Large Weight Gain In Pregnancy Tied To Increased Infant Size

Dr. Enrique Jacome MD

Obese mothers who gain excessive weight during pregnancy are nearly seven times more likely to give birth to a large infant at risk for a lifetime of obesity. Moreover, excess gestational weight gain (GWG) increases the risk of having a large infant, even in mothers who have a healthy prepregnancy body mass index (BMI), according to a study published April 17 in the Journal of Maternal-Fetal and Neonatal Medicine.

The study, by Zachary M. Ferraro from the Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada, and colleagues, showed that overweight and obesity were associated with an increased risk of having a child considered large for gestational age (LGA) — a risk factor in future obesity. The risk of having an LGA infant increased dramatically if an overweight mother gained more weight during pregnancy then recommended by Institute of Medicine (IOM) guidelines.

The researchers analyzed data from 4321 mother-infant pairs recruited from 2002 to 2009 in the Ottawa and Kingston Birth Cohort. Their goal was to determine the effect of maternal weight and weight gain during pregnancy on the likelihood of giving birth to a child weighing more than 4000 g (8.8 pounds), which puts the child in the 90th percentile for infant weight.

Mothers who reported a prepregnancy BMI indicating overweight — 25 to 29.9 kg/m2 — were nearly twice as likely to give birth to an LGA infant (odds ratio [OR], 1.99; 95% confidence interval [CI], 1.17 - 3.37) as women of healthy weight. For obese women, with a BMI of 30 kg/m2 or more, the OR was 2.64 (95% CI, 1.59 - 4.39).

If a mother's GWG exceeded IOM guidelines, the risk of having an LGA infant increased for women of any weight at pregnancy, (OR, 2.86; 95% CI, 2.09 - 3.92), after adjustment for a mother’s prepregnancy BMI, age, smoking, and maternal height. The problem was compounded if a woman was already overweight or obese: ORs were 3.59 for overweight women (95% CI, 2.60 - 4.95) and 6.71 for obese women (95% CI, 4.83 - 9.31).

"Obesity can become part of an intergenerational cycle," Kristi Adamo, MSc, PhD, coauthor of this report, said in a news release from the University of Ottawa. Dr. Adamo is also the cofounder of the Healthy Active Living and Obesity Research Group at Children's Hospital of Eastern Ontario Research Institute.

"Birth weight averages can be an indicator of the weight a child will carry through preschool and even into adulthood. It's critical for a mother to understand that her healthy eating and lifestyle decisions during pregnancy will impact much more than a nine-month gestation period," she continued.

The adjusted analysis also found smoking mothers were less likely than nonsmokers to deliver an LGA infant (OR, 0.53; 95% CI, 0.35 - 0.79). Parity was associated with an increased risk for an LGA infant (OR, 1.49; 95% CI, 1.22 - 1.82).

The range of acceptable weight gain during pregnancy recommended by the IOM changes according to a mother's weight at the time of pregnancy. Women considered underweight, with a BMI less than 18.5 kg/m2, should gain 12.5 to 18 kg (28 to 40 pounds). Healthy-weight women — BMI of 18.5 to 24.9 kg/m2 — should gain 11.5 to 16 kg (25 to 35 pounds). Overweight women are advised to gain 7 to 11.5 kg (15 to 25 pounds), and obese women, 5 to 9 kg (11 to 20 pounds).

In the study, only 29.3% of the women stayed within IOM GWG guidelines. Another 57.7% exceeded the recommendations. Before pregnancy, 23.7% of women in the study were overweight, and another 16.2% were obese.

"We have shown that the majority of women in our birth cohort population entered pregnancy at an unhealthy weight and gained in excess of recommendations during gestation," the authors noted. "At any weight, excessive GWG has a significant effect on the likelihood that their child will be born LGA, and research has demonstrated that size at birth contributes to obesity development down-stream."

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Women Who Don't Exercise Are At Greater Risk Of Developing Metabolic Syndrome

Dr. Enrique Jacome

A national study shows that women are less likely than men to get at least 30 minutes of exercise per day, resulting in greater odds of developing metabolic syndrome - a risky and increasingly prevalent condition related to obesity.

Metabolic syndrome is a name for a group of risk factors - including high cholesterol, high blood pressure and extra weight around the middle part of the body - which occur together and increase the risk for coronary disease, stroke, and Type 2 diabetes.

The study, now online in the journal Preventive Medicine, was conducted at Oregon State University by Paul Loprinzi and Bradley Cardinal, professor of social psychology of physical activity at OSU. Loprinzi is now an assistant professor of exercise science at Bellarmine University. He conducted the research when he was a student in Cardinal's lab at OSU.

"The results indicate that regular physical activity participation was associated with positive health outcomes for both men and women; however, there was a greater strength of association for women," Loprinzi said.

Looking at more than 1,000 men and women from a nationally represented sample, the researchers found that women were getting only about 18 minutes of moderate-to-vigorous exercise daily, compared to men who, on average, were getting 30 minutes of moderate-to-vigorous exercise daily.

"Those who get at least 30 minutes of exercise a day are less likely to be depressed, less likely to have high cholesterol and less likely to have metabolic syndrome," Loprinzi said.

Loprinzi and Cardinal's study is unique in part because it is the first to use an "objective" measure of physical activity - in this case participants were outfitted with accelerometers that measured daily activity. In their study, slightly more than one in three women had metabolic syndrome, and one in five had symptoms of depression.

"It's pretty striking what happens to you if you don't meet that 30 minutes a day of activity," Cardinal said. "Women in our sample had better health behavior - they were much less likely to smoke for instance, but the lack of activity still puts them at risk."

Cardinal said depression puts people at more risk of abdominal fat and insulin resistance, and both are risk factors for metabolic syndrome.

"Physical activity has been shown to reduce depression," he said. "So the key message here is to get that 30 minutes of exercise every day because it reduces a great deal of risk factors."

While their study does not address why women were not getting enough exercise, the authors said research shows that physical activity patterns often begin in childhood.

"Research has shown that around ages 5 or 6 these patterns begin," Cardinal said. "Parents tend to be more concerned with the safety of girls, and have more restrictive practices around outdoor time and playtime than with boys."

Loprinzi said this pattern tends to continue into adulthood, and that overall confidence may be a factor.

"Some evidence indicates that women, compared to men, have less confidence in their ability to overcome their exercise-related barriers," Loprinzi said, adding that women also often cite a lack of time to exercise due to child-rearing.

The researchers have a study coming out that may help those time-challenged women. Loprinzi said he and Cardinal found that adults can still enhance their health by accumulating physical activity in short periods throughout the day, such as taking the stairs instead of the elevator or pacing while talking on the phone. 

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The Link Between False-Positive Mammography Results And Breast Cancer Risk

Dr. Enrique Jacome MD

False-positive mammograms could be an indicator of underlying pathology that could result in breast cancer, according to a study published in the Journal of the National Cancer Institute.

Screening mammography is associated with false-positive test results in disease-free women, and those women are usually referred back for routine screening after the initial diagnostic work-up does not reveal cancer. Suspicious findings on screenings leading to false-positives include asymmetric densities, skin thickening or retraction, tumor-like masses, recently retracted nipples or suspicious axillary lymph nodes. It is unknown if women whose mammographic screenings show these results have a higher long-term risk for breast cancer compared to women who initially test negative.

In order to determine if women who test false-positive after mammography screenings have a higher risk of developing breast cancer than those who test negative, My von Euler-Chelpin, Ph.D., in the department of public health at the University of Copenhagen and colleagues, gathered data from a long-standing population-based screening mammography program in Copenhagen, Denmark from 1991-2005. They evaluated the risk of breast cancer and ductal carcinoma in situ in women who had received false-positive test results between the ages of 50-69 . The age-adjusted relative risk of breast cancer for women who had tested false-positive for breast cancer was compared to women who had tested negative.

The researchers found that women who had tested negative for breast cancer had an absolute cancer rate of 339/100,000 person-years at risk, compared to women who tested false-positive, who had an absolute cancer rate of 583/100,000 person-years at risk. The relative risk of breast cancer in women with false-positive tests was statistically significantly higher than women who tested negative even at 6 or more years after the test. However, the researchers caution that "The excess breast cancer risk in women with false-positive tests may be attributable to misclassification of malignancies already present at the baseline assessment," the authors write. Thus, new screening methods such as high-resolution ultrasound and stereotactic biopsy may result in more accurate diagnoses and fewer false positives on first screen.

The authors also caution that the experience of a false-positive may cause anxiety, which may discourage women from attending regular screenings. However, the long-term excess risk of breast cancer in women who tested false-positive underscores the need for women to have regular screenings. "Based on the findings in this study, it may be beneficial to actively encourage women with false-positive tests to continue to attend regular screening."

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Protect Against Breast Cancer Risk Factors With Flax Seeds

Celeste M. Smucker, MPH, PhD (NaturalNews) 

In the United States 1 in 8 women will be diagnosed with invasive breast cancer during her lifetime, and 1 in 3 of them will die from the disease. In 2011, there were 2.6 million breast cancer survivors coping with this diagnosis which is both personally devastating and financially expensive. At a national level, the annual cost for treatment alone is close to $14 billion. While the standard remedies of radiation, chemotherapy and surgery are well known, there are effective natural approaches for prevention and treatment which can have a significant impact on the disease. One of these is flax seeds which are the richest source of plant based omega-3 fatty acids and are high in lignans and fiber all of which help reduce breast cancer risk. According to breast cancer specialist Christine Horner, MD, in her book Waking the Warrior Goddess, "If you were given only one choice of a food to take as medicine, your best choice would be the tiny seed from the flax plant."


Omega-3 fatty acids
As a significant source of omega-3 fatty acids, flax seeds help reduce breast cancer risk by ameliorating inflammation and reducing the rate at which breast cells divide in response to estrogen. The power of omega-3s was demonstrated in a recent study at the Fred Hutchinson Cancer Research Center in Seattle in which the researchers questioned 35,000 postmenopausal women who had not been diagnosed with breast cancer. Six years later they did a follow up questionnaire and found that regular use of fish oil, another potent source of omega-3 fatty acids, reduced breast cancer risk by 32 percent. For women who already have breast cancer, Dr. Horner states that omega-3s will help shrink tumors and help keep them confined so that they don't spread.

Fiber

Whole ground flax seeds are also a significant source of fiber, long thought to be important for preventing breast and colon cancer. A recent study funded by the World Cancer Institute found that every 10 grams of fiber consumed daily reduces breast cancer risk by 5 percent. It is thought that the fiber binds to estrogen in the intestines and helps move it out of the body before it can do more harm.

Lignans
Lignans, another big contributor to the prevention of and healing of breast cancer, are natural plant compounds found in fruits, vegetables and grains such as wheat, broccoli, garlic, carrots and dried apricots. However they are also abundant in flax seeds which have 100 times the lignans found in other known edible sources. In a recent German study researchers evaluated bloods samples from 1,140 postmenopausal women diagnosed with breast cancer. They measured levels of enterolactone, a known bio-marker for lignans and found that women with the highest amounts of this substance were associated with a 40 percent lower mortality risk from breast cancer. Previous research by the same scientists had already established the importance of lignans for prevention of breast cancer.

Horner also stresses the importance of lignans stating that they promote change in the breast structure in a way that makes the tissue more resistant to the toxins that can cause cancer. In addition, lignans decrease tumor growth factors, help prevent metastasis and reduce estrogen production by fat cells.

View the original article here. 

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Pregnancy And Fish Oils - Good For Mom & Better For Baby

Dr. Enrique Jacome MD

Pregnant women are being advised to consume omega-3 fatty acids in order to ensure proper development of the fetal neurological system. Even after birth, fish oil supplementation can improve the early development of a newborn's brain, visual system, and motor function in women who breastfeed. These fish oils, most notably the fatty aciddocosahexaenoic acid (DHA)is part of a group of omega-3s known as polyunsaturated fatty acids (PUFAs). The human brain is full of PUFAs that modulate inflammation and provide integrity to the neuronal network. By supplying a developing brain with plenty of PUFAs, a mother can support their child's proper development. Along with benefits to the child, a pregnant mother that consumes fish oils can prevent pre-term labor, reduce the risk of pre-ecclampsia, and may even help in the prevention of post-pardum depression (PPD).

Another breakthrough in fish oil research shows that fish oil supplementation during pregnancy decreases the risk of a newborn developing eczema. In a study of 700 pregnant women, those who took fish oil supplements versus a placebo had a decreased incidence of infant eczema by three times. When DHA and eicosapentaenoic acid (EPA) enter the cell membrane, they suppress inflammation that could potentially lead to various allergies and skin reactions that develop in early childhood. This study is ongoing as it plans to follow the children until age six to determine the extent of the lasting benefits.

If you want to start taking fish oils, the FDA recommends not exceeding the maximum dosage of 3000 mg of fish oil per day. The American Pregnancy Association recommends that pregnant and lactating women consume 500-1000 mg of fish oil per day ensuring that at least 300 mg are DHA. Although most capsules of fish oil supplements are 1000 mg, this does not indicate the amounts of actual fish oil (EPA and DHA) in each capsule, which is usually between 200-500 mg. Instead of taking a supplement, one can simply eat raw fish. The most EPA and DHA dense fish is salmon. Additionally, pregnant mothers should make sure they are getting their fish oils from a natural source free of heavy metals (mercury, BPA). To avoid heavy metal toxicity, avoid consuming fish that are high in the food chain (shark, swordfish), or be sure to purchase supplements from a reputable source with natural ingredients.

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Dr. Jacome's Healthy Eating Tips: Egg Yolks - A Superfood

Egg yolks are a leading source of lutein and zeaxanthin - a dynamic antioxidant duo that accumulates in the retina and protects eye health. Better still, US Researchers at Tufts University recently discovered that lutein is more readily absorbed from eggs than other sources, such as spinach.

Egg yolks also provide selenium, vitamin E, high quality protein and choline - a nutrient that can help improve heart health.

Preparation Tip: If you tire of the classic boiled-scrambled-poached triumvirate, bring a little Mexican flavour to your mornings with breakfast tacos. Just top tortillas with scrambled eggs, diced tomatoes and basil. Muy bien, as they say in Guadalajara.

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Study: Pregnant And Breastfeeding Mothers Should Avoid Exposure To BPA

Dr. Bev Blessing FNP, PHD

An Oct 2011 report looked at the risk of transferring BPA exposure to infants while breastfeeding. BPA is very common and found in the fat cells of about 90% of the population. It is felt that we get it from various food and beverage products housed in plastics and tin cans. This substance was originally synthesized as an estrogen compound and it is felt that early exposure to this substance can increase the infants risk for hormonal changes and indicates a potential increased risk for breast cancer.

 The bottomline of the study was "pregnant and breastfeeding mothers should avoid exposure to BPA as it may affect their daughters' breast tissue." That means avoiding use of BPA plastic bottles and most foods and beverages that come in tin cans, (including sodas). Please read the full article below:

BPA Exposure in Utero May Increase Predisposition to Breast Cancer

ScienceDaily (Oct. 3, 2011) — A recent study accepted for publication in Molecular Endocrinology, a journal of The Endocrine Society, found that perinatal exposure to environmentally relevant doses of bisphenol A (BPA) alters long-term hormone response and breast development in mice that may increase the propensity to develop cancer.

BPA, a human-made chemical produced and marketed largely for specific industrial purposes, is detected in body fluids of more than 90 percent of the human population. It was originally synthesized as an estrogenic compound and there has been concern that exposure to BPA could have developmental effects on various hormone-responsive organs including the mammary gland.

"I want it to be clear that we do not provide evidence that BPA exposure causes breast cancer per se," said Cathrin Brisken, MD, of the Swiss Institute for Experimental Cancer Research and co-author of the study. "We do provide evidence that BPA exposure alters mammary gland development and that this may increase the predisposition of the breast to breast cancer."

In this study, researchers mimicked human exposure to BPA as it occurs with beverages and food from BPA containing vessels (such as plastics and the lining of tin cans) by adding the compound to the drinking water of breeding mice. Female pups born from BPA-consuming parents were transferred to a BPA-free environment at weaning and followed over time.

Researchers analyzed changes in the mammary gland of female offspring that were exposed to BPA through their mothers in utero and while being breast fed. The mammary glands of BPA exposed females showed an increased response to the hormone progesterone. Lifetime exposure to progesterone has been linked to increase breast cancer risk.

Furthermore, researchers found that adult females who had been exposed to BPA in utero and while breast fed, showed a 1.5 fold increase in cell numbers in their milk ducts. This is comparable to what is seen upon similar exposure to another estrogenic compound, diethyllbestrol (DES). Uterine exposure to DES in the human population has been shown to increase the relative risk of getting breast cancer two-fold as women reach their fifties.

"While we cannot extrapolate these results directly from mice to humans, the possibility that some of the increase in breast cancer incidence observed over the past decades may be attributed to exposure to BPA cannot be dismissed," said Brisken. "Our study suggests that pregnant and breastfeeding mothers should avoid exposure to BPA as it may affect their daughters' breast tissue."

Other researchers working on the study include Ayyakkannu Ayyanan, Ouahiba Laribi, Sonia Schuepbach-Mallepell, Christina Schrick, Maria Gutierrez, Tamara Tanos and Ozden Yalcin-Ozuysal of the Swiss Institute for Experimental Cancer Research; and Gregory Lefebvre and Jacques Rougemont of École polytechnique fédérale de Lausanne in Switzerland.

View the article on Science Daily's website here.

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