In small doses, it can actually be a good thing, helping you to perform well under pressure and keeping you motivated. Stress can occur with feelings of anger, sadness or even when you are happy and excited. It’s when stress becomes constant and prolonged that you run the risk of developing anxiety and damaging your health and quality of life.

Anxiety is a general term used for several disorders that cause nervousness, fear, apprehension and worry. Anxiety is a common source of mental illness with over 2 million Australians suffering from anxiety each year. In New Zealand, the figures are just as bad, with one in four people experiencing an anxiety disorder at some time in their lives.

Anxiety nearly always occurs with a sense of fear, worry or apprehension and is often related to situations perceived as uncontrollable or unavoidable. It can be caused by worrying about an upcoming event or it may occur when there is, in fact, no identifiable trigger. Anxiety can greatly impact on your life, reducing your ability to cope with day-to-day living. It can affect your relationships and social life, and can interfere with your ability to work.

When anxiety goes beyond constant worrying it can develop into a phobia, panic disorder, social anxiety, obsessive-compulsive disorder and post-traumatic stress disorder, which can be terribly debilitating and isolating for people. Anxiety can also be the cause of substance abuse, physical addictions and comfort eating, all in an attempt to suppress feelings of anxiety.

Physiological effects of anxiety

When you’re feeling anxious, the same “fight or flight” response that’s caused by stress is also evoked, triggering a release of stress hormones, namely cortisol, which causes your heart rate and breathing to increase, your muscles to tense and blood flow to be diverted away from your digestion to your brain and muscles. It can also make you feel nauseous and light-headed and may cause frequent urination and diarrhoea in some people. While the acute regulation of stress is an important protective mechanism, there are downsides to constantly feeling anxious with persistently high levels of circulating cortisol.

Cortisol has an immunosuppressive effect, meaning if you have constantly high cortisol levels you are considerably more vulnerable to infections and illness.

Chronic anxiety can also impact on your digestive health. Anxiety can reduce the production of stomach acids and enzymes, leading to poor digestion and absorption of nutrients, resulting in digestive issues such as heartburn, indigestion, wind and bloating. Irritable bowel syndrome (IBS) is also associated with anxiety.

Anxiety nearly always occurs with a sense of fear, worry or apprehension, and is often related to situations perceived as uncontrollable or unavoidable.

Constant high cortisol levels can also disrupt your gut flora balance, reducing beneficial bowel bacteria in the digestive tract, which allows pathogenic bacteria to flourish. It’s important to have a healthy balance of gut flora to support your immune, digestive and emotional health.

Evidence suggests that people with anxiety are at a greater risk of developing a number of chronic diseases, including cardiovascular disease.

Anxiety with raised cortisol levels promotes excess abdominal fat, which is related to increased risk of diabetes and heart disease, according to a Yale study in 2000. Increased abdominal fat is associated with raised “bad” LDL cholesterol and reduced “good” HDL cholesterol levels, with an increased risk of heart attack and stroke.

Chronic anxiety and raised cortisol levels can impair cognitive function and memory, increase the risk of depression and mental illness, and cause sleep problems and insomnia. Anxiety can also affect your sex drive, menstrual cycle and fertility.

Your bone density can also suffer if you have chronic anxiety. High cortisol levels increase calcium in the blood by reducing intestinal calcium absorption and bone formation, which can in time lead to low bone density and an increased risk of osteoporosis.

Anti-anxiety medications

The most commonly prescribed types of anti-anxiety medications include benzodiazepines such as Xanax and Klonopin (recommended for short-term use) and antidepressants like SSRIs (selective serotonin reuptake inhibitors), including Zoloft (prescribed for long-term treatment of anxiety and panic disorders). A recent report has found a huge 95.3 per cent increase in the prescription of antidepressants in Australia between 2000 and 2011, making Australia the second highest prescriber of anti-depressants in the world, second to Iceland, which raises the question of over-prescribing.

Mindfulness meditation, which involves you focusing your attention, without judgment, on the present moment, can lower cortisol levels.

While these drugs can be effective for some people when used judiciously, they have an addictive component and do come with many unwanted side-effects. Not all people will experience these side-effects, though; it very much depends on the person. Common side-effects include anxiety and depression, headaches, muscle tension, chronic pain, insomnia, low appetite, low libido, nausea, dizziness, hair loss, stomach issues and diarrhoea, abnormal heartbeat and suicidal thoughts. According to the US FDA, all antidepressants can cause increased suicidal thoughts, especially in children, teenagers and young adults under 25, particularly during the first few weeks after starting or when dosage is changed or reduced.

The other problem with taking antidepressants is they are extremely difficult to stop. You can’t simply go “cold turkey” because of the risk of experiencing extreme symptoms; you need to taper them off slowly over a long period of time to prevent this. It’s not uncommon to see a person’s anxiety reduce when they start taking these anti-anxiety drugs, but when they start to come off them their anxiety returns, sometimes more amplified than before.

Fortunately, nature has provided us with natural medicines that can help alleviate anxiety by calming the nervous system, lowering cortisol levels and boosting adrenal health and serotonin and dopamine production.

Calming herbal medicines

Withania (Withania somnifera)

Also known as ashwagandha, withania is a popular Ayurvedic herb that’s a highly effective “adaptogen”. It’s used widely by herbalists to improve the body’s resistance to stress along with strengthening the immune system. Withania supports adrenal health and calms the nervous system, making it beneficial for alleviating anxiety in people who feel stressed, strung-out and exhausted. It also helps promote better-quality sleep. Taken as a fluid extract, the recommended dosage is 3-7.5mL daily.

Skullcap (Skullcap lateriflora)

An American herb used traditionally by Indian tribes as a sedative, skullcap is used by herbalists to treat anxiety and support nervous system health and vitality. This calming herb is also beneficial for treating insomnia, depression and exhaustion associated with stress. Skullcap can be drunk as a herbal infusion or as a fluid extract: 2–4mL, three times a day.

Valerian (Valeriana officinalis)

A well-known herb used by herbalist today to treat insomnia and sleeping difficulties, due to its mild sedative and tranquillising effect, valerian helps you fall asleep without making you feel groggy the next morning, unlike pharmaceutical equivalents. Valerian is also an effective treatment for anxiety as it helps sustain levels of the neurotransmitter GABA in the brain. Valerian can be taken as a single dose before bed or, for anxiety, 0.3–1mL three times a day.

Lemon balm (Melissa officinalis)

This lemon-scented herb and member of the mint family has long been used for its soothing medicinal qualities and aromatic properties. Arabs in the 11th century introduced lemon balm as a remedy for depression and anxiety. They believed it caused the mind and heart to be merry. Today, lemon balm is popular among herbalists for treating insomnia and anxiety-related conditions, including nervous gastrointestinal complaints such as indigestion, nervous dyspepsia and nausea. Lemon balm has a sedative and calming effect on the nervous system. It contains rosmarinic acid, which enhances GABA availability in the CNS (central nervous system). As a culinary herb, lemon balm is used in salads, soups and other dishes or can be taken as a fluid extract: 2–4mL, three times a day.

Chamomile (Matricaria recutita)

Chamomile has been used for centuries for its wonderful calming and anti-inflammatory properties, making it useful in the treatment of insomnia and nervous complaints. Chamomile has a mild sedative action, helping to promote a sense of calmness, which eases anxiety along with inducing restful sleep. Chamomile is also specific for treating digestive problems associated with anxiety, including nervous dyspepsia, IBS, diarrhoea, constipation and nausea. Chamomile can be enjoyed as a herbal infusion three times a day, made with 1–2 teaspoons of the dried herb steeped in boiling water for 10 minutes. It makes a perfect night-time drink. Or it can be taken as a fluid extract: 1–4mL, three times daily. People with a ragweed allergy may be allergic to chamomile, too.

Passionflower (Passiflora incarnata)

A herb used for its sedative and anxiety relieving properties, passionflower helps calm and support the nervous system, making it extremely beneficial for calming restlessness and nervous tension. Passionflower is also the herb of choice for treating insomnia, as it aids the transition into restful sleep without the side-effects of sleeping tablets. According to the University of Maryland Medical Center in the US, studies have found that passionflower can be equally effective as benzodiazepine drugs to improve anxiety. The best way to have passionflower is as a herbal infusion three times a day, made with 1–2 teaspoons of the dried herb in boiling water for 10 minutes. Or, taken as a fluid extract: 0.5–1mL, three times a day.

Kava (Piper methysticum)

Native to the South Pacific Islands, kava has been used there for centuries as a medicine and as a part of important ceremonies. Kava has a calming effect on the nervous system; it produces brainwave changes similarly to Valium and other calming medicines. Kava helps relieve anxiety and insomnia and other stress-related symptoms like muscle tension. Kava is traditionally prepared as a special tea but it’s also available as a fluid extract taken at 2–4mL, three times a day. Kava may slow reaction times and if you have a previous history of liver problems, you should consult your health practitioner before using.

Oats (Avena sativa)

Oats can be a tonic and restorative for the nervous system. They contain compounds that have a sedative and soothing action on the brain and nervous system. Oats can also act as a natural libido booster, increasing sexual desire, and performance, in women and men. This herb can be given as a food, herbal infusion or fluid extract at 0.6–2mL, three times a day. Oats can contain gluten, so this herb is not recommended for anyone with an intolerance to gluten.

Lavender (Lavandula angustifolia)

In folklore, lavender was used in pillows to help people sleep. Lavender is a highly aromatic flower often used as a remedy for insomnia, anxiety and depression. When lavender essential oil is inhaled, it has a soothing and calming effect on the mind and nervous system, helping to promote relaxation and lift mood. Having a massage using lavender essential oil can be particularly beneficial for alleviating anxiety and muscle tension. For a calming massage oil, combine two drops of lavender essential oil per tablespoon of carrier oil, such as almond oil. Lavender essential oil should NOT be taken internally. Lavender flowers, however, can be used as a tea, found often in night-time blends.

Vervain (Lemon verbena)

Vervain has a long history of use as a herbal remedy for easing anxiety and for soothing stomach spasms and digestive problems. This lemon-scented herb helps calm the nervous system and promotes a sense of relaxation. Commonly used as a culinary herb, vervain can be drunk as a herbal infusion or taken as a fluid extract: 2–4mL, three times a day.

Anti-anxiety nutrients

B vitamins

B vitamins are important nutrients for helping to maintain emotional and mental health. B vitamins are needed for proper nervous system function and for the production of energy from food. B vitamins are considered one of the most important “anti-stress” nutrients, helping to relieve anxiety, and are important for treating depression. B vitamins also help to boost energy levels.

Deficiencies in B vitamins can cause mood changes, depression, insomnia, anxiety and fatigue. Niacin (B3), pyridoxine (B6) and folic acid (B9) all work alongside tryptophan to produce serotonin. Eating a diet rich in B vitamins and supplementing with a good multi B-complex vitamin daily is recommended.

Foods rich in B vitamins include legumes, wholegrains, nuts, seeds, green leafy vegies, eggs, chicken, red meat and milk. A diet high in refined grains and processed foods will be lacking these important mood-enhancing B vitamins.

Magnesium

Magnesium is an essential mineral for good health and vitality. It’s needed for many cellular functions in the body, particularly for energy production. Magnesium is considered the “anti-stress” nutrient as it helps to calm and support the nervous system, making it beneficial for anxious and worn-out people. Magnesium is also useful for people who find difficulty in sleeping. Magnesium deficiencies are associated with fatigue, weakness, twitching and muscle cramps, and a predisposition to anxiety and insomnia. Magnesium occurs abundantly in whole foods. People who consume large amounts of processed refined foods will risk becoming deficient in this important mineral.

The best dietary sources include tofu, legumes, seeds (flaxseeds, pepitas, sesame), nuts (cashews, peanuts, almonds), wholegrains (oats, barley, millet, quinoa), wheat bran and green leafy vegetables such as spinach. Take a magnesium supplement that also contains calcium; recommended dosage is 600–1000mg of elemental magnesium daily.

GABA

GABA (gamma-aminobutyric acid) is a major inhibitory neutrotransmitter that helps regulate brain activity and mood and mental clarity, along with helping regulate muscle tone. GABA has an inhibitory function, helping to slow down neuron firing, which helps you feel more calm and relaxed and can promote sleep. Many herbs and medicines used to treat anxiety work by affecting GABA levels and how it works in the brain. Valium and Xanax, which are used to treat anxiety and panic disorders, work by increasing GABA. Other substances like alcohol and cannabis that are often used to relieve anxiety also get their effect through boosting GABA in the brain. To naturally enhance the way GABA works in the brain, you need to be getting enough vitamin B6, which is needed for GABA synthesis. Magnesium is also needed for GABA activity, boosting GABA sensitivity on nerve receptors.

L-theanine

An amino acid found in tea and also available in supplement form, L-theanine can be beneficial for people who suffer from anxiety. L-theanine stimulates alpha brain waves, which are associated with waking and feeling relaxed. Dopamine levels are also increased in the brain in response to L-theanine. Dopamine is a neurotransmitter that helps regulate the brain’s pleasure and reward centres. L-theanine may also boost GABA to help reduce anxiety and induce a state of relaxation. The recommended dosage is 200mg a day.

Anxiety-easing dietary changes

Reduce caffeine

Millions of people rely on their morning coffee hit to kick-start their day. Many say caffeine is addictive because it boosts energy levels and makes them feel more alert. Caffeine is naturally found in certain leaves, seeds and fruits. The most common sources in our diet are coffee, tea, cocoa beans, soft drink, energy drinks and some medications and weight-loss supplements. Caffeine stimulates your fight-or-flight response by stimulating the production of stress hormones, namely cortisol, which gives you a temporary boost in energy levels but can also contribute to levels of anxiety, irritability, muscle tension, weakened immunity and insomnia.

Caffeine also inhibits GABA, which can make you feel more anxious. Caffeine can also inhibit the absorption of the hormone adenosine, needed to give you a sense of calmness, which can contribute to sleeping problems.

Better choices to help reduce your anxiety include caffeine-free herbal teas like chamomile, holy basil, passionflower and licorice, which are all great calming and adrenal-nourishing herbals. If you love your coffee, stick to just one. Given that caffeine can stay in your system for eight or more hours, don’t drink coffee or caffeine-containing teas after 2pm so it won’t disturb your sleep. If you make the switch to decaffeinated coffee, make sure it has been filtered out using water, not chemicals.

Keep blood sugar levels balanced

There is a direct link between your mood and blood sugar levels. If your blood sugar levels fluctuate during the day, so too will your mood and energy levels, and this can be a big contributing factor in people with anxiety and depression. Eating a diet high in sugary and “white” processed carbohydrate foods will cause sudden peaks and troughs in the amount of glucose in your bloodstream, which can result in irritability, fluctuating mood, anxiety, tiredness and poor concentration.

The best way to keep blood sugar levels stable is by limiting sugary foods and eating natural, unprocessed foods rich in fibre, including wholegrains (brown rice, whole oats, quinoa), fresh fruits, vegetables and legumes.

Eating smaller meals more regularly and including protein-rich foods with each meal and as snacks are also excellent ways to stabilise blood sugar levels and curb sugar cravings. Healthy protein-rich foods include raw nuts and nut butters, seeds (including quinoa and tahini), chicken, fish, red meat, legumes (hummus), eggs, yoghurt and dairy foods.

Super Nut & Seed Protein Balls

Keep your blood sugar levels balanced with this protein-rich snack.

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Reduce alcohol

Research shows that people with anxiety, in particular social anxiety, are up to three times more likely to abuse drugs and alcohol, which will only end up further exacerbating their anxiety. Drinking excessively can also affect levels of serotonin. When serotonin levels are low, you are more prone to depression and anxiety. It can also increase your heart rate and lead to unstable blood sugar levels and dehydration, which can all trigger bouts of anxiety.

Eat tryptophan-rich foods

Serotonin is manufactured in the body using the amino acid tryptophan. This essential amino acid cannot be produced in the body, so it must be supplied through the diet. Tryptophan is also needed to produce melatonin, which is vital for helping us sleep. Low serotonin levels are linked to depression, anxiety, insomnia and fatigue. Including foods rich in tryptophan in your daily diet is recommended to help treat anxiety; these include turkey, chicken, beef, brown rice, fish, milk, eggs, cheese, nuts, fruit (bananas) and vegetables (peas, pumpkin, potato, corn, spinach).

Tryptophan-Boosting Smoothie

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Probiotic-rich fermented foods

The health of your digestive system is closely related to your emotional state. The gut plays a key role in guarding against developing anxiety and depression-related disorders. A large percentage of our neurotransmitters, such as the feel-good hormone serotonin, are produced in the gut, so if you have an imbalance of bacteria in your gut it can affect your emotional health, too.

Consuming probiotic-rich foods or supplementing your diet with a good-quality probiotic supplement will replenish friendly bacteria in the gut to promote good gut health and support immune function. Antibiotics, other medications, poor diet and prolonged anxiety deplete these beneficial bacteria, leaving room for harmful bacteria to flourish. Excessive harmful bacteria produce by-products that can interfere with neurotransmitter production and can increase the risk of depression and anxiety. Probiotic-rich foods that should be included regularly in your diet include fermented foods like yoghurt, kefir, fermented vegetables (eg sauerkraut) and miso.

Making your own fermented vegetables is extremely easy and cheaper than the bought stuff, and you can experiment with different vegetables and spices. Fermented vegetables are traditionally eaten in many countries around the world, but are unfortunately missing from modern Western diets. Fermented vegetables are highly nutritious foods. When foods are fermented they create beneficial bacteria such as lactobacilli, which enhances the growth of beneficial bowel bacteria. The fermenting process also boosts the vegetables’ digestibility and increases their nutrient content. You only need to add a spoonful of fermented vegetables to your lunch or dinner daily to reap their wonderful health benefits.

Probiotic-rich Fermented Vegetables

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Maca

Maca is a root vegetable native to Peru that has been used for thousands of years as a nutritious food staple. This Peruvian superfood is considered an adaptogen, as it works wonders for improving energy levels and helping you cope with the stressful demands of modern life. Maca therefore can be beneficial for reducing symptoms of anxiety. Maca is also called “Nature’s Viagra”, as it’s best known for its aphrodisiac qualities and ability to improve libido and sexual performance.

Maca contains high levels of B vitamins, which are essential for producing energy and helping the body cope with stress, and is also a good vegetarian source of B12, necessary for healthy functioning nerves. Maca is also beneficial for your bones and for prevention of osteoporosis as it contains calcium and magnesium. Maca powder has a light, nutty flavour, which works well in smoothies, protein balls and sprinkled over breakfast cereal.

Practise mindful eating

Prepare your meals with love and care and think about what you are putting in your mouth. You should always try to eat sitting down when you are feeling calm and relaxed. You should avoid eating too fast or on the go. When you are stressed and running around, your digestion slows down. An important part of healthy digestion that’s often overlooked is chewing your food properly. Digestion actually starts in your mouth: chewing physically breaks down and mixes your food with saliva (which begins to digest carbohydrates). Chewing also signals to the rest of your digestive tract to get ready for food.

Homœopathic remedies for anxiety

Homœopathy is a powerful system of medicine that has been around for over 200 years, widely respected in India, Germany and England and gaining more popularity in Australia. Homœopathy uses thousands of specifically prepared medicines from various natural substances such as plants and minerals, in very small and highly diluted doses. The way these remedies are prepared makes them extremely gentle, side-effect free and highly effective.

Homœopathic remedies work by gently stimulating the body’s own healing powers to treat symptoms and bring physical and emotional balance back to the body. There’s a number of excellent homœopathic remedies commonly prescribed for anxiety:

  • Aconitum napellus Beneficial for treating panic attacks accompanied by a strong sense of fear, even fearing death. This remedy is also recommended for panic attacks with intense palpitations and shortness of breath.
  • Argentum nitricum Use this remedy if you feel extremely anxious before an exam, job interview or performance. You may also have diarrhoea and feel dizzy.
  • Arsenicum album People who do well on this remedy are very anxious, especially about their health; they can suffer from panic attacks and can be obsessive about neatness and have a need to control everything.
  • Gelsemium This is a great remedy for people who suffer from stage-fright or who have a fear of public speaking or crowds. These people get so anxious that they feel paralysed with fear; they feel weak and tremble, perspire and may have diarrhoea.
  • Ignatia amara The person who requires ingnatia is feeling anxious as a result of loss, grief or some stressful emotional event. They are sensitive, moody.
  • Kali phosphoricum Those who are feeling anxious, exhausted and overworked do well on this remedy. They feel overwhelmed and unable to cope; they can be very sensitive and may suffer from insomnia.
  • Natrum muriaticum This remedy is beneficial for anxious people who are very emotional, feel lonely and tend to isolate themselves from others. They can be shy and easily hurt, and will tend to dwell on unhappy things and hold grudges. They prefer to be on their own.
  • Phosphorus Those who will benefit from phosphorus are extremely anxious and very sensitive to their surroundings and those around them. They are very sensitive and sympathetic to others, to the point of exhaustion, and can have intense fears. They feel better in the company of others.
  • Pulsatilla This remedy is specific for those who feel anxious and can be very moody, weepy and clingy. They need constant company and comforting. Women who get anxious and emotional around the time of their periods often do well on this remedy.

Lifestyle changes for beating anxiety

There are many highly effective therapies available to treat anxiety, including psychotherapy and cognitive-behavioural therapies (CBT), as well as lifestyle changes that can help reduce high cortisol levels and relieve anxiety.

Therapy

Cognitive-behavioural therapy is a type of therapy that helps people identify and change unhealthy thinking habits that can cause anxiety. It can teach people how to react differently to situations that trigger anxiety.

Psychodynamic psychotherapy can help explore and resolve deep-seated emotional conflicts, behaviours or traumatic experiences that may be triggering anxiety. It helps people become aware of how the past may be affecting their present behaviour and how they cope with particular situations.

Exercise

Exercise is one of the best ways to alleviate anxiety and depression. It’s vital for maintaining mental health and helping you deal with stress in a healthier way. When your body feels fit and healthy, so does your mind.

There is abundant evidence favouring the positive affects of exercise on mood, alleviating anxiety, boosting self-esteem and helping you sleep and, of course, myriad other health benefits such as cardiovascular care, weight management and social interactiveness.

When you exercise, endorphins and serotonin are released, which are brain chemicals that help ease stress and discomfort and can help improve feelings of anxiety. Regular aerobic exercise has been shown to help stabilise mood and reduce tension. Studies have shown that people who are physically active have lower rates of depression and anxiety compared to people who lead sedentary lives.

Choose a form of exercise you enjoy: anything from walking, swimming, dancing or soccer to surfing. Team sports are great for increasing social interaction, which has been shown to help improve mood and reduce stress levels.

Meditation

Meditation is an excellent way to relax your mind and body. When you meditate it produces alpha brain waves that help promote calmness and relaxation. Meditation has been found to be a beneficial treatment for anxiety. Studies have shown that mindfulness meditation, which involves you focusing your attention, without judgment, on the present moment, can lower cortisol levels. Mindfulness meditation practice for just 25 minutes for three consecutive days can alleviate psychological stress, helping the body to become more resilient under stress.

Laughter

Having a good laugh is another great way to reduce your cortisol levels and lessen anxiety symptoms. Meeting up with friends for a laugh or watching a funny movie is a good remedy when you are feeling anxious.

Lisa Guy

Lisa Guy

Lisa Guy is a respected Sydney-based naturopath, author and passionate foodie with 16 years of clinical experience. She runs a naturopathic clinic in Rose Bay called Art of Healing and is the founder of Bodhi Organic Tea.

Lisa is a great believer that good wholesome food is one of the greatest pleasures in life and the foundation of good health. Lisa encourages her clients to get back to eating what nature intended: good, clean, wholesome food that’s nutrient-rich and free from high levels of sugars, harmful fats, artificial additives and pesticides. Her aim is to change the way people eat, cook and think about food.

Lisa is an avid health writer, being a regular contributor to The Sunday Telegraph's Body and Soul, and leading magazines including WellBeing. Lisa is an author of five books to date, including My Goodness: all you need to know about children’s health and nutrition , Pregnancy Essentials, Heal Yourself, Listen to your Body and Healthy Skin Diet .

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