Pregnancy and Nutrition

Pregnancy is a time when women should pay extra attention to quality nutrition.  But an article in the Journal of the American Dietetic Association suggests that this may not be as easy as it sounds.  The article specifically highlights choline, a member of the B vitamin family.

Choline, like so many other nutrients, has many roles in the body.  One of the most famous roles is acting as a substrate to make acetylcholine, an important neurotransmitter.  It is also vital for cell signaling and maintaining the integrity of the cell membrane.  Choline is found in food often as phosphatidylcholine (aka lecithin).  Phosphatidylcholine is present in egg yolks, meat products, soy, brussel sprouts, broccoli, beef liver and more.  

During pregnancy, a great amount of choline is concentrated in the growing baby.  By the time he is born, his blood choline concentration is 3 times higher than Mom's!  Clearly, pregnancy is a critical time for choline availability.  Taken to an extreme, choline deficits can lead to neural tube defects in the embryo as well as cognitive impairment.  

According to Dr. Caudill, the author of the article being referenced here, "the majority of pregnant (and presumably lactating) women are not achieving the target intake levels and that certain common genetic variants may increase requirements for choline beyond current recommendations."

Ideas like this show us we have a long way to go if we want to truly provide comprehensive prenatal care.

Massage- Real Benefits

Most people enjoy receiving massages.  But in recent years, massage therapy has been gaining steam as a legitimate therapeutic modality.  Beyond rubbing muscles to make you "feel good" for an hour, it is very likely that there are discernible biological changes that occur as a result of a good massage.

The New York Times reported on a recent research article that highlights some of the benefits of massage therapy.  It appears that volunteers had lowered cortisol levels after a massage compared to controls. Cortisol is regarded as the "stress hormone" that often runs out of control in our lives. In other words, massage lowers stress levels.  This may not be a surprise, but it is good to see that our this effect is more than psychological; it actually changes our biochemistry.

It also "decreased IL-4, IL-5, IL-10, and IL-13 levels relative to baseline measures."  Interleukins (IL) are chemicals that cells in your body use to talk to each other.  Many are produced by immune cells.  A decrease in these levels is interpreted as a generally good thing in this context.  We want cells in your body to talk to each other, not scream at each other.

Dr. Mark Hyman Rapaport, the lead author of the study is quoted as saying the findings are “very, very intriguing and very, very exciting — and I’m a skeptic.” 

Massage therapy probably won't replace regular visits to your doctor, but it may deserve as place alongside "healthy diet & regular exercise" as staples of a healthy lifestyle.

Stress and epigenetics

I've written previously on the concept of epigenetics, the study of gene expression.  We know that for all intents and purposes, your genes do not change.  However, the little signals that tell your body when to express those genes (epigenetic signals) can be altered.  Food certainly has a powerful role in this although we do not understand all the details.  A recent paper also demonstrates that chronic stress will alter epigenetic markers.

Researchers at the Johns Hopkins School of Medicine found that the markers on genes were different after mice were exposed to stress hormones.  They believe that this may have a significant role in the development of  mood disorders.  Notably, the changes were found to be long lasting.  The epigenetic changes were presents for weeks even after the hormones had been removed from their environment.  In other words, these are potentially long lasting epigenetic changes.

 

"These behaviors, which were probably advantageous earlier in evolution, aren't as useful today with modern stressors that we can't fight or flee, such as work deadlines, Potash adds. Consequently, chronic stress might instead lead to depression or other mood disorders triggered by epigenetic changes."

I spend a lot of time talking about the benefits of eating good food.  But total health requires a life style adaptation as well.  Some people believe they thrive when under pressure; we even take pride in it.  Nobody can argue that some individuals genuinely do well under chronic stress. However, we must understand that your performance (at your job, school etc.) does not necessarily correlate with your well-being.  Chronic stress comes with a price.  Much of it has been well described (HPA dysfunction, hypercortisolemia etc.) We now have evidence that even your DNA expression may be altered by stress.

A Doctor to Listen To

Dr. Preston Maring was featured in the New York Times in a piece discussing his activism in bringing good food into the health care setting.  We've all been a part of a conversation that went something like this, "yeah yeah yeah.... I know I know... eating well is important.." as we shrug our shoulder and move on with our lives. 

Many doctors will say with their mouth, "nutrition is important" but not really believe their own words.  If anything, they believe it 'just a little bit' as they continue to eat fast food dinners and vending machine snacks.

From the article:

Dr. Maring, 64, a gynecologist and obstetrician with three decades as a surgeon, is well known as a former physician in chief at the hospital... But increasingly, his reputation and perpetual motion revolve around his conviction that in the health professions, the kitchen must become as crucial as the clinic. Food is at the center of health and illness, he argues, and so doctors must make all aspects of it — growing, buying, cooking, eating — a mainstay of their medical educations, their personal lives and their practices. 

I agree with him 100%.  The kitchen must absolutely be as crucial as the clinic (in the management of any disease).  In the prevention of chronic disease, it may be the most important place in your world.

Garlic and immune activity

I just saw an advertisement for flu shots at the local pharmacy.   I wanted to remind readers that in addition to conventional methods, tweaking your diet can go a long way in helping prevent colds and flu this season.

Garlic has long been used as a delicious addition to our foods.  But it has also served medicinal purposes.  Garlic is known to have antimicrobial and antiviral properties.  It carries with it a long list of fancy-sounding compounds like:

(allicin, alliin and agoene), volatile oils, enzymes (allinase, peroxidase and miracynase), carbohydrates (sucrose and glucose), minerals (selenium), amino acids such as cysteine, glutamine, isoleucine and methionine ... bioflavonoids such as quercetin and cyanidin, allistatin I and allistatin II, and vitamins C, E and A which help to protect us from oxidation agents and free radicals, and other vitamins such as niacin, B1 and B2 and beta-carotene.

Here's a simple way to prepare garlic in the oven.  You can spread this roasted garlic over crackers or toast for a delicious snack.  Or roast some brocooli and peppers and serve together.  Roasted garlic can be used in all kinds of dressings or sauces.

As we're in back to school season (with runny noses and shared germs), this can be yummy way to help your immune system.

Vitamin D and Pregnancy

Another paper on the significance of vitamin D has recently been published.  In it, the authors report,

"low maternal levels of 25 hydroxyvitamin D are associated with adverse outcomes for both mother and fetus in pregnancy as well as the neonate and child."

Further, low vitamin D seems to be linked with "infertility, preeclampsia, gestational diabetes and an increased rate of caesarean section."

Clearly, it is very important for pregnant women to maintain healthy vitamin D levels.  The general recommendation for most people is to maintain serum 25-OH D levels above 55 ng/mL.  The absolute bottom threshold seems to be around 33ng/mL but greater than 55 is generally believed to be a more optimal range.  

The authors of this study admit that whether low vitamin D causes problems during pregnancy or is simply associated with them is unclear.  However, they also acknowledge that there are plausible physiological mechanisms that could explain how low vitamin D would cause the issues.

With 3/4 of American deficient in vitamin D, it appears that we need to pay special attention to pregnant mothers.