DIETARY CHANGES FOR BOTH THE PREGNANT AND THE TRYING TO GET PREGNANT WOMEN (By: Godday Ojore Aghedo)

INTRODUCTION

The state of health of everyone largely depends on the quality of food everyone consumes. This includes fertility. Dietitians at Loyola University Health System say women who watch their weight and closely follow a Mediterranean-style diet high in vegetables, vegetable oils, fish and beans may increase their chance of becoming pregnant. Going organic is still the best option for everyone seeking a healthy life - (Ezekiel 47:12, Genesis 1:24-2:18). 

“Establishing a healthy eating pattern and weight is a good first step for women who are expecting to conceive. They help with fertility and may also influence fetal well-being as well as reducing the risk of complications during pregnancy” - (Brooke Schantz).

Thirty percent (30%) of infertility is due to either being overweight or underweight, according to the National Infertility Association. Both of these extremes in weight cause shifts in hormones (or hormonal imbalances), which can affect ovulation. Reducing weight by just 5 percent (5%) can enhance fertility. Thus, the following information should be very vital to both intending and already pregnant women:

• Pay attention to your diet
• Practice good habits for pregnancy
• Take prenatal vitamins
• Get enough folic acid
• Maintain a healthy weight
• Keep a lid on soda and fruit juice
• Get your thyroid hormone level checked
• Get your vaccinations
• Stock up on these supplements
• Maintain a regular exercise routine.

Don't wait until you're pregnant to improve your eating habits. Set the stage now with healthy diet changes to ensure your baby gets off to a strong start.

Ø Pay attention to your diet

For both men and women, food and fertility are linked. Stick to a balanced diet to boost your chances of a healthy baby. Diet is a key public health subject because; the levels of pregnancy hormones, vitamins, protein, minerals and other nutrients are determined by the QUALITY and QUANTITY of our foods. In reality, many health abnormalities can be prevented, managed or cured by healthy diets and eating patterns.

Eat several servings of fruit, vegetables, whole grains, and calcium-rich foods such as yogurt, cheese, and milk every day. Not getting enough nutrients can affect your periods, making it difficult to predict when you ovulate. And you may not ovulate at all if you're significantly underweight or obese.

Your partner should also pay attention to his diet since certain vitamins and nutrients – such as zinc and vitamins C and E, and folic acid – are important for making healthy sperm.

How can I get pregnant quickly?

These things you can do to maximize your chances of getting pregnant quickly.

Fish is a nutritional powerhouse for a growing baby, offering low-fat protein with omega-3 fatty acids, but you need to take care to avoid types that are high in mercury, which can be dangerous to your unborn baby. The U.S. Food and Drug Administration urges women to eat 8 to 12 ounces of a variety of fish each week.

Because mercury can accumulate in your body and linger there for more than a year, avoid high-mercury fish such as shark, swordfish, king mackerel, and tilefish. Instead, eat lower-mercury fish such as salmon and canned light tuna (not albacore, which is higher in mercury) once or twice a week. 

Processed meats can be particularly dangerous for pregnant women and should be consumed in small amounts, and smoked or raw meats should be avoided entirely during pregnancy. Even hot dogs or deli meats should be heated until they are steaming before you eat them if you are pregnant.

Ø Practice good habits for pregnancy

For many mothers-to-be, pregnancy prompts an abrupt change in eating and drinking habits – but some habits are hard to break. Make it easier on yourself by changing habits now, and help ensure your baby gets off to a good start from the moment you conceive.

Some solid advice: The occasional bottle of beer or glass of wine probably won't affect your chances of getting pregnant, but alcohol can harm a developing baby. And since you may not know exactly when you ovulate or conceive, you may want to play it safe and cut out alcohol completely. 

On a related note, if you use any recreational drugs or smoke, quit now. All of these substances and habits can harm a developing fetus.

You may also want to cut back on caffeine. The research on whether caffeine can affect fertility is mixed. Experts generally agree that low to moderate caffeine consumption, less than 300 mg a day or about the equivalent of two 8-ounce cups of coffee, won't affect your fertility, but your healthcare provider may recommend that you cut caffeine out entirely to play it safe. Learn more about caffeine and fertility. It is also better to AVOID SOFT DRINK LIKE COKE.

And once you are pregnant, experts recommend limiting yourself to less than 200 milligrams of caffeine a day (that's a little less than a 12-ounce cup of coffee). This is because higher amounts of caffeine have been linked to an increased risk of miscarriage. If you have a strong coffee or soda habit, you might want to start weaning yourself off it now.

Ø Take prenatal vitamins

Although you can meet almost all of your nutritional needs through a balanced diet, many experts believe that even the healthiest eaters can use extra help. Taking a prenatal vitamin ensures that you're getting enough folic acid and other essential nutrients to boost your chances of conceiving a healthy baby. Do not avoid the prenatal vitamin supplements!

Remember that a supplement is a safeguard, not a substitute for a sound diet. And since regular over-the-counter multivitamins may contain mega doses of vitamins and minerals that could be harmful to a developing baby, choose a pill formulated specifically for pregnant women. If you have a vegetarian diet, you may also need vitamin D and B-12 supplements, along with extra protein. Make sure your body has the folic acid, vitamins B₆ & B₁₂, iron omega-3 fatty acid, and calcium it needs to get pregnant and support a healthy pregnancy.

Omega-3 fats are a superfood for pregnant women

Omega-3 fats contain a powerhouse of nutrients to ensure that your baby will develop properly – and that you won’t struggle with depression or anxiety (which can be common in pregnant women). Omega-3 fatty oils protect your baby from brain injuries such as autism, pervasive developmental delay, and ADHD.

In addition, omega-3 fats have been found to be effective in combating cardiovascular disease and depression in you (i.e. the mother). With hormones fluctuating so wildly during this time, you might find yourself dealing with emotions you didn’t expect.

I always advise that you talk to your healthcare provider about the right prenatal supplement for you.

Ø Get enough folic acid

Folic acid has been proven to reduce a baby's risk of neural-tube birth defects such as spina bifida, and it is linked to a lower incidence of heart attacks, strokes, cancer, and diabetes.

Most women of child-bearing age should take a supplement with 400 micrograms (mcg) daily for at least a month before pregnancy and 600 micrograms during pregnancy. If you have a family history of neural-tube birth defects or take medication for seizures, your healthcare provider may suggest that you boost your daily intake to 4,000 mcg, or 4 mg, starting at least a month before you conceive and continuing throughout your first trimester.

A good over-the-counter prenatal vitamin should contain more than the minimum recommendation of folic acid, between 600 and 800 mcg – the amount you'll need during pregnancy. In addition, you can eat folate-rich foods, such as dark green leafy vegetables like spinach, citrus fruits, nuts, legumes, whole grains, and fortified breads and cereals.

Folic acid is a water-soluble vitamin, so your body will flush out the excess if you consume too much. Here is the downside to being water-soluble too: You can lose a lot of this vitamin in cooking water, so steam or cook vegetables in a small amount of water to preserve the folate.

Be aware also of getting too much folate may hide a vitamin B-12 deficiency, which is sometimes a problem for vegetarians. Ask your doctor or midwife if you think you may be at risk.

Ø Maintain a healthy weight

It might be a good idea to shed some pounds, or gain a few if you're underweight, while you're trying to get pregnant, since you want to be as close as possible to your recommended weight when you conceive. Being over- or underweight can make it harder to get pregnant. Also, obese women have more pregnancy and birth complications, and underweight women are more likely to have a low-birth-weight baby. ‘Women whose body mass index [BMI] is between 24 and 30 are most fertile,’ according to a medical research.

In addition to following a smart eating plan with low-fat, high-fiber foods, get regular exercise. If you're overweight, aim at losing one to two pounds a week, which is a safe rate of weight loss. Extreme weight loss from crash dieting can deplete your body's nutritional stores, which isn't a good way to start a pregnancy.

Ø Keep a lid on soda and fruit juice

There's a lot of conflicting advice out there about how your diet affects fertility. What people tend to agree on is avoiding soda and fruit juice. They're both very high in sugar, they raise blood sugar very quickly and that can have a negative impact on fertility. It's also a good idea to eliminate trans- fats from your diet too, as consuming too much has been linked to infertility.

Ø Get your thyroid hormone level checked

Hypothyroidism (an underactive thyroid) is very common in women. According to Mary M. Gallenberg, on MayoClinic.com, "Low levels of thyroid hormone can interfere with the release of an egg from your ovary (ovulation), which impairs fertility. In addition, some of the underlying causes of hypothyroidism — such as certain autoimmune or pituitary disorders — may impair fertility."

Ø Get your vaccinations

If you haven't received vaccinations or boosters in years, talk with your doctor about what he/she suggests you get and when. Some school of thoughts recommend at least three months before getting pregnant. The major ones are MMR (measles-mumps-rubella) but you also want to get booster shot for, DTP (Diphtheria, Tetanus, and Pertussis).

Ø Stock up on these supplements

It's important to start taking a folic acid supplement about three months before you plan to get pregnant because it takes a while to build up in your body. Buy it over the counter or at a supplement store. It's also a good idea to make sure you're getting enough vitamin B₁₂ in your diet as some studies have linked a deficiency to infertility. Vitamin B₆ and omega-3 fish oil supplements have also been linked to possibly aiding the treatment of infertility.

Ø Maintain a regular exercise routine

How much exercise you should be getting during pregnancy is often a hot debate. Researchers suggest that moderate exercise can improve fertility. Too much can throw off your cycle but if you're doing too little, that's also not good. The American College of Sports Medicine and the American Heart Association recommend at least 30 minutes of moderate exercise on 5 days each week or at least 20 minutes of vigorous exercise on 3 days each week for optimum health. However, I recommend simple exercises like taking a long walk, squatting and standing repeatedly, amongst other simple ones you may find convenient.

FOODS TO AVOID WHEN YOU’RE TRYING TO GET PREGNANT

During your pregnancy there are a few things that might stress you out, but eating shouldn't be one of them. Unfortunately, all of the advice you hear -- from friends, family, and yes, even total strangers -- about what is and isn't safe during pregnancy is enough to confuse anyone. "There are a lot of old wives' tales out there," says Elizabeth Ward, Massachusetts. So if you're wondering what's okay to eat (and whether you have to give your favourite foods the boot for nine months), here is some reliable advice for you:

Foods to Avoid if You Want to Get Pregnant

Whether you’re pregnant or trying to conceive, focus on minimizing PROCESSED FOODS while increasing your intake of vegetables, healthy fats, and high-quality sources of protein. Why are some foods off-limits when you are pregnant - but fine if you are not? First, changes to your immune system now make you more vulnerable to food-borne illnesses. What would have meant stomach upset before could mean serious complications now; ranging from dehydration to miscarriage.

Therefore to be on the safer side, avoid the following:

1. Soybeans and soy foods

The plant form of estrogen (phytoestrogens) in soybeans won’t help when you are trying to get pregnant – and it is especially important to avoid high soy consumption if you are coping with infertility. “For those trying to conceive, the excess estrogen activity is enough to induce a hormone imbalance that may affect egg production and ovulation.”

 

Decrease your soy intake six months before you start trying to get pregnant, and remember that soy is “hidden” in foods such as oils, flour, milk, and texturized vegetable protein (TVP). But, make sure you get enough protein from other food sources other than soy. 

2. Peanut butter and spinach

Peanut butter and spinach are foods to avoid when you’re trying to get pregnant because they deplete calcium – which is a mineral that is essential for your baby to develop and grow. Make sure you’re getting enough calcium if you’re trying to get pregnant.

3. Soda pop, high-sugar fruit drinks, and candy

Excessive sugar can lead to low blood sugar, which can upset levels of reproductive hormones. You need your hormones to be as balanced and stable as possible when you’re trying to get pregnant. Consequently, avoid sugary foods if you’re trying to get pregnant.

4. Coffee, tea, chocolate, cola and some medications

Excessive caffeine can not only reduce your chances of getting pregnant, it can increase the risk of miscarriage. When you’re trying to get pregnant, drink tea in moderation – and stick to decaffeinated tea.

In Getting Pregnant Lauersen and Bouchez wrote, “Cut out caffeine when you can, and when you can’t, minimize consumption by taking into account your total daily intake from all sources.” Single doze or short-term use of caffeine-rich products won’t cause infertility, but they are good things to avoid when you’re trying to conceive.

5. Watch the painkillers/stimulants/diet pills and caffeine

These aren’t exactly “foods not to eat when you’re trying to get pregnant,” but things like Extra Strength Excedrin, Maximum-Strength Midol, Vanquish, Anacin, and Amaphen are pain relievers that may contain significant amounts of caffeine. No-Doz is a stimulant that has caffeine, and many diet pills also contain caffeine…these aren’t substances to avoid if you’re trying to get pregnant, but they’re definitely factors that can affect your fertility levels!

CONCLUSION

• Reduce intake of foods with trans- and saturated fats while increasing intake of monounsaturated fats, such as avocados and olive oil
• Lower intake of animal protein and add more vegetable protein to your diet
• Add more fiber to your diet by consuming whole grains, vegetables and fruit
• Incorporate more vegetarian sources of iron such as legumes, tofu, nuts, seeds and whole grains
• Consume high-fat dairy instead of low-fat dairy
• Take regular women’s multivitamin supplements: folic acid, vitamin B-complexes, iron, calcium, and omega-3 FAs.

If you want to get pregnant, you need to maintain a healthy body weight and consume a balanced diet. Eat often, for both yourself and your unborn baby in mind.

SHALOM! 

G. O. Aghedo

HIV-EXPOSED UNINFECTED CHILDREN - BY: GODDAY OJORE AGHEDO

The increasing success of the prevention of mother to child transmission (PMTCT) of HIV is a clear indication that HIV-exposed uninfected (HEU) children have continued to abound in number. HEU children simply refer to those babies born to HIV positive mothers, but who are uninfected with the virus or who turned out to be HIV negative. The evidence for health problems among HEU children, the causes of such problems and the possible solution or control measures, form the focus of this article.

One of the most emotive and tragic dimension of the HIV epidemic is the HIV infection of infants through mother to child transmission (MTCT). As a consequence, health challenges of HEU infants should be of enormous public health significance; but unfortunately, there appears to be limited available information on this subject matter. Most available reports are those obtained from developed and industrialized countries. But in Africa where many countries are either underdeveloped or developing, poor diets or malnutrition, exposure to malaria and other infections, parental drug abuse, stressful home condition/environment and poverty are prevalent. These are in themselves, are serious threats to the health of HEU infants. If these threats are not professionally addressed in good times, it may lead to the death of HEU infants, which is an undesirable result of PMTCT.

In developed countries MTCT has drastically reduced to a negligible level through a combination of highly active antiretroviral therapy (HAART), elective caesarean section and complete avoidance of breastfeeding. However, in Africa, world health organisation (WHO) advocates exclusive breastfeeding for a minimum of six months; since replacement feeding are very expensive and may be out of the purchasing reach of many HIV infected mothers. Breastfeeding affects the growth, immune system development as well as exposure to HIV in no small measures.

Bye and large, the health problems with HEU children include but not limited to maternal death and low maternal CD4 count, low birth weight (LBW), severe maternal and child anaemia, poverty, single parenting, pneumonia caused by pneumocystis jiroveci and poor cognitive and motor development in the children. On the other hand, lack of parental care, bad infant feeding practices, immune abnormalities, exposure to other infections and even exposure to ARV (especially Zidovudine containing regimen) are potential causes of poor health and nutrition in HEU children.

In conclusion, HEU children and their mothers especially, should be given adequate relevant psychosocial supports. Medical supports like: improving maternal health, providing ART, iron-folate and other micronutrient supplements, prophylactic antibodies against opportunistic infections; as well as socioeconomic supports, are earnestly needed in order to efficiently tackle the health problems confronting the HEU children. Just the same way, HIV-infected infants are given all necessary attention to foster their survival, requisite attention should be directed to HEU children too, since they represent the success of the PMTCT efforts. Consequently, mortality and morbidity among HEU children can be reduced to a minimal level; although it is on record that mortality among HEU children is higher than in HIV unexposed babies.

BY:

GODDAY OJORE AGHEDO

PREVENTION OF TB AMONG PEOPLE LIVING WITH HIV - by: Godday Aghedo

Tuberculosis (TB) is an airborne disease caused by my mycobacterium tuberculosis. It is one of the top causes of death in HIV infected persons; as an opportunistic infection (OI). TB care and prevention among people living with HIV (PLHIV) and HIV care and prevention among TB patients are still an urgent need. According to surveillance and survey data, world health organisation (WHO) estimates that 9.27 million new cases of TB occurred in 2007, of which 14.8% (approximately 1.37 million) were estimated as HIV positive. Africa has the highest burden of the TB and HIV co-epidemic with 37% of TB patients estimated to be HIV-infected. This accounted for 23% of the estimated HIV deaths in 2007.

Considering the aforementioned, urgent steps are needed to be taken in view of preventing TB among PLHIV. Though the prevalence and mortality rates have continued to decline globally, the pace is still slow. As a result, the 2015 targets of halting, reversing and halving the 1990 prevalence and mortality rates were not met. However, intensifying efforts at preventing and treating TB among PLHIV, is  

Promoting linkages between tuberculosis (TB) and human immunodeficiency virus (HIV) treatment and prevention programs in resource-constrained environments where both diseases are prevalent is essential to improve the diagnosis, treatment, and outcomes for patients affected by both diseases. In this article, we share insights based on our experiences supporting integrated TB and HIV service delivery programme, including intensified TB case finding, isoniazide preventive therapy, infection control, and initiation of antiretroviral therapy. 

Our experience indicates that successful integration of TB and HIV services in resource-constrained environments is feasible, although programmatic, infrastructural, and staffing challenges remain. Successful implementation of TB and HIV collaborative activities requires consideration of the realities that exist on the ground and the importance of tailoring interventions in a manner that enables their seamless introduction into existing programs that are often overwhelmed with large numbers of patients and a paucity of human and other resources.