I swell up with fluid retention before every period, which makes me feel fat and miserable. What can I do about it?
Again, it's those female hormones at work here - according to some experts, oestrogen tend to make the body retain salt, which in turn means water retention. (At any time of the month, if you eat a lot of salt your body will retain extra water because it is literally trying to dilute the extra salt to safe levels.) Other experts believe that lack of vitamin B6 and/or magnesium, both of which are important in retaining fluid balance, may cause pre-menstrual fluid retention.
The truth is that we still don't know exactly what causes PMS fluid retention in all women (and why some don't suffer from it). The fluid will probably become most apparent in your breasts and abdomen and can cause not only bloating and weight increase but also pain, especially in the breasts (although not all pre-menstrual breast pain is due to fluid retention).
You can help to minimise this fluid retention by eating a low-salt diet and by avoiding foods containing highly refined starches and sugars, such as cakes and biscuits, which also contribute to fluid retention (the 'blotting paper' syndrome). It is also wise to avoid all the salty, sugary, refined foods and drinks in any case as they add little to your diet in terms of nutrition, and such snacks can add to your pre-menstural misery by making cravings and other symptoms worse. High insulin levels, stimulated by sugar, can cause more sodium retention, creating a 'vicious circle'.
A diet rich in potassium will also help eliminate fluid - most fruits and vegetables contain good amounts of potassium. Foods rich in vitamin B6, magnesium, calcium, vitamin E and essential fatty acids may also help. You should also drink plenty of water which helps to dilute the salt - paradoxically, this won't increase the fluid retention. Although coffee is a diuretic it's wise to avoid it at this time of the month as it can aggravate PMS symptoms especially breast pain.
Don't take diuretic pills - long-term they can actually increase the fluid retention problem and have other adverse effects.
And lastly don't forget that a day or so after your period begins your body fluid level should return to normal. A healthy diet all month long will help the symptoms to be less severe next month.
I have been dieting and regaining weight for 20 years now; is my metabolism shot to pieces?
The idea that yo-yo dieting permanently lowers your metabolism has almost gone into folklore now - but it isn't altogether true.
If you lose weight and then re-gain it there IS a tendency for your body to contain less lean tissue (muscle) than it did before you began dieting. This is because when you lose weight you lose lean and fat, but when most people put weight back on, they gain mostly fat. Fat is less metabolically active than lean, and so repeated dieting and weight regaining will predispose the yo-yo dieter to having a lowered metabolic rate, making it slightly harder to lose weight next time.
However, most studies indicate that the change in lean tissue isn't great - particularly if you haven't crash-dieted - and that the reduced metabolic rate because of this isn't great either. For example, one famous scientific trial at what was then the government-sponsored Dunn Clinical Nutrition Centre in Cambridge found that the metabolic rates of people after repeated bouts of dieting were not significantly lowered.
The truth is that when you lose weight, your basal metabolic rate naturally lowers, whether you diet just once, or whether you yo-yo diet, simply because of your reduced bodyweight.
And the fact is that however many years you have yo-yo'd, your metabolism can 'improve'. As you'll see in "Your Body, Your Weight", an individual's metabolic rate isn't a static, unchanging thing. So even if at the moment you have a lower proportion of lean tissue in your body than you would have had, had you never dieted, it is possible to increase your lean tissue percentage once again and raise your metabolic rate once more.
The way you can do this is through exercise. When I wrote above that 'when most people put weight back on, they regain mostly fat', I was not implying that this is inevitable. It isn't. If people were to do adequate regular exercise a fair proportion of the new weight gain would be lean tissue.
Resistance exercise to build muscle, will raise your metabolic rate, as will regular aerobic exercise.
As you get older, the body naturally tends to lose lean tissue as you age - so you may never be able to bring your muscle percentage - and therefore your metabolic rate - up to the level it was in your 20's. But you can definitely make significant improvements - and I suggest that you embark on a gentle calorie-reduced diet at the same time - creating no more than a 500- calorie a day deficit (for most women this is equivalent to a diet of about 1,500 calories a day). If you don't aim for too low a bodyweight and follow all this advice, your previous years of yo-yo dieting should not impede your progress to a slimmer body.
Once at a sensible weight, though, you will need to continue with the exercise programme and undertand that, at a lower weight, your metabolic rate will naturally be lower - therefore you need to make a permanent adjustment in your calorie intake to account for this, or weight will return. I stress this is NOT because you are an ex-yo-yo-dieter - it happens to all slimmers. And the more exercise you do, the less likelihood there is of lost weight returning and the more you can eat without gaining weight.
How can I get rid of cellulite?
Diet, exercise and massage will help.
A healthy diet, low in salt, sugar and junk food and reduced in calories will help shift any surplus weight from the lower body, where cellulite most often occurs. Although slim people can get cellulite, it is less noticeable if you are a reasonable weight.
Exercise, such as walking, cycling or jogging helps to tone up the lower body and improve its appearance. And field trials show that massaging the skin above the cellulite also improves the look of the cellulite. (Use a massage mit and some body lotion - there's no need for expensive 'cellulite' creams.)
But don't expect quick results.
I am putting on weight too fast during my pregnancy; what advice can you give me?
The average total amount of weight it's wise to gain is described in the next question. If you were an average weight (BMI 20 - 25) at the start of your pregnancy, after the first three months of pregnancy you should gain, on average, no more than about 1lb a week until the last four weeks when weight often stabilises. If you are gaining much more than this it would be wise to see your specialist straight away for a check.
The weight gain may be fluid, which needs medical advice.
If you know you are eating a lot more than usual, then this could be the reason for your weight gain. Pregnant women need only an extra 300 calories a day or so, and only for the last 3 - 4 months of the pregnancy. That's equivalent to one sandwich or a 15% increase in portion sizes of all meals. Try to cut down on fatty, sugary foods and substitute complex carbohydrates such as wholemeal bread and potatoes, fruit and, to a lesser extent, nuts, seeds and lean protein such as chicken or fish. If you feel ravenous between meals snack on fruit, rye crispbreads, or similar.
If you were underweight at the start of the pregnancy, gaining more weight than average may not be a disadvantage. But do talk to your specialist about your fears - they should weigh you regularly in any case and should advise you even without your asking them. By the way, above average weight gain should not effect the health of your baby negatively.
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