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Ms. Ayla Coussa

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About Ms. Ayla Coussa

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    Abu Dhabi Guide
  1. BMI & Heart Disease

    It is not just how much fat you have, or your weight, but rather, the distribution of fat in your body that plays an important role in the development of certain diseases. Latest scientific evidence has reported that waist-to-hip ratio may be another valuable marker, if not a greater indicator of some cardiovascular illnesses (ex. coronary heart disease, stroke) than the commonly-used measure of BMI. Elevated central or abdominal body fat (measured by waist-to-hip ratio), is significantly associated with higher risks of coronary heart disease and type 2 diabetes. It was also shown that abdominal obesity has a stronger effect on stroke risk than BMI. While it is difficult to disentangle the two measures, they should both be taken into account when estimating the impact of fat distribution on health and identifying patients at risk of cardiovascular diseases. By Ms. Ayla Coussa Clinical Dietitian Fakih IVF
  2. Yes we all know that the heat in U.A.E during summer is sometimes unbearable and we all try to hide out in our apartments and offices with the AC on full blast, and head straight to our cars without even saying bye to our peers from the fear of melting. Well, now there is a bright side to all this for couples who are trying to conceive through IVF, getting that tan from JBR or Kite Beach could boost your chances for a successful IVF. Recent studies show that with the right amount of Vitamin D your chances of a successful IVF may be doubled. With this said, you now have a better reason to hit the mall & buy that swim suit you've been eyeing! Vitamin D – The Sunshine Vitamin!! A dose of sunshine is the best natural source of Vitamin D and can also increase your chances of IVF success. We have always known how Vitamin D helps in pregnancy for a long time and helps in the development of the baby. But now, there is a growing body of research into its contribution to positive IVF treatment outcomes as well. Importance of Vitamin D in pregnancy: Your body needs vitamin D to maintain proper levels of calcium and phosphorus, which help build your baby's bones and teeth. Vitamin D, known as the “sunshine” vitamin, enhances and helps to regulate the intestinal absorption of essential minerals including calcium, magnesium, phosphate, and zinc. These levels are maintained through either dietary ingestion or through the skin’s exposure to sunlight. What happens if your body doesn’t get enough Vitamin D? Vitamin D deficiency is common during pregnancy. Inadequate vitamin D can lead to abnormal bone growth, fractures, or rickets in newborns. Some studies link vitamin D deficiency to a higher risk of pregnancy complications such as gestational diabetes, preeclampsia, preterm birth, and low birth weight, but more research is needed to confirm these links. The symptoms of a vitamin D deficiency can be subtle. They may include achy muscles, weakness, bone pain, and softened bones, which may lead to fractures. You can also have a vitamin D deficiency without any symptoms. And if that happens while you're pregnant, your baby can suffer a deficiency, too. Could Vitamin D also contribute to IVF Success? So getting a tan this summer might just boost your chances for a successful IVF treatment. Researchers followed 154 women who were vitamin D deficient and 181 women who had sufficient levels of vitamin D in their blood. The women who had sufficient vitamin D were nearly twice as likely to conceive through their IVF cycle as their deficient counterparts. Women who had vitamin D levels of at least 20 ng/ml in their blood were considered to have sufficient levels of the hormone. Levels of 30 ng/ml are recommended for general health. However this is not always the true, the result may vary based on a person’s race. Briana Rudick at Columbia University Medical Center in New York and her partners thought about vitamin D levels and IVF achievement rates in white Hispanic, white non-Hispanic, and Asian ladies from south-east Asia and the Indian subcontinent. Every one of the 188 ladies incorporated into the investigation was having IVF surprisingly. Of these ladies, just 42 percent had the suggested levels of vitamin D – a little more than a third had lacking levels, while a fifth was totally insufficient. The analysts found that white ladies who were vitamin D packed were four times more inclined to have a fruitful pregnancy when contrasted with ladies of a similar race who were insufficient in the vitamin. Out of the blue, the turnaround was valid for Asian ladies as those with the least vitamin D levels were destined to get pregnant What steps can you take to get Vitamin D? Research suggests sensible sun exposure (usually 5-10 min of exposure of the arms and legs or the hands, arms, and face, 2 or 3 times per week) can help as well. However, the best way to really ensure adequate vitamin D is through simple supplementation. When supplementing, your choices will be between two forms of vitamin D. Ergocalciferol is the vegetarian form of vitamin D and cholecalciferol is the animal-sourced form, usually derived from fish liver oil or lanolin from sheep. Practices that reduces Vitamin D: Sunscreen SPF 50 may prevent skin cancer, but it also blocks vitamin D production. Fat cells obese patients produce vitamin D less rapidly than patients of normal weight. Melanin Darker-skinned people produce vitamin D at a slower rate than those who have fair skin. The pigment in dark skin (melanin) doesn't absorb as much UV radiation. Age Older people also produce vitamin D more slowly. Among the population of reproductive age, however, the effect of age is minimal. Latitude Northern latitudes, with their longer winters and shorter summers, provide less opportunity for sun exposure. Note: More than 85% of U.A.E residents suffer from deficiency of Vitamin D and the condition seems to be extensive during summer- one reason for this could be due to lack of outdoor activities. It would be a good idea to involve yourself with some outdoor activities to help increase the Vitamin D that your body needs. Always remember to make sure you have all the vitamins and nutrients your body needs to function properly, is an important part of taking care of your overall health! Fakih IVF
  3. It is well established that gaining the right amount of weight during pregnancy is as important as the quality of the diet. The diet of pregnant women is strongly associated with children’s health and predisposition to medical conditions. Recent studies have shown that women who had non-diet sodas (or sugar-sweetened beverages) during pregnancy are more likely to have kids who carry extra body fat by age 7. However, a higher BMI in kids was surprisingly NOT reported with maternal consumption of juices and diet sodas. This association was found independently of mothers' weight, race or ethnicity, the child's gender or the amount of soda children themselves drank. Protect your kids by aiming for a healthier diet during your pregnancy... By Ms. Ayla Coussa Clinical Dietitian Fakih IVF
  4. Managing Diabetes during Ramadan

    Fasting during Ramadan is considered to be the most significant spiritual practice, but many diabetes patients might be wondering about the effect of fasting during this holy month. Fakih IVF is here to take care of everything you need to know: The importance of a Dietitian: Nutrition therapy plays a vital role in diabetes management, and an individual’s religion and culture should be considered when preparing their diet plan. It is recommended that the diet of a person with diabetes during Ramadan should be comparable with that followed for the rest of the year. However, Ramadan can result in an extra burden of calories. Iftar, the meal taken when the fast is broken at sunset, often turns into a celebration, with huge volumes of food laden with sugar and carbohydrates. Regional variations exist in the timings of meals during Ramadan, and physicians need to understand regional and cultural differences to advise the patient accordingly. Because of the different types of foods traditionally eaten at Iftar by different cultures, a well-trained dietician should be at the center of the diabetes management and follow-up team. It is true, many people with diabetes can fast safely, but each person is different. Part of the decision you will make with your doctor has to do with the kind of diabetes medicine you take. It is important to schedule an appointment 2-3 months before Ramadan to discuss how fasting might affect your diabetes. Your doctor or healthcare provider may suggest a change in your medication plan. Despite being exempt, many people with diabetes do participate in fasting during Ramadan. It is important that the decision about whether to fast is made on an individual basis in consultation with the patient’s treating physician, taking into account the severity of illness and the level of risk involved. Fasting during Ramadan may provide enduring benefits. Indeed, Ramadan can provide an opportunity for a better lifestyle, facilitating weight loss and smoking cessation. For patients with diabetes who choose to fast, Ramadan may help to strengthen the therapeutic alliance between patient and physician and may provide an opportunity to improve diabetes management, with a focus on self-care and the regulation of medication and meal timing. What risks should a diabetes patient be aware of? These are the key risks: Low blood glucose (or hypoglycemia) – The risk of blood glucose levels going too low is highest in people taking insulin or certain diabetes pills. Limit physical activity during fasting hours and be more active after sunset. Talk with your healthcare provider to find out if your medicine puts you at risk for low blood glucose and discuss how to prevent it. High blood glucose (or hyperglycemia) – While low blood glucose levels may happen during the day after the fast is broken, there is a greater risk to overeat. Watch out for eating too many sweets and keep the portion sizes moderate. Even though Ramadan is known as a time of fasting – it is not uncommon for people to gain weight during this month, as in some families, every evening meal is a celebration. Dehydration – This is especially a problem during the longer and hotter summer days. Aim to drink sugar-free and caffeine-free drinks frequently throughout the evening and before dawn. Many people think of stopping their medicine as they feel that it will break their fast but that’s not true. You should continue taking your diabetes medicine but your dose timings should be changed. This is why it is advisable to speak and discuss with your doctor 2-3 months before Ramadan so that you can plan ahead of how your diabetes medicine which may need to change. It is very important to understand for a patient that they must immediately break their fast if hypoglycemia <60 mg/dl [3.3 mmol/l]), occurs since there is no guarantee that their blood glucose will not drop further if they wait or delay treatment. The fast should also be broken if blood glucose reaches <70 mg/dl (3.9 mmol/l) in the first few hours after the start of the fast, especially if insulin, sulfonylurea drugs, or meglitinide are taken at predawn. Finally, the fast should be broken if blood glucose exceeds 300 mg/dl (16.7 mmol/l). Patients should avoid fasting on “sick days.” Diet Tips: Whole grain cereal, low-fat milk, cottage cheese with sliced peaches topped with toasted almonds Plain Greek Yogurt flavored with blueberries and cinnamon, whole wheat toast with nut butter. Foul (a hearty Middle Eastern breakfast dish made of lentils or fava beans), small serving of sliced fruit Whole wheat roti (unleavened bread) and egg khagina (a southeast Asian dish) Traditionally the fast is broken (Iftar) after sunset and begins with the eating of dates and drinking water. Limit dates to 1-2 each evening. Drink plenty of water and sugar-free beverages though out the evening, but avoid caffeine beverages as they can be dehydrating. Follow instructions of your healthcare provider to celebrate Ramadan in a healthier way and don’t forget to exercise as it reduces the glucose level of your body. “Spread Sweetness this Ramadan by avoiding Sweets”
  5. Why are soups important during Ramadan?

    Soup, a traditional dish at Iftar, a popular meal among all family members, comes with many types and flavors and provides you with many nutritional benefits: · Replenishes fluid lost during fasting · Warms stomach and may prevent bloating or stomach discomfort after a long day of fasting. It is often rich in fibers (e.g. vegetables, legumes) which also help maintain a healthy digestive system. · Enriches your meal with protein, vitamins, and minerals, etc. · Provides a feeling of satiety, which helps you control your food portions at Iftar. E.g. lentil soup, vegetable soup, chicken and rice soups, and oat soup. It is advisable to avoid creamy ones and instant soup as much as possible. Don’t hesitate to enjoy a wide variety of nutritious soups during Ramadan with one each and every day! Ramadan Kareem... By Ms. Ayla Coussa Clinical Dietitian Fakih IVF Fertility Center
  6. Miracle foods for magical health??!

    Food industries are trying to convince us that eating some foods slow down the ageing process, alleviate depression and boost our intelligence. Many of us want to believe that a single fruit containing certain antioxidants will cure a disease such as cancer. A new so called “super” ingredient or food item pops up every day, which makes us wonder what “super” means. There is no official definition of “superfoods”, no a legal recognition by health authorities. It is simply a marketing tool to promote notoriously unpopular, forgotten or expensive food items. Foods that have been labeled as such include those rich in antioxidants (such as beta-carotene, vitamins A, C, E, flavonoids) and omega- 3 fatty acids; from exotic natural foods (ex: goji berries, açaí berries) to starfish fruit, nuts, wheatgrass and seaweed in sushi. The branded so called “super”…foods can have lots of nutritional value as claimed by the marketing campaign, but it is worth checking how much of the product one would have to consume to obtain the “benefit” claimed. For instance, you would have to eat about 28 cloves a day to obtain the antioxidant dose in garlic alleged to reduce cholesterol. When identifying some trendy foods as “super”, consumers can be misled that their basic foods such as apples and oats, which are less costly and more widely available, are not as nutritious. While fruits and vegetables are great sources of vitamins and minerals, meat and alternatives are essential for their protein content, whole grains fuel us with energy and dairy products provide calcium. Hence, it is important to remember that not a single food item provides all the body needs, but a well-balanced diet is key to good health! By Ms. Ayla Coussa Clinical Dietitian Bareen Hospital
  7. MYTH - A common misconception! During the initial stages of weight-loss, you have the fastest weight-loss pattern and your body is still trying to adapt to the lower caloric intake; hence sports may seem more tiring than usual. If you exercise when dieting: You will build muscles which will add some body weight and it will take some time to see the number you aiming for on the scale. Exercise is recommended throughout the stages of weight-loss as it helps maintain muscle mass, burn calories, and aids in fat loss! If you don’t exercise when dieting: You lose more muscle than fat mass and your metabolism slows down, making it difficult for you to lose weight more effectively! By Ms. Ayla Coussa Clinical Dietitian Fakih IVF Fertility Center
  8. THE TRUTH - We eat too much sodium

    THE TRUTH - We eat too much sodium, but the salt shaker is not the biggest culprit. Sodium is everywhere, from milk, chips, turkey, salted nuts, pickles, dressings to ready-to-eat pasta or the Big Mac Combo… Over 75% of the sodium we eat comes from processed foods, packaged and ready-to-eat foods, and restaurant meals; and only about 11% comes from salt added when cooking at home or salt shaker. Food industry adds salt to increase the flavor and shelf life, just like the tasty fries from McDonald’s! Studies have also shown that salt can be an appetite stimulant and full-scale assault on our taste buds, which make us want more and more food. To limit the sodium you eat: -Limit pre-packaged convenience foods and restaurant meals -Opt for fresh rather than canned and frozen foods -Flavor foods with fresh herbs and spices, lemon, lime, vinegar, or salt-free seasoning blends, which are sodium free. By Ms. Ayla Coussa Clinical Dietitian Fakih IVF Fertility Center
  9. Portion Control & Holiday Season

    Tune into your body's own wisdom about what, when and how much to eat… Portions are spinning out of control. Children eat cookies the size of their face and popcorn from tubs that is the height of their body. Obesity is not only a problem of QUALITY but also of QUANTITY of food we eat. Portion sizes served to us in restaurants over the last 20 years have increased. For instance, a standard serving of tuna as recommended by the U.S. Department of Agriculture is one-fourth of a pound and 340 calories, but now many outlets sell a tuna sandwich containing approximately 720 calories. Marketing campaigns and cookbooks are also enticing us to consume more. Is eating a need or a source of pleasure? Food supplies us with energy and nutrients necessary to respond to our body’s needs, including normal brain and heart functions. We also eat for social reasons, such as during family reunions, friend gatherings and weddings. Special events and occasions are celebrated with symbolic food items such as birthday cakes, chocolate for Valentines and Christmas gingerbread and cookies. A naturally controlled system: Under normal circumstances our body sends hunger and satiety signals to help in controlling what, how often and how much to eat. Hunger is usually manifested 2 - 4 hours after a meal, whereby our empty stomach gurgles and sends signals to the brain that we need to eat. Satiety, also called fullness, is reached when the stomach sends a signal to the brain to inform him of fullness. However, these signals can be overrun and instead many people allow the size of their foods’ portions to determine their satiety state. What can distort our signals? Constant dieting may result in numbing of hunger signals and inability to recognize fullness. Quality of food plays a critical role in regulating our signals; unbalanced meals will not adequately induce a fullness sensation. Fat is not an immediate source of energy and will not make you full as fast as carbohydrates do. This explains why we overeat when having a high-fat meal or when asking for a second serving of a tasty chocolate cake. Rate at which we eat plays a critical role in our feeding sensations. It takes 20 minutes for your stomach to realize it is full. Hence, eating slowly will give enough time for the stomach to signal the brain that you are full and prevent you from overeating. Eating while doing another activity, such as reading, watching TV or working on the computer, may distract our attention from eating, leading to over- or under-eating. Studies have shown that people tend to eat more and faster when they are in a noisy place or when loud music is being played. Reconnecting yourself to your inner signals Eating slowly will give you enough time to listen to your signals and prevent you from overeating. Ideally, a meal should take 20 – 45 min. Eat mindfully: always eat seated and at the table and never walk around while eating. Observe your food, Smell it and marvel at its deliciousness. Focus your attention fully on your food so you’ll know when you’ve had enough to eat. Eat small frequent meals rather than "saving" your appetite for a huge meal and don’t skip meals. Start your meal with a salad or soup to help you eat less during mealtime. Chew your calories instead of drinking them, since liquids are less satiating than solids; for instance prefer the fruit rather than the juice. At restaurants: Avoid bread starters, limit your carbs (e.g. pasta, rice) and eat mainly protein and vegetables “Half is the new whole!” Restaurant entrees can be up to 2,000 calories (not including bread). Share a starter, meal or dessert Choose either a starter OR a dessert At home: Use smaller plates, because by serving yourself a large plate of food, you guarantee overeating. Avoid supersizing: the much larger drink of soda is 1.24 L (approx.. 410 calories) and the larger fries is nearly 200 g (approx. 610 calories); that’s over 1000 calories in one sitting of just drink and fries. Given that our daily intake is about 2000 calories, it is easy to see why we put on weight. Hence, order the small size and make it last as long as eating the larger portion. Challenge yourself to try one or two of these tips for a week and see how it works for you. Holiday tips: Don’t try to lose weight during the holidays. Instead, focus on maintaining your current weight. Do some pre-holiday planning by deciding ahead of time how to handle the different events. For non-festive days, opt for healthy meals and get some exercise. Avoid going hungry to parties. Eat a snack before arriving at a party. This will keep you from being overly hungry. Make your experience tastier and enjoy your treats in smaller portions rather than "fat-free," “diet,” “low carb” and “low sugar” items. Avoid guilty pleasures, which you can have anytime, such as chocolate or chips and go with seasonal favorites such as fruitcake and Christmas cake. Keep Santa’s heart healthy with whole-wheat flour, minimal butter to reduce saturated fat and cholesterol intake, heart-healthy fruits like dried cranberries and berries as well as antioxidant-rich almonds. Make popcorn with canola oil instead of butter. Flavor it with spices and paprika (chili powder) instead of cheese and sweeten it with cinnamon or vanilla instead of caramel. Portion sizes Measure your portion sizes using your hands Your hand size is unique to you and relative to your body size. Likewise, a child has a smaller hand size and as such the portion sizes dictated are smaller. Measure your portions using the following guide: Proteins = 1 open palm (animal sources: meat, fish, eggs, dairy; vegetable sources: beans, legumes, nuts, seeds) Vegetables or fruits = 1 closed fist Grains = 1 cupped hand Healthy fats = 1 thumb (cold pressed oils, avocado, butter or ghee, coconut milk) Per meal 1 palm protein 2 fists vegetables 1 cupped hand of grains 1-2 thumbs healthy fats Recipes Fruit and Nut Ice Cream Pudding Makes 6-8 Servings Preparation Time: 15 min Ingredients ¾ cup almonds (toasted, chopped) 2 cups dried fruit 1.5 L vanilla yogurt 1 ½ teaspoons mixed spices 60 mL apple juice Optional: Slithered almonds (for decoration) Method Place fruit in a large mixing bowl, pour apple juice over fruit and leave for 2 hours. Add almonds and mixed spices Fold together with yogurt Line a 6-8 cup pudding basin with plastic wrap Spoon in mixture Cover with plastic wrap and freeze overnight Cut into cake-sized slices and serve in dessert bowls with a sprinkle of slithered almonds Gluten free banana bread Makes 1 loaf; 12 Servings Preparation time: 20 min Ingredients 400 g ripe banana 6 medium eggs 4 fresh-pitted dates 2 teaspoons vanilla extract 60 mL canola oil ½ teaspoon ground cinnamon 2 teaspoons gluten free baking powder 70 g coconut flour 20 g chia seeds or flaxseeds Method Preheat the oven to 150˚C Grease one loaf tin and then line with baking paper Combine all ingredients, except the coconut flour and chia seeds, into a blender or food processor and blend until creamy mixture Add coconut flour and chia seeds and mix, though being careful not to over mix Allow mixture to rest for 10 minutes so the chia and coconut flour can expand Spoon batter into the tin and sprinkle the top with extra cinnamon Bake for 50 – 55 minutes Check if it is ready by placing a skewer into the center. It should come out dry Remove from the oven and allow to cool before turning out the loaf By Ms. Ayla Coussa Clinical Dietitian Fakih IVF
  10. Myth or Fact? - Low In Fat

    Myth or Fact? If a food is "low in fat", "fat-free", "light" or "reduced-fat", it must be healthy? MYTH: Lot of foods that are low in fat are definitely not healthy choice: candy, pop, low-fat cookies and fat-free frozen treats. “Fat-free" is can also be taste-free!! To make up for that, food industries tend to pour other ingredients, like sugar, flour, thickeners, and salt into the products, which add up calories, just like our famous low fat FROZEN YOGURT). Some foods are higher in fat but provide good fats - essential fatty acids (e.g. omega-3): oily varieties of fish, avocados, nuts and seeds. Essential fats are important for maintaining healthy blood vessels, making hormones and for the optimal functioning of our nervous system. When reading food labels, consider the overall nutrient content of a food item rather than judge it by its fat content alone! By Ms. Ayla Coussa Clinical Dietitian Fakih IVF Fertility Center Dubai
  11. Myth or Fact? - Food Matters

    1- Myth or Fact? Spinach contains more iron than meat! MYTH: Although usually portrayed as the richest source of iron, spinach is actually a good source but NOT the best source: -100g (almost 3 cups!!) of spinach contains 2.7 mg of iron - 100g of red meat contains 2.6 mg in. Almost the same amount... BUT the difference is that iron from animal foods has a higher absorption rate in the body than that from plant/vegetables sources. Hence, spinach contains a good amount of iron however in a form less available for absorption than iron in meat. The good news is that you can enhance iron absorption from spinach and other green leafy vegetables by eating vitamin-C rich foods with your meal, such as tomatoes, bell pepper, oranges, melons, or strawberries. By Ms. Ayla Coussa Clinical Dietitian Bareen International Hospital 1- True or False? Eggs increase blood cholesterol FALSE.. Cholesterol from eggs does not automatically raise blood cholesterol! How so? When we eat a high cholesterol-containing food, the excess dietary cholesterol is removed from the body through the liver which also down-regulates the production of cholesterol in the body. Cholesterol is essential to make estrogen, testosterone, vitamin D, and other vital compounds. Keep in mind that “saturated fats” found in animal products like butter, ghee, fatty meats and full fat dairy, have a more significant effect on blood cholesterol than dietary cholesterol itself, making it a bigger threat to heart health. - Limit the number of eggs consumed to 2-3 per week for people with a high risk of heart disease. - Choose lean cuts of meat and low fat versions of dairy. -It is true, egg yolks carry cholesterol, fat and saturated fat of the egg. However, other nutrients come with that: fat-soluble vitamins (e.g. Vitamin A and D), essential fatty acids and other nutrients (e.g. B vitamins, carotenoid, etc). By Ayla Coussa Clinical Dietitian To find out more, http://fakihivf.com/our-team/dubai/dietitian/ms-ayla-coussa/