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May 23, 2012
Blue_night01: What is the right age for Cosmetic Surgery?

Aesthetic Surgeon at CosmeSurge - Dubai:
The best age to have cosmetic surgery is when your aging face or body bothers you enough to correct it - when you don't look like you any more. Most of the patients for face surgeries are in their forties or fifties but CosmeSurge can perform it earlier if your face has aged enough. CosmeSurge have much younger patients requesting Botox®, treatment for acne, acne scars or pigmentations, breast surgery, tummy tuck, nose reshaping or liposuction. Ask yourself the magic question: "Will I gain enough (improved appearance and increased self-esteem) for it to be worth the cost (time, money, risk and what your mother might say)? If your answer is, "yes", then do it now. If it is "no", then wait until the answer becomes "yes"…if it ever does. Another question to ask yourself is: "When do I want to look the best I can look? Now? …or some other time?"

May 15, 2012
Liveyourlifesimple: Is dental x-ray is safe?

Dental Specialist at Noa Dental Clinic - Dubai:
Some patients have concerns about the safety of X-rays, as well as the need for them in the dental office. Although x-rays and radiation sound intimidating, the amount of radiation used to expose dental x-rays is very small. In fact, the average patient may actually receive more radiation from sitting in front of the television during a year than from traditional X-rays taken at most dentists' office. Dental x-rays are an indispensable part of diagnosing your oral health.

X-rays are taken to detect a number of conditions or diseases in the mouth. By taking them periodically, it helps us detect adverse situations early. If you're generally in good health and have had routine dental care, chances are you may only need to have them every year or two.

At Noa Dental Clinic, they protect patients during the taking of x-rays with a lead apron. This apron is draped over your shoulders and protects you from your neck to mid-thighs.

Embryonic tissues are also sensitive to radiation. If you're in the first trimester of pregnancy (the first three months) or think you may be pregnant, please tell us. Noa Dental Clinic generally avoid taking x-rays during this time, unless you have a specific dental emergency. Once you past the first trimester, if there's reason for taking x-rays, the clinic will take every precaution to protect you and your unborn baby from any harmful radiation.

March 22, 2012
Bluberrymuffins: What is the evidence about the role of good nutrition in fertility?

Dr. Ussma Ghani, Dietician/Nutritionist, Primavera Medical Centre – Dubai::
There is a growing body of evidence that suggests that there is a link between nutrition and fertility, for example:

Prospective randomized trial of multiple micronutrients in subfertile women undergoing ovulation induction: a pilot study. Agrawal R, Burt E, Gallagher AM, Butler L, Venkatakrishnan R, Peitsidis P. Reprod Biomed Online. 2011 Oct 14. http://www.ncbi.nlm.nih.gov/pubmed/22138521

Effect of L-carnitine and/or L-acetyl-carnitine in nutrition treatment for male infertility: a systematic review. Xin Zhou MD, Fang Liu MD, and Suodi Zhai MD. Asia Pac J Clin Nutr 2007;16 (Suppl 1):383-390. http://apjcn.nhri.org.tw/server/apjcn/volume16/vol16suppl.1/XinZhou(383-390).pdf

Nutrition and fertility. Pinelli G, Tagliabue A. Minerva Gastroenterol Dietol. 2007 Dec;53(4):375-82. http://www.ncbi.nlm.nih.gov/pubmed/18043554

Dietary fatty acid intakes and the risk of ovulatory infertility. Jorge E Chavarro, Janet W Rich-Edwards, Bernard A Rosner and Walter C Willett. American Journal of Clinical Nutrition, Vol. 85, No. 1, 231-237, January 2007. http://www.ajcn.org/content/85/1/231.short

The Obese Patient with Infertility: A Practical Approach to Diagnosis and Treatment.
L. J. Moran BSc (Hons), BND1,2, R. J. Norman MD. Nutrition in Clinical Care. Volume 5, Issue 6, pages 290–297, November 2002. http://onlinelibrary.wiley.com/doi/10.1046/j.1523-5408.2002.05604.x/abstract

Effects of folic acid and zinc sulfate on male factor subfertility: a double-blind, randomized, placebo-controlled trial. Wong WY, Merkus HM, Thomas CM, Menkveld R, Zielhuis GA, Steegers-Theunissen RP. Fertil Steril. 2002 Mar;77(3):491-8. http://www.ncbi.nlm.nih.gov/pubmed/11872201

There is also a lot of buzz around the role certain nutrients like zinc and iron play in combating infertility however we do not have enough research on specific nutrients to prove their role in fertility just yet. In fact sometimes the research can be conflicting as is the case for soy and caffeinated products.

That being said, making sure that your system is at the healthiest it can possibly be to produce a new life (this goes for both men and women) is important.

We know that women are born with all the follicles that can become fertilized eggs in the future. It is also common knowledge that what an expectant mother eats during pregnancy significantly impacts the health of her child. For this reason, it isn’t far fetched to assume that the role of nutrition in conception may be just as important.

In men, new sperm is produced every 64 days. And just like people, sperm requires adequate nutrition to ensure that it is healthy (in terms of quantity, quality and motility).

Unfortunately not many of us consume enough of the foods that our body needs to maintain optimal health. In fact we live in an era where a large proportion of the population is overweight but undernourished. We know that nutrition deficiencies can affect fertility rates in developing countries, so it makes sense that undernourishment would have a similar if less obvious impact on fertility in this population as well.

While certain vitamins and minerals may be specifically responsible for fertility, making sure that your diet is optimal by including fruits and vegetables, whole grains, dairy and meats and limiting caffeine, alcohol and highly processed foods is important. It is also important to ensure that you are at a good weight for your height.

March 14, 2012
Amber: I would like to know to what extent a person who eats reasonably well would need to also include any kind of supplements in their diet eg multi vit. Or is it more a case of supplements helping when diet isn't so good for some reason?

Dr. Ussma Ghani, Dietician/Nutritionist, Primavera Medical Centre – Dubai:
There is an ongoing debate about this even between experts in the field. Some experts are of the opinion that if you are a young healthy adult who eats a balanced diet, there is no need to supplement your intake with a multivitamin. There are exceptions however. For example as we age our digetsive system does not absorb nutrients from our foods as well. Furthermore some people tend to lose their appetitie more quickly as they get older and their system doesn’t absorb as many nutrients through digestion. For this reason taking a multivitamin may be a good idea, especially if you have a frail physique. Also it is a good idea for women of child bearing age to take a folic acid supplement and because many women tend not to get enough dairy and are more prone to developing oesteoperosis a calcium and vitamin D supplement may be beneficial.

On the other side of the debate, experts argue that because of the industrialization of our food supply, the food that reaches us no longer holds as much nutrition as it did in the past. The overfarming of land has basically stripped the earth which in turn means many nutrients are missing in the food raised on this land. For this reason, even if you eat healthy, you may still be deficient in some vitamins and minerals.

Regardless of which side you choose to follow, I think it is important to note that although water soluble vitamins and minerals like vitamin C are easily excreted out of our system (you’ll notice that your pee is much darker in color and smells quite different when you take supplements), you can actually develop toxicity from fat soluble vitamins and minerals like vitamn A and E.

In my opinion, if you eat well you should still get a sufficient amount of nutrients from your food. You know better whether you may require additional supplements like calcium or if you get your 2 servings of dairy in every day. Keep in mind that just because you take a multivitamin, it doesn’t mean that you don’t need to eat nutritiously. There are many substances found in food that are vital to good health outside your vitamins and minerals.

At the end of the day, I think its important to be informed and then make the best decision for you.

March 13, 2012
Angelique K.: My son (3 years) has recently been diagnosed with intolerance to potatoes. I need some ideas for different carbohydrates to give him at meal times; he doesn’t like rice and will only eat pasta if it is in a sauce. I had been giving him vegetables mixed in with mashed potatoes but we can’t do that anymore.

Dr. Ussma Ghani, Dietician/Nutritionist, Primavera Medical Centre – Dubai:
It's always challenging at first when you are faced with an inotolerence in the family. Although potatoes are considered a vegetable, you are right to relate them more with starchy foods like rice and pasta. Does your son enjoy eating bread/sandwiches? My sister has a cookie cutter shaped like a dinosaur and my nephew just loves his dinosaur sandwiches. Whole grain pita bread pizzas can also be a fun way for your son to get in a wholesome meal. You can also incorporate vegetables into your pasta sauce if he enjoys this. Since rice is quite a nuetral flavored grain, you can try cooking it with extra water and some butter and then mashing it so that you can mix vegetables into it (please note that it is a bit more sticky than potatoes would be). Oats or cream of wheat also have a similar texture to potatoes and can be eaten with savory foods. Consider adding some broth to them instead of sugar and milk.

Other grains you may try are quinoa or couscous, though these tend to have their own flavors.

Sometimes though it is just about helping your son develop his tastebuds a bit so that he can enjoy pasta and rice more. I know it’s hard to do sometimes, but if he doesn’t have any other options, he will eventually come around.

February 21, 2012
Anna G.P.: How many calories should I be eating in a day?

Dr. Ussma Ghani, Dietician/Nutritionist, Primavera Medical Centre – Dubai::
This depends on a number of factors including your age, height, gender, activity level, whether you are pregnant or breastfeeding, how healthy you are overall as well as your current eating and lifestyle habits and whether you are looking to maintain, lose or gain weight. On average women need between 1,600 to 2,200 calories a day, while men need between 2,000 to 3,000 calories a day.
However, sometimes we get so wrapped up in counting calories that we forget to make sure that we are eating nutritiously enough to give our body everything that it needs to be its healthiest. A good place to start when you are trying to figure out what you need to eat everyday in order to meet both your caloric and nutrient needs is a Food Guide. I personally find that Canada’s Food Guide is quite easy to use. http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php Another popular food guide is the USDA’s MyPyramid which has recently been revised to MyPlate http://www.choosemyplate.gov. IT may also be worth your while to speak to a dietitian about meeting your nutritional needs.

January 23, 2012
Caroline: I am currently quite overweight and trying to loose weight with diet and exercise. I have an underactive thyroid and pcos, any advice on what the best way to achieve good results would be?

Dr. Ussma Ghani, Dietician/Nutritionist, Primavera Medical Centre – Dubai::
It is excellent to hear that you are planning to achieve a healthy weight through incorporating changes in your eating habits as well as by increasing your activity level. There is a lot of research that suggests that women with PCOS can significantly improve their symptoms by achieving a healthy wieght or by losing as little as 5% of their body weight.

Because your weight is more than likely related to your underlying medical issues, it is important for you to touch base with your physician who can determine if your thyroid levels are normal as well as determine if your PCOS is causing any insulin resistence.

Also it is important for you to be realistic about your weight loss goals. Think slow long term results rather than quick short term weight loss. The fact is “diets” don’t work because they put us in the wrong frame of mind. With a diet we often think of a beginning and an end of a way of eating, versus focusing on making small permanent changes. Keep in mind that healthy weight loss means losing between 0.5-1 kg of weight per week on average. Considering that you have 2 underlying medical conditions, 0.5/week would be very good weight loss for you. Another side effect of PCOS and hypothyroidism is water retention so don’t get disheartened if some weeks you don’t see the scale move at all or go up even though your week was good in terms of eating and activity. You will know if you are retaining water if your rings are tight or if you feel bloated.

Because PCOS does effect your body’s sensitivty to insulin, it is important for you to consider excluding highly processed foods that are higher on the Glycemic Index. Incorporating 6 small meals and snacks into your day rather than sticking with 3 large meals will be beneficial for you as well.

It may be beneficial for you to recruit the help of an expert like a dietitian who can help guide you through this process.

January 12, 2012
Mariam Ali: As someone with a strong family history of breast cancer, I have received a lot of advice from people about cancer prevention through diet. One of the most common advice I receive is to avoid soya products and reduce my intake of lentils. Is this true?

Dr. Ussma Ghani, Dietician/Nutritionist, Primavera Medical Centre – Dubai::
This advice stems from the fact that women who opt to use Hormone Replacement Therapy (HRT) have an increased risk of developing breast cancer. Since HRT uses synthetic estrogen to eleviate postmenopausal symptoms, some people believe that foods like soy and lentils which contain phytoestrogens may also lead to an increased risk of developing breast cancer. However, research suggests quite the opposite. Unlike synthetic estrogens, it has been found that the presence of phytoestrogen in the body decreases the need for estrogen production. Estrogen is the hormone that, among other things, causes breast tissue to grow and divide. It is thought that the weaker plant estrogens may not produce the stronger signals needed for cancer cell development. However the research is not conclusive in regards to how beneficial including these foods actually is. It is known that in Asia, where tofu and soy are consumed in larger quantities, women have lower rates of both menopausal symptoms and breast cancer. However there are other dietary habits that may be responsible for this difference. For example Asian women tend to eat more fruits and vegetables and drink less alcohol than Europeans and North Americans. They also tend to be closer to their ideal body weight and are more active than us.

In terms of nutrtition and cancer, as is the case with other illnesses, maintaining a healthy body weight (BMI of 18-25) is important. Limiting red meats, fat and alcohol has also been shown to be important for women who are at risk of developing hormone related cancers like breast or ovarian cancers. Incorportaing fruits and vegetables, especially cruceferous vegetables (such as cauliflower, cabbage, cress, bok choy and broccoli), including omega-3 fatty acids (found in coldwater fish, such as sardines, salmon, herring, tuna, cod, mackerel, halibut, and shark) and increasing fibre can also be beneficial. In fact, some researchers believe increasing your intake of plant based foods, which tend to be high in phytochemicals (like beta carotene and other carotenoids in fruits and vegetables, and isothiocyanates in cruciferous vegetables are compounds that are produced by plants which are believed to protect cells from damage that could lead to cancer), may reduce your risk of developing cancer by as much as 40%. And although the research is not conclusive, including soy, beans and lentils may actually be beneficial in reducing your risk of developing breast cancer.

January 08, 2012
Anneta, Dubai: My 4 yr old niece is dairy intolerant. She has been on special formula, then soya, since she was 6 mths old. I'd like to ask your advice on how to keep the fat, and calcium, content of her food up to toddler levels. We use a dairy free spread, cook with olive oil and and lots of coconut milk, and sneak avocado into meals.

Dr. Ussma Ghani, Dietician/Nutritionist, Primavera Medical Centre – Dubai::
It can be hard to know whether or not a loved one is getting all they need from food when they have an intolerance. This is especially true when we talk about young children with a dairy intolerance when their sole source of nutrition is “milk” for the first 6 months of life.

While it’s true that young children require a greater amount of fat in their diet, as it is important for proper brain and nervous system development, these requirements steadily decrease so that by the time they reach the age of 5 they need the same amount of fat as adults. Like adults, four to eight year olds should get about 30% of their energy from fat, while about 10% of this energy should come from saturated fat. So children who consume about 1200-1800 kcals, need to get around 33 – 45 g of total fat a day; with 3-4 g of that coming from saturated fat. To put this in perspective, 1 teaspoon of oil or butter contains about 5 g of fat. Saturated fat usually comes from animal sources but is also found in coconut. A hundred grams of lean beef or chicken contain about 2-3 g of saturated fat. Similarly 1 tablespoon of coconut milk has about 3 g of saturated fat in it.

So from what you have said, it sounds like you are already taking a lot of good steps to ensrure that your neice is getting enouh good fat into her diet. You are also incorporating a good source of saturated fat by including coconut milk.

In regards to calcium, four to eight year olds require about 800 mg per day. Since soy products like soy milk, soy yogurt and ice cream are often fortified with calcium your niece will get some of her calcium from these. In fact a cup of soy milk contains about 200 mg of calcium. Other non-dairy sources of calcium include leafy greens (about 60 mg per ¼ cup), fortified juices (between 100-250 mg per serving), tofu (about 200 mg per ¼ cup), broccoli (about 180 mg per cup), canned salmon (about 60 mg in a 30 g serving), sardines (370 mg in 8) and fortified breads (about 100 mg per slice). By including 2 servings of dairy alternatives along with other sources of calcium every day, your niece should get all that she needs.

However there are some other nutrients to keep in mind like vitamins A and D, riboflavin, and phosphorus which are commonly found in dairy foods. Make sure to incorporate food sources of these vitamins and minerals into her intake as well Food sources of vitamin A are orange colored fruits and vegetables. Vitamin D include salmon, tuna, mackerel and egg yolks. Riboflavin and phosphorus are found in meats, legumes, nuts and whole grains.

It is important to note that many children grow out of their food intolerances with time. Now I am not sure about the specifics of your niece’s case, however it is a good idea to re-challenge young children periodically under the supervision of their doctor.

Your niece’s doctor can also assess her calcium status periodically; and if needed may recommend supplements for her.

November 03, 2011
Nataliya: I heard a lot about kegel’s exercises, can I apply the exercise since I just gave birth 2 weeks ago?

Dr. Rosalie A. Sant, Consultant Obstetrician & Gynaecologist, Primavera Medical Centre – Dubai:
Kegel’s exercises strengthen the pelvic floor preventing prolapsed of the uterus and vagina as well as incontinence of urine. They should be practiced by every woman at all times. They are particularly important during pregnancy and after the pregnancy as the pelvic floor is put to the test with the weight of the baby. So you should certainly be doing them if you delivered 2 weeks ago. Do 20 every time you feed the baby – your pelvic floor will certainly regain its strength then!

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