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Diet Plan for Post Pregnancy Weight Loss

After delivering a child, many women find themselves struggling to shed the extra weight gained during pregnancy. While it is important to focus on nourishing your body and recovering from childbirth, it is also natural to want to get back to your pre-pregnancy weight. A well-balanced postnatal diet can help you achieve this goal while ensuring that you are getting the nutrients you need.

The key to successful postpartum weight loss lies in a healthy and sustainable diet plan. It is important to remember that crash diets or extreme calorie restrictions are not recommended, as they may negatively impact your energy levels and milk supply if you are breastfeeding. Instead, focus on consuming nutrient-dense meals that are rich in vitamins, minerals, and fiber.

Start by incorporating plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats into your diet. These foods will provide you with the energy you need to care for your newborn, boost your mood, and support your body’s recovery process. Avoid processed and sugary foods as much as possible, as they can contribute to weight gain and hinder your efforts to lose the pregnancy weight.

In addition to a balanced diet, incorporating regular physical activity into your routine can further aid in weight loss after pregnancy. Consult with your healthcare provider before starting any exercise program to ensure that it is safe for you. Remember to listen to your body and start with gentle exercises, gradually increasing intensity as you feel comfortable. Stay hydrated, get enough rest, and seek support from loved ones to help you stay motivated and committed to your weight loss goals.

Start with a Balanced Diet

After pregnancy, many women struggle with postpartum weight loss. The key to losing weight after childbirth is to start with a balanced diet. A well-rounded and nutritious meal plan can help new mothers shed those extra pounds and regain their pre-pregnancy shape.

When creating a postnatal diet plan, it is important to focus on consuming a variety of nutrient-dense foods. This includes incorporating lean proteins, whole grains, fruits, vegetables, and healthy fats into each meal. These foods provide the necessary vitamins, minerals, and antioxidants that support post-pregnancy weight loss and overall well-being.

It is also essential to pay attention to portion sizes and avoid overeating. This can be achieved by practicing mindful eating and listening to your body’s hunger and fullness cues. Additionally, staying hydrated by drinking plenty of water throughout the day can help with digestion and keep cravings at bay.

Avoid skipping meals, as this can disrupt your metabolism and lead to overeating later in the day. Instead, aim to eat regular meals and snacks throughout the day to keep your energy levels stable and prevent excessive hunger.

Incorporating physical activity into your daily routine is also crucial for postnatal weight loss. Alongside a balanced diet, engaging in regular exercise, such as walking, yoga, or strength training, can further accelerate your weight loss journey and help build strength and endurance.

In summary, post-pregnancy weight loss can be achieved by starting with a balanced diet that includes a variety of nutrient-dense foods. Remember to listen to your body’s needs, stay hydrated, and incorporate regular exercise into your routine. With dedication and consistency, you can achieve your weight loss goals after childbirth.

Include Lean Protein Sources

When planning your diet for post pregnancy weight loss, it is essential to include lean protein sources in your meals. After childbirth, your body requires adequate protein to support tissue repair, promote muscle recovery, and maintain overall health.

Lean protein sources such as chicken breast, turkey, fish, tofu, eggs, and low-fat dairy products should be incorporated into your daily meals. These protein options not only provide essential nutrients but also help you feel fuller for longer, which aids in controlling your appetite and reducing cravings.

Including lean protein in your diet plan after pregnancy can also help stabilize your blood sugar levels and prevent energy crashes. Protein-rich meals can provide sustainable energy throughout the day, which is particularly important for new moms who often experience fatigue and lack of sleep.

It is recommended to spread your protein intake throughout the day by including protein sources in each meal and snack. For example, you can start your day with eggs or Greek yogurt, have a chicken salad for lunch, snack on a handful of nuts or a protein shake, and enjoy grilled fish or tofu with vegetables for dinner.

Don’t forget to consult with your healthcare provider or a registered dietitian to ensure that your postnatal diet plan meets your individual needs and takes into account any specific dietary restrictions or considerations.

Add Whole Grains to Your Diet

After giving birth, it is important to focus on a healthy postnatal diet plan to support weight loss and overall well-being. Including whole grains in your meals can be a nutritious and satisfying addition to your postpartum diet.

Whole grains, such as brown rice, quinoa, and whole wheat bread, provide essential nutrients like fiber, vitamins, and minerals. They are also low in fat, which makes them a great choice for post-pregnancy weight loss.

Adding whole grains to your diet can help regulate blood sugar levels, boost your metabolism, and keep you feeling fuller for longer. This can be especially beneficial when trying to shed those extra pounds gained during pregnancy.

Some delicious options for incorporating whole grains into your daily meals include:

  • Quinoa Salad: Mix cooked quinoa with fresh vegetables, herbs, and a squeeze of lemon for a refreshing and filling meal.
  • Whole Wheat Toast: Start your day with a slice of whole wheat toast topped with avocado or nut butter for a nutritious and energizing breakfast.
  • Brown Rice Stir-Fry: Sauté your favorite vegetables and protein with cooked brown rice for a flavorful and fiber-rich dinner option.

Remember to choose whole grain options whenever possible. Look for labels that say “100% whole grain” to ensure you are getting the most nutritional benefits. Including whole grains in your postnatal diet can help support your weight loss journey and provide you with essential nutrients for your recovery after childbirth.

Stay Hydrated with Water

Proper hydration is essential for postpartum recovery and maintaining good overall health. Drinking an adequate amount of water is especially important after childbirth, as your body goes through various physical changes.

A well-balanced postnatal diet should include plenty of fluids, with water being the best choice. Hydrating your body with water helps in flushing out toxins, aids digestion, and supports the proper functioning of all your body’s systems. It can also contribute to weight loss by promoting metabolism and reducing hunger cravings.

After pregnancy, your body needs to replenish the fluids lost during childbirth and breastfeeding. Aim to drink at least eight to ten glasses of water per day, or more if you are engaged in physical activities or living in a hot climate. Keep a bottle of water handy so that you can easily access it throughout the day.

In addition to water, you can also include other hydrating fluids in your diet, such as herbal teas, coconut water, and fresh fruit juices (without added sugar). However, it’s important to limit your intake of caffeinated beverages and sugary drinks, as they can dehydrate your body and contribute to weight gain.

To ensure that you stay hydrated, try to drink water before, during, and after each meal. You can also incorporate foods with high water content, such as watermelon, cucumbers, and oranges, into your diet. These fruits and vegetables not only hydrate your body but also provide essential vitamins, minerals, and antioxidants.

Remember, staying well-hydrated is crucial for your postpartum recovery and weight loss journey. Make it a habit to prioritize water and other hydrating fluids in your daily diet, and you will notice the difference in how you feel and look.

Eat Plenty of Fruits and Vegetables

When it comes to weight loss after postnatal period, a healthy and balanced diet plan is essential. Fruits and vegetables should be a key component of your postpartum meal plan. They are packed with essential vitamins, minerals, and fiber that can help you shed those extra pounds gained during pregnancy.

Including a variety of colorful fruits and vegetables in your diet will not only provide you with essential nutrients but also help satisfy your hunger, making it easier to stick to your weight loss goals. They are low in calories and high in water content, making them a great choice for losing weight in a healthy way.

Here are some tips to incorporate more fruits and vegetables into your diet:

1. Fill Half Your Plate with Fruits and Vegetables

Make it a habit to fill half of your plate with fruits and vegetables during meal times. This ensures that you are getting a good amount of essential nutrients, while also helping you control portion sizes of other high-calorie foods.

2. Choose a Variety of Colors

Eating a variety of colorful fruits and vegetables ensures that you are getting a wide range of essential nutrients. Different colors indicate different types of vitamins and minerals present in them. So, aim for a rainbow of colors on your plate.

Here are some examples of colorful fruits and vegetables:

  • Red: strawberries, tomatoes, red bell peppers
  • Orange: oranges, carrots, sweet potatoes
  • Yellow: bananas, corn, yellow bell peppers
  • Green: spinach, broccoli, kiwi
  • Blue/Purple: blueberries, eggplant, purple cabbage

By including a variety of colors, you are ensuring that you are getting a wide range of nutrients to support your post-pregnancy weight loss goals.

In conclusion, incorporating plenty of fruits and vegetables into your postnatal meal plan is essential for postpartum weight loss. They are nutrient-dense, low in calories, and can help satisfy your hunger. Aim for a variety of colorful options to ensure you are getting a wide range of essential nutrients.

Include Healthy Fats in Your Meals

Following a healthy diet plan is crucial for post-pregnancy weight loss. After childbirth, your body needs essential nutrients to recover and nourish both you and your child. Including healthy fats in your meals is an important part of this plan.

Contrary to popular belief, not all fats are bad for you. In fact, healthy fats can provide numerous benefits for postnatal women. They help in hormone production, provide energy, and enhance nutrient absorption. Including the right types and amounts of fats in your diet can aid in weight loss and promote overall wellness.

When selecting healthy fats for your meals, aim for options such as avocados, nuts, seeds, and fatty fish like salmon. These foods are rich in omega-3 fatty acids, which are known to improve heart health, reduce inflammation, and support brain function. Additionally, they can help you feel full and satisfied, reducing the temptation to snack on unhealthy foods.

It’s important to note that while healthy fats are beneficial for weight loss, they are also calorie-dense. Therefore, it’s crucial to consume them in moderation as part of a balanced meal plan. Incorporate healthy fats into your diet by adding avocado slices to your salads, sprinkling nuts or seeds on your yogurt, or incorporating fatty fish into your meals a few times a week.

Remember, postpartum weight loss takes time, and it’s important to be patient with yourself. Including healthy fats in your meals can help you achieve sustainable weight loss while nourishing your body and supporting your overall well-being.

Healthy Fats to Include in Your Diet
Avocados
Nuts and seeds
Fatty fish (salmon, mackerel, sardines)

Avoid Processed Foods and Sugary Drinks

As a new mom, it’s important to follow a healthy and balanced diet to support your postnatal weight loss journey after pregnancy. One key aspect of this diet is to avoid processed foods and sugary drinks.

Processed foods often contain high levels of unhealthy fats, added sugars, and refined grains. They are typically low in essential nutrients and can contribute to weight gain and other health issues. Additionally, sugary drinks such as soda, energy drinks, and fruit juices can be calorie-dense and provide little to no nutritional value.

Instead, focus on consuming whole, unprocessed foods that contain important nutrients for both you and your baby. Include lean proteins, such as chicken, fish, and legumes, as well as plenty of fruits and vegetables. These foods provide essential vitamins, minerals, and fiber to support your overall health and weight loss goals.

It’s also important to stay hydrated by drinking plenty of water throughout the day. Water is essential for optimal bodily functions and can help control appetite and support weight loss.

By avoiding processed foods and sugary drinks and choosing nutrient-dense options, you’ll not only support your postpartum weight loss but also provide your body with the necessary nutrients to recover from childbirth and nourish your baby.

Watch Your Portion Sizes

One of the key components of a postnatal weight loss meal plan is paying attention to your portion sizes. After pregnancy, your body might still be adjusting to the changes brought on by childbirth, and it’s important to provide it with the right amount of food to support postpartum recovery while also promoting weight loss.

Eating the right portion sizes can help you avoid overeating and consuming more calories than necessary. It’s important to remember that your body’s needs have changed since before pregnancy, so your portion sizes should also be adjusted accordingly.

Here are some tips to help you watch your portion sizes:

1. Use smaller plates and bowls

Using smaller plates and bowls can trick your mind into thinking that you’re eating more than you actually are. This can help you feel satisfied with smaller portions and prevent overeating.

2. Measure your food

Instead of eyeballing your portion sizes, use measuring cups or a kitchen scale to accurately measure your food. This can give you a better understanding of how much you’re eating and help you make adjustments if needed.

3. Fill your plate with healthy, nutrient-dense foods

Fill your plate with a variety of colorful fruits, vegetables, lean proteins, and whole grains. These foods are not only beneficial for weight loss but also provide essential nutrients for postpartum recovery and breastfeeding if applicable.

Remember, losing weight after pregnancy takes time and patience. It’s important to focus on nourishing your body with a balanced diet rather than restricting calorie intake too much. Consulting with a healthcare professional or a registered dietitian can also provide personalized advice and guidance for your postpartum weight loss journey.

Eat Regularly and Avoid Skipping Meals

Eating regularly and not skipping meals is crucial after pregnancy as part of a postpartum weight loss plan. Your body has just undergone the incredible process of childbirth, and it needs proper nourishment to recover and rebuild.

Skipping meals can actually hinder weight loss efforts. When you skip a meal, your body goes into survival mode and tries to conserve energy by slowing down your metabolism. This can make it even harder to shed those extra pounds.

Instead, strive to eat regular, balanced meals throughout the day. Aim for three main meals and two smaller snacks. This helps keep your metabolism active and prevents cravings that can lead to overeating later on.

Importance of a Well-Balanced Meal Plan

A well-balanced meal plan is essential for postpartum weight loss. It should include a good mix of macronutrients, such as carbohydrates, proteins, and healthy fats, as well as plenty of fruits and vegetables.

Complex carbohydrates, like whole grains and legumes, provide sustained energy and help keep you full for longer. Lean proteins, such as chicken, fish, and tofu, support muscle growth and repair. Healthy fats, like avocados and nuts, are crucial for hormone production and brain health.

Avoid highly processed and sugary foods, as they can spike blood sugar levels, lead to energy crashes, and contribute to weight gain. Instead, opt for natural, nutrient-dense options.

Tips for Meal Planning

  • Plan your meals ahead of time to ensure you have healthy options readily available.
  • Include a variety of colors on your plate to ensure you’re getting a wide range of nutrients.
  • Prepare meals in advance and freeze them for busy days.
  • Stock up on healthy snacks, such as cut-up fruits and vegetables, nuts, and Greek yogurt.
  • Stay hydrated by drinking plenty of water throughout the day.

By eating regularly and avoiding skipping meals, you’ll provide your body with the fuel it needs to recover from pregnancy and support healthy postpartum weight loss.

Incorporate Physical Activity into Your Routine

After childbirth, it is natural for new mothers to focus on their postpartum recovery and taking care of their newborns. However, it is also important to start thinking about weight loss and incorporating physical activity into your routine. A combination of a healthy meal plan and regular exercise can help you shed those extra pounds gained during pregnancy.

Before starting any diet or exercise plan, it is important to consult with your doctor, especially if you had a complicated pregnancy or delivery. Your doctor can give you recommendations on when it is safe to start exercising and what types of activities are suitable for you.

Start with Low-Impact Exercises

When you are ready to start exercising, begin with low-impact exercises such as walking, swimming, or gentle yoga. These activities are less strenuous on your body, making them ideal for post-pregnancy fitness. Start slowly and gradually increase the intensity and duration of your workouts as your body becomes stronger.

Find Activities You Enjoy

It is important to find physical activities that you genuinely enjoy doing. Whether it’s dancing, cycling, or playing a sport, choosing activities that you look forward to will make it easier to stick to your exercise routine. Remember, exercise doesn’t have to be boring or feel like a chore.

Consider joining a postpartum workout class or finding an exercise buddy to keep you motivated and accountable. This can also provide a support system, as you connect with other new moms who are on a similar weight loss journey.

Make Exercise a Priority

With a new baby and a busy schedule, finding time to exercise may seem challenging. However, it is important to make exercise a priority. One way to do this is by scheduling your workouts in advance and treating them as non-negotiable appointments. Wake up a little earlier or use nap times as an opportunity to get some exercise in.

Add variety to your routine by trying different exercises and activities. This will not only keep you motivated, but it will also target different muscle groups for a full-body workout. Aim for at least 150 minutes of moderate-intensity aerobic activity every week.

  • Some examples of moderate-intensity aerobic activities include:
  • Brisk walking
  • Swimming
  • Cycling
  • Dancing

Remember to listen to your body and take it slow. If you experience any pain or discomfort, stop exercising and consult with your doctor.

Incorporating physical activity into your routine along with a balanced diet plan can help you achieve your post-pregnancy weight loss goals. Stay consistent, stay motivated, and gradually increase the intensity of your workouts for long-term success.

Breastfeed if Possible

One of the most important components of a postpartum meal plan for weight loss is breastfeeding. Breastfeeding not only provides essential nutrients for your child but also helps you shed those extra pounds gained during pregnancy.

After childbirth, your body goes through various hormonal changes, and breastfeeding is known to speed up the process of weight loss. It burns calories and fat, helping you return to your pre-pregnancy weight more quickly.

In addition to its weight loss benefits, breastfeeding has many other advantages for both you and your baby. It promotes bonding, boosts your baby’s immune system, and lowers the risk of various health issues, such as ear infections and allergies.

Considerations for breastfeeding moms

If you choose to breastfeed, it’s important to ensure that you have a well-balanced diet that provides enough nutrients for both you and your baby. Here are some considerations:

  • Stay hydrated by drinking plenty of water throughout the day.
  • Include a variety of fruits, vegetables, whole grains, and lean proteins in your diet.
  • Avoid or limit the consumption of alcohol, caffeine, and highly processed foods.
  • Consult with a healthcare professional or a registered dietitian to ensure that you are getting all the necessary nutrients.

Remember that breastfeeding requires additional calories, so make sure you are consuming enough to support both yourself and your baby. Avoid restrictive diets or extreme calorie-cutting as it can negatively impact milk production and your overall health.

The benefits of breastfeeding for weight loss

Breastfeeding can offer several advantages when it comes to postnatal weight loss:

  1. Breast milk production burns calories, helping you lose weight.
  2. It stimulates the release of the hormone oxytocin, which helps your uterus contract and return to its pre-pregnancy size.
  3. Breastfeeding can increase your metabolic rate, aiding in weight loss.
  4. It promotes a healthier lifestyle as breastfeeding mothers often make better dietary choices.

However, it’s important to remember that everyone’s journey is unique, and not all women are able to breastfeed. If breastfeeding is not possible for you, consult with your healthcare provider for an appropriate meal plan and weight loss strategies.

Seek Professional Guidance

When developing a diet plan for postnatal weight loss, it’s important to seek guidance from a healthcare professional or a registered dietitian. They can provide expert knowledge and personalized advice tailored to your specific needs.

Dietitian or nutritionist can help you create a well-balanced meal plan that takes into consideration necessary nutrients and supports healthy weight loss after pregnancy. They will also ensure that you are getting enough calories to support breastfeeding if you choose to do so.

Professionals can guide you in making the right food choices, helping you understand portion sizes and providing tips on food preparation and cooking techniques. They can also help you identify any potential dietary deficiencies and suggest appropriate supplements if needed.

Remember that each postpartum weight loss journey is unique, and seeking professional guidance can help ensure that you are making sustainable and healthy choices for both you and your baby.

Consider Postnatal Supplements

After childbirth, your body goes through numerous changes, and it’s essential to provide it with the necessary nutrients to aid in postpartum weight loss. Along with a healthy diet, postnatal supplements can play a crucial role in replenishing the nutrients your body may be lacking.

Here are a few supplements to consider incorporating into your post-pregnancy meal plan:

1. Omega-3 Fatty Acids

Omega-3 fatty acids are beneficial for weight loss as they help reduce inflammation in the body, improve heart health, and support brain function. They can be obtained through supplements or by consuming fatty fish like salmon, mackerel, and sardines.

2. Calcium and Vitamin D

Calcium and vitamin D are essential for bone health and can aid in weight loss by promoting proper metabolism and reducing fat storage. You can find these nutrients in dairy products, leafy greens, fortified cereals, and supplements.

Always consult with your healthcare provider before starting any new supplements, especially if you are breastfeeding or have any underlying health conditions.

Remember, maintaining a balanced diet and regular exercise routine are crucial for postnatal weight loss. Supplements should complement a healthy lifestyle rather than replace it.

Get Adequate Sleep

Getting enough sleep is crucial for overall health and weight loss, especially after childbirth. Lack of sleep can disrupt your hormones and increase your cravings for unhealthy foods, which can hinder your diet plan for postnatal weight loss. It’s important to prioritize your sleep and create a routine that allows you to get enough rest.

Here are some tips to help you get adequate sleep:

– Establish a regular sleep schedule: Try to go to bed and wake up at the same time every day to regulate your body’s internal clock.

– Create a sleep-friendly environment: Make sure your bedroom is dark, cool, and quiet to promote better sleep. Use earplugs, eye masks, or white noise machines if necessary.

– Limit caffeine and electronics: Avoid consuming caffeine and using electronic devices, such as smartphones and tablets, close to bedtime. These can interfere with your sleep quality.

– Practice relaxation techniques: Engage in calming activities before bed, such as taking a warm bath, reading a book, or practicing deep breathing exercises. These can help relax your mind and prepare your body for sleep.

– Take short naps, if needed: If you’re feeling fatigued during the day, taking short power naps can help boost your energy levels. Just make sure not to nap for too long or too close to bedtime.

– Seek support: If you’re having difficulty sleeping, don’t hesitate to seek support from your partner, family members, or a healthcare professional. They can provide guidance and solutions to improve your sleep quality.

By prioritizing and getting adequate sleep, you’ll not only support your weight loss efforts but also enhance your overall well-being after pregnancy.

Stay Consistent with Your Diet and Exercise Plan

After giving birth, many women are eager to lose the postnatal weight that they gained during pregnancy. Following a proper diet and exercise plan can help you in achieving your weight loss goals and getting back in shape.

Diet Plan

A postpartum weight loss diet plan should focus on providing essential nutrients and promoting gradual weight loss. It is important to include a balanced meal that consists of a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats. Additionally, it is crucial to stay hydrated by drinking enough water throughout the day.

Try to avoid crash diets or extreme calorie cutting, as it can be harmful to both you and your baby during breastfeeding. Instead, opt for a sensible and sustainable approach to weight loss. This can involve reducing portion sizes, choosing healthier alternatives for snacks, and avoiding processed foods and sugary drinks.

Exercise Plan

Incorporating regular exercise into your postpartum weight loss plan is beneficial for both physical and mental health. It is important to start gradually and consult with your healthcare provider before beginning any exercise routine, especially if you had a cesarean section or experienced complications during childbirth.

Consider including a mix of cardio exercises, strength training, and flexibility exercises like yoga or Pilates. Start with low-intensity workouts such as walking or swimming, and gradually increase the intensity and duration as your body gets stronger. Aim for at least 150 minutes of moderate-intensity exercise per week.

Meal What to Include
Breakfast Whole grain cereal with fresh fruits and low-fat milk
Lunch Grilled chicken or fish with steamed vegetables and quinoa
Snack Yogurt with mixed nuts or a piece of fresh fruit
Dinner Salmon with roasted sweet potatoes and a side salad
Snack Carrot sticks with hummus or a handful of almonds

Remember, consistency is key when it comes to post-pregnancy weight loss. Stick to your diet and exercise plan, and be patient with yourself. It may take time to shed the extra weight, but with dedication and perseverance, you can achieve your goals and improve your overall well-being.

Be Patient and Don’t Rush the Weight Loss Process

After pregnancy and childbirth, many women have the desire to lose weight and get back to their pre-pregnancy shape. However, it is important to remember that the postpartum period is a time for healing and recovery, and the focus should not solely be on weight loss.

Creating a postnatal diet plan is important for both your physical and mental well-being. It is crucial to provide your body with the necessary nutrients to heal and regain strength after childbirth. Instead of rushing into a strict diet, focus on a balanced meal plan that includes a variety of foods from different food groups.

Importance of a Balanced Diet

A balanced diet can help replenish the nutrients that your body needs after pregnancy and delivery. It should include essential macronutrients such as carbohydrates, proteins, and healthy fats, along with a variety of vitamins and minerals.

Carbohydrates provide energy, which is especially important during this demanding period. Include whole grains, fruits, and vegetables in your meals to get a good source of carbohydrates and fiber.

Proteins are essential for tissue repair and recovery. Include lean meats, fish, eggs, legumes, and dairy products in your diet to get a good source of protein.

Healthy fats, like those found in nuts and avocados, are important for hormone production and overall health. Incorporate these foods into your meals in moderation.

Remember to include a variety of fruits and vegetables in your diet to get a wide range of vitamins and minerals. These nutrients not only support your post-pregnancy health but also benefit your baby if you are breastfeeding.

Don’t Rush into a Strict Diet

It is essential to be patient and understand that weight loss after pregnancy takes time. Your body has gone through significant changes and needs time to recover. Pushing yourself too hard and rushing into a strict diet can be detrimental to your physical and mental health.

A gradual weight loss approach is recommended. Aim to lose about 1-2 pounds per week by making healthy lifestyle changes such as eating a balanced diet and incorporating regular physical activity into your routine. This will ensure sustainable weight loss and prevent any nutrient deficiencies.

Remember to be kind to yourself during this postnatal journey. Focus on nourishing your body with wholesome foods and engaging in activities that make you feel good. Consult with a healthcare professional or a registered dietitian for personalized guidance and support in achieving your weight loss goals.