Niamh Dunne

The Impact of Alcohol When Trying to Conceive and in Pregnancy Introduction Alcohol is a common part of socialising and relaxing around friends. While this is generally acceptable in moderation, when you are trying to conceive or are pregnant, there are different recommendations to protect you and your baby. Recently, there has been a growing awareness of alcohol, fertility and pregnancy. This blog will explore effects of alcohol on conception and pregnancy and provide you with some alternatives so you can still have fun whilst socialising, without missing out on some delicious drinks! Does alcohol hinder chances of conception? Alcohol decreases the chance of conception. Why? Alcohol can affect hormones and ovulation (Emanuele, Wezeman and Emanuele, 2024) Men drinking alcohol also reduces the chance of conception (Finelli, Mottola and Agarwal, 2021) Moderate drinking may delay conception NICE recommend 1-2 units once or twice a week, at most (NICE, 2017). This may look like 1 small glass of wine or a half pint of beer. However, the chances of conception are highest if you and your partner stop drinking while trying to conceive. Alcohol during pregnancy NICE do not recommend any consumption of alcohol during pregnancy. This is because there is no safe level of consumption of alcohol in pregnancy. Any consumption of alcohol in pregnancy increases the risk of: Why? Alcohol passes through the placenta, so your baby would be exposed to the alcohol you drink. Without a fully developed liver, this is very dangerous for your baby’s health and development. Drinking alcohol during pregnancy may lead to Fetal Alcohol Spectrum Disorder (FASD). Fetal alcohol spectrum disorder causes difficulties such as: (CDC, 2024; CanFASD, 2017) The more alcohol consumed, the greater the risk for you and your baby’s health. There is no safe amount of alcohol that can be consumed during pregnancy. Avoiding alcohol during pregnancy supports your health and your babies development. There is always a risk, even occasional drinks (NHS, 2023) (NICE, 2022). Alcoholic drink alternatives A lot of non-alcoholic drinks are very high in sugar. Here are some alternatives that aren’t super high in sugar: Conclusion Reducing alcohol consumption may increase the chances of conceiving and protect the health of you and your unborn baby. However, there is no safe amount to drink during pregnancy. Try some of the alternatives in this blog to keep social events fun at this exciting time of your life! If you are struggling, please reach out to a healthcare professional. For more information on Nutrition during Pregnancy, read here Written by nutrition student Millie Rose, reviewed and edited by Niamh Dunne References CanFASD. (2017). Basic Information – CanFASD. [online] Available at: https://canfasd.ca/topics/basic-information/. CDC (2024). About Fetal Alcohol Spectrum Disorders (FASDs). [online] Fetal Alcohol Spectrum Disorders. Available at: https://www.cdc.gov/fasd/about/index.html. Emanuele, M.A., Wezeman, F. and Emanuele, N.V. (2024). Alcohol’s Effects on Female Reproductive Function. Alcohol Research & Health, [online] 26(4), p.274. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6676690/. Finelli, R., Mottola, F. and Agarwal, A. (2021). Impact of Alcohol Consumption on Male Fertility Potential: A Narrative Review. International Journal of Environmental Research and Public Health, 19(1), p.328. doi:https://doi.org/10.3390/ijerph19010328. Jensen, T.K., Hjollund, N.H.I., Henriksen, T.B., Scheike, T., Kolstad, H., Giwercman, A., Ernst, E., Bonde, J.P., Skakkebak, N.E. and Olsen, J. (1998). Does moderate alcohol consumption affect fertility? Follow up study among couples planning first pregnancy. BMJ, 317(7157), pp.505–510. doi:https://doi.org/10.1136/bmj.317.7157.505. NHS (2023). Drinking alcohol while pregnant. Available at: https://www.nhs.uk/pregnancy/keeping-well/drinking-alcohol-while-pregnant/. NICE (2017) Fertility problems: assessment and treatment. Available at: https://www.nice.org.uk/guidance/cg156/resources/fertility-problems-assessment-and-treatment-35109634660549 NICE (2022) Fetal alcohol spectrum disorder. Available at: https://www.nice.org.uk/guidance/qs204/chapter/Quality-statement-1-Advice-on-avoiding-alcohol-in-pregnancy

Can Our Diet Help Manage Menopause Symptoms? Written by Millie Rose What is menopause? Menopause occurs when the hormone estrogen reduces and your period eventually stops. This usually occurs between 45 and 55, although it can happen earlier. It can happen naturally or surgically, by hysterectomy. In the lead up to menopause, you may begin to have symptoms but still have periods, this is called perimenopause. After 12 months without a period, menopause is determined. Made using Canva What symptoms does menopause cause? Menopause and perimenopause can be difficult for many women, causing anxiety, brain fog, hot flushes, and irregular periods. Many women have these symptoms during perimenopause and after menopause. As well as this, a lot of women also struggle with weight gain during this time. HRT, hormone replacement therapy, is a common treatment prescribed by doctors to treat symptoms of menopause or perimenopause. This treatment works by increasing the levels of oestrogen, a hormone that naturally decreases at menopause. (NHS, 2019) While HRT can be used to treat symptoms, many women still struggle with weight gain at menopause. For women in menopause, or perimenopause, it may be useful to use a combination of HRT and small changes in dietary habits to improve symptoms. As well as this, at menopause, there are some nutrients that may need more attention to, in order to protect your body. This blog will delve into key nutrients at menopause, how your diet can affect symptoms, how to eat for your symptoms and behaviour techniques to keep menopause weight off; to make you feel the most comfortable in your body. Read until the end for a sample menopause meal plan! Key nutrients at menopause Vitamin D and Calcium The reduction in estrogen can lead to reduced bone density, which can lead to osteoporosis, a disease which weakens bones and increases the chance of fractures (NHS, 2022). During this time, adequate consumption of calcium and vitamin D is vital. Adults need 700mg of calcium per day, this should be achieved through diet unless advised by a healthcare professional otherwise. In the UK, it is advised to take a 10mg vitamin D tablet per day during autumn and winter. Foods high in Calcium include: (NHS, 2020) Foods high in Vitamin D: (NHS, 2020) Magnesium Women during menopause may feel more tired or fatigued, which may lead to increased need for naps during the day. When deficient in magnesium, these symptoms can be heightened. Foods high in Magnesium: (NHS, 2020) B vitamins- B1, B5, B6 The different B vitamins are essential for heart function, mental performance and regulating hormones. This is vital during menopause when hormones are changing. Foods high in B vitamins: B vitamin sources (NHS, 2020) Zinc During menopause, some women experience dry skin, brittle hair, and nails. Zinc can improve this, as well as immunity and mood stability. Foods high in Zinc: (NHS, 2020) (BNF, 2022) How can diet affect menopause symptoms? The British Menopause Society have identified that caffeine, alcohol, and spices may increase hot flushes and disturb sleep (BMS, 2023). Estrogen normally enhances the fullness hormone, leptin, and suppresses ghrelin, the hunger hormone, however both decrease at menopause. Due to the removal of some of the estrogen, the body is less sensitive to leptin, making it more difficult to know when you’re full and cravings increase, making it more likely for you to put on weight at menopause. There is evidence to show this in animals, but further research is needed for clarification in humans (Ainslie et al., 2001). The British Dietetic Association have claimed that “increasing wholegrains, fruit, and vegetables, and reducing fat intake are moderately effective in reducing hot flushes.” They found these effects were also larger for women who also lost weight too. Additionally, some evidence suggests having a healthy gut microbiome may affect hormone levels. To optimise your gut health, it is recommended to eat 30 different plant foods each week (BDA, 2019). This includes wholegrains, such as beans, lentils, nuts, seeds, herbs and spices. Even dark chocolate (>70% cocoa) and tofu count. The key here is variety. When purchasing peppers, purchase a selection of red, green, orange and yellow rather than just red. These will count as 4 (for 4 colours) plant points. Additionally, consuming fermented foods regularly such as sauerkraut, kimchi and kefir can improve our gut health. Research shows that a Mediterranean style diet protects bone density, reduces the risk of heart disease, and supports a healthy diet at menopause (BNF, 2022). The Mediterranean style diet includes a diet rich in whole foods, such as fruits, vegetables, wholegrains, nuts, seeds, legumes, olive oil and fish. Plant oestrogens, found in plants, such as soya beans, flax seeds and linseeds, may help at menopause as they help our gut bacteria (BDA, 2019). They do not feed the gut like fibre, but they use gut bacteria to be converted into compounds that mimic estrogen. This helps to reduce symptoms like hot flushes in some women. Cholesterol tends to rise at menopause; this can affect your heart health (BDA, 2019). Read blog on Nutrition for Heart Health to make sure you are protecting your heart health. Food habits Sometimes it is not what you eat, but how you eat. Your behaviour and habits surrounding food can affect food choices and how much you eat. Creating intention with mealtimes, such as preparing a food shop with foods that make you feel good ensures you have those foods accessible when it comes to cooking. Read blog ‘Do you need to change your behaviour around food?’ to read about: 10 tips to improve your symptoms with dietary changes: Sample meal plan Breakfast: Yoghurt with my Pecan, Almond & Cinnamon Granola Lunch: My Rice Buddha Bowl Dinner: My Salmon, lemony asparagus, roasted vegetables and mash Snacks: My Crunchy Chocolate Quinoa Bites, my Delicious Veggie Sausage Rolls Drinks: Water, unsweetened decaffeinated tea or coffee and Kombucha- a drink containing probiotics, meaning it feeds your gut. Look out for no added sugar varieties Conclusion

Do you need to change your behaviour around food? Written by Millie Rose Introduction to behavior change and food Healthy eating isn’t just about knowing what‘s good for you, it’s also about changing the habits and behaviour that shape your food choices. The way we think, the people around us, and even the environment we live in all play a big role in what ends up on our plates. In this blog, we’ll explore: Psychology of Food Choices Psychology looks at why we choose the foods we do. It’s powerful because small changes in how we think or what we’re surrounded by can shift our eating patterns. One important idea here is cognitive bias. This means automatic errors in thinking that affect how we see food and the choices we make, often without realising it (Da Silva, Gupta and Monzani, 2023). Simply, our brain sometimes tricks us into making food choices that don’t always match our long-term goals. Cognitive biases often show up in emotional eating (my blog on intuitive vs mindful eating may be helpful). This is when we eat to try and change how we feel rather than because we’re hungry. Emotional eating is guided by feelings rather than hunger cues, and it can have a big impact on our food decisions (Betancourt-Núñez et al., 2022). It can also reduce appetite at first, but then lead to hunger and overeating later in the day (Betancourt-Núñez et al., 2022). 30% have increased appetite when experiencing a negative emotion48% have decreased appetite when facing a negative emotion22% appetite doesn’t change when facing a negative emotion(Betancourt-Núñez et al., 2022) Habit Formation and Breaking Bad Eating Habits Food habits can form at any time, from childhood into adulthood. There are many factors to forming habits, such as work pattern, taste and texture preferences, culture, budgets and surrounding environment (Fisberg, Giogia and Maximino, 2023). There are two types of behaviour: Habitual: a repeated behaviour cued by the environment/external stimuli (Brown, 2024), they are automatic or unconsciousNon-habitual: a behaviour followed after consideration, they are deliberate and conscious (Wood, Quinn and Kashy, 2002) Habitual problems can be problematic. But why? 4 things we can do: The Role of Social Influences in Eating Family, friends and your social circle can impact your food choices as we often mirror what people around us are doing. This may happen with portion sizes, time of eating and food choice. Follow these 3 tips to navigate social influences and peer pressure: Motivation: Intrinsic vs. Extrinsic Intrinsic motivation = doing a behaviour because you want to, perhaps because you enjoy it or you want to reap the benefits of the action, for example, increasing your exercise from 1 x week to 3 x week because you want to feel fitter and stronger Extrinsic motivation = doing a behaviour for external rewards or to avoid judgement, for example, following a diet for praise from family or friends (Morris et al., 2022) What drives sustainable behaviour change? Using Nudges to Improve Eating Habits Nudges are subtle prompts that may help you change your eating behaviours. Some nudges that may help you: Practical Tips for Lasting Behaviour Change 2. Identifying the effect of the problem behaviour 3. Identifying a solution to the problem behaviour 4. Identifying the positive effect of changing your problem behaviour 5. Holding yourself accountable 6. Overcoming setbacks Conclusion: Long-term Healthy Eating Embracing food change as a continuous process, not a quick fix, can take time to figure out. However, by making small changes over time to your behaviour and environment, you can make positive changes to your relationship with food and your diet. References Betancourt-Núñez, A., Torres-Castillo, N., Martínez-López, E., De Loera-Rodríguez, C.O., Durán-Barajas, E., Márquez-Sandoval, F., Bernal-Orozco, M.F., Garaulet, M. and Vizmanos, B. (2022). Emotional Eating and Dietary Patterns: Reflecting Food Choices in People with and without Abdominal Obesity. Nutrients, [online] 14(7), pp.1371–1371. doi:https://doi.org/10.3390/nu14071371. Brown, R. (2024). Habitual Health-Related Behaviour and Responsibility. Oxford University Press eBooks, [online] pp.210–226.doi:https://doi.org/10.1093/oso/9780192872234.003.0010. Butcher, L.M., Batt, C., Royce, S., Barron, E., Giglia, R. and Begley, A. (2024). Analysing the behaviour change techniques in an effective food literacy program to inform future program design. Nutrition & Dietetics. doi:https://doi.org/10.1111/1747-0080.12908. Celis-Morales, C., Livingstone, K.M., Marsaux, C.F., Macready, A.L., Fallaize, R., O’Donovan, C.B., Woolhead, C., Forster, H., Walsh, M.C., Navas-Carretero, S., SanCristobal, R., Tsirigoti, L., Lambrinou, C.P., Mavrogianni, C., Moschonis, G., Kolossa, S., Hallmann, J., Godlewska, M., Surwillo, A. and Traczyk, I. (2017). Effect of personalized nutrition on health-related behaviour change: evidence from the Food4Me European randomized controlled trial. International journal of epidemiology, [online] 46(2), pp.578–588. doi:https://doi.org/10.1093/ije/dyw186. Da Silva, S., Gupta, R. and Monzani, D. (2023). Editorial: Highlights in Psychology: Cognitive bias. Frontiers in Psychology, [online] 14(1242809). doi:https://doi.org/10.3389/fpsyg.2023.1242809. Fisberg, M., Gioia, N. and Maximino, P. (2023). Transgenerational transmission of eating habits. Jornal de Pediatria, 100.doi:https://doi.org/10.1016/j.jped.2023.11.007. Morris, L.S., Grehl, M.M., Rutter, S.B., Mehta, M. and Westwater, M.L. (2022). On What Motivates us: a Detailed Review of Intrinsic v. Extrinsic Motivation. Psychological Medicine, 52(10), pp.1–16. Wood, W., Quinn, J. and Kashy, D. (2002). Habits in Everyday Life: Thought, Emotion, and Action. Journal of Personality and Social Psychology, [online] 83(6). doi:https://doi.org/10.1037/0022-3514.83.6.1281. Shivani Kachwaha, Kim, S.S., Das, J.K., Rasheed, S., Gavaravarapu, S.M., Pooja Pandey Rana and Menon, P. (2024). Behavior Change Interventions to Address Unhealthy Food Consumption: A Scoping Review. Current Developments in Nutrition, 8(3),pp.102104–102104. doi:https://doi.org/10.1016/j.cdnut.2024.102104.