April 3, 2017

Maternal and Child Health Series

The single most important avenue for preventing dysfunctional human health is nutrition. I think of the Robert Frost Poem, The Road Not Taken, where he was faced with two paths to travel. Both looked good to him but the choice he made has made all the difference.

In the context of maternal health, preparing one's body for a baby requires that a mother have adequate macro and micronutrient stores for a successful pregnancy. If a mother to-be has inadequate fat stores, the likelihood of becoming pregnant drops rapidly. Conversely, obesity raises many issues including reduced ability to have a healthy pregnancy. Obesity is associated with infertility, spontaneous miscarriage, fetal malformations, thromboembolic complications, gestational diabetes, stillbirth, preterm delivery, cesarean section, fetal overgrowth and hypertensive complications. (1)

What is the optimal nutritional scenario for a healthy pregnancy? There are two paths to follow. Clearly, following the path and the principles of The Blue Zones along with the preponderance of the published literature, we recommend a balanced diet akin to the anti-inflammatory Mediterranean diet long espoused by Dr. Andrew Weil.

Not knowing the specifics of your unique genetic makeup forces us to look at population based data to come up with suitable recommendations for health. What is beyond a doubt is that we should not consume large volumes of refined foods from any source. By this we mean, limiting all forms of bread, pasta, cakes, cookies, chips, sugar sweetened beverages and flour/sugar based foods in general.

Excessive maternal sugar and flour consumption drives the hormone insulin to shove sugar into fat cells for storage purposes. This fat is metabolically active in an pro inflammatory way when excessive. These fat cells release chemicals called cytokines that signal cascades of events that are damaging to a mother's metabolism and pregnancy.

The other side effect of excessive maternal sugar consumption falls squarely on the fetus. Excessive maternal insulin production to handle the excessive sugar acts like a growth hormone for the baby. The baby grows larger than what is natural which has two side effects: 1) makes for a riskier delivery as the child is larger than nature had planned for him or her to be, thus making it difficult to pass through the vaginal canal safely, 2) increased caesarian section rates which has negative consequences on the baby's gut microflora and infant bonding immediately following delivery.

The other problem associated with excessive maternal insulin production is that the insulin permeates the bloodstream of the newborn after birth, which can cause blood sugar instability for the first few days after birth further disrupting the bonding experience. This is crucial for establishing effective breastfeeding and temperament.

Pregnancy requires larger volumes of high quality foods to provide the macro and micro-nutrients for all cellular metabolic functions. Simply put, large volumes of vegetables and fruits, preferably organic, are key to providing the vitamins, minerals, fats, proteins and carbohydrates for OPTIMAL function. If you could only see the dizzying wall of a medical school's biochemistry department where they have a poster showing the myriad of chemical reactions in the body to support function, you would have a glimpse of what we are talking about. As we continue to learn more about the body, it is clear that these biochemical reactions are critical to optimal health and need to be supported.

10 or more servings of vegetables and fruits per day would be ideal. Leaning more towards vegetables is also a good idea. I (Dr. M) am always thanking and feel grateful for Chef Herron at our hospital for serving me four vegetable plates for lunch as I feel my cells exploding with happiness at the bolus of nutrients coming down my esophagus.

Cold water fish and grass fed natural meats are also very beneficial as they provide a healthy fat called an omega 3 poly unsaturated fat. This fat source has been well studied and is critical for the developing brain and immune system of mom and her baby. We recommend smaller cold water fish like salmon, sardines, trout, mackeral as they don't have high levels of mercury and other heavy metal toxins to hurt the fetus. Avoid corn fed or finished meats as they are an inflammatory based food. Look for your local farmer like Wild Turkey Farms to provide these high quality foods for you and your babe.

See other newsletters below for more information.

Collaborating for you,

Dr. M and Dr. Grey

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3871181/#R50
Micronutrient Newsletter
Young Women and Iron