PCOS -Weight Loss Diet
PCOS – Weight Loss Management (Fertility Programme) PCOS – Polycystic ovary syndrome is the most common hormonal disorder in women of reproductive age. It affects about one in 10 women and usually starts from puberty and can continue through to menopause. PCOS can cause multiple problems, including infertility, acne, excess hair growth, period irregularity and excess weight. Why does PCOS make it difficult to lose weight? PCOS has a link to multiple issues. What does the clinical evidence say for PCOS and Fertility? Many large studies across the world have shown that women who were overweight were able to lose weight before getting pregnant significantly improved both their fertility treatments and pregnancy outcomes. This is why international guidelines have recommended that weight loss should be the first line treatment for women living with obesity before undergoing fertility treatment or planning a family. How can a 121 Dietitian weight management programme help you? There is no one size fits all regime for losing weight, nor is there one specific fertility diet. Furthermore, women who are overweight with conditions such as polycystic ovary syndrome can find weight loss particularly difficult.All of the recent evidence has indicated that crash diet/exercise regimes tend not to work and can even cause harm, in other words, weight management does not mean starving yourself! The best approach is to have a sensible and achievable long-term plan to reduce weight and keep it off for GOOD. Who is this plan for? • Women with polycystic ovary syndrome (PCOS) experiencing difficulty losing weight• Women who are over or underweight experiencing a delay in achieving a pregnancy• Women who want to achieve weight and lifestyle improvement before trying for a baby• Men who have modifiable risk factors with diet and weight. Weight management for PCOS The aims of the weight management and or fertility programmes we offer are: • To achieve a realistic goal. We, therefore, focus on a 5-10% body weight loss over 4-6 months as this has been shown to improve fertility treatment outcomes.• To achieve sustainable weight loss – not just short-term gain• To provide a personalised dietary and exercise programme with appropriate psychological support – this has been shown to be the most effective way to achieve sustainable weight loss as well as improve quality of life – helping you to feel good about yourself• To empower you to help you feel more in control of everyday life so that you can avoid returning to unhealthy lifestyle behaviours. We haven’t forgotten the men in your lives…. Men can contribute to infertility issues also. Our programmes allow for both or either partner to be treated for infertility. How does our PCOS and Fertility plan work? You will meet a specialist dietitian throughout a period of a minimum of 6 months….Prior to an appointment, you will be asked to complete a 121 Dietitian – 7 Day Food Diary and Diet Plan Questionnaire. These will be assessed by Gillian Killiner RD, specialist Dietitian, and an appointment will be arranged to discuss the findings and begin the best nutritional programme bespoke to you. This can be via our online secure portal or face-to-face at our Holywood clinic. Week 1 – At this initial appointment Gillian will include nutritional information, motivation and lifestyle changes. A nutritional programme, recipes and shopping list will be written up for you to follow with SMART goals. Nutritional optimisation is the goal and this will include assessment of gut health/mental health/bloods and corrected with diet and supplements as required. Week 4 –6 – at this dietetic review Gillian will reassess the recommendations and assist you with setting further achievable goals. If you are wishing for a reduction in weight you will be aiming for 1kg/2lb weight loss as a steady and manageable reduction each week. Week 12-15 – Review with Gillian – you will be asked to forward a new food diary prior to this, the appointment is online/phone call &/or email. Week 22 -28 – Final appointment with Gillian – reassessment of weight and medical and general health parameters in conjunction with your fertility team. Partners together weight management fertility package £800 Either Partner weight management fertility Individual programme £600 Weight Loss for PCOS For women with PCOS who wish to lose weight only, our programmes will be tailored specifically to your requirements. PCOS weight management programme £500
Check your BMI – Body Mass Index calculator
Check Your BMI BMI Calculator BMI (body mass index) is a measure of whether you’re a healthy weight for your height. BMI gives a good estimate of your weight-related health risks for most adults, there are exceptions. Ethnicity, pregnancy, being muscular and anyone under 18 or over 60 this calculator may over or underestimate and so additional calculations or measurements are required. I will cover this in another blog. How to check your BMI (BMI Calculator) to see if you are in a healthy weight range. To do this you need your current weight (kg) and height (cm) measurements. This will give you a number that is called your Body Mass Index (BMI) Generally if your BMI is over 35, or under 18, your health is at risk. You can calculate your Body Mass Index using the BMI Calculator below. Understanding your BMI result Underweight Being underweight (BMI<18.5) could be a sign you’re not eating enough or you may be ill. If you’re underweight, we can assist you with nutritional advice on how to get your weight back to a healthy range. A detailed programme is created for you with recipes and a shopping list to make it as easy as possible. Healthy weight A healthy weight range (BMI 8.5-24.5) is where you want to be, so that is great if you are at the ideal body weight for you. But do remember this is a wide range and further tweaking may be required regarding your fat stores and muscle mass. Important to prevent future health issues. Overweight If you are overweight (BMI 24.5-29.9) chances are you have tried a few if not several times to change this. Weight loss is a specialist area at 121 Dietitian and we have helped thousands of people safely lose weight and most importantly keep this in control and enjoy life. Following our specialist, personalised plan and building in appropriate exercise is the goal. Obese A BMI of over 30 means you are in the obese category and clinically obese is where your BMI is over 35. It can feel overwhelming and lonely when you are faced with the thought of losing weight, especially if you have a lot to lose. Chances are like many you have tried repeatedly to tackle this yourself or with some form of generic programme and ended up back to the weight you were or heavier. Here at 121 Dietitian we work with you to ensure this doesn’t happen again. We know it can take a few weeks to several months to get everything optimal in your life and health to see successful and permanent weight loss. You may need some blood tests for this which we will guide you on. A personalised programme is created for you taking into account every aspect of your life: including your health, your likes, dislikes, cooking ability, finances etc. Our Plus programme will monitor you for up to a year to ensure you are meeting your goals AND more crucially keeping the weight off for good. BMI for Black, Asian and other minority ethnic groups Black, Asian and other minority ethnic groups have a higher risk of developing some long-term (chronic) conditions, such as type 2 diabetes. Checking your BMI figure Black, Asian and other minority ethnic groups adults with a BMI of: 23 or more are at increased risk 27.5 or more are at high risk What to do next about your BMI or anything else.. If you are unsure of how to increase or decrease your weight, change your eating habits or need help optimising the foods you eat and are not sure what programme to select please do contact us. We would love to help you or your family and friends with any nutrition-related queries big or small.
Wegovy – New Diet Drug
Wegovy – New Diet Drug 121 Dietitian is excited by the launch of the New Diet Drug Wegovy for weight loss and obesity. A game changer for weight loss, but not without consequences. If you decide this is for you, you need to ensure you get the maximum results possible. As weight loss experts 121 Dietitian wants the best for you, we are seeing a massive push on online prescribing. What support do you get with this????? In most cases, it is lip service and not personalised. These drugs are not a quick fix, they are expensive, require 18 months of time commitment and stop working when you don’t inject. So what can you do? How to get maximum results with Wegovy- new diet drug If you decide Wegovy is for you. You may be surprised to read that the only way to get maximum results is by working with a Specialist. Dietitians like us here at 121 being the gold standard! Wegovy is not the golden ticket to weight loss. We know and have many years of experience assisting thousands of people with optimising their diet and health for life. Wegovy what you need to know As a Dietitian for nearly 30 years, I have watched many drugs come and go regarding weight loss. Wegovy is one of the newer kids on the block. Big breakthroughs have been the headlines over the years and many people eager to get their hands on the latest launch, pay big bucks for something they know nothing about. Creating drugs to allow for a substantial amount of weight loss without serious side effects is the dream for many pharmaceutical companies and many attempts have been made. In this blog, I hope to provide you with all you need to know about these medications the positives and negatives of taking these drugs and what alternative may work better for you long term. How Do These Anti-Obesity Drugs Work? In normal digestion, the gut secretes hormones after food intake, stimulating insulin secretion. These pharmaceutically created peptides (Wegovy) mimic these same gut hormones and provide more GLP-1 to flood the system and allow for additional weight loss. Wegovy and Mounjaro work differently in the body but both keep you fuller for longer by delaying gastric emptying, increasing insulin sensitivity, decreasing glucagon, and reducing high glucose levels. Both drugs reduce triglycerides, LDL and raise HDL cholesterol, along with reducing blood pressure. Who is eligible for Wegovy? Wegovy is intended for use by adults aged 18-75 who have a BMI of 30 or above, or a BMI of 27 or above AND a weight-related health condition such as (asthma, cardiovascular disease, depression, diabetes, fatty liver disease, gallbladder disease, high blood pressure, a history of certain cancers, osteoarthritis or gout, or polycystic ovary syndrome (PCOS). Side effects of Wegovy – New Diet Drug Something that is often overlooked or underplayed is the side effects of drugs. For Wegovy and Mounjaro (Tirzepatide) include nausea vomiting abdominal pain constipation diarrhoea There is a concern of 4.5 x higher intestinal obstruction in 25,000 people studied. Fatigue and headache are also very common, mainly as doses increase. Other common side effects include: feeling lightheaded excess passing wind gastroesophageal reflux injection site reactions hair loss hypoglycemia in patients with type 2 diabetes Less common side effects have been noted with these drugs including allergic reactions gallstones (which can occur with a large amount of weight loss) the potential of medullary thyroid cancer You are also at risk of acute kidney injury. In rare cases, there can be serious side effects, such as pancreatitis or anaphylaxis. A list NOT to be ignored. How is Wegovy Given and Practical Considerations Wegovy (Semaglutide), is in a prefilled self-injection delivered under the skin in the arm, abdomen or thigh. 0.25 mg for a month, increasing monthly to a maximum dose of 2.4 mg in the 5th month. It takes a year to 18 months to have full effect. As with any medication, there are positives and negatives and I have spent most of the last 15 years in my clinics trying to reduce my patient’s medication lists where possible! I am aware however that some medications are beneficial, and it is a major hope that these drugs will genuinely assist in weight loss for the select individual. One thing for sure is that they do seem to be a better option than bariatric surgery which is a blog for another day! Currently, the hype is big and no doubt we will find out more as time goes by, but for now, I prefer to recommend you don’t get swept up too soon and spend extortionate amounts of money without doing the following first. Wegovy -Work with a Dietitian Obesity is a complex, chronic disease with multifactorial causes, and taking a drug and expecting life-changing weight loss is too simplistic. For those seeking to improve their health and lose weight and really stuck these drugs may be a short sharp kickstart but no more. It is clear from the research that when people stop taking Wegovy/Ozempic, they rapidly regain the weight. It is very expensive and there are important issues that need to be highlighted regarding everyday considerations like how alcohol impacts blood sugar control, fasting, health risks and other medication interactions. Verdict on Wegovy – New Diet Drug As a Dietitian, I have been asked repeatedly about weight loss drugs. I always consider all options and for the greater good of all who may be thinking about using these and believe in working on lifestyle, diet and fitness interventions first or alongside any targeted medication. I am concerned that vulnerable people who are really in need of significant weight loss may need to stay on Wegovy indefinitely in order to maintain any weight loss achieved, and this definitely raises concerns about long-term use. As 121 Dietitian offer weight loss services it is something for you to consider. You can invest in a 121 Dietitian programme, the
Gallstones Diet: What to Eat and What to Avoid
How common are gallstones? Gallstones are very common and there are many gallstones diets out there. It’s estimated more than 1 in every 10 adults in the UK has gallstones, although only a smaller number develop unpleasant symptoms. Here at 121 Dietitian we see and assist patients each week with gallstones. This blog is to help you if you have symptoms and are needing trusted advice for a gallstones diet. What are Gallstones? There are two types of gallstones: The most common are cholesterol gallstones, made up of excess cholesterol in the bile. Less common pigment gallstones are made up of excess bilirubin. The processing of these stones being made takes place in the gallbladder which is a small sac below the liver. The stones can be very small like gravel to single large stones. Interestingly gallstones can cause no symptoms in two out of three people who have them. If you do experience symptoms you may find problems such as upper right abdominal pain, yellowing of the skin or the whites of your eyes (jaundice), inflammation of the pancreas (pancreatitis), and gallbladder inflammation with paler stools and diarrhoea. Surgery is the treatment offered for people whose gallstones cause symptoms. A combination of diet and lifestyle factors and genetics are likely the cause of gallstone formation. Who is at risk of Gallstones? Women people over 40 overweight people Gallstones are also more likely if: Your bile contains too much cholesterol The outlet from your gallbladder is blocked or infected You have an underlying health condition – diabetes, liver disease, or sickle cell disease You have a family history of gallstones What can flare up a gallbladder? When we eat food, our digestion requires the gallbladder to actively squeeze bile salts, phospholipids, cholesterol, conjugated bilirubin, electrolytes, and water out of the gallbladder and down the bile duct to the small intestine. If you have an inflamed gallbladder anything in the stomach can trigger this action and irritate it. We know the gallbladder has to squeeze harder when there is fat in the stomach so anything fried, greasy, fatty, pizza, pastries, will upset the gallbladder. Symptoms of a Gallbladder attack Gallstones may lead to your gallbladder becoming inflamed (cholecystitis), which can cause: Pain below your ribs on the right-hand side Pain in your back and right shoulder Fever Nausea Biliary colic If gallstones pass down your bile duct into your duodenum, you will experience a painful condition known as biliary colic. The pain is usually felt in the upper part of your abdomen, in the centre, or a little to the right, and often occurs about an hour after a meal that has a particularly high-fat content. The pain can be so severe that some people report they feel like they’re having a heart attack. Also, people can feel sick and may vomit. Gallbladder and Obesity If you are overweight or obese, losing weight will be really beneficial. Avoiding highly restrictive plans when you have gallstones is essential, as rapid weight loss has been associated with developing more gallstones. A safe weight loss of 1-2 lbs(0.5 to 1 kg) per week is what you want. 121 Dietitian’s specialist programmes provide you with a personal, safe and enjoyable lifelong plan. What diet can I eat when I have gallstones? It is best to have smaller, more frequent meals and best not to fast for long periods. Choosing small amounts of fats like olive oil can assist the smooth regular contractions of the gallbladder. Eat more foods that are high in fibre these can be fruits and vegetables, lean meats and fish and wholegrain carbohydrates like Brown Rice and Quinoa, and lower-fat dairy products. Avoid refined carbohydrates and sugar. What foods to avoid if you have gallstones? Avoid eating too many foods with a high saturated fat content as cholesterol is involved in forming gallstones. These include: meat pies. sausages and fatty cuts of meat. butter, ghee and lard. cream. hard cheeses. cakes and biscuits. food containing coconut or palm oil. What is best to drink with gallstones? Water is ideal for drinking as it dilutes and detoxifies impurities that impact your gallbladder. If you are experiencing an attack and you are not eating, drinking some protein water can assist with additional plant-based protein. Alcohol is very interesting in regard to gallstones. Research has found that a moderate alcohol intake may help reduce the risk of gallstones, although researchers aren’t sure how this happens. It is always necessary to note that even though it is thought drinking in moderation may lower the risk of gallstones, excess alcohol consumption can increase the risk of many health conditions. What foods help heal gallstones? Fresh fruits and vegetables. Whole grains (whole-wheat bread, brown rice, oats, buckwheat flakes) Lean meat, poultry, and fish. Low-fat dairy products. Finally on the natural options Getting active when you can is really important. Regular exercise is beneficial for your overall health. It can also help you maintain a moderate weight and prevent gallstones. Ensuring you keep stress to a minimum and sufficient sleep are both important for assisting or reducing gallstone formation, attack, weight and health. Our 121 Wellness shop provides essentials to help you. Medical treatments for gallstones If natural recommendations do not treat gallstones effectively, then medications or surgery may be required. Medication for gallstones Ursodeoxycholic acid and chenodeoxycholic acid may be used to treat smaller gallstones. These medications can take time to work (up to 2 years) and if stopped gallstones may return. Surgery for gallstones Cholecystectomy is the name for gallbladder removal surgery. Removing the gallbladder ensures that the gallstones cannot re-form. If you are unsure of how to change your eating habits or need help optimising the foods you eat please do contact us. We would love to help you or your family and friends with any nutrition-related queries big or small. In the meantime please check out our 121Dietitian Shop If you have enjoyed this blog we would love you to share this with your
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High Blood Pressure Diet – Top Tips
Blood Pressure Diet What is hypertension and why is a Blood Pressure diet so important? It is something many of us never think about, but it keeps you alive and it is important to stay in a healthy range! In this blog, we cover all you need to know and how to improve it. Blood pressure is when your heart pumps blood through your arteries, putting pressure on the artery wall. This naturally goes up and down with your normal daily activities. A normal blood pressure level is less than 120/80 mmHg What do blood pressure numbers mean? Blood pressure is recorded with two numbers: The first number is called systolic blood pressure. This is the pressure in your arteries when your heart beats. The second number is called diastolic blood pressure. This measures the pressure in your arteries when your heart rests between beats. If you have never had this checked yourself you may have seen a Dr on TV using a cuff and stethoscope on patients to listen to their arm! This is checking blood pressure. An electronic blood pressure monitor is the up-to-date way of checking your home blood pressure: What is High Blood Pressure? High blood pressure, also known as hypertension, is when your blood pressure is higher than normal. The higher your blood pressure means you are at greater risk of heart disease heart attack heart failure stroke Not what you want to be hearing. High blood pressure also increases your risk of developing the following health problems Kidney disease Vision problems, retinal changes Sexual dysfunction, such as erectile dysfunction Circulatory problems, including peripheral artery disease (leg pain when walking) Atrial Fibrillation – Abnormal heart rhythms Vascular dementia Aortic Aneurysm – vessel swelling in the abdomen So how common is High Blood pressure? Nearly 1/2 the population in America have high blood pressure and in the UK it is not far behind with 1 in 3 adults (around 16 million) having high blood pressure (a reading of 140/90 or higher). This rises to at least 1 in 2 over-65s. Unfortunately, most people will never know they have high blood pressure as it is known as the silent killer. If you do have the following symptoms: Headaches, anxiety, nosebleeds, and palpitations do get them checked out as these can be signs of high blood pressure. Why do we get High Blood pressure? The top risk factors for high blood pressure include: Being overweight/obese – The more you weigh the more blood flow is required to the tissues to supply nutrients and oxygen. Blood vessels increase and so does the pressure inside your arteries. Too much salt (sodium) in your diet – your body retains fluid when there is too much sodium in your diet. This causes the arteries in your body to narrow. Both increase blood pressure. Too little potassium in your diet -Potassium is important to help balance the sodium in your cells. Potassium causes the smooth muscle cells in your arteries to relax, which lowers blood pressure. Not being physically active – Exercise lowers blood pressure by increasing blood flow through all the arteries of the body. This leads to the release of natural hormones and cytokines relaxing blood vessels. Lack of physical activity also increases the risk of being overweight which as we know now is a risk factor in itself. What lifestyle change lowers blood pressure the most? Weight loss for high blood pressure Weight loss is one of the most effective lifestyle changes for controlling blood pressure. If you’re overweight or have obesity, losing even a small amount of weight can help reduce blood pressure. Blood Pressure diet – Nutrient-rich foods Many people embark on trying to lose weight for multiple reasons, many due to health, and they hit a brick wall after a few weeks or months. Following macros, friends’ recommendations, or very kcal-restricted diets. They start with the best of intentions, but if they are not focused on the long game the diet becomes boring, and tasteless and can lead to far more problems than they started with. I have written about this in other blogs and also have several videos on my YouTube channel about weight loss, macros and intuitive eating. The focus for blood pressure is getting key nutrients in each day potassium, calcium and magnesium are just a few. These nutrients help control blood pressure. While building these in, reducing sodium, saturated fat and added sugars is critical. Salt/Sodium and High Blood Pressure Salt/sodium intake is directly correlated to high blood pressure and is found in so many processed foods – both sweet and savoury. Adults should eat no more than 6g of salt a day (2.4g sodium) – that’s around 1 teaspoon in all the foods and fluids you consume. Children aged: 1 to 3 years should eat no more than 2g salt a day (0.8g sodium) Bacon, sausages, ham, meat pies, sausage rolls, pizza, crisps, bread….. are all high-salt processed foods. One slice of pan-fried pork bacon alone has 194 milligrams of sodium! Thankfully there are no special foods required to reduce your blood pressure, just focus on eating a wide range of vegetables, fruits, and whole grains. Including low-fat dairy products, fish, poultry, beans, nuts, and unrefined oils. 121 Dietitian programmes are created especially for you to ensure you get all of the correct nutrients and still make it tasty and enjoyable lifelong. How did we design our Blood Pressure Diet? DASH The DASH eating plan was designed from the Dietary Approaches to Stop Hypertension clinical study funded by the National Heart, Lung, and Blood Institute in 1997. This study found that populations who consume diets rich in vegetables and fruits have a lower blood pressure than those whose diets are low in vegetables. In addition to fruits and vegetables, dietary fibre, potassium, calcium, magnesium, and protein were all essential. All these important nutrients are the cornerstone of our 121 specially designed programmes! Drinking less alcohol Having more than two drinks per day
