Dining For Two

The pregnant mom's advice is the same as what Hippocrates told physicians all those eons ago: first do no harm. So within reason, if we are not sure, gynos are apt to recommend caution in pregnancy, and that extends to dietary guidelines. It's a concern to those who preform prenatal care  when the media dissuades patients from following standard medical advice as in today's Wall Street Journal's article. Eating in pregnancy is complex,  we want the baby to grow to healthy size and weight, we want to maximize brain and eye development, we want to have the mom also be healthy as anything that restricts nutrients to the mom will restrict them to the baby as well. Understanding how food choices from a huge selection of wholesome foods can promote a healthy pregnancy is part of what you want to seek prenatal advice about. As physicians we advise our patients to avoid unpasteurized foods as they are more likely to have bacterial contamination, especially with serious agents that are uncommonly seen otherwise, like listeria. We also like women to avoid deli meat because of concerns regarding bacteria, but also concerns regarding the chemicals you consume. For a long time we have speculated that it is not really just stress, and weight, but actually diet that controls much of our blood pressure woes in pregnancy. There have been studies of Andean women at altitude, intercity studies, and studies of women in times of conflict that have all postulated that blood pressure problems can be linked to dietary food nutrient intakes. Some studies have tried to look at specific dietary components such as too much fat intake or too little calcium intake, and other studies have merely looked at the numbers of calories we consume. Many readers will consider themselves part of Generation R, thus will find some fascinating results from the Generation R Study. In a recent publication lead by Dr. Sara Timmermans from the Erasmus Medical Center Rotterdam, the Netherlands has specifically looked at pregnant women's diets and their blood pressure. This early publication specifically talks about the top number of your blood pressure reading, or the "Systolic Blood Pressure". She was asking: if you eat a Mediterranean diet, mostly; will this be better for your blood pressure in pregnancy or if you eat mostly a Traditional meat based diet will this be better for your pregnant blood pressure? The answer was that if you rarely eat Mediterranean meals your blood pressure will be higher. The reason is that this type of eating helps your levels of folate, homocysteine and your blood markers of inflammation will be reduced! Now what wasn't clear to me from the reading of this one study is that the 'traditional form of Mediterranean diet' has alcohol consumption. This we don't recommend in pregnancy, and ACOG reinforces that no amount of alcohol is safe in pregnancy. It is important to note that their research found that from the very first trimester eating the Mediterranean diet improved blood pressure! So if you are thinking about pregnancy, talk to your ob or your gyno about the diet changes that can make your pregnancy healthy.


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