|
|
|
Women's Health Concerns
A heart-to-heart on cardiovascular disease: Make simple changes to help you beat the odds against heart disease, a leading cause of death. According to research or other evidence, the following self-care steps may be helpful:
- Get smoke-free
- Quit smoking and stay clear of cigarette smoke to lower your risk of several types of cardiovascular disease
-
Watch what you eat
-
Eat lots of fruits, vegetables, legumes, whole grains, fish, and avoid fats from meat, dairy, and processed foods high in hydrogenated oils
These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full cardiovascular disease article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.
About cardiovascular disease
Cardiovascular disease is a wide-encompassing category that includes all conditions that affect the heart and the blood vessels.
Cardiovascular disease is the number one cause of death in the United States. This introductory article briefly discusses several diseases that have a role in the development of cardiovascular disease. Many risk factors are associated with cardiovascular disease; most can be managed, but some cannot. The aging process and hereditary predisposition are risk factors that cannot be altered. Until age 50, men are at greater risk than women of developing heart disease, though once a woman enters menopause, her risk triples.
Many people with cardiovascular " cholesterol) and high LDL cholesterol (known as the "bad" cholesterol) are more specifically linked to cardiovascular disease than is total cholesterol. A blood test, administered by most healthcare professionals, is used to determine cholesterol levels.
Atherosclerosis (hardening of the arteries) of the vessels that supply the heart with blood is the most common cause of heart attacks. Atherosclerosis and high cholesterol usually occur together, though cholesterol levels can change quickly and atherosclerosis generally takes decades to develop.
The link between high triglyceride levels and heart disease is not as well established as the link between high cholesterol and heart disease. According to some studies, a high triglyceride level is an independent risk factor for heart disease in some people.
High homocysteine levels have been identified as an independent risk factor for heart disease. Homocysteine can be measured by a blood test that must be ordered by a healthcare professional.
Hypertension (high blood pressure) is a major risk factor for cardiovascular disease, and the risk increases as blood pressure rises. Glucose intolerance and diabetes constitute separate risk factors for heart disease. Smoking increases the risk of heart disease caused by hypertension.
Abdominal fat, or a "beer belly," versus fat that accumulates on the hips, is associated with increased risk of cardiovascular disease and heart attack. Overweight individuals are more likely to have additional risk factors related to heart disease, specifically hypertension, high blood sugar levels, high cholesterol, high triglycerides, and diabetes.
What are the symptoms?
People with cardiovascular disease may not have any symptoms, or they may experience difficulty in breathing during exertion or when lying down, fatigue, lightheadedness, dizziness, fainting, depression, memory problems, confusion, frequent waking during sleep, chest pain, an awareness of the heartbeat, sensations of fluttering or pounding in the chest, swelling around the ankles, or a large abdomen.
Dietary changes that may be helpful
Preliminary evidence has linked high salt consumption with increased cardiovascular disease incidence and death among overweight, but not normal weight, people. Among overweight people, an increase in salt consumption of 2.3 grams per day was associated with a 32% increase in stroke incidence, an 89% increase in stroke mortality, a 44% increase in heart disease mortality, a 61% increase in cardiovascular disease mortality, and a 39% increase in death from all causes. Intervention trials are required to confirm these preliminary observations.
Moderate alcohol consumption appears protective against heart disease. However, regular, light alcohol consumption in men with established coronary heart disease is not associated with either benefit or deleterious effect.
A high intake of carotenoids from dietary sources has been shown to be protective against heart disease in several population-based studies. A diet high in fruits and vegetables, fiber, and possibly fish appears protective against heart disease, while a high intake of saturated fat (found in meat and dairy fat) and trans fatty acids (in margarine and processed foods containing hydrogenated vegetable oils) may contribute to heart disease. In a preliminary study, the total number of deaths from cardiovascular disease was significantly lower among men with high fruit consumption than among those with low fruit consumption. A large study of male healthcare professionals found that those men eating mostly a prudent diet (high in fruits, vegetables, legumes, whole grains, fish, and poultry) had a 30% lower risk of heart attacks compared with men who ate the fewest foods in the prudent category. By contrast, men who ate the highest percentage of their foods from the typical American diet category (high in red meat, processed meat, refined grains, sweets, and desserts) had a 64% increased risk of heart attack, compared with men who ate the fewest foods in that category. The various risks in this study were derived after controlling for all other beneficial or harmful influencing factors.
A parallel study of female healthcare professionals showed a 15% reduction in cardiovascular risk for those women eating a diet high in fruits and vegetables,compared with those eating a diet low in fruits and vegetables.1
Lifestyle changes that may be helpful
Both smoking and exposure to secondhand smoke increase cardiovascular disease risk.
Moderate exercise protects both lean and obese individuals from cardiovascular disease.
Other therapies
Surgical treatments, such as angioplasty, bypass surgery, valve replacement, pacemaker installation, and heart transplantation, may be recommended for severe cases. Individuals with cardiovascular disease are strongly encouraged to stop smoking.
Go to top
Copyright ) 2007 Healthnotes, Inc. All rights reserved. www.healthnotes.com
 
New Vitality Web Specials 
Go to top
Stand tall against osteoporosis. No matter what your age, it's never too late to stop bone loss now for better posture and fewer fractures down the road. According to research or other evidence, the following self-care steps may be helpful.
- Pump it up
- Make weight-bearing exercise a regular habit to increase bone density and prevent osteoporosis
-
Get your soy
-
Make tofu, soy milk, soy protein, and other sources of beneficial isoflavones a regular part of your diet
These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full osteoporosis article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.
About osteoporosis
Osteoporosis is a condition in which the normal amount of bone mass has decreased.
People with osteoporosis have brittle bones, which increases the risk of bone fracture, particularly in the hip, spine, and wrist. Osteoporosis is most common in postmenopausal Asian and Caucasian women. Premenopausal women are partially protected against bone loss by the hormone called estrogen. Black women often have slightly greater bone mass than do other women, which helps protect against bone fractures. In men, testosterone partially protects against bone loss even after middle age. Beyond issues of race, age, and gender, incidence varies widely from society to society, suggesting that osteoporosis is largely preventable.
What are the symptoms?
- Osteoporosis is a silent disease that may not be noticed until a broken bone occurs. Signs may include diminished height, rounded shoulders, dowager's hump, and evidence of bone loss from diagnostic tests. Symptoms may include neck or back pain.
Dietary changes that may be helpful
Studies attempting to uncover the effects of high animal protein intake on the risk of osteoporosis have produced confusing and contradictory results. The same is true of studies attempting to find out whether vegetarians are protected against osteoporosis. Moreover, while some studies report that protein supplementation lowers death rates and shortens hospital stays or reduces bone loss among people with osteoporosis, others have found that such supplementation is of little value.
These conflicting findings may occur in part because dietary protein produces opposing effects on bone. On one hand, dietary protein increases the loss of calcium in urine, which should increase the risk of osteoporosis. On the other hand, normal bone formation requires adequate dietary protein, and low dietary protein intake has been associated with low bone mineral density. Current research shows that finding the line between too much protein and too little protein remains elusive, though extremes in protein intake,either high or low, might possibly increase the risk of osteoporosis.
Short-term increases in dietary salt result in increased urinary calcium loss, which suggests that over time, salt intake may cause bone loss. Increasing dietary salt has increased markers of bone loss in postmenopausal (though not premenopausal) women. Although a definitive link between salt intake and osteoporosis has not yet been proven, many doctors recommend that people wishing to protect themselves against bone loss use less salt and eat fewer processed and restaurant foods, which tend to be highly salted.
Like salt, caffeine increases urinary loss of calcium. Caffeine intake has been linked to increased risk of hip fractures and to a lower bone mass in women who consumed inadequate calcium. Many doctors recommend decreasing caffeinated coffee, black tea, and caffeine-containing soft drinks as a way to improve bone mass.
Curiously, while caffeine-containing tea consumption has been linked to osteoporosis in some studies, others have reported that tea drinkers have a lower risk of osteoporosis than do people who do not drink tea. Possibly, the calcium-losing effect of caffeine in tea is overridden by other constituents of tea, such as flavonoids.
-
People who consume soft drinks have been reported to have an increased incidence of bone fractures, although short-term consumption of carbonated beverages has not affected markers of bone health. The problem, if one exists, may be linked to phosphoric acid, a substance found in many soft drinks, particularly colas. In one study, children consuming at least six glasses (1.5 liters) per week of soft drinks containing phosphoric acid had more than five times the risk of developing low blood levels of calcium compared with other children. In a study in adults, higher consumption of cola beverages was associated with more bone loss in women, but not in men. Consumption of non-cola carbonated drinks, on the other hand, was not associated with bone loss. Although a few studies have not linked soft drinks to bone loss, the preponderance of evidence now suggests that a problem may exist.
-
Soy foods, such as tofu, soy milk, roasted soy beans, and soy protein powders, may be beneficial in preventing osteoporosis. Isoflavones from soy have protected against bone loss in animal studies. In a double-blind trial, postmenopausal women who supplemented with 40 grams of soy protein powder (containing 90 mg of isoflavones) per day were protected against bone mineral loss in the spine, although lower amounts were not protective. In a double-blind study, administration of the soy isoflavone genistein (54 mg per day) to postmenopausal women for one year reduced bone breakdown, increased bone formation, and increased bone mineral density of the hip and spine. The effect on bone density was similar to that of conventional hormone-replacement therapy. The same amount of genistein also prevented bone loss in a two-year double-blind study.
-
The effect of dairy products on the risk of osteoporosis-related fractures is subject to controversy. According to a review of 46 studies, different dairy products appear to have different effects on bone density and fracture rates. Milk, especially nonfat milk, probably does more good than harm because of its relatively lower protein and salt content, as well as its higher level of calcium. Cottage cheese and American cheese, on the other hand, probably do more harm than good. Cottage cheese is high in protein and salt but low in calcium, factors which could contribute to bone loss. American cheese is extremely high in salt and high in protein. These foods are not recommended as calcium sources for the prevention of osteoporotic fractures. Although there may be better ways of getting calcium, younger women who wish to prevent osteoporosis might consider nonfat milk and nonfat yogurt to be reasonable dietary calcium sources.
Lifestyle changes that may be helpful
Smoking leads to increased bone loss. For this and many other health reasons, smoking should be avoided.
Exercise is known to help protect against bone loss The more weight-bearing exercise done by men and postmenopausal women, the greater their bone mass and the lower their risk of osteoporosis. Walking is a perfect weight-bearing exercise. For premenopausal women, exercise is also important, but taken to extreme, it may lead to cessation of the menstrual cycle, which contributes to osteoporosis.
Excess body mass helps protect against osteoporosis. As a result, researchers have been able to show that people who successfully lose weight have greater bone loss compared with those who do not lose weight. Therefore, people who lose weight need to be particularly vigilant about preventing osteoporotic fractures.
Other therapies
-
Healthcare providers also recommend adequate dietary calcium intake and weight-bearing exercise.
Vitamins that may be helpful
Although insufficient when used as the only intervention, calcium supplements help prevent osteoporosis. Though some of the research remains controversial, the protective effect of calcium on bone mass is one of very few health claims permitted on supplement labels by the U.S. Food and Drug Administration.
In some studies, higher calcium intake has not correlated with a reduced risk of osteoporosis, for example, in women shortly after becoming menopausal or in men. However, after about three years of menopause, calcium supplementation does appear to take on a protective effect for women. Even the most positive trials using isolated calcium supplementation show only minor effects on bone mass. Nonetheless, a review of the research shows that calcium supplementation plus hormone replacement therapy is much more effective than hormone replacement therapy without calcium. Double-blind research has found that increasing calcium intake results in greater bone mass in girls. An analysis of many trials investigating the effects of calcium supplementation in premenopausal women has also shown a significant positive effect. Most doctors recommend calcium supplementation as a way to partially reduce the risk of osteoporosis and to help people already diagnosed with the condition. In order to achieve the 1,500 mg per day calcium intake many researchers deem optimal, 800 to 1,000 mg of supplemental calcium are generally added to the 500 to 700 mg readily obtainable from the diet.
While phosphorus is essential for bone formation, most people do not require phosphorus supplementation, because the typical western diet provides ample or even excessive amounts of phosphorus. One study, however, has shown that taking calcium can interfere with the absorption of phosphorus, potentially leading to phosphorus deficiency in elderly people, whose diets may contain less phosphorus. . The authors of this study recommend that, for elderly people, at least some of the supplemental calcium be taken in the form of tricalcium phosphate or some other phosphorus-containing preparation.
Ipriflavone is a synthetic flavonoid derived from the soy isoflavone called daidzein. It promotes the incorporation of calcium into bone and inhibits bone breakdown, thus preventing and reversing osteoporosis. Many clinical trials, including numerous double-blind trials, have consistently shown that long-term treatment with 600 mg of ipriflavone per day, along with 1,000 mg supplemental calcium, is both safe and effective in halting bone loss in postmenopausal women or in women who have had their ovaries removed. Ipriflavone has also been found to improve bone density in established cases of osteoporosis in most, but not all, clinical trials. Some studies have shown that ipriflavone therapy not only stops bone loss, it also actually increases bone density and significantly reduces the number of vertebral fractures and amount of bone pain.
However, one double-blind study has failed to confirm the beneficial effect of ipriflavone. In that study, ipriflavone was no more effective than a placebo for preventing bone loss in postmenopausal women with osteoporosis. The women in this negative study were older (average age, 63.3 years) than those in most other ipriflavone studies and had relatively severe osteoporosis. It is possible that ipriflavone works only in younger women or in those with less severe osteoporosis.
-
Vitamin D increases calcium absorption, and blood levels of vitamin D are directly related to the strength of bones. Mild deficiency of vitamin D is common in the fit, active elderly population and leads to an acceleration of age-related loss of bone mass and an increased risk of fracture. In double-blind research, vitamin D supplementation has reduced bone loss in women who consume insufficient vitamin D from food and slowed bone loss in people with osteoporosis. However, the effect of vitamin D supplementation on osteoporosis risk remains surprisingly unclear, with some trials reporting little if any benefit. Moreover, trials reporting reduced risk of fracture have usually combined vitamin D with calcium supplementation, making it difficult to assess how much benefit is caused by supplementation with vitamin D alone.
Impaired balance and increased body sway are important causes of falls in elderly people with osteoporosis. Vitamin D works with calcium to prevent some musculoskeletal causes of falls. In a double-blind trial, elderly women who were given 800 IU per day of vitamin D and 1,200 mg per day of calcium had a significantly lower rate of falls and subsequent fractures than did women given the same amount of calcium alone. Vitamin D in the amount of 800 IU per day effectively prevented falls in a double-blind study of elderly nursing home residents, but lower amounts were ineffective.
-
Despite inconsistency in the research, many doctors recommend 400 to 800 IU per day of supplemental vitamin D, depending upon dietary intake and exposure to sunlight.
A preliminary trial found that elderly women with osteoporosis who were given 4 grams of fish oil per day for four months had improved calcium absorption and evidence of new bone formation. Fish oil combined with evening primrose oil (EPO) may confer added benefits. In a controlled trial, women received 6 grams of a combination of EPO and fish oil, or a matching placebo, plus 600 mg of calcium per day for three years. The EPO/fish oil group experienced no spinal bone loss in the first 18 months and a significant 3.1% increase in spinal bone mineral density during the last 18 months.
Vitamin K is needed for bone formation. People with osteoporosis have been reported to have low blood levels and low dietary intake of vitamin K. One study found that postmenopausal (though not premenopausal) women may reduce urinary loss of calcium by taking 1 mg of vitamin K per day. People with osteoporosis given large amounts of vitamin K2 (45 mg per day) have shown an increase in bone density after six months and decreased bone loss after one or two years.
Other preliminary studies have reported that vitamin K supplementation increases bone formation in some women and that higher vitamin K intake correlates with greater bone mineral density. Some doctors recommend 1 mg vitamin K1 to postmenopausal women as a way to help maintain bone mass, though optimal intake remains unknown.
In a preliminary study, people with osteoporosis were reported to be at high risk for magnesium malabsorption. Both bone and blood levels of magnesium have been reported to be low in people with osteoporosis. Supplemental magnesium has reduced markers of bone loss in men. Supplementing with 250 mg up to 750 mg per day of magnesium arrested bone loss or increased bone mass in 87% of people with osteoporosis in a two-year, preliminary trial. Supplementing with magnesium (150 mg per day for one year) also increased bone mass in pre-adolescent and adolescent girls in a double-blind study. Some doctors recommend that people with osteoporosis supplement with 350 mg of magnesium per day.
One trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C, B vitamins, vitamin D, zinc, copper, manganese, boron, and other nutrients for an eight- to nine-month period. In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11%, compared to only 0.7% in women receiving hormone replacement alone.
Levels of zinc in both blood and bone have been reported to be low in people with osteoporosis, and urinary loss of zinc has been reported to be high. In one trial, men consuming only 10 mg of zinc per day from food had almost twice the risk of osteoporotic fractures compared with those eating significantly higher levels of zinc in their diets. Whether zinc supplementation protects against bone loss has not yet been proven, though in one trial, supplementation with several minerals including zinc and calcium was more effective than calcium by itself. Many doctors recommend that people with osteoporosis, as well as those trying to protect themselves from this disease, supplement with 10 to 30 mg of zinc per day.
Copper is needed for normal bone synthesis. Recently, a two-year, controlled trial reported that 3 mg of copper per day reduced bone loss. When taken over a shorter period of time (six weeks), the same level of copper supplementation had no effect on biochemical markers of bone loss. Some doctors recommend 2 to 3 mg of copper per day, particularly if zinc is also being taken, in order to prevent a deficiency. Supplemental zinc significantly depletes copper stores, so people taking zinc supplements for more than a few weeks generally need to supplement with copper also. All minerals discussed so far: calcium, magnesium, zinc, and copper, are sometimes found at appropriate levels in high-potency multivitamin-mineral supplements.
Boron supplementation has been reported to reduce urinary loss of calcium and magnesium in some, but not all, preliminary research. However, those who are already supplementing with magnesium appear to achieve no additional calcium-sparing benefit when boron is added. Finally, in the original report claiming that boron reduced loss of calcium, the effect was achieved by significantly increasing estrogen and testosterone levels, hormones that have been linked to cancer risks. Therefore, it makes sense for people with osteoporosis to supplement with magnesium instead of, rather than in addition to, boron.
Interest in the effect of manganese and bone health began when famed basketball player Bill Walton's repeated fractures were halted with manganese supplementation. A subsequent, unpublished study reported manganese deficiency in a small group of osteoporotic women. Since then, a combination of minerals including manganese was reported to halt bone loss. However, no human trial has investigated the effect of manganese supplementation alone on bone mass. Nonetheless, some doctors recommend 10 to 20 mg of manganese per day to people concerned with maintenance of bone mass.
Silicon is required in trace amounts for normal bone formation, and supplementation with silicon has increased bone formation in animals. In preliminary human research, supplementation with silicon increased bone mineral density in a small group of people with osteoporosis. Optimal supplemental levels remain unknown, though some multivitamin-mineral supplements now contain small amounts of this trace mineral.
-
Strontium may play a role in bone formation, and also may inhibit bone breakdown. Preliminary evidence suggests that women with osteoporosis may have reduced absorption of strontium. The first medical use of strontium was described in 1884. (Strontium supplements do not contain the radioactive form of strontium that is a component of nuclear fallout.) Years ago in a preliminary trial, people with osteoporosis were given 1.7 grams of strontium for a period of time ranging between three months and three years; afterward, they reported a significant reduction in bone pain, and there was evidence suggesting their bone mass had increased. More recently, in a three-year double-blind study of postmenopausal women with osteoporosis, supplementing with strontium, in the form of strontium ranelate, significantly increased bone mineral density in the hip and spine, and significantly reduced the risk of vertebral fractures by 41%, compared with a placebo. The amount of strontium used in that study was 680 mg per day, which is approximately 300 times the amount found in a typical diet. Increased bone formation and decreased bone pain were also reported in six people with osteoporosis given 600 to 700 mg of stable strontium per day. Although the amounts of strontium used in these studies studies was very high, the optimal intake remains unknown. Some doctors recommend only 1 to 3 mg per day less than many people currently consume from their diets, but an amount that has begun to appear in some mineral formulas geared toward bone health. Strontium preparations, providing 200 to 400 mg per day, were used for decades during the first half of the twentieth century without any apparent toxicity. No significant side effects were observed in people taking large amounts of strontium; however, animal studies have demonstrated defects in bone mineralization, when strontium was administered in large amounts in combination with a low-calcium diet. People interested in taking large amounts of strontium should be supervised by a doctor, and should make sure to take adequate amounts of calcium. It should be noted that, although supplementing with strontium increases bone mineral density, only part of the increase is real. The rest is a laboratory error that results from the fact that strontium blocks X-rays to a greater extent than does calcium. People taking large amounts of strontium should mention that fact to the radiologist when they are having their bone mineral density measured, so that the results will be interpreted correctly.
Folic acid, vitamin B6, and vitamin B12 are known to reduce blood levels of the amino acid homocysteine, and homocystinuria, a condition associated with high homocysteine levels, frequently causes osteoporosis. Therefore, some researchers have suggested that these vitamins might help prevent osteoporosis by lowering homocysteine levels. In a double-blind study of people who had suffered a stroke and had high homocysteine levels, daily supplementation with 5 mg of folic acid and 1,500 mcg of vitamin B12 for two years reduced the incidence of fractures by 78%, compared with a placebo. The reduction in fracture risk appeared to be due to an improvement in bone quality, rather than to a change in bone mineral density. Whether these vitamins would be beneficial for people with normal homocysteine levels is not known. For the purpose of lowering homocysteine, amounts of folic acid and vitamins B6 and B12 found in high-potency B-complex supplements and multivitamins should be adequate.
Preliminary evidence suggests that progesterone might reduce the risk of osteoporosis. A preliminary trial using topically applied natural progesterone cream in combination with dietary changes, exercise, vitamin and calcium supplementation, and estrogen therapy reported large gains in bone density over a three-year period in a small group of postmenopausal women, but no comparison was made to examine the effect of using the same protocol without progesterone. Other trials have reported that adding natural progesterone to estrogen therapy did not improve the bone-sparing effects of estrogen when taken alone and that progesterone applied topically every day for a year did not reduce bone loss. In a more recent double-blind study, however, progesterone had a modest bone-sparing effect in post-menopausal women.
In a preliminary trial, bone mineral density increased among healthy elderly women and men who were given 50 mg per day of DHEA as a supplement. Similar results were found in a one-year double-blind trial that used 50 mg of DHEA per day. It is not known if supplementation would have the same effect in people with established osteoporosis.
Some whey proteins may reduce bone loss. Milk basic protein (MBP) is a mixture of some of the proteins found in whey protein. A preliminary trial found that 300 mg per day of MBP improved blood measures of bone metabolism in men, suggesting more bone formation was occurring than bone loss. A double-blind trial found that women taking 40 mg per day of MBP for six months had greater gains in bone density compared with those taking a placebo. No osteoporosis-related research has been done using complete whey protein mixtures.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
In a double-blind study, supplementation with isoflavones from red clover for one year reduced the amount of bone loss from the spine by 45%, compared with a placebo. The supplement used provided daily 26 mg of biochanin A, 16 mg of formononetin, 1 mg of genistein, and 0.5 mg of daidzein.
Horsetail is a rich source of silicon, and preliminary research suggests that this trace mineral may help maintain bone mass. Effects of horsetail supplementation on bone mass have not been studied.
Black cohosh has been shown to improve bone mineral density in animals fed a low calcium diet, but it has not been studied for this purpose in humans.
Go to top
Copyright ) 2007 Healthnotes, Inc. All rights reserved. www.healthnotes.com
New Vitality Web Specials
Go to top
PMS
 Know your body and find your balance despite PMS. Because every woman is different, no single treatment effectively relieves all symptoms in all women. According to research or other evidence, the following self-care steps may be helpful:
- Check out calcium and magnesium
- A daily supplement of 1,000 to 1,200 mg of calcium and 200 to 400 mg of magnesium to reduce the risk of mood swings, bloating, headaches, and other symptoms
These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full premenstrual syndrome article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.
About premenstrual syndrome
Premenstrual syndrome (PMS) is a poorly understood complex of symptoms occurring a week to ten days before the start of each menstrual cycle.
PMS is believed to be triggered by changes in progesterone and estrogen levels.
What are the symptoms?
Many premenopausal women suffer from symptoms of PMS at different points in their menstrual cycle. Symptoms include cramping, bloating, mood changes, and breast tenderness tied to the menstrual cycle.
Dietary changes that may be helpful
Women who eat more sugary foods have been reported to have an increased risk of PMS. Some doctors recommend that women with PMS cut back on sugar consumption for several months to see if it reduces their symptoms. However, no trials have yet to study the isolated effects of sugar restriction in women with PMS.
Alcohol can affect hormone metabolism, and alcoholic women are more likely to suffer PMS than are nonalcoholic women. Some doctors recommend that women with PMS avoid alcohol for several months to evaluate whether such a change will reduce symptoms.
In a study of Chinese women, increasing tea consumption was associated with increasing prevalence of PMS. Among a group of college students in the United States, consumption of caffeine-containing beverages was associated with increases in both the prevalence and severity of PMS. Moreover, the more caffeine women consumed, the more likely they were to suffer from PMS. A preliminary study showed that women with heavy caffeine consumption were more likely to have shorter menstrual periods and shorter cycle length compared with women who did not consume caffeine. Some doctors recommend that women with PMS avoid caffeine.
Several studies suggest that diets low in fat or high in fiber may help to reduce symptoms of PMS. Many doctors recommend diets very low in meat and dairy fat and high in fruits, vegetables, and whole grains.
Lifestyle changes that may be helpful
Women with PMS who jogged an average of about 12 miles a week for six months were reported to experience a reduction in breast tenderness, fluid retention, depression, and stress. Doctors frequently recommend regular exercise as a way to reduce symptoms of PMS.
Vitamins that may be helpful
Many, though not all, clinical trials show that taking 50-400 mg of vitamin B6 per day for several months help relieve symptoms of PMS. A composite analysis of the best designed controlled trials shows that vitamin B6 is more than twice as likely to reduce symptoms of PMS as is placebo. Many doctors suggest 100-400 mg per day for at least three months. However, intakes greater than 200 mg per day can cause side effects and should never be taken without the supervision of a healthcare professional.
Women who consume more calcium from their diets are less likely to suffer severe PMS. A large double-blind trial found that women who took 1,200 mg per day of calcium for three menstrual cycles had a 48% reduction in PMS symptoms, compared to a 30% reduction in the placebo group. Other double-blind trials have shown that supplementing 1,000 mg of calcium per day relieves premenstrual symptoms.
Women with PMS have been shown to have impaired conversion of linoleic acid (an essential fatty acid) to gamma linolenic acid (GLA). Because a deficiency of GLA might, in theory, be a factor in PMS and because evening primrose oil (EPO) contains significant amounts of GLA, researchers have studied EPO as a potential way to reduce symptoms of PMS. In several double-blind trials, EPO was found to be beneficial, whereas in other trials it was no more effective than placebo.
Despite these conflicting results, some doctors consider EPO to be worth a try; the amount usually recommended is 3-4 grams per day. EPO may work best when used over several menstrual cycles and may be more helpful in women with PMS who also experience breast tenderness or fibrocystic breast disease.
Women with PMS have been reported to be at increased risk of magnesium deficiency. Supplementing with magnesium may help reduce symptoms. In one double-blind trial using only 200 mg per day for two months, a significant reduction was reported for several symptoms related to PMS (fluid retention, weight gain, swelling of extremities, breast tenderness, and abdominal bloating). Magnesium has also been reported to be effective in reducing the symptoms of menstrual migraine headaches. While the ideal amount of magnesium has yet to be determined, some doctors recommend 400 mg per day. Effects of magnesium may begin to appear after two to three months.
A preliminary, uncontrolled trial found that women with severe PMS who took potassium supplements had complete resolution of PMS symptoms within four menstrual cycles. Most participants took 400 mg of potassium per day as potassium gluconate plus 200 mg of potassium per day as potassium chloride for the first two cycles, then switched to solely the gluconate form (600 mg potassium per day) for the remainder of the year-long trial. Without exception, all of the women found their symptoms (i.e., bloating, fatigue, irritability, etc.) decreasing gradually over three cycles and disappearing completely by the fourth cycle. Controlled trials are needed to confirm these preliminary observations.
The amino acid, L-tryptophan has been shown to help relieve PMS symptoms. In a double-blind trial, women with premenstrual discomfort received 6 grams per day of L-tryptophan or placebo for 17 days. Those who took L-tryptophan had significant improvement of symptoms, including mood swings, tension, irritability, breast sensitivity, water retention, and headache. There was a slight reduction in premenstrual depression, but it was not statistically significant. L-tryptophan is available only by prescription. It has not been determined whether 5-hydroxytryptophan (5-HTP, a metabolic byproduct of L-tryptophan that is available without prescription) has similar effects.
In a double-blind trial, supplementing with soy protein (providing 68 mg of isoflavones per day) for two menstrual cycles was significantly more effective than a placebo at relieving premenstrual swelling and cramping. The placebo used in this study was cow's milk protein. Some doctors believe that cow's milk, because of its estrogen content, can worsen premenstrual symptoms. If that is the case, then the beneficial effect of soy protein may have been overestimated in this study.
Although women with PMS do not appear to be deficient in vitamin E, a double-blind trial reported that 300 IU of vitamin E per day may decrease symptoms of PMS.
Krill oil from Antarctic krill (a zooplankton crustacean) has been shown in a double-blind trial to be an effective treatment for premenstrual syndrome. Krill oil was significantly more effective than regular fish oil in relieving emotional symptoms and breast tenderness related to premenstrual syndrome. The amount of krill oil used in this study was 2 grams per day for the first month. In the second and third months the women took two grams per day beginning eight days prior to menstruation and continuing for two days after the start of menstruation.
Some of the nutrients mentioned above appear together in multivitamin-mineral supplements. One double-blind trial used a multivitamin-mineral supplement containing vitamin B6 (600 mg per day), magnesium (500 mg per day), vitamin E (200 IU per day), vitamin A (25,000 IU per day), B-complex vitamins, and various other vitamins and minerals. This supplement was found to relieve each of four different categories of PMS symptoms. Related results have been reported in other clinical trials.
Most well-controlled trials have not found vaginally applied natural progesterone to be effective against the symptoms of premenstrual syndrome. Only anecdotal reports have claimed that orally or rectally administered progesterone may be effective. Progesterone is a hormone, and as such, there are concerns about its inappropriate use. A physician should be consulted before using this or other hormones. Few side effects have been associated with use of topical progesterone creams, but skin reactions may occur. The effect of natural progesterone on breast cancer risk remains unclear; some research suggests the possibility of increased risk, whereas other research points to a possible reduction in risk.
Very high amounts of vitamin A-100,000 IU per day or more, have reduced symptoms of PMS, but such an amount can cause serious side effects with long-term use. Women who are or who could become pregnant should not supplement with more than 10,000 IU (3,000 mcg) per day of vitamin A. Other people should not take more than 25,000 IU per day without the supervision of their doctor. As yet, no trials have explored the effects of these safer amounts of vitamin A in women suffering from PMS.
Many years ago, research linked B vitamin deficiencies to PMS in preliminary research. Based on that early work, some doctors recommend B-complex vitamins for women with PMS.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Vitex has been shown to help re-establish normal balance of estrogen and progesterone during the menstrual cycle. Vitex also blocks prolactin secretion in women with excessive levels of this hormone; excessive levels of prolactin can lead to breast tenderness and failure to ovulate. A double-blind trial has confirmed that vitex reduces mildly elevated levels of prolactin before a woman,s period. Studies have shown that using vitex once in the morning over a period of several months helps normalize hormone balance and thus alleviate the symptoms of PMS. A preliminary trial and a double-blind trial have found that women taking 20 mg per day of a concentrated vitex extract for three menstrual cycles experience a significant reduction in symptoms of PMS.
Vitex has been shown to be as effective as 200 mg vitamin B6 in a double-blind trial of women with PMS. Two surveys examined 1,542 women with PMS who had taken a German liquid extract of vitex for their PMS symptoms for as long as 16 years. With an average intake of 42 drops per day, 92% of the women surveyed reported the effectiveness of vitex as "very good,""good," or "satisfactory."
Some healthcare practitioners recommend 40 drops of a liquid, concentrated vitex extract or one capsule of the equivalent dried, powdered extract once per day in the morning with some liquid. Vitex should be taken for at least four cycles to determine efficacy.
A double-blind trial has shown that standardized Ginkgo biloba extract, when taken daily from day 16 of one menstrual cycle to day 5 of the next menstrual cycle, alleviates congestive and psychological symptoms of PMS better than placebo. The trial used 80 mg of a ginkgo extract two times per day.
In Traditional Chinese Medicine, dong quai is rarely used alone and is typically used in combination with herbs such as peony (Paeonia officinalis) and osha (Ligusticum porteri) for menopausal symptoms as well as for menstrual cramps. However, no clinical trials have been completed to determine the effectiveness of dong quai for PMS.
Black cohosh is approved in Germany for use in women with PMS. This approval appears to be based on historical use as there are no modern clinical trials to support the use of black cohosh for PMS.
Based on anecdotal evidence, yarrow tea has been used by European doctors when the main symptom of PMS is spastic pain. Combine 2-3 teaspoons of yarrow flowers with one cup of hot water, then cover and steep for 15 minutes. Drink three to five cups per day beginning two days before PMS symptoms usually commence. In addition, 1-3 cups of the tea added to hot or cold water can be used as a sitz bath.
Copyright ) 2007 Healthnotes, Inc. All rights reserved. www.healthnotes.com
New Vitality Web Specials
Go to top | |
|
|
|
Everyday Vitamins For Women
While certain nutritional needs can change, some nutrients remain particularly important throughout a woman's life. By eating well, women can get much of what they need, such as protein and fiber, but many can benefit from taking supplements to ensure they get enough of certain essential vitamins and minerals that the diet doesn't always provide, such as calcium, vitamin D, and zinc.
A happy family
For starters, it's a good idea for every woman to take a daily multivitamin to get a family of vitamins and minerals, including vitamin C (200 to 1,000 mg per day) and the B-complex vitamins. The B-vitamins that are part of this complex are thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pantothenic acid (vitamin B5), pyridoxine (vitamin B6), biotin, folic acid, and cobalamin (vitamin B12). Most multivitamins will also contain beneficial zinc, vitamin A, and vitamin E for healthy skin and immune function, and to protect against a wide variety of diseases.
The strength is in the bones
A woman's bones need extra care to help preserve bone mass and avoid possible osteoporosis later in life. Body After Baby author and nutrition expert Jackie Keller says Women need calcium at all stages of life, and we generally don't get enough in our diets through food sources. Look for a calcium supplement that, combined with diet and what you might get in a multivitamin, gives you around 1,000 mg per day, 1,200 if you're over 51. To further protect bones, doctors recommend to also supplementing with 400 IU of vitamin D per day when taking calcium.
Fatty is good
Omega-3 fatty acids are considered essential for the body's health. For women, they protect against a wide range of conditions, including osteoporosis, heart disease, and depression. Food sources include cold-water fish, walnuts, flaxseeds, and canola oil. Common supplement forms of omega-3s are fish oil capsules (1,000 to 4,000 mg per day) and ground flaxseed (1 tablespoon (15 ml) one or two times a day). You can easily grind your own flaxseeds in a small coffee bean grinder to guarantee freshness.
Go to top
Copyright ) 2007 Healthnotes, Inc. All rights reserved. www.healthnotes.com
New Vitality Web Specials
Weight Loss and Obesity
Get the skinny on weight loss. Discover what works for you to improve your chances of losing weight and keeping it off. According to research or other evidence, the following self-care steps may be helpful:
- Aim for total nutrition with a multivitamin
- Extra vitamins and minerals will help ensure your body gets the nutrition it needs, especially if you are avoiding certain foods
-
Create a custom exercise plan
-
Exercise you truly enjoy is much easier to stick to, so find activities that fit your personal style, fitness level, and workout opportunities
These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full weight loss and obesity article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.
About weight loss and obesity
About two-thirds of the adult U.S. population is overweight. Almost one-third not only exceeds ideal weight, but also meets the clinical criteria for obesity. In the 1990s, rates of obesity more than doubled, and are currently rising by over 5% per year. Excess body weight is implicated as a risk factor for many different disorders, including heart disease, diabetes, several cancers (such as breast cancer in postmenopausal women, and cancers of the uterus, colon, and kidney), prostate enlargement (BPH), female infertility, uterine fibroids, and gallstones, as well as several disorders of pregnancy, including gestational diabetes, preeclampsia, and gestational hypertension. The location of excess body fat may affect the amount of health risk associated with overweight. Increased abdominal fat, which can be estimated by waist size, may be especially hazardous to long-term health.
For overweight women, weight loss can significantly improve physical health. A four-year study of over 40,000 women found that weight loss in overweight women was associated with improved physical function and vitality as well as decreased bodily pain. The risk of death from all causes, cardiovascular disease, cancer, or other diseases increases in overweight men and women in all age groups. Losing weight and keeping it off is, unfortunately, very difficult for most people. However, repeated weight loss followed by weight regain may be unhealthy, as it has been associated with increased heart disease risk factors and bone loss in some studies. Rather than focusing on weight loss as the most important health outcome of a change in diet or lifestyle, some doctors advocate paying more attention to overall fitness and reduction in known risk factors for heart disease and other health hazards.
Excess body mass has the one advantage of increasing bone mass-a protection against osteoporosis. Probably because of this, researchers have been able to show that people who successfully lose weight have greater loss of bone compared with those who do not lose weight. People who lose weight should, therefore, pay more attention to preventing osteoporosis.
Dietary changes that may be helpful
Breast-feeding
In a preliminary study, breast-feeding during infancy was associated with a reduced risk of developing obesity during early childhood (ages three to four years).1
Calorie restriction
Calories in the diet come from fat, carbohydrate, protein, or alcohol. Weight-loss diets are typically designed to limit calories either by restricting certain foods that are thought to result in increased calorie intake, and/or by emphasizing foods that are believed to result in reduced calorie intake. Some currently popular diets restrict fat while emphasizing fiber and a balanced intake of healthful foods. Others restrict carbohydrates, either to extremely low amounts as in the Atkins diet, or to a lesser degree, emphasizing foods low in the glycemic index or high in protein. Discussions of the research on these diets follow; however, it should be remembered that no diet has been proven effective for long-term weight loss, and many people find it difficult to stay on most diets.
Low-fat, low-calorie, high-fiber, balanced diets are recommended by many doctors for weight loss. According to controlled studies, when people are allowed to eat as much food as they desire on a low-fat diet, they tend to lose more weight than people eating a regular diet. However, low-fat diets have not been shown to be more effective than other weight-loss diets that restrict calories. Nonetheless, a low-fat, high-fiber, balanced diet has additional potential benefits, such as reducing the risk of chronic diseases including heart disease and cancer.
Preliminary research indicates that people who successfully lost weight got less of their total calories from fat and more of them from protein foods. They also ate fewer snacks of low nutritional quality and got more of their calories from "hot meals of good quality." Other preliminary studies find that dieters who maintain long-term weight loss report using fat restriction and eating a regular breakfast as key strategies in their success.
Low-carbohydrate, high-protein diets
Low-carbohydrate, high-fat diets such as the Atkins diet are very popular among people trying to lose weight. In a preliminary study, overweight individuals who adhered to a very-low-carbohydrate diet (25 grams per day initially, increased to 50 grams per day after a certain weight loss target was achieved), with no limit on total calorie intake, lost on average more than 10% of their body weight over a six-month period. The participants also engaged in aerobic exercise at least three times a week, so it is not clear how much of the weight loss was due to the diet. An analysis of other preliminary studies of this type of diet concluded that its effectiveness is primarily due to reduced calorie intake. Recently, three controlled trials found people using low-carbohydrate, high-fat diets lost more weight in six months than those using diets low in fat and calories. However, 20 to 40% of these dieters did not stay on their diets, and were not counted in the results. In addition, one of these trials continued for an additional six months, at the end of which there was no longer a significant difference in weight loss between the two diet groups. A recent 12-week controlled trial found that overweight adolescents also lost more weight with a low-carbohydrate diet than with a low-fat diet, even though they consumed 50% more calories than did the children on the low-fat diet. That study suggests that the weight loss occurring on the Atkins diet is not due entirely to calorie restriction. Blood tests suggest that low-carbohydrate diets induce a condition called mild metabolic acidosis, which might increase the risk of osteoporosis and kidney stones.
The effect of low-carbohydrate diets on cardiovascular risk is also an unresolved issue. The short-term studies discussed above found that blood cholesterol levels did not worsen with these diets. Other heart-disease risk factors (triglyceride levels and insulin sensitivity) actually improved with a low-carbohydrate diet. Some studies, however, have shown a worsening of certain cardiovascular risk factors in people using a low-carbohydrate, high-fat diet for up to one year. Adverse changes included increases in blood levels of homocysteine, lipoprotein(a), and fibrinogen, and a decrease in blood flow to the heart. Individuals wishing to consume a very-low-carbohydrate diet for weight loss or for other reasons should be monitored by a doctor.
Some research has investigated weight-loss diets that are high in protein, but moderate in fat and not as low in carbohydrate content as the diets discussed above. While this type of diet does not usually lead to greater weight loss than other diets when calorie intakes are kept equal, one controlled trial found greater body fat loss in women eating a diet almost equal in calories and fat but approximately twice as high in protein and lower in carbohydrate compared with a control group's diet. Another controlled trial compared two diets similar in fat content but different in protein and carbohydrate content. People allowed to eat freely from the higher protein diet (25% of calories from protein, 45% calories from carbohydrate) consumed fewer calories and lost more weight compared with people eating the lower protein diet (12% of calories from protein, 59% calories from carbohydrate).
One small study has shown that the most effective weight-loss diet for any particular person might depend on whether or not they have insulin resistance. In obese people with insulin resistance, weight loss was greater with a low-carbohydrate (40% of calories), high-fat (40% of calories) diet than with a high-carbohydrate (60% of calories), low-fat (20% of calories) diet. In contrast, obese people who did not have insulin resistance lost more weight on the high-carbohydrate, low-fat diet.
Low-glycemic-index foods
Diets that emphasize choosing foods with a low glycemic index have been shown to help control appetite in some, though not all, controlled studies. A controlled study in two phases found no difference in weight loss between a low- and a high-glycemic-index diet in the first 12-week phase, but when the diets were switched for a second 12-week phase, the low-glycemic-index diet was significantly more effective for weight loss. A preliminary study reported that obese children using a low-glycemic-index diet lost more weight compared with a similar group using a low-fat diet.
Fiber
Adequate amounts of dietary fiber are believed to be important for people wishing to lose weight. Fiber adds bulk to the diet and tends to produce a sense of fullness, helping people consume fewer calories. While research on the effect of fiber intake on weight loss has not produced consistent results, a recent review of weight-loss trials that did not restrict calories concluded that higher fiber diets improved weight-loss results, especially in people who were overweight.
Stabilizing food sensitivities
Although the relationship between food sensitivities and body weight remains uncertain, according to one researcher, chronic food allergy may lead to overeating and obesity.
Long-term changes
People who go on and off diets frequently complain that it takes fewer calories to produce weight gain with each weight fluctuation. Evidence now clearly demonstrates that the body gets "stingier" in its use of calories after each diet. This means it becomes easier to gain weight and harder to lose it the next time. Dietary changes need to be long term.
Lifestyle changes that may be helpful
Support
Many doctors give overweight patients a pill, a pep talk, and a pamphlet about diet and exercise, but that combination leads only to minor weight loss. When overweight people attend group sessions aimed at changing eating and exercise patterns, keep daily records of food intake and exercise, and eat a specific low-calorie diet the outcome is much more successful. Group sessions where participants are given information and help on how to make lifestyle changes appear to improve the chances of losing weight and keeping it off. Such changes may include shopping from a list, storing foods out of sight, keeping portion sizes under control, and avoiding fast-food restaurants.
Exercise
According to most short-term studies, the effect of exercise alone (without dietary restriction) on weight loss is small, partly because muscle mass often increases even while fat tissue is reduced, and perhaps because some exercising people will experience increased appetites. The long-term effect of regular exercise on weight loss is much better, and exercise appears to help people maintain weight loss. People who have successfully maintained weight loss for over two years report continuing high levels of physical activity. Combining exercise with healthier eating habits results in the best short- and long-term effects on weight loss, and should reduce the risk of many serious diseases.
Avoid weight cycling
People who experience "weight cycling" (repetitive weight loss and gain) have a tendency toward binge eating (periods of compulsive overeating, but without the self-induced vomiting seen in bulimia), according to a review of numerous studies focusing on weight loss. The researchers also found an association between weight cycling and depression or poor body image. The most successful weight-loss programs (in which weight stays off, mood stays even, and no binge eating occurs) appear to use a combination of moderate caloric restriction, moderate exercise, and behavior modification, including examination and adjustment of eating habits.
Other therapies
Other treatment typically includes dietary changes to limit fat and calorie intake, increased exercise, and changes in eating habits or patterns. Severe cases might require surgical options to reduce the size of the stomach or to bypass a portion of the stomach and intestines.
Vitamins that may be helpful
Multiple vitamin minerals
Diets that are low in total calories may not contain adequate amounts of various vitamins and minerals. For that reason, taking a multiple vitamin-mineral supplement is advocated by proponents of many types of weight-loss programs, and is essential when calorie intake will be less than 1,100 calories per day.
Pyruvate
Pyruvate, a compound that occurs naturally in the body, might aid weight-loss efforts. A controlled trial found that pyruvate supplements (22 to 44 grams per day) enhanced weight loss and resulted in a greater reduction of body fat in overweight adults consuming a low-fat diet. Three controlled trials combining 6 to 10 grams per day of pyruvate with an exercise program reported greater effects on weight loss and body fat than that seen with a placebo plus the exercise program. Animal studies suggest that pyruvate supplementation leads to weight loss by increasing theresting metabolic rate.
5-HTP
5-HTP (5-hydroxytryptophan), the precursor to the chemical messenger (neurotransmitter) serotonin, has been shown in three short-term controlled trials to reduce appetite and to promote weight loss. In one of these trials (a 12-week double-blind trial), overweight women who took 600 to 900 mg of 5-HTP per day lost significantly more weight than did women who received a placebo. In a double-blind trial with no dietary restrictions, obese people with type 2(non-insulin-dependent) diabetes who took 750 mg per dayof 5-HTP for two weeks significantly reduced their carbohydrate and fat intake. Average weight loss in two weeks was 4.6 pounds, compared with 0.2 pounds in the placebo group.
7-KETO
The ability of 7-KETO (3-acetyl-7-oxo-dehydroepiandrosterone), a substance related to DHEA, to promote weight loss in overweight people has been investigated in one double-blind trial. Participants in the trial were advised to exercise three times per week for 45 minutes and to eat an 1,800-calorie-per-day diet. Each person was given either a placebo or 100 mg of 7-KETO twice daily. After eight weeks, those receiving 7-KETO had lost more weight and lowered their percentage of body fat further compared to those taking a placebo. These results may have been due to increases in levels of a thyroid hormone (T3) that plays a major role in determining a person's metabolic rate, although the levels of T3 did not exceed the normal range.
HMB
Biochemical and animal research show that HMB has a role in protein synthesis and might, therefore, improve muscle growth and overall body composition when given as a supplement. However, double-blind human research suggests that HMB may only be effective when combined with an exercise program in people who are not already highly trained athletes. Double-blind trials found no effect of 3 to 6 grams per day of HMB on body weight, body fat, or overall body composition in weight-training football players or other trained athletes. However, one double-blind study found that 3 grams per day of HMB increased the amount of body fat lost by 70-year old adults who were participating in a strength-training program for the first time. A double-blind study of young men with no strength-training experience reported greater improvements in muscle mass (but not in percentage body fat) when HMB was used in the amount of 17 mg per pound of body weight per day. However, another group of men in the same study given twice as much HMB did not experience any changes in body composition.
Calcium
In a study of obese people consuming a low-calorie diet for 24 weeks, those receiving a calcium supplement (800 mg per day) lost significantly more weight than those given a placebo. Calcium was effective when provided either as a supplement, or in the form of dairy products. In a second study, however, the amount of weight loss resulting from calcium supplementation (1,000 mg per day) was small and not statistically significant. In that study, participants' typical diet contained more calcium than in the study in which calcium supplementation was more effective. Thus, it is possible that calcium supplementation enhances weight loss only when the diet is low in calcium.
CLA
A double-blind trial found that exercising individuals taking 1,800 mg per day of conjugated linoleic acid (CLA) lost more body fat after 12 weeks than did a similar group taking a placebo. However, two other studies found that amounts of CLA from 0.7 to 3.0 grams per day did not affect body composition. Most double-blind trials have found that larger amounts of CLA, 3.2 to 4.2 grams per day, do reduce body fat; however, one double-blind study of experienced strength-training athletes reported no effect of 6 grams per day of CLA on body fat, muscle mass, or strength improvement.
Fiber
Fiber supplements are one way to add fiber to a weight-loss diet. Several trials have shown that supplementation with fiber from a variety of sources accelerated weight loss in people who were following a low-calorie diet. Other researchers found, however, that fiber supplements had no effect on body weight, even though it resulted in a reduction in food intake.
Glucomannan
Supplementation with 3 to 4 grams per day of a bulking agent called glucomannan, with or without a low-calorie diet, has promoted weight loss in overweight adults, while 2 to 3 grams per day was effective in a group of obese adolescents in another controlled trial.
HCA
(-)-Hydroxycitric acid (HCA), extracted from the rind of the Garcinia cambogia fruit grown in Southeast Asia, has a chemicalcomposition similar to that of citric acid (the primary acid in oranges and other citrus fruits). Preliminary studies in animals suggest that HCA may be a useful weight-loss aid. HCA has been demonstrated in the laboratory (but not yet in clinical trials with people) to reduce the conversion of carbohydrates into stored fat by inhibiting certain enzyme processes. Animal research indicates that HCA suppresses appetite and induces weight loss. However, a double-blind trial found that people who took 1,500 mg per day of HCA while eating a low-calorie diet for 12 weeks lost no more weight than those taking a placebo. A double-blind trial of Garcinia cambogia (2.4 grams of dry extract, containing 50% hydroxycitric acid) found that the extract did not increase energy expenditure; it was therefore concluded that this extract showed little potential for the treatment of obesity at this amount Nonetheless, another double-blind trial found that using the same amount of Garciniacambogia extract significantly improved the results of a weight-loss diet, even though the amount of food intake was not affected.
Amylase inhibitors
Amylase inhibitors are also known as starch blockers because they contain substances that prevent dietary starches from being absorbed by the body. Starches are complex carbohydrates that cannot be absorbed unless they are first broken down by the digestive enzyme amylase and other, secondary, enzymes. When starch blockers were first developed years ago, they were found not to be potent enough to prevent the absorption of a significant amount of carbohydrate. Recently, highly concentrated starch blockers have been shown to be more effective, but no published human studies exist investigating their usefulness for weight loss.
Blue-green algae
Blue-green algae, or spirulina, is a rich source of protein, vitamins, minerals, and essential fatty acids. In one double-blind trial, overweight people who took 2.8 grams of spirulina three times per day for four weeks experienced only small and statistically nonsignificant weight loss. Thus, although spirulina has been promoted as a weight-loss aid, the scientific evidence supporting its use for this purpose is weak.
Chitosan
Chitosan is a fiber-like substance extracted from the shells of crustaceans such as shrimp and crab. Animal studies suggested that chitosan supplementation reduces fat absorption, but controlled human trials have found no impairment of fat absorption from supplementation with 2,700 mg of chitosan per day for seven days or 5,250 mg per day for four days. A double-blind study found that people taking 1,500 mg of chitosan three times per day during a weight-loss program lost significantly more weight than did people taking a placebo with the same program. Similar benefits were seen in another double-blind study that used 3,000 mg of chitosan per day. Other studies using smaller amounts of chitosan have reported no effects on weight loss.
Chromium
The mineral chromium plays an essential role in the metabolism of carbohydrates and fats and in the action of insulin. Chromium, usually in a form called chromium picolinate, has been studied for its potential role in altering body composition. Chromium has primarily been studied in body builders, with conflicting results. In people trying to lose weight, a double-blind study found that 600 mcg per day of niacin-bound chromium helped some participants lose more fat and less muscle. However, three other double-blind trials have found no effect of chromium picolinate on weight loss, though in one of these trials lean body mass that was lost during a weight-loss diet was restored by continuing to supplement chromium after the diet. A recent comprehensive review combining the results of ten published and unpublished double-blind studies concluded that chromium picolinate supplementation may have a small beneficial effect on weight loss.
DHEA
One double-blind trial found 100 mg per day of DHEA was effective for decreasing body fat in older men, and another double-blind trial found 1,600 mg per day decreased body fat and increased muscle mass in younger men, . However, DHEA has not been effective for improving body composition in women or in other studies of men.
Guar gum
Guar gum, another type of fiber supplement, has not been effective in controlled studies for weight loss or weight maintenance.
L-carnitine
The amino acid L-carnitine is thought to be potentially helpful for weight loss because of its role in fat metabolism. In a preliminary study of overweight adolescents participating in a diet and exercise program, those who took 1,000mg of L-carnitine per day for three months lost significantly more weight than those who took a placebo. A weakness of this trial, however, was the fact that the average starting body weight differed considerably between the two groups. A double-blind trial found that adding 4,000 mg of L-carnitine per day to an exercise program did not result in weight loss in overweight women.
Sesamin
Sesamin is substance present in sesame oil that manufacturers claim may enhance fat burning by increasing the activity of several liver enzymes that break down fatty acids. It is believed that optimizing the liver's fat-burning capacity may promote fat loss; however, Healthnotes has not seen published research to support the claims.
Soy
Animal and human studies have suggested that when soy is used as a source of dietary protein, it may have several biological effects on the body that might help with weight loss. A preliminary study found that people trying to lose weight using a meal-replacement formula containing soy protein lost more weight than a group not using any formula. However, controlled studies comparing soy protein with other protein sources in weight-loss diets have not found any advantage of soy. When soy protein is used for other health benefits, typical daily intake is 20 grams per day or more.
Whey protein
Whey protein may aid weight loss due to its effect on appetite. In a preliminary study, people were given 48 grams of either whey protein or milk protein (casein). Whey consumption resulted in more hunger satisfaction and reduced the amount of food eaten 90 minutes later compared with casein consumption. However, a double-blind study found that men taking 1.5 grams per 2.2 lbs body weight per day of whey protein for 12 weeks along with a low-calorie diet and a strength training exercise program lost the same amount of weight and body fat as did a control group that followed a similar program, but took a casein supplement instead of whey protein.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Cayenne
Research has suggested that incorporating cayenne pepper into the diet may help people lose weight. Controlled studies report that adding 6 to 10 grams of cayenne to a meal or 28 grams to an entire day's diet reduces hunger after meals and reduces calories consumed during subsequent meals. Other controlled studies have reported that calorie burning by the body increases slightly when 10 grams of cayenne is added to a meal or 28 grams is added to an entire day's diet However, no studies have been done to see if regularly adding cayenne to the diet has any effect on weight loss.
Green tea
Green tea extract rich in polyphenols (epigallocatechin gallate, or EGCG) may support a weight-loss program by increasing energy expenditure or by inhibiting the digestion of fat in the intestine. Healthy young men who took two green tea capsules (containing a total of 50 mg of caffeine and 90 mg of EGCG) three times a day had a significantly greater energy expenditure and fat oxidation than those who took caffeine alone or placebo. In a preliminary study of moderately obese individuals, administration of a specific green tea extract (AR25) resulted in a 4.6% reduction in average body weight after 12 weeks. The amount of green tea extract used in this study supplied daily 270 mg of EGCG and 150 mg of caffeine. While caffeine is known to stimulate metabolism, it appears that other substances besides caffeine were responsible for at least part of the weight loss. Although the extract produced few side effects, one individual developed abnormal liver function tests during the study. In another study, consuming approximately 12 ounces of oolong tea (a semifermented version of green tea) daily for 12 weeks reduced waist circumference and the amount of body fat in a group of normal-weight to overweight men. Additional studies are needed to confirm the safety and effectiveness of green tea extracts for promoting weight loss.
Hoodia
One small, double-blind clinical study in humans found that hoodia latex and inner plant can significantly reduce food intake. Available products are of unknown quality and much more work remains to be done to determine if hoodia will be a sustainable, safe way to reduce appetite.
Yohimbine
The ability of yohimbine, a chemical found in yohimbe bark, to stimulate the nervous system, and to promote the release of fat from fat cells, has led to claims that it might help weight loss by raising metabolic rate, reducing appetite, or increase fat burning. Although a preliminary trial found yohimbine ineffective for weight loss, a double-blind study found that women taking 5 mg of yohimbine four times per day along with a weight-loss diet lost significantly more weight than those taking a placebo with the same diet after three weeks. However, a similar study using 18 mg per day of yohimbine for eight weeks reported no benefit to weight loss compared with a placebo. A double-blind study of men who were not dieting reported no effect of up to 43 mg per day of yohimbine on weight or body composition after six months. All of these studies used pure yohimbine; no study has tested the effects of yohimbe herb on weight loss.
Bitter orange
Although historically used to stimulate appetite, bitter orange is frequently found in modern weight-loss formulas because synephrine is similar to the compound ephedrine, which is known to promote weight loss. In one study of 23 overweight adults, participants taking a daily intake of bitter orange (975 mg) combined with caffeine (525 mg) and St. John's wort (Hypericum perforatum, 900 mg) for six weeks lost significantly more body weight and fat than the control group. No adverse effects on heart rate or blood pressure were found. Bitter orange standardized to contain 4 to 6% synephrine had an anti-obesity effect in rats. However, the amount used to achieve this effect was accompanied by cardiovascular toxicity and mortality.
Coleus
Although no clinical trials have been done, there are modern references to use of the herb coleus for weight loss. Coleus extracts standardized to 18% forskolin are available, and 50 to 100 mg can be taken two to three times per day. Fluid extract can be taken in the amount of 2 to 4 ml three times per day.
Guarana
The herb guarana contains caffeine and the closely related alkaloids theobromine and theophylline; these compounds may curb appetite and increase weight loss. Caffeine's effects are well known and include central nervous system stimulation, increased metabolic rate, and a mild diuretic effect. In a double-blind trial, 200 mg per day of caffeine was, however, no more effective than a placebo in promoting weight loss. Because of concerns about potential adverse effects, many doctors do not advocate using caffeine or caffeine-like substances to reduce weight.
Guggul
Coupled with exercise in a double-blind trial, a combination of guggul, phosphate salts, hydroxycitrate, and tyrosine has been shown to improve mood with a slight tendency to improve weight loss in overweight adults. Daily recommendations for guggul are typically based on the amount of guggulsterones in the extract. A common intake of guggulsterones is 25 mg three times per day. Most guggul extracts contain 5 to 10% guggulsterones and can be taken daily for 12 to 24 weeks.
Relora
Manufacturers of relora, a product derived from Magnolia officinalis and Phellodendron amurense bark, claim that the extract helps balance hormones such as cortisol, which are associated with weight gain. Healthnotes has not seen published research demonstrating that relora promotes weight loss.
Go to top
Copyright ) 2007 Healthnotes, Inc. All rights reserved. www.healthnotes.com
New Vitality Web Specials
Go to top
Pregnancy and Postpartum Support
Enjoy a happy, healthy pregnancy. A healthy baby begins with a healthy mom, so start as soon as possible to prepare your body and mind for motherhood. According to research or other evidence, the following self-care steps may be helpful:
- Prenatal supplement
- Starting before you become pregnant, if possible, take a multivitamin supplement high in folic acid, iron, and calcium to prevent complications due to vitamin or mineral deficiencies
- Eat well
- A well-balanced and varied diet that includes fresh fruits and vegetables, whole grains, legumes, and fish will provide the nutrients you and your baby need
- Avoid harmful habits
- Give up alcohol, caffeine, smoking, and recreational drugs to reduce the risk of birth defects and pregnancy complications
- Gain the right amount of weight
- Follow the advice of your healthcare provider to prevent problems associated with inadequate or excessive weight gain
These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full pregnancy and postpartum support article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.
About pregnancy and postpartum support
Pregnancy, the period during which a woman’s fertilized egg (embryo) gestates and becomes a fetus, lasts an average of 40 weeks from the date of the last menstrual period to delivery of the infant.
In the first trimester (13 weeks), many pregnant women experience nausea. Usually these women report that they feel best during the second trimester. During the third (final) trimester, the increasing size of the fetus begins to place mechanical strains on the expectant mother, often causing back pain, leg swelling, and other health problems.
Dietary changes that may be helpful
Nearly all pregnant women can benefit from good nutritional habits prior to and during pregnancy. The increased number of birth defects during times of famine attest to the adverse effects of poor nutrition during pregnancy. For example, in a dietary survey of pregnant women, higher dietary intake of niacin (a form of vitamin B3) during the first trimester was correlated with higher birth weights, longer length, and larger head circumference (all signs of healthier infants).
Women who consume a standard Western diet (high in fat and sugar and low in complex carbohydrates) during pregnancy and breast-feeding may not get adequate amounts of essential vitamins and minerals, which can result in health problems for the newborn. Pregnant women should choose a well-balanced and varied diet that includes fresh fruits and vegetables, whole grains, legumes, and fish. Refined sugars, white flour, fried foods, processed foods, and chemical additives should be avoided. In one study, women who consumed a healthful diet (consisting mainly of fish, low-fat meats and dairy products, oils, whole grains, fruits, vegetables, and legumes) had a 90% reduction in the incidence of preterm deliveries, compared with those who consumed their usual diet.
Consumption of moderate to large amounts of caffeine while pregnant has been associated with an increased risk of miscarriage. Although some studies suggest that only very large amounts of caffeine increase the risk of miscarriage, an analysis of clinical trials found that women who consumed more than 150 mg of caffeine (roughly one to two cups of coffee) per day while pregnant had an increased risk of miscarriage or delivering a baby with a low birth weight. The FDA has advised women to avoid drinking coffee and consuming other caffeine-containing foods and beverages during pregnancy.
Lifestyle changes that may be helpful
A woman can reduce her risk of complications during pregnancy and delivery by avoiding harmful substances, such as alcohol, caffeine, nicotine, recreational drugs, and some prescription or over-the-counter drugs.
Even minimal alcohol consumption during pregnancy can increase the risk of hyperactivity, short attention span, and emotional problems in the child. Pregnant women should, therefore, avoid alcohol completely.
Cigarette smoking during pregnancy causes lower birth weights and smaller-sized newborns. The rate of miscarriage in smokers is twice as high as that in nonsmokers, and babies born to mothers who smoke have more than twice the risk of dying from sudden infant death syndrome (SIDS).
Weight Gain in Pregnancy
No single maternal weight gain target meets the needs of all women. The amount of weight a woman optimally gains varies with her height, age, plans to breast feed, and whether she is delivering twins. However, a few basic guidelines are generally accepted: Women who enter pregnancy at more than 120% of standard weight still have an obligatory weight gain of 15–25 pounds at a rate of about 0.7 pounds per week. Women who are at ideal body weight and are not going to nurse have a target of gaining about 22 pounds overall at a rate of 0.8 pounds per week. Women who enter pregnancy between 90% and 110% of ideal body weight and plan to nurse have a target weight gain of 25–35 pounds overall at a rate of 0.9 pounds per week during the second and third trimesters. Physically immature adolescents and women less than 90% of ideal body weight have a target weight gain of 32 (28–40) pounds at a rate of 1.1 pounds per week. Women who know they are going to have twins have a target weight gain of 40 (35–45) pounds with a weekly rate of 1.4 pounds during the last 20 weeks of pregnancy.
Another way to determine the appropriate weight gain for pregnancy is by using the Body Mass Index (BMI). The BMI is calculated by dividing your body weight (in kilograms) by the square of your height (in meters). (A kilogram is equal to 2.2 pounds; a meter is equal to about 39 inches.) According to the standard set in 1990 by the Institute of Medicine (IOM) of the National Academy of Sciences, a woman with a low BMI (less than 19.8) should gain a total of 12.5–18 kg (27.5–39.7 pounds) during pregnancy; a woman with a normal BMI (19.8–26) should gain a total of 11.5–16 kg (25.4–35.3 pounds) during pregnancy; a woman with a high BMI (greater than 26.0–29.0) should gain a total of 7–11.5 kg (15.4–25.4 pounds) during pregnancy. Adolescents and black women should strive for gains at the upper end of the recommended range. Short women (less than five feet) should strive for gains at the lower end of this range. Obese women (BMI greater than 29) have a separate recommended target weight gain of about 6 kg (13.2 pounds). Published studies suggest that only 30–40% of American women actually have weight gains within the IOM’s recommended ranges. Although the IOM’s national recommendations concerning pregnancy weight gain have been widely adopted, they have not been universally accepted. The amount of weight gain during pregnancy varies considerably among women with good pregnancy outcomes. For that reason, weight gain alone is not likely to be a perfect screening tool for pregnancy complications. Nevertheless, weight gains outside the IOM’s recommended ranges are associated with twice as many poor pregnancy outcomes than are weight gains within the ranges. A systematic review of all studies published between 1990 and 1997 that specifically examined fetal and maternal outcomes showed that weight gain within the IOM’s recommended ranges is associated with the best outcome for both mothers and infants.
Weight loss programs are not generally recommended during pregnancy. Nevertheless, it should be noted that being overweight while pregnant increases the incidence of various conditions in both the mother and the fetus, such as gestational diabetes and blood pressure problems. The risk is proportional to the amount of excess weight. Overweight women have a higher risk of cesarean deliveries and a higher incidence of anesthetic and post-operative complications in these deliveries. Poor responsiveness in the newborn, large head, and some birth defects are more frequent in infants of obese mothers. Maternal obesity increases the risk of newborn death. The average cost of hospital prenatal and postnatal care is higher for overweight mothers than for normal-weight mothers. Infants of overweight mothers require admission into intensive care units more often than do infants of normal-weight mothers.
Some women will be concerned that the IOM’s recommended weight gain will result in too much weight gain or more weight retention after the baby is born, but there is no evidence to support this concern. Although there are risks associated with being overweight during pregnancy, dieting during pregnancy can seriously endanger the health of the fetus. A low rate of pregnancy weight gain has been shown, in most studies, to increase the risk of premature delivery. There is no evidence that restricting normal weight gain in pregnancy is either safe or beneficial.
Other therapies
With some health problems that develop during pregnancy (such as preeclampsia and eclampsia), bed rest, restriction of salt intake, and medication to lower blood pressure may be recommended. Women who are pregnant are advised to avoid caffeine, alcohol, nicotine, and other drugs (including over the counter medicines) that have not been prescribed by their doctor.
Vitamins that may be helpful
Most doctors, many other healthcare professionals, and the March of Dimes recommend that all women of childbearing age supplement with 400 mcg per day of folic acid. Such supplementation could protect against the formation of neural tube defects (such as spina bifida) during the time between conception and when pregnancy is discovered.
The requirement for the B vitamin folic acid doubles during pregnancy, to 800 mcg per day from all sources. Deficiencies of folic acid during pregnancy have been linked to low birth weight and to an increased incidence of neural tube defects (e.g., spina bifida) in infants. In one study, women who were at high risk of giving birth to babies with neural tube defects were able to lower their risk by 72% by taking folic acid supplements prior to and during pregnancy. Several preliminary studies have shown that a deficiency of folate in the blood may increase the risk of stunted growth of the fetus. This does not prove, however, that folic acid supplementation results in higher birth weights. Although some trials have found that folic acid and iron, when taken together, have improved birth weights, other trials have found supplementation with these nutrients to be ineffective. The relationship between folate status and the risk of miscarriage is also somewhat unclear. In some studies, women who have had habitual miscarriages were found to have elevated levels of homocysteine (a marker of folate deficiency). In a preliminary study, 22 women with recurrent miscarriages who had elevated levels of homocysteine were treated with 15 mg per day of folic acid and 750 mg per day of vitamin B6, prior to and throughout their next pregnancy. This treatment reduced homocysteine levels to normal and was associated with 20 successful pregnancies. It is not known whether supplementing with these vitamins would help prevent miscarriages in women with normal homocysteine levels. As the amounts of folic acid and vitamin B6 used in this study were extremely large and potentially toxic, this treatment should be used only with the supervision of a doctor.
In other studies, however, folate levels did not correlate with the incidence of habitual miscarriages.
Preliminary and double- blind evidence has shown that women who use a multivitamin-mineral formula containing folic acid beginning three months before becoming pregnant and continuing through the first three months of pregnancy have a significantly lower risk of having babies with neural tube defects (e.g., spina bifida) and other congenital defects.
In addition to achieving significant protection against birth defects, women who take folic acid supplements during pregnancy have been reported to have fewer infections, and to give birth to babies with higher birth weights and better Apgar scores. (An Apgar score is an evaluation of the well-being of a newborn, based on his or her color, crying, muscle tone, and other signs.) However, if a woman waits until after discovering her pregnancy to begin taking folic acid supplements, it will probably be too late to prevent a neural tube defect.
Biotin deficiency may occur in as many as 50% of pregnant women. As biotin deficiency in pregnant animals results in birth defects, it seems reasonable to use a prenatal multiple vitamin and mineral formula that contains biotin.
In a preliminary study, pregnant women who used a zinc-containing nutritional supplement in the three months before and after conception had a 36% decreased chance of having a baby with a neural tube defect, and women who had the highest dietary zinc intake (but took no vitamin supplement) had a 30% decreased risk.
Iron requirements increase during pregnancy, making iron deficiency in pregnancy quite common.58 Iron supplement use in the United States is estimated at 85% during pregnancy, with most women taking supplements three or more times per week for three months. Pregnant women with a documented iron deficiency need doctor-supervised treatment. In one study, 65% of women who were not given extra iron developed iron deficiency during pregnancy, compared with none who received an iron supplement. However, there is a clear increase in reported side effects with increasing supplement amounts of iron, especially iron sulfate. Supplementation with large amounts of iron has also been shown to reduce blood levels of zinc. Although the significance of that finding is not clear, low blood levels of zinc have been associated with an increased risk of complications in both the mother and fetus.
Iron supplementation was associated in one study with an increased incidence of birth defects, possibly as a result of an iron-induced deficiency of zinc. Although additional research needs to be done, the evidence suggests that women who are supplementing with iron during pregnancy should also take a multivitamin-mineral formula that contains adequate amounts of zinc. To be on the safe side, pregnant women should discuss their supplement program with a doctor.
Supplementation with fish oil (providing either 2.7 g or 6.1 g per day of the omega-3 fatty acids EPA and DHA) significantly reduced recurrence of premature delivery, according to data culled from six clinical trials involving women with a high risk for such complications. Fish oil supplementation did not prevent premature delivery of twin pregnancies, nor did it have any preventive effect against intrauterine growth retardation or pregnancy-induced hypertension. Fish oils should be free of contaminants, such as mercury and organochlorine pesticides. Women who eat substantial amounts of certain types of seafood (e.g., swordfish, tuna) may be consuming contaminants that can increase the risk of brain and nervous system abnormalities in their offspring. Exposure to mercury and polychlorinated biphenyls (PCBs) was found to be increased in relation to maternal intake of seafood. Higher exposure to these toxic contaminants has been linked to an increased risk of deficits in the developing brains and nervous systems of the children.
SAMe (S-adenosylmethionine) supplementation has been shown to aid in the resolution of blocked bile flow (cholestasis), an occasional complication of pregnancy. Premature rupture of membranes (PROM) affects 10 to 20% of all pregnancies. It is an important cause of preterm delivery and is associated with increased rates of complications in both the mother and child. In a double-blind study, supplementing with 100 mg of vitamin C per day, beginning in the twentieth week of pregnancy, reduced the incidence of PROM by 74%. The women in this study were consuming only about 65 mg of vitamin C per day in their diet, which is less than the RDA of 80 to 85 mg per day for pregnant women.
Calcium needs double during pregnancy. Low dietary intake of this mineral is associated with increased risk of preeclampsia, a potentially dangerous (but preventable) condition characterized by high blood pressure and swelling. Supplementation with calcium may reduce the risk of pre-term delivery, which is often associated with preeclampsia. Calcium may reduce the risk of pregnancy-induced hypertension, though these effects are more likely to occur in women who are calcium deficient. Supplementation with up to 2 grams of calcium per day by pregnant women with low dietary calcium intake has been shown to improve the bone strength of the fetuses.
Pregnant women should consume 1,500 mg of calcium per day from all sources—food plus supplements. Food sources of calcium include dairy products, dark green leafy vegetables, tofu, sardines (canned with edible bones), salmon (canned with edible bones), peas, and beans.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Many tonic herbs, which are believed to strengthen or invigorate organ systems or the entire body, can be taken safely every day during pregnancy. Examples include dandelion leaf and root, red raspberry leaf, and nettle. Dandelion leaf and root are rich sources of vitamins and minerals, including beta-carotene, calcium, potassium, and iron. Dandelion leaf is mildly diuretic (promotes urine flow); it also stimulates bile flow and helps with the common digestive complaints of pregnancy. Dandelion root is traditionally used to strengthen and invigorate the liver.
Red raspberry leaf is the most frequently mentioned, traditional herbal tonic for general support of pregnancy and breast-feeding. Rich in vitamins and minerals (especially iron), it is traditionally used to strengthen and invigorate the uterus, increase milk flow, and restore the mother’s system after childbirth.
Nettle leaf is rich in the minerals calcium and iron, is mildly diuretic, and is diuretic. Nettle leaf is rich in the minerals calcium and iron, is and mildly diuretic. Nettle enriches and increases the flow of breast milk and restores the mother’s energy following childbirth.
In one study, the addition of lavender oil to a bath was more effective than a placebo in relieving perineal pain after childbirth (the perineum is the area between the vulva and the anus.) The improvement was not statistically significant, however, so more research is needed to determine whether lavender oil is truly effective.
Numerous herbs, known as galactagogues, are used in traditional herbal medicine systems around the world to promote production of breast milk. These are known as galactagogues. Vitex is one of the best recognized herbs in Europe for promoting lactation. An older German clinical trial found that 15 drops of a vitex tincture three times per day could increase the amount of milk produced by mothers with or without pregnancy complications, as compared with mothers given vitamin B1 or nothing. However, vitex should not be taken during pregnancy.
Goat’s rue (Galega officinalis) has a history of use in Europe for supporting breast-feeding. Taking 1 teaspoon of goat’s rue tincture per day is considered by some European practitioners to be helpful in increasing milk volume. Studies to support the use of goat’s rue as a galactagogue are lacking.
Sage has traditionally been used to dry up milk production when a woman no longer wishes to breast-feed. It should not be taken during pregnancy.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
Holistic approaches that may be helpful
In one preliminary study, acupuncture relieved pain and diminished disability in the low back during pregnancy better than physiotherapy.
A controlled trial found that acupuncture significantly reduced symptoms in women with hyperemesis gravidarum, a severe form of nausea and vomiting of pregnancy that usually requires hospitalization. Treatment consisted of acupuncture at a single point on the forearm three times daily for two consecutive days. Acupressure (in which pressure, rather than needles, is used to stimulate acupuncture points) has also been found in several preliminary trials to be mildly effective in the treatment of nausea and vomiting of pregnancy.
Copyright ) 2007 Healthnotes, Inc. All rights reserved. www.healthnotes.com
New Vitality Web Specials
Go to top |
|
