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Veganism During Pregnancy

London Gynaecology’s nutritional therapist, Laura Southern, discusses whether veganism can be safe and healthy during pregnancy.

Whether a vegan diet is problematic in pregnancy depends on how good the vegan diet is. I give a nutritional consultation to all the pregnant women who are on London Gynaecology’s Early Pregnancy Package, and the vast majority of them can’t face their usual healthy food. They opt instead for starchy, processed and sweet foods. If a pregnant lady is feeling like this, and already omitting the animal food groups, then there is a chance of missing out on vital nutrients.

The benefits of a healthy vegan diet include blood sugar balance (so support for energy, mood and insulin levels), a wide variety of nutrients consumed, and lots of fibre to support digestion. Challenges are ensuring nutrient needs are met. Supplementation is essential, alongside regular blood checks to ensure iron levels are adequate.

A vegan diet can be low in three areas vital for a healthy pregnancy – protein, iron and omega 3.

Protein is essential in pregnancy because its used for growth and building. It is possible to get protein from a vegan diet from seeds, nuts, beans, legumes and soya products, however ‘complete’ protein, where all the essential amino acids are present in one food, is more easily found in animal products. The NHS doesn’t offer specific levels of protein for pregnant women to consume. There have been some studies, on both humans and animals, which show that a lack of protein in pregnancy can cause both muscle issues and chronic diseases in the offspring. Symptoms of low protein in pregnancy can include severe fluid retention, muscle weakness and frequent infections.

Iron is another nutrient essential in pregnancy. It’s used to make haemoglobin which transports oxygen around the blood for both baby and mum. Iron deficient anaemia is common in pregnancy making the mum feel lousy – symptoms include severe dizziness, fatigue and breathlessness. It is possible to gain iron from plant based foods such as green leafy veg, nuts, lentils and dried fruit, but this is the ‘non-heme’ sort, which is less easy to absorb than the ‘heme’ source found in meat.

Omega 3 is essential in pregnancy to provide a substance called DHA which is vital for the baby’s developing brain. Lack of DHA in the pregnant mother’s diet can cause the mother’s body to take it from stores to give to baby. Studies have shown a lack of DHA to be associated with postnatal depression. Plants such as seeds, seed oils, nuts, avocado and coconut are rich in omega 6, also essential, however it is harder to convert omega 6 to DHA. The most bioavailable source of omega 3 is from oily fish, such as salmon, mackerel and sardines.

Absorption of the nutrients from all these foods is dependent on the mother’s digestion, how much she’s eating, and variety. If nausea and sickness are occurring during pregnancy then this can negatively impact on what and how much the mother is eating and absorbing. Therefore including all food groups during pregnancy is helpful.

Animal products (of the right sort) are, in my opinion, vital in pregnancy, and though the quantity doesn’t need to be large, a pregnancy lacking in any animal produce might run some risks. A ‘flexitarian’ diet (mainly vegan, but with small amounts of animal produce, e.g. dairy, eggs, fish, sometimes included) can be a very healthy way of eating if done well. It includes all the food groups, but favours plants – high in nutrients, high in fibre and generally low in inflammatory forming foods. Eating like this usually supports both blood sugar, minimising the risk of gestational diabetes, and digestion due to the high vegetable and fibre content.

To book an appointment with Laura Southern, please call us on 0207 10 11 700.

Raising Babies Vegan

According to reports, Meghan Markle and Prince Harry are planning to raise their baby a vegan. Though the 37-year-old has never confirmed she’s a vegan herself, she reportedly follows a plant-based diet on weekdays. She is by no means the only person experimenting with a plant-based diet. There are now thought to be 540,000 vegans in Britain, up from 150,000 a decade ago, and many parents are choosing to raise their babies and children in the same way.

London Gynaecology’s nutritional therapist, Laura Southern, put together some tips for parents who are keen to raise their babies and children on a vegan diet for Yahoo!. Read them here.

 

Everything you need to know about Epidurals

One in four women have an epidural during labour. They help to reduce the pain during child birth, but not everyone likes the idea. However, the latest research indicates that the risks associated with epidurals – such as nerve injury and infection – are far lower than previously thought. Consultant Gynaecologist Meg Wilson gives the lowdown on everything to do with on epidurals in this article for NetDoctor.

 

Walk To Work Day

Today is Walk to Work Day. If you can, why not take this opportunity to put on some trainers and try your commute on foot. It might take a bit longer but chances are you’ll feel better for it. Walking more regularly is great for our mental and physical health, and of course much better for the environment. We asked our fitness ambassador Ellie Baker some quick questions about the benefits of walking and how we should be doing it.

Is walking a good form of exercise? 

Walking is a good form of exercise, it is extremely accessible and people of all ages can do it.

What are the benefits for our physical and emotional health?

The physical benefits of walking are that it improves: fitness, cardiac health, builds stamina, reduces risk of diabetes, cancer, dementia, weight loss, vitamin D, improves circulation, posture, helps you sleep better and builds strong bones.

The mental benefits of walking are it alleviates depression, improves mood, releases feel good endorphins, reduces stress, reduces anxiety.  

How many steps do most people walk a day?  

The average person takes between 3,000-4,000 steps per day.

How many steps should we be walking a day?

Ideally people should walk around 10,000 steps per day.

What is a good speed to walk at? 

A brisk walking pace is 3.0 miles per hour / 5 kilometres per hour which is the 12 minutes per 1 kilometre. 

Is duration or speed more important in terms of fitness benefits; what else should we consider, e.g. heart rate? 

When it comes to fitness benefits when walking you will get more the faster you walk, however if you’re unable to walk very fast it would be better to walk for a longer duration of time.  30-60 minutes is good to aim for.  I wouldn’t consider heart rate when it comes to walking but I would go on how I feel. 

Why Meghan could give birth any day now

The Duchess has revealed her due date will fall around end of April to beginning of May, but she could give birth much earlier than that – and it is because of a phenomenon that occurs in a mother’s womb. A study by the Journal of Clinical Investigation says that a woman can give birth at anytime once the foetus secrets protein from their lungs, releasing amniotic fluid that triggers the birthing process. Consultant Gynaecologist Meg Wilson speaks to the Daily Express about labour and how it starts. Read the full article here.

Talking about Urinary Incontinence

Female incontinence is very common and up to 40% women suffer from it. In this post, Consultant Gynaecologist Narendra Pisal discusses what can contribute to it and how women can deal with it. 

Women needn’t be afraid or embarrassed to report urinary incontinence, and you should see a doctor straightaway if you are concerned. Any accidents are not a part of normal physiology, and if this is interfering with your life such as exercise, work or sex-life, you need to see your doctor. Learning to do pelvic floor exercise is very easy and you can do these practically anywhere. Your doctor will often recommend a specialist women’s health physiotherapist. The easiest way is to download an NHS app (smartphone application) called Squeezy. You need to pay a small fee for it, but it is definitely worth it.

Below are some of the most common causes:

Directed pelvic floor exercise is the first line of treatment for this condition and makes a huge difference in 6 out of 10 cases (see the Squeezy NHS app). A specialist will be able to advise when surgery is appropriate. 

Smoking, chronic cough, constipation, lifting heavy weights can all affect pelvic floor muscles and can exacerbate an existing weakness. So, avoiding constipation and learning to contract the pelvic floor muscles when sneezing, coughing etc would be preferable. Avoiding caffeinated drinks that can irritate the bladder can also be helpful. Staying fit and the right weight is also helpful.

Vaginal mesh has been used in the past for repair of pelvic floor but has been associated with problems recently. It is best to avoid this option for now unless it has been recommended in a specialist unit. It is only used now for a very small group of carefully selected women where other treatment options have not worked.

Simply by talking about incontinence, women will realise how common the condition is, especially in the over 50s, and they might be able to help themselves before needing to go and see a doctor. Learning to do pelvic floor exercise is very easy and you can do these practically anywhere using the Squeezy smartphone application.

If you have any concerns about urinary incontinence, speak to your GP or contact us on 0207 10 11 700.

Veganism and Pregnancy

Nutritional Therapist Laura Southern discusses whether a vegan diet is sufficiently supportive during pregnancy. Read the full article here.

Smoking and Women’s Health

On No Smoking Day 2019, Consultant Gynaecologist Narendra Pisal looks at the effect of smoking on women’s health, outlining overall risk levels for gynaecological cancer and the problems associated with smoking during pregnancy and the menopause.

What is the link between smoking and gynaecological cancers?

There is a strong link between smoking and cervical, vaginal as well as vulval cancers. These cancers are caused by Human Papilloma Virus (HPV) infection and smoking is known to affect immune response to HPV. As a result, smokers are less likely to shake off this infection.

Smoking paralyses ‘cells of Langerhans’ which are responsible for carrying the ‘HPV antigen’ to the immune system which then leads to ‘antibody’ formation. As these cells are paralysed, smokers are not able to mount an immune response to Human Papilloma Virus and are more likely to have persistent infection and hence higher risk of cancer.

Some types of ovarian cancers are also more common in smokers (e.g. Mucinous ovarian cancers). The exact mechanism of how this risk increases is not known.

How much more are you likely to develop these cancers if you smoke?

According to IARC (International Agency for Research on Cancer), 21% of cervical cancer cases in the UK are caused by smoking. Risk of developing the commonest type of cervical cancer (Squamous Cell Carcinoma) is 46% higher in current smokers when compared with women who have never smoked.

Will your risk decrease after stopping smoking?

Cervical cancer is not associated with past smoking, so stopping smoking is known to reduce the risk of developing cancer. This is because the effect of tobacco on the immune system is reversed after quitting smoking.

What are the dangers of smoking while pregnant?

Smoking when pregnant is associated with increase in the risk of miscarriage, ectopic pregnancy, small baby (growth restriction), still birth, premature labour and abrution of the placenta. Smoking can also affect the newborn child by increasing risk of asthma, chest infection, cot death and poor performance at school. All in all, it is best to quit smoking as soon as possible when you are planning a pregnancy. Stopping smoking will reverse all the above risks.

Can smoking affect menopause symptoms?

It is known that smoking can affect ovarian reserve and function and can lead to early menopause. Smokers are also likely to have lower oestrogen levels. Smokers also have more menopausal symptoms such as hot flushes and poor quality of sleep. Women who smoke often don’t know that they are prone to earlier menopause and more severe menopausal symptoms. It is important to get this message out so that women have another incentive to give up smoking.

If you’re looking to quit smoking, NHS Smokefree can help. If you have any questions or concerns, feel free to contact us on 0207 10 11 700.

Discharge, Smells and Swollen lips: what every woman should know about her vagina

It can be so easy to ignore any changes or new symptoms, for fear of embarrassment and judgement. But really, we should all listen to what our bodies are saying. Although some symptoms can be unpleasant and uncomfortable to talk about, knowing the difference between a harmless change and a serious one could save you from more serious medical problems down the track. Consultant Gynaecologist Narendra Pisal talks to Glamour about the vaginal symptoms you shouldn’t ignore. Read the full article here.

What is ‘Normal’ Vaginal Discharge?

Consultant Gynaecologist Narendra Pisal explains what’s normal and what isn’t when it comes to vaginal discharge.

It is normal to get creamy whitish discharge, which can increase at certain times during the menstrual cycle. However, ‘normal’ can mean different things to different women and if your discharge has changed, you should see your GP. Excessive amount of discharge can be caused by some common and benign conditions such as cervical polyp and cervical ectropion.

Watery discharge may indicate leakage of urine or (in pregnancy) amniotic fluid.

Green discharge is often a sign of infection such as candida or bacterial vaginosis. It can also be present in presence of retained foreign body such a tampon. It is advisable to see your GP or gynaecologist promptly.

Smelly discharge can also be because of bacterial vaginosis or candida infection. The best way to get rid of the smell is to start appropriate treatment after seeing a doctor.

A sudden increase in discharge, which continues for weeks on end, means that you seek medical attention promptly. It could again be due to infections or retained tampon.

Swollen vaginal lips (labia) are often caused by severe thrush (candida / yeast) infection, or sometimes allergic reaction to sanitary products or even fabric softener. What other symptoms do you have? If there is itching and discharge, it is more likely to be thrush. If there is more redness, it may be allergic reaction. Again, it is best to see your doctor for an assessment and advice.