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.
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.”
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.
Perhaps, especially if you have a vaginal prolapse.
When you have a painful back, neck, or knee, you most likely seek a physiotherapist’s help. However, have you ever considered seeing one if you have pelvic floor symptoms? These symptoms can include leaking with cough, sneezing or exercise, heaviness vaginally, bowel symptoms, or pain with intercourse. Such symptoms are less talked about – they can even be taboo – and yet, they commonly occur throughout a woman’s lifetime. Pelvic health physiotherapists are experts in the treatment of these pelvic floor symptoms. They undergo extensive post-graduate training to help manage these personal, often complex, and emotional issues.
What Led Me Down the Road of Pelvic Health?
During my physiotherapy degree and after, when I began working, I knew very little about pelvic floor issues. It wasn’t until the birth of my first baby 10 years ago that I delved into the world of pelvic health physiotherapy. After a difficult birth and a slow recovery, I started to feel symptoms of heaviness vaginally, and that something was just not quite right down there. Scared and unsure, I went to see a pelvic floor physiotherapist who diagnosed me with vaginal prolapse.
If I’m honest, I didn’t even know what a prolapse was until that point! This diagnosis and my subsequent recovery journey catapulted me into the world of pelvic health. I felt a need to educate myself and women about these taboo and stigmatised issues – to spread the word that there is help and support out there. Pelvic health is now my passion! I travelled to Melbourne University to complete my post-graduate education in this area in 2015 and I haven’t looked back since. All my work and education is now in this area.
What Is a Vaginal Prolapse or Pelvic Organ Prolapse (POP)?
POP is when one or more of the pelvic organs (bladder, bowel, uterus) descend into the vagina. The pelvic organs are supported by connective tissue and the pelvic floor muscles. This support system can be affected by many lifestyle factors. Pregnancy and childbirth injuries (as in my case) are probably the more well-known. Other factors such as chronic constipation, genetics, menopause, being overweight, and chronic cough can also contribute to it. It’s quite prevalent, with about 50% of women (over 50) having some degree of prolapse, but only 3-6% of women are symptomatic. Despite this, very few women know what a prolapse is unless they experience symptoms.
What Are the Symptoms?
Vaginal dragging or heaviness, and visually seeing or feeling a bulge vaginally is the most common symptom. Others – bladder or bowel symptoms, difficulty inserting a tampon, pain with intercourse, and pain in the back or abdomen – may also be present. These symptoms can vary in intensity and be influenced by many factors, including fatigue, menstrual cycle, stress, menopause, and pregnancy. The good news is it’s not all doom and gloom! Physiotherapy can help manage symptoms and get you back to doing what you love.
What Should You Do If You Suspect POP?
I highly recommend seeing your OBGYN and a pelvic health physiotherapist – and the research agrees! The guidelines recommend pelvic floor muscle training for at least 16 weeks, supervised by a professional as first-line treatment of women with mild to moderate POP. One large study found that individualised pelvic floor muscle training is effective at improving prolapse symptoms.
My Journey to Recovery
When I first developed symptoms, I will admit I was devastated. I felt a vast spectrum of emotions from sadness to fear, grief, and rage. Exercising was a massive part of my self-care, and I felt my symptoms every time I tried to work out and even when lifting my baby. I felt like my body was failing me, and it took me time (and a lot of tears!) to accept my prolapse and come out of this mindset.
My pelvic health physiotherapist supported and empowered me, and with treatment and a progressive exercise programme, I was back doing the things I love. Yes, it took time, effort, and commitment, but seeing the results inspired me to continue. My recovery was much more than kegels/pelvic floor exercises – but they played a large part! It included whole-body conditioning, education, manual release of scar tissue internally, progressive loading of the pelvic floor and surrounding muscles, maintaining good bowel habits, and managing stress and sleep. Plus, a great friend, family, and professional support network was key. It’s not just the physical part that needs to heal, but also the emotional. This experience opened my eyes and was the main driver for me to educate myself and others on pelvic health issues.
What Happens When You See a Pelvic Health Physiotherapist?
I know it can be daunting initially and, rest assured, we are here to put you at ease. Being informed is vital, and all aspects of the session are explained in detail so you can make an informed, autonomous decision in your care. Firstly, we have a chat discussing your main concerns, what you want to achieve, and your goals.
Next is the physical assessment based on your goals and issues. For example, assessing movements that you find difficult or symptomatic and finding ways to make these more manageable for you. We may also look at certain muscle groups or specific joint and nerve tests. Then, we move to the internal vaginal assessment where we assess pelvic floor muscle strength, endurance, coordination, and relaxation, as well as the position of your pelvic organs and scarring if present. This assessment is performed privately and at your pace.
We check how it is by lying first and potentially in standing or during functional movements, such as squatting. After the physical evaluation, you are provided with education and an individualised programme. The session might also include a manual, hands-on treatment of the pelvic floor or other areas of the body and, of course, time to answer any questions you may have. Let’s break the taboo and begin talking about these issues candidly and openly!
Neasa Barry is a pelvic health physiotherapist at Heal Hub Rehabilitation Center in Dubai. Visit @herphysio for more information.
The wellness world is obsessed with detoxes – detox teas, detox diets, detox face masks, detox scrubs – so it was only a matter of time before the armpit detox craze took over the internet. Editors, YouTubers, influencers, and natural living enthusiasts the world over have been slathering their pits with green sludge-like masks in the name of sweating less and smelling better. And yet, not a lot of people in the Middle East seem to have jumped on the bandwagon – is acknowledging that women sweat still considered taboo? In a city where temperatures hover above 40ºC on a daily basis every August, we figured it was time to talk armpits.
This trending treatment is essentially about transitioning from antiperspirant to natural deodorant with the help of a DIY mask that contains bentonite clay and apple cider vinegar. For the uninitiated, ‘antiperspirant’ and ‘deodorant’ are not interchangeable terms. The former is designed to stop you from sweating – hence the name – through the use of aluminium, which physically blocks sweat from coming out of your pores. In contrast, deodorants prevent odour by targeting bacteria and/or masking it with fragrance.
Anyone seeking a more wholesome lifestyle should give it a try, especially as an armpit detox will speed up the transitory phase of sweating and stinking more when switching from traditional antiperspirants to natural deodorants. And there’s plenty of reasons to make the switch. For starters, conventional antiperspirants often contain ingredients like aluminium, fragrance, parabens, and phthalates – all nasty and harmful in their own way. Furthermore, anyone who feels like their armpits stink (it’s okay, it happens!) or their deodorant isn’t working as well can benefit from a detox.
First and foremost, it eliminates odour – apple cider vinegar has antibacterial properties and can therefore eliminate odour-causing bacteria. It is also believed to bring the natural bacteria that live on the skin back into a balanced state, thereby curbing odour and creating a more natural scent. An armpit detox removes the toxins that build up over the course of antiperspirant use, courtesy of bentonite clay. Drawing out impurities will give the area a break, increasing the effectiveness of natural deodorant in the process. Even better? You may also notice that any skin irritation caused by antiperspirant ingredients is soothed, especially as conventional antiperspirants dry the skin in an effort to reduce sweating. Bonus: armpit detoxes are easy, inexpensive, and take next to no time.
Simply mix a tablespoon of bentonite clay with a teaspoon of apple cider vinegar and enough water (roughly one to two teaspoons) to form a mixture that’s not too thick, but not too runny either – you want to reach the consistency of sour cream. Avoid using a metal bowl and/or spoon. Next, evenly spread the mask on your armpits for 5-20 minutes, sticking to the lower end of the spectrum if it’s your first time. Allow the mixture to dry before washing it off in the shower or with a wet washcloth. For best results, repeat this process weekly or biweekly for a month. And like any other skincare product, discontinue use if any irritation occurs. Happy detoxing!
Was this helpful? Learn more ways to improve your health and well-being in our Wellness section.
8 Common Menstrual Disorders You Need to Know About
Let’s break the silence.
Menstrual disorders are problems that affect a women’s normal menstruation cycle. There are several types of menstrual disorders, and problems can range from heavy, painful periods to no periods at all. There are many variations in menstrual patterns, but in general, women should be concerned when periods come fewer than 21 days or more than three months apart, or if they last more than 10 days. Such events may indicate ovulation problems or other medical conditions. These are some of the most common menstrual disorders.
Dysmenorrhea literally means painful menstruation. Pain occurs in the lower abdomen, but can spread to the lower back and thighs. Dysmenorrhea is usually referred to as primary or secondary:
Primary dysmenorrhea (spasmodic): Cramping pain caused by menstruation. The cramps occur from contractions in the uterus and are usually more severe during heavy bleeding.
Secondary dysmenorrhea: Menstrual-related pain that accompanies another medical or physical condition, such as endometriosis or uterine fibroids.
Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. If you have one or two periods with heavy or prolonged bleeding, there’s probably no reason to worry. Although heavy menstrual bleeding is a common concern, most women don’t experience blood loss severe enough to be defined as menorrhagia.
With menorrhagia, you can’t maintain your usual activities when you have your period because you have so much blood loss and cramping. If you dread your period because you have such heavy menstrual bleeding, talk with your doctor. There are many effective treatments for menorrhagia. Signs and symptoms may include:
Soaking through one or more sanitary pads or tampons every hour for several consecutive hours
Needing to use double sanitary protection to control your menstrual flow
Needing to wake up to change sanitary protection during the night
Bleeding for longer than a week
Passing blood clots larger than a quarter
Restricting daily activities due to heavy menstrual flow
Symptoms of anaemia such as tiredness, fatigue, or shortness of breath
Do call your healthcare professional if the heavy bleeding is accompanied by pain that is not relieved by ibuprofen or acetaminophen. Avoid taking aspirin because it could worsen the bleeding problem. If you have bleeding after menopause, or the abnormal bleeding is accompanied by fever or other symptoms, again, consult your healthcare professional.
Amenorrhea is when you don’t get your monthly period. It can be temporary or permanent. Amenorrhea can result from a change in function or a problem with some part of the female reproductive system. There are times when you’re not supposed to get your period, such as before puberty, during pregnancy, and after menopause. If amenorrhea lasts for more than three months, it should be investigated. There are two classifications of amenorrhea:
Primary amenorrhea: This is when you haven’t gotten a first period by age 15 or within five years of the first signs of puberty. It can happen due to changes in organs, glands, and hormones related to menstruation.
Secondary amenorrhea: This is when you’ve been getting regular periods, but you stop getting your period for at least three months or you stop your menses for six months when they were previously irregular. Causes can include pregnancy, stress, and illness.
Having regular periods is an important sign of overall health. Missing a period – when not caused by pregnancy, breastfeeding, or menopause – is generally a sign of another health problem. Some examples include anorexia nervosa, hyperthyroidism, and excessive exercise, which affects the menstrual cycle. If you miss your period, talk to your healthcare provider about possible causes, including pregnancy. A complete medical history and blood tests will be the first steps your healthcare professional takes to identify the cause of your amenorrhea and develop a treatment plan.
Hypomenorrhea, also known as short and scanty periods, is extremely light menstrual blood flow. In some women, it may be normal to have less bleeding during menstrual periods. Less blood flow may be genetic and, if enquiries are made, it may be found that woman’s mother and/or sister also have decreased blood flow during their periods. Pregnancy can normally occur with this type of decreased flow during the period. The incidence of infertility is the same as in women with normal blood flow.
Hypomenorrhea can occur normally at the extremes of the reproductive life – just after puberty and just before menopause. This is because ovulation is irregular at this time, and the endometrial lining fails to develop normally. But normal problems at other times can also cause scanty blood flow. Ovulation due to a low thyroid hormone level, high prolactin level, high insulin level, high androgen level, and problems with other hormones can also cause scanty periods.
Premenstrual Syndrome (PMS)
Premenstrual syndrome, or PMS, refers to the physical and emotional symptoms that many women experience in the lead-up to menstruation. Although the cause of PMS isn’t clear, you can manage it with medication and other strategies. Additionally, symptoms ease during the woman’s period and there is usually at least one symptom-free week before the symptoms return. PMS is a complex condition that includes physical and emotional symptoms. Research shows that:
women with PMS are hypersensitive to their own normal cyclic hormones (progesterone and oestrogen) during their menstrual cycle
symptoms do not occur during pregnancy or after menopause
PMS differs from one woman to the next, spanning physical and mood symptoms. They can include:
digestive upsets, including constipation and diarrhoea
breast tenderness or swelling
joint or muscle pain
poor sleep or sleepiness
headache and migraine
hot flushes or sweats
increased sensitivity to sounds, light, and touch
Premenstrual Dysphoric Disorder (PDD)
Premenstrual dysphoric disorder (PMDD) is a severe, sometimes disabling extension of premenstrual syndrome (PMS). Although PMS and PMDD both have physical and emotional symptoms, PMDD causes extreme mood shifts that can disrupt daily life and damage relationships.
In both PMDD and PMS, symptoms usually begin seven to 10 days before your period starts and continue for the first few days of your period. Both PMDD and PMS may cause bloating, breast tenderness, fatigue, and changes in sleep and eating habits. In PMDD, however, at least one of these emotional and behavioural symptoms stands out:
The cause of PMDD isn’t clear. Underlying depression and anxiety are common in both PMS and PMDD, so it’s possible that the hormonal changes that trigger a menstrual period can worsen the symptoms of mood disorders.
Uterine fibroids are benign (not cancerous) growths that develop from the muscle tissue of the uterus. They are also called leiomyomas or myomas. The size, shape, and location of fibroids can vary greatly. They may be inside the uterus, on its outer surface or within its wall, or attached to it by a stem-like structure. A woman may have only one fibroid or many of varying sizes. A fibroid may remain very small for a long time and suddenly grow rapidly, or grow slowly over a number of years. Fibroids may have the following symptoms:
Constipation, rectal pain, or difficult bowel movements
Enlarged uterus and abdomen
Fibroids also may cause no symptoms at all, and may be found during a routine pelvic exam or tests for other problems.
Polycystic Ovarian Syndrome (PCOS)
Polycystic ovary syndrome (or polycystic ovarian syndrome – PCOS) is a complex hormonal condition. ‘Polycystic’ literally translates as many cysts. This refers to the many partially formed follicles on the ovaries, which each contain an egg. These rarely grow to maturity or produce eggs that can be fertilised. Women with PCOS commonly have high levels of insulin that don’t work effectively or male hormones known as ‘androgens’, or both. The cause is not fully understood. However, family history and genetics, hormones, and lifestyle play a role.
Insulin-resistance is present in up to four out of five women with PCOS. Women who have a mother, aunt, or sister with PCOS are 50% more likely to develop PCOS. The condition is also more common in women of Asian, Aboriginal and Torres Strait Islander, and African backgrounds. PCOS is relatively common, especially in infertile women. To be diagnosed with PCOS, women need to have two out of three of the following:
irregular or absent periods
acne, excess facial or body hair growth, scalp hair loss, or high levels of androgens (testosterone and similar hormones) in the blood
polycystic ovaries (many small cysts on the ovaries) visible on an ultrasound
Women who have PCOS may experience the following symptoms, but you don’t have to have all of these to have PCOS:
irregular menstrual cycles – periods may be less or more frequent due to less frequent ovulation (release of an egg)
amenorrhoea (no periods) – some women with PCOS do not menstruate, in some cases for many years
excessive facial or body hair growth (or both)
scalp hair loss
reduced fertility (difficulty in becoming pregnant) – related to less frequent or absent ovulation
mood changes, including anxiety and depression
Treating Menstrual Disorders
Treatments for menstrual disorders range from over-the-counter medications to surgery, with a variety of options in between. Your treatment options will depend on your diagnosis, its severity, which treatment you prefer, your health history, and your healthcare professional’s recommendation.
3 Lifestyle Tips to Manage Period Pain
1. Don’t put up with painful periods. If your menstrual periods cause mild to moderate discomfort, relief may be as close as your medicine cabinet. Acetaminophen (Tylenol) often relieves mild menstrual pain. Ibuprofen, naproxen, and mefenamic acid (brands such as Motrin IB, Advil, Bayer Select Pain Relief Formula, and Midol IB) can relieve moderate to more severe pain. These medications work best when symptoms first begin. If menstrual pain lasts several days, your doctor may prescribe another type of pain reliever. Discuss your symptoms and treatment options with your healthcare professional.
2. Relax yourself to ease painful menstruation. Next time you get painful menstrual cramps, lie down with a heating pad on your abdomen. Then, use your fingertips to lightly massage your belly in a circular motion. Drinking warm beverages that aren’t caffeinated, taking a warm shower, performing waist-bending exercises, and walking can help.
3. Oral contraceptives or contraceptive patches often alleviate menstrual pain. If you have menstrual pain, your doctor may offer to put you on an oral contraceptive as a means of treating your discomfort. Unless you wish to stay on the pill for contraception, you can discontinue taking it after six to 12 months. Many women report continued relief from menstrual pain even after they stop taking oral contraceptives.
Discover more about your body by following OBGYNDr. Amna Raees Khan on Instagram.