September 10, 2018
The Perfect Diet for a Mother-To-Be Through a Macronutrients Lens
When I think of the perfect diet for mothers-to-be, based on all of the accumulated knowledge to date, I decidedly have to look backwards in time. The diets of the Blue Zones or the Tsimane Indians or other minimally processed ancestral diets seem to possess the best of what is available for the mother child dyad.
When exploring diets, we need to first look at the macronutrients and how they are functional in the pregnancy experience.
Let us look at protein first. Like carbohydrates and fats, protein is necessary for growth and maintenance. It is a major macronutrient that is necessary for the building blocks of muscle, cell signaling, DNA formation, cellular transport and much more. Without adequate protein intake these mechanisms begin to falter and the child's outcome may be compromised.
The volumes necessary on a day to day basis are variable based on exercise, physiologic makeup and stress. However, current recommendations are for pregnant women to get 1.1 grams per kilogram per day of protein in the diet although new research points to slightly increasing needs towards the third trimester. (Elango et. al. 2016)
Assuming that a pregnant women gets adequate protein volumes daily, what should the source be. When looking for literature on which type of protein to eat during pregnancy, meat or vegetarian, there were crickets in cyberspace. At this point we are left extrapolating from epidemiological data over the last century.
I think that the human longevity data sets are likely the most useful in this position of extrapolation. Here again, I point to the data sets from the Tsimane Indians and the Blue Zones. There are no references to pregnancy in these studies. The information presented was specifically related to coronary artery disease risk for the Tsimane Indians and mortality for the Blue Zones. .
The Tsimane Indians of Bolivia ate a diet that was only 14% protein and was made up of primarily vegetarian sources mixed with wild game meats and fish. This diet was associated with almost negligible heart disease risk. The Blue Zones longevity data showed that there are many reasons that certain groups live long and healthy, but one key component was the dietary influences of large volumes of vegetarian based foods spiked with wild game animal meats, sparingly.
The research of the esteemed journalist, Michael Pollan, was put into his book, In Defense of Food: The Eaters Manifesto, where he has concluded that a diet predominantly based on vegetarian sources is associated with the best health outcomes.
Recent data points to evidence that wild game or grass-fed pasture raised meats are healthier than commercially grain fed processed meats because of reduced inflammatory signaling. Inflammation is a main driver of risk for all diseases. (Ayra et. al. 2010) (McDaniel et. al. 2013) (McAfee et. al. 2011)
I am fully aware of the fact that this conclusion is not rooted in science as it relates to pregnancy, however, it is directly related to the human condition. I believe that meat was always a part of the human diet, and not associated with disease until humans altered the quality of the meat and began to significantly over-consume it. Globally and epidemiologically, eating animal flesh sparingly seems to be associated with the best human health. Thus, I do not think that it is a significant stretch to extrapolate this data to pregnancy and early childhood.
Protein recommendations:
1) Eat 1.1 -1.3 grams per kilogram per day.
2) Eat mostly vegetarian sources of protein especially legumes like lentils, whole organic soy and garbanzo beans.
3) Eat wild caught fish like salmon, sardines, mackerel and herring.
4) Eat wild/traditionally grass or naturally fed animal meats. This is most likely to be associated with the lowest inflammation risk.
5) Eat chicken, duck or quail eggs.
6) Nuts and seeds have healthy volumes of protein.
7) Spirulina and nutritional yeast added to smoothies.
8) Quinoa, amaranth and teff are high protein grains worth consuming
9) If you are not dairy sensitive, small volumes of fermented dairy, yogurt and high quality organic cheeses are loaded with protein.
Dr. M
Tsimane Indians
Advances in Nutrition Elango Article
Blue Zones
In Defense of Food
British Journal of Nutrition Arya Article
Nutrition Research McDaniel Article
British Journal of Nutrition McAfee Article
