Male fertility is all obviously all about sperm – how many and how able each sperm is able to survive the perilous journey to the egg. The moment the sperm starts its journey it is attacked by molecules that can damage the sperm and render it immobile and usless. It is easy to appreciate that the more sperm there are, the greater the chance that healthy sperm will reach the egg, but what is as or more important is that only well fuelled, fast swimming, healthy sperm will have a chance of surviving the perils ahead. So, male fertility is all about the number (sperm count) and the health (viability) of the sperm

As many as 1 in 5 young men between the ages of 18 and 25 produce abnormally low sperm counts, and of those with normal sperm counts just 5-15% of sperm produced are classed as normal under the World Health Organisation criteria. For anyone who skimmed over that last piece of information, read again…..’Daddies’ of the future have falling sperm counts and high levels of abnormal sperm.

Contra to traditional beliefs, infertility is roughly equal between men and women, with 32% of cases attributed to men and 32% to women, whilst the remaining cases involve either both partners or are unexplained (HFEA, 2007). The number of couples who are struggling to conceive has risen to over 25% and so it isn’t surprising that more and more couples are now seeking fertility treatment. But is that the only option or are there alternative solutions to try first?

‘Changes to lifestyle and diet, plus a good supplement regime, can make a massive difference to male fertility’

Scientific evidence estimates a 50% decline in sperm production over the last 50 years, as well as a correspnding decline in sperm quality. This sudden fall in sperm numbers and quality has occured too rapidly for genetic influences to be considered responsible; a combination of both environmental and lifestyle factors are the root causes.

Research suggests that changes to diet and lifestyle routines will significantly improve both female and male fertility in the majority of individuals.   So far, at least 19 trace elements are known to influence human fertility, and many other nutrients are also likely to be important but not yet adequately researched.  Deficiencies in nutrients that are known to be key to male fertility are common in the UK, and these deficiencies are likely to affect sperm counts as well as compromise the quality of the sperm produced, thus reducing the likelihood of a viable sperm reaching the egg for fertilisation to take place.

One group of nutrients that greatly influence male sperm production and quality are the Omega-3 fatty acids, in particular Docosahexaenoic Acid (DHA). Over the last 50 years, i.e the same time frame as the falling sperm count, we have seen a drmataic  decline in intakes of the omega-3 fish oils. In Western societies our typical intake of omega-6 PUFA, the alternative family of fatty acids, is very high and the ratio of the omega-6: omega-3 fatty acids in the UK is now thought to be greater than 10:1 and even as high as 25:1 in some adult diets. In comparison, the omega-6: omega-3 ratio dietary intake of primitive man was closer to 1:1.

Intakes of omega-6 fatty acids have increased, primarily to displace the saturated fats in our diet , and it is high intakes of these fats that are now  associated with heart disease, stroke and cancer due to their inflammaotory influences. The main sources of omega-3 fatty acids in the UK diet were green leafy vegetables, diary produce and meat produced from cattle grazing on grass, and eggs produced from chickens which fed naturally on seeds. In contrast with the rise in omega-6 intakes, the fall in popularity of green leafy vegetables, and changes in animal feeds to maize and corn based foods, have resulted in a dramatic decline in our intakes of these omega-3 fatty acids and an enormous imbalance in the ratio of the consumption of the two fatty acids familites.

The omega-6: omega-3 ratio affects numerous male and female reproductive processes; omega-3 fatty acids are extremely important for male sperm count, motility and morphology; which then supports conception and embryo development.

Research enthusiastically supports the role of omega-3 fatty acids in male fertility;  fertile men have been found to have sperm levels of omega-3 FAs compared to infertile men and patients with high omega-6 fatty acid and low omega-3 fatty acid concentrations in sperm were found to have lower overall sperm counts, sperm motility and sperm morphology.

Unsurprisingly, male fertility can be enormously improved by making careful nutritional and lifestyle choices that  support sperm production and viability. If I could offer just one piece of advice to all men wishing to start a family it would be to take a DHA rich omega-3 fatty acid supplement such as my own DHAPURE Conception which is completely free from all impurities and contains a high concentration of key omega-3 fatty acid, DHA.

Lifestyle, diet and supplement plan to improve male fertility

• Take an omega- 3 supplement, such as DHAPURE Conception
• Eat a balanced, unprocessed, nutrient-rich diet
• Exercise 2-3 times weekly
• Stop smoking
• Drink very little alcohol
• Protect yourself from environmental chemicals

Juliet, as one of the UK’s leading fertility nutritionists, will be there for each day of the show, with members of  her team on hand to offer helpful advice on what you can do naturally to boost fertility and support treatments such as IVF that you may be undergoing. Simon Thornton from CARE also will be talking about boosting fertility in women over 40. There’s lots to choose from in learning about the new fertility treatment options becoming available, clinic issues, what to do to help yourself and what will happen next if you are struggling to conceive. There’s also seminars on what alternatives are available to consider if your current fertility treatment isn’t working.

If you would like to book a personal appointment with Juliet please ring one of our customer services team direct on 07585 357017.

So what does that mean? It means that our Advanced Formula Antenatal contains no impurities, toxins or other contaminants that you wouldn’t want to be consuming during this time. Whats more, in  vitamin and mineral supplements each nutrient is bound to a compound that helps to maintain the nutrient’s stability, but unfortunately many of these binding compounds render the nutrient ‘bio-unavailable’ when swallowed – that’s of little use to you or your baby. Our nutrients have been bound to compounds that maintain ‘high-bioavailability’ so that you and your baby have the full benefit of every nutrient. Its costs us quite a bit more to  produce such a high quality formula;  but I think we would all agree it is worth ensuring that quality is maximised.

Deficiencies and sub-optimal intakes of a number of key reproductive nutrients, such as iron, folate, selenium, magnesium, are frighteningly common in the UK. Juliet Wilson recommends a balanced diet, as well as her Advanced Formula Antenatal, and DHAPURE Pregnancy supplements for use from pre-conception through to breastfeeding – ensuring all your nutritional needs are met and to bring you peace of mind.

We were really sorry to hear that Amanda Holden has lost her baby earlier this year. Often the cause of the stillbirth cannot be defined, although poor placental health and fetal development are known risk factors. Nutritional factors are a big influence here, and are likely to be prominent in other risk factors as well. I suggest that you follow a healthy diet from the word go, before conception if you can, and take your ante-natal multivitamin and mineral as well as the fish oils daily to help reduce the risk of any pregnancy complications.

Juliet Wilson’s Premium DHA Fish Oils

Juliet Wilson’s Advanced Antenatal

Congratulations to Miranda Kerr and Orlando Bloom on the birth of their gorgeous baby boy, Flynn. Its lovely to see Miranda looking so natural and relaxed while breastfeeding.

We were delighted to hear that the goverment has announced that it will review the evidence regarding the advice it currently gives mother’s on exclusive breastfeeding. For more information read my article ‘Babies need solid food not just breast milk’

The article ‘Six months of Exclusive Breastfeeding: how good is the evidence?’ in the  British Medical Journal has created an opportunity to  clear up this confusing issue.

In 2003 the health minister announced that the UK was to comply with the World Health Organisation (WHO) recommendation that all infants should be exclusively breastfed for six months; yet the evidence for supporting this major change in public health policy underwent little scrutiny. In fact there was little evidence to endorse this policy.

There is a substantial amount of researched evidence to support the importance of infant nutrition for long term health, through influences that include cognitive function, obesity and the risk of heart disease, cancer, and diabetes. It’s really important that infants receive the best nutrition possible during this period of rapid growth and development.

The Basis of the WHO Recommendations.

Much of the WHO argument to support exclusive breastfeeding was based on a number of studies that had been carried out in the developing world; where nutritional and environmental conditions vary considerably from those in the UK.

The primary benefit that has been cited to support exclusive breastfeeding for 6 months was to reduce the risk of infection in infants. However, whilst in a developing country, infant infection can have significant impact on morbidity and mortality, this is not so for infants in developed countries such as the UK.  Breastfeeding eliminates the need for sterile equipment, clean water sources and fresh hygienic food sources, which is of considerable value in a developing country; however, here in the UK we have the luxury of considering feeding options that offer the greatest health and development benefits to our infants, while clean water sources and rotten foods are not a concern.

In developed countries there was some evidence that exclusive breastfeeding reduced the risk of infection but really only in infants fed solids before 3 months. The normal recommended age for weaning is 4 – 6 months, beyond 3 months, and so delaying the introduction of foods until 6 months would offer little or no additional protection from infection to babies in developed countries.

The most important concern regarding extended exclusive breastfeeding in the UK is whether breastmilk will provide the nutrition required by the rapidly developing and growing infant, and in the majority of cases I believe it would not. A breastfed infant’s nutrition would depend greatly on their mother’s nutrition, and in the UK (a typical developed country) there are a number of nutritional inadequacies that will be reflected in the mother’s breastmilk. For example, of major concern is iron deficiency, which is common in UK, a deficiency in this critical nutrient in early life will irreversibly impact the infants motor, mental and social development. Other nutrient deficiencies are highly likely, the effect of which could be considerable.

How long should I exclusively breastfeed my Baby?

There is no doubt that breastfeeding your baby will have many positive effects for both you and your baby and whenever possible I absolutely recommend that you try to breastfeed exclusively for the first 4 months. Breastfeeding helps create a powerful bond between mother and baby, but many other benefits are known both the mother and child; breastmilk contains maternal immune factors that protect the baby from illness until their own immune systems are more developed. Studies also support reduced risk of maternal breast cancer, and reduce obesity, heart disease and diabetes in infants.

At some point, beyond 4 months, you will feel that your baby has ‘outgrown’ exclusive breastfeeding. It could be that their energy requirements are simply beyond what you are able to provide in breastmilk, or that your infant’s stomach is not large enough to take the necessary volumes in. At some point they will probably seem unsatisfied and permanently hungry – that’s the cue for food!

So When Do I wean my Baby?

There are some really good and clear guidelines to consider here to help you decide when to wean your baby. If there was one bit of advice I could give, it would be not to become anxious about it. Having taken a few things into account, it’s basically up to you when you start to introduce foods; mostly it’s when it feels right.

The important thing to remember is that nothing is critical or defined – if you try to wean your baby but they don’t seem interested then leave it a week or two and try again.  Don’t be concerned if your baby’s timing isn’t exactly in sync with yours. You will grow to understand each other.

The following recommendations should help you decide when it the right time to introduce solid foods.

Important Weaning Considerations:

1. Your infant is over 4 months old. `
2. The intervals between feeding are closing and your baby seems hungry ‘all the time’
3. You are tired and finding it hard to keep up with your baby’s demands.
4. After 4 months your baby will have grown considerably, instinct may tell you that the baby nutritional needs  are too big now for you to solely provide through milk alone.

Stay healthy while you breastfeed.

Your health is paramount while you breastfeed. Your nutritional status will reflect upon your baby’s nutritional status, but also just being run down, tired and poorly will be no fun for either of you. Try to eat a diet rich in fruits, vegetables and high quality meats with some fish . Oily fish, such as salmon, trout, sword fish, shark, tuna and mackerel, can be high in toxic chemicals and contaminants, the government guidelines suggest eating a maximum of 2 portions a week – I would recommend a supplement rather than eating any oily fish at all because I feel we absorb a lot of chemicals daily as it is, I wouldn’t recommend adding to that burden knowingly, particularly whilst breastfeeding. It is best to supplement with omega-3 fish oils whilst breastfeeding. Omega- 3 fish oils are key nutrients during this period as they are critical for the development of your baby’s rapidly growing brain and eyes, amongst other things.

Juliet Wilson DHAPURE offers one of  the best value pharmaceutically graded, highly purified, concentrated source of omega- 3  fatty acids available.

It is also important that you continue with your ante-natal supplements, Juliet Wilson Advanced Ante-natal Formula will support you nutritionally whilst breastfeeding, it will ensure that you have the vitamins and minerals you need to pass on adequate levels of these nutrients to your baby as well as supporting your own health.

Reference:

Fewtrell et al (2011) Six months of exclusive breast feeding: how good is the evidence? British Medical Journal 342:c5955

 It is important that pregnant women make sure they take extra precautions against flu -particularly so given that swine flu is still virulent  and that the outbreak of  a seasonal flu virus generally affects younger people rather than older members of the population.

In pregnancy, the immune system is naturally suppressed. This means that pregnant women are more likely to catch flu and, if they do catch it, they are more likely to develop complications (see below). However, your immune system still functions and the risk of complications is very small. Most pregnant women will only have mild symptoms.

Symptoms and risks

If you are pregnant and you catch H1N1 (swine flu) flu, the symptoms should be similar to those of regular flu. You will typically have a fever or high temperature (over 38C/100.4F) and two or more of the following:

• unusual tiredness
• headache
• runny nose
• sore throat
• shortness of breath or cough
• loss of appetite
• aching muscles 
• diarrhoea or vomiting

Most pregnant women will have only mild symptoms and recover within a week. However, there is evidence from previous flu pandemics that pregnant women are more likely to develop complications.

Possible complications are:

• pneumonia (an infection of the lungs)
• difficulty breathing 
• dehydration

In pregnant women, these are more likely to happen in the second and third trimester.

If a pregnant woman develops a complication of H1N1 flu, such as pneumonia, there is a small chance this will lead to premature labour or miscarriage. There is not yet enough information to know precisely how likely these birth risks are.

It is, therefore, important to be well prepared and to take precautions against H1N1 flu.

Vaccination and pregnancy

Pregnant women are advised to take the seasonal flu jab, whatever the stage of pregnancy. This includes pregnant women not in high-risk groups (who have not previously been vaccinated against swine flu).

This year’s seasonal flu jab offers protection against the H1N1 (swine flu) virus, as well as other strains of flu virus.

There is no evidence that inactivated vaccines, such as the seasonal flu vaccine, will cause any harm to pregnant women or their unborn baby. Every year, the seasonal flu vaccine is given to pregnant women who are at risk of flu.

The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency has given a clear recommendation that the GlaxoSmithKline vaccine Pandemrix can be given safely to all pregnant women.

Special precautions

If you are pregnant, you can reduce your risk of infection by avoiding unnecessary travel and avoiding crowds where possible. Good hygiene is essential as is eating a healthy, balanced diet to maintain body nutrient levels. Consider supplementing your diet with high quality antenatal  supplements such as Juliet Wilson’s Antenatal supplement to ensure your body  is naturally provided with the key nutrients during this critical time.

Essential nutrients for fighting flu are anti-oxidants (especially vitamins C & E and lycopene), Vitamin A, Vitamin D (get out in the sun if you can !), highly purified Omega 3s (such as Juliet Wilson’s DHAPure  Pregnancy), folate, protein, magnesium, and zinc. 

DHAPure Pregnancy

Almonds, apricots, broccoli, canteloupe, carrots, cashews, celery, chicken, chocolate, citrus fruits, garlic, dark greens, eggs, fruits, garlic, green tea, mango, meat, mushrooms, onion, peaches, peanuts, pineapple, pumpkin, spinach, squash, sweet potato, tomato, tomato products, walnuts, watermelon.

Foods that act as a natural anti-viral

Apple, blueberries, broccoli, cabbage, cayenne, garlic, herbs, honey, lemon, mustard, onion, plums, raspberries.

Foods that help you reduce your flu symptoms and duration –

Garlic, Echinacea, Cayenne pepper, Lemon juice (fresh), Tomato Juice, Orange juice, Vitamin C, Ginger, Green tea, Chicken Soup.

Avoid Dairy if you can and try to use a steamer.

If you know you have been exposed to flu, don’t wait for symptoms. Start your defence right away – eating more fruits and vegetables, drinking orange juice and green tea, and taking your antenatal vitamins – especially vitamin C, vitamin D, and Zinc. It’s no coincidence that flu season starts when we have less exposure to sunlight. Vitamin D is very important.

If you think you may have H1N1 flu, call your doctor for an assessment. Your doctor will advise you what to do if they think you have flu. Unless you have H1N1 flu symptoms, carry on attending your antenatal appointments to monitor the progress of your pregnancy.

H1N1 flu treatment

Antivirals

If you are pregnant and diagnosed with H1N1 flu, you may be given a course of antiviral drugs.

If you have an uncomplicated illness due to influenza and do not have an underlying disease, you can take either Relenza or Tamiflu. Relenza is recommended as a first choice.

Relenza is inhaled using a disk-shaped inhaler. It is recommended for pregnant women because it easily reaches the throat and lungs, where it is needed, and does not reach significant levels in the blood or placenta. Relenza should not affect your pregnancy or your growing baby.

However, Tamiflu should be offered instead of Relenza if you:

• have a condition such as asthma or chronic obstructive pulmonary disease
• have difficulty taking an inhaled antiviral
• develop a severe or complicated disease due to influenza (where you will probably be treated in hospital)

An expert group reviewed the risk of antiviral treatment in pregnancy. It is much smaller than the risk posed by the symptoms of H1N1 flu.

Some people have had wheezing or serious breathing problems when they have used Relenza. Relenza is therefore not recommended for people with asthma or chronic obstructive pulmonary disease (COPD). Other possible side effects of Relenza include headaches, diarrhoea, nausea and vomiting.

In a small number of cases, nausea is a side effect of Tamiflu.

If you take an antiviral and have side effects, see your healthcare professional to check that you are OK.

Painkillers

You can also take paracetamol to reduce fever and other symptoms. This is safe to take in pregnancy.

However, pregnant women should not take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Nurofen).

Congratulations you’ve made it past the first difficult hurdle of becoming pregnant!  However putting on a bikini next summer is probably the last thing on your mind. When you’re pregnant or have given birth there are so many other things to worry about that it’s easy to forget (or simply not care!) about the way you look, as your body, diet, routine and relationships are all adapting to make way for your baby.

But  it is important to give yourself some time as well.  Between 75 and 90% of women develop stretch marks during pregnancy. As you put on weight, the tummy is gradually stretched further and further, usually causing stretch marks to appear in the sixth or seventh month. If you’re really unlucky, stretch marks can appear on the thighs, buttocks and on the breasts as they get bigger and heavier.

The marks start off as thin, parallel red lines in the dermis (the middle layer of skin). They happen when the skin is stretched over a short period of time, and as time goes on, the skin becomes thin and silvery and may appear scar-like. Whilst the marks can fade and become less noticeable, this may take years and a few simple steps from the early days of pregnancy can help keep you in bikinis just that little bit longer.

Not everyone gets stretch marks. Doctors think some people get stretch marks because their bodies produce more of the hormone, corticosteroid, than normal. This hormone decreases the amount of collagen in the skin, and collagen is the protein which keeps our skin fibres stretchy. Most people’s skin needs daily help to give it the best chance to survive the 9+ months intact and free from stretchmarks.

Massage your skin, maintain a healthy diet

Massaging your skin everyday with a moisturising cream or oil  can really help to improve circulation, which encourages new tissue to grow. It is also important to eat a balanced diet rich in vitamins, especially vitamin E, vitamin C, zinc and silica that all help to keep skin the healthy. Consider taking antenatal health supplements to boost your intake of key nutrients.

Drinking lots of water will help with many aspects of pregnancy, including keeping your skin hydrated.

Moisturisers, oils and creams

Start early, and pick creams and oils which contain vitamin E derivatives such as Tocopherol or vitamin A derivatives such as Retinol Palmitate.

Shea Butter (which forms the base ingredient  of Juliet Wilson’s award-winning Nutrilastin Stretchmark Cream) is a skin moisturiser which, although more expensive to produce than traditional moisturising base creams,  has moved to the skin care products forefront because of its recognised moisturising properties. As a result it is used by the majority of the premium brand skin care companies in their top of the range products. Shea is a very unique skin emollient and moisturizer.  Shea Butter, extracted from nut of the African Shea tree,  has proven to be a highly  effective moisturizing, anti-inflammatory agent. It has become an effective treatment for a number of skin maladies, including scars, eczema, wounds, burns, rashes, acne, dry skin, dark spots, skin discolorations, wrinkles, and most importantly, stretch marks. Because of its unique ability to reduce and heal scars, it is understandable that Shea has surged to the top of stretch mark reducing treatments. Shea extract absorbs easily into the skin and does  not leave the body (or face) feeling greasy.

Whilst Shea Butter is important as a moisturising base cream – there are several other naturally occurring active ingredients that are important in stretchmark treatment and prevention. One of the most important  of these is  Rose Hip oil, again included in both the Nutrilastin Stretch Mark Crream and Body Treatment Oils as a key ingredient. A range of scientific research studies  by skin care specialists has demonstrated that rosehip oil greatly reduces the appearance of imperfections in the skin such as stretch marks as well as wrinkles. This natural Gamma Linoleic Acid is an essential oil which research  over many years has shown to contain highly effective skin-repairing ingredients such as polyunsaturated fatty acids and Vitamin A which helps to heal scarring as well as reduce the reddening that is typically associated with stretchmarks. It is also mild enough to be used on even the most sensitive skin. Rosehip Oil is extracted from rose seeds.

Juliet Wilson's Body Treatment Oil for Stretchmark Prevention

Rosehip oil is the only known natural vegetable oil that naturally contains Vitamin A, which has anti-ageing properties such as cell regeneration and collagen promotion. It helps promote skin cell growth and reproduction, in turn regenerating damaged skin. The oil also contains essential fatty acids (oleic, linoleic and linolenic acids) and Vitamin E, which help moisturize skin to keep it radiant and healthy. It is also referred to as a “dry” oil, which means that when applied to the skin, it does not leave an oily film.

Grapeseed oil, as contained in Juliet Wilson’s Nutrilastin Body treatment Oil, is well known for being a non-greasy massage oil with excellent skin healing properties. Grapeseed oil contains more linoleic acid than other carrier oils which aids general skin health and is highly beneficial for stretchmark treatment and prevention because of its highly  regenerative and skin healing qualities.

The Use of Collagen in Stretchmark Prevention

Collagen is a protein that serves to support your tissues, cells, organs, and bone structure. Collagen makes up around 75% of healthy skin. It represents such a huge proportion of our skin that when collagen fibres  get damaged or when collagen production decreases, the overall health of our skin gets significantly affected. Examples of bad effects are fine lines, wrinkles, and premature ageing of the skin. Another bad effect is the development of stretch marks.

During pregnancy, some hormones make the collagen found in the ligaments around a woman’s abdomen softer in order to prepare the body for the birthing process. Unfortunately, these hormones also affect the collagen found in the skin. Since the skin collagen becomes weaker, stretch marks form as the body grows in order to accommodate the growing baby.

Aside from physical damage to the skin like overstretching of the skin due to extreme weight changes, other factors may bring about the breakdown of the collagen in our skin or cause the rate of new skin production to decline. One example is sunlight exposure.  If unprotected,  skin exhibits damage in the form of premature aging compared to those people who use skin protection like sunscreen and clothing.

In order to prevent and reduce stretch marks, you should aim to stimulate production of new collagen in addition to the maintenance of the levels of healthy collagen in your skin. One way of doing this is to ensure that you are getting enough amounts of Vitamin C and other ant-oxidants. Vitamin C is not only a powerful antioxidant, but also a promoter of collagen synthesis. Eating a balanced diet will help you get the recommended daily allowance of vitamin C, also consider taking a good antenatal health supplement during pregnancy to boost nutrient levels. The addition of hydrolysed collagen to the skin through inclusion within moisturising creams and oils, as contained within Juliet Wilson’s Nutrlastin Stretchmark Cream,  has been shown to also contribute to improvement in skin collagen levels.

Don’t Eat for Two!

Your appetite increases at various points in your pregnancy and it’s normal to put on weight, but it is a myth that you need to ‘eat for two’. Pregnant women need to take in extra calories to nourish the baby (about 500 extra calories per day), but make sure these calories are from nutritious foods, not fatty ones, so that you put on weight gradually and are able to shed pounds easily once you’ve finished breastfeeding. As a rough guide:

• It is normal to gain 1 to 2kg (2 to 4.5 lb) over the first 12 weeks
• From week 12 to 28 it is normal to gain 300 to 400g (10 to 14oz) per week
• From weeks 28 to 40 (the last 3 months) it is normal to gain 1 to 3kg (2 to 6lb) per month.

See your GP, midwife or health visitor for advice if you are worried that you aren’t gaining weight at the correct rate.

Surgery

There are a number of options available and it pays to do research on the latest alternatives on the market as technology in this area is improving all the time. Laser surgery, for example, doesn’t strictly remove stretch marks, but it can help them to fade. Laser light therapy is a non-invasive procedure that serves to darken old stretch marks in order to make them blend with the surrounding skin. This treatment option serves to disguise your stretch marks by turning them into a darker shade. In addition, laser light therapy aid in fading old stretch mark as well as improve the elasticity of the skin and promote the production of collagen.  However, laser light therapy is not only expensive and isn’t available on the NHS, but is also rather painful.  An even more extreme option is abdominoplasty, again an expensive operation, which removes excess fat, skin and stretch marks from your tummy area. In all cases such treatments should not be considered lightly and do consult your GP, midwife or health visitor  before you make any decision.

Diet is the most easily modifiable risk factor for depression, and usually the most successful.  A number of nutrients have strong associations with depression, and over the coming years, the  impact of others will no doubt become more understood.  Women who are anywhere between the pre-conception period and having an infant under 3 years old should consider eating a structured diet to protect against pregnancy and/or post natal depression.

If you feel you are feeling low or depressed at this time, the following advice will help you to make the first steps to feeling better.

Post Natal Depression Risk Assessment:

Pregnancy and lactation are likely to be the most  nutritionally demanding times of every  woman‘s life. Intense nutrient demands, and emotional challenges mean that many women are at risk of depression during this vulnerable period. Many of us have at least one ‘risk factor’, but the risk of you developing depression may not depend on how many risk factors are in your life; stress, for example, is a very undefinable risk factor.   If you instinctively feel that you have a lot on your plate, now is the time to consider making some changes to help protect you from the symptoms of depression. Known high risk factors include:

◊    A personal history of depression or low mood

◊    A history of depression or low mood in your immediate family

◊    Pregnancy complications.

◊    Seasonal Affective Disorder (SAD)

◊    Feeling of Being Unsupported

◊    A Single Parent

◊    Stress- any

◊    Weight Loss over 7lb in the last 3 months

◊    Inadequate nutrition due to illness, or other factors

◊   Eating  a Typical Western Diet.

Signs and Symptoms of Pregnancy and Post Natal Depression

• Persistent sad or ‘empty’ mood
• Loss of pleasure in daily activities
• Sleep disturbance changes
• Feelings of guilt, worthlessness and helplessness
• Difficulty concentrating
• Crying for no reason
• Thoughts of death or self harm.

What to Do if You Feel Depressed.

Step 1: Go and talk to your GP. Your GP will talk things through with you and probably carry out an assessment; in most cases this assessment will be based on the ‘Edinburgh Postpartum Depression Scale’. The assessment is simple; it helps your GP to estimate the severity of your feelings. From there they will decide on how best to help you. They may offer counselling, medication or ask you to come back in a couple of weeks for a review.

Step 2: Take some key supplements. We recommend our Advanced Antenatal Formula to bring up your levels of mood – enhancing key nutrient levels such as folic acid, vitamin B6, vitamin B12, iron, zinc and selenium. Omega-3 fatty acids are important. Improvements in nutritional levels can take up to 3 months to make their full impact so the early you  can start to improve Omega-3 levels, the better. Our DHAPURE Omega 3 fish oil  capsules are a highly concentrated and purified source that will benefit your mood as well as being key in many other aspects of your health during this period.

Step 3: Try to make some dietary changes to incorporate some of the foods that contain the key  nutrients that are known to help combat depression.

Step 4: Sleep. Try a relaxing bath before you go to bed, and a glass of milk which is rich in tryptophan, an amino acid that is known to increase level of serotonin in the brain which is associated with ‘calm’ and sleep.

Step 5: Tell people. Talk about how you feel to your friends and family. Some people will understand better than others, find those that are easier to talk to and let them know how you feel.

Step 6: Get out and about. Try to go for a walk each day, breath in the fresh air and get your circulation going. Exercise releases endorphins, chemicals, in the brain that promote feelings of wellbeing and happiness.

Nutrients that Help Treat Pregnancy Depression and Postnatal Depression.

Omega-3 Fatty Acids and Depression:

Poor omega-3 fatty acid (fish oils) status increases the risk of depression and supplementing fish oils into the diet has been found to successfully treat depression.

Folate (Folic acid) and Depression.

Folate levels are closely correlated with depression as folate is involved in a number of processes that regulate mood.  Not only is folate status linked to the incidence of depression, but the severity of depressive symptoms. There are several factors that can lead to decreased folate status alongside poor dietary intakes which are common. Other factors include use of oral contraceptives, antibiotics, increased nutritional requirements typical of pregnancy, inherited metabolic conditions, mal-absorption syndromes and chronic disease states such as rheumatoid arthritis. Poor dietary intakes are common in the UK, in addition folate is easily destroyed during food preparation and cooking.

In studies only between 5 and 12% of women report taking the recommended 440ug supplement of folic acid, which suggests that very high numbers of women may conceive with low folate status.

Vitamin B6 and vitamin B12 and Depression.

Poor status of the vitamins folate, vitamin B6 and vitamin B12 leads to an elevated level of the amino acid compound ‘homocysteine’. These nutrients are essential for the detoxification of this compound, which if not adequately removed from the brain, can interfere with cognitive function and lead to depression. In one study 17% of mildly depressed women and 27% of severely depression women were found to have low vitamin B12 status. Further studies indicate that over 15% of women of child-bearing age have raised homocysteine levels, which would put them at risk of pregnancy and postnatal depression, and that additional supplementation of B vitamins can reduce homocysteine levels.

Iron Status and Depression

Iron deficiency is the most common single nutrient deficiency in the world with estimates that over 50% of all women of child bearing age are affected. There is a strong association between maternal iron status and anxiety, stress and depression. Post Natal Depression may have strong associations with maternal iron status. Studies also suggest that low iron status may also adversely affect mother-child interactions and infant development.  Iron rich foods include offal such as liver, thyme, twiglets and malt bread.

Zinc and Depression

Even mild zinc deficiency can affect cognitive function and mood. Zinc is an essential component of over 70  enzymes in the human body. In addition it has structural, regulatory and catalytic roles which all in all make it a very important nutrient for our health. Zinc has a role in the storage of neurotransmitters in the brain and the symptoms of zinc deficiency may include irritability and emotional disturbance. Mild zinc deficiency is common in the UK and, in addition, pregnancy increases the requirement for this nutrient, exacerbating the degree of deficiency, which in turn, contributes to mood swings and depression. Zinc rich foods include oysters, beef, lamb and pumpkin seeds.

Selenium and Depression

Depression in European countries such the UK may be due, in part, to diets containing low levels of selenium which is a trace mineral. Low selenium levels in the UK diet are being blamed on the use of  European grain which is deficient in selenium as compared to grain from other continents. This grain which is used, for example, to make flour for bread in the UK is nutritionally inferior to the grain previously obtained from Canada. However the good news appears to be that by eating foods that are  naturally high in selenium such as brazil nuts (one nut contains 20 μg) or by taking a good quality selenium supplement, it is possible to improve mood significantly.

• Other good selenium sources include: brewer’s yeast, offal, meat, fish, shellfish, grains, cereals and eggs.

To further boost selenium levels in your diet it is also recommended you choose unrefined grains (such as wholemeal bread, flour, pasta, rice) because the refining process can reduce the selenium content of food by 50-75%.

Juliet Wilson  Recommended Supplements and Products to Help Combat Depression

1. Advanced Ante-natal Formula;

Compared to many lower quality products on the market, the nutrients  in this formula have been carefully selected for their high bioavailability, which means that your body is better able absorb and use the high percentages of vitamins and minerals from the supplement that you need.  The carefully researched formula contains all the key nutrients for health during pregnancy, breastfeeding and childbirth, in just the right amounts including zinc, iron, magnesium, B12, B6, folic acid and selenium – the nutrient deficiencies most associated with depression. We recommend 2 tablets daily.

2. DHAPURE:

This is a highly purified blend of fish oils, dicosahexaeonic acid and eicosapentanoic acid. Over time these fatty acids are incorporated into the cells of the brain, replacing saturated fats and other less healthy fatty acids, where they are beneficial to brain function, mood and anxiety. We recommend 2 tables daily.

3. Nutrilastin Body Treatment Oil:

Relax! It is important that you find ways to let your body relax as much as possible. This wonderful blend of oils which provides added nutrition to your skin, can be used as massage oil, a moisturiser or as a bath oil. It is truly relaxing and contains pure oils such as lavender, to help relaxation and promote sleep. Formulated from natural oils and rich in oleic and linoleic acids, the nutrients contained within the oil will nourish the skin, ensure maximum suppleness and have active ingredients designed to help prevent the occurrence of stretchmarks.

Foods That Help Treat Low Mood and Depression.

Many foods contain nutrients that will help to combat depression, particularly those that are rich in omega-3 fatty acids, iron, zinc, B vitamins and magnesium. If you already have depression then supplements are the best solution, a known dose of each key nutrient will give you the peace of mind that you are getting what you need, as long as it’s a good supplement that is. As you begin to feel better, dietary changes will ensure that future depressive periods will be kept at bay.

Alongside a good multivitamin and mineral supplement, such as our Advanced Formula Ante-Natal supplement which contains 24 high bio-available nutrients  and a concentrated, highly purified,  fish oil supplement, such as DHAPURE, foods that are rich in the amino acid tryptophan are also useful as they help to increase levels of the neurotransmitter serotonin which regulates mood. Eat plenty of turkey;  milk products which contain high concentrations of tryptophan and salmon are also a good source -although intakes of such fish should be limited because of the potential for high concentrations of toxic contaminants such as mercury and PCBs that exists due to water pollution.

When you need more help.

The links below may be useful if you need to speak to someone or find out more information.

1. Association for Postnatal Illness

A helpline, leaflets and information supported by a network of volunteers who have suffered from PND. Tele 0207 386 0868

2. Depression Alliance

Information and support for people who suffer from depression and relatives who want to help. Tele 0845 123 2320  or email information@depressionalliance.org.

3. Cry-sis

Self-help and support for families with excessive crying and demanding babies. Helpline 08451 228669

4. Family Action

Support and help for families affected by mental illness. Tele 020 7 254 6251

5.   Meet-a-Mum Association (MAMA)

Support and information for all mums and mums-to-be who are lonely, isolated or depressed in pregnancy or after a baby -tele 0845 120 3746.

Sources:

Bread J et al (2005) Maternal Iron Deficency Anaemia Affects Postpartum Emotions and Cognition:  Nutritional Epidemiology . The Journal of Nutrition.

D’Angelo et al (2007) Preconception and interconception health status of women who recently gave birth to live-born infant- PRAMS 2004. MMWR Surveillance Summ 56(10):1-35

Folstein  et al (2007) The Homocysteine Hypothesis of Depression. American Journal of Psychiatry 164:861-867

Leung BM, Kaplan BJ (2009) Perinatal depression: prevalence, risks and the nutrition link – a review of the literature. Journal of the American Dietetic Association 109(9):1566-75

Jonathon et al (1997). Nutrition and Depression: The Role of Folate-  Lead Review Article. Nutrition Reviews 55(5): 145- 150

The prevalence of vitamin D deficiency is epidemically high in the UK, and most western populations.  The typical Western lifestyle of long working hours indoors and the avoidance of the midday sun to prevent skin cancers has exacerbated the problem to the point that we are now seeing the return of rickets and other features of vitamin D deficiency.

Pregnant women used to safe guard against vitamin D deficiency in pregnancy by taking Cod Liver oil supplements and as a result rickets and vitamin deficiency symptoms were virtually non-existent by the 1930’s. Unfortunately however, vitamin A levels in Cod Liver oil crept dangerously high and as a result of the tetrogenic dangers of excessive vitamin A intakes in pregnancy Cod liver oil supplementation has not been recommended since the 1990’s.

A deficiency in vitamin D during pregnancy may be associated with pre-eclampsia, pre-term labour, miscarriage, and other pregnancy related complications.

Advice on vitamin D supplementation in pregnancy has been conflicting, with some authorities citing no supplementation is necessary and others recommending large doses of supplementation.

Here at Juliet Wilson Nutrition we recommend as part of our guidance on eating for pregnancy the following where possible:

1.       Take a good antenatal supplement containing at least 5 µg vitamin D daily 3 months before conception if possible. A degree of vitamin D deficiency is likely to be present in mist women so it’s best to correct the deficiency before conceiving.

2.       Get outdoors and enjoy the sunshine where possible. In summer months the early morning or late afternoon sun is fine, but during the winter months make an extra effort to spend some time outdoors at lunch time when the sun is highest.

3. Eat regular sources of vitamin D when you are pregnant:

• Quaker and Kellogg’s supplement most of their breakfast cereals with vitamin D so you could try to add a few of their cereals into your diet 2 or three times a week. Examples include; Quaker oats or Kellogg’s All Bran, Special K, Cheerios or Corn flakes but always check the packaging.
• Eggs.
• Oily fish (salmon, tuna, and mackerel) are rich in vitamin D but take care not to consume more than 2 portions of oily fish a week.
• Enriched oils and margarines. Most margarines are fortified with vitamin D

1. Avoid Dehydration

A good fluid intake is really important during pregnancy as you have both your own fluid requirements and also that of your growing baby. Fluids help flush out toxins which can cause tiredness and lead to break- outs and acne during pregnancy. If you think you might not be getting enough fluids, check if you are showing any of these other common signs of dehydration:

• dark coloured urine and not passing much when you go to the toilet
• headaches
• confusion and irritability
• lack of concentration

Try to avoid drinks that contain caffeine and high concentrations of sugar or artificial sweeteners such as undiluted fruit juices, fizzy drinks, sports drinks, tea , coffee and cola. Ideal drinks are water, diluted fruit juice, weak squash, fruit and some herbal teas such as peppermint tea to ease digestion.

2. Exercise during Pregnancy:

Some gentle exercise each day to increase your heart rate and warm up your body temperature. This dilates the blood vessels and increases the amount of blood to the surface of the skin which ensures delivery of vital nutrients and oxygen as well as the removal of toxins to help maintain healthy and radiant skin.

3. Relax during Pregnancy:

Try to ensure that you have plenty of sleep and find some time for relaxation during pregnancy. Slow down while you are pregnant, it’s a great time to have a massage. Essential oils such as Rose Hip Oil have been found to have a relaxing effect; to be calming, to slow breathing, to reduce blood pressure and other measures of stress and can also be useful for the treatment of lower back pain. Almond Oil helps to protect against skin damage by sunlight, chemicals and Rosemary Oil is a natural antioxidant which helps to protect the skin from damaging chemicals.  Nutrilastin Body Treatment Oil is the perfect massage oil when pregnant as it is quickly absorbed into the skin and smells absolutely gorgeous. It contains the right mix of oils plus many other nutrients to promote skin elasticity and help prevent stretch marks.

4. Essential Fatty Acids:

Skin hydration and elasticity during pregnancy can be altered by the foods we eat. During pregnancy the health of skin is very important; elasticity, thickness, cell renewal and hydration help to reduce stretch marks and other skin conditions such as eczema, and psoriasis. Several key nutrients will help maintain skin health and should be included within your diet, supplements and skincare products used.

Omega-3 fatty acids are incorporated into the cells of the skin and have been found to improve skin elasticity and prevent stretch marks. It is very difficult to eat enough omega-3 fish oils to meet the requirements of you and your growing baby. A Omega-3 supplement is really important during pregnancy but ensure you choose a pharmaceutically graded, highly purified product, such as DHAPURE so that you can be confident that there are no unwanted toxins and contaminants in the fish oils.

Essential Fatty Acids: The essential fatty acid gamma linoleic acid (GLA) helps reduce trans-dermal water loss and maintain skin hydration. GLA is also useful for maintaining hormonal balance and can help prevent or treat acne and other skin disorders. Foods that are rich in GLA include; nuts, seeds and evening primrose oil.

5. Antioxidant Rich Foods during Pregnancy

Each day our skin protects us from the damaging rays of the sun and the numerous environmental chemicals that we are exposed to. Foods and skincare products that are rich in antioxidants help to prevent skin damage that causes ageing, dryness and help maintain skin thickness. Vitamin E, selenium, carotenoids (beta-carotenine, lycopene and lutein) are all antioxidants that are associated with benefits to skin health and can be found in a number of foods including; sunflower oil, almonds, rapeseed oil, eggs, brazil nuts, blackcurrants, watercress, orange juice, apricots, carrots and tomatoes.

6.  Top up your diet with a good ante-natal supplement to help promote healthy skin:

 A good ante-natal supplement such as Advanced Formula Antenatal will help provide all the nutrients, such as antioxidants and zinc, that you need to keep your skin healthy as well as ensure you have all the other nutrients that you and your baby require. Your ante-natal supplement should be rich in the antioxidants; vitamin C, vitamin E, selenium, beta-carotene and lycopene to ensure maximum skin health.  Juliet Wilson Advanced Formula Antenatal contains the optimal concentrations of 23 high bioavailability nutrients to support you through pregnancy.

7.  Avoid Processed Foods during Pregnancy:

Ready meals and processed foods are notoriously full of sugar and saturated fats, whilst also being very low in nutrients. These foods can cause metabolic chaos and result in erratic blood sugars, hormone confusion, clogged pores, spots and dull, lifeless skin.  

8. Moisturise, moisturise, moisturise:

A good moisturiser is really important during pregnancy as it is a period of rapid cell renewal and moisturising to help maintain skin hydration and elasticity is vital.  Creams containing vitamin E have been found to help protect skin from damage that leads to ageing and stretchmarks, whilst collagen holds moisture and helps hydrate the skin. Nutrilastin Stretchmark Cream contains a luxurious blend of the highest grade nutrients specifically developed to help prevent and treat stretchmarks.

9. Protect your skin from sunlight during pregnancy:

During pregnancy your skin is more vulnerable to sun damage. Use a good sun protection product. Ensure you take a supplement which contains vitamin D because pregnant women are at high risk of vitamin D deficiency and this nutrient is partcularly important for your baby’s growth and development.

10. Avoid harsh chemicals such as those contained in household cleaning products and check the ingredients of your skincare products:

Try to avoid cosmetics and skin care products that contain any of the following:

• Ethoxylated alcohols, such as sodium laureth sulphate (SLF) which can cause skin irritation, particularly during pregnancy when skin is sensitive.
• Amines and derivatives, such as diethanolamine (DEA) and monoethanolamine (MEA) which are known to irritate the skin and may be linked to cancer.
• Parfum and fragrances, such as artificial musk which can build up in the body and has been found in breast milk.
• Formaldehyde (a preservative), which is hidden in ingredients such as DMDM-hydantoin, metheneamine and sodium hydroxymethylglycinate. This form of preservative is one of the leading causes of allergic reactions.
• Parabens, such as butylparaben can be absorbed and accumulate in the body.

Nutrilastin Stretchmark Cream

In the latest (October’s) Practical Parenting magazine, Juliet’s unique Nutrilastin Stretchmark cream has been reviewed against other leading brands and has been assessed as being one of the best stretchmark creams available to provide nourishment and elasticity to the skin during pregnancy.

Nutrilastin Stretchmark Cream has been specifically developed to tackle stretchmarks  using the latest research available and is packed full of antioxidant vitamins and active ingredients such as Rose Hip Oil to help reduce redness and scarring.