Omega-3 Overview and Book Review of "Queen of Fats" by Susan Allport

You can’t swing a dead fish these days without hearing about its good fats. The term “omega-3” is now well known throughout the world of nutrition, but this wasn’t always so. Science writer Susan Allport accomplishes the task of chronicling the discovery and rise to stardom of omega-3 oils in The Queen of Fats: Why Omega-3s Were Removed from the Western Diet and What We can Do About Them.

Omega-3s, specifically long-chain omega-3s DHA and EPA found naturally in fish, have overtaken the world of nutrition as one of the most exciting areas of research in the last few decades. They are now recognized as essential for cardiovascular health and guarding against heart disease; DHA for being the most abundant fat in our brains and a key nutrient for infant and brain development as well as long-term brain health in adults; and EPA because it acts to replace other fatty acids in eicosanoid pathways to reduce inflammation in joints and the body overall.

No one would have predicted these facts half a century ago. Back in the 1960s, fats were all considered evil. There was no distinction between what fat was “good” or “bad”, writes Allport. Out of this type of thinking was born the American Heart Association’s low-fat recommendation, which was a recipe for disaster in eating.

As Allport puts it: “… that’s what happens when the center doesn’t hold, when the marketplace is full of such absurdities as overly sweetened breakfast cereals, such as Cocoa Puffs and Lucky Charms, being endorsed by the American Heart Association (because they have no cholesterol or saturated fat)—when the overly simplistic, low-fat mantra of the 1980s and 1990s made the Atkins craze almost inescapable. As a dieter in Texas confides, ‘Eating low-fat guarantees that I will binge on fried foods. Eating low-carb guarantees that I will binge on a bag of chips.’”

All this back-and-forth advice on nutrition has led millions of Americans to binging in and out of diets such as Atkins and terrible eating habits that include uncontrolled portion sizes, too many calories, too many high-glycemic carbs, too much trans fats and too little exercise. Wrong advice has led to epidemics in obesity, diabetes and, soon, Alzheimer’s disease.

Omega-3s removed from food

In her book, Allport seeks to highlight another aspect of what happens when ignorance in nutritional advice food processing lifts out a key nutrient from our diets. Despite what most people might think, omega-3s are not at all rare in nature and were not even rare in what people ate only half a century ago. In fact, omega-3s are the most abundant fats on the planet, making up a part of all plant cells. However, over time, omega-3s have been purposely removed from foods completely.

Why? Because omega-3s turn rancid quickly, getting them out of vegetable oils and out of processed foods increases their stability over time. Canola oil, for example, was once high in omega-3 alpha linolenic acid (ALA) and is still one of the greatest sources of omega-3s over the last few decades in the diets of Americans. However, plant biologists have been developing lower-ALA versions for years. The same thing has happened to soy oil and other oils.

To improve shelf life of processed foods, vegetable oils included in them were also often hydrogenated to improve shelf life. They still are. Hydrogenation—whether partially or fully hydrogenated oils—drastically improves stability of the oils, but completely destroyed omega-3 content. Too often enough, partially hydrogenation also introduces harmful trans fats.

At the same time, omega-3s have been removed from the diets of the animals we eat. As Allport explains it, plants accumulate oils in form of omega-3s in their leaves while concentrating the more stable omega-6s in their seeds. As the diets of animals, such as cows, switched from one that was grass-fed to one of grains, the content of omega-3s in their flesh diminished. For example, cows that ate grass were diverted to a diet of mostly corn in their animal feed. When the animals stopped receiving sufficient omega-3s in their diets, humans as consumers also had omega-3 levels in their bodies diminish.

Giving our food an extended shelf life of food and our meat plenty of flavor through the marbling effect of feeding animals corn are an understandable goal for food producers, but, unwittingly, the removal of omega-3s from our diet, not to mention the addition of high amounts of omega-6s and trans fats, have high implications on our health.

Omega-3 Discovery

In a “stroke of luck”, writes Allport, two Danish researchers, Dr. Hans Olaf Bang (now deceased) and Dr. Jørn Dyerberg, led the world back onto the path of eating heart healthy fats. Had it not been for their discoveries, we may still be avoiding omega-3s today.

The two researchers’ curiosity had been sparked by reports that the native Inuit of Greenland, or Eskimos (as they’re commonly called), had a mysteriously low incidence of heart disease in spite of a diet rich in meat and fat, or blubber.

Dr. Bang and Dr. Dyerberg knew the world was changing and that the Inuit were becoming more Westernized by the day. They had to act right away if they were ever going to find out what in the Inuit’s diet protected their health.

Once in Greenland, they collected dozens of blood samples hoping to support an educated guess that the cardioprotective factor was due to dietary polyunsaturated fats. Upon analyzing blood samples back home in Denmark, their hypothesis was confirmed.

Their original discovery was long-chain omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) and their cardioprotective benefits.

Later, research in total parenteral nutrition would reveal that omega-3s should be considered an essential fatty acid, joining omega-6. Omega-6 had beforehand earned itself the name, “the King of Fats” and omega-3s would then be its "queen".
Both these families of essential fatty acids, as Allport discusses, appear to compete for the same enzymes in the body.
Naming omega-3s

Why are DHA, EPA and ALA all considered part of the same omega-3 family? The concept of separating both omega-3s and omega-6s into families was the brainchild of Dr. Ralph Holman.

Because chemists often use the first letters of the Greek alphabet to indicate position of chemical groups, Dr. Holman came out with the idea that “omega”, ω, the last letter of the alphabet could be used to distinguish the tails of fatty acids to put them into families.

Writes Allport, Dr. Holman’s naming convention was to help bring more attention to the relationship between these oils by avoiding their chemical names and addressing them by the end of the fatty acid chain, their tails. When metabolized in the body, the tails didn’t change and it made sense to bring more light to this fact. It also allowed the writing of the name of the oil to be shorter. For example, the chemical name of alpha-linolenic acid would simply be “18:3ω3” instead of “cis,cis,cis-9,12,15-Octadecatrienoic acid”.

Dr. Holman worried about how other researchers would react to the new terminology, but after a while he found that more and more studies began to take on the new vocabulary. Later on, Dr. Holman would find it exciting to see his “omega-3” name be adopted around the world to educate the public about the oils.

Speedy omega-3s, slow omega-6s

As all things in nature, there is a balance to be associated with fats in the wild. It appears, for example, that in most cases the speedier animals contain greater levels of omega-3s, specifically DHA, while slower animals accumulated omega-6 oils and saturated fats.

For example, slow-speed lizards and toads have more saturated fatty acids than high-speed hummingbirds, which contain plenty of DHA. In addition, large, slow animals such as elephants would have much greater omega-6 fatty acids and saturated fats than fast animals such as mice.

Omega-3s and omega-6s may also have a role in hibernation, writes Allport. It turns out, for example, that the yellow-bellied marmot’s natural diet has more omega-3s in the summer and a great deal more omega-6s in the winter. This is a relationship between leaves and nuts. But when given a diet high in linseed oil, which is high in omega-3s, the marmot doesn’t’ go into hibernation and, when given omega-6 laboratory food, they fall asleep on schedule.

Despite differences in omega-3 content in the body, Michael Crawford was the first to discover that percent content of DHA was consistent in brains throughout the animal kingdom. DHA is also found in greater concentrations in the eyes of animals.

Bringing omega-3s back into the diet

Because of a high intake of fish, the Japanese currently have a much higher amount of omega-3 fatty acids in their diet and live longer than Westerners. How can everyone be sure they are getting enough omega-3s, especially if they don't eat much fish?

Allport writes that it will take a concerted effort of education and working with food producers to put omega-3s back into the food we eat. Already, however, we are seeing a greater leaning toward offering foods higher in omega-3s.

Consumers can help to protect their health by following some steps that Allport has laid out, which include eating plenty of fruits and vegetables, consuming oils with a healthy balance of omega-3s to omega-6s, eating a wide variety of fish, eating omega-3 enriched eggs, avoiding trans fats, cutting down on saturated fats, choosing free-range meats, and using supplements.

In conclusion, Allport makes a startling, but healthy prediction—that omega-3 status will not join serum cholesterol, LDL to HDL ratio, and C-reactive protein, but replace these other indicators as a risk factor for heart disease.

NSI Determine Checklists - Grandma and me

Grandma

My grandma, 79, scored a 6 on the NSI Determine Checklist, which puts her at “high nutritional risk.” Her eating habits are affected by GERD and she tries to avoid any processed foods high in sodium because of hypertension. She also eats alone most of the time and eats fewer than two meals per day. Although she dislikes eating fruits and vegetables, she does manage to obtain some of them in her diet. She drinks plenty of milk and uses dairy products liberally. She doesn’t drink alcohol, has enough money for food she needs (although she said she could use more), and only takes one prescription medication. She has not gained or lost 10 pounds without wanting to in the last six months. She shops and cooks for herself and reports that she also picks at food throughout the day.

Me

I, 31, scored a 0 on the NSI Determine Checklist. I have no conditions that affect my diet, I eat balanced meals along with vegetables, fruits and milk products, and don’t drink more than one glass of wine daily. I have no mouth problems, have money to buy food, eat with others most of the time, don’t take any prescriptions, have maintained the same weight for years, and often shop and cook for myself.

Thoughts

Although there is a stark contrast between my nutritional risk and that of my grandmother’s, it doesn’t escape me that in 48 years I could be in the same situation as she is now. I realize that when I eat too much I too am susceptible to GERD symptoms such as reflux and heartburn. This may affect my nutritional risk in the future unless I am conscientious enough to make change in my diet to reduce inflammation in my esophogaus. As for my grandma, her high nutritional risk concerns me greatly because at her age, she should be more focused on nutrition than I am. We will need to change that.

Female Athlete Triad

When I was in high school, one of my best friends was a long-distance runner and a dancer. After only a few months of training, I knew something was wrong. She changed her diet to one of protein and almost no other calories. She was obsessed with exercise leading to a loss of many of her friends. Later on she lost a lot of weight and, to me, instead of becoming healthier she appeared to look pretty unhealthy.

What I didn't know then was that my friend may have suffered from the "female athlete triad". It is a three-part syndrome that affects the health and performance of female athletes and includes osteoporosis, disordered eating and menstrual disorders. Each of these are inter-related and inter-play. Together they can cause serious illness or death.

Writing in a review in British Medical Journal, Dr. Karen Birch explains that the syndrome can be caused by pressures psychological and physiological associated with a sports requirements to perform optimally, which can lead to a perception of needing a "low body mass, result of high-volume training" (1).

Being somewhat controversial, at least one medical researcher has called for abandonment of the syndrome. Dr. Michael Cullen of the British Association of Sport and Exercise Medicine points out that the term "blurs the concepts of a true eating disorder with that of a driven athlete who is simply ignorant of nutritional demands" and that osteoporosis in atheletes is rare (2).

Despite whether a syndrome should be recognized or not, clinicians should continue to recognize which women are most at risk, which are teen girls and female athletes of many kinds, especially where body image counts: gymnasts, figure skaters, ballerinas, swimmers, endurance runners, and so on (3).

The first signs of the female athlete triad may be low-calorie dieting or exercising to excess or obsession (3). The low-calcium diet contributes to low bone density. If amenorrhea results, it may be linked to decreased estrogen levels (3). It has also been my experience that smoking usually is another sign of an eating disorder among teens. The reasons why is because the teens see it as an effective method to control appetite and weight (4). Unfortunately, for a teen suffering already from female athlete triad, smoking can cause an exacerbated loss of bone (5 & 6). The impact of female athlete triad can lead to infertility and stress fractures in the future (1).


References

1. Birch K. Female athlete triad. ABC of sports and exercise medicine. British Medical Journal. Available at: http://www.bmj.com/cgi/content/extract/330/7485/244.

2. Cullen M. et al. 10 Feb 2005. The Female Athlete Triad. Available at: al.http://www.bmj.com/cgi/content/extract/330/7485/244.

3. WebMD. The Female Athlete Triad. Available at: http://www.webmd.com/a-to-z-guides/female-athlete-triad.

4. http://www.ncbi.nlm.nih.gov/pubmed/17056404

5. Gropper SS, Smith JL, Groff JL. Advanced Nutrition and Human Metabolism. Belmont, CA: Thomson Wadsworth, 2009.

6. http://www.ausport.gov.au/participating/women/issues/osteo

Family influence on meals

My thoughts after reading "A Review of Family Meal Influence on Adolescents' Dietary Intake" by Sarah Woodruff and Rhona Hanning:

It's pretty easy to imagine why having dinner with one's family would instill positive nutritional habits. Even the word family exudes in its meaning what goes further to credit an environment of caring and, above all, nurturing.

When mother and father are at the table, they are naturally given to see to it that their children are eating well. At the same time, they must also set the right example. Thus, it's clear why the authors of the article found that the studies reviewed found that those adolescents who ate with their families had a higher intake dairy, fruits and vegetables.

I would further suggest that family influence comes with wisdom as to healthy eating pattens. For example, when grandma or grandpa or mom or dad make a meal, they themselves are passing on food traidtions that may have well sustained generations with better health. When family is not available and adolescents are left to choose their own eating patterns, one could imagine they're much more inclined to make poorer choices as they have to "reinvent the wheel" so to say.

One element I would have liked to have seen the article address with more detail was actual preapartion of food. It's my own experience that a personal relationship with food can go a long way in how nutritious it is to a person. You might call it a greater food consciousness--more understanding of what's about to be eaten. Food consciousness is often lost on teens when going out to eat or when leaning on the microwave meals. When a teen prepares his or her own food, just the creativity itself involved by choice and cooking is likely to play a factor in actual nutrition.

Baby Steven

John and Susan are both prone to being overweight. They are concerned that their infant son, Steven will also have weight problems. They are referred to you when Steven is 5 months old. Steven's growth data are as follows

Age Weight Length
Birth 8lb 20inches
1 week 8lb 1oz 20 inches
1 month ll lb. 21.5 inches
2 month 12lb 8oz 23 inches
3 month 14lb 8oz 23.5 inches
4 month 16lb 25.5 inches
5 month 18lb 26.5 inches

Steven breast feeds six times daily for about 20-25 minutes at each feeding. He is not presently receiving any other sources of nourishment. Answer the following questions for John and Susan:

Their pediatrician told them that Steven's weight is above average. Is he gaining too much weight?

When charted, Steven’s birth weight and weight gain for the next two months is at about the 50th percentile (1 p. 566). His weight gain afterward appears to be higher than average and he is at the 90th percentile by 5 months (1 p. 566). Steven’s birth length for four months is at about the 50th percentile and then flows upward slightly closer to the 75th percentile (1 p. 567).

Because Steven’s length is slightly higher than average, I would judge that it is the extra growth that may also explain the extra weight gain. The weight gain, then, is probably not at a level that should be worried about. I will agree with others who have replied that at this moment the primary concern should be making sure Steven’s fed well to best support his physical and neurodevelopment that occur in the first year of life (1 p. 216).

Should they delay adding solid foods or add something now? If they should add something, what would recommend?

At Steven’s age of 5 months, the appropriate foods to be supplying him are breast milk or formula, infant cereal and strained fruits and vegetables. He’ll be teething soon, so within two or three months, he’ll be able to enjoy strained meats and breads (1 . Within five to seven months, he’ll be chomping on chopped fruits, vegetables and meats. Steven ca be weaned around 2 to 3 years (1 p. 200).

Should they give Steven juice in a bottle?

No, they should not. According to the American Academy of Pediatrics, there is no reason why juice should be given to Steven at all based on nutritional considerations (2). This is the case even as he grows older. From my own experience with my children, I can tell you that juice, while sure to be fascinating to a baby’s taste buds, would simply turn into a habit whereby breast milk and formula are avoided.

In fact, my own mother tells me all the time that she wishes she never would have given me juice because, as a baby, I immediately stopped breastfeeding when I tried it. The fruit juice also displaced nutrition I could have received otherwise (1 p. 242). Eventually baby bottle tooth decay would also be my fate (1 p. 242).

A neighbor has suggested that Steven could be given skim milk instead of breast milk, Do you recommend this?

Steven’s breastfeeding of six times daily is normal for babies of 2-3 months (1 p. 239). Once reaching 3-6 months, the level normally should drop to 4-5 and he should be introduced to other foods as mentioned above (1 p. 239). Steven should not be given milk at all, be it raw, whole, 2% or skim. Breast milk is best because of its unique properties such as lactoferrin, immunoglobulins and the bifidus factor (1 p. 231-232). These are able to prevent allergies, asthma and infections over time (1 p. 231-232). Infant formula is acceptable, however, and, unlike cow’s milk, can also provide a commonly deficient nutrient in infants: iron (1 p.236). Infant formula is carefully formulated and fortified with vitamins, minerals and essential fats to best support child development (1 p. 235).

References
1. Mitchell MK. Nutrition Across the Life Span. "Chapter 9: Nutrition During Growth: Preschool through Preadolescence". Second Edition. Waveland Press: Long Grove, Illinois, 2003.
2. http://pediatrics.about.com/od/weeklyquestion/a/0806_baby_juice.htm

Kid Nutrition

Nutritional and energy needs for a child differs profoundly from that of an adult because of a child's continual growth and development. A child is in greater need of nutrient-dense foods--although not to the extent as infants--and requires more energy for basal metabolic rate, physical activity and thermic effect of food. Energy needs are highest during rapid growth and expansion of lean mass.

Each individual child is best understood by first dividing stages of child growth and development into two periods: a preschool period and a school-age period:

• During the pre-school period, from 2-6 years of age, the child grows more slowly in comparison to infancy. A toddler will quadruple birth weight in a full year or so. The brain of the toddler also grows more slowly than as was expected as an infant so head circumference will only increase by a couple of centimeters. A toddler's weight increase can range from 2.5 kg per year for ages 2 and 3 to 2 kg per year for ages 4 and 5. She or he will also grow about 12 cm from age 2 and 3. During that time, body composition will also change as total body water content settles to a comfortable 60-65% and growth of new cells and skeletal muscle causing a decrease in extracellular fluid and increase in intracellular fluid.
  
• The school-age period, or latent growth period, beigns from 6 until puberty of which girls can reach a little earlier at 10 and boys normally at 12. As "baby fat" is lost, the child becomes leaner and mor muscular. The pattern of growth is highly individual. On average, weight increase will be about 3-3.5 kg per year during this period. The child will move beyond the limited vocabulary of three-word-sentences and begin adapting to an environnment of greater language skills, motor skills, as well as personal-social skills. This, of course, will also mean more control over diet through self-feeding.

As both periods represent critical times for growth and development, the focus of recommendations for energy and nutrient intake are based on supporting optimal outcomes. The recommendations are, again, more critical than for adults because of dire long-term consequences. A child, for example, will need special attention to be sure that they receive proteins of high biologic value for growth requirements. Fat and carbohydrate needs will be greater during rapid growth periods as will numerous vitamins and minerals, especially vitamin D and calcium of which are largely deficient in children. Fiber too, which helps normalize bowel movements, is critical for ensuring a child lives free of future risk of disease. All in all the goal is to provide the best support to provide children with bright futures.

Summarized from

Mitchell MK. Nutrition Across the Life Span. "Chapter 9: Nutrition During Growth: Preschool through Preadolescence". Second Edition. Waveland Press: Long Grove, Illinois, 2003, pp. 271-300.

Energy needs of healthy term and high-risk infant

The infant, despite whether healthy term or high-risk, will require energy for BMR, thermic effect of food, physical activity, maintenance, growth and for energy lost in feces and urine. There is also energy needed just to maintain body temperature until the early extrauterine period passes. The newborn requires approximately 108 kcal/kg for about six months followed by 98 kcal/kg for the next six.

The high-risk newborn will have the same energy requirements, but Calorie needs will differ in whether or not the infant is enterally fed or parenterally fed. The enterally fed infant needs a greater amount of Calories, at 120/kg, than the healthy infant due to specific dynamic action and cold stress. The parentally fed will need fewer amount of Calories, at about 80-90 kcal/kg, than the healthy infant because of the infant won't use as many calories for activity, cold stress, specific dynamic action or stool losses. Caloric needs for both enterally and parenterally fed high-risk infants will aslo need to depend on medical problems and growth needs.

Assessment methods by which energy needs are determined include anthropometry, biochemical assessment and dietary assessment. Anthropometry assesses weight, length and head circumference. Because weight is most important for the high-risk infant, it will need to be weighed one or more times daily. Biochemcial lab measurements will need to be performed over several days in the high-risk infant to determine development.

The high-risk infant will also need a clinical assessment and a nutrient intake assessment. The clincal assessment will evaluate condition including state of hydration relative to urine and weight gain as well as feeding tolerance including vomiting records. Nutrient intake will evaluate nutrient sources in a qualitative fashion as well as nutrients in terms of quantity. Nutrient sources will need to depend on the condition of the high-risk infant such as state of digestive abilities. Nutrient amounts depends on absorption capacities, whether parenterally or enterally fed and weight.

Reference

Mitchell MK. Nutrition Across the Life Span. Second Edition. Waveland Press: Long Grove, Illinois, 2003.

Protein-deficient diet and teratogenicity

One interesting detail I came across while researching teratogens is that a protein-deficient diet may enhance the effects of xenobiotics in general.

For example, dietary protein deficiency along with exposure to inorganic arsenic through injection in mice was found to increase risk of birth defects, possibly because of lack of methyl donors for arsenic methylation (1). Also, high-dose caffeine teratogenicity is increased when in combination with protein deficiency (2).

Other xenobiotics such as tobacco carcinogens, anticonvulsants and sedatives appear to be teratogenic depending on the status of the cytochrome P450 system of the fetus (1). The effect may or may not be related to protein deficiency. The toxicity is thought to occur due to lack of anitoxidative enzymes such as GSH peroxidase and GSH reductase, which would increased endogenous oxidative stress and cumulative damage (3).

Reference List

1. Lammon CA, Hood RD. Effects of protein deficient diets on the developmental toxicity of inorganic arsenic in mice. Birth Defects Res B Dev Reprod Toxicol 2004;71:124-34.
2. Nehlig A, Debry G. Potential teratogenic and neurodevelopmental consequences of coffee and caffeine exposure: a review on human and animal data. Neurotoxicol Teratol 1994;16:531-43.
3. Wells PG, Kim PM, Laposa RR, Nicol CJ, Parman T, Winn LM. Oxidative damage in chemical teratogenesis. Mutat Res 1997;396:65-78.

Caffeine and pregnancy

I was shocked to learn that FDA in 1980 had determined that caffeine in amounts exceeding 300 mg could potentially be teratogenic (1). Teratogens are agents that cause fetal malformations or birth defects. Good thing caffeine does not harm the fetus when taken in smaller amounts, despite evidence in rats to the contrary (1-2).

However, after digging deeper, I found that the researchers did find that caffeine potentiated teratogenic effect of smoking and alcohol (2). The mechanism appears to be through inducing materno-fetal vasoconstrictions that lead to ischemia (2).

If caffeine potentiates effects of other teratogens in amounts less than 300 mg, I imagine it's still wise of pregnant women to avoid caffeine altogether during pregnancy just in case they are exposed to teratogens of some kind and are unaware of it.

Reference List

1. Mitchell MK. Nutrition Across The Life Span. Long Grove, IL: Waveland Press, 2003.
2. Nehlig A, Debry G. Potential teratogenic and neurodevelopmental consequences of coffee and caffeine exposure: a review on human and animal data. Neurotoxicol Teratol 1994;16:531-43.

Cannabis Teratogenicity

Cannabis sativa’s psychoactive tetrahydrocannabinol (THC) has not been established as a human teratogen (1), but there is a history of teratogenic effects linked to use by expectant mothers (2). The perinatal exposure is thought to interfere with neurodevelopment and affect neurobehavorial outcomes (1-2).

Although the teratogenicity of marijuana is not as catastrophic as other illicit drugs such as cocaine, it’s harm can still lead to problems such as disturbed sleep and attention deficit disorder (2-3). Worth noting is that when cocaine exposure is accompanied by marijuana, the neurological effects can be pronounced (3).

There is also indication that maternal marijuana use may increase risk of acute myeloid leukemia, however, more recent research has not been able to confirm this relationship (4).

Reference List

1. Kozer E, Koren G. Effects of prenatal exposure to marijuana. Can Fam Physician 2001;47:263-4.
2. Reece AS. Chronic toxicology of cannabis. Clin Toxicol (Phila) 2009;47:517-24.
3. Frank DA, Augustyn M, Knight WG, Pell T, Zuckerman B. Growth, development, and behavior in early childhood following prenatal cocaine exposure: a systematic review. JAMA 2001;285:1613-25.
4. Trivers KF, Mertens AC, Ross JA, Steinbuch M, Olshan AF, Robison LL. Parental marijuana use and risk of childhood acute myeloid leukaemia: a report from the Children's Cancer Group (United States and Canada). Paediatr Perinat Epidemiol 2006;20:110-8.

When you’re eating for twins or more

Nutritional needs soar when you have a multiple pregnancy. According to Barbara Luke from University of Miami, the mother has a “greater nutritional drain” on her body. Because of quicker glycogen depletion that might slow fetal growth rate, Luke suggests a diabetic regimen with caloric ratio of 40% carbs, 20% protein, and 40% fat. In addition, she suggests supplementation with iron, calcium, magnesium and selenium for preventing “complications and improvement of postnatal health”.

Reference List

Luke B. Nutrition and multiple gestation. Semin Perinatol 2005;29:349-54.

Eggs for Pregnancy

Eggs, considered a nutritional powerhouse, is an excellent food to recommend to these women during pregnancy. According to Niva Shapira of Tel-Aviv University in Israel, eggs can provide various nutrients, vitamins and minerals that are also found in human milk and that support peak brain development (1).

If those eggs are also produced in such a way as to contain high levels of DHA, then they become even more supportive to the young one’s brain (2).

Reference List

1. Shapira N. Modified egg as a nutritional supplement during peak brain development: a new target for fortification. Nutr Health 2009;20:107-18.

2. Carlson SE. Docosahexaenoic acid supplementation in pregnancy and lactation. Am J Clin Nutr 2009;89:678S-84S.