What is Polycystic Ovary Syndrome?

Polycystic (literally, many cysts) ovary syndrome (PCOS or PCO) is a complex condition, characterise by hormonal imbalances that affects the ovaries (the organs in a woman’s body that produce eggs). In PCOS, the ovaries are generally bigger than average. The outer surface of the ovary has an abnormally large number of small follicles (the sac of fluid that grows around the egg under the influence of stimulating hormones from the brain).The ovaries are polycystic, with many small follicles scattered under the surface of the ovary (usually more than 10 or 15 in each ovary) and almost none in the middle of the ovary. In PCOS, these follicles remain immature, never growing to full development or ovulating to produce an egg capable of being fertilised.

This means that ovulation (releasing an egg) may rarely occur and can therefore lead to reduced fertility. In addition, periods may be irregular or absent. Other features include excess weight and body hair.

What are the symptoms of Polycystic Ovary Syndrome?

Symptoms that occur if you do not ovulate

• Absent, irregular or light periods- periods can be as frequent as every five to six weeks, but might only occur once or twice a year, if at all
• Fertility problems – you need to ovulate to become pregnant. You may not ovulate each month, and some women with PCOS do not ovulate at all. PCOS is one of the most common causes of infertility.

Symptoms that can occur if you make too much testosterone (male hormone)

• increased facial and body hair (hirsutism): usually found under the chin, on the upper lip, forearms, lower legs and on the abdomen (usually a vertical line of hair up to the umbilicus) .This is the only symptom in some cases.
• Acne: which may persist beyond the normal teenage years.
• Thinning of scalp hair (similar to male pattern baldness) occurs in some cases .

Other symptoms

• Being overweight or obese: a common finding in women with PCOS because their body cells are resistant to the sugar-control hormone insulin. This insulin resistance prevents cells using sugar in the blood normally and the sugar is stored as fat instead
• Miscarriage (sometimes recurrent): one of the hormonal abnormalities in PCOS, a raised level of luteinising hormone (LH – a hormone produced by the brain that affects ovary function), seems to be linked with miscarriage. Women with raised LH have a higher miscarriage rate (65 per cent of pregnancies end in miscarriage) compared with those who have normal LH values (around 12 per cent miscarriage rate).

• Depression or poor self-esteem may develop as a result of the other symptoms.

Diagnosis

At least two of the following occur in PCOS, and often all three:

• At least 12 follicles (tiny cysts) develop in your ovaries.
• The balance of hormones that you make in the ovaries is altered. In particular, your ovaries make more testosterone (male hormone) than normal. The main hormones that are made in the ovaries are oestrogen and progesterone – the main female hormones, but the ovaries also normally make small amounts of male hormones (androgens) such as testosterone.
• You do not ovulate each month. Some women do not ovulate at all. In PCOS, although the ovaries usually have many follicles, they do not develop fully and so ovulation often does not occur. If you do not ovulate then you do not have a period.

Therefore, it is possible to have polycystic ovaries without the typical symptoms that are in the syndrome. It is also possible to have PCOS without multiple cysts in the ovary.

Incidence

PCOS is relatively common among infertile women. If affects up to 10 per cent of all women between the ages of 15 and 50. In the general population, around 25 per cent of women will have polycystic ovaries seen on an ultrasound examination. But most have no other symptoms or signs of PCOS and have no health problems. The ultrasound appearance is also found in up to 14 per cent of women on the oral contraceptive pill.

What causes polycystic ovary syndrome?

The exact cause is not totally clear. Several factors probably play a part. These include the following:

1. A small increase in the amount of insulin and cellular resistance to its actions- insulin is a hormone that you make in your pancreas and its main role is to control your blood sugar level. Insulin acts mainly on fat and muscle cells to stimulate them to take in sugar (glucose) when your blood sugar level rises (as excess levels are toxic to cells). Insulin also stimulates the ovaries to produce testosterone (male hormone).

Women with PCOS have what is called insulin resistance, meaning that cells in the body are resistant to the effect of a normal level of insulin. Thus, more insulin is produced to keep the blood sugar normal.  Raised levels of insulin in the bloodstream are thought to be the main underlying reason why PCOS develops because this causes the ovaries to make too much testosterone. A high level of insulin and testosterone interfere with the normal development of follicles in the ovaries. As a result, many follicles tend to develop but often do not develop fully. This causes problems with ovulation: hence period problems and reduced fertility. Increased testosterone levels in the blood cause excess hair growth on the body and thinning of the scalp hair.
2. Raised luteinising hormone (LH) in the early part of the menstrual cycle- This hormone is made in the pituitary gland and stimulates the ovaries to ovulate and works alongside insulin to promote testosterone production. A high level of LH is found in about 4 in 10 women with PCOS. A high LH level combined with a high insulin level means that the ovaries are likely to produce too much testosterone.

3. Lower amounts of the blood protein that binds to and carries all sex hormones (called sex-hormone-binding globulin)- this  means that testosterone levels are higher and therefore more active. Sex-hormone-binding globulin levels are reduced in insulin resistance (meaning there are high insulin levels).

4. Hereditary factors- one or more genes may make you more prone to developing PCOS. PCOS is not strictly inherited from parents to children, but it may run in some families.

5. Weight- Being overweight or obese is not the underlying cause of PCOS. However, if you are overweight or obese, excess fat can make insulin resistance worse, a contributing factor to PCOS. This may then cause the level of insulin to not only rise even further, but high levels of insulin can contribute to further weight gain, producing a ‘vicious cycle’.

Risk factors for PCOS

• a tendency in the family towards Type 2 diabetes (non-insulin dependent diabetes)
• a close relative who already has PCOS
• a tendency towards early baldness in the men in the family (before 30 years of age).

Nutritional and lifestyle approaches to PCOS

Research has shown that weight control improves many aspects of PCOS. Menstrual cycles become more regular, testosterone levels are reduced, fat and sugar metabolism improves, and spontaneous pregnancy may follow. Obese patients do not have to reach the normal body mass index; a weight reduction of even a few percent has clinical benefits. This is because visceral fat (intra-abdominal fat located inside the abdominal cavity, packed between the organs) is metabolically more hormonally active, and weight loss of a few percent is associated with significant loss of visceral fat.

Weight management through nutrition and exercise is now recommended to all overweight/obese women with PCOS (Kovacs 2006).

So, here are some tips to help reduce the hormonal imbalances associated with PCOS:

1. Research has shown that fat intake should be restricted to not more than 30% of total calories with a low proportion of saturated fat, which is found mostly in animal products such as meat and dairy. Healthy fats such as olive oil, nuts/seeds, avocados, and fish oil, and avocado are important parts of a PCOS–friendly diet however (Farshchi et al 2007).

2. Choose whole grain carbohydrates. The insulin level in your blood goes up after you eat. It increase the most after you eat or drink something that contains carbohydrates. Carbohydrates are found in grains (such as bread, pasta, rice, cereal, and potatoes), vegetables, fruits and drinks such as soda and juice. Even if you eat two foods that have the same amount of carbohydrate, they may have a different effect on your insulin level. This effect has a lot to do with the type of carbohydrate the food has.

Whole grain carbohydrates which contain fibre such as brown rice, whole wheat bread and pasta, oats, barley, etc. have a low Glycaemic Index (GI). GI is a term used to describe how a food affects blood sugar; the higher a food raises blood sugar, the higher the glycaemic index. The benefit of consuming low GI foods is that it helps keep your insulin level down, and also keeps hunger at bay for longer, thus aiding weight management. Sugary foods or refined grains (such as white bread, white rice and white pasta) on the other hand have a high GI and can cause insulin levels to go up and are also not very filling (which means you may feel hungry again shortly after eating them.

3. Always have some protein with each meal or snack- combining a carbohydrate food with protein lowers the GI because protein slows the release of sugar from foods into the bloodstream. This helps reduce blood sugar spikes and therefore helps prevent high insulin levels. Protein can be found in lean meats, fish, poultry, dairy products, tofu, eggs, beans, nuts and seeds. Try to consume plenty of plant proteins which are often high in fibre and low in fat, rather than just sticking to animal proteins.

4. Have balanced meals containing carbohydrates, protein, and fat - combining foods that contain protein or fat with a carbohydrate will help to slow down the absorption of the carbohydrate and keep insulin levels low. For example, have almond butter or hummus on bread rather than just a piece of bread by itself. A typical plate of food should consist of ¼ carbohydrates, ¼ protein and the remaining ½ plate of vegetables!

5. Have smaller, more frequent meals (every 3-4 hours) to help control blood glucose levels. Your insulin will go up much more if you have 3 cups of pasta than if you have 1 cup of pasta. This means it’s usually better to have small meals and snacks during the day than it is to have fewer really big meals to keep your insulin level lower.

6. Exercise- Research has shown that at least 150 minutes of moderate or vigorous activity per week for diabetes prevention. This is because exercise helps  your cells become more receptive to the effects of insulin which in turn helps lower insulin levels (Knowler et al 2002).

7. Supplements- there are a number of supplements which can be very helpful to rebalance hormones. Recommendations are based on your individual health profile and are discussed at your visit.

References

Cahill D (2010) Polycystic ovary syndrome (PCOS) last accessed 21.3.2013 online at http://www.netdoctor.co.uk/womenshealth/facts/pcos.htm

Farshchi H Rane A Love A Kennedy RL (2007) Diet and nutrition in polycystic ovary syndrome (PCOS): pointers for nutritional management.  J Obstet Gynaecol 27 8 762-73

Kenny T (2010) Polycystic Ovary Syndrome last accessed 21.3.2013 online at http://www.patient.co.uk/health/Polycystic-Ovary-Syndrome.htm

Knowler WC Barrett-Connor E Fowler SE et al (2002) Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346 393-403

Kovacs P (2006) Viewpoint: Lifestyle Modification is First-Line Treatment for PCOS last accessed 21.3.2013 online at http://www.medscape.com/viewarticle/522390

Do we really need to worry about what we eat?

These days, more and more people are telling us that healthy eating is very important for our health and well being. However, is it really all that important? A human being is made up of roughly 63% water, 22% protein, 13% fat and 2 % minerals and vitamins (Holford 2005). Every single molecule comes from the food you eat and the water you drink. Eating the highest-quality food, in the right quantities, can help you to achieve your highest potential for health, vitality and freedom from disease. For example, there is good evidence that eating a healthy diet can reduce your risk of obesity and illnesses such as diabetes, heart disease, stroke, osteoporosis and some types of cancer, including those of the bowel, stomach, mouth, and breast (Cancer Research UK 2009).

But eating healthily doesn’t just reduce your risk of ill health, it will also help boost your energy levels, mood, concentration and help you handle stress better, making you feel better all round.

How have our diets and lifestyles changed?

Although we are living in the 21st century, our human genome is greater than 10,000 years old.  The genome refers to our entire DNA, including our genes. Genes carry information for making all the proteins required by the body. These proteins determine, among other things, how well the body metabolises food or fights infection, and sometimes even how it behaves. Our ancestors consumed only natural and unprocessed food from the environment which provided them with a diet of moderate protein, high in fibre, vitamins, minerals, antioxidants and other beneficial plant chemicals. Thus, many researchers argue that there is a striking discrepancy between the diet we were biologically designed to eat and what we actually eat today.

Rapid changes in diets and lifestyles have occurred with industrialisation, urbanisation, economic development and market globalisation. While standards of living have improved, food availability has expanded and become more diversified, there have also been significant negative consequences in terms of inappropriate dietary patterns, decreased physical activities and increased tobacco use. This has corresponded with an increase in diet-related chronic diseases which are becoming increasingly significant causes of disability and premature death. For example, traditional, largely plant based diets have been replaced by an emphasis on animal-based foods and energy-dense diets which are high in fat- particularly saturated fat, and low in complex carbohydrates. Alongside this shift in dietary patterns, we have also switched to a much more sedentary lifestyle due to motorised transport, labour-saving devices in the home, the phasing out of physically demanding manual tasks in the workplace, and leisure time that is predominantly devoted to physically undemanding pastimes (World Health Organisation 2003).

Can nutrition help prevent disease?

It has been calculated that, in 2001, chronic diseases contributed to approximately 60% of the 56.5 million total reported deaths in the world and to approximately 46% of the global burden of disease- this is expected to increase to 57% by 2020(World Health Organisation 2003).

Chronic diseases are largely preventable diseases (World Health Organisation 2003). Although more basic research may be needed on some aspects of the mechanisms that link diet to health, the currently available scientific evidence provides a sufficiently strong and plausible basis to justify taking action now (World Health Organisation 2003). Modern dietary patterns and physical activity patterns are risk modifiable behaviours. Furthermore, nutrition has been shown to have the capacity to modify the expression of critical genes associated with normal physiological processes, as well as those associated with the development of disease, including age-related processes and cancer (Choi & Friso 2010). But diet, while critical to prevention, is just one risk factor. Physical inactivity, is now recognized as an increasingly important determinant of health, and is the result of a progressive shift of lifestyle towards more sedentary patterns.

What should we be eating?

There is no single “diet” which suits everyone-one man’s elixir could be another’s poison. However, there are some basics which apply to us all. Most people in the UK eat and drink too many calories, and too much fat, sugar and salt, and not enough fruit, vegetables and fibre.

Increase Fruits & Vegetables

It has been estimated that eating at least 5 portions of a variety of fruit and vegetables a day could reduce the risk of deaths from chronic diseases such as heart disease, stroke, and cancer by up to 20% (Department of Health 2000). But eating fruit and vegetables can help to achieve other dietary goals too, including increasing fibre intake, reducing fat intake, helping to maintain a healthy weight, and displacing foods with added sugars.

The reason why fruit and vegetables are so beneficial is because as well as containing fibre, vitamins and minerals, fruit and vegetables also contain many complex plant components called phytochemicals.  Phytochemicals are nonessential nutrients, meaning that they are not required by the human body for sustaining life, but they have protective or disease preventative properties. It is well-known that plants produce these chemicals to protect themselves but recent research demonstrates that they can also protect humans against diseases.

How many fruits and vegetables do we need?

The UK government recommends that we have AT LEAST 5 portions (400g) of a variety of fruit and vegetables daily, 2 of fruit and 3 of vegetables.

One portion of fruit:

• half a large grapefruit
• a slice of melon
• 2 satsumas
• 3 dried apricots, or 1 tablespoon of raisins
• A glass of 100% juice- but you can only count juice as 1 portion a day, however much you drink. This is because it has very little fibre.

One portion of vegetables:

• 3 tablespoonfuls of cooked carrots or peas or sweet corn
• 1 cereal bowl of mixed salad.
• Beans and other pulses, such as kidney beans, lentils and chick peas, count only once a day, however much you eat. While pulses contain fibre and protein, they don’t give the same mixture of vitamins, minerals and other nutrients as fruit and vegetables.
• Potatoes don’t count towards 5 A DAY because they are starchy

Increase healthy fats

Eating too much fat can make us more likely to put on weight, because foods that are high in fat are also high in energy (calories). Being overweight raises our risk of serious health problems. However, this doesn’t mean that all fat is bad. We need some fat in our diet because it helps the body absorb certain nutrients, provides energy and essential fatty acids that the body can’t make itself.

Reading nutrition labels on food packaging can help you to reduce the amount of fat you eat:

• High fat foods: more than 20g of total fat per 100g
• Low fat foods: less than 3g of total fat per 100g

Reduce Saturated fats

There are two main types of fat found in food: saturated and unsaturated. Saturated and unsaturated fat contain the same amount of calories, but most people in the UK eat too much saturated fat: about 20% more than the recommended maximum. Eating a diet high in saturated fat can cause the level of cholesterol in your blood to build up over time which can increase your risk of heart disease. The main sources of saturated fat are meat and dairy products.

• The average man should eat no more than 30g of saturated fat a day.
• The average woman should eat no more than 20g of saturated fat a day.

Look out for “saturates” or “sat fat” on the label: this tells you how much saturated fat is in the food.

• High: more than 5g saturates per 100g. May display a red traffic light.
• Low: 1.5g saturates or less per 100g. May display a green traffic light.

Unsaturated fats

There are also 2 kinds of unsaturated fats: monounsaturated fats which are found in olive oil and avocados, and polyunsaturated fats called omega-3 and omega-6 which are found in nuts, seeds and oily fish.

Omega-3 and omega-6 polyunsaturated fats are essential for optimal functioning of the brain and nervous system, immune system, cardiovascular system and skin health. Pumpkin and flaxseeds as well as oily fish (including salmon, mackerel, trout, herring, fresh tuna, sardines and pilchards) are rich in omega- 3 fats, while sesame and sunflower seeds are rich in omega-6 fats.

We should aim to eat a small handful of a combination of seeds and nuts daily, as well as eat at least one portion of oily fish weekly. In addition, by increasing our intake of plant foods, as opposed to animal foods, we naturally shift to a more healthy fat consumption.

Avoid hydrogenated and Trans fats

Trans fats are formed when manufacturers turn liquid oils into solid fats. Think shortening and hard margarine. Manufacturers create trans fats via a process called hydrogenation, a process by which vegetable oils are converted to solid fats simply by adding hydrogen atoms. Why hydrogenate? Because hydrogenation increases the shelf life and flavour stability of foods. Indeed, trans fats can be found in vegetable shortening, margarine, crackers, cereals, candies, baked goods, granola bars, chips, salad dressings, fried foods, and many other processed foods.

Like saturated fats, trans fats can raise cholesterol levels in the blood. This is why it’s recommended that trans fats should make up no more than 2% of the energy (calories) we get from our diet. For adults, this is no more than about 5g a day.

Increase fibre

Fibre is the structural part of a plant that supports and holds it together. Fibre can be chewed, swallowed and subjected to stomach acid, yet much of it passes through the body unchanged.

Fibre is important because it:

• stimulates the digestive tract and helps it work efficiently
• encourages the presence of health-giving bacteria in the large intestine
• softens the stool (bowel motion) and helps prevent constipation
• slows down carbohydrate absorption, makes you feel fuller and so helps to control your appetite, and therefore helps with weight management
• has also been associated with a decreased incidence of certain cancers of the digestive tract.

There are two types of fibre:

• Insoluble fibre- insoluble fibre is less easily broken down by bacteria in the colon, so it passes through the gut, helping other food and waste products move through the gut more easily. It holds water very effectively (up to 15 times its weight in water) thus contributing to an increase in stool weight. Fruit and vegetables with their skins and pips, wholegrain cereals (wheat, quinoa, rye, rice) as well as nuts and some pulses are good sources of this kind of fibre.
• Soluble fibre-this fibre forms a gel-like substance which can bind to other substances in the gut. It also has the extra benefits of lowering cholesterol levels and slowing down the entry of glucose into the blood, thereby helping to maintain good energy levels, concentration and mood. Fruits, vegetables, oats and pulses are good sources.

How much fibre do I need?

The recommended intake of fibre for adults in the UK is 18g a day, but 20 g -35 g in the US. However, most people in the UK don’t eat enough – the average intake is 12.6g a day for women and 15.2g a day for men.

So what does 18g of fibre look like? A few examples of the amount of fibre in some common foods include the following.

• One bowl (30g) of high-fibre cereal, e.g. bran flakes – 4g
• One slice of wholemeal bread – 3 to 4g (white bread contains less than half this amount)
• One baked potato (with skin) – 5g
• Half a tin of baked beans (200g) – 7.7g
• Portion of dried figs (50g) – 3.8g
• One medium-sized apple – 1.8g

Don’t forget the fluid

Without fluid, dietary fibre cannot do its job. Insoluble fibre, in particular, acts like a sponge absorbing water, increasing stool weight and size, thus putting pressure on the bowel wall and facilitating the movement of the stool. Without fluid this fibre is pointless and will only result in constipation.

Water

Two-thirds of the body consists of water and the body loses 1.5 Litres of water a day through the skin, lungs and gut and via the kidneys as urine, ensuring that toxic substances are eliminated from the body(Holford 2005). We also make about a third of a litre of water a day when glucose is “burned” for energy.  So our minimum water intake from food and drink needs to be more than 1 litre a day, with the ideal begin around 2 litres daily. Fruit and vegetables consist of around 90% water- 4 pieces of fruit and four servings of vegetables  can provide a litre of water, leaving 1  litre to be taken as water or diluted juices or herb or fruit teas. Alcohol acts as a diuretic and causes considerable losses of vitamins and minerals so it doesn’t count in this regard.

Should we be eating less?

We need to eat the right number of calories for our level of activity, so that we balance the energy we consume with the energy we use. Although consideration of calorie intake on its own is a simplistic view of weight management (and therefore also health management) if you eat or drink too much, you’ll put on weight. Likewise, if you eat too little for your energy requirements you’ll lose weight. The average man needs around 2,500 calories a day. The average woman needs 2,000 calories. Most adults are eating more calories than they need, and should eat fewer calories.

In fact, controlled, supervised calorie restriction is widely viewed as the most potent dietary means of slowing the aging process (Fontana et al 2004; Colman et al 2009).   Calorie restriction is a dietary regimen that restricts calorie intake, where nutrient dense, low-calorie foods are consumed to supply sufficient quantities of vitamins, minerals and other important nutrients. Generally, a calorie-restriction diet may call for 20 to 30 percent fewer calories than usual. Adult-onset calorie-restriction works best when it is imposed slowly, over two or three years, to allow the body to adjust.

How should we be eating?

We should always eat in a way which helps us maintain steady blood sugar levels. Why? Food is turned into glucose or sugar, which is the fuel that drives all cells and bodily processes. Thus, maintaining a steady supply of glucose to cells is key for optimal mental and physical functioning. However, blood sugar levels must be kept within strict boundaries, since too much is toxic to cells on the one hand, and too little makes us feel tired and lethargic on the other. This balancing process happens through the actions of two hormones. Firstly, insulin stimulates cells to take in glucose when there’s too much of it in the blood- this helps lower high blood sugar levels, but also provides cells with the fuel they need. Secondly, another hormone called glucagon breaks down stored sugar when blood sugar levels are low.

The negative effects of imbalanced blood sugar levels include irritability, poor concentration, fatigue, depression and food cravings- especially for sweet foods or stimulants such as tea, coffee and cigarettes, all of which in turn cause further blood sugar roller coasters.

How you can maintain steady blood sugar levels

1. Eat breakfast. The meaning of the word “breakfast” is literally “breaking the fast”. Blood sugar levels are low after an overnight fast and skipping breakfast will result in an inadequate supply of glucose to the cells. This can make you feel fatigued, moody and affect your concentration.

2. Don’t skip meals. This is for the same reason you shouldn’t skip breakfast- it will lead to low blood sugar.

3. Choose complex carbohydrates. Complex carbohydrates are broken down more slowly into glucose because of their fibre content and therefore provide a steady supply of fuel to brain cells. Complex carbohydrates are found in whole grains, nuts, seeds, legumes, and vegetables.

4. Avoid refined carbohydrates. They convert more quickly into glucose than complex carbohydrates. This causes rapid blood sugar spikes, which is then followed by blood sugar lows because the body keeps blood sugar levels within a narrow range to protect against the potentially toxic effects of sugar on cells. This rapid drop in blood glucose levels (below the optimal reference range) starves the brain of its primary fuel and we experience symptoms such as energy slumps, cravings for sweets and stimulants (tea, coffee, and cigarettes), irritability, mood swings, poor memory, poor concentration and fuzzy thinking.

Refined carbohydrates are found in white pasta/bread/rice (as opposed to their whole grain versions) and anything containing added sugar like cakes, sweets, ice cream etc. Natural sugars are found in fruit and are better sources of simple carbohydrates because they contain protective antioxidants as well as fibre, which slows down the release of fruit sugar into blood and so reduces blood sugar spikes.

5. Avoid stimulants such as coffee, chocolate and nicotine which increase levels of the stress hormones cortisol and adrenaline (Lovallo et al 2006) which sharply spike up blood sugar levels and subsequently leads to an energy slump as described above. Adrenaline and cortisol are “fight-or-flight” hormones, biologically evolved to help survival under stressful situations by breaking down stored sugar to heighten alertness and fuel muscles for emergencies. However, unless the extra sugar released in the blood stream is burned off through a physical response as in the “fight-or-flight” reaction in a genuine emergency, blood sugar levels will remain high. This will trigger a large insulin response and lead to low blood sugar levels because the body keeps blood sugar levels within a narrow range to protect against the potentially toxic effects of sugar. Usually this results in reaching for another cup of coffee or more chocolate and the blood sugar roller coaster starts over. When stimulants are consumed, blood sugar levels remain high because the “fight-or-flight” reaction has been artificially induced rather than through a genuine emergency and requires no physical “fight-or-flight” response which would use up the extra blood sugar and naturally lower blood sugar levels to safe ranges.

6. Make sure you consume protein with each meal and snack – this helps slow down the release of sugar from food into the blood. Choose from chicken and turkey, game, white fish, oily fish (tuna, mackerel, herrings, pilchards, sardines, and salmon), pulses, eggs, yoghurt, cottage cheese, feta, nuts and seeds.

How do you make healthy eating a habit?

• Don’t try to change everything at once.
• Set an easy goal you can reach, like having a salad and a piece of fruit each day.
• Make a long-term goal too, such as having one vegetarian dinner a week.

• Aim for balance. Most days, eat from each food group-vegetables and fruit, grain products, milk and alternatives, and meat and alternatives. Listen to your body. Eat when you’re hungry. Stop when you feel satisfied.
• Look for variety. Be adventurous. Choose different foods in each food group. For example, don’t reach for an apple every time you choose a fruit. Eating a variety of foods each day will help you get all the nutrients you need.
• Practice moderation. Don’t have too much or too little of one thing. All foods, if eaten in moderation, can be part of healthy eating. Even “treats” can be okay.

References

Cancer Research UK (2009) Diet, healthy eating and cancer last accessed 12.12.2011 at http://info.cancerresearchuk.org/healthyliving/dietandhealthyeating/.rs

Choi SW & Friso S (2010) Epigenetics: A New Bridge between Nutrition and Health. Adv Nutr (Bethesda)11 8-16

Colman RJ  Anderson RM Johnson SC (2009) Caloric restriction delays disease onset and mortality in rhesusMonkeys Science 325 5937 201–204

Department of Health (2000) The NHS Plan. London: Department of Health

Fontana L Meyer TE Klein S Holloszy JO (2004) Long-term calorie restriction is highly effective in reducing the risk for atherosclerosis in humans Proc Natl Acad Sci USA 101 6659-6663

Holford P (2005) The New Optimum Nutrition Bible Rev Upd Edition Crossing Press

Lovallo WR  Farag NH  Vincent  AS  Thomas  Wilson T(2006) Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women Pharmacol Biochem Behav 8 3 3  441–447

World Health Organisation (WHO) (2003) Technical Report Series 916: Diet, Nutrition And The Prevention Of Chronic Diseases last accessed 12.12.2011 at http://whqlibdoc.who.int/trs/who_trs_916.pdf

Copyright secured by Digiprove © 2011 Sylvia Hensher

By London Nutritionist Sylvia Hensher

Introduction

Brian Wansink from Cornell University has spent much of his scientific career trying to understand what influences our food choices. His conclusion is that most of us are unaware of what influences how much we eat. We all think we’re too smart to be tricked by packages, lighting or the size of plates. We might acknowledge that others can be tricked, but not us. Yet every single one of us is influenced by what’s around us when it comes to deciding what and when we will eat.

In other words, we over-eat not because of hunger, but because of family and friends, packages and plates, names and numbers, labels and lights, colours, shapes and smells, cupboards and containers.

Read on to hear about his fascinating findings from decades of research into behaviour and eating patterns.

Brian Wansink on how to lose weight without thinking about it

The average person makes well over 200 decisions about food every day. Breakfast or no breakfast? Bread, bun or bagel? Part or all of it?

Every time we pass a dish of sweets or open up our desk drawer and see a piece of chewing gum, we make a food decision. Yet we can’t really explain most of these 200-plus decisions. Most of us are blissfully unaware of what influences how much we eat. Because although you can eat too much without knowing it, you can also eat less. Because, let’s face it, the best diet is the one you don’t know you’re on…

Strategy 1- Remove The Mindless Margin

Just ten extra calories a day – one stick of gum or three jelly beans – will make you a pound heavier in a year. And 140 calories a day – or one can of soft drink – will make you put on a stone. And you won’t even notice.

Fortunately, the same thing happens in the opposite direction. This is known as the mindless margin: those few extra calories that you can consume – or not consume – every day that you really don’t notice. By cutting out 100 to 200 calories a day, you can lose weight. That can mean not having one of your daily Starbucks. Or not tucking into a packet of crisps when you get in from work.

Cutting out your favourite foods entirely, however, is a bad idea: you’ll just feel deprived. Cutting down on how much you eat of them, on the other hand, is mindlessly do-able.

Simply dish out 20 per cent less than you think you will want before you start to eat. You probably won’t miss it. For fruit and vegetables, though, think 20 per cent more. If you cut down the pasta you eat by 20 per cent, increase the veggies by 20 per cent.

Strategy 2- See All You Eat

When people put their food on a plate, they eat about 14 per cent less. So instead of eating directly out of a package or box, put everything you want to eat on a plate before you start eating – whether it’s a snack, dinner, ice cream or even crisps. Leave the packaging in the kitchen and eat elsewhere. You’ll also eat less if you are able to see what you’ve already eaten.

Strategy 3- Be Your Own Tablescaper

(more…)

Copyright secured by Digiprove © 2011 Sylvia Hensher

by London Nutritionist Sylvia Hensher

There is a connection between our adrenal glands, thyroid glands and weight gain. When these two glands are not kept in a healthy state, the result can often be weight gain. The good news is that on the other hand, if these two glands are supported through proper nutrition and a healthy lifestyle, it can lead to a natural weight loss.

What our adrenal glands do

The adrenal and thyroid glands are very closely connected in how they enable the body to function properly. The adrenals are small triangular shaped glands that sit on top of both kidneys. They are responsible for releasing the hormones adrenaline and cortisol which among other functions, help control body fluid balance, blood pressure, blood sugar and are designed to help the body deal with physical and psychological stress. In addition, the adrenal glands produce small amounts of oestrogen when women enter into menopause and the ovaries reduce their oestrogen output. This is why it’s so important to maintain adrenal function in the menopause years.

Adrenal Fatigue

Adrenal Fatigue is a collection of signs and symptoms, known as a “syndrome” that results when the adrenal glands function below the necessary level.  This happens most often when you are exposed to constant , uninterrupted stress so that your body (and adrenal glands) cannot fully recover, or during or after acute or chronic infections. Consequently, the adrenal glands become fatigued and are unable to continue responding adequately to further stress.

You may look and act relatively normal with adrenal fatigue and may not even have any obvious signs of physical illness, yet you live with a general sense of feeling unwell, tiredness or “grey” feelings. People suffering from Adrenal Fatigue often have to use coffee, tea and other stimulants to get going in the morning and to prop themselves up during the day.

Some Manifestations Of Adrenal Fatigue: (more…)

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PART 2

by London nutritionist Sylvia Hensher

Hi again! In part 1 of this series on the thyroid we talked about what the thyroid is, how it might be affecting your weight, symptoms of an underactive thyroid and a simple test you can do at home to give you an indication, but no firm diagnosis, as to how well your thyroid is functioning.

In this 2^nd part of the series, we’ll look at how you can support optimal thyroid functioning, and therefore optimal weight management, through nutrition.

Foods to help support optimal thyroid functioning

1. Iodine is required to manufacture the thyroid hormones. Without sufficient iodine, your thyroid cannot produce adequate thyroid hormones to help your body function on an optimal level. Seafoods, iodised salt and sea vegetables such as kelp, as well as foods grown in iodine rich soil, are rich sources of iodine. It should be noted, however, that too much iodine can actually trigger thyroid problems and worsen symptoms, so it’s important to have a healthy balance.

2.       Zinc is another essential mineral for optimising thyroid health.

3.      Selenium: This mineral is critical for the proper functioning of your thyroid gland, and is used to produce and regulate the active T3 hormone. Selenium can be found in foods such as shrimp, snapper, tuna, cod, halibut, calf’s liver, button and shitake mushrooms and Brazil nuts.

4.      Zinc, Iron and Copper are needed in trace amounts for your healthy thyroid function. Low levels of zinc have been linked to low levels of TSH, whereas iron deficiency has been linked to decreased thyroid efficiency. Copper is also necessary for the production of thyroid hormones. Seafood, whole grains, green leafy vegetables, nuts and seeds can help provide these trace metals in your diet.

5.      B vitamins help to manufacture thyroid hormones and play an important role in healthy thyroid function. They are found in whole grains, pulses and green leafy vegetables. (more…)

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By London nutritionist Sylvia Hensher

1. Nutrition-the danger of insulin resistance

If you want to lose weight it’s very important to eliminate obvious sugar from your diet. We’re not just talking about obvious forms found in desserts and processed foods, but also to reduce our consumption of hidden ones in foods most of us consider to be healthy. Hidden sugars are also found in carbohydrates such as grains which break down to simple sugars and can contribute to insulin resistance. What is insulin resistance you may ask? Well, the cells in our body need a continuous supply of glucose (or sugar) for their energy requirements. Glucose, however, cannot penetrate the outer membrane of a cell without the assistance of insulin, a hormone which acts as a gatekeeper, allowing glucose to enter cells. Insulin stimulates the body to convert excess glucose (or sugar) which our cells don’t need (i.e. think too much chocolate etc) into fat and then helps to block the breakdown of this stored fat for energy production, making weight loss difficult.

For various biochemical reasons, the body may become less sensitive to its own insulin and compensates by producing more. Higher insulin levels not only make your body store even more fat, it also makes it more difficult to lose weight by blocking the release of fat from the fat cells so it can be burned for fuel. This explains why so many people have problems losing weight.

2. Exercise- high-intensity interval training & weight lifting

High-intensity interval training done 2-3 times weekly can boost your metabolism and increase fat loss, but is also a potent “anti-aging” strategy, as it will naturally increase your body’s production of human growth hormone (HGH).HGH promotes muscle, effectively burns fat and plays an important role in promoting overall health/longevity.

Weight lifting is another essential part of a programme for kick-starting your metabolism. Having more muscle is one of the best ways of burning fat you will ever come across because it helps you burn more calories, without you having to actually “do” more.

This is because muscle is metabolically very active and requires energy just to sit on your frame – even when you sleep. For every pound of muscle that you gain, your body will burn approximately 50-70 calories more per day, and burning more calories leads to a reduction of excess fat.

3.  Are you getting enough sleep? (more…)

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