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Monday, September 27, 2010

Pregnancy and Diet - Facts vs Myths

Pregnancy is a beautiful time in a woman's life and more so because she has the greatest gift from nature to give a new life to this world of ours. When a girl or woman discovers she is pregnant her immediate concern is the welfare of the baby growing within her and so is the concern of people around her be it her family or her husband/ boyfriend or her partner's family or her friends/ neighbors. Often these concerns take shape into things that should be completely avoided and sometimes should be kept minimalistic but of course old school of thoughts are tough to rub off. Today I will discuss the essentials of pregnancy and its diet requirements along with busting the most common myths that have held on for generations especially in the eastern hemisphere.

Changes occurring when you are pregnant - Fertilization by the sperm in the falopian tube occurs after 24 hours of ovulation. Somewhere near 30 hours after fertilization the first cell division or first cleavage occurs which initiates life process. Around the 7-8 days after fertilization the embryo attaches itself to the uterine wall (the stage called nidation occurs) and thus pregnancy in the uterus takes place. This is the beginning of the placenta being formed which releases the human chorionic gonadotropin hormone or HCG that is an indicative for a pregnancy test. It takes another7-8 days for the HCG hormone to give a positive test result. This is the time where 15 days have passed by after fertilization and it is the week later that the next period is missed when the female realizes the possibility of a pregnancy. By the time the pregnancy is usually detected the female is 3- 4 weeks in her pregnancy and the pregnancy  is counted from the first day of the last menstrual cycle for the next 40 weeks.

Getting Fat - During pregnancy the female gains around 25 - 30 pounds of weight of which 7-8 pounds is that of the foetus,  and the rest is composed of placenta, body tissues, amniotic fluid, uterine tissue, blood volume (increases by half the original). The fat deposition that occurs as a natural protection and insulation to the foetus is approximately 7 pounds (around 3.3 kg) which means one need not go into a frenzy of fat loss post pregnancy if the diet is calculated as per BMI and Pre pregnancy birth weight. Some females are grossly under weight when they get pregnant which may cause a life threatening situation for the baby as well as develop nervous disorders or retarded growth of the foetus during pregnancy. Under nourished females are known to have complications like still birth, spinabifida (neural tube defect due to deficiency of folic acid & B12), retarded growth of the baby etc. The ideal weight gain for normal BMI females is 25-30 pounds, low BMI is 30-40 pounds, obesity grade I onwards females should gain around 15 - 20 pounds as the fat is excessive in the body and may also complicate the birth.

How to control excessive fat gain? - It is a very hard habit to break for the eastern world where the family stuffs the pregnant woman or girl with every thing under the earth that would increase her weight in the pretext that it would nourish the baby. If fat food was to nourish the baby every dietitian would be jobless as far as this section is concerned. The energy intake needed to be increased during the second & third trimester is 350 kcal maximum daily. If a woman needs 1800 kcal in her diet pre pregnancy then during her 1st trimester the same diet can continue and 2100 kcal can be started off during 2nd & 3rd trimester.

Diet Overalls - The daily carbohydrate recommendation is around 135 - 150 gm where as the protein is additional 15 gm/ day or 60 - 70 gm/day, restrict fat to 25 % of the daily energy intake. Dietary fiber should be around 25 gm/ day to avoid constipation & hemorrhoids that are caused as a side effect to pregnancy. Make sure that your diet is rich in nutrients like folic acid (600mcg/ day), vitamin B12, B6, B1, B2, B3, vitamin C, Vitamin E and under recommended dietary allowances for Vitamin A (750 mcg/day for under 18 years & 770 mcg/day 19 years and older). Women who have taken higher Vitamin A during pregnancy have know to have birth defects in the foetus especially neural tube defects. The myth about not eating papaya during pregnancy has this as its reason. There is no harm in eating papaya during pregnancy provided it falls inside the vitamin A RDA. Alcohol and caffeine should be completely avoided during pregnancy as these are potent drugs harming the foetus growth and causes still birth.

Hopefully this gist of Diet for pregnancy would have sorted some of the many myths & misunderstandings with regards to the subject. It is a time to cherish but do it well organized and glow in the beauty of it. For more detailed diet consultation contact at Wellness & I.

Wish you wellness.


Tuesday, September 21, 2010

Nutritional Therapy for Anorexia Nervosa & Bulimia Nervosa




Previously we saw through the symptomatology of the two most prevalent eating disorders amongst females anorexia nervosa and bulimia nervosa. Today we look at how we approach their treatment nutritionally. To begin with we need to understand what is the immediate call to action in rehabilitating an eating disorder patient. While counselling a patient it is important to understand the energy intake through the day by analyzing an average weekly diet recall.

Energy Intake - Be sure of it that the patient is extremely cautious of how many calories are consumed and what is their daily intake, therefore you must account for everything that they could be telling you. In anorexic patients who refrain from receiving any treatment escalate their caloric intake so to give an impression that they are eating well in which case one must judiciously gauge a week to week diet history. In taking the caloric intake of a bulimic patient we must first calculate an average calories on a restrictive phase and then calculate the purging phase separately. Now how we get to the reality of the energy intake on binge-purge phase is by accounting the food that doesn't come out. Bulimia patients think that while purging they remove all the food out where as the truth is only half of the food is thrown out or sometimes nearly half. Which brings us to the e.g. that if on a binge the patient ingested 2000 Kcal of food then after the purge approximately 1000 Kcal can still be accounted for in the energy intake. While calculating the binge phase energy intake first see how many binges have there been in a week or month then calculate the total caloric intake on a binge day and account for half of it then take the average intake per day along with restrictive diet days.

Carbohydrates - Malnourishment is the obvious effect of the eating disorders and although bulimia doesn't leave the person looking malnourished the constant purging leaves the gastrointestinal canal devoid of its good microorganisms and its tissue layer which secrets enzymes for digestion and also helps in absorbing the nutrients. By regular purging the cell layer sloughs off leaving the body malnourished as the nutrients do not get absorbed in the intestine. Due to the low carbs fixation common amongst anorexic patients the rehabilitation must account for lactic acidosis in the body, ketoacidosis, elevated serum amino acids and hypoglycemia. It should also be considered that due to constant starvation or binge eating the insulin secretion has been continuously tampered with and thus a very careful increase in the carbohydrate content should be taken. In patients with bulimia who undergo repeated purging could have esophageal bleeding which cannot allow roughage and hence low fiber carbohydrate should be included in the rehabilitation process. If fiber could be allowed then fruits rich in vitamins like E, C, and A should enrich the diet to reduce the oxidative stress developed int he body due to anaerobic respiration, mental stress, and substance abuse that occurs during reduction of body weight. So as to not set the insulin levels ballistic and also to provide as much energy in little food that gets ingested during initial stages, a frequent yet small quantity of simple carbohydrates rich in nutrients should be added such as dried figs, fruit pulp, sorbets, cottage cheese on small toasts, etc.

Protein - The muscle and tissue have been wasted to provide the body with some energy source and derive vitamins and minerals as they lack from the scanty food ingested. For binge - purgers there is a lot to deal with since they have corroded their teeth along with anorexics who have brittle fragile hair with scaly skin and fragile bones have a long way to sail till they rejuvenate their whole body with good protein that would heal, repair, build & strength the body frame to flesh all over. High biological value protein is the most essential in these cases as the intestinal aborption has been reduced and more over easily absorbed proteins would rehabilitate the body of its lost stores of essential amino acids, key building blocks in repair, immunity, strength. Proteins that like meat, veal, offal, seafood (shell & mollusks) even poultry and pulses should be given a wait for a while till the dairy, tofu, egg and fish (very little). In eating disorder s the kidney function does get affected as the body is dehydrated, filled with toxins, or on only protein diet. It becomes important to give protein in the diet based on the renal profile of the patient.

Fat - Well it will be a task to get a patient of an eating disorder to ingest fat in their diet but since we need to rehabilitate sparing the liver that has been over worked due to all the toxins, protein wasting and glucose deprivation, best suited fat could be with medium chain fatty acids or clarified butter, butter, dairy fat. Well one can also look at inherent essential fatty acids for immunity, repair and antioxidants by supplementing the diet with nuts and dried fruits as well as steamed or grilled fish. Fat in the diet will spare the proteins to be wasted and give the body lubrication, insulation, skin repair, protection against heart disease and gastric complications. Since the body is frail and so is the heart of the anorexic patients it would be advisable to stick to omega 3 rich fat source like vegetable oils.

Now the best thing you can do if you have anyone close to you who needs rehabilitation from an eating disorder is to make sure when they are rehabilitated in a 24 hour center and be given extreme love and support as they need it. For more information about your health related consultation please do fill out the contact form on top of the page.

Wish you wellness.


Friday, September 3, 2010

What does the brain have to do with hunger pangs?

Ever wonder how come you get hungry at the precise time everyday? Or how you end up gorging on the wrong food aka Fat Diet or Sugar Diet when you are ravenously hungry and can't seem to decide what is right food from the wrong one. When you lengthen your hunger signal do you end up eating more than you would have if you hadn't ? The answer to your curiosity is very simple and precisely the fact that if you wish to lose weight by fooling your body into starvation better watch out for the backfire in the strategy because your body is much more smarter than you think. Today I will unleash the truth of your vicious cycle from curbing food or wrong food and ending up more fat than you were.

Impulse Diet - The brain controls hunger because it has the control center for it which is in the hypothalamus situation below the mid-brain and above the brain stem. It basically controls hormonal secretions of the body but also is a center for pleasure, pressure, thirst, hunger. Now what exactly does it do to make us hungry and to stop us from eating. Neurologically speaking the nuclei for stimulating hunger sends the impulse to the Gastrointestinal system to send the body hunger stimulus and in extreme cases hunger pangs. The head feels lighter and geedy because it is the decrease in brain glucose level that instigates the nuclei in the hypothalamus. The blood glucose being less for the brain to utilize it any further leads it to send out hunger signals to the body to start eating and increase the glucose level in the blood. Thereby if you miss out on the hunger signals initially the body becomes impatient to increase glucose levels and tends you to go for anything that is available at that moment. Whenever you starve or delay your meal time for any reason you will either eat high sugar or high fat food due to the desperation of your body to fill it with fuel or you will tend to over eat the right food which is also not recommended for fat loss program or weight management.

Traffic Signal for hunger - Now that we know how we get hungry we need to know how does the brain stop us from eating any more. When you are ingesting food there is a hormone called CCK or cholecystokinin  which literally means 'bringing the bile from the gall bladder', now what CCK does is it slows down the passage of the food from stomach into the duodenum for proper digestion of fat and protein in the small intestine. Once it slows the gastric emptying it slowly gauges the amount of food entering the intestine and sends signals to the hypothalamus to send out an impulse of satiety or fullness. When you experience satiety you tend to stop eating and the body makes you realize the physical load in your stomach and intestine so as to stop you from eating anymore. Also the fat cells in the body release the hormone leptin to indicate the brain to stop eating and start burning the fat for fuel. CCK also inhibits ghrelin the hormone that stimulates hunger in the stomach. Now of course you'd want to know if this mechanism of stop signal exists in our body how come we overeat and don't feel fullness once adequate food has been ingested. When you et fast due to extreme hunger or starvation you will eat large portions of food in lesser time. The faster and greasier you eat the faster the passage of the food from stomach to small intestine and the later it takes CCK to slow down emptying of the stomach into the intestine. If CCK acts upon late due to the speed and quantity of food ingested in lesser time then you miss out on the satiety que as they come later when you have over done eating already. During weight loss you are always advised not to skip meals and eat slowly this is your reason - Satiety Que. People who have high fat food have faster gastric emptying than those who have good amount of fiber and who chew their food well, because the fiber slows the emptying as well as chewing properly helps in giving out proper signals from the gastric system to the brain inorder to stop eating.

So now you know how and why you must listen intently to your hunger and satiety que to lose weight or maintain it through life. For fat loss program contact at Wellness & I.

Wish you wellness.


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