Diets & Exercise Tips to Regain Your Pre-Pregnancy Body Shape

WORDS DR VICKY KOH

DR VICKY KOH
Medical Director
Clinic RX
WELL, READ THIS FIRST

Every woman’s body is unique. Therefore, the question of the ‘right option’ or ‘best option’ is something that each and every woman has to figure out on her own.

For example, mothers that breastfeed often experience rapid weight loss and may benefit from an increased intake of certain nutrients or supplements. Women that gave birth via caesarean section may need a longer time to recover. Existing health issues and lifestyle variables also need to be considered.

If you are interested to find out more about the topics discussed below, you should discuss the matter further with your doctor.

BREASTFEEDING CONSIDERATIONS

Postpartum weight loss averages about 4.5 to 5.5 kg in the first 6 weeks. Women often return to their pre-pregnancy weight within a year, though this time frame varies depending on how much weight was gained during their pregnancy.

Breastfeeding aids in weight loss since it consumes extra calories, resulting in a natural weight loss for many women.

Breastfeeding women should pay special attention to their diets at this time.

While experiencing weight loss after giving birth may seem like a good idea, doing so too quickly will actually hinder healing!

POST-PREGNANCY DIETARY RECOMMENDATIONS

Dietary recommendations should include a variety of fresh produce, whole grains, lean proteins, and healthy fats.

Breastfeeding mothers, in particular, should drink a lot of water (6-10 glasses daily). Try to stay away from sodas and other sugary drinks.

Meanwhile, for moms that had a C-section, they should focus on eating foods that are high in protein. Avoid junk foods and take vitamin supplements, especially if they are nursing.

Vitamin and mineral supplements are crucial for moms during and after pregnancy.

This is because nutrients such as calcium, iron, vitamin D, folic acid, zinc, and more are normally redirected from the mother’s bloodstream to the developing infant.

Furthermore, the delivery process as well as breastfeeding depletes the body of essential vitamins.

Hence, postnatal supplements such as calcium, vitamin D, B vitamins, docosahexaenoic acid (DHA), magnesium, selenium, iodine, and choline may be helpful in replenishing nutrients that were used up during pregnancy and after childbirth.

EXERCISE RECOMMENDATIONS

Regular exercise after childbirth will help strengthen and tone your muscles while increasing your energy levels and making you feel less weary.

It also aids in the loss of excess weight.

During the first 6 weeks, the uterus returns to its pre-pregnancy size, and some women may feel uterine cramping and discharge.

However, mothers are recommended to gradually resume their exercise habits, starting with less strenuous activities during the first few weeks after giving birth.

A few days after delivery, you can start doing gentle abdominal and pelvic floor exercises if they don’t cause you any pain.

Try to proceed at your own pace—you can gradually increase the duration and tempo of your workout of over time.

Swimming, cycling, yoga, pilates, mild weight training, and low-impact aerobics are all good alternatives after the first few weeks.

5 Ways to Eat Healthily and Merrily During Deepavali

WORDS GURSHARON KAUR GILL

GURSHARON KAUR GILL
Dietitian

With Deepavali being around the corner, the thought of delicious, mouth watering dishes comes to mind for most Malaysians.

Be it the sweet delicacies or the main dishes, festive food is known to be a crowd favourite. It is during festive seasons, that most people let go of their healthy eating habits and indulge in more than their usual food portion. Because, who doesn’t love their mutton curry, chicken varuval or pineapple tarts?

However, the brunt of all the overindulging comes about after the festive season. You might start seeing some extra pounds in your weight and perhaps even spikes in your blood sugar level from all that over indulging. So, why not make your festive season this time a little healthier by following some of my simple tips below.

TIP 1
PREPARE YOUR OWN DISHES & SWEETS

This allows you to modify the recipe to make it a healthier version, such as by reducing the amount of ghee or oil used in the original recipe.

Alternatively, you may also switch from ghee, which contains high amount of saturated fats, to vegetable oil, which contains unsaturated fats and is hence more friendly for your heart health.

You can also reduce the amount of sugar or condensed milk by half from the original recipe for the sweet items. This method helps to reduce the overall calorie of the food items.

TIP 2
PRACTICE PORTION CONTROL

While it can be hard to resist the mouth watering festive food, it is still important to practice portion control.

When it comes to your favourite festive food like jalebi, kesari, pineapple tarts or muruku, practice sharing these food items with family or friends.

You can also practice portion control by limiting to only 1-2 pieces of these food items onto your plate, so that you avoid over indulging, more so if you have multiple houses to visit!

Another trick is to avoid eating cookies straight out of the cookie jars, as this usually causes one to lose track of how much they have eaten.

TIP 3
KEEP AWAY FROM SUGARY DRINKS

Sugary drinks like cordials or packet drinks are commonly served at open houses. However, these drinks are just loaded with sugar without providing your body with any nutrients.

Hence, it is advisable to limit your intake of sugar sweetened beverages to no more than 1 to 2 servings per day.

It is very easy to over consume these sugary drinks as you go about visiting from one house to the other or even while catching up with family and friends. Hence, for those hosting open houses this year, some healthier options to consider would be lower-calorie drinks. Great examples that are also simple to prepare are:

  • Ginger lemonade, with half the sugar from the original recipe
  • Infused water; you can always replace plain water with sparkling water for that extra fizziness in the drink

And for those visiting, if there is no other option of lower-calorie drinks, opt for plain water!

TIP 4
EAT MINDFULLY

Mindful eating helps you to listen to your body for hunger and satiety cues. This is important as it prevents you from mindless eating that adds up to your daily calorie intake.

Over-indulging is common, especially if you are busy catching up with family and friends, and unknowingly end up eating more than you need to. Hence, check in with yourself to identify your hunger and satiety cues is helpful.

Always remember to stop eating before you feel full, as your brain takes 20-30 minutes to register the feeling of fullness.

Tip 5
APPLY THE MALAYSIAN HEALTHY PLATE PRINCIPLES
The Malaysian Healthy Eating Plate. Click on the image to view a larger version.

It is always back to basics when it comes to eating healthily during festive season. The Malaysian Healthy Plate concept encourages the suku-suku-separuh (quarter-quarter-half) method, which helps to ensure a balanced meal with less sugar, salt and fat intake.

This concept simply means filling:

  • ¼ of your plate with grains (preferably whole grains)
  • ¼ of your plate with low fat protein sources (chicken, fish, mutton, eggs, prawns)
  • ½ of your plate with vegetables
HOW YOU CAN PRACTICE THE HEALTHY PLATE CONCEPT DURING DEEPAVALI 
EXAMPLE 1
  • Grains: Idli (2 small pieces)
  • Protein sources: Chicken varuval (1 palm-sized lean chicken)
  • Vegetables: Stir-fried cabbage with turmeric (2 handfuls of veggies)
EXAMPLE 2
  • Grains: Thosai (1 piece)
  • Protein sources: Mutton Curry (4 matchbox-sized pieces of lean mutton)
  • Vegetables: Stir-fried bhindi masala (2 handfuls of veggies)
EXAMPLE 3
  • Grains: Jeera rice (2 to 3 flat rice scoops)
  • Protein sources: Chicken peratal (1 palm-sized lean chicken)
  • Vegetables: Stir-fried bittergourd with turmeric (2 handfuls of veggies)

The bottom line is, you can definitely enjoy the festive food that usually comes about only once a year. However, the key is to practice moderation when consuming them. That way, you get to enjoy the good food and yet not have to deal with untoward health problems after the festive season is over!

Yikes! It’s cellulite!

Yikes! It’s cellulite!

May 1, 2022   Return

Zits and now, cellulite? That’s preposterous! Yes, cellulite is the slight bulge you see on your thighs, hips, buttocks and abdomen. Some called it the “orange-peel”; it commonly affects adolescent and adult women. And, it is downright unsightly! I mean, how are you going to boast of your slim body if cellulite is in sight?

What is cellulite?

Cellulite is not harmful.  It is simply unattractive dimpled-fat-lump that most women wish to be rid of. Cellulite is commonly found in body parts with fat reserves such as thighs, hips, and buttocks. What happens is that the tissues connecting the fats to the muscles change their positioning between layers of various tissues. Called septa, the connective tissues may stretch, break down or pull tight. Under this condition, the fat bulges out near to the skin surface and bam, cellulite! It can happen to anyone regardless of age, gender, and body size.

Here are the 3 grades of cellulite.

  • Grade 1: No visible cellulite observed, but a microscopic cell examination can identify the changes.
  • Grade 2: No visible cellulite observed. But, an “orange peel” texture is observed when the skin is pinched.
  • Grade 3:  Cellulite is visible with rough skin texture along with Grade 2 signs. But, it may disappear when lying down.

What causes it?

There are some theories that can perhaps explain its occurrence:

  • Hormones: Hormones such as oestrogen and prolactin are believed to play a role in cellulite production. Low levels of oestrogen, for instance, are associated with cellulite development.
  • Genes: Certain genes can contribute to cellulite development. These genes affect characteristics associated to cellulite production such as gender, race, slow metabolism, and fat distribution.
  • Hereditary: Your risk of cellulite is increased if your mother or grandmother has them too.
  • Diet: People who consume too much fat, carbohydrates, high-sugar products, salt and too little fibre have higher risk of developing cellulite., Dehydration seems to play a role too.
  • Lifestyle: Cellulite is more likely to happen to those who are inactive, smoke and sit or stand in one position for long periods.
  • Age:  Yes, age can be a factor. As a woman ages, her body produces less oestrogen and this can lead to of cellulite formation. Plus, the skin loses its elasticity overtime.

What can you do?

Lose some kilos:

  •  Regularly perform exercises that involve muscle strengthening in the legs, thighs, buttocks and abdomen. 
  • The firming and toning of the muscles will tighten the skin over time; hence creating the illusion that cellulite is not present.
  • Practise strength training moves such as lunges

A healthy diet:  

  • Eat a well-balanced diet –especially plant-based foods–to improve your unsightly “orange peel”.
  • Eat fruits and vegetables which contain more than 90% water such as cucumbers, radishes, tomatoes and bell peppers
  • Consume anti-oxidant rich foods such as berries and red kidney beans.
  • Reduce intake of refined, processed and artificial foods that contain sweeteners, additives and chemicals.
  • Cut down on dairy, high-fat products and sugary products.
  • Stay hydrated

Surgical and lasering treatment: 

If you’re looking to remove cellulite, consult a dermatologist. Here are some options you can take to remove cellulite.

  • Laser and radio-frequency treatment:
    • Stimulates collagen production.
    • Alters the septa so that they do not cause dimples and hence, no more cellulite.
    • May require 1 or 2 maintenance treatments per year to remove cellulite.
  • Laser-assisted liposuction: 
    • Destroys fat cells and tightens the skin
    • May take up to 6 months for the skin to tighten around the treated area

Should I use…?

Take caution if you plan to use alternatives such as cellulite creams as they may not be effective. Some common ones are:

Cellulite creams

There are no proven studies to prove their efficacy. They usually contain a mixture of ingredients such as vitamins, minerals, herbal extracts and antioxidants that are said to improve cellulite. When used, it can cause skin rashes or allergic reactions in some people.

Mesotherapy

This involves injection of substances such as enzymes, vitamins, and amino acids into the tissues below the skin. It may bring slight improvement to cellulite. But it can also cause infection or swelling.

Massage and spa treatments

This form of treatment offers temporary effects and do not remove cellulite.

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References:

Harlow, C.R., et al. (2007). Oestrogen formation and connective tissue growth factor expression in rat granulose cells. Journal of Endocrinology. 192(1), 41-52

Health. Available from www.health.com

Healthline. Available from www.healthline.com

Mayo Clinic. Available from www.mayoclinic.org

Medical News Today. Available from www.medicalnewstoday.com

MedicineNet. Available from www.medicinenet.com

MedlinePlus. Available from www.nlm.nih.gov/medlineplus

WebMD. Available from www.webmd.com

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How to Lose Weight (Without Gaining It Back)

How to Lose Weight (Without Gaining It Back)

May 1, 2022   Return

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E_Prof Winnie Chee

Prof Dr Winnie Chee   Dietitian & Professor, Division of Nutrition & Dietetics, International Medical University

Madam G is a busy 40-something career woman, wife and mother. Over the past 3 years, she gained 30kg and became obese.  When the doctor informed Madam G that she might not live to see her children get married if she didn’t do something about her weight, she embarked on a crash diet – replacing her daily meals with protein shakes.

To her delight, she lost 35kg in 1 month. This new weight lasted only 6 months, unfortunately. She couldn’t keep up her liquid diet any longer, went back to her old eating habits, and her weight ballooned again until she became 20kg overweight.

The truth is, there is no secret or short cut to obtaining and maintaining a healthy weight. It is all about balancing the intake of food with the amount of physical activities done to burn off the excess calories; all done in a sensible and sustainable way.

Aim for 5- 10% in 6 months

Madam G made the mistake of thinking she needed to lose all of her excess weight to be healthy.

The scientific truth is that no matter whatever your weight loss goal may be, a modest weight loss of 5-10% of your initial body weight is likely to produce health benefits.

For example, if you are 80 kg, you need to lose 4 kg to see improvements in blood pressure, blood cholesterol level, and blood sugar level.

Numerous clinical studies have shown that when you lose as little as 5- 7% of your body weight, there are remarkable improvements to your body’s ability to process blood sugars, reducing your risk of diabetes by 50%! You may still be overweight or obese, but you will learn new habits that can help you live a healthier lifestyle. These habits may help you maintain your weight loss over time.

The 5-10% weight loss should be achieved gradually. Drastic weight loss methods don’t give the individual the chance to learn how to cultivate healthy eating habits which are sustainable throughout life.  Scientific studies have also shown that weight loss goals usually take 6 months to achieve.

Lose it good

Scientific studies show that only 20% of individuals are able to lose weight and keep it off for longer than a year. But never let that discourage you. The dilemma of weight loss and maintenance has spurred researchers to observe the behaviour of 3000 individuals in the United States from the National Weight Control Registry (NWCR). They had successfully lost weight mainly through diet and exercise and maintained a healthy weight at 5 and 10 years later!  Here’s how and why:

Consistently choose foods with lower calorie and lower fat.

Body weight is very much dependent on the amount of energy we eat and the amount of energy we expand. Hence, the participants in the study ate around 1,800 kcal a day, about 500-1,000 kcal less than their energy expenditure for Americans. Malaysians who wish to lose weight and ensure they maintain their weight should eat around 1,500-1,800 kcal a day, especially if they lead a mostly sedentary lifestyle. 

Fat is one of the main contributors of calories in food. One gram of oil contributes twice the calories of one gram of sugar or protein.  Hence, when we switch from high-fat foods to lower fat choices, as shown below, we save 100-200 calories or more in a day and this will help maintain a healthy weight.

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Ref : Malaysian Food Composition Table & Singapore Food Composition Table

High fat foods

Low fat alternatives

Calories saved

Type

Approx calories per serving

Type

Approx calories per serving

 

Roti telur

415

Thosei

192

223

Fried mee

495

Soup mee

300

195

Curry mee

531

Asam laksa

432

99

Fried popiah

188

Wet popiah

95

93

Eat breakfast every day of the week.

In the study, 78% of registry members report eating breakfast every day of the week and reported eating cereals and fruits as the most frequent breakfast eaten. Breakfast eaters tend to eat fewer calories, less saturated fat and cholesterol and have better overall nutritional status than breakfast skippers.

One study in 2005 found evidence that people who skip breakfast compensate later in the day with more refined carbohydrates and fats and fewer fruits and vegetables.  But when you eat breakfast, your body feels nourished and satisfied, making you less likely to overeat the rest of the day. Choose healthier options when eating breakfast, preferably incorporate wholegrain choices such as capati, wholemeal bread, brown rice porridge and oats with fruits.

If you never eat breakfast, try starting on the weekend when you have more time, then expand your routine to weekdays. You may be surprised how much easier your morning goes, and how much more healthily you eat throughout the day!

Eat home-cooked foods more often.

Those who are successful in losing and maintaining weight report consuming only 2.5 meals a week in restaurants and less than once a week of their meals in fast food establishments.  

A recent study by John Hopkins University Researchers examined the self-reported food records obtained from more than 9,000 adults, aged 20 and older.  The study showed that the most frequent home cooks consumed around 200 fewer calories daily, and around 16 grams of sugar (4 teaspoons).

Recently with the increase of food costs in restaurants and eateries, Malaysians have been bringing their own lunch from home, perhaps a healthy consequence of GST implementation. Suitable meals to bring from home include wholemeal sandwiches or a balanced meal of rice with vegetables and chicken/ fish (which may be heated leftovers from dinner last night, topped up with vegetables and fruits).

Engage in high levels of physical activity.

Another characteristic observed by researchers of weight maintainers was their engagement in high levels of physical activity. They performed at least 1 hour of moderate-intensity activity, most days of the week and majority (76%) of the participants did brisk walking.  If you have rarely been active, you could begin with at least 30 minutes of exercise 3 times a week and gradually build it to 5 days a week and a longer duration of 60-90 minutes. The table below shows the energy you would expend if you were to perform the various activities for half an hour. 
 

Ref: Harvard Heart Newsletter (2004) http://www.health.harvard.edu/

Activities

Calories expanded in 30 minutes for 55 kg person

Calories expanded in 30 minutes for 70 kg person

Low impact Aerobics

165

205

Stationary bike, moderate pace

210

260

Bowling

90

112

Golf, with cart

105

130

Tai Chi

120

149

Brisk walking

135

167

Dancing, moderate

180

223

Swimming

300

372

Running

375

465

Gardening, weeding

139

172

Food shopping with cart

105

130

 

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Monitor weight once a week.

This frequent monitoring of weight would allow you to catch small weight gains and initiate corrective behaviour changes.

A study conducted on 1,226 adults who were enrolled in a weight gain prevention trial, and 1,800 adults who were enrolled in a weight loss trial showed that higher weighing frequency was associated with greater 24-month weight loss or less weight gain and lower fat intake.

Hence, perhaps one of the best things to do if you wish to have a healthy weight is to invest in a good durable weighing machine at home, weigh yourself once a week before meals and take action early if you see the needle going up before it gets worse!

Be consistent in your eating habits. How many times have we looked at a piece of cheesecake and thought, “I’ll start my diet again tomorrow!”?  Well, being consistent is the final secret to maintaining a healthy weight!

Interestingly, results from the NCWR study indicated that participants who reported a consistent diet across the week were 1.5 times more likely to maintain their weight over the subsequent year compared to participants who dieted more strictly on weekdays.  Individuals who were “flexible” and ate high-calorie foods on holidays had greater weight re-gain than those who were more disciplined and maintained consistent healthy eating habits.

Hence, it is perfectly fine if 9 out of 10 times we choose to have fruit salad instead of cheesecake at the buffet lunch table!

References:

M. N. Ismail, S. S. Chee, H. Nawawi, K. Yusoff, T. O. Lim and W. P. T. James. (2002). Obesity In Malaysia. Obesity reviews 3: 203–208.

J. Graham Thomas, Dale S. Bond, Suzanne Phelan, James O. Hill, Rena R. Wing. (2014). Weight-Loss Maintenance for 10 Years in the National Weight Control Registry. American Journal of Preventive Medicine; 46 (1): 17. DOI: 10.1016/j.amepre.2013.08.019

Farshchi HR, Taylor MA, Macdonald IA. (2005). Deleterious effects of omitting breakfast on insulin sensitivity and fasting lipid profiles in healthy lean women.  Am J Clin Nutr.; 81(2):388-96

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