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Tuesday, May 14, 2013

To wrap or not to wrap?

Have you ditched the bread in favour of a healthier ‘wrap’ or ‘bagel? Would you rarely eat a sandwich but happily order a wrap when grabbing lunch on the run? Does Lebanese or Mountain bread frequent your shopping basket to be used as a pizza base or low carb bread-like option? Unfortunately, despite the growing popularity of bread alternatives, it seems that we may be being misled when it comes to thinking that these are a better option nutritionally. In fact, with some wrap style bread options and bagels containing more carbohydrate than four regular slices of bread, a simple sandwich made using small, grain based slices of bread may not be such a bad option after all.

For some time, the humble loaf of bread has been the diet taboo for many, with claims and beliefs that bread is the enemy when it comes to digestive comfort, weight control and cravings for sweet foods. And, to defend this, there are a growing number of people being diagnosed with gluten intolerance, wheat intolerance, other food allergies and coeliac disease, for which wheat based foods are best avoided. In addition, there are also a growing number of people who simply prefer not to eat bread for a range of reasons including the effect these carbohydrate rich foods appear to have on their weight and digestive health in general.

Enter the bread revolution – Mountain Bread, Lebanese bread, a huge range of oat, barley, chia and rice wraps you may have noticed taking up more and more space in bread aisle of the supermarket. Alas though, when we take a closer look at the numbers, what may appear to be a ‘healthier’ choice, may simply be a concentrated volume of various types of flour compressed into a ‘healthier’ looking wrap style sandwich. Sure there are some lighter options in which a single wrap is equivalent to less than a slice of regular bread in terms of both carbohydrate content and calorie load, but these options are rarer; they are much more likely to fall apart when you make a decent sandwich out of them and they cannot be guaranteed to taste as good as a hearty sandwich would.

The other nutritional issue is that many of the commonly purchased wraps have a high GI – the nature of processing means that the flour used to make wraps is heavily refined, leaving a bread product that is digested quickly and results in a subsequent quick rise in blood glucose levels and long term this is a big issue for insulin levels and weight control.

So, this is not to say that there are not some great wrap choices out there simply check those labels as just because it is a wrap, does not make it a better choice.

Bread                                       Cal           Carbs         Sug        Fib

2 slices Burgen Soy Lin           198          21.2          2        4.6
White Lebanese                         275           53            3        3
Wholemeal Lebanese                  240          45            3        4.5
Mission White                            216          33.6         4.3     1.8
Freedom Gluten Free                  143          28.2        1.4     0.6
Pita Pocket                                 165         31.8        2.1     1.8
Bagel                                        223         43.1         5.3     2.6       
Mountain Bread                       72           3               1        1.1
BarleyMax                               100          10.6         0       10.4
Soji Wholemeal                        87          16.1         0.6     1.8
Wattle Valley Grain                 129        19.7          1.8      3.6

Tuesday, May 7, 2013

Why what you eat is important when you are trying to get pregnant

Each week, on average I would see at least two women at my private clinic who have been referred by a leading endocrinologist for help with their diet while they try and maximize their chances of getting pregnant. Some of these women are overweight or obese; others have PCOS or insulin resistance and a high proportion of them of spending significant amounts of money on various fertility treatments to improve their chances of getting pregnant. One of the things I tell these women very early on in our interaction is that in my experience, weight loss, even a relatively small loss, seems to increase fertility significantly. Now admittedly, this is based on my clinical experience only, but over the past 12 years I could tell you of numerous women who have lost a few kg using a classic reduced carbohydrate dietary regime, who then find themselves pregnant within a few months.

 And now, we have some research available that supports this observation. Research released just this week at the American College of Obstetricians and Gynecologists Annual Clinical Meeting reported that patients undergoing IVF treatments who consumed a moderate carbohydrate, increased protein meal plan had higher pregnancy rates than those with a lower protein intake.

There are numerous explanations for this observation – a higher protein diet is likely to support egg quality, while a reduced carbohydrate intake may help to reduce levels of the growth hormone insulin, high levels of which can promote inflammation the body. A higher protein diet or any diet that is being carefully controlled with a focus on fresh foods is also likely to boost total nutrient intake and in turn improve health and fertility in general.

Now while these results are preliminary in nature and more in depth studies do need to be completed to support this dietary approach universally, for me it makes sense that much more attention should be paid to pre, post and total pregnancy nutrition in general. We know that mothers who do not gain excessive amounts of weight are much more likely to have an easier birth, find it much easier to return to their pre pregnancy weight and also have a healthier baby. For this reason, it makes sense that good nutrition and weight control be the focus right from the beginning, to not only enhance our chances of getting pregnant but for doing it in the most health way possible.

So if you, or someone close to you is going through the intense process of IVF, let them know that their diet may be one important variable also worth considering. Indeed, for a number of issues relating to infertility, changing your diet is certainly a much cheaper option.