The myths and misconceptions about the best nutrition for pregnancy may be more abundant than the delusions that hamper the mainstream fitness and weight loss world. With all the attention being given to Beyoncé and Jay-Z's pregnancy, it occurs to me that even celebrities are often in the dark about proper nutrition during their pregnancy just like the rest of us. Don’t worry! Here, I provide Part 1 with nine nutrition and lifestyle tips to help you deliver and raise the healthiest and smartest baby. Tomorrow, I’ll post
Part 2 with another nine tips that you won’t want to miss out on. You’ll find the usual suspects that always pop up when I talk about optimal nutrition such as omega-3s and vitamin D, and some surprising micronutrients such as iodine and carnitine that are just as critical for growing the healthiest, happiest baby with the highest IQ.
Be aware that if you are pregnant or nursing, or may become pregnant, you should always consult your physician before taking any dietary supplements.
Omega-3s and Fish Oil
The omega-3 fatty acids make up the number one most important nutritional component for maternal and fetal health. They have dramatic benefits and influence the effectiveness of a number of other essential nutrients in the development of a growing fetus. They play a primary role in brain development and support a pregnant woman’s good mood and body composition.
What Are the Omega-3 Fatty Acids and Why Are they Always Mentioned with Fish Oil?
The omega-3 fatty acids include docosahexaenoid (DHA), eicosapentaenoic (EPA), and alpha linolenic (ALA) acids. Be aware that Linoleic Acid is commonly confused with ALA and is also a fatty acid, but a different kind—it is an omega-6, which I’ll discuss below.
Omega-3s naturally occur in high quantities in seafood and are essentially fish oil. You can get them by eating seafood, but due to concerns of contamination in seafood, many people prefer to supplement with fish oil. I recommend eating small cold water fish such as herring and Arctic char, and supplementing with fish oil daily. Avoid swordfish and tuna at all costs because they are loaded with mercury.
Take note that research shows that despite the concern of contaminated fish and a U.S. Federal Drug Administration caution that pregnant women limit their fish intake due to toxic levels of methyl mercury, it is more important to get the omega-3s from fish for the best fetal cognitive development than to avoid the contamination! A study found that keeping fish consumption below 340 grams a week (the U.S. FDA recommendation) did not protect children from adverse neurological outcomes due to fears of contamination. Rather, researchers found that children whose mothers had eaten more than 340 grams of fish a week during pregnancy performed better on cognitive function tests, while children whose mothers ate less than 340 grams a week were more likely to score lower on IQ tests and have diminished outcomes for pro-social behavior, communication, and social development. Of course, supplementing with fish oil is the easy alternative to avoid toxic seafood, but it is clear that omega-3s are critical for healthy brain development of the fetus.
Fish Oil is Linked to Cognitive Development and IQ
Of greatest interest to prospective mothers is extensive evidence that taking omega-3s, and particularly getting ideal amounts of DHA during pregnancy and lactation, results in a higher IQ in the child at four years of age. Researchers compared giving pregnant women cod liver oil containing 1183 mg of DHA and 800 mg of EPA with taking corn oil that contains primarily omega-6s (linoleic acid and a small amount of omega-3s from alpha-linolenic acid) on IQ and mental processing in offspring. The children of the cod liver oil group had higher scores on mental processing tests, indicating that omega-3s have a favorable effect on mental development in children.
A new literature review on the benefit of maternal omega-3 supplementation on fetal brain development showed significant evidence both that high fish intake and optimal omega-3 supplementation resulted in higher IQs because omega-3s are key for neuroreceptor signaling and effective enzyme activity in the brain. Of interest is evidence that women with Type-1 diabetes who had low omega-3 intake during pregnancy and lactation had children with poorer working memory than diabetics with high omega-3 intake.
Post-partum depression also influences cognition of newborns, particularly in boys—one study found it resulted in lower adolescent IQ. Of course, researchers didn’t test for low nutritional levels that are commonly related to depression such as omega-3s or vitamin D. This would be a good place to start for mothers who want to avoid feeling blue and have children with high IQs.
DHA—If You Take One Thing During Pregnancy, Take DHA
Above, I mentioned that maternal DHA supplementation improves cognitive function in children and the benefits of this fatty acid don’t stop with brain development. Taking DHA during pregnancy improves immune function and results in reports of less sickness in infants. Researchers found that taking 400 mg of DHA daily (a small amount) during pregnancy resulted in a 26 percent shorter duration of cold symptoms at one month of age. At three months the infants in the DHA group had spent 14 percent less time ill than a control group.
We also have evidence that mothers with higher DHA intake had babies with better sleep patterns—you’ll know this is a MAJOR benefit if you’ve already had a baby. Better baby sleep means better parent sleep, which can support better brain function and a leaner body composition, so take note.
DHA Influences Role of Other Essential Nutrients
There is evidence that omega-3s support the role of other essential nutrients in the body. A new study on rats found that too much folic acid (B9) in conjunction with too little vitamin B12 in the diet results in oxidative stress in both the mother and fetus. The excess folic acid intake ended up lowering omega-3 DHA levels in the mother, leading to lower fetal brain DHA—a bad environment for brain development. Supplementing with omega-3s, despite the overdosing of folic acid, offset the decrease in fatty acids and minimized the oxidative stress, providing reasons to take omega-3s—they can make up for nutrition errors!
Be aware that folic acid supplementation is commonly suggested for pregnant women to avoid birth defects. Women who have good nutrition shouldn’t be at risk for low folic acid because the recommended amount is .4 mgs to .6 mgs a day. Foods that have naturally high levels include asparagus, bananas, all green leafy vegetables, beans, oranges, nuts, and peas. Also, if you are making the mistake of eating enriched cereal, bread, or pasta you will be getting more than enough folic acid because the FDA has required food manufacturers to fortify these products with folic acid.
Omega-3s and Depression: They Make You Happier
Omega-3s are crucial for staying happy during and after pregnancy, and you can imagine that maternal mood and well-being will have a significant influence on a child. There is a relationship between low omega-3 intake and high levels of depression during pregnancy and post-pregnancy. In one study, women who consumed no omega-3s were more likely to be depressed than those who consumed 1.5 grams of omega-3s a week—a very low amount. Researchers have suggested that maternal depression can negatively influence cognitive development and social behavior in children.
Omega-3s and Pre-Term Delivery
You want your baby to be of normal birth weight, not large or small for optimal health and neurological development. Length of gestation can influence birth weight and a pre-term delivery is a bad thing because babies who are born early typically have more health issues including insulin resistance, metabolic disorders, and decreased cognition. Eating seafood and taking omega-3s are linked with longer gestation and ideal birth weight.
In a study that tested the relationship between intake of seafood in pregnancy, risk of pre-term delivery and low birth weight, researchers found that pregnant women who never ate seafood during pregnancy had 8.57 days shorter gestation and 19.6 greater odds of pre-term delivery than high fish consumers. Also odds of elective delivery were reduced. No or low fish consumption during pregnancy is an extremely strong risk factor for pre-term delivery and lower birth weight.
Likewise, length of gestation can be influenced by fish oil supplementation. A Danish study found that consuming 2.7 grams of omega-3 fatty acids per day during the third trimester led to longer gestation length than taking no supplement or taking the same quantity of olive oil. Gestation length in the fish oil group was on average four days longer than the olive oil group, leading to higher birth weights of about 107 grams.
A second study found that in women with a history of pregnancy complications such as pre-term delivery, intrauterine growth retardation, or pregnancy induced hypertension, supplementing with fish oil effectively delayed delivery and diminished negative symptoms in women who ate no fish. The fish oil supplement didn’t affect delivery for women who normally had high intake of seafood, indicating that fish oil can aid women who choose not to eat adequate amounts of fish to get the necessary omega-3s.
Omega-3s and Visual Acuity
Because omega-3s support brain development and IQ, it’s understandable that they also influence visual development. Supplementing with fish oil during the third trimester and when nursing results in enhanced visual development in infants. Infants with the highest levels of omega-3s in their red blood cells had better visual acuity at four months of age.
Omega-3s, Omega-6s, and Body Composition
Omega-3s and -6s are both fatty acids and consuming the right ratio is critical for body composition in pregnant women and offspring. Omega-6s (from flax, corn, and other plant-based foods) are fairly abundant in the typical Western diet, while the omega-3s are generally lacking unless you supplement. Ideally, you want a ratio that is close to equal because a distorted ratio is one of the primary reasons for the increase in disease rate over the last fifty years such as cancer, inflammatory-related disorders, and cardiovascular and autoimmune diseases.
A new study tested giving pregnant rats flax oil in order to determine the effect of omega-6 supplementation. Researchers found that supplementing with flax resulted in an imbalance between omega-3s and omega-6s. Mothers had increased body mass (not good) and there was an increased risk of offspring being overweight. Research on humans supports this, linking low omega-3 intake during pregnancy with an increased risk of babies being overweight at three years of age. Researchers caution against encouraging flax or omega-6 supplementation in the diets of humans because of possible negative health outcomes.
Smarter Kids and Higher IQ with Breastfeeding
The benefits of breastfeeding for a baby’s health and brain development are significant and well known. Cognitive development and IQ are higher if a baby is breastfed. One new study from the European Journal of Pediatrics found that children who were breastfed for at least the first three months had IQs that averaged 2.1 points higher compared to those who weren’t. Longer breastfeeding for more than six months after birth increased the IQ variance to 3.8 points greater than those who were not breastfed,
L-Carnitine, Omega-3s, and Body Composition
L-carnitine helps burn fat and supports muscle protein turnover, meaning that it is an important component in the management of maternal weight gain and healthy fetal development. Research shows that maternal carnitine levels decrease to about half of normal. Things get even more interesting when we learn that the most important function of carnitine is its role in the transport of fatty acids—omega-3 and -6s—in the body!
In fact, all the tissue that use fatty acids as a fuel source need carnitine for normal function. Carnitine is involved in mitochondrial function, meaning it is important for energy production as well as for other biochemical mechanisms. Research shows that supplementing with 500 mg/day of carnitine can raise plasma levels during pregnancy and prevent the normal decline. In addition, it appears that low iron negatively influences carnitine, and supplementing with iron and omega-3s can offset the natural decrease that comes with pregnancy. Of course your best bet is to take all three.
A second study clarifies the connection between carnitine and omega-3s in pregnancy and sheds light on how they support a lean physique. An increase in plasma free fatty acids in pregnant women leads to insulin resistance. The problem here is that without carnitine in the system, the fatty acids are in the plasma and not getting metabolized properly. Research shows that supplementing with carnitine solves the problem: giving pregnant women 2 g/day of carnitine results in a significant decrease in plasma free fatty acids, indicating better uptake of omega-3s and improved insulin sensitivity.
References #1 and #2
Hay, D., Pawbly, S., et al. Antepartum and Postpartum Exposure to Maternal Depression: Different Effects on Different Adolescent Outcomes.
Journal of Child Psychology and Psychiatry. October 2008. 49(10), 1079-1088
Roy, S., Kale, A., et al. Maternal Micronutrients (Folic Acid and Vitamin B12) and Omega-3 Fatty Acids: Implications for Neurodevelopment Risk in the Rat Offspring. Brain Development. February 2011. Published Ahead of Print
Imhoff, B., Stein, A., et al. Prenatal Docosahexaenoic Acid Supplementation and Infant Morbidity: Randomized Controlled Trial. Pediatrics. August 2011.
References #3
Helland, I., Smith, L., et al. Maternal Supplementation with Very-Long-Chain N-3 Fatty acids During Pregnancy and Lactation Augments Children’s IQ at Four Years of Age. Pediatrics. January 2003. 111(1), e39-44.
Hibbelm, J., Davis, J., et al. Maternal Seafood Consumption in Pregnancy and Neurodevelopmental Outcomes in Childhood (ALSPAC Study): an Observational Cohort Study. Lancet. February 2007. 369(9561), 578-585.
Ryan, A., Astwood, J., et al. Effects of Long-Chain Polyunsaturated Fatty Acid Supplementation on Neurodevelopment in Childhood: A Review of Human Studies. Prostaglandins, Leukotrienes, and Essential Fatty Acids. April-June 2010. 82(4-6), 305-314.
Temple, R., Hardiman, M., et al. Cognitive Functioning 6- to 12-Year-Old Offspring of Women with Type 1 Diabetes. Diabetes Medicine. July 2011. 28(7), 845-848.
Reference #4
Golding, J., Steer, C., et al. High Levels of Depressive Symptoms in Pregnancy with Low Omega-3 Fatty Acid Intake From Fish. Epidemiology. July 2009. 20(4), 598-603.
References #5
Olsen, S., Secher, N. Low Consumption of Seafood in Early Pregnancy as a Risk Factor for Preterm Delivery: Prospective Cohort Study. British Medical Journal. February 2002. 324(7335), 447.
Olsen, S., Osterdal, M., et al. Duration of Pregnancy in Relation to Seafood Intake During Early and Mid Pregnancy: Prospective Cohort. European Journal of Epidemiology. 2006. 21(10), 749-758.
Olsen, s., Osterdal, M., et al. Duration of Pregnancy in Relation to Fish Oil Supplementation and Habitual Fish Intake: A Randomized Clinical Trial with Fish Oil. European Journal of Clinical Nutrition. August 2007. 61(8), 976-985.
Olsen, S., Sorensen, J., Secher, N., et al. Randomized Controlled Trial of Effect of Fish-Oil Supplementation on Pregnancy. The Lancet. April 1992. 339(8800), 1003-1007.
Boris, J., Jensen, B., Salvig, J., et al. A Randomized Controlled Trial of the Effect of Fish Oil Supplementation in Late Pregnancy and Early Lactation on the N-3 Fatty Acid Content in Human Breast Milk. Lipids. December 2004. 39(12), 1191-1196.
Reference #6
Lauritzen, L., Jorgensen, M., Mikkelsen, T., et al. Maternal Fish Oil Supplementation in Lactation: Effect on Visual Acuity and N-3 Fatty Acid Content of Infant Erythrocytes. Lipids. March 2004. 39(3), 195-206.
References #7
Fernandes, F., de Souza, A., et al. Maternal Intake of Flaxseed-Based Diet (Linum Usitatissimum) on Hippocampus Fatty acid Profile: Implications for Growth, Locomotor Activity and Spatial Memory. Nutrition. March 2011. Published Ahead of Print.
Donohue, S., Rifas-Shiman, S., et al. Prenatal Fatty Acid Status and Child Adiposity at Age Three Years: Results from a U.S. Pregnancy Cohort. American Journal of Clinical Nutrition. April 2011. 93(4), 780-788.
References #8
Jedrychowski, W., Perera, F., et al. Effect of Exclusive Breastfeeding on the Development of Children’s Cognitive Function in the Krakow Prospective Birth Cohort Study. European Journal of Pediatrics. June 2011. Published Ahead of Print.
References #9
Lohninger, A., Radler, U., et al. Relationship Between Carnitine, Fatty Acids, and Insulin Resistance. Gynakol Geburtshilfiche Rundsch. 2009. 49(4), 230-235.
Keller, U., Van der Wal, C., et al. Carnitine Status of Pregnant Women: Effect of Carnitine Supplementation and Correlation Between Iron Status and Plasma Carnitine Concentration. European Journal of Clinical Nutrition. September 2009. 63(9), 1098-1105.