Broccoli

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The greener the vegetables, the better for your body. Broccoli is a great snack you can eat raw, or steamed. It lowers cholesterol, gets rid of toxins and is packed with vitamin D, vitamin A and vitamin K. If you’re busy, you’re better off packing raw broccoli florets in a bag, and eating them on the go.

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Good Fat vs Bad Fat

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Healthy Fats

Eating healthy fats, in moderation, during weight loss fulfills your dietary fat needs without increasing your chronic disease risks. Examples of heart-healthy fats include plant-based oils — such as olive, canola, walnut, soybean and flaxseed oils — nuts, seeds, nut butters, avocados and olives. Nuts and seeds are rich in heart-healthy fats as well as fiber and protein, which increase satiety more than carbs or fat, so they are an ideal choice when you’re trying to shed pounds.

Fats to Avoid

Bad fats are those that increase your chronic disease risk when consumed in excess. These include saturated animal fats — found in butter, lard, whole milk, ice cream, cream, cheese and high-fat meats like bacon. Plant-based fats that have been hydrogenated and contain trans fat — found in margarines, shortenings, fried foods and commercial baked goods — also increase your risk for heart disease, so avoid them when you’re trying to healthfully lose weight.

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Beating your Sugar Cravings

Barlene-Sweet-Tooth

Make a low-sugar meals

Swap breakfast cereal for oats and try adding fruits such as bananas or berries as a sweetener.

Eat small and often

This means three meals and two snacks, so try having something on hand mid-morning, mid-afternoon.
A handful of almonds or some vegetables should do the trick.

Increase your intake of Vitamin C

Some studies have shown that a very high intake of Vitamin C, helps reduce blood sugar levels and lowers the damaging effects of sugar.

Stay away from caffeine

You might have decided coffee was to be your crutch while you kicked sweets, but caffeine also disrupts blood-sugar balance. Instead drink green tea it has antioxidants that will help repair any damage done by yo-yoing blood sugar levels.

Use sugar replacements

Work out the times of day you eat something sweet and replace it with something less sugary. For example: a punnet of strawberries has the same effect on your blood-sugar levels as 10 raisins, or one date. Xylose, the sugar in berries, is available in supermarkets as xylitol. You can add this to hot drinks or porridge and bake with it. Manuka honey is a great replacement for refined sugars as well.

Supplement help

Once you’ve balanced your blood sugar, you need to make sure insulin is working as it should. Cinnamon supplements will help with this. Tryptophan can help reduce sugar cravings (take 200mg a day) and tyrosine will help you deal with the low moods and flatness in the initial stages (take 500mg twice a day, but none too late in the day to avoid disrupting sleep).

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Poor Nutrition Symptoms

Junk Food Pyramid

There has been much research and many theories into the link between diet and disease.

Any of the following, may indicate poor nutrition in a human.

-Obese people often experience breathing difficulties.

-Backache may occur as a result of obesity.

-Too much food, particularly fat and carbohydrates, will lead to obesity. Too little food will cause wasting of the tissues and ultimately starvation. Failure to thrive in children may be a sign of marasmus (too little energy intake) or kwashiorkor (too little protein and energy intake).

-Heart disease can occur as a result of obesity, and heart failure may be a result of extreme anorexia nervosa as the balance of electrolytes is disturbed.

-Softening of the bones may be a sign of rickets (lack of vitamin D).

-Loss of motor function in the legs may be a sign of beriberi (lack of vitamin B1, or thiamine).

-Lesions in the spinal cord may be a sign of vitamin B12 deficiency.

-There are a number of conditions affecting the stomach and digestive system as a result of diet.

-Symptoms may include diarrhoea, nausea, vomiting, pain and cramps.

-Stones may form in the kidneys as a result of insufficient fluid; obese people may be prone to kidney failure.

-Adrenal glands may enlarge as a result of pantothenic salt deficiency (related to the B vitamins).

-The formation of gallstones is associated with a fatty diet.

-Too much alcohol may cause cirrhosis of the liver.

-Insufficient iron will cause anaemia.

-Constipation can be caused by lack of fibre in the diet.

-Piles (haemorrhoids) may also be a result of lack of fibre.

-Swelling and painful feet may be a sign of vitamin B12 deficiency.

-Numbness in the toes may be a sign of vitamin deficiency.

-The hair may become dull and brittle, or it may fall out or change colour.

-Headaches may be related to vitamin deficiency.

-Night blindness may arise from lack of vitamin A.

-The tongue may become inflamed as a result of a number of vitamin deficiencies.

-Bleeding gums may be a sign of scurvy (vitamin C deficiency).

-Enlargement of the thyroid gland (goitre) may be linked to iodine deficiency.

-Rashes, itching, soreness, scaliness and cracking of the skin may be a sign of a number of vitamin deficiencies.

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How Can I Get Enough Protein? The Protein Myth

Protein

The Building Blocks of Life

Protein is an important nutrient required for the building, maintenance, and repair of tissues in the body. Amino acids, the building blocks of protein, can be synthesized by the body or ingested from food. There are 20 different amino acids in the food we eat, but our body can only make 11 of them. The 9 essential amino acids, which cannot be produced by the body, must be obtained from the diet. A variety of grains, legumes, and vegetables can also provide all of the essential amino acids our bodies require. It was once thought that various plant foods had to be eaten together to get their full protein value, otherwise known as protein combining or protein complementing. We now know that intentional combining is not necessary to obtain all of the essential amino acids.1 As long as the diet contains a variety of grains, legumes, and vegetables, protein needs are easily met.

Protein Requirements

With the traditional Western diet, the average American consumes about double the protein her or his body needs. Additionally, the main sources of protein consumed tend to be animal products, which are also high in fat and saturated fat. Most individuals are surprised to learn that protein needs are actually much less than what they have been consuming. The Recommended Dietary Allowance (RDA) for protein for the average, sedentary adult is only 0.8 grams per kilogram of body weight.2

To find out your average individual need, simply perform the following calculation:

Body weight (in pounds) X 0.36 = recommended protein intake (in grams)

However, even this value has a large margin of safety, and the body’s true need is even lower for most people. Protein needs are increased for women who are pregnant or breastfeeding. In addition, needs are also higher for very active persons. As these groups require additional calories, increased protein needs can easily be met through larger intake of food consumed daily. Extra serving of legumes, tofu, meat substitutes, or other high protein sources can help meet needs that go beyond the current RDA.

The Problems with High-Protein Diets

High-protein diets for weight loss, disease prevention, and enhanced athletic performance have been greatly publicized over recent years. However, these diets are supported by little scientific research. Studies show that the healthiest diet is one that is high in carbohydrate, low in fat, and moderate in protein. Increased intake of whole grains, fruits, and vegetables are recommended for weight control and preventing diseases such as cancer3 and heart disease.4 High-carbohydrate, low-fat, moderate-protein diets are also recommended for optimal athletic performance.5 Contrary to the information on fad diets currently promoted by some popular books, a diet that is high in protein can actually contribute to disease and other health problems.

Osteoporosis

High protein intake is known to encourage urinary calcium losses and has been shown to increase risk of fracture in research studies.6,7 Plant-based diets, which provide adequate protein, can help protect against osteoporosis. Calcium-rich plant foods include leafy green vegetables, beans, and some nuts and seeds as well as fortified fruit juices, cereals, and non-dairy milks.

Cancer

Although fat is the dietary substance most often singled out for increasing one’s risk for cancer, animal protein also plays a role. Specifically, certain proteins present in meat, fish, and poultry, cooked at high temperatures, especially grilling and frying, have been found to produce compounds called heterocyclic amines. These substances have been linked to various cancers including those of the colon and breast.8-10

Long-term high intake of meat, particularly red meat, is associated with significantly increased risk of colorectal cancer. The 1997 report of the World Cancer Research Fund and American Institute for Cancer Research, Food, Nutrition, and the Prevention of Cancer, reported that, based on available evidence, diets high in red meat were considered probable contributors to colorectal cancer risk. In addition, high-protein diets are typically low in dietary fiber. Fiber appears to be protective against cancer.3 A diet rich in whole grains, fruits, and vegetables is important in decreasing cancer risk,3 not to mention adding more healthful sources of protein in the diet.

Impaired Kidney Function

When people eat too much protein, it releases nitrogen into the blood or is digested and metabolized. This places a strain on the kidneys, which must expel the waste through the urine. High-protein diets are associated with reduced kidney function. Over time, individuals who consume very large amounts of protein, particularly animal protein, risk permanent loss of kidney function. Harvard researchers reported recently that high-protein diets were associated with a significant decline in kidney function, based on observations in 1,624 women participating in the Nurses’ Health Study. The good news is that the damage was found only in those who already had reduced kidney function at the study’s outset. The bad news is that as many as one in four adults in the United States may already have reduced kidney function, suggesting that most people who have renal problems are unaware of that fact and do not realize that high-protein diets may put them at risk for further deterioration. The kidney-damaging effect was seen only with animal protein. Plant protein had no harmful effect.11

The American Academy of Family Physicians notes that high animal protein intake is largely responsible for the high prevalence of kidney stones in the United States and other developed countries and recommends protein restriction for the prevention of recurrent kidney stones.12

Heart Disease

Typical high-protein diets are extremely high in dietary cholesterol and saturated fat. The effect of such diets on blood cholesterol levels is a matter of ongoing research. However, such diets pose additional risks to the heart, including increased risk for heart problems immediately following a meal. Evidence indicates that meals high in saturated fat adversely affect the compliance of arteries, increasing the risk of heart attacks.13 Adequate protein can be consumed through a variety of plant products that are cholesterol-free and contain only small amounts of fat.

Weight Loss Sabotage

Many individuals see almost immediate weight loss as a result of following a high-protein diet. In fact, the weight loss is not a result of consuming more protein, but by simply consuming fewer calories. Over the long run, consumption of this type of diet is not practical as it can result in the aforementioned health problems. As with any temporary diet, weight gain is often seen when previous eating habits are resumed. To achieve permanent weight loss while promoting optimal health, the best strategy involves lifestyle changes including a low-fat diet of grains, legumes, fruits, and vegetables combined with regular physical activity.

Protein Checklist

High protein diets are unhealthy. However, adequate but not excess amounts of protein to maintain body tissues, including muscle, are still important and can be easily achieved on a vegetarian diet. If you are uncertain about the adequacy of protein in your diet, take inventory. Although all protein needs are individual, the following guidelines can help you to meet, but not exceed, your needs.

* Aim for 5 or more servings of grains each day.This may include 1/2 cup of hot cereal, 1 oz. of dry cereal, or 1 slice of bread. Each serving contains roughly 3 grams of protein.
* Aim for 3 or more servings of vegetables each day. This may include 1 cup of raw vegetables, 1/2 cup of cooked vegetables, or 1/2 cup of vegetable juice. Each serving contains about 2 grams of protein.
* Aim for 2 to 3 servings of legumes each day. This may include 1/2 cup of cooked beans, 4 oz. of tofu or tempeh, 8 oz. of soymilk, and 1 oz. of nuts. Protein content can vary significantly, particularly with soy and rice milks, so be sure to check labels. Each serving may contain about 4 grams to 10 grams of protein. Meat analogues and substitutes are also great sources of protein that can be added to your daily diet.




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What does a healthy diet look like?

Food Pyramid

What you should be looking for in a healthy long term diet.

• Consists primarily of fresh, unprocessed plants (fruits, vegetables, nuts and seeds) which can be made into a variety of delicious recipes (raw food chefs are especially good at this craft).

• Minimizes consumption of meat or animal products (including dairy).

• Avoids virtually all processed, manufactured foods and beverages, or only uses them sparingly.

• Consists of a wide variety of different foods so that phytonutrient diversity is high, providing consumers with a steady supply of plant-based medicine that prevents disease.

• Includes substantial time outdoors, in nature, where vitamin D can be created and stored in the body.

• Minimizes or eliminates all refined sugars and carbohydrates (like white flour).

• Eliminates GMOs from the food supply in order to avoid the health damage caused by GM foods.

• Minimizes consumption of foods sprayed with chemical pesticides or fungicides. This not only helps prevent disease caused by such chemicals; it also protects the environment from chemical contamination.

• Incorporates adequate hydration from clean water (while avoiding dubious liquids such as sodas and sports drinks).

• Includes nutritional supplementation to correct nutritional imbalances or deficiencies. (This can be accomplished through superfoods, food-based vitamins, etc.)

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Great Tips for Keeping Fat Away

Fat Away

1. Drink more coffee or tea.

If caffeine does not bother you then have a little coffee or tea in the morning to give you a boost to get you started in your day!

2. When on vacation, try to exercise.

When on a vacation try to get some exercise each day to help you burn off those excess calories you consume and help you not feel so guilty when you get home.

3. Keep you carbs low, but your protein high!

You do not want to cut carbs out altogether, because you will need them for energy. Just choose from healthy complex carbs such as sweet potatoes, brown rice, whole grain bread, and veggie pastas! Choose from chicken, turkey, white pork, lean red meat, fish, and egg whites for your lean meat and low-fat protein choices.

If you want to try some low-carb protein bars.

4. When you eat out, go lean.

When you do have to eat out get a lean meat and veggie meal and no fries, smothered potatoes, fried chicken and gravy or greasy burgers!

5. Get 8 hours of rest per night. Take a nap if needed.

Make sure you get at least eight hours of rest per night and a half hour to an hour and a half nap in the afternoon preferably! This will keep you immune system strong and help you be stronger and livelier throughout your day!

6. Eliminate stress.

Keep stress to a minimum so you will not gorge yourself with food to help you deal with stressors in your life!

7. Keep an active social life.

Keep an active social life so you will not stay around the house all the time and be tempted by food constantly.

8. Eat 5 – 6 small meals a day.

Always try to eat at least five to six small meals per day to help you keep your metabolism running high. Never miss meals because that would slow your metabolism down and you will store more fat!

9. Do yard work to burn extra calories.

Get out and do some good old yard work to burn some extra calories!

Buy a push mower instead of a riding mower to get some more exercise!

10. Make your healthiest meal, your last one!

Make your healthiest meal of your day the last one before bed, which is usually dinner. Try to have a lean white meat and a green vegetable! No carbs and no sugars would be a great idea since your body is slowing down for the day and you have that eight hours of sleep in front of you!

11. Cut back on sugar!

12. Take walks or perform other types of cardiovascular activities at least twenty to thirty minutes per day!

13. Walk more.

Do not park up-close to a store when you can park a little farther away to burn more calories walking in!

14. Take the steps instead of the elevator or the escalator!

This will help you to get your blood flowing and burn some extra fat!

15. Start a weight-training program on your own or with a trainer!

Try to start with a total body routine two to three times per week with 10-15 repetitions. Make sure to stretch often to improve you flexibility and improve circulation. Weight training will give you added muscle which will help you burn fat all day even when you are sleeping!

16. Drink more water!

Staying hydrated is important to having a healthy immune system, healthy skin, and a quicker responding, less cloudy brain.

17. Know The Facts.

Know what kind of calories you are eating by cooking and preparing your own meals instead of getting take-out or eating out! Who knows what you get when you eat at a buffet!

18. Cut back on fats.

Cut back on saturated fats such as fat from red meat and greasy or fried foods!

19. Don’t Believe Everything You See.

Stop believing in FAT-FREE foods because most of them have hidden fats, which are synthetic or fake fats that actually hurt you more than ordinary saturated fat! These bad fats are called trans fatty fats or hydrogenated oils/fats!

20. Eat in moderation!

Too much of any food will be too much for your body to use for energy, so it will be stored as fat! Listen to you body and when it says it is satisfied it means it!

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Protein Shakes or Real Food?

ProteinShakeorRealfood

Regardless of what many ads tell you, protein shakes do not offer any muscle building benefit, nor “secret muscle building ingredient”, above and beyond what real food offers you. Yes, I have read the ads too with all sorts of speedy muscle building promises but I can assure you through experience that most of the ingredients advertised as miraculous have not been proven to work neither by science (even though most ads of this nature usually talk about research studies that usually do not exist) nor by actual results at the gym. These products however have been proven beyond the shadow of any scientific doubt to shrink the size of your wallet and bank account.

In addition, real food has what is called a “thermic effect”. A “thermic effect” is the impact that real food has in your metabolism. Because real food requires digestion, your body burns more calories in processing it; as opposed to shakes which are already pre-digested.

There are so many nutrients that real food contains, many of which have not even been discovered yet, that you would be doing yourself a disservice by limiting the amount of real food that you are eating.

What protein shakes do offer the bodybuilder and fitness enthusiast is a convenient way to ingest your protein, thus allowing you to have your five to six meals every day without having to ingest real food in all of them. In addition, the best protein shakes in the market offer a protein blend of different sources of protein, something that introduces amino acid variety into your bodybuilding diet, thus making your diet more complete. However, do not ever think that protein shakes are superior to food.

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Pregnancy Nutrition

During pregnancy the body is going though many changes and as result nutrition is of most importance during this time. As an example, in Canada there are specific programs (e.g., The Canada Prenatal Nutrition Program (CPNP)) that are targeted to vulnerable pregnant women which typically provide food supplements and individualized counselling. The CPNP aims to reduce the incidence of unhealthy birth weights, improve the health of both infant and mother and encourage breastfeeding. The general consequences of malnutrition during pregnancy include:

• Fetal growth retardation
• Congenital malformations
• Miscarriage and stillbirth
• Premature birth
• Low infant birthweight

Malnutrition and low birth weight contribute to over 50% of deaths of children under the age of 5 worldwide. To support the changes in pregnancy and the growth of the baby, more nutrients and calories are needed. In addition, there are a variety of other nutrition-related concerns that can occur during pregnancy and can be effectively managed. These are discussed in further detail.

First, we begin with an overview of pregnancy

Placental Development

The placenta develops in the early stages of pregnancy. The amniotic sac and umbilical cord also develop in the early stages. These three structures play critical roles during pregnancy and are expelled from the uterus after childbirth. The placenta is a spongy tissue in which fetal and maternal blood each flow side by side, each in its own blood vessels. Maternal blood transfers oxygen and nutrients to the fetus’ blood and picks up fetal waste products. The placenta plays the roles of the lungs, kidney and digestive system for the fetus. It is a metabolically active organ that requires energy and nutrients. The placenta also produces hormones that maintain the pregnancy and prepare the mother’s breasts for lactation.

Fetal Growth and Development
Fetal development begins with the fertilization of the egg (ovum) and goes through three stages:

1. Zygote
The fetus begins as a single cell and becomes multi-cellular. Within 2 weeks the zygote embeds itself in the uterine wall in a process called implantation. As development proceeds, the zygote becomes an embryo.

2. Embryo
At first, the number of cells in the embryo double every 24 hours then the rate slows down. At 8 weeks, the embryo is 30 mm in length and has a complete central nervous system, a beating heart, a digestive system, well defined fingers and toes and the beginnings of facial features.

3. Fetus
The fetus is a developing infant from 8 weeks on and is full term at 38 weeks. Fetal growth is amazing – going from < 1 g to 3500 g (7.5 pounds- on average) during that time. Critical Periods are times of intense development and rapid cell division. They are critical in that an event can only occur then. If adversely influenced at this point, development is permanently impaired. Each organ and tissue is most vulnerable to adverse effects during its own critical period. For example, the neural tube forms the beginning of the brain and spinal cord. Its critical period is from 17 - 30 days of gestation. During this time neural tube development is most vulnerable to nutrient deficiencies or toxins. At this point, many women do not know that they are pregnant and abnormal development of the neural tube or failure of it to close completely can cause a major defect in the central nervous system. This is referred to as a neural tube defect. The most common neural tube defects are anecephaly (a fatal condition characterised as a partial absence of brain tissue) and spina bifida (incomplete closure of the spinal cord). With spina bifida (latin for 'open spine'), there are varying degrees of paralysis, depending on the extent of the spinal cord damage. Common problems of spina bifida include club-foot, dislocated hip, kidney problems, muscle weakness, impaired mental abilities, motor and sensory losses. Mild cases may not even be noticed but severe cases can result in death. The addition of folic acid to the diet of women of child-bearing age (approximately 14 to 45 years) may significantly reduce, although not eliminate, the incidence of neural tube defects. It is estimated, however, that 70% of all NTDs could be prevented simply by consuming enough folate. As previously indicated in the preconception nutrition notes, it is recommended that all women of child-bearing age consume 0.4 mg of folic acid daily, especially those attempting to conceive or who may possibly conceive. It is not advisable to wait until pregnancy has begun, since by the time a woman knows she is pregnant, the critical time for the formation of a NTD has usually already passed. Grain products are fortified with folate and adequate folate intake is estimated to reduce NTD by 50%. There is however, the risk of masking B12 deficiency. NUTRITION-RELATED CONCERNS The nutrition issues in pregnancy related to weight status, macronutrient needs, micronutrient and fluid needs and common conditions that arise in pregnancy that can affect nutrition. These are discussed in further detail. 1. Energy Needs and Weight Status

Birthweight is the most reliable indicator of an infant’s health. Generally, higher birth weights indicate less health risk for infants. The mother’s pre-pregnancy weight and weight gain during pregnancy may affect birthweight of the infant.

Underweight Women

Underweight women (BMI < 18.5) tend to have smaller babies than heavier women. A woman who is underweight prior to pregnancy is at risk for a low birthweight baby (<3500 grams) particularly if she is not able to gain adequate weight during pregnancy. The rates of preterm births and infant mortality are higher and extra weight gain during pregnancy (recommended range of weight gain is 12.7 to 18.2 kg or 28 to 48 lbs) is recommended. Overweight or Obese Women

Overweight (BMI 25.1 to 29.9) or obese (BMI => 30) women have an increased risk of complications during pregnancy and childbirth such as hypertension and gestational diabetes. Overweight women tend to have more induced labor and C-sections. Infants are more likely to be born post term and weigh more than 4 kg (9 pounds). Weight loss diets are not advisable during pregnancy as good nutrition is important as well as some weight gain (recommended range of 6.8 to 11.4 kg or 15 to 25 lbs). It is recommended that, women reach a healthy weight prior to becoming pregnant and avoid excess weight gain during pregnancy.

Healthy Weight

The ideal pre-pregnancy weight range should fall within a BMI of 18.5 to 25. Weight gain during pregnancy is necessary, and a gain of 11.5 – 14 kg (25 – 30 pounds) is recommended. If the mother is expecting twins weight gain should range between 16 to 20 kg (35 to 40 lbs).

This distribution of weight gain is outlined in Table 1.

The norm is to gain 1-2 kg (2-4 pounds) in the first trimester and 0.5 kg (1 pound) per week thereafter.

Table 1: Weight Gain in Pregnancy
Blood 2 kg
Breasts 1.5 kg
Placenta 0.5 kg
Amniotic Fluid 1 kg
Baby 4.5 to 5.5 kg
Extra fat stores 2.5 to 3.5 kg

Most women generally lose the weight after pregnancy. Although, some women may still look pregnant, there is some weight loss immediately at delivery. There continues to be a loss of blood volume and fluids over several weeks. Most women tend to return to a weight slightly above their prepregnancy weights.

2. Macronutrient Needs in Pregnancy

During the 1ST trimester the body requires an extra 100 kcal/day. During the 2nd and 3rd trimesters this increases to an extra 300 kcal/day. Nutrient needs expand more than energy needs so the mother needs nutrient dense foods. Protein needs increase of 5 g, 20 g, 25 g per day in each trimester is needed. Protein needs are easily met. Carbohydrate intake should be at least 130 g per day to prevent ketosis. Requirements for fat do not change; however, it is important to note that the essential fatty acids are a key nutrient required in pregnancy.

Docosahexaenoic (DHA), an omega 3 fatty acid is critical to brain and eye development. Good sources are coldwater fish and it is generally recommended that pregnant women can safely consume 340 g (12 ounces) of fish per week to avoid mercury contamination. Large fish like swordfish, shark, fresh or frozen tuna, and marlin as well as canned tuna from the large “Albacore” or “Bluefin” species (often labelled as “White”) should be avoided in pregnancy.

3. Micronutrient and Fluid Needs in Pregnancy

The key nutrients during pregnancy include folate/folic acid, vitamin B-12, vitamin C, vitamin A, vitamin D, calcium, iron, zinc, and iodine.
Folate and vitamin B12 are needed for cell division. The recommended intake for folate, more than doubles in pregnancy (RDA is 600 mcg/day). Dietary sources should be emphasized although supplements are usually recommended. There is a slight increase in B12 needs. In diets that contain animal products, it is not a problem to obtain adequate amounts.

Insufficient intake of vitamin D and calcium may result in abnormal fetal bone development. Adequate vitamin D is usually obtained from milk and sunlight. Vegetarians who do not eat milk, eggs and fish must get vitamin D from the sun or fortified soy milk as there is an increased risk of toxicity with supplements. The RDA for vitamin D during pregnancy is 5 mcg/day. Calcium absorption, more than doubles during pregnancy. Fetal bones begin to calcify in the last trimester. In the final weeks of pregnancy more than 300 mg of calcium is transferred each day. Calcium needs are met with an adequate intake of milk and dairy and other calcium rich foods or supplements. The DRI for calcium during pregnancy is 1300 mg/day for women <18 and 1000 mg/ay for women 19-50 years. More iron is needed to support the increased maternal blood volume and for placental and fetal needs. There are changes that help meet iron needs. Periods stop, iron absorption increases (3 times) and transferrin levels increase. Anemia often occurs at the beginning of the second trimester and can mask as simply "pregnancy fatigue." It is common for physicians to test hemoglobin status at this point in the pregnancy. The fetus draws on maternal iron stores to lay its own stores for the first 6 months as milk is the only food and it is low in iron. Women tend to have low iron stores so iron supplements are recommended. Hemoglobin should be tested at the beginning of the pregnancy to determine iron stores. Zinc is required for DNA and RNA synthesis and a low zinc status leads to low birthweight. Zinc supplements are not generally recommended. Vitamin A needs in pregnancy increase from 700 to 770 mcg/day. Women taking a prenatal supplement should be advised not to take more than 10,000 IU per day of Vitamin A. This could increase the risk of birth defects. Provitamin A (beta-carotene converted to vitamin A in the body) has not been associated with birth defects. Vitamin C requirements increase by 10 mg/day in pregnancy in order to produce collagen.Lastly, iodine needs increase from 150 mcg to 220 mcg/day and is easily achieved through the diet. The AI for total fluid intake is 3 L per day of nondiuretic fluid (e.g., water, soups, juices, milk and sport beverages). This helps to prevent fluid retention, constipation and urinary tract infections. Nutritional SupplementsMost women take a daily prenatal multivitamin and mineral supplement (e.g. 'Materna' contains 1 mg folate and 30 mg iron). The needs for most nutrients except for iron are easily met with a varied diet. 4. Other Common Nutrition-Related Concerns During Pregnancy

There are some common discomforts and disorders of pregnancy women that are related to their general nutrition.

Nausea and Vomiting

Nausea can be mild to severe and is referred to as ‘morning sickness’. Women with severe nausea and vomiting (hyperemesis gravidarum) are at risk for dehydration, electrolyte imbalances, abnormal metabolism and weight loss. Fifty to eighty percent of pregnant women experience nausea and vomiting; about one percent suffer severe symptoms. It seems to be relate to hormonal changes. The best way to counteract nausea is to eat dry crackers, ginger, have small, frequent meals and avoid offensive odours.

Constipation and Hemorrhoids

Constipation affects 11 to 38 % of pregnant women. Dietary and lifestyle changes usually correct it.Constipation during pregnancy is linked to several physiological changes associated with pregnancy and an eating pattern low in fibre and liquids. The hormones of pregnancy alter muscle tone and absorption of water from the colon, the growing fetus pushes on internal organs. Ways to overcome these problems are to increase fiber intake, drink plenty of water, exercise and use the bathroom frequently. Decreased physical activity, extra bed rest and iron supplements may also contribute to this common discomfort.Increase fibre intake by eating more whole grain breads and cereals; vegetables; and fruit and legumes such as beans, split peas and lentils as well as drinking between 8 and 12 cups of fluid every day in the form of water, milk and juice may help. Maintaining an active lifestyle, for example, by walking or swimming regularly can also prevent this problem.

Heartburn

Heartburn is caused by gastric reflux. Reflux is more likely to happen during pregnancy because the enlarging uterus presses on the stomach and can force stomach contents up into the esophagus. To prevent heartburn consuming small, frequent meals, avoiding spicy and greasy foods, sitting up while eating, sleeping with the head of the elevated, and waiting an hour after eating before lying down are general suggestions that are provided.

Food Cravings and Aversions

These are likely related to hormone-induced changes in sensitivity to taste and smell. Pica, the craving for non-founds such as clay can be a concern.

Preexisting Diabetes

It is best to get diabetes under control before becoming pregnant. Poor control can also result in decreased fertility. Being hypo- or hyperglycemic, or having hypertension can result in miscarriage.

Gestational Diabetes

Approximately 1 in 25 women develop gestational diabetes. Gestational diabetes occurs typcially during the second half of pregnancy. It is standard procedure to for pregnant women to have a glucose tolerance screen between 24-28 weeks of gestation. If gestational diabetes is diagnosed, it is treated with a combination of diet, exercise and usually insulin. The most common consequences of gestational diabetes are high birth weight and complications during labour and delivery. After childbirth, the mom’s glucose levels return to normal. However, women who had gestational diabetes are at risk for developing type 2 diabetes later in life.

Hypertension

It is best to bring hypertension under control with diet, weight loss or medication, prior to becoming pregnant. During pregnancy transient hypertension can occur. For most women this is very mild and of no concern. If severe, it results in a low birth weight baby or stillbirths (the placenta becomes detached). Pregnancy Induced Hypertension (Pre-eclampsia) is a complication of pregnancy characterized by high blood pressure, protein in the urine and edema. Pre-eclampsia is associated with genetics and deficiencies in vitamin C, vitamin E and magnesium. It usually occurs after 20 weeks, most often near term and results in reduced blood flow to the baby. The placenta can detach resulting in a stillbirth. It can progress to eclampsia resulting in coma and convulsions. This condition needs prompt medical attention.

Pregnancy in Adolescence

Young women have high nutrient needs for growth and development. They are still growing themselves, laying down bone, so their calcium needs are high. The needs of the baby are over and above these. The recommended weight gain for teenage mothers is higher than for older women. Young mothers have unique physical, economic and psychosocial concerns and may be at greater nutritional risk as most have limited finances. They are experiencing many situations such as school, peer pressure, poor self confidence and fear if they are single. Prenatal care is important. There are programs in Canada available for high risk pregnancies such as ‘Healthiest Babies Possible’.

Lifestyle Factors and Pregnancy

Drugs (including alcohol), whether medical or illicit as well as smoking/chewing tobacco can affect oxygen and nutrient delivery as well as waste removal. This can lead to increased pre-term, low birth weight and infants more prone to SIDS. Children may have abnormal behaviour and poor cognitive development. Alcohol intake during pregnancy can result in birth outcomes of fetal alcohol effects and fetal alcohol syndrome (discussed later).

Environmental contaminants such as lead and mercury as well as vitamin and mineral megadoses can have toxic effects. Caffeine has not been linked specifically to birth defects but it is recommend to limit intake to 300 mg/day from all sources. This is 100 mg/day less than the limit for the average adult. Caffeine is consumed as a natural part of coffee, tea, chocolate and certain flavours (e.g. those derived from kola and guarana), and may be added to cola-type beverages. Caffeine exhibits a number of biological effects resulting from its diuretic and stimulant properties. Currently, pure caffeine may be added to cola-type beverages and it must be declared in the ingredients list on the product label. Caffeine may not be added to any other food. Many foods and food ingredients contain caffeine from natural sources. The caffeine in food from natural food ingredients, crude extracts or natural flavours is not regulated when such ingredients are added to food. Other products, such as guarana, a Brazilian plant whose seeds are high in caffeine, and yerba mate, a South American herb used to make tea, are also natural sources of caffeine. These are increasing in popularity, and are being used more and more as food ingredients. Energy drinks and beer-like products containing guarana have recently appeared in the Canadian marketplace.

Vegetarianism in general is of no concern in pregnancy. However women who are vegans need to carefully select their foods to ensure adequate vitamin D, vitamin B-6, vitamin B-12, calcium, iron, and zinc. Supplementation with calcium beyond the standard prenatal vitamin/mineral supplement may be needed.
Weight loss dieting is not recommended during pregnancy as it may deprive the fetal brain of glucose. Weight gain is needed.

The use of artificial sweeteners and sugar substitutes in moderation during pregnancy have not been associated with adverse birth outcomes.

Some herbal teas can be harmful in pregnancy. The following are herbal teas generally considered safe if taken in moderation (no more than 2 cups/day): citrus peel, ginger, lemon balm, linden flower, orange peel and rose hip.

Exercise during pregnancy is beneficial and generally recommended.

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Preconception Nutrition

Since a number of pregnancies are unplanned, many families do not find out they are pregnant until a few weeks or more after conception. The lifestyle choices made prior to pregnancy and in those first few weeks of pregnancy can have dramatic effects on the health of a baby. Therefore it is important for women to emphasize nutrition and healthy eating throughout the childbearing years.

Healthy eating before pregnancy also ensures that there will be adequate nutrients available to support a healthy pregnancy. Following Canada’s Food Guide to Healthy Eating is the best way to ensure that one is receiving a diet that is balanced, adequate and varied. It is important to note that both maternal and paternal nutrition in the preconception period are both important to birth outcomes. For example, malnutrition/food deprivation can interfere with fertility. Women develop amenorrhea and men have a decreased ability to produce viable sperm.

Nutrition-Related Concerns

Three of the most important nutrition-related concerns in the preconception period are body weight, teratogens, and adequacy of folate.

Healthy Body Weight

A healthy body weight before pregnancy sets the pattern for appropriate weight gain during pregnancy. Being overweight prior to pregnancy increases risk of gestational diabetes, pre-eclampsia and poor pregnancy outcome. Being under-weight prior to pregnancy increases risk of infertility, anemia, and complications during childbirth.

Teratogens

The avoidance of teratogens (ie.g., alcohol, illegal drugs) are important for both parents in this stage of life. Women should also be cautious about caffeine intake, as well as the use of medications, herbs, and supplements (other than prenatal supplements).

Adequate Folate/Folic Acid

Folic acid/folate is an important vitamin to include in the preconception and during early pregnancy. Folate (form found in food) or folic acid (in pill form) is a B vitamin that has been proven to help decrease the risk of neural tube defects (NTDs). Neural tube defects are serious birth defects that affect a baby’s spine and brain. They include spina bifida and other abnormal developments of the brain and spinal cord.

All women who could become pregnant should take a supplement containing 0.4 mg of folic acid every day. To further help reduce the risk of NTDs it is recommended that you take folic acid 2-3 months prior to pregnancy and continue through the first three months of pregnancy. This can be in the form of a multivitamin, as prenatal supplements.

Good food sources of folate include:

• beets ½ cup,
• broccoli ½ cup,
• cauliflower ½ cup,
• corn ½ cup,
• bran cereal 30g,
• cantaloupe or melon 1/10 fruit,
• green peas ½ cup,
• Romaine lettuce 1 cup,
• oranges and orange juice ½ cup,
• and peanut butter 2 tbsp.
• eggs 1 large,

Ideally, 3 of these should be consumed everyday. Excellent food sources of folate include:

• asparagus 4 spears,
• sunflower seeds ¼ cup,
• baked beans with pork 2/3 cup,
• peanuts ¼ cup,
• ½ cup of kidney beans,
• lentils, or chick peas,
• spinach 1 cup.

Two of these should be consumed everyday.

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