Our Agony Aunt on Family Nutrition and expert Nutritionist Melody Mackeown FROM NATURAL NUTRITION responds to our questions

'Beating PMS. Your guide to guide to eat your way out of your monthly miseries'

THE GOOD NEWS:

The good news is that you really can eat your way out of PMS. As well as first hand evidence I get back from my clients, more and more studies are showing that changes to your diet can lessen, and in some cases completely eradicate PMS. And that is what this guide is all about.

It tells you what to include in your diet, and what you should ideally try and avoid. Did you know that there are certain foods which are though to aggravate PMS? This article points out the likely culprits. Plus there is a day's meal plan to help you put the guidelines into practise.

The main aim is to help you follow basic and healthy eating principles to provide you with the optimum nutrition - the building blocks to enable you to take control and manage your PMS and its symptoms. The second aim is enjoyment. There's no need for a dull and dreary diet to beat the problems of PMS. In fact, the very opposite is true!

However, be patient! It can take up to 3 months for your altered diet to have a noticeable effect on your symptoms, because the body takes some time to adjust and respond – although you may well notice a difference much sooner.

FOODS AND DRINKS THAT ALLEVIATE PMS

Balancing your blood sugar: complex carbohydrates

It is thought that a diet rich in certain slowly broken down starches - which are also called 'unrefined' or 'complex' carbohydrates - may help reduce PMS symptoms by maintaining an even blood sugar level.

For most of us, blood sugar levels are maintained within normal levels. However, under certain circumstances, or with certain foods, blood sugar levels rise quickly, but are then followed by a sharp drop. This drop is called 'hypoglycaemia' or low blood sugar and the condition is associated with the following symptoms: ANXIETY, IRRITABILITY, AGGRESSIVE OUTBURSTS, FORGETFULNESS, CONFUSION, INABILITY TO CONCENTRATE, PALPITATIONS, CRAVINGS How many of them do you recognise from PMS?

Following the Nutritional Guides below will help you balance your blood sugar levels.

INCREASE YOUR FIBRE

Increasing fibre can also help alleviate the common problem of pre-menstrual constipation. It may also help to bring down levels of the hormone oestrogen in the body by preventing re-absorption of oestrogen from the gut. What's more fibre also helps improves blood sugar control.

Foods that are good sources of complex carbohydrates are also good sources of fibre and the following foods are good sources of both:

Grains like brown rice, oats, wheat, barley, rye, couscous, millet

Pastas including wholewheat, durum wheat, buckwheat, millet, brown rice pastas

Legumes like lentils, chickpeas, aduki beans, kidney beans, flageolet beans

Vegetables like peas, broccoli, corn, cabbage, green beans, sweet potatoes

Including phytoestrogens

Phytoestrogens are naturally occurring substances in food that have a hormone-like action and have a very interesting effect on the body as they have a balancing effect on oestrogen.

If levels are too high, phytoestrogens can block oestrogen receptors thereby sending out weaker signals, however, if oestrogen levels are too low, they will latch on to oestrogen receptors and send out stronger signals.

This is particularly important in PMS as there is conflicting evidence regarding whether too much or too little oestrogen may cause PMS. In addition to the food sources below, phytoestrogens are found to a lesser extent in most fruit, vegetables, nuts and seeds.

The following foods are good sources of phytoestrogens

Soya, including naturally fermented miso, tofu, tempeh

Grains like brown rice, oats, wheat, barley, rye

Legumes like lentils, chickpeas, aduki beans, kidney beans

Vegetables like peas, broccoli, carrots, celery, garlic

Seeds including flaxseeds (also know as linseeds), sesame, pumpkin, poppy, caraway, sunflower

Fruits like apples, plums, cherries, cranberries, citrus fruits

Some herbs and spices such as cinnamon, sage, fennel, parsley

Increase essential fatty acids

Increasing essential fatty acids (EFAs) has been found to be helpful in reducing PMS symptoms. Deficiency signs include IRRITABILITY, DEPRESSION, FATIGUE, FORGETFULNESS, FLUID RETENTION, BREAST TENDERNESS

Once again, how many of them do you recognise from PMS?

There are two main EFAs implicated in alleviating PMS symptoms; the omega-3 and the omega- 6 family, and these are found in the following foods:

Omega 3– family

Salmon, trout, mackerel, herring, sardines, fresh tuna and flaxseeds (also know as linseeds), pumpkin seeds, walnuts; and their oils and organic omega-3 rich eggs

Omega 6 – family

Sunflower, sesame and pumpkin seeds and their oils

Eat more fruit and vegetables

Increasing your fruit and vegetable intake may help to increase essential minerals (Zinc and Magnesium) and vitamins (Vitamin C, B3 and B6) which are important for your body to process these fats. Some examples of fruits and vegetables rich in these mineral and vitamin groups are set out below:

Vitamin C: All citrus fruits, berries e.g. strawberries, apples, papaya, mangoes, parsley, onions, garlic, broccoli, tomatoes, red and green peppers

Vitamin B3: Green leafy vegetables e.g. kale, spinach, broccoli leaves, mushrooms, potatoes

Vitamin B6: Sweet potatoes, Green leafy vegetables e.g. kale, spinach, broccoli leaves, seaweeds, carrots, peas

Magnesium Green leafy vegetables e.g. kale, spinach, broccoli leaves, avocados, pears, dried fruit e.g. dates, apricots, raisins,

Zinc: Bananas, seaweeds, mushrooms, potatoes, asparagus, parsnips

Cruciferous vegetables are rich in a family of nutrients called glucosinolates, which help the liver in the detoxification process. This is particularly important in PMS, as one of the liver's primary functions is to control the level of hormones, such as oestrogen circulating in the blood.

Cruciferous vegetables include:

Broccoli

Cauliflower

Kale

Cabbage

Brussels sprouts.

FOODS AND DRINKS THAT AGGRAVATE PMS

Saturated and trans Fats

A diet high in saturated fats which is largely found in meat and diary products and trans (or hydrogenated) fats which are made from hygrogenating vegetable oils are particularly implicated in making PMS worse as they compete with and block the body from using EFAs effectively.

Trans fats are particularly bad as they are polyunsaturated fats that have been processed (hydrogenated) or fried. Frying polyunsaturated oils can result in oxidising the oil, which means that they can also damage body cells. Cooking in extra virgin olive oil is a good alternative as it is not as vulnerable to oxidation.

Saturated fats to minimise and avoid were possible include:

Diary products including butter, cream, ice cream, full fat milk, cheese, suet, lard and ghee

Trans fats are to be completely avoided include:

Sweets and cheap chocolate bars (with a low coca content and vegetable fats instead of coca butter)

Potato crisps and corn chips

Biscuits

Doughnuts

Margarines and mayonnaise (although some are now trans free - please check the label)

Avoid refined sugar

Processed foods which contain starches and sugars that are quickly broken down by the body can cause rapid fluctuations in blood sugar levels which can make PMS worse.

Processed foods to avoid include:

White bread, pasta and rice

Certain breakfast cereals (e.g. cornflakes, puffed rice)

Chocolate and confectionary

Sweets

Cakes

Ice cream

Sugary drinks (e.g. Lemonade, Coca Cola, Fanta, Squash)

White refined sugar

Cut down on alcohol

Alcohol can aggravate PMS symptoms for a number of reasons: it can cause fluctuating blood sugar levels, which are thought to impact on PMS symptoms, alcohol can disrupt sleep patterns and cause tension, which may be a symptom of your PMS; and alcohol can lower stores of essential nutrients such as zinc which is necessary for the processing of EFAs which have been helpful in reducing PMS symptoms.

Unfortunately if you enjoy a tipple or two, there are no known substitutes for alcohol! Therefore you should try and reduce your intake – you may need to stop drinking alcohol completely to see a reduction in your PMS symptoms.

Cut down on caffeinated drinks

Decreasing the consumption of caffeinated beverages may help to alleviate breast tenderness. Caffeine is also a known aggravator of sleep and can cause tension, which may already be upset by PMS. Also, drunk in large quantities (e.g. 5+ cups of tea/coffee or caffeinated soft drinks) can also lower the level of some important minerals in the body. The tannin in tea also hinders the absorption of certain minerals such as iron and calcium.

Caffeine can be found in: Tea, Coffee, Fizzy drinks, such as Coca Cola, Fanta, Doctor Pepper etc

Good alternatives, include: Herbal teas, including green tea, Dandelion coffee, Hot water with lemon, 100% Fruit juices (with no added sugar), Water

'EATING FISH WHEN PREGNANT AND BREASTFEEDING FOR LONGER THAN 6 MONTHS BOOST CHILD DEVELOPMENT'

A Danish study involving 25,446 children established that children of mums who ate the most fish while pregnant had a 30% better physical and mental development at 6 and 18 months of age than the children of mums who ate little or no fish. In addition, the study found that children who were breastfed for 10 months or more had a 30% better physical and mental development at 6 and 18 months of age than those who were breastfed for one month or less.

What this means is that both breastfeeding and eating fish during pregnancy were just as good at boosting physical and mental development, which means it is very important to eat fish during pregnancy (or supplement with fish oils or vegetarian equivalents if you do not like fish) if you do not plan to breast feed or in case you are unable to breastfeed.

Associations of maternal fish intake during pregnancy and breastfeeding duration with attainment of developmental milestones in early childhood: a study from the Danish National Birth Cohort. Oken E et al., Am J Clin Nutr. 2008 Sep;88(3):789-96

Source: www.ncbi.nlm.nih.gov

'Pregnancy: How Exercise can help just as well as medication'

As many as one in eight women will develop gestational diabetes sometime during their pregnancies, increasing health risks for themselves and their babies. According to Dr Green, www.drgreene.com, researchers at the University of Southern California School of Medicine studied a group of women who had already developed gestational diabetes and who had fasting blood glucose levels high enough to require insulin. Half of the women in the study received the recommended insulin. The other half got personal trainers instead. The trainers supervised the women while they did simple twenty-minute stints on exercise bikes.

The results, says Dr. Green, were startling: moderate aerobic exercise was equally effective to insulin! Blood glucose levels were statistically the same in both groups.

Studies have already shown that exercise can improve insulin sensitivity and help to manage Type II diabetes. This adds to the weight of evidence that exercise is important during pregnancy and if you undertake moderate exercise before and during your pregnancy, you may avoid gestational diabetes in the first place.

Dr Greene also looked at a number of other common pregnancy problems, such as gestational hypertension (or pre-eclampsia) and found that exercise could also help reduce high blood pressure too! Another common postnatal condition post-natal depression (which affects at least 1 in 10 mums) could also be helped with regular exercise prior to having your baby.

Making the correct food choices can also alleviate and prevent a host of pregnancy conditions including gestational diabiates, hypertension and post-natal depression.

I have written a free e-book on how you can improve your diet during your pregnancy, which can be obtained by clicking on my link www.naturalnutrition.uk.com.

Important Note: Please talk to your midwife or GP before embarking on an exercise programme during your pregnancy (especially if you did not exercise regularly beforehand). If you decide to employ a personal trainer, I can highly recommend personal trainer, Giuseppe Minetti, Director of Token Yard www.tokenyard.co.uk, just behind The Body Shop, on Putney High Street. Alternatively, can you look for a personal trainer via www.absolutefitness.co.uk.

Two additional useful websites regarding exercise include: www.lifestylexperts.com and www.newbornfitness.co.uk which supply pregnancy exercise balls/birthing balls.

To find out more about Nutritional support before, during or after your pregnancy, contact Nutritionist Melody Mackeown, Dip ION (mBANT) specialist in pre-conceptual care, fertility and pregnancy care on www.naturalnutrition.uk.com.

'Smoking: what to do if you would like to quit'

It is well known that smoking can adversely affect your fertility rate and can harm your baby. "So, now would be a good time to quit, if you are planning on having a baby this year", says Nutritionist and Foresight Practitioner Melody Mackeown. With the introduction last July of a smoking ban, excellent NHS Stop Smoking services and the availability of a wider range of treatment products (such as Nutritional Therapy or hypnosis), finding the right support to help you stop smoking has never been so good.

So why is stopping smoking so hard?

If you have ever unsuccessfully tried to give up smoking in the past, then you will know that it is fraught with difficulties. Firstly, when you are deprived of nicotine, smokers experience withdrawal symptoms such as depressed mood, irritability, poor concentration, sleep disturbance, hunger and cravings to smoke. Using tobacco puts an immediate end to these, which explains why the relapse rate is so high.

How can Nutritional Support help?

As smoking can upset your blood sugar balance, one of the first things I would look at, as a Nutritionist, are ways to regulate your blood sugar imbalance. Many foods can impact negatively on your blood sugar levels, as well as other stimulants such as coffee, tea, alcohol and chocolate. There are also a number of supplements that may help reduce your craving for nicotine. You may be interested to know that a blood sugar imbalance can also mirror many of the symptoms above, such as irritability and poor concentrations. Consequently, stabilizing your blood sugar is a must.

Tips for successful quitting:

Pick a date to quit that will be stress-free and stick to it

Book an appointment with your local NHS Stop Smoking service, who will advice you on aids to stop smoking or call the NHS Smoking Helpline 0800 169 0 169 for support or visit your GP

Book an appointment to see a Nutritional Therapist, who can advice you on ways to reduce your nicotine cravings via food and supplementation

Plan ahead and avoid stressful situations or people that could tempt you back to smoking

Take it one day at a time and congratulate yourself for every smoke-free day

Keep back the money you are saving and treat yourself (e.g. book yourself in for a massage)

There's no such thing as having 'just one' cigarette (remember it normally takes 90 days or 3 months to effectively quit). Don't do it!

Think positively - tell yourself - I can and will do it! If there are images in this attachment, they will not be displayed.

To find out more about how Nutritional Therapy can help you give up smoking, please contact Melody Mackeown.www.naturalnutrition.uk.com.

CASE STUDY: "How Nutritional Therapy can work wonders for your child"

"When I (Monica Costa, Putney) came to see Melody, Diego was waking up 4-5 times a night and had terrible wind. After explaining to me what foods help promote sleep and what might be contributing to Diego's wind, Melody gave me some sensible dietary advice, which was surprisingly easy to incorporate which made it all the easier!" "When we met up again about a month later, Diego's wind had completely gone and he was only waking up 1-2 times a night."

Case study

Diego, aged 15 months. Case study outline provided by Melody Mackeown, Nutritional Therapist, Dip ION, from Natural Nutrition (www.naturalnutrition.uk.com).

Problem

Waking up 4-5 times a night and suffering from excessive wind (which I thought might be contributing to the frequent night awakenings). Pregnancy history: good. Delivery: normal at 40 weeks. Diego was diagnosed with neutropenia (temporary low white blood cell count), and in part as a result of this has had several courses of antibiotics since his birth.

Possible causes

Gut bacteria imbalance (antibiotics can destroy bad as well as good gut bacteria) which may have been contributing to his wind, low blood sugar (which may have been contributing to his frequent night awakenings), low in nutrients required to make hormones like melatonin which promote sleep.

Actions

Symptomatic relief of wind with a course of probiotics (to help replace the friendly gut flora destroyed during the course of antibiotics.

Blood sugar balancing diet. Replace white refined foods (e.g. pasta and rice) with brown/wholewheat equivalents. This is because they are rich in the nutrients needed to promote good sleep (refined products have many of the nutrients removed). Digestion also takes longer, so babies may not wake as frequently for additional feeds during the night.

Progress after 1 month

Excessive wind had completed stopped.

Night awakenings were reduced from 4-5 to 1-2 times a night.

ARTICLE: "Breast feeding: the best start in life"

Breast is the best form of nutrition you can give your baby. It plays an essential role in supporting your baby's immune system during the first year whilst it is developing. Breast feeding will also help to protect your baby from a variety of infections and other illnesses.

Benefits for your baby

1) Babies who are breastfed have a higher IQ and score up to 7 points higher! - see www.bbc.co.uk.

2) Babies who are breast fed for at least six months, develop fewer colds, ear infections, gastric infections and pneumonia.

3) Friendly bacteria called Bifido bacteria help to protect your baby's gut from harmful bacteria and reduces your baby's risk of colic and allergies to food, eczema, asthma and hay-fever.

4) Breast fed babies are thirty percent less likely to develop obesity than formula fed babies.

5) Vitamins and minerals in breast milk are up to twenty times more easily absorbed than those in formulas. This means your baby is less likely to suffer from deficiencies, such as iron.

6) Breast fed babies also have a lowered risk of developing Diabetes and have better neurological development.

7) Research has shown that there may be a protective effect against Sudden Infant Death Syndrome (SIDs).

Benefits for you

1) Reduces your risk of developing breast cancer. The longer you breast feed the lower the risk. Women who breast feed for between four to twelve months have an approximately 22% lower risk. There is also a reduced risk of ovarian cancer.

2) Encourages bonding between you and your baby (promoted by the hormone oxytocin).

3) Encourages your uterus to contract back into its pre pregnancy size and can reduce blood loss after birth. This means you recover from the birth experience more quickly.

4) Helps shed weight gained during pregnancy. Breastfeeding uses around 500 calories per day!

5) May help you have stronger bones in later life (thereby reducing your risk of developing osteoporosis).

6) Feel less stressed (prolactin encourages calmness)

7) Have increased mental alertness (oxytocin boosts Short-Term memory)

8) Convenience: no need to get up the middle of the night to make up a bottle of milk. It also doesn't cost you anything!

9) Weaning may be easier as your baby is 'primed' to accept different tasting foods more readily as they taste them via your breast milk.

Breastfeeding Tips

1) Breast feed within the first thirty minutes of birth in order to begin establishing feeding while your baby's suckling reflexes are strong.

2) Avoid over stimulation of baby before the first feed. This means that bathing, dressing weighing and measuring all take second place to breast feeding.

3) When at home, make sure you are comfortable before you begin to breast feed. Have a large glass of water and some snacks close to hand (as breastfeeding can make you very hungry!). Have plenty of pillows to support your baby and your back or buy a breastfeeding pillow (from experience I found the Widgey Nursing Support Pillow invaluable).

4) Don't worry that your milk supply is little within the first 3-4 days of birth. This initial colostrum plays a valuable role in preventing infection and is designed to coat your baby's intestine with valuable antibodies. Babies often don't feed much within the first 24-48 hours.

5) Breastfeeding shouldn't be painful. If it is, your baby is probable not attached correctly. Ask the hospital breastfeeding nurse, midwife or health visitor to check that your baby is correctly positioned and attached.

6) Dark green cabbage leaves (organic) are very effective in relieving engorged breasts. Lightly steam them and let them cool before putting them on your breasts.

VERY IMPORTANT: Don't start a feeding routine until your baby is at least six weeks old. Breast milk is digested much faster than formula milk so your baby should feed on demand. This may be anywhere between 1- 5 hourly. Starting a routine too early may reduce your milk flow and create problems.

What should I do if I have problems?

1) Speak to your midwife or health visitor.

2) See your doctor: you or your baby may have thrush (or another condition) which is causing the problem and can be treated medically.

3) See a cranial osteopath.

4) See a breast feeding counsellor (also called lactation counsellor). They will come to your home (not cheap, but worth every penny). Do not rely on telephone support as you need to be shown how to hold your baby correctly when breastfeeding.

The better breastfeeding diet!

To prevent poor milk supply, it is advisable to eat well during your pregnancy so that you have all the right nutrients to make good quality milk as well as a plentiful supply! This includes:

1) Eating 3 meals and 2 good snacks a day: Breast feeding increases your appetite

2) Eating plenty of complex carbohydrate: Wholegrains, vegetables, pulses/legumes; Oatcakes, bean, avocado or humous dips

3) Eating good quality protein: Quiona, millet, soya, fish, beans, lentils, eggs, chicken, cottage cheese, natural yoghurt, seeds and nuts

4) Eating oily fish at least twice a week: Mackerel, salmon , herring, sardine/pilchard, fresh tuna. These are good sources of essential fatty acids for you and your baby

5) Eating at least 5 portions of fruit and vegetables a day: Apples, pears, courgettes, spinach, tomatoes

6) Snacking on fruit, nuts and seeds: And not on sugary snacks, such as biscuits

7) Drinking at least 1.5 litres (21/2 pints) of filtered or mineral water a day: Always have a drink beside you when you sit down to feed as your baby's sucking will stimulate thirst. There is nothing more annoying than wanting a drink when you have just got settled.

8) The UK DoH recommends that all breastfeeding mothers take a vitamin and mineral supplement to ensure your breast milk has enough nutrients for your baby.

And avoiding: 1) Caffeine found in tea and coffee (which can agitate your bay and prevent restful sleep), alcohol (which prevents a baby from feeding as long and can damage brain cells) and

2) dieting (you need all the energy you have to make a plentiful milk supply).

Sources:

www.bbc.co.uk

www.birthinlondon.co.uk

Unicef

DOH

Article posted on 17th November 2007.

Our nutrition expert: Melody Mackeown

Melody Mackeown, Dip ION, BANT, BSc Psychology (Hons), runs a successful nutritional therapy practice in SW London and provides nutritional guidance, supplement and diagnostic testing recommendations for adults, babies and children. Melody also runs regular weaning classes at the Vitality Centre, 155 Merton Road, SW18. T: 020 8871 948307790 831 254 or www.naturalnutrition.uk.com. She would be very happy to speak with you over the phone if you or your family have any health concerns.