Tag Archive | Exercise

Building a Strong Foundation for Your Pregnancy

Contemplating pregnancy?  Nutritional and optimal health should be priority number one!  Women contemplating pregnancy must keep in mind that healthy eating habits and healthy lifestyle behaviors should be established before pregnancy to make sure proper nutrient levels for early embryo development and growth.

Eating a balanced diet that includes the proper amount servings of protein, grains, fruit, and vegetables is key. Protein is essential to the very foundation of your baby’s growth. Eating enough protein ensures that your little one, from the very beginning, is getting adequate food stores to support cell growth and blood production.  Regular exercise should also be incorporated in your daily routine to prepare your body for the demands of pregnancy. Habits such as drinking or smoking must be avoided to allow for optimal health and development of the child during pregnancy and after birth.  Good habits should  include taking a daily multivitamin or a daily prenatal vitamin.  Even if you are consuming healthy foods daily, you can miss out on key nutrients.  A daily prenatal vitamin — ideally starting three months before conception — can help fill any gaps.  A quality, fast absorbing prenatal vitamin is necessary for all the basic micronutrients needed during pregnancy.eat-well-teaser

Through the course of pregnancy there is an increased need for nutrients and calories to make sure proper fetal growth. The increased need for vitamins and minerals such as folate, calcium and iron is necessary to prevent birth defects, ensure proper bone formation/retention, and to reduce the risks of preeclampsia or anemia. Folic acid intake increases to a daily amount of 800 mcg, calcium to 1200 mg, and iron to 30 mg. Your Vitamin D levels should be checked with your initial prenatal labs to be sure you levels are not insufficient or deficient.  Fetal needs for vitamin D increase during the latter half of pregnancy, when bone growth and ossification are most prominent. Vitamin D travels to the fetus by passive transfer, and the fetus is entirely dependent on maternal stores. Your body needs vitamin D to maintain proper levels of calcium and phosphorus, which help build your baby’s bones and teeth. A vitamin D deficiency during pregnancy can cause growth retardation and skeletal deformities. It may also have an impact on birth weight.  Therefore, maternal status is a direct reflection of fetal nutritional status.

Researchers believe that a vitamin D deficiency during pregnancy can affect bone development and immune function from birth through adulthood.

Blog by Shelia Kirkbride

Best Exercises for Your Pregnancy

yogamomCongratulations on your pregnancy! Now you can sit back, relax and put your feet up for the next nine months, right? Not so fast! Attitudes and beliefs about prenatal exercise have drastically changed over the past twenty years. No longer is pregnancy viewed as a time to sit, watch TV and each chocolate. These days, moms can actually maintain and improve their fitness levels while pregnant. And exercise provides many numerous benefits such as a boost in your mood and energy levels, helps you sleep better, helps prevent excess weight gain and increases your stamina and muscle strength. You cannot lose!

Regular exercise during your pregnancy can improve not only your heart health and boost your energy, but improve your overall health. Maintaining a healthy body and healthy weight gain can help reduce common pregnancy complaints and discomforts like lower back pain, fatigue and constipation and can even help with shortening your time during labor by strengthening your endurance.

First, consult your health care provider if it is okay to exercise. If you have been participating in a regular exercise regimen and are having a healthy pregnancy, there should not be a problem continuing with your regimen in moderation. You may have to modify your exercise according to your trimester of pregnancy.

If you have not participated in an exercise regimen three times a week before getting pregnant, do not jump into a new, strenuous activity. Start out with a low-intensity activity and gradually move to a higher activity level.

The best type of exercise during pregnancy:
• Increases your heart rate steadily and improves your heart circulation
• keeps you flexible and limber
• manages your weight gain by burning calories
• prepares your muscles for labor and birth
• won’t cause you to push your body too hard

Research shows that healthy pregnant women who exercise during their pregnancy may have less risk of preterm labor and birth and a shorter labor process, are less likely to need pain relief, and recover from childbirth faster.

Regular, moderate exercise not only gives you a healthier pregnancy, it may give your baby a healthier start. Research shows that when pregnant women exercise, their developing babies have a much lower heart rate. Babies of active moms may also have a healthier birth weight. Experts recommend that you exercise for 30 minutes a day, on most days. Most exercises are safe to perform during pregnancy, as long as you exercise with caution and do not overdo it.

Your pregnancy exercise regimen should strengthen and condition your muscles. Always begin by warming up for five minutes and stretching for five minutes. Following your choice of exercise, finish your regimen with five to ten minutes of gradually slower exercise that ends with gentle stretching.

The safest and most productive activities to perform during your pregnancy are brisk walking, swimming, indoor stationary cycling, prenatal yoga and low-impact aerobics (taught by a certified aerobics instructor). These activities carry little risk of injury, benefit your entire body, and can be continued until the birth of your baby. Other activities such as jogging can be done in moderation. You might want to choose exercises or activities that do not require great balance or coordination, especially later in your pregnancy.

Use common sense:
• Avoid exercising that involves lying on your stomach or flat on your back after the first trimester of pregnancy.
• Stay well hydrated and drink plenty of fluids before, during and after you exercise.
• Avoid overheating and humidity, especially during the first trimester when the fetus is undergoing its most important growth and development.
• Stop exercising if you feel fatigued, develop persistent pain or experience any vaginal bleeding; check with your healthcare provider if regular contractions occur more than 30 minutes after exercise (possibly a sign of pre-term labor).
• Avoid heavy weightlifting and any activities that require straining.
• Avoid exposure to extremes of air pressure, as in high altitude exercise (unless you’re accustomed to it) or scuba diving.
• Do not increase the intensity of your workout beyond pre-pregnancy intensity level
• Eat small, frequent meals throughout the day. Sedentary pregnant women need about 3,000 calories per day during the second and third trimesters; if you are physically active, your caloric needs will be higher to make up for the calories burned up during your exercise regimen.

Basic exercise guidelines:
• Wear loose-fitting, comfortable clothes, as well as a good support bra
• Choose shoes that are designed for the type of exercise you choose. Proper shoes are your best protection against injury
• Exercise on a flat, level surface to avoid injury
• Finish eating at least one hour before exercising
• Get up slowly and gradually to prevent dizziness
• Never exercise to the point of exhaustion. If you cannot talk normally while exercising, you are probably over exerting yourself, and you should slow down your activity.

Physical changes during your pregnancy will create extra demands on your body. Keeping in mind the changes listed below, remember you need to listen to your body and adjust your activities or exercise regimen as necessary.
• Your developing baby and other internal changes require more oxygen and energy.
• Hormones (relaxin) produced during pregnancy cause the ligaments that support your joints to stretch, increasing the risk of injury.
• The extra weight and the uneven distribution of your weight alters your center of gravity. The extra weight also puts stress on joints and muscles in the lower back and pelvic area, and makes it easier for you to lose your balance

If you have any medical condition, such as asthma, heart disease, hypertension or diabetes, exercise may not be advisable. Again, consult with your health care provider before beginning any exercise regimen.

Exercise may also be harmful if you have a pregnancy-related condition such as:
• vaginal Bleeding or spotting
• Low placenta (low-lying or placenta previa)
• Threatened or history of recurrent miscarriage
• Previous premature births or history of early labor
• Weak cervix

Talk with your health care provider before beginning any exercise program. Your health care provider can also suggest personal exercise guidelines, based on your medical history.

Stop exercising and consult your healthcare provider if you:
• Feel pain
• Have abdominal, chest, or pelvic pain
• Notice an absence of fetal movement
• Feel faint, dizzy, nauseous, or light-headed
• Feel cold or clammy
• Have vaginal bleeding
• Have a sudden gush of fluid from the vagina or a trickle of fluid that leaks steadily (when your bag of “water” breaks, also called rupture of the amniotic membrane)
• Notice an irregular or rapid heartbeat
• Have sudden swelling in your ankles, hands, face, or experience calf pain
• Have increased shortness of breath
• Have persistent contractions that continue after rest
• Have difficulty walking

Regular exercise will keep you and your baby healthy while staying fit, and enjoying your pregnancy!

Written by: Angel J. Miller, MSN, CNM, certified nurse-midwife, Midwifery Service Director, Washington, D.C. Area and co-author: Nine Months In ~ Nine Months Out.
References
Miller, Angel, Kelly, Stacia, Kirkbride, Shelia, Matthews, Corry. Nine Months In ~ Nine Months Out. Sterling, Va. Ironcutter Media, 2011.
http://www.webmd.com/baby/exercise-during-pregnancy
http://kidshealth.org/parent/index.jsp?tracking=P_Home
http://www.mayoclinic.org/healthy-living/pregnancy-week-by-week/in-depth/pregnancy-and-exercise/art-20046896

Limiting Weight Gain during Pregnancy

How much weight should I gain?
Gaining the right amount of weight during pregnancy by eating a healthy, balanced diet is a good sign that your baby is getting all the nutrients he or she needs and is growing at a healthy rate.

Weight gain should be slow and gradual. In general, you should gain about 2 to 4 pounds during your first three months of pregnancy and 1 pound a week for the remainder of your pregnancy, unless otherwise directed by your healthcare provider.

Your healthcare provider will tell you how much weight you should gain during pregnancy. A woman of average weight and height and/or normal BMI before pregnancy can expect to gain 25 to 35 pounds during pregnancy. You may need to gain more or less weight, depending on what your healthcare provider recommends.

It is not necessary to “eat for two” during pregnancy. It’s true that you need extra calories from nutrient-rich foods to help your baby grow, but you generally need to consume only 200 to 300 more calories than you did before you became pregnant to meet the needs of your growing baby.

Follow the guidelines below if you are gaining weight too quickly during pregnancy.

What if I have gained too much weight?
If you have gained more weight than recommended during the beginning of your pregnancy, DO NOT try to lose weight. It is never safe to lose weight during pregnancy — both you and your baby need the proper nutrients in order to be healthy.

Be sure to eat a variety of foods to get all the nutrients you and your baby need. Follow the guidelines and serving recommendations on The Food Guide Pyramid to avoid further excess weight gain. Think about the foods you eat and avoid those foods that will not give you and your baby the nutrition you both need. Follow the glycemic index,which is simply a measurement of the impact carbohydrates have on your blood sugar levels. Check out http://tinyurl.com/8vqbtv. Make sure you are active and getting adequate time in for exercise.

Keep in mind that you will lose some weight during the first week your baby is born. You’ll be surprised at how quickly you lose the remaining weight by following a balanced diet and exercising.

If you are gaining weight too fast during pregnancy…

When eating out at a fast food restaurant, choose lower fat items such as broiled chicken breast sandwich with tomato and lettuce (no sauce or mayonnaise), side salad with low-fat dressing, plain bagels or a plain baked potato. Avoid fried foods such as french fries, mozzarella sticks or breaded chicken patties.Avoid whole milk products. You need at least 4 servings of milk products every day. However, using skim, 1 or 2 percent milk will greatly reduce the amount of calories and fat you eat. Also choose low-fat or fat-free cheese or yogurt.Limit sweet or sugary drinks. Sweetened drinks such as soda, fruit punch, fruit drinks, iced tea, lemonade or powdered drink mixes provide many calories with little nutrients. Choose water, club soda, or mineral water to avoid extra calories.

Do not add salt to foods when cooking. Salt causes your body to retain water.

Limit sweets and high calorie snacks. Cookies, candies, donuts, cakes, syrup, honey and potato chips provide many calories with little nutrition. Try not to eat these types of foods every day. Instead, try fresh fruit, low-fat yogurt, angel food cake with strawberries, or pretzels as lower calorie snack and dessert choices.Use fats in moderation. Fats include cooking oils, margarine, butter, gravy, sauces, mayonnaise, regular salad dressings, sauces, lard, sour cream and cream cheese. Try the lower fat substitutes that are available for these foods.Prepare meals using low-fat cooking methods. Frying foods in oil or butter will increase the calories and fat of that meal. Baking, broiling or boiling are healthier, lower fat methods of cooking. Read Labels of food you purchase!

Exercise. Moderate exercise, as recommended by your healthcare provider, can help burn excess calories. Walking or swimming is safe, effective exercises for pregnant women. It is perfectly safe for you to walk 30 to 60 minutes every day. Wear comfortable shoes and clothes. Open your front door and walk away from your house for 15 minutes as fast as you can. If you can sing while you walk, you are not walking fast enough.

Be sure to talk to your healthcare provider before starting an exercise program.

DO’S AND DON’TS OF PREGNANCY

What to Strive For During Pregnancy
DO:
Develop a positive attitude. Pregnancy is for most women a happy, healthy time in which their bodies function the way they were designed to do. It is a time of looking forward not only to having an adorable baby, but also to starting an exciting, and challenging phase of life. Even though it can be a little scary because it is a new experience, most fears can be overcome, by thinking of it as a great adventure with a great reward at the end. Maintaining a realistic but optimistic attitude goes a long way in helping you through the pregnancy and birth even when everything does not go exactly as you expect. Please trust your body and your intuition. Trust your healthcare providers so that they can work with you to make your pregnancy, birth and early parenting experiences the best that they can be. Learn all you can about pregnancy, birth, and parenting. Read, take classes and watch DVD’s. Your healthcare providers want to help you become a well-informed consumer so let them know what you need to know during your visits. Ask questions!!

Eat well. Good nutrition is important for a healthy mom and baby. Eat a well-balanced diet with adequate protein, fruits, vegetables, whole grains, and calcium. Most need extra calcium and magnesium supplements for bone health along with Vitamin D3. In addition to a balanced diet women should take a prenatal vitamin throughout the pregnancy. Some women may also need additional iron supplementation or an increase in iron rich foods. Optimal weight gain varies depending on your starting weight. A weight gain of about 15 pounds is recommended for those who are overweight at the beginning of pregnancy. The average weight for height woman should plan to gain 25-35 pounds. Those who are underweight need to gain approximately 28-40 pounds during pregnancy to ensure optimal nutrition for the fetus as well as building their own reserves.
Exercise. Along with eating well, regular exercise is an important part of being healthy. With a normal pregnancy it is safe and helpful to exercise throughout your pregnancy, though some forms of exercise might not be appropriate during late pregnancy (i.e., kickboxing). Check with your healthcare provider especially if beginning an exercise program. You need to pay special attention to hydration, heart rate and body temperature, but, if done appropriately, exercise can help you have an easier pregnancy and labor! If you are able to talk through your activity, that exercise activity is appropriate.
Women who exercise routinely will have:
• less interventions during birth
• fewer Cesarean births
• shorter labors
• less risk for gestational diabetes
• lower rates of depression
General Exercise Guidelines:
• Thirty minutes of moderate exercise almost every day is appropriate for a normal pregnancy. (If you were inactive pre-pregnancy, you will need to start at a much slower level).
• Make sure you balance exercise with periods of rest and relaxation.
• Listen to your body; it is possible to hurt yourself, even with gentle exercise. As your belly grows, your center of gravity changes, joints soften, and positions or exercises that were easy become challenging. Listen to your body if it says “I need a break.” Avoid long periods in the supine position (lying directly on your back).
• Pay special attention to hydration, heart rate and body temperature. If you start to feel overheated, you should slow down and stop.
• No directed abdominal exercises after 20 weeks of pregnancy. As your baby and belly grow, abdominal muscles separate and focused strong abdominal exercise will exacerbate the separation.
Enjoy sex during pregnancy. Enjoyment of sex during pregnancy is a healthy, satisfying part of a couple’s total relationship. Female orgasm during late pregnancy will cause uterine contractions, which are harmless to the baby and will not cause premature labor. (If orgasm did cause labor, induction of labor would be a simple, fun procedure!) Different positions for intercourse will need to be used as the woman’s abdomen enlarges. Any position which is comfortable is safe. Increased or decreased desire in women is normal both during pregnancy and the postpartum period.
Intercourse should be avoided under the following conditions:
• After the membranes (bag of water) have ruptured – there is danger of infection.
• When bleeding or premature labor occurs, or if you have been told that there is a medical reason to avoid sex (such as with Placenta Previa)
• Women who have had repeated miscarriages (more than 2) should avoid intercourse during the time they usually miscarry.
• The only sexual activity reported as dangerous is blowing air into the vagina of a pregnant woman. This can detach the placenta from the uterine wall and/or cause an air embolism. If you have questions about sex, please feel free to discuss them with the nurse-midwives.
Travel if you wish. All types of travel are permitted during a normal low risk pregnancy. In pregnancies after 36 weeks, you should consider the fact that you may end up giving birth in an unfamiliar place with an unfamiliar provider. Try not to travel more than one hour away from your planned facility for your birth. Air travel is permitted as long as the airplane cabin is pressurized. Most airlines require a letter from your provider after 34 weeks gestation. Travel to high altitude locations is also permitted up to approximately 6000 feet. Be sure to drink plenty of water and walk around intermittently during the trip (every 60-90 minutes)
Prepare your birth plan. You may develop a birth plan during your childbirth education class with your partner. Please be realistic and limit to two pages. Decide who you want to be with you and what each person will do to help. Be sure to tell your healthcare provider of any special procedures that you would like or want to avoid. Be sure when you complete your birth plan or “wish list” you discuss it in detail with your healthcare provider(s).
Purchase and properly install an infant car seat. Most if not all states have child seat safety laws. Please obtain an infant car seat by 36 weeks so you may safely transport your newborn to and from home.
Choose a pediatrician or family practice doctor. The following are some sample questions to ask:
• Where is the office located in relation to your home? The ease of travel to the office at any time and especially in an emergency is very important.
• If the doctor is a family practice physician, ask him/her what arrangements he has made in case of an admission to a hospital. Does he/she routinely see newborns?
• Where does the doctor have hospital privileges? What are the special practices, if any, of that hospital’s pediatric unit, i.e., open visiting or rooming-in?
• Does the doctor have staff privileges at the hospital where you might go for the birth of your baby? If not, who will see your baby?
• What is the size of the practice? How long do you have to wait to obtain an appointment? How much time is designated for each appointment?
• Who are the other persons who may be associated with the physician, another physician you might see, and/or a pediatric nurse associate who can answer many of the daily parental concerns? Is there a telephone hour?
• What are the arrangements for covering emergency calls, including nights and weekends?
• What are the various costs for care: office visit, immunization, telephone consultation, emergency visits?
• What are the doctor’s views on infant feeding? (Bottle and breast feeding as well as how to start the intake of solid food.)
• Is the doctor supportive of breastfeeding?
• What is the doctor’s management for newborn jaundice?
• How many times does the physician expect to see the baby for normal health maintenance?
• What are the doctor’s responses to your questions? If invited into the office, take the opportunity to observe doctor-child interaction. Did you feel comfortable talking with the physician?
• Discuss circumcision vs. no circumcision and his/her views on immunizations.
• Ask your friends who they use and what they think of their relationship with their pediatrician or family practice doctor.

Since these are suggested guidelines, you may have some other criteria upon which you are making your decision. You need to feel comfortable with the physician you choose for your baby.
What to Avoid During Pregnancy
DON’T:

• Take any medications (prescription or over-the-counter) without consulting your healthcare provider.
• Consume excessive amounts of caffeine. Recent studies have shown small amounts of caffeine are not harmful.
• Drink alcohol. The current recommendation is that no amount of alcohol is proven safe during pregnancy.
• Smoke. In addition to the risks of tobacco related disease for the mother:
• Babies born to mothers who smoke average 6 ounces less at birth than babies of nonsmoking women (a lot when only considering 7 or 8 lbs.!)
• Nicotine restricts the blood vessels and oxygen circulation of the mother.
• Increased carbon monoxide in the mother reduces oxygen levels in the fetus’ blood.
• Vitamin metabolism is disturbed in both mother and fetus.
• Incidence of low birth weight babies greatly increases for those who smoke one pack or more per day.
• There is a direct correlation that exists between smoking during pregnancy and the increased incidence of premature rupture of membranes, preterm labor, placenta abruption and stillbirth.
• Behavioral effects on infants of smoking mothers, determined by developmental testing, are noted as long as 8 months after birth.
We urge you and/or your partner, if either or both of you smoke, to register in a Smoking Cessation Program in your area. IT is the best thing to do for you, your partner, and your baby.

Water, Water Everywhere-How Much should you Drink?

Your water needs depend on many factors, including your health, how active you are and where you live.
Most individuals seem to know that drinking water is good for them, but maybe don’t know exactly why and have a hard time reaching their intake goals each day. We know all the excuses:

– I don’t like the taste
– I simply forget
– I can’t drink that much
– Who has time for that many bathroom breaks!

Well, we are going to inform you on why you should always have a water bottle nearby, how much you really need to drink and some tips to help you reach that goal.

Why You Should Be Downing That Water

Water is the most important nutrient for your body. From flushing out toxins, transporting nutrients throughout your body, and other vital actions, water necessary for every single system in your body needs water to function.

On average, water makes up 60% of our body weight. Even slight dehydration can prevent your body from carrying out normal bodily functions, draining your energy or even causing a headache.

5 reasons why you should have a glass of cool, refreshing H20:

1. Drop a few pounds: Remember just a moment ago when we said water is necessary for every function in your body. This includes breaking down fat for weight loss. Also, water is calorie free and is often an appetite suppressant. In fact, most people often confuse hunger for thirst.

2. Drink for your health: Drinking the right amount of water improves the health of your heart, and can even lower your risk of a heart attack. Also, increasing your water intake can improve digestive health by aiding in the breakdown of food. And, most of you probably already know that drinking water is one of the best things you can do for healthy skin – giving it a glow from the inside out.

3. Energy: The first all natural energy drink is water! Test it out next time you’re feeling a little sluggish by having a couple glasses of water.

4. Headache prevention: Know those dull headaches that come in the afternoon, especially after sitting at your desk all day? You’d be surprised how many of those headaches are caused by a slight dehydration.

5. Cleansing: Flush out all those unhealthy toxins!

Now that you’re sold on why to drink more water, let’s talk about how much – and how!
For years we’ve been told to follow the “8 by 8” rule – drink eight 8-ounce glasses of water per day, but for some people that just is not enough water. Here’s a new formula to use when calculating how much water you need. Simply divide your weight (in pounds) by two to give you the number of ounces of water you should strive to drink each day. For example, if you weigh 160 lbs., strive to drink 80 ounces of water daily.

Dietary recommendations: The Institute of Medicine advises that men consume roughly 3 liters (about 13 cups) of total beverages a day and women consume 2.2 liters (about 9 cups) of total beverages a day.

If you drink a lot of caffeine, exercise or your job requires a lot of physical activity, you may need to consume even more water to replenish your body.

Whoa, that’s a lot of water!

Need some help reaching your new water intake goal? Try these tips:

1. Get a reusable bottle and figure out how many times you must empty it through out the day to reach your goal.

2. Have a glass of water before (and with) every meal.

3. Keep a pitcher of water in your office, at your desk or in the fridge – this will also help track how much you’ve already had for the day.

4. Add lemon or lime slices, or mint leaves to give your water a light, refreshing taste. (Hint: the mint may need to soak in the water up to 12 hours to give it any flavor.)

5. Set a daily alarm on your cell phone to remind you of your water intake goal.

6. Go slow. If you rarely drink water and just the thought of your recommended intake makes your bladder a little uneasy, take a few days or even a week to work your way up to that magical number.

Even apart from the above approaches, if you drink enough fluid so that you rarely feel thirsty and produce 1.5 liters (6.3 cups) or more of colorless or slightly yellow urine a day, your fluid intake is probably adequate.

Factors that influence water needs
You may need to modify your total fluid intake depending on how active you are, the climate you live in, your health status, and if you’re pregnant or breast-feeding.

Environment. Hot or humid weather can make you sweat and requires additional intake of fluid. Heated indoor air also can cause your skin to lose moisture during wintertime. Altitudes greater than 8,200 feet (2,500 meters) may trigger increased urination and more rapid breathing, which use up more of your fluid reserves, thus increasing your fluid intake needs.

Illnesses or health conditions. Signs of illnesses, such as fever, vomiting and diarrhea, cause your body to lose additional fluids. In these cases you should drink more water and may even need oral rehydration solutions, such as Gatorade or Powerade. On the other hand, some conditions such as heart failure and some types of kidney, liver and adrenal diseases may impair excretion of water and even require that you limit your fluid intake.

Pregnancy or breast-feeding. Women who are expecting or breast-feeding need additional fluids to stay hydrated. Large amounts of fluid are used especially when nursing. The Institute of Medicine recommends that pregnant women drink 2.3 liters (about 10 cups) of fluids daily and women who breast-feed consume 3.1 liters (about 13 cups) of fluids a day

Other Sources of Water
Although it’s a great idea to keep water within reach at all times, you don’t need to rely only on what you drink to satisfy your daily fluid needs. What you eat also provides a significant portion of your fluid needs. On average, food provides about 20 percent of total water intake, while the remaining 80 percent comes from water and beverages of all kinds.
For example, many fruits and vegetables, such as watermelon and tomatoes, are 90 percent to 100 percent water by weight. Beverages such as milk and juice also are composed mostly of water. Even beer, wine and caffeinated beverages — such as coffee, tea or soda — can contribute, but these should not be a major portion of your daily total fluid intake. Water is one of your best bets because it’s calorie-free, inexpensive and readily available.

Staying safely hydratedIt’s generally not a good idea to use thirst alone as a guide for when to drink. By the time you become thirsty, it’s most likely you are already dehydrated. Further, be aware that as you get older your body is less able to sense dehydration and send your brain signals of thirst. Excessive thirst and increased urination can be signs of a more serious medical condition. Talk to your healthcare provider if you experience either.

To ward off dehydration and make sure your body has the fluids it needs, make water your beverage of choice. Nearly every healthy adult can consider the following:
 Drink a glass of water with each meal and between each meal.
 Hydrate before, during and after exercise.
 Substitute sparkling water for alcoholic drinks at social gatherings.
If you drink water from a bottle, thoroughly clean or replace that bottle often.

Though uncommon, it is possible to drink too much water. When your kidneys are unable to excrete the excess water, the electrolyte (mineral) content of the blood is diluted, resulting in low sodium levels in the blood, a condition called hyponatremia. Endurance athletes, such as marathon runners, who drink large amounts of water, are at higher risk of hyponatremia. In general, though, drinking too much water is rare in healthy adults who consume an average American diet.

If you’re concerned about your fluid intake, check with your healthcare provider or a registered dietitian. He or she can help you determine the amount of water that’s best for you.

Posted by Living Well Today on June 17, 2009
Excerpts from Mayoclinic.com/health/water

Four Ways to Boost Your Energy in Pregnancy

Are you exhausted during your pregnancy? Here are four ways to increase your energy levels and stay happier and healthier as your due date approaches.

Do pregnant and energetic seem contradictory? Pregnancy typically conjures up thoughts of fatigue and lethargic episodes—and while nearly every pregnant woman experiences a decrease in energy at some point during pregnancy, there are ways to boost energy levels and keep going strong until you give birth.

Booster #1: Fitness
“The single most common factor my more energetic patients have is that the exercise,” says Dr. Randy Fink, MD, FACOG, and an OB-GYN in private practice in Miami, Florida. “A little time committed to physical activity can make a huge difference. But what sort of exercise gets your energy soaring? Just about anything that gets you on your feet and moving is beneficial.
• Get Moving: With your healthcare provider’s permission, make it a habit to engage in physical activity each day. Take a brief walk outside on your lunch hour or perform some yoga stretches while dinner cooks, suggests Dr. Kathleen Hall, PhD, author of A Life in Balance: Nourishing the Four Roots of True Happiness.

• Make TV Time Productive: Rather than sitting to watch your favorite TV show, use those 30 minutes for exercise. Pedal a stationary bike or take a walk on the treadmill. Low-impact exercise is best, but the overwhelming message is the same: exercise will “reenergize and increase your oxygen, blood, and nourishment to your body,” says Dr. Hall.

• Make Exercise Fun: Getting fit doesn’t limit you to isolated exercises and toning individual muscles. When you were a child, you naturally got exercise by running around on the playground, playing kickball, and riding your bike. Using this childlike approach to exercise can make fitness more fun! Invest in an exercise DVD with music you love or if you have other children, dance with them as you watch one of their favorite Disney musicals! Getting the blood pumping will make you feel good and reinforce a positive outlook on fitness.

Booster #2: Sleep
In our fast-paced society, making time for sleep is essential to feeling alert and ready to take on the day during pregnancy and even after your birth. The key to maintaining energy is getting enough sleep. “Proper rest” means getting at least eight to nine hours of good sleep every night. Nowadays, this may seem like a lot, considering the majority of the country is running on empty. A hundred years ago, the average American slept nine hours at night, which has now been whittled down to six hours.

Booster #3: Healthy Eating

Anything you eat can be considered energy, and you’ll benefit most from foods that provide plenty of nutrient and energy producing substances. Broccoli is a great source of beta carotene with vitamin C to keep you energized. Likewise, blueberries contain protective antioxidants and stimulate the brain. You can boost your body’s healing capabilities by eating foods containing vitamin B6 which helps the body produce serotonin, creating a calming effect. Eat chicken, sweet potatoes, and bananas for a B6 boost!
Along with your food intake, be sure to drink plenty of water. As a society, we walk around chronically dehydrated and we don’t even realize it. Pregnant women, especially, should drink the recommended eight, eight-ounce glasses of water a day (64 ounces) to keep healthy and maintain stamina. But be wary of caffeinated beverages. Be sure to ask your healthcare provider before reaching for that iced mocha.

Booster #4: Peace of Mind
Having a calm and collected mind is vital to staying healthy during pregnancy. A few ways to keep the peace include:
• Meditation: Closing your eyes, clearing the mind, and focusing on a single image or thought for a few minutes a day can reduce blood pressure, boost the immune system, create more energy for the day, says Dr. Hall. If meditation isn’t your thing, try taking deep breaths for a two-minute interval. By slowly and deeply inhaling and exhaling, you calm the body and mind, and restore energy.

• Take time for you: Being pregnant can be stressful at times. Taking time each day for yourself can significantly lower stress and keep your energy levels high. Feeling extra drained? Take a brief nap to restore expended energy. Listen to your favorite band or artist. Indulge in a good book. Whatever your pleasure, set aside time to enjoy it.

• Take time for your loved ones: You and your partner are in this baby journey together; make time for your partner during these busy nine months. Sharing a laugh with the one you love can boost your energy—and your outlook.

Energy during pregnancy doesn’t have to be a rarity. By listening to your body and taking care of yourself, energy can be more readily at your fingertips for use in planning, wondering, and thinking about the new joy in your life.

Osteoporosis Prevention

Osteoporosis is a “silent” disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These broken bones, or fractures, occur typically in the hip, spine, and wrist. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain, and deformity. Women are four times more likely than men to develop this debilitating disease.

Five Steps to Bone Health and Osteoporosis Prevention:
Get your daily recommended amounts of calcium and vitamin D
Many women and young girls consume less than half the amount of calcium recommended to grow and maintain healthy bones. Adults under age 50 need 1,000 mg of calcium daily, and adults age 50 and over need 1,200-1500 mg of calcium daily. If you have difficulty getting enough calcium from the foods you eat, you may take a calcium supplement to make up the difference. Calcium citrate is absorbed when taken with Vitamin D or Magnesium.

Vitamin D – Vitamin D is needed for the body to absorb calcium. Without enough vitamin D, you will be unable to absorb calcium from the foods you eat, and your body will have to take calcium from your bones. Vitamin D comes from two sources: through the skin following direct exposure to sunlight and from your diet. According to the National Osteoporosis Foundation (NOF) recommendations, adults under age 50 need 400-800 IU of vitamin D daily, and adults age 50 and over need 800-1,000 IU of vitamin D daily. There are two types of vitamin D supplements. They are vitamin D3 and vitamin D2. Previous research suggested that vitamin D3 was a better choice than vitamin D2. However, more recent studies show that vitamin D3 and vitamin D2 are equally good for bone health. Vitamin D allows calcium to leave the intestine for absorption, and works in the kidneys to reabsorb the calcium that would otherwise be excreted.

Engage in regular weight-bearing exercise
Exercise is also essential to good bone health. If you exercise regularly in childhood and adolescence, you are more likely to reach your peak bone density than those who are inactive. The best exercise for your bones is weight-bearing exercise such as walking, dancing, jogging, stair-climbing, racquet sports and hiking. If you have been sedentary most of your adult life, be sure to check with your healthcare provider before beginning any exercise program.

Avoid smoking and excessive alcohol
For men, alcoholism is one of the leading risk factors for osteoporosis. In men and women, excess consumption of alcohol reduces bone formation and interferes with the body’s ability to absorb calcium.

Talk to your healthcare provider about bone health
Speaking with your healthcare professional about osteoporosis will help you better understand your own risk for the disease as well as available prevention or treatment options. Listed below are several questions that are intended to help you discuss osteoporosis with your healthcare professional:
• Based on my medical history, lifestyle and family background, am I at risk for osteoporosis?
• How do I know if someone in my family suffered from osteoporosis? (What physical signs or symptoms should I be looking for?)
• Am I currently taking any medication that puts me at higher risk for developing osteoporosis?
• How do I best prevent (or treat) osteoporosis?
• How do I know if my bone density is low?
• How much calcium is right for me? How do I best obtain this calcium?
• Should I engage in exercise? What kind of exercise is best? How often should I exercise?
• How do I know if I have fractured a bone in my spine?
If you have osteoporosis or if your healthcare provider believes you are at high risk for the disease, you may want to ask the following questions:
• What medications are available to help me?
• What are the benefits/side effects of these medications? Will these medications interact with other medications I am already taking for other conditions?
• How do I know that my prevention or treatment program is effective?
• Do any of the medications I am taking for other conditions cause dizziness, light-headedness, disorientation or a loss of balance that could lead to
• When appropriate, have a bone density test and take medication

Osteoporosis testing is performed by measuring bone mass using a dual energy x-ray absorptiometry machine (DXA). DXA is the best method of obtaining an individual’s bone density which is critical to prevention, diagnosis and treatment of osteoporosis. While the use of DXA scans is recognized the World Health Organization, the US Surgeon General and the Centers for Medicare and Medicaid Services, as the gold standard for the testing for osteoporosis, only about one in four Medicare women receive their DEXA scan every two years. Without early diagnosis and treatment, osteoporosis can lead to debilitating fractures, loss of mobility, permanent disability, costly nursing home stays, and even death .A recent study by Kaiser Southern California’s Healthy Bones program found that increased utilization of DXA testing and subsequent treatment resulted in a 37% decrease in hip fracture rates and a $30.8 million savings among its 3.1 million members in one year alone. Patient access to DXA testing is threatened as inadequate reimbursement forces more physicians to stop providing this critical preventative service. Medicare reimbursement has been reduced by 50% since 2006 and more budget cuts are scheduled for 2010. More information regarding this issue can be attained at http://www.nof.org.

Information from the National Osteoporosis Foundation: www. NOF.org and ACNM.org

For more info on risk factors of osteoporosis: http://www.mayoclinic.com/health/osteoporosis/DS00128/DSECTION=risk-factors