Infants and Vitamin D

The American Academy of Pediatrics increased their vitamin D recommendations for infants in late 2008.  A recent report in Pediatrics takes a look at how we're doing. The answer is; bad.  The vast majority of infants still do not get adequate amounts of vitamin D.

Pregnant moms should make sure their vitamin D levels are on the high end of normal.  Mom should make sure her vitamin D levels are high while she is nursing her infant.  And infants should also be given supplemental vitamin D.

Maternal Diet and Chronic Disease

A recent review article was published in the Journal of Nutrition.  In it, the authors state, "Micronutrient status in fetal and early life may alter metabolism, vasculature, and organ growth and function, leading to increased risk of cardiometabolic disorders, adiposity, altered kidney function, and, ultimately, to type 2 diabetes and cardiovascular diseases."

This means mom's nutrient deficits have potential to create long term harm in the child.  By now, this kind of research shouldn't be surprising.

Up until recently, most prenatal nutrition recommendations were relatively boiler-plate.  Get enough folic acid to prevent neural tube defects and take a fish oil capsule.  Some advised women to avoid fish due to mercury contamination and many experts even spend the effort to figure out how much coffee women can "get away with" without long term negative effects.

But rather than thinking about how "not to hurt" the developing child, it is time we focus on providing him/her the best chance for long term health and wellness.

Will Your Child Develop Metabolic Syndrome?

Metabolic syndrome is a major problem in the United States.  It is marked by insulin resistance, inflammation, dyslipidemia, hypertension and a number of other variables.  Within the past 10 years, the prevalence has risen dramatically among adolescents.  Over 45% of adolescents have at least 1 risk factor for metabolic syndrome and with overweight and obesity on the rise, this number is likely rise.

A recent study in Diabetes Care found that hyperinsulinemia in pregnant women predicted an increase in overweight and metabolic syndrome in the offspring!  

Other researchers propose that changes in the nutritional environment of the pregnant mother may lead to "a long term re-setting of cellular energy homeostasis, most probably via epigenetic modification of genes involved in a number of key regulatory pathways."  In other words, the genes themselves may not change but mom may profoundly influence the expression of the child's genes.  This doesn't suggest that the health of the child is now predetermined.  But it does tell us that your child has now been, "dealt a bad hand."  Nat Rev Endocrinol 2009 Nov;5(11):604-10. Epub 2009 Sep 29.

"Eating for two" should take on a different light now.  The abuse of chocolate cake and twinkies will forever affect your child. 

More on Respiratory Health

Here's another piece that reinforces the ideas presented in the previous post.  In this study, researchers found that low birth weight predicts decreased lung health in adults.  The report reviews 627 adults born in Beijing between 1948-1954.  While the researchers are cautious to draw conclusions, they acknowledge the possible role of fetal programming secondary to poor maternal nutrition.

Asthma and fetal programming

The prenatal environment is very important.  That's a bit of an understatement.  It is absolutely instrumental in programming the health of your child for the rest of his/her life. Although I highlighted vitamin D, B12 and probiotics in my previous posts, we have to keep the larger picture in mind.  There is no single 'magic' nutrient that will optimize your child's health.  Here's a great article that talks about prenatal care in the context of asthma. 

"A large body of evidence shows that the intrauterine and early childhood environments are crucial for development of diabetes and coronary heart disease, and asthma has been increasingly included in a similar category of diseases "programmed" in utero."

The authors present evidence for breastfeeding, vitamin D consumption, essential fats, probiotics and more.  But we must acknowledge that that intrauterine environment that Mom provides during pregnancy is subject to influence from many variables.  Deciphering the "influence of diet" alone is quite difficult.  But even with those difficulties, there is enormous promise in elucidating this influence.

"Diet could modulate epigenetics, intestinal microbiota, physiological development, airway remodeling, and immune maturation – factors highly relevant to the etiology of asthma."

If we understand there is power behind a healthy diet in determining the child's risk of asthma, diabetes and heart disease, could the same be true of many other diseases?  It is likely.

Where does that leave a pregnant Mom?  Moms, you have a huge influence over your child's lifelong health.  These next two years set the tone for the rest of his life.  These years... you don't get back.