Our previous column - on applying Chinese medicine to a mother's health - began a series on how to promote the well-being of mothers. Naturally, fathers and children need well-being, too, but in our experience, it is usually the mother who is the most stressed and depleted person in the family. By improving her well-being from negative to at least neutral - and then going further into positive wellness - she's able to be at her best for herself, her children, and her partner.
In this column and the next one, we discuss perhaps the most fundamental thing that a mother can do for her long-term health and well-being: get proper nutrition. We admit we're zealous about this, even to the point of being big nags. But the truth is, most of us are eating in a CRAZY way today, utterly at odds with the foods a body needs after millions of years of evolution. The hunter-gatherer diet consisted mainly of fruits, vegetables, nuts, and meat, basically without any grains, dairy products, refined sugars, or refined oils. Just 10,000 years ago - a mere blip on the evolutionary time scale - the modern diet began with the invention of agriculture, and it's only the last 50 years that have seen the widespread use of packaged foods, pesticides, heavy refining that strips away nutrients, and artificial ingredients. Bearing, breastfeeding, and rearing a child is an enormously physical activity, and to pull it off, you've just got to honor the fundamental biology of your body in a way you never had to before children. And that means eating a lot more like your great-great-Paleolithic-grandmother than the usual fare of bagel and coffee for breakfast, factory-farmed lettuce and processed oils at lunch, and microwave-fresh something for dinner.
For a snapshot of how you're eating, please look at the self-assessment in the box. You could already be taking good care of yourself. But if not, there are two ways to improve your diet: (1) make sweeping changes all at once, or (2) work your way into it. Whichever path you take, we urge you to stay on it until you end up with truly nurturing nutrition. It's a little more work to eat well, but your health is worth it. Experiment with different foods, and take a look at books on nutrition. But the fundamental recipe is very simple: Build up your body's balance sheet by eating more healthy foods and fewer worthless or toxic ones. At every meal, a few trillion molecules at a time, you'll be rebuilding the very tissue of your body.
Please don't give up because you slip up! Everybody slips. Just return to the path for your next meal. You can motivate yourself by remembering the health benefits of eating right, for yourself and your children. Try to understand the factors that keep you from eating well so you can take charge of them, rather than vice versa. For instance, Jan worked with a single mom who ate a huge, double handful of chocolate chips each day. She knew it wasn't healthy, but she said: I know it's not good, but I work hard all day long, and this is about the only thing I do for me. By finding other, healthier ways to nurture herself, she was able to cut down on this daily blast of sugar.
Pull out
Your Nutritional Self-Assessment
Put one or more points in the boxes that apply to you on a typical day in the past week. A serving is roughly half a cup of solid food or one cup of leafy vegetables.
Pluses:
[ ] Number of servings of fresh fruit (up to 2 points)
[ ] Number of servings of fresh vegetables (count one point for every serving)
[ ] Number of servings of a whole grain (two slices of bread from completely unrefined flour, 1/2 cup of brown rice or bulgur) (up to 2 points)
[ ] Drank four or more cups of water
[ ] Number of servings of protein (meat, fish, tofu, eggs, cheese) (up to 3)
[ ] At least half of all foods were organic
[ ] Oils used were mainly unrefined (virgin olive oil or oils labeled "unrefined")
[ ] Ate foods rich in Omega-3 essential fatty acids (salmon, mackerel, flax oil) or took an Omega-3 supplement
[ ] Took a good multivitamin/multimineral supplement
Minuses:
[ ] Number of sweet desserts you ate (a soft drink, donut, candy bar, ice cream cone, piece of pie) (if large, multiply by 2)
[ ] Number of servings of processed foods (potato chips, canned soups, packaged noodles and cheese, TV dinners, or any product made with white flour)
[ ] Consumed hydrogenated or partially hydrogenated fats (Crisco, most potato chips, margarine)
[ ] Had three or more caffeinated drinks (coffee, black tea, some soft drinks)
[ ] Had two or more alcoholic drinks (one "drink" is a beer, small glass of wine, or shot of liquor)
Add up your pluses. Add up your minuses (remember to count each serving of a sweet dessert or processed food). Subtract the minuses from the pluses. A score of 13 or above means you are doing well, 8 to 12 is pretty good but could be improved, and a score of 7 or below (including negative numbers) indicates a real need to make some changes in your diet.
Eat Your Veggies!
A mother needs vegetables more than any other food because they're rich in vitamins and minerals, and they contain phytochemicals, hormone-like substances that seem to help balance the endocrine system. The U.S. Department of Agriculture recommends three to five servings a day, but less than one mother in eats this much. Plus people under stress need more nutrients than the standard amount. Therefore, we recommend you have five to seven servings of vegetables per day. So when you tell your kids to eat their vegetables, that means you, too! (Fresh fruits are also packed with nutrients, but they carry lots of sugar as well, so two to three pieces of fruit a day is plenty.)
All vegetables are not created equal: a cup of broccoli is vastly more nourishing than a cup of iceberg lettuce. Three types of vegetables - roots (carrots, beets), cruciferous vegetables (broccoli, cauliflower), and best of all, dark greens (kale, collard, spinach) - have especially high concentrations of the micronutrients you need, including calcium, potassium, magnesium, folic acid, and phytonutrients. Women who are pregnant or breastfeeding should try to eat from all three types, particularly the dark greens. Fresh is best, which typically have two to three times as many micronutrients as frozen or canned.
Raw is the easiest way to get good veggies into your body. Washed well - with skin intact, where the wild nutrients are - a couple of carrots, beets grated over salad, broccoli florets, or cauliflower nuggets are delicious and surprisingly sweet. You're going to want to offer fresh vegetables to your children anyway, so you may as well make some extra for yourself. Cooking can make vegetables easier to digest, but that takes some time, so we like to keep it simple. A baked sweet potato makes an excellent breakfast - more often than not, Jan's morning fare for several years. You could steam four cups or so of veggies in the morning, and eat them throughout the day. You might make a big pot of hearty vegetable soup on the weekend that could last most of the week. It's easy to blend up a vitalizing elixir in a sturdy juicer. Corny or not, there's something about preparing fresh, living foods that feels inherently peaceful, and you can take in a serving of stress relief with your meal.
Organic When Possible
Organic foods - from carrots to cows - are a three-part prescription for your health:
#1 - More good molecules, because they come from richer soils. One study found that pears, apples, potatoes, corn, and wheat had 90% more vitamins and minerals when they were organic.
#2 - Fewer bad molecules, because they contain no pesticides or artificial fertilizers. The "safety" of these manufactured chemicals has usually been established through short-term studies using single substances, often on laboratory animals. The actual experiment, though, is being carried out on human beings who consume numerous chemicals in combination for a lifetime - and the plausible findings include an increase in cancer and autoimmune conditions such as asthma. Organisms that are developing rapidly or are vulnerable - such as children or pregnant, stressed, or depleted women - are even more likely to be affected by the mounting accumulation of potentially toxic molecules.
#3 - Better taste than conventionally raised foods: simply compare an organic tomato with one from the supermarket.
Organic products can be found in health food stores, and they are increasingly available in regular supermarkets. Farmer's markets are another good source, plus they can be an easier place to shop with young children. Food co-ops may have organic foods, and they're a good way to meet other parents.
You shouldn't drive yourself crazy to eat only organic foods, since a single episode - whether it's lunch at MacDonald's or a salad of organic greens - doesn't make a big difference. It's the accumulation over time that counts. If you nudge your family's food sources in the organic direction, the rewards will add up every day.
Down with Sugar
Suppose a mom starts her day with a bran muffin and juice, shares lunch with her toddler -peanut butter and jelly sandwich, soda, and a couple of cookies - has a bagel and soft drink for a snack in the afternoon, with a late dinner of spaghetti with tomato sauce, canned corn, and ice cream for dessert. Sounds pretty healthy - until you realize she ate about a third of a pound of sugar that day, amounting to 135 pounds or so per year. That's the amount the average American consumes, over one hundred pounds per year more than was consumed just a century ago. Making things worse, all those white-flour carbohydrates were quickly converted to sugars as well.
Bitter health consequences come along with that sweetness, especially for mothers. Within a few hours, high sugar intake is often followed by a crash in energy and mood, especially if you've had caffeine, which accelerates sugar metabolism. Regular sugar makes the body less sensitive to insulin, which lessens its capacity to function under stress and increases the risk of adult-onset diabetes. Additionally, sugar forcefeeds pathogenic microbes, disturbing your gastrointestinal system, so you get less out of the foods you eat. Besides depleting your body of B-vitamins, chromium, calcium, magnesium, and copper, sugar has also been shown to increase the risk of breast cancer, heart disease, arthritis, migraines, gallstones, and obesity.
The average American consumed nineteen grams of sugar a day in 1815 - still much more than her Paleolithic grandmother - and a reasonable goal nowadays would be to stay under twenty grams a day (about five teaspoons). Women with digestive problems (discussed further in the next chapter) should consume less than ten grams of sugar a day. Food labels tell how many grams of sugar a serving contains, and it doesn't much matter if the sugar is refined or"natural" (like fructose or honey).
To find out where you stand, keep a "sugar diary" while eating normally for a few days, and the daily average will show how big your sweet tooth actually is and identify where you could make some changes. (Naturally occurring sugars in fresh fruits, milk, or vegetables needn't be counted since they enter the bloodstream more slowly.) Please see the chart in the box for the sugar content of common foods.
Eating less sugar can be challenging. Sugar begets the craving for sugar in order to avert a hypoglycemic crash. Sweet snacks are convenient and they feel like a treat. They're easy bribes or rewards with children - and a chance to grab a cookie yourself. Nonetheless, some simple steps can make it easy to stay under twenty grams a day:
* Drink water or tea instead of soda or juice, since two soft drinks a day adds up to about sixty-five pounds of sugar a year. Studies have found that drinking sodas does not lead people to eat fewer calories elsewhere, making sodas a major source of both unwanted pounds and disturbed physiology. Try diluting juice to half or three-quarters water. You can also make delicious herbal iced teas, and flavor them with stevia if you like. Cutting out the sweet drinks is the easiest and best way to lower your sugar overall!
* Eat protein at breakfast (eggs, nuts and nut butters, low-fat sausage) and whenever you crave sugar. (See next month's column for more on protein.)
* Sugar isn't good for kids, either, and there are other rewards and delicious treats, like fresh fruits. Try not to get them started in the first place so they can still appreciate a juicy orange or apple.
* Avoid temptation by not keeping cookies, candy, ice cream or other desserts at home. If you want something sweet,purchase a single item. And if you do want to have some dessert around, try to have just one or two kinds, since we tend to eat more if there is a variety.
* Although artificial sweeteners such as aspartame (NutraSweet) are widely used, on principle we're cautious about man-made molecules for mothers. The Food and Drug Administration (FDA) and other organizations have judged these substances to be safe, but some individuals still report negative reactions, including nausea, fatigue, and disturbed vision; about three quarters of the non-drug complaints to the FDA are for aspartame. A natural alternative is an extract of the plant, stevia rebaudiana, which tastes intensely sweet without any calories; it comes in liquid or powdered form and is available in health food stores. You can use it just like sugar, including baking, an advantage over aspartame.
* Check the labels on processed foods like breakfast cereal, peanut butter, or spaghetti sauce and try brands with less sugar. Think twice about "discretionary sugar," like tons of jam on toast or a second helping of ice cream after dinner.
Sugar in Common Foods
Food Grams
Teaspoon of honey 5
Raisin Bran (1 cup) 20
Instant oatmeal (one packet) 17
Pancake syrup (1/4 cup) 39
Tomato soup (one small can) 11
Fruit cocktail (small can) 23
Fruit juice (1 cup) 20-30
Power Bar 14
Fruit roll-up (one) 5
Small cardboard container of apple juice 28
Chocolate milk (1 pt.) 31
Lemonade (1 pt.) 28
Can of soft drink (12 oz.) 39 - 41
Strawberry yogurt (6 oz.) 31
Spaghetti sauce (1 serving) 8
Small cookie 3 - 5
Ice cream (1/2 cup) 21
M & M's (small bag) 31
Milky Way bar (small) 35
Coming Up Our next column will complete this summary of good nutrition for a mother by discussing how to get enough protein, quick alternatives to processed foods, good fats versus bad ones, and sensible supplements.
Up with Protein
A mother needs lots of protein for these reasons:
* She loses protein during pregnancy and nursing.
* Her body needs more protein when it is chronically stressed by everything that comes with raising a family today.
* Protein helps regulate the insulin and blood sugar levels that are also perturbed by maternal stress.
Nonetheless, in our experience, most mothers do not eat all the protein they should. You can make sure you are getting what you need by eating more of these foods:
* Lean meat - Most mothers - especially when nursing or pregnant - seem to need animal-based protein (though some do fine with a vegetarian diet). Lean meats help counteract the increased risk of weight gain and cardiovascular disease after children, plus reduce the toxic loading on your already burdened body, since toxins concentrate in animal fats. Organic meats are safest of all and increasingly available. In particular, if you eat liver - a great source of iron - be sure to get it organic since toxins are concentrated in that organ. If you're looking for convenience, many health food stores sell different kinds of tasty "jerkies" made from beef or turkey, but without any artificial chemicals.
* Fish - If you can, minimize fish at the top of the ocean food chain - like tuna, shark, or swordfish - because mercury and other toxins increase as you move up the food chain. Salmon is a good alternative, plus it contains high levels of the essential fatty acids (EFA's) every mother needs (see below for more on EFA's). You can also find salmon jerky in some health food stores.
* Eggs - You may have avoided eggs because of concerns about cholesterol, but recent studies have shown that eggs do not increase the risk of heart disease, and in fact they may raise the level of good, HDL cholesterol. Try to get eggs from free range hens on a healthy diet; your farmer's market may have eggs that are really fresh. If you're in a hurry, you can hard boil eggs in advance and eat one or two at breakfast.
* Nuts - You can nibble on nuts during the day; almonds are particularly high in protein. Or you can easily create your own customized trail mix, and kids often like to help: just combine your favorite nuts with some non-sulfered dried fruit. Nut butters are also delicious. We suggest you try almond or sesame butter instead of peanut butter since many people are allergic or sensitive to peanuts. Almond butter on a rice cake topped with apple slices is a delicious and healthy breakfast.
* Hummus - This Middle Eastern food is made from chickpeas. You can buy it in most supermarkets or even make your own. Spread it on crackers for a super-convenient, high-protein snack.
* Protein shakes - Just put the mix in a blender with juice, milk, or soymilk, and perhaps some fresh fruit, and voila!, you've got an instant high-protein snack or even the better part of a meal. If you can, get a mix without any artificial ingredients. Of course, don't rely on these shakes as your main source of protein since they usually contain just one type. And since we recommend minimizing your overall intake of sugars, try diluting fruit juice or using other liquids.
* Soy (beans, tofu, soy flour, soy milk) - Soybeans are high in protein, and they may also help prevent cardiovascular disease and cancer. You can add soybeans to stews or soups, or toss in some tofu chunks to your stirfry or casseroles. In your baking, you could experiment with replacing half or more of the wheat flour with soy flour. Soymilk comes in many flavors, and you may find that your children really like it; the small packs that come with a straw don't need refrigeration and are a great source of quick protein and nutrition for kids on the go.
* Combining vegetarian foods - If you eat vegetarian, as each of us have done at different times, you probably know about using food combinations (like rice and beans) for maximum protein (Diet for a Small Planet offers a good introduction to this subject). Since meat is the only real source of iron in the diet, a vegetarian mother should usually take iron as part of a good, daily supplement.
Milk, cheese, and yogurt are also good protein sources. But they're best used in moderation because many people - especially those whose ancestors came from Africa or Asia - have difficulty digesting the lactose in milk, and keeping her gastrointestinal tract in good shape is a top priority for a mother. Another problem with milk products is that calcium and iron interfere with the absorption of each other, one more reason not to have a sweet milkshake with your hamburger. If you have excess mucus, sinus infections, gastrointestinal disturbance, or dark circles under your eyes, we suggest you experiment with a couple of weeks of eating no dairy products and see how you feel. You can try goat milk instead, and you can get a fair amount of calcium in cauliflower, broccoli, peas and beans.
We recommend you try to eat protein at every meal, but especially breakfast. Rather than starting your day by hopping onto the insulin roller-coaster with some sugar and refined flour, try a breakfast with four ounces of protein (ie. two eggs, a piece of lean chicken, a large handful of almonds). If you make morning protein the foundation of your day's nutrition, you'll have less of a midday crash and irritability in the afternoon. As the day goes on, if you want something sweet, have some protein instead, like a handful of almonds, hummus on crackers, or a piece of turkey jerky.
Cut Down on Processed Foods
The essential formula for a mom's long-term health and well-being is profoundly simple: increase the good things (ie. nutrients, rest, support from others) and decrease the bad things (ie. empty calories, toxins, stress). Do this every day - little by little, moment by moment, molecule by molecule - and the benefits add up dramatically: you'll feel better, have more energy, get sick less often, be in a better mood, have more to offer your children and partner, cope better with adversity and hassles, and probably live longer.
This formula is so obvious that everybody knows it's true. The trick is to live it every day and to make the right choices at each little opportunity to get off track. Processed foods are a great example. Tempting as they may be, they completely reverse the formula for maternal well-being: they contain less of the good (nutrients) and more of the bad (artificial chemicals) than healthy and convenient alternatives. There are three kinds of processed foods: refined oils and grains, and packaged foods. Let's see what the problems are with these manufactured foods, and how to replace them in time-saving ways.
Refined oils. Walk through a supermarket, and most of the oils you'll find have been refined. These include hydrogenated or partially hydrogenated fats (such as Crisco or margarine) and liquid oils that are not clearly marked "unrefined" or "virgin" (as in olive oil). Refining takes out vitamin C and lecithin, and creates the trans-fatty acids that have been implicated in cardiovascular disease and other health conditions. Instead, use virgin olive oil or other, unrefined oils, and judicious amounts of real butter.
Refined grains. Besides converting quickly to sugar and jolting your insulin, refined grains lack the nutrients contained in the portion that was hulled away, including B-vitamins and fiber. Although some refined grain products are "enriched" by adding back a few vitamins, the complete array of micronutrients is never restored. B-vitamins help us cope with stress and maintain our energy, so they're particularly important for a mother. And since a mom carries a heightened risk for gastrointestinal disturbance, she's wise to consume fiber for digestive regularity, absorbing toxins, and decreasing risk for colon cancer. It's easy to replace white rice with brown, and refined flours with good-tasting whole wheat pastry flour, rice flour, or soy flour. Since many people have an allergy or sensitivity to the gluten in wheat, you might like to try rice, quinoa, soy, or corn flour as good tasting alternatives.
Packaged foods. Most packaged foods - such as breakfast cereals, donuts, chips, TV dinners, macaroni and cheese, or canned goods - are loaded with white flour, hydrogenated oils, salt, or artificial colors and preservatives. Many essential nutrients have also been stripped away during manufacturing. Happily, health food stores are increasingly carrying packaged foods made from organic ingredients and whole grains, without artificial ingredients. You can also prepare a quick bite for yourself or the kids without resorting to prepackaged "snack packs." It's easy to buy a week's worth of mini carrots, whole grain rolls or pretzels, dried fruits or nuts, package them in plastic bags or containers, and grab them in the morning on your way out the door.
Get Your Essential Fatty Acids
Essential fatty acids (EFA's) are "good fats" needed for the membranes of your cells and a healthy heart, and they comprise 60% of your brain. Unfortunately, they are often deficient in mothers, since they are drawn on heavily to grow a baby during pregnancy, and breast milk is loaded with them. Increasing your EFA's can help prevent cardiovascular disease, rheumatoid arthritis, asthma, diabetes and depression - all of which are at increased risk for a mom.
These oils are called essential because they cannot be synthesized by the body and must be consumed through foods or supplements. There are two types of EFA's, Omega-3 and Omega-6. Since the typical person today eats way too few Omega-3 oils, and often too many Omega-6's, you should particularly look for ways to increase your Omega-3's. Omega-3 oils are found in flax seed, walnuts, unrefined flax or canola oil, and fatty fish such as salmon, mackerel, trout or sardines. Omega-6's are in unrefined safflower, sunflower, soybean and sesame oils.
You can use unrefined flax or canola oils in salad dressings, but frying with them destroys the EFA's. Or eat Omega-3 rich fish; they don't need to be sushi, since cooking (especially poaching) isn't hot enough to be a problem. You could also grind flax seeds in a coffee grinder and add the flakes to baked goods or sprinkle them over a salad. Flax seeds provide excellent fiber and other nutrients in addition to Omega-3 oils, but be sure to keep drinking a reasonable amout of water to avoid feeling clogged up.
If your diet doesn't include large amounts of EFA-rich foods (like fish almost daily), consider supplements available at any health food store and many supermarkets. (The blood thinning effect of fish oils is usually good for the cardiovascular system, much like an aspirin a day. But if you are on a blood thinning medication, or have a bleeding disorder, please consult with your doctor before supplementing EFA's.) Fish or flax oil will give you the Omega-3's. Primrose or borage oils provide Omega-6's; in general, supplement Omega-3's in a three-to-one ratio to Omega-6's. Daily suggested doses are given on the labels, and you can experiment with increasing that amount by up to 50% and see if it helps.
Take High Potency Multi-Vitamin and Multi-Mineral Supplements
In addition to eating a well-balanced diet, we recommend you take a good vitamin/mineral supplement for several reasons:
* The best sources of nutrients are always fresh, whole foods. Nonetheless, in real life, not some textbook, you probably rely on quick snacks, meals on the run, and processed foods that lack the Recommended Daily Allowances (RDA's) of all the nutrients you need.
* The RDA's are the minimum necessary to prevent diseases of nutritional deficiency, not necessarily what promotes long-term health and well-being. For example, the amount of vitamin C that prevents scurvy is less than that which maximizes lifetime cardiovascular health. Similarly, a growing body of research has substantiated the benefits of above-RDA levels of various nutrients for inflammation, autoimmune diseases, heart attack, stroke, depression, and Alzheimer's disease.
* Even as a minimum condition, we think you need more than the standard RDA's, anyway, since growing and nursing a baby are nutrient-draining, hard work and stress require extra nutrients, and the GI disturbance common among mothers impairs absorption. Building up nutritional reserves is also an insurance policy against future days of high stress or poor nutrition.
* By their nature, micronutrients help bodily processes go well. These molecular helping hands may help protect a vulnerable mother from the widespread artificial chemicals that tend to make things go badly.
While you are pregnant, breastfeeding, and for at least a year after weaning, you should continue taking your prenatal vitamin/mineral supplements, or an equivalent alternative. Make sure these contain iron, zinc, copper, manganese, iodine, selenium and chromium. You may need to add magnesium (400 mg) and calcium (1000 mg) in separate pills to get the appropriate amounts each day. Of course, supplements are no substitute for a balanced diet or medical care.
After this period, keep taking a high potency, vitamin/mineral supplement from a reputable company, although it no longer needs to be "prenatal." Supplements vary in their quality, so you should ask a knowledgeable professional or staff person at a health food store about the brands available. Take a look at the label on the bottle to see if most of the minerals are amino acid chelated (which aids absorption), indicated by the name of the mineral followed by a word ending in -ate, such as citrate, aspertate, malate, gluconate or picolate; chelated minerals are also a sign of a quality supplement from a good company. If you can't get iron in a chelated form, look for ferrous - not ferric - sulfate, fumorate or gluconate.
Unfortunately, there is no way that all the micronutrients you need can fit into a single supplement smaller than a hefty marble. You just have to get in the habit of taking a few pills a couple of times each day. It takes less time than brushing your teeth, and it is at least as important for your health in the long run.
A Mother's Daily Recipe for Good Nutrition
Gather a variety of mainly organic and unprocessed foods.
Add several servings of fresh fruits and vegetables.
Combine with at least four servings of protein and six cups of water.
Spice with essential fatty acids and a good multivitamin/multimineral supplement.
Use sweets sparingly: no more than one a day.
Take an extra moment to savor and enjoy your meal.
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