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.

Low-fat vs low-carb and Med-diet

On July 17, 2008, a study was published (1) that I believe should change how nutritionists and dietitians would look at the current Dietary Guide for Americans, the Food Guide Pyramid and the whole concept of a “heart-healthy” low-fat diet as recommended by the American Heart Association.

The paradigm-shift study was a 2-year intervention trial in The New England Journal of Medicine in which weight loss was compared among moderately obese subjects who were assigned to either a restricted-calorie Mediterranean diet, a non-restricted calorie low-carbohydrate, or a typical restricted-calorie low-fat diet (1). What did they find? Surprising results.

All the subjects lost weight, but were greater in both the low-carbohydrate group (despite nonrestricted calories) and the Mediterranean-diet group (1). The lipid profiles, more surprisingly, improved in the Mediterranean-diet group and most in the low-carbohydrate group (1). Best LDL cholesterol levels were found among the Mediterranean-diet group (1). The level of high-sensitivity C-reactive protein, most surprisingly, improved only in the Mediterranean-diet and low-carbohydrate groups (1).

The study, going further, took into consideration those with diabetes by measuring their fasting plasma glucose, insulin and glycated hemoglobin levels. There were no significant changes in fasting plasma glucose levels, but drastic decreasaes in insulin levels across the board (1). But the glycated hemoglobin decreased the most in the low-carb group (1).

Given the results of this study, my inclination is to adopt the Harvard School of Public Health’s Healthy Eating Pyramid because it appears to more resemble the Mediterranean-style of eating. And I would add recommendation for lower-carb eating in general along with inclusion of monounsaturated fat from olive oil and higher intake of fish versus red meat, etc.

Reference List

1. Cheskin LJ, Kahan S. Low-carbohydrate and Mediterranean diets led to greater weight loss than a low-fat diet in moderately obese adults. Evid Based Med 2008;13:176.

Fighting a Losing War That Must Be Won

Once the “war on cancer” was declared in 1971 by Congress, researchers have sought to defeat it (1), but after losses of many knights in shining armor, a newfound respect has come around for this dragon of a disease (1). In the 1990s and 2000s, however, a new sense of hope had come about.

“End cancer by the year 2015” was the message shared in 2003 by Andrew C. von Eschenbach, MD, director of the National Cancer Institute (NCI). And although he’s had many critics saying it couldn’t be done, others joined him in saying it could. Just two years afterward, in 2005, NCI modified it’s lofty goal to a softer “alleviate pain, suffering and death associated with cancer” (2). The change meant a new direction of “controlling” but not “curing” the disease .

The same year, 2005, one Eschenbach supporter put forward a plan for a victory (3). His name was Mikhail V Blagosklonny, MD, PhD, and his approach was by combining strategies that target cancerous cells directly while protecting normal cells in targeted tissues (3). Blagosklonny’s three-pronged attack (as suggested cures tend to be) may appear relatively simple, but so far scientists are finding the goal nothing more than elusive.

At cancer’s core there is a only one etiology, which strikes like sabotage at the core of the human body’s own blueprint: mutation. Genetic instability is why cancer has proved to be a more formidable enemy than diabetes or heart disease. The disease is completely unpredictable, arising any number of tissues, with more than 100 possible etiologies (1), and by the time you know its there, it’s an army of cancerous cells reproducing faster than rabbits, using healthy cells to shield itself from attacks, and ultimately making its final blow in a battle of attrition.

Can the 2015 goal be sustained? And, more curiously, will there ever be a cure? As always judgment will be left up to science leaving all with a need for patience, but over the years since the ‘70s much has been learned thanks to thousands of studies on cancer. Marching onward it is progressive understanding and creativeness in treatments that present hope that researchers will eventually prevail.

Reference List

1. Hesse BW. Harnessing the power of an intelligent health environment in cancer control. Stud Health Technol Inform 2005;118:159-76.
2. Conrads TP, Hood BL, Petricoin EF, III, Liotta LA, Veenstra TD. Cancer proteomics: many technologies, one goal. Expert Rev Proteomics 2005;2:693-703.
3. Blagosklonny MV. How cancer could be cured by 2015. Cell Cycle 2005;4:269-78.

Anti-Soy Fiction

I just read a citizen's petition to FDA by Gail Elbek calling for the removal of soy because of antinutrients (trypsin inhibitors and phytates) and endocrine disruptors. Gave me a bit of a laugh, but I expect it will scare a lot of unwitting people.

The outrageous claims Ms. Elbek makes are not grounded in any science. Soy phytotoxicity is going to “kill our children”? Please. I’m not about to throw out my soy milk, tofu and soy sauce. What’s next? Spinach. Spinach contains a lot of phytates. Many raw foods like raw soybeans contain all sorts of anti-nutrients, but that’s why we dehull, cook, or ferment these raw foods. Most anti-nutrients are eliminated just by the processing.

There is a point to be made about high amounts of concentrated phytoestrogens (soy isoflavones) in a few dietary supplements, which are often marketed to women as natural hormonal therapy. These are basically drugs of which we don’t know enough about. The research is still out on whether or not they’re beneficial or if they can do harm.

But, again, there’s really not really anything raise eyebrows regarding levels of isoflavones in tofu or other soy products. The low levels of isoflavones that are in them are probably even good for you. So even if we ever did offer a soy protein shake, I don’t think I’d be too worried. We mustn’t forget that there have been more than 40 human clinical studies on soy protein’s health benefits. Not to mention that an entire, but relatively insignificant, country called China pretty much subsists on soy.

Boron and Disease

Boron's ability to induce sex hormone levels give it a role preventing chronic disease. For example, adequate dietary boron may potentially reduce risk of lung cancer (1). The effects also explain why boron supplementation may support bone density guarding against osteoporosis (2).

However, caution should be exercised before supplementation with boron. Greater estrogen levels due to boron supplementation may potentially increase risk of breast cancer (1;2). Thus, boron should not be taken by women with high risk of breast cancer or who've had breast cancer.

Reference List

1. http://www.pccnaturalmarkets.com/health/2813008/
2. http://www.osteopenia3.com/Boron-Osteoporosis.html

Nickel toxicity

Nickel is a known carcinogen. When in the diet in toxic amounts it contributes to oxidative stress, just as mercury and cadmium do, by reducing glutathione thereby interfering with cell membrane integrity and increasing lipid peroxidation (1). The oxidative damage, like from free iron or copper, can cause DNA damage (2).

Reference List

1. Valko M, Morris H, Cronin MT. Metals, toxicity and oxidative stress. Curr Med Chem 2005;12:1161-208.

2. Tkeshelashvili LK, Reid TM, McBride TJ, Loeb LA. Nickel induces a signature mutation for oxygen free radical damage. Cancer Research; 53, 4172-4174, September 15, 1993.