Nutritional Influences on Fertility & Supporting a Healthy Pregnancy

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The dependence of effective reproduction upon optimum nutrition

This fully scientifically referenced newsletter reviews a wide range of nutritional research that supports the sometimes controversial idea that a healthy diet, often supported with effective natural food supplements when combined deliver optimum levels of key nutrients that can be demonstrated to safely support people with fertility issues, or alternatively for pre conceptual care, or during and after pregnancy, while breast feeding and into young childhood.

Written by: Dr Lawrence G. Plaskett B.A. Ph.D., C.Chem

1. Introduction

The present author writes as the father of five. The start of each fresh pregnancy is an exciting moment to all prospective parents. The birth of each new life is unique, and we soon learn that each one will differ from ourselves in personality and maybe they will all be surprisingly different from us. What they never are is a replication of us and they never possess exactly the same foibles and peculiarities. Neither will they ever have the same ambitions, the same priorities in life. They may not want the same career, handle their partnerships in the same way or possess the same levels of temper, curiosity, courage, fear or anything else. All that we should expect or desire for our children is to grow up free and strong and able to cope and, above all, to express their own personalities as they wish to do. We do, of course, want them to have the chance to realise their own full potential. All this requires a healthy mind in a healthy body, i.e. "mens sana in corpora sano". Thinking along these lines we come to the most positive aspects. We can give our offspring the very best equipped bodies and minds for future life.All the evidence seems to suggest that the more luxurious the nutrition during the sensitive stages of the reproductive process, the more free our children will be from detrimental effects such as weakness, small size and 

susceptibility to disease. They should be freer from structural and developmental abnormality, freer from learning disabilities, freer too from emotional imbalance and mental illness. They should also be better equipped to maintain good and favourable body biochemistry throughout life and hence to enjoy both long life and high quality of life. These are the things that most parents want for their children. Yet relatively few parents have any real understanding of how crucially these much-desired attributes depend upon very good nutrition before and after conception and before and after birth. When I was running a Clinic as a Practitioner in Nutritional Medicine, the majority of the patients were people with illnesses and symptoms that they wanted to address through nutrition. However, among them there were also quite a few mothers-to-be, who usually had no symptoms, apart from signs that were normal in pregnancy. They came just to ensure that their nutrition during their pregnancy would be as optimal as possible for their growing child and for themselves. The result of giving them the very best nutrition in accord with the then current knowledge was really great.

Did you know that  the most common reason that women, between the ages of  20-45, visit their GP are issues with infertility?

First and foremost, there were no complications of any kind arising from the pregnancies and, given the numbers involved, it was very clear that this represented a considerable improvement over average expectations. Complications of pregnancy are commonplace. They range from spontaneous abortion, and so loss of the pregnancy, through the birth of abnormal or disadvantaged babies, through to actual death of the foetus as in stillbirth. It was also delightful to note that, apart from the absence of any of these potentially very bad outcomes, there was so much that was positive. Mothers tended to be happy and comfortable through their pregnancy, the actual delivery was never unduly long or traumatic in the cases I saw and the babies were particularly strong and healthy. They were bouncing babies, you might say.

We all want more. We all want for our children an abundance of energy and joy in life, a radiant health and radiant expression of their own personalities. We want them to drink deeply in the Cup of Life. There is no research that addresses that aspect, for you cannot measure these far more subtle aspects. I had to rely upon my observations.

The really happy picture, seen in so many advertisements; of the mother holding or playing with a smiling, very normal baby, was being made real. Of course, they cried as well, and my treatment never yet produced a non-crying baby, so I am afraid that has to be rated as "normal" and parents still have to endure the consequences.

What this blog sets out to show is that some degree of disadvantage will always be suffered if the nutrition of a mother is significantly below the best standards. I also want to show that this is to be expected from what we know about the nature of the reproductive process. There will be a relationship between the degree of nutritional lack and the degree of disadvantage that will result. Small deficiencies in nutrition are more likely to lead to small disadvantage, while great deficiency is associated with greater problems and more serious outcomes. Statistics play their part too, for not all mothers with a given level of nutritional deficiency will develop a given symptom or outcome. Rather, the worse the nutrition the greater the chances of mothers suffering that symptom or outcome. This is a serious topic and in my view all intending mothers should know the facts - intending fathers too for that matter.

Yet through observing of hundreds of expectant mothers through their pregnancies and watching their children afterwards, leads me to believe that energy, joy, radiant good health and positivity are likely to result from looking after both male and female nutrition to a high standard through all the phases of reproduction.

"To this day very few parents truly realise just how important a good nutritional foundation is for their unborn child and its long term physical and mental health".

2 Inherent Strengths and Weaknesses

Genetically inherited diseases will not be overcome through nutrition and we should not expect that. But where genetics are normal, excellent nutrition can greatly enhance our expectation of strong and healthy organs and body systems. We should bear in mind that each one of us enters Life with an inherited "constitution". This has been recognised by naturopaths down the centuries and in recent times it has received confirmation from the study of human genetics. Geneticists have been finding genes that confer relative vulnerability to one chronic disease or another. Possession of one of these genes does not condemn you to suffer the disease itself but does increase the chances that you will do so. In view of the successes of Nutritional Medicine in dealing with many chronic ailments, it is reasonable to expect that by following good nutritional practices in adulthood, we can greatly lessen the chances of such diseases appearing. If the genetic susceptibility is, shall we say, to rheumatoid arthritis, we may be able to take protective action to avoid the ultimate expression of that gene.  It is clear that we are all the possessors of a whole range of genetic weaknesses and strengths. These particular things cannot be changed through the nutrition of our parents and will always have to be handled later in Life.

Did you know that the subtle processes at work during foetal development are especially vulnerable to nutritional deficiencies?

3 The Theory behind the Special Need For Nutrients

Before we get into the scientifically established facts about the human needs for nutrients for reproduction, let us look first at why this phase of life is so very crucial from a nutritional standpoint. There are several a priori reasons to view the reproductive processes as being by far the most critical, the most sensitive, the most easily disturbed of all our body processes and the one that, above all others, results in the most dire consequences if not given fullest care and attention. These reasons are:

The Production and Storage of Gametes

The gametes are the eggs of the female and the sperm of the male. These are produced by a "reduction division" of the cells, by which the chromosome content of each cell is halved, ready to combine again to the normal level when fertilization takes place. The chromosomes, which are in pairs in the body cells, become only single chromosomes in the gametes. It may be that this "reduction division" or "meiosis" is more vulnerable to nutritional deficiencies than is ordinary body cell division, called "mitosis", though this is not certain. What is certain is that the DNA strands, which carry the genetic data to the next generation, will be more vulnerable to damage than is the double-stranded DNA of the body cells. This is because, in body cells, if one strand of the DNA is damaged, so altering the genetic information, the second strand acts as a back-up, which is rather like being able to back-up your computer. The information is not lost or altered when one strand is broken or damaged. When there is only one strand present, as in the gametes, there is no back-up possible and information lost or altered can be lost or altered permanently.

Moreover, in both males and females, there is storage of gametes that are ready-made, awaiting fertilization. There are also more gametes waiting to be formed. In females, the primary oocytes, some of which will form eggs, are mainly present from about 20 weeks of foetal life and so must be stored in quiescent form in the ovary until they (some of them) are released for fertilization. These are held quiescent at an intermediate stage of "reduction division". Hence the process of "oogenesis", or the production of the female gametes, takes 15 - 30 years from start to finish.

The safe storage of live but quiescent reproductive cells can be expected to be nutrient dependent in both the male and the female. So, ready-formed gametes are potentially exposed to dangers.

In the male, normally ten to thirty billion sperm are produced each month. The time taken to produce sperm is about 64 days, during which the sperm DNA must be protected, but storage will be for longer than this unless the sperm are shed at once and during this time excellent nutritional conditions, if they can be realised, are likely to offer protection.

The Vulnerability of the Gametes and of the Early Embryo
Looking closely at the literature on the reproductive process and its relationship to nutrition, one realises what a crucially vulnerable process it is. Nutritional deficiency during the reproductive process is positively linked to both total loss of the foetus and to a wide variety of birth defects. In other words, it can mess up the process really thoroughly. Moreover, it appears that what passes today as "average nutrition" may not be enough to prevent these things from happening. Advice to expectant mothers to "just eat normally" amounts to advice to continue to indulge in all the defects of the typical British diet and, as most of us now know, births in the UK are accompanied by a substantial number of birth defects, which can be dramatically reduced by luxury nutrition, a simple fact that fully exposes the vulnerability of the reproductive process.
However, it all seems to be even more crucial than that simple conclusion. Nutritional deficiency in a grandparent may well lead to the effects of nutritional deficiency in the grandchildren, showing that the results of nutritional deficiency can jump a generation. No one really knows for sure whether they can jump more than one generation, because the investigations have not been done. The research was done on the immunity function. Other work, before and since, had shown that this was particularly susceptible to impairment of function through nutritional deficiency (Fernandes et al 1079, Bach, 1981, Dardenne et al 1982, Fraker et al 2000, Kaplan et al 1988, Lesourd 1997, Prasad, 2000, Shankar & Prasad 1998).

Did you know that nutritional deficiencies in the grandparents may well lead to the effects of nutritional deficiency in their child or grandchild?

The research was done with mice, due to their short generation time. In that experiment pregnant mice were given a zinc-deficient diet. Their offspring had defective immune function, even though they and their mothers were fed a zinc-adequate diet as soon as they were born. Second and third generations of mice also had defective immune system function (although less severe), all while maintaining a zinc-adequate diet. This was the work of Beach et al 1980, 1982 and 1983. These authors comment upon the importance of their own work in the following vein: "This study has important implications for public health and human welfare, as the consequences of foetal impoverishment may persist despite generations of nutritional supplementation. Dietary supplementation beyond the levels considered adequate might allow for more rapid or complete restoration of immuno-competence".

For all of us the implication is obvious. If we allow babies to be conceived and developed in utero in disadvantageous nutritional conditions, then the effects are not going to be limited to that individual or to that individual's offspring. We cannot be at all sure that zinc is the only nutrient of which this is true. It seems more than likely that other nutrients may follow suit.

So, what are the reasons for the extreme susceptibility of the cells and tissues at the time of conception and development?  Why is the reproductive process so much more easily disrupted than the functions of adult tissues?

There seem to be three main reasons:
1. The involvement of a different kind of cell division, meiosis.
2. The fact that after conception there is very rapid cell division, far more rapid than in adult cells.
3.The vulnerability of the special processes of foetal development - those subtle influences that determine which cells form which organs and systems of the body and determine how they grow. Among other things, these controls determine whether a particular group of cells will form a leg, an arm or a liver.

To assure complete normality there seems to be a requirement for somewhat higher levels of nutrients than are customary in current diets, which leave expectant mothers with a certain measurable risk of foetal abnormality.

Did you know that the subtle processes at work during foetal development are especially vulnerable to nutritional deficiencies?

The Role of Toxins
We are all exposed to environmental toxins and to some toxins that are produced within our bodies. What we have to face up to is that the cells involved in the reproductive process are much more vulnerable to these toxins than are the cells of the adult body. This makes it more than usually important during the reproductive phases, to follow a low toxin diet, a diet that does not promote toxin formation in the body and to avoid toxin exposure from non-foods.

This was true of the drug thalidomide, which resulted in severely damaged foetuses and therefore in severely damaged people (Knightley et al 1979, Stephens et al 2001), but it did not harm non-pregnant adults. As the two references show, this drug has been re-introduced for uses unrelated to pregnancy. These uses include erythema nodosum leprosum, a cutaneous manifestation of leprosy (Burkholz 1997). It is used as a sedative-hypnotic and a medication for multiple myeloma and, because it is immunomodulatory, for HIV associated recurrent aphthous stomatitis. It is also generally anti-inflammatory.

The group of environmental toxins referred to as dioxins may be among the most worrying toxins for human health because levels of exposure can easily exceed the very low levels thought to be safe. The name is short for polychlorinated dibenzodioxins, a group of halogenated organic compounds. Members of this family have been shown to bioaccumulate in humans and wildlife due to their fat-soluble properties, and are known teratogens, mutagens and suspected human carcinogens. Note that teratogens are substances or environmental agents which cause the development of abnormal cell masses during fetal growth, resulting in physical defects in the foetus. Environmental campaigners describe dioxins as among the most dangerous poisons known. Their teratogenic effects are substantiated by the work of Peters et al (1999), Bruggeman et al (2003), Carney et al (2006) and Kransler et al (2007). This conclusion is also supported by a US National Toxicity Program Report of 2006.

Did you know that the toxins referred to as dioxins are among the most worrying environmental toxins for human health?

Dioxins arise in the environment from the manufacture of chemicals, from the incineration of chlorine-containing substances such as the plastic, polyvinyl chloride and from the bleaching of paper. There are also some natural sources such as volcanoes and forest fires. There have been many incidents of dioxin pollution resulting from industrial emissions and accidents.

Animal studies show that dioxin exposure is associated with decreased fertility and litter size and inability to carry pregnancies to term (Murray et al 1979, Allen et al 1979). Offspring have lowered testosterone levels, decreased sperm counts, birth defects, and learning disabilities (Kociba et al 1976, Schantz et al 1989). Many of these effects are seen at very low exposure levels, demonstrating the exquisite sensitivity of the developing foetus to dioxin. In one rat study, a single low maternal dose of dioxin (0.16 micrograms/kg) on day 15 of pregnancy reduced male testosterone levels, delayed descent of the testicles, made the genital area more female¬like, and reduced sperm production and prostate weight in male offspring (Mably et al 1992).

"In the U.S., a breast-feeding infant is exposed to approximately 50-60 picograms of dioxins (TEQ)/kg/day, a level considerably higher than average adult exposure levels of approximately 3 picograms/kg/day. Nursing infant exposures are at levels that cause abnormalities in animal studies. All studies of dioxin toxicity indicate that early development is the life stage of greatest sensitivity to many of its health effects. However, since many of the adverse effects of foetal or infant dioxin exposure may be apparent only much later in life, human epidemiological studies of the results of those exposures have yet to be conducted since early exposures are impossible to estimate with accuracy."

Dioxins are just one of the groups of environmental toxins giving cause for concern. The facts show that it really is important to avoid toxin exposure as far as humanly possible during all stages of the reproductive process. It is also strongly indicated to apply detoxification procedures prior to conception. These would not ideally be the type of intensive programme that lasts a week or two, but a thoroughgoing programme over 6 to 12 months, since the body needs time to significantly reduce its toxic burden.

"Breast-fed infants in the USA are exposed to dioxin levels that cause abnormalities in animals".

Whether or not that is done, all mothers will start pregnancy with toxins still remaining in the body. The best way in which one can diminish the effects of residual toxins is to ensure that nutrient intake is at a luxury level. The nutrients do exert real protective effects. In some cases there is a specific relationship between one toxin and one nutrient. One such example is the ability of indole-3-carbinol to counteract the toxicity of dioxin. One might tackle this by eating a lot of broccoli or cabbage or by using a supplement. Equally, heavy metal toxicity can be reduced with supplementary nutrients such as Vitamins C, E, and A; alpha-lipoic acid; glutathione, and selenium and zinc, cysteine, N-acetyl-cysteine (NAC), MSM (methylsulfonylmethane), glycine, Vitamin B12, and Vitamin B6 and S-adenosylmethionine. A basic mixture of Vitamins C and E with zinc and selenium and cysteine can be very helpful. Some of the other specialized nutrients can be quite expensive. One does not need all of these to achieve this effect. Some prefer to use herbal preparations that include dandelion root, yellow dock root, sarsparilla root, echinacea, licorice root, garlic, green tea, alfalfa, silymarin. Some of the herbs are rather more general detoxifiers.

The final example I shall cite of toxicity in pregnancy relates to smoking. Smoking contributes a very wide range of toxins to the body. These include polycyclic aromatic hydrocarbons such as benzanthracene and benzpyrene, heterocyclic compounds such as quinoline, dibenzacridine and furan, N-nitrosamines such as N-nitrosodiethylamine and N-nitrosodimethylamine, aromatic amines such as 2-naphthylamine and 4-aminobiphenyl, N-heterocyclic amines and many other miscellaneous compounds such as nitrogen oxides, hydrazine, hydrogen cyanide and hydrogen sulphide. These comprise a very potent toxic cocktail. The resulting risks that arise during the pregnancy are:

• Having an ectopic pregnancy
• Having a miscarriage
• Having the placenta attach too far down in the uterus/detaching before the baby is born
• Having a premature baby
• Low birth weight babies. These babies are much more likely to have problems, some serious and life-threatening, as infants

In addition, children born to mothers who smoke are more at risk of:
• Cot death
• Glue-ear (middle ear infection)
• Asthma
• Behavioural problems
• Retarded mental development

Obviously, then, all mothers should be encouraged strongly to avoid smoking at all through any of the reproductive phases, since any smoking involves risk of damage. Smoking by fathers is also important, since the habit will result in mother and baby experiencing passive smoking. There is an association between passive smoking and loss of the foetus (Venners et al 2004, Blackburn 2005). This could be due to the mother receiving toxicity or from damage to the quality of the father's sperm. Most probably luxury nutrients will provide some level of protection against the effects of smoking, but then it makes no sense to detoxify and re-toxify at the same time and smoking should certainly be avoided.

Therefore, the following picture emerges. In all phases of reproduction shortage of nutrients, even a modest shortage, can be a hazard to development of a healthy foetus and a healthy baby. This level of hazard can be much increased by the simultaneous presence of toxins in the body. The worse the level of toxins, the more of a hazard they represent. Some individual toxins present in high doses, will represent a large hazard on their own, the sheer high dosage being only partially combated by nutrients. More often, it seems, the toxic levels may be sub-clinical for most individual toxins, but the simultaneous presence of several toxins in low amount may exert mutually synergistic effects, and taken together, such toxins can represent a significant hazard. However, this kind of combined toxicity from general environmental sources may be counteracted very significantly by fully adequate nutrition or, even better, by luxury nutrition.

We should view either nutrient shortage or toxin contamination to be primary hazard to the foetus and to the reproductive process. On the other hand we can view nutrients as having a protective function. Therefore, the exact level of hazard for the foetus will be a function of the balance between the toxic levels and the nutrient levels. The lower the former and the higher the latter, the more secure is our position.

Did you know that cigarette smoke entrains a dangerous cocktail of toxins that may badly damage our natural reproductive processes?

4. Outcomes of Nutrient Deficiency & The Power Of Nutrition

The Foresight organisation, makes the statement that one out of six couples is infertile, one in four pregnancies end in miscarriage, one baby among 17 is malformed and one child in four has learning difficulties. They further make the claim that by applying proper nutrition and lifestyle corrections 78.4% of the previously infertile couples have healthy babies compared to the mere 22.6% success rate of IVF.  By specifying "healthy babies" we exclude those with birth defects and those pregnancies that end in stillbirths. The fact that more than 75% of infertility cases can be solved nutritionally is very impressive. Apparently, based upon the above data, only some 21.6% of cases suffer infertility for a deeper reason. For these figures to be attained the fathers need to participate, since male infertility may be the whole or part of the problem through low sperm count, sperm immobility or sperm deformity. Note that the 78.4% success rate found with infertile couples compares with the 22.6% success rate with IVF (fertilization outside of the body). However, the use of nutrition also increases the IVF success rate further.

Furthermore, with these nutritional and lifestyle measures only 3.5% of pregnancies result in miscarriages instead of 25% (a reduction of 86% in miscarriages) and only 0.47% of babies are malformed instead of 6%, a reduction in malformations of 92.2%. Prematurity drops from 6% to 1.3%. In view of the hazards associated with prematurity, especially central nervous system disorders and mental problems, one should note that none of the premature babies whose mothers were treated nutritionally suffered any permanent effects. All of the above can be seen in the website reference to Foresight. These outcomes were corroborated by a study on "Preconception Care and the Outcome of Pregnancy" undertaken by the University of Surrey (Ward 1995).

In the above work we are told only about the total numbers of abnormalities. These will include a good many well-known types such as limb abnormalities (dysmelia), neural tube defects like spina bifida and anencephaly and heart defects, cleft lip and palate and clubfoot. It is recognised in orthodox circles that dietary deficiencies are among the causes, along with both toxins and infections. Orthodox nutrition is aware of some individual connections, such as the link between spina bifida and folic acid deficiency and the connection between alcohol, mercury and the drug phenytoin and some recognizable combinations of birth defects. What is not really recognised or understood in orthodox circles is the connection between multiple suboptimal deficiencies and incidence of birth defects. What I have done here is to accept the University of Surrey/Foresight evidence regarding the incidence of birth defects overall and the response to a combined protocol of nutrition and lifestyle factors.

There are many case where mixed toxins synergise, i.e. increase each other actions within the body.  

The fact that infertility, miscarriages, birth defects and pre-maturity are so dramatically responsive to nutritional and naturopathic care, is extraordinarily impressive. The results raise the question of what sort of a society we live in that can have such clear evidence laid before it and then virtually fail to respond. The slight personal inconvenience of the care measures should be as nothing to the extra degree of security in producing a healthy baby. The publication of the University of Surrey study (Ward 1995) had invoked some hostile orthodox criticism (just as if orthodoxy doesn't want nutrition to improve the outcome of pregnancy) but no concrete action in terms of either widespread application of the results or for further confirmatory studies. This work definitively needs a positive response. For scientists and medical people to bury their heads in the sand and wish that the subject would go away is a very non-scientific and, indeed, biased response. The adverse orthodox criticism comes from the NHS Centre for Reviews and Dissemination, based at the University of York. Criticism was made on the basis of no controls in the study. However, they missed the point that the whole of the rest of the UK population, on which there are good statistics, acts as the control. 

However, of course, the negative effects of poor preconceptual care, pregnancy care and precautions during lactation, do not end here. The baby may be of low birth weight, or, even when the baby is born apparently normal in every way, there may be effects that will show up afterwards and affect the lives of the baby and his or her parents. Among the more immediate effects of deficiencies and toxicities, the mother may suffer from post-natal depression and mother and child may experience breastfeeding difficulties. Moreover, at any time from, say 0-10 years, the child may suffer from poor resistance to infection, handicap, including learning problems, hyperactivity, eczema and/or asthma. The Foresight literature indicates that the nutritional and naturopathic programme can offer protection against all of these.
The research published does not clearly distinguish between extra nutrition and naturopathic protection offered in preconception as compared to the same offered during pregnancy. To a large extent it's a matter of common sense that the preconceptual care must help, since it is essential for the body to have time in which to adjust to the new conditions being applied. The effect cannot be instant.

Note too that all the available evidence concerns the avoidance of disasters to the foetus. I found none that address the question of the baby reaching higher-than-average levels of health or of responsiveness or alertness or intelligence. We do not know whether the babies that receive the extra care behave better at school, have more friends or go to University in greater numbers. It would be good to know these things. These favourable things might well happen but we would not know it.

5. The Official Advice of Government Backed Committees

In the UK the Report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy has produced recommendations for vitamin and mineral intakes during pregnancy. They have not provided any recommendation for preconceptual care, which they appear not to recognise.

You will be able to note that the Government- backed Committee only offers any extra recommendation in pregnancy compared to the non-pregnant condition in the cases of Vitamin A, riboflavin, folate and Vitamins C and D. All the other listed nutrients are kept just as normal during pregnancy.

The huge importance of supplying these essential nutrients is emphasised by studies that show that intake of micronutrients has been related to various measures of mental performance, including performance in intelligence tests, hyperactivity and deficiency has even been related to criminality (Schauss, 1981).

Now please look at the fourth column, which provides the amounts of these same nutrients as they are offered in the programme of the Foresight organisation. I insert a caveat here because in practice these prescriptions of supplement levels are done on a somewhat individual basis. Taking mean levels where given and making the best estimates of the levels of each supplement most likely to be given, gives the figures in the column. Note that in most cases these are above, sometimes vastly above, the figures suggested by the learned Committee. The most extreme case of this is with Vitamin B12, which is offered by Foresight at a level some 33 times the official Committee's level.

I think that readers should take note of that, i.e. that such generous levels of supplements are being used and that the results with the newborn babies are so good. In this age, when the orthodoxy are, it seems, always seeking to denigrate supplements and to suggest that they are unsafe, no baby involved in the trial seems to have suffered anything adverse, only the relief from adverse conditions that would have been likely to happen otherwise.

Did you know that the main government- backed committee on this topic suggests increased intakes of only a very few nutrients during pregnancy and hardly addresses pre-conceptual care?

6. Suggested Levels of Supplementary Vitamin & Mineral Supplements  In Preconceptual Care, Pregnancy & Lactation 

Some of the levels of supplement intake that have been used are very high and although reports show that only benefit seems to have resulted, the cost of such major amounts is significant. The Table that follows gives a more "middle of the road" idea of supplementation levels to use that would seem to meet all known requirements for the particular nutrients plus a safety margin. There have been no trials of these levels, but, taken as a group, they tend to fall between the official Committee's guidelines and the higher levels that appear in the literature. There are no guarantees of particular outcomes here. Nor do these figures represent treatment for any particular person. They are for information only. There is expectation, however, that such levels would improve the outcomes of pregnancy, over and above current experience. The assumption is made here that the prospective parent exhibits no contra-indications for using the supplements listed. If in doubt the best way to be sure is through the advice of a qualified practitioner. In most cases the levels listed cover a range. 

Did you know that pregnant or lactating mothers need to ensure that their own intake of DHA reaches 300mg/daily, so as to ensure that the breast milk contains enough of this important nutrient for the child's healthy development?

7 The Need for Oils

Both Omega-6 and Omega-3 oils (essential fatty acids) are very important in pregnancy. It has been estimated that there are some 8,000 published studies showing health benefits from maintaining at least an adequate status in the essential fatty acids. Most of these benefits are not directly related to pregnancy. Clearly, though, we wish expectant mothers to be in the best general health possible and they are well advised to use Omega oils, especially Omega-3 oils, since the Omega-6 are usually well provided in UK diets. However, there are special and additional reasons for providing the Omega-3 oils in all phases of reproduction. The long-chain fatty acid DHA (docosahexaenoic acid), with 22 carbons in the chain, appears to play an essential role in the development of the foetal brain and eyes (Hornstra, 2000, Jensen, et al, 2005). The only way the foetus can obtain this is from the mother's blood stream through the placenta and the worry is that Western lifestyles very often go with an inadequate maternal intake of DHA (Denomme et al 2005). Although DHA may be formed in the human body from 18-carbon alpha-linolenic acid (as present in vegetable sources such as flaxseed) or from the 20-carbon EPA of fish oil, the conversion to DHA may be inefficient and sluggish in people with a compromised metabolism. So flaxseed supplementation is not always sufficient as the only source of Omega-3 in pregnancy. Fish oils from marine fish (use oils from the body of the fish, not from the fish liver) contain both EPA and DHA. Specific supplementation with DHA or with fish oil increases maternal levels of DHA (Connor 1996) and has produced benefits (Smuts 2003). During lactation, increasing maternal intake of DHA with dietary supplements improves maternal, breast milk and infant DHA levels (Makrides et al 1996, Gibson et al 1997, Jensen et al 2000).

Did you know that in a university analysis of luxury nutrition for pre conceptual care showed congenital abnormalities reduced by 92%?

Eating a healthy, balanced diet during pregnancy and lactation is very important for mother and baby. On average, Western diets (especially American diets) are low in long-chain polyunsaturated fatty acids, including DHA. The daily DHA intake of pregnant or lactating American women averages 60-80mg, which is only 20-25% of the 300mg/day recommended by at least one expert body (Benisek, D., et al., 2000, Simopoulos, A.P, et al 1999). It is therefore essential that pregnant and lactating mothers increase their dietary intake of DHA in order to provide an adequate supply of this fatty acid to their infants.

This implies that expectant mothers need to consume enough fish or fish oil to give the suggested 300mg of DHA per day in addition to the minerals and vitamins listed in the above Table. There is an algal DHA available to those who are vegetarian and object to eating the fish or fish oil.

8 Diet for the Expectant Mother

The diet for the expectant mother should exclude the major errors of the UK diet but it does not have to be a fully naturopathic "treatment" diet to the highest degree. Assuming that the mother-to- be has no special dietary requirements to start with, only some simple rules need be followed, that will allow a wide range of foods to be used. Whole organic grain products should be used, not refined flour products, so as to maximize fibre and nutrients. This applies to all foods based upon grains, not just bread. Whole-wheat bread, scones, cakes and biscuits can be made with this flour, though some organic bread may be bought. 

Rice, millet, corn, potato, soya, sago and buckwheat flour can all be used, but one's objective should be to exclude sugar and to keep the fat content down. White flour products should be avoided, such as white buns, cakes, scones, biscuits, pasta, some of which are likely to contain sugar. Sago, tapioca and cornflour may be used.

Fresh vegetables and fresh fruits (not canned or frozen) should be eaten at levels well above the UK average for their content of fibre and phytonutrients. These items should be a major component of the diet. Good fresh potatoes should be used.

All meats and fish should also be fresh, never tinned and never "made up" products like sausages, burgers, pates or faggots, but it will be best to eat more fish than the UK average and less meat than average (dioxins concentrate in meats). Indeed, up to 50% of animal-derived foods can be replaced with protein-rich plant foods such as lentils, chickpeas, kidney beans other de-shucked peas and beans. It is not necessary to be vegetarian if that is not your wish. Frying of the common kind is not advised due to the production of damaged, oxidized fats at high temperature, although a quick stir-fry of vegetables is certainly permissible. Use some eggs if you wish from the best free-range or organic sources. Naturopaths commonly advise against dairy products on stricter versions of a pregnancy diet, though some will accept unpasteurised goat's milk from healthy TT accredited herds. If you want to use dairy products anyway, use only fresh whole milk, butter, cheese, cream and yoghurt. Avoid using unnecessary salt, since sodium is rather high in most UK diets, and it is especially high in a wide range of processed food items. Avoid liver, since its Vitamin A content can be too high. Avoid all foods considered as "junk" foods, avoid food additives where possible and avoid foods that are known allergens for the mother.

9 Non-Nutritional Lifestyle Factors

A naturopathic lifestyle is implicit in the whole philosophy behind the nutritional approach to the various stages of reproduction. That is because nutrients and toxins together just do not make sense of any kind. Clearly no one should smoke at any of the stages of reproduction as it is accompanied by such negative consequences. Alcohol is very strongly contraindicated too and adverse effects are clearly seen at 18 to 20 units of alcohol per week (Ulleland 1972, Abel & Sokol 1987). These include babies of low birth-weight that are more than normally likely to suffer illness in the immediate post-delivery period. There is also "foetal alcohol syndrome", characterized by restriction of the foetal growth-rate, neurological abnormalities, developmental delay, intellectual impairment and facial deformities. There may be infant irritability and hyperactivity, later on, intellectual impairment. Due to these factors, the best advice for an expectant mother is to avoid alcohol altogether, since it is not clear that there is any threshold for the negative effects to start as alcohol consumption rises.

There are also many hazards from drugs in pregnancy. Most are not known to cause birth defects but they do increase the levels of "xenobiotics" (foreign substances) in the body. It is obvious for expectant mothers to exclude street drugs, but prescription drugs should also be avoided wherever this is possible and safe, so the doctor should be consulted about their use. But some will want to apply higher standards of toxin avoidance than most doctors are used to. Be sure, though, to use the medicines if truly needed. Those who normally use natural medicines (especially homoeopathic) will probably wish to continue doing so long as they are effective and no over-riding medical problems arise. Other forms of toxin are to be avoided by using filtered drinking and cooking water and avoiding exposure wherever possible to household or garden chemicals.

10 Distinctions between Preconception, Pregnancy & Lactation

For the most part the same programme of diet, supplements and naturopathic living may be applied throughout preconceptual care, pregnancy and lactation. Much the same conditions apply for the foods, nutrients and avoidance of toxins at all these stages. During the preconceptual stage the mother's body does not yet have to supply extra iron or calcium to build up stores of these within a foetus. Nonetheless it is just as well to build up the mother's status in these elements. There is no direct and immediate need to supply DHA (docosahexaenoic acid) while there is no foetus present, but the use of the fish oil is still favourable during preconception.

During lactation there is a very large need to supply calcium and Vitamin A. In the case of calcium the Government Committee recommends 550mg/day above the RNI, a large amount. So the supplementary calcium suggested in the Table above does need to be increased to this level, which is a total of around 1150mg/day inclusive of the likely dietary contribution, which is not exactly known. The suggestion here is to take 500-600mg/day of supplementary calcium during lactation, preferably supplied as the citrate, together with raising the total Vitamin A intake to 950mcg/day. Of course, a high Vitamin A diet may well supply the implied requirement for 350mcg above the RNI level. At this stage of lactation, however, it may be far safer, since the dietary contribution is not known, to take a low-level Vitamin A supplement to make sure, so long as any further immediate pregnancy is excluded. In the same way, use of a Vitamin A supplement of, say 1000mcg/day can be considered safe during preconception, to build up a mother's reserves of the vitamin, but in that case it should be removed a month before conception occurs. There has been much published recently about the negative effects of Vitamin A in pregnancy. But this has only been found at higher levels of intake, often said to be 10,000 International Units or (3,300mcg of retinol) and one should also remember that shortage of Vitamin A in pregnancy could cause birth defects, making it imperative to supply sufficient. It is possible that current literature stresses avoidance of the vitamin too strongly and minimizes the danger of deficiency.

The Government Committee recommendations provide for increases in lactation also for riboflavin, niacin, Vitamin C, magnesium, zinc, copper, selenium and Vitamin B12. These make good sense. However, these extra requirements will in general be at least met by the nutrient intake suggestions given above in conjunction with a suitably diverse diet.


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