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I have always struggled with the fitness side

Did I mention I've been running lately? Don't get the wrong idea, when I say 'running', I am really referring to a light jog. A healthy eater I may be, but I have always struggled with the fitness side of things. It doesn't help that my so-called friends tell me that I run like an oversized puppy, or and I am not sure how this fits with the first the Queen. As I don't think anyone has ever seen the Queen out jogging, I don't think this is a fair comparison. I am also pretty certain that the Queen has never appeared in public with sweaty butt marks. Unfortunately two lanes of traffic on East Broadway witnessed mine last week. I will have to stop running in the midday heat. I may actually have to stop running altogether. When I began my desperate bid for fitness a few months ago, I wasn't quite prepared for the public humiliation of inappropriate sweat patches. Nevertheless, I am building up my resiliency to embarrassment, helped along by the solidarity of my girlfriends. Happily, they've had plenty of stories to share too my favourite being one friend in France who tried to introduce herself as a lawyer, but instead spent the evening saying 'hello, I am a goat.' All this reminded me that it's been a while since we explored some of the most uncomfortable and embarrassing health issues. Even though doctors have seen it all and heard it all before, it can be hard discussing things like thrush and alarming bowel habits. Obviously it's always better to discuss a health issue with your physician rather than burying your head in the sand. However I can at least show you some preventive strategies for a few of the toe curling ailments out there. This week let's take a fresh look at cystitis though please note that if you have anything other than a brief and mild case, it's important to see your doctor. Firstly let's get to grips with what we're dealing with. Cystitis is a bacterial infection of the urinary tract that makes peeing burn a bit at best, and at worst, makes it absolutely agonising. Think hot knives! One of the problems is that to cure it, you need to drink plenty of fluids, but as this increases urinary flow, many people are afraid to drink. Fortunately there are some excellent medications that can help, but unfortunately, cystitis is a recurring drama for many people. This is a classic example of where modern medicine can sometimes fail us. Because as the focus is to get rid of the symptoms in the short-term, the root causes of the problem are often not addressed. This means the infection can just keep on coming back. So let's look at cystitis in more detail. Yes, it's a bacterial infection, but there are several factors that can trigger it or make it worse. Below are the triggers, some dietary steps you can take to prevent cystitis and some suggestions for supplements.

Triggers: 1. Dehydration By this I mean a lack of water, not just a lack of fluids. Sugary, artificially sweetened and caffeinated drinks can all irritate the urinary tract. Dehydration itself also irritates the urinary tract as the lack of urinary flow prevents bad bacteria being washed out. Each person needs to drink approximately 1.5 litres of water daily and an extra cup of water for every caffeinated or alcoholic drink. 2. Low levels of friendly bacteria. Friendly bacteria in your digestive tract are responsible for at least 60 percent of your immunity. They are also present in the vagina. A low level can mean vulnerability to any infection. Although antibiotics are sometimes given for bad cases of cystitis, they also deplete friendly bacteria and so can trigger recurrences in the longer term. Therefore, it's important to follow a course of antibiotics with a course of probiotics (friendly bacteria) more on this in the supplements section. Please also bear in mind that the birth control pill, sugar, stress, alcohol and yeast are also known to deplete levels of friendly bacteria. 3. Excess alcohol As well as causing dehydration and depleting friendly bacteria, excess alcohol can irritate the urinary tract. 4. High sugar intake Sugar depletes friendly bacteria and increases unfriendly bacteria in the digestive tract and vagina both of which can irritate the urinary tract. Cookies, candy, cakes, pastries, concentrated fruit juice, sodas and fruit punch are all obvious forms of sugar. Be careful of hidden sugars too, in sauces, soups and flavoured yoghurts. Anything that has 10g of 'sugars' or more, per serving, is high in sugar. 5. High sexual activity Lots of sex can aggravate cystitis, especially in the absence of lubrication (natural or otherwise!) Sexual contact can also put you at risk from infection if you are not using condoms. I'm not suggesting you cut back, but make sure you are comfortable and protected. 6. Structural abnormality Structural abnormality of the urinary tract can prevent free-flow of urine and cause irritation. Your doctor will be able to tell you if this may be a concern for you.

Dietary steps for preventing and addressing cystitis: Ÿ Drink LOTS of water! Filtered, mineral, spring or clean tank water. Aim for 1.5 litres daily and have an extra cup for any caffeinated or alcoholic drink. Ÿ Eat plain, natural, live or 'active' yoghurt as this contains friendly bacteria. You can add a little fresh fruit for sweetness. Ÿ Replace tea/coffee with decaf herbal teas. Ÿ Avoid alcohol totally if you have cystitis, until a week after you have got rid of the infection. Afterwards if/when you do drink, avoid sugary mixers and make sure you fully rehydrate afterwards. As a preventive measure, don't exceed seven alcoholic drinks a week. Ÿ Avoid all forms of refined sugar sugar itself, cookies, candy, cakes, sodas, dried fruit etc. Snack on raw veg with salsa, hummus or cottage cheese instead. Try whole-wheat toast with almond or peanut butter. Fresh fruit, nuts, sunflower and pumpkin seeds are also good options. Ÿ Replace refined carbohydrates (white rice, white bread, mashed potato, most breakfast cereals) with complex carbs (brown rice and bread, sweet potatoes, whole-grain cereals.) Sugar and refined carbs promote the growth of unfriendly bacteria. Ÿ If you currently have cystitis, try 100 percent cranberry juice so long as it's just real cranberry juice no added sugar or artificial extracts (which are both irritants.) Cranberry extract has been shown to prevent bad bacteria adhering to the wall of the urinary tract. Blueberry juice is also good! eight fluid oz max daily though, and preferably diluted with water (still or sparkling) as it's still high in natural sugars. Beneficial supplements (please consult your GP before taking supplements): 1. A quality multi vitamin and mineral. Choose one with a good vitamin A content (soothes the mucous membrane of the urinary tract) so long as you are not pregnant, or planning on becoming pregnant (pregnant women should not exceed 750ug daily.) Also choose one with a high antioxidant content as antioxidants boost immunity. Life Extension, Solgar, Twinlab and Natrol are all good brands. 2. Friendly bacteria. Critical for replacing friendly bacteria. The Kyo-Dophillus and Solgar brands are great. Once opened, keep in the fridge and do not take with hot food or drinks. 3. 1000mg vitamin C daily. Look for Ester-C as this is gentle on the stomach. This helps to boost the immune system and fight infection. As vitamin C can thin the blood, consult your doctor before taking if you are on blood thinning meds. 4. Uva Ursi, Cranberry extract or Grapeseed extract (warning this tastes VERY bitter!). These are natural antibacterial agents. Take at a different time of day to the friendly bacteria. Check with your doctor if you are already on any medications. l

The advice given in this article is not intended to replace medical advice, but to complement it. Always consult your GP if you have any health concerns. Catherine Burns BA Hons, Dip ION is a fully qualified Nutritional Therapist trained by the Institute for Optimum Nutrition in the UK. Please note that she is not a Registered Dietitian. She can be contacted at nourishbda[AT]gmail.com

Good to drink: Cranberry juice