Basics of Eating Well

Eat often throughout the day. You may just have to change some of your food so that the energy you consume is efficient and gives you more bang for your buck. Try for 5 or more small portioned meals spread throughout the day.

Drink water to aid body in all functions. 

Depending on body size adults require about 2 – 3 litres of water day or you can think of it as 8 glasses a day. 

We need more than this during hot weather or physical exertion. Tea is a great option instead of water but water is best

Go for Low GI (glycemic index) foods.

Carbohydrates that break down rapidly during digestion have the highest glycemic indices.

Carbohydrates that break down slowly, releasing glucose gradually into the blood stream, are low GI. A lower GI suggests slower rates of digestion and absorption of the sugars and starches in the foods and thus resulting in reduced kilojoule consumption.

Most fruits, vegetables, dairy and unprocessed grains are low GI

Most processed, white carbohydrates and syrups are High GI. Avoid whenever possible.

To learn more about the GI in the foods you eat go to

http://www.the-gi-diet.org/lowgifoods/

Chewing each mouthful of food well, this will slow down your meals, giving you the opportunity to enjoy the taste of the food, and may help you eat less, because you will feel satisfied with a smaller amount of food. It takes a while for the satiety centre of the brain to send out the message that you have eaten enough. If you eat quickly it is easy to over eat before you become aware that you are full you then suffer by feeling stuffed. So slow down, enjoy your meals fully.

Eat foods high in fibre, they are digested more slowly and this slows the rise in blood glucose after eating, which is useful for people with diabetes.

Approximately 30 grams of fibre per day is recommended. Most Australians only eat around 20 grams per day.

Dietary fibre is the part of plants taken as food, which passes mostly undigested into the large bowel (colon).

There a two major types of fibre, soluble and insoluble. Some fibre is insoluble and supports the plant structure; other fibre is soluble, such as vegetable gums.

Animal foods such as meat or eggs have no fibre.

Decrease fat intake.

Decide on reduced fat options when available and avoid unnecessary animal based cholesterol/ fats when you are cooking for instance. Use spray vegetable oils as an alternative to pouring oil.

Grill, dry-fry, bake, steam or microwave

Watch your spreads and dressings like margerine (20g fat per tbsp), mayonnaise (1 tbsp 12 g fat).  Use non-stick cook wear.

Fat should account for 25% of you daily energy requirements. Remember that fat is more energy rich than carbohydrates and proteins. Each gram of fat providing 37Kj as apposed to 17Kj per gram from carbohydrates or proteins:

Theses are the guidelines:

30 – 40 grams of Fat daily for those wanting to reduce body fat

What about Alcohol

Calories are added to food intake by consuming alcoholic beverages. Alcohol is not a nutrient because it cannot be used in the body to promote growth, maintenance, or repair. It is a toxin that is broken down as an energy (calorie) source and can be converted to fat.

1 gram of fat = 9 calories = 38kj

1 gram of alcohol = 9calories = 38k

1 gram of carbohydrate = 4 calories = 17kj

1 gram of protein = 4 calories =

Training Post-Natal Women

Post-Natal training review for trainers to understand the body durring and after pregnancy.  These are my lecture notes.

1.Content includes:

Rectus abdominous separation at the linea alba

Mastitis, inflammation of the breast tissue

Perineum, (small cut to be made in some cases)

Strains on ligaments and muscles surrounding pelvis and in particular the pelvic floor.

Hormonal changes

Relaxin released by placenta

Lower back pain due to weak abdominal muscles if separation does not reduce in the weeks after birth.

Incontinence due to stretching of pelvic floor muscles or perineal trauma.

2.

In early pregnancy pelvis protects baby within its bony framework.

Later in pregnancy the pelvis bones support and hold its contents underneath like a sling. During pregnancy the joints of the pelvis become flexible due to the relaxin hormone. The pelvis has about 36 pairs of muscles attached to it. Pelvic outlet is enclosed with the pelvic floor muscles.

3.

Pelvic Floor: its main roll in pregnancy is to support the abdominal organs and the growing baby. The pelvic floor encloses the pelvic outlet and is made up of layers of muscles that stretch like a hammock from the lower limb of the pubic arch to the base of the spine.

When the pelvic floor is trained the hammock becomes stronger and more secure for the baby. This relieves the pressure that would otherwise be on the joints of the pelvis eg. Sacroiliac Joints.

4.

Pregnancy hormone (relaxin) softens ligaments and supportive tissue, thereby reducing stability of joints throughout the body.

This is desirable, as a little more 'give' within the joints of the pelvic girdle allows more room for manoeuvring when the baby enters the pelvic girdle, engages and settles into the delivery position (usually head down).

The increase of body weight, increasing lordosis (extra curvature of the lumbar spine) and change in centre of gravity all produce more stress for joints around the body. Any exercise must take into account the increased dangers to joints, especially in the pelvic girdle and spine.

There should be no impact during exercise regimes, no jumping up and down where the impact would be transmitted through the joints.

Relaxin hormone also affects the 'stretch' part of a fitness class. The unwary trainer can exploit relaxin hormone and potentially destabilise joints even more. As ligaments have a poor blood supply it may be months before the ligament returns to its pre- stretched normal length and gives joint stability once more.

The effects of relaxin linger on from 3-5 months post-natal in the body, even though the placenta was delivered after the baby.

Post-natal classes and general exercises should be structured with the effects of relaxin hormone in mind that is minimal impact, maintenance stretch techniques and emphasis on pelvic floor exercise and abdominal work adaptations.

5.

During pregnancy Oestrogen and Progesterone relax the smooth muscle of the uterus, bladder, intestines and veins. Oestrogen and Progesterone are also partly responsible for the fluid retention common during pregnancy.

After birth the levels of Oestrogen and Progesterone drop within minutes and are often very low by the second day. This returns the tissue to its original state but can result in mood changes after birth such as feeling that life is meaningless, feeling unable to cope, tearfulness and irritability. An exercising, post-natal mother can expect the following benefits.

New goals, a sense of purpose/something to aim for.

A release of chemicals into the blood associated with improved mood, sleep and memory (they are called opioid peptides and include endorphins and serotonin).

Improvements in muscular and heart and lung function, increased blood flow and neurotransmitter efficiency to the brain and muscle relaxation.

These all make the post- natal mother feel physically better.

6.

Diastasis- The separation of the rectus abdominous muscle at the linea alba.

Can become a problem for a new mother as the loss of strength and tone can increase the curve of the spine causing back pain and leg pain.

This can be rectified by exercising the abdominal wall.

7.

Incontinence due to stretching or compression of pelvic floor muscles or perennial trauma. Women who develop this in the postpartum period regain continence in the following 3-6 days. If recovery is taking longer then exercising the abdominal wall and pelvic floor muscles is advised.

8.

Mastitis- Inflammation of the breast tissue normally caused by a cracked nipple or duct blockage. Germs get into the breast milk and cause it to go stagnant.

If training a woman with this condition be sure she does not overheat. Recommend that the baby be fed before the work out as lactic acid builds up gets into the breast milk. It takes 1 to 1.5 hours for the body to get rid of the lactic acid.

Basics on Post-Natal Exercise

Post-Natal training review for trainers to understand clients needs after their pregnancy.

Some of the many benefits of postnatal exercise include:

• Speedier healing and recovery from the rigours of the birthing process
• Faster return to your pre-pregnancy shape and level of fitness
• Increased energy to cope with the demands of new motherhood
• Reduced stress and depression.

Post Natal Exercises can be started 2-3 days after the birth of your baby if no complications occurred in labour and a natural delivery was achieved.

• Exercise pelvic floor muscles specifically
• Exercise abdominal muscles

• These exercises should not cause any pain or strain
• They should be done slowly
• Consult a Physiotherapist if you are unsure about any exercise.

Twelve (12) Weeks After Your Baby's Birth

Check your pelvic floor strength by:

• Stopping the flow of urine mid stream
• Coughing with a full bladder (incontinence at this point means a weak PF).
• Jumping with a full bladder.
• See a Women's Health Physiotherapist if incontinence occurs

Back care

When caring for your new baby, take care of your back by:

Standing 'tall' with your tummy muscles pulled in and your bottom tucked under

Sitting in a comfortable chair with good back support particularly when feeding your baby

Lifting correctly by bending your knees, keeping your back straight, tightening your stomach and pelvic floor muscles and holding the object firmly and close to your body. Try not to bend or tilt forward from the hips as this stresses the lumber vertebrae and they take allot of strain during pregnancy.

Avoiding sudden and repetitive bending and twisting movements

Making sure that your working surfaces are at the waist / hip height

Alternating sitting and standing jobs.

See a chiropractor you feel comfortable with if you have back pain.  It is very likely that vertebrae have shifted during gestation and labour.

Helpful Hints

For further fitness begin a walking programme or join a Post Natal exercise class conducted by a Physiotherapist.

To get out of bed, bend your knees, roll onto your side and use your hands to push into a semi-sitting position, at the same time move your legs over the side of the bed.

Pram Walks are great to:

• Increase of self-esteem
• Improve sleep
• Improve cardiovascular fitness
• Help to loose weight and gain muscle
• Decrease depression, anxiety, blood pressure and lower cholesterol.
• Gets mother out of the house so she feels less isolated.
• Save money because there is no need for child care

Risks

Build up of lactic acid which effects breast milk 1 to 2 hours after exercise.

Potential of overheating.

Weather may effect mother and child

Exercise recommendations for post-natal resistance training

Resistance training with weights, elastic bands, or your own body weight

Beginners view

Sets 2-3

Reps 12

Rest 30 – 40 seconds

Compound Exercises (multi-joint) with a functional focus eg. Work rhomboids/ mid trap/ upper back as these muscles are needed for feeding and carrying postures. Done in exercise such as rows, lateral pull downs.

Isolated exercise used only for clients psychological benefit.

Baby blues/ Depression

Before you read the starchy information let me speack from personal experience.  The baby blues are real.  For me giving birth was a dramatic and life altering event.  My journey was 5 days in hospital after birth, going around in underwear and PJ's.  I didn't step out of the room until day 4 and that was just to get more nappies, that were situated on a rack just outside my door.  It was nurses comming in, going out and lots of monitoring. On our first night at home i was crying and sobbing in an uncontrolable fashion trying not to let my husband or baby hear me.  I needed to cry and move through those heavey feelings.  I needed to talk to God about everything that had happened and to thank Him for my baby girl.

The Baby Blues
In the first week after the birth of a baby, up to 80 percent of all women will experience a period of mild depression commonly called the baby blues. This is usually a time of extra sensitivity and symptoms include tiredness, anxiety, tearfulness, insomnia and mood changes that tend to peak between 3-5 days as the the breast milk is developed.

Post partum Psychosis
Post partum psychosis is the least common of postnatal disorders. This condition usually appears within the first couple of months following childbirth and may occur in mothers with a personal or family history of schizophrenia or bipolar disorder (manic depression). This is a medical emergency and help should be sought immediately.

Postnatal Depression
Postnatal depression has a much slower insidious onset. It is most likely to occur between the 3rd and 9th month after the birth of the baby. It is not a transitory condition and it may persist for 6-15 months or longer. Experiences vary considerably but usually include several of the following symptoms. Some symptoms may not indicate a severe problem. However, persistent low mood or loss of interest or pleasure in activities, along with four other symptoms occurring together for a period of at least two weeks indicate clinical depression and require treatment.

It's Diabetes week

Diabetes mellitus is a syndrome characterized by disordered metabolism and inappropriately high blood sugar (hyperglycemia) resulting from either low levels of the hormone insulin or from abnormal resistance to insulin's effects coupled with inadequate levels of insulin secretion to compensate.

The characteristic symptoms are excessive urine production (polyuria), excessive thirst and increased fluid intake (polydipsia), and blurred vision; these symptoms are likely absent if the blood sugar is only mildly elevated.

2.

There are three main forms of diabetes mellitus.type 1, type 2, and gestational diabetes (occurring during pregnancy), which have similar signs, symptoms, and consequences, but different causes and population distributions. While, ultimately, all forms are due to the beta cells of the pancreas being unable to produce sufficient insulin to prevent hyperglycemia.

Type 1 diabetes is usually due to autoimmune destruction of the pancreatic beta cells. Type 2 diabetes is characterized by insulin resistance in target tissues, this causes a need for abnormally high amounts of insulin and diabetes develops when the beta cells cannot meet this demand.

Gestational diabetes is similar to type 2 diabetes in that it involves insulin resistance; the hormones of pregnancy can cause insulin resistance in women genetically predisposed to developing this condition.

3.

Central obesity (fat concentrated around the waist in relation to abdominal organs, but not subcutaneous fat) is known to predispose individuals for insulin resistance. Abdominal fat is especially active hormonally, secreting a group of hormones called adipokines(cell-to-cell signalling proteins), that may possibly impair glucose tolerance. Obesity is found in approximately 55% of patients diagnosed with type 2 diabetes.

In the last decade, type 2 diabetes has increasingly begun to affect children and adolescents, likely in connection with the increased prevalence of childhood obesity.

4.

When type 2 diabetes goes unnoticed complications can result such as renal failure due to diabetic nephropathy, vascular disease (including coronary artery disease), vision damage due to diabetic retinopathy(which could eventually lead to blindness), loss of sensation or pain due to diabetes neuropathy, and liver damage from non-alcoholic steatohepatitis( fatty inflammation of the liver).

5.

Type 1diabetics may vary in the manifestation and intensity their symptoms.

It should be noted that there is no known preventive measure that can be taken against type 1 diabetes. Diet and exercise cannot reverse or prevent type 1 diabetes.

Type 1 treatment must be continued indefinitely. Treatment does not impair normal activities, if sufficient awareness, appropriate care, and discipline in testing and medication is taken.

6.

Ask about the condition. Everyone is different and no 2 clients are alike even if they have they both have type 1 diabetes.

Most people affected by type 1 diabetes are otherwise healthy and of a healthy weight. Do not become complacent because of this. Find out what you need to do in the event that your client manifests symptoms.

Find out what those symptoms look like. Have a safe word defined so the client can tell you when they are feeling unwell and not just fatigue from the work out.

Urge the client to always come prepared with what they need in an emergency to deal with their type 1 diabetes.

7.

Blood glucose Hits:

Sultanas, Glucose Tablets, Jelly beans, Low fat milk, Honey, OJ

8.

When Hypoglycaemia occurs administer 15 grams of a fast actin carbohydrate.

9.

Blood glucose can drop rapidly and sharply and a person can lose consciousness in only a matter of minutes. They will then need to be injected with glycogen.

• Give glycogen if:

the person is unconscious

the person is unable to eat sugar or a sugar-sweetened product
the person is having a seizure or convulsions, or
repeated administration of sugar or a sugar-sweetened product such as a regular soft drink or fruit juice does not improve the patent's condition.

Glycogen will only work when injected under the skin into muscle or into fatty tissue.