Hi Shelly,

Thanks for your question.

Firstly I would advise you to visit your GP if you have noticed a recent change in your bowel habits to have this checked over, on the other hand if you have always struggled with constipation/regularity there are some dietary and lifestyle changes that you may like to incorporate that may offer you support. Frequency of bowel movement is different for everyone with some people going every other day and some more than once a day.

Water - include around 2ltrs of water daily as being dehydrated may contribute to constipation, the stool requires water to help it pass through the colon.

Increasing fibre intake - make sure you include plenty of vegetables within your diet which are loaded with fibre as well as fruits. I recommend 5 portions of vegetables and 2 fruits daily in line with the BANT eat the rainbow guidelines which can be found online.

Linseeds - a great source of fibre, they can be added to porridge a smoothie, soups and salads. Start with around a teaspoon. The seeds swell up therefore it is important to drink plenty of water.

Magnesium - increasing magnesium in the diet may offer support. Many of us are thought to be deficient in the mineral Magnesium, magnesium may offer support in some people as it is known to support relaxation of muscles. Good sources include dark leafy greens, nuts and seeds, mackerel, lentils, wholegrains, figs, avocados and a square of dark chocolate will provide approx. a quarter of the daily dosage.

Probiotics - to support the good bacteria which play a part in a healthy gut microbiome.

Digestive enzymes - to support in the breakdown of foods in the gut.

Lifestyle factors are also important, incorporating relaxation techniques such as meditation and exercising for 30 minutes around 5 times a week (NHS official guidelines) may also provide helpful.

Best Wishes

Sharon

Hi E, thanks for your question. Other good plant protein sources are beans, lentils, peas, chickpeas, seeds and you could have small amounts of spirulina and chlorella in juices and smoothies. You'll also get good amounts of protein from brown rice, quinoa and millet. Hope this helps!

Hi Tina, thanks for your question. IBS is a term for a digestive disorder with no known cause; however, there are several different causes including stress, certain foods, impaired digestion of foods, or an imbalance of bacteria in either the large or small intestine. Without knowing what the cause is it is difficult to be specific about the diet that is best for you. You may find that reducing grains helps both in terms of IBS symptoms and weight loss; however, this can sometimes make people feel worse and cause constipation, particularly if constipation is already a problem. I recommend you do a food diary and try to determine whether any particular foods make your symptoms worse and if they do then try doing an exclusion of them and see if this helps in terms of IBS and weight, as sometimes foods that cause digestive symptoms can also cause fluid retention and when you remove them you lose the fluid. As a general guide though, removing refined carbohydrates, sugar, harmful fats found in cakes, biscuits, crisps and other processed food, and keeping alcohol and caffeine to a minimum should help you to lose weight and will also be good for gut health. Having beneficial fats e.g. avocado, olive oil, oily fish, nuts and seeds (although these last two can sometimes irritate the gut further as they can be hard to digest) is also good for the gut and will help weight loss as fat is more likely to be used for energy than stored, unlike refined carbohydrates and sugar which if not used for energy will be stored as fat. I hope this helps!

Hi Tina,

Thanks for your question.

I agree with Elizabeth's advice and further advice would depend on gathering further information regarding symptoms experienced due to IBS (i.e. constipation or diarrhoea, or alternating).

Linseeds are thought to offer support and may help with healthy bowel movements in both constipation and loose bowel movements. It is important to drink lots of water and start with a small amount such as 1 teaspoon increasing gradually to approx. 1 tablespoon. Opting for a mix of whole seeds and milled seeds may offer the best support as whole linseeds are helpful in supporting formation of a healthy stool whereas milled allow the absorption of nutrients more easily from the seeds including omega 3 fatty acids.

Some IBS sufferers have found support following the low FODMAP diet (Fermentable, oligo, di, mono-saccharides and polyols). These are a group of short-chain carbohydrates that are not very well absorbed in the gut. They can be easily fermented causing fluid to enter the large bowel, leading to gas, bloating and diarrhoea. Reducing the amount of these sugars may improve IBS symptoms for some people.

Including probiotics in the diet to support the health of the gut may also prove beneficial with some studies specifically linking the strain bifidobacterium infantis to improvement in symptoms.

It is also important to build relaxation into your weekly routine to limit stress as many people report symptoms to be increased during times of increased stress.

Best Wishes

Sharon

Hi Smurfqueen, thanks for your question. Unfortunately it tends to be harder to lose weight with hypothyroidism, as you have a slower metabolism so it's more difficult to burn calories. Having said that, it's really important to make sure you are eating enough calories for your Basal Metabolic Rate (BMR). You can work this out using an online BMR calculator and then if you multiply your BMR by 1.55 for your exercise rate this will give you the approximate number of calories you need to be eating to provide enough energy for your daily needs. If you'd like to lose weight then start by reducing the number of calories from this total by 500 and you could gradually reduce it up to 1000 calories. It is recommended that you don't eat less than 1200 calories as this can slow down your metabolism further. The other thing you could try is changing the pattern of your eating so eating in an 8 hour window, commonly known as the 16:8. I don't recommend you diet, as often this can affect your metabolism and you may miss out on important nutrients but if you eat the right amount of calories in a shorter space of time then research shows that it can help you lose weight whilst improving other aspects of your health such as your blood sugar, cholesterol etc. You could also try varying your exercise, so doing some weights as well as cardio, as a combination of the two may benefit you more. Also, don't forget that even though you've not lost weight you may have still lost inches and you could have put on muscle and lost fat, so it would be worth measuring these things also.

Hi Anna, thanks for your question. Are you aware of what's causing the raised prolactin levels, as there are a number of causes and some of these could be causing the fluid retention, the increased appetite and the difficulty in losing weight. One cause is hypothyroidism and if this is the case then losing weight will be more difficult but possible with the right protocol i.e. certain nutrients to support the thyroid and it is also important to ensure you are eating enough calories to prevent your metabolism slowing further. In order to work out your BMR (Basal Metabolic Rate - the calories you need to function) you can use an online BMR calculator. You then need to account for your exercise level (the BMR calculator will tell you how to do this) and then you can minus this total by 500 to 1000 calories in order to lose weight. It is advised that you never eat less than 1200 calories a day. The other thing you mention is you really love bread and there is evidence to show that prolactin levels can be raised by gluten (collection of proteins found in wheat, rye, barley, triticale), particularly if you are coeliac. If you haven't been tested already I would ask your doctor to test you for coeliac disease (an autoimmune disorder where you have an adverse reaction to gluten). Even if it comes back negative you may still have a problem with gluten. This can sometimes be the case if you crave gluten containing products so you may benefit from doing a 14 day gluten exclusion, where you remove all gluten from your diet for 14 days and then reintroduce it three times on day 15. If you start to lose weight, your prolactin levels come down or you generally feel better during this 14 days and then things get worse when you reintroduce it this can be a sign that you have a problem with gluten and I usually advise that you remove it altogether. I would advise that you have further investigations done to determine the cause of the raised prolactin and then it will be easier to decide on a way forward. Good luck.

Hi Anna, thanks for your question. I agree with Elizabeth that having raised prolactin levels may be contributing to your fluid retention, increased appetite and difficulty in losing weight, therefore trying to find out and address the underlying cause is a priority.

In terms of dietary and lifestyle suggestions to try to help you to increase your metabolism: firstly incorporating more activity and/or exercise into your daily routine (with the approval of your doctor)
For example - setting yourself a goal of walking a number of steps per day and tracking your progress using your mobile or a sports watch, making time for some exercise (starting with a low intensity and duaration) such as swimming or cycling, and including an exercise session using weights (perhaps seek the help of a personal trainer to do this safely).
Secondly try making small changes to your eating habits -
For example - When considering your meal, divide the plate so that it’s: one quarter (palm-size portion) protein such as lean meat, fish, seafood, eggs, beans, peas or pulses, one quarter (palm-size portion) slow-releasing carbohydrates such as oats, brown rice, root vegetables, or sweet potatoes, and half (two palm-size portions) non-starchy vegetables such as leafy greens.
Cut down or avoid simple sugars (in fizzy drinks, sweets and chocolate and alcohol) to help keep your sugar cravings at bay, balance your blood sugar levels and to help you to lose weight. Reducing your portion sizes and eating little and often (every 3-4 hours) will also help with this.
Lastly, Keep well hydrated. Hunger can be confused with thirst. If you find that you’re constantly hungry, try having a drink and waiting ten minutes to see if you are still hungry before eating. Try sipping water or herbal teas between meals to stay well hydrated.

Hi Anna,

Thanks for your question.

As Elizabeth and Joanne have advised it is important that you seek to find out if there is an underlying cause for your raised levels of prolactin and at the very least rule out potential causes. This will provide a clearer picture for you to move ahead.

To support weight management I would echo the above suggestions provided by Joanne in relation to diet and exercise.

Building in relaxation time is also important as well as aiming for 7 - 9 hrs of sleep each night to support health and wellbeing. If you are getting less sleep than the required amount the stress hormone cortisol may be increased. Excess cortisol production is linked to promoting fat storage specifically around the middle.

Limiting fruits to 1 portion a day and opting for low sugar options including berries may help to avoid blood sugar spikes. Fruit is rich in antioxidants with many associated health benefits and also contains fibre, however as it still contains sugar and may be best eaten alongside a source of protein such as nuts/seeds or yogurt.

Aim to balance snacks/meals with a source of protein, slow release carbohydrate and good fats to support blood sugar balance. Aim to eat the rainbow including many different vegetables on a daily/weekly basis with each meal.

Best Wishes

Sharon

Hi Hamish,

Thank you for your question. I believe you mean an 'energy' boosting smoothie? To do this I'd suggest using half a frozen banana, some frozen berries, a handful of spinach or kale and blend it with natural yogurt.

Why is this good for you? Bananas provide slow-releasing energy, as well as being rich in potassium. The berries will help to provide energy, sweeten the smoothie and are full of antioxidants. Iron is one of the most common mineral deficiencies and can affect energy levels. This fantastic smoothie has an abundance of it, thanks to the spinach orkale. The natural yogurt contains protein that will help slow-down your digestion helping to satisfy your appetite and repair any damage after exercise. Enjoy!

Hi Hamish

Thanks for your question. Joanne's idea sounds great and you could also try using green vegetables such as kale, spinach, broccoli stalk and chard as a base for your smoothies. I would also add avocado, celery, cucumber, lemon juice and ginger to make the smoothie more palatable. You could add some low sugar fruit such as berries or pear and also seeds such as flax seed (linseed) or chia seeds will also provide some protein and healthy fats. This combination is not only nutritious but will keep your blood sugar balanced and provide some protein for muscle repair after exercising. Adding a little bit of coconut oil to the smoothie, which contains medium chain fatty acids can also provide an energy boost. Hope this helps.

Hello Funmi
Many people struggle to lose weight and keep it off, it is easy to start a diet then lose focus after a few weeks. Once you restrict your diet or cut calories your body inevitably thinks there is a famine out there and that causes stress, stress causes the body to release adrenaline, this encourages your body to store fat and slows down the metabolism making it harder to lose the weight and keep it off. The solution is to look at changing the way you eat once and for all rather then embarking on a 'diet'. One of the best ways to lose weight and keep it off is to eat to balance your blood sugar by following a plan that avoids sugar and stimulants and reducing start your carbohydrates will have a positive effect on this.
It might sound complicated but the principles are easy, ensure you eat regular meals, always combining carbohydrate rich foods with protein and ensure that over half of your plate is full of non starchy vegetables. It would also be wise to look at having a session with a nutritionist so you can look in more detail at your specific diet and lifestyle factors that might be hindering any weight loss.
You also mention that you don't like exercise but increasing your activity levels will help, you don't have to join a gym or do a specific exercise class. activities such as walking, dancing or swimming can all help to increase activity levels and boost metabolism.
Good luck!

Hi Leanne,
Thanks for your question.

It is normal to experience a variation in your body composition after having a baby. A lot of changes have occurred during your pregnancy, an unfortunately a few of them remain after the birth, even thought that is undesired.

The good news is that we can correct that. Unfortunately there is no way to lose fat from a specific part of your body. However, if you follow a healthy weight-loss diet (with vegetables and fruits as the stars of the diet), you can reduce the amount of body fat of your body. The diet has to be rich in good quality fats especially if you are breast feeding your baby, and in this case you should not reduce the calories intake too much.

The way you lose this fat and the parts of your body that it comes out from first, varies quite a lot between individuals (your genes determine this). But if you combine this kind of diet with exercise, some of the exercises should be with your abdominal muscles. This would make your abdomen stronger, which makes more difficult that the content of the abdomen “comes out”. If you are able to do this kind of exercise already, depends on how exigent was the birth physically for you (e.g. if the birth was wit C-section that makes quite a difference, and your doctor or physiotherapist should determine this).

Hi Celia,
Thank you for your question.

Drinking the water with lemon and turmeric is a good habit. The lemon juice contains immune-boosting vitamin C, and other beneficial nutrients i.e. calcium, iron and potassium. This will help to hydrate you and flush out toxins. The turmeric is also a great anti-inflammatory. However if you suffer with dental issues the lemon may not be good for your dental enamel, so wait at least 20 minutes before brushing your teeth or stick to plain water!

As far as drinking coffee is concerned. The caffeine contained within it will act as a stimulant. Therefore in a fasted state first thing in the morning it would be better to eat a breakfast containing protein, healthy fats and slow-reasing carbs (such as poached eggs and salmon on whole-grain toast) first and then drink your coffee. This will help you to avoid peaks and troughs in your blood sugar level and feel more energised.

So perhaps try changing the order around slightly to improve your habit...

Hi Ian,

Thanks for your question.

When participating in intense training regimes such as that for an ironman event it is important to ensure you are getting enough energy to fuel your workouts and provide essential nutrients to your diet. Your requirements will be much higher than usual.

Ensuring you include each of the main food groups is important to ensure your body is getting a good balance of nutrients.

Complex carbohydrates could be classed as the preferred source of fuel due to the fact they provide a good energy source that can be utilised efficiently once the body breaks them down into simple sugars.

This option provides a slower release energy source than that of simple carbohydrates which offer an instant energy burst as they contain simple sugars that hit the blood stream directly - this may be useful for during an event in the form of a homemade energy drink once your energy has been depleted and an instant boost is needed to support performance and get you to the finish line.

Carbohydrates that are not used as energy are stored in the muscles and liver as glycogen and then as fat in the body. Glycogen in the muscles also helps the body retain water which may support training further.

Including a good source of lean protein at each meal is also important to to support muscle growth and repair.

As your energy needs are high, including foods that offer high kcal per portion size is recommended. Nuts and seeds are good additions to the diet as they are a rich source of good fats offering 9kcal per gram which is more than carbohydrates and protein.

Including lots of vegetables and fruits rich in vitamin C to provide the body with a good level of antioxidants which are important during training.

Staying hydrated is paramount. Ensuring you get time to recover during your training plan as well as eating within 15 minutes of a training session to refuel and support muscle growth and repair.

You may like to consider adding beetroot to your eating plan as some studies have concluded that beetroot may support endurance and in some trials saw a 5% increase in speed during running.

Best Wishes and Good Luck!

Sharon