Nutrition in pregnancy: a determining factor of health throughout life

It is no mystery to anyone today that pregnant women’s lifestyle and diet can affect the health of the baby to be. Research continues to show that maternal diet and possible deficiencies not only have a determining effect on the mental and physical health of babies and children, but also that of adults even late in life. This article will touch briefly on the major aspects of diet and supplementation during pregnancy but also provides interesting reading for anyone seeking to improve their health.

In fact scientists in this field now consider maternal nutrition to be a risk factor for cancer, diabetes and heart disease, regardless of when these might occur in life. Not only, but this risk factor is independent of other known factors like a person’s own diet, lifestyle and genetics. Lack of nutrients in pregnancy can turn on genes that would otherwise lie dormant and cause no harm, but that once activated become triggers for illness at any time in life.

In most cases, aside from being told to “eat well” and take a multivitamin, women are not informed of new research in this field or all the components of a healthy pregnancy that contribute to thriving babies who grow into healthy adults.

Diet
The three major dietary factors that were found to adversely affect the baby are insufficient protein, excessive sugar and starchy foods, and lack of fresh fruits and vegetables.

Protein is basically what the body is made of. It is the most essential building-block for the baby to be, but it is also as essential for the mother’s own health maintenance. Lack of protein in pregnancy can deplete the mother setting the stage, among other things, for post-partum depression.

The body has no way of storing protein, so it has to be consumed on a daily basis, and preferably several times a day. In the excellent book (now out of print) “Metabolic Toxemia of Late Pregnancy”, Thomas Brewer, MD showed how pre-eclampsia and eclampsia can be effectively prevented by making sure women eat enough protein during pregnancy.

According to the FDA a pregnant woman weighing 150 lbs needs 75 grams of protein a day. This is likely to be an underestimate because of a medical anti-protein bias that exists today and therefore it should be considered as a strict minimum. To give you an idea of how much food is involved, 2 large eggs contain a total of 12 grams of protein, lean meats or seafood around 7 grams per ounce, hard cheese 10 grams per ounce, and beans 7-10 grams per half cup cooked.
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Are you pregnant? Here’s more evidence that you should take extra vitamin D

According to a newly released study pregnant women taking 4,000 units of vitamin D daily cut their risk of preterm labor, preterm delivery, and infections by more than half. This dose of vitamin D is ten times greater what was recommended previously. Most prenatal multivitamins only contain 400 units of vitamin D, a dose now understood to be insufficient.

Prior to this study, higher doses of vitamin D had already been shown to lower the risk of infection, strengthen the immune system, reduce the risk of several types of cancer, and promote healthy nervous system development in fetuses.

When selecting the type of vitamin D you take I recommend that you choose vitamin D3, which is the natural form of this vitamin, and avoid the synthetic vitamin D2.

Because the body makes most of its vitamin D from the sun, nutritional needs of this vitamin vary depending on how much time we spend in the sun, what latitude we live in, the color of our skin and, most importantly, whether we use sunscreen, which inhibits vitamin D formation.

Recent research has shown that with regular sun exposure blood levels of vitamin D stabilize around 70-100 ng/ml, a level now considered optimal. For the majority of Americans blood levels of vitamin D are 30 or lower. If you’d like to find out where your levels stand and you are my patient let me know, as this can be found through a simple blood test.  If you are not my patient you can ask your doctor to run a simple and inexpensive blood test called 25-hydroxy-vitamin D, which is the correct way to assess vitamin D levels.

Read more about the study here: http://www.edmontonjournal.com/health/Vitamin%20halves%20risk%20preterm%20delivery%20study/2974828/story.html

Sunscreens and Cancer: Your Options

Now that summer is in full force and the sun is brutal most of the time, especially here in Houston, many of us feel we need to cover our bodies with sunscreen every day before we go out. But is that really such a good idea? And will it really prevent cancer?

I have always found it intriguing that while humans evolved under the sun – not in caves – the sun is increasingly blamed for skyrocketing skin cancer rates. If the sun was truly the culprit, and sun block a major defense, wouldn’t rates of skin cancer be dropping and not rising?

The facts, however, tell a different story. Today skin cancer is more common in the United States than all other forms of cancer combined. Its incidence is also growing faster than all other cancers, increasing by 6-7% each year.
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Dealing with the latest flu scare

When it comes to flu scares, I guess you could consider me a skeptic. Basically I continue to see the flu as a mild though annoying seasonal illness that can be effectively prevented, or its impact lessened, with a few simple measures.

Over centuries there have been a small number of more severe flu outbreaks that caused thousands of deaths over short periods of time. While the risk of such an outbreak in our lifetimes is remote, it does exist, as do the risk of being struck by lightning, being run over by a car, or drowning at the beach.

If and when a severe flu outbreak does strike it will be from a suddenly mutated strain of the flu virus and vaccines will be of no use. In fact, there will be little to do aside from the simple preventive measures I am about to discuss below.
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Anxious about the economy?

The economy may be slowly on the mend, but one major aspect of hard times like these is the effect they have on mental health. Based on the calls we are receiving at my office, anxiety about the future and personal finances is widespread and people are seeking help.

A news release that recently crossed my desk suggests that up to one in three Americans are losing sleep over the state of the economy. No matter how you look at it, losing sleep will not get you any closer to finding a solution. While the drug companies may be quietly benefiting from this state of affairs, it is important to remember that natural solutions work equally well or better, with no side effects, no risk of addiction, and often with beneficial effects for health in general. Unfortunately, the people who suffer the most are often also the least likely to seek help from a qualified natural health professional like myself because the expense involved generates its own stress and anxiety.
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“Killer” vitamins!

These days it is becoming almost common for people to come to their appointment with me carrying the latest article they cut out from a newspaper or magazine describing the dangers of this antioxidant or that vitamin. One might think that vitamins are becoming a major cause of illness and death in today’s world, when they are actually essential to life and that the modern diet is depleted of them!

Most of these articles do not present original research but statistical reevaluations of prior research, much of which was flawed to begin with. The fact that they even get published in respected medical journals is indicative of a bias against nutritional products, and it always amazes me how quickly the media picks up on this “news.”

By contrast, here are two studies you are not likely to hear about on the morning talk shows:
One happens to be the first study to show that a vitamin can improve memory. Researchers followed close to a thousand people aged 50 to 75 over a three-year period. Some were given 800 mcg of folic acid daily as a supplement, whereas others received a placebo. Those who took the supplement ended up scoring significantly higher on a variety of cognitive tests. As far as memory is concerned, their scores on average were equal to those of people 5.5 years younger who had not taken the vitamin (Neurobiol Aging. 2006 Feb; 27 (2): 334-43).

The second study analyzed results of 63 prior studies in relation to vitamin D status and cancer rates, reaching the conclusion that adequate status of this vitamin was associated with significantly lower rates of several types of cancer, including colon, breast, ovarian and prostate cancers. In their conclusions, researchers stated that “vitamin D supplementation could reduce cancer incidence and mortality at low cost, with few or no adverse effects” (Am J Public Health. 2006 Feb; 96 (2): 252-61).

Meanwhile the media continues to focus on “killer” vitamins.

Safe sunscreens

Let me start by saying that the best way to approach the sun this summer is in moderation. Some dermatologists try to convince you that, for your health, every inch of exposed skin should be smeared with a thick layer of sunscreen every time you step into the sun. This couldn’t be further from the truth.

In fact, in a May 2005 article in USA Today Dr. Edward Giovannucci, a Harvard University professor of medicine and nutrition, laid out his case in a keynote lecture at an American
Association for Cancer Research meeting. His research suggests that vitamin D might help prevent 30 deaths for each one caused by skin cancer. “I would challenge anyone to find an area or nutrient or any factor that has such consistent anti-cancer benefits as vitamin D,” Giovannucci told the cancer scientists. “The data are really quite remarkable.”

The best source of vitamin D is from the sun. The body converts the perfect amount that you need and actually destroys any excess vitamin D. And unlike other parts of the country, we have the ability to use this wonderful and free resource for vitamin D almost year-round. It is a shame that most people block it completely at all times.

With this being said, it doesn’t give you free rein to fry yourself on a beach with baby oil. But “safe sun” – starting with 5 to 15 minutes or so every day of fully exposed skin without any sunscreen at the beginning of the season, and increasing it slowly – is actually very important for your health.

Back to the point of this article though: the fact is that there are some days or times that you may find yourself in the sun all day long. And if this is the case, you need to be aware what is in your sunscreen bottle; it may be more toxic than overexposure to the sun itself.

You want a sunscreen that has a sun blocker in it, like titanium dioxide, zinc oxide, or both. They should not be nano-particles or micronized, because this will allow the particles to be absorbed into the body instead of being kept on the skin as a barrier (and out of your bloodstream). The only issue is that a sunscreen like this will leave a whitish hue on the skin when applied. I think that is a small price to pay to keep the particles out of my body.

In researching this article, I have found different chemicals that should raise a red flag when seen on your sunscreen bottle. Many of these products become more harmful when
exposed to sunlight. Try to avoid:

Benzophenones (dixoybenzone, oxybenzone)
Propylene glycol
Cinnamates (cinoxate, ethylhexyl, p-methoxycinnamate)
Salicylates (ethylhexyl salicylate, homosalate, octyl salicylate)
Avobenzone (butyl-methyoxydibenzoylmethane)
Digalloyl trioleate
Menthyl anthranilate
PABA and PABA esters (ethyl dihydroxy propyl PAB, p-aminobenzoic acid padimate O)

The sunscreen I use for my family when it is necessary is Mexitan. I have to order it online, because there is not a retailer in this area. Another one that a lot of people recognize as a safe and natural sunscreen is from Aubrey Organics but I have questions about it since it contains PABA esters. The more research I do on PABA, the more conflicting reports I get. So I will leave that judgment call up to you.

My best piece of advice if you are in for a day at the beach or water park is to bring along a shade umbrella and a hat and spend short 20 to 30 minute periods in the water or on the beach volleyball court, and let the sun work its magic on your body as it should.

Add osteoporosis drugs to the list of toxic medications

The problem with modern drugs is simple: virtually all of them are made from chemicals that are foreign to the human body and potentially toxic. They might be fine as long as they are used occasionally or for brief periods of time, but when these new drugs are prescribed “forever” you can bet trouble is around the corner.

An article just published in the New York Times reveals that women who have been on the common osteoporosis drugs are now coming down with osteonecrosis of the jaw, a condition where parts of the jaw bone deteriorate and then die. This is apparently becoming so common that some dentists refuse to treat women on these medications or ask them to stop taking them for some time before dental work. However, this precaution is unlikely to help since these chemicals remain in bones for years after being discontinued.

For the full article, go to http://www.nytimes.com/2006/06/02/health/02jaw.html. What the Times calls a “mysterious side effect” is not a mystery at all to me. I even anticipate that in time we will see this complication develop at other sites as well, not only in the jaw. In fact when these drugs first came out skeptics remarked that while they increased bone density, they also caused the quality of the bones to deteriorate – so we could say that this outcome was predicted from the beginning.
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Vitamin D Update

Anyone who has been following this newsletter for a while will recognize that I am back to one of my favorite topics, vitamin D. The truth is that studies on the benefits of vitamin D never cease to amaze me.

Here I’ll cover two interesting studies. The first one (Nutr Cancer 2005; 51: 32-6) looked at 15 men previously treated for prostate cancer who experienced a recurrence. They were each given 2,000 IU of vitamin D a day for 10 months with no other treatment. Three of these patients experienced a drop in PSA – the blood marker used to monitor prostate cancer progression – while the others experienced an average 75% slowdown in its rate of growth. Quite an impressive finding!

While this is a small study and definitive conclusions cannot be drawn from it, to me it’s enough of an indication to include vitamin D, a completely non-toxic substance, in any type of
treatment strategy for prostate cancer. Not only will it not interfere with other treatments but with vitamin D you only get added benefits!

Considering all that we are learning about this vitamin and its health-enhancing and anticancer effects, I feel that maintaining an adequate status of vitamin D and correcting any possible deficiency is an essential step in maintaining health for everyone.

In the second study (Brain Res Bull. 2005 Mar 15; 65 (2): 141-8) Australian researchers discovered that maternal vitamin D deficiency permanently damages the brains of baby rats.

Unfortunately, supplementing vitamin D to the babies does not reverse the damage.

Although this is a rat study, its conclusions are very likely to apply to humans as well and the authors noted that vitamin D deficiency is very common in young women – an unfortunate consequence of modern society’s sun phobia. In addition, prenatal vitamins do not contain nearly enough vitamin D to correct possible deficiencies.

According to the authors, appropriate sun exposure or supplementation at effective doses could help prevent an as-yet-undetermined percentage of neurological and neuropsychiatric disorders in children.

If you wish to learn more on vitamin D and its benefits, you can search my website for articles I have written in the past about it. You can also go to http://www.vitamindcouncil.org/ for extensive information on vitamin D and regular research updates. The fact is that, while excessive exposure to the sun has its dangers, it only takes a few minutes of daily sun exposure (without sun block) to provide all the vitamin D we need.

Diet is simply not an adequate source of this important vitamin, and most over-the-counter supplements have been designed with insufficient vitamin D because of old misconceptions concerning potential vitamin D toxicity. It seems now that supplementation in the range of 1,000 to 2,000 IU per day is a good starting point but several times this amount may be needed to correct a deficiency.

Vitamin D for chronic inflammation, MS and (possibly) autism

The more we learn, the more it becomes evident that chronic inflammation is a universal troublemaker that plays a part in almost every ongoing health condition.

Acute inflammation is one of the most beneficial, and often life-saving, defense mechanisms of the body. Acute inflammation is what gives us a fever when our bodies are fighting a virus, a sore throat in response to strep bacteria, or a swollen ankle after a hard fall. In every case like these, inflammation helps promote recovery.

However, chronic inflammation is a superfluous and harmful process. It’s a healthy process that forgot when to stop and no longer serves a useful purpose. What causes it?

According to recent British research, air pollution – something most of us breathe on a daily basis – can cause it. See news.bbc.co.uk/1/hi/health/4277113.stm. Exposure to toxins like mercury or lead can also be a cause, as can too much copper, iron, or even calcium in the blood. Studies have shown that a progressive shift in the human diet from consuming mostly omega-3 fats to mostly omega-6 can also set the stage for chronic inflammation (see “The Omega-3 Connection” by Andrew Stoll, MD). Finally, a simple lack of vitamin D can be the culprit.
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Seasonal Affective Disorder (SAD) and Vitamin D

If you suffer from SAD, the end of daylight savings time is always bad news. SAD is characterized by symptoms of depression that flare up in the winter months when daylight hours decrease. It is far more prevalent up north, but I have seen it even here in Houston.

Since lack of sunlight obviously has something to do with SAD, treatment often involves daily exposure to bright white fluorescent light. However, this approach often doesn’t help and so many doctors just prescribe antidepressants.

An interesting theory is that it is not the lack of sunlight that causes depression, but the resulting vitamin D deficiency. Several studies appear to support this view.

In one study, 37 patients with marginal blood levels of vitamin D were given either 600 or 4,000 IU per day of vitamin D3 for three months, December through February. After this period, all patients reported improved wellbeing, with the higher-dose group faring significantly better (Nutr J 2004 Jul 19; 3 (1): 8).

In an older study, 15 patients with SAD were randomly assigned to receive vitamin D or daily light therapy. In this study only the group receiving vitamin D recovered (J Nutr Health Aging 1999; 3 (1): 5-7).

Last January I wrote about the many benefits of vitamin D (click on “Vitamin D” on the topics list of the Newsletters page on my website to view the full article). This vitamin plays important roles in calcium and bone metabolism, immunity, and protection from critical illness. If you suspect you are prone to SAD, that may be one more good reason to have your blood levels of vitamin D tested. The correct test to measure your vitamin D levels is one called “25-hydroxy vitamin D.” It is also important to ignore the lab’s reference ranges because they are based on the average of a vitamin D-deficient population. Instead, a good range is between 35 and 50 ng/ml.

If your levels are low, consider supplementing with vitamin D3, the most natural and safest form of this vitamin. Supplements in the range of 4,000 to 6,000 IU per day are safe for adults and probably necessary to reestablish adequacy if you are deficient. However, if you take high doses, it is important to monitor your blood levels of vitamin D through periodic testing and regular communication with your healthcare professional. Excessively high levels of Vitamin D can have toxic effects that could include kidney stones. Once an adequate level has been established, long-term maintenance intake of 1,000 IU per day has been shown to be safe (Am J Clin Nutr 2001; 73: 288-94).

More News on Vitamin D

Although I have written about the importance of vitamin D before, new information on this vitamin continues to surface. The more we learn about vitamin D, the more we find how many critical roles it plays in the body.

A “Vitamin D Council” was set up as a cooperative effort by a group of research scientists and recently launched a new website that can be found at www.cholecalciferol-council.com

Members of this council include Robert Heaney, MD, Professor of Medicine at John A. Creighton University. Dr. Heaney is considered the world’s leading expert on vitamin D, having published over three hundred original papers on this topic.

According to Dr. Heaney, the current government vitamin D recommendations are so low they ensure deficiency for anyone who adheres to them and also avoids the sun. Oddly enough, Dr. Heaney participated in setting up those very recommendations, but later discovered that humans need 4,000 IU of vitamin D per day, not the recommended 400.
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Vitamin D: is it the missing link in (bone) health?

Most women past the age of menopause have probably been offered one of several drugs to treat or prevent osteoporosis. These drugs work primarily by inhibiting hormones like parathyroid, although in most cases these hormones are at healthy levels and are not what causes bone loss. The drugs may well lead to stronger bones, but toxicity and side effects are a real concern.

All of us know about the importance of calcium for bone growth in children and healthy bones in adults. However taking calcium alone has not been shown to help reduce bone loss and osteoporosis. One reason is that the body needs vitamin D to absorb calcium and deposit it in bones.

A recent study showed that taking 800 to 900 IU of vitamin D in addition to 1,200-1,300 mg of calcium resulted in increased bone density in both younger and older postmenopausal women. The study also revealed that vitamin D deficiency was widespread among aging individuals. Ensuring adequate intake of vitamin D and calcium would seem to be a reasonable first step in manag ing osteoporosis before even considering drugs that cause undesirable hormone disruption (J Women’s Health (Larchmnt) 2003 Mar; 12:2: 151-6).

Unlike other vitamins, our bodies can make Vitamin D. The skin has enzymes that, when exposed to the ultraviolet rays of the sun, convert cholesterol into Vitamin D. We also obtain some Vitamin D from food, but since the amount we get from the sun can vary a great deal, it is a challenge to determine exactly how much Vitamin D we need from our food or supplements.

The US recommended daily allowance (RDA) is 400 international units (10mcg) daily from infancy to adulthood, and it was long thought that intakes exceeding 2,000 IU daily posed a risk of toxicity. However, expert opinion is shifting on this point since it has become apparent that the body can make many times more Vitamin D from even brief exposure to the sun.

Deficiency of Vitamin D is probably becoming more common in part because of widespread use of sunblocks that interfere with the skin’s ability to synthesize this vitamin. Large doses of Vitamin A, while beneficial in certain cases, can also induce a deficiency of Vitamin D if the levels of the two vitamins are not monitored and maintained in proper balance.

Studies have also shown that Vitamin D plays a central role in regulating the immune system. People with low blood levels of Vitamin D have been shown to have a higher occurrence of numerous cancers, including prostate, breast, colon, and others. The rate of autoimmune disease is higher in those who are deficient in this important vitamin.

Regular but sensible exposure to the sun may be the best way to ensure adequate stores of Vitamin D. Individuals at risk for osteoporosis, those who take Vitamin A supplements, or those with immune system disorders should ask their healthcare professional to order a simple test called 25-hydroxy-vitamin D to help determine their level of this important vitamin.