Obesity and Fertility

Transcription

1 Obesity and Fertility 1

2 This brochure is developed in collaboration with nutritionist Celine Bjercke. Also a big thanks to nurse Ellen Eriksen at Fertilitetsavdelingen Sør and nurse Anne-Mette Monge Hallan at Fertilitetssenteret. 2

3 TABLE OF CONTENS WHY DOES OBESITY REDUCE THE POSSIBILITY OF BECOMING PREGNANT? 4 HORMONES 4 OVULATION 4 OBESE WOMEN AND HORMONE BALANCE 5 COMPLICATIONS DURING PREGNANCY 6 LIFESTYLE CHANGES 7 NUTRITION 7 PHYSICAL ACTIVITY 8 HOW TO CHANGE YOUR LIFESTYLE 9 HOW TO GET STARTED 9 DIETARY ADVICE 10 UNDERSTANDING HEALTHY AND CORRECT PORTION SIZES IS CRITICAL TO LONG TERM WEIGHT MANAGEMENT. 14 SUGGESTION ON HOW TO EAT THROUGHOUT THE DAY. CHOOSE ONE OF THE OPTIONS WITHIN EACH CATEGORY. 15 TIPS FROM THE DIETICIAN 16 PHYSICAL ACTIVITY 17 CREATE AN ACTIVE LIFESTYLE 17 3

4 Why does obesity reduce the possibility of becoming pregnant? Hormones The word hormone is Greek and means to initiate. Hormones are chemical messengers that regulate processes in our body. If there is an imbalance in one of the hormones this will affect the others. To maintain a good hormone balance it is important to provide the body with the right amounts of nutrients and to stay physically active. Ovulation Our adipose tissue can be considered a hormone-producing organ. Hormones produced by the adipose tissue have an important influence on the hormones that regulate the menstrual cycle, natural development of eggs, and ovulation. Being either overweight or underweight can cause ovulation problems. It is welldocumented that obesity in both men and women reduces the chance of getting pregnant. However, it is shown that a weight loss of 5-10% of a person s total weight may be enough to get ovulation started. Some women have to undergo a hormone treatment to achieve pregnancy. Being overweight inhibits the action of this treatment. 4

5 Obese women and hormone balance Insulin: Is a vital hormone with many functions in the body. Insulin s main role is to regulate the blood sugar. Androgens: Generic term for male sex hormones. Obesity may cause hormone interferences such as high insulin levels in the blood. This in turn can lead to more production of androgens from the adrenals and ovaries. Increased levels of androgen in the blood will inhibit ovulation. This is part of the reason why obese women have irregular periods, or miss them altogether. A weight reduction can help to normalize the levels of insulin, which again will lower the androgens. This might lead to spontaneous ovulation and more regular menstrual cycles. Spontaneous abortion Obese women are more likely to have a miscarriage. This applies particularly to early spontaneous abortions. The reason for this is unknown, but a weight loss of 10% has been shown to normalize the risk of spontaneous abortion. Obese women are more likely to have a miscarriage 5

6 Complications during pregnancy Obesity increases the risk of complications during pregnancy. Examples of this are: High blood pressure Blood clots Preeclampsia Gestational diabetes Premature birth Birth complications Increased risk of infections Birth Being overweight interferes with a woman s ability to give birth vaginally. Overweight women have more complications during birth and often end up having a cesarean. Injury to the mother and child, and sudden fetal death may occur. Obesity increases the risk of complications during pregnancy 6

7 Lifestyle changes Making a change in lifestyle requires effort especially in the beginning. The important thing is to establish good habits over time. This is where the word priority becomes important. You have to make room for the things you want. Instead of starting with everything at once, make small changes to start with. Some changes will take place by themselves, while you will need to work harder for others. Why nutrition and physical activity is so important Health is the foundation of well-being and self-expression in everyday life. We are all personally responsible for our health. How we choose to live will determine our health later in life. Nutrition It is important to have a healthy and balanced diet in order for the body to function optimally. Good nutrition means getting the right amounts of nutrients in the right combinations. Energizing nutrients as carbohydrates, fats and proteins are important for supplying the energy we need to survive and function. Fats and proteins additionally act as the body s building blocks. Vitamins and minerals do not provide energy, but are vital for numerous processes in our body. Among others, they are crucial for the regulation of the body s metabolism. In addition, they are important for blood circulation, the function of our nervous system, and in the development and maintenance of muscles, bones, skin, and mucous membranes. To meet your body s regular nutritional needs, eat varied and healthy foods. If we eat more than we need, the excess of energy is stored as adipose tissue. 7

8 Physical activity Our body is designed for movement. Physically active people live longer and have better health than those who are not active. All functions of the body work better when the body is regularly active. These include appetite regulation, digestion of food, and sleep. Physical activity is any movement with your body resulting in increased energy consumption. Our body is designed for movement 8

9 How to change your lifestyle It s often easy to think I m going to lose weight with this diet, and then I m going to make a lifestyle change. This is probably the main reason why 90-95% of those who reduce their weight gain the weight back again within 1-5 years. To succeed, you need to make the decision, and you need to plan. How to get started A common mistake is to set your goals too high or make too many changes at once. To change a habit is actually a bit painful. It is important to set up weightloss goals. A good start is to ask yourself some simple but important questions. Write down your answers so you can go back and get motivation on the days that are harder than others. Take your time and be as honest as possible in terms of what you want and what is realistic to achieve for you. 1. What kind of good and healthy habits do I have? 2. What new habits do I want? 3. How is my relationship with food? Do I eat because of hunger, sugar cravings, emotional eating, or rewarding myself with food? 4. What do I want to change in my daily life? 5. Why do I want to change this? 6. What is going to happen when I change this? Make a priority list of what you want to change with a start time. 9

10 Dietary advice To avoid sugar cravings and large drops in your blood sugar, you should eat meals at regular intervals: breakfast, lunch, supper, and dinner, as well as 1-2 snacks. Eat every 3-4 hours, 4-6 meals per day. This will stable your blood sugar, improve your concentration, give you more energy and improve your performance. Eat at least 5 servings of vegetables, fruits and berries every day Explore your grocery store. Try out new fruits and vegetables. Choose different colors and experiment with the groceries. - One serving equals 100g. This may be a small bowl of salad, a carrot or a medium-sized apple. - You can use fresh, frozen or heat-treated vegetables, fruits and berries. Three of the five a day should be vegetables. - Pulses such as beans, lentils, seeds, spices and herbs are not included in the five a day. - Potatoes are not included in the five a day but belong in a varied diet. The potato contains more dietary fiber, vitamins and minerals than ordinary rice and pasta. Choose baked, boiled or mashed potatoes rather than fried or creamed potatoes. 10

11 Eat wholegrain products - Choose cereals with high levels of whole grains and small amounts of sugar and salt. - The coarse grain products should all together provide grams of whole-grains per day. Examples of how this amount can be covered per day: - Four slices of whole-grain bread. - A serving of cereal and two slices of whole-grain bread. - A portion of oatmeal and a portion of brown rice or whole-grain pasta. Eat at least two or more fish meals a week - This corresponds to grams of pure fish per week. - At least 200 grams should be oily fish like salmon, trout, mackerel or herring. Choose lean meat and limit the amount of processed and red meat. It is wise to think about what kind of meat you re choosing, and how much and how often you are eating it. Pure ingredients are better than processed. - Choose white meat, clean meat, and meat products with little salt. - Limit the amount of processed meat that is smoked, salted, or preserved with nitrate or nitrite. Examples include bacon and sausage. - Limit the amount of red meat and processed products of red meat to 500 grams per week. This corresponds to 2-3 dinners. Examples of red meat are pork, beef, mutton, and goat. Milk and cheese. Here it is advisable to limit the use of dairy products high in saturated fat and replace them with leaner products. Examples of products high in saturated are cream and fatty cheese. Choose dairy products with little or no added sugar and salt. It is important to ensure a good fatty acid composition of the diet. 11

12 We have two main types of fat: saturated and unsaturated fatty acids. Saturated fatty acids are mainly found in processed meat, dairy products, cakes, and chocolate. Unsaturated fatty acids may be monounsaturated or polyunsaturated. These fatty acids are found in oily fish, avocadoes, nuts, and vegetable oils like olive oil and canola oil. A high intake of saturated fat is associated with increased risk of cardiovascular disease. So choose your fat sources wisely. Choose foods with little salt, and limit the use of salt in your cooking. Do you want more flavor in the food you make? Use spices and herbs. Processed foods contribute to an average of % of salt intake. Therefore, choose foods low in salt when choosing prepared meals. 12

13 Avoid foods and drinks with lots of sugar on a daily basis. Soft drinks, juices, cakes, and sweets are the biggest sources of added sugar in our diet. Our body is able to store 500 grams of sugar as glycogen in our body. When the storage is full, the sugar is stored as fat. Choose water when thirsty. Water is essential to maintain the body s normal functions. Plain water provides the liquid needed without contributing unnecessary calories. 13

14 Understanding healthy and correct portion sizes is critical to long term weight management. The plate model is a tool to balance a meal. To lose weight the plate should be divided as follow: 1. Divide your plate in two. 2. Fill one-half with vegetables and fruits. 3. Take the other half and divide it in two again. Fill one part with carbohydrates like pasta/ rice/ potatoes, and fill the other half with protein such as fish/ meat/ eggs/ legumes. 14

15 Suggestions on how to eat throughout the day. Choose one of the options within each category. Breakfast - Oatmeal with cinnamon and berries - Omelet made of 2 eggs and vegetables - 2 slices of whole-grain bread with toppings - Cereal with yoghurt or milk, ½ a banana and berries - Breakfast smoothie Lunch - Lettuce in all colors of the rainbow with chicken, shrimp or beans - Dinner leftovers - Chees and ham muffins - 2 slices of whole-grain bread with toppings such as fish, eggs, vegetables and a piece of fruit - A whole-grain wrap filled with chicken and vegetables Snack - A piece of fruit and a handful of unsalted nuts or a tablespoon of nut butter without added sugar as dip - ½ an avocado topped with shrimp - Vegetables and dip - 1 dl natural yoghurt, 2 tablespoons cereal and some berries - Homemade nutrition bar Dinner - Chicken Thai wok and brown rice - Baked cod with mashed sweet potatoes and asparagus - Minced meat sauce with red lentils - Salmon pasta with herb sauce - Carrot and chili soup Evening snack - Tomato salad with mozzarella and ham - Crispbread with topping such as cheese, ham and vegetables - Cottage cheese with 10 crunched almonds and berries - Omelet made of 2 eggs and vegetables 15

16 Tips from the dietician - Plan your meals week by week - Write a shopping list before you go to the store - Do not go to the store when you are hungry. Then it is easy to fall into temptations and select more unhealthy food items - Calculate the amount of ingredients you are going to use in your cooking - Make your meals pleasant - Eat regularly, every 3-4 hours - Do not skip meals, as it often leads to overeating at the next meal - Do not drink your calories - Be sure to get enough water - Stay focused on what is going well and give yourself praise - Accept that there will be tough times - Do not give up! After a difficult period, it will be easier again Continuity is the key to success! - Some exercise is better than nothing - Get enough sleep 16

17 Physical activity It is never too late to start exercising. Regardless of age and starting point, anyone who starts exercising will notice a change for the better. Good physical health is beneficial in terms of blood pressure, insulin sensitivity, and obesity. A combination of cardio and strength training will provide the best health benefits. The biggest mistake many make is being too ambitious when they start exercising. If you are not used to exercising you should start easy and increase activity as your physical health improves. Find an activity you enjoy so you can hold on to it. The most effective training is the training you actually do. Create an active lifestyle A lot of people avoid physical activity because they don t like it, think they have to be a member at a gym, have little motivation to exercise alone, or think it s impractical. By finding a form of exercise you enjoy and letting physical activity become a natural part of life, it will soon become a habit. 17

18 Start out easy. Set specific and attainable goals. When the target is reached, increase your efforts. - Go for a walk around the block where you live after dinner - Instead of using your car to go to work, ride your bicycle - Get off the bus or the subway one stop before you planned - Take the stairs instead of the elevator Make exercise fun and convenient. - Choose activities you enjoy. Tennis or dancing might be more fun than walking on a treadmill - Work out with a friend or a personal trainer - Chose a time to work out that fits into your calendar so it will get done Stay motivated. - Vary your routines. Go for a walk in the woods one day and swimming the next - Challenge your strength or endurance once a week and then do more moderate workouts on other days - Make notes so you can see your progress - Pat yourself on the shoulder often - Reward your progress 18