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    Archive for the ‘pregnancy’ Category

    You Ask, I Answer: Pre-Pregnancy Nutrition

    Don-Farrall-positive-pregnancy-testIs there a necessary [nutrient] formulation for women who are preparing to get pregnant, or will any kind of multivitamin do?

    — Coco
    Via the blog

    In most cases, a general multivitamin will do.  Steer clear of multivitamins that provides extremely high amounts, though, as these can negatively impact the health of a growing fetus.

    The two main nutrients women looking to conceive should be particularly mindful of are folic acid (known as ‘folate’ in its “from-food” form) and iron.

    Adequate intakes of folic acid/folate significantly lower the risk of fetal neural tube development problems, which occur around the third week of conception (often times a few weeks before a woman even knows she’s pregnant).  This is why it is crucial to get sufficient folate when trying to conceive.

    Most multivitamins offer 100 percent of the daily folate requirement, while the average prenatal multivitamin offers, on average, an additional 50 percent.

    Remember, though, that most cereals are multivitamins in their own right (a serving of most breakfast cereals offers 100 percent of the daily folate requirement).

    Iron is also crucial to both prevent the mother from developing anemia and to ensure that the growing fetus receives the necessary amounts of red blood cells to get enough oxygen.

    Although most breakfast cereals offer a day’s worth of iron, remember that non-heme (plant-based) iron is not as absorbable as that from animal products.

    Women looking to get pregnant who do not have a history of anemia and who eat meat (that includes chicken, pork, and seafood) regularly don’t necessarily need to supplement iron.  Vegetarian and vegan women, on the other hand, should.

    Must all women looking to conceive buy special supplements?  It depends.

    If their diet includes a variety of foods naturally rich in folate (spinach, peanuts, broccoli, avocado) as well as those fortified with folic acid (breakfast cereals, commercial breads), there is no reason for additional supplementation.  Similarly, if they regularly consume foods high in iron (meats, chickpeas, breakfast cereals) they should be in good shape.

    One of the absolute best things women looking to get pregnant can do is lose excess weight, particularly to minimize health risks for themselves — and their future babies.


    Go Fish (Even if You’re Pregnant!)

    tuna_sushi_0123My most recent leisure read is Steven Shaw’s Asian Dining Rules: Essential strategies for eating out at Japanese, Chinese, Southeast Asian, Korean, and Indian restaurants.

    I love food (and culinary cultures) as much as nutrition, so this was a perfect find.

    The first chapter — devoted to sushi — includes a short aside titled “Pregnant Sushi.”  I thoroughly enjoyed it and wanted to summarize the main points for you:

    • In the United States, raw fish is considered a no-no for pregnant women.  In Japan, it is considered “part of good neonatal nutrition.”  Just in case, I researched this on my own and, sure enough, the Japanese Ministry of Labor, Health, and Welfare only cautions pregnant women to eat fish high in mercury sparingly.  There is no mention of “raw fish” as a food to avoid during pregnancy.
    • Raw mollusks (especially clams and oysters) are responsible for approximately 85 percent of seafood-related foodborne illnesses.
    • “If you take raw and partly cooked shellfish out of the equation, the risk of falling ill from eating seafood is one in 2 million servings; by comparison, the risk from eating chicken is one in 25,000.”
    • Foodborne illnesses from fish are mostly caused by cross-contamination or inadequate storage conditions, not by virtue of eating a raw piece.
    • Fish served in sushi restaurants has been previously flash frozen, which kills parasites as effectively as cooking.
    • “Most of the fish likely to have parasites, like cod and whitefish, are not generally used for sushi.  Fish like tuna are not particularly susceptible to parasites because they dwell in very deep and cold waters.  Sushi restaurants typically use farmed salmon to avoid the parasite problems wild salmon have.”

    The author makes a strong point when he states that “the Japanese government is fanatical about public health… you can be sure that, were there documented complications resulting from pregnant women eating sushi in Japan, there would be swift government intervention.”


    In The News: More Is Not Better

    Today’s Sydney Morning Herald briefly touches upon the problem of vitamin mega dosing among pregnant women, particularly since extremely high doses of vitamins A, D and E during pregnancy have been linked with birth defects.

    Historically, the field of nutrition looked at health problems from an “undernutrition” standpoint; that is, what can happen when we don’t eat enough or get a sufficient amount of nutrients?

    We are now starting to see an increasing amount of studies focus on the problem of overnutrition.

    Whether it’s too many calories, or too much of one specific vitamin, it is important for consumers to realize that the key to health, much like Goldilocks’ dilemma, lies in getting just the right amount.

    Although harmless, the last wave of overconsumption I witnessed — at least here in the United States — was the bottled water craze. It’s almost as if people forgot that their bodies had thirst mechanisms!

    Drinking three liters of water a day doesn’t accomplish much of anything other than more frequent trips to the bathroom.


    In The News: "Second Hand" Obesity

    Today’s New York Times reports on a new pooled analysis study published in the Journal of the American Medical Association which concluded that “obese women are more likely to have babies with rare but serious birth defects, including spina bifida and other neural tube defects.”

    Although spina bifida is generally associated with insufficient maternal intake of folic acid, lead study author Dr. Judith Rankin theorizes that in the case of obese women, “insulin resistance and undiagnosed diabetes may be playing a causative role in birth defects… though the precise mechanism is not known.”

    This new study gives further credence to weight-loss recommendations given to obese women planning to start a family.


    You Ask, I Answer: Caffeine and Pregnancy

    My friend and I are both pregnant, but the advice we have gotten about caffeine [intake] during our pregnancy is very different.

    My doctor was vague. He said that caffeine “once in a while” was okay.

    Her doctor said she should refrain from having any.

    Isn’t that too strict?

    — Marcia (last name withheld)
    (location withheld)

    Unless there are specific conditions that put your friend at a high risk for miscarrying, I am not sure I understand the reasoning behind the “completely abstain from caffeine” recommendation.

    Although liberal consumption is not recommended for pregnant women, it is believed they can safely consume up to 200 milligrams of caffeine per day without placing their developing fetus’ health at risk (the main concerns being a higher risk for miscarriages as well as problems with cellular development).

    Sticking to less than 200 milligrams of caffeine each day isn’t really too difficult.

    A 12 ounce can of Coca Cola, for instance, only contains 35 milligrams.

    Your average 8 ounce cup of green tea adds 50 milligrams to your day, and a 16 ounce latte (that’s “grande” if you speak Starbucks) clocks in at 150 milligrams.

    For those who like a stronger cup of Joe, the average 8 ounce cup of percolated coffee clocks in at anywhere from 130 to 200 milligrams of caffeine.

    Other sources — like coffee ice cream or a chocolate bar — offer very little caffeine (anywhere from 10 to 25 milligrams per serving.)


    Give Birth, Lose Weight!

    The latest issue of Us Weekly features Christina Aguilera’s amazing 40-pound weight loss in just 4 months!

    Something smell fishy? It should.

    For starters, her “before” photo isn’t exactly due to one too many Big Macs.

    And the “40 pounds” figure is slightly misleading.

    Find out more in Small Bites’ latest YouTube video!


    In The News: Sure, Blame Mom

    According to this article, women who consume junk food while pregnant may be putting their babies at risk for craving overly sweet and salty snacks as children!

    Well, at least that’s what researchers in Great Britain’s Royal Veterinary College are guessing might occur based on a study they performed on… rats.

    Turns out the pregnant rats who had the least healthy diet gave birth to little ones who craved junky snacks.

    There is one major flaw with this study, though. Unlike the rats in this study, human babies are not given free reign to eat whatever they please.

    Human mothers are instructed to start their babies off with certain foods and slowly introduce new ones with time, not leave a box of Dunkin’ Donuts on the counter and see if two-month-old Jessica reaches for them.

    If anything, what truly determines the possible pattern of a child’s dietary habits as they grow older is what they are fed at home. A toddler living in a household stocked with TV dinners and Doritos bags has no interest in vegetables because he has no idea how they taste.

    Similarly, a first grader’s daily fruit intake should not be a Fruit Roll-Up. Of course children should have and enjoy treats, but these formative years are key for introducing them to new foods, flavors, and textures.

    Our experiences with food as children have far-reaching consequences, well into our adult lives. Look at your own dietary habits and preferences. Can’t many of them be traced back to family traditions and tastes?

    In any case, pregnancy is a time when rare cravings can occur, and I would hate for a first-time expecting mother to think her midnight vanilla ice cream and pickle snack is dooming her future child’s health.

    Once children can be fed a variety of foods, though, mothers should not be discouraged by an initial dislike. It often takes eight or nine tries of a new food (i.e.: broccoli) before a child truly accepts it.

    For the record, nutrition authorities aren’t putting their eggs into this basket.

    For instance, “Dr. Atul Signham, from the Institute of Child Health in London, said he was slightly skeptical about the likely scale of “fetal programming” in a child’s diet until it could be proved in human studies.”



    Nutrition History: Healthier Breads

    Look at the food label for any grain product (even the most refined of breads) and you’ll always see 4 B-vitamins (thiamin, niacin, riboflavin, folate) and iron listed.

    Thiamin(B1), riboflavin (B2), and niacin (B3), are bread’s enriched vitamins, while iron is its enriched mineral. Meaning, the flour lost these nutrients while undergoing the milling process, so they are added back in.

    The requirement of replenishing these nutrients stems from the Enrichment Act of 1942, an initiative to lower the rates of vitamin and mineral deficiencies at the time.

    In February of 1996, the Food & Drug Administration required that folic acid (the bioavailable version of folate, another B vitamin) be added to all grain products,in an effort to lower rates of neural tube defects (research unequivocally demonstrated that babies of women who consumed low levels of folate during the first trimester of pregnancy had a higher risk of being born with neural tube defects.)

    Folate is not originally found in the endosperm of grains (which is the only part white bread is made from), so it is put in via fortification (added on), rather than enrichment (added back).

    Since folate is a B vitamin (which is water soluble), it is crucial to get the required amount every single day.

    Whole grains naturally contain folate, so they do not need extra amounts.

    Quick lesson on whole wheat vs. white or regular wheat bread:

    Whole wheat breads use all 3 parts of the wheat shaft: the germ, bran, and endosperm
    Refined wheat breads only use the endosperm (thus completely missing out on nutrients found exclusively in the bran and germ, such as vitamin E and selenium).

    Fortunately, the folate initiative has worked! Since the fortification of folate to breads, cereals, and pastas, neural tube defects have decreased by 25 percent in this country.

    Why bread products? They are widely consumed by people in the United States, regardless of age, socioeconomic level, or ethnicity.

    That being said, commercial breads are not the best sources of folate. Spinach, asparagus, and all sorts of legumes (lentils, chickpeas, black beans, kidney beans, etc.) provide more substantial amounts of this crucial B-vitamin.


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