Diet changes helpful for pregnancy diabetes
CBC News Last Updated: Wednesday, September 30, 2009 | 6:54 PM ET
Treating mild diabetes that develops during pregnancy helps prevent serious problems that can occur when an infant gains too much weight, a new U.S. study suggests.
Women with gestational diabetes — temporarily high blood sugar levels during pregnancy — have a higher risk of cardiovascular disease than the general population.
The condition can also cause the fetus to grow too large and require delivery by caesarean section. Such children are at greater risk of becoming obese when young and developing Type 2 diabetes as adults.
About four per cent of pregnant women in the United States develop gestational diabetes, resulting in about 135,000 cases a year, said Dr. John Thorp, the study’s author and a professor of obstetrics and gynecology at the University of North Carolina at Chapel Hill.
In a study of 958 women that appears in Thursday’s issue of the New England Journal of Medicine, researchers found that, compared to women with untreated diabetes, those treated for mild gestational diabetes had:
· Fewer babies that were overly large (7.1 per cent versus 14.5 per cent). · Fewer cesarean sections (26.9 per cent versus 33.8 per cent). · Less shoulder damage during birth (1.5 per cent versus 4.0 per cent).
“There is every reason to fully treat women with even the mildest [gestational diabetes] based on our results,” said the study’s leader, Dr. Mark Landon of Ohio State University Medical Center in Columbus.
The study started with women who were between 24 and 31 weeks pregnant. They were randomly assigned, with 485 women receiving treatment, including dietary changes, blood-glucose monitoring and insulin, if necessary, and 473 getting no treatment.
There were no deaths in either group, and no difference in other birth-related complications.
Excess weight gain minimized
Of those in the treatment group, 93 per cent were able to keep their blood sugar under control through diet alone. The other seven per cent needed insulin.
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Read Full Post | Make a Comment ( None so far )Breastfed score higher in IQ testing
Breastfed score higher in IQ testing
Sharon Kirkey, Canwest News Service
Published: Tuesday, May 06, 2008
Canadian study in Belarus
In the largest study of its kind, Canadian researchers following nearly 14,000 Belarusian children are reporting that those who were exclusively breastfed longer score higher on IQ tests and in academic performance in reading and writing.
This is not the first study linking breastfeeding to an IQ advantage, but many observers have not been so convinced. That is because it has been impossible in the past to separate out how much of the difference was due to breastfeeding, and how much to differences in the mothers and the way they interact with their babies.
The Montreal team believes its study, the largest randomized trial ever conducted in the area of human lactation, offers the strongest evidence yet that it is cause-and-effect — in other words, “that prolonged and exclusive breastfeeding makes kids smarter,” said lead investigator Dr. Michael Kramer.
“We still don’t know if it’s something in the milk, a hormone or protein or something that’s not in formula or cow’s milk,” said Dr. Kramer, a professor of pediatrics and epidemiology and biostatistics at McGill University. “Or whether it’s just the physical contact between mother and baby, or the kind of exchanges that occur, emotional or verbal even, during the act of breastfeeding that don’t occur in formula feeding” that might lead to permanent changes affecting brain development.
“I’d like to hope that it’s something in the physical contact rather than in something that the formula manufacturers can manage to put in a bottle. But there’s no evidence for that.”
Despite the findings, Dr. Kramer said, “There are lots of ways you can improve your child’s health and intellectual development. I wouldn’t bet a lot of money that breastfeeding was more important than reading and playing with your kid.”
Psychologist Alan Leschied said the differences in IQ scores were meaningful but not large, and that a standard IQ score “is a pretty solitary thing.”
“It doesn’t accurately predict things like academic achievement, not necessarily. It doesn’t predict vocational success. So you don’t want to overstate wh at IQ scores actually mean,” said Dr. Leschied, psychologist and professor in the faculty of education at the University of Western Ontario in London, Ont.
One of the study’s strengths is its size, “and I think we cannot get much better in terms of methodology,” said Dr. Valerie Marchand, a pediatric gastroenterologist at St. Justine Hospital in Montreal and chair of the Canadian Paediatric Society’s nutrition committee.
The study appears in the most recent issue of Archives of General Psychiatry. Until now, human lactation studies have been hampered by the fact researchers cannot randomly assign women to breastfeeding versus formula feeding. “It’s not ethical or feasible to say, you breastfeed and you don’t,” Dr. Kramer said.
So he and his colleagues evaluated the children in 31 Belarusian hospitals and clinics. Half the mothers were exposed to an intervention that encouraged prolonged and exclusive breastfeeding. The other half had the usual maternity and pediatric care.
A total of 7,108 babies and mothers who visited facilities promoting breastfeeding and 6,781 infants and mothers who visited the “control” hospitals were followed up between 2002 and 2005. Both groups of women were similar in age, socioeconomic status, education, number of other children at home, whether they smoked during pregnancy, birthweight and other factors.
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Read Full Post | Make a Comment ( None so far )Babies of heavy mothers have more fat, less muscle
Babies of heavy mothers have more fat, less muscle
Anne Harding, Reuters
NEW YORK (Reuters Health) – Babies born to overweight or obese women have more fat and less muscle than infants born to normal-weight moms, according to one of the first studies to compare newborns’ body composition to their mothers’ pre-pregnancy body mass index (BMI).
Obesity is on the rise among pregnant women, while more and more North American and European infants weigh 4,000 grams (8 pounds 13 ounces) or more at birth, Dr. David A. Fields of the University of Oklahoma Health Sciences Center in Oklahoma and colleagues Fields and his team note in their report in American Journal of Obstetrics & Gynecology. These unusually heavy infants are more likely to grow up to be obese.
Body weight alone, however, doesn’t provide a clear picture of infant growth and health, the researchers add; both low and high birth weight have been tied to an increased risk of diabetes and other conditions in adulthood.
To better understand how prenatal growth might influence future health, Fields and his team used the PEA POD, a “body composition system” made by Concord, California-based Life Measurement Instruments, to measure the percentage of body fat, fat-free body mass, and total fat mass in 72 babies no older than 35 days.
There was no difference in average birthweight between babies born to women with normal BMIs and those whose mothers were overweight or obese.
However, infants of the 39 overweight or obese moms had significantly higher percentages of body fat (13.6 vs. 12.5 percent), higher fat mass (448.3 grams vs. 414.1 grams), and lower fat-free mass (3,162.2 grams vs. 3,310.5 grams) than the babies born to the 33 normal-weight women, Fields and his team found.
Babies born to heavy mothers may face a greater risk of diabetes because they have less muscle mass, Fields noted in an interview. “That could be reason why these kids, probably many of them, will get diabetes, because muscle is your largest consumer of sugar,” he said.
“It’s been very, very difficult to measure the body fat in the baby,” Fields noted. Previously, doing so required using several different machines and took hours. The PEA POD can gauge body composition in five minutes, according to Life Measurement Instruments’ Web site.
The machine is expensive, Fields noted, estimating that just 15 are in use worldwide. Nevertheless, he predicted that more and more hospitals will begin using them.
Gauging babies’ body composition at birth could provide a clearer picture of their health than weight alone, Fields added, but then the question remains as to what should be done if babies are found to have a high percentage of body fat. One possibility, Fields said, would be to encourage their mothers to breastfeed. His own research has demonstrated that formula-fed babies tend to be fatter.
SOURCE: American Journal of Obstetrics & Gynecology, April 2008.
© Reuters 2008
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Read Full Post | Make a Comment ( None so far )A pregnant approach to fitness
A pregnant approach to fitness
Exercise intensity depends on state of mother-to-be
Dr. Tim Rindlisbacher, National Post
Published: Tuesday, April 29, 2008
Alexander Drozdov, AFP, Getty ImagesPregnant women should start slow and gradually increase the duration and frequency of their exercise routine.
When an expectant mother is preparing to bring a new life into the world, it’s natural that she’ll want to improve her own. The brief nine months of pregnancy are physiologically unique, and a concern for the well-being of the developing child often leads to some major lifestyle changes. Quitting smoking is a terrific one. As well, regular exercise moves to the front burner (if not already there), and safety-related questions begin to fly about doctors’ offices.
This month, the Canadian Academy of Sport Medicine, the sports medicine physician group of Canada, released their formal position statement on the matter of exercise and pregnancy. High-risk pregnancy and exercise just don’t mix. The PARmed-X for Pregnancy tool (www.csep.ca) is useful for defining exercise parameters for women who were regularly active before becoming pregnant. In general, if you exercised regularly prior to hearing the great news then you may continue to a maximum of 30 to 40 minutes three to four times per week as tolerated. If, however, this life change motivates you to start an exercise program, it’s best to wait until your first three months of pregnancy passes. Common sense and scientific evidence suggest that you begin gradually with respect to the duration, frequency, intensity and type of exercise program. Newbies should start with 15 minute bouts three times per week. Both aerobic and strength-training exercises are allowed during pregnancy. Less strenuous forms like stationary biking, brisk walking and swimming are recommended. After the fourth month of pregnancy, women should not exercise while lying on their backs. Exercising in this position or breath-holding during weight-training negatively impacts maternal and fetal blood flow.
If you’re a persistently pulse-palpating person, don’t trust this parameter. It’s not a reliable gauge of exercise intensity during pregnancy. The “talk test” is recommended. If you can carry on a conversation then you’re within the safe zone of intensity. And don’t forget, while pregnant you’ll always have a conversation partner very nearby. Maybe you can start talking your baby into staying active … long after the cord has been cut. – For all the safety tips pertaining to your specific pregnancy visitwww.casm-acms.org. Dr. Tim Rindlisbacher, BSc (PT), MD, diploma in sport medicine, is director of sports health at the Cleveland Clinic in Toronto.
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Read Full Post | Make a Comment ( 1 so far )Study: Diabetes Pre-Pregnancy Rises
Study: Diabetes Pre-Pregnancy Rises
AP/Alicia Chang
Monday, Apr. 28, 2008
(LOS ANGELES) — The number of pregnant women with pre-existing diabetes has more than doubled in seven years, a California study found, a troubling trend that means health risks for both mothers and newborns.
And the number of diabetic teenagers giving birth grew fivefold during the same period, according to the study, the largest of its kind.
Expectant mothers who don’t control their diabetes face an increased risk of miscarriage and stillbirth. Their babies have a higher chance of being born with birth defects.
“These are high-risk pregnancies,” said Dr. Florence Brown, an expert on pregnancy and diabetes. “All women with pre-existing diabetes need to plan their pregnancies.”
Brown is co-director of the Joslin-Beth Israel Deaconess Medical Center diabetes and pregnancy program in Boston. She had no role in the study, which was done by researchers at Kaiser Permanente, a California-based health care provider.
The researchers focused on health records from more than 175,000 ethnically diverse women who gave birth in a dozen Kaiser hospitals in Southern California from 1999 to 2005. Experts believe the findings likely reflect the overall U.S. population.
The actual number of pregnant women with pre-existing diabetes was small. In 1999, there were 245 such women; by 2005, there were 537. That translates to a rate that rose from 8 per 1,000 pregnancies to 18 per 1,000.
The rate increased the greatest among 13- to 19-year-olds giving birth. It ballooned from about 1 per 1,000 pregnancies to 5.5 per 1,000 during the seven-year period.
Blacks, Asians and Hispanics were more likely to have diabetes before pregnancy than whites.
The rise of diabetes among women of childbearing age mirrors the prevalence of the disease in the general population. The most common form of diabetes is Type 2, which is linked to obesity.
About 15 million people in the United States are diagnosed with diabetes, and 1.5 million new cases were diagnosed in people age 20 and older in 2005, according to the American Diabetes Association.
Pre-pregnancy diabetes is different from gestational diabetes, which is developed during pregnancy and disappears later. Gestational diabetes affects 3 percent to 8 percent of pregnant women in the U.S.
In the study, Kaiser researchers did not look at whether any of the women had prenatal diabetes care or how the babies fared after birth. They also could not determine the type of diabetes the women had.
Type 2, which is linked to obesity, occurs when the body makes too little insulin or cannot use what it does produce. Type 1 occurs when the body doesn’t produce insulin.
Results of the study were published online Monday in the journal Diabetes Care, a publication of American Diabetes Association, which funded the research.
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Chocolate may reduce pregnancy complication risk
Chocolate may reduce pregnancy complication risk
Thomas Reuters
Published: Monday, April 28, 2008
NEW YORK — Indulging in chocolate during pregnancy could help ward off a serious complication known as preeclampsia, new research suggests.
Chocolate, especially dark chocolate, is rich in a chemical called theobromine, which stimulates the heart, relaxes smooth muscle and dilates blood vessels, and has been used to treat chest pain, high blood pressure, and hardening of the arteries, Dr. Elizabeth W. Triche of Yale University in New Haven, Connecticut and colleagues write.
Preeclampsia, in which blood pressure spikes during pregnancy while excess protein is released into the urine, has many features in common with heart disease, the researchers add.
To investigate whether chocolate’s possible cardiovascular benefits also might help prevent preeclampsia, the researchers looked at 2,291 women who delivered a single infant, and asked them about how much chocolate they consumed in their first and third trimesters. The researchers also tested levels of theobromine in infants’ umbilical cord blood.
Women who consumed the most chocolate and those whose infants had the highest concentration of theobromine in their cord blood were the least likely to develop preeclampsia. Women in the highest quarter for cord blood theobromine were 69% less likely to develop the complication than those in the lowest quarter.
Women who ate five or more servings of chocolate each week in their third trimester of pregnancy were 40% less likely to develop preeclampsia than those who ate chocolate less than once a week.
A similar, but weaker, relationship between chocolate consumption and preeclampsia risk was seen in the first trimester, with women eating five or more servings of chocolate each week at 19% lower risk than those who ate chocolate less than once a week.
Theobromine could improve circulation within the placenta while blocking oxidative stress, or it could also be a stand-in for other beneficial chemicals found in chocolate, Triche and her team note in the May issue of Epidemiology.
“Our results raise the possibility that chocolate consumption by pregnant women may reduce the occurrence of preeclampsia,” they write. “Because of the importance of preeclampsia as a major complication of pregnancy, replication of these results in other large prospective studies with a detailed assessment of chocolate consumption is warranted.”
© Thomson Reuters 2008
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Read Full Post | Make a Comment ( None so far )Caffeine and Pregnancy: How Risky?
A pregnant woman sips coffee at the office.
Daniel Berehulak / Getty
Several studies suggest a link between caffeine consumption and risk of miscarriage. But the cause and effect has never been clear: does caffeine increase a woman’s risk of miscarrying, or do women who are already at low risk for miscarriage tend not to drink caffeine? (To wit: morning sickness, which is a sign of a healthy pregnancy, hardly makes you crave a cup of Joe.) At Kaiser Permanente Northern California’s Division of Research, reproductive and perinatal epidemiologist Dr. De-Kun Li wanted to parse the association. He and colleagues recruited 1,063 women in early pregnancy, quizzed them about their caffeine intake and followed them to the end of their pregnancies. The researchers also checked to see, crucially, whether women had altered their caffeine-drinking habits after becoming pregnant – that way, scientists were able to control for the effect of morning sickness.
Q: How much caffeine is safe to drink during pregnancy?
A: What we found is that for women whose caffeine intake was more than 200 mg every day, the risk of miscarriage was double compared with women who did not have any caffeine during pregnancy. For those who consumed more than 200 mg a day, their miscarriage rate was about 25%. Below 200 mg, we also saw a slight increase in risk, [but] we were not able to make a more definitive assessment. Generally speaking, though, for [risks due to] environmental exposure in the context of miscarriage, there is rarely a threshold effect. Usually, the higher the dose, the bigger the effect.
I would think, given this study finding and other study findings before, the first choice for women should probably be to stop drinking caffeine entirely – at least for the first three to four months of pregnancy. But if you really have to drink, I think you should limit yourself to one regular coffee a day or less. Two hundred mg of caffeine is roughly about one-and-a-half to two [8 oz] cups of regular coffee. [In our study], most of the caffeine came from regular coffee. [It’s also found in tea, hot chocolate and soda.] [If you drink] regular soda, 200 mg is roughly equivalent to five 12 oz cans.
There are two mechanisms that have been hypothesized up to this point, linking caffeine to miscarriage. First, we know that caffeine can directly, easily cross the placental barrier. While adults can usually metabolize caffeine, a fetus usually can’t, particularly in the early stages of development. So caffeine has a direct effect on cells, membranes and tissues. Those kinds of things for adults are OK. That’s why we actually drink caffeine – because it interacts with our cell receptors. But for a fetus, particularly at the early stages of development, it may interfere with development.
Second, it’s been known for a long time that high doses of caffeine can have a vaso-constrictive effect [in adults], which means it can make blood vessels contract. If the effect is severe in the mother, hypothetically it can reduce blood flow to the placenta and to the fetus. It’s totally possible that [caffeine could have an impact in later pregnancy as well]. There could be other [associated] outcomes, like low birth weight, preterm delivery, even birth defects, or [problems with] neurological development. Those are all biologically plausible effects. It’s just that we haven’t demonstrated them. They’re harder to study.
The message here is probably the less, the better. I would think if you wanted to be safe, you should probably cut down or even stop caffeine-drinking throughout pregnancy.
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Read Full Post | Make a Comment ( None so far )Breast-fed babies OK for iron in first six months
Breast-fed babies OK for iron in first six months
Thomas Reuters
Published: Thursday, March 27, 2008
Full-term babies who are exclusively breast-fed are not at heightened risk of low iron stores by the age of six months, even if their mothers were iron-deficient during pregnancy, a new study shows. The findings, published online in the International Breastfeeding Journal, support experts’ belief that breast milk alone provides most infants with adequate nutrition for the first six months of life. Breast milk is low in iron, but infants can absorb it much more easily than they absorb the iron in fortified formula. In general, it’s recommended that breast-fed babies start on iron-fortified foods, like infant cereal, at about six months. The researchers, led by Dr. Shashi Raj of the University College of Medical Sciences in Delhi, conclude that there is no need to add iron-rich foods or iron drops to the diets of exclusively breast-fed full-term infants before the age of 6 months.
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Maternity Cares 