WHILE you are overjoyed with your pregnancy, you are probably also eager to ensure a healthy pregnancy. To achieve this goal, one of the vital aspects you need to pay attention to is nutrition.

Eating for two

While nurturing a new life inside you, your body undergoes significant physiological changes to adapt to your new role. To cope with the changes during pregnancy, your daily requirements for energy, protein, and certain vitamins and minerals increase dramatically.

You need extra energy and nutrients to help you gain healthy pregnancy weight, to support the growth and development of your unborn child, and to nourish the placenta and tissues in the uterus.

Eating well at this stage will also help you better prepare your body for breastfeeding when baby is born.

Therefore, you need to eat a sensible and well-balanced diet to maintain your own health, as well as your unborn baby’s. This is what “eating for two” is all about, and not what most people believe as eating double of everything!

In general, pregnant mums can fulfil their daily nutritional needs by consuming adequate amounts of nutrient-dense foods. When it comes to eating right and well throughout your pregnancy, the key words are: balance, moderation, and variety.

Balance – Eat a balanced diet that combines foods from the five major foods groups in the Malaysian Food Pyramid to provide a proper balance of nutrients. For busy working mums-to-be, who may not have time to eat nutritious meals every time, key nutrients such as iron, folic acid, zinc, and calcium can also be obtained from fortified milk or supplements.

Moderation – Eat the right amounts of foods to maintain a healthy weight gain throughout your pregnancy, and to optimise your body’s metabolic processes.

Variety – Eat different types of foods from each of the food groups every day to optimise your intake of various nutrients.

Mums-to-be should not “go on a diet” just because they are concerned about gaining too much weight during pregnancy, or just because they are worried about the possibility of not being able to lose weight after delivery.

Remember, gaining weight is a natural part of the pregnancy process. If you deprive yourself of essential nutrients, you run the risk of delivering an undernourished baby.

However, it is just as important to maintain a healthy well-balanced diet, as too much fat intake may lead to excessive maternal postpartum weight retention. Therefore, pregnant mums should wisely select foods that are rich in essential nutrients, yet low in fat. This will help in controlling calorie intake while providing crucial nutrients at the same time. Obesity during pregnancy has been found to be an independent risk factor for neural tube defects, foetal mortality, and pre-term delivery.

Adequate intake of certain vitamins and minerals are particularly crucial during pregnancy. Iron and folic acid are two of the most important.

Iron needs

Your iron needs during pregnancy can increase up to almost twice of that before pregnancy. This is because your blood volume increases, and you need extra iron to make haemoglobin to produce additional blood. Your growing foetus also needs iron to make blood.

If you started off your pregnancy without sufficient stores of iron, you may suffer from iron-deficiency anaemia.

The first symptoms you notice are paleness (eg in the fingernails, lips), tiredness and fatigue, and light-headedness. If severe, you will experience dizziness, rapid heartbeat, headache, and shortness of breath.

But anaemia is more than just symptoms. It can lead to potentially fatal pregnancy complications. Anaemia has been associated with higher risks of miscarriage, preterm delivery, stillbirth, and low birth weight.

The most common cause of anaemia during pregnancy is a diet low in iron. The iron requirement for pregnant women is so great that it cannot be met with just diet alone. That is why iron supplementation (100mg daily) is usually recommended for pregnant women.

For anaemic women, higher doses may be required to help increase blood haemoglobin levels.

Pregnant mums can do a few things to increase their dietary iron intake or encourage iron absorption from their diet:

Eat more iron-rich foods – Iron can be obtained from foods of animal and plant sources. However, iron from plant sources (eg cereals, legumes, vegetables and fruits) is less well absorbed by the body (ie lower iron bioavailability) compared to iron from animal sources (eg meat, poultry and seafood).

Increase your vitamin C intake – Vitamin C aids absorption of iron from plant sources. This is important for pregnant mums who are vegetarians, as their daily diet is made up mainly of plant-based foods that have lower iron bioavailability.

So consume vitamin C-rich foods or drinks when you are eating cereals, beans, and vegetables for better iron absorption.

Many local fruits, such as guava, starfruit, mango and papaya, are high in vitamin C.

Watch how you eat – Certain foods hinder iron absorption. Coffee and tea, for instance, contain a group of plant chemicals known as tannins that can affect iron absorption from plant-based foods. Calcium in milk affects iron absorption from animal sources.

If you need to drink these beverages, drink two hours after main meals to avoid interfering with iron absorption.

Folic acid

Folic acid, or folate, is a vital nutrient during pregnancy. It is essential for the development of your unborn baby’s nervous system. Folic acid is also needed in the formation of red blood cells and in cell multiplication.

Folic acid deficiency during pregnancy is another cause of anaemia. More importantly, if you don’t receive adequate folic acid during pregnancy, especially in the first three months, your baby will be at risk for neural tube defects (ie defects in the formation of the foetus’ spinal cord).

Your daily folic acid requirement during pregnancy is 600 micrograms, compared to 400 micrograms when you are not pregnant. In fact, women planning to get pregnant should ensure they get sufficient folic acid from their diet in the months before they become pregnant. Deficiency can arise if your dietary intake of folic acid is poor.

While folic acid is plentiful in legumes, green leafy vegetables and fortified cereals, it is not stored in the body in large amounts. Also, overcooking destroys folic acid in vegetables and fruits. Therefore, a continual supply of folic acid through diet is necessary to maintain your body’s reserves of the vitamin.

Pregnant mums are encouraged to eat a variety of folic acid-rich foods, such as breakfast cereals, spinach, asparagus, broccoli, and different types of beans, peas and lentils, as well as egg yolk and liver. Your doctor may likely prescribe folic acid supplements. You should take it daily or according to doctor’s instructions.

Pregnant women should also be more aware of other dietary components that can help in providing health benefits for both mother and child. Fructooligosaccharides or FOS, is a type of fibre that can benefit the overall health of our digestive systems. It is a “prebiotic” that promotes the growth of beneficial microflora in the gut, which in turn helps suppress harmful organisms in the intestinal tract.

An adequate fibre intake helps reduce constipation during pregnancy. By Dr Poh Bee Koon, The Star

It might be your preference to crack open a bottle of red wine at the end of a hard day but you may be better off pouring a pint.

Researchers at the German Cancer Research Centre in Heidelberg have discovered that beer contains a powerful molecule that helps protect against breast and prostate cancers.

Found in hops, the substance called xanthohumol blocks the excessive action of testosterone and oestrogen. It also helps to prevent the release of a protein called PSA which encourages the spread of prostate cancer.

Scientists have long known that substances in hops help to block oestrogen. This is the first time, however, that they have been found to also inhibit testosterone.

‘Research is still early but in trials we hope to further demonstrate that xanthohumol actively prevents prostate cancer development,’ says Clarissa Gerhauser of the Heidelberg centre. If successful, xanthohumol may one day be developed as a cancer-fighting drug.

So which brews are likely to be richest in xanthohumol?

‘Hops give beer its bitter flavour, so traditional bitters and ales will contain far more of this substance than light lagers,’ explains Ben McFarland, author of the World’s Best Beers.

Beers highest in hops, he says, are India pale ales such as those made by the Meantime Brewery in Greenwich, South-East London. First brewed in the 1800s, these ales were made with high levels of hops to act as a natural preservative for export.

Ales such as Sharp’s and local bitters will also be hop-rich, containing around three to four times more than a typical light lager. Drinks such as Guinness owe their dark colour to malt and contain moderate levels of hops.

Alcohol Concern warns you should only drink beer within recommended limits – two to three units a day for women, three to four units for men. By Anastasia Stephens, The Daily Mail

These calculations are based on the projection that in 10 years 43% of Americans adults may be obese, which is roughly 30 or more pounds over a healthy weight, if obesity continues to rise at the current rate. Extra weight increases the risk of diabetes, heart disease and many types of cancer.

This report comes as the country struggles to find ways to curb medical costs and Congress debates health care legislation.

“Obesity is going to be a leading driver in rising health-care costs,” says Kenneth Thorpe, chairman of the department of health policy and management at Emory University in Atlanta. Thorpe did this special analysis on obesity for America’s Health Rankings, the 20th annual assessment of the nation’s health on a state-by-state basis.

“There is a tsunami of chronic preventable disease about to be unleashed into our medical-care system which is increasingly unaffordable,” says Reed Tuckson of United Health Foundation, sponsor of the report with the American Public Health Association and Partnership for Prevention.

Using weight data, Census statistics and medical expenditure information, Thorpe found:

•An obese person will have an average of $8,315 in medical bills a year in 2018 compared with $5,855 for an adult at a healthy weight. That’s a difference of $2,460.

•If the percentage of obese adults doesn’t change but stays at the current rate of 34%, then excess weight will cost the nation about $198 billion by 2018.

•If the obesity rate continues to rise until 2018, then Colorado may be the only state with less than 30% of residents who are obese.

•More than 50% of the population in several states could be obese by 2018: Oklahoma, Mississippi, Maryland, Kentucky, Ohio and South Dakota.

The report adds to the growing body of evidence of obesity’s impact on medical costs. A study released in July showed that obese Americans cost the country about $147 billion in weight-related medical bills in 2008, double what it was a decade ago. It now accounts for about 9.1% of medical spending.

Overall, the United States spends about $1.8 trillion a year in medical costs associated with chronic diseases such as diabetes, heart disease and cancer, and all three are linked to smoking and obesity, the nation’s two largest risk factors, according to the America’s Health Rankings report.

Smoking is still the No. 1 preventable cause of death in the country, accounting for about 440,000 deaths annually, the report says.

About one in five Americans smoke. More than 3 million people quit smoking this past year. The percentage of people who smoke varies by state, from 9.3% in Utah to more than 25% in Kentucky, Indiana and West Virginia, the study says.

“This report is an urgent call to take much more aggressive action to deal with key disease risk factors such as obesity and smoking,” Tuckson says.

Health economist Eric Finkelstein, co-author of The Fattening of America, says medical costs won’t go down unless Americans make a serious effort “to slim down by improving their diet and exercise patterns.”  By Nanci Hellmich, USA TODAY

As part of her doctoral research, Wendy Chan She Ping Delfos from Curtin’s School of Public Health (CSPH) compared three serves of dairy with five serves of dairy within a reduced calorie diet prescribed for obese participants over a 12-week weight loss trial.
Participants who consumed five daily dairy serves were found to have higher mean levels of weight loss; higher mean levels of fat mass loss; greater drop of systolic blood pressure; and greater total percentage abdominal fat loss, according to a CSPH release.

”Many people commonly believe that when trying to lose weight dairy products are key foods that they have to cut out of their diet as they are high in fat,” Chan Delfos said.

”Participants who had five serves of dairy and engaged in resistance exercise had similar health benefits to participants consuming five serves of dairy only,” she said. Khaleej Times.

“It’s clear that smoking bans work,” said Dr. Lynn R. Goldman of the Johns Hopkins Bloomberg School of Public Health, who led the panel that produced the report. “Bans reduce the risk of heart attacks in nonsmokers as well as smokers.”

“There’s no question that secondhand smoke has an adverse health impact in workplaces and public environments,” said Dr. Clyde Yancy, president of the American Heart Association. “We must continue to enact comprehensive smoke-free laws across the country to save lives and reduce the number of new smokers.”

Nearly 440,000 Americans die each year from smoking-related illnesses — more than one-third from heart disease — according to the heart association. About 38,000 of those deaths are related to secondhand smoke, which has many characteristics of other types of air pollution linked to heart disease. The association between illness and secondhand smoke was reinforced by a 2006 report by the U.S. surgeon general on the consequences of exposure to environmental smoke.

Among the report’s conclusions: While heavier exposure to secondhand smoke is worse, there’s no safe level. It also cited “compelling” if circumstantial evidence that even less than an hour’s exposure might be enough to push someone already at risk of a heart attack over the edge.

That’s because within minutes, the smoke’s pollution-like small particles and other substances can constrict blood vessels and increase blood’s propensity to clot — key heart attack factors. Yet many people don’t know they have heart disease until their first heart attack, making it important for everyone to avoid secondhand smoke, said Dr. Neal Benowitz of the University of California, San Francisco, who co-wrote Thursday’s report.

“Even if you think you’re perfectly healthy, secondhand smoke could be a potential threat to you,” he said.

Still, bans on smoking have remained controversial, in part because of fears that they might keep customers away from bars and restaurants. Last year, the Centers for Disease Control and Prevention commissioned the Institute of Medicine to study the evidence. Some of the members of the panel initially were skeptical about the benefits of such bans, according to statistician Stephen E. Fienberg of Carnegie Mellon University in Pittsburgh, but they quickly changed their minds when they began reviewing the evidence.

The panel examined 11 studies of heart attacks in areas where bans were implemented and found a decrease in heart attacks in every study, ranging from a low of 6 percent to a high of 47 percent, depending on how the study was conducted.

“Such consistent data confirms for the committee that smoking bans do, in fact, decrease the rate of heart attacks,” they wrote. One study, for example, found that hospitalizations for heart attacks in Pueblo dropped 41 percent in the three years after the city banned smoking in the workplace.

In most of the studies, it was difficult to isolate the benefits for nonsmokers from those for smokers, but two of the studies showed a very clear benefit for nonsmokers.

The committee also surveyed the evidence from laboratory studies in animals and concluded that these results supported bans. By Thomas H. Maugh II, Denver Post.

In the study, researchers found no evidence of reduced risk for diabetes among adults who ate more fish, or the essential omega-3 fatty acids obtained primarily from seafood.

Rather, their findings suggest that eating 2 or more servings of fish a week may slightly increase diabetes risk.

Diet is a key factor in preventing the onset of diabetes in adults, but how omega-3 fatty acid intake impacts diabetes risk is still unresolved, Dr. Frank B. Hu, at Harvard School of Public Health in Boston, Massachusetts, and colleagues explain in the American Journal of Clinical Nutrition.

They examined ties between fish and omega-3 fatty acid intake and the development of diabetes among 152,700 women enrolled in the Nurses’ Health Study and 42,504 men enrolled in the Health Professionals Follow-Up Study.

Overall, 9,380 cases of adult-onset diabetes developed among these healthcare workers during up to 18 years of follow up.

After adjusting for lifestyle and other dietary factors, plus body weight, family history of diabetes, and menopausal status and hormone use when applicable, Hu’s team noted increased diabetes risk “in all cohorts” consuming higher levels of omega-3 fatty acids.

Diabetes was 1.17 times more likely among people who ate fish 2 to 4 times a week, and 1.22 times more likely among those who ate fish 5 or more times a week, relative to those who ate lesser amounts of fish.

Dr. Hu and colleagues emphasize that numerous studies have demonstrated beneficial effects of fish and omega-3 fatty acids on multiple risk factors associated with diabetes, and on heart disease — the major sequelae of diabetes.

They say further study is needed to figure out the “clinical relevance” of the current findings and determine the mechanisms behind their observation that high fish intake may raise diabetes risk. Yahoo Daily News.

It is the first time an autoimmune response – a condition whereby the body can attack itself – has been shown to cause damage to bones directly.

Researchers from the University of Edinburgh studied a protein called osteoprotegerin (OPG) in people with coeliac disease – a digestive condition that affects 1 in 100 people.

In healthy people, OPG plays a crucial role in maintaining bone health by controlling the rate at which bone tissue is removed.

The latest research shows that 20 percent of coeliac patients produce antibodies that attack the OPG protein and stop it working properly. This results in rapid bone destruction and severe osteoporosis.

It was previously thought that osteoporosis – a known complication of coeliac disease –develops in coeliac patients because they cannot properly absorb calcium and vitamin D from their diet. Both nutrients are essential for healthy bone development.

The team found that although this new form of osteoporosis did not respond to calcium and vitamin D supplements, it can be easily treated with drugs that prevent bone loss. The research is published in the New England Journal of Medicine.

Professor Stuart Ralston, of the Institute of Genetics and Molecular Medicine at the University of Edinburgh, who led the team, said: “This is a very exciting step forward. Not only have we discovered a new reason to explain why osteoporosis occurs in coeliac disease, but we have also found that it responds very well to drugs that prevent bone tissue removal. Testing for these antibodies could make a real and important difference to the lives of people with coeliac disease by alerting us to the risk of osteoporosis and helping us find the correct treatment for them.” Red Orbit.

Lymphatic filariasis, more commonly known as elephantiasis, afflicts many of the world’s most vulnerable communities.  A parasite that infects the human lymphatic system is responsible for elephantiasis, which causes swelling and deformity of the limbs and other body parts.

Mosquitoes spread the tiny parasitic worm that causes elephantiasis from person to person.

The disease is endemic in 83 tropical countries, and Professor David Molyneux of Britain’s Liverpool School of Tropical Medicine says anyone living in those places is at risk. “The total numbers of people which have been estimated by the World Health Organization to be at risk in these 83 countries is about 1.3 billion people, so let’s say a fifth of the planet is at risk,” he says.

There are few conditions in the world more socially alienating. The Global Alliance to Eliminate Lymphatic Filariasis has been at the forefront of those fighting the disease.  As the group’s video shows, elephantiasis mainly affects the rural poor, forcing infected people – like this man from Uganda – further into poverty.  “I am a carpenter.  It’s quite a problem for me when I have to stand at my work for long periods,” he says.

Washing infected limbs can help ease the suffering, but it does not cure or stop the spread of the condition.

This man comes from a village in Tanzania where elephantiasis is endemic. “I do not mind being seen in public because many other people have this disease, too,” he says.

Set up nine years ago, the Global Alliance aims to eradicate elephantiasis as a public health threat by 2020.

The group has teamed up with the U.N. World Health Organization and major drug companies such as GlaxoSmithKline and Merck.

Andy Wright heads up GlaxoSmithKline’s elephantiasis program. “When the program started, there was a global plan produced by the WHO for how you could achieve this goal within 20 years, and progress against that plan is very much on target.  So there is a lot of very strong evidence that the program is succeeding, and a lot of confidence that in the vast majority of countries, it will be successful before 2020,” he says.

The eradication program consists of two drugs – albendazole, donated by GlaxoSmithKline, and Mectizan, donated by Merck.  Those living in endemic areas take two pills a year for five years.  The drugs significantly reduce the number of worm larvae in the blood, which means far fewer mosquitoes carry the infection to those they bite.  “We made an agreement with the World Health Organization to donate one of our anti-parasitic drugs, albendazole, to every country that needs it, until the disease is eliminated.  And that’s an enormous commitment that will take 20 years or more, and will involve billions [of doses] of … albendazole,” says Wright.

Despite these efforts, there is much more to do in the fight to eradicate lymphatic filariasis.  Populous countries, such as Nigeria and Indonesia, and others face logistical problems in delivering and implementing the program nationwide.

Professor Molyneux says it should be viewed as the most important public health program of our generation.  “If we can’t afford to implement this intervention within existing health financing environments, I don’t believe we could afford to do anything in public health,” he says.

Elephantiasis was once considered one of the world’s most neglected afflictions, but those fighting it hope that by 2020 the disease will be gone. By Rachel Smalley, Voa News.

When used in aromatherapy, lemon enhances mood.  In animals, the aroma of lemon alone is known to alter anxiety and decrease pain perception. As essential oil, lemon has a calming effect.  For an insomniac, lemon oil can help induce sleep.

Lemon oil is an anti-fungal, anti-microbial, anti-infection, detoxifying genius.  It has been used to treat stress disorders, skin disorders, and hair disorders.  It is often used in anti-septic soaps and in astringents.  It has been used in deodorizers, in flea tonics, for insect bites, and on greasy skin.

Lemon juice itself is an extremely powerful healing agent.  It aids in digestion, relieves heartburn, relieves bloating, relieves gas, and stimulates the liver.  Lemon juice is known to nourish the brain and nerve cells and aids in the body’s ability to rid itself of toxins.  It helps aid in the treatments used for malaria and it is useful when it comes to asthma, colds, coughs, sore throats, fevers and rheumatism.

The greatest thing about lemon is that it is so east to obtain.  Whether you are looking for candles, soaps, astringents, or the fruit itself, it is not hard to come by. Source: healthrepublic.com

What do we know already?

Trichomoniasis, sometimes called trich, is a sexually transmitted disease. It’s caused by a single-celled parasite called Trichomonas vaginalis. Around 3 percent of young men carry this infection, although more than half of them will never get any symptoms. When symptoms do occur they’re often mild, such as slight irritation or discharge. The infection can clear up on its own, so you may never know you had it. A 2006 study found a slight link between trichomoniasis in men and a higher risk of getting prostate cancer. One theory is that inflamed tissue is more vulnerable to cancer, and infections could be a cause of inflammation. In a new study, researchers looked at 673 men with prostate cancer and compared them with the same number of healthy men. The average age was 68. All the men had blood samples taken, which were tested for antibodies to trichomoniasis, to find out who’d been infected in the past. The researchers wanted to see if men with prostate cancer were more likely to have had the infection.

What does the new study say?

The new study doesn’t entirely agree with previous research. It found no link between trichomoniasis and developing prostate cancer in the future. However, men with prostate cancer who’d been infected with trichomoniasis did seem more likely to get an aggressive form of cancer that spread outside the prostate gland. Of men with prostate cancer who hadn’t been infected with trichomoniasis, 14 percent had cancer that spread outside their prostate. Of men who’d had the infection, 21 percent had cancer that spread.

How reliable are the findings?

It might be that trichomoniasis leads to a higher risk of aggressive prostate cancer, but it’s difficult to be sure. Finding two things at once doesn’t necessarily mean that one caused the other.

Where does the study come from?

The study was done in the US, with two of the researchers based at Harvard. It appeared in the Journal of the National Cancer Institute, published by Oxford University Press. Funding came from several sources, including the National Cancer Institute and the Harvard University Milton Fund.

What does this mean for me?

It’s possible that trichomoniasis could slightly increase the risk of more severe prostate cancer, but if so, it’s likely to be one factor among many. Of all the men with more serious prostate cancer, only a third had antibodies showing they’d had trichomoniasis, so it obviously doesn’t lead to aggressive cancer in all cases. For most people, trichomoniasis isn’t serious, and can be treated with a short course of a drug called metronidazole; often just one dose.

What should I do now?

For advice about preventing or treating sexually transmitted infections, talk to your GP or visit a genitourinary medicine (GUM) clinic. You can find a clinic near you by visiting http://www.condomessentialwear.co.uk or by calling the NHS sexual health helpline on 0800 567 123. If you’re worried about prostate cancer, talk to you GP. Symptoms such as problems urinating, pain, tiredness, and loss of appetite, should always be investigated. There’s a blood test, called a PSA test, that can be used to screen for prostate cancer in men without any symptoms. However, there are pros and cons to having this test. Your doctor can help you decide if it’s worth you getting tested. BMJ Group News