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Monday, 21 January 2013

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Healthy food for healthy pregnancy

Nithya Ramakrishnan Department of Applied Nutrition Wayamba University of Sri Lanka

The nine months of pregnancy is the most rapid period of growth and development among the life stages of human beings.

Most of the factors that affect the pregnancy period can be controlled. One of the important factors among them is nutrition during pregnancy. The most priceless gift that a mother can give her baby is a nutritious and well balanced diet. Adapting a healthy eating plan is ideal but equal concern should be given during and after pregnancy to ensure the wellness of both mother and baby.

Pregnancy is the period in our life where the eating habits of one directly affects the other. There is a myth that ‘if a woman gets pregnant, she should eat twice.’ It is totally a wrong concept and the truth is that mother should consume food that are sufficient for two lives. During pregnancy the nutritional needs of a mother is increasing. Almost all the requirements for all nutrients do increase, but among them, some are vital for the pregnancy period such as protein, iron, calcium and folic acid. (See Table)

Iron-rich foods

Hemoglobin in the red blood cell carries oxygen and nutrients to the cells. The hemoglobin molecule contains iron, an essential mineral found in our diet. The requirement of iron doubles during pregnancy, and to meet that requirement the pregnant mother should eat iron- rich food items. Food items which have higher amounts of iron are shown in the table. Liver provides a higher amount of iron but it contains higher amounts of Vitamin A too. Because of that, the health professionals advise to avoid liver, it may affect the growth of baby, in certain instances it would even cause a miscarriage.

Iron present in animal sources are much easier to absorb but in the case of plant sources, it is difficult. Vitamin C enhances the absorption of iron in the plant source, so better to incorporate Vitamin C rich food items with the meal.

Most of the fruits are rich in Vitamin C. Furthermore Vitamin C prevents both the mother and baby from infections. Drinking tea during the meal or immediately after having the meal may reduce the absorption of iron.

Folic acid is another crucial nutrient during this stage as it is important for the growth and development of the baby. Adequate folic acid consumption is important before conception and at least for 3 months afterwards. If a woman fails to take enough Folic acid during this particular time, she faces the risk of having a baby with a birth defect involving incomplete development of brain and spinal code.

This kind of defect will occur during the first 28 days of pregnancy (during this period a woman does not know that she is pregnant.) All the women in the child - bearing age should have adequate amount of Folic acid to reduce the risk of having a baby with defects whether they plan to have a baby or not because most of the pregnancies in Sri Lanka are unplanned.

Folic acid rich food items are listed in the above table. Folic acid requirement for a day cannot be achieved through a usual diet. Therefore, it is more beneficial to take Folic acid supplement under the advice of a health care provider. Another important nutrient during pregnancy is Calcium. It is important for both mother and the baby. Calcium is essential to build up strong bones and teeth, for nerve and muscle development as well as normal heart functioning of the baby. Furthermore Calcium is stored in the body to prepare the body for breastfeeding.

If a pregnant mother doesn't get enough Calcium from her meal, baby will draw it from mother's bones. It may cause serious consequences to the mother in later years.

Especially there is a risk of developing osteoporosis- like bone conditions. Because of that an adequate amount of Calcium should be taken by a pregnant woman. Calcium rich food items are listed in the above table. Incorporate Calcium rich food items in an appropriate level is important.

In addition to the above mentioned nutrients, other nutrients are also needed in higher amounts than the normal requirement. Each and every pregnant mother should take a well-balanced diet consist of adequate amounts of whole grain, lean meats (visible fat removed), fish and egg, milk and dairy products, legumes, a variety of vegetables and fruits. Another important aspect during the pregnancy is appropriate weight gain.

During this period, body changes will occur to facilitate the growth of the baby. It is amazing to feel that your weight begins to increase and it is considered as a proof that your body is nurturing your growing baby well.

To accomplish all these changes body needs extra 300 cal per day during the 2nd and 3rd trimester of pregnancy. It can be achieved by eating a well- balanced diet.

However needs for the energy requirement may differ from individual to individual based on their pre pregnancy body weight. It is better to discuss with a health - care provider and it is essential to follow his/her advice to gain appropriate weight. As a whole nutrition during pregnancy should be given priority to enhance the well being of both mother and baby, to deliver a healthy baby, complication free labor and to get rid from nutrition related diseases during pregnancy and non communicable diseases in later life.


Eating fast food cause for childhood asthma and allergies

Teenagers more likely to have severe asthma and eczema if they eat fast food more than three times a week, study shows


Young boy using asthma inhaler

An international collaboration of scientists has found that young teenagers in particular are nearly 40% more likely to have severe asthma if they eat burgers and other types of fast food more than three times a week. Children aged six to seven had an increased risk of 27%. Children eating fast food were also more likely to get severe eczema and rhinitis - a condition where the nose blocks or runs and the eyes are itchy and water.

The scientists, from New Zealand, Spain, Australia and Germany as well as Nottingham in the UK, say their study could have “major public health significance owing to the rising consumption of fast foods globally” if the link they have found turns out not to be coincidence but causal.

The good news was that eating fruit appeared to protect young people from asthma and allergies. Eating three or more portions a week reduced the severity of the symptoms by 11% among teenagers and 14% among younger children.

The research, published in the journal Thorax, part of the BMJ group, came out of a large collaborative project called the International Study of Asthma and Allergies in Childhood (ISAAC), which involves nearly 2 million children in more than 100 countries, making it the biggest of its kind.

The fast food study involved a relatively small proportion of the children taking part in ISAAC, from two age groups: 319,000 13- to 14-year-olds from 51 countries and 181,000 six- to seven-year-olds from 31 countries.


Close-up of a hamburger with french-fries on a plate

The children and their parents were sent questionnaires about their eating habits over the previous 12 months.

They were asked how often they had eaten specific foods, including meat, fish, fruit and vegetables, pulses, cereals, bread and pasta, rice, butter, margarine, nuts, potatoes, milk, eggs, and fast food/burgers. They were also asked whether and how often they suffered from specific asthma and allergy symptoms - and if so, how severe they were and whether they stopped them sleeping or interfered with daily life.

Fast food - the authors specifically mentioned burgers only because it was the reference to fast food that most people would understand - was the only food type associated with asthma and allergies across all age ranges and countries. The authors said that “such consistency adds some weight to the possible causality of the relationship”. But they said more research would be needed to discover whether fast food is definitely a problem.

The fast food link was stronger among teenagers than among the young children, which the authors suggest may be because adolescents have more independence, money and control over what they eat.

The paper says a link between fast food and asthma and allergies is biologically plausible.

It could be “related to higher saturated fatty acids, trans fatty acids, sodium, carbohydrates and sugar levels of fast food and possibly preservatives”. Fast foods have high levels of industrially hydrogenated vegetable fats such as margarine, which can be a source of trans fatty acids - “and there is some evidence that dietary intake of trans fatty acids is associated with asthma and allergy”, say the authors. In the teenagers, eating butter, margarine and pasta was also associated with asthma symptoms.

Studies which involve asking people about their diet can be problematic, because people either forget or tailor the truth. Professor Hywel Williams, from the centre of evidence-based dermatology at Nottingham University, said recall over the 12 months of the study was more likely to be inaccurate than biased and this would tend to dilute any association between fast food and asthma, rather than the reverse.

“Now if there was a widespread belief already out there that fast foods are ‘bad’ for allergies, then you could say the data was simply reflecting such prior prejudices/beliefs. But we are not aware of any such widespread prior belief. People often believe fast foods are associated with things like acne, obesity and hyperactivity, but not allergies, and severe allergies at that. And even if one country had such a belief, how could you explain such consistency across so many countries and cultures and socio-economic groups?”

The study did not differentiate between types of fast food. “Our question simply asked, ‘In the past 12 months, how often, on average, did you (did your child) eat or drink the following: meat; seafood; fruit; vegetables (green and root); pulses (peas, beans, lentils); cereal; pasta (including bread); rice; butter; margarine; nuts; potatoes; milk; eggs and fast food/burgers?’,” he said. “So we could analyse each of these categories, but not split them down any further.

“And before we put the boot into burgers specifically, it does not mean they are always “fast” as some of us (including me) make very nutritious “slow” burgers at home - but it seemed like a well understood anchor for fast foods since burgers are one of the commonest types of fast food sold around the world.”

Malayka Rahman, from Asthma UK, said: “This research adds to previous studies that suggest a person's diet can contribute to their risk of developing asthma, and indicates the benefit of further research to determine the effects that particular food groups can have on the chances of developing asthma or the impact it may have on severity.

Evidence suggests that the vitamins and antioxidants found in fresh fruit and vegetables have a beneficial effect on asthma, therefore Asthma UK advises people with asthma to eat a healthy, balanced diet including five portions of fruit or vegetables every day, fish more than twice a week, and pulses more than once a week.”

Many parents of children with asthma and allergies will already be watching carefully their child's diet since certain foods - notoriously nuts - are known to trigger allergic reactions.

With news that studies show apparently bland burgers, nuggets, pasties and similar fast foods could contribute to the risk, they will be keen to know what research suggests are the safer options for family dinners.

One better bet appears to be a Mediterranean diet. Asthma UK cites research into diet and asthma arried out in Athens in 2011 by Grigoropoulou and colleagues, which compared school children in the city with those in a rural part of Greece. They found that the urban children were more likely to get asthma, but eating a Mediterranean diet, rich in vegetables, fish and oils, appeared to protect them.

Fish oils on their own, however, did not do so well in a study from Edinburgh University published in 2009.

This was a review of a number of studies where children had been given omega 3 and omega 6 supplements in the hope of preventing allergies, while other comparable children had been given placebos - dummy pills.

The researchers found no clear evidence that the supplements had any protective effect.

“Contrary to the evidence from basic science and epidemiological studies, our systematic review and meta-analysis suggests that supplementation with omega 3 and omega 6 oils is probably unlikely to play an important role as a strategy for the primary prevention of sensitization or allergic disease,” they concluded.

Trans fatty acids have been linked to asthma and allergies before, in addition to raising cholesterol levels and the NHS advises people to reduce their intake. The fast food study suggests that the best advice for parents wanting to protect their children from asthma and allergies is to try to ensure they have a generally healthy diet, with plenty of fruit and hopefully some vegetables, and to steer clear of fast food restaurants.

-Guardian.co.uk


Weuda PMCU wins an excellence award


Weuda PMCU, Kandy Road, Kurunegala

Staff of Weuda PMCU

Dr. A. Weerasinghe receives the award

Tharindu Weerasinghe Well managed Weuda (Kurunegala) Primary Medical Care Unit

PMCU has won one of the excellence awards at the Health Excellence Awards 2012 (North Western Province) organized by the Department of Health Services (North Western Province) held recently.

Chief Guest of the function was Minister of Health Maithripala Sirisena and the guests of honor were:

North Western Province Governor (NWP) Thissa R. Balallla , Chief Minister of NWP Athula Wijesinghe, Minister of Health, Indigenous Medicine, Sports & Youth Affairs of NWP Ashoka Wadigamangawa .

The staff of the Weuda PMCU headed by Dr.A.Weerasinghe (RMO in-charge) was very happy about their achievement as they work with dedication and integrity to give the maximum support to the villagers for their medical problems and requirements.

This is a good example for other health units around the country.

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