1.  Eat small portions of up to 5 meals per day.  That is try to eat something every 3-4 hours.

2.  Eat low GI carbohydrates.  They include multigrain breads, pasta, apple, orange, pear, dried apricots, milk, yoghurt and legumes.

3.  Remove energy drinks, sports drinks, fruit juices, soft drink (including ‘diet’), lattes and cordials.

4.  Forget diet foods like rice cakes, corn thins, water crackers and plain biscuits – they are all high GI and will cause weight gain.

5.  Try to avoid large amounts of sugar, lollies, sweets, donuts, cakes, biscuits, chocolate, ice cream and sorbets.

6.  Avoid the traps of fast food.  A large meal deal will provide you with a whole days worth of calories.

7.  Drink plenty of water

8. Eat 2 fruits per day and 5 vegetables

9.  Have protein at each main meal eg. eggs, tuna, chicken

10.  Walk 30 mins in morning and 30 minutes in afternoon.  Or any other combination of activity where you get up to 60min a day.

It is very important to get support during this time.  A new baby can be quite draining and demanding of your time and energy.  A Dietitian can guide you through your food choices and an Exercise Physiologist or Personal Trainer can motivate you through an exercise plan.

Many pregnant women are cutting out foods unnecessarily for fear that it contains Listeria. Good food handling and hygiene will reduce the chances of infection such as washing hands, wash raw fruit and vegetables, well cooked foods served hot not lukewarm, never refreezing something that has thawed, always thaw foods in the fridge not on the bench or in warm water, and consuming foods before the Listeria has time to multiply. IF IN DOUBT, THROW IT OUT.  It is important to know what foods are at risk of containing the Listeria bacteria (see table)

Why do some kids seem hungry all the time?  Consider the following possibilities:

1.  Did you ever think about the possibility of intestinal worms or parasites?  As revolting as that may sound, it may be the answer.  These parasites are basically eating all the good nutrition your child is meant  to get.  So ask your pharmasist for treatment if you suspect that this may be contributing to hunger.  There are medical treatments like Combandtrim or herbal treatments from Blackmores.

2.  Are your children getting enough low GI (Glycaemic Index) Foods?  Low GI foods are slow to digest keeping children’s tummies full over a longer period of time.  These foods also slow the rate that gluocse and insulin are release in the body controlling appetite and energy levels.

Low GI Foods include: multigrain bread, Vitaweet (or wholegrain) crackers, apples, pears, oranges, bananas, milk, yoghurt, custard, corn, sweet potato, baked beans and dried apricots.

3.  Are your children eating too many empty calories?  These are foods that contain alot of calories but very little nutritional value.  What they do is give a quick but short boost of energy and then hunger quickly returns – so children are likely to eat more.  Empty calorie foods include puffed breakfast cereals, rice crackers, rice cakes or corn thins, lollies, fruit roll-ups, potato crisps, other savoury crisps and snacks, chocolate, soft drinks and white bread.

4.  Do your children eat 5 small meals a day?  Most children are grazers and need to eat small meals throughout the day.  This means breakfast, morning tea, lunch, afternoon tea and dinner.  Sometimes an extra snack is needed on top of this, particulalry if the child is experiencing a growth spurt.

5.  Do your children eat snacks in front of the TV?  Research shows that children who eat in front of the TV are more likely to gain weight than those who eat their meals and snacks at a regular meal place, like the meals table.  Part of the body’s ability to sense satisfaction in a meal and the feeling of fullness is to see and enjoy food.  When you sit in front of the TV you are unaware of the whole eating process and satiety (feeling full) is limited.

6.  Sometimes children are simply going through a growth-spurt and their bodies are letting them know that they need more food.  You will know if this is the case if they grow up rather than out.  If they are growing up then you can provide extra protein like meat, tuna, eggs, baked beans, milk, yoghurt and cheese.  Also, extra sources of carbohydrate will help like bread, cereals, rice, pasta and potatoes.

Here are some tummy-filling recipes for those hungry children:

EASY FRUIT SLICE

• 1 cup self raising flour
• 1 cup sugar
• 1 cup mixed dried fruit (eg sultanas, apricots, cranberries)
• ½ cup coconut
• ½ cup quick oats
• 1 cup milk
• Choc bits (optional)

Mix all ingredients together in a bowl.  Pour into large slice tin lined with baking paper.  Bake 180°C for 35-40mins.

PINEAPPLE OAT MUFFINS

1 can crushed pineapple with juice
1 cup quick oats
½ cup buttermilk

Combine and let sit 15 minutes.

1/3 cup margarine
1 tsp grated orange rind
1/3 cup brown sugar

Combine and mix well. Mix with above mixture.

Beat in 1 egg and then add 1 ¼  cup self raising flour

Spoon into 1 dozen large greased muffin pans. Bake at 200 °C  for about 25 minutes.

BREAKFAST MUFFINS

• 1½ cups self raising flour
• 1 cup grated light tasty cheese
• 3 rashers bacon, no fat, diced
• 1 zucchini, grated
• 1 carrot, grated
• ½ cup corn
• fresh herbs (eg. parsley, basil, rosemary)
• ¾ cup milk
• 2 eggs
• ¼ cup fruit chutney

Preheat oven to 200°C. Sift flour into a large bowl. Add cheese, bacon, vegetables and herbs. Whisk milk, eggs and chutney in a jug until well combined. Make a well in centre of dry ingredients. Pour in milk mixture. Using a large metal spoon, gently mix until just combined. Spoon into muffin pan.  Bake for 15 to 20 minutes or until a skewer inserted into the centre comes out clean. Stand in pan for 3 minutes. Turn onto a wire rack to cool. Store in an airtight container.

SNACK IDEAS:

• Fruit Kebabs – thread pieces of fruit onto skewers
• Popcorn
• Multigrain French Toast
• Pancakes – try using buckwheat flour, chick pea flour or quick oats
• Cheese and Vegemite on Vitaweet Crackers (or wholegrain crackers)
• Multigrain English Muffins with creamed honey or marmalade
• Vitaweet snack bites and carrot sticks with hummous dip
• Baked bean jaffles (toasted sandwiches) or toasted cheese and tomato fingers
• Carrot, celery, capsicum sticks with cream cheese dip

Sometimes children are simply bored and eating is an activity they can come up with.  Try to provide engaging activities that do not involve the TV, computer or other electronic device.  Creative activities may be able to occupy a child long enough (3-4 hours) before they need to look for food.

Good luck.  Let me know what you come up with or what works in your household.

Of those with gestational diabetes, 3.7 per cent had developed full-blown diabetes nine months after delivery, and 19 per cent developed diabetes within nine years, after birth.

Even very healthy women have a chance of developing gestational diabetes.  If you fall into one of the high-risk groups the incidence increases to 25% or 1 in 4 pregnancies resulting in GDM.

A high-risk group includes:

• Women over 30 years of age
• Women with Polycystic Ovarian Syndrome (PCOS)
• Women with a family history of type 2 diabetes
• Women who are overweight or obese
• Indigenous Australians
• Torres Strait Islanders
• Women of particular ethnic groups including Indian, Chinese, Vietnamese, Middle Eastern, Polynesian and Melanesian women
• Women with a history of gestational diabetes in a previous pregnancy.

Not all pregnant women are routinely tested for gestational diabetes, so many go undiagnosed.  You can request a glucose tolerance test at around week 24-28.  You will be required to drink a small sweet drink (containing glucose) and then after 2 hours a blood test will reveal whether or not high amounts of glucose still remain in your blood.  If it has, then you have Gestational Diabetes Mellitus.  Having a diagnosis for GDM is better than not knowing because you can now implement simple strategies to reduce complications. The way to obtain these strategies is through health professionals who know about gestational diabetes like Accredited Practising Dietitians, Diabetes Educators and Endocrinologists.

A resounding message that is portrayed to the infertile community is to lose excess weight to improve chances of pregnancy success.  Studies are indeed showing positive results from even small amounts of fat loss.  What this message can lead to though is unwise choices in “weight loss” diets.  Sure the result of most diets is rapid weight loss but they may also be greatly lacking in essential nutrients needed for pregnancy and embryo development.  It is very easy to get caught up in the task of falling pregnant at any cost whilst putting aside the health of the mother-to-be and growing baby.  A common weight loss strategy is to restrict food intake and go “low fat” everything, which may be required for some people with specific medical conditions. However, this type of dieting is not suitable for all couples trying to conceive and maintain a healthy pregnancy.  As mentioned earlier, your body requires essential nutrients in order to undergo certain biochemical actions for conception and pregnancy – going on a restrictive diet is likely to impede these actions.  This also applies to those who are requiring assisted fertility treatment – ultimately there may be a baby that requires essential nutrients to grow and develop.

Full-cream milk and the Fertility Diet

Skim milk has been part of many weight loss diets (or some even cut dairy out altogether) this is because it has less fat and calories than full-cream milk.  However, according to a study¹ by Jorge Chavarro at the Harvard School of Public Health in Boston, it was discovered that women who consumed full-cream milk produced better pregnancy outcomes than in women who consumed low fat milk.  They assigned full cream milk to a “fertility diet” and recommended women change their diet to help fall pregnant.

Warning about Milk and Fertility

Now don’t go overboard with this suggestion to change to full cream milk – there is a bigger picture to consider first.  When you compare the nutritional component of milk types (see table) there are actually more benefits in choosing milk that is middle of the range i.e. Trim or Reduced Fat Milks rather than the extremes of full-cream and skim.  Choosing reduced fat milk would be a much better choice than choosing all full-cream dairy products or choosing all skim dairy products.  However, this requires an individual assessment because people have different needs and medical backgrounds.  I would suggest seeing an Accredited Practising Dietitian to balance your diet with suitable dairy products according to your situation.

Nutritional Comparison of Milk Types.

The main problem with low fat diets in general is that the balance of both good and bad fats can get out of kilter and this affects the way your body produces hormones necessary for conception and pregnancy.  And the problem with following the “Fertility Diet” with the full cream dairy products is the extra kilojoules and saturated fat that your body has to deal with, possibly increasing fat stores that you may not need.  Once again this depends on the individual’s health and specific requirements: one person may need full cream milk (eg. to increase fat stores) and another may only be able to have reduced fat milk (eg. to improve insulin problems).

Too little and too much body fat will affect conception and pregnancy outcomes.  The amount of fat stores in a woman’s body affects the hormone levels that are necessary for conception and pregnancy.  Studies³ exploring dietary intake patterns and body weight in various population groups indicate that those who consume greater amounts of dairy foods weigh less than those who consume less dairy.  This finding can be attributed to several reasons including important nutrients in milk that aid weight loss, the satiety level that milk gives (so less overeating), and the way it can control insulin levels therefore reducing weight gain.  There are also important nutrients in milk like Calcium, Protein, Essential Fatty Acids (eg Conjugated Linoleic Acid CLA), Vitamins A, D, E & B12, Phosphorus, Riboflavin and Pantothenic acid.  All these benefits combined contribute to the important role dairy has in fertility.  See list below for a list of the nutrients in milk and how they can assist in fertility and pregnancy.

How Dairy Food can Help Improve Fertility

Protein: The building blocks for new cells, sperm development, DNA protection, assists in fertilisation and embryo implantation.

Calcium: Animal studies have shown that the success of ICSI is greatly enhanced when sufficient calcium is present.

Essential Fatty Acids: Important for fetal development particularly in the brain and central nervous system.  Can reduce incidence of fluid retention and pre-eclampsia.

Vitamin D: Known to assist in bone formation together with calcium, but also has a role in normal cell growth, hormonal balances and immunity.  A deficiency in Vitamin D is linked to obesity, depression, insulin resistance and heart disease.

Vitamin A: Contributes to normal reproduction, vision and immune function.

Vitamin B12: Has a close relationship with folate and need each other to function properly for the production of genetic material in the body (DNA and RNA).  It is essential for growth and replication of cells. Vitamin B12 is important for the activity of certain enzymes within calls that control fat, amino acid and carbohydrate metabolism.

Phosphorus:  Every cell contains phosphorus, which means this mineral has an important role in almost every chemical reaction in the body.

Riboflavin (Vit B2): Riboflavin is vital for normal reproduction, growth, repair and development of body tissues.  Riboflavin is involved in adrenal gland function and in the production and regulation of certain hormones.

Pantothenic acid (Vit B5): Pantothenic acid is essential for the release of energy from food.  Normal adrenal gland function requires pantothenic acid as it is essential for production of adrenal hormones, such as cortisone, which play an essential part in the body’s reaction to stress. Pantothenic acid is also necessary for the production of other steroid hormones Antibody synthesis requires pantothenic acid and it is also involved in wound-healing.

Low GI: Can help regulate insulin and blood sugar levels and this in turn may help sex hormones to regulate ovulation successfully.  Also assists in weight loss.

How much Dairy should you have each day?

The Australian Dietary Guidelines recommends 3 serves of dairy for non-pregnant women.  If you are trying to fall pregnant I would suggest the following daily serves of dairy:

• 250mL reduced-fat milk
• 200g full-fat yoghurt
• 40g light cheese or 2 small scoops low-fat ice-cream

References

1. Jorge E. Chavarro, Janet W. Rich-Edwards, Bernard A. Rosner, and Walter C. Willett. “Diet and Lifestyle in the Prevention of Ovulatory Disorder Infertility.” Obstetrics & Gynecology. Vol. 110, No. 5, November 2007.
2. Beales PE, Elliott RB, Flohé S, Hill JP, Kolb H, Pozzilli P, Wang GS, Wasmuth H, Scott FW. 2002. A multi-centre, blinded international trial of the effect of A1 and A2 beta casein variants on diabetes incidence in two rodent models of spontaneous Type 1 diabetes. Diabetologia 45:1240-1246.
   1. Gunther CW, Lyle RM, Legowski PA, James JM, McCabe LD, McCabe GP, Peacock M, Teegarden D. Fat oxidation and its relation to serum parathyroid hormone in young women enrolled in a 1-y dairy calcium intervention. Am J Clin Nutr. 2005 Dec;82(6):1228-34. PMID:16332655.
   2. Laugesen M & Elliott R.  Ischaemic heart disease, Type 1 diabetes, and cow milk A1 beta-casein.  2003. New Zealand Medical Journal 116(1168) U295.

Your baby will need you to provide protein in the form of lean meat like beef, pork, lamb, chicken breast and kangaroo. Fish and seafood are also good sources of protein. Make sure your protein sources are well cooked – not raw or rare.  Certain types of fish are best avoided due to potentially higher levels of mercury – they include flake, ling, orange roughy (deep sea perch), swordfish, marlin and catfish.  Canned fish such as salmon, tuna and sardines are fairly safe to eat.  Other sources of protein include baked beans, lentils, chick peas, nuts, soy milk and other soy products, tofu and dairy products.

All vitamins and minerals are essential for development of a healthy baby; but getting adequate intakes of calcium, iron, folic acid, phosphorus, magnesium, vitamin B6 and zinc is particularly important during pregnancy. Surveys show that many women do not consume adequate amounts of these nutrients in their daily diets.

Protein is found in both animal and plant sources.  It is recommended to include both sources in the diet to get the benefits of other components like antioxidants, fibre, vitamins and minerals.

Recommended Daily Intake of Protein:

• 0.75g/kg for adult women
• 0.84g/kg for adult men
• Around 1g/kg for pregnant and breastfeeding women

Here are some sources of PROTEIN:

Beef & Vegetable
½ kg gravy beef (chuck or blade)
½ cup sweet potato, diced
½ cup dried split peas
1 stick celery, finely diced
1 carrot, diced
1 onion, finely diced
½ cup pumpkin, diced
2 teaspoons fresh herbs, chopped
2 cups natural beef stock (eg Campbells real stock or homemade)

Brown meat in a frying pan first and then place in slow cooker with the rest of the ingredients. Cook for about 6 hours or until the beef is soft and tender. Blend or cut up until the right consistency for your child. Add extra liquid if needed. Freeze in ice-cube trays until required.

Before baby food was readily available in supermarkets, babies simply ate what the rest of the family was having, in a mashed or finely cut form.  As convenience food was demanded, pre-prepared baby food became available.

Generally, most baby food products are satisfactory in terms of nutrition but homemade versions would be far superior in terms of taste, nutrition and value for money.  Commercial baby food generally contains added thickeners and fillers like maize.  These are added to thicken the food for better consistency for baby and to reduce the cost of making the product.  There are many thickeners and fillers added to processed food these days that increase our carbohydrate intake.  This may be linked to our increasing obesity rates.  Many of the thickeners and fillers in commercial baby food are derived from maize or rice.  These particular carbohydrates are high in Glycaemic Index (GI).  This means that when this food is eaten the baby’s blood glucose levels rise fairly rapidly and then drop early which means the baby is more likely to be hungry earlier requiring more food.  Using a carbohydrate such as pasta, split peas or other lentils helps to lower the GI and helps satisfy hunger for longer.  Motherly cubes provides convenience without the unnecessary high GI fillers, they use split peas as their main thickening agent.

There is a place for convenience and the baby food on offer at the moment can be useful for the busy family but it would be sensible to include homemade meals as well to avoid overfeeding and the risk of obesity.

Check out Motherly Cubes, a baby food company that specialises in organic, gluten-free, dairy-free and additive-free baby and toddler food (without the maize fillers):   http://www.motherly.com.au

Introducing Solids Guidelines

6-7 Months (Smooth Texture)

• Iron-fortified cereals eg rice cereal
• Mashed banana
• Smooth avocado
• Pureed apple, pear, peach, mango
• Pureed cooked pumpkin, potato, sweet potato, carrot or broccoli
• Pureed meat & chicken

7-9 Months (Lumpy Texture)

• Yoghurt, custard, cheese, cottage cheese
• Weetbix, porridge, rice cereal
• Mashed vegetables
• Processed fruits with small lumps
• Cooked Mince
• Egg yolks, cooked
• Bread
• Pasta
• Rice

9-12 Months (Finger Food)

• Cut up pieces of soft fruit
• Beef, lamb and chicken strips
• Bread, pancakes
• Pasta
• Rice
• Cooked pieces of carrot, sweet potato, potato, zucchini, beans
• Baked beans
• Cheese, yoghurt, cows milk (or soy alternatives)

Sometimes all we need is some sort of motivating factor like ‘trying to fall pregnant’ to make healthy changes.  Even then, it can take a few disappointing pregnancy results before there is enough motivation to change or seek help.

The ‘stages of change’ theory predicts when a person is likely to step up and actually make a change in their lifestyle. The stages of change are:

1. Precontemplation (Not yet acknowledging that there is a problem behavior that needs to be changed)
2. Contemplation (Acknowledging that there is a problem but not yet ready or sure of wanting to make a change)

3.  Preparation/Determination (Getting ready to change)

4. Action/Willpower (Changing behavior)

5. Maintenance (Maintaining the behavior change)

6. Relapse (Returning to older behaviors and abandoning the new changes)

7. Contemplation (accepting the relapse but going back to try again)

Often, all it takes is for someone to believe in you and be willing to support your changes (regardless of the number of set-backs).  This support can come in many forms: family, friends, health professionals and yourself.

My advice is this: work through the stages of change theory – wherever you are right now, and do what you need to do to get to the next stage.  Get information, seek professional advice, rally up support, get organised, set a date, set in place equipment (like walking shoes) and write out your plans.

There is always time to make changes.  It just depends where you are on the stages of change timeline, so don’t rush it just get yourself ready.

We value the balance between a healthy mind and a healthy body.