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Nutritional and Dietary Guidance

1.   FOR WOMEN:

A woman’s reproductive life - encompassing menstruation, pregnancy, breastfeeding and menopause - means that her nutritional needs differ greatly from those of a man. With the popularity of crash dieting, nutritional deficiencies are common, especially among young women. Good nutrition means eating a wide variety of foods every day, which isn’t possible on a restrictive diet.

Food and premenstrual syndrome (PMS)

The interplay of hormones throughout a woman’s menstrual cycle affects her body and state of mind. Energy intakes are generally higher in the premenstrual phase and some women also have food cravings as their period approaches. Eating high protein foods every few hours can often temper or stop the cravings. This should not be done at the expense of other food groups, especially carbohydrates, which should form the basis of the diet.

Fluid retention is common in the days leading up to a period because certain hormones encourage the body to hold salt (sodium). The more sodium held, the more fluid retained in the tissues.

Other common symptoms of premenstrual syndrome (PMS) include moodiness, tiredness and constipation. There is some evidence that taking B group vitamins, particularly vitamin B6, can help. Light to moderate exercise, such as a 30 minute brisk walk each day, has also been shown to noticeably reduce symptoms of PMS.

Iron and anemia

Iron is a mineral that works with other substances to create haemoglobin, the compound that carries oxygen in the blood. Women and men metabolise iron from food at roughly the same rate. However, while men need around 7mg of iron in their daily diet, women need up to 16mg. This is to make up for the amount of iron they lose in their menstrual period, which averages around 1mg or so lost for every day of bleeding.

Iron deficiency is the most common nutrient deficiency in women. Insufficient iron can lead to anaemia. Common symptoms include tiredness and breathlessness. Iron deficiency in pregnant women increases the risk of having a premature or low birth weight baby, which can have a negative impact on the short and long term health of the baby. Good sources of iron include:

  • Liver and red meat
  • Fortified cereals
  • Egg yolks
  • Legumes and nuts
  • Leafy green vegetables.

Iron absorption can be impaired by very high fibre diets, alcohol and the tannic acid in tea.

Get More Information on Anemia Here

Vitamins, minerals and pregnancy

The extraordinary demands on the female body during pregnancy can lead to nutritional deficiencies if the mother does not alter her diet. Pregnant women only need 600kJ or 140 kilocalories (kcal) more than non-pregnant women, which can be easily achieved by eating a little more from each of the five food groups daily. The most common deficiencies in pregnant women include:

  • Calcium - although a developing baby needs a lot of calcium, which is taken from the mother’s bones, most women rapidly replace this bone loss once the baby has stopped breastfeeding. The woman should make sure she has enough calcium in her diet during pregnancy as this may protect her bone mass, while also meeting the needs of the foetus. Good sources of calcium include dairy products (milk, cheese and yoghurt).
  • Folic acid (folate) - the recommended daily intake (RDI) for folic acid doubles during pregnancy. Folic acid is needed for the development and growth of new cells. Research suggests that insufficient folic acid at conception and in the first trimester of pregnancy can increase the risk of neural tube defects in the unborn baby. Good sources of folic acid include leafy green vegetables, poultry, eggs and cereals, particularly fortified cereals.
  • Iron - the developing foetus draws enough iron to last through the first five or six months after birth. Iron supplements are frequently prescribed for pregnant women, especially during the third trimester. Iron-rich foods include liver, red meat, egg yolks and leafy green vegetables.
  • Zinc - zinc is needed to maintain the health of cells. Taking iron supplements may interfere with the absorption of zinc, so women taking iron supplements may also need zinc supplements. Foods high in zinc include meat, liver, eggs and seafood. Leavened wholegrain products can also be helpful (yeast helps release the bound zinc).
Get More Information on Pregnancy Here

Deficiencies during breastfeeding

Nutrient requirements generally increase a lot more during breastfeeding (500-800kcal) than in pregnancy (140kcal). Important nutrients during this time are protein, calcium, vitamin C, folate, zinc, magnesium, vitamin B6 and fluids. Women who have not accumulated sufficient iron stores during pregnancy can develop iron deficiency anaemia when they are breastfeeding. This can be addressed by increasing the amounts of iron-rich foods eaten every day or, if necessary, taking supplements.

Calcium and osteoporosis

Osteoporosis is a disorder characterised by a thinning of the bones until they are weak and easily fracture or break. Women are at greater risk of developing osteoporosis than men, particularly after menopause, because oestrogen levels are reduced. There are many factors involved, for example:

  • Low calcium intake during the growing years - this increases the susceptibility to osteoporosis later in life. Bone strength in later life depends on the development of bones earlier in life, and adequate calcium intake during youth is essential to achieve peak bone mass.
  • Diet - salt, caffeine and alcohol interfere with the balance of calcium in the body because they increase the amount lost in the urine. Consume them sparingly.
  • Exercise - or the lack of it, can also affect the development of osteoporosis.
  • Low body weight - maintaining a low body weight (body mass index less than 18) has been associated with the development of osteoporosis.

Get More Information on Osteoporosis Here

Vitamin D and calcium

Vitamin D increases calcium absorption and is required for normal bone metabolism. The main source of vitamin D for most people is sunshine. Good dietary sources are margarine, liver, eggs and fatty fish from the northern hemisphere such as mackerel and sardines.

Good sources of calcium include dairy foods, calcium-fortified soymilk and sesame seeds. However, for women who can’t eat these foods, calcium supplements may be desirable.

Phytoestrogens

Phytoestrogens have been linked to a range of health benefits, especially for women. They are natural substances found in certain plant foods including:

  • Wholegrains including cracked wheat and barley
  • Flaxseed (linseed)
  • Sesame seeds
  • Nuts including almonds
  • Legumes especially soy and chickpeas
  • Alfalfa sprouts
  • Herb teas especially sage and aniseed
  • Extra virgin olive oil.

Oestrogen and phytoestrogens

Phytoestrogens are natural oestrogen-like substances. Oestrogen is a hormone that is necessary for optimal health. There is a link between oestrogen levels and the development of heart disease, cancer and osteoporosis. At present there is no evidence that increasing the intake of phytoestrogen will prevent heart disease, cancer and osteoporosis.

Things to remember

  • Iron and calcium deficiencies are common in women.
  • Vitamin B6 can help ease the symptoms of premenstrual syndrome.
  • Large quantities of foods like tea, alcohol, caffeine and salt can interfere with the absorption and excretion of important minerals. 

2.    FOR MEN:

To maintain a stable weight, your energy intake needs to equal the energy you use. If you use more energy than you consume, you will lose weight. On the other hand, if you eat more than you use, you will gain weight. The sensible answer to losing excess body fat is to make small healthy changes to your eating and exercise habits. These changes should be things that you can maintain as part of your lifestyle – that way you will lose weight and keep it off.

Don’t skip meals

Skipping meals is not recommended. In fact, if you skip meals, you may find you eat more when you do eat and this may lead to a larger stomach capacity. Studies show that stomach capacity can increase if large individual meals are eaten. This can then increase the amount of food you need at each meal before you feel ‘full’. This is not a reason to starve yourself if you’re trying to lose weight.

‘Yoyo’ diets will slow your metabolism

Many people who need to lose weight try crash dieting, which is a short-term solution that will increase your body fat levels in the long term. Continual cycles of dieting, weight loss and weight gain are called ‘yoyo’ dieting. Yoyo dieting does not help you to maintain a healthy body weight. Your body responds to these periods of semi-starvation by lowering its metabolic rate. When you lose weight, you lose fat and muscle. Muscle burns calories but fat doesn’t. So, when you then stop dieting and eat normally again, your body will burn even fewer calories than before because the relative amount of muscle in your body has decreased and your metabolic rate is slower. This kind of eating pattern can also affect your general health – just one cycle of weight loss and weight gain can contribute to an increased risk of coronary heart disease, regardless of body fat levels. That’s why it’s important to maintain the weight loss. Get More Information on Metabolism Here

Think about when and why you overeat

Some of the factors that can lead to weight gain include:

  • Night eating
  • Social eating
  • Habitual eating
  • Eating food while drinking alcohol.

If you can avoid eating at these times, and keep to regular meals and snacks, it will help you to lose weight. You could also try to eat less food at each meal and increase the number of high fibre, high carbohydrate, low saturated fat meals and snacks throughout the day.

You should try to find healthy ways to cope with stress or emotional upsets.

A healthier approach to food

You can lose body fat by making a few easy changes to your eating habits. It will help you lose body fat if you:

  • Avoid yoyo diets.
  • Eat a wide variety of food from all food groups. Check that you eat from the following food groups every day – bread and cereals, vegetables, fruit, milk and dairy, and meat, fish or legumes.
  • Have six small, frequent meals and snacks rather than three large meals a day.
  • Reduce your intake of foods that are high in fat, sugar and salt. Make soft drinks, lollies and snack foods an occasional ‘extra’. Most adults should eat no more than one or two ‘treats’ a day. If you are overweight or inactive, you may need to limit treats to less than one a day.
  • Try to balance an ‘extra’ food with extra exercise. The more energy you burn, the more treats you can afford to have. Remember, you should only add extra foods after you have covered your nutrient needs with choices from the healthier food groups.
  • Cut down on saturated dietary fats and alcohol.
  • Try to eat more fresh foods and less processed foods.
  • Avoid using food for comfort, such as when you are upset, angry or stressed. Explore other healthy ways to cope with these feelings.
  • Try to stop eating once you’ve had enough. If you continue to eat, particularly foods high in saturated fat, the extra kilojoules will be stored as fat.

Exercise is important to weight loss

Exercise prevents muscle loss. So it is important to exercise when you are losing weight. Exercise will protect your muscles and keep your metabolic rate ticking over at a healthy level. The number of people who are overweight and obese is increasing every year. This is because we have become more sedentary (inactive). For most of us, physical activity is no longer a natural part of our lifestyle so it must be structured into our daily schedule. Get More Information on Weight Loss Here

Get moving – it will give you energy

Some people feel too busy or too tired to exercise regularly, but exercise will actually increase your energy levels and help you to feel less tired. Exercise does not have to be overly strenuous to do any good. Even moderate amounts of physical activity can speed up the metabolic rate and aid weight loss. The amount of energy you ‘burn up’ depends on your age, your gender and your activity level. Young people burn more energy than older people. Men burn more energy than women. More physically active people burn more energy than your average couch potato!

A healthier approach to exercise

The best approach to increasing the level of physical activity in your life is to take it slowly. You can increase your activity levels by simply increasing movement throughout the day. The human body is designed for movement and any physical activity brings benefits. Moderate intensity exercise – walking, gardening, cycling, even mowing the lawn – has been shown to help reduce body fat.

Other suggestions for a more active lifestyle include:

  • Play a sport that you enjoy.
  • Walk instead of taking the car on short trips.
  • Get off the train, bus or tram one stop early and walk the rest of the way.
  • Play more outdoor games with your children.
  • Walk the dog.
  • Take stairs instead of lifts.
  • Choose exercise activities that you think are fun, rather than those you think are ‘good’ for you.

Nutrition Consultations 

Take the first step in developing a lifestyle change program that addresses your individual needs. Beginning with a consultation with Judy Penta our nutrionist, you’ll learn how the foods you eat can affect inflammation and pain and influence your overall health. In addition, you’ll find out how to tailor your diet to control weight, improve health and increase energy.




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For those that can make the journey, we are happy to welcome new patients to our medical center in New York City. Call us at 1-212-794-8800 . We are here to listen and to help.

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