Tagged Sugar

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Swelling and Water Retention

I’d be willing to bet that every woman reading this has experienced bloating and water retention at one time or another. Although normal hormonal fluctuations can cause fluid retention at any time, there is no time when this is more obvious than in pregnancy. In fact fluid retention in the form of swollen ankles is probably one of the most well-known symptoms of later pregnancy.

Water retention occurs during pregnancy for a variety of reasons. The first, and the one you’re probably familiar with from your pre-pregnancy days, is fluctuating hormones. The surge in hormones you experience just prior to your period is actually your body getting ready for pregnancy. The rising levels of estrogen and progesterone that occur premenstrually trigger an increase in aldosterone – a hormone that encourages your kidneys to hold onto water.

If you don’t get pregnant during your cycle, these hormone levels drop, signaling the start of your menses and allowing your body to release its premenstrual water weight gain. When you do become pregnant, those hormones stay elevated and you continue to hold onto the fluids you’ve accumulated.

One of the reasons for this increase in fluid retention is that your blood volume increases dramatically during pregnancy. This increase in blood volume really steps up in the second and third trimester, which is why it’s likely that you’ll notice a big increase in swelling during that time. Since your blood is over 80% water by volume, it makes sense that your body would need to hold onto a lot of water in order to increase the production of blood.

Making swelling worse is the increased pressure your growing uterus puts on the blood vessels that carry blood to and from your legs. One of the reasons swelling is usually the most noticeable in the legs, especially during the third trimester, is that this pressure makes it harder for your body to move blood and lymph out of your legs. Gravity doesn’t help this process and if you spend long periods on your feet, you’ll probably notice the swelling gets even worse.

So what can you do to prevent or decrease swelling and fluid retention?

#1 – Drink More Water and Eat More High Water Content Foods
I know this is one of those tips that’s all over the internet, but in this case there’s a reason for it. If you limit your fluid intake, your body will freak out and think you’re in danger of becoming dehydrated. It will compensate by hoarding every ounce of fluid you do take in.

In addition to drinking more water, eating more high water content fruits and vegetables can do wonders for fluid retention. You know the old spa trick of adding cucumber slices to pitchers of water? Well, there’s a reason for it. Not only do many juicy fruits and veggies contain compounds that can act a diuretics, the water and electrolytes contained in them will convince your body that it’s in no danger of dehydration. In addition to cucumber, melons, citrus fruits, greens, and berries are all excellent choices.

#2 – Walk More
Another well-known tip that actually works is to increase exercise, especially walking. The main way your body gets rid of excess fluid left behind in the tissues is through the lymphatic system. Unlike your circulatory system, your lymphatic system doesn’t have it’s own pump. It relies on movement to help move lymph fluid around the body. One of the best ways to accomplish this is walking.

Every time you take a step, all throughout your body muscles contract and relax, and joints flex and extend. All this movement is perfect for helping your lymph system move fluids throughout your body. While standing still or sitting can make fluids pool in your legs and increase swelling, walking actually does the exact opposite. Try getting up and walking around frequently throughout the day to decrease swelling in your legs during late pregnancy.

#3 – Cut Out Sugar and Grains
When most people think of water retention, they don’t usually think of sugar, they think of another white powdered food additive – salt. But unless you have a salt sensitivity or your kidneys aren’t working efficiently due to disease, salt probably has less to do with your tendency to retain water than you think.

A much more likely culprit is sugar. The reason for this is two-fold. One, sugar creates inflammation in the body, causing the release of many anti-inflammatory compounds, including histamine. Among other things, histamine increases the permeability of blood vessels, primarily to allow white blood cells and fluids access to areas of injury (this is one of the reasons you experience swelling when you sprain your ankle or slam your finger in the car door). However in the case of systemic inflammation (like that caused by sugar), this leaking of fluids into the surrounding tissue does not serve a specific function and can increase swelling all over the body.

The second has to do with the way your body stores glucose, one of the building blocks of sugar. If your body has more glucose circulating than it can use at one time, it converts this sugar to glycogen to be stored in muscles and fat cells. In order for the glycogen to make it’s way into the cells, it must first attach itself to several molecules of water. So in order to store extra sugar, your body stores three to four times the amount of water along with it, leading to swelling and fluid retention.

Eating grain products has a similar effect. In addition to being some of the most highly allergenic and inflammation-causing foods we consume, grains (even those “healthy” whole grains we keep hearing so much about) break down into glucose, so they’re processed and stored in the same way as glucose – along with the extra water.

Now I’m not suggesting you go on Atkins while you’re pregnant… Or anytime for that matter. You should continue to eat good for you carbs like fruits and veggies, including starchy veggies like sweet potatoes. But eliminating the excess carbs in sugar and grain products will go a long way toward enhancing your overall health and eliminating fluid retention.

#4 – Epsom Salt Soak and Massage
After trying the things above, if you find you’re still having trouble with swelling, you may want to try an epsom salt foot soak. While plain epsom salt will work, you may want to consider a soak formulated specifically for pregnancy, like this one. The magnesium in epsom salt can sooth inflamed tissues (as well as prevent nighttime leg cramps common in the third trimester) and increase circulation. Most soaks that are formulated for pregnancy include additional herbs and / or essential oils that are known to reduce swelling.

After soaking your feet, massage them gently with oil to further increase circulation. Any high quality oil will work, but again, oils specifically formulated for use during pregnancy (like this one) will usually contain additional ingredients to improve circulation and reduce swelling.

Have you found any of these methods to be effective for reducing or eliminating swelling? In what other ways have you dealt with fluid retention during pregnancy?

Avoiding Swelling and Water Retention in Pregnancy

Natural Morning Sickness Remedies: Diet Change

The internet abounds with dietary advice to help keep morning sickness at bay. Unfortunately, much of this well-intentioned (but misguided) advice centers around keeping saltines on hand at all times… Possibly some of the worst advice ever. The good news is that there are much more effective dietary measures that can be taken to combat the nausea and vomiting of early pregnancy.

Although the exact cause of morning sickness remains unknown, it can be greatly aggravated by falling blood sugar. Many women notice that if they go too long without eating, morning sickness returns with a vengeance. The advice to eat saltines when you start to feel nauseated is based on this fact and the idea is that a fast infusion of glucose into the bloodstream will quickly raise blood sugar and relieve the resulting queasiness.

The problem with this advice, as most people now know, is that empty, white-flour carbs (like those found in saltines) will cause a blood sugar spike and subsequent crash that may leave you feeling even worse once the initial effects of the carbs wear off.

Alternately, a diet higher in protein and lower in quickly absorbed carbs (sugar, white flour, etc) will help keep blood sugar at a more consistent level throughout the day. In fact one study published by the University of Michigan Medical Center showed that meals high in protein decreased nausea and digestive dysrhythmia much better than meals that emphasized carbohydrates or fats.

Although many women experience strong aversions to meat and eggs during their first trimester (probably a biological left-over from the days before refrigeration when these types of foods spoiled quickly), if you can stomach them, they’re great sources of the healthy protein your body needs to grow a baby. Don’t worry if you find it difficult (or impossible) to eat meat and eggs, you still have plenty of other good protein options available.

Smoothies made with fruit, milk and whey, egg, rice, or pea protein can satisfy cravings for sweets while also upping your protein intake. Just make sure the protein powder you choose doesn’t contain any sugar, artificial sweeteners, or additives. I feel comfortable recommending limited amounts of stevia-sweetened powders to my pregnant patients (and consuming them myself), but check with your midwife or OB if your pregnancy is high-risk or if you have concerns regarding stevia. My favorite all natural, stevia-sweetened protein powder comes in egg and whey varieties and can be found here.

Many women with food aversions can tolerate dairy products, so Greek yogurt and hard cheeses can be another good protein option. Choose full-fat dairy products that are organic and / or grassfed when possible. As Greek yogurt has increased in popularity, so have knock-offs that contain far more sugar than protein. Look for plain, unsweetened versions that contain at least twice the amount of protein as carbs. My personal favorite is Fage Total (check out their store locator to find the Classic Plain at a store near you).

Nuts are another good source of protein and can also help with salt cravings. Raw unsalted nuts pack the biggest nutritional punch, but roasted salted nuts can be a great substitute for those nutrient deficient saltines everyone keeps trying to push on you. Choose dry-roasted nuts when possible and be sure to check labels for added sugars, sweeteners, and additives.

Sometimes when you’re experiencing morning sickness you’re just going to have to eat whatever you can get (and hopefully keep) down, but if you aim to keep your protein intake high on most days while keeping sugar (including honey, maple syrup, agave nectar, etc) and starchy carbs to a minimum, you’ll greatly reduce the nausea most women experience during the first trimester.

What diet changes have you made that have helped with your morning sickness?

References:
Jednak MA, Shadigian EM, Kim MS, et al. Protein meals reduce nausea and gastric slow wave dysrhythmic activity in first trimester pregnancy. Am J Physiol. 1999;277(4 Pt 1):G855–G861. http://www.ncbi.nlm.nih.gov/pubmed/10516152