The big post-partum diet Q & A with Libby Mills

 This week we're answering your post-partum diet questions, with a very special guest;

Spokesperson for the Academy of Nutrition and Dietetics; Libby Mills (MS, RDN, LDN, FAND). She's giving you expert answers to the questions you sent in.

Some of the questions you put to her are;

Is the KETO diet safe to do when you're breastfeeding?

Can you get enough fiber in your diet if you cut out brown bread/rice etc. if those foods make you bloat?

How can I stop sugar cravings when I'm trying to cut out processed sugar during my pregnancy?

Has my pregnancy, and previous dieting, made my "set-point" go up? And does the body even have a set-point?

How do I eat enough (especially at snacks) without eating too many ultra processed foods, and without giving myself even more to do by preparing fresh food? Especially if I’m already crashing, I need things I can eat quickly and things I can carry with me if I’m out.

What can I do so I am not hungry and tired all the time but also don’t spend too much time cooking/preparing snacks on the weekend?

We also talk a lot about macros (carbs, protein and fats), what a good post-partum diet looks like and she has a lot of tips and easy to grab ideas


The Academy of Nutrition and Dietetics is the world's largest organization of food and nutrition professionals, they have a tonne of great information out there so check them out if you're looking for more information.

Their website https://www.eatrightpro.org/
Follow them on Facebook
And on Instagram

Libby also hosts her own show on https://wche1520.com/ called Libby's Luncheonette where she has conversations, eats and tips that focus on our local food system and how sustainable choices can positively affect our personal, community and ecological health and well-being.

And, finally, here are some of the  "Lazy and delicious"  magazine recipes she mentioned!

Don't tell me we don't give you a tonne of expert info on this podcast!!


No "In the news this week" segment in the usual way but I do briefly encourage everyone who is pregnant and hasn't had the vaccine yet to please get it. All the studies show that getting vaccinated when you're pregnant is a good ide as it's completely safe whereas getting severely ill with COVID when you're pregnant really is not.

Here are a couple of studies that should reassure you;

https://www.news-medical.net/news/20211022/Study-finds-no-link-between-COVID-19-vaccinations-and-risk-of-early-miscarriages.aspx

https://www.eurekalert.org/news-releases/932380



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Playing us out this week; "Spanish Ladies" (Stripped version) by Fare Ye Well.

Transcript

Peter

Hey, welcome to the Healthy Postnatal Body Podcast with your Post Natal expert Peter Lap. That, as always, would be me. This is the podcast for the 31 October and boy, do I have a treat for you!

 A couple of weeks ago I said we would do a diet Q and A. Everything to do with postpartum health and postpartum diet. I had a special guest.. Well, I've done better than that. Unfortunately the special guest, the dietitian I had lined up, had to pull out. So I got in touch with the wonderful people at the Academy of Nutrition and Dietetics. Who are THE guys in the US when it comes to registered dietitians, and they very kindly make one of their spokespeople available to me,  Libby Mills came on, gave me an hour of her time and then some. She sent some files over later on as well when she thought here's a bit more information you can do with. This is a superb hour of postpartum diet discussion, postpartum health discussion where she basically just answers us your questions. You sent them in, you have to listen now, right? You have to listen to what the answer is, right? So without further ado, here we go.

Peter

Right. So we'll start with the very first one, if you don't mind. That is one from the forum. 

Hey, Peter, I have a wedding coming up in three months time. I'm still breastfeeding my youngest ,Brian, is two and was wondering if the keto diet was okay to do. I only have a few inches to lose around my waist and have had some good results with keto before. So I'd like to go back to that as I know what I'm doing with it. If not keto, then what is an easy alternative that can fit around my busy life? 

So what would you say to that one; is keto OK to do when you're still breastfeeding? 

Libby; 

Right. And thank you so much for asking me about this, because it's really important when you're breastfeeding and when you're trying to lose weight that you are nourishing your body. And eliminating food groups absolutely eliminates some of the sources for getting key nutrients. So one of the significant, let's just kind of start with what the keto diet is a reduction in carbohydrates, and predominantly, you're going to be keeping the carbohydrate count in terms of what you're eating to about 100 grams or less. 

What this means is that there's not going to be a lot of room for getting in key nutrients/key food groups from that we know are good for us. Like fruits. You can pretty much work a few vegetables into keto, but it's going to eliminate most fruits, most whole grains, legumes. And these are great sources of nutrients like potassium, fibre, magnesium. And then, of course, iron and zinc come from these food groups. So eliminating food groups doesn't make sense. And especially if you're breastfeeding, it really doesn't make sense because you need to have not only enough calories to support making the milk for the baby. But you also need to have the right nutrients to support your body, make sure that you're nourished so that your energy level stays elevated, and you can function in your day. 

Peter; Now, that's an excellent point. I wrote about this a long time ago, and I don't mind reminding listeners of this. Your baby is a parasite, is what I always said, as in with the best will in the world. And I don't mean that in a bad way, but I mean the baby gets his or her nutrients from you. And if you don't have them enough and you don't top them up on a daily basis, it will get them from you. This is why you see so many mums looking, for want of a better word, tired and grey and their skin isn't 100% looking as healthy as it should be because they're not getting the nutrients in that they need to pass on to their child, isn't it? So of course that leads us, we'll get to what can you do instead of keto in a little bit? Because there's a ton of questions that came in are very similar so no keto when you're breastfeeding. No Atkins when you're breastfeeding and all that sort of silly stuff, right?

I never use names on the podcast of people that email in, right? Because sometimes they give up where they live and all that sort of stuff. And there's enough crazies out there without me adding a whole bunch of names and information out there.

If you only have five kg to lose, so to speak, especially if you just have a couple of inches around your waist or something like that, you don't really need to go extreme anyways, right? 

If you want to lose the weight and if you have a fair bit of time and only want to lose an inch or two, then that doesn't take that much work. Assuming, of course, that you have anything to lose, and if you're already not severely undernourished.

Libby; Well, when it comes to weight loss, what we do know is that it's very individualized and what works for one person might need to be tweaked for another person. So when I work with folks, it's definitely starting with where they are. And the number one thing that I focus on is making sure that first and foremost, mom is getting the nutrition that she needs. And what happens with this? Like you said, it's topping off those nutrients supplies. Making sure that the nutrients are available for making the milk and passing on to baby without being at the expense of mom. But more importantly, mom needs the energy to function through the day and be active.

 So when it comes to weight loss, a couple of things that we know are important; 

Getting the right amount of calories to not only support as you said, baby, but also support mom. For most nursing women, that's to support making the breast milk is around 1800 calories. Now, again, this is individualized. So there's definitely some variation there, but about that much is going to guarantee that the right nutrients are available for making the milk. The other thing that we know is important here, obviously making sure that mom is hydrated. So getting anywhere if you're breastfeeding from twelve to up to 16 cups of water. And I know that you guys work in the metric. 

Peter; Yeah, we’ll have translate that, convert that, into new money.

Libby; That’s okay. I did a quick little conversion and that's up to like, maybe 3.7 liters of water. Put that in perspective. So these are really important things. Now, when mom's getting the right nutrients, a couple of great things happen. One; mom has the energy to not only take care of the things that she needs to do during the day, take care of baby, but take that extra step and include activity that's going to be good for her. Now, for most people, that might be a simple… I say simple, but when you've got a busy hectic schedule finding 30 minutes a day. It can be challenging, but this can be divided up throughout the day, 15 minutes here, 15 minutes there, or maybe even five or ten minutes of activity. But accumulatively aiming for about 30 minutes of activity or 150 minutes per week is about what mom, is a great place for starting. If you can do more, pat yourself on the back because more that's just going to add to this positive your ability to burn calories. Now, the other thing that's important here is looking at lean body mass because mom's been through a lot. You've carried around baby, you've put on extra weight, that's there for nourishing baby. But at the same time, your activity level has probably decreased and certainly the last trimester and maybe the first couple of months of having baby at home. When activity decreases and when you are cutting back ever so slightly on calories, you're going to yes, burn some fat. But you're also going to burn some lean body mass at the same time. So being able to keep your energy up in order to do activity that maintains your muscle mass. Now you're starting to stoke the furnaces that can burn, even when you're sitting on the couch relaxing. And that's what you want to happen. Circling back to the idea of the keto diet. What happens is when you are cutting out carbohydrates from the food choices that you're eating. Essentially, your body is going to tap into stores of carbohydrate that we have in our bodies. Now we store carbohydrates in our liver, in our muscle tissue, and it's there for when we, you know, we eat and that food that we eat for lunch sticks with us for about four or 5 hours. If we're lucky. And we know that we've blown through that energy that we ate for lunch because around dinner time, we're starting to feel pretty hungry. And this is a natural cue that we've used that energy that we just ate. But when we're not, and let me just say, that when we by chance, go an extra fifth hour trying to get dinner on, and maybe it doesn't quite get on the table on schedule, we begin tapping into our stored carbohydrates. So that carbohydrate’s there to help extend periods of time when we're not able to fuel ourselves as we need. But it's also there to fuel our activity. 

So when we begin extending the amount of time that we're going out for walks or pushing the stroller around the neighbourhood or going up and down the stairs carrying the wash, all of this adds up. But when we begin to extend that workout time, then our bodies not only are using the glucose that's floating around in our bloodstream, but our bodies begin tapping into that glycogen. That's what it's there for. And the more fit we are, the more we tap into that glycogen, we pull it out, we use it, and then we need to refuel it. And the more we replace it by eating carbohydrates, the more efficient our bodies run, and the more efficiently we're able to use that energy. So these are really important things that, like I said, when you are eliminating an almost entire food group of carbohydrates, now your body has to tap into that glycogen to sustain itself, because carbohydrates are our main energy source. We deplete our glycogen stores and, at the same time, we are using our muscle tissue for energy. And so at the end of the day, you might reach your goal following one of these low carbohydrate eating plans. But your furnace, your lean body mass, is operating at a much lower level. And just subsequently, that is going to mean that to sustain that body weight, you're going to need to either continue with what you're doing, which in the long run, is eliminating really key nutrients, or you're going to need and/or you're going to need to maintain a much lower calorie level because you just don't have that furnace that's operating fully stoked. So eating from all the food groups obviously provides the nutrients that we need. 

And so that's number one, but also progressing on a weight loss journey that is sustainable is going to be number two. And this is going to mean that if when you reach your goal, you plan on having a slice of pizza. Well, you better figure it out a way you might as well eat pizza along the weight loss journey so that you can understand how to fit it in along the way, because how you get to that goal is kind of how you have to maintain it. So if you get there by extreme measures, Ouch, you're going to have to maintain it at extreme measures. So just circling back. Number one is nutrition making sure you get the nutrients. Number two, that's going to maintain your lean body mass while taking care of baby, but also providing you the energy to be active. And like I said, maintain your lean body mass. 

Peter; No, that makes an awful lot of sense. Like I always say; it's better to just be in a small calorie deficit and then once you reach your goal, you don't have to be in a deficit anymore. You can just continue on your merry way rather than doing something remarkably extreme and then having to reintroduce carbs and all that sort of stuff. Which I,s if you've cut out carbs for prolonged period of time, it's a very difficult thing to do. What you said ties in very nicely with the next one.

 Hi, Peter. 

I’m a regular listener to the podcast, I love these expert interviews. I have a question. I'm a mother of two year old twins. Oh, there you go. We're right in the middle of the terrible twos. I love the interview did about positive parenting, so I hope that will help. 

I'm trying really hard to lose some of the weight that I've put on since my pregnancy, and it's really difficult. If I eat too many carbs I feel tired all the time and already feel tired from having two children, but they are the easiest to grab when I'm in a rush. (Well, that kind of makes sense, right? Sandwiches are always easy to grab). What healthy protein things can I grab? That won't make me smell bad. (That's a good question). Like eggs and fish do. And I hate the idea of spending my entire Sunday cooking for the rest of the week. So what can I do? So I'm not hungry and tired all the time, but also don't spend too much time cooking and preparing snacks on the weekend??. 

That's an excellent question. 

Libby; I think anyone who has a busy schedule can relate to this question and then tossing them two children in their two just totally adds to the busyness. I can understand it comes down to the plan. Success is in the planning. First, think through what are the foods that you're going to need to fuel your body? And it sounds like, in this particular case, her real question really comes down to what snacks are going to be good because she's very busy. She's looking for things that she can grab on the fly and maybe even take with her when it's not just being within the home but also taking with her when she's out on a walk or perhaps running errands. 

So just take a moment and freethink what are the foods that I need to have around? And that starts with identifying “what's going to be a good snack for me”. So the more active you are, the more calories that can actually make up a snack. But something around 200 calories might be a perfect snack, especially you're trying to keep the calories somewhat contained, but you need enough to provide you some fuel. So keeping that in mind and then thinking about maybe some quick ways to hit that target. So that might be an apple with a smear of nut butter, if you can just quickly slice it, or even if you can't slice it, a spoonful of that peanut butter with the apple. Now, some people do like fish. So slicing the apple, you can put tuna between the apple or between the apple slices, or even layer tuna and apple onto a whole grain half sandwich. Sub out the tuna, and you can put almond butter or even a slice of low fat cheese. That would be awesome. Perhaps three cups of popcorn. Popcorn doesn't take a lot of attention to air pop, for example. But you can pop quantity and then bag this up in three cup portions so that boom. There you've got something you can sprinkle that with, perhaps some parmesan cheese. Now you've got a pretty nice combination. Maybe even a bowl of oatmeal that you sprinkle some nuts on top if you make this, especially with a cup of milk. Now you've got a really nice, hearty sustaining snack. Now you might have noticed a couple of trends in the snacks that I suggested because they include foods from a couple of different food groups. So you probably noticed that. And you probably also were looking or thinking about the macronutrients that are present. So these snacks are going to be just like mini meals. They're going to have some carb and perhaps maybe predominantly carb with some fibre, and they're going to have some protein and they're going to have just a little bit of fat, too, because we know that these are the elements. That one; Again, we're looking for maximizing the nutrition, but two; that are going to sustain us through the next couple of hours. And that's the goal. 

So first step, think through what are some possibilities here. What are the foods that you need to have on hand? And then the next step is going to be to plan ahead and prepare. So you've got some foods that you want to have on hand, some great things that are great to stock, of course. And I can appreciate not wanting to do a lot of washing and chopping. If you can when you bring home the produce from the store, wash it before you put it in the fridge. That can be a time saver. If you're making a meal and making a salad, let's say, taking an extra step and chopping up a few extra pepper slices or carrot slices or celery sticks that you can just have on hand. What's really nice about some produce, like carrots and celery. You can prepare these in advance. Keep the carrots in a jar of water, for example. They keep for several days, and they can just be an awesome goto snack. Now, you can also buy a lot of this pre-cut at the store, which might be a timesaving option.

So making sure that you have the right foods on hand in the fresh produce or thinking about the fresh things first that might be hitting the produce section looking for pre-cut produce that you can use for time savers. But making sure that you have easy snackable produce, whether it's the carrots or peppers that can be sliced or cucumbers. That's always a favourite of mine. But also, if you're just inspired to cut up something more, I guess snacky, like an artichoke. I mean, go forth. These are really great things to have. You can nuke them fast, and that can be kind of a fun snack. But then, as you work around the perimeter, some other options that are really awesome. Don't overlook the prepared food that might be in the deli section of the supermarket, where you can buy premade salads or sliced lunch meat that can easily roll around a piece of cheese or round out a quick sandwich with some tomato and lettuce on it. As you continue through the store, hitting up the granola aisle so that you have perhaps a granola bar that in and of itself might just be mostly carbohydrate, but put a smear of peanut butter on that and then maybe a few raisins. Wow, that's kind of a little bit more exciting than the same old granola bar. 

Heading up that aisle and then working your way over to, like, the fresh dairy section. This can be keeping milk on hand. That makes a great snack because it takes little effort to pour up a glass of milk. And in the milk, you're getting carbohydrate, you're getting protein. Couple that with maybe…. I don't know why I stopped.

I actually was thinking of some muffins that I made that were like chocolate chip muffins. I'm like, oh, that would really go with a glass of milk. That's where my mind went. So I'm sorry, I really got off track, but; Having maybe that granola bar with the glass of milk, that would be perfect. Again, these are two things that are super convenient keeping things around, like ricotta cheese or low-fat cottage cheese. I love cottage cheese because it's sometimes the overlooked hero. It's got its protein, some carbohydrates, but it pairs fantastically with a handful of berries, perhaps a few nuts and a sprinkle of high fibre cereal. And you got something really yummy, in fact. 

And then it's a little bit different than the traditional yogurt that really dominates almost the entire dairy section these days.

Peter Because that is quite often because you're bang on. That is quite often the thing, isn't it? When we start to look at the pre-packaged snacks, so the yogurt in the UK Muller Light and all that sort of stuff is kind of like a go to fruit corners. So basically, you have yogurt on one side and then there's a corner of fruit and you dump that fruit in with the yogurt that's kind of the plan of that stuff. They're fine within themselves as a one off, so to speak. But they are not actually the same as having Greek yogurt with a piece of fruit. 

Or they're not the same as a bit of ricotta cheese with a bit of fruit and with something else because, well, there's a reason the company makes as much money as it does, right? The sugar content of those things tends to be significantly higher than if you take a minute to make it yourself. 

And I think it's interesting what you said. You mentioned lots of easy things. I think for a lot of people, they start to think that it's all or nothing. So they start to think that meal prep is the bodybuilder type meal prep, as in; on Sunday, I have to cook all my chicken. I have to cook all my broccoli and all my rice and then put it all into containers. And that takes you the entire day on a Sunday. And if you're a bodybuilding, you have that kind of time, then that's awesome. I'm not knocking it. You don't mind eating the same thing six days in a row and all that sort of thing. 

But we have a tendency to make food very complicated, as in snack time, especially. I don't know about you, but I definitely use associate snacks with convenience food. 

It's called the snack aisle for a reason. And then there's a different section that is the deli, and that's the fruit and veg. Therefore, by definition, regularly. I've had this with clients and I've done this myself. I will go to Tesco, I will go to the supermarket and I'll buy a load of fruit and I'll buy a load of veg and I buy my shopping and all that sort of thing. And then I think to myself, I haven't eaten anything today yet. Maybe I'll pick myself up something that I can eat in the car. 

And I've immediately forgotten about all the fruit that I just bought because I'm conditioned to think that the things that we can easily grab are snackable items. And they’re, by definition, they come pre made and they tend to be fairly high in sugar and all that sort of stuff. They tend to be more treats than they are snacks. So it's interesting what you're saying. 

We covered one of the other things here as well, which was about diet and fatigue. Yeah, I think the snacks and all that. What she was saying was I do find I need to eat a lot and often to maintain my energy levels, and if I go too long without eating. How do I eat enough? Because this is a very active lady. She's breastfeeding do more than twelve and a half thousand steps every day looking after a newborn and a toddler. So she uses a ton of energy. I mean, that is just crazy busy. So how do you eat enough snacks without eating too many ultra-processed foods or indeed haven't to do too much by preparing fresh food already, because especially if you're already crashing missed mid-morning snack time? How do you then grab something that has a quick result? Because fruit is quite often can take a little while before that hits you in the sweet way that the Mars Bar does, so to speak. 

Libby; Understandable, I think the key word here is ultra-processed, because the ideal snack again, it's going to have about 200 calories give or take. Now, this particular mom might be needing just a little bit more. So it's not uncommon for a snack to get up around 300 calories, but you want to really maintain it 300 or less. There are plenty of processed foods that are probably already in your pantry. It would be what I would say to her. And these are things that you can easily stock and have around that will be sustaining. My favourite goto to talk about our canned beans, lentils chickpeas. These things are very complex carbohydrates. They're loaded with both fibre and a little soluble fibre, so that's good for the heart. But it's got a lot a pretty good amount of fibre per half cup, about 7 grams and about -78 grams of protein and some carbohydrates. So even if you just ate canned beans that you opened up the can, you rinse them under the water and just ate them, you would be getting a pretty decent snack. Now, there are other things that you can have around the home that can just jazz it up a little bit, be it a dash of herbs or spices or perhaps even a salad dressing. 

I realize it's a personal choice if you go for something that's premade. A lot of times the oil and vinegar that's in that salad dressing are pretty straightforward, but you can easily just a splash of your own vinegar and olive oil and your set. Other things from the canned aisle that are really, canned food aisles, that are awesome. Again, they are processed but no differently than how your grandmother probably canned food. So this would include like, except now canned foods are actually being made with 100% fruit juices and no sugar added. So while your grandmother probably did dump a bunch of sugar into canned fruit. Yeah, that's not really the case. We have so many more choices with our canned foods. 

So you can buy fruits like peaches, which great for vitamin A. You've got that bright Orange colour or pears or fruit cocktail all in its normal all in 100% fruit juice syrup, which is very nice. So you can eat the fruit. You can even save the syrup and utilize it. It is just 100% fruit juice so you can utilize it in other ways, dilute it into your water because hydration is also going to be a key part of this weight loss journey. But other things, keeping around whole grain crackers, whole grain tortillas, for example. Real quick snack might be grab a tortilla, a slice of cheese that you got from the deli section and having some salsa tossing that into the microwave. Wow, it doesn't take much to add a handful of lettuce to that. And you've got something that's really super tasty and pretty super convenient. I could pull this together in about a minute. Well, it would take a minute in the microwave, so maybe two minutes total. 

Peter; No, that sounds awesome. That sounds really nice, actually. See, easy tacos. That's essentially what that is interesting. You mentioned fibre because that brings us on to the next one. 

Peter, a big fan of the podcast for doing this. I've been following the program for about two months and I'm seeing good results. Well, that's always nice here. I take your point about not eating foods that cause bloating. (Just for you (Libby), because we're dealing with a lot of diastasis recti/core related issues. These things are exacerbated by internal pressure on the core, so I always tell people try not to eat foods that bloat you and it's completely individualized.  That is always for some people an apple is fine. And for some other people, they bloat after an Apple. Other people can have dominos, whereas I can't and all that sort of stuff. So for the time being, whilst you have diastasis recti, I say, please avoid foods that bloat until we've dealt with that particular issue). So what this lady is saying For me unfortunately, all brown rice pasta and bread or brown bread causes me to bloat. And if I eat them, my belly is huge at the end of the day, she's fine with white is what she said. If I cut this out, will I still get enough fibre from fruit and vegetables? And of course, like you said, kidney beans and legumes and all that? So can you. Just because in the UK, we've always been told brown bread, brown rice, brown pasta is better than white rice. But can you get your fill of fibre, so to speak, without having any of those items? Assuming you have a normal diet?

Libby;  Absolutely. And one of the recommendations I would make when somebody has found that certain foods are affecting them, like with bloating it is definitely worth reaching out to a registered dietitian and talking with them to get to the bottom of this because it really could be something that it just deserves an expert opinion. And again, it goes back to that individualized program so that you make sure that you're meeting all your needs, but with minimum symptoms. But to your point, yes, you can get the fibre that you need. Now let's back up a step and just kind of define like, how much fibre does a person need. If you're kind of a sedentary female, which I realize most moms are nuts. But let's say you are and you happen to be listening to this and maybe you're eating about 1500 calories, you would need about 21 grams of fibre. And if you're more active, consuming more calories or happen to be male, if you're super active, you might be getting up around 2500 calories. That would not be for weight management, really, but you would need maybe about 35 grams of fibre. So the numbers are pretty up there. But it's totally possible, because if you're focusing on a wide variety of foods, you're going to have those fibre possibilities right there at your fingertips. Reaching for fruit, vegetables. Like you said, the legumes, whether that's beans, chickpeas, dried peas or the lentils, these are great things to include. And as I mentioned, per half cup of one of any of these legumes, you're getting about 7 grams of fibre so you can see how quickly it can add up. In a half cup of I can't remember if she said oatmeal was one of her... Well, regardless, in a half cup of oatmeal, you would get about 4 grams of fibre. In an apple, you could get anywhere from two to 4 grams of fibre depending on the size. 

Peter; It’s a pretty easy hit isn’t it? Get a couple of plums and all that sort of stuff in there and you're laughing.

Libby;  And variety is the spice of life. I mean, really, if we had to eat the same food every day like a bodybuilder, Ouch. To me, that just does not sound exciting. I'm not saying I couldn't do it or I wouldn't do it. But I like variety. Variety keeps us interested and certainly eliminates the food fatigue. And if it takes even that extra 30 seconds to put together, but it's exciting. Now it might be worth it.

Peter; Yeah, absolutely. And I always think, you know, for me, and this is just for me. I'm okay having the same for breakfast every morning because I don't really care enough, it’s just breakfast. A bit of fruit will usually do lunch, obviously doesn't have to be terribly exciting. It's nice when it is, but it's okay if it's not, but dinner. You don't want to eat chicken and rice five days a week. And it's interesting because when we're talking about weight loss, there are some trains of thought out there that say, actually, the wider a variety of foods you have, the more difficult it is to stick to a diet. But that is predominantly then, because they're focusing on cutting out certain food groups rather than looking at their calories and their macros. Right. If you just go back to small calorie deficit and you hit your macronutrients and all that sort of stuff. You are pretty much, unless there are other things in your life that are going horribly wrong and not sleeping and all that sort of stress related things, you're pretty much always going to lose weight if you stick to the basics. If you get the basics right. So you don't have to eat the same foods every day to lose weight is kind of what you're saying.

Libby; Absolutely. That's true. It's a range of things because we know that a variety of things go into why we are the way we are. One you have just given birth to a baby. There's a big factor. But then genetics plays into this and our age, our gender, our level of activity and kind of circling back to what we talked about earlier in the program. Age and gender relate to how much lean body mass do we have. So there are a couple of perspectives here. Of course, nutrition is very important because you want to make sure that you have all the building blocks and not just the amino acids from protein. I'm talking the vitamins and minerals from all the food groups. You want to make sure that all of that nutrition is present for when you do your activity or even lifting baby. That is activity and it's muscle building. So doing that 50 times a day does and is contributing to maintaining your lean body mass? 

Peter; Absolutely. It's very interesting that you're talking about, that there is more to it than just food, because obviously genetics. It's interesting. Genetics kind of goes everybody in biology-101 the human body-101 was taught about the ectomorph, the endomorph and the mesomorph, right. The three body types. And everyone is a mix of all of them although I was very much the skinny kid in school, but everybody's kind of in between a little bit here. Some people find it easier to put on muscle mass. Some people find it easier to some people find it impossible to gain any weight until they hit about 30, 35, and then they balloon, like my dad did for one. So when we're talking about things that contribute, it's interesting. 

One of the emails I had was saying;

Hi Peter, 

a long time listener to the podcast. Here's my question for the dietitian. I'm currently four weeks postpartum, so not exercising or dieting yet. (Good, because I was going to almost give her a telling off. Four weeks. We're not doing anything yet at all, just taking care of ourselves.) But I have read a lot about the body having a set point, Has my pregnancy made mine go up. And can I now no longer lose the weight I put on? 

Set point theory is an interesting one with regards, because it is just theory, isn't it? That is something that people have thrown out there, and some people accept it as truth. But this is not like the theory of gravity and relativity and all that sort of stuff. What's your opinion on that?

 First of all, does the body have a set point and then does your pregnancy make it go up? 

Libby; You said it best at that point is a theory that's out there and it's actually not well supported because…From the standpoint, we can see how people, regardless of giving birth or not, people have gradually increased their weight over time, and that it has been mostly related to food choices, like choosing more fast food or just over consuming on total calories. So in America or in the United States, rather, that's what we have seen over the past couple of decades is that overall weights have gone up, which defies the set point in of itself. I really have to circle back to the things that we know determine calorie needs. And there is a reduction in calories for weight loss, and especially when her time comes that she's going to begin giving this a little bit more attention. We're not looking for great reductions in calories, and in fact, I would expect and want no more than 5lbs of weight loss per month, which is a very moderate amount of weight loss. So doable. But at the same time, nothing radical. But what we know goes into calculating a person's needed calories. Like I said, it's their height, weight, gender, age and activity level. These are the components that go in. Yes, everything is still very individualized and would like if I were visiting with somebody face to face. I can numerically calculate their calorie needs, but I would also want to know where they're starting from in terms of how many calories they're consuming now and what is a reasonable reduction for them. So in spite of whatever my numbers say, I can say that, but really, it's all relative to the person where they're starting from and what's reasonable for them in terms of moving them towards their goals and what they can do in their day and in their lifestyle. So kind of the same mindset folds over when we look at how we want to evaluate a person's progress. Again, it's starting with where you are. And there are different things that happen to a woman's body that change how you're going to measure success. So success might be something on the scale, it might be an inches. It might be the fact that, hey, you have been struggling to get in snacks period, and you've been reaching for snack cakes up to this point. And this week you chose fruit and cheese. You chose nuts and seeds. You made like a bean salad mixed with some chopped up vegetables that you could keep in the refrigerator for just a quick grab and go snack. And you successfully chose these high, nutrient dense snacks all week long. Now that is a win, and it pays off. It's not the kind of thing. As long as the calories are a deficit from where you started, you can gradually see progress. But at the same time, there are lots of ways to measure that progress. 

Peter; Absolutely. I always say..With both part time clients, I never focus on weight loss. I focus on health. And if I focus on health, any weight loss will follow because that's kind of just how it happens. If you eat well and you don't over consume calories. If you have weight to lose, you will lose it. That is kind of; In the beginning let's focus on sleep and all that stuff. I'm very happy that she said she's four weeks pregnant and not doing anything yet. 

And indeed, listen, I've been a little bit less diplomatic than you are with regards to set point theory and all that sort of stuff. With people saying that diets don't work, that there is no point in trying to lose weight, because you can't lose weight because your set point changes. I think it's Hokum. I think it's nonsense. There's a lot of that out there, but it's usually being said to you by people that have something to sell. And I always get very nervous when people say to me; “you can eat whatever you want. Buy my book and I'll show you how”. How about if I don't buy a book and you just tell me.

 But the interesting one. This is the last of the emails that I wanted to touch on because this is a very interesting one, and I think a lot of women will be struggling with this. 

Five months pregnant. 

Hi Peter

Greetings from Berlin. I am a 41 year old mother of two and I'm five months pregnant. I want to give up sugar because I want the baby to be as healthy as she can be because I'm old and pregnant. (Very German sort of line there). But I struggle because when I give up the sugar, I get hungry and have really bad cravings. What can I do to help? Vielen Dank.

That's an interesting one, because everybody I think when she means giving off, sure, she means the processed stuff. She can't be talking about because she's talking about health and therefore it won't be fruit.

Libby; I completely understand. So anytime, when you try to give up sugar, a lot of people tell me that they have cravings and these cravings are absolutely… they're intense. So the main goal here is to eliminate the cravings. A lot of times the cravings are stimulated by fluctuations in blood sugar. So looking at things that can control that is going to be key. This is going to include plenty of fibre, eating more fibre. So when you do eat, you're going to want to imagine your plate or whether that's a snack or a meal. Imagine your plate, kind of this is tried and true but it works, where half of the plate contribute is dedicated to your fruits and vegetables. A quarter of your plate, maybe your complex carbohydrate, whether that's beans, lentils, chickpeas, or perhaps even a whole grain. Love the whole grains because again, these are kind of the unsung heroes here. They are great with antioxidants, which are also very important, but they have the fibre and protein that can help, again, balance out how this meal is going to affect your blood sugar and then have a quarter of the plate devoted to, let's say, a chicken breast or a piece of fish, for example. So getting the plate and that meal or that snack kind of composed along these lines. Again, macronutrients, focus on the complex carbohydrates making up kind of the bulk, the filling part of that meal, and then including some protein and some fat, too. Because you don't want to include too much fat, because that equals extra calories. So the fibre, the protein and just this kind of composition of the plate are three things that are going to help maintain the blood sugar. 

The other thing, or two more things, that I can say that will help with cravings would include drinking plenty of fluids. 

A lot of times we mistake a hunger or craving by just simply being thirsty. And a lot of people will say, oh, but water is so tasteless compared to X-Y-Z. Well, you can make it fun by adding some. If you've chopped up some strawberries, save the top of the strawberries where some of the fruit  is still attached and put it into a water canister that you keep in the refrigerator for a day and that water is going to be deliciously strawberry flavoured. Or having perhaps a seltzer water with lemon or cucumber and lemon. Or if you've got some herbs that are still out in your garden or you pick up at this store, thyme or rosemary can kind of add an interesting element to waters. But drinking plenty of fluids is going to be important. What that might mean for most women is around twelve cups, which might be about 2.7 litres. If you're nursing, that's going to bump up like I said earlier, to about 16 cups, it's more like that 3.5 3.7 and then thirdly, again, you're trying to knock these cravings, keep your blood sugar level. It's not just what you eat and what you drink, but it's also what you do, because moving more is going to again, better help you utilize that available energy that's in your bloodstream. And the goal is to keep the energy from not going too high and obviously not dropping too low. That doesn't feel good either. Keeping it right in the middle, and when we move, it allows the glucose that's circulating in our bloodstream to get into our cells so that we can make energy. And when we feel energized, we're not searching for that quick pick me up of sugar, for example. And sugar could be something sweet, but it could also be something processed sweet, or it could also be like a refined carbohydrate, like white bread. So these are things that can really help, of course, getting plenty of sleep. When we're tired that's definitely a vulnerable time, but recognizing it. So if you didn't get a good night's sleep because everybody was up with a cold in the middle of the night, it happened... But recognizing that you're going to be more vulnerable, makes it that much more important to go back to the basics of what you know is going to be best for you in terms of high fibre, complex carbohydrate choices. Whole grains, those legumes, including some lean proteins, perhaps some nuts and seeds, and just kind of rounding out that meal or snack even if you ate a little bit more that next day. But it was from these good nutrient-dense foods. At least you would be not setting yourself up for that rollercoaster of cravings. Snack bridge your hunger between meals I've got a few ideas that are quick, easy, and portable and being prepared will help prevent you from a nosedive crash between meals. Simple snacks like one half peanut butter and banana sandwich on whole grain bread or hard cooked eggs and six whole wheat crackers.Or a quarter cup or 35 grams trail mix are great on the go ideas. Try roasting chickpeas with your favourite herbs and spices, or buy baked vegetable chips like kale or beet or blend one cup or 240 ml of fat-free milk and frozen fruit. My secret; I love adding a drop or two of vanilla. You can find these and more snack ideas at eatright.org. Staying off the blood sugar roller coaster can start with making better meals rather than overhauling all your goto recipes. Start by simply adding vegetables, legumes and whole grains to what you usually make instead of white bread or white rice. Try whole grain bread or brown rice. Or add a side dish like sliced Brussels sprouts with apple and tossed with sunflower seeds. Dress that with Apple cider, vinegar, Cayenne and a touch of Maple syrup. Mix cannelloni beans with a little red onion and herb like oregano, tarragon or thyme and a simple oil and vinegar dressing. Opt for chickpea, lentil or bean pasta to make with tomatoes, chopped peppers, sliced artichoke hearts and a drizzle of olive oil. It's great warm or cold and leftovers make a perfect snack.

 Instead of reaching for sweet pastries cakes and candies skillet, toast a whole grain tortilla folded over almond butter and sliced strawberries or banana for something ooey gooey and delicious. Freeze fruit like grapes, pineapple chunks or mango cubes for an easy grab and go treat. Or try peanut butter on celery with raisins or other dried fruit. 

Peter; Yeah, absolutely. I think that is bang on, and that makes an awful lot of sense. Just a very quick one because I know someone is going to email in and ask me this because I did an episode a while ago and you mentioned macros quite a bit, macronutrients and all that. I said a while ago that people in the west, predominantly in the west, especially in the fitness industry, make way too big a deal out of the macronutrients split. As in. Does it need to be 40, 30 30 or 33-33? If I go over on my carbs for the day, will it ruin my progress, and someone's going to email him because you mentioned it, and it would be almost a disgrace not to ask you, because someone's going to call me a Jackass if I don't. 

Am I right in saying that it really, generally speaking, unless you're a professional athlete, doesn't matter whether you have 40% carbs, 30% protein, 30% fat, or the other way around on any given day. That it's not that big a deal. If you go 35% carbohydrates one day and 30% the next.

Libby; it's quality that counts. So circling back to making sure that the foods that you are choosing, we're going to find that there's no one food that is. Well, sugar is one food that's strictly carbohydrate. There really is nothing else to it. There's no fat, there's no protein. But pretty much all other foods are going to be a combination of these macronutrients that we pay attention to. Now we know our bodies primarily use carbohydrate for energy, and thus that's why they get a lot of attention. But we also need protein for building muscle, keeping up, making hormones and antibodies. And then, of course, fats. We need them to absorb our fat-soluble nutrients. Everything has its purpose and importance. 

And as long as you're choosing quality, that's going to be more important. Making sure that your food choices have our nutrient dense and making sure that you get a variety. As much as we do know about nutrition, some of the science is still yet to be discovered. We know, for example, that there are antioxidants in garlic, for example, that can help lower cholesterol, but when we isolate them and give them to people, they're not quite as effective as when we eat them in combination with food. 

So there are nuances of how these compounds in our food interact with one another and actually optimize the nutrition that we're eating. So making sure that you're getting a variety. And this could not be more true than when we look at the plant based foods that we choose. Because even if you only ate plant-based foods, you can still meet your protein needs. You can meet your fat needs and your carbohydrate needs and, of course, get plenty of fibre. But we can really look at variety here because it's so visual. And we know that people who've been through their pregnancy already know the emphasis that's been given to eating the colours of the rainbow. That could not hold more true for actually any of us making sure that we get dark leafy greens that we're getting orange, yellow. I mentioned the greens, but the reds and blues and purples, even browns and whites. Sometimes they are overlooked. But all of the colours in the spectrum contribute antioxidants and compounds that our bodies use to optimize our nutrition.

Peter; Absolutely. It comes back to the interesting thing, I will round up after this, like something that Gabriella Rose who I interviewed a while ago. She's a fertility expert. She said this a while ago. “Act pregnant to become pregnant”. As in live your healthiest life possible and you will become pregnant. 

But if you just live your healthiest life possible all the time, like when you say “pregnant women get told this is a good idea”. 

It's actually something we should be told as five and six year olds. It's not just something we should be doing, when we have something growing inside of us. Just take care of yourself. Eat all the colours on the rainbow, predominantly, as I always say, eat your vegetables. Most of the stuff on your plate should be plant based rather than, I'm not saying don't have meat on your plate. I'm just saying it should be plant based and not ultra-processed. And it's interesting what you were saying with grass. We don't know how the food interacts because we do know for one that a steak with chips or fries, as you say in America, is different from a steak with spinach. As in; It doesn't respond in the same way. I feel great if I have steak with spinach, I feel phenomenal. If I have steak with fries, I'm immediately tired afterwards. 

It's the same steak and it can't just be the fries if you know what I mean. So yes, taking care of yourself and wide variety of stuff. Sounds like good advice. 

Was there anything else you wanted to touch on, Libby?

Libby;, I think we’ve covered…. Your listeners had awesome questions that I think have universal appeal. I think a lot of have certainly been in those positions and can relate and certainly can benefit from that question being asked. So thank you very much for letting me come in and talk.

Peter; No it is very much appreciated. Like I said, you're qualified beyond anyone else Ive, well to be fairI’ve had some really good experts on the program. But you are by far the best I could have had for this particular segment.

And to go and prove that, Libby very kindly afterwards, sent me another file saying “I've missed one or two things. I'd like to correct one or two things”. 

And she very kindly recorded everything at home, so she'll be here talking about her big tip list, a couple of recipes where you can find the recipes. I will obviously link to them as well, and without further ado. Again, back to Libby. 

Libby; Keeping Changes simple is the key to success. The award-winning Food and Nutrition magazine has a column called Lazy Delicious, where the recipes are always super simple and use ingredients you probably already have. I want to share a kid friendly Lazy Delicious way to make nutrient dense foods with lots of flavour that the whole family can enjoy. 

Here's a pumpkin, mac and cheese from registered dietitian Serena Ball. 

Follow the directions on a box of mac and cheese with a few modifications along with the boxed pasta. Add one, two cup of regular, chickpea or whole wheat pasta to the boiling water. When adding the powdered cheese packet. Also stir in one cup of canned pumpkin. 

Registered Dietitian Sarah Gallagher published this kid friendly pizza.

Lightly top a whole wheat tortilla with your preferred pizza sauce and cheese, plus any leftover diced vegetables such as carrots or peppers. 

Cook in a toaster oven or on a lime sheet pan in the oven at 350 degrees Fahrenheit or 100 degrees Celsius for one to five minutes until evenly browned.

 Listeners looking for quick kid friendly meals and snacks, tips and evidence-based nutrition information should go to Kidseatright.org. For more information and to find great recipes, tips, strategies, or to find a registered dietitian, visit the Academy of Nutrition and Dietetics eatright.org. 

Peter;  So like I said, thanks again to Libby for coming on. 

Thanks ever so much to the Academy of Nutrition and Dietetics, who are the guys in America! These are the qualified people. Thanks so much to them for jumping in. When I asked if they had someone available and for making Libby available, she's one of their spokespeople and one of the most qualified dietitians in the US. 

So for her to come on here and answer the questions that you guys are very kindly sent in, much appreciated. I love getting questions from people and then putting them towards ..putting them to someone who's genuinely qualified.

 I thought there was loads of good stuff in there. I will make a transcript available and we'll probably break this up into four or five different segments as well that I'll put out. 

So if you like to listen to shorter segments, you can do it one question at a time, I suppose already, but we'll throw it up on the YouTube channel.

If you liked this podcast, and I hope you do. If you liked this episode, give us a like, give us a subscribe, tell other people you like it. Leave us a little review. 

That is how we can basically get some more listeners. And the last few weeks I've had some great experts on Gabriella springs to mind, Dr. Kylie springs to mind and now Libby, obviously Stephanie last week as well. These are all people at the very top of their game, on top of their profession and all that sort of stuff. I'd like to get more guests of this caliber on. So the more listeners I get, the more eager people are to come on to my little podcast, right?

I believe we're now number one postpartum podcast in quite a few areas, and I'd like to continue that. I like to rise up a little bit through the rankings and get you the best information brought to you by genuine experts rather than some hackey people. 

Anyways, that's all for the podcast this week. There is no in the news this week other than; Guys. All the articles and I will link to this is all the studies say you're much better off when you're pregnant, getting the COVID vaccine. Please, please go get your shot. If you haven't already. I know take up is very low amongst pregnant women, but this is not something to be messing with, especially not with winter flu season and all that sort of thing coming up. Hospitals are full this is not a good time to catch this stuff and to get ill with it. So get your vaccine. Take care of yourself. 

I will link to three or four studies that have come out to show you that it's completely safe and it's definitely safer than caching it, right. You take care of yourself. New bit of music. Any questions? Any comments? Peter@healthypostnatalbody.com That's what we're there for. All right, bye now.