FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

DIET PILLS NOT A GOOD IDEA FOR NURSING MOM -- OR THE REST OF US

Question: Are there certain medications or dietary supplements to avoid while breastfeeding? Specifically, I am interested in a supplement called apple cider vinegar dietary supplement. It is supposed to aid in fat loss.

Answer: Nutrition is a big issue for all of us since we all need to eat, and we want to stay healthy. It is obvious that what we eat plays a role in our health. In your case, what you eat plays a role in your baby's health as well.

There are many areas of confusion regarding food. Part of this problem is because we humans eat a wide variety of foods. (Technically, we are "omnivores," who eat anything that doesn't eat us first!) And, despite what diet we eat, if we are protected from disease and violence, we all seem to live a reasonable number of decades. Therefore, it is quite challenging to "prove" that one diet has significant health advantages over another one. That said, there is considerable evidence that some dietary practices contribute to developing some disease conditions. And conversely, there are claims that some foods or food supplements help reduce the risk of disease.

The greatest nutritional hazard for our society at the moment is excess calories. Or, in the vernacular, "We eat too darn much!" Obesity is associated with an increased risk of diabetes, high blood pressure, heart disease, arthritis, and also premature death. Your concern about your weight may be because of these risks, or more likely it is just that you would like to get your figure back after having your child.

When more calories are consumed than are used up in the course of the day, weight is gained. Weight loss is accomplished by using up more calories than the diet supplies. Nursing imposes some special concerns because the quality of breast milk is influenced by your diet. A mom of a new infant produces 600 to 900 ml of milk each day. That requires an additional 600 or more calorie each day just to make that milk. Some of the weight that is gained during pregnancy is extra fat (energy stores) to be used in milk production. Other nutrients such as vitamins and proteins need to be consumed daily.

Use of a weight loss supplement is, in my opinion, generally unnecessary and usually ineffective as well. If you are convinced that apple cider vinegar will help you, I'd suggest that you use a quality cider vinegar as part of your salad dressing rather than taking a "pill" supplement that you hope will make dieting easier.

There are quite a few diet medicines, both prescription and non-prescription that have come and gone over my years of practice. That is because if the product actually worked, it also impacted the metabolism in such a manner some health problem eventually developed. Most diet aids that are sold now are primarily psychological aids. That is, they are a crutch to help people cope with the stresses of dieting. And, if history is a good teacher, there are also some products out there that will ultimately prove to cause troubles that are worse than the health problems associated with obesity itself. Unfortunately, today no one can tell which products actually fall into this category.

March is National Nutrition Month. I encourage you to eat a balanced and diverse diet. Go easy on animal fats. Watch the carbohydrates; this includes such common culprits as white flour, potatoes, white rice and sugar. Talk to your doctor and a dietitian about the best diet for you, and in your case, also the best one for your baby. Save your money on the diet supplement. Instead, buy the baby a new toy.

"Family Medicine" is a weekly column.

To submit questions, write to John C. Wolf, D.O., at Post Office Box 110, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.