According to the World Health Organization, approximately 116 million women worldwide are affected by Polycystic Ovary Syndrome (PCOS). But what does PCOS mean for you if you’re diagnosed with it? To understand more, let’s first dive into the basics of the female reproductive system.
How Does the Female Reproductive System Work?
The female reproductive system performs a number of vital activities. The egg cells, known as ova or oocytes, are made by the ovaries. The oocytes are subsequently moved to the fallopian tube, where they may be fertilised by a sperm. The fertilised egg is then transferred to the uterus, where the uterine lining has thickened in reaction to the usual reproductive hormones. The fertilised egg can then implant into the thicker uterine lining and continue to grow once inside the uterus. If implantation fails, the uterine lining is lost as menstrual flow. In addition, the female reproductive system creates female sex hormones, which help to keep the reproductive cycle going.
What Is Ovulation?
The follicle-stimulating hormone causes follicles in one of your ovaries to develop each month, between days six and 14 of your menstrual cycle. However, only one of the maturing follicles becomes a completely developed egg between days 10 and 14. A rise in the luteinising hormone on day 14 of the menstrual cycle leads the ovary to release its egg. The egg then begins its five-day journey to the uterus via a small, hollow structure known as the fallopian tube. The level of progesterone (another hormone) rises as the egg travels through the fallopian tube, helping to prepare the uterine lining for pregnancy.
What Is PCOS?
PCOS is a common health issue caused by reproductive hormonal imbalances. Your ovaries (which create the egg that is released each month) suffer as a result of this imbalance. With PCOS, the egg may not mature or may not be released like it should during ovulation. PCOS is therefore one of the most prevalent reasons for female infertility. Below is a comparison of a healthy ovary (left) versus a PCOS ovary (right).
What Are the Symptoms of PCOS?
PCOS can cause several symptoms, some of which you may disregard as minor, but if they collectively persist, they need to be addressed by a doctor. Women with PCOS may miss their period, have fewer periods (fewer than eight in a year), or their periods may come more often (every 21 days). Some women with PCOS even cease having menstrual periods. PCOS can produce excessive hair development on the face, chin, or other areas of the body where males usually have hair. This is known as hirsutism and up to 70% of women with PCOS suffer from it.
PCOS may bring on acne on the face, chest, and upper back.
PCOS can lead to hair thinning or loss, akin to male-pattern baldness.
PCOS can trigger weight gain or make losing weight difficult.
PCOS can cause darkening of the skin in the neck creases, groin, and beneath the breasts. Skin tags, which are little extra flaps of skin, can also develop in the armpits or neck.
What Causes PCOS?
The exact cause of PCOS is not known. Most scientists believe that a variety of variables, including genetics, have a role. Other factors can include:
High Levels of Androgens
Androgens are commonly referred to as “male hormones”, despite the fact that all women produce modest levels of androgens. They regulate the development of masculine characteristics such as male-pattern baldness. Women with PCOS have higher levels of androgens than usual, which can hinder the ovaries from producing an egg (ovulation) throughout each menstrual cycle, as well as produce excessive hair growth and acne – all of which are symptoms of PCOS.
High Levels of Insulin
Insulin is a hormone that regulates how food is converted into energy. Insulin resistance arises when the body’s cells do not respond appropriately to insulin. This makes the insulin levels in your blood rise above normal. Many PCOS women have insulin resistance, particularly those who are overweight or obese, have poor eating habits, do not get enough physical activity, and have a family history of diabetes (usually Type 2 diabetes). Insulin resistance can progress to Type 2 diabetes over time.
Is PCOS Treatable?
There are several types of medicines that treat PCOS and its symptoms.
Hormonal birth control – including the pill, patch, injection, vaginal ring, and hormone intrauterine device (IUD) – is one method of birth control that can help manage PCOS symptoms. Hormonal birth control can help women who don’t wish to get pregnant by:
Aiding in the treatment of acne and the reduction of excess hair on the face and body.
It’s essential to see your doctor before starting birth control that includes both estrogen and progesterone.
These medications inhibit the action of androgens, which can aid in the reduction of hair loss, facial and body hair growth, and acne. The Food and Drug Administration (FDA) has not authorised them to treat PCOS symptoms, although there have been patient cases where these medications have been beneficial. These drugs can also create complications during pregnancy; therefore, it is critical to consult with your doctor before using them.
Metformin is often used to treat Type 2 diabetes and may benefit some individuals suffering from PCOS symptoms. It is not authorised by the FDA to treat PCOS symptoms, so see your doctor first. Metformin enhances insulin’s capacity to decrease blood sugar levels, and has the potential to lower both insulin and androgen levels. Metformin may help restart ovulation after a few months of usage, although it typically has minimal effect on acne and excess hair on the face or body. According to new studies, metformin may offer additional benefits such as decreasing body mass and improving cholesterol levels.
Previous studies have demonstrated that Myo-inositol is capable of restoring spontaneous ovarian activity, and consequently fertility, in most patients with PCOS. Some studies have also investigated the role of folic acid contained in the inositol preparation. The use of Myo-inositol and folic acid per day was shown to be a safe and promising tool in the effective improvement of symptoms and infertility for patients with PCOS, including improving oocytes.
Taking folic acid may help manage infertility rooted in ovulation problems for both women with and without PCOS. A study of over 18,000 women over an eight-year period indicates that having a high-quality multivitamin supplement containing folic acid may be beneficial. According to the data, using a supplement at least six times each week may lessen ovulation issues by 40%. Interestingly, the experts who led the study identified folic acid as one of the most plausible explanations for the patients’ increased fertility.
Three survivors, three truly inspiring success stories.
As Breast Cancer Awareness Month continues, it’s important to take a moment to acknowledge the human side of this disease. In the past, we’ve shared an at-home health check recommended by a leading gynecologist and spoken to a variety of experts about what causes cancer and what you can do to prevent it – but we’ve saved the best for last. Here, we speak with three breast cancer survivors who have gone on to inspire those around them in their own unique ways. Here are their stories.
Anisha Oberoi, Entrepreneur
For clean beauty junkies across the region, the name Anisha Oberoi needs no introduction. For others, here’s a brief one. The Indian entrepreneur founded Secret Skin in February 2020 with a commitment to carrying brands that are ethically sourced, responsibly curated, and cruelty-free – Rahua and Grown Alchemist included. As for what prompted the birth of this sustainable beauty platform? Anisha fought breast cancer back in 2010 and experienced firsthand just how challenging it can be to find clean beauty brands, especially as the combination of chemotherapy and heavy medication shattered her self-esteem. “I had to relook at everything, including what I considered were standards of my beauty – my hair, my lashes, my brows, everything fell, so I had to look in the mirror and accept who I was. I had to look at that girl in the mirror and say, ‘It’s going to be okay.’ That’s something I wish I knew back then.”
While the rollercoaster of emotions between diagnosis and recovery can’t be easy to articulate, Anisha does so beautifully. “I said my life cannot be all about this, so I looked out with childlike wonder, like a kid at a windowpane. I asked, ‘What else is the world going to bring me?’ And I wish I knew back then that it was going to be incredible because I wouldn’t have been so scared.” She says that while stubbornness, the will to stay alive, and her dream to pursue an MBA at INSEAD collectively kept her going, the reactions to her resilience brought with them moments of impostor syndrome. “At one point, you feel impotent and ugly, with steroids fattening you up. And you’re having issues with your digestive system and your drainage, and you’re unable to imagine anything different. It defeats your spirit.” Anisha recalls needing her doctor’s permission to join friends headed to a wedding in Jaipur by bus after her third round of chemotherapy and, in case you’re wondering, she was the last one on the dance floor.
“My head was shorn, I was wearing a sari, and I was living life. But I couldn’t always be that shiny beacon of light because there would be times that I’d feel defeated and my pillow case would be covered in night sweats and I wouldn’t be able to eat because anything could trigger an infection. I remember feeling useless and incomplete. I felt my life had been cut short.” Today, as Anisha is 12 years into remission and celebrating the second anniversary of Secret Skin, she has a few observations when it comes to the region’s interest in all things clean beauty. “Other parts of the world, like the UK and the US, are a lot more evolved because their journey with clean beauty started a lot longer ago, which is a bit ironic because no one spends more on personal care and beauty than this region. What’s more, about 67% of people who shop are millennials and they’re living online, so I’m a bit surprised that the movement arrived late. I’m also glad because it makes us the first mover.”
Anisha says finding toxin-free products when she moved to Dubai three and half years ago came with challenges – exorbitant shipping charges and customs duties included. “With everything coming back to global footprint, I felt there was a huge opportunity here. The customer today is becoming smarter with regard to what goes into their products, and the pandemic has only accelerated the emphasis on clean living. More people are engaging in skincare rituals rather than makeup, so it was the right time for us to launch Secret Skin.” The ambitious entrepreneur admits that she struggles to slow down, describing this past one year as equal parts rewarding and terrifying. “I force myself to take breaks. It’s really important for my mental health because that aspect has suffered since I’m a new entrepreneur. I’m a personality type that always needs to keep the action going, and this was very prevalent when I was sick – well-meaning relatives kept telling me that I should take a step back, relax, and not pursue the ambitious career that I’ve always envisioned.”
But Anisha did exactly the opposite almost immediately post-recovery – she headed to a prestigious business school, moved countries, and accepted a job as one of the founding members of Amazon Fashion India. “It gave me wings. It was the biggest job I’d ever had, it anchored my resume, and it taught me everything I know that has enabled me to run Secret Skin the way we do.” Considering Anisha is both a survivor and savvy businesswoman, I can’t help but gauge her opinion of pinkwashing, a marketing tactic that admittedly irks me to no end. While I respect the role played by private entities in fundraising efforts, do we really need candles, cupcakes, and yoghurt containers in varying shades of Barbie pink? Anisha concurs.
“To be honest, I do know that come October, everybody will want to slap a pink ribbon everywhere. I think the intention is right, but you can’t do anything with good intentions unless you actually put something in motion. It’s great that you see it everywhere, but it’s so overused that it loses its credibility if not done right. And it’s not just a matter of it being done right – it’s also a matter of what else you are doing to carry it forward, how many lives you are touching, and how many changes you have created.”
Maruf Azimov, Model
I’d be remiss words if I didn’t acknowledge that breast cancer affects the lives of both men and women worldwide all year round – not just in October. Yes, it is rare, but men can get breast cancer, contrary to popular belief. And while it is most common in older men, it can occur at any age – just ask Maruf. The model, brand ambassador, and winner of the Mr. Dubai 2019 title was only 24 when he was diagnosed. Today, he’s vocal not only about erasing the stigma around a man battling ‘a woman’s disease’, but also the importance of regular health check-ups. “There are people who can’t even grasp the concept of male breast cancer,” he says. “Yes, there were times I felt shy or ashamed, but it is on the rise – not just breast cancer, but cancer in general. That’s why my message is to just go for a check-up if something feels different in your body, whether you’re a man or a woman. Don’t waste time feeling ashamed in front of anyone because you deserve to be healthy. Check-ups are easy and affordable. The alternative isn’t.”
Maruf is quick to admit that men are a lot less likely to seek professional help for things like depression and anxiety. He says that while his doctor did recommend speaking to a therapist, he chose to carry the burden all alone for four years. His reason? Family. “I was the only one in my family who was working at the time, and I just couldn’t bring myself to tell anyone – not my wife, not my parents. Besides, they’ve already given me everything and I didn’t want to see them suffer,” he explains. With Maruf deciding to tackle the illness on his own, a friend recommended that he move from his hometown of Tashkent, Uzbekistan, to Dubai. “What’s worse is that an issue with my heart put my lump removal surgery on hold. Of course, I felt scared, but I worked on being happy for the sake of my family,” he says. With the encouragement of his doctor, Maruf channelled all his efforts towards his mindset, focusing on his health by way of staying positive. “I would repeat the words, ‘You are not sick’ to myself. I started enjoying my life – this is crucial if you want to improve your mental health.”
Naturally, there were good days and bad days. He says that in the absence of conventional approaches like therapy, spirituality got him through his darkest moments, reinforcing the countless studies concluding that spirituality and mental health are interconnected. “I still remember those early days, when I first moved to Dubai. I didn’t have a lot of money, so I was working as a salesman during the day, and a security guard at night. I’d go to chemotherapy and check-ups between the two. It wasn’t easy. I’d survive on bread, tea, and instant soup. But the best doctor is God. I would sit at home, saying prayer after prayer, sharing all my problems with God. ‘I want to buy my father a car so he can work as a taxi driver and I want to help my two sisters get married, so please don’t take my life right now,’ I’d beg. And you know what? I managed to do it all and I’m here. I’m alive. So much good has happened because I believed,” he says, visibly emotional.
Today, a mere glance at his Instagram account speaks volumes of how far he has risen from his humble beginnings. In an industry fixated on physical perfection, Maruf has had to work much harder than his peers as a result of the fatigue, exhaustion, and weight loss that comes with battling cancer, but does so to set an example for his children. “My doctor thought I was crazy for going to the gym during chemotherapy, but I wanted to show my kids that their father is strong. I get that from my father. He has always been the strongest male presence in my life.” With over 316,000 followers on Instagram, Maruf is not immune to the occasional internet troll, but says that he posts photos of his physique to inspire others. “I’m not just flaunting my body. I’m encouraging others to fight harder, to fight for their lives. If I can do it after all that medication and all those treatments, anyone can.”
In retrospect, Maruf says he wouldn’t do anything differently when it comes to protecting his family members from his pain. “This disease is not like the others – it’s not like a broken foot. A small lump in the chest isn’t visible, so it’s not something your family will initially understand. My advice? Talk to yourself first. Tell yourself that you can do it, and everything will be okay. It’s the smiles of your family members that will get you through any hardship. You can tell them once you’ve started treatment and need their support, but why upset them from the very beginning? In fact, I didn’t even feel any pain until much later. I was told at my very first check-up that I had reached stage 2,” he recalls.
Selfless, family-oriented, and utterly devoted to his wife and three children, Maruf has a message for the caregivers of a male breast cancer patient – and it’s one that is echoed by others. “Don’t treat your loved one like a sick person,” he suggests. “Show them the same love and care as you would under normal circumstances.” He reveals that it was a long four-year period until he was allowed to undergo surgery in Uzbekistan and, this time around, he confided in his wife. Maruf was actually debating how to tell his mother about the severity of his condition, considering he didn’t receive his results for nearly a month. “All I kept thinking was, ‘How can I tell my mom if there’s no change? How do I tell a mother that her son may die?’ I felt I had to mentally prepare her for the worst.” That’s when his doctor called to give him the all-clear: “My boy, you are a winner.”
Tina Chagoury, Nutrition Consultant
The phrase ‘timing is everything’ comes to mind with speaking with Tina Chagoury. At a time when the world went into lockdown – i.e. panic mode – the multihyphenate was starting to celebrate a new lease on life. A nutrition consultant, a health behaviour educator, and a regular presence in local media, Tina was diagnosed with breast cancer in the summer of 2019, when she was on holiday in her native country of Lebanon. It goes without saying that the rest of the year brought with it countless challenges. Not only did she have to relocate herself and her two children to Beirut because of her treatment, but the October 2019 revolution also made getting to chemotherapy that much harder. “The roads were closed, there were ongoing riots,everything was a mess. The journey to the hospital usually takes 30 minutes, but we would leave two hours in advance,” she describes. Schools across Beirut also closed as a result of the revolution, forcing Tina to arrange remote learning – months before it became the ‘new normal’ for parents worldwide.
Fear and anxiety aside, Tina recalls feeling a deep sense of missing out. “In the deepest corners of my mind, there was a recurring thought: I’m missing out on my career. My field is rooted in ongoing learning, so if you’re off for a couple of months, you have to go back and do the training, apply for more CMEs, update your license. But then I’d remind myself to be patient. I’d tell myself everything will go back to the way it was.” As 2020 began, she gradually began planning for the year ahead – returning to a routine in Dubai and enrolling the kids in school again. And then coronavirus happened. As someone who was travelling back and forth between Beirut and Dubai, Tina was repeatedly advised to wear a mask as her immunity was still low post-chemotherapy, but she resisted. “On paper, my immunity looked fine. And with a bald head, no eyelashes, and no eyebrows, the last thing I wanted was one more thing that will make me stand out in a crowd.”
A complete lockdown was announced as Tina had two last rounds of radiotherapy left and distinctly remembers the surreal sight of an empty Sheikh Zayed Road. The unprecedented situation, she says, brought it with a sense of relief. “It felt like the stars were lining up because I wasn’t the only one missing out on life – no one was doing anything. I was happy because not only did I get to spend more time with the kids at home without the distractions of extracurricular activities, but it also gave me a chance to recharge. I was still recovering and very physically weak. Everyone around me was panicking, but I realised that it was a blessing for me. I actually felt very peaceful at the time. We were worried about the situation, of course, but I took that time to heal, to regain a bit of my health before returning to work in July.” Today, Tina is an adjunct instructor at Abu Dhabi University and sees clients at multiple clinics across Dubai. Considering she’s a licensed clinical dietician with over 20 years of experience, I can’t help but ask what has changed in terms of her approach to health and nutrition now that she’s in remission.
Interestingly, a period of retrospection has brought with it one big revelation. Besides changing her stance on supplements, she says it’s her approach to fitness that has shifted drastically. “Because of how I was taught, I believed that supplements were only needed in the case of a deficiency, but research made me realise their importance for optimal health. I still eat the way I used to, but I now know that I was overexerting my body,” she says. Tina reveals that she used to be an avid devotee of bikram yoga, practising it several times a week. “It was an addiction, but I noticed something during the last few months before my diagnosis: I was feeling more tired than usual during my sessions. Hot yoga is very hardcore and, even though I’d been practising yoga for 10 years at that point, I would leave midway through my sessions because of exhaustion. I was also doing HIIT three times a week. We all know how important exercise is, but what I’ve learnt is that over-exercising is incredibly inflammatory for women.” Her advice? Everything in moderation – exercise included.
Mental health, meanwhile, is high on Tina’s list of priorities, her sentiments towards faith echoing those of Maruf. “Everyone has a different approach to self-care, especially when post-traumatic stress strikes. I’m a very spiritual person and prayer has played a big role in my life, both during and after treatment. Also, your perspective changes when you come close to the idea of death. I end up depressed if I let myself think about the possibility of recurrence, and snap myself out of it by thinking, ‘I am alive and I am well. I am here today.’ That alone is a huge gift.” Tina looks back on the days in Beirut, when simply watching Netflix with her husband was all she wanted. “It might sound cliché, but when something like this happens, you live for those little things.” Tina admits that sporadic anxiety is inevitable and, at such moments, her self-talk is about not wasting the ‘now’ by making assumptions. “I wasted so much time worrying about the silliest things before my diagnosis,” she explains, encouraging everyone to have a plan and pursue what they’ve always wanted. “You don’t know what tomorrow holds, so follow your intuition and balance will set on its own.”
Another nugget of wisdom? Tina’s advice to the caregivers out there. “You should know that just your presence is valuable, it’s all she needs. You don’t need to go over and above, especially since you don’t want to make her feel any less capable.” She says caregivers often forget something important: “Yes, she might be physically and psychologically weaker, but mentally, she is still the same. She can handle her home, she can make family decisions. And unless she’s unwell because of the treatment, don’t make her feel like her life is on hold. There’s nothing more frustrating to a mother than to be told, ‘We’ll take care of your children, you just take care of yourself.’ Taking care of my children is a part of taking care of myself,” she asserts. Instead, Tina recommends simply being there, cracking jokes, baking a cake for the kids, or gifting something she’d like. “I met other women during treatment who felt the same way. ‘Come on, lock me into my room and run my life,’ we’d laugh. I may not have eyelashes or eyebrows, but I’m still the same person. We knew that it comes from a good place, though.”
According to a lactation consultant extraordinaire.
While breastfeeding doesn’t come naturally, especially in the early days, most mothers assume they’re supposed to know exactly what to do from the get-go – and inevitably feel like a failure when things go wrong. But nursing a baby is no easy feat, especially if you’re new to it, and that’s where lactation consultants come in.
Specialising in the clinical management of breastfeeding, these health professionals are on hand to help with everything from sore nipples and diminishing milk supply to finding an optimal breastfeeding position for you. We tapped one such professional whose experience and expertise awaits at King’s College Hospital in Dubai: Dr Sabeen Adil. Certified as an International Board Certified Lactation Consultant, she has been working in the field of lactation for the last 12 years and is deeply passionate about supporting families – not just new mothers – through the breastfeeding journey. Here, she shares eight things about breastfeeding that every beginner should know.
1. The onus is not just on the mother.
“Mothers should know that breastfeeding is not just their job. It will work only if everyone around her – her family, her doctors, her support system – comes together and supports breastfeeding. Only then it can work. Many times, the mother has not made any mistakes, but she did not get the support she needed from her paediatrician or her place of work, and that is why breastfeeding did not work out for her.”
2. A little preparation is in order.
“It’s common for new mothers to think that they don’t have to do anything to prepare themselves for breastfeeding. In fact, I often encounter mothers who admit that they didn’t think it would be hard. I recommend that pregnant women seek help, seek information before the baby is born because you will need to know how to breastfeed soon enough. Take some time to get yourself properly educated because, many times, it’s actually breastfeeding that becomes the most difficult part of the whole process. Luckily, there’s so much more information online compared to a few years ago. And of course, a lactation consultant would be happy to give you antenatal breastfeeding classes.”
3. Milk supply and a mother’s diet aren’t correlated.
“Breastfeeding is a natural continuation of pregnancy; that’s the normal physiology. Pregnancy ends and breastfeeding begins, so take care of yourself – hydrating adequately and getting the right nutrition – just as you did while you were pregnant. This will ensure that your own well-being is in order. Breastfeeding problems happen when there’s an impediment in the transfer of milk from the mother’s body to the baby’s body. And while there’s no specific diet that a mother needs to follow, a reduction in milk production indicates that a problem has already arisen.”
4. Breastfeeding products aren’t necessary but can help.
“You don’t actually need anything to breastfeed, but there are things like nursing pillows and nursing bras that can help – this can change from situation to situation. Breast pumps do have some utility in different scenarios, especially for working mothers and mothers who want to gain some of their independence back. It is a great tool because not only can it help in situations where milk supply is low or there’s a problem with milk transfer, but you can also use it to bottle-feed your baby after a certain period. There are more specialised devices out there, but I would only recommend using them under the care of a lactation consultant.”
5. Persistent soreness is a sign that something is off.
“I usually recommend that a mother apply her own milk to the areas that are sore because it really helps – but we don’t want to assume that soreness is a normal thing that will always occur. Yes, you might feel sore in the first week or so of your breastfeeding journey, but if the soreness and pain persists beyond that, you need to see a lactation consultant and get it sorted. Something’s wrong if breastfeeding is hurting.”
6. Stress will negatively impact the lactation process.
“One very important aspect within the environment is the mother’s stress levels. Oxytocin, the hormone that causes milk ejection, will be released if she is relaxed. And it will not be released if her stress hormones are high. This is the physiology of breastfeeding, so it’s really important that she is comfortable, not in pain, not in a hurry, and not worried about anything. If we want breastfeeding to work well, we really need to support the mother – ensure that her pain is being managed, that she’s eating enough. I always recommend you put on music or watch the next episode of your Netflix show while you’re breastfeeding so that you are relaxed and comfortable.”
7. A foolproof breastfeeding position doesn’t exist.
“There’s no one perfect position – I like saying that there are 360 ways a baby can latch on! As for my favourite position to teach? Breastfeeding while lying down. A mother can simply lie down and have the baby next to her. It’s a very comfortable position. Many, many women don’t know how to nurse in that position, and they’re surprised when I guide them on how to – it’s my favourite thing to teach new mothers.”
8. Understanding newborn behaviour can help new parents.
“It’s normal for a baby to ask for milk again and again. It’s normal for a baby to not sleep long hours – no baby sleeps like a baby. That’s such an incorrect concept. Every baby’s breastfeeding pattern is different, and it’s not something you can clock or time. Another thing I remind new parents is that a newborn has only two things to do in life: sleeping or eating. This means when he or she is done sleeping, it’s most probably time to eat, so don’t wait for your baby to cry out of hunger – crying is actually a very late sign of hunger. A good time to initiate a breastfeeding session is the moment a baby is waking up and getting alert about their surroundings. A crying baby is agitated and really hungry, so getting into an organised state becomes very difficult. As adults, we lose our patience when we are hungry – it’s no different for babies.”
Today marks World Alzheimer’s Day, annually uniting people worldwide to raise awareness and challenge the stigma that persists around Alzheimer’s disease and all types of dementia – many still wrongly believe that dementia is a normal part of ageing, according to the World Alzheimer Report 2019. As for the unsung heroes in this picture? The caregivers who take on the burden of creating a safe living space and helping their loved ones with everyday tasks, inevitably experiencing stress in the process.
It’s the early days of caregiving that are arguably most overwhelming, which is why we tapped not one, but two experts from Cleveland Clinic Lou Ruvo Center for Brain Health for their insights. Dr Lucille Carriere (LC) is Clinical Health Psychologist, while Dr Jennifer Pauldurai (JP) is a Behavioural Neurology Fellow. Collectively, they address the key aspects of Alzheimer’s disease – behavioural symptoms, communication challenges, maintaining adequate nutrition, the importance of establishing a routine, and more. Above all, their advice is a reminder that you, as a caregiver, are doing the best you can.
Understand what your role entails upfront.
LC: “In comparison to non-dementia caregivers, dementia caregivers often provide more daily hours of care and higher levels of care (assist with the likes of dressing and feeding), which may increase their risk of experiencing mood and physical health symptoms. Additionally, the roles and tasks of caregiving gradually become more intensive and time-consuming as the disease slowly progresses, thus heightening feelings of social isolation.
Alzheimer’s disease affects not only a loved one’s cognitive functioning, but also their sense of self, personality, and behaviour. In addition to providing daily care, caregivers also experience loss and grief over the loved one they once knew and cherished. They may also have to learn new skills to manage behavioural symptoms such as agitation and hallucinations in their loved ones.”
A healthy lifestyle can slow the progression of symptoms.
JP: “Staying physically active and mentally engaged is very important to maintaining quality of life and daily function. Consider taking your loved one on a daily walk in the park or regularly participating in hobbies, such as yoga or craft-making classes. There is also evidence that optimising our lifestyle, such as our diet and sleeping patterns, can help slow the progression of cognitive decline. Consume a diet rich in varied fruits and vegetables, and low in processed sugars and red meat. A regular routine for daytime activities can promote rest at night.”
Establishing a routine is key for you and your loved one.
LC: “Daily and predictable routines become an important tool to help individuals with Alzheimer’s feel safe, supported, and engaged since the environment around them becomes scarier and more unfamiliar as the disease progresses. It’s important to incorporate meaningful and stimulating activities into daily routines, which allow for opportunities to experience positive emotions and interactions.
Activities should ideally be tailored to the individual’s interests, cognitive and physical abilities, and preferred time of day to optimise the benefits. Because the responsibilities of a caregiver are endless while the number of hours in a day are limited, routines help to remove some of the guesswork out of how to organise the day for both their loved one and themselves. And it’s okay if your loved one is having a ‘bad day’ and necessary changes are made to the routine – remember, there is always tomorrow.”
You can help your loved one maintain some of their independence.
LC: “Even a mild decline in cognitive abilities can negatively interfere with the responsibilities of an individual living with early stage Alzheimer’s, but finding creative and practical ways to compensate can help boost their confidence and sense of purpose. Caregivers can help them maximise independence by maintaining daily routines, providing verbal reminders, encouraging use of memory compensatory skills such as note-taking, or reducing clutter at home. Patients may be more open to trying new compensatory strategies if they’re tailored to their preferences and abilities, so discussing this directly may be helpful in the early stages.”
Patience is key when it comes to communication challenges.
JP: “Alzheimer’s disease causes changes to the brain’s ability to store and retrieve information (memory) and to communicate (language). Over time, you may find that your loved one has difficulties in finding the right word or name to say. Others may have trouble following a complex conversation or understanding how a familiar object is used. Use different methods of communication, like whiteboards or scheduling notes on the phone. Offer to work on activities together to help reinforce ideas. People with memory trouble generally remember feelings better than fact. Communicating with kindness and patience is always more important than getting everything right.”
Be mindful when responding to behavioural symptoms.
LC: “It’s important to first understand the potential causes of behavioural symptoms like agitation or aggression, such as physical (illness, pain, discomfort) or environmental contributors (too much or too little stimulation). Such individuals may have trouble communicating their physical or emotional distress, which may manifest in disruptive behaviours. Discussing concerns with your loved one’s medical team may be helpful in ruling out medical reasons.
For caregivers, remaining patient, calm, and reassuring in reaction to behavioural symptoms is important. The content of your communication may be less important (or understood) than how you communicate. Being mindful of your non-verbal communication style (posture, tone of voice, touch) can be helpful in de-escalating stressful situations. Additionally, it may be helpful for caregivers to engage their loved one in a relaxing and enjoyable activity, or physical activity (going for a walk) to reduce agitation and depressive symptoms.”
Putting your own life on hold isn’t necessary.
LC: “Incorporating regular self-care into a caregiver’s daily routine is beneficial for their emotional and physical health. Support groups and mental health counselling may provide avenues if you’re seeking additional emotional support and problem-solving skills. Caregiver skills programmes have also been developed specifically for caregivers to provide dementia education, behavioural symptom management, and caregiver wellness strategies. Opportunities for respite, or short periods of relief from caregiving responsibilities, can also be beneficial. This can range from asking a friend or family member to sit with your loved one while you run a quick errand to utilising an adult day centre a few days a week.”
Adequate nutrition can improve their quality of life.
JP: “Ideal nutrition intake should be three well-balanced meals that include a variety of fruits, vegetables, and whole grains. Berries and nuts, such as walnuts, provide healthy antioxidants. Whole-grain foods and plant-based meals that are low in processing provide healthy energy to the brain without more toxins. In contrast, the likes of sugar and processed foods introduce chemicals that our body has to metabolise and eliminate. The MIND diet and the Mediterranean Diet are two great plans for incorporating healthy nutrients, but be sure that they’re accompanied by lots of water, especially in the heat of summer. Dehydration and poor food intake can worsen confusion and brain fog.”
Be alert for a sudden and persistent change in activity.
JP: “There may be fluctuations in a patient’s cognition and behaviour, so some days will be better than others. Look out for excess confusion, sleepiness, or decreased responsiveness that persists, which may indicate that their condition is worsening. Falls, head injuries, new abnormal movements, and changes in balance should also get medical attention. Increased (or decreased) urination, coughing, diarrhea or constipation, change in appetite, or shortness of breath may indicate a new illness or infection. Remember, your loved one may not be able to communicate discomfort or might not remember an injury, so be observant and check for signs of something wrong (bruising or cuts, fever, unusual odours). Trust your instincts and seek help if something feels off.”
Lastly, never doubt or underestimate yourself.
LC: “The role of a dementia caregiver is multifaceted, dynamic, and ever-changing. Therefore, it’s not uncommon for caregivers to doubt or underestimate their personal strength and resiliency at any time point along the caregiving journey. With the aid of a care team – consisting of both personal and professional support – caregivers can feel more supported, equipped, and confident in their role.”
Over the past few decades, there has been a growing demand for a more sustainable, accessible, and nutritious food supply. There has been increased interest among governmental and private sectors in controlled environment agriculture methods, including vertical farms, greenhouses, hydroponics, and aquaponics. These approaches enable crops to grow in closed spaces and allow for factors such as climate, lighting, and water supply to be controlled. Microgreens are an important example of crops that can easily be grown using controlled environment agriculture approaches.
What Are Microgreens?
Microgreens are immature green vegetables harvested after the cotyledonary leaves have developed. They differ from baby leaves (cut greens for salads) and sprouts (germinated seeds with entire roots). Growing conditions (soil vs hydroponic) can impact the growth of the plant and the levels of phytonutrients and minerals. Microgreens are being recognised as functional foods with potential health benefits.
They have become increasingly popular as a culinary ingredient due to their distinctive flavours, attractive colours, delicate textures, and high nutrient density. Microgreens can be produced from many vegetables, herbaceous plants, aromatic herbs, legumes, and grains. Common varieties are grown from mustard, cabbage, radish, buckwheat, parsley, pea, kale, spinach, and broccoli. These are often added to enhance salads or edible garnishes on various dishes.
Nutritive Content and Potential Health Benefits
Microgreens may be considered better alternatives to sprouts due to their rich nutritional content and stronger flavour. Research has shown that microgreens may also be superior to their mature counterparts as they have been found to contain higher levels of vitamins, minerals, and phytochemicals. For instance, cucumber and spinach microgreens had greater vitamin C levels than their mature stages. Moreover, microgreens had higher levels of several trace minerals such as copper, zinc, and selenium.
These minerals play an important role as cofactors in producing powerful antioxidant enzymes like superoxide dismutase. Phytochemicals, such as carotenoids and phenolics, which have strong antioxidant properties, are also abundant in microgreens. There has been growing research in studying the potential value of microgreens in preventing chronic diseases such as obesity, type 2 diabetes, and cardiovascular diseases.
The high bioaccessibility of bioactive compounds like polyphenols and glucosinolates in microgreens such as the Brassicaceae family (kale, red cabbage, kohlrabi, purple radish) may provide anti-inflammatory, anti-cancer, anti-microbial, and anti-diabetic benefits after digestion. One study indicated the antiproliferative effects of kale, radish, mustard, and broccoli microgreens on colon cancer cell development. Other microgreens – such as red cabbage – can positively regulate lipid metabolism, reduce cholesterol levels, and reduce liver inflammatory markers.
Optimising Nutritional Content in Microgreens
Due to the delicate nature of microgreens, several interventions are being implemented during the pre-harvest and post-harvest stages to optimise nutritional content and prolong shelf life. For example, light exposure before harvest is critical to promote plant growth and nutrient composition. Moreover, post-harvest interventions – including packaging, storage temperatures, and lighting – can impact nutrient concentrations, extend shelf life, and enhance the appearance, texture, and taste of microgreens.
Any Potential Risks?
While they can benefit health, there may be some concern about the risk of contamination of some microgreens with bacteria such as Escherichia coli. Sources of the contamination may include irrigation water and the soil (or another medium) in which they are grown. When buying microgreens from the supermarket, ensure they come from a reputable supplier and check the sell-by/best-before date. The shelf life of microgreens varies from 10 to 14 days after harvesting and are best kept in the fridge at a maximum of 5°C.
Adding More Microgreens to Your Diet
Microgreens are versatile and sustainable crops from cultivation to consumption. Due to their rich nutrient profile, microgreens are a great way to boost a meal’s vitamin, mineral, and phytochemical content. Moreover, they can enhance colour, add texture, and elevate the flavour of dishes. Unsure what to do with microgreens? Here are some ways to add more of these potent plant foods to your diet:
as a garnish on salads, soups, and omelettes
in smoothies and smoothie bowls
in sandwiches and wraps
to your favourite pesto sauce
Farah Hillou is a Registered Dietitian Nutritionist and an Integrative and Functional Nutrition Certified Practitioner. For more information, please visit @wellness.in.colours or connect with her via LinkedIn.
Why Pelvic Floor Exercises Are Crucial for New Mothers
Recover from childbirth more quickly.
First things first: what is the pelvic floor?
Kegels, squeezes, pelvic floor exercises – whatever term is familiar to you, the pelvic floor is essential for all women, especially if you are planning to have a baby, are pregnant, or have a baby already. Now is the time to start thinking about the muscles down there! If you are like me, the pelvic floor didn’t even enter my radar until I was pregnant. Also, if I’m honest, I had no idea what I was doing when I tried to strengthen them.
Yes, I’m a pelvic health physiotherapist now, and the pelvic floor is my life and passion, but back then? They were just another group of muscles – muscles that I could not see and, therefore, difficult to connect with them. I am a visual learner, so what helped me understand where they were and what they did was understanding the anatomy and educating myself about their function and movement. Educating and knowing about the pelvic floor can be a game changer in our journey as a mum and beyond.
The pelvic floor muscles are a sling or group of muscles that span the whole base of your pelvis, attaching from your pubic bone to your tailbone and both sitting bones. It wraps around your orifices – anus, urethra, and vagina – and acts like a sling or a hammock, supporting our pelvic organs (bladder, bowel, and uterus).
Why are the pelvic floor muscles important?
These muscles are a powerhouse and have many impressive roles in our body, or the five S’s:
Support: They support your pelvic organs against gravity and against an increase in abdominal pressure (like coughing, sneezing, jumping). When pregnant, they support your growing baby.
Sphincteric: As they wrap around the opening of the bladder and anus, they help us control wind and urine, especially with increases in abdominal pressure. They also relax to allow you to empty your bladder or bowel.
Stability: The pelvic floor is part of your ‘core’ along with your deep abdominals, diaphragm (breathing muscle), and deep back muscles. They act to support your pelvis and your back.
Sexual function: These muscles are essential for orgasm and sensation during intercourse and, if too tight, can cause pain during intercourse.
Sump-pump: The pelvic floor acts to pump lymph and blood in the pelvis. Lack of this action can cause congestion or swell within the pelvis.
When any one of these functions is compromised, it can lead to dysfunction. Here are signs to recognise when the pelvic floor is under stress or not working well:
Urinary leakage with coughing, sneezing, movement, exercise, or on the way to the toilet. Urinary frequency and urgency, when the number of times we run to the toilet increases (>8 times), or we feel high urges to pass urine and need to go urgently
Bowel symptoms such as constipation, leaking, unable to control wind
Pelvic organ prolapse – when one or more of the pelvic organs (bladder, bowel, or uterus) descend into the vagina or rectum
Painful, heavy periods
If you experience any of these symptoms, it is a must to visit your OBGYN and see a pelvic health physiotherapist to help you on the road to recovery.
What happens to the pelvic floor during pregnancy?
Pregnancy and delivery can put significant physical stress on your body. The growing baby’s weight during pregnancy puts pressure and stress on the pelvic floor muscles and the surrounding connective tissue. They have to work much harder than usual to support your baby and can become weaker.
Emotionally, pregnancy can be a joyous and beautiful nine months, but for some, it can be a challenging and anxious time. Many women can hold stress within their pelvic floor, leading to tension and tightness. Your pelvic floor muscles will be affected, whether you have a vaginal birth or a C-section. Pelvic floor issues during pregnancy can lead to urinary incontinence, pelvic girdle pain, and pelvic organ prolapse in some instances.
I encourage all pregnant women to start pelvic floor exercises during pregnancy to help prevent dysfunction, and the guidelines agree. However, it can be hard to know how to do them. In some ladies, the pelvic floor may have increased tone, and pelvic floor exercises will need to be altered and tailored to focus more on relaxation initially. I highly recommend seeing a pelvic floor physiotherapist who will assess and coach you on how to do the exercises correctly. More on this is coming up!
What happens to the pelvic floor during delivery?
“The pelvic floor is your baby’s door” – I love this saying by Diane Lee, a physiotherapy guru. During vaginal birth, the pelvic floor needs to be able to relax and lengthen considerably during delivery to allow your precious baby to pass through. Vaginal births (especially those with forceps) stretch the pelvic floor, ligaments, and connective tissue, and therefore may cause tearing. These tears will often heal naturally. However, more serious tears can affect the pelvic floor muscles or muscles around the rectum, complicating recovery.
If you experience bladder or bowel control issues, pain, or heaviness vaginally post-delivery, you must talk to your OBGYN and get referred to a pelvic health physiotherapist. If you had a C-section, the nerves, skin, and fascia (connective tissue throughout the body) are affected and may contribute to symptoms after delivery. When immersed in new motherhood, putting yourself and your health and emotional needs on the back burner is easy. However, focusing on your pelvic health will be worth it. I always recommend seeing a pelvic health physiotherapist from six weeks post-partum.
I believe that this should be as routine as seeing your OBGYN at six weeks. We thoroughly assess your body – posture, movement, strength, abdominal wall, and pelvic floor. From this assessment, we can guide you on what’s best for your body. We provide an individualised, tailored, and achievable home exercise programme focusing on your goals and needs. Your health and strength are essential when seeing your baby through infancy and beyond.
I’m planning on getting pregnant in the future. Should I do pelvic floor exercises?
Yes! The more awareness and connection you have to your pelvic, the increased likelihood of success with pelvic floor strengthening. However, research has shown that over 50% of women perform them incorrectly under verbal instruction. Therefore, I strongly recommend getting a pelvic health physiotherapist assessment to guide you along the right track.
How do I do my pelvic floor exercises?
Firstly, I recommend familiarising yourself with the pelvic floor and what it looks like. Visually knowing where the pelvic floor muscles are can help with the connection. You can also use a hand mirror to look at your external anatomy, aiding in connection.
Lie down with your knees bent in a comfortable place with no distractions. Start with a connection to your breath. Your pelvic floor works in unison with your diaphragm (breathing muscle at the base of your rib cage). Therefore, connecting with your breath can help connect to the pelvic floor. Inhale into the bottom of your rib cage, shoulders relaxed. Imagine your ribcage like an umbrella, gently opening as you breathe in, and air fills your lungs and closes as you breathe out. Please do not force your breath. Aim for relaxed breathing in and out.
After a few rounds of relaxed diaphragmatic breathing, bring your awareness into your pelvis and visualise the pelvic floor muscles. On your exhale, think of stopping passing wind and urine. You should feel a gentle squeeze and lift of the pelvic floor. If unsure, place your hand on your perineum (area between the anus and vagina), and you will feel a lift as you perform the exercise. You can also use a mirror to see the perineum gently lift. Inhale, let go, and relax. Other analogies I like to use are gently lifting a blueberry or blackberry with your vagina or thinking of your tailbone, pubic bone, and sitting bones moving towards each other.
Once happy that you can connect and hold for the exhale, hold for 5-10 seconds, and repeat up to 10 times. It is crucial not to hold your breath; tighten your buttock, thigh, or abdominal muscles as you perform the exercise.
The relaxation is as important as the contraction. Therefore, in between repetitions, the relaxation phase should be as long – if not longer – than the contraction time. During this time, relaxed breathing and thinking of the tailbone, pubic bone, and sitting bones gently moving away from each other or visualising the pelvic floor like a sling or a hammock, soft and relaxed.
The pelvic floor consists of two types of fibres: slow and fast twitch fibres. Therefore, we also need to perform quick contractions to train the fast twitch fibres. These fibres react reflexively or under conscious control to increased abdominal pressure like coughing, sneezing, or jumping. Perform these quick contractions for one second 10-15 times.
Once happy with your contractions (both slow and fast), performing pelvic floor exercises in different positions and functionally is a must. Start with lying, then moving to sitting, four-point kneeling, standing, and movement. Your pelvic floor physiotherapist will guide you on this.
As a woman, your pelvic health will play an important role throughout your journey through life. Your pelvic floor is essential, and it’s never too late or early to begin your pelvic health journey.
Neasa Barry is a Pelvic Health Physiotherapist at Heal Hub Rehabilitation Centre. Visit @herphysio and @healhub_rehab for more information.
As a Culinary Nutritionist, I’ve done nutrient profiling for thousands of recipes. Beverages are the ones that have almost always managed to surprise me – to say I was shocked when I worked out the calories of a matcha frappe would be an understatement!
For the quantity of matcha served (about 300ml), it had 600+ Kcal, which is the equivalent of a meal. And most people would have an additional consumption or bite with this. There’s nothing wrong with this per se, except when it’s consumed by someone who’s got a generally sedentary lifestyle – and the majority of us fall into this group unfortunately). Your drinks could start from the 0-5 Kcal black coffee to a 1,000+ Kcal milkshake (at times even more), and everything in between based on the ingredients used and quantity served.
It’s a total letdown considering these are marketed with an illusionary health halo. People miss the point that these are sometimes even higher in calories than a meal, especially when presented as containing the goodness of trending ‘superfoods’ like matcha, turmeric, and dark chocolate.
1. Specialty Coffees
We agree that the real deal with coffee is black (Americano) coffee. If you are going out to meet a friend for coffee and end up ordering a frappuccino, then it’s basically like you went out for dessert. Let’s say you went out thrice this week to Starbucks (using them for illustrating the point since its nutrition information is easily available) and ordered the Coffee Frappuccino (294 Kcal). That’s an easy 882 Kcal in total for three of them, if you are unaware.
We often would also order a bakery treat with this, and let’s assume you went with the Triple Chocolate Cookie at 377 Kcal twice, taking it to a whopping 754 Kcal. Add it all in, and you’ve easily clocked in 1,636 Kcal. This will be pretty much the same scenario with most coffee shops. Everyone loves a good coffee, but if fat loss is a health goal and you aren’t seeing much progress, you may want to audit these drinks that are part of your weekly energy intake.
There is a common misconception that smoothies are inherently low-calorie and often marketed as a weight loss tool, thanks to them being heavily showcased by social media influencers, whose underlying message is ‘eat like me to look like me’ (#saynotodietculture). The truth is far from this. Some smoothies can easily pack over 1,000 Kcal depending on their size and ingredients.
Imagine a tall glass with a smoothie composed of avocado, dates, banana, peanut butter, milk, and honey – all ‘healthy’ ingredients that can easily take a person out of a calorie deficit if they are not fully aware of their nutrient profile. Smoothies are an excellent choice for those who are in a rush, but want to stay on top of the game when it comes to their nutrient intake. All you have to do is keep blender blunders at bay and not jeopardize the calorie-deficit principle, which is the most crucial for fat loss.
The usual blender blunders are adding in excess amounts of high-calorie ingredients like avocado, nuts, and seeds, as well as all types of sugar, honey, and maple syrup. When speaking about weight loss, it is important to remember that smoothies need not work to everyone’s benefit. Some folks see them as an easy way to monitor food portions and stay on top of their weight loss goals, while many don’t feel satisfied when they drink their calories rather than eat them. Smoothies are to be individualised for better outcomes.
Moving on to milkshakes – we are not talking about the Monster milkshakes or Freakshakes clocking in at 1,600 Kcal, which are a trend thanks to their Insta-worthy appearances. One glance, and you know they’re calorie bombs. From whipped cream, sprinkles, lollipops, doughnuts, and waffles to cookies, brownies, and chocolates, they feature a whole lot of sugary ingredients that are easy to stockpile.
In my opinion, it is the regular milkshakes that most of us tend to misjudge for their actual calorie content. These can provide the same energy as a meal if we aren’t mindful around them. For the purpose of illustrating this, let’s take the case of the peanut butter milkshake from Five Guys that clocks in at about 1,002 Kcal, the chocolate shake at 594 Kcal from Burger King, or the peanut butter banana protein smoothie from Jamba Juice with 650 Kcal… now who would’ve thought we’d talk about healthy outlets and fast food joints in the same sentence?
4. Sodas and Sugary Drinks
By now, everyone knows these provide empty calories, but most folks cannot fathom how quickly a few over a week can add up. People who drink these don’t feel as full as if they had eaten the same calories from solid food. Research indicates they also don’t compensate for the high caloric content of these beverages by eating less food. It’s a rare person who will remember a glass of soda or fruit-flavoured drink downed with a grilled chicken sandwich.
Unfortunately, sodas and sugary beverages are a regular drink of choice for millions around the world and a major contributor to the obesity epidemic. Adding to this is the rising portion sizes over the past 40 years – a standard soft drink bottle was about 200ml during the 1950s, and now it’s easy to get the same in 1-litre bottles.
5. Speciality Cocktails and Mocktails
These may sound fancy but can be heavy on calories, especially when you don’t make them yourself. The mixers like soda, juice, and pre-made blends are the ones that pile up the calories. Additionally, it’s not too difficult to down a couple of these when the food and company are good. When counting calories, many people will meticulously track their meals, but often forget to take drinks into account, which could wreak havoc on their healthy eating plans. Approach all of the above beverages with awareness to suit your health goals.
I’m not here to tell you that you should avoid these completely, but it’s important that you are aware that many of them have more calories than a meal and you will likely still be hungry after having liquid calories such as these beverages. Remember, they add up quickly and taking them seriously is hard, which is why they have stealthily contributed to the obesity epidemic. I hope this will help you make informed decisions when it comes to your choice of beverages.
Lovely Ranganath is a licensed clinical dietician. Visit @good.food.guru for more information.
PMS stands for Pre-Menstrual Syndrome, referring to a group of symptoms that women can experience in the week or so leading up to the beginning of the menstrual cycle. PMS symptoms include puffiness, bloating, cramps, headache, migraine, insomnia, changes in appetite, weight gain, back pain, lower back pain, swelling and tenderness of the breasts, nausea, constipation, anxiety, irritability, anger, fatigue, restlessness, mood swings, and crying.
PMS can affect the quality of life with varying levels. About 50% of women of reproductive age worldwide are affected by PMS. Among these, about 20% of women experience symptoms severe enough to disrupt their daily activities, and the remaining have mild to moderate symptoms. Even though PMS is pretty common, it is not actually biologically normal! Let’s explore why.
Causes of PMS
In short, the absolute or relative imbalance between estrogen and progesterone is the cause of the symptoms of PMS. Progesterone and estrogen are the two main hormones involved in the menstrual cycle. Absolute balance here means high estrogen level with moderate progesterone, and relative refers to moderate estrogen with low or absent progesterone.
Going one level deeper, there are three top contributors to this imbalance known as Estrogen Dominance. But note that the absolute or relative high estrogen level is not because the body is making a mistake and producing too much. So what are the main contributors to this imbalance?
1. Exposure to xenoestrogens
Xenoestrogens are synthetic compounds that have estrogenic-like effects within the body, mimicking the strong type of estrogen that easily bind with the cell receptors in our bodies and cause hormonal imbalances. Xenoestrogens come from pesticides, herbicides, conventional makeup, nail polishes, birth control, plastics, BPA, conventionally raised meat, etc.
2. Poor detoxification function in the liver
As part of natural hormonal balancing, the body regulates circulating amounts of hormones and neurotransmitters by producing them, then breaking them down, and excreting them from the body through the methylation and detoxification process.
The liver’s detoxification process requires ample amounts of nutrients such as B vitamins, minerals (like magnesium), and amino acids. The liver cells and the whole digestive system needs to be healthy and functioning optimally for this process. Detoxification is also important to maintain a balanced level of estrogen circulating in the body.
3. Low progesterone or receptor ability to bind with progesterone
This can occur for a variety of reasons such as high or ongoing stress state, blood sugar imbalances, insulin resistance, and toxic exposure.
How to Manage Your PMS Naturally for Relief and Prevention
You might have noticed already that the underlying reasons for hormonal imbalance have many factors that are actually in your control. Here are 10 tips to manage your PMS.
1. Ensure good hydration
Estrogen and progesterone influence your body’s hydration levels, especially at the late luteal phase before the period starts, so you will need more fluids at that time. Another point to note is that dehydration – with or without menstruation – is known to cause fatigue, bloating, constipation, and headaches. By drinking water during menstruation, you can reduce the severity of common unpleasant symptoms and discomforts of PMS.
2. Eat quality and balanced variety of foods
Quality: The foods we eat play a big role in hormone balance. Our hormones are made using amino acids from proteins and fatty acids from fats. The better quality materials we use, the better quality hormones our bodies create. Eating mostly real whole foods (versus processed) makes a big difference.
Balanced variety: Every type of food has a different structure and offers a different group of micronutrients. To keep our systems balanced, we need everything in the right amount. Too much of one micronutrient can throw off the balance of another. The Healthy Eating Plate by Harvard Education is a great guide to making balanced meals so that you’re getting the nutrients you need for healthy organs and optimal liver detoxification function.
3. Reduce refined carbohydrates and sugar
Eating too many refined carbohydrates and sugar for your unique body raises blood sugar, which triggers an excess insulin response. And this hyperinsulinemia state affects your hormonal balances, leading to lower progesterone, which is one of the dynamics causing PMS symptoms. Following balanced meal guidelines, as mentioned in the second tip, is a great resource. Keep in mind that natural sugar is still sugar, so consume it mindfully with balanced meals.
4. Manage stress response
A 2018 study in Saudi Medical Journal found female college students who were highly stressed were nearly three times as likely to experience worse PMS symptoms in the luteal phase and twice as likely to have painful cramps during their period. Stress can affect the immune system, adrenals, and blood pressure, which tends to amplify and increase pain, creating a vicious cycle of ever-increasing stress and pain.
Stress is a complex topic as it can be induced by mental, emotional, physical (whether trauma or excessive exercise), or physiological stressors. Physiological stressors could be due to inflammation, insulin resistance, pathogens and imbalanced microbiome, food sensitivities, messed up circadian rhythm (like working night shifts or staying up late watching movies), and many other possible reasons. Understanding your stressors and addressing them is key to wellness.
Some suggestions to tackle stress include:
Exploring possible food sensitivities: Food insensitivities, while common, can go unacknowledged for several years, wreaking havoc by increasing inflammation and raising stress hormones. Gluten and dairy are among the top culprit foods. Try an elimination diet followed by structured reintroduction to determine if this is an issue with you. Reach out if you need support in this process.
Supporting your gut health: Most imbalances and diseases start in the gut, and learning more about developing a healthy gut can help your overall health.
Stress-busting diets: Stress affects your food choices, and your food choices impact your stress level. One way to tackle this is by adopting food that fights stress in your diet. This can include fermented food, oatmeal, walnuts, etc.
There are many wellness tools to manage your stress response and reduce its impact on your body. I would encourage you to make a list that works for you or that you like to try and be committed to doing them frequently. Some examples include diaphragmatic breathing (my favourite, as it is very quick in shutting off the stress response), meditation, yoga, journaling, talk therapy, laughter therapy, nature walks, uplifting music, dancing, and anything else that helps you calm your nervous system. Remember, stress affects your hormonal balance, so investing some time in relaxation techniques is vital for your health and reducing PMS symptoms.
5. Prioritise sleep
Poor sleep, with or without menstruation, induces irritability and fatigue. And not getting enough quality sleep can surely worsen your PMS symptoms, as hormonal regulations and cell repair happen during your sleep. Unfortunately, symptoms from a few sleepless nights can get you into a catch-22 situation, such as when a hormonal imbalance (like low progesterone) also affects your sleep.
Following a healthy bedtime routine can help you get better quality sleep and reduce symptoms associated with poor sleep. A healthy bedtime routine can include taking a relaxing bath in the evening, stopping screen time at least an hour before bed, going to bed at the same time each night, avoiding late heavy meals, and preparing your bedroom environment for sleeping by keeping it cool, dark, and quiet.
6. Reduce toxin exposure
We live in a world that’s becoming a chemical soup and our frequent exposure to these toxins is a huge burden on our bodies. Hormone-disrupting chemicals known as xenoestrogens are a big contributor to the imbalance leading to PMS. This list includes some key environmental chemicals. Here’s how to be mindful of these toxins.
Reduce toxin exposure from food: Organic produce means you avoid the harsh chemical pesticides, herbicides, and fertilisers that are absorbed by plants and cannot be fully washed away. Check the annual release of the Dirty Dozen for the most contaminated produce to know what to be cautious with. Free-range chicken and eggs, grass-fed meats, and dairy have more nutrients, no antibiotics or hormones, and a natural feed. Eating real whole foods versus processed food products will help you avoid all additives like colourings, flavourings, bulking agents, anti-caking agents, preservatives, and more that your body needs to put an effort into detoxing.
Reduce toxin exposure from the environment: Your skin is basically a giant mouth, so be mindful of what you’re putting on it. Makeup, personal hygiene products, moisturisers, body sprays, and so on get absorbed deep into your cells without the normal filtration that happens when we take in something by eating and passing it through the digestive system.
Watch out for the ingredients in your products, avoid products with synthetic fragrances (major xenoestrogen), and choose clean beauty products. Also, keep an eye out for ‘greenwashing’ as some brands promote their products as being environmentally friendly when in reality, they still have harmful ingredients that can disrupt your health. Smoking also affects your PMS symptoms because of the nicotine content in cigarettes.Other ways to reduce toxin exposure include being careful of the materials used in food prep, storage and heating, wall paint, flame retardants on furniture, etc.
7. Reduce coffee and alcohol
Both of these have a diuretic effect, increasing the amount of water lost by the body. If not replenished as quickly as it’s lost, this can trigger dehydration, which can worsen your symptoms. Alcohol, of course, affects liver health and subsequently the detoxification process, and also affects estrogen receptors contributing to imbalances. Anything beyond one drink a day for a few nights will have an impact. Coffee raises the cortisol hormone and affects estrogen receptors, so both of these mechanisms contribute to hormonal imbalances.
8. Prioritise movement
Physical activity not only helps to keep a balanced body composition, but also produces ‘happy hormones’ such as dopamine, serotonin, and endorphins that reduce stress and anxiety. A systemic review of several studies in 2020 has shown the positive impact of exercise in reducing physical and psychological symptoms in women with PMS.Physical activity is recommended throughout the month – not necessarily just during the menstruation period. Some women are happy with light cardio exercise when their period starts, while others opt to rest for a couple of days. Always listen to and honour your body’s needs.
9. Check your vitamins
Check your vitamin D level as it’s pro-hormone and has an important role in regulating calcium. B vitamins play an essential role in mood regulation. This effect is related to the production of serotonin, and tryptophan metabolism. B vitamins are therefore particularly helpful if you suffer from headaches, irritability, tiredness, or anxiety. Good food sources of B vitamins include beef, poultry, avocado, banana, legumes, nuts, and whole grains.
If you want to go down the supplementation route, then it is better to get some lab tests done to gauge your needs and always choose quality bio-available forms of supplements (yes, you need to read the labels and ingredients of supplements). Magnesium is a mineral and one of the key nutrients that help to keep estrogen receptors appropriately sensitised. It also has a role in converting vitamin D to its active form and helps ease constipation. Check your RBC Mg level for accurate internal sufficiency.
10. Try seed cycling
Seed Cycling – also called Seed Rotation – is a method to stabilise the female hormonal balance in a natural way, using seeds and kernels to help you achieve a regular cycle and fewer PMS symptoms. The idea is to provide the body with the nutrients needed at each phase to boost production or metabolism (breaking down) excess.
Follicular Phase – Ovulation (Days 1-14): eat 1-2 tablespoons each of raw, fresh ground flaxseeds and pumpkin seeds
Ovulation – Luteal Phase (Days 15-28): eat 1-2 tablespoons each of raw, fresh ground sunflower and sesame seeds
A detailed guide to seed cycling is available here. Caution: You might find reviews of how amazing seed cycling is and all the amazing benefits women got from following this. However, please keep in mind that there are many factors that affect the body, and doing just one thing may not give you the results that you are looking for.
Seed cycling is not a magic fix-all solution, so I encourage you to follow as many tips as possible that apply to your case along with seed cycling to reap the benefits you are looking for. You have an amazing body that can heal itself if you give it the chance. Changing your food and lifestyle has a big impact on your illness and wellness. I understand it is not an easy journey. However, it is doable, and working with a health coach will help you change your mindset and habits into healthier ones that support your unique body.
I’ve had severe PMS symptoms along with other issues for so long that I thought that’s just my normal! Where I am now is so far from my ‘past life’ – it’s been a journey to change my lifestyle, but it was totally worth it considering the vibrant energy and the better quality of life I enjoy. Don’t accept your symptoms as “normal” and never give up on seeking solutions for you to feel better naturally – this is key to avoiding the side effects of commonly prescribed solutions like pain relief medication and birth control pills.
If you are old enough to remember Jane Fonda, the cabbage soup diet, dancing around your bedroom to Spandau Ballet, or daydreaming over Simon Le Bon, then you will now be classed as Generation X. But it doesn’t matter which generation you are from, as one thing is a constant between women of all ages: the fear of how we look, and how our bodies change as we age. This is especially true as we head into our 40s and 50s. I am here to tell you that even in your 40s and 50s, you can look good, feel amazing, and be even sexier.
Someone once said, “At the age of 20, we have the health and appearance we inherited. At 50 and beyond, we have the face and body we created.” Your 40s and 50s can be a positive life stage if done right. It’s an opportunity to optimise your health and well-being, which benefits you from the inside out. It can prolong your health span and increase the number of active healthy years you have ahead of you. So, how do you go about it? You might have gotten away with neglecting your health in your younger years, but now it’s time to buckle up and get serious.
Why Health and Well-Being Management Is Vital
First, let’s look at what could be happening in our 40s and 50s:
You may be more sedentary due to aches and pains in joints
Eating habits change
Physical activity may have dropped off
Energy levels fluctuate
It would be wrong of me at this point not to mention menopause, something that plays a huge role in our well-being. Peri- to post-menopause is a natural biological process, and our bodies will experience changes internally and externally. Due to our hormones declining, we can experience several changes (like the ones listed above) and this is because of the declining oestrogen and other hormones.
We have oestrogen receptors all over our body, and the decline of this hormone can produce other symptoms like hot flashes, bloating, weight gain, mood swings, dry skin and vagina, UTIs, and more. Other hormones and chemicals like testosterone and progesterone, insulin, cortisol, and DHEA plus a few others also contribute to this – and can affect us physically and mentally once out of balance.
Some things to be mindful of as women due to our hormones changing is that we are at a higher risk of cardiovascular disease, osteoporosis, and insulin-resistance. In summary, hormonal changes in our 40s and 50s – while not responsible for everything – can cause physiological and psychological changes that make us more susceptible to health issues and, more importantly, have an impact on how we feel and take care of ourselves.
Here’s the Good News
You can do something about it today and feel the difference straight away. There are so many easy steps you can take to stay feeling great and help relieve and prevent some of these changes, create a higher quality of life, and help slow down (and sometimes reverse) age-related changes! Putting one’s health first begins with wonderful nutrient-rich food, as it helps as a protector against diseases and delivers lots of relief to our nervous system, and even aids menopausal symptoms.
Here are some culprits contributing to our health issues and exacerbating symptoms:
What Does Food Fix?
A higher intake of alkaline food is necessary as they are designed to help your body repair and heal inflammation. Western diets can be heavy on acid-forming foods such as meat, grains, sugar, and processed foods. As we age, our daily diet should consist of 60-80% of alkaline-forming foods and 20 -40% acid-forming depending on the degree of symptoms that show up in the gut, liver, joints, and muscles. You may also benefit from a plant-based or Mediterranean diet to help calm down the immune system. Alkaline foods include:
Salmon, sardines, tuna, fatty fish, mackerel
All the berries – blue, black, and red
Olive oil, especially extra-virgin olive oil
Peppers, including bell and chilli peppers
Leafy greens, beetroot, avocado
Sweet potato yams
Garlic, ginger, celery
Hormones are chemical messengers that impact every part of your health – from your energy and cognitive ability to your body weight and sex drive. More and more research is emerging, showing how food affects us and the impact it has on our ever-changing hormones. One important link is that food supplies the building material to make hormones. Eating good fats is essential for hormone production – think: olive oil, flaxseed oil, avocado oil, raw unsalted nuts or seeds, nut butter, and avocados.
Food also increases levels of hormones like insulin and change the way estrogen and other female sex hormones are metabolised. It can also elevate oxytocin, your feel-good ‘’love” hormone. Examples include anything containing vitamin D, vitamin C, magnesium, fatty fish, mushrooms, peppers, tomatoes, spinach, and avocados.
It can even stimulate the release of testosterone, which is important for energy and sex drive. Some of the best nutrients to increase levels are zinc, magnesium, B vitamins, omega 3, onions, ginger, green leafy vegetables, pomegranates, olive oil, eggs, almonds, and pumpkin seeds. Note that balanced testosterone will not turn you into Miss Universe nor will it give you facial hair, but the lack of it will lower your sex drive and energy levels and the ability to maintain muscles.
Decreases Insulin Resistance:
A diet high in sugar is never a good thing – no matter what age we are. Once our cells shut their doors and say enough, then we have a problem. High levels of sugar intake can lead to weight issues, diabetes, insulin resistance, and more inflammation issues.
Remove processed carbs and sugars from your diet as much as possible. This includes anything that ends in “ose’’ – including high-starch foods like rice, pasta, bread, cereals, and potatoes. Make sure to then replace them with low-glycemic foods to provide you with fuel for energy and that steady flow of glucose into your bloodstream.
Improves Gut Health:
The health of your gut is extremely important to the health of your entire body. The gut houses trillions of healthy bacteria, constantly working hard to metabolise your nutrients, produce vitamins, and detoxify (among other things). As we age, the ratio between good and bad bacteria can change, along with lower bile production. The consequences can be bloating, reflux, and constipation.
A daily serving of sauerkraut, kimchi, kefir, sour pickles, kombucha, or live culture yoghurts can help balance your gut bacteria. It’s also good to stay away from processed foods that cause inflammation and bloating. Build your meals around wholesome, fibre-rich foods, vegetables, beans, seeds, and nuts. And drink more water. Your microbiome can be restored within a few days of eating well and some symptoms will dissipate quite quickly – going back to those quick wins!
10 Top Tips to Nourish and Nurture Your 40s – and Beyond
Variety is vital: Restrictive diets should be left in the 80s – now is the time to nurture your microbiome.
Wholesome, not hole some: Eat rich wholesome foods that are dense with nutrients, not empty processed high-sugar foods.
Experiment: We are all different when it comes to when and how much we eat. You must choose what’s right for you. Just because your friend is on a keto diet doesn’t mean it will work for you.
Taste new things: Just because you have never had it doesn’t mean you won’t like it! Try cooking things in different ways, as sometimes this can also alter the taste.
Easy does it: Follow portion control, have smaller meals, eat when hungry, and choose quality over quantity.
Go for quick wins for a big difference: Throwing some nuts and seeds onto your daily meals has so many benefits – you can even turn your microbiome around in a few days.
Out with the old habits: It’s time to create new healthy habits! This can be a healing, fun, and exciting time of discovery about food and you.
Healthy fats: Add healthy fats to your diet like avocado, extra-virgin oil, and any plant-based oil.
Get a good night’s sleep: If this is something you need to work on, hatch a sleep hygiene management plan.
Move more: It doesn’t have to be hardcore HIIT training; just choose what’s right for you and your needs and move! Although, I always recommend weight training as a must.
Create a Checklist of Foods
Sometimes, we get in a rut, eating the same things and getting the same results. Write a list of all the foods (not meals) you eat in one week. Do you eat the same thing week in and week out? Do you feel the same, or experience any symptoms? What nutrients are you getting from your list? Is it working for you? What things could you swap for better nutrition?
This is what I eat weekly – it can be used as a checklist of foods to include in your weekly meals (p.s. I’m no saint and do have the odd chocolate or slice of pizza over the weekend).
I am a firm believer in getting as many nutrients as possible through our food as nothing beats the nutrient power of a healthy diet. No matter what your goal is when taking supplements, one thing is certain: supplements are just that – a supplement to something. They are not a replacement for a nutrient-dense and healthy diet. I know sometimes this can be difficult for a multitude of reasons, but a word of caution: if you do buy supplements, make sure they are not full of binders and other toxic ingredients that will do more harm than good and undo all the good work you have done healing your microbiome. Maybe take liquid form or powder as an alternative.
Here is a quick rundown of daily recommendations for macronutrients. They all play their part in keeping us balanced!
Sources: any fruit or vegetables with red, yellow-orange skin
Vitamin E (15mg)
Sources: plant-based oils seeds and nuts, fish, meats, liver, mango
Vitamin D (800IU)
Sources: sunshine, mushrooms, fortified foods, eggs, fish
Nutrition advice can be confusing and controversial, with a constant flux of what we can and can’t eat. There is no one better than you to understand what you need to stay in top shape. Listen to your mind and body, swap things around a little, and have the right mindset towards change. Things are going to change, and therefore you must change with it. We need to swap the constant ‘fear’ for constant ‘change’. Life is about change and if you don’t embrace this, you will be stuck back in the 80s, always replaying the same tape.
Or the food service that wants to bring it to your plate?
With a history that goes back 5000 years, fonio is one of Africa’s oldest grains. This not-so-well-known grain is packed with nutrients, goes with any cuisine, is climate-friendly, and is about to take the world by storm. Here, we’re going to dive deep into why we think you need fonio in your diet and a Dubai-based food service that aims to help you do just that.
A Nutritional Powerhouse
Coming from the millet family, with a variety of brown or white, fonio is one of the smallest ever grains and is considered a whole grain. This is important as whole grains like fonio have all three components of the kernel – bran, endosperm, germ – as opposed to refined grains, which have had the germ and bran removed during processing. The Whole Grains Council, a non-profit consumer advocacy organisation, estimates that when the bran and germ are removed from a grain, about 25% of the protein is lost. Fonio, on the other hand, has plenty of protein.
This nutritious food also has low carbs, a low glycaemic index (a scale that gives an estimation of the impact of carbohydrates on blood sugar), and is gluten-free. Plus, it contains a range of amino acids, particularly cysteine and methionine, with the former being important for body tissue growth and repair, hair growth, nail health, and skin elasticity. The latter, meanwhile, helps with detoxification and protein synthesis. The amount of amino acids also makes it perfect for those who follow plant-based diets.
A Friend for All Diabetic Folks
For diabetics, the low GI and low sugar content of fonio can help to lessen fluctuations in blood sugar and insulin levels. The is common knowledge in West Africa, and doctors in Nigeria are often said to advise fonio to diabetic patients. Another reason that fonio is a good option for diabetics, according to the Collaborative Crop Research Programme (CCRP), is that it contains more insulin-secreting amino acids (valine, leucine, isoleucine) than other cereals like rice, maize, or millet.
Cooking Made Easy!
Fonio is perfect for our modern-day lifestyles as it cooks in less than five minutes. It is super-versatile and can be used in both sweet and savoury recipes. It’s a wonderful blank canvas that takes on the flavour of how it’s prepared, making it perfect for jollof, the iconic one-pot rice dish from West Africa. It can also be eaten warm or cold, simply cooked and added to a salad, or as a healthy porridge to start your day. Plus, its nutty flavour satisfies hunger for longer, substituting many starchy foods.
There’s Just One Problem
While fonio may sound like the perfect grain so far, unfortunately, very few people outside West Africa actually know about it. And in truth, very few people in West Africa even eat fonio. Veghana (Dubai’s locally grown meal delivery and catering service and one of only a handful of vegan African food brands that exist anywhere in the world) is determined to change this and bring the glory of fonio and West African food to the Middle East and beyond. Being both plant-based and African, Veghana is in an awkward position – a niche within a niche – which is often not a great recipe for business success, but chef and founder Nana-Serwa Mancell is a woman on a mission.
“I’m a recent convert to veganism and I’m finding it super-easy because I’m eating mostly plant-based West African food. Without this, I would be bored by endless quinoa and pumpkin – often the only option on restaurant menus,” she says.
Nana re-interprets the Ghanaian food she grew up eating for Veghana’s menu, which features fonio as a healthier alternative to yam or rice. She also firmly believes that Veghana is not just for vegans. Anyone who loves tasty comfort food will love it, according to her – even committed carnivores! But the benefits and joys of vegan African food and fonio are multifold, impacting more than just the diner.
For a Sustainable Future
The fonio crop reaches harvest within only six to eight weeks of planting and, once harvested, the roots are left and continue to nourish the soil. Fonio, which hails from the borders of the Sahara desert, is also exceptionally climate-friendly. Even in the driest and sandiest soil beds, its extensive root systems are able to find water deep underground. Frequently referred to as “the new quinoa”, fonio can also flourish in harsh conditions of drought or floods – both regular occurrences in the fonio-growing region. Compared to other grains, it also does not need much water, pesticides, or fertiliser to grow – thereby earning it the title of “lazy farmer’s crop”.
But how did the region go from traditional foods like fonio to more imported varieties? Large tracts of land were taken over during colonialism for plantations that produced cash crops for export like sugar, tea, and cocoa, while the ‘green revolution’ of the 20th century promoted the idea of growing high-yield grains to fight world hunger.
Although the plantations continued to expand, they did not increase biodiversity. Such popular imports needed the ecosystem to be modified to ensure the proper growing conditions, which involved clearing vast tracts of diverse land that were initially covered by traditional African farming systems that allowed the growing of multiple crops in close proximity that are better suited to survive.
Now, experts believe that agrobiodiversity (or lack of diversity in agriculture) is a serious threat to food security, can make us more sensitive to the effects of climate change, and decrease the diversity of plants and animals. Knorr and WWF-UK have created a list of 50 nutrient-dense plant-based ingredients that people should eat to improve one’s health and lessen the negative effects of food production on the environment. And featuring in the Future 50 Foods report is, of course, fonio.
Empowering Women Farmers
Amaati is a social enterprise that pioneered the revival of fonio in Northern Ghana. Amaati generates income for 8,000 farmers through fonio farming. These farmers are mostly landless women living in some of the most impoverished regions in the world, and the increasing demand for fonio has the potential to change their lives for the better.
The majority of women in the area make their living by working on men’s farms. Due to culture and tradition, these women have no access to fertile lands. The only available lands are degraded lands that can’t support the cultivation of food crops, jeopardising the security of the food supply. Fonio’s hardiness makes it perfect to grow on such land, and Amaati helps women grow it by providing them with various agricultural support services, thus securing a livelihood for them. Nana, the founder of Veghana, initially heard about fonio from the new generation of African diaspora chefs, who independently promote fonio much as she does now.
She then hurried back to Ghana to find out more, which is where she learned about Amaati. “My initial aim with Veghana was to spread a love of West African food and make it the next trendy global cuisine. I have now moved on from this,” explains Nana. “I still want those things, but I also want Veghana to regenerate our land. At our core must be a mission to use plants like fonio to reinvent and regenerate West African farming, dish by delicious dish.”
To taste fonio, order from Veghana. If you would like a free sample of fonio, you can collect one from Veghana’s kitchen in Downtown Dubai by sending a WhatsApp message to 050 956 9277. And for the recipe to Veghana’s Fonio Jollof, visit this post on Veghana’s Instagram account.
The marketing trend that promotes alkaline water as a product that slows ageing, helps digestion, improves immunity, prevents chronic diseases like cancer, and more is quite an old one. But what’s alkaline water anyway? And does it have any benefits? Let’s explore.
What Does ‘Alkaline’ Even Mean?
When your body breaks down food, the process produces waste. These chemicals (or waste) can be either alkaline or acidic, and is also often referred to as ‘ash’. This ‘bit of science’ was used as the basis for the acid-alkaline theory of disease. The claim was that this acid /alkaline ash can have a direct effect on our health – the acidic ash being disease-causing, the alkaline ash being health-promoting. The hope was that by eating certain foods or drinking certain kinds of beverages like alkaline water, you can change the body’s acid level – also called its pH levels – which in turn can improve health.
To help gauge this, there is the pH scale that measures how acidic or basic (alkaline) something is on a scale of 0 (very acidic) to 14 (very alkaline). Something that is alkaline is on the basic end of the scale, or greater than seven (neutral pH). The pH of regular water is around seven, whereas alkaline water has a higher pH level than regular drinking water (typically eight or nine), with the addition of minerals like calcium, magnesium, and potassium, making it a perfect fit to market as the superior water.
How Did ‘Alkaline’ Become a Diet?
This entire school of thought was picked up by Robert O’Young to whip up the Alkaline Diet, which included alkaline water in its list of elixirs to disease-free longevity. The naturopath went on to publish several books on the topic that have sold millions of copies worldwide with celebrity endorsements from the likes of Victoria Beckham, Elle Macpherson, and Gwyneth Paltrow ensuring its position as a popular diet. It is also worth noting that he was sentenced to jail time in 2017 for illegally treating people at his ranch without any medical training.
What Is the Flaw in This Diet?
The diet per se is not too bad considering it prompts people to include more fruits and vegetables, drink water, and reduce intake of foods high in calories from ingredients like sugar, fat, etc. It is the claims about the mechanism of how alkaline water (or food) works that are widely criticised since it is not supported by evolutionary evidence, human physiology, or any reliable study on humans. The suggested mechanism is flawed because it’s a fact that our body has a tightly controlled inbuilt regulatory system (involving the lungs and kidneys), which keeps the blood pH in the normal range (7.35 to 7.45) – and it is not possible for diet or water to change this.
To reiterate, food and drinks can’t influence the pH of your blood. It is critical for health that the pH of your blood remains constant and can be fatal if untreated – this only happens during certain disease states (e.g., kidney disease) and has absolutely nothing to do with the foods or water you eat/drink every day. Now, food can change the pH value of the urine, but it’s temporary. Eat a large steak and several hours later, your urine will be more acidic as the body removes it from your system. Urine pH is a very poor indicator of overall body pH and general health.
In my opinion, people who promote alkaline water are most likely confused between blood and urine pH. Excreting waste through your urine is one way your body regulates its pH level. It is also interesting to note that the pH levels throughout your body vary – and they need to. Your stomach is acidic (pH 2-3.5) to break down food, while your blood is always slightly alkaline (pH ~7.3-7.4). You don’t need alkaline water to ‘detox’ – your kidneys, liver, and other organs do that for you for free.
To state it explicitly, alkaline water is a scam. While some small low-quality studies have been done (many in test tubes or mice), the claims simply haven’t been backed up by reliable human studies and the evidence for drinking alkaline water to help any health condition just isn’t there. While I can’t comment on specific brands, most so-called alkaline waters are just bottled mineral waters. Just like food, this water could change the pH levels of your saliva or urine – not your blood (thankfully).
Does That Mean Alkaline Water Is Unsafe?
Water that’s naturally alkaline occurs when water passes over rocks – like springs – and picks up minerals, which increase its alkaline level. This type of natural alkaline drinking water is generally considered safe as long as it is clean and potable.
However, many people who drink alkaline water buy alkaline water that’s been through a chemical process called electrolysis. This technique uses a product called an ioniser to raise the pH of regular water. Makers of alkaline ionised water say that electricity is used to separate molecules in the water that are more acidic or alkaline. The acidic water is then funnelled out, leaving you with water that is alkaline in nature.
People also attempt to make alkaline water at home. One way is by using water ionisers that are sold in many large chain stores. Adding baking soda is another way to make water more alkaline. If the water is properly filtered to remove contaminants, ionised and re-mineralised, or purchased from a quality source, there’s no evidence to suggest a limitation on how much alkaline water can be consumed daily. You should use caution with artificial alkaline water, however, which likely contains fewer good minerals than its high pH would have you believe – and may even contain contaminants. The water quality of the original source, before ionisation, is crucial to ensuring contaminants aren’t present in the drinking water.
A 2014 study cautions against drinking water with low mineral content, which is created by reverse osmosis, distillation, and other methods (without additional mineralisation) on a regular basis. Some scientists advise using reverse osmosis to adequately purify water before connecting an alkaline ioniser, which can raise pH and add minerals. The health claims around this aren’t backed by quality research and more research is needed to determine its benefits. So, if you find labelled alkaline water expensive, don’t worry – you’re not missing out on anything! Just drink enough regular water and make sure it’s clean.