Tips on What to Eat When Pregnant

ByJane Grant

What is the ideal diet when you are pregnant?

Finding out you’re expecting can be one of the greatest joys in life. Whether the baby is planned or a pleasant surprise, it is an exciting life-changing addition to a family. In fact, the changes happen right away as the mother prepares the fetus for life outside the womb. Important changes, such as improving the diet, help the mother and the fetus stay healthy throughout the pregnancy. Changes in diet must be discussed with a doctor, especially if the pregnant woman suffers from gastrointestinal issues, such as Crohns or colitis. However, there are a few general guidelines every pregnant woman should follow.

Keep Up on Fruits and Veggies

The body naturally compensates for the growing baby, properly distributing nutrients. This makes fruits and vegetables essential. Moms on diets, such as the lazy keto diet, may have to adjust intake to increase folic acid and calcium. Luckily, many fruits and veggies on both the keto diet and a healthy pregnancy diet are the same. Dark, leafy greens are high in folic acid, which must be increased during pregnancy. They are also high in iron, which is part of the keto diet. Citrus fruits, such as lemons and oranges, also cross both diets, and are high in essential Vitamin C.

Making the Bread and Grain Switch

Carbohydrates are the pregnant body’s main source of energy, so many pregnant women will eat more grains as the stress of growing a human begins to drain the body. This is a deviation from the keto diet, but it is often necessary. A generally healthy pregnant diet consists of six to eleven servings of bread and grains a day. Additionally, fortified grains include extra folic acid. Whole grains include Vitamin B, fiber, and small amounts of protein.

Eat the Meat, Beans, and Eggs

Protein, Vitamin B, and iron are found in meat, eggs and beans. These are especially essential in the second and third trimesters, when the baby is growing organs, muscles, and the brain. Further, the added iron in the diet helps move oxygen through the blood, providing energy to the mother and warding off depression. The recommended daily iron intake is 27 mg. Fish is an excellent source of iron and vitamins, as long as it is either mercury-free or has a low mercury content. The best fish to eat is the fish recommended by the doctor. These proteins are the staples of the keto diet, as well.

Keeping a Food Diary

It is smart to keep a food diary of the general foods eaten daily. If there are any mysterious symptoms, the doctor can look at intake to help determine the cause. For example, dizziness is a common side effect of pregnancy if the mother does not take in enough iron. This can be easily remedied by increasing meat or green, leafy vegetable intake.

Having a baby is a wonderful experience that requires a smart prenatal plan. Switching to a diet suitable for pregnancy helps keep mommy and baby strong throughout the experience.

Nail the Nutrition Basics

By Dr Catherine Wall

The nature of IBD means it can be hard to maintain adequate nutrition status and nutrition intake during disease flares, but also when your disease is in remission.

Many research studies have shown that people with IBD are more likely to have suboptimal nutrition status compared with their healthy peers. What can you do to try and get the most nutrition, and hopefully enjoyment too, from your diet? As a dietitian I see many people with IBD who have searched online about what to eat and found a lot of conflicting information and often end up more confused than previously. One of my top recommendations is that you concentrate on nailing the basics! One of the most important basics is 5+ a day of fruit and vegetables.

In New Zealand only half of adult men and two thirds of adult women eat 2 pieces of fruit per day and 70 % of adult females and 60% of adult males eat three servings of vegetables per day. International research suggests that if you have IBD you are likely to eat less fruit and vegetables than the general population. We can therefore probably say that the majority of adults with IBD do not eat 5 + a day of fruit and vegetables.

Fruit and vegetables are an especially important food group. Fruit and vegetables are a great source of fibre, the vitamins, minerals and phytochemicals. Many of vitamins and minerals found in fruit and vegetables play a crucial role in maintaining a strong immune system, helping the body to fight inflammation and help the body to recover from a disease flare. Eating a variety of fruit and vegetables is also associated with a more diverse gut microbiome, which we think is important for good health. Eating a variety of fruit and vegetables has been also associated with increased well-being and happiness!

Do you struggle to eat 5+ a day of fruit and vegetables? Here some tips to make it easier to get your 5+ a day of fruit and vegetables:

1. Try to eat fruit and vegetables that are in season. When you eat seasonally you tend to eat a greater variety of foods across the year.

2. Aim to include vegetables in both your lunch and dinner meals. If you manage to do this most days you are more likely to eat 3+ a day of vegetables

3. Eat a “rainbow” of fruit and vegetables. Eating different coloured vegetables provides you with different nutrients.

4. If you struggle to digest particular vegetables try changing the texture of the vegetable. For example, steam leafy greens and then puree them before adding them to a dish e.g minced meat, pasta sauce, soup. Other ways to change the texture: grate vegetables into mixed dishes; serve vegetables well-cooked rather than stir-fried or lightly steamed; use canned vegetables e.g. tomatoes, beetroot; try small amounts of pickled or fermented vegetables

5. If you struggle to digest raw fruit you can also change the texture of the fruit. Try adding peeled and grated fruit to a smoothie, porridge or Bircher style breakfast. Cook the fruit first and eat it cold mixed through yoghurt. If possible, try to eat whole fruit rather than drinking fruit juice.

If you would like to read more about food, nutrition and IBD visit www.gutnutrition.co.nz/blog to read my recent blogs “What oil should I use?” and “Orange autumn produce”.

Have you heard of the Eating and Activity Guidelines for New Zealand Adults or the Food and Nutrition Guidelines for Children and Young People? (links to each are at the bottom of the article) These guidelines provide general healthy eating information which is relevant to all New Zealanders and especially for you with IBD.

Here are links to the New Zealand food and nutrition guidelines which contain other tips to help you eat 5 + a day of fruit and vegetables.

Young children guide https://www.healthed.govt.nz/resource/eating-healthy-children-aged-2-12nga-kai-totika-mo-te-hunga-kohungahunga

Young people guide https://www.healthed.govt.nz/resource/healthy-eating-young-people

Adult guide https://www.health.govt.nz/publication/eating-and-activity-guidelines-new-zealand-adults

Older adult guide https://www.healthed.govt.nz/resource/eating-healthy-older-peoplete-kai-t%C5%8Dtika-e-ora-ai-te-hunga-kaum%C4%81tua

The Positive Effects of Exercise

By Georgina Fagan

Regular physical activity is the holy grail of health.

Regular physical activity is the holy grail of health. The benefits of regularly exercising stretches far and wide, including improving mental health, heart health, gut health, and increasing muscle and bone strength. While we know of all the benefits of regular physical activity, it can often be hard to keep up an active lifestyle in this day and age. In fact, New Zealand is one of the least active countries in the developed world.

So, this is where this exercise and IBD study came in. It was carried out in Dunedin last year and looked at the benefits of a personalised exercise programme for people with IBD. The study also focused on if the programme was effective at encouraging participants to increase their level of physical activity and stick with their exercise programme.

The study, which had 82 people involved, encouraged each person to aim to do some sort of physical activity every day, even if it was only for 5 minutes, for a period of 4 months. The main element of the study was the personalised exercise booklet that each person received. In it there were sections on goal setting, barrier planning, and trouble shooting. Using the flow chart (pictured left) each person was able to decide and plan out their programme for the week – aiming to exercise a minimum of 5 days a week. The types of physical activity varied greatly between people with some choosing walking, others lawn bowls, and even ball room dancing. It all counted as long as each person aimed for 5 sessions a week.

The key elements which we believe made such a huge change included:

Realistic goal setting – bring physical activity into your daily life is a marathon not a sprint. Start with a very small amount to begin with and once you can do that every-day then start to increase it. Again, when you increase the level of exercise you do, start small. It doesn’t have to be a huge increase initially.

Being flexible – When the weather packs in, it’s important not to give up doing some exercise. Why not try doing something inside such as going to the pool or a circuit right in your own living room.

Over-coming barriers – we all have different barriers that stop us from exercising and they can be really hard to overcome. Here are some examples:

If you find you need to go to the bathroom more when you exercise try planning an exercise route where you will go past bathrooms. Have a look at your local city council’s website, it can show you where the nearest toilets are to you so that you can plan a walking/running/cycling route around these.

Exhaustion can also be a difficult thing to deal with. Listen to your body but also try and push yourself. If you feel too tired to exercise, try doing something super light that day – a gentle walk or bike ride. You may surprise yourself with what you can do. Over time we know that people who regularly exercise often have more energy than before so keep at it.

Motivation is also hard. There are always days when we don’t feel like doing anything. Exercising with someone else can be helpful with this – whether it’s your partner, child, or work colleagues. You can help each other when you’re struggling with motivation.

Using the booklet & some of the tools mentioned above, over 80% of those in the study were able to successfully implement this programme and exercise 5 times a week. There was a significant increase in physical activity levels following the study. There was also a significant improvement in peoples’ well-being including a reduction in disease activity, fatigue, depression, anxiety, and an improvement in quality of life.

All great things!

This study highlights just effective regular physical activity can be for patients with Inflammatory Bowel Disease. Even five minutes a day can have a positive effect on your health and improve your quality of life. Because of this, we have released the programme for everyone to use for free. It can be found here shortly:

https://www.guthealthnetwork.com/tools-and-links/exercise/

Thank you very much for everyone who was involved in the study, especially every one of the participants! Without your help and enthusiasm this study would not have been as successful as it was.

If you have any questions about the study or would like to know more feel free to get in touch by emailing: exercise.dunedin@gmail.com.

Helping your body through your mind – the experience of an Ulcerative Colitis patient

By Ilse Breitweiser

Just after Christmas 2017 my bowels started to produce mucus, and a week later I saw the first drops of blood. The symptoms got worse, and two months later, a couple of weeks after my 60th birthday, I got diagnosed with Ulcerative Colitis. My specialist hoped to get it easily into remission, but it turned out quite differently. I started with Colifoam, then added Pentasa, then Prednisone, but the bleeding just got worse and worse. I saw an excellent dietician, tried lactose free and gluten free diets, I also tried acupuncture, but nothing helped. In October I developed my first severe Iritis. By that time, I went on long term sick leave. I was home bound because I spent most of the day in the small room. I started Azathioprine, but had a negative reaction to it, then Methotrexate injections, but didn’t cope with them either. I developed Iritis on the other eye. In early December I had my first Infliximab infusion, but after the third infusion my symptoms still had not improved. An iron infusion gave me more energy. By that time, I had lost ten kilograms, although I didn’t have much weight to lose in the first place. I looked like skin and bones. I felt more like a zombie than a human being. My specialist mentioned the dreaded word “surgery”, but fortunately exactly at that time the bleeding suddenly got a lot less. Now we decided to “throw everything at it”, added Methotrexate tablets, Colifoam, and doubled the Infliximab dose and shortened the intervals for the infusion. The bleeding stopped and the frequency of my runs to the small room decreased from 20 plus (on most days uncountable) to just one per day! Since May I am in remission. Meanwhile I have reduced medication to a standard dose of Infliximab, small dose of Methotrexate once per week, and Pentasa 4g per day. I started going back to work part-time in May and I am working full-time since mid-July. I am so happy that I am back at work, have gained weight, and I am looking so healthy and also feel like it.

I am very grateful for the excellent medical treatment and support I have received. At my first specialist appointment, I was given the Crohn’s and Colitis New Zealand handbook for people with inflammatory bowel disease. The book states that although the primary cause of IBD is not emotionally based, body and mind are inseparable and that “it has been observed that flare-ups of IBD symptoms can occur at the time of stressful situations”. Therefore, I investigated how to support by body with my mind.

After my first iritis I used the little energy I had left to learn and practice mindfulness techniques which helped me coping with my situation and my body to relax. At that time, I came across an advertisement for an introductory seminar by Empower Therapies’ Mel Abbott who is using mind-body techniques to resolve chronic illness. Her motto is “Your mind is your most powerful tool. You just need to know how to use it”. Mel claims on her website http://www.empowertherapies.co.nz/ that about 90% of her patients with chronic diseases, and that includes inflammatory bowel disease, gained significant improvement after attending her course “The Switch”. Her website and Facebook has plenty of testimonials from her clients; many of them were completely healed after attending The Switch although they had suffered from chronic disease for many years.

So, I gave the introduction seminar a go. It covered

Her own and others’ recovery stories to get us inspired and hopeful
Activities to focus us forwards onto our own recovery
The role of the stress response in chronic illness
Techniques to calm our stress response and anxiety, so that our bodies can recover
How to rewire our neural patterns away from chronic illness patterns
The neurology of chronic pain and how to start changing it
Simple interventions to resolve depression
How to generate more energy
How to curb emotional eating patterns
How emotions get trapped in the body and cause illness
An action plan for moving forwards into our own recovery

Although I am such a sceptical person and consider all “alternative psychological stuff” as highly suspicious, I perceived the seminar as interesting enough to do the follow up training and read more about Neurolinguistic Programming (NLP). After a few more months of reading, I decided to apply for the four-day course of The Switch. I still had a lot of doubts whether the course would suit me, but the good things was that there was no risk because Mel talks with all applicants before the course and accepts only those who have a very high chance of success. I was accepted to the course in mid-July.

The Switch really impressed me. I perceived Mel as an excellent trainer with plenty of expertise in NLP. She built The Switch on her NLP experience, but her experience includes also a Bachelor of Science in Psychology, Lighting Process Practitioner, Bruce Lipton’s Biology of Belief seminar, Psych-K certification, The Wholeness Process certification, mBIT certification, Network Spinal Analysis, BodyTalk and much more.

Course content (from Mel Abbot’s Empower Therapies website http://www.empowertherapies.co.nz/ ):

I thoroughly enjoyed the course and soaked up each minute of wisdom. I am practicing The Switch several times a day, and I am very impressed by Mel’s follow up. In my opinion, one of the strengths of The Switch is that it is very simple. It doesn’t require reading piles of books (Mel has done that for her clients and summarises things in an easy to understand, engaging and fun way!), and the techniques are very simple. I am practicing The Switch many times each day. However, this practice doesn’t take much time, and I can integrate it easily into my daily life. The Switch is also very down to earth, and that’s what suits me. It’s early days to know what effect The Switch has on my Ulcerative Colitis, particularly since my Ulcerative Colitis was already in remission when I attended The Switch. I do believe though that by attending The Switch I have now the tools to support my body with my mind, and this should assist keeping my Ulcerative Colitis in long-term remission or hopefully permanent remission. This is because I have learned so much about myself, and my life feels now so much better. I am approaching life differently now. I feel a lot calmer, my energy levels are so much better, but I am also much better in accepting my limits and looking after myself. The Switch is for me not only a tool for dealing with my Ulcerative Colitis, it is a life tool.